구내 건조증을 호소하는 환자에서 역동적 타액선 신티그라피: 정적영상과의 비교

김의녕(Euy Neyng Kim),손형선(Hyung Sun Sohn),최정은(Jung Eun Choi),김성훈(Sung Hoon Kim),정용안(Yong An Chung),정수교(Soo Kyo Chung),김춘열(Choon Yul Kim) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.1

N/A Purpose: In this study, we compared the quantitative characteristics of dynamic salivary gland scintigraphy with static scintigraphy in patients with clinical sicca syndrome using Tc-99m pertechnetate. Materials and Methods: Fifty-two parotid glands and 52 submandibular glands out of 26 patients with clinical sicca syndrome were studied by dynamic and static salivary gland scintigraphy. Ten normal volunteers were also studied as a control group for comparison of scintigraphic parameters. Ten minutes after injection of 370 MBq Tc-99m pertechnetate, we obtained pre-stimulus static images for a few minutes. Then dynamic salivary gland scintigraphy with lemon juice stimulation was performed for 20 minutes. Finally we obtained post-stimulus static images after dynamic images. On dynamic study, functional parameters such as uptake rate, secretion rate and re-uptake rate were calculated. The results of dynamic study and static images were compared. Results: On dynamic study, we could obtain functional parameters of salivary glands successfully. On dynamic study, 22 parotid glands and 22 submandibular glands out of each of 52 glands are abnormal. The static images demonstrated somewhat different results, of which reasons we could assume via dynamic study. Conclusion: Dynamic salivary gland scintigraphy using Tc-99m perechnetate were more functional than static images and might be useful in the assessment of the functional change of the salivary gland in patients with clinical sicca syndrome. (Korean J Nucl Med 2001;35:43-51)

Different Uptake of Tc-99m ECD and Tc-99m HMPAO in the Normal Brains : Analysis by Statistical Parametric Mapping 통계적 파라미터 지도를 사용한 분석

Kim, Euy Neyng,Jung, Yong An,Sohn, Hyung Sun,Kim, Sung Hoon,Yoo, Ie Ryung,Chung, Soo Kyo 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.4

목적: 이번 연구는 두 명의 경험 있는 핵의학과 의사에 의하여 정상이라고 판독된 뇌 혈류 단일광자방출전산화단층촬영 영상에서 사용한 방사성의약품에 따라 혈류 분포에 차이가 있는지를 통계적 파라미터 지도를 사용하여 분석하여 보았다. 대상 및 방법: 정상이라고 판독된 뇌 혈류 단일광자방출전산화단층촬영 53 증례를 후향적으로 분석하였고, 그 중 32증례는 Tc-99m ECD를 방사성의약품으로 사용하였으며 나머지 21 증례는 Tc-99cm HMPAO를 방사성의약품으로 사용하여 획득한 영상이었다. 모든 뇌 혈류 단일광자방출전산화단층촬영 영상은 통계적 파라미터 지도 분석에 적합하도록 미리 표준화 시킨 후 분석을 시행하였고 분석결과 통계적으로 두 그룹간에 corrected P value가 0.05 이하인 경우에 서로 의미 있는 차이라고 해석하였다. 결과: 정상으로 판독된 뇌 혈류 단일광자방출전산화단층촬영 중에서도 방사성의약품을 어느것을 사용하느냐에 따라 분명한 혈류 분포의 차이를 나타내었다. Tc-99m ECD를 사용한 뇌 혈류 단일광자방출전산화단층촬영에서는 Tc-99m HMPAO를 사용하였을 때 보다 전두엽, 측두엽, 후두엽, 기저핵, 시상 및 소뇌의 상부 등 광범위한 부위에서 높은 혈류분포를 보였으며 반대로 Tc-99m HMPAO를 방사성의약품으로 사용한 경우에는 Tc-99m ECD를 사용하였을 경우보다 전두엽의 피질하 부위, 측두엽 일부 및 소뇌의 하부 등 국소적인 부위에서 상대적으로 증가된 혈류분포가 관찰되었다. 결론: 통계적 파라미터 지도를 사용하여 분석하여 본 결과 정상으로 판독된 뇌 혈류 단일광자방출전산화단층촬영에서 사용된 방사성의약품에 따라 유의한 혈류분포의 차이를 나타내었다. 따라서 뇌 혈류를 평가하는데 있어서는 어떠한 방사성 의약품을 사용하였는가를 반드시 고려하여야 한다.(대한핵의학회지 2002;36;244-54)

정상인과 파킨슨병 환자에서 [I-123]IPT SPECT를 이용한 도파민 재섭취부위의 영상화

손형선,김의녕,이경진,나형균,손병철,최창락,Sohn, Hyung Sun,Kim, Euy Neyng,Lee, Kyung Jin,Rha, Hyung Keun,Son, Byung Chul,Choi, Chang Rhack 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.3

Objective : Dopamine transporter concentrations have been known to decrease in Parkinson's disease(PD). The aim of the present study was to evaluate the correlation between SPECT measurements of [I-123]N-(3-iodopropene-2-yl)-$2{\beta}$-carbomethoxy-$3{\beta}$-(4-chlorophenyl) tropane(IPT) as an imaging agent for measuring changes in transporter concentrations with PD. Patients and Methods : IPT labelled with $4.87{\pm}1.29mCi$($180.19{\pm}47.73MBq$) of [I-123] was intravenously injected into 23 patients(age : $58{\pm}12$) with PD and three normal controls(NC)(age : $37{\pm}7$) as bolus. Brain SPECT were then performed at 1 hour and 2 hours after injection on a double headed camera. The statistical parameters were the contrast ratio of left basal ganglia(BG) and right basal ganglia to occipital cortex(OCC) per milli curies of injected radiotracer at 1 hour and 2 hours. The correlations were evaluated between these parameters and Hoehn-Yahr classification of the patients. Results : The(BG - OCC)/OCC/mCi ratios at 1 hour and 2 hours for PD and NC were $0.14{\pm}0.07$ and $0.27{\pm}0.07$(1 hour) and $0.12{\pm}0.07$ and $0.34{\pm}0.04$(2 hour), respectively. The(BG - OCC)/OCC/mCi ratios of Parkinson's disease were decreased with higher grade of Hoehn-Yahr classification of the patients. The ratio between BG and OCC for PD were clearly separated from NC and may be useful outcome measures for clinical diagnosis. Conclusion : The findings suggest that IPT may be a very useful tracer for early diagnosis and treatment of PD and study of dopamine re-uptake site.

교차소뇌해리현상 : SPECT와 MRI 소견의 비교와 임상징후

손형선,김의녕,신광현,나형균,최창락,Sohn, Hyung Sun,Kim, Euy Neyng,Shin, Kwang Hyun,Rha, Hyung Kyun,Choi, Chang Rack 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.6

Objectives : The purpose of our study was to compare findings of brain SPECT representing crossed cerebellar diaschisis(CCD) with brain MRI, to evaluate relation between CCD and location of lesions on MRI and to elucidate clinically apparent cerebellar sign in patients with CCD. Methods : The study population was 20 patients representing CCD on SPECT. Percentage differences(${\triangle}%$) of activity on each cerebellar hemisphere were obtained from ipsilateral and contralateral cerebellum[${\triangle}%cbll=(IL-CL)/IL{\times}100$] and from cerebrum [${\triangle}%cbr=(CL-IL)/CL{\times}100$]. From MR studies, the percentage differences of signal intensity were also calculated as the same method. We compared the degree of percentage differences with location of cerebral lesions and with clinical cerebellar signs of the patients. Results : Among those representing CCD, the parietal lesions were the most common. There was significant correlation of the percentage differences in cerebellum between SPECT($18.8{\pm}7.22$) and MRI($4.4{\pm}3.38$) (p<0.05) and in cerebrum between SPECT($28.7{\pm}15.35$) and MRI($42.8{\pm}10.94$) (p<0.05). Cerebellar signs were observed in 3 of the 20 patients. However, there was no statistically significance between degree of percentage differences of each cerebellar hemisphere on SPECT and clinical cerebellar sign(p>0.05). Conclusion : Using the percentage differences in the cerebellum, the CCD evaluation can be easily done. On MRI, the signal changes of cerebellum were not as definite as SPECT. Despite of our assumption, there was no significant correlation between clinical cerebellar signs and CCD on SPECT.

Evaluation of SPECT Analysis in Patients withTransient Global Amnesia

조보영,김의녕,정용안,손형선,김성훈,정수교,이형구,서태석 한국자기공명학회 2002 Journal of the Korean Magnetic Resonance Society Vol.6 No.1

Objectives: This study investigated alterations in regional cerebral blood flow (rCBF) in patients with transient global amnesia (TGA) using statistical parametric mapping 99 (SPM99). Methods: Noninvasive rCBF measurements using 99mTc-ethyl cysteinate dimer (ECD) SPECT were performed on 8 patients with TGA who have ongoing symptoms and 17 age matched controls. The relative rCBF maps in patients with TGA and controls were compared. Results: In patients with TGA, significant decreased rCBF was found along the L superior temporal extending to L parietal region of the brain and L thalamus. There were areas of increased rCBF in the R temporal, R frontal region and R thalamus. Conclusion: We could demonstrate decreased perfusion in left cerebral hemisphere and increased perfusion in right cerebral hemisphere in patients with TGA using SPM99. The imbalanced change of rCBF between bilateral cerebral hemisphere in patients with TGA might suggest that imbalanced neuronal activity between the bilateral hemispheres may have strong relationship to the pathogenesis of the TGA. For quantitative SPECT analysis in TGA patients, we recommend SPM99 rather than the ROI method because of its definitive advantages. 영어논문

갈륨 신티그라피와 자기공명영상으로 진단한 근육 유육종증

손형선,김의녕 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.6

Gallium-67 scintigraphy is helpful in the assessment of active extrapulmonary sarcoidosis. Muscular involvement of sarcoidosis is often asymptomatic or nonspecific, and laboratory examinations do not provide convincing evidence of muscular involvement. We report a case of muscular sarcoidosis, which was detected by gallium-67 scintigraphy. In a patient who was suffering from fever and arthralgia of knee joint, gallium-67 scintigraphy showed mediastinal and hilar involvement of sarcoidosis with unexpected extensive muscular uptake. Magenetic resonance imaging revealed the detailed depiction of intramuscular infiltration of sarcoid granuloma. Gallium-67 scintigraphy is useful in detecting inflammatory muscular involvement of sarcoidosis as well as other multiorgan involvement.

뇌 기능영상에서의 TE값의 변화에 따른 1.5T와 3.0T MRI의 자화율 변화 비교

김태,최보영,김의녕,서태석,이흥규,신경섭,Kim, Tae,Choe, Bo-Young,Kim, Euy-Neyng,Suh, Tae-Suk,Lee, Heung-Kyu,Shinn, Kyung-Sub 대한자기공명의과학회 1999 Investigative Magnetic Resonance Imaging Vol.3 No.2

목적 : 1.5T와 3.0T에서의 FLASH (fast low-angle shot) 기법를 이용한 운동중추영역의 뇌기능 자기공명영상에서 TE 값 변화에 대한 $T_2^{*}$ weighting 효과를 관찰하고 TE 값의 변화에 따른 BOLD (blood oxygen level dependent) 효과를 서로 비교하고자 한다. 그리고 활성화 영역에서 활성화상태와 휴식상태의 정량적인 값인 $T_2^{*}$에 의한 차이값을 영상화 하고자 한다. 대상 및 방법 : 24세에서 35세까지의 오른손잡이 10명의 건강한 남녀 (남:8명, 여:2명)를 대상으로 가능한 2Hz의 속도로 오른손에서 finger-tapping task (엄지 손가락과 나머지 네 손가락을 차례로 서로 마주치게 하는 운동)를 시행하였다. 운동자극은 처음에 한벤의 휴식상태 (3영상)를 가진 후2번의 활성화상태 (6영상)와 휴식상태 (6영상)를 반복하였다. FLASH (TR/flip angle: $l00ms/20^{\circ}$, FOV: 230mm) 방법를 이용하여1.5T'에서는 26, 36, 46, 56, 66 ms 의 TE를 사용하였고 3.0T에서는 16. 26, 36, 46, 56 ms의 TE를 사용하였다. 영승L을 얻은 후 PC에서 상관계수방법을 이용하여 자체 개발한 프로그램과 상관계수 0.45를 사용하여 분석 하였다. 기능적 영상에서 활성화된 영역에서 l.5T와 3.0T에서 각각의 TE에셔 활성화 상태와 휴식상태 의 차이값을 사용하여 fitting을 하여 적절한 TE값을 찾고 기능적 $T_2^{*}$영상을 구하였다. 결과 : FLASH기법을 사용하여 뇌 기능영상을 얻기에 최적의 TE 값은 1.5T에서는 $61.89{\pm}2 2.68{\;}ms,{\;}3.0T에서는{\;}47.64{\pm}13.34였다$. 뇌 활성화 영역에서 자화율 변화에 따른최대 선호 강도변화는 1.5T에서는 TE, 66ms에서 3.36%. 3.0T에서는 TE. 46ms에서 10.05%로 3.0T가 1.5T에 비해 약 3배 정도 변화가 큰 것을 알 수 있었다. 산출된 최적의 TE 값은 각각의 TE 값에서 얻은 활성화 상태와 휴식상태의 차이값의 최대의 TE 값와 일치하였다. 결론 : 뇌 기능영상에서 3.0T MRl는 1.5T에 비해 deoxyhemoglobin에 의한 자화율의 변화를 약 3배정도 잘 반영하므로 뇌 기능영상 측정시 보다 유용성이 있는 것으로 사료된다. Purpose : The purpose of this study was to find the optimum TE value for enhancing $T_2^{*}$ weighting effect and minimizing the SNR degradation and to compare the BOLD effects according to the changes of TE in 1.5T and 3.0T MRI systems. Materials and Methods : Healthy normal volunteers (eight males and two females with 24-38 years old) participated in this study. Each volunteer was asked to perform a simple finger-tapping task (sequential opposition of thumb to each of the other four fingers) with right hand with a mean frequency of about 2Hz. The stimulus was initially off for 3 images and was then alternatively switched on and off for 2 cycles of 6 images. Images were acquired on the 1.5T and 3.0T MRI with the FLASH (fast low angle shot) pulse sequence (TR : 100ms, FA : $20^{\circ}$, FOV : 230mm) that was used with 26, 36, 46, 56, 66, 76ms of TE times in 1.5T and 16, 26, 36, 46, 56, 66ms of TE in 3.0T MRI system. After the completion of scan, MR images were transferred into a PC and processed with a home-made analysis program based on the correlation coefficient method with the threshold value of 0.45. To search for the optimum TE value in fMRI, the difference between the activation and the rest by the susceptibility change for each TE was used in 1.5T and 3.0T respectively. In addition, the functional $T_2^{*}$ map was calculated to quantify susceptibility change. Results : The calculated optimum TE for fMRI was $61.89{\pm}2.68$ at 1.5T and $47.64{\pm}13.34$ at 3.0T. The maximum percentage of signal intensity change due to the susceptibility effect inactivation region was 3.36% at TE 66ms in 1.5T 10.05% at TE 46ms in 3.0T, respectively. The signal intensity change of 3.0T was about 3 times bigger than of 1.5T. The calculated optimum TE value was consistent with TE values which were obtained from the maximum signal change for each TE. Conclusion : In this study, the 3.0T MRI was clearly more sensitive, about three times bigger than the 1.5T in detecting the susceptibility due to the deoxyhemoglobin level change in the functional MR imaging. So the 3.0T fMRI I ore useful than 1.5T.

피질하 혈관성 치매 환자에서 단광자방출단층촬영과 Statistical Parametric Mapping을 이용한 뇌혈류 흐름의 분석 : Adaptation of Statistical Parametric Mapping

양동원,김범생,김의녕,손형선,김상윤 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.1

Background: Subcortical vascular dementia(SVaD) is relatively homogeneous subtype of VaD, but the mechanisms of cognitive dysfunction of subcortical VaD are not completely understood yet This study investigated the changes of cerebral blood flow(CBF) in patients with SVaD and the contribution of the white matter hyperintensity(WMHI) and clinical severity to CBF changes. Methods: 99mTc-ethyl cysteinate dimer single photon emission computed tomography(SPECT) was performed to measure the regional CBF and statistical parametric mapping(SPM)99 software was applicated to automated and objective analysis of the SPECT image data Twenty three patients (male 12, female 11) of mild to moderate dementia who met both the criteria of the DSM-IV and probable or possible NINDS-AIREN for VaD and have subcortical white matter changes and lacunar infarction on brain MRI and seventeen normal control subjects (male 7, female 10) were evaluated The severity of the WMHI was measured by semi-quantitative scale method proposed by Mantyla. The seventy of dementia was measured by clinical dementia rating (CDR) scale Results: SPM analysis of SPECT image revealed significantly reduced regional CBF in the right thalamus, left caudatd nucleus, cingulate, bilateral superior temporal, and left ventral subcallosal gyri in SVaD patients when it compared to normal controls (corrected p<0 001). Among four WMHIs, only the WMHI was associated with the small CBF reduction in the left superior temporal gyrus (uncorrected p<0 01) The reduction of CBF according to the severity of dementia was noted in the anterior and posterior association areas (uncorrected p<0 01). Conclusions: our study suggests that cognitive dysfunction of SVaD may be related with CBF reduction in the above mentioned brain areas, which probable are not associated with the severity of periventncular WMHI and dementia.

누비공신티그라피를 이용한 기능적 누도폐쇄의 진단

김성훈,정용안,임현욱,손형선,김의녕,정수교 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.6

Purpose: To evaluate the value of dacryoscintigraphy in the assessment of patients with a clinical diagnosis of functional nasolacrimal duct obstruction. Materials and Methods: Dacryoscintigraphy was performed in symptomatic 35 lacrimal drainage systems in 18 patients (age range: 37∼76, 8 males, 10 females) that were patent on syringing. Results: Abnormalities were detected with dacryoscintigraphy in 75.8% of systems. The positive scintigrams were subdivided into those demonstrating prelacrimal sac delay (31.8%), delay at the lacrimal sac/junction (40.9%), or delay within the duct (27%). Conclusion: Dacryoscintigraphy is noninvasive useful technique in the assessment of the functional nasolacrimal duct obstruction and very sensitive at detecting abnormalities in patients with lid laxity caused by senile change and facial nerve palsy.

46차 대한핵의학회 추계학술대회 포스터 : 고순도 [18F]Fluoroestradiol의 합성과 실험동물 영상획득

이상주,오승준,지대윤,김의녕,김석영,박수아,임기천,강종순,김환묵,문대혁 대한핵의학회 2007 핵의학 분자영상 Vol.41 No.5