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폐동맥 고혈압으로 발현한 선천성 간문맥 형성부전의 증례 보고
전수령,이활,천정은,김우선,김인원,연경모 대한영상의학회 2007 대한영상의학회지 Vol.57 No.5
Congenital absence of the portal vein (CAPV) is a rare malformation in which intestinal and splenic venous flow bypasses the liver and drains directly into the systemic circulation via a congenital portosystemic shunt. We describe two cases of CAPV presenting as pulmonary hypertension that were initially suspected as primary pulmonary hypertension. However, subsequent ultrasonography and CT detected the absence of a portal vein and the presence of a portosystemic shunt. Pulmonary hypertension is a recognized complication of liver disease and portal hypertension. However, these two cases illustrate that CAPV may result in pulmonary hypertension without liver disease or portal hypertension. 선천성 간문맥형성부전은 문맥혈류가 간을 우회하여 문맥-체정맥 단락을통해 대정맥으로 직접 배출되는 드문 기형이다. 저자들은 일차성 폐동맥고혈압으로 진단되었다가 초음파 및 전산화단층촬영을 통해 문맥의 형성부전 및 선천성 문맥-체정맥 단락을 비침습적으로 발견해 냄으로써, 이로 인한 이차성 폐동맥 고혈압이 발생하였음을 밝힐 수 있었던 증례를 2예 보고하고자 한다.
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영상의학과 전공의에 의한 응급실 컴퓨터단층촬영, 자기공명영상의 야간 예비 판독:얼마나 정확한가?
진광남,제환준,신청일,채지원,전수령,신상도,강영준,나동규 대한응급의학회 2008 대한응급의학회지 Vol.19 No.2
Purpose: At many institutes in Korea, preliminary interpretations of after-hours CT and MR images are performed by radiology residents, with the attending radiologist’s reviewing the interpretations the next day. The purpose of this study was to assess the rate of discrepancy between residents’ interpretations and the final interpretations performed by attending radiologists. Methods: We reviewed the interpretations of 1381 CT and 404 MRI scans that were obtained at the emergency department of our institute over three months. Any discrepancies between the preliminary and final interpretations were categorized as either major or minor discrepancies with a major discrepancy defined as one resulting in a change in diagnosis and treatment plans. We conducted patient follow-up via a retrospective review of the medical records to evaluate the clinical outcomes of the discrepancies. Results: The rate of major discrepancies was 2.5%, and the rate of minor discrepancies was 11.4%. Major discrepancies led to a change in diagnosis or patient treatment plans, but did not lead to any increase in patient morbidity. Conclusion: The discrepancy rate at our institution was relatively insignificant, and patient care at the emergency department was not adversely affected by having radiology residents interpret CT and MRI scans after-hours and the attending radiologist review the interpretations the next morning. Still, further efforts are needed in order to reduce the frequency of major discrepancies.
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