정상 비장과 다른 조영 양상을 보여 췌장 종괴로 오인된 췌장 내부비장

박준석 ( Jun Seok Park ),김완중 ( Wan Jung Kim ),정영규 ( Yeong Gyu Jeong ),박윤선 ( Youn Sun Park ),구현철 ( Hyun Cheol Koo ),이태일 ( Tae Il Lee ),최교창 ( Gyo Chang Choi ),김숙 ( Sook Kim ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.6

Most cases of accessory spleen show similar features as normal spleen in imaging studies. However, some accessory spleen has unusual scan feature which can be misdiagnosed. We present a case of intrapancreatic accessory spleen that was discovered incidentally during a workup for abdominal pain in a 47-year-old woman. CT and MRI revealed a different enhancing pattern from that of the spleen. Further evaluation with endoscopic ultrasonography failed to identify the pancreatic mass. Therefore, it was surgically removed and diagnosed pathologically as an accessory spleen. (Korean J Gastroenterol 2011;58:357-360)

위암의 병기결정에 있어서 이중시기 나선식 CT의 유용성

최교창 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Purpose: To evaluate the usefulness of two-phase spiral CT in the staging of gastric carcinoma. Materials and Methods: The author preformed two-phase spiral CT in 49 patients with gastric carcinomas surgically and pathologically proven after endoscopic biopsy. CT scans were obtained after ingestion of 800-1000mL of water. In all 49 patients, two-phase spiral CT findings of gastric carcinoma were retrospectively evaluated and correlated with surgical and pathological findings. Results: The author correctly detected 15(83.3%) of 18 early gastric carcinomas and 31(100%) of 31 advanced gastric carcinomas by two-phase spiral CT. The overall detection rate of gastric carcinomas was 93.9%(46 of 49 cases). The detection rate of early gastric carcinoma was 100%(5 of 5 cases) among elevated lesions and 76.9%(10 of 13 cases) among flat or depressed lesions. With regard to the depth of tumor invasion, there was good correlation between CT findings and pathologic findings in 28 of 49 cases(57.1%). Overstaging occurred in 24.5%(12 of 49 cases) and understaging in 18.4%(9 of 49 cases). In lymph node staging, good correlation between CT findings and pathologic findings was noted in 33 of 49 cases(67.3%). Understaging occurred in18.4%(9 of 49 cases) and overstaging in 14.3%(7 of 49 cases). All of liver metastases(3 cases) and peritoneal carcinomatosis(1 case) were correctly diagnosed by two-phase spiral CT. Conclusion: In the staging of gastric carcinoma, two-phase spiral CT is useful in the deterction of early gastric carcinoma and distant metastasis. However, for determining the depth of tumor invasion and for the evaluation of metastasis to lymph node its usefulness is limited. Further research using various analytic approaches will therefore be necessary.

혈전이 동반된 간외 간문맥 동맥류

최교창 순천향의학연구소 2010 Journal of Soonchunhyang Medical Science Vol.16 No.1

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경도관 동맥색전술을 이용한 비정상 자궁출혈의 치료

양승부,최교창,이상진,정영진,임한혁,한효상,황인철,조환성 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Objective : Our purpose of this study is to evaluate the effectiveness of the transcatheter arterial embolization for the management of abnormal uterine bleeding. Materials and Methods : 14 patients with massive or recurrent uterine bleeding underwent percutaneous transcatheter arterial embolization between February 2003 and September 2004. We reviewed 14 cases of uterine artery or internal iliac artery embolization using gelfoam or PVA particles. Results : Good management of uterine bleeding was achieved in 13 of 14(93%) cases. The cause of abnormal uterine bleeding was myoma(5 case), post D & E bleeding(3), acquired vascular malformation(3), pseudoaneurysm(1), adenomyosis(1), and endometrial hyperplasia(1). Conclusion : Transcatheter artery embolization is an effective and life-saving procedure in massive or recurrent uterine bleeding. Early diagnosis and prompt transcatheter arterial embolization is a useful mangement of uterine bleeding.

골반 골절에 동반된 동맥 출혈에서의 경피적 동맥색전술의 유용성

양승부,임한혁,최교창 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1

Purpose : To determine the usefullness of transcatheter embolization of arterial bleeding in patients with pelvic bone fracture. Materials and Methods : Between March 2003 and December 2004, we evaluated 13 injuried arteries of eight patients with pelvic bone fracture, All patients underwent angiography, followed by transcatheter arterial embolization using gelfoam. We investigated the vital sign, survival rate and complication of transcatheter arterial embolization. Results : Angiography revealed extravasation of cantrast media in six patients; extravasation and abrupt cut-off of an artery in two. The injured arteries involved(n=13) were internal pudendal(n=4), obturator(n=3), inferior gluteal(n=3), iliolumbar(n=2) and superior gluteal artery(n=1). Transcather arterial embolization was technically successful and there was no complication in all cases. Old age patients(n=2, >60years) died due to hypovolemia and pulmonary complication. Conclusion : Transcatheter arterial embolization of arterial bleeding is a useful procedure in lowering the mortality and complication in pelvic bone fracture.

유방암과 섬유선종의 방사선학적 소견 : 유방 단순촬영술과 유방 초음파검사 소견의 비교 연구 Studies on mammographic and ultrasonographic findings evaluation

임한혁,최득린,고은석,이혜경,임철완,이상진,홍현숙,최교창,김영화,박재성 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Purpose : To evaluate the utility of mammography and ultrasonography in study of morphologic differential diagnosis between malignant and benign mass. Materials and Methods : Average age of patients with breast cancer was 48.4 year-old, and that of fibroadenoma was 29.4 year-old. The equipments used for examination were MF-159 high frequency mammography(Bennet Co.) and Acoustic image 5200S. We evaluated mammographic findings about breast parenchymal pattern, calcification, margin and size of the mass associated tumor nature, and ultrasonographic findings about shape, height and width, internal homogenicity and echo pattern, wall contour, boundary echo, and posterior shadow in breast mass. Thirty-seven of mammographic findings and 34 cases of ultrasonogreaphic findings in pathologically proven breast cancer and 34 case of mammographic findings and 71 cases of ultrasonographic findings in breast fibroadenoma were reviewed retrospectively. Results : In mammographic study, the parenchymal patterns of breast cancer according to Wolfe classification were NI(16.2%), PI(24.3%), P@(37.8%), and DY(21.6%) and those in fibroadenoma were NI(3.1%), Pl(11.7%), P2(35.2%),and DY(50%). Mammographic findings about presence of calcification were as follows; only calcification(16.2%), only mass(51.3%), and mass with calcification(32.5%) in breast cancer, and only mass(91.2%), mass with calcification(8.8%) in fibroadenoma. The features of mass margins were classified as ill-defined margin(45.9%), well-defined(5.4%), and well-defined with partial spiculation(48.6%) in breast cancer and ill-defined(20.5%), well-defined(73.5%), and well-defined with partial spiculation(5.8%) in fibroadenoma. The mass were grouped by size; 1-2cm(37.8%), 2-4cm(45.9%), and 4-6cm(16.3%) in breast cancer and 1-2cm(79.4%), 2-4cm(17.6%), and 4-6cm (3.0%) in fibroadenoma. On ultrasonographic study, the shape of masses in breast cancer were lobulated(82.3%),oval(14.7%), and round(3.0%),and those in fibroadenoma were lobulated(14.0%), oval(57.7%), and round(18.3%). The cases that the height was longer than width were 32.3% in breast cancer and 0% in fibroadenoma. The findings about homogenecity and echo patterns were as follows; hypoechoic(52.9%) and mixed(47.1%) in breast cancer and hypoechoic(2.8%), hypoechoic(63.4%), and mixed(33.8%) in fibroadenoma. The margin of masses were smooth in 85.9% of fibroadenoma, and irregular in 73.6% of breast cancer. The boundary echoes of masses and decreased posterior echo shadow were seen only in 61.8% and 55.9% of breast cancer, respectively. Conclusion: The margin and calcifications are more clearly delineated on mammography but breast cancer and fibroadenoma, both are more commonly developed in dense parenchymal pattern(P2+DY),and there findings are easily obscured in mammography. So ultrasoography is very useful in these masses evaluation, especially amoung young patients.