양성 요관 협착의 선행성 풍선확장술 및 요관 스텐트 설치술

김승협 대한영상의학회 1994 대한영상의학회지 Vol.30 No.1

목 적: 양성 요관 협착에서의 선행성 풍선확장술 및 요관 스텐트설치술의 효과를 판단하기 위한 연구였다. 대상 및 방법: 46명의 양성요관협착 환자를 대상으로 하였으며 요로협착의 원인은 요로결핵 20명, 선천성 신우요관이행부협착 8명, 요관이나 신우 분합부 협착 5명, 결석과 연관된 협착 8명, 수술 및 외상에 의한 협착 4명, 후복막강 섬유화중에 의한 협착이 1명이었다. 결 과: 46명중 43명에서 시술에 성공하였고 나머지 3명은 요로결핵 환자로 유도철선이 협착부를 통과하지 못하여 실패하였다. 4-76개월의 추적기간에서 경정맥요로조영술상 호전이 있었던 경우는 결핵성협착의 76%(13/17), 요로결석과 연관된 협착의 88%(7/8) 및 수술등에서의 요관 손상에 의한 협착의 100%(4/4) 이었고 호전이 없었던 경우로는 요관문합부 협착 (1/5)와 후복막강섬유화증(0/1)등 이었다. 결 론: 선행성 풍선확장술은 결핵성 요관협착을 포함하는 양성요관협착에 대해서 대체로 효과적인 치료방법이라고 생각되며 원인질환에 따라서는 매우 좋은 결과를 기대할 수 있으리라고 생각한다. Purpose: To evaluate the role of antegrade balloon dilatation and uteteral stenting in benign ureteral stricturesMaterials and Methods : Percutaneous antegrade balloon dilatation was attempted in 46 patients with benign ureteral strictures. The underlying causes of the strictures were urinary tract tuberculosis in 20 patients, congenital ureteropelvic junction obstruction in eight, ureteroneocystostomy or ureteroileostomy state in five, postoperative or post-extracorporeal shock wave lithotripsy state for ureteral calculi in eight, ureteral injury during surgery in four, and retroperitoneal fibrosis in one.Results : Antegrade balloon dilatation was performed with initial technical success in 43 patients but the procedure was aborted in the remaining three with urinary tract tuberculosis due to the failure in passing a guidewire through the stenotic lesions. Intravenous urograms obtained 4-76 months after the procedure showed improvements in 76%(13/17) with urinary tract tuberculosis, in 63%(5/8) with congenital ureteropelvic junction obstruction, in 88%(7/8) with strictures associated with ureteral calculi, and in 100%(4/4) with iatrogenic ureteral injury. The results were relatively poor in strictures of the ureteral anastomosis(1/5) and in ureteral strictures associated with retroperitoneal fibrosis(0/l ).Conclusion : Antegrade balloon dilatation of the urinary tract combined with ureteral stenting was an effective technique for the management of the benign ureteral strictures.

경피 체내 뇨관스텐트 설치술

김승협 대한영상의학회 1990 대한영상의학회지 Vol.26 No.6

Antegrade placement of ureteral stents has successfully achieved in 41 of 46 ureters. When it was difficult to advance ureteral stent through the lesion, it was facilitated by retrograde guide-wire snare technique through urethra. Complications associated with the procedure were non-function of ureteral stent by occlusion, upward migration, and spontaneous fracture of ureteral stent. These complications were managed by percutaneous nephrostomy and removal of ureteral stents by guide-wire snare technique and insertion of a new reteral stent. White blood cell in urine was markedly increased in about 50% of patents following the procedure.

전이성 신장암의 CT 및 초음파 소견

김승협 대한영상의학회 1995 대한영상의학회지 Vol.32 No.2

Purpose: To evaluated imaging characteristics of metastatic renal tumors in CT and US. Materials and methods:Renal metastases were diagnosed in 25 patients by surgery (n=2), US-guided biopsy (n=15), or follow-up CT (n=8).The primary tumors metastasized to kidney were lung cancer (n=11), adenoid cystic carcinoma (n=3), stomach cancer(n=2), and choriocarcinoma (n=2). Twelve cases invloved one kidney and 13 invloved both kidneys. CT was performedin all 25 patients while US was done in 14. We analysed CT findings in respect to number, size, shape, exophyticdegree, margin, and degree and homogeneity of the contrast enahncement of the lesion ; US findings in regand toechogenicity and homogeneity of the lesion. Results: The average number of the lesions per patient seen on CT wasthree; average diameter of the lesion was 3.6 cm; and 75% (57/76) of all tumors had exophytic degree of 0%. Thecharacteristic CT findings of metastatic renal tumors were round shape (52/76), ill-defined margin (54/76), andpoor (76/76) and inhomogeneous (45/76) contrast enhancement. The echogenicity of the tumors were homogeneous(11/18) and isoechoic (10/18) on US. Conclusion: Metastatic renal tumors had a tendency of multiple, small,ill-marginated, and less-exophytic nature on CT, and homogeneous, isoechoic appearance on US. The familiarity withthe constellation of CT and US findings of renal metastasis described may be helpful in making a correctdiagnosis.

경피뇨로결석 제거술

김승협 대한영상의학회 1988 대한영상의학회지 Vol.24 No.3

it has been well established that percutaneous nephrostolithotomy is safe and effective method for the management of most urinary culculi at tenal pelvis, calyces and proximal ureter. Authors have experienced 29 cases of percutaneous nephrostolithotomy from Oct. 1986 to Sep. 1987, and analyzed the outcome and the complications of the procedures, Among the total 29 cases, there were 2complete failure of retained calculus fragements after ultrasonic lithotripsy. The complications associated with the profedure were rare. One case of pseudoaneurysm of renal arterial branch with gross hematuria was treated by renal arteriography and gelfoam embolization. One perirenal branch with gross hematuria was treated by renal arteriography and gelfoam embolization. One perirenal hematoma and one prolonged leakage of urine through the track wer improved by conservative management. We think that perutaneous nephrostolithotomy has its valus as a safe and effective method for the management of calculi at upper urinary tract and as a complementary modality to extracorporeal shock wave lithotripsy.

자궁경부암의 병기결정에 있어서 CT와 MRI 의 비교 연구

김승협 대한영상의학회 1992 대한영상의학회지 Vol.28 No.1

One hundred and twenty seven patients with uterine cervical carcinoma underwent computed tomography(CT) and magnetic resonance(MR) imaging. Followed by surgical exploration. MR imaging was superior to CT in visualization of the tumor, for parametrial evaluation, and for tumor staging. MR imaging had an accuracy of 74% in the assessment of thickness of cervical stromal invasion, The accuracy rates for parametrial evaluation were 78% for CT and 88% for MR imaging. The overall accuracy rates for tumor staging were 68% for CT and 80% for MR imaging. Our findings suggest that MR imaging is supperior to CT in preoperative stanign of uterine cervical carcinoma.

혈관성 발기부전증 환자에서의 음경동맥조영술

김승협 대한영상의학회 1989 대한영상의학회지 Vol.25 No.2

In nine patients with suspected vasculogenic impotence magnification penile pharmacoarter-iography was performed to evaluate detailed anatomy of penile arteries. Penile arteriography was done with aid of papaverine which was injected both into corpus cavernosum and intraarterially. In all nine cases selection of internal pudendal arteries of both sides was successful and satisfactory arteriograms of penile arteries were obtained.

백서소장의 방사선손상에 있어서의 미세혈관 변화에 관한 연구

김승협 대한영상의학회 1982 대한영상의학회지 Vol.18 No.2

The experimental study was performed to evaluate the microvascular changes in postirradiation injury of small intestine. With a total of 28 rats, 24 rats were on right upper quadrant of abdomen with a single dose of 2000 rads and each group of 4 rats were followed up in 1,2,4,5,12 and 16 weeks and remaining 4 rats were used for normal control group. Evaluation of the microvascular changes were done by observing both mocroangiographic and histopathologic findings in groups of each follow-up week. The results were as follows: 1. The main microangiographic findings were strethcing and diffuse narrowing of vessels and extravasation of microbarium in post-irradiation 1-4 weeks, and focal narrowing and dilatation, irregular branching pattern and tortuosity of vessels in post-irradiation 8-16 weeks. Poor opacification of capillary network was continuously observed in all follow-up period. 2. The degree of vascular tortuosity in microangiography was consistent with the degree of vascular wall thickening in histopathollgy. 3. It is inferred that the results in this experimental study with microangiography can be used as a guide line for further studies of post-irradiation injury of small intestine.

Doppler US and CT Diagnosis of Nutcracker Syndrome

김승협 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.12

Nutcracker syndrome (NCS) is a syndrome caused by compression of the left renal vein (LRV), between the abdominal aorta and the superior mesenteric artery, resulting in hypertension of the LRV and hematuria. Doppler ultrasonography (US) has been commonly used for the diagnosis of NCS. However, several technical issues, such as Doppler angle and sample volume, need to be considered to obtain satisfactory results. In addition, morphologic changes of the LRV and a jetting phenomenon across the aortomesenteric portion of the LRV on contrast-enhanced computed tomography (CECT) are diagnostic clues of NCS. With proper Doppler US and CECT, NCS can be diagnosed noninvasively.

위점막미난 -방사선학적 고찰-

김승협 대한영상의학회 1985 대한영상의학회지 Vol.21 No.6

70 cases of gastric mucosal erosions were diagnosed by double contrast upper gastrointestinal examinations and endoscopic findings. Analyzing the ratiographic findings of these 70 cases of gastric mucosal erosions, the following results were obtained. 1. Among the total 70 cases, 65 cases were typical varioliform erosions showing central depressions and surrounding mucosal elevations. Remaining 5 cases were erosions of acute phase having multiple irregular depressions without surrounding elevations. 2. The gastirc antrum was involved alone or in part in all cases. Duodenal bulb was involved with gastric antrum in 4 cases. 3. The majority of the cases had multiple erosions. There were only 2 cases of single erosion. 4. In 65 cases of varioliform erosions; 1) The diameter of the surrounding elevations varied from 3 to 20mm with the majority (47 cases) between 6 and 10mm. 2) In general, the surrounding elevations with sharp margin on double contrast films were also clearly demons rated on compression films but those with faint margin were not. 3) The size of the central barium collections varied from pinpoint to 10mm with the majority under 5mm. The shape of the central barium collcetions in majority of the cases were round with a few cases of linear, triangular or star-shape. 5. In 5 cases of acute phase erosions; 1) All the 5 cases were females. 2) On double contrast radiography, all the cases showed multiple irregular depressed lesions without surrounding elevations. 3) 1 case had the history of hematemesis. 4) In 1 case, there was marked radiological improvement on follow-up study of 2 months interval. 6. In 23 cases, there were coexistent diseases with gastric mucosal erosions. These were 13 cases of duodenal bulb ulcers, 7 cases of benign gastric ulcers and 3 others.

방사선 폐염에 대한 고찰

김승협 대한영상의학회 1983 대한영상의학회지 Vol.19 No.1

Radiologic findings of the 29 cases of radiation pneumonitis and fibrosis diagnosed by chest radiography at Seoul National University Hospital were evaluated and compared with clinical symptoms according to the passage of time after radiation therapy. The results were as follows : 1. The first radiographic signs of radiation pneumonitis and fibrosis were observed 7.6 weeks and 19.3 weeks after radiation therapy respectively. Especially in 8 cases of small cell ca., they were found 5.6 weeks and 10.4 weeks, appearing slightly earlier than those of 12 cases of squamous cell ca., of lung. 2. The appearing time and severity of the radiographic changes of radiation pneumonitis and fibrosis had no specific relationship with field size, tumor dose or time-does-fractionation factors of the treatment. 3. The most constant and characteristic radiological finding of radiation pneumonitis was the sharp and straight margin of the lesion, which was not that of normal anatomical structures of the lung. Other findings were diffuse haziness, indistinct normal pulmonary markings, alveolar and nodular densities, air-bronchograms and indistinctness of heart border. In radiation fibrosis stage, the lesion also had sharp and straight border in all cases and linear streaks radiating from the lesion was also characteristic and constant finding. Other findings were indistinctness of heart border, diaphargatic tenting and compensatory emphysema.