다낭성 이형신의 산전 초음파 소견 : 낭종의 분포 양상을 중심으로 Emphasis on Cyst Distribution

문민환,조정연 대한초음파의학회 2003 ULTRASONOGRAPHY Vol.22 No.3

In Utero Development of the Fetal Gall Bladder in the Korean Population

문민환,Jeong Yeon Cho,김주희,이영호,Sung Il Jung,Myung Sook Lee,Hyeun Cha Cho 대한영상의학회 2008 Korean Journal of Radiology Vol.9 No.1

Objective: To provide reference ranges of the fetal gall bladder in the Korean population. Materials and Methods: Fetal gall bladder development was evaluated in welldated, non-anomalous fetuses in the Korean population between February and April 2003 and the visualization rate and reference values were determined from the obtained data. Results: The visualization rate of the fetal gall bladder increased as gestation advanced to a plateau above 90%, which was maintained between 16 and 34 weeks. The measured parameters from the fetal gall bladder had a significant positive relationship with gestational age (p = 0.000 for all cases), and the correlation of length and area with the gestational age (r = 0.741 and r = 0.690, respectively) was better than the correlation of width, height, and volume with gestational age. The repeatability coefficients and coefficients of variation between the two operators were 5.56 mm and 12.9% for the length and 344.11 mm2 and 33.52% for the area. The median length of the fetal gall bladder in the Korean population was not significantly different from the mean length of gall bladders in the Caucasian and African-American populations (p = 0.915). Conclusion: We have provided reference values for the fetal gall bladder throughout the gestation period in the Korean population.

Role of Ultrasound Volume Measurements of Testes in Evaluation of Infertile Men with Azoospermia

문민환,서주태,전이경,성창규,조정연,김승협 대한초음파의학회 2012 ULTRASONOGRAPHY Vol.31 No.2

Purpose: The purpose of our study was to assess the usefulness of ultrasounddetermined testicular volume in the evaluation of the infertile men with azoospermia. Materials and Methods: A computerized search from October 2005 to June 2010generated a list of 45 infertile men with azoospermia (mean age, 34 years; age range,26-44 years) who underwent both scrotal ultrasound and testis biopsy. Ultrasounddetermined testicular volumes were compared between infertile men with obstructive azoospermia and those with non-obstructive azoospermia. Results: Testicular volume for obstructive azoospermia ranged from 6.4 ml to 26.9ml, with a median volume of 14.0 ml. This volume was significantly larger than that of those with non-obstructive azoospermia, which ranged from 1.0 ml to 12.8 ml, with a median volume of 6.1 ml (p < 0.001). The area under the ROC curve for distinguishing non-obstructive azoospermia from obstructive azoospermia using testicular volume was 0.91. A cutoff value of less than or equal to 11.4 ml could distinguish non-obstructive azoospermia from obstructive azoospermia, with a sensitivity of 94.1% (95% CI;71.3-99.9%) and a specificity of 73.3% (95% CI; 54.1-87.7%). Conclusion: Ultrasound-determined testicular volume can be helpful in the differentiation of obstructive azoospermia from non-obstructive azoospermia.

전립선암의 진단에서 경직장초음파검사의 유용성: 규칙적 6분 생검 결과와의 비교

문민환,성창규,정준용,최혁재,심정석,김승협 대한영상의학회 2001 대한영상의학회지 Vol.45 No.2

목적: 전립선암의 진단에 있어서 규칙적 6분 생검(systemic sextant biopsy) 결과를 토대로 경직장초음파검사(transrectal ultrasonography: TRUS)의 유용성을 평가하였다 대상과 방법: 전립선암이 의심되어 경직장초음파 유도하에 규칙적 6분 생검을 시행한 84명의 환자 중 미만성 병변으로 보인 9예를 제외한 75명을 대상으로 하였다. 경직장초음파 소견상 전립선 변연부에 국소적 병변을 보인 14명의 환자에서는 국소 병변에 대한 생검을 추가로 시행함으로써 총 464개의 생검 조직을 얻었으며 이들 생검 조직을 경직장초음파 소견과 후향적으로 비교하였다. 결과: 전립선암의 진단에 있어 전립선 변연부의 국소적 저음영을 양성 소견으로 하여 평가한 경직장초음파검사의 민감도, 특이도는 각기 48%. 97%였으며 양성전립선비대증 결절에 의한 위양성률(false positive rate)은 53%였다. 국소적 저음영은 전립선암의 경우 전립선 주변대의 바깥쪽 1/2에 위치하는 경우가 가장 많았고, 양성전립선비대증 결절의 경우는 이와는 반대로 안쪽 1/2에 위치하는 경우가 가장 많았으며 , 이들 두 그룹간에 통계적으로 유의한 타이를 보였다(p= 0.01) . 결론: 전립선암의 진단에 있어서 국소적 저음영의 위치가 전립선암과 양성전립선비대증 결절간의 감별 진단에 도움이 되며 양성전립선비대증 결절에 의한 경직장초음파검사의 위양성률을 줄 일 수 있으리라고 생각한다 Purpose: To retrospectively compared the usefulness of the transrectal ultrasonography LEAVE A SPACE (TRUS) and systemic sextant biopsy in the diagnosis of prostate cancer. Materials and Methods: A total of 84 patients with clinical and laboratory findings suggestive of prostate cancer undenwent TRUS and systemic sextant biopsy. Nine patients with diffuse prostatic lesion had been excluded from the list. Following sonographic evaluation, additional targeted biopsy for the focal lesion was performed in 14 patients. A total of 464 biopsy specimens were obtained and retrospectively compared with the monographic findings. Results: For cancer, the sensitivity, specificity and false-positive rate of TRUS were 48%, 97% and 53%, respectively. The hypoechoic nodules seen in prostate cancer were more commonly located in the outer half of the peripheral zone of the prostate, while most BPH lesions were located in the inner half of this zone. Between prostate cancer and BPH there was a statistically significant difference in the location of hypoechoic nodules revealed by TRUS (p = 0.01). Conclusion: The location of the hypoechoic nodules provides useful information for differentiating between BPH nodoles and malignant prostatic nodules and may reduce the false-positive rate of TRUS in the diagnosis of prostate cancer.

남성 불임에 있어 초음파 검사의 역할

문민환,성창규 대한초음파의학회 2012 ULTRASONOGRAPHY Vol.31 No.3

US evaluation is the mainstay of diagnostic imaging of infertile men. In this editorial,we review the spectrum of diseases responsible for male infertility, discuss the way in which US imaging studies can be used for evaluation of male infertility, and illustrate characteristic US imaging features that allow for specific diagnosis. The discussion will be divided into three main categories: obstruction in sperm passage, impairment of sperm function, and defect in sperm genesis. 남성 불임의 평가에 있어 가장 기본이 되는 영상의학적검사는 초음파 검사이다. 이번 종설에서는 남성 불임을 일으킬 수 있는 질환들을 정자 통과 장애, 정자 기능 장애, 정자 형성 장애의 세 가지 범주로 나누어 알아보고, 이들 각범주에 어떤 질환들이 있으며, 초음파 검사가 이들 질환들의 평가에 있어 어떤 역할을 담당할 수 있는지, 그리고 각질환들의 특징적인 초음파 검사 소견에 대해 알아보고자하였다.

저 전력 초 재생 수신기의 DC 감쇠효과 보상을 위한 채널 등화기 설계

문민환(Moon Min Hwan),김재석(Kim Jae Seok) 한국통신학회 2012 한국통신학회 학술대회논문집 Vol.2012 No.6

Guidelines for Transrectal Ultrasonography-Guided Prostate Biopsy: Korean Society of Urogenital Radiology Consensus Statement for Patient Preparation, Standard Technique, and Biopsy-Related Pain Management

이명석,문민환,김찬교,박성윤,최문형,정성일 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.4

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners’ situation and preferences.

부신우연종: 영상의학적 접근과 감별진단

이명석,문민환,성창규 대한영상의학회 2019 대한영상의학회지 Vol.80 No.6

Adrenal incidentaloma refers to adrenal masses that are accidentally found on imaging performed for other reasons, without clinical symptoms of adrenal disease. Generally, adrenal masses measuring less than 1 cm are not considered adrenal incidentalomas. The purpose of radiologic examination in evaluating non-functioning adrenal incidentalomas is to distinguish between benign and malignant masses to establish the treatment plan. In this review, based on previously published research and recommendations, we describe the radiologic approach for adrenal incidentaloma and describe the imaging findings of representative diseases. 부신우연종(adrenal incidentaloma)은 부신 질환을 의심할 만한 임상증상 없이, 다른 이유로 시행한 영상검사에서 우연히 발견된 1 cm 이상의 부신 종괴를 의미한다. 내분비 기능이없는 부신우연종에서 영상의학적 검사의 목적은 양성과 악성을 감별하여 치료 방침의 수립에 도움을 주는 것이며, 특히 부신우연종의 80% 이상을 차지하는 부신선종을 감별하는 것이중요하다. 본 종설에서는, 이전에 발표된 연구 및 권고안들을 근거로 하여 부신우연종의 영상의학적 접근방법을 기술하고, 대표적인 종괴의 영상 소견을 기술하고자 한다.

Renal Doppler ultrasonography for predicting non-diabetic kidney disease in patients with diabetes

정성일,문민환,성창규,이명석,박정환,Oh Sohee 대한초음파의학회 2023 ULTRASONOGRAPHY Vol.42 No.3

Purpose: This study was conducted to assess the role of renal Doppler ultrasonography (US) in predicting non-diabetic kidney disease (NDKD) in patients with diabetes, using histologic findings as the reference standard. Methods: Fifty-nine consecutive patients with diabetes who underwent renal Doppler US and native kidney biopsy were included in this retrospective, single-institutional study. Based on histologic findings, patients were classified as having diabetic nephropathy (DN) or NDKD. Renal Doppler US findings, including cortical echogenicity, corticomedullary differentiation, and the resistive index (RI), were compared between DN and NDKD. A subgroup analysis according to chronic kidney disease (CKD) status was also performed. Results: Cortical echogenicity and corticomedullary differentiation showed no significant differences between DN and NDKD (P=0.887 and P>0.99, respectively), whereas the RI was significantly higher in patients with DN than in those with NDKD (P=0.032). The subgroup analysis revealed a significant difference in the RI between DN and NDKD in patients with diabetes and CKD (P=0.010), but a significant difference was not found in those without CKD (P=0.713). When limited to patients with diabetes and CKD, the RI had an area under the curve value of 0.759, sensitivity of 57.1%, specificity of 81.0%, positive likelihood ratio of 3.0, and negative LR of 0.5 for predicting NDKD, using a cutoff value of ≤0.69. Conclusion: Renal Doppler US may be useful in predicting NDKD in patients with diabetes and CKD.

3cm 이하의 신세포암과 혈관근지방종의 혈관 분포에 따른 감별

임근영,문민환,김효철,김승협 대한초음파의학회 2003 ULTRASONOGRAPHY Vol.22 No.3