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      • KCI등재

        주변부 고립결절성 폐암의 전산화단층촬영 소견

        김홍,김옥배,우성구,서수지,김성수,Kim, Hong,Kim, Ok-Bae,Woo, Seong-Ku,Suh, Soo-Jhi,Kim, Sung-Soo 대한영상의학회 1985 대한영상의학회지 Vol.21 No.5

        It is diffidult to distinguish benign from malignant, ulmonary nodule by conventional roentgenologic examination. But CT makes it easier to evaluate adjacent parenchymal invasion, pleural or mediastinal extension, or early metastasis to intra- or extrathoracic lymph node as well s distant organs, although only a solitary peripheral pulmonary nodule is seen on plain radiograph. Authors reviewed CT of 22 cases of histopathologically confirmed primary lung cancer seen as a solitary peripheral pulmonary mass from May 1980 to September 1984 at Dongsan Medical Center, Keimyung University. The results are as follows: 1. The incedence was most common in the 6th decade(36%). Male to female ratio was 10:1 and 2 females all had bronchioloalveolar cell carcinoma. 2. The distributions of histologic cell type were as follows: squamous cell carcinoma 40%, adenocarcinoma, small cell carcinoma, bronchioloalveolar cell carcinoma and unclassified carcinoma 14% in each cases, and adenoid cystic c rcinoma 4%. 3. The computed tomographic findings were as follows: a) Superior and posterior basal segments of both lower lobes were most frequently involved(68%). b) The mean diameter of the mass was 48mm, and most common in the range of 30-49mm in the greatest dimension(46%). c) The mean CT attenuation value was 57 H.U., and most common in the group of 41-70 H.U.(64%). d) Lymph node metastasis was found in 13(59%) of 22 cases, and the involved nodes were as follows: hilar nodes 10 cases, paratracheal nodes 8 cases, subcarinal nodes 7 cases and extrathoracic nodes 3 cases. In 2 of 3 cases with small cell carcinoma, diffuse multiple lymph nodes were involved. e) Distant metastasis was seen relatively early in 3 cases: cerebral metastasis in 1 case of squamous cell carcinoma, right adrenal metastasis without intrathoracic lymph node metastasis or invasion of adjacent structures in 1 case of bronchioloalveolar cell carcinoma, and liver and bone metastases in 1 case of unclassified carci oma. f) Adjacent pleural or mediastinal invasion was found in 7 cases(32%): pleural invasion alsong chest wall in 4 cases, and invasion of adjacent mediastinal pleura in 3 caes of 2 squmous cell carcinoma and 1 unclassified carcinoma. g) Calcifications within the mass were found in 5 caes(23%), and most common in squamous cell carcinoma(3 caes). In all cases, a few granular calcifications were seen along the peripheral margin of the mass. h) Tumor necrosis was seen in 4 cases(18%), and 3 cases were squamous cell carcinoma, and one of them showed irregular central cavitation. i) The margins of tumor were irregularly lobulated with radiating spiculations in all except one of adenoid cystic carcinoma, which revealed oval shaped, smooth clear margin. j) In 9(41%) of 22 cases, some enlargement of pulmonary vessels with perivascular linear infiltrations were found in the adjacent lung parenchymes of the mass, which were thought to be retrograde perivascular lymphangitic spread along pulmon ry vessels.

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      • KCI등재

        Ilizarov 시술 후 추적검사에 있어 초음파검사의 유용성 : 단순촬영과의 비교

        이종훈,지성우,이호원,이성문,김정식,김홍,송광순,조길호,우성구,Lee, Jong Hoon,Jee, Sung Woo,Lee, Ho Won,Lee, Sung Moon,Kim, Jung Sik,Kim, Hong,Song, Kwang Soon,Cho, Kil Ho,Woo, Sung Ku 대한영상의학회 1998 대한영상의학회지 Vol.38 No.6

        Purpose : To compare the usefulness of ultrasonography in follow up evaluation after the Ilizarov procedurewith that of plain radiography. Materials and Methods : We analyzed ultrasound findings in twelve patients who hadundergone the Ilizarov procedure, and retrospectively compared the results with the findings of plain radiography.The procedure was performed due to post-traumatic limb deformity or non-union(nine of twelve patients), congenitalpseudoarthrosis(one case), sequelae of poliomyelitis(one case), and short stature(one case). The patients' meanage was 29 years ; eleven of twelve were male. Ten of twelve procedures were performed on the tibia and two on thefemur. After 7-10 days, distraction was initiated at a rate of 0.25mm four times a day. Ultrasonography wasperformed with a 5-10 MHz linear or convex transducer ; new bone formation was defined as dotted or linearechogenic foci within a hypoechoic distraction gap. Initial ultrasonographic examination was performed 2-4 weeksafter distraction, and the results were compared with those of plain radiography. Color Doppler imaging wasperformed in three cases. Results : On ultrasonograms, new bone formation was initially detected 18-29(mean, 23)days after distraction, and on plain radiographs, 37-58(mean, 45) days after this procedure ; ultrasonography thusdetected new bone formation at least three weeks earlier than did plain radiography. Complication after theIlizarov procedure were four cysts at the distraction site, and one pin site infection, as seen on ultrasonograms.None of these four cysts, the size of which was 12-22mm(mean, 17mm), was visible on plain radiographs. In one casein which a cyst was present, ultrasound-guided aspiration was performed. Color Doppler examination was performedin three of twelve patients, and in all three, periosteal vascularity at the edge of the distracted gap was seento be preserved. Conclusion : After the Ilizarov bone lengthening procedure, ultrasound appears to be useful forfollow-up examination. New bone formation, as well as complications, can be detected earlier ; it can indicatewhether ultrasound-guided interventional procedure is required, and if combined with color Doppler study, is ableto detect the periosteal blood supply. Further evaluation of the clinical significance of preserved periostealblood supply seems however, to be needed.

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