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- 저자 : 고창순 ( Jeong Seok Yeo (검색결과 2 건)
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모야모야병에서 EDAS 수술효과의 평가를 위한 수술전후 99mTc-HMPAO SPECT 의 유용성
고창순(Chang Soon Koh),정준기(June Key Chung),이경한(Kyung Han Lee),여정석(Jeong Seok Yeo),이상형(Sang Hyung Lee),곽철은(Chul Eun Kwark),이명철(Myoung Chul Lee),조병규(Byoung Kyu Cho) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1
N/A Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure ofr treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients efore (1.3 mo) and after (6.8 mo) EDAS with 99mTc-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade 1 to V stenosis in 6%, 9%,62%,12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal loves being the most frequently involved site. 4*4 pixel sezed ROIs were applied on the frontotemmporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as; PI (%)= average FT activity/average cerebellar activity*100 Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean:74.3 +- 17%) and increased significantly after operation (81.4 +- 17%, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement ( CI) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70~89) showed a significantly higher CI (3.3) compared to group I (PI<70, 1.57) of group III (PI>90, 0.5) (p<0.001). The amount of perfusion improvement ( PI) showed signifiant correlation with CI (r-0.42, p=0.04). PI did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patiets. Serial HMPAO SPECT is an useful noninvasive study ofr assessing perfusion improvement after EDAS in childhood moyamoya patients.
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Tc-99m-MIBI 심근 SPECT 의 분절 육안 분석시 판독자간의 일치도
여정석,이동수,이경한,김종호,손경수,조성욱,곽철은,정준기,이명철,서정돈,고창순 ( Jeong Seok Yeo,Dong Soo Lee,Kyung Han Lee,Jong Ho Kim,Kyung Soo Shon,Sung Wook Cho,Cheol Eun Kwark,June Key Chung,Myung Chul Lee,Jeong Don Seo,Chang Soon 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3
The accuracy of dipyridamole stress/rest 99mTc-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent obervers, blinded to clinieal data, was evaluated in SPECT images of 131 patients (94 males, 38 fe- males, mean age 58+7 yr) with suspected coronary artery disease who underwent both dipyridamole st,ress/rest 99mTc-MJBI myocardial SPECT and coronary angiography, The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five point scale (segmental score : O=normal, 1 =equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear- sons correlat.ion coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlat,ion of 0.45 (all p<0,001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agr eement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather (han to a difference in perceiving the degree of the hypoactivity, Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and acruracy of scan ditagnosis.
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