대학생 상품화하는 방송프로그램 자제해야

최나미 사회발전연구소 1993 한국인 Vol.12 No.6

간경변증과 만성간염의 감별에 조영증강 회색조하모닉영상에서 측정한 간정맥전이시간의 유용성

최나미,이원재,임효근,임재훈 대한초음파의학회 2004 ULTRASONOGRAPHY Vol.23 No.3

PURPOSE : To evaluate the usefulness of the hepatic vein transit time (HVTT) obtained by contrast-enhanced gray-scale harmonic imaging for the detection of liver cirrhosis (LC) in patients with chronic hepatitis (CH). MATERIALS and METHODS : Over a recent 8-month period, 31 patients with pathologically proven chronic hepatitis and liver cirrhosis (n=8) or chronic hepatitis alone (n=23) were prospectively examined using contrast-enhanced pulse inversion harmonic imaging (HDI 5000: Philips, Bothell, Wash). The HVTT was defined as the time interval from the initiation of an intravenous bolus injection of a microbubble contrast agent to the arrival time of the first echogenic bubbles in the hepatic vein. The HVTTs of the LC and CH groups were compared. Also, the diagnostic value of different values or ranges of HVTT for the detection of LC was assessed. RESULTS : The HVTT of the patients with LC (range, 11-22 seconds; mean, 16.1±3.8 seconds) was significantly shorter than that of the patients with CH (range, 13-35 seconds; mean, 22.7±5.8 seconds) (p < .001). An HVTT of 22-24 seconds showed a sensitivity of 100%, but poor specificity (39-52%) and a poor positive predictive value (32-45%) for the detection of LC. In the range of HVTT from 18 to 24 seconds, 19 seconds seemed to provide the best predictive value for the detection of LC. CONCLUSION : HVTT appears to be useful for the detection of LC in patients with CH, however further study is 목적 :만성간염 환자에서 간경변증을 검출하는 데 있어 조영증강 회색조하모닉영상에서 측정한 간정맥전이시간의 유용성을 알아보고자 하였다.대상 및 방법 : 8개월 동안 조직학적으로 확진된 간경변증(n=8)이나 만성간염(n=23)을 가진 31간은 초음파조영제를 정맥에 일시 주사한 후 미세기포가 우간정맥에 최초로 도달하는 시간을 측정하여 얻었다. 측정 항목은 간경변증 환자와 만성간염 환자 간의 간정맥전이시간을비교하였고, 여러 간정맥전이시간의 간경변증 진단에 대한 진단값을 구하였다.결과 : 간정맥전이시간은 간경변증 환자에서 11-22초(평균, 16.1±3.8초), 만성간염 환자에서 13-< .001). 간경변증 진단에 대한 간정맥전이시간 22-24초는 100%의 민감도를 보였으나 특이도(39-52%)와 양성예측도(32-45%)의 값은 저조하였다. 간정맥전이시간 18-24초 중에서는 19초에서 가장 우수한 진단값을 보였다. 결론 : 간정맥전이시간은 만성간염 환자에서 간경변증을 검출하는데 유용한 것으로 생각된다. 그러나 우리 결과에서 얻어진 진단값이 제한적인 점을 고려하면 더 많은 연구가 필요할 것으로 생각된다.

2차 의료기관에서 국가암검진사업으로 시행된 선별유방 촬영술: 1년간의 성적 보고

최나미,이아름,이혜경,차장규,이범하 대한영상의학회 2009 대한영상의학회지 Vol.60 No.1

Purpose: We performed a medical audit of the mammograms performed as part of the existing public cancer screening program to propose a plan for improving the program. Materials and Methods: We analyzed the results of 3,317 mammograms performed between March 2006 and February 2007. The American College of Radiology Breast Imaging Reporting and Data System (ACR BI_RADS) guidelines were used for follow-up and outcome monitoring. Cases in categories 0, 4, and 5 were followed up by a review of the patient's medical records and a phone call survey to determine the reasons for not continuing with follow-up examinations. Results: The mean age of the women enrolled in this study was 51 years. The rate of recall was approximately 6.4% and the cancer detection rate was 2.1 out of every 1000 women examined. Positive predictive values (PPV) of 1, 2 and 3 were observed in 3.3%, 33.3% and 70.0%, respectively. The sensitivity and specificity were 100% and 93.8%, respectively. As a result of the phone-call survey to determine the reasons for not following up with additional examinations, 53.8% of cases were 'belittled since there was no subjective symptom,' and 16.3%, 'didn't check the cancer examination notice thoroughly or did not fully understand it'. Conclusion: The result of medical audit indicates that reading and follow-up examinations were conducted in a relatively proper manner. Taking into consideration the characteristics of the objects for public examination, it is thought that active follow-up management as well as a written notice of the results, is necessary for patients who were found to be abnormal. 목적: 국가암검진사업항목으로 40세 이상 여성에서 1년간 시행된 유방촬영술의 의학적 감사 결과를 보고하고, 효율적 공공검진을 위한 방안을 제시하고자 한다. 대상과 방법: 2006년 3월부터 2007년 2월까지 유방촬영술을 시행한 3,317명의 여성을 대상으로, 미국방사선학회에서 정한 유방영상판독 및 데이터체계의 권고에 따라 0에서 5까지 6단계로 분류하고, 추적 및 결과분석에서 제시한 바에 따라 의학적 감사를 시행하였다. 범주 0, 4, 5의 여성에 대하여 본원 의무기록과 전화로 그 결과를 추적하고, 추가검사를 시행하지 않은 여성에 대하여 그 이유를 조사하였다. 결과: 총 3,317건의 유방촬영술을 시행하였고 대상군의 평균연령은 51세였다. 범주 0, 4, 5는 212 예로 소환율은 6.4%였으며, 유방암 발견율은 2.1/1,000명(7/3317), 양성예측도 1은 3.3%, 양성예측도 2는 33.3%, 양성예측도 3은 70.0%였다. 민감도는 100%, 특이도는 3.8%였다. 추가검사 미시행 이유는‘자각증상이 없어 대수롭지 않게 생각했다’가 53.8%, 암 검진 결과통보서의 내용을 제대로 확인하지 못하거나 이해하지 못했다’가 16.3%로 조사되었다. 결론: 본원의 공공검진 유방촬영술의 판독과 추적검사는 적절하게 이루어졌으며, 이상소견이 발견 시는 대상군의 특성을 고려하여 서면을 통한 결과통보 이상의 더욱 적극적인 사후관리가 필요하리라 생각한다.

Thyroid Incidentaloma Detected by Time-Resolved Magnetic Resonance Angiography at 3T: Prevalence and Clinical Significance

최나미,문원진,김한영,노홍기,최진우 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.3

Objective: To determine the prevalence of thyroid incidentalomas detected by time-resolved magnetic resonance angiography (TRMRA) and to evaluate their clinical significance by using an ultrasonographic (US) and cytologic correlation. Materials and Methods: We retrospectively reviewed 2010 consecutive TRMRA examinations performed at our institution between August 2006 and April 2010. The TRMRA findings of thyroid incidentalomas were analyzed according to location, size, as well as vascularity, and were correlated with the US findings and cytologic results. Each nodule was classified as suspiciously malignant, indeterminate or probably benign according to the US criteria recommended by the Korean Society of Thyroid Radiology. Results: A total of 102 incidentalomas were detected in 90 of 2010 patients (5%). TRMRA showed homogenous hypervascularity in 48 (47%), inhomogeneous hypervascularity in 46 (45%), and hypovascularity in 8 (8%) thyroid nodules. At follow-up study, out of 26 patients with 30 incidentalomas on TRMRA, 27 nodules were identified on US. Of the 27 nodules, 24 (89%) nodule were classified as indeterminate, two (7%) as probably benign, and one (4%) as suspiciously malignant. Among the 16 nodules with available cytopathologic results, 14 (82%) were benign, one (6%) was indeterminate, and one (6%) was malignant. Conclusion: Thyroid incidentalomas are found in 5 % of TRMRA examinations. Although their presence does not necessarily indicate malignancy, nonspecific findings of detected incidentalomas on TRMRA require further evaluation by US. Objective: To determine the prevalence of thyroid incidentalomas detected by time-resolved magnetic resonance angiography (TRMRA) and to evaluate their clinical significance by using an ultrasonographic (US) and cytologic correlation. Materials and Methods: We retrospectively reviewed 2010 consecutive TRMRA examinations performed at our institution between August 2006 and April 2010. The TRMRA findings of thyroid incidentalomas were analyzed according to location, size, as well as vascularity, and were correlated with the US findings and cytologic results. Each nodule was classified as suspiciously malignant, indeterminate or probably benign according to the US criteria recommended by the Korean Society of Thyroid Radiology. Results: A total of 102 incidentalomas were detected in 90 of 2010 patients (5%). TRMRA showed homogenous hypervascularity in 48 (47%), inhomogeneous hypervascularity in 46 (45%), and hypovascularity in 8 (8%) thyroid nodules. At follow-up study, out of 26 patients with 30 incidentalomas on TRMRA, 27 nodules were identified on US. Of the 27 nodules, 24 (89%) nodule were classified as indeterminate, two (7%) as probably benign, and one (4%) as suspiciously malignant. Among the 16 nodules with available cytopathologic results, 14 (82%) were benign, one (6%) was indeterminate, and one (6%) was malignant. Conclusion: Thyroid incidentalomas are found in 5 % of TRMRA examinations. Although their presence does not necessarily indicate malignancy, nonspecific findings of detected incidentalomas on TRMRA require further evaluation by US.

Invasive Ductal Carcinoma in a Mammary Hamartoma: Case Report and Review of the Literature

최나미,고은숙 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.6

Mammary hamartomas are typically a benign condition and rarely develop into malignant lesions. Only 14 cases of carcinomas associated with a hamartoma have been documented in the literature. In this case report, we describe a case of invasive ductal carcinoma within a hamartoma in a 72-year-old woman. Mammography, ultrasonography, and magnetic resonance imaging showed the features of a typical hamartoma with a suspicious mass arising in it. This case illustrates the importance of identification of unusual findings in a typical mammary hamartoma on radiologic examinations.

난소 성숙기형종의 초음파 진단: 병리학적으로 증명된 112 증례의 형태학적 분석

최나미,김찬교,박병관 대한초음파의학회 2006 ULTRASONOGRAPHY Vol.25 No.4

PURPOSE : To establish the morphologic US classification of mature cystic teratoma of the ovary and document the reliable sonographic features in the diagnosis of this neoplasm. MATERIALS and METHODS : The study subjects comprised 103 patients with 112 pathologically proven, mature cystic teratomas. All patients underwent preoperative pelvic US in transabdominal and/or transvaginal approach. One radiologist retrospectively analyzed the US findings and the tumors were classified into 6 groups based on the morphologic US features. For each tumor, additional US findings, including posterior sonic shadowing, fat-fluid level and vascularity, were also evaluated. RESULTS : The common US patterns were hyperechoic area within a cyst (type IV; 36 tumors, 32.1%), solid and cystic mass (type V; 32 tumors, 28.5%), and a diffusely hyperechoic mass (type VI; 25 tumors, 22.3%). All solid and cystic masses (type V) showed hyperechogenicity in at least one solid portion, resulting in hyperechogenicity within a mass being seen in 93 of the 112 tumors (83.0%), with pure cystic masses (types I-III) accounted for the remaining 19 tumors (17.1 %). Of the 112 tumors, 68 (67.1%) showed posterior sonic shadowing which was demonstrated only in the hyperechoic area of types IV-VI. CONCLUSION : Any adnexal masses representing a hyperechoic area within a cyst, solid and cystic tumors containing hyperechogenicity or diffusely hyperechoic mass, especially when accompanied by posterior sonic shadowing, should be suspected as indicative of mature cystic teratoma. 목적 : 난소성숙기형종을 초음파 소견에 따라 분류하고, 특이적인 초음파소견이 있는지를 알아보고자 한다. 대상 및 방법: 수술 전에 골반초음파검사를 받고 수술 후 난소성숙기형종으로 확진된 103명 환자의 112종괴를 대상으로 하였다. 한명의 방사선과의사가 이들의 초음파소견을 후향적으로 분석하였다. 난소성숙기형종의 유형은 6가지 형태로 구분하여 분류하였고, 또한 각각의 종괴에 대하여, 후향감쇠와 지방-액체층 유무 및 색도플러 초음파에서의 종양 혈관에 대하여 평가하였다. 결과 : 난소기형종의 초음파 유형으로는 낭종 내 고에코형(4형)이 36예(32.1%)로 가장 많았고 충실성 및 낭 성 종괴형(5형) 이 32예(28.5%), 전체적인 고에코형(6형)이 25예(22.3%)의 순으로 나타났다. 충실성 및 낭성 종괴형(5형)으로 분류된 모든 종괴에서 적어도 하나 이상의 고에코영역이 보였다. 따라서 종괴 내 고에코영역은 4, 5, 6형을 모두 포함한 93개의 종괴(83.0%)에서 보였다. 1형에서 3형에 이르는 순수낭성 종괴는 19예로 17.1%에 해당하였다. 68예(67.1%)에서 후향감쇠가 보였으며, 이는 모두 4형-6형에 해당하는 종괴의 고에코영역에서 나타났다. 결론 : 골반초음파 검사에서 고에코영역을 가진 낭종, 혼합성 종괴 또는 고형종괴를 발견했을 때, 특히 이들의 고에코영역이 후향감쇠를 동반했을 때 난소의 성숙기형종의 가능성을 반드시 고려하여야 한다.

전북지역 주부들의 전통발효식품 섭취실태 및 소비현황 조사

최나미 ( Na Mi Choi ),차진아 ( Jin A Cha ) 대한가정학회 2008 Family and Environment Research Vol.46 No.4

Chronic-Contained Rupture of an Isolated Internal Iliac Arterial Aneurysm: A Case Report

차장규,최나미,이범하,이종세,김대호,박성일 대한영상의학회 2008 대한영상의학회지 Vol.58 No.6

We describe here a 57-year-old woman with a chronic-contained rupture of an internal iliac arterial aneurysm, and this was eroding the sacral neural foramen. Although an isolated internal iliac arterial aneurysm is known to be rare, the ruptured internal iliac arterial aneurysm was diagnosed based on the characteristic radiolgic findings with performing color Doppler ultrasound, MRI and multi-slice computed tomography. The ruptured aneurysm was successfully treated by coil embolization. Color Doppler US, MRI and multi-slice CT are useful for evaluating a mass of a vascular origin that involves the neural foramen.

양폐야의 다발성 결절로 보이는 전이성 부신경절종

최승아,최나미,박재성,백상현,고은석,신화균,차장규,홍현숙 대한영상의학회 2007 대한영상의학회지 Vol.57 No.4

경부에 발생한 부신경절종에 대한 완전 절제를 시행 받았던 24세 남자에서 우연히 양폐야의 다발성 결절이 발견되었다. 이 결절들은 흉부 전산화단층촬영에서 다양한 크기로, 경계가 분명하였으며 강하게 조영증강 되었다. 가장 큰 결절은 F-18 fluorodeoxyglucose의 양전자방출단층촬영에서 높은 섭취를 보였다. 이 병변은 비디오 내시경을 이용한 생검술을 통하여 부신경절종으로 진단되었다. 부신경절종은 드문 신경내분비계 종양으로서, 폐실질에 발생하는 경우는 매우 드물다. 지금까지 보고된 폐실질의 부신경절종의 개수는 두 개 이하이며 다발성 결절에 대한 증례는 없었다. 이에 우리는 폐실질에서 발생한 전이성 다발성 부신경절종에 대해 보고하려 한다. A 24-year-old man that had previously undergone a complete resection of a cervical paraganglioma presented with multiple well-defined intrapulmonary nodules on contrast-enhanced computed tomography. All of the nodules showed homogeneously intense enhancement. The largest nodule was a hot spot on F-18 fluorodeoxyglucose positron emission tomography. It was diagnosed as a paraganglioma using wedge resection via video-assisted thoracoscopic resection. Paragangliomas are rare neuroendocrine tumors and are exceedingly rare in the lung parenchyma. A few reports have described one or two intrapulmonary lesions, including primary tumors and metastases. We report a unique case of a multiple metastatic paraganglioma in the parenchyma of both lungs.

Artificial Intelligence for Breast Cancer Screening in Mammography (AI-STREAM): A Prospective Multicenter Study Design in Korea Using AI-Based CADe/x

장윤우,안진경,최나미,고경희,김기환,한경화,류정규 한국유방암학회 2022 Journal of breast cancer Vol.25 No.1

Purpose Artificial intelligence (AI)-based computer-aided detection/diagnosis (CADe/x) has helped improve radiologists’ performance and provides results equivalent or superior to those of radiologists’ alone. This prospective multicenter cohort study aims to generate real-world evidence on the overall benefits and disadvantages of using AI-based CADe/x for breast cancer detection in a population-based breast cancer screening program comprising Korean women aged ≥ 40 years. The purpose of this report is to compare the diagnostic accuracy of radiologists with and without the use of AI-based CADe/x in mammography readings for breast cancer screening of Korean women with average breast cancer risk. Methods Approximately 32,714 participants will be enrolled between February 2021 and December 2022 at 5 study sites in Korea. A radiologist specializing in breast imaging will interpret the mammography readings with or without the use of AI-based CADe/x. If recall is required, further diagnostic workup will be conducted to confirm the cancer detected on screening. The findings will be recorded for all participants regardless of their screening status to identify study participants with breast cancer diagnosis within both 1 year and 2 years of screening. The national cancer registry database will be reviewed in 2026 and 2027, and the results of this study are expected to be published in 2027. In addition, the diagnostic accuracy of general radiologists and radiologists specializing in breast imaging from another hospital with or without the use of AI-based CADe/x will be compared considering mammography readings for breast cancer screening. Discussion The Artificial Intelligence for Breast Cancer Screening in Mammography (AI-STREAM) study is a prospective multicenter study that aims to compare the diagnostic accuracy of radiologists with and without the use of AI-based CADe/x in mammography readings for breast cancer screening of women with average breast cancer risk. AI-STREAM is currently in the patient enrollment phase. Trial Registration ClinicalTrials.gov Identifier: NCT05024591