MDCT의 다양한 알고리즘과 관상동맥내 삽입된 스텐트 내경측정의 영향

정명진(Myung Jin Jung),전재두(Jae Doo Jeon),노지숙(Ji Sook Noh),전진만(Jin Man Jeon),김동훈(Dong Hun Kim) 대한CT영상기술학회 2008 대한CT영상기술학회지 Vol.10 No.1

Purpose To analyze diameter of stem within phantom and coronary artery and to recognize various algorithm effects that make blooming artifact commonly. Materials and Methods Phantom model was manufactured as follows: stem located in center of thin plastic pipe was situated in glass bottle and mixed saline and contrast (10:1) was filled in bottle. Total 80 patients (man : woman = 53 : 27, mean age = 60.8 years old) who undergo percutaneous coronary intervention (stenting) were included in this study. Coronary CT angiography was performed with the use of a 16- slice MDCT scanner with a 0.42-s rotation time (Sensation 16, Siemens, Erlangen, Germany) and a 64-slice MDCT scanner with a 0.42-s rotation time (Brilliance 64, Philips Medical Systems, Best, The Netherlands) with retrospective ECG gating.A standard scanning protocols were applied. Six radiological technicians measured internal diameter of stem within phantom and coronary artery respectively. As much as possible, we exclude artifacts including blooming artifact. For evaluation of images, window width and window center were used as 900 ± 100 and 400 ± 100 each. Results In phantom model, average inside diameter measured by each algorithms appeared most greatly as 2.35 mm (B50f in S company) and 2.53 mm (XCB in P company) respectively. In patients, in stent resolution processed by XCC was scored as 7.67 (highest) and others (XCA, XCB, XCD) got similar scores. Conclusion B40f (S company, 16 slice MDCT) and XCC (P company, 64 slice MDCT) are appropriate algorithms for evaluating internal patency of stent within coronary artery.

Brain CTA에서 HU값 변화에 대한 환자 인자의 관련성 연구

정명진(Myung Jin Jung),나유리(Yu Ri Na),전진만(Jin Man Jeon),노지숙(Ji Sook Noh) 대한CT영상기술학회 2012 대한CT영상기술학회지 Vol.14 No.1

목적 본 연구에서는 Brain CTA검사를 내원한 질환이 없는 환자를 대상으로 조영제 주입 후 중대뇌동맥에 도달하는 조영제의 HU 값을 조사하여, 환자의 성별, 연령, 신장, 체중, 심박동수, 혈압, 체질량 지수에 대한 HU값의 변화에 어떠한 관련성이 있는지를 알아보았다. 대상 및 방법 20101년도 7월부터 12월까지 광주광역시 C대학병원에 Brain CTA 검사를 위해 응급실로 내원한 환자 중에서 영상판독결과 질환이 없는 환자 75명을 대상으로 조사하였다. 조사대상의 평균연령은 67.44세(16~91세)로, 남성은 34명, 여성은 41명이었고, 혈압과 심박동수는 검사직전에 측정된 혈압과 심박동수를 사용하였다. 최대강도신호 관상면 영상에서 MCA부위에 HU값을 측정하였고, 측정한 HU값의 측정오류를 최소화하기 위하여 한 연구자가 근위부에서 원위부까지 각각 3회씩 측정하여, 이들 HU값의 평균과 표준편차를 구했다. 통계분석은 성별, 나이, 혈압, 심박종수 체중, 신장, BMI의 평균비교를 위해 독립표본 t-test 검정을 시행하였고, p<0.05인 경우에 통계학적으로 유의한 것으로 보았다. 결과 Brain CTA 검사 후 최대강도선호 관상면 영상에서의 HU 측정값은 HU1 위치에서는 483.09±53.46, HU2 위치에서는 452.49±50.31, HU3 위치에서는 413.63±51.46으로 측정 되었고, 이 세 부위의 평균값은 449.79±49.47으로 나타냈다. 각 환자 인자 값에 HU값과의 독립표본 t-test 검정을 한 결과 나이, 혈압, 성별, BMI에서는 HU값의 변화와 유의성이 떨어지는 것으로 나타났고(p>0.05), 몸무게와 신장 및 심박동수와는 유의하게 나타났다(p<0.05). 결론 Brain CTA검사 시 혈관들이 기시부에서 말단부까지 대조도가 높고 균일해야 검사가 잘 되었다고 말할 수 있으며, 보다 나은 영상를 제공하여 질환을 판별하는데도 유용하므로 좀 더 좋은 영상을 얻기 위해서는 환자의 인자에 따른 검사 조건을 조정을 한다면 더욱더 정확한 검사가 될 것으로 생각된다. I. Purpose In this study, who presented Brain CTA scan in patients with disease-free after contrast injection of contrast agent to reach the MCA by examining the value of HU, the patient’s gender, age, height, weight, heart rate, blood pressure, BMI for the HU if any relevant changes in the values investigated. II. Materials & Method July-December 2010 University Hospital, Gwangju C Brain CTA patients admitted to the emergency room for examination of patients with visual readings disease were investigated in 75 patients. 67.44 The average age of survey length, male 43, female 41 patients, blood pressure, heart rate and blood pressure and heart rate measured immediately before the tests were used. MIP coronal image area in the MCA was measured in the HU value of the measured HU values in order to minimize measurement: errors, a researcher from the proximal to distal, each measured three times, they got HU mean and standard deviation values. Statistical analysis of gender, age, blood pressure and heart rate weight, height, BMI compared to the average for the independent samples t-test was performed to test, p<0.05 as statistically significant if looked at. III. Result Brain CTA MIP image after the test location in the HU measurements in HU1 483.09±53.46, HU2 position, the 452.49±50.31, HU3 position, the measuring 413.63±51.46, and the average of these three areas appeared as a 449.79±49.47. HU values - value for each patient factors independent sample t-test results of one test for age, blood pressure, gender, BMI change and the HU values appeared to be less significance (p>0.05), body weight and kidney, and heart rate and showed a significantly(p<0.05). IV. Conclusion Brain CTA inspections vessels originating by the Department distal to the contrast is high and be uniform inspection went well to say, and a better image by providing a disease to determine the useful for, so a better image in order to obtain the patient’s argument according to the inspection protocol If the adjustment is considered to be more accurate tests.

IV route에 따른 Neck CTA 영상의 적정성에 관한 고찰

정명진(Myung Jin Jung),전재두(Jae Doo Jeon),정지훈(Ji Hoon Jung),박상록(Sang lok Park),전진만(Jin Man Jeon),노지숙(Ji Sook Noh) 대한CT영상기술학회 2012 대한CT영상기술학회지 Vol.14 No.2

목적 본 연구에서는 Ⅳ route에 따라 Neck CTA검사 시 Ⅳ route 확보에 대한 문제점의 해결과 높은 진단영상 획득을 위한 프로토콜을 제시하고자 한다. 대상 및 방법 2011년도 12월부터 2012년 2월까지 광주광역시 C 대학병원에 Neck CTA 검사를 위해 내원한 환자 중에서 영상판독결과 질환이 없는 환자를 대상으로 하였고, Ⅳ route를 상지혈관에 확보한 환자 23명과 하지혈관에 확보한 환자 30명을 연구대상으로 조사하였다. Curved MPR 영상에서 ICA부위에 HU값을 측정하였고, 측정한 HU값의 측정오류를 최소화하기 위하여 한 연구자가 근위부에서 원위부까지 각각 3회씩 측정하여, 이들 HU값의 평균과 표준편차를 구했다. 평가방법은 영상의학과 전문의 2명, 방사선사 3명에 의해 평가하였으며, 조영제에 의한 인공물이 혈관에 미치는 정도와 조영증강 정도에 따라 최고점수 5점을 부여하였고, 나머지는 차례로 1점 단위로 하위점수를 부여하여 평가하였다. 통계분석은 독립표본 t-test 검정을 시행하였고, p<0.05인 경우에 통계학적으로 유의한 것으로 보았다. 결과 상지에 혈관을 확보한 군의 HU 평균값은 463.36±94.77, 하지에 혈관을 확보한 군의 HU 평균값은 372.98±74.32로 나타났고, 영상 평가한 결과 상지에 혈관을 확보한 환자의 검사영상에서 4.14±0.81점, 하지에 혈관을 확보한 환자의 검사영상에서 4.18±0.65점으로 나타났다. HU값과 영상평가에 따른 독립표본 t-test 검정을 한 결과 통계적으로 유의하였다 (p<0.05). 결론 Neck CTA 검사 시 상지에 혈관을 확보 시에도 Dual injector를 이용한 조영제와 생리식염수를 투여하고 검사방향을 머리에서 발쪽으로 높은 피치로 검사함으로써, 견측 부위에서의 조영제로 인한 인공물 발생을 줄일 수 있어 진단적으로 양질의 영상을 얻을 수 있었다. I. Purpose This study aims to present a protocol to attain solutions to problems involving Ⅳ route in Neck CTA and acquire diagnostic images according to Ⅳ routes. II. Meterial and Methods For the purpose, this study analysed patients who came to C university hospital for Neck CTA from December 2011 to February 2012 and had no diseases as a result of image reading. The subjects were categorized in the following: 23 patients with Ⅳ route at their upper extremity and 30 ones with Ⅳ route at their lower extremity. HU values were measured at the ICA of the curved MPR images and to minimize errors in the HU values, this study measured them from the proximal to the distal three times for a subject to obtain means and standard deviations. Two radiologists and three radiological technologists participated in the evaluation, and a maximum of five points were given according to the degrees that contrast media affected blood vessels and the intensity of contrast enhancement, and sub-points were given to the rest. For a statistical analysis, a t-test was conducted and in case of p<0.05, it was suggested that it was significant. III. Result The mean HU values of the group with Ⅳ route at the upper extremity were 463.36±94.77 and those of the group with Ⅳ route at the lower extremity were 372.98±74.32. As a result of evaluating the images, the points of the former subjects were 4.14±0.81 and those of the latter subjects were 4.18±0.65. It was discovered that the results of the HU values and the t-test were statistically significant(p<0.05). IV. conclusions In the Neck CTA, to secure IV routes at the upper extremity, contrast media and saline were injected with a use of a dual injector and an examination was done from the head to the leg to decrease occurrence of artificial things due to contrast media and to attain good-quality images.

CT검사에서 환자정보관리 프로그램을 이용한 조영제 주입 후 모니터링 시간 변경에 따른 피폭선량 감소에 관한 연구

나유리(Yu Ri Na),전진만(Jin Man Jeon),정명진(Myung Jin Jung),노지숙(Ji Sook Noh) 대한CT영상기술학회 2012 대한CT영상기술학회지 Vol.14 No.1

목적 CT검사 시 조영제 주입 후 모니터링 시간에 따라 환자의 피폭선량에는 많은 차이가 있다. 본 연구에서는 조영제 주입 후 모니터링 시간과 모니터링 과정에서의 피폭선량을 환자정보관리 프로그램에 기록하고 추후 검사 시 이를 참고하여 모니터링 과정에서 시간과 mAs를 변경하여 검사한 후 선량 감소가 되는지 알아보고자 한다. 대상 및 방법 2010년 6월부터 2011년 6월까지 두부 CT검사와 흉부 CT검사를 시행하는 환자를 대상으로 환자정보관리프로그램에 조영제 주입 후 모니터링 시간과 모니터링 과정에서의 환자의 피폭선량을 기록하였다. 환자정보관리 프로그램에 입력된 환자수는 총 150명이었으며 추적 시행한 환자수는 총 50명으로 두부CT와 흉부CT에 각각 25명이었다. 장비는 64절편 MDCT(Philips brilliance 64, Philips Medical System, Cleaveland, USA)를 이용하였으며 추적검사 전 두부CT의 경우 관전압 120kVp와 선량 10mAs를 사용하였고, HU값은 300으로 하고 2초 간격으로 스캔하였다. 흉부CT는 관전압 120kVp와 전량 30mAs를 사용하였고, HU값은 150으로 하고 2초 간격으로 스캔하였다. 추적검사 시 두 검사 모두 선량을 장비가 할 수 있는 최소 mAs로 변경하였다. 추적 검사를 시행한 환자 50명에 대해 전후 모니터링 시간과 선량을 조사 분석하였다. 결과 두부CT를 추적 검사한 환자에서 조영제 주입 후 모니터링 시간을 변경하여 검사하였을 때 변경 전ㆍ후 시간은 평균 10.84s 감소하였고 선량은 34.944mGy에서 3.776mGy 평균 31.168mGy 감소하였다. 흉부CT를 추적 검사한 환자에서는 변경 전ㆍ후 시간은 평균 9.80s 감소하였고 선량은 18.396 mGy에서 4.8 mGy로 평균 13.596mGy 감소하였다. 결론 환자정보관리 프로그램을 이용한 추적환자의 CT검사에서 조영제 주입 후 모니터링 시간을 변경하여 검사함으로써 환자의 피폭을 줄일 수 있었다. I. Purpose CT scan after injecting contrast agents for monitoring patients over time, there dare many differences in the radiation dose. In this study, after injecting contrast medium in the process of monitoring time and monitoring the radiation dose to the patient records and information management program for future inspection and monitoring in the course of time and refer to it by changing the mAs reduction in dose is then scanned to investigate. II. Materials and Method June 2010-June 2011 head CT scan and chest CT scans performed in patients with a patient information management program after injecting contrast medium in the process of monitoring time and monitoring the patient1s radiation dose was recorded. Patient Information Management program, a total of 150 people. head CT and chest CT of 50 people each had 25 people. Equipment is 64-slice MDCT(Philips brilliance 64, Philips Medical System, Cleaveland, USA) was used track before the test head CT dose, 120 kvp and 10 mAs was used, HU 300, and every two seconds to scan were 120 kvp with a dose chest CT was used 30 mAs, HU values, and 150 were scanned every two seconds. Both the two tests at follow-up doses can be the instrument was changed to the minimum mAs. Around 50 people who underwent. monitoring for tracking time and dose were investigated. III. Result Track head CT scan after injecting contrast agents in patients who monitored the test by changing the time before the change when, hours after the dose is decreased by an average of 10.84sec at 34.944mGy to 3.776mGy average fell 31.168 mGy. Chest CT scan to track changes in a patient before and after an average of 9.80 s 18.396mGy dose was reduced from an average of 4.8mGy was reduced 13.596 mGy. IV. Conclusion Using patient information management programs track the patient’s CT scan after contrast agent injection monitoring by changing the amount of time by checking the patient’s dose could be reduced.

측두골 질환의 진단을 위한 검사 추이분석 : 일반촬영, CT촬영과의 비교

차장원(Jang Won Cha),전진만(Jin Man Jeon),전재두(Jea doo Jeon),노지숙(Ji sook Noh) 대한전산화단층기술학회 2007 대한CT영상기술학회지 Vol.9 No.1

Purpose As there is to a disease of temporal bone, will recognize a tendency recent of an inspection for a diagnosis of a comparative analysis temporal bone disease to the patient who executed the Temporal bone CT which used CT equipment and the pati-ent who executed a general radiography inspection. Materials and methods Investigated the patient who executed a patient, general radiography inspection and the Temporal bone CT inspection that executed a Temporal bone CT inspection within a period like the patient who executed a general radiography inspection of mastoid general of mastoid at the same time by the inspection number of cases by diseases to the objects for three years until 2006 August from 2003 August. Also, general radiography inspector and CT thread inspector executed was Moniter-ing the 30 people of 155 people who inspected Temporal bone CT in the times like the general radiography 10 people who inspected of mastoid during patients until August from 2006 January. The Monitering is Investigated whether or not there was inconvenience of a inspector after inspection time an inspection, inspections whether or not there was image acquisition time, inconvenience of a patient. Results Showed the results compared with the patient 200 people who inspected general radiography of total Mastoid series to 32 people in 2005 years at 82 people in 2003 years during general radiography inspections of Mastoid series inspection case number decrease, and the annual increasing Temporal bone CT inspections of inspection case number that compared with the total 648 people who inspected Temporal bone CT to 233 people in 2005 at 96 people in 2003, and to increase. Also, Answered that were inconvenient, and general radiography than CT, patients and inspector too. and general radiography was over the 10 minutes but CT appeared to inspection time of the 10 minutes under and the time that it takes in an inspection is in an inconvenience matter in case of an inspection answered. Conclusion Inspection time is short, and there is not inconvenience and the CT inspection a patient or a inspector are increasing every year compare with general radiography inspections as accuracy of an inspection is high. Think that it must be improved in the trend that an CT inspection is enlarged to have a lot of regulation of insurance application in order to let you reduce an economic burden of a patient. As there are more advantages CT than general radiography in spite of these economic burdens recent and to diagnosis a disease of a temporal bone CT inspections than be used so as to be useful

외상에 의한 흉곽 골절에 유용한 다절편 CT의 재구성 영상

김승국(Seung Kook Kim),노지숙(Ji Sook Noh),전재두(Jea Doo Jeon),전진만(Jin Man Jeon),김동훈(Dong Hoon Kim) 대한CT영상기술학회 2007 대한CT영상기술학회지 Vol.9 No.1

Purpose This article evaluate the usefulness of three-dimensional reconstructive images using multi detector computed tomography (MDCT) in thoracic traumatic patients visiting emergency room clinics for out-patients. Materials and methods 76 patients with fractures of 105 patients who visited our emergency room complaining of thoracic trauma were analyzed retrospectively. All patients performed thoracic MDCT and three-dimensional reconstructive images were taken. Fractures were confirmed by axial CT, clinical information, whole body bone scan, and multi planar reformation images. Plain x-ray was analyzed by fractured sites in a blind comparison of two radiologists’ readings, and then that finding was compared with them of axial CT scans and three-dimensional reconstructive images. Results The fracture sites were rib (n=68), sternum (n=14), clavicle (n=6), scapula (n=3), spine (n=5) and combined fractures (n=14). Plain x-ray and axial CT scans had correspondency of 0.555 for rib fractures. Axial CT scans and three-dimensional reconstructive images had 0.952. For sternal fracture, those were 0.692 and 0.928 each. Axial CT scans and three-dimensional reconstructive images showed sensitivities for rib and other fractures, 94 % and 91 % and for sternal fracture, 93 % and 100 % each. Three-dimensional reconstructive image had high sensitivity in the diagnosis of sternal fracture especially. Conclusion While evaluating thoracic trauma at emergency room, three-dimensional reconstructive image was useful to diagnose extent of fracture easily and very sensitive to detect sternal fracture.

Accuracy comparison of buccal bite scans by five intra-oral scanners

박지만,전진,허성주,Park, Ji-Man,Jeon, Jin,Heo, Seong-Joo Korean Academy of Stomatognathic Function and Occl 2018 구강회복응용과학지 Vol.34 No.1

목적: 이 연구의 목적은 다양한 구강 스캐너를 사용하여 협측 악간관계 스캔에 따른 상하악 악궁 관계의 정확성을 비교 평가하는 것이다. 연구 재료 및 방법: 정상 교합을 보이는 상하악 전악 모델을 5종(Cerec Omnicam, CS3500, iTero, Trios, TruDef)의 구강 스캐너로 제조사의 지시대로 스캔하였다. 폴리비닐실록산 교합 재료로 고정시킨 금속 지그를 이용하여 우측 구치부를 1, 2, 3, 4 mm 단계적으로 올린 후 좌측 협측 악간관계 스캔을 채득하였다. 두 데이터를 중첩하여 전체적인 삼차원 변이를 평가하였고, 교합 평면에 수직인 단면을 분석하여 교두간 거리의 양과 방향을 평가하였다. 결과: 중첩연구에서 Cerec Omnicam ($165.5{\mu}m$)이 가장 적은 변이를 보였고, CS3500 ($369.0{\mu}m$)이 가장 큰 변이를 보였으며(P < 0.01), 1 mm 보다 3, 4, 2 mm 이개 그룹에서 변이가 유의미하게 컸다(P < 0.01). 단면 연구에서는 Cerec Omnicam이 교두끼리의 거리가 가장 먼 변이를 보였고($-242.8{\mu}m$), CS3500이 가장 가까워지는 변이를 보였으며($312.5{\mu}m$), 다른 거상 높이 보다 3 mm 이개 그룹에서 유의하게 변이가 컸다(P < 0.01). 결론: 구강 스캐너 마다 협측 악간관계 스캔을 이용해 상하악 교합 관계를 재현하는 정확성이 달랐다. Purpose: The purpose of this study was to investigate the accuracy of the interocclusal relationship between upper and lower teeth according to the buccal interocclusal record scan using various intraoral scanner systems. Materials and Methods: The upper and lower full arch Models with normal occlusion were scanned with 5 intraoral scanners (Cerec Omnicam, CS3500, iTero, Trios, True Definition). Buccal interocclusal record scan was taken only at the left side while occlusion was intentionally raised by 1 mm, 2 mm, 3 mm, and 4 mm with metal cylinder core embedded within polyvinylsiloxane bite registration material at the right molar region. The superimposition analysis was done to evaluate overall three-dimensional deviation and cross-section analysis was done to evaluate the degree and the direction of deviation of interocclusal relationship. Results: From the superimposition study, Cerec Omnicam showed the least deviation ($165.5{\mu}m$) and CS3500 ($369.0{\mu}m$) showed the largest (P < 0.01). And the deviation was greater in 3, 4, 2 mm group than 1 mm (P < 0.01). From the cross-section study, Cerec Omnicam showed the farthest deviation ($-242.8{\mu}m$) and CS3500 showed the closest deviation ($312.5{\mu}m$) and a significantly high value was shown in 3 mm group. Conclusion: Every intraoral scanner has different accuracy in reproducing interocclusal relationship.

Accuracy comparison of buccal bite scans by five intra-oral scanners

Ji-Man Park(박지만),Jin Jeon(전진),Seong-Joo Heo(허성주) 대한턱관절교합학회 2018 구강회복응용과학지 Vol.34 No.1