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박경찬 ( Park Gyeong Chan ),권중구 ( Kwon Jung Gu ),유길종 ( Yu Gil Jong ),배종석 ( Bae Jong Seog ),신재욱 ( Sin Jae Ug ),원태경 ( Won Tae Gyeong ),조규현 ( Jo Gyu Hyeon ),허성욱 ( Heo Seong Ug ),김은영 ( Kim Eun Yeong ),이창형 ( 대한소화기학회 2003 대한소화기학회지 Vol.42 No.6
There are diverse ring-like narrowings in the lower esophagus: mucosal ring, muscular ring, ring-like annular peptic stricture. Esophageal muscular ring is extremely rare and generally asymptomatic. It occurs at the proximal border of the esophageal vestibule that corresponds to the upper end of the lower esophageal sphincter. We experienced a case of lower esophageal muscular ring with a symptom of intermittent mild dysphagia for 40 years and report the findings with a review of the literature.(Korean J Gastroenterol 2003;42:539-543)
간내담석 환자에서 자기공명 담도췌관조영술의 유용성 및 제한점
박도현 ( Park Do Hyeon ),김명환 ( Kim Myeong Hwan ),이상수 ( Lee Sang Su ),김선영 ( Kim Seon Yeong ),김정호 ( Kim Jeong Ho ),김현준 ( Kim Hyeon Jun ),배종석 ( Bae Jong Seog ),서동완 ( Seo Dong Wan ),이성구 ( Lee Seong Gu ),김아영 대한소화기학회 2003 대한소화기학회지 Vol.42 No.5
Diagnosis of bile duct strictures as well as detection and localization of hepatolithiasis is important for an effective treatment of hepatolithiasis. For this purpose, endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) have been preferred as the diagnostic modalities of choice for hepatolithiasis. At present, magnetic resonance cholangiopancreatography (MRCP) is rapidly replacing ERCP. To determine the usefulness and limitation of MRCP for detecting hepatolithiasis and biliary strictures, we compared the result of MRCP with that of percutaneous transhepatic cholangioscopy (PTCS) as the standard reference. Methods: Sixty-six patients with primary hepatolithiasis who underwent both MRCP and PTCS were enrolled. All patients underwent PTCS within 2 weeks of MRCP. The results of MRCP were reviewed by radiologists who were unaware of the clinical information about the location of hepatolithiasis and the presence of biliary strictures. Results: The sensitivity and specificity of MRCP for detecting intrahepatic stones were 72.4 and 90%, respectively. The sensitivity of MRCP for depicting intraheptic bile duct strictures was 64%. The overall agreement between MRCP and PTCS for intrahepatic stones showed a good reliability (kappa value=0.64, p<0.05). The agreement of MRCP for hepatolithiasis with intrahepatic bile duct strictures with reference to PTCS showed a moderate reliability (kappa value=0.47, p<0.05). Imaging findings such as pneumobilia and hepatic parenchymal atrophy were related to false positive results in location of hepatolithiasis (p<0.05). Conclusions: MRCP has a good agreement rate in evaluation of intrahepatic stones and a moderate agreement rate in intrahepatic strictures, compared to PTCS. (Korean J Gastroenterol 2003;42:423-430)