간아세포종의 항암치료전후의 CT소견 : 병리조직과의 비교

서준범 대한영상의학회 1998 대한영상의학회지 Vol.38 No.5

Purpose : The purpose of this study was to analyze the CT findings of hepatoblastoma before and afterchemotherapy, and to compare them with surgical and pathologic features. Materials and Methods : Twelvehepatoblastoma patients underwent chemotherapy prior to surgery; in all cases, CT scanning was performed beforeand after chemotherapy. We reviewed the findings with special attention to changes in tumor volume, the extent andpattern of contrast enhancement, the extent of low-attenuation area in the tumor, the presence of a septum, andcalcification or ossification within the mass before and after chemotherapy. Post-chemotherapy CT findings werecompared with operative and pathologic findings. Results : After chemotherapy, the volume of the tumor massdecreased in all patients, and the extent of involved segments decreased in nine(75%), the non-enhancing areawithin the mass, on the other hand, increased in nine (75%). On pre-chemotherapy CT, calcifications were detectedin seven patients(58%), and on post-chemotherapy CT, in nine (75%); the extent of calcification increased in sevenpatients. On the basis of CT findings, viable tumor and necrosis areas could not be distinguished. Massivecalcification or an osteoid mixed with loose connective tissue was noted in the mesenchymal component of thetumor; the whirling pattern of enhancement within the area of low density asen on CT scanning corresponded toosteoid mixed with loose connective tissue, which contained rich blood vessels. Conclusion : We describe the CTfindings of hepatoblastoma both before and after chemotherapy, highlighting the changes which occurred. Anunderstanding of these changes is helpful for the proper management of this condition.

결절성 간세포암 : 나선상 CT의 동맥강조기와 문맥강조기에서 조영증강양상

서준범 대한영상의학회 1996 대한영상의학회지 Vol.35 No.2

Purpose : To evaluate the enhancing patterns of nodular hepatocellular carcinomas (HCCs) in the arterial- andportal-dominant phases of spiral CT. Materials and Methods : A retrospective analysis of enhancing patterns wasperformed in 100 patients with HCCs diagnosed by pathologic findings (n=30) or clinical and radiological findings.CT images were obtained 30 seconds(arterial-dominant phase) and 65 seconds(portal-dominant phase) after beginninginjection of contrast medium (120mL, 3mL/sec). After transarterial chemoembolization, 179 tumors detected oniodized oil-CT were divided into four groups according to their largest diameter, as follows ; group I(smallerthan 1cm, n=51), II(1-2cm, n=46), III(2-3cm, n=32), IV(larger than 3cm, n=50). The enhancing patterns of tumorscompared with attenuation of surrounding liver parenchyma, were divided into four types, namely high, iso, low andmixed. Results : Each group showed a different enhancing pattern ; group I showed iso-attenuation in botharterial- and portal-dominant phases (n=41, 80% and n=50, 98%), group II showed high-attenuation in thearterial-dominant phase (n=38, 83%) and iso-attenuation in the portal-dominant phase(n=34, 74%), group III showedhigh-attenuation in the arterial-dominant phase(n=19, 59%) and low-attenuation in the portal-dominant phase(n=17,53%), and group IV showed mixed-attenuation in both arterial- and portal-dominant phases(n=30, 60% and n=26, 52%).Conclusion : Hepatocellular carcinomas showed variable enhancing patterns on two-phase spiral CT according to thesize of tumors, and this reflected their hemodynamic characteristics.

인공지능과 의료혁신

서준범 대한내과학회 2019 대한내과학회 추계학술대회 Vol.2019 No.2

재발한 거대세포종의 자기공명영상

서준범 대한영상의학회 1995 대한영상의학회지 Vol.32 No.6

말초혈액 호산구증을 동반하는 국소적 간병변들 : 다양한 질환의 방사선학적 소견

서준범 대한영상의학회 1999 대한영상의학회지 Vol.40 No.1

최근까지 초음파, 전산화 단층촬영, 자기공명 영상 등 영상 진단방법의 발전과 각정 국소적 간병변의 방사선학적 소견에 대한 연구들에 의하여 방사선 검사는 국소적 간병변의 감별진단에서 중요한 역할을 담당하고 있다. 그러나 때때로 여러 방사선학적인 검사에서 비특이적이거나 흔치 않은 소견을 보이는 병변을 만나면 정확한 진단이 어려워진다. 이 때 혈중 호산구증의 존재 여부가 감별진단에 도움을 주는 경우가 있다. 저자들은 혈중 호산구증을 동반할 수 있는 여러 국소 간병변의 방사선학적인 소견을 보여주고자 한다. Due to the recent advent of various imaging modalities such as ultrasonography, computed tomography andmagnetic resonance imaging, as well as knowledge of the characteristic imaging features of hepatic lesions,radiologic examination plays a major role in the differential diagnosis of focal hepatic lesions. However, various'nonspecific' or 'unusual' imaging features of focal hepatic lesions are occasionally encountered, and this makescorrect diagnosis difficult. In such a situation, the presence of peripheral eosinophilia helps narrow thedifferential diagnoses. The aim of this pictorial essay is to describe the imaging features of various diseaseentities which cause focal hepatic lesions and peripheral eosinophilia.

특별강연-폐암의 조기발견:영상검사

서준범 대한방사선과학회(구 대한방사선기술학회) 2003 방사선기술과학 Vol.26 No.1

Trust-HUB 기반 하드웨어 백도어의 구현가능성 분석

서준범(Joon Beom Seo),김동규(Dong Kyue Kim) 대한전자공학회 2020 대한전자공학회 학술대회 Vol.2020 No.8

Pulmonary Complication of Novel Influenza A (H1N1) Infection: Imaging Features in Two Patients

이충욱,서준범,송재우,이현주,이진성,김미영,채은진,송진우,김원영 대한영상의학회 2009 Korean Journal of Radiology Vol.10 No.6

Novel influenza A (H1N1) virus is the pathogen of recent global outbreaks of febrile respiratory infection. We herein report the imaging findings of pulmonary complication in two patients with novel influenza A (H1N1) infection. The first patient without secondary infection showed the ill-defined ground-glass opacity nodules and patch areas of ground-glass opacities. The second patient with secondary pneumococcal pneumonia showed areas of lobar consolidation in the right middle lobe and left lower lobe and ground-glass opacities.

조영증강 3차원 자기공명영상을 이용한 폐관류의 정량적 평가: 건강한 성인에서의 폐관류 변수의 국소적 차이 분석

김성수,서준범,김남국,도경현,이영경,김진환,송재우,이진성 대한영상의학회 2007 대한영상의학회지 Vol.56 No.2

Purpose: We wanted to evaluate the regional differences in such perfusion parameters as pulmonary blood flow (PBF), mean transit time (MTT) and pulmonary blood volume (PBV) in the entire lung of healthy volunteers with using three-dimensional, contrast-enhanced MR imaging (3D CEMRI). Materials and Methods: Six healthy volunteers underwent dynamic 3D CEMRI (TR/TE 2.7/0.6 msec; flip angle 40° matrix 128×96; reconstructed matrix 256×192; rectangular field of view 450×315 mm; coronal 100- 150mm-thick×10 slabs; temporal resolution 1.0 sec; 35 dynamic phases) For all subjects, 2 mL of Gd-DTPA mixed with 3 ml of physiologic saline was administered as a bolus at a rate of 5 mL/sec, and this was followed by 20 mL of physiologic saline flush. From the signal intensity-time curves, the PBF, MTT and PBV maps were generated using indicator dilution theories and the central volume principle on a pixel-by-pixel basis. A total of 54 round, 1-cm sized ROIs were placed in the lung in each subject (6 ROIs per slab×9 slices except for the most posterior slab). The regional differences of the measured parameters were statistically evaluated in the gravitational direction and in the upper-mid-lower direction by one-way ANOVA tests. Results: The calculated PBF, MTT and PBV in the entire lung were 141.8±53.4 mL/100 mL/min (mean±SD), 5.35±1.38 sec, and 13.4±6.48 mL/100mL, respectively. In the gravitational direction, there was a significant increase in the PBF and PBV as it goes to the posterior direction (p < 0.05). No statistical difference was found in PBF or PBV between the upper, mid and lower lung zone areas. Conclusion: Regional difference in the various perfusion parameters of the lung in healthy volunteers can be quantitatively assessed with performing 3D CEMRI. 목적: 3차원 조영증강 자기공명영상을 이용하여 건강한 성인에서 국소적 폐혈액량, 평균저류시간, 폐혈류량과 같은 폐관류 변수의 국소적 차이를 알아보고자 하였다. 대상과 방법: 6명을 대상으로 3차원 역동적 조영증강 자기공명영상(TR/TE 2.7/0.6 msec; 숙임각 40°; 매트릭스 128×96; 재구성 매트릭스 256×192; 직사각형시야 450×315 mm; 관상면 두께 100-150 mm×10 판; 시간해상능 1.0 sec; 35 역동반복획득)을 시행하였다. 모든 대상인에 대하여 2 mL의 Gd-DTPA 를 3 mL의 생리 식염수와 섞어 5 mL/s로 일시주사하고, 그 후 생리식염수 20 mL를 같은 속도로 주입하였다. 각 픽셀당 신호강도-시간 곡선을 바탕으로 지표희석이론, 중심부용적원칙 등을 기반으로 하여 폐혈액량, 평균저류시간, 폐혈류량의 변수지도를 제작하였다. 직경 1 cm 크기의 원형의 관심영역을 환자마다 9개의 판에서 각 6개씩 폐구역을 선택하여 총 54개의 영역을 선택하였다. 각 변수의 중력방향 및 상-중-하 방향 등 지역에 따른 국소적 차이를 one-way ANOVA 법을 이용하여 통계적으로 평가하였다. 결과: 전체 폐에서 계산된 폐혈액량, 평균저류시간, 폐혈류량의 평균값은 각각 13.4±6.48 mL/100 mL(mean±SD), 5.35±1.38 sec, 141.8±53.4 mL/ 100 mL/min이었다. 중력방향에서 후방부위로 갈수록 폐혈액량과 폐혈류량은 증가하였으나(p < 0.05), 등중력방향에서는 통계적 유의성이 없었다. 결론: 역동적 조영증강 3차원 자기공명영상를 이용하면 건강한 성인에서의 다양한 폐관류 변수의 국소적인 차이를 정량적으로 평가할 수 있다. 추후 만성 폐색전증이나 폐기종 등 다양한 폐질환에서의 연구와 임상적용이 가능할 것으로 기대된다.

Comparison of Usual Interstitial Pneumonia and Nonspecific Interstitial Pneumonia: Quantification of Disease Severity and Discrimination between Two Diseases on HRCT Using a Texture-Based Automated System

박상옥,서준범,김남국,이영경,이정진,김동순 대한영상의학회 2011 Korean Journal of Radiology Vol.12 No.3

Objective: To evaluate the usefulness of an automated system for quantification and discrimination of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). Materials and Methods: An automated system to quantify six regional high-resolution CT (HRCT) patterns: normal, NL; ground-glass opacity, GGO; reticular opacity, RO; honeycombing, HC; emphysema, EMPH; and consolidation, CONS, was developed using texture and shape features. Fifty-four patients with pathologically proven UIP (n = 26) and pathologically proven NSIP (n = 28) were included as part of this study. Inter-observer agreement in measuring the extent of each HRCT pattern between the system and two thoracic radiologists were assessed in 26 randomly selected subsets using an interclass correlation coefficient (ICC). A linear regression analysis was used to assess the contribution of each disease pattern to the pulmonary function test parameters. The discriminating capacity of the system between UIP and NSIP was evaluated using a binomial logistic regression. Results: The overall ICC showed acceptable agreement among the system and the two radiologists (r = 0.895 for the abnormal lung volume fraction, 0.706 for the fibrosis fraction, 0.895 for NL, 0.625 for GGO, 0.626 for RO, 0.893 for HC, 0.800 for EMPH, and 0.430 for CONS). The volumes of NL, GGO, RO, and EMPH contribute to forced expiratory volume during one second (FEV1) (r = 0.72, ß values, 0.84, 0.34, 0.34 and 0.24, respectively) and forced vital capacity (FVC) (r = 0.76, ß values, 0.82, 0.28, 0.21 and 0.34, respectively). For diffusing capacity (DLco), the volumes of NL and HC were independent contributors in opposite directions (r = 0.65, ß values, 0.64, -0.21, respectively). The automated system can help discriminate between UIP and NSIP with an accuracy of 82%. Conclusion: The automated quantification system of regional HRCT patterns can be useful in the assessment of disease severity and may provide reliable agreement with the radiologists’ results. In addition, this system may be useful in differentiating between UIP and NSIP. Objective: To evaluate the usefulness of an automated system for quantification and discrimination of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). Materials and Methods: An automated system to quantify six regional high-resolution CT (HRCT) patterns: normal, NL; ground-glass opacity, GGO; reticular opacity, RO; honeycombing, HC; emphysema, EMPH; and consolidation, CONS, was developed using texture and shape features. Fifty-four patients with pathologically proven UIP (n = 26) and pathologically proven NSIP (n = 28) were included as part of this study. Inter-observer agreement in measuring the extent of each HRCT pattern between the system and two thoracic radiologists were assessed in 26 randomly selected subsets using an interclass correlation coefficient (ICC). A linear regression analysis was used to assess the contribution of each disease pattern to the pulmonary function test parameters. The discriminating capacity of the system between UIP and NSIP was evaluated using a binomial logistic regression. Results: The overall ICC showed acceptable agreement among the system and the two radiologists (r = 0.895 for the abnormal lung volume fraction, 0.706 for the fibrosis fraction, 0.895 for NL, 0.625 for GGO, 0.626 for RO, 0.893 for HC, 0.800 for EMPH, and 0.430 for CONS). The volumes of NL, GGO, RO, and EMPH contribute to forced expiratory volume during one second (FEV1) (r = 0.72, ß values, 0.84, 0.34, 0.34 and 0.24, respectively) and forced vital capacity (FVC) (r = 0.76, ß values, 0.82, 0.28, 0.21 and 0.34, respectively). For diffusing capacity (DLco), the volumes of NL and HC were independent contributors in opposite directions (r = 0.65, ß values, 0.64, -0.21, respectively). The automated system can help discriminate between UIP and NSIP with an accuracy of 82%. Conclusion: The automated quantification system of regional HRCT patterns can be useful in the assessment of disease severity and may provide reliable agreement with the radiologists’ results. In addition, this system may be useful in differentiating between UIP and NSIP.