칼라와 모션 정보를 이용한 비디오 구조화 시스템 구현

송창준,고한석,권용무 한국방송공학회 1999 한국방송공학회 학술대회 Vol.1 No.1

선천성 고관절 탈구와 Legg-Calve-Perthesqud에 있어서 고관절조영술의 의의

송창준 대한영상의학회 1990 대한영상의학회지 Vol.26 No.2

Hip arthrogram is often requested for both congenital hip dislocation and Legg-Calve-Perthes disease in pediatric age group and has been known as a valuable procedure to evaluate the contour of cartilaginous femoral head, and the relationship of acetabulum and femoral head, which are not observed on plain film, But, arthrogram is an invasive study, and we have experienced a number of confusions for its role in taking care of patients involved in congenital dislocation of the hip and Legg-Calve-Perthes disease. For this reason, centered on its significance in determining treatment plan and predicting prognosis, we retrospectively reviewed 41 arthrograms in 36 patients; 16 arthrograms of congenital dislocation of the hip in 13 patients and 25 arthrograms in Lee-Calve-Perthes disease in 23 patients, which were performed at Department of Diagnostic Radiology, College of Medicine, chungnam national University from January 1985 to May 1989. The results were as follows. 1. Congenita dislocation of the hip 1) Under the fluoroscopic control we evaluated the possibility of closed reduction after injection fo contrast media into the joint capsule and if closed reduction was not successful, obstacles to closed reduction were observe. As a result, failure of closed reduction was appreciated in 12 cases of 16 patients and inhibiting factors of closed verse acetabular ligament thickening : 10 cases, ligament teres thickening : 8 cases, iliopsoas muscle thickenign : 8 cases, capsular adhesion : 7 cases, other space occupying lesions such as fatty and / or fibrous tissue : 9 cases. 2) Hip arthrogram was an excellent method to evaluate the possibility of success of closed reduction and to find inhibiting factors of closed reduction before open reduction. 2. In Legg-Calve-Perthes disease Hip arthrogram was an useful means to evaluate deformity or irregularity of cartilaginous femoral head, enlargement and lateral extrusion of femoral head, and incongruity of hip joint, but it was not satisfactory to determine treatment plan and to product prognosis based on its findings during process of disease.

신생아 저혈당증에 의한 뇌손상: 증례 보고

송창준,Song, Chang-Jun 대한영상의학회 2003 대한영상의학회지 Vol.49 No.4

신생아의 저혈당은 비교적 흔하게 관찰되지만 저혈당에 의한 뇌손상에 대한 국내보고는 드물다. 뇌손상에 의한 신경학적 증상으로 혼미, jittering, 발작 등이 있을 수 있으나 임상증상은 대개 경미하여 진단이 지연되거나 어려울 수 있다. 생후 3일된 신생아가 2일전부터 시작된 설사, 수유곤란과 함께 생체활성도가 떨어져 응급실로 내원하여 저혈당증으로 진단된 후 입원했다. 생후 11일째 시행한 자기공명영상소견은 T2및 확산강조영상에서 주로 후두엽, 두정엽, 측두엽을 포함한 대뇌의 후방에 피질과 피질하 맥질에 고신호강도의 병변이 관찰하여 문헌 고찰과 함께 보고하고자 한다. Although hypoglyemia may be common among neonates, brain injuries resulting from isolated neonatal hypoglycemia are rare. The condition may cause neurological symptoms such as stupor, jitteriness, and seizures, though in their absence, diagnosis is delayed or difficult. Hypoglyemia was diagnosed in a three-day-old neonate after he visited the emergency department with loose stool, poor oral intake, and decreased activity, first experienced two days earlier. Two days after his visity, several episodes of seizure occurred. T2 and diffusion-weighted magnetic resonance (MR) scanning, performed at 11 days of age, revealed bilateral and symmetrical high signal intensity lesions in ocipital, parietal, and temporal lobes. We report the MR findings of hypoglycemic encephalopathy in a neonate.

미만성 축삭손상의 자기공명 영상소견

송창준 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Purpose : To assess how accurately magnetic resonance image can demonstrate the diffuse axonal shearing injury which is believed to be developed after head trauma by the mechanism to which Holbourn suggested, to analysis the MR findings of shearing injuries, and to do comparative study of MR and CT. Materials and method : Twelve patients studied to evaluate the sequelae of head trauma who underwent MR and had diffuse shear injuries on magnetic resonance images were included in the series. Patients who have a possibility of cerebral infarction, have a widened Virchow-Robin space due to cerebral atrophy, and have a possibility of fat embolism from the clinical course were excluded from the study. The author evaluated MR findings with the special attention to the prevalant location, size, shape and presence of hemorrhage, and tried to define the respective roles of MR and CT. Results : The locations of the lesions were Gray-white matter junction of lobar white matter, corpus callosum, subcortical gray matter, internal capsule, brainstem, and cerebellum. Non-hemorrhagic lesions were snore common than hemorrhagic lesions, especially in the gray-white matter junction. Size and shape of the lesions in the gray-white matter junction and of the lesions in the rest were punctate and small granular, and oval or round shaped lesions, respectively. MR was found to be equal or superior to CT in all the cases. Conclusion : MMR is extremely valuable in the assessment of patients with head trauma and recommend it as the primary imaging method in all patients with minor head trauma as well as in those with moderate to severe injuries in the subacute, chronic, or remote, though CT still remains as an important imaging modality for the acutely injured patients with significant neurologic impairment because of the limitations of MR in the identification of subarachnoid hemorrhage, acute parenchymal hemorrhage and skull fracture.

칼라와 모션 정보를 이용한 비디오 구조화 시스템 구현

송창준,고한석,권용무 한국방송·미디어공학회 1999 한국방송공학회 학술발표대회 논문집 Vol.1999 No.-

결핵성 경부임파선염의 전산화 단층촬영 소견

송창준,정연수,최창락,윤완규,조준식 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Purpose : To evaluate the computed tomography (CT) findings of the cervical tuberculous lymphadenitis Methods and materials : The CT features in 10 patients of tuberculous lymphadenitis were retrospectively reviewed. We characterized the morphologic appearances of lymphadenopathy on post-contrast CT scan and comparatively evaluated the densities of central necrotic portion and peripheral solid portion of necrotic nodes on pre-contrast CT scan. All examines were performed on a General Electric Hispeed Advantage RP System. Ten millimeter and five millimeter contiguous sections from skull base to thoracic inlet were obtained for the pre-contrast and post-contrast images respectively. Results : Most patients were young adults. A painless neck mass was the most common chief complaint and the duration of the symptoms was about 5 months. The average number of diseased lymph nodes was 3.7. Unilateral involvement was 4 times as common as bilateral location. Central necrotic lymphadenopathy was 78.3% of 37 enlarged lymph nodes and the density of the nerotic portion was isodense to the density of the peripheral wall on pre-contrast images in 71.4% of necrotic lymph nodes. The most common morphologic features of cervical tuberculous lymphadenitis was the type of a multichambered or conglomerated necrotic lymphadenopathy with a peripheral irregular enhancement. Conclusion : The tuberculous cervical lymphadenitis was highly suggestive when the diseased lymph nodes show the central necrosis, the morphologic features of multichambered or conglomerated necrotic lymphadenopathy with a strong peripheral irregular contrast enhancement, and necrotic materails isodense to peripheral solid portion on pre-contrast CT scan in young adult patients who complain of a painless neck mass.

성인에서 발견된 비인두의 기형종: 1예 보고

송창준,강대영,Song, Chang-Jun,Gang, Dae-Yeong 대한영상의학회 2002 대한영상의학회지 Vol.47 No.2

Nasopharyngeal teratomas are rare congenital tumors which mainly cause neonatal respiratory difficulty or feeding problems. We report an extremely rare case of nasopharyngeal teratoma in which a 34-year-old woman experienced a foreign body sensation. Simple radiographs and CT scans revealed the presence of an exophytically growing mass with a region of fatty attenuation and a well-formed tooth in the nasopharyngeal wall. The mass was surgically removed, and found at histopathology to be a mature teratoma. 비인두에서 발생한 기형종은 매우 드문 선천성 종양으로 주로 신생아에서 호흡 장애나 수유곤란을 초래하는 종괴로 알려져 있다. 저자들은 목에 이물감이 있어 내원한 34세의 여자로 단순 촬영과 CT에서 잘 발달된 치아와 지방 성분을 함유한 외장성 종괴가 발견되어 수술을 시행한 결과 성숙 기형종으로 진단된 1예를 경험하였기에 이를 보고하고자 한다.

뇌전이암 진단에서 세부절개 이중조영증강 전단화단층촬영

송창준,Song, Chang-Jun 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:뇌전이암 결절의 진단에서 고식적 조영증강 전산화단층촬영(computed tomography,CT)과 비교하여 세부절개 이중조영증강 CT의 유용성을 알아보고자 하였다.대상과 방법:뇌전이암 결절이 있었던 16명의 환자를 대상으로 하였다.촬영방법은 10 mm 두께의 고식적 조영증강 전 후 CT를 얻은 직후 조영제 100 ml를 추가로 주입하여 10 mm와 5mm 두께의 이중조영증강 CT를 얻고 각각의 검사방법에서 발견된 뇌전이 결절수를 비교하였다.조영증강 자기공명영상(magnetic resonance image,MRI)을 같이 시행한 7명의 환자를 대상으로 MRI와 CT를 비교하였다. 결과:발견된 뇌전이암 결절은 고식적 조영증강 CT에서 14개 (39%),이중조영증강 CT에서 22개 (61%),세부절개 이중조영증강 CT에서 36개 (100%)로 세부절개 이중조영증강 CT에서 고식적 조영증강 CT에 비해 2.6배 많았다.이중조영증강 CT에서는 16명의 모든 환자에서 뇌전이암 결절이 발견되었으나 고식적 조영증강 CT에서는 7명에서 뇌전이암 결절이 있었고 5명에서는 뇌부종만 관찰되었으며 나머지 4명은 정상이었다.5 mm 이하의 크기가 작은 결절은 고식적 조영증강 CT에서 4개,이중조영증강 CT에서 7개,세부절개 이중조영증강 CT에서 18개였다.조영증강 MRI를 같이 시행한 7명의 환자에서는 세부절개 이중조영증강 CT에서 11개, 조영증강 MRI에서 17개의 뇌전이암 결절을 발견하였다.조영증강 MRI에서 발견되었으나 세부절개 이중조영증강 CT에서 발견되지 않은 결절은 모두 크기가 5 mm 이하였고 소뇌나 두개골에 연한 하부 측두엽에 위치하였다.결론:뇌전이암 결절의 진단에서 세부절개 이중조영증강 CT는 고식적 조영증강 CT에 비해 월등히 우수하였다. Purpose: To compare the usefulness of double-dose contrast-enhanced CT (DDCE-CT) and conventional contrast- enhanced CT (CCE-CT) in the detection of metastatic brain lesions. Materials and Methods: Sixteen patients with brain metastases were evaluated with both CCE-CT and thinslice DDCE-CT. For CCE-CT, an initial injection of 100 ml contrast medium was given, and DDCE-CT with both 10-mm and 5-mm thickness was performed after the addition of an extra 100 ml of contrast medium. The numbers of metastatic lesions detected by CCE-CT and by DDCE-CT were compared, as were the findings of contrast-enhanced MRI (CE-MRI) and thin-slice DDCE-CT in seven patients who underwent both these procedures. Results: Fourteen metastatic brain lesions were detected by CCE-CT, 22 by 10-mm-thickness DDCE-CT, and 36 by 5-mm thickness DDCE-CT. Thus, almost 2.6 times more lesions were detected by thin-slice DDCE-CT than by CCE-CT. Metastatic lesions were detected by 10-mm-thickness DDCE-CT in 16 patients and by CCECT in seven; in five, edema only was detected, while in four there were no detectable metastases. CCE-CT detected four lesions of less than 5 mm in diameter, while 10-mm-thickness DDCE-CT and 5-mm-thickness DDCE-CT detected seven and 18 lesions, respectively. Eleven lesions were detected by thin-slice DDCE-CT and 17 by CE-MRI in the seven patients who underwent both CE-MRI and DDCE-CT. The lesions detected only by CE-MRI were less than 5 mm in diameter and were discovered in the cerebellum or inferior temporal lobe. Conclusion: Thin-slice DDCE-CT was superior to CCE-CT in detecting metastatic brain lesions.

뇌졸중 환자에서 자발성 미세 뇌출혈에 대한 경사에코 자기공명영상

송창준,Song, Chang-Jun 대한영상의학회 2003 대한영상의학회지 Vol.49 No.2

목적: 경사에코 자기공명명상에서 발견된 자발성 미세 뇌출혈 환자를 대상으로 미세 뇌출혈의 위험인자와 동반된 뇌질환을 분석하여 미세 뇌출혈의 임상적 의의와 영상진단의 역할을 알아보고자 하였다.대상과 방법:2001년 9월부터 2002년 12월까지 16개월간 경사에코기법을 이용한 자기공명영상에서 신호강도의 소실로 보이는 미세 뇌출혈이 있었던 32명의 환자 (남자 21명,여자 11명, 평균나이 63세)를 대상으로 후향적으로 분석하였다.자기공명영상은 1.5 T 기기를 사용하여 스핀에코 T1강조,고속스핀에코 T2강조,확산강조영상 및 경사에코영상을 얻었다.경사에코 자기공명영상에서 출혈의 크기가 5 mm 이하인 경우 미세 출혈로 정의하여 미세 출혈의 수와 위치를 알아보았고 환자의 임상정보를 통해 고혈압,당뇨병,심장질환,고지혈증 등과 미세 출혈의 상관관계를 알아보았다.미세 출혈과 함께 자기공명영상에서 발견된 동반된 뇌질환의 자기공명영상 소견을 분석하였다.동반된 뇌졸중을 뇌출혈,소공경색,및 대뇌동맥영역의 뇌경색으로 나누어 조사하였다. 결과:32명의 환자에서 총 563개(1-66개,평균 17.6개)의 미세 출혈이 있었고,병변의 위치는 피질 및 피질하 백질에 216개,기저핵에 173개,시상에 92개,소뇌에 41개,뇌간에 36개,그리고 뇌량에 1개였고,20명은 양측성이었고 12명은 일측성이었다.동반된 질환은 고혈압이 26명,고지혈증이 12명,심장질환이 4명,당뇨병이 3명이었다.뇌졸중 병변은 32명 중 27명에서 있었고 뇌출혈이 10명,소공경색이 24명,그리고 대뇌동맥영역의 뇌경색은 4명이었다. 결론:미세 출혈은 노령,고혈압,고지혈증 환자와 뇌출혈이나 소공경색이 있었던 환자에서 발생빈도가 높았다.미세출혈의 가능성이 높은 환자에서 대량출혈로 이어질 수 있는 미세뇌출혈의 진단을 위해 경사에코기법 자기공명영상은 유용한 검사방법으로 사료된다. Purpose: To investigate the spontaneous cerebral microbleeding occurring at gradient-echo MRI, and its relationship with associated stroke lesions and risk factors. Materials and Methods: Between September 2001 and December, 2002, 32 patients (21 men and 11 women; mean age 63 years) in whom cerebral microbleeding occurred at gradient-echo MRI were retrospectively investigated. Using a 1.5 T MR imager, spin-echo T1-weighted, fast spin-echo T2-weighted, diffusion-weighted, and gradient-echo images were obtained. The number and location of microbleeds seen on gradient echo images, patient data, and associated stroke lesions such as intracerebral hemorrhage and lacunar and territorial infarction were assessed. Results: Among the 32 patients, 563 microbleeds and between 1 and 66 (mean, 17.6) were noted at gradientecho imaging. Microbleeding occurred in the cortical/subcortical area (n=216), the basal ganglia (n=173), thalamus (n=92), cerebellum (n=41), brainstem (n=36) and corpus callosum (n=1), and in 20 patients was bilateral. Patients had a history of hypertension (n=26), hypertriglycemia (n=12), heart disease (n=4), and diabetes mellitus (n=3). Stroke lesions were seen in 27 patients, intracerebral hemorrhage in ten, lacunar infarction in 24, and territorial infarction in four. Conclusion: The incidence and number of microbleeds was greater in older patients and in those with hypertension, hypertriglycemia, and stroke lesions such as intracerebral hemorrhage or lacunar infarction. The detection of microbleeding at gradient-echo imaging is helpful, since it predicts the possibility of cerebral hemorrhage in these patients.

요추간판팽윤증 환자에서 전산화단층촬영술과 척수강조영술의 역할

송창준 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Computed tomography is beginning to play a major role in the diagnosis of lesions of the spine. Many physicians, reluctant to subject their patients to myelography, are beginning to rely on computed tomography as the primary method for the evaluation of lumbar spinal stenosis and diseases of the lumbar intervertebral discs. But, as availability of computed tomography is increased, the possible role of the computed tomography, in interpreting the degree of thecal sac compression based on narrowing of the spinal canal, in predicting pathologic focus consistent with radiculopathy and in confindently confirming diffuse bulging disc to the cause of the radiculopathy has been debated in reports of the literature. The purpose of this study was to determine the reliability of computed tomographic measurements and to correlate such measurements with the myelographic findings in patients with diffuse bulging of lumbar intervertebral discs. The computed tomographic scans and myelograms, which had been simultaneously performed, of twenty-six patients with diffuse bulging discs were retrospectively reviewed. In 5 cases of 12 cases(41.6%) which anterior-posterior(AP) diameter of the spinal canal on crosssectional image obtained by computed tomography was less than 1.2 cm, degree of the thecal sac compression on lateral myelogram was less than 20%. In 8 cases of 16 cases(50%) which showed 20% to 40% thecal sac compression on myelogram, AP diameters of the spinal canal were more than 1.4 cm. Cutoff of nerve root sleeves were observed in 5 cases which spinal canal AP diameter was more than 1.2 cm, and evidence of nerve root compression was not observed in 8 cases of 24 cases(33%) which AP diameter was less than 1.2 cm. In conclusion, from this comparative review, measurements of computed tomography in diffuse bulging of the lumbar intervertebral discs are not reliable and lumbar myelography is to be considered as an adjunctive modality in the cases requiring active treatment such as surgical management.