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성진용 대한영상의학회 1996 대한영상의학회지 Vol.34 No.4
경동맥소체에서 발생한 부신경절종은 드문 종양으로 양성 또는 국소 침윤성 종양으 로 알려져 있다. 저자들은 34세 남자에서 발생한 부신경절종의 다발성 원격전이 1예를 보고 한다. 환자는 우측경동맥 소체의 부신경절종을 진단받은 2년후 내원하여 경부 및 흉추의 자 기공명영상 및 혈관조영술과 전신골주사를 시행하였고 경부 임파절과 척추, 늑골, 장골 등에 서 다발성의 전이 병소들이 확인되었다. 전이병소들은 원발 종양에서와 같은 고혈류분포를 보였다. Paragangliomas of the carotid body are rare tumors, usually regarded as benign. We report a case of multiple metastases from a paraganglioma which occurred in a 34-year-old man. Paraganglioma, which has originated two years previously in the right carotid body, was diagnosed. We performed neck and thoracic spine MRI, whole body bone scan, and neck and thoracic spinal angiography revealed multiple metastatic lesions in cervical lymph nodes, spines, ribs, and ilia. Metastatic lesions showed hypervascularity similar to that of a primary tumor.
Parathyroid ultrasonography: the evolving role of the radiologist
성진용 대한초음파의학회 2015 ULTRASONOGRAPHY Vol.34 No.4
Previously, radiologists played a limited role in the treatment of parathyroid disease,primary focusing on the preoperative localization of parathyroid lesions responsible forhyperparathyroidism. But, the widespread use of high-resolution ultrasound has lead to theincreasing detection of parathyroid incidentalomas (PTIs). Consequently, radiologists may berequired to differentiate PTIs from thyroid lesions, which is most reliably accomplished throughthe fine needle aspiration-parathyroid hormone analysis. Various nonsurgical treatmentmodalities for hyperfunctioning parathyroid lesions have been developed with some efficacy. Especially for symptomatic nonfunctioning parathyroid cysts, simple aspiration is a first-lineprocedure for diagnosis and treatment, while ethanol ablation is a subsequent treatmentmodality for recurrent cases.
뇌동맥류 진단에 있어서의 전산화단층촬영 혈관조영술 : SSD기법과 MIP기법의 비교
성진용 대한영상의학회 1998 대한영상의학회지 Vol.38 No.5
Purpose : To evaluate the usefulness of CT angiography and to compare SSD(Shaded Surface Display) andMIP(Maximum Intensity Projection) in the diagnosis and preoperative evaluation of the cerebral aneurysms.Materials and Methods : Twenty-six aneurysms in 20 patients were diagnosed on conventional angiography and surgerywas performed. For preoperative evaluation, all patients underwent CT angiography, with spiral CT for preoperativeevaluation. Using SSD and MIP techniques, the results were proccessed and compared; three radiologistsretrospectively analysed detectability, size, neck visualization, delineation of shape, direction, therelationship with surrounding vessels-including the feeding artery of the aneurysm-and intraluminal thrombicontaining calcification. Results : Twenty five of 26 aneurysms (96.2%) were detected by CT angiography, while MIPand SSD depicted 25 (96.2%) and 24 (92.3%), respectively. The largest diameter of the aneurysms was 11-15mm infour cases, 6-10mm in ten, and 3-5mm in 12 (mean 7.38mm, SD=3.34). With regard to detectability, MIP led to onefalse negative result, and SSD to two false negative and one false-positive results. Aneurysm neck assessment byMIP was clear in 96.0% of cases (24/25), and by SSD in 83.3% (20/24). For the depiction of directions and feedingvessels of the aneurysms, and intraluminal thrombi containing calcification, MIP was superior to SSD, while fordepicting shape and the relationship with surrounding structures, SSD was superior to MIP. Conclusion : For theassessment of cerebral aneurysms, MIP is somewhat superior to SSD. The characteristics of aneurysms and theirrelationship with surrounding structures can, however, be better evaluated by combining the two techniques.
요추 추간판 탈출증의 자기공명영상 소견:왕와위-복와위간의 형태변화
성진용 대한영상의학회 1997 대한영상의학회지 Vol.37 No.6
Purpose:To determine morphologic change in a herniated lumbar disc, as seen on MR imaging, according to position change(supine and fiexed-prone positions) Materials and Methods:A hundred and twenty-two patients with herniated lumbar discs, as seen on supine MR imaging, underwent repeat MR imaging in the fiexed-prone position;100 patients, who showed more than 2$^{\circ}$ of flexion angle difference, were included in this study. Sixty-two were men and thirty-eight were women, and thier ages ranged from 13 to 59(mean, 30) years. Disc degeneration ws graded as 1, 2, or 3, depending in the area of decreased signal intensity seen on a T2-weighted MR image. Difference in the angle of flexion is defined as the angle difference of lumbar curvature, calculated by the Begg-Falconer method in supine and flexed-prone positions. Morphologic changes in herniated discs in different positions were analysed on the basis of shape change of anterior epidural spaces, thecal sacs and posterior margins of herniated discs, and classified as either A(not changed) or B(changed). Group B was subtyped as type I(decreased herniaion without change of shape), type II(decreased herniation with change of shape) or type III(increased disc herniation). We statistically analysed correlation between a patient's age, morphologic change in a herniated disc in different positions, and degree of degeneration in such a disc, as well as the correlation between morphologic change in a herniated disc in different positions and the degree of the flexion angle. Results:Disc degeneration was apparent in 99 of 100 patients. Grades 1, 2, and 3 were seen in 32(32.3%), 49(49.5%), and 18(18.2%) patients, respectively;the difference in the angle of flexion ranged from 2 to 24$^{\circ}$(mean 7.97;SD=6.20). Group A consisted of 37(37.4%) patients, adn group B of 62(62.6%)(type I in 29(29.3%), type II in 27(27.3%), and type III in 6(6.0%). There was no sigdificant statisticl correlation between a patient's age and morphologic change in a herniated disc in different positions(correlation coefficient=0.0183;p=0.086), and between the degree of degeneration of a herniated disc and morphologic change in such a disc in different positions(correlation coefficient=0.1736;p=0.249). The mean angle of flexion was 5.15$^{\circ}$(SD=4.94) in group A and 1.06$^{\circ}$(SD=6.28) in group B ; there was significant statistical correlation between this and morphologic change in a herniated disc(p=0.0017). Conclusion : In the flexed-prone position, which is similar to that used during surgery, MRI can reveal various morphologic changes in a herniated lumbar disc, mainly decreased herniation, and is helpful in making decisions related to surgery.