스포츠손상의 자기공명영상 진단

양승오 ( Seoung Oh Yang ),정선관 ( Seon Kwan Juhng ) 대한스포츠의학회 2010 대한스포츠의학회지 Vol.28 No.1

스포츠손상의 진단에는 임상에서 필요한 경우에 MRI를 포함한 여러 가지 영상 검사를 시행하게 된다. 이러한 검사를 추가로 시행하면 진단에 확신이 서고, 손상의 범위와 정도를 정확하게 알 수 있으므로 좀 더 적극적으로 적절한 치료법과 재활요법을 선택할 수 있는 장점이 있다. 이런 노력을 통해 아마추어는 물론이고, 직업적 운동 선수의 운동 능력을 온전히 보전하게 하여 오랫동안 최상의 경기력을 지킬 수 있게 하는 것이 스포츠의학의 최종 목표이다. 그러나 영상진단에서 관찰되는 이상 소견이 모두 임상적 연관성이 있는 것은 아니므로, 영상 결과의 임상 적용에 주의를 요하며, 궁극적으로는 환자의 증세를 치료해야 하는 것이지, 방사선 영상의 이상 소견을 치료하는 것이 아니라는 사실을 기억해야 한다. 따라서 엘리트 운동 선수의 경우, 손상을 받을 경우와의 비교를 목적으로 평소에 기준 영상 검사를 해 둘 가치가 있을 것이다. 우리나라도 프로스포츠의 발달이 계속되고 아마추어 운동을 즐기는 인구가 폭발적으로 증가하고 있으므로, MRI를 포함한 여러 영상법을 스포츠의학에 활발하게 적용하기 위하여 더욱 많은 스포츠관련 의사의 지속적인 관심과 열의가 필요하다. MRI (magnetic resonance imaging) is widely applied to diagnose sport-related injuries including bone and soft-tissue injuries. Because the MR characteristics of hydrogen nuclei depend upon on their local tissue environment, soft tissue structures of similar density may exhibit difference in signal intensity (brightness on image). This enables MRI to get high soft-tissue contrast resolution superior to other imaging modalities such as computed tomography (CT). Advantages of MRI are its capacity to depict occult bone trauma or bone bruise and ligamentous or tendinous injuries that are not visible on conventional radiographs. MRI does not expose the patient to radiation dose, so it can be used safely for pediatric patients. In this review, we will discuss on the osseousand soft-tissue injuries of the extremities which could be helpful from MRI in various clinical situations.

신경내분비종양 진단에 있어서 I - 123 MIBG 조기 평면 영상과 SPECT 영상의 임상적 유용성

양승오(Seoung Oh Yang),최윤영(Yun Young Choi),이희경(Hee Kyung Lee),원경숙(Kyoung Sook Won),류진숙(Jin Sook Ryu),서용섭(Yong Sup Suh),신중우(Jung Woo Shin),김희중(Hee Jung Kim) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.4

N/A The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(l adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), l false positive(hepatocellular carcinoma) and 3 false negatives(l recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.

[ I - 123 ] IPT SPECT를 이용한 도파민 재섭취부위의 영상화 : 반정성적 분석방법을 이용한 정상인과 파킨슨병 환자의 차이

양승오(Seoung Oh Yang),최윤영(Yun Young Choi),이희경(Hee Kyung Lee),김희중(Hee Joung Kim),류진숙(Jin Sook Ryu),임주혁(Joo Hyuck Im),이명종(Myung Chong Lee) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.1

N/A Dopamine transporter concentrations have been known to decrease in Parkinson's disease (PD) or increase in Tourette's disorder. The purpose of this study was to evaluate the effectiveness of [I-123]N-(3-iodopropene-2-yl)-2β-carbomethoxy-3β-(4-chlorophenyl) tropane (IPT) as an imaging agent for measuring changes in transporter concentrations with PD. IPT labelled with 6.69+/-0.64 mCi (247.53+/-23.68 MBq) of I-123 was intravenously injected into ten patients(age: 55+/-11) with PD, and six normal controls(NC)(age: 46+/-14) as a bolus. Dynamic SPECT scans of the brain were then performed for 5 minutes each over 120 minutes on a triple headed camera. Time activity curves were generated for the left basal ganglia(LBG), right basal ganglia(RBG), and occipital cortex(OCC). The statistical parameters included the time to peak activity, the contrast ratio of LEG and RBG to OCC at several time points, and the accumulated specific binding counts/mCi/pixel (ASBC) from 0 to 115 minutes. The uptake of IPT in the brains of PD and NC peaked within 10 minutes of injection in all subjects. The maximum target to background ratio in the basal ganglia of PD and NC occurred at 85+/-20 min and 110-+/-6 min of injection, respectively. The BG/OCC ratios at 115 minutes for PD and NC were 2.15+/-0.54 and 4.26+/-0.73, respectively. The ASBC at 115 minutes for PD and NC were 152.91+/-50.09 and 289.51+/-49.00, respectively. The ratio of BG/OCC for the NC was significantly higher than the ratio for PD. SPECT data matched with clinical diagnosis for PDs. The ratio between BG and OCC and the ASBC for PD were clearly separated from NC and may be useful outcome measures for clinical diagnosis. The findings suggest that IPT may be a very useful tracer for early diagnosis of PD and study of dopamine reuptake site.

이소플라본 보충이 난소절제 흰쥐의 골대사에 미치는 영향

박영희(Young-Hee Park),윤선(Sun Yoon),정수연(Soo-Youn Chung),양승오(Seoung-Oh Yang),유태무(Tae-Moo Yoo),양지선(Ji-Sun Yang),권대중(Dae-Joong Kwon) 한국식품영양과학회 2001 한국식품영양과학회지 Vol.30 No.4

이소플라본 보충이 골다공증의 예방 및 치료에 미치는 영향을 관찰하고자 Sprague-Dawley 암컷을 수술없이 일반식이를 제공한 군(CON), sham-operation 후 일반식이를 제공한 군(SH), 난소절제한 뒤 일반식이를 제공한 군(OVX), 난소절제 후 isoflavone을 공급한 군(OL, OM, OH)으로 나눈뒤, 난소절제 4일 및 8주 후부터 8주간 이소플라본을 공급하여 혈액의 ALP, 뇨 중의 hydroxyproline의 변화, 골밀도, 골강도 및 골무게 등을 연구하였다. 골다공증의 예방에 대하여 isoflavone의 효과를 관찰한 결과, ALP는 난소를 절제한 OVX군에서는 CON군과 SH군에 비해 유의적으로 높은 값을 보였다. 그러나, 난소절제 후 4일부터 8주간 isoflavone을 보충시킨 결과 ALP 활성과 urinary hydroxyproline 함량은 SH군과 비슷하게 낮아졌다. 특히 OM(0.8 g/㎏ diet)군의 경우 ALP 활성과 urinary hydroxyproline 함량이 가장 낮아서 OVX군과 유의적인 차이를 보였다(p<0.05). 난소적출 후 8주 후에 골밀도를 측정한 결과, 난소절제군의 골밀도가 CON군과 SH군에 비해 유의적으로 낮은 것으로 나타났다. Isoflavone을 보충한 결과 골밀도가 증가하였으나 유의적인 차이는 없었다. 골다공증의 치료효과에 대한 연구결과 alkaline phosphatase activity의 감소, urinary hydroxyproline 농도의 감소, 골밀도, 골강도 및 골무게가 증가하였으나 유의적인 차이는 나타나지 않았다. 이상의 결과는 난소절제 후에 일어나는 골격 대사의 이상은 isoflavone을 보충시킴으로써 어느 정도 정상화시킬 수 있음을 시사한다. 따라서, 적절한 양의 isoflavone 보충은 폐경 후 여성의 골대사에 유익한 효과를 줄 것으로 풀이된다. Osteoporosis that is associated with ovarian hormone deficiency following menopause (postmenopausal osteoporosis) is by far the most common cause of age-related bone loss. Isoflavone has been reported as a natural substance that possibly minimizes bone loss in postmenopausal women. This study was conducted to investigate the preventing, treating effects of isoflavone on bone loss in ovariectomized rats. 120 Sprague Dawley rats of 13 week-old were devided into 2 groups, a treatment group and prevention group. Each group was consisted of six subgroups; control (CON), sham operated (SH) or ovariectomized (OVX) and isoflavone supplemented groups: OVX+0.25 ㎎ isoflavone/㎏ diet (OL), OVX+0.8 ㎎ isoflavone/㎏ diet (OM) and OVX+2.5 ㎎ isoflavone/㎏ diet (OH). To study the preventing effects of isoflavone on bone loss, OL, OM and OH groups were fed with isoflavone from 4 days after ovariectomization. Treating effects of isoflavone on bone metabolism were investigated with OL, OM, OH groups supplemented with isoflavone from 8 weeks after ovariectomization. Isoflavone supplementation continued for 8 weeks. At 8 weeks after ovariectomization significant increase in alkaline phosphatase occured comparing with CON and SH group. By isoflavone supplementation from 4 days after ovariectomy alkaline phosphatase and urinary hydroxyproline were lowered and bone mineral density, bone strength of the femur and tibia and bone dry weight were slightly enhanced with no significant difference. Isoflavone supplemented group at the level of 0.8 ㎎/㎏ diet (OM group) had significantly lower serum alkaline phosphatase, urinary hydroxyproline, and higher strength of femur than OVX group. Groups with isoflavone supplementation from 8 weeks after ovariectomy had lower level of serum alkaline phosphatase, urinary hydroxyproline than OVX group. Bone mineral density, bone dry weight and bone strength of the femur and tibia were slightly enhanced by isoflavone supplementation. However there was no significanct difference between OVX and isoflavone supplementation groups. The results suggest that isoflavone might have potential role for preventing postmenopausal bone loss. Isoflavone supplementation at early stage of postemenopause may be beneficial to age-related bone health.

골스캔상 신세포암의 골전이 양상과 신장섭취 형태에 관한 연구

천혜경,양승오,신중우,원경숙,최윤영,류진숙,이희경 ( Hae Kyung Chun,Seoung Oh Yang,Joung Woo Shin,Kyoung Sook Won,Yun Young Choi,Jin Sook Ryu,Hee Kyung Lee ) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.4

$^{18}F$-FDG PET/CT검사에서 지연영상을 이용한 갑상선 우연종 감별의 유용성 평가

이현국,양승오,송기덕,송치옥,이기흔,Lee, Hyun-Kuk,Yang, Seoung-Oh,Song, Gi-Deok,Song, Chi-Ock,Lee, Gi-Heun 대한핵의학기술학회 2008 핵의학 기술 Vol.12 No.2

본 연구의 목적은 $^{18}F$-FDG PET/CT검사 시 우연히 발견된 갑상선병변의 악성여부를 평가하기 위하여 위양성으로 판독되어지는 양성종양이나 염증질환과 악성 종양의 감별이 가능한 검사법으로 지연영상(Delay scan)을 적용하고 결과 값(SUV)의 기준안을 마련하며 이 연구에서 제시되는 검사법의 유용성을 평가하는데 그 목적이 있다. 2008년 1월부터 2008년 4월까지 E대학병원에 내원하여 $^{18}F$-FDG PET/CT를 시행한 환자 800명을 대상으로 후향적 분석을 실시하였다. 같은 연구기간 중에 갑상선의 원발암으로 $^{18}F$-FDG PET/CT을 실시한 1명은 연구에서 제외하였다. 최종적으로 799명이 연구대상이었으며 $^{18}F$-FDG PET/CT검사를 실시한 이유는 기존에 암이 증명되어 예후 관찰로 검사하거나 암이 의심되는 경우가 696명, 건강 검진 목적으로 실시한 경우가 103명이었다. $^{18}F$-FDG PET/CT영상 촬영은 SIEMENS사에서 만든 Biograph-Duo에서 시행하였으며, $^{18}F$-FDG PET/CT 정상영상(1 hr)을 취득한 후 갑상선 이상섭취가 있고 SUV 2.0 이상인 환자를 대상으로 1시간 후에 갑상선부위를 1 bed 지연영상을 촬영하였고, 한 bed에 2분 동안 영상을 얻었다. 갑상선 이상섭취가 있고 SUV 2.0 이상인 환자를 대상으로 이상섭취가 있는 부위의 1시간 영상과 2시간 지연영상의 SUVmax를 측정하여 비교 분석하였다. 본 연구에서 $^{18}F$-FDG PET/CT 검사 시 우연히 갑상선에 $^{18}F$-FDG 섭취를 보인 환자 중 갑상선 우연종(Thyroid incidentaloma)이 5명으로 0.63%로 나타났으며 모두 양성병변을 시사하는 소견을 나타냈다. 그리고 우연히 갑상선에 $^{18}F$-FDG섭취가 있는 경우 먼저 갑상선부위의 2시간 지연검사를 통해 $SUV_{max}$의 변화치를 이용하여 간접적으로 양성 혹은 악성여부를 판단하는 하나의 기준이 될 수 있고 판독의 오류도 줄일 수 있다. 발견된 갑상선 우연종(Thyroid incidentaloma)의 경우 1) 국소부위의 갑상선병변 SUVmax가 5.0 이상이고, 2) $^{18}F$-FDG PET/CT 정상검사(1 hr)와 지연검사(2 hr)의 갑상선병변 $SUV_{max}$차이가 $1.0{\pm}0.5$인 경우 Malignant를 의심하고 조직학적 확진을 진행한다. 그렇지 않은 경우에도 추후 PET이나 CT를 이용한 면밀한 영상검사로 추적 관찰하는 것이 병변의 진단을 위한 합리적인 접근방법이라고 생각한다. Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

$^{18}F$-FDG PET/CT 검사에서 이뇨제 사용여부에 따른 $^{18}F$-FDG 배설 특성

장동근,양승오,이상호,배종림,김정구,Jang, Dong-Gun,Yang, Seoung-Oh,Lee, Sang-Ho,Bae, Jong-Lim,Kim, Jeong-Koo 대한방사선과학회 2012 방사선기술과학 Vol.35 No.2

$^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG)는 상당한 양의 방사능이 신장과 비뇨기계에 저류 되어 영상의 질을 저하시키고 진단 성능을 저하시킨다. 이러한 $^{18}F$-FDG의 비뇨기계 저류를 막기 위해 이뇨제를 사용하여 검사를 진행하게 된다. 이때 사용되는 이뇨제가 영상에 미치는 영향과 $^{18}F$-FDG 배설률에 미치는 영향을 알아보고자 하였다. PET/CT 검사를 시행한 환자 중 신장의 원발성 종양 또는 전이 병변이 없는 환자를 대상으로 $^{18}F$-FDG와 함께 이뇨제를 주사한 그룹, 생리식염수를 주사한 그룹, $^{18}F$-FDG만을 주사 한 정상군 그룹으로 진행하였으며, 각 그룹의 관심영역을 설정하여 SUV를 측정하였다. 또한 정량적 분석을 위하여 $^{18}F$-FDG를 주사 후 이뇨제 투여 여부에 따른 SUV를 비교 평가하였다. SUV 측정에 따라 영상의 배후방사능이 감소된 영상을 얻을 수 있었으며 이뇨제 사용으로 배설된 소변의 양이 늘어났지만, 소변에 방사능량의 변화가 없는 상반된 결과가 나타났다. 따라서 이뇨제가 영상의 배후방사능을 줄일 수는 있지만 $^{18}F$-FDG 배설에는 영향을 미치지 못함을 확인 하였다. $^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG) causes a significant amount of radioactivity retention in kidneys and urinary tract and degrades image quality and diagnostic performance. Diuretics are used to perform tests and prevent the urinary tract retention of $^{18}F$-FDG. The purpose of the study is to investigate how the diuretics affect images and excretion rates of $^{18}F$-FDG. The study consists of a group using diuretics for patients with no primary tumors or transfer lesions in kidneys according to PET/CT images, a group using physiological saline and the control group injecting only $^{18}F$-FDG and SUVs are measured by configuring interested areas for each group. Also, SUVs are compared and evaluated depending on the lasix injection after basic inspection and injecting $^{18}F$-FDG for quantitative analysis. The study shows that images with decreased background radioactivity and increased urine excretion due to using diuretics. However, an opposite result that there is no change in the amount of radioactivity in urine appears. The study concludes that the diuretics may decrease background radioactivity in the images but may not affect the $^{18}F$-FDG excretion.

갑상선암 수술 전 진단목적의 $^{18}F$-FDG PET/CT Dual Time Point영상에서 SUV값과 방사능 농도 측정법의 유용성 평가

이현국,강현수,양승오,한만석,Lee, Hyun-Kuk,Khang, Hyun Soo,Yang, Seoung-Oh,Han, Man-Seok 대한핵의학기술학회 2012 핵의학 기술 Vol.16 No.2

Purpose : This study is designed to compare two parameters reflecting $^{18}F$-FDG uptake, SUV and radioactivity, for diagnosis of thyroid cancer in dual time $^{18}F$-FDG PET/CT imaging and to find which parameter is more useful to decide whether the tumor is malignant or not. Materials and Methods : We performed retrospective study for 40 patients. All patients are diagnosed as primary thyroid cancer and examined $^{18}F$-FDG PET/CT. First, we got the dispersion of scattering beam of neck and lung apex to set a background and compared each dispersion, mean value, standard deviation of maxSUV and radioactivity. Also, mean maxSUV, ${\Delta}maxSUV$, ${\Delta}maxBq$/ml(%) and radioactivity between groups according to lesion's size based on biopsy are compared with independent-sample t-test. Results : the values that were from maxSUV and radioactivity measurement technique were compensated and calculated to practical values for mean comparison and patients were divided to two groups based on tumor size, Group1 ($size{\leq}1$ cm, n=21), Group2 (size>1 cm, n=19) for accurate comparison. In Group1, maxSUV (semi-quantitative analysis) was increased from $5.64{\pm}5.85$ (1.89~17.84) at first image to $5.90{\pm}5.01$ (1.95~18.22) at second image and radioactivity (Bq/ml) (quantitative analysis) showed similar increase from $5.93{\pm}6.38$ (2.50~16.75) at first image to $6.01{\pm}5.25$ (2.66~16.58) at second image. In Group2, TFmaxSUV was $10.54{\pm}14.36$ (2.54~33.89) in true first image, TSmaxSUV was $9.85{\pm}12.88$ (2.62~26.20) in true second image separately. The maxSUV showed a significant difference in the mean comparison between the two groups (p=0.035) But, mean radioactivity (Bq/ml) was $5.93{\pm}6.38$ (4.81~40.99) in true first image, $6.01{\pm}5.25$ (4.51~36.93) in true second image and didn't show a significant difference statistically (p=0.126) Conclusion : In diagnosis of thyroid tumor, SUV and radioactivity depending on $^{18}F$-FDG uptake showed high similarity with coefficient of determination (R2=0.939) and malignant evaluation results using dual time also showed similar aspect. Radioactivity for evaluation of malignant tumor didn't show better specificity or sensitivity than maxSUV.

뇌종양의 재발과 방사선 괴사의 감별을 위한 탈륨 SPECT의 역할

문대혁(Dae Hyuk Moon),양승오(Seoung Oh Yang),이희경(Hee Kyung Lee),원경숙(Kyoung Sook Won),류진숙(Jin Sook Ryu),이정교(Jung Kyo Lee),권병덕(Byung Duk Kwun) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.4

N/A Following radiation therapy for brain tumors, patients often have clinical deterioration due to either radiation necrosis or recurrent tumor progression in the treatment field. The distinction between these entities is important but difficult clinically or even with CT or MRI. T1-201 has been known to accumulate in various tumors and be useful to grade, predict prognosis or detect recurrence of glioma. The aim of this study was to evaluate the usefulness of T1-201 SPECT in the differentiation of recurrent tumor from radiation necrosis. Of 67 patients who did T1-201 brain SPECT imaging with clinically suspected recurrent tumor or radiation necrosis, 20 patients underwent histopathological examination and constituted the study population. T1-201 uptake indices on T1-201 brain SPECT imaging were calculated and correlated with histopathological diagnosis. Of 20 patients, 15 were histopathologically confirmed as recurrent original tumor or malignant transformation of benign tumor and 5 were diagnosed as radiation necrosis. On T1-201 SPECT, 18 of 20 had T1-201 index above 2.5 which was regarded as positive indicator for the presence of tumor. Seventeen cases showed concordance, which consisted of 15 true positive and 2 true negative. Discordant 3 cases were all false positive. There was no case of false negative. The sensitivity, specificity, positive and negative predictive value of T1-201 SPECT were 100%, 40%, 83% and 100%. In conclusion, T1-201 brain SPECT is a sensitive diagnostic test in the detection of recurrent tumor following radiation therapy and is useful in the differentiation of recurrent tumor from radiation necrosis. Relatively low specificity should be evaluated further in larger number of patients in consideration of sampling error and referral bias for pathologic examination.

Sturge - Weber 증후군의 뇌관류 SPECT 영상 : 자기공명영상과의 비교

문대혁(Dae Hyuk Moon),양승오(Seoung Oh Yang),최윤영(Yun Young Choi),이희경(Hee Kyung Lee),류진숙(Jin Sook Ryu),고태성(Tae Sung Ko),유시준(Shi Joon Yoo) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.1

N/A 자가면역성 갑상선질환에서의 혈청 Thyrotropin-Binding Inhibitine Immunoglobulin치 In order to evaluate the significance of thyrotropin-binding inhibiting immunoglobulin (TBII) in the patients with autoimmune thyroid diseases, the authors investigated 402 cases of Graves' disease and 230 cases of Hashimoto's thyroiditis comparing 30 cases of normal healthy adult at Kyung Pook University Hospital from February 1993 to August 1994. The TBII was tested by radioimmunoassay and assesed on the dynamic change with the disesase course, thyroid functional parameters, and other thyroid autoantibodies; antithyroglobulin antibody(ATAb) and antimicrosomal antibody(AMAb) including thyroglobulin. The serum level of TBII was 40.82±21.651(mean±SD)% in hyperthyroid Graves' disease and 8.89±14.522% in Hashimoto's thyroiditis and both were significant different from normal control of which was 3.21±2.571%. The frequency of abnormally increased TBII level was 92.2% in hyperthyroid Craves' disease, 46.7% in euthyroid Graves' disease or remission state of hyperthyroidism, and 23.9% in Hashimoto's thyroiditis. The serum levels of increased TBII in Graves' disease were positively correlated with RAIU, serum T3, T4, and FT4, but negatively correlated with serum TSH(each p〈0.001). The TBII in Graves' disease had significant positive correlation with serum thyroglobulin and AMAb, but no significant correlation with ATAb. In the Hashimoto's thyroiditis, the serum levels of TBII were positively correlated with RAIU, serum T3, TSH and AMAb, but not significantly correlated with serum T4, FT4, thyroglobulin and ATAb. Therefore serum level of TBII seemed to be a useful mean of assessing the degree of hyperthyroidism in Graves' disease and correlated well with thyroidal stimulation. The serum level of TBII in Hashimoto's thyroiditis is meaningful for the degree of both functionl abnormality reflecting either hyperfunction or hypofunction and the immunologic abnormality.