• 대한방사선기술학회지:방사선기술과학
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• 제30권3호
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• pp.213-219
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• 2007

중재적 시술의 시술자를 대상으로 방사선 방호용구의 안과 밖의 실제 방사선량을 측정하여 이를 바탕으로 방사선 방호용구의 방사선 차폐율을 비교 분석하는 것이다. 2005년 5월부터 9월까지 중재적 시술 중에서 시행 빈도가 높은 TACE, PTBD를 시행하는 중재적 시술자 4인에게 방사선 방호용구의 착용 시 피폭선량 감쇄효과를 측정하기 위해 각 신체부위별 방호용구 안과 밖에 TLD를 부착하여 피폭선량을 측정하였다. TLD 부착부위는 Goggle inside, Goggle outside, Thyroid protector inside, Thyroid protector outside, Apron inside(waist level), Apron outside(upper chest level), Hand 4th finger(ring type TLD)와 환경방사선을 측정하기 위해 TLD 10개를 Control room 여러 곳에 위치시켰다. TACE 검사시 0.07 mmPb Goggle의 사용으로 연속투시방식에서는 평균 53.8%의 선량율감쇄를 보였으며 펄스투시방식에서는 77.6%의 감쇄효과를 보였고, 0.5 mmPb Thyroid protector의 사용에서는 연속투시방식에서는 평균 88.9%의 선량율감쇄를 보였으며 펄스투시방식에서는 92.8%로 선량율감쇄에서는 유의한 차이가 없었다. PTBD 검사시 0.07 mmPb Goggle의 사용으로 평균 62.7%의 선량율감쇄를 보였으며, 0.5 mmPb Thyroid protector의 사용에서는 평균 89.1% 선량율이 감쇄 되었고 0.5 mmPb Apron의 사용에서도 평균 87.9%의 감쇄효과가 있었다. PTBD 시술은 TACE 시술에 비해 평균 투시시간은 6.14 min이나 적었으나 피폭선량은 체부에서 약 3배, 손에서는 40배 이상 피폭되었다. 납당량이 두꺼운 방호용구를 착용하거나 최소한 권고되어지는 0.5 mmPb 이상의 것을 착용하여야 하며, 시술시 눈을 보호하는 Goggle의 착용을 생활화해야 한다. 테이블 아래쪽에 납커튼을 장착하면 복부의 피폭선량율은 평균 38.4% 감쇄하므로 납커튼을 장착하여 산란선을 차폐하여야 한다. 펄스투시방식을 이용하면 연속투시에 비해 피폭선량율이 평균 59.0% 감쇄되므로 연속투시보다 펄스투시방식을 선택하여 피폭선량을 감소시켜야 한다.

• Tuberculosis and Respiratory Diseases
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• 제59권5호
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• pp.473-479
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• 2005

연구배경 : 폐색전증은 비특이적인 증상과 징후로 인해 진단이 지연될 수 있고 이로 인해 치명적인 결과를 가져 올 수 있으나 정확한 진단과 적절한 치료를 시행하는 경우 재발 및 사망의 경우가 흔치 않다. 폐색전증과 관련되어 나타나는 예방 가능한 사망의 대부분은 치료실패 보다는 진단이 지연되는 경우에서 기인하므로 보다 정확하고 빠른 검사법을 요구하게 되었다. 나선형 흉부 전산화 단층촬영은 혈전을 직접 관찰할 수 있고 이외의 부가적 진단이 가능하며 최근 multidetector-row spiral CT의 도입으로 중심 및 말초의 혈전도 더 정확한 진단이 가능해져 나선형 흉부 전산화 단층촬영술이 진단에 어느 정도의 신뢰성을 보이는지 비교, 연구하였다. 방 법 : 2002년 9월부터 2004년 9월까지 임상적 소견 및 나선형 흉부 전산화 단층촬영을 통해 폐색전증을 의심하거나 진단하였던 환자 64명을 대상으로 하였다. 진단시의 임상적 소견은 Wells 등의 "Rules for predicting the probability of embolism"을 기준으로 하여 평가하였다. 진단 당시 시행한 나선형 흉부 전산화 단층촬영 소견은 2명의 흉부 방사선과 의사가 독립적이고 맹검의 방식으로 각 병변의 해부학적 위치 및 진단적 근거에 대해 재판독을 시행하였다. 결 과 : 임상적 가능성에 대한 총 점수의 평균값은 $3.91{\pm}0.30$ (0-9)였고 저확률군은 9례, 중등도 확률군은 36례, 고확률군은 5례 였다. 관찰자간의 일치율은 주폐동맥에서 95.0%, 엽폐동맥에서 85.0%, 분절 폐동맥에서 91.2% 및 아분절 폐동맥에서 96.0%를 보였다. 두 관찰자 모두에서 음성소견을 보인 분지를 제외한 후의 일치율은 주폐동맥에서 76.2% (kappa 0.83), 엽폐동맥에서 57.6% (kappa 0.63), 분절 폐동맥에서 51.5% (kappa 0.63) 및 아분절 폐동맥에서 34.6% (kappa 0.49)를 보였다. 결 론 : 폐색전증이 의심되는 경우 진단에 일차적으로 이용되고 있는 나선형 흉부 전산화 단층촬영은 주폐동맥, 엽폐동맥 및 분절 폐동맥에서 관찰자간의 일치율이 높아 신뢰할 수 있는 검사법으로 비교적 신속하고 정확하나 아분절 폐동맥 이하의 작은 폐동맥은 진단적 오차가 커질 수 있다.

• Korean Journal of Radiology
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• 제25권1호
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• pp.11-23
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• 2024

Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm² was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive. The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4-79.9), 90.8% (95% CI: 85.6-94.2), and 83.5% (95% CI: 78.6-87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8-97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9-89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1-79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52-0.63) before training and 0.68 (95% CI: 0.62-0.74) after training, with a difference of 0.11 (95% CI: 0.02-0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69-0.74) before training and 0.79 (95% CI: 0.76-0.80) after training (P = 0.002). Conclusion: Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

• 치과방사선
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• 제27권2호
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• pp.49-61
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• 1997

The purpose of this study was to compare E-speed film, CDR, and modified CDR images by means of observing some artificial defects of alveolar bone wall in the sound human dried mandibles. High diagnostic accuracy was shown in 1 wall and 4 wall defects by all 5 observers (2 Radiologists, 2 Periodontists, 1 General practitioner), but the diagnosis in 2 wall and 3 wall defects was inaccurate. Modified CDR images had the more diagnostic accuracy than E-speed film and CDR images, but there was no statistical difference among them. Finally, radiologist used modified CDR images more than others and used equalization effect more than the change in contrast and/or brightness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.356-360
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• 2017

The tympanic plate is a small part of the temporal bone that separates the mandibular condyle from the external auditory canal. Fracture of this small plate is rare and usually associated with other bony fractures, mainly temporal and mandibular bone. There is a limited amount of literature on this subject, which increases the chance of cases being overlooked by physicians and radiologists. This is further supported by purely isolated cases of tympanic plate fracture without evidence of other bony fractures. Cone-beam computed tomography is an investigative three-dimensional imaging modality that can be used to detect fine structures and fractures in maxillofacial trauma. This article presents four cases of isolated tympanic plate fracture diagnosed by cone-beam computed tomography with no evidence of fracture involving other bones and review of the literature.

• Clinics in Shoulder and Elbow
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• 제18권4호
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• pp.254-260
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• 2015

With the advancement of shoulder arthroscopy, use of biodegradable suture anchors in the surgical repair of rotator cuff tears has increased. Because of the radiolucency of these anchors, radiography is not appropriate for early detection of anchor failure. Ultrasonography is an advantageous modality in visualizing biodegradable, radiolucent anchors on a real-time basis without risk of radiation exposure. We report on two cases of displacement of a biodegradable suture anchor diagnosed on ultrasonography during the postoperative follow- up, which has not been previously reported. Because this displacement could be missed in the postoperative follow up ultrasonography, we describe the ultrasonographic features of the displaced biodegradable anchors. Surgeons and radiologists should pay special attention to the possibility of displacement of the suture anchor in patients who underwent rotator cuff repairs using suture anchors.

• Tuberculosis and Respiratory Diseases
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• 제58권2호
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• pp.111-119
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• 2005

The introduction of high-resolution CT (HRCT) in recent years has improved the ability of radiologists to detect and characterize the diffuse infiltrative lung disease (DILD). The detection and diagnosis of diffuse lung disease using HRCT are based on the recognition of specific abnormal findings. In this article, pattern recognition of HRCT findings is reviewed in the differential diagnosis of diffuse infiltrative lung disease. In general, HRCT findings of lung disease can be classified into four categories based on their appearances. These categories consist of (1) nodules and nodular opacities, (2) linear and reticular opacities, (3) increased lung opacity, and (4) decreased lung opacity, including cystic lesions.

• 대한디지털의료영상학회논문지
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• 제3권1호
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• pp.20-23
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• 1997

The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

• International Journal of Contents
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• 제9권1호
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• pp.38-41
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• 2013

The clamp meter maintains electric safety as a non-invasive method while measuring the absolute value of tube current with it has been recently developed for an X-ray high-tension cable. Especially this can show high accuracy at short X-ray exposure time. Considering such a condition, this study is to evaluate the feasibility of a clamp meter in measuring X-ray tube current by taking the measurements and comparing with those of the Dynalyzer III which has been considered as a standard measuring device. From measuring the tube current accuracy depending on changes in tube voltage and exposure time, the clamp meter showed higher accuracy rate which was -1.3~4.2% difference. Thus clamp meter can be used for clinical radiologists who are not familiar electric circuit to manage X-ray devices easily and correctly in the future.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2002년도 춘계학술대회 및 총회
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• pp.25-27
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• 2002

With the advent of multidetector-row CT, lung cancer imaging is much more promising than before. However, the effectiveness of multidetector-row CT in making an initial diagnosis, staging, and evaluating post-treatment changes of lung cancer still remains to be proved. Fast imaging along with volumetric data set and attendant multi-planar imaging provide much more details on the anatomic changes and pathology associated with lung cancer. However, with images showing anatomic and pathologic changes only, radiologists confront with several questions the answers of which may help evaluate lung cancer more thoroughly. The frequent questions that I have in dally practice of chest CT interpretation are as follows.