유방질환의 각종 방사선학적 영상에 관한 연구

오기근 대한영상의학회 1985 대한영상의학회지 Vol.21 No.2

Radiographic examination of the breast has been so improved that it became a routine complement to physical examination. From November 1, 1983 through September 30, 1984, 684 patients with complaints of various breast problem were examined by low-dose film mammography at Yoon Dong Hospital, Yonsei University. Among them, a comparative studies, independently conducted physical examination, 97 cases of film mammography, 35 cases of ultrasound mammography, 16 cases of aspiration cytology, and 3 cases of galactography were performed for our pathologically proven 98 cases of breast diseases. Combined and complementary studies for breast diseases were analyzed in 37 proven cases and authors found that specificity of those combined immediate complementary study techniques for breast diseases were 94% under dose cooperation with surgeon in Yong Dong Hospital, Yonsei University.

부 유방의 초음파 소견

오기근 대한영상의학회 1993 대한영상의학회지 Vol.29 No.4

Accessory breast is an ectopic breast tissue from developemental remnants. It sometimes begins to make symptoms, pain and swelling during premenstrual period or pregnancy. For it has been known as a rere condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenits or hidradenitis. We have analyzed 52 accessory breast tissues prospectively. to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts. Presence of nipple and /or areola. The obliteration of sucutaneous fat layer, and the dowward displacement of axilla wighout interruption.

비촉지 유방병소를 위한 위치결정의 의의

오기근 대한영상의학회 1990 대한영상의학회지 Vol.26 No.6

As mammography has become more popular for the evaluation of breast symptoms and for the screening of asymptomatic women, the smaller lesions are being detected before they become palpable, therefore preoperative localization became necessary. This has led to the development of several methods for preoperative localization of nonpalpable lesions. Authors analyzed 50 cases with preoperative localizations in 45 patients which had abnormal findings on film mammogram or ultrasonomammogram since October 1985 through March 1990 at Yongdong severance Hospital, College of medicine, Yonsei University. the results were as follows; 1. Techniques of localization were spot method in 8 cases, conventional needle localization method in 38 cases and Kopan's needle localization method in 4 cases. 2. The most common mammographic indication for localization was focal calcifications in 29 cases(58%), which was followed bya newly developed mass in 25 cases(50%) 3. Outcome of pathologically confirm d diagnosis put into benign lesions in 37 cases(74%) and malignant lesions in 13 cases926%). 4. Among the cases with localization of lesions which has suggested as benign lesions in film and ultrasonomammogram, all cases(100%0 were confirmed in benign lesions pathologically. Among the cases with localization of lesions which has suggested as malignant lesions in film and ultrasonomammogram, pathologic malignancy has been proved of 44% and possible histopathologic precursor of malignancy was resulted in 25% such as atypical hyperplasia and adenosis. conclusively, authors considered that the abnormal areas should be removed in their entirety with the sacrifice of minimum volume of contiguous normal breast tissue through the preoperative localization, hence our preoperative localization has contributed faverable prognosis based on minimal lesions in early stage breast cancer.

병합방사선 진단방법을 이용한 한국인 여성 유방암의 연구

오기근 대한영상의학회 1986 대한영상의학회지 Vol.22 No.5

Since October1, 1983 until April 15, 1986, authors analyzed variable combined imaging diagnosis and histopathologic correlation for confirmed 100 breast carcinoma among 2773 patients whom authors took care of them. 1. Incidence of female breast carcinoma was3.6% among 2773 patients who visited Yong Dong Severance Hospital , and overall breast carcinoma occupied 29.7% among 337 confirmed breast diseases. 2. Prevalent cancer age for korean women breast carcinoma was ages between 40-49 years old (42%) however authors experienced 5% breast carcinoma amon gtwenteeth, and 22 % breast carcinoma among thirtieth . 3.Most common histopathologic type for breast carcinoma was infiltrating ductal carcinoma , scirrhous type(65%). And most common breast parenchymal pattern related to breast carcinoma was DY pattern (42%) followed by N1 pattern(25%). 4. Common film mammographic findings of breast carcinoma were ; ill defined bordered mass (68.4%), spiculation of mass (82.9%), vessel dila ation (59.8%) and then calcification (44.4%). 5. Frequently visible ultramammographic findings were ; irregular mass contour(79.6%), nonuniform intermal echoes(87.0%), and posterior wall shadowing(86.0%). 6. Trials of above combined imaging modalities for breast carcinoma resulted in his sensitivity of diagnosis(93.3%).

1996년도 추계 학술대회 발표주제 및 초록집

오기근 대한방사선과학회(구 대한방사선기술학회) 1996 방사선기술과학 Vol.19 No.2

한국인 여성에 발생한 엽상낭성육종의 임상 및 방사선소견 분석

오기근 대한영상의학회 1988 대한영상의학회지 Vol.24 No.5

Cystosarcoma phylloides is an unusual breast tumor which presents difficulties in diagnosis with film mam-mogram of breast only. Even though histopathologic reports of benign cystosarcoma phylloides it commonly recurrs locally if the lesion is inadequetely excised and it may metastase hematogeneously. Ultramammogram has proved useful in the study of breast disease and has permitted the display of some tumor characteritics. Authors analyzed clinical characters of histopathologically confirmed 48 cystosarcoma phylloides and analyzed imaging findings in 20 cases with imaging studies since 1983 through July 1988 at Yongdong and Shinchon Severanc hospital College of Medicine Yonsei University. The results are followed by : 1. Incidence of 48 cystosarcoma phylloides is 2.2% of all admited and operated patients with breast disease 3.2% of breast tumors and 6.1% of benign breast diseases. 2. The age distribution of cystosarcoma phylloides was 12 years old through 55 years old most commonly in teen age (33.3%) and the mean age was 29.2 years old. 3. Most common symptom duration of papable breast mass was between 2month-11.9months(61.3%) and mean symptom duration was 1.8years. 4. Incidence of malignant cystosarcoma phylloides was 6.2% recurrence rate was 18.8% bilaterality and multiplicity of cystosarcoma phylloides was 8.3% respectively 5. Involvement of cystosarcoma phylloides in normal breasts were 47 cases and one of cystosarcoma phylloides was involved in right accessory axillary breast, Common location of cysosarcoma phylloides was central portion of breast both upperand outer portion and upper central portion breast. 6. Mean tumor size of cystosarcoma phylloides was 6.75cm and the commonest size was between 3.1-9.0cm (69.3%) however there was no difference in size between benign and malignant cystosarcoma phylloides. 7. Film mammographic findings of cystosarcoma phylloides in 16 cases showed DY parenchymal pattern (93.7%) well defined (56, 3%) spherical mass (62.5%) with well preserved symmetricity (75%) bulging of skin (62.5%) and halo sign (56.3%) however secondary signs of breast carcinoma were rare findings in cystosarcoma phylloides. 8. Ultramammographic findings were diagnostic in 18 cystosarcoma phlloides; oval (44.4%) or lobulating (38.9%) mass with smooth border(66.7%) intermed diate internal echoes (100%) mild posterior enhacement (77.8%) nonuniform and scattered multinodularities surrounded by tree like or cavitary dilated duetal system which are characteritic findings of cystosarcoma phylloides. 9. 1 case of malignant cystosarcoma phyllodies has been confused with primary breast cancer in film mam-mographically however ultramammographic finding was diagnostic to put exact diagnosis with huge mass necrotic lesions.

한국인 유방암 조기 진단의 방사선학적 접근

오기근 가톨릭중앙의료원 가톨릭암센터 1996 암심포지움 Vol.- No.1

조기유방암에 대한 정의는 다양하다. Gallaghar와 Martin은 초기에 미세유방암(mininal breast concer)이라는 명칭을 정했으며, 그 병변이 소엽상피내암(lobular carcinoma in situ), 관내상피세포암종(ductal carcinoma in situ) 혹은 침윤성유방암이라도 그 직경이 0.5cm를 넘지 않는 경우를 지칭했다. 그러나 미세유방암의 정의를 후에 Breast Concer Detection Demonstration Proje(BCDDP)에서 유방암의 종괴 크기가 1cm이하인 경우로 결정했다.

비수유서 유즙분비질환에서 유선조영술의 이용가치

오기근 대한영상의학회 1988 대한영상의학회지 Vol.24 No.5

Nipple discharge ifs a relatively frequent initial symptom of a pathologic lesion in the nonlactating breast which brings the patient to the physician for treatment. Eventhough only stressful significance of a sanguinous discharge all type of nipple discharge will indicate that abnormal nipple discharge is a symptom of a pathologic change in the ductal and secretery susrem of the breast and galactogram often offers information to etiology. Galactography using water soluble contrast media is a valuable procedure to evaluate women with nonlacta-tional nipple discharge or bleeding which are usually due to benign diseases such as intraductal papilloma papillomatosis secretory disease or malignant lesions, Contrast galavtography can often accomplish such localiza-tion and sometimes can suggest or confirm the nature of the pathologic process Authors have experienced 5077 cases of mammograms and among them 195 cases with nipple discharge have been at Youndong Severance Hosital. yonsei University since October 1 1983 through June 10, 1988 . The results were: 1.Incidence of nonlactating nipple discharge was 3.9% among 5077 cases. 2. Most frequent histopathologic disease among surgically confirmed 100 cases was papilloma(35%) which was followed by papillomatosis (28%) fibrocystic disease(14%) and then breat carcinoma (13%) 3. Age distribution of patient of nonlactating nipple discharge showed no differences in comparing to the pa-tients with the same histopathologic disease without nipple discharge. 4. Bloody nipple discharge is the commonest finding(61%) which was followed by serous(22%) milkish (8%) and then serosanguinous (5%) nipple discharge. In analyszing relationship between histopathologic diagnosis and nipple discharge papilloma and papillomatosis had bloody nipple discharge (69% 57%) frequently and serous nipple discharge (26% 25%) Breat cancer had mostly bloody nipple discharge (85%) incontrast to the fibrocystic disease which showed 50% bloody and 28% milkish nipple discharge. 5. Galactographic characteristics fo papilloma were single duct dilatation(63%) with single intraductal filling defect (66%) along with ductal obstruction (31%) Papillomatosis showed single duct dilatation with numorous filling defects (79%) and tortousity (25%) Breast carcinoma showed ductal obstruction (69%) irregular filling defects (79%) and tortousity (25%) Breast carcinoma showed ductal obstruction (69%) irregular filling defects (54%) intraductal calcification (38%) pefiductal mass (38%) with easy extravasation of contrast media(23%) Fibrocystic disease had almost normal findings with tortousity mild stenosis and cyst formation. 6. Galactographic study was the method of choice to put exact diagnosis of the lesion in the lactiferous duct. Diagnostic accuracy of papilloma 83% papillomatosis 81% breast cancer 92% breast abscess and fibrocystic disease 100 respectively.

유방섬유선종의 역동적 자기공명영상 및 병리조직학적 세포형태의 비교연구

오기근 대한영상의학회 1995 대한영상의학회지 Vol.33 No.3

Purpose : To analyze the dynamic MR imaging of breast fibroadenoma according to the histologic type fordifferentiation from breast carcinoma. Materials and Methods : Dynamic MR images of 26 lesions from 22 breasts in19 patients showing atypical clinical features or film mammogram and ultrasound manifestations were performed. Weanalyzed the speed and the maximal amount of contrast enhancement and the patterns, such as shape, border, andinternal signal intensity, among the histologic types during five minutes after contrast injection. Results : Thespeed and maximal amount of contrast enhancement of fibroadenoma were in descending order of myxoid, sclerotic,glandular, and calcified type. Among those, the value of maximal amount of contrast enhancement of myxoid andsclerotic type were more than 700 NU, but only myxoid type was enhanced more than 700 NU within the first 1 minuteafter contrast injection, similar to the findings to carcinoma. In general, fibroadenoma showed the tendency ofsmooth surface(69%), well-defined border(88%) with safety rim, and internal homogeneous signal intensity(65%).However, sclerotic type of fibroadenoma had relatively high incidence of heterogeneous internal signalintensity(78%) after Gd-DTPA injection. Conclusion : Dynamic MR imagins of atypical breast fibroadenoma mimickingbreast malignancy was very useful to differentiate it from carcinoma and had the benefit of classifyingfibroadenoma according to its histologic types.

유방암에서 Gd-DTPA를 이용한 역동적 조영 자기공명영상소견

오기근 대한영상의학회 1995 대한영상의학회지 Vol.32 No.1

Purpose : To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma insitu(DCIS) and to differentiate from the atypical ductal hyperplasia (ADH). Materials and Methods : Fifty breastlesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteenbreasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique usingGd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection ofGd-DTPA (0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer.Results : The maximal amount of enhancement were 1,161.84$\pm$394.44 NU in infiltrating ductal carcinoma,982.11$\pm$458.35 NU in DCIS, and 1,035.94$\pm$305.20 NU in ADH. The speed of enhancement was 827.33$\pm$384.20 NU withinthe first 1 minute with a sudden increase in signal intensity after injection and a much slighter increasethereafter in infiltrating cuctal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70$\pm$487.36 NU), and ADH showed significant increased enhancement (765.40$\pm$313.61 NU) at 3 minutes afterinjection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductalcarcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement atthe central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS orADH. Conclusion : Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and indifferentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma,multiplicity, and bilaterality of breast carcinoma.