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RISS 인기검색어
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- 저자 : 백승연(Seung Yon Back) (검색결과 2 건)
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폐쇄성 황달 환자에 있어서 자기공명 담도 촬영술의 유용성
이선영(Sun Young Yi),백승연(Seung Yon Back) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5
N/A Backgound/Aims: The effectiveness of magnetic resonance cholangiography(MRC) for diagnosing obstructive jaundice, as a noninvasive alternative to direct cholangiography(endoscopic retrograde cholangiopancreatpgraphy; ERCP or percutaneous transhepatic cholangiography;PTC) is studied. The goal of the study is to evaluated the level of reliability and efficacy of MRC for identifying the obstruciton site and the cause of it. Methods: Thirty two consecutive patients with obstructive jaundice are included in the study. Non-breath-hold, heavily T2-weighted, fast spin echo MRC is used to obtain; 2D-axial, coronal, and 3D-images with maximal intensity projection protocol. We evaluated all patients retrospectively by ERCP, PTC, or operation to compare the results. Results: The causes of obstruction are 13 common bile duct cancer cases, 2 pancreatic cancer cases, 8 extrahepatic duct stone cases, 3 intrahepatic duct stone cases, and 3 intra and extrahepatic duct stone cases. The level of obstruction is correctly diagnosed with MRC for 100% of common bile duct cancer and pancreatic cancer cases, 90.9% of extrahepatic duct stone cases, and 66.7% of intrahepatic duct stone cases. MRC revealed the correct causes of obstrcution for 80% of common bile duct cancer and pancreatic cancer, 81.8% of extrahepatic duct stone, and 50% of intrahepatic duct stone. Conclusions: MRC provided a accurate level of obstruction and diagnosis for common bile duct cancer, pancreatic cancer, and extrahepatic duct stone but not for intrahepatic bile duct stone. Therefore, MRC may be used with caution as a noninvasive altemative to invasive cholangiography, if not as a cornplete replacement of it. (Korean J Gastroenterol 1996; 2S:690 - 696)
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간경변증 환자에서 Doppler Sonography를 이용한 신장기능 측정의 의의
이선영,백승연 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3
Background/Aims: Kidney dysfunction, a well-recognised complication of established liver disease, is characterized by early renal hemodynamic changes(vasoconstriction) that was formerely clinically recognized as kidney disease. Resistive index(RI) is time-velocity wave-form analysis of Doppler signals from small arteriolar resistance. To investigate whether the RI is useful in the diagnosis of kidney failure and prediction of survival of cirrhotic patients with ascites. Methods: We obtained Rl by Doppler sonography, and conducted chemical tests of kidney and liver function. The plasma level of renin, aldosterone, and antidiuretic hormone was obtained from 8 healthy subjects and 29 patients with cirrhosis with or without ascites. A total of 18 clinical and laboratory variables were analyzed for prognostic value. Results: Five variables were correlated with liver function status including, BUN, creatinine, GFR, plasma renin activity and antidiuretic hormone(P$lt;0.01). RI was significantly increased in patient with Child-Pugh class C group(Group III) compared with Child-Pugh class A or B group(Group II) and healthy subject group(Group l)(P=0.01, P=0.001). And RI was correlated inversely with glomerular filtration rate. Also RI was significantly increased in patients with ascites compared to patients without ascites (P=0.001). The sensitivity and specificity of the RI in detecting kidney failure in patients with ascites were 77% and 79%, respectively. Conclusions: RI is a sensitive method to assess intrarenal hemodynamics in patients with cirrhosis and ascites. It also has a predictive value for survival of these patients.
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