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방사선 투시 유도하 흉부병소의 자동총 생검 : 진단성적 및 합병증
오희술,한영민,최기철,손명희,김종수,정경호,이상용,박학훈,임영수 대한영상의학회 1998 대한영상의학회지 Vol.39 No.6
Purpose : To determine the diagnostic accuracy and frequency of complications of fluoroscopy-guidedtransthoracic needle biopsy, using an automated gun biopsy system. Materials and Methods : We retrospectivelyreviewed 86 patients who underwent automated gun biopsy between October 1995 and October 1996. An 18-gauge cuttingneedle was used in all cases. All biopsies were performed under fluoroscopic guidance by one interventionalradiologist. Results : Tissue sufficient for histologic diagnosis was obtained in 73 of 86 biopsies(84.9%).Fifty-six lesions were malignent and 30 were benign. Sensitivity and diagnostic accuracy for malignant lesionswere 87.5% and 87.5%, respectively while cell type specificity in malignant diagnosis was 91.7%(11/12).Sensitivity and diagnostic accuracy for benign lesions were 80.0% and 73.3%, respectively. Postbiopticpneumothorax occurred in three of 86 biopsies(3.5%), one of which required placement of a chest tube. Conclusion :Automated gun biopsy is a simple, safe method for the diagnosis of focal chest lesions. An automated biopsy deviceoffers high diagnostic accuracy in cases involving malignant and benign lesions of the chest, and is particularlyuseful for determining malignant cell type and specific diagnosis of benign lesions.
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장간막 동맥의 색전술에 있어서 금속코일과 젤폼 색전 위치에 관한 실험적 연구
이동원,진공용,오희술,임영수,이상용,이정민,김종수,한영민,이동근 대한영상의학회 1998 대한영상의학회지 Vol.39 No.1
Purpose : To determine the effective embolic material and appropriate embolic site by comparing bowel changes after arterial embolization in dogs in which the proximal or distal level of the superior mesenteric artery had been occluded with gelfoam particles or a coil. Material and Methods : Using the coaxial catheter system, superselective arterial embolization was performed at sixteen sites in four dogs. In groups A and B, each site was occluded at the proximal or distal marginal artery, respectively, with gelfoam particles and in groups C and D, at the proximal or distal artery, respectively, with a coi. All dogs were sacrifed one day after the procedure, and gross and microscopic histologic findings were evaluated. Results : In all dogs, the procedure was successful. In group B, significant mucosal destruction, lymphocyte proliferation in submucosa and mucosa, and diffuse swelling in all layers of the intestine were found at all sites. The vessel in the submucosal layer was completely obstructed by red blood cells and gelfoam. At three sites, the intestine showed diffuse ischemic change, and at one other site, focal ischemic change was observed. In group D, exudation with destruction of mucosa and submucosal hemorrhage occurred at one site, but in groups A and C, intestinal layers were found to be normal. Conclusion :Using a coil, superselective arterial embolization was successful, even up to the distal level of the intestinal artery, and the intestine showed no ischemic change. Embolization with gelfoam must be performed carefully at the proximal level, and since it can cause severe intestinal necrosis, must be avoided at the distal level.
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