토끼에서 급성 요로 폐색 시의 신정맥 도플러 초음파: 신정맥 임피던스 지수의 유용성

손경명,정수교,이성용 대한영상의학회 2004 대한영상의학회지 Vol.50 No.5

Purpose: To evaluate the usefulness of the impedance index of the renal vein for the diagnosis of acute obstructive uropathy in rabbits. Materials and Methods: Ligation of the left ureter was done in 12 rabbits. Doppler sonography of the interlobar veins in both kidneys was checked before and 30 minutes, 1, 3, 6, 9 and 24 hours after ureteral ligation. The venous impedance index〔 (peak flow signal-least flow signal)/peak flow signal〕was compared between the obstructed and non-obstructed kidneys for all periods. The change in the impedance index after ureteral ligation was also compared between the obstructed and non-obstructed kidneys. Results: A decrease in the impedance index of the intrarenal vein was observed starting from 30 mins after ureteral ligation, and the index remained low up to 24 hours after ureteral ligation. The obstructed kidneys had a significantly lower impedance index than the contralateral kidneys for all six of the postligation measurements (p< 0.05). There were significant differences in the change of impedance index after ureteral ligation between the obstructed and non-obstructed kidneys (p< 0.05). Conclusion: The impedance index of the intrarenal vein was significantly decreased in the obstructed kidneys. The measurement of the impedance index of the intrarenal vein using Doppler sonography could provide a useful method of diagnosing obstructive uropathy. 목적: 토끼의 급성 요로 폐색 진단에 도플러 초음파를 이용한 신정맥 임피던스 지수 측정이 유 용한지를 알아보고자 하였다. 대상과 방법: 12마리의 토끼에서 좌측 요관을 견사로 결찰함으로써 요로 폐색 모델을 만들었다. 요로 폐색을 유발하기 전과 요로 폐색 유발 후 30분, 1시간, 3시간, 6시간, 9시간, 24시간에 도 플러 초음파 검사를 시행하여 신장 엽간 정맥의 임피던스 지수를 측정하였다 [(최고 혈류 신 호-최저 혈류 신호)/최고 혈류 신호]. 폐색 신장과 정상 신장에서 신정맥 임피던스 지수를 시 간별로 비교 분석하였고, 요관 결찰 후에 생긴 임피던스 지수 변화량에 대해서도 시간별로 폐 색 신장과 정상 신장을 비교하였다. 결과: 요관 결찰 후 30분부터 신정맥의 임피던스 지수의 감소가 관찰되었고, 24 시간 경과까지 낮은 임피던스 지수가 유지되었다. 결찰 후의 여섯 시점 모두에서 폐색 신장의 신정맥 임피던 스 지수가 정상 신장보다 유의하게 낮았다(p<0.05). 요관 결찰 전 시행한 임피던스 지수를 기 준으로 측정한 임피던스 지수 변화량의 비교에서도 폐색이 있는 신장에서 정상 신장에 비해 결 찰 후 여섯 시점 모두에서 유의하게 큰 변화량을 보였다(p<0.05). 결론: 급성 폐색 신장에서 신정맥의 임피던스 지수가 유의하게 감소하였다. 신정맥의 도플러 초 음파 검사에 의한 임피던스 지수 측정은 급성 요로 폐색의 진단에 유용할 것으로 사료된다.

후복강에 발생한 기관지원성낭종: 증례 보고

손경명,김기준,맹이소 대한영상의학회 2007 대한영상의학회지 Vol.57 No.5

An retroperitoneal bronchogenic cyst is extremely rare and often mimics other cystic diseases such as a lymphangioma, pseudocyst, or cystic tumor of the pancreas. We have recently experienced a case of a peripancreatic bronchogenic cyst in 32-year-old woman. We report this case with a description of the CT findings and a review of the literature. 후복막 기관지원성낭종은 극히 드문 질환으로 흔히 림프관종, 거짓낭 또는 췌장의 낭종으로 오인된다. 저자들은 32세 여자 환자에서 췌장주위에 발생한 기관지원성낭종을 경험하였기에 문헌고찰과 함께 컴퓨터 단층 촬영소견을 보고한다.

위암의 림프절 병기 평가에 있어서 CT의 유용성

손경명 대한영상의학회 1992 대한영상의학회지 Vol.28 No.5

An accurate preoperative evaluation of lymph nodes(LNs) in gastric cancer is a prerequisite for successful surgery and favorable prognosis. We retrospectively analyzed the CT accuracy in perigastric LN localization and LN staging of gastric cancer as well as the size criteria for the metastasized LN in 64 patients who fed undergone a surgery for gastric cancer. The results of perigastric LNs evaluation by CT are as follows;sensitivity 67%(64/95), specificity 90%(839/929), accuracy 88%(903/1024). of 95 pathologically metastasized LN groups, 66 could be retrospectively identified on CT scans(69%). In LN staging, CT was correct in 60%(38/64), overstaged in 32%(21/64), and understaged in 8%(5/64). The perigastric LN groups which were easily localized on CT were #3, 7, 8, and 13. The mean size of metastasized LNs on CT according to the LN group was #3 (13mm), #4 (9mm), #6 (10mm), #7 (10.5mm), #8 (10mm), #9 (11mm), #13 (9mm).

경구 투여한 가스트로그라핀의 요배설 : 위절제술을 받은 환자에서의 임상적 의의

손경명 대한영상의학회 1998 대한영상의학회지 Vol.39 No.2

부신 종양에서 조영증강 전후 및 지연시기 CT로 산출되는 조영증강 배출율의 의의: 선종과 전이암과의 비교

손경명,이성용,Son, Gyeong-Myeong,Lee, Seong-Yong 대한영상의학회 2003 대한영상의학회지 Vol.48 No.5

목적:조영증강 전후 및 지연시기 CT로 산출되는 조영증강 배출율이 부신 종양의 양성 및 악성 감별에 유용한지를 알아보고자 하였다. 대상과 방법:크기가 5 cm 미만인 부신 종양 40예를 대상으로 조영증강 전과 조영제 주입 60초 후,그리고 평균 10분 지연시기에 CT 촬영을 하였다.각 시기의 CT 스캔에서 부신 종양의 CT 감쇠계수를 측정하여 다음과 같이 조영증강 배출율을 산출하였다.〔(문맥시기 CT 감쇠계수-지연시기 CT 감쇠계수)/ (문맥시기 CT 감쇠계수-조영증강전 CT 감쇠계수)$\times$100 〕.부신 종양은 역치 이상의 조영증강 배출율을 보이는 경우에 양성 종양으로 진단하였다.조영증강 배출율의 역치 값으로는 60%와 50%를 각기 적용시켰으며 최종 임상 진단과 비교하여 그 정확도를 알아보았다. 결과:부신 종양은 29예의 양성종양(선종)과 11예의 악성종양(전이암)으로 이루어졌다.부신선종의 지연시기 조영증강 배출율은 평균 66.7%(n=29)이었고,전이암은 평균 21.8%(n=11)의 배출율을 보여서 양군간에는 유의한 차이가 있었다(p 〈.01).선종의 경우 1예를 제외하고는 모두 50%이상의 배출율을 보였고 전이암은 모두 50%미만의 배출율을 나타내었다.조영증강 배출율의 역치를 60%로 하였을 때 양성종양에 대한 민감도는 82.7%(24/29),특이도는 100%(11/11),정확도는 87.5%(35/40)이었다.역치를 50%로 하였을 때의 민감도는 96.5%(28/29),특이도는 100%(11/11),정확도는 97.5%(39/40)이었다. 결론:조영증강 전과 후의 CT로 산출되는 지연시기 조영증강 배출율은 5 cm미만인 부신종양의 양성 및 악성 감별진단에 유용하다.그리고,조영증강 배출율의 역치로는 60%보다 50%인 경우가 더 높은 정확도를 보였다. Purpose: To determine the usefulness of percentage enhancement washout value calculated on unenhanced, enhanced and delayed enhanced CT scans for the characterization of adrenal masses. Materials and Methods: Forty adrenal masses less than 5 cm in size were assessed using a protocol consisting of unenhanced CT, enhanced CT 60 seconds after intravenous administration of contrast material, and delayed enhanced CT at 10 minutes. The CT attenuation value of adrenal tumors was estimated on each scan, and percentage enhancement washout value was calculated as follows: [(attenuation value at enhanced CT-attenuation value at delayed CT)/ (attenuation value at enhanced CT-attenuation value at unenhanced CT)x100]. An adrenal mass was considered benign if its percentage enhancement washout value was at the threshold value, set to 60% and 50%, or higher. The accuracy of the procedure was determined by comparing its findings withthe final clinical diagnosis. Results: Twenty-nine massess were benign and 11 were malignant. The mean percentage enhancement washout value of the former was significantly higher than that of the latter (66.7% vs. 21.8%; p<0.01). All adenomas except one had a washout value of more than 50%. With a percentage washout threshold of 60%, 35 of 40 lesions were correctly characterized as benign or malignant [sensitivity 82.7% (24/29), specificity 100% (11/11), accuracy 87.5% (35/40)]; with a threshold of 50%, 39 of 40 lesions were correctly characterized [(sensitivity 96.5% (28/29), specificity 100% (11/11), accuracy 97.5% (39/40)]. Conclusion: Percentage enhancement washout values are useful for characterizing an adrenal mass as benign or malignant. For characterization, a threshold value of 50% was more accurate than one of 60%.

폐배아 발생 이상 : 30예의 방사선학적 소견

손경명 대한영상의학회 1990 대한영상의학회지 Vol.26 No.5

Bronchogenic cyst, pulmonary sequestration, congenital cystic adenomatoid malformation and congenital lobar emphysema are four major congenital cystic pulmonary diseases that represent a spectrum of closely related anomalies arising at early stage of embryonic lung bud maturation. Most of them present with recurrent pulmonary infections or chest pain since childhood and usually the diagnosis is made at this age. Sometimes the lesions are silent and found at adult age. We retrospectively analyzed the plain chest radiograms for 30 patients with a lung bud anomaly. The diagnosis was established by surgery and biopsy, but bronchography, computed tomography and ultrasonography aided in the diagnosis, seventeen bronchogenic cysts, 8 pulmonary sequestrations, 2 congenital cystic adenomatoid malformations, 2 congenital lobar emphysema and 1 congenital bronchial stenosis are included in this study. Nine out of 13 intrapulmonary bronchogenic cysts involvoed the lower lobes : thin-walled cysts with or without air-fluid level were the characteristic chest roentgenographic finding. However, mediastinal bronchogenic cyst showed well-marginated mass. The pulmonary sequestration showed similar cystic mass with or without air-fluid levels in five out of eight patients, but the cyst wall was not so sharply defined as in the bronchogenic cyst. In two patients of congenital cystic adenomatoid malformation, a large thin-walled cyst with air-fluid level was noted and differentiation form intrapulmonary bronchogenic cyst was difficult both by chest roentgenogram and computed tomography. Two partients of congenital lobar emphysema and one patient of bronchial stenosis showed unilateral hyperlucent lung without discrete cystic mass formation.

경추 경막외부에 발생한 골격외 유잉육종: 증례 보고$^1$

김기준,이재희,손경명,이성용,Kim, Gi-Jun,Lee, Jae-Hui,Son, Gyeong-Myeong,Lee, Seong-Yong 대한영상의학회 2003 대한영상의학회지 Vol.48 No.1

골격외 유잉육종은 비교적 젊은 연령층에서 주로 체간의 척추주위와 사지의 심부 연부조직에 생기는 드문 악성 종양이다. 저자들은 고령 환자에서 경추주위의 경막외 연부조직종괴로 발생한 골격외 유잉육종을 2예 경험하였기에 이를 보고하는 바이다. 자기공명영상과 전산화단층 촬영에서 경추주위 경막외 종괴가 추간공을 통하여 척추간 내로 침입하여 척수 신경과 건초낭을 압박하는 소견을 보였다. 종괴는 T1강조자기공명영상에서 근육과 동신호강도, T2 및 $T2^*$ 영상에서 고신호강도로 관찰되었으며 조영제 주입후 중심부의 일부를 제외하고 조영증강이 잘 되었다. 골격외 유잉육종은 비록 드물지만 척추의 경막외 종괴의 감별진단에 포함되어야 할 것으로 생각한다. Extraskeletal Ewing sarcoma is a rare malignant tumor found in children and young adults. It commonly occurs in deep soft tissue of the trunk, especially in the paravertebral region and extremities. We report two cases of extraskeletal Ewing sarcoma occurring as a cervical epidural tumor in elderly patients. The MRI and CT findings showed that paravertebral epidural tumors had invaded the spinal canal through the intervertebral foramen. At T1-weighted MR imaging, the masses were isointense to muscle, and at $T2^*$ and T2-weighted images were hyperintense, and heterogeneous contrast enhancement was observed. Extraskeletal Ewing sarcoma, though quite rare, should be borne in mind in the differential diagnosis of paraspinal epidural tumors.

부신의 출혈성 가성낭

김경미,이안희,손경명,박승만,심상인 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.7

Detection of Breast Cancer in Asymptomatic and Symptomatic Groups Using Computer-Aided Detection with Full-Field Digital Mammography

박창숙,김기준,정현석,손경명,오세정,정나영 한국유방암학회 2013 Journal of breast cancer Vol.16 No.3

Purpose: We aimed to determine the sensitivity of computer-aided detection (CAD) applied to digital mammography in asymptomatic and symptomatic breast cancer patients. Methods: We retrospectively analyzed digital mammography and CAD images from 210 patients diagnosed with breast cancer. The patients were divided into symptomatic and asymptomatic groups. The sensitivity of CAD in both groups was assessed in relation to breast tissue density, histopathological type of breast cancer,and tumor size. Results: The detection rate of the CAD system was 87.8% in the asymptomatic group. The sensitivity in different tissue densities was 100% in fatty breasts (P1), 88.9% with scattered fibroglandular densities (P2), 94.4% in heterogeneously dense breasts (P3), and 66.7% in extremely dense breasts (P4). The detection rate of the CAD system in the symptomatic group was 87.2%, and the sensitivity was 90.5%, 90%, 86.6%,and 75% in P1-P4 breasts, respectively. In the asymptomatic group, the CAD system detected 90.3% of invasive ductal carcinomas,not otherwise specified (IDC-NOS) and 88.9% of ductal carcinomas in situ (DCIS), but did not detect other types of malignancy. In the symptomatic group, the CAD system detected 88.2% of IDC-NOS, 88.9% of DCIS and 75% of other types of malignancy. When analyzed according to tumor size, the sensitivity of CAD in the asymptomatic and symptomatic groups was 82.6% and 83.3% for tumors <1 cm, 76.5% and 82.4% for tumors between 1 and 2 cm, and 91.7% and 89% in tumors >2cm. Conclusion: The sensitivity of CAD was low in P4 breasts and high for tumors larger than 2 cm, with no statistically significant differences between the asymptomatic and symptomatic groups for IDC-NOS and DCIS. CAD showed greater sensitivity for other neoplasms in symptomatic patients.

CT 및 MRI에 의한 위암의 술전 병기

박승만,김욱,박조현,손경명,김경미 대한외과학회 2001 대한외과학회 학술대회 초록집 Vol.2001 No.11