간 방선상균증의 CT와MR소견: 증례 보고

정용연,강형근,Jeong, Yong-Yeon,Gang, Hyeong-Geun 대한영상의학회 2003 대한영상의학회지 Vol.48 No.4

방선상균증은 Actinomyces에 의한 만성적인 감염성 질환으로 크게 목얼굴형(cervicofascial), 흉부형과 복부형의 세가지 형태로 구분할 수 있는데, 간 방선상균증은 복부형의 약 15%를 차지하는 흔하지 않은 형태이다. 방선상균증에 대한 보고는 많이 있으나 간에 생긴 방선상균증의 자기공명영상에 대한 문헌 보고는 거의 없었다. 저자들은 간에 생긴 방선상균증 1예에서 관찰된 전산화 단층촬영 및 자기공명영상 소견을 보고하고자 한다. Actinomycosis is an uncommon chronic infectious disease caused by Actinomyces. There are three distinct forms of the condition, namely cervicofascial, thoracic, and abdominal; the hepatic variety is an unusual form of abdominal actinomycosis, accounting for about 15% of cases of this type. Many reports of actinomycosis have been published, but few have detailed the MR findings of hepatic actinomycosis. We describe the contrast-enhanced CT and MR findings in one case of hepatic actinomycosis.

간VX2암종의 맥관형성평가: 관류 CT의 유용성

정용연,강형근,윤웅,김정,서정진,정태웅,정광우 대한영상의학회 2003 대한영상의학회지 Vol.49 No.1

[만화] 곤충기

정용연 새얼문화재단 2011 황해문화 Vol.72 No.-

성인에서 발생한 석회화성 중배엽성 신종: 1예 보고$^1$

정용연,강형근,Jeong, Yong-Yeon,Gang, Hyeong-Geun 대한영상의학회 2002 대한영상의학회지 Vol.46 No.3

중배엽성 신종은 신생아에서 흔하지 않게 보고되고 있으며, 성인에서 발생한 경우는 매우 드물다. 저자들은 성인에서 종괴 내부에 석회화를 동반하고 있어 신세포암과 감별이 어려운 중배엽성 신종 1예를 보고하는 바이다. Mesoblastic nephroma is an uncommon renal tumor reported in infants but rarely in adults. We describe a case of calcified mesoblastic nephroma occurring in an adult. It is difficult, on the basis of radiologic images, to differentiate between calcified mesoblastic nephroma and calcified renal cell carcinoma.

자궁 경부암이 있는 가임기 여성에서 방사선치료 전후 자기공명영상에서 난소의 변화

정용연,강형근,임효순,윤웅,정태웅,서정진,Jeong, Yong-Yeon,Gang, Hyeong-Geun,Im, Hyo-Sun,Yun, Ung,Jeong, Tae-Ung,Seo, Jeong-Jin 대한영상의학회 2001 대한영상의학회지 Vol.45 No.6

목적: 자궁 경부암을 가진 가임기 여성에서 방사선 치료 전후 난소의 변화를 자기 공명(Magnetic Resonance, MR)영상에서 알아보고자 하였다. 대상과 방법: 자궁경부암이 있는 가임기 여성에서 방사선치료를 하고 치료 전과 후에 MR 검사를 시행한 33명을 대상으로 하였다. 총 방사선 조사량은 평균 11,279cGy (체외 평균:5,352 cGy, 체내 평균:5,927 cGy)였다. MR 추적 영상은 치료 도중(n=29)혹은 치료 후(n=4)에 얻었다. MR 영상은 환자의 횡단면 T1 강조영상, 횡단면과 시상면 T2강조영상을 얻었다. 두 명의 방사선과 의사의 합의 하에 난소의 존재 유무, 난소의 크기, 난소당 낭종의 수와 난소의 수질과 피질의 구역 구분 유무를 분석하였다. 결과: 모든 환자는 월경의 소실이 있었다.방사선치료 전 MR 영상에서는 94%(62/66), 치료 후 MR 영상에서는 39%(26/66)에서 난소가 발견되었다(p <.05). 난소의 평균 크기는 방사선치료 전 2.6 $\times$1.9 $\times$2.2 cm, 치료 후에는 1.7 $\times$1.3 $\times$1.4 cm 였다(p <.05). 난소 당 낭종의 수는 방사선치료 전 평균 5.1개, 치료 후 평균 3.1개였다(p <.05). T2강조영상에서 난소의 구역 구분은 방사선치료 전 74%(46/62), 치료 후에는 15%(4/26)에서 가능하였다(p <.05). 결론: 자궁 경부암 환자에서 방사선 치료 후 난소 발견율 및 크기가 감소하였고, 난소의 구역 구분이 불가능해진 경우가 많았다. 이는 정상적인 폐경기 난소의 변화와 유사하며 MR 영상이 방사선 치료후 난소의 구조적 변화를 반영할 수 있다고 생각된다. Purpose: To investigate changes in the ovary revealed by MR imaging before and after radiotherapy in premenopausal patients with cervical carcinoma. Materials and Methods: Thirty-three premenopausal patients with cervical carcinoma underwent radiation therapy at an average dosage of 11,279 (external: 5,352; internal: 5,927) cGy. Before and after this therapy, all underwent pelvic MR imaging using a 1.5T MR scanner (GE Medical Systems, Milwaukee, U.S.A.). The average interval of follow-up MR imaging was 7.2 months, and axial T1-weighted and axial and sagittal T2-weighted MR images were obtained. The presence, size number of follicles, and differentiation of the zonal anatomy of the ovary were determined by two radiologists, who reached a consensus. Results: After radiation therapy, all patients ceased menstruation. For ovaries, the detection rates before and after radiation therapy were 94% (62/66) and 39% (26/66) (p<0.05), respectively, and average ovary size was 2.6${\times}$1.9${\times}$2.2 cm before and 1.7${\times}$1.3${\times}$1.4 cm after therapy (p<0.05). The average number of ovarian follicles before and after therapy was 5.1 and 3.1, respectively (p<0.05). T2-weighted imaging, demonstrated differentiation of zonal anatomy in 74% of cases (46/62) before radiotheraphy, and 15% (4/26) after (p<0.05). Conclusion: Our study has shown that after radiation therapy in premenopausal patients with cervical cancer, detection rates, average size, and the number of ovaries decreased, findings which are similar to those for normal postmenopausal ovary. MR imaging can reveal structural change in ovaries.

Gd-BOPTA 조영증강 지연기 MR영상에서 국소 간종괴의 조영증강양상

정용연,강형근,신상수,임효순,윤웅,박승진,Jeong, Yong-Yeon,Gang, Hyeong-Geun,Sin, Sang-Su,Im, Hyo-Sun,Yun, Ung,Park, Seung-Jin 대한영상의학회 2003 대한영상의학회지 Vol.49 No.5

목적:Gd-BOPTA 지연기 영상에서 간종양의 조영증강의 양상과 감별진단에 도움이 되는 소견을 알아보고자 하였다. 대상과 방법:국소적 간종양(간세포암;32예,혈관종;15예,전이암 1 4예 및 간담도암;3예)이 있어 Gd-BOPTA 조영증강 M R I를 시행한 4 0명의 6 4예의 국소 간종양을 대상으로 하였다.1.5T MR 기기에서 조영전과 G d -B O P T A 를 주입한 후 역동적 조영증강영상과 지연기(6 0분)에 in-phase T1강조 경사에코영상을 얻었다.조영전과 지연기에서 정량적 분석은 간실질의 대조 잡음비(signal to noise ratio,이하 S N R )와 종양과 주변 간실질의 대조 잡음비(contrast to noise ratio,이하 CNR )와 병변의 조영증강률(enhancement percentage of lesion,이하 EPL )을 구하였다.정성적 분석은 지연기에 조영증강 양상 및 종양의 명확도(lesion conspicuity)를 두 명의 방사선과의사가 독립적으로 분석하였으며 이견이 있는 경우는 합의점을 찾았다. 결과:간의 SNR은 조영전 영상보다 지연기영상이 통계적으로 유의하게 증가하였다(p<.05).전체 병변의 절대값 CNR은 조영전에 비하여 지연기 영상에서 유의하게 증가하였다(p<.05).종양의 E P L은 모든 종양에서 조영전에 비해서 지연기영상에서 증가를 보였다.병변의 명확도는 조영전과 지연기영상과 차이가 없었다(p>.05).간세포암에서 불균질한 저신호강도,간혈관종은 균질한 동 또는 고신호강도,전이암은 과녘모양의 조영증강이 가장 흔한 조영증강 형태였다. 결론:Gd-BOPTA 의 지연기영상에서 간세포 기원의 간세포암 뿐만 다른 국소 간종양도 조영 증강되어 지연기 조영증강 양상만으로 병변의 감별에는 한계가 있으리라 생각된다.그러나 지연기 영상에서 혈관종의 균질한 등신호 또는 고신호강도의 조영증강과 전이암의 과녘모양의 조영증강양상은 다른 종양과 감별진단하는데 도움이 되는 소견이라 생각된다. Purpose: To investigate the enhancement pattern occurring at delayed gadobenate dimeglumine (Gd-BOPTA) MR imaging, as used to characterize focal hepatic tumors. Materials and Methods: Forty patients with 64 focal hepatic tumors (32 hepatocellular carcinomas [HCC], 15 hemangiomas, 14 metastasis and 3 cholangiocarcinomas) underwent MR imaging before and 60 minutes after the intravenous administration of 0.1 ml/kg Gd-BOPTA. For all MR studies, a 1.5-T MR system was used, and T1-weighted in-phase gradient echo (GRE) imaging was porformed. The quantitative assessment of early and delayed images included determination of the signal-to-noise ratio (SNR), tumor-to-liver contrast-to-noise ratio (CNR), and degree of enhancement (DE). Two experienced radiologists evaluated lesion conspicuity and the pattern of contrast enhancement (CE), reaching their conclusions by consensus. Results: At delayed imaging, SNR and CNR showed significant increases (p>0.05), and the DE of all lesions had also increased. Lesion conspicuity, however, was not significantly different between (p>0.05). The most common enhancement patterns seen at delayed imaging were inhomogeneous hypointense in HCCs, homogeneous iso- or hyperintense in hemangiomas, and target-like in metastases. Conclusion: At delayed imaging with Gd-BOPTA, tumors of both hepatocytic and non-hepatocytic origin showed enhancement, and in the characterization of focal hepatic lesions, observed differences in enhancement are thus of limited usefulness. However, the observed homogeneous iso- or hyperinteuse enhancement of hemangiomas, and the target-like enhancement of metastases, may help differentiate then from other tumors

원발성 간암의 영상학적 감별진단

정용연 대한간학회 2005 Clinical and Molecular Hepatology(대한간학회지) Vol.11 No.1(S)

뇌종양의 병기결정에서 자기공명영상의 유용성:가토를 이용한 실험 모델과 임상 증례 비교

정용연,강형근,서정진,김윤현,박진균,김재규,정현대,오종석,이민철 대한영상의학회 1997 대한영상의학회지 Vol.37 No.6

Purpose:The purpose of this study is to evaluate th usefulness of MR imaging in the staging of brain abscesses and to determine the correlations between pathologic and MR findings. Materials and Methods: Experimental brain abscesses were induced by direct inoculation of 1ml suspension of $10^6$/ml Streptococcus pneumoniae into the brain parenchyma of ten New Zealand white rabbits. The evolution of abscess formation was divided inro four stages, based on pathological, criteria : early cerebritis (days 1 to 5), late cerebritis )days 6 to 10), early capsular (days 11 to 15), and late capsular (day 16 and later). The brain abcsess of each animal was exmained by MR imaging and light microscopy at 3, 8, 13, and 28 days;T1-weighted, T2-weighted and Gd-enhanced images were obtained. The MR images and pathologic findings of 13 pathologically confirmed clinical cases were compared to MR images of the experimental model. Results:In the experimental model, signal intensity of the abcsess content was at all stages hypointense on T1-weighted and hyperintense on T2-weighted images. In all ten cases, Gd-enhanced images showed an ill-defined contrast-enhanced leison at the early cerebritis stage, and in four of seven cases, irregular ring enhancement at the late cerebritis stage. Pathologic specimens at this latter stage revealed prominent vascular proliferation and infiltration to chronic inflammatory cells. Signal intensity of the abscess wall during the capsular stage showed isointense relative brain parenchyma on T1-weighted images and this was hypointense on T2-weighted images. Gd-enhanced images demonstrated smooth ring enhancement of the abscess wall. At the early capsular stage, pathologic specimens revealed a discrete necrotic center surrounded by infiltration of reticulin and some collagen;at the late capsular stage, these specimens showed marked infiltration of collagen. In clinical cases, the signal intensity of abscess content was at all stages demonstrated ill-defined subtle contrast enhancement at the early cerebritis stage and irresular ring enhancement at the late cerebritis stage. In all cases, signal intensity of the abscess wall during the capsular stage was hypointense on T2-weighted images;at this stage, the abscess wall was showed a pattern of smooth ring enhancement. In clinical cases, hypointensity of the abscess wall, as seen on T2-weighted images, and the enhancement pattern of this wall were identical to these findings in the experimental model. Conclusion:In an experimental model, correlation between sequential MR findinds can be used to predict the stage of a brain abscess;in clinical cases essential indicators are hypointensity and enhancement pattern of the abscess wall, as seen on T2-weighted images. In cases of brain abscess, MRI is a useful diagnostic modality, and in such cases, also helps determine the most suitable treatment.

Molecular Imaging

정용연 대한소화기학회 2007 대한소화기학회 춘계학술대회 Vol.2007 No.-

MR Imaging Findings of Clonorchiasis

정용연,강형근,김진웅,윤웅,Tae Woong Chung,Seog Wan Ko 대한영상의학회 2004 Korean Journal of Radiology Vol.5 No.1

Clonorchiasis is an important parasitic disease of the bile ducts caused by chronic infestation of Clonorchiasis sinensis following ingestion of raw freshwater fish flesh in East and South-east Asia (1, 2). Clonorchiasis is one of the most frequent causes of cholangiocarcinoma and cholangitis in endemic countries, and therefore its early diagnosis is critical for the prevention of complications (3 5). Several reports have described the radiological features of clonorchiasis on holangiography, ultrasonography and CT (6 10). MR imaging has been used in the diagnosis of various diseases of the biliary system, and MR cholangiography (MRC) is a relatively new noninvasive type of imaging for evaluation of the extrahepatic biliary pathology (i.e. strictures, stones, and obstruction). MR cholangiography is generally comparable with endoscopic retrograde cholangiopancreatography (ERCP) for the demonstration of segmental and peripheral intrahepatic bile ducts, and may show intrahepatic ductal abnormalities in a comparable fashion to that of ERCP (11 14). To our knowledge, only one radiological report has briefly reviewed the MR findings of clonorchiasis (15). The purpose of our study was to evaluate the MR imaging and MRC findings of clonorchiasis.