디피리다몰 심근관류 SPECT 를 이용한 관동맥질환 진단에 있어 남녀간의 진단율 비교

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),민정준(Jung Jun Min),송호천(Ho Cheon Song),정환정(Hwan Jeong Jeong) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.2

N/A Purpose: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. Materials and Methods: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTs were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of ≥ 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). Results: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p〈0.05), 81% vs 57% (p〈0.01), 78% vs 48% (P〈0.01), respectively Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p〈0.05). Conclusion: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.

부하 - 휴식과 휴식 - 부하 1일 심근관류영상법의 관동맥질환 진단율 비교

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),민정준(Jung Jun Min),송호천(Ho Cheon Song) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1

N/A It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age 57±9 years) and 120 patients (79 males, 41 females, mean age 59±10 years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by≥50%. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35%and 68%, respectively. Those of rest-stress protocol were 96%, 47%, and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using Tc-99m agents were comparable and were very sensitive tests in detecting coronary artery diseases.

Tc - 99m MIBI 와 Tl - 201 심근 SPECT에서 역재분포의 임상적 의의

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),송호천(Ho Cheon Song),박주형(Joo Hyung Park),정명호(Myung Ho Jeong),조정관(Jeong Gwan Cho),박종춘(Jong Choon Park),강정채(Jung Chaee Kang),길광채(Kwang Chae Gill) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.1

N/A Reverse redistribution(RRD) refers to a perfusion defect that develops or becomes more evident on rest imaging compared with the stress imaging. This phenomenon was not uncommonly noted on myocardial perfusion single photon emission computed tomography(SPECT). However, the clinical significance and pathophysiological mechanism of RRD were unclear. The aim of this study was to evaluate the incidence and clinical significance of RRD on either dipyridamole T1-201 or Tc-99m MIBI myocardial perfusion SPECT. RRD was defined as≥10% decrease in relative T1-201 and Tc-99m MIBI uptakes on rest images compared to the stress images or as an appearance of new perfusion defects on rest images. It was observed in both T1-201 (44/463, 9.5%) and Tc-99m MIBI (124/999, 12.4%) myocardial SPECTs similarly, with an overall incidence of 11.5%(168/1462). Many apparently unrelated disease groups showed the finding: post-revascularization(53.9%), coronary artery disease(24.6%), myocardial infarction(l2.3%), and those with normal coronary arteries(9.2%). Clinical and angiographic characteristics of 65 consecutive patients who underwent coronary arteriography in 168 patients who had RRD on myocardial perfusion SPECT were reviewed. Tc-99m MIBI was used in 44 patients, and TI-201 was used in 21 patients. Of the 81 myocardial segments analyzed which showed RRD, 32 segments(39.5%) were in septum, 24(29.5%) in inferior wall, 12(14.8%) in anterior wall, 7(8.7%) in apex and 6(7.4%) in lateral wall. There was no clear association between RRD and coronary arterial stenosis or presence of collateral circulations. Ventriculographical wall motion was evaluated in 27 regions with RRD; it was normal in 12 regions, hypokinetic in 12 regions and dyskinetic in 3 regions. In 14 of 21 patients who showed RRD on T1-201 myocardial SPECT, T1-201 reinjection was performed immediately after the 3-4 hour redistribution studies. Ten of 14(71.4%) showed enhanced T1-201 activity(≥10% increased) after reinjection. We conclude that RPD is not related to mode of stre

부하-휴식 1일 영상법을 이용한 심근관류 SPECT 에서 99mTc-tetrofosmin 과 99mTc-MIBI 의 관동맥질환 진단율 비교

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),민정준(Jung Jun Min),송호천(Ho Cheon Song),정환정(Hwan Jeoung Jeoung) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.2

N/A Purpose: Tc-99m-tetrofosmin(TF) is a recently proposed myocardial imaging agent which has similar biokinetic characteristics to Tc-99m-sestamibi(MIBI). The aim of this study was to compare TF and MIBI myocardial perfusion SPECTs in detecting coronary artery disease. Materials and Methods: One hundred and sixty patients(l0l males, 59 females, mean age 57±9 yr) who had undergone both myocardial perfusion SPECT (M- SPECT) and coronary angiography within 1 month were studied. M-SPECT was performed using TF in 115 patients and MIBI in 45 patients. Stress-rest one day protocol was used in all patients A coronary stenosis was considered significant when the luminal diameter ≥50% was compromised. The chi square test was used to compare, differences in sensitivity and specificity between the two groups. Results: There was no difference in age and diseased coronary artery branches between the two groups. There were more male patients in TF group: Male-to-female ratios of TF and MIBI groups were 78:37 and 23:22, respectively (p〈0.05). The overall sensitivity of TF study was 92% and specificity 36%. The overall, sensitivity and specificity of MIBI study were 93% and 30% respectively. There was no difference between TF and MIBI groups in identifying individual diseased coronary artery branches. Conclusion: One day stress-rest myocardial SPECT using either TF or MIBI was comparable and was a very sensitive test in detecting coronary artery disease.

인체말초혈액 림프구와 마우스골수세포에서 중기염색체 분석법과 미소핵검사법을 이용한 방사선적응반응 평가

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),민정준(Jung Jun Min),송호천(Ho Cheon Song),최근희(Keun Hee Choi),정환정(Hwan Jeong Jeong),이승연(Seung Yeon Lee) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.6

N/A Purpose: Radiation adaptive response in human peripheral lymphocytes and mouse bone marrow cells was investigated using both metaphase analysis and micronucleus assay. We assessed the correlation between both tests. Materials and Methods: Two groups of the human peripheral lymphocytes and mouse bone marrow cells were exposed to low dose (conditioning dose, 0.18 Gy) or high dose (challenging dose, 2 Gy) γ-rays. The other 4 groups were exposed to low dose followed by high dose after several time intervals (4, 7, 12, and 24 hours, respectively). The frequencies of chromosomal aberrations in metphase analysis and micronuclei in micronucleus assay were counted. Results: Chromosomal aberrations and micronuclei of preexposed group were lower than those of the group only exposed to high dose radiation. Maximal reduction in frequencies of chromosomal aberrations were observed in the group to which challenging dose was given at 7 hour after a conditioning dose (p<0.001). Metaphase analysis and micronucleus assay revealed very good correlation in both human lymphocytes and mouse bone marrow cells (r=0.98, p<0.001; r=0.99, p=0.001, respectively). Conclusion: Radiation adaptive response could be induced by low dose irradiation in both human lymphocytes and mouse bone marrow cells. There was a significant correlation between metaphase analysis and micronucleus assay

정상 심근관류신티그라피 소견을 보인 흉통환자의 예후

김지열(Ji Yeul Kim),범희승(Hee Seung Bom),민정준(Jung Jun Min),송호천(Ho Cheon Song) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1

N/A Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age 53±12 years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% per year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary a disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of cardiac event rates between patients with normal and abnormal coronary angiograms.

방사성옥소 치료를 위해 입원한 중증 갑상선기능저하 상태의 분화갑상선암 환자에서 관찰되는 가역적 임상화학검사 변화 소견

정환정(Hwan-Jeong Jeong),김창근(Chang-Guhn Kim),이광만(Kwang Man Lee),정수정(Soo-Jeong Jeong),송호천(Ho Cheon Song),범희승(Hee-Seung Bom) 대한외과학회 2004 Annals of Surgical Treatment and Research(ASRT) Vol.66 No.1

게이트 심근 SPECT의 관동맥우회로술후 심근 벽운동 호전 예측능

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),송호천(Ho Cheon Song),윤석남(Seok Nam Yoon),김기봉(Ki Bong Kim),이명묵(Myoung Mook Lee) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1

N/A Though myocardial perfusion was usually expected to improve after coronary artery bypass graft(CABG) surgery, some myocardial segments were aggravated after operation, as we compared perfusion changes on postoperative SPECT with preoperative ones. In this study, we evaluated perfusion changes after operation in rest and stress myocardial SPECT in 44 patients (M:F=25:19, age 57.1 year±8.2) who had CABG before and 3 months after operation. We tried to find out possible causes for perfusion aggravation with multivariate logistic regression analysis regarding whether bypass graft was artery or vein and which coronary artery territory was operated. Among 616 myocardial segments which were operated, 89(14.4%) aggravated after operation. In the univariate analysis, myocardial segments in the left circumflex arteries(LCx) aggravated more often(p〈0.0l) than others and segments having operative angioplasty did less often(p〈0.0l). Multivariate logistic regression revealed that LCx was risk factor for perfusion aggravation [odds ratio=2.54 (95% confidence interval : 1.53-4.22, p〈0.01)]. However, this was not the case when we analysed in terms of arterial territories. Among 106 coronary arterial territories which were operated, 27(25.5%) aggravated. The territories having aggravated had similar characteristics regarding whether they received arterial or venous grafts, angioplasty and whether the operated territories were left anterior descending, right coronary or left circumflex arteries. In conclusion, myocardial segments in the left circumflex artery tended to aggravate more often after bypass surgery than the others. In short-term comparison of perfusion after surgery, we could not find any tendency that arterial or venous graft was associated with more frequency of the aggravation of perfusion after operation.

한국 정상인에서 연령에 따른 뇌혈류분포와 혈류예비능의 변화 : Tc-99m HMPAO SPECT 에 의한 연구

문대혁,이희경,송호천,이재태,범희승,손혜경,정환정,민정준,김지열 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.3

Purpose: The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. Materials and Methods: Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3±24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Results: Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalami rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9±12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Conclusion: Quantitative assessment of CVR was possible by ACZ Tc-99m HMPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference.

갑상선암 전이병소로 오인된 타석증 증례

범희승,김지열,민정준,송호천,정환정,김성민 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.1

We report a false positive case of I-131 scan due to a sialolithiasis in right submandibular gland. I-131 images showed not only remnant thyroid tissues and functional metastases in the anterior neck but also a hot uptake near right submandibular gland. We confirmed the sialolithiasis by radiologic studies. Sialolithiasis should be regarded as a false positive cause when I-131 scan shows a hot spot near salivary bed. (Korean J Nucl Med 2000;34:94-8)