• Title/Summary/Keyword: tomography.

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A Clinical Study of Renal Abscesses in Children (소아 신농양의 임상적 고찰)

  • Hwang You-Sik;Rhie Young-Jun;Ahn Sun-Young;Han Sang-Won;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.64-68
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    • 2005
  • Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

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Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET (F-18 FDG 양전자단층촬영을 이용한 생존심근 평가 후 수술한 허혈성 심근병증 환자의 수술 결과)

  • Kim, Jae-Sung;Lee, Dong-Soo;Hong, Suk-Keun;Lee, Young-Tak;Kim, Yu-Kyeong;Kim, Youn-Jung;Moon, Keon-Sik;Won, Tae-Kyoung;Hwang, Hweung-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.276-284
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    • 2000
  • Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

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Crossed Cerebellar Hyperperfusion on Ictal Tc-99m HMPAO Brain SPECT: Clinical Significance for Differentiation of Mesial or Lateral Temporal Lobe Epilepsy and Related Factors for Development (발작기 Tc-99m HMPAO 뇌 SPECT에 나타난 교차소뇌과혈류: 내외측 측두엽간질의 감별에 대한 임상적 의의와 발생에 영향을 주는 요인)

  • Park, Soon-Ah;Lee, Dong-Soo;Kim, Seok-Ki;Lee, Sang-Gun;Jang, Myoung-Jin;Sohn, Myung-Hee;Lim, Seok-Tae;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.312-321
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    • 2000
  • Purpose: The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. Materials and Methods: We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; $27.4{\pm}7.8$ years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class I, II). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec ($32.6{\pm}19.5sec$) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propagation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis Results: CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=0.01) and age (p=0.02) were related to the development of CCH. Conclusion: Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral temporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.

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Radiation Absorbed Dose Measurement after I-131 Metaiodobenzylguanidine Treatment in a patient with Pheochromycytoma (갈색세포종 환자에서 Medical Internal Radiation Dose법을 이용한 I-131 Metaiodobenzylguanidine 치료 후 흡수선량 평가)

  • Yang, Weon-Il;Kim, Byeung-Il;Lee, Jae-Sung;Lee, Jung-Rim;Choi, Chang-Woon;Lim, Sang-Moo;Hong, Sung-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.422-429
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    • 1999
  • Purpose: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. Materials and Methods: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. Results: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. Conclusion: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.

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Two Cases of Long-Term Changes in the Retinal Nerve Fiber Layer Thickness after Intravitreal Bevacizumab for Diabetic Papillopathy (당뇨병유두병증에서 유리체강내 베바시주맙 주입술 후 망막시경섬유층 두께의 장기간 변화 2예)

  • Kim, Jong Jin;Im, Jong Chan;Shin, Jae Pil;Kim, In Taek;Park, Dong Ho
    • Journal of The Korean Ophthalmological Society
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    • v.54 no.9
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    • pp.1445-1451
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    • 2013
  • Purpose: To report long-term changes in the average retinal nerve fiber layer (RNFL) thickness in 2 patients who had intravitreal bevacizumab (IVB) injection for diabetic papillopathy. Case summary: A 36-year-old patient with diabetes complained of decreased visual acuity (20/200) in the right eye. The fundus examination showed optic disc swelling in both eyes. The average RNFL thickness based on optical coherence tomography (OCT) increased to $278{\mu}m$ and Goldmann perimetry showed nasal visual field defect in the right eye. The IVB was injected into the right eye. Three weeks after the IVB injection, RNFL thickness decreased to $135{\mu}m$ and visual acuity improved to 20/25 in the right eye. However, RNFL thickness increased from 126 to $207{\mu}m$ and visual acuity decreased to 20/32 in the left eye. Thus, IVB was injected into the left eye. In week 3, RNFL thickness decreased to $147{\mu}m$ and visual acuity improved to 20/20 in the left eye. At 12 months after IVB injection, RNFL thickness was $87{\mu}m$ in the right eye and $109{\mu}m$ in the left eye. A 57-year-old patient with diabetes complained of decreased visual acuity (20/200) and showed optic disc swelling in the right eye. The average RNFL thickness increased to $252{\mu}m$ and Goldmann perimetry showed an enlarged blind spot in the right eye. IVB was injected into the right eye. After 3 weeks, RNFL thickness decreased to $136{\mu}m$ and visual acuity improved to 20/70 in the right eye. Six months after IVB injection, RNFL thickness was $83{\mu}m$ in the right eye. Conclusions: Visual acuity progressively improved within 3 weeks and RNFL thickness measured by spectral domain OCT showed progressive thickness reduction in 2 cases of diabetic papillopathy patients who had IVB injections.

Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration (중기 나이관련황반변성 환자에서 항산화영양제 복용 후 장기 관찰 결과)

  • Bang, Seul Ki;Kim, Eung Suk;Kim, Jong Woo;Shin, Jae Pil;Lee, Ji Eun;Yu, Hyeong Gon;Huh, Kuhl;Yu, Seung-Young
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1152-1159
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    • 2018
  • Purpose: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). Methods: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. Results: The mean patient age was $72.46{\pm}7.16years$. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was $0.13{\pm}0.14logMAR$ and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. Conclusions: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.

Usefulness of Customized Cervical Spine Immobilizer in Head & Neck Image-Guided Radiation Therapy with Tomotherapy® (토모테라피를 이용한 두경부암 영상유도 방사선 치료 시 개인별 경추고정용구의 유용성 평가)

  • Jin, Sung Eun;Chang, Se Wuk;Choi, Jung Hoan;Kim, Min Joo;Ahn, Seung Kwon;Lee, Sang Kyu;Cho, Jung Heui
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.65-71
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    • 2018
  • Purpose : Standardized pillow may not support patient's individual cervical spine thoroughly when head and neck radiation therapy with $Tomotherapy^{(R)}$. Therefore, the purpose of this study was to make a comparative analysis for the difference of using standardized pillow only and using customized cervical spine immobilizer with standardized pillow. Materials and Methos : The head and neck cancer patients who are treated image-guided radiation therapy(IGRT) with $Tomotherapy^{(R)}$ were divided into two groups, 20 patients using standardized pillow only, and 20 patients using customized cervical spine immobilizer with standardized pillow. We achieved 20 mega-voltage computed tomography(MVCT) image per patient, compared curvature of the cervical spine in MVCT with curvature of the cervical spine in CT-simulation. Results : Results of comparative analysis were curvature consistency 95.9 %, maximum error of distance 41.9 mm, average distance error per fractionation 19.4 mm, average standard deviation 1.34 mm in case of using standardized pillow only, curvature consistency 98.9 %, maximum error of distance 12.9 mm, average distance error per fractionation 5.8 mm, average standard deviation 0.59 mm in case of using customized cervical spine immobilizer with standardized pillow. Conclusion : Using customized cervical spine immobilizer shows higher reproducibility and low distance error, therefore customized cervical spine immobilizer could be useful for head and neck cancer patients who need radiation therapy.

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Time-Lapse Crosswell Seismic Study to Evaluate the Underground Cavity Filling (지하공동 충전효과 평가를 위한 시차 공대공 탄성파 토모그래피 연구)

  • Lee, Doo-Sung
    • Geophysics and Geophysical Exploration
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    • v.1 no.1
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    • pp.25-30
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    • 1998
  • Time-lapse crosswell seismic data, recorded before and after the cavity filling, showed that the filling increased the velocity at a known cavity zone in an old mine site in Inchon area. The seismic response depicted on the tomogram and in conjunction with the geologic data from drillings imply that the size of the cavity may be either small or filled by debris. In this study, I attempted to evaluate the filling effect by analyzing velocity measured from the time-lapse tomograms. The data acquired by a downhole airgun and 24-channel hydrophone system revealed that there exists measurable amounts of source statics. I presented a methodology to estimate the source statics. The procedure for this method is: 1) examine the source firing-time for each source, and remove the effect of irregular firing time, and 2) estimate the residual statics caused by inaccurate source positioning. This proposed multi-step inversion may reduce high frequency numerical noise and enhance the resolution at the zone of interest. The multi-step inversion with different starting models successfully shows the subtle velocity changes at the small cavity zone. The inversion procedure is: 1) conduct an inversion using regular sized cells, and generate an image of gross velocity structure by applying a 2-D median filter on the resulting tomogram, and 2) construct the starting velocity model by modifying the final velocity model from the first phase. The model was modified so that the zone of interest consists of small-sized grids. The final velocity model developed from the baseline survey was as a starting velocity model on the monitor inversion. Since we expected a velocity change only in the cavity zone, in the monitor inversion, we can significantly reduce the number of model parameters by fixing the model out-side the cavity zone equal to the baseline model.

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A Study on the Fabrication and Comparison of the Phantom for CT Dose Measurements Using 3D Printer (3D프린터를 이용한 CT 선량측정 팬텀 제작 및 비교에 관한 연구)

  • Yoon, Myeong-Seong;Kang, Seong-Hyeon;Hong, Soon-Min;Lee, Youngjin;Han, Dong-Koon
    • Journal of the Korean Society of Radiology
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    • v.12 no.6
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    • pp.737-743
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    • 2018
  • Patient exposure dose exposure test, which is one of the items of accuracy control of Computed Tomography, conducts measurements every year based on the installation and operation of special medical equipment under Article 38 of the Medical Law, And keep records. The CT-Dose phantom used for dosimetry can accurately measure doses, but has the disadvantage of high price. Therefore, through this research, the existing CT - Dose phantom was similarly manufactured with a 3D printer and compared with the existing phantom to examine the usefulness. In order to produce the same phantom as the conventional CT-Dose phantom, a 3D printer of the FFF method is used by using a PLA filament, and in order to calculate the CTDIw value, Ion chambers were inserted into the central part and the central part, and measurements were made ten times each. Measurement results The CT-Dose phantom was measured at $30.44{\pm}0.31mGy$ in the periphery, $29.55{\pm}0.34mGy$ CTDIw value was measured at $30.14{\pm}0.30mGy$ in the center, and the phantom fabricated using the 3D printer was measured at the periphery $30.59{\pm}0.18mGy$, the central part was $29.01{\pm}0.04mGy$, and the CTDIw value was measured at $30.06{\pm}0.13mGy$. Analysis using the Mann - Whiteney U-test of the SPSS statistical program showed that there was a statistically significant difference in the result values in the central part, but statistically significant differences were observed between the peripheral part and CTDIw results I did not show. In conclusion, even in the CT-Dose phantom made with a 3D printer, we showed dose measurement performance like existing CT-Dose phantom and confirmed the possibility of low-cost phantom production using 3D printer through this research did it.

Evaluation of the influence of a visual design of an examination guide on patient comprehension and testing accuracy (검사 안내문의 시각적 디자인화가 환자의 검사 이해도 및 정확성에 미치는 영향 평가)

  • Kang, Young-Eun;Jung, Woo-Young;Hong, Bo-Ruem
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.29-34
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    • 2019
  • Purpose An examination guide is a useful medium to provide the patient with an overview, pre- and post-test preparation, and precautions of nuclear testing. The design and arrangement of existing written texts and announcements were evaluated to elucidate the comprehension of patients undergoing testing. Materials and Methods Informational material describing bone scanning and $^{201}thallium$ myocardium perfusion single-photon emission computed tomography (SPECT), as a secondary examination, which accounts for the largest portion of gamma imaging at Asan Hospital (Seoul, South Korea), was selected as an improvement target in consultation with a national innovation center. Existing informational material was dispensed to patients scheduled for bone scans from November 2016 to February 2017 and the revised material was issued from March 2017 to May 2017. A survey was conducted of 200 patients who underwent $^{201}thallium$ myocardium perfusion SPECT before and after the revisions (n = 100 each time period) to assess the patients' understanding of the informational material. Results When comparing the use of the conventional vs. revised material, the number of patients who received treatment before bone scanning had decreased from 130 to 60, while the number of those who required additional imaging decreased from 53 to 14. Prior to the revision, 43% of patients underwent testing before preparation and 18% underwent additional testing. The decreased need for additional image acquisition after revision of the informational material resulted in a decrease in acquisition time of about 2 min, from 16.5 to 14.2 min. In the case of $^{201}thallium$ myocardium perfusion SPECT, patient comprehension of all five items surveyed had increased, while the number of patients who had repeatedly asked about various facets of the procedure pre- and post-testing had decreased from 36% to 16% and 31% to 14%, respectively. Conclusion Lower patient comprehension is accompanied by a decrease in image quality due to non-compliance during pre-testing and may lead to repetitive questions from the patient, which may also negatively affect the fatigue and work efficiency of the examiner. Improved readability and visibility of informational material through visualization was correlated with greater patient comprehension as well as improved image quality and acquisition time.