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비부비동 반전성 유두종의 전산화 단층촬영상과 자기공명영상의 분석
배창훈 ( Chang Hoon Bai ),서영중 ( Young Jung Seo ),이석춘 ( Seok Choon Lee ),천승민 ( Seung Min Chen ),백운회 ( Un Hoi Baek ),정은채 ( Eun Chae Jung ),송시연 ( Si Youn Song ),김용대 ( Yong Dae Kim ) 영남대학교 기초/임상의학연구소 2005 Yeungnam University Journal of Medicine Vol.22 No.2
Background: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP.1) Materials and methods: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. Results: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. Conclusion: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.
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비부비동 반정성 유두종의 전산화 단층촬영상과 자기공명영상의 분석
배창훈,서영중,이석춘,천승민,백운희,정은채,송시연,김용대 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2
Background: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in case of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. Materials and methods: CT and MRI were retrospectively reviewed in 9 case of IP. Patients were categorized into staged based on CT and MRI findings according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. Results: Differentiation of IP from inflammatory disease may be more successful in routine case where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. Conclusion: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.
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배창훈,서영중,예상백,최영호,김용대,송시연 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.1
본 연구에서는 1993년 1월부터 2002년 12월까지 10년간 비인강암으로 진단받은 환자 54예를 환자의 의무기록과 전화상담을 통하여 후향 적으로 분석하여 비인강암의 임상적인 특징과 생존율에 미치는 인자에 대하여 알아보고자 하였다. 환자의 연령분포는 16~78세로 평균 연령은 46.9세였다. 40대(26.0%)와 50대(27.8%)에서 호발하였으며, 남자가 여자보다 3.5배 많았다. 경부 종물을 주소로 내원한 환자가 30예(55.5%)로 가장 많았으며, 조직학적 유형은 WHO 제3형이 29예(53.7%)로 가장 많은 분포를 나타내었다. 조직학적 유형에 따른 5년 생존율은 제1형은 40.0% 제 2형은 45.5% 제 3형은 54.1%였다. 비인강암의 발생위치는 Rosenmu¨ller fossa를 포함한 측벽에서 35예(64.8%)로 가장 많이 발생하였다. 진단 시 Ⅲ, Ⅳ기의 진행된 병기군이 79.6%로 비인강암은 비교적 늦게 발견됨을 알 수 있었다. 전체적인 5년 누적 생존율은 46.5%였으며, 초기 병기군과 진행된 병기군의 5년 누적 생존율은 각각 58.3%, 44.2%로 초기 병기군의 생존율이 높은 것을 알 수 있었으나 통계학적 의의는 없었다. 원격전이의 경우 17예(31.5%)에서 발생 하였으며 골, 폐, 뇌, 척추, 간 등의 순서였다. 원발 부위의 완전관해 후 6예(11.1%)에서 국소 재발하여 다시 방사선치료를 시행하거나 항암화학요법과 방사선치료를 병행하여 치료하였다. 이상의 결과에서 보면 비인강암은 50대의남자에서 호발하며, 국내에서는 WHO 제 3형이 가장 빈발한다는 것을 알 수 있었다. 또한 TNM 병기는 비인강암의 생존율을 예측하는데 적절하지 않다고 생각되며, 생존율과 연관된 인자를 찾기 위해 향후 더 많은 연구가 시행되어야 하며 그에 따라 새로운 분류법이 제시되어야 할 것으로 사료된다. Background: Nasopharyngeal cancer is a rare disease with a relatively poor prognosis because it tends to be diagnosed at an advanced stage. The aim of this study was to establish the clinical characteristics of nasopharyngeal cancer. Materials and Methods: The medical records of 54 patients with nasopharyngeal cancer from January 1993 to December 2002 were reviewed retrospectively. Forty one cases were male (75.9%) and thirteen were female (24.1%). The average age was of 46.9 (range 16 to 78 years) years. The majority of patients (79.6%) were diagnosed in the advanced stage. The most common complaints were a neck mass (55.5%) and the WHO type 11I (53.7%) was the most frequent histological type. Results: The cumulative survival rate for a 5-year period was 46.5% and the T stage, N stage, pathologic type, and clinical stage were not significantly related to the survival rate. Sixteen of 54 (31.5%) cases presented with a distant metastasis of the bone, lung, brain, spine, and liver, and six cases (11.1%) presented with a locoregional recurrence. Conclusion: TNM staging is not appropriate for predicting survival rate of nasopharyngeal carcinoma patients. Therefore, a newer staging system, which includes new factors, is needed to predict the prognosis.
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