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임석태,김민우,손명희,Lim, Seok-Tae,Kim, Min-Woo,Sohn, Myung-Hee The Korea Society of Nuclear Medicine 2003 핵의학 분자영상 Vol.37 No.5
A 43-year-old woman with diabetic nephropathy underwent a Tc-99m MAG3 renal scintigraphy for the evaluation of renal function. Posterior images at 60 minutes demonstrated a migration of radiotracer activity beyond the lower pole of the left kidney, which might be incorrectly interpreted as urine leaks. However, the increased activities were moving along the bowel lumens over time. Another ring-like radioactivity was also seen in the suprasplenic region, and increased with time. These radioactivities were in the gastric fundus and gastrointestinal tract and caused by free Tc-99m pertechnetate.
초기 골스캔에서 뼈, 폐와 심낭으로의 전이를 보인 골육종
임석태,김민우,손명희,황평한 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5
Purpose: A 6-year-old boy with osteogenic sarcoma of the left humerus underwent bone scintigraphy. Tc-99m MDP was accumulated not only in the primary tumor but also in the osseous and extraosseous (pulmonary and pericardial) metastases. Osteogenic sarcoma directly produces osteoid, both in the primary and metastatic lesions. Tc-99m MDP is avidly taken up by tumor osteoid. At initial presentation, only 2% of cases have both pulmonary and osseous metastases. The patient had osseous, pulmonary, and pericardial metastases at presentation. This case presents that increased uptakes of Tc-99m MDP by the primary and metastatic tumor were demonstrated on bone scintigraphy at presentation.
홍역 후 발생된 급성 뇌염 진단시 Tc-99m ECD 뇌혈류 SPECT의 임상적 유용성
임석태,손명희 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.4
목적 : 홍역 감염 후 속발되는 뇌염은 사망률이 높아 조기진단 및 적극적인 치료가 예후에 중요하다. 저자들은 홍역 후 발생된 뇌염에 대한 Tc-99m ECD 뇌혈류 SPECT와 뇌핵자기공명영상(MRI)의 진단 성능을 비교하였고 뇌혈류 SPECT상 중등도 이상의 심한 뇌혈류 감소가 호발하는 부위를 알아보았다. 대상 및 방법 : 홍역으로 진단받은 112명 중에서 의식저하, 경련, 마비 등의 임상증상과 혈청 및 뇌척수액에서 홍역 특이항체가 관찰되어 홍역 후 급성 뇌염으로 진단받고 Tc-99m ECD 뇌혈류 SPECT와 MRI를 시행받은 11명(M : F=4, 연령 1.6∼14세)을 대상으로 하였다. SPECT상 관찰되는 뇌혈류는 0(정상)에서 3(결손)으로 점수화하였고 2점 이상인 경우를 중등도 뇌혈류 감소로 정의하였다. 홍역 후 발생된 뇌염 환아에서 MRI와 SPECT의 두부병소 진단 성능과 중등도 뇌혈류 감소의 호발부위를 알아보았다. 결과 : MRI 시행결과 7명(63.6%)에서 T2-강조영상에서 회백질의 고강도 변화가 관찰되었으나, SPECT상 11명(100%) 모두에서 뇌혈류 감소 부위가 관찰되었다. 중등도 뇌혈류 감소는 전두엽(81.8%), 측두엽(72.7%), 후두엽(27.3%), 기저핵(27.3%), 두정엽(9.1%) 순서로 호발하였다. 결론 : 홍역 후 발생된 뇌염 환아에서 두부병소를 진단하는데 MRI에 비하여 Tc-99m ECD 뇌혈류 SPECT가 좀더 도움이 될 것으로 사료된다. Purpose : since the prognosis of measies encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Materials and Methods : Eleven patients (M : F=4 : 7, age ragne 18 months-14 yrs) with acute measies encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect), according to perlusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Results : Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). Conclusion : We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis.
임석태,손명희 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.4
Purpose: SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate scintigraphic findings and to compare with radiologic findings is SAPHO syndrome. Materials and Methods: Five patients (M:F=5:0, Age 22.8±4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone sicntigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally performed SPECT of the spine to evaluate the location and extent of spinal lesion. Results: All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroillac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. Conclusion: As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment. (Korean J Nucl Med 2002;36;255-60)