Cushing병: 하주체 정맥 조영술 및 혈액 호르몬 검사

정태섭 대한영상의학회 1991 대한영상의학회지 Vol.27 No.4

Hypersecretion of ACTH in patients with Cushing's syndrome originates from either a pituitary tumor(Cushing's disease) or an ectopic ACTH-secreting tumor. These 2 entities may be clinically indistinguishable, and additional difficulty arise because pituitary microadenomas may be radiologically occult. Recently, bilateral selective venous sampling from the inferior petrosal sinuses became the procedure of choice for confirming a false negative study of a combined hormonal test and pituitary ACTH hypersecretion. We performed selective venous catheterization and smapling for ACTH. The central location of the lesion was detected in 1 case(intersinus gradient=1.1:1), and the remaining 5 cases revealed lateralization of the lesions(intersinus gradient=3.7-20.1:1), which correlated well with transsphenoidal microadenomectomies in all the cases. we concluded that selective venows ACTH sampling from the inferior petroal sinus is a reliable and useful aid in the diagnosis of Cushing's disease when standard clinical and biochemical studies are inconclusive.

임파부종의 간접임파조영술

정태섭 대한영상의학회 1988 대한영상의학회지 Vol.24 No.4

Indirect lymphangiography is a new technique for the evaluation of lymphedema. The major advantage of the indirect lymphangiography is its noninvasiveness using onoionic water-soluble contrast media. It could be performed by injecting contrast media intradermally so unnecessary skin incision could be avoided. Few manuscripts were reported concerning indirect lymphangiography in the all over the world so far. we now report our observartion of indirect lymphangiography using lsovist 240 (Schering A G) We have encountered 3 primary hypoplastic lymphedema of lower extremity and 2 secondary lymphedema of upper extremity. The results were as follows : 1. In 3 primary hypoplastic lymphedema lymphatics were few and tiny. The injected contrast media showed localized and prolonged stasis. 2. In 2 secondary hypoplastic lymphedema contrast media was easely absorbed in numerous and ectatic lym-phatics. 3. Indirect lymphgiography is a satisfactory meth9od to see the pathologic changes of lymphatics in our 5 cases.

요추부 화학적 수핵용해술의 예후평가를 위한 추간판초음파 검사: 예비보고

정태섭 대한영상의학회 1988 대한영상의학회지 Vol.24 No.3

There has been no reported change of ultrasonographic findings of nucleus pulposus on chemonucleolysis. we fane found that the particles of herniated nudeus pulposus are highly echogenic and change to low echogenic after chemonucleolysis. On an invitro experimental study ultrasonography of the surgical specimen of the her niated nucleus pulposus was highly echogenic. After soaking the chymopapain into the surgical specimen of the herniated nucleus pulposus the echogenicity was progressively lowered as time passed from 3 minutes to 12 hours. Our preliminary results are divided as two folds; 1. High echogenic shadows of outside of annulus fibrosus on ultrasonography of herniated lumbar disc will be important indicator of selection of patients for good therapeutic results of chemonucleolysis. 2. Progressively lowered echogenicity of high echogenic shadow after chemouncleolysis suggests good reac-tion of chymopapain with herniated nucleus pulposus.

후두전적출술후 식도발성에 대학 방사선학적 고찰

정태섭 대한영상의학회 1988 대한영상의학회지 Vol.24 No.2

Total laryngectomee requires some form of alaryngeal speech for communication. Generally esophageal speech is regarded as the most available and comfortable technique for alaryngeal speech.But esophageal speech is difficult to train so many patients ar unable to attain esophageal speech for communication. To understand mechanism of esophageal speech on total laryngectomee evaluation of anatomical change of the pharyngoesophageal segment is very important. We used videofluoroscopy for evaluation of pharyngesophageal segment during esophageal speech. Eigh-teen total laryngectomees were evaluated with videofluoroscopy from Dec. 1986 to May 1987 at Y.U.M.C Our results were as follows: 1. Peseudoglottis is the most important factor for esophageal speech which is visualized in 7 cases among 8 cases of excellent esophageal speech group. 2. Two cases of longer A-P diameter at the pseudoglottis have the best quality of esophageal speech than others.3. Two cases of mucosal vibration at the pharyngoesophageal segment can make excellent esophageal speech. 4. The causes of failed esophageal speech are poor aerophagia in 6 cases abscence of pseudoglottis in 4 cases and poor air ejection in 3 cases. 5. Aerophagia synchronizes with diaphragmatic motion 8 cases of excellent esophageal speech.

Globus 증후군의 방사선학적 고찰

정태섭 대한영상의학회 1986 대한영상의학회지 Vol.22 No.6

The globus sysmptom is a patients, often middle aged women, complains of a lump and chocking sensation in the throat, Functional disturbance of the cricopharyngeal muscle, rendering it incapable of relaxing during swallowing, has long been recognized as a cause of globus symptom and dysphagia. We wanted to find out how often and to what extent disturbed relaxation of the cricopharyngeal muscle can be seen in patients with globus symptom with routine examination and videoesophagogram. The results were as follow : 1. Male : female ratio was 1: 2.4. 2. Globus symptom was most frequent in the age group between 30-39 of female. 2. Organic lesions were seen in 43.6%(24Pts) of globus patients. 4. Cricopharyngeal muscle was visualized in 29.1%(16Pts) of globus patients. And other findings were esophageal web in 7.3%(4Pths), esophageal diverticulum in 3.6%(2Pts) and degenerative spondylosis in 3.6%(2Pts). 5. Incidence of visualization of cricopharyngeal muscle were higher in male group 50%) than female one(20.5%). 6. Cricopharyngeal muscle was most frequently visualized on early swallowing phase(12/16Pts).

한국인 뇌경색증의 경동맥 색조도플러 혈류영상

정태섭 대한영상의학회 1990 대한영상의학회지 Vol.26 No.5

Until now, there have been no reported document concerning the incidence of atheroma of the carotid artery associated with occlusive cerebrovascular disease in Korea. We tried to identify atheroma of the carotid artery in acute cerebral infarction patients using duplex sonography and color flow imaging. Recent reports state that duplex sonography and color flow imaging were reported to be more accurate and safer non-invasive method of detecting carotid atheroma than carotid antiography. Atheromas were detected in 41(56%) out of total of 73 acute cerebral infarction patients. However, other conditions such as hypertension (37/73), cardiac problems(22/73), diabetes mellitus(10/73), and conditions of unknown etiologies(13/73) were also observed in association with acute cerebral infarction. We conclude that carotid atheroma presents as the most important cause of cerebral infarction in Korea.

Phantom상 내경동맥기시부 협착에 따른혈류변화:자기공명혈관촬영술, 디지털감산 혈관촬영술, 전산유체역학과의 비교

정태섭 대한영상의학회 1996 대한영상의학회지 Vol.34 No.6

Purpose : The most important factor discrediting the reliability of MRAs is the overestimation of the degree of stenosis in the internal carotid artery(ICA). The purpose of this study is to evaluate the secondary hemodynamics and the cause(s) for the overestimation of the degree of variable stenotic phantoms of the carotidartery using steady-state flow on MRAs. Materials and Methods : Using acrylic materials, normal and variable stenotic phantoms of the bifurcated carotid artery were constructed (40% and 65%). Flow patterns were evaluated with axial and coronal imaging of MRAs (2D-TOF and 3D-TOF) and DSAs of phantoms constructed from an automated closed-type circulatory system filled with 10% glucose solution. These findings were then compared with those obtained from CFD. Results : 3D-TOF axial MRA of asymmetrically 40 percent stenotic phantom revealed 40 percent stenosis identical to the stenotic region of phantoms with continued poststenotic signal loss, whereas 3D-TOFzsial MRA of symmetrically 65 percent stenotic phantom showed markedly decreased signal intensity at the poststenotic segment resembling occlusion. Source image of 2D-TOF coronal MRA showed redistribution (from the internal to external carotid artery side) of the central axis of inflow depending upon the degree of stenosis of the ICA ; this redistribution can be a cause of the decreased signal at the poststenotic segment, due to a reduced volume of flow through the stenotic segment. The general hemodynamics of the variable stenotic phantoms on MRA were identical to the hemodynamics on DSA and CFD. Conclusion : Although dephasing from turbulent flow and character of maximum intensity projection (MIP) were suggested as the main cause of the decreased poststenotic signal, our study indicated that a hemodynamically redistributed central axis of inflow and reduced flow volume through stenotic channel is one of the basic factors of the decreased signal intensity at the poststenotic segment on MRA.

궤양형 내경동맥협착모형을 이용한 자기공명혈관조영술에서 조정변수의 적정화에 관한 실험연구

정태섭 대한영상의학회 1997 대한영상의학회지 Vol.36 No.4

자궁경부암 환자에서 내장골 임파절의 새로운 방사선학작 검사방법 : 임파조영 전산화단층촬영

정태섭 대한영상의학회 1992 대한영상의학회지 Vol.28 No.1

Preoperative evaluation of metastasis to internal iliac lymph nodes are very important in the designing of the patient's therapeutic plan and the predicting the prognosis of carcinoma of the uterine cervix. Until now, no study has reported on the subject of selective visualization of the internal iliac lymph nodes. Indirect lymphangiography is a simple method for evaluating local lymphatic system. The internal iliac lymph nodes can be visualized by combining indirect lymphangiiography of the upper one-third area of the vagina and thin section CT scan. We applied theis method to 25 cases of FIGO B and A stage of the carcinoma of the uterine cervix, and correlated our findings with results of radical abdominal hysterectomy. We were able to visualize the internal iliac lymph nodes in 24 cases out of 25 and their size range was 3-15mm. No nodal metastasis were found in all the patients and these were varified by subsequent pathologic examination from radically dissected lymph node .

자기공명혈관촬영술을 이용한 분지형 경동맥 Phantom 상 혈류의 표현성에 대한 실험 연구

정태섭 대한영상의학회 1995 대한영상의학회지 Vol.33 No.2

Purpose : A common finding of carotid artery on magnetic resonance angiograms(MRAs) is a signal dropout along the posterior wall of carotid bulb due to reverse flow. The purpose of this study is to evaluate variable flow patterns on bifurcated carotid arterial phantoms using steady-state flow. Materials and Methods : We designed phantoms of a bifurcated carotid artery with acrylic materials. Flow patterns were evaluated with axial and coronal imaging of MRA(2D-TOF, 3D-TOF), color Doppler imaging, and computational fluid dynamics (CFD), within the phantoms constructed of an automated closed-type circulatiory system filled with 4% sugar solution. These findings were compared with findings obtained from normal volunteers. Results : Axial 3D-TOF MRA images exhibited colser resemblance to the contour of the inner wall of phantoms when compared to coronal 2D-TOF MRA imaging. However,2D-TOF MRA showed good contrast difference of signal intensities between forward flow area and reverse flow area. Dark zones with reduced signal intensities due to reversed flow were separated from the outer wall of the internal and external carotid arteries by a thin layer of forward flow along the wall on the source slice image of MRA. The general hemodynamics of the phantoms on MRA were identical to hemodynamics on color Doppler imaging and CFD. The results obtained with the phantoms matched the findings on normal volunteers. Conclusion : Although representations of bifurcated carotid arterial phantoms on axial 3D-TOF MRA were excellent if ideally desinged, the zone of reversed flow could be a significant factor in creating distorted image when the zone of reversed flow contacted directly with curved or deformed arterial wall.