신생아 괴사성 장염의 진단에 있어 Iohexol 경구 복용 후 소변의 CT 조영 증강 계수의 유용성

문증희,윤은주,윤대영,이유진,서영란,최철순,우지영,양승,조영아,장윤우 대한영상의학회 2006 대한영상의학회지 Vol.55 No.4

Purpose: We wanted to evaluate the clinical efficacy of an increased computed tomography attenuation coefficient (CTAC) of urine after the oral administration of iohexol in neonates who are suspected of suffering with neonatal necrotizing enterocolitis (NEC). Materials and Methods: During a recent 1 year-period, seventeen neonates were admitted for suspected NEC, and they were divided into the suspected and definite groups based on their clinical signs and radiographic findings; we also included ten normal neonates as the control group. Diluted iohexol was administered and the CTACs of collected urine samples at 8-12 hour intervals were measured. Comparative analysis of the three groups was done and statistical significance was determined by the Scheffe test. Results: Among 17 neonates, there were 13 neonates in the suspect group and 4 neonates in the definite group. The mean CTACs of urine in each group were 2711 HU (control group), 3411 HU (suspected group), and 7625 HU (definite group), respectively. There was a significant difference between the mean CTAC of the definite group and that of the control or suspected groups (Scheffe t >2.65). However, no statistically significant difference was seen between the suspected and control groups (Scheffe t=1.14). Conclusion: Although measurements of the CTAC of urine showed no significant diagnostic efficacy in the suspected group, the CTAC of urine, which reflects the correlated degree of bowel mucosal injury, can be a useful aid for determining the severity and progression of NEC. 목적: 신생아 괴사성 장염이 의심되는 환아에서 iohexol을 경구 투여한 후 배설된 소변의 전산화 단층 촬영술(CT) 감약 계수 증가의 임상적 유용성을 알아보고자 하였다. 대상과 방법: 최근 1년 동안 내원한 환아 중 신생아 괴사성 장염이 의심되는 증세가 있는 신생아 17명을 대상으로 iohexol을 경구 투여한 후 단순 복부 영상 및 임상 소견을 바탕으로 괴사성 장염 의심군과 괴사성 장염군으로 구분하고, 10명의 건강한 신생아를 대조 군으로 하였다. 희석된 iohexol을 투여한 후 8시간에서 12시간 사이의 소변을 모아 CT 감약 계수를 측정하였다. 계수의 비교는 분산 분석을 시행하고 이때 보이는 차이의 의미는 Scheffe test를 이용하였다(p < 0.05). 결과: 17명중 괴사성 장염 의심군이 13명, 괴사성 장염군은 4명이었다. CT 감약 계수의 평균은 대조 군이 27±11 HU, 괴사성 장염 의심군이 34±11 HU, 괴사성 장염군은 76±25 HU로 측정 되었다. 괴사성 장염군은 대조군과 괴사성 장염 의심군 모두에서 통계학적으로 의미있는 차이를 보이나(Scheffe t > 2.65), 괴사성 장염 의심군은 대조군과 통계학적으로 차이가 없었다(Scheffe t=1.14). 결론: CT 감약 계수 측정 방법이 신생아 괴사성 장염의 진단적 의의는 떨어지나 장 점막 손상의 정도를 반영함으로써 병의 중증도와 진행 정도를 판단하는 보조적인 지표로 유용하리라 생각된다.

방광에 생긴 염증성 가성종양: 증례 보고

문증희,남은숙 대한영상의학회 2003 대한영상의학회지 Vol.48 No.3

Inflammatory pseudotumor of the urinary bladder is a rare benign lesion. Because it is difficult to differentiate from other tumors clinically and pathologically, histopathologic confirmation is needed, and to avoid unnecessary cystectomy, it should be included in the differential diagnosis. A 47-year-old male presented with hematuria and voiding difficulty. IVP revealed a triangular filling defect in the urinary bladder, and CT demonstrated the presence there of a strongly enhancing mass. We deseribe this case, in which inflammatory pseudotumor was diagnosed, and review the literature. 방광에 생기는 염증성 가성종양은 매우 드문 양성 병변이다. 임상 소견과 방사선학적 영상 소견으로 다른 악성 종양과의 감별이 어려워 병리 조직학적 확진이 요구되나 불필요한 근치적 방광절제술을 피하기 위해 감별 진단으로 고려되어야 한다. 저자등은 혈뇨와 배뇨 곤란을 주소로 내원한 47세 환자의 경정맥조영술에서 삼각형 모양의 충만결손과 CT에서 소엽상 종괴로 강한 조영증강을 보이는 방광의 염증성 가성종양을 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

원발성 고환 유암종: 증례 보고

문증희,윤대영,최철순,윤은주,박상준,서영란,황임경,이유진,김성용 대한영상의학회 2005 대한영상의학회지 Vol.53 No.1

Primary testicular carcinoid tumors are extremely rare and account for less than 1% of all testicular tumors. We recently experienced a case of primary carcinoid tumor of the testis in a 50-year-old man who presented with scrotal swelling. The ultrasonographic findings were evaluated and compared with those of previous reports. 원발성 고환 유암종은 매우 드물며 전체 고환암 중에서도 약 1% 미만의 빈도를 보인다. 저자들은 최근 음낭 부종을 보이는 50세 남자에서 발생한 원발성 고환 유암종 증례를 경험하였다. 초음파 소견을 평가하고 이전 문헌과 비교해 보고자 한다.

Angiomyofibroblastoma Arising from the Posterior Perivesical Space: a Case Report with MR Findings

임경자,문증희,윤대영,차지현,이인재,민선정 대한영상의학회 2008 Korean Journal of Radiology Vol.9 No.4

Angiomyofibroblastoma is a rare benign soft tissue neoplasm that predominantly occurs in the genital region of middle-aged women. We present a case of an angiomyofibroblastoma that involved the posterior perivesical space in a 48-year-old woman. We have documented the magnetic resonance imaging features of this case.

갑상선 소결절:초음파를 이용한 양성과 악성의 감별

민선정,윤대영,최철순,임경자,문증희,서영란,박상준,윤영철,윤은주,강익원,이경규 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.1

목적 :갑상선에서 직경 10 mm 미만의 소결절의 초음파 소견을 분석하여 양성과 악성결절의 감대 상 및 방 법 : 58명의 환자에서 수술 및 세침흡인검사에 의해 병리조직학적으로 확진된 최대직경 10 mm 미만의 갑상선 소결절 72예(양성 44예, 악성 28예)의 초음파 소견을 후향적으로 분석하였다. 양성과 악성결절에서 병변의 경계, 내부에코의 양상 및 미세석회화, 결절내부 낭성변화, 결절주위 저에코의 테두리 존재여부를 비교하였다. 결과 : 초음파소견에서 악성결절은 불분명한 경계면을 보이는 경우가 많았다(61% vs 11%, p < 0.05). 내부에코 양상에서는 양성결절은 등에코나 고에코를 보이는 경우가 많았으며(45% vs 18%, p < 0.05) 악성결절은 현저한 저에코를 보이는 경우가 많았다(39% vs 18%, p < 0.05). 미세석회화는 악성결절에서 더 많이 관찰되었고(36% vs 9%, p < 0.05) 결절내 부의 낭성변화(39% vs 7%, p < 0.05) 및 결절주위 저에코의 테두리(41% vs 18%, p < 0.05)는 양성결절에서 더 많이 관찰되었다. 결론 : 초음파는 갑상선 소결절에서 양성과 악성결절의 감별에 도움이 될 것으로 사료된다. PURPOSE : To evaluate the usefulness of ultrasonography in the differentiation between benignity and malignancy in the evaluation of small thyroid nodules (the longest diameter < 10 mm). MATERIALS and METHODS : Fine needle aspiration or surgery was performed for the evaluation of seventy two (44 benign and 28 malignant) small thyroid nodules from fifty eight patients. Ultrasonographic findings were retrospectively reviewed for the margin, echogenecity, presence of microcalcification, intranodular cystic change and peripheral hypoechoic halo. RESULTS : Ill-defined margin was more common in malignant nodules (61% vs 11%, p<0.05). In internal echogenecity, either iso- or hyperechogenicity was more coomon in benign nodules (45% vs 18%, p<0.05) while malignant nodules were often markedly hypoechoic (39% vs 18%, p<0.05). Malignant nodules contained more microcalcifications (36% vs 9%, p<0.05) whereas benign nodules often showed intranodular cystic change(39% vs 7%, p<0.05) and hypoechoic halo (41% vs 18%, p<0.05). CONCLUSION : Ultrasonography can be useful in the differentiation between benign and malignant small thyroid nodules.

갑상성 소결절 : 초음파를 이용한 양성과 악성의 감별 Ultrasonographic Differentiation between Benign and Malignant Lesions

민선정,윤대영,최철순,임경자,문증희,서영란,박상준,윤영철,윤은주,강익원,이경규 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.1

당뇨병성 족혈관 질환의 도플러 초음파 : 족혈관의 정량적 혈류량 분석 Quantitative Analysis of Blood Flow Volume

서영란,김호철,최철순,윤대영,한대희,문증희,배상훈 대한초음파의학회 2002 ULTRASONOGRAPHY Vol.21 No.3

정상 신장의 초음파 화질 평가: 기본 영상, 조직 하모닉 영상과 펄스 역전 하모닉 영상의 비교

윤은주,최철순,윤대영,박상준,이수현,서영란,문증희,배상훈 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.4

PURPOSE : To compare the fundamental imaging (FI), tissue harmonic imaging (THI) and pulse inversion harmonic imaging (PIHI) in an ultrasonographic (US) evaluation of a normal kidney. MATERIALS and METHODS : Ninety-five normal kidneys from 50 patients [24 males and 26 females aged 18-74 (mean, 48) years] were examined. The US evaluation including the 3 above mentioned imaging modalities (FI, THI, and PIHI) was performed by a radiologist using a 2-5 MHz convex transducer (HDI 5000 scanner, Advanced Technology Laboratories, Bothell, CA, U.S.A.) at the same condition (level, depth, magnification, focus). On the PACS (Picture Archiving and Communications System) monitor, the images were separately analyzed by two radiologists for the following parameters: conspicuity, the overall image quality, and range of delineation, and the grading were determined by the consensus using a 3-point scale. Statistical analysis was performed using Wilcox singed rank test. RESULTS : The pulse inversion and tissue harmonic images were better than the fundamental images in terms of conspicuity (p < 0.001), but there was no statistically significant difference between the pulse inversion and tissue harmonic images. The pulse inversion harmonic image showed the best overall image quality, which was followed by the tissue harmonic and fundamental image (p < 0.001). However, in the range of delineation, there were no statistically significant differences in the 3 above mentioned imaging modalities. CONCLUSION : In an ultrasonographic evaluation of a normal kidney, the conspicuity and the overall image quality of pulse inversion and tissue harmonic imaging are superior to those of fundamental imaging. The overall image quality of pulse inversion harmonic imaging is superior to tissue harmonic imaging. However, the 3 imaging techniques do not have any influence on the range of delineation. 목적 : 정상 신장의 초음파 검사에 있어서 기본 영상, 조직 하모닉 영상, 펄스역전 하모닉 영상을 각각 비교하고자 하였다. 대상 및 방법 : 50명(남:여 24:26, 연령범위: 18-74세, 평균연령 48세)의 환자에서 95개의 정상 신장을 대상으로 하여 한 명의 방사선과 전문의가 HDI 5000 scanner(Advanced Technology Laboratories, Bothell, CA, U.S.A.)와 2-5 MHz의 볼록형 탐촉자를 사용하여 동일한 조건하에 정상 신장의 세 가지 영상을 얻었다. 신장 외연의 선예도, 전반적인 영상 의 질과 검사가능한 가시범위를 지표로 하여 두 명의 방사선과 전문의가 합의하여 각각을 3등급으로 분류하였고 통계는 Wilcoxon signed rank test를 이용하였다. 결과 : 신장 외연의 선예도는 펄스역전 하모닉 영상과 조직 하모닉 영상이 기본 영상보다 통계학적으로 유의하게 우수하였으나 (p < 0.001) 펄스역전 하모닉 영상과 조직 하모닉 영상은 두 방법간에 큰 차이가 없었다. 전반적인 영상의 질은 기본 영상보다는 조직 하모닉 영상 이, 조직 하모닉 영상보다는 펄스역전 하모닉 영상이 더 우수하였고 이는 통계학적으로 유 의하였다 (p < 0.001). 그러나 검사가능한 가시범위는 3가지 방법 모두에서 통계학적으로 유의한 차이가 없었다. 결론 : 정상 신장의 초음파 검사에서, 신장 외연의 선예도나 전반적인 영상의 질은 펄스역전 하모닉 영상과 조직 하모닉 영상이 기본 영상보다 우수하였고 그 중 전반적인 영상의 질은 펄 스역전 하모닉 영상이 조직 하모닉 영상보다 우수하였다. 하지만 검사가능한 가시범위는 3 가지 방법에 영향을 받지 않았다.

Publication Rates for Abstracts Presented by Korean Investigators at Major Radiology Meetings

하태호,윤대영,구동현,장석기,서영란,윤은주,문증희,이유진,임경자,최철순 대한영상의학회 2008 Korean Journal of Radiology Vol.9 No.4

Objective: To determine the publication rate of abstracts presented by Korean investigators at national and international radiological meetings, and to identify predictive factors of publication. Materials and Methods: Abstracts presented at the annual meetings of the Korean Radiological Society (KRS), and abstracts presented by Korean investigators at the annual meetings of the Radiological Society of North America (RSNA) and European Congress of Radiology (ECR) from 2001 to 2002 were searched for subsequent publication, using PubMed and the Korean Medical Database. The following variables were evaluated. 1) The overall publication rate; 2) the publication rates according to the radiological subspecialty, presentation type (oral or poster), sample size ( 20, 21 50, or > 50), study design (prospective or retrospective), statistical analysis (present or absent), and study outcome (positive or negative); 3) the time to publication; 4) the journal where the study was published; 5) consistency between the abstract and the final publication. Results: Of 1,097 abstracts, 301 (27.4%) were subsequently published, at an average of 15.8 13.8 months after presentation in 48 journals. The publication rates for studies presented at the RSNA (35.4%) and ECR (50.5%) conferences were significantly higher than that for the KRS conference (23.6%, p < 0.05). Vascular/interventional radiology studies had the highest publication rate (33.1%), whereas musculoskeletal radiology studies had the lowest publication rate (17.1%). Other factors associated with subsequent publication were prospective design, use of statistical testing, and a positive study outcome. Conclusion: The publication rate is significantly lower for the KRS (23.6%) meeting abstracts as compared to those of the RSNA (35.4%) and ECR (50.5%). Prospective design, use of statistical testing, and positive study outcome have a statistically significant effect on the publication rate. Objective: To determine the publication rate of abstracts presented by Korean investigators at national and international radiological meetings, and to identify predictive factors of publication. Materials and Methods: Abstracts presented at the annual meetings of the Korean Radiological Society (KRS), and abstracts presented by Korean investigators at the annual meetings of the Radiological Society of North America (RSNA) and European Congress of Radiology (ECR) from 2001 to 2002 were searched for subsequent publication, using PubMed and the Korean Medical Database. The following variables were evaluated. 1) The overall publication rate; 2) the publication rates according to the radiological subspecialty, presentation type (oral or poster), sample size ( 20, 21 50, or > 50), study design (prospective or retrospective), statistical analysis (present or absent), and study outcome (positive or negative); 3) the time to publication; 4) the journal where the study was published; 5) consistency between the abstract and the final publication. Results: Of 1,097 abstracts, 301 (27.4%) were subsequently published, at an average of 15.8 13.8 months after presentation in 48 journals. The publication rates for studies presented at the RSNA (35.4%) and ECR (50.5%) conferences were significantly higher than that for the KRS conference (23.6%, p < 0.05). Vascular/interventional radiology studies had the highest publication rate (33.1%), whereas musculoskeletal radiology studies had the lowest publication rate (17.1%). Other factors associated with subsequent publication were prospective design, use of statistical testing, and a positive study outcome. Conclusion: The publication rate is significantly lower for the KRS (23.6%) meeting abstracts as compared to those of the RSNA (35.4%) and ECR (50.5%). Prospective design, use of statistical testing, and positive study outcome have a statistically significant effect on the publication rate.

췌장병변에 있어 18-Gauge 절단침을 사용한 초음파유도하 생검의 유용성

윤은주,최철순,윤대영,박상준,서영란,문증희,임경자,배상훈 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.2

목적 : 췌장병변에 있어 18 G 절단침을 이용한 초음파유도하 생검의 진단적 가치와 합병증에 대해 알아보고자 하였다.CT나 초음파검사에서 췌장병변이 의심되는 43명의 환자(남:녀=27:16)를 대상으로 18 G 절단침(ACECUT, TSK laboratory, Tochigi-shi, Tochigi-ken, Japa n)을 이용하여 초음파(Sequoia 512, Acuson, Mountain View, Ca, U.S.A.)유도하 생검을 시행하였다.췌장병변의 위치는 두부와 구상돌기가 11예(25%), 경부와 체부가 각각 2예(5%)와 15예향적으로 분석하였다.결과 : 43명의 환자중 38명(88%)의 환자에서 병리학적 진단이 가능하였으며 선암종이 26예, 전이암이 3예, 악성세포의심이 1예, 염증성 가성종양이 1예, 소낭성 낭선종이 1예, 만성췌장염이 6예였다. 경증의 발열과 일시적인 복부통증(4예)을 제외한 주요합병증은 없었다. 결론 : 췌장병변에 있어 18 G 절단침을 이용한 초음파유도하 생검은 효과적이고 안전한 진단방법이다. PURPOSE : To evaluate the diagnostic yield and to assess the complications after ultrasonography-guided biopsy using an 18 G cut needle for pancreatic lesions. MATERIALS and METHODS : Ultrasonography (Sequoia 512, Acuson, Mountain View, Ca, U.S.A.) guided biopsies using an 18 G through-cut needle (ACECUT, TSK laboratory, Tochigi-shi, Tochigi-ken, Japan) were performed on 43 patients (27 men and 16 women, mean age = 59 years) with detected pancreatic lesions. The locations of pancreatic lesions were 11 (25%) in the head and uncinate process, 2 (5%) in the neck, 15 (35%) in the body, 10 (23%) in the tail, and 5 (12%) were of the diffuse type. The diagnostic yield and assessment of complications were retrospectively analysed. RESULTS : Tissue adequate for pathologic diagnosis was obtained in 38 (88%) of 43 patients. The pancreatic lesions were confirmed as adenocarcinomas (n=26), metastasis (n=3), suspicious malignancy (n=1), inflammatory pseudotumor (n=1), microcystic cystadenoma (n=1), and chronic pancreatitis (n=6). No major complications were seen, but mild fever and transient abdominal pain did occur (n=4). CONCLUSION : Ultrasonography-guided biopsy using an 18 G cut needle is an effective and safe diagnostic method for the evaluation of pancreatic lesions.