방사성동위원소 심조영술상 심전도게이트 일회통과법을 이용한 우심실 박출계수

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),이성용(Sung Yong Lee),이해규(Hae Giu Lee),문영희(Young Hee Moon),박석민(Suk Min Park),임정익(Jeong Ik Yim),김영균(Young Gyun Kim),권순석(Soon Seog Kwon) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.1

N/A Radionuclide cardioangiography has been widily applied and has played mjor foles in moninvasive assessment of cardiac function. Three techinques, first-pass gated first and gated equlibrium nethods have commonly been used to evaluate right ventricular ejection fraction which usually abnormal in the patients with cardiopulmonary disease. It has been known that the gated first pass method is most accrate method among the three rechiques in assessment of fight ventricuiar ejection fraction. The radionuclide right ventricular ejection fraction values were determined in 13 normal subjects and in 15 patients with chronic obstructive puimonary disease by the gated first pass method and compared with those of the first pass method because there has been no published data of fight ejection fraction by the gated first pass method were compared with the detas from the pulmonary function test performed in the patients wih chronic obstructive pulmomar desease. The results were as follows; 1) The values of fight ventricular ejection fraction by the gated first pass method were 50.1 +- 6.1% in normal subjects and 38.5 +- 8.5 in the patients with chronic obstructive pulmonary disease. There was statistically significant difference between the right ventricular ejection fraction of each of the two groups (p<0.05) 2) The right ventricular ejection fraction by the gted first pass method was not linearly correlated ith FEV, VC. DLCO. and FVC as well as PO2 and PCO2 of the patients with chronic obstructive pulmonary disease. We concluded that right ventricular ejection fraction by the gated first pass method usingradionuclide cardioangiography may be suseful in clinical assessment of the right ventricular function.

폐기종의 연무흡입 폐환기스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박영하(Young Ha Park),전정수(jeong Su Jeon) 대한핵의학회 1990 핵의학 분자영상 Vol.24 No.2

N/A Perfusion and ventilaion imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonary emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebulizer with 15 mCi of Tc- 99m-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to l0-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with Tc-99m-MAA was performed in 12 patients. In five patients, we performed fo1low-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was diffuse (6/21), discrete(6/21), intermediate (3/21), or combined (6/21). In 12 patients studied also with perfusion scans, perfusion defects matched closely with ventilation defects in location and configuration. But the size of the ventilation defects was generally larger than the perfusion defects. In all four patients treated with bronchodilators, the follow-up study demonstrated decrease in abnormal of radioaerosol deposition in the central airway with improvement of ventilation defects. RII was useful technique for the evaluation of regional ventilatory abnormality and the effects of treatment with bronchodilators in pulmonary emphysema.

이중병소를 가진 갈색종의 131I - MIBG 신티그라피

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),김성훈(Sung Hoon Kim),박영하(Young Ha Park),김학희(Hak Hee Kim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1

Sternocostoclavicular hyperostosis (SCCH) is a chronic, nonsuppurative inflammatory disease involving sternum, clavicle, upper ribs and its adjacent soft tissue. It is a relatively newly described syndrome, characterized by ossification in the region between the clavicle and the first rib, and hyperostosis of the medial end of the clavicle with simultaneous involvement of the sternum and juxtasterna1 ribs. We experienced one case of sternocostoclavicular hyperostosis, diagnosed by pinhole bone scintigraphy. This paper describes characteristic pinhole scintigraphic findings of SCCH, with comparative study with radiographic and pathologic findings.

기관지 천식의 연무흡입 폐환기스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박정미(Jeong Mi Park),신경섭(Kyung Sub Shinn),박영하(Young Ha Park),김범수(Bum Soo Kim),정명희(Myung Hee Chung) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and sirnple application system. To evaluate its clinica1 utility in the study of irnpaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Wledical colle#ge, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a HARC(Bhabha Atomic Reserch Center, 1nc]ia) nebulizer with 15 mCi of Tc-phytate. The scanning was performed in anterior, posterior and lateral projections foIlowing 5-rninute inhalation of radioaerosol on sitting position. The scans were analyed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusio#n image with ' Tc-MAA. Follow-up scans were obtained in 5 patients after bronchodilator therapy. 1 he patients were divided into (1) att.ack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bron- chial wall and accentuation of hasal interstiti.al markings in 26 of the 31 patients. Chest radiographs were normal in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Rroomstick sign was present in 1.7 patients. The abnorrnality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abormality and the effect of treatrnent with bronchodilators in patients with bronchial asthma.

일과성 뇌허혈 발작 환자에 있어서 99mTc - HMPAO 국소 뇌혈류 SPECT의 유용성

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),이성용(Sung Yong Lee),김종우(Jong Woo Kim),박영하(Young Ha Park),안명임(Myeong Im Ahn) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.2

N/A Transient ischemic attacks (TJAs) is a syndrome resulting from brain ischemia lasting less than 24 hours. The mechanisms of TIAs may be similar to those of cerebral embolism and thrombosis, and thus TIAs may be followed by cerebral infarction. Despite the availability of CT scanning, the diagnosis and management of TIAs continue to be difficult. Recently SPECT has been advocated as a diagnostic imaging modality. We performed Tc-99m-HMPAO regional cerebral blood flow (rCRF) SPECT in 24 patients with the clinical diagnosis of TIAs to assess its ability to detect early changes of rCBF, and determine the diagnos(ic value. l en men and fourteen women with an average of 51 years (range; 27- i4 years) were i ncluded. All but 8 patients had normal brain CT prior to SPECT. The two patients had mdderate degree of hrain atrophy and the 6 patients nonspecific calcifications. Eighteen of the 24 patients had abnormal Tc-99m-HMPAO rCBF SPECT. Fifteen had unilateral involvement and the other three had bilateral involvemeots. Seventy-five percents of the defects were found in the left cerebral hemisphere. According to the distribution of the lesions (total number: 34 tesions), fourteen were in the parietal, eight in the ternporal, and the remainders were elsewhere. Tc-99m-HMPAO rCHF SPECT is sensitive in detecting vCRF abnormalities in patients with TIAs, and represent the most accurate diagnostic tool available in the diagnosis of TIAs.

반사성 교감신경계 기능장애 증후군 ( RSDS ) 의 손 3상 골스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박정미(Jeong Mi Park),신경섭(Kyung Sub Shinn),김성훈(Sung Hoon Kim),박영하(Young Ha Park),안명임(Myeong Im Ahn) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A Reflex sympathetir. dystrophy syndrome (RSDS), known also as Sudecks atrophy, is an uncomrnon disoder recognized by its distinctive symptom complex consisting of pain and tenderness, vasomotor instability, swelling, and dystrophic skin changes and radiologic changes. The present study has been carried out to prospectively establish scintigraphic diagnostic criteria for RSDS using three-phase radionuclide bone scintigraphy (TPBS). In addition, the csefulness in the evaluation of treatment of RSDS was assessed. Patients included were 6 men and 7 women with the age ranging from 25 to 63 years (average 47 years). Diagnosis was based on typical clinical symptoms and signs as described above. Associated r.linical conditions in these patients were cerebral infarction (4 patients), lung cancer (2 patients), trauma (1 patient), lymphoma (1 patient), and unknown cause (5 patients). All patients showed diffuse radionuclide accumulation in juxtaarticular region on the delayed static image and 11 patients showed diffusely increased activities also on scintiangiogram and blood-pool image. Fillow-up TPBS after corticosteroid therapy in 4 patients revealed near normal return of abnormal radionuclide accumulations in the affected hand. TPBS is an useful test for the diagnosrs of as well as the evaluation of the therapeutic effects of RSDS.

201Tl / 99mTc Pertechnetate 감영스캔을 이용한 부갑상선 항진증의 진단

박용휘(Yong Whee Bahk),김춘열(Choon Yul Kim),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),김성훈(Sung Hoon Kim),손형선(Hyung Sun Sohn),안보영(Bo Young Ahn),김의녕(Euy Neyung Kim) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.4

N/A 201Tl/99mTc pertechnetate subtraction scintigraphy of the parathyroid gland performed in a study of 8 patients with clinical and biochemical evidence of hyperparathyroidism for diagnosis and localization of the lesion prior to sugery. 6 cases of parathyroid adenomas were accurately localized and 2 cases of diffuse hyperplasia associated with chronic renal failure(CRF) and multiple endocrine neoplasia(MEN) type I. 201Tl/99mTc pertechnetate scan was useful for patients with hyperparathyroidism, especially in definite localization preoperatively.

골스캔상 신장의 미만성 방사능집적 증가소견의 임상적 의의

박용휘(Yong Whee Bahk),신경섭(Kyung Sub Shinn),양우진(Woo Jin Yang),변재영(Jae Young Byun),성미숙(Mi Sook Sung),박정미(Jung Mi Park) 대한핵의학회 1990 핵의학 분자영상 Vol.24 No.1

N/A Unexpected renal abnormality can be detected on bone scan using Tc-99m-MDP. The purpose of the study is to evaluate the diagnostic significance of diffusely increased bliateral renal uptake on bone scan. 1,500 bone scan were reviewed and 43 scans which showed diffusely increased bliateral renal uptake were selected for analysis. Laboratory findings for renal and liver function tests including routine urinalysis were reviewed in 43 patients. 26 of 43 case showed abnormality in urinalysis and renal function study. 20 of 43 cases showed abnormal liver function study and 3 of these cases were diagnosed as hepatorenal syndrome later. 13 of those 20 cases had liver cirrhosis with or without hepatoma. 12 of 43 cases showed abnormality both in renal and liver function studies. 2 of 43 cases showed diffusely increased bilateral renal uptake after chemotherapy for cancer but not on previous scans before chemotherapy. 2 of 43 cases showed hypercalcemia and 8 of 43 cases had multifocal bone uptake due to metastasis or benign bone lesion. but the latter showed no hypercalcemia at all. There was no significant correlation between increased renal uptake and MDP uptake in soft tissue other than kidneys. This study raised the possibility that the impaired liver and/or renal function may result in diffuse increase of bliateral renal uptake of MDP of unknown mechaninsm. It seems to need further study on this correlation.

99mTc - DISIDA를 이용한 간 혈류 중 동맥 분획의 측정

양일권(Il Kwon Yang),박용휘(Yong Whee Bahk),이해규(Hae Giu Lee),임계연(Gye Yeon Lim),김학희(Hack Hee Kim),임정익(Jung Ik Lim),한석원(Sok Won Han),한남익(Nam Ik Han),이영석(Young Sok Lee) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.2

N/A Arteriai fraction of total hepatic blood flow was estimated by a new method, slope method, on radionuclid angiogram using 99mTc-DISIDA and was compared with that from 99mTc-Phytate radionu clide angiogram. This study included ll of normal subjects, 37 of intermediate group with various liver diseases, and 25 patients with liver cirrhosis. We analyzed the datas with slope method from radionuclide angiograms and the results were compared with hepatic arterial fractions from uptake method, introduced by Lee et al. at 1986. The hepatic arterial fractions from radionuclide angiograms using Tc-DISIDA and 99mTc- Phytate were 0.32 +- 0.09 and 0.31 +- O.11 respectively in normal subjects, and 0.75+0.18 and 0.77+0.21 respectively in patients with liver cirrhosis. The hepatic arterial fractions by the slope method was well correlated with those of the uptake method on 99mTc-DISIDA scan. There was high correlation between the hepatic arterial fractions from 99mTc-DISIDA and 99mTc-Phytate scans. Hepatic arterial fraction estimated by the slope method is a useful index for the diagnosis of liver cirrhosis and the evaiuation of status of portal hypertension.

99mTc - DISIDA 신티그래피를 이용한 간세포암 간외 전이의 진단 : 원발 간세포암과의 비교

박석희(Seog Hee Park),박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),김성훈(Sung Hoon Kim),백준현(Joon Hyun Baik),김영주(Young Joo Kim),천경아(Kyung Ah Chun),신경섭(Kyung Sub Shin) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.4

N/A It is well known that hepatobiliary agent are taken up by metastatic hepatocellular carcinoma(HCC) as well as primary HCC. But the reported cases of the extrahepatic metastasis of HCC diagnosed by hepatobiliary scintigraphy are for the most part hematogenous ones. The relation of the uptake pattern of hepatobiliary agent in the primary and metastatic HCC is also still remains unknown. So we undertook this study to evaluate the relation of the hepatobiliary scintigraphic patterns of primary and metastatic HCC with different metastiatic routes. Nine patients with primary HCC and twelve cases of metastaic HCC including four lung metastases, one bone metastasis, one right atrial metastasis, one peritoneal wall metastasis, and five lymph node metastases were studied with Tc-99m-DISIDA scintigraphy. The images were taken on 10, 30 minutes, 1, 2, 4-6 hours. The overall detection rates of hematogenous metastases(lung and bone) is 60%(3 of 5), direct metastasis(right atrium and peritoneal wall), 100%(2 of 2) and lymphatic metastases, 0%(0 of 5). In four of five metastatic cases demonstrated with hepatobiliary scintigraphy, biliary agent is also taken up by primary HCC lesions. And the appearing time of the radioactivity in the direct metastatic HCC lesion is same as that of primary HCC and in the cases of hematogenous metastasis, earlier than that of primary HCC. Hepatobiliary scintigraphy is more useful in the diagnosis of the metastatic HCC than primary HCC, in the cases of hematogenous and direct metastasis.