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ERCP 소견중 double duct sign 의 진단적 의의
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myoung Moon),이상인(Sang In Lee),전재윤(Chae Yoon Chon),김원호(Won Ho Kim),신성태(Sung Tae Shin) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1
N/A We analysed 43 patients which showed double duct sign among 1570 ERCP cases. In these cases, 15 were confirmed by operation, and the rest were diagnosed by ultrasonography, abdominal C-T scan, angiography and clinical features. The results were as follows: 1) Among 43 cases, 34 were malignancies and 9 were benign diseases. Out of 15 cases operated, 7 were confirmed as pancreatic cancer, 1 bile duct cancer, 1 papillary cancer and remaining 6 were proved to have chronic pancreatitis with or without common bile duct stone. 2) There were 27 cases which showed obstruction of pancreatic duct and/or bile duct in the 34 cases of malignancy. However, all benign 6 cases have no obstructive lesion. 3) The lesions were classified as abrupt or gradual by ductal narrowing or obstructive characteristics, and irregular or smooth by the margin of involved ductal segment. The predominant type was abrupt-irregular pattern in malignancy, but any other shape was not useful in differentiation of benignancy or malignancy. 4) The distance from papilla to lesion of pancreatic duct and common bile duct was no significant in differentiation of the malignancy and benign disease. Also the distance between the lesion of pancreatic duct and bile duct was no significant. This analysis suggested that the double duct sign is not indicative of malignancy. But, double duct sign with ductal obstruction is nearly diagnostic for malignancy. So the cases with double duct sign must be carefully evaluated for other ductal characteristics to enhance the ability of differentiating the benign and malignant lesion.
만성간질환에 있어서 간조직 echogenicity 의 변화
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myung Moon),이상인(Sang In Lee),전재윤(Chae Yoon Chon),김원호(Won Ho Kim),신성태(Sung Tae Shin) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1
N/A Specific tissue characterization by gray scale ultrasound is an evolving area that may prove to be a major advance in diagnostic imaging. The association of high amplitude echoes returned from the cirrhotic liver and fatty liver is well recognized. And some degree of correlation between the severity of histologic change and tissue echo pattern was reported. But it is very difficult to differentiate specific types of pathologic finding on tissue echo pattern. We have undertaken a study on the characteristic ultrasound appearance to assess its clinical significance. Mean echogenicity of the normal liver was 6.41 dB, 9.55 dB in chronic active hepatitis, 11.41 dB in cirrhosis and 18.86 dB in primary hepatoma. And the tissue pattern of the ultrasonography was homogeneous and was composed by relatively low amplitude echoes in normal liver. In diseased liver, however, the amplitude of echo was higher and tissue echo pattern was more coarse and irregular. Sound wave processing alters echo amplitude before it is displayed on the oscilloscope. Time gain compensation curve and focal length also contributes to alter the echogenicity in various portions of the beam profile. With the improvement of the equipment and standardization of the various parameters, the analysis of the tissue echo pattern will give more diagnostic value, and correlation between the histologic and ultrasonographic finding will be increased.