관상동맥 질환 진단에서 ATP 부하 T1-201 심근 관류 SPECT 의 안전성과 유용성

배문선,박찬희,윤석남,김원,김한수 ( Moon Sun Pai,Chan H Park,Seok Nam Yoon Won Kim,Han Soo Kim ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.3

Purpose: ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet been sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-201 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. Materials and Methods: Thalliurn-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/kg/min for 6 rnin). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. Results: Although 76.5% of the patients had sorne adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. Conclusion: Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease. (Korean J Nucl Med 1998;32:250-8)

급성심근경색환자의 심근생존능 평가에 있어서 T1-201 재분포영상과 24시간 재주사영상의 역할

윤석남,배문선,박찬희,윤명호,최병일 ( Seok Nam Yoon,Moon Sun Pai,Chan H Park,Myung Ho Yoon,Byung Il William Choi ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4

Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in Tl-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection Tl-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or l (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assess-ment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress- reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of rnyocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other. (Korean J Nucl Med 1998;32:325-31)

유즙분비가 있는 갑상선암 환자에서 I-131 치료

서정호(Jung Ho Suh),박찬희(Chan H. Park),배문선(Moon Sun Pai),김경래(Kyung Rae Kim) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.1

N/A We report a 37 year-old-female patient with papillary thyroid cancer treated by surgery who demonstrated residual thyroid and bilateral breast uptake on a diagnostic I-131 whole body scan. She had an extrathyroidal extension needing I-131 ablative therapy. Her galactorrhea was investigated and treated with low doses of bromocriptine prior to I-131 therapy. Her galactorrhea was due to the decreased secretion of PIF induced by empty sella.

High Strength Titanium Alloy Design for Additive Manufacturing

P. L Narayana(나라야나),Jae H. Kim(김재혁),Sang-won Lee(이상원),Chan-hee Park(박찬희),Jong-Taek Yeom(염종택),Jae-Keun Hong(홍재근) 대한용접·접합학회 2023 대한용접학회 특별강연 및 학술발표대회 개요집 Vol.2023 No.5

급성심근경색 환자에서 역재분포를 보인 심근의 Thallium 재주사에 의한 생존능의 평가

윤석남(Seok Nam Yoon),배문선(Moon Sun Pai),박찬희(Chan H Park) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.6

N/A Purpose: The aim of this study was to evaluate whether T1-201 reinjection distinguishes viable from non-viable myocardium in patients with reverse redistribution after acute myocardial infarction. Materials and Methods: We studied 42 patients with acute myocardial infarction (age, 55±12 years). Eighteen (43%) out of 42 showed reverse redistribution on dipyridamole stress-4 hour redistribution T1-201 single photon emission computed tomography (SPECT). T1-201 reinjection was performed at 24 hours. Reverse redistribution was defined as worsening of perfusion defect at 4 hour delayed scan. All patients underwent follow-up echocardiography in 4 months to assess regional wall motion improvement. T1-201 uptake on reinjection images were analyzed for the prediction of myocardial wall motion improvement. Results: Of 36 segments with reverse redistribution, 17 segments showed normal wall motion on echocardiography, while 19 segments showed all motion abnormalities. Of 19 the segments with reverse redistribution, 11 (58%) showed enhanced uptake after 24 hour reinjection. Myocardial wall motion was improved in 10 of 11 segments (90%) with enhanced uptake on reinjection. Wall motion improvement was not seen in 5 of 8 segments (63%) without enhanced thallium uptake. When myocardial viability was assessed by the uptake on reinjection image, nine of 10 segments (90%) with normal or mildly decreased uptake showed improved wall motion. Wall motion was not improved in 5 of 9 segments (56%) with severely decreased uptake. Conclusion: In patients with acute myocardial ifarction, T1-201 reinjection imaging on myocardial segments with reverse redistribution has a high positive predictive value in the assessment of myocardial viability

비소세포폐암의 림프절 병기 결정에서 Coincidence PET의 역할

이선민 ( Sun Min Lee ),최영화 ( Young Hwa Choi ),정성철 ( Seong Cheoll Cheong ),오윤정 ( Yoon Jung Oh ),박광주 ( Kwang Joo Park ),황성철 ( Sung Chul Hwang ),이이형 ( Yi Hyeong Lee ),박찬희 ( Chan H. Park ),한명호 ( Myung Ho Hah 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.47 No.5

자발성 두개 내 저혈압의 뇌조조영술 소견

박찬희,윤석남,배문선,김수지,오윤민,김장성 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.2

We report four cases of spontaneous intracranial hypotension that were investigated by radionuclide cisternography Tc-99m-diethylenetriamine pentaacetic acid radionuclide cisternography of all our patients showed direct sign of cerebrospinal fluid leakage as well as indirect signs of less activity than expected over the cerebral convexities and rapid appearance of bladder activity. The headache of all patients was eventually controlled with bed rest and hydration.

핵의학 유방영상법을 이용한 작은 유방암 진단

박찬희,Gonsalves, Carin,Rosenberg, Ann,Rosato, Francis,Feig, Stephen A . 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.4

부갑상선 기능 항진증 환자에서의 ^(99m)Tc-Sestamibi를 이용한 부갑상선 영상

황경훈,박찬희,윤석남,배문선,김수지,진윤미 아주대학교 의과학연구소 1999 아주의학 Vol.4 No.1

Parathyroid imaging with ^(99m)Tc-sestamibi (MIBI) was performed in patients with biochemical diagnosis of primary hyperparathyroidism to localize or lateralize the parathyroid lesion. Eleven patients with suspected hyperparathyroidism were subjected to a MIBI study prior to surgical exploration of the neck. Surgical exploration of the neck was performed in 7 patients, 6 patients among them showing parathyroid adenoma and one parathyroid carcinoma. MIBI scan correctly diagnosed and localized all 6 parathyroid adenomas and localized 1 parathyroid carcinoma. In conclusion, parathyroid imaging with ^(99m)Tc-sestamibi (MIBI) is an effective method for detection and localization of parathyroid adenomas in patients with primary hyperparathyroidism.

알쯔하이머병의 단일 광전자 방출 뇌전산화 촬영에서 전형적인 유형과 관계를 보이는 요인

곽용태,한일우,방오영,박찬희,구민성 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 최근 기능적 영상진단의 발전은 치매 환자의 진단에 많은 도움을 주고 있으며 이중 단일광자방출전산화단층촬영(SPECT ; single photon emission computed tomography)은 알쯔하이머 병의 특징적인 양측 두정측두엽의 혈류 감소를 보이므로 알쯔하이머 병의 진단에 많이 사용되어지고 있다. 본 연구는 알쯔하이머병의 SPECT 소견을 분석함으로써 알쯔하이머병의 진단에 있어서 SPECT 검사의 유용성 및 알쯔하이머병에서 전형적인 유형에 영향을 미치는 요인이 무엇인지를 규명한다. 방 법 : NINCDS-ADRDA진단 기준에 의거한 probable AD환자 26명을 대상으로 SPECT 검사를 시행하였으며 이중 14명은 전형적인 SPECT 소견을 보였으며 나머지 12명은 비전형적인 SPECT소견을 보였다. 치매의 정도는 Mini-Mental State Examination(MMSE)에 의하여 결정하였고 SPECT소견은 2명의 핵의학과 전문의의 합의에 의하여 정성적으로 판독하여 분석하였다. SPECT의 전형적인 소견과 연관이 있는 요소들을 확인하기 위하여 판별함수분석을 시행하였다. 결 과 : 알쯔하이머 환자에서 SPECT의 민감도는 53.8%이며, 조기 발병군의 경우에는 민감도가 76.9%이었다. 알쯔하이머의 전형적인 형태인 양측성 두정측두엽에 혈류량이 감소한 경우는 조기 발병군에서 유의하게 관찰되었으며, 이외에 이환기간, 교육정도, 성,병의 진행정도, 아포지단백E등은 유의한 연관성이 없었다. 결 론 : SPECT검사의 민감도는 높지 않으나 이를 조기 발병군에서만 적용하였을 경우 그 임상적 유용성이 높을 것으로 생각되며 조기 발병군에서 SPECT검사의 민감도가 만기 발병군에 비하여 유의하게 높은 것으로 보아 알쯔하이머병이 단일하지 않고 이질적인 집단의 증후군일 가능성이 높을 것으로 생각된다. 즉 SPECT검사가 알쯔하이머병의 진단뿐 아니라 병태생리적 기전의 이해에 도움이 될 것으로 생각되며 앞으로 정량화와 많은 중례를 확보하여 이에 대하여 좀더 규명할 필요가 있을 것으로 생각된다. Objectives : During the past few years, the development of functional brain imaging techniques has allowed to describe brain impairment in cognitive disorders. Among them, based on the observation of bilateral parietotemporal hypoperfusion in Alzheimer's disease(AD), single photon emission computed tomography(SPECT) is advocated by some as powerful diagnostic tool in the evaluation of demented patients. The aim of this study is to investigate the usefulness of SPECT in the diagnosis of AD and to clarify the associated factors of parietotemporal hypoperfusion, the typical SPECT pattern of Alzheimer's disease(AD). Methods : We reviewed the SPECT scans of 26 patients fulfilling NINCDS-ADRDA criteria for probable AD, 14 with typical pattern of SPECT and 12 with atypical pattern of SPECT. Dementia severity was assessed by the Mini-Mental State Examination. Inage interpretation was done visually by the consensus opinion of 2 experienced nuclear medicine physicians who were blind to clinical information. To estimate the association of typical pattern of SPECT with other variables of interest, discriminant function analysis was done. Results : Though the overall diagnostic sensitivity of SPECT in AD was 53.8%, it was 76.9%, in early-onset AD patients. Typical pattern of SPECT was more frequent in the patients with early onset on the symptoms. Duration of symptoms, duration of education, se, severity of disease was not associated with this SPECT pattern. Conclusion : These findings may be useful in the clinical setting and point to heterogeneity of AD according to age at onset.