백혈병 환자의 골스캔 소견

박용휘(Yong Whee Bahk),김춘열(Choon Yul Kim),정수교(Soo Kyo Chung),박정미(Jeong Mi Park),신경섭(Kyung Sub Shinn),최효선(Hyo Sun Choi),손형선(Hyeong Seon Sohn) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1

N/A The leukemias represent diffuse lesions of the bone marrow and significant bony abnormalities are associated with the more aggressive varieties of leukemias and with the younger age groups. On plain film, several roentgenographic findings are observed such as diffuse osteopenia, radiolucent metaphyseal bands, osteolytic lesions and periostitis. We evaluated bone scintigraphic findings using Tc-99m-methylene diphosphonate (Tc-99m-MDP) in ten patients with proven leukemia. The scan is abnormal in 90%. We classified abnormal scintigraphic findings to 3 types and these are increased diffuse juxta-articular uptake, focal increase of uptake and combined type. The common sites of focal uptake were femur, humerus, tibia, spine, ribs, calvarium, scapula and mandible. We concluded that Tc-99m-MDP bone scintigraphy is sensitive imaging modality in leukemic patients with bone pain.

간혈관종 진단에 있어서의 표지 적혈구 SPECT 스캔의 유용성

박용휘(Yong Whee Bahk),이명희(Myung Hee Lee),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),양우진(Woo Jin Yang),김현숙(Hyeon Sook Kim) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A The usefulness of 99mTc-labeled RBC single photon emission CT (SPECT) scanning in the diag- nosis of hepatic heminagiomas was evaluated in 22patients with various focal hepatic lesions including 15 cases of hemangiomas, 3 cases each of hepatomas and rnetastasis and 1 case of abscess. The diagnoses were based on ultrasonography and/or CT scanning, clinical stability of lesion for at least 6 months or surgical exploration. Seven cases of 1S hemangiomas were detected by delayed planar RRC scanning, whereas 4 cases were detected by delayed RBC-SPECT scanning. The smallest hemangioma shown hy delayed RBC-SPECT scanning was 1.0 cm m diameter, compared with 2,2 cm by planar RBC scanning. One smaIl hemangioma (2 0 cm) located adjacent to the heart was not found by either method. The sensitivities in detecting the hemangioma according to the size by planar imaging were 16.6% (l.0 1.9 cm), 66. 7% (2.0 2.9 cm) and 83.3% (more than 3.0 cm) and by SPECT were 50.0%, 66.7% and 100%, respectiively Seven cases of non-hemangiomatous Iesions did not show any significant increase in activity in the delayed blood pool images. It is concluded that 99mTc-RBC blood-pool SPECT scanning is clearly more sensitive in detecting small hemangioma than planar scanning and is, therefore, a choice of method for the detection of hepatic hemangiorna.

99mTc - HMPAO를 이용한 자가백혈구표지 및 그를 이용한 염증병소의 스캔

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),양우진(Woo Jin Yang),김훈교(Hoon Kyo Kim) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.2

N/A Inflammation scan using radiolabelled leukocytes has high sensitivity and specificity. Several methods for labelling leukocytes have been evaluated using P-32 diisopropyl fluorophosphate (DFP -32), H-3 thymidine, Cr-5I chromate, Ga-67 citrate and Tc-99m-sulfur colloid. In-lll-oxine has proved so far to be the most reliabte agent for labelling leukocytes. In-111-oxine is, however, expensive, not easily available when needed, and its radiation dose to leukocytes is relatively high. Moreover, resolution of the resultant image is relatively poor. Tc-99m is still the agent of choice because of, as compared with the indium, its favorable physical characteris- tics, lower cost and availability. Now the technique for labelling the leukocytes with technetium is successfully obtained using the lipophilic HAPAO with higher efficiency for granulocytes than for other cells. With this technique it is possible to label leukocytes in plasrna to improve the viability of the leukocytes. Inflammation scan using Tc-99m-HMPAO has been evaluated in several laboratories, and difference in methods for separation and labelling accounts for difference in efficiency, viability and biodistribution of the labelled leukocytes. We performed inflammation scan using leukocytes labelled with Tc-99m-HMPAO in three dogs 24 hours after inoculation of live E. Coli and S. Aureus in their right abdominal wall. We separated mixed leukocytes by simple sedimentation using 6% hetastarch (HES) and labelled the leukocytes with Tc-99m-HMPAO in 20% cell free plama diluted with phosphate buffer solution(Fig. 1). Uptake was high in the liver and spleen but is was rninimal in the lungs on whole body scan. Kidneys and intestine showed minimal activity although it was high in the urinary bladder(Fig. 2). Uptake of labelled leukocytes in the inflammation site was definite on 2 hour-postinjection scan and abscess was cleariy delineated on 24 hour-delayed scan with high target-to-nontarget ratio(Fig. 3, 4). Inflammation scan using mixed leukocytes labelled with Tc-99m-HMPAO is very sensitive and specific in early detection of inflammation

바늘구멍 골스캔에 의한 갑상선암 골전이 병소내 중격의 묘출

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),김성훈(Sung Hoon Kim) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2

Metastatic thyroid carcinoma in bone shows characteristic expansile, trabeculated lysis on radiogram. The ordinary scintigraphy manifests with a simple photopenic defect. We were able to portray trabeculation within photopenic defects. We present papillary thyroid carcinoma and follicular thyroid carcinoma, one each, pinhole bone scintigraphic findings of which are cold area with septated increased uptake at the iliae bone. These findmgs correspond very well with their X-ray pictures.

정상 골스캔에서 치골 핵종 섭취 패턴

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),김성훈(Sung Hoon Kim),정명희(Myung Hee Chung),이홍재(Hong Jae Lee),임정익(Jung Ik Yim) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

N/A In order to establish the clinical significance of pubic bone uptake of radionuclide on Tc- 99m-MDP bone scintigraphs, we analyzed uptake patterns of normal adult pubic bone in 300 randomly sampled subjects. Bone scintigraphy was performed in each patient for the reasons other than pubic or pelvic problems. One-hundred-fifty-four were men and 146 women. The age ranged from 8 to 78 years. The pubic uptake was graded arbitrarily into 4 grades by comparing the pubic uptake density with that of L5 vertebra. Thus, grade I was defined as the L5 density greater than the pubic density, grade II as the L5 density equals to the pubic density, grade III as the L5 density less than the pubic density, and grade IV as the L5 density much less than the pubic density. Statistical analysis revealed negative trend in the pubic uptake from grade IV to grade I with age. There was no sexual difference in the pubic uptake. The women in the 3rd and 4th decades disclosed higher pubic uptake (grades III, IV) probably due to pregnancy and labor.

방사성동위원소 심조영술상 심전도게이트 일회통과법을 이용한 우심실 박출계수

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),신경섭(Kyung Sub Shinn),이성용(Sung Yong Lee),이해규(Hae Giu Lee),문영희(Young Hee Moon),박석민(Suk Min Park),임정익(Jeong Ik Yim),김영균(Young Gyun Kim),권순석(Soon Seog Kwon) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.1

N/A Radionuclide cardioangiography has been widily applied and has played mjor foles in moninvasive assessment of cardiac function. Three techinques, first-pass gated first and gated equlibrium nethods have commonly been used to evaluate right ventricular ejection fraction which usually abnormal in the patients with cardiopulmonary disease. It has been known that the gated first pass method is most accrate method among the three rechiques in assessment of fight ventricuiar ejection fraction. The radionuclide right ventricular ejection fraction values were determined in 13 normal subjects and in 15 patients with chronic obstructive puimonary disease by the gated first pass method and compared with those of the first pass method because there has been no published data of fight ejection fraction by the gated first pass method were compared with the detas from the pulmonary function test performed in the patients wih chronic obstructive pulmomar desease. The results were as follows; 1) The values of fight ventricular ejection fraction by the gated first pass method were 50.1 +- 6.1% in normal subjects and 38.5 +- 8.5 in the patients with chronic obstructive pulmonary disease. There was statistically significant difference between the right ventricular ejection fraction of each of the two groups (p<0.05) 2) The right ventricular ejection fraction by the gted first pass method was not linearly correlated ith FEV, VC. DLCO. and FVC as well as PO2 and PCO2 of the patients with chronic obstructive pulmonary disease. We concluded that right ventricular ejection fraction by the gated first pass method usingradionuclide cardioangiography may be suseful in clinical assessment of the right ventricular function.

반사성 교감신경계 기능장애 증후군 ( RSDS ) 의 손 3상 골스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박정미(Jeong Mi Park),신경섭(Kyung Sub Shinn),김성훈(Sung Hoon Kim),박영하(Young Ha Park),안명임(Myeong Im Ahn) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A Reflex sympathetir. dystrophy syndrome (RSDS), known also as Sudecks atrophy, is an uncomrnon disoder recognized by its distinctive symptom complex consisting of pain and tenderness, vasomotor instability, swelling, and dystrophic skin changes and radiologic changes. The present study has been carried out to prospectively establish scintigraphic diagnostic criteria for RSDS using three-phase radionuclide bone scintigraphy (TPBS). In addition, the csefulness in the evaluation of treatment of RSDS was assessed. Patients included were 6 men and 7 women with the age ranging from 25 to 63 years (average 47 years). Diagnosis was based on typical clinical symptoms and signs as described above. Associated r.linical conditions in these patients were cerebral infarction (4 patients), lung cancer (2 patients), trauma (1 patient), lymphoma (1 patient), and unknown cause (5 patients). All patients showed diffuse radionuclide accumulation in juxtaarticular region on the delayed static image and 11 patients showed diffusely increased activities also on scintiangiogram and blood-pool image. Fillow-up TPBS after corticosteroid therapy in 4 patients revealed near normal return of abnormal radionuclide accumulations in the affected hand. TPBS is an useful test for the diagnosrs of as well as the evaluation of the therapeutic effects of RSDS.

일과성 뇌허혈 발작 환자에 있어서 99mTc - HMPAO 국소 뇌혈류 SPECT의 유용성

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),이성용(Sung Yong Lee),김종우(Jong Woo Kim),박영하(Young Ha Park),안명임(Myeong Im Ahn) 대한핵의학회 1989 핵의학 분자영상 Vol.23 No.2

N/A Transient ischemic attacks (TJAs) is a syndrome resulting from brain ischemia lasting less than 24 hours. The mechanisms of TIAs may be similar to those of cerebral embolism and thrombosis, and thus TIAs may be followed by cerebral infarction. Despite the availability of CT scanning, the diagnosis and management of TIAs continue to be difficult. Recently SPECT has been advocated as a diagnostic imaging modality. We performed Tc-99m-HMPAO regional cerebral blood flow (rCRF) SPECT in 24 patients with the clinical diagnosis of TIAs to assess its ability to detect early changes of rCBF, and determine the diagnos(ic value. l en men and fourteen women with an average of 51 years (range; 27- i4 years) were i ncluded. All but 8 patients had normal brain CT prior to SPECT. The two patients had mdderate degree of hrain atrophy and the 6 patients nonspecific calcifications. Eighteen of the 24 patients had abnormal Tc-99m-HMPAO rCBF SPECT. Fifteen had unilateral involvement and the other three had bilateral involvemeots. Seventy-five percents of the defects were found in the left cerebral hemisphere. According to the distribution of the lesions (total number: 34 tesions), fourteen were in the parietal, eight in the ternporal, and the remainders were elsewhere. Tc-99m-HMPAO rCHF SPECT is sensitive in detecting vCRF abnormalities in patients with TIAs, and represent the most accurate diagnostic tool available in the diagnosis of TIAs.

기관지 천식의 연무흡입 폐환기스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박정미(Jeong Mi Park),신경섭(Kyung Sub Shinn),박영하(Young Ha Park),김범수(Bum Soo Kim),정명희(Myung Hee Chung) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1

N/A Radioaerosol inhalation imaging (RII) has been used in radionuclide pulmonary studies for the past 20 years. The method is well accepted for assessing regional ventilation because of its usefulness, easy fabrication and sirnple application system. To evaluate its clinica1 utility in the study of irnpaired regional ventilation in bronchial asthma, we obtained and analysed RIIs in 31 patients (16 women and 15 men; age ranging 21-76 years) with typical bronchial asthma at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Wledical colle#ge, from January, 1988 to August, 1989. Scintiscans were obtained with radioaerosol produced by a HARC(Bhabha Atomic Reserch Center, 1nc]ia) nebulizer with 15 mCi of Tc-phytate. The scanning was performed in anterior, posterior and lateral projections foIlowing 5-rninute inhalation of radioaerosol on sitting position. The scans were analyed and correlated with the results of pulmonary function study and the findings of chest radiography. Fifteen patients had concomitant lung perfusio#n image with ' Tc-MAA. Follow-up scans were obtained in 5 patients after bronchodilator therapy. 1 he patients were divided into (1) att.ack type (4 patients), (2) resistant type (5 patients), (3) remittent type (10 patients) and (4) bronchitic type (12 patients). Chest radiography showed hyperinflation, altered pulmonary vascularity, thickening of the bron- chial wall and accentuation of hasal interstiti.al markings in 26 of the 31 patients. Chest radiographs were normal in the remaining 5 patients. Regardless of type, the findings of RII were basically the same, and characterized by the deposition of radioaerosol in the central parts or in the main respiratory air ways along with mottled nonsegmental ventilation defects in the periphery. Peripheral parenchymal defects were more extensive than that of expected findings from clinical symptoms, pulmonary function test and chest radiograph. Rroomstick sign was present in 1.7 patients. The abnorrnality of RII was poorly correlated with perfusion scans. In all 5 patients treated with bronchodilators, follow-up study demonstrated a decrease in the degree of radioaerosol deposition in the central air way with improved ventilation defects. This study indicates that RII is a useful technique for the evaluation of regional ventilation abormality and the effect of treatrnent with bronchodilators in patients with bronchial asthma.

폐기종의 연무흡입 폐환기스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박영하(Young Ha Park),전정수(jeong Su Jeon) 대한핵의학회 1990 핵의학 분자영상 Vol.24 No.2

N/A Perfusion and ventilaion imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonary emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebulizer with 15 mCi of Tc- 99m-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to l0-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with Tc-99m-MAA was performed in 12 patients. In five patients, we performed fo1low-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was diffuse (6/21), discrete(6/21), intermediate (3/21), or combined (6/21). In 12 patients studied also with perfusion scans, perfusion defects matched closely with ventilation defects in location and configuration. But the size of the ventilation defects was generally larger than the perfusion defects. In all four patients treated with bronchodilators, the follow-up study demonstrated decrease in abnormal of radioaerosol deposition in the central airway with improvement of ventilation defects. RII was useful technique for the evaluation of regional ventilatory abnormality and the effects of treatment with bronchodilators in pulmonary emphysema.