유방 고형 종괴의 출력 도플러 초음파 소견과 병리조직학적 최대 미세혈관수와의 관련성$^1$

국신호,Guk, Sin-Ho 대한영상의학회 2002 대한영상의학회지 Vol.46 No.2

Purpose: To compare the power Doppler ultrasonographic (PDUS) findings of angiogenesis occurring in solid breast with the histopathologic findings. Materials and Methods: Thirty-one cases of pathologically proven solid breast lesions (eight benign, 23 malignant) were retrospectively reviewed, focusing on tumor size (< 3 cm, $\geq$ 3 cm), the amount (none, mild,marked), morphology (none/linear, branching, disordered) and pattern (none/peripheral, central, penetrating), as demonstrated by power Doppler ultrasonography. We compared the PDUS findings with microscopic micro-vessel density (Max-MVD, the number of micro-vessels revealed at pathologic examination after factor - VIII staining). Statistical significance was determined using the x2-test. Results: Max-MVD tended to increase according to fumor size, but the relationship was not statistically significant. In solid breast lesions there was close correlation between the observed increase in the intensity of Doppler signals and increased Max-MVD (P < 0.05). Morphologically, branching and disordered vessels were more often seen in malignant lesions, though the relationship between this finding and increased Max-MVD was not statistically significant. Penetrating and central Doppler signals were more frequent in malignant lesions and showed close correlation with increased Max-MVD (P < 0.05). Conclusion: The increased intensity of Doppler signals and the central and penetrating pattern of solid breast lesions seen at power Doppler sonography were closely related with increases in Max-MVD. 목적: 고형 유방 종괴의 출력 도플러 초음파 소견과 병리조직학적 종양의 신생혈관의 정도를 비교하여 연관성을 알아보고자 하였다. 대상과 방법: 유방 고형 종괴 총 31예 (악성 23예,양성 8예)의 출력 초음파 소견은 종괴의 크기(<3 cm, $\geq$3 cm), 도플러 신호의 양(없음, 소량, 많음), 모양(선형, 분지형, 불규칙한형), 분포 유형 (변연성, 중심성, 침투성)으로 나누어 분석하였다. 신생혈관의 정도는 조직 표본을 Factor VIII으로 특수 염색한 후에 측정한 최대 미세혈관 수(Maximum Micro-Vessel Density; 이하 Max-MVD로 표기함)로 분석하였다. 각각의 초음파 소견이 MVD에 따라 차이가 있는지 에 대해서 알아보았고 이의 통계적 유의성은 x$^2$-test를 이용하여 검증하였다. 결과: Max-MVD와 종괴 크기와의 관계는 크기가 커질수록 Max-MVD의 수치가 증가하는 경향을 보였으나 통계적인 유의성은 없었다. 도플러 신호 양의 증가와 Max-MVD의 증가는 상관관계를 보였고 통계적으로 유의하였다 (p <0.05). Max-MVD와 도플러 신호의 모양과의 관계를 보면 악성에서 비교적 특징적으로 볼 수 있는 분지형이나 불규칙한 모양의 경우 Max-MVD의 증가와 유의적 상관관계가 없었다.Max-MVD와 도플러 신호 분포 유형사이에서는 악성에 특징적인 중심성 및 침투성의 경우 Max-MVD의 증가와 밀접한 상관관계가 있었으며 통계적으로 유의하였다(p <0.05). 결론: 유방 고형 종괴의 출력 도플러 소견에서 도플러 신호 양의 증가와 도플러 신호 분포 유형 중 중심성 및 침투성은 Max-MVD의 증가와 밀접한 연관성이 있었다.

뇌동맥류의 임상적 및 방사선학적 상관관계에 대한 고찰

국신호 대한영상의학회 1987 대한영상의학회지 Vol.23 No.2

CT is now well established for the initial examination of the ruptured intracranial aneurysm. Aside its role in the detection of subarachnoid blood, its uses include prediction of aneurysm locaton and identification of complications. Altyough its role as an indicator of preperative prognosis is not certain, it might be expected that the extent of bleeding would correlate with the preoperative clinical grade and severityof bvasospasm. CT and angiographic findings in 34 patients with subarachnoid hemorrhage, due to proven intracranial aneurysms were analyzed for prognosticsignificance in relate with the preoperative clinical grade and severityof vasospasm. RESULT: 1. Male to female ratio was 0.9:1 and the most prevalent age group was 41 to 60 years. 2. The locations of the aneurysm, in order of frequency, were; anterior cerebral artery and anterior communicating artery aneurysm in 20 cases, middle cerebral artery in 7 cases posterior comunicating artery and internal carotid art ry in 5 cases. 3. The diameter of themost common of the intracranial aneurysm was 3 to 6 mm in 14 cases. 4 There was direct correlation between CT classification, severity of clinical grade and vasospas. 5. In conclusion, CT is useful as a prognostic indicator in intracranial aneurysm patient.

여성화유방의 초음파소견과 병리학적 소견의 연관 연구

국신호 대한영상의학회 1996 대한영상의학회지 Vol.35 No.1

Purpose : To define and correlate characteristic sonographic and pathologic findings in men with gynecomastia.Materials and Methods : We reviewed medical records and sonographic findings of 26 patients with pathologicallyproven gynecomastia. All of the chief symptoms, physical findings and causes were categorized. Characteristicsonographic patterns of gynecomastia were analyzed and compared with pathologic findings. Results : Gynecomastiawas most common in the 20- to 40-year-old age group (50%) 6;palpable mass was found in 62% of all those cases.Gynecomastia was unilateral or asymmetrical in 22 men (85%), and was caused idiopathically in 21 (81%). Thecharacteristic sonographic patterns correlated with pathologic findings were as follows : (1) focal subareolarsmooth oval (or triangular) indistinct margined homogeneous hypoechoic(or isoechoic) patterns were found in 14cases (54%). Eight of these (57%) were of the florid type of gynecomastia (67%) ; (2) diffuse homogeneoushyperechoic (or isoechoic) patterns were found in five cases (19%) ; four of these (80%) were of the intermediateor fibrotic type : (3) involuting female breast parenchymal patterns were found in seven cases (27%), of which six(86%) were of the intermediate or fibrotic type. Conclusion : The characteristic sonographic patterns ofgynecomastia correlate closely with pathologic types related to the duration of the condition. Ultrasonography isa useful primary diagnostic modality for the evaluation of gynecomastia.

유방 낭성 림프관종의 유방촬영, 초음파 및 자기공명영상소견 : 1예보고

국신호 대한영상의학회 1996 대한영상의학회지 Vol.35 No.2

Lymphangiomas are congenital malformations that occur most commonly in the head, neck or axilla and 80-90% oflesions are detected by the age of two years. Cystic lymphangioma of the breast in a 37-year-old woman ; it showedtypical well-defined tubular and nodular opacity on mammogram, a multilocular septated anechoic mass onultrasonogram, and low and high signal intensity on T1- and T2-weighted MR images, respectively. These findingsbefore surgery indicated cystic lymphangioma.

유방낭성변화:유방암 저위험군에서의 단순 유방촬영술과 초음파소견

국신호 대한영상의학회 1996 대한영상의학회지 Vol.34 No.1

Purpose : We performed this study to define the characteristic mammographic and ultrasonographic findings inlower risk lesions of fibrocystic change and also tried to evaluate the role of both modalities in planning thetreatment of these lesions. Materials and Methods : We retrospectively reviewed 38 cases of mammography and 46cases of ultrasonography in biopsy proven 55 cases of fibrocystic change, histologically showing thenonproliferative pattern or proliferative pattern without atypia. We analyzed the mammographic andultrasonographic findings, final assessments, and compared the effectiveness of each modality. Results : Onmammography, there were no abnormalities in 20 cases(53%), nodules or masses in 9 cases(24%), microcalcificationsin 6 cases(16%) and asymmetric density in 5 cases(14%). On ultrasonography, there were 40 cases(87%) of focalsonographic abnormality and no abnormality in 6 cases(13%). Most focal sonographic abnormalities were smooth(40cases, 93%), well-defined(21 cases, 49%) or ill-defined(22 cases, 51%) round or oval(36 cases, 84%) shaped,homogeneous(31 cases, 67%), hypoechoic(30 cases, 65%) lesions. Final assessment revealed that only 7 cases(18%) ofmammography and 8 cases(18%) of ultrasound examinations were included into the category of indeterminate andmalignancy groups which were recomended biopsy. Mammography was excellent to demonstrate the microcalcificationsand ultrasonography was effective in depiction of the focal lesions. Conclusion : The mammography andultrasonography findings were not specific in diagnosing lower risk group of fibrocystic change. But complementarystudy of both modalities in conjunction with clinical findings will be helpful in making decinion amary biopsy,fine needle aspiration, and simple close follow up of the lesions.

폐흡충증의 전산화단층촬영 소견

국신호 대한영상의학회 1992 대한영상의학회지 Vol.28 No.5

Though the incidence of paragonimiasis has been remarkably decreased since 1970, it is still not a rare disease in Korea. Major problems in the diagnosis of pulmonary paragonimiasis on chest radiography are its differentiation from pulmonary tuberculosis and lung cancer. Chest radiographic findings have been described in detail, but little have been reported on CT findings. We reviewed CT findings of 10 patients with pulmonary paragoinmiasis. The characteristic CT findings were similar to those on chest radiography, such as air-space consolidation (70%), nodular mass (50%), pleural effusion (40%), cystic lesion (30%), small low density within the mass (30%), linear density (20%), pneumothorax (20%), and burrow track (20%). CT depicted the cystic lesions and the burrow tracks more clearly and showed the small worm-retaining cysts within the mass that were not detectable on chest radiography. In conclusion, all of these CT findings are useful in the diagnosis of pulmonary parago imiasis especially when differentiation from tuberculosis or lung canceris difficult on chest radiography.

Legg-Calv$\acute{e}$ -Perthes 질환의 자기공명영상소견

국신호 대한영상의학회 1992 대한영상의학회지 Vol.28 No.2

To evaluate the role of MR in the examination of Legg-Calv -Perthes(LCP) disease, we retrospectively analysed the signal intensity of the osseous lesion, thickness of the articlar cartilage, change of surrounding soft tissue, joint effusion and femoral head containment in 32cases of LCP diseases in 27 patients. The bony lesion was limited witin the epiphysis in 19cases(59%) and extended to the Physis and metaphysis in 13cases(41%). The epiphyseal lesion showed homogeneous(26/32) or heterogenous(6/32) low signal intensity(SI) on T-1 weighted images (T1WI), and homogeneous(16/28) or heterogeneous(12/28) low SI on T-2 weighted images (T2WI). The metaphyseal lesion showed low SI (13/13) on T1WI, and low (9/11) or iso(3/11) SI on T2WI. Associated metaphyseal cyst showed low SI on T1WI and high SI on T2WI. An althought physeal involvement(13/32) was indistinct, the lesion showed increased SI on both T1 and T2WI. Thickening of articular cartilage(32/32). swelling of the ligamentum te es(7/32). synovial hypertrophy (7/32) and joint effsion(27/32) were demonstrated. Lateral subluxation of the femoral head on coronal image indicated incongruity of the femoral head in 25cases(78%). We conclude that MR is an useful tool for the diagnosis as well as treatment planning in LCP disease.

원시성 신경외배엽 종양의 전산화단층촬영 및 자기공명영상 소견

국신호 대한영상의학회 1991 대한영상의학회지 Vol.27 No.4

Cerebral primitive neuroectodermal tumor(PNET), consisting of undifferentiated primitive cells, is a neoplasm of children and young adults that occurs predominantly in the supratentorial compartment. In this report, we retrospectively reviewed and analyzed 18 CT and 6 MR findings in 18 patients with pathologically-proven PNET to discover the characteristic findings, if any. The most characteristic feature of the PNETs was a well-defined multilobular oval or round large mass with components of peripheral cystic change or calcification in the cerebral hemisphere, especially in the parietal lobe. Usually there was only minimal surrounding edema. The CT density of the tumor was iso-or slightly high density with homogeneous contrast enhancement in the solid portion and low density in the cystic area. MR findings demonstrated is0-singal intensity on both T1-weighted(T1W1) and T2-weighted(T2WI) images and dense enhancement in the solid element. The cystic portion revealed low intensity on T1W1 and high intensity on T2WI.

전산화단층촬영술에 의한 소아복부종괴에관한 고찰

국신호 대한영상의학회 1988 대한영상의학회지 Vol.24 No.1

UItrasonography is a very useful diagnostic modality for evaluation of the pediatric abdominal masses, due to faster cheaper and no radiation harzard than CT. But CT has more advantages in assessing precise anatomic location and extent of the pathologic process and also has particular value in defining the size relationof the mass to surrounding organs and detection of lymhadenopathy. We analyzed CT features of 35 cases of pathologically proven pediatric abdominal masses for recent 2 years at Ewha Womans University Hospital. The results were as follow : 1. The most common originating site was kidney (20 cases 57.1%) followed by gastrointestinal (5 cases 14.3%) nonreal retroperitoneal (4 cases 11.4%) hepatobiliary ( 3cases 8.6%) and genital (3 cases 8,6%) in order of frequency. 2. The most common mass was hydronephrosis (11 cases 31.4%) Wilms tumor (7cases 20.0%0 neuroblastoma choledochal cyst periappendiceal abscess (3 cases 8.6% respectively) ovarian cyst (2 cases 5.7%) were next in order of frequency. 3. Male to female ratio was 4-5 and choledochal cyst and overian cyst were found only in females. The most prevalent age group was 1-3 year old (12 cases 34.3%) 4. With CT the diagnosis of hydronephrosis was easy in all cases and could evaluate of its severity renal function and obstruction site with high accuracy. 5. Wilm's tumor and neuroblastoma were relatively well differentiated by their charateristic CT features ; such as location shape marrgin midline cross calyceal appearance and calcification etc. 6. Ovarian and mensentric cysts had similar CT appearance. 7. In other pediatric abdominal masses CT provided excellent information about anatomic detail precise extent of tumor and differential diagnostic findings. So CT is useful inaging modality for the demonstration and diagnosis of abdominal mass lesions in pediatric patients.

다발성모낭낭종증의 유방촬영 및 초음파 소견 : 1예 보고

국신호 대한영상의학회 1997 대한영상의학회지 Vol.36 No.4

저자들은 최근 유방에 생긴 종괴를 주조로 내원하여 수술 후 다발성모낭낭종증으로 확진된 환자에서 유방촬영술과 초음파소견으로 수술전 진단이 용이하였던 예를 보고하고자 한다. 유방촬영소견상 다발성의 얇고 균일한 벽과 크기를 같는 원형 또는 타원형의 유낭종 들(oil systs)이 석회화나 주변 조직의 변화없이 유방 실질의 변연부, 액와의 피하에 위치하 였고, 초음파소견은 유방실질내의 병변없이 경계가 명확하거나 부드러운 경계의 피하 지방 과 같거나 약간 증가된 에코를 보이는 결절들로 유방과 액와의 진피 밑의 피하지방층에서 관찰되었다. Steatocystoma multiplex, a cutaneous disorder involving the appearance of sebaceous cysts on the trunk and upper arms, is often inherited as an autosomal dominant trait. The authors present mammographic and US findings of steatocystoma multiplex in a 35-year-old woman with breast masses. On mammograms, multiple uniform thin walled round or oval shaped oil cysts were seen in the peripheral portion of the breasts and axilla, and on US, well-defined or smooth ill-defined round or oval shaped nodules were seen in the subcutaneous layer of the breasts and axilla; compared with subcutaneous fat, there was iso- or slightly increased echogenicity.