피하 결절의 진단에 있어 초음파 검사의 정확성에 대한 통계적 연구

김윤환 ( Yoon Hwan Kim ),이승재 ( Seung Jae Lee ),박지혜 ( Ji Hye Park ),최종원 ( Chong Won Choi ),이가영 ( Ga Young Lee ),김원석 ( Won Serk Kim ) 대한피부과학회 2013 대한피부과학회지 Vol.51 No.6

Background: Ultrasonography is an important diagnostic tool for many aspects of clinical medicine. It is a non-invasive method of examination that provides high-resolution images in real time. However, some dermatologists may be anxious about the efficacy of ultrasonography. Objective: To evaluate the diagnostic accuracy and to assess the utility of diagnostic ultrasonography for subcutaneous benign lesions. Methods: The study included 96 patients with subcutaneous benign lesions who underwent ultrasonography and then received a pathologic diagnosis after biopsy or surgery at our hospital from July 2010 to December 2012. This study evaluated the number of cases in which the preoperative diagnosis after ultrasonography or just after physical examination agreed to the pathologic diagnosis. Results: Ultrasonography significantly increased the diagnostic yield of subcutaneous benign lesions (after physical examination, 54.2%; after ultrasonography, 84.4%; p<0.001). The sensitivity for the diagnosis of lipoma (after physical examination, 70%; after ultrasonography, 92.5%; p<0.001) and the specificity for the diagnosis of epidermal cyst (after physical examination, 84.1%; after ultrasonography, 94.2%; p<0.001) significantly increased after ultrasonography. The sensitivity for the diagnosis of epidermal cyst and pilomatricoma also tended to increase after ultrasonography. Conclusion: The study results suggested that ultrasonography is useful for diagnosis and/or preoperative examination of subcutaneous benign lesions.

2차원 및 3차원 초음파를 이용한 태아표면의 해부학적 선별 검사에 관한 연구

윤석범,이해혁,이정재,최경훈,이순곤,이임순,이권해 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

Objective : Our purpose of this study was to determine the clarity and consuming time of fetal surface screening in thirty-eight fetuses from 24 to 32 weeks of gestation by use of two and three-dimensional ultrasonography. Methods : From May 1998 to July 1998, we performed the fetal surface screening of the fetal face, extremities, and spine. Thirty-eight fetuses of 24-32 weeks of gestation (thirty-seven normal fetuses and one abnormal fetus) were studied by use two-dimensional (AI 5200S, 3.5-5.0MHz; Acoustic Imaging Technologic Cooperation, U.S.A.) and three-dimensional ultrasonography (Volusion 530D, 3.5-5.0 MHz ; Kretz-Medicine, Korea). On the fetal face, we evaluated both orbits, nose, lips and brow. Both hands and feet, five digits and toes should be seen in this study. We evaluated cervical spine and lumbosacral junction of the spine. Results : The maternal average age of 38 patients was 29.9 years and the average gestational age was 29.7 weeks. The results of fetal surface screening were as follows : face (both orbits 89.5%, lips 92.1%, nose 92.1%, and brow 89.5%), extremities (both hands 68.4% and feet 73.7%), and spine (cervical spine 94.7% and lumbosacral junction 97.4%) by use of two-dimensional ultrasonography. By use of three-dimensional ultrasonography, results were as follows : face (both orbits 76.3%, lips 81.6%, nose 81.6%, and brow 78.9%), extremities (both hands 76.3% and feet 78.9%), and spine (cervical spine 71.1% and lumbosacral junction 73.7%). Consuming time for two-dimensional ultrasonography were 4.7 minutes for face, 11.6 minutes for extremities, and 5.7 minutes for spine. Using three-dimensional ultrasonography results were 12.8 minutes for face, 17.9 minutes for extremities, and 11.7 minutes for spine. Average consuming time of all fetal anatomic screening was 22.0 and 42.4 minutes by use of two and three dimensional ultrasonography. In one abnormal fetus had cleft lip and polydactyly of right foot which were detected all by three-dimensional ultrasonography, but we couldn't detect the polydactyly by two-dimensional ultrasonography. Conclusion : Three-dimensional ultrasonography was more time-consuming method, but we suggested that three-dimensional ultrasonography was superior than two-dimensional ultrasonography in fetal surface screening.

Orbscan Topography System 과 A-scan ultrasonography 를 이용한 전방깊이 측정값의 비교

변장원,박영진,남상훈,김대구,최종민,마기중,권용성 대한시과학회 2000 대한시과학회지 Vol.2 No.1

Orbscan Topography System 및 A - scan Ultrasonography로 전 방깊 이 훌 측정 하 여 두 기 기 의 신 뢰 도를 평 가하고, A - scan Ultrasonography률 gold standard로 간주 하여 Orbscan Topography System으로 측정한 전방깊이 값의 정확도를 분석하였다. 20안올 대 상으로 Orbscan Topography System 및 A - scan Ultrasonography롤 이 용 하여 측정한 test 와 retest 차이에 대한 평균값은 각각 0.030 :t 0.150 mm와 0.016:t 0.065mm 였다. 또한 54안을 대상으로 Orbscan Topography System과 A - scan Ultrasonography로 측정한 전방깊이 값의 평균은 각각 3.200:t 0.302 mm와 2.999:t 0.239mm로, Orbscan Topography System 측정 값이 더 높았으며 (t = 10.α)3, p<O.αX)1), 두 기기의 측정값 사이에 높은 상관관계가 있었다 (r = 0.824, p<O.OOül). Orbscan Topography System 측정값을 A - scan Ultrasonography 측정값과 직접 비교하기 위해서는 환산공식이 필요하다. The study assessed repeatability of the anterior charnber depth estimates provided by the Orbscan Topography System. and an A - scan U1trasonoragpy, and assessed comparability of the Orbscan Topography Systme and A - scan Ultra -sonography as gold standard. In the 20 eyes, mean of the differences of Test and Retest in anterior charnber depth measured by Orbscan Topography System and A - scan Ultrasonography were 0.03O:t 0.150 mm and 0.016 mm, respectively. In 54 eyes, mean of ACD measured by Orbscan Topography System and A - scan Ultrasonography were 3.2oo:t 0.302 mm and 2.999:t 0.239 mm, respectively. Mean ACD values measured by Orbscan Topography was more deeper than that of measured by A - scan Ultrasonography(t=10.oo3, p<O.α)()1) , and the correlation coefficient between Orbscan and ultrasonography was 0.824(p <0.0001). Therefore, there was required conversion factor when ACD values measured by Orbscan Topography System was directly compared to that of measured by A - scan Ultrasonography.

T1-2 유방암 환자에서 액와부 초음파의 정확도

한부경,신정희,고은영,임효근,조은윤,남석진,양정현,최윤라 대한초음파의학회 2009 ULTRASONOGRAPHY Vol.28 No.3

Purpose: We wanted to investigate the accuracy of axillary ultrasonography for detecting axillary nodal metastasis in patients with T1-2 breast cancer and we also wanted to determine the factors affecting the sensitivity. Materials and Methods: Two radiologists performed axillary ultrasonography in 119 consecutive patients with T1-2 breast cancer and clinically uninvolved axillae. We analyzed the accuracy of ultrasonography for detecting axillary nodal metastasis with the histologic results being used as a reference standard. We evaluated the number of involved lymph nodes, T staging and the histologic grade of the tumors. Results: Axillary nodes were involved in 39% of total patients (46/119); 30% of the patients with T1 cancer and 55% of the patients with T2 cancer. The sensitivity, specificity, positive predictive value and negative predictive value were for 52%, 92%, 80% and 75%, respectively. The sensitivity was significantly lower for the cases with one to two lymph nodes metastasis and T1 cancer than in those cases with 3 or more lymph nodes metastasis and T2 cancer (35% and 75% in the cases with 1-2 cancer and the cases with > 3 lymph nodes metastasis, respectively, p = 0.009; 38% and 68% in the cases with T1 and the cases with T2 cancer, respectively, p = 0.045). Conclusions: The ultrasonographic sensitivity for detecting axillary lymph node metastasis is low, especially in the cases with one to two lymph nodes metastasis and the cases with T1 cancer. Detailed analysis and adoption of cytologic examination of the axillary lymph nodes are necessary to improue the accuracy of ultrasonography. Purpose: We wanted to investigate the accuracy of axillary ultrasonography for detecting axillary nodal metastasis in patients with T1-2 breast cancer and we also wanted to determine the factors affecting the sensitivity. Materials and Methods: Two radiologists performed axillary ultrasonography in 119 consecutive patients with T1-2 breast cancer and clinically uninvolved axillae. We analyzed the accuracy of ultrasonography for detecting axillary nodal metastasis with the histologic results being used as a reference standard. We evaluated the number of involved lymph nodes, T staging and the histologic grade of the tumors. Results: Axillary nodes were involved in 39% of total patients (46/119); 30% of the patients with T1 cancer and 55% of the patients with T2 cancer. The sensitivity, specificity, positive predictive value and negative predictive value were for 52%, 92%, 80% and 75%, respectively. The sensitivity was significantly lower for the cases with one to two lymph nodes metastasis and T1 cancer than in those cases with 3 or more lymph nodes metastasis and T2 cancer (35% and 75% in the cases with 1-2 cancer and the cases with > 3 lymph nodes metastasis, respectively, p = 0.009; 38% and 68% in the cases with T1 and the cases with T2 cancer, respectively, p = 0.045). Conclusions: The ultrasonographic sensitivity for detecting axillary lymph node metastasis is low, especially in the cases with one to two lymph nodes metastasis and the cases with T1 cancer. Detailed analysis and adoption of cytologic examination of the axillary lymph nodes are necessary to improue the accuracy of ultrasonography.

P100 : Diagnostic value of ultrasonography in subcutaneous benign lesions

( Eun Jung Hwang ),( So Young Yoon ),( Jin Yong Kim ),( Gyeong Yul Park ),( Hyun Sun Yoon ),( So Yun Cho ),( Hyun Sun Park ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2

Background: Ultrasonography has become an important diagnostic tool in dermatology in recent years. It is easy to use, completely safe, and provides important diagnostic information. Objectives: This study was done to compare the diagnostic accuracy of ultrasound with clinical diagnosis in patients with subcutaneous benign lesions. Methods: Data from 100 patients with subcutaneous benign lesions who were performed ultrasonography and then were confirmed a pathologic diagnosis after biopsy or surgery at our hospital from January 2010 to May 2013, were analyzed for this retrospective study. Results: Results: Ultrasonography significantly increased the diagnostic yield of subcutaneous benign lesions (after physical examination, 49%; after ultrasonography, 81%; p=0.003). The sensitivity and specificity for the diagnosis of lipoma were 61.5% and 92.0% after physical examination vs 100% and 100% after ultrasonography. Those of epidermal cyst were 67.3% and 74.5% after physical examination vs 93.9% and 92.2% after ultrasonography. Those of pilomatrixoma were 12.5% and 98.9% after physical examination vs 75.0% and 100% after ultrasonography. Those of neurogenic and vascular tumors were also analyzed. Conclusion: The study results suggested that ultrasonography is a simple and reliable tool that can be the first choice for diagnosis of subcutaneous benign lesions.

급성 충수돌기염 산모에서 초음파 검사와 MRI 검사의 비교 연구

유복열,정성필,유제성,구재은,주영선 대한응급의학회 2015 대한응급의학회지 Vol.26 No.2

Purpose: The purpose of this study is to compare the sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography versus magnetic resonance imaging (MRI) in evaluation of pregnant patients with clinically suspicious acute appendicitis. Methods: This study was a retrospective cohort study. A total of 60 pregnant patients who presented to the emergency department with suspected appendicitis and underwent ultrasonography or MRI were included. The official interpretation reports and pathologic reports were extracted and analyzed. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for ultrasonography and MRI for diagnosis of acute appendicitis. We also calculated and compared area under the curve (AUC) of both diagnostic tests with the receiver operating characteristic (ROC) curve analysis. Results: Among 60 patients, 43 (71%) underwent ultrasonography, 37 (61%) underwent MRI, and 20 (33%) underwent both diagnostic tests. Twenty patients were confirmed as pathologically-proven acute appendicitis. The sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography for diagnosing acute appendicitis were 67%, 77%, 53%, and 86%, while those of MRI were 100% for all parameters. In ROC analysis, the AUC was 0.656, respectively, for ultrasonography, and 1.000 for MRI (p value<0.0001). Conclusion: This study suggests that MRI is more accurate than ultrasonography for the diagnosis of acute appendicitis in pregnant women, especially when the appendix is invisible with ultrasonography.

7개 병원 검진센터에서 1년간 시행된 선별유방촬영술과 초음파검사의 민감도와 특이도 조사

김현성,강봉주,이재희,임현우,정승은,최병길,김현숙,차은숙,김성헌,정나영,박창숙,황인용 대한초음파의학회 2010 ULTRASONOGRAPHY Vol.29 No.1

목적: 유방암 검진에 있어서 선별유방촬영술과 유방초음파검사의 민감도와 특이도를 비교하여 유방초음파검사의 선별검사로서의 유용성을 알아보고자 하였다. 대상 및 방법: 2004년 3월에서 2005년 2월까지 7개 병원의 검진센터 방문 여성 중, 유방촬영술과 초음파검사를동시에 시행했던 여성의 유방촬영술 단독과 유방촬영술과초음파검사를 병행한 경우의 민감도와 특이도를 비교하였다. 참고기준은 1년 후 추적검사와 조직검사로 하였다. 결과: 유방촬영술과 초음파검사를 모두 시행하고 1년 후추적 검사가 진행된 환자는 모두 1123명이었다. 유방촬영술과 초음파검사를 동시에 시행한 1123명의 유방촬영술단독의 민감도, 특이도는 14.3%, 86.9%, 유방촬영술과 초음파검사를 합한 민감도, 특이도는 85.7%, 85.9%로, 유방촬영술과 초음파검사를 합하면 민감도가 유의하게 증가되었다 (< 0.05). 결론: 유방촬영술과 초음파검사가 모두 시행된 경우 민감도가 향상된다 Purpose: We wanted to evaluate the sensitivity and specificity of screening mammography and ultrasonography for breast examinations and we assessed the clinical usefulness of breast ultrasound for cancer screening. Materials and Methods: Of all the women who visited the health promotion center of seven medical institutions from Mar 2004 to Feb 2005, we compared the sensitivity and specificity between a single use of mammography and mammography with ultrasonography for the patients who underwent both mammography and ultrasonography. Here, the reference criteria were the follow-up and the histopathology, which were performed after one year. Results: A total of 1123 patients underwent both mammography and ultrasonography and they could be followed up for a year. For the 1123 patients who underwent both mammography and ultrasonography, the sensitivity and specificity of a single use of mammography were 14.3% and 86.9%, respectively. The sensitivity and specificity of mammography with ultrasonography were 85.7% and 85.9%, respectively. These results showed that the sensitivity was significantly increased when mammography was combined with ultrasonography (< 0.05). Conclusion: The sensitivity was improved for the cases that underwent both mammography and ultrasonography.

Clinico-ultrasonographic characteristics of non-vascular skin tumors misdiagnosed as vascular tumors by ultrasonography

( Woo-il Kim ),( Tae-rim Kim ),( Kihyuk Shin ),( Min-young Yang ),( Won-ku Lee ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Hoon-soo Kim ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Ultrasonography is a very useful tool in the diagnosis of various dermatoses. Especially, vascular structure in ultrasonographic imaging is helpful for differential diagnosis of vascular and non-vascular skin tumors. Sometimes, however, there are some cases of non-vascular skin tumors confused as vascular tumor by ultrasonography. Objectives: The purpose of this study was to investigate clinico-ultrasonographic characteristics of non-vascular skin tumors misdiagnosed as vascular tumors by ultrasonography. Methods: We retrospectively reviewed medical records, ultrasonopgraphic findings and clinical photos of patients who underwent ultrasonography in the department of dermatology at Pusan National University (Pusan and Yangsan) from 2010 to 2019. Results: A total of 33 cases of non-vascular skin tumors misdiagnosed as vascular tumor by ultrasonography were obtained. The mean age of patients was 32.9 years old, and 44% of patients were male. The most common histopathologically confirmed diagnosis was pilomatricoma, followed by epidermal cyst. Hemangioma was the most common vascular tumor described by ultrasonography by radiologists. Only 9% of all cases were clinically suspected with vascular tumor as the first impression by dermatologists. Conclusion: This study shows various clinico-ultrasonographic findings of non-vascular skin tumors misdiagnosed as vascular tumor by ultrasonography. Our results could be useful for dermatologists who perform ultrasonography directly.

Utilization of Ultrasonography in Dermatology: Two Case Reports of Calcinosis Cutis

( Jae Wan Park ),( Hye Sung Han ),( Guk Jin Jeong ),( Ji Yeon Hong ),( Kui Young Park ),( Seong Jun Seo ) 대한피부과학회 2022 Annals of Dermatology Vol.34 No.1

Development of newer generation of cost-effective ultrasonic devices in recent years has increased the use of ultrasonography in dermatology. Several lesions can be diagnosed and managed using ultrasonography. Calcinosis cutis involves the deposition of insoluble calcium salts in the cutaneous and subcutaneous tissues. On ultrasonography, it specifically presents as hyperechoic deposits with a posterior acoustic shadowing artifact due to the acoustic properties of calcium. A 62-year-old female patient presented with a solitary, skincolored, palpable nodule on the inner side of the right lower leg. The lesion was beneath the intact skin and detectable only on palpation. However, ultrasonography demonstrated a clear delineation of the lesion, showing hyperechoic deposits with a posterior acoustic shadow (15 MHz, linear probe). Skin biopsy and curettage were performed, revealing histological features consistent with calcinosis cutis. Four weeks after the procedure, ultrasonography performed to evaluate the outcome of treatment, showed recurrence. Another 18-year-old female patient presented with a skin-colored deep-seated nodule on the left temple. On ultrasonography, linear hyperechoic deposits with a posterior acoustic shadow were visible. Skin biopsy was performed, and histopathologic features showed calcified material in the subcutaneous tissue. These two cases of calcinosis cutis highlight the diagnostic value of ultrasonography in dermatology.

초음파 진단장치를 이용한 축우의 번식효율증진에 관한 연구 I. 무발정 젖소에서 기능성황체를 평가하기 위한 직장검사와 초음파검사의 진단정확성

손창호,강병규,최한선,강현구,오기석,신창록,Son, Chang-ho,Kang, Byong-kyu,Choi, Han-sun,Kang, Hyun-gu,Oh, Ki-seok,Shin, Chang-rok 대한수의학회 1996 大韓獸醫學會誌 Vol.36 No.4

The accuracy of rectal palpation and ultrasonography for predicting the presence of a functional corpus luteum in subestrous dairy cows was investigated, using the result of a radioimmunoassay for progesterone in plasma. Luteal status (high or low progesterone concentrations) was diagnosed in 820 cows, using rectal palpation and B-mode transrectal ultrasonography, and the results of rectal palpation and ultrasonography were compared in $2{\times}2$ contingency table with plasma progesterone concentrations. A $2{\times}2$ contingency table analysis allowed the calculation of sensitivity, specificity and predictive values for rectal palpation and ultrasonography. The sensitivity, specificity, predictive value of a positive test and predictive value of a negative test were 81.9%, 67.5%, 79.0% and 71.4% for rectal palpation, and 96.3%, 88.8%, 94.5% and 92.4% for ultrasonography, respectively. The percentages of observed agreement and expected agreement between rectal palpation and ultrasonography were 71.8% and 57.1%, respectively. An evaluation of agreement between rectal palpation and ultrasonography, the value of Kappa was 0.34. It was concluded that a ultrasonography was more sensitive and specific than rectal palpation in predicting the presence of a functional corpus luteum. Therefore, ultrasonographic examination is a reliable method for assessing the functional status of ovarian structures in subestrous dairy cows.