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급성심근경색증 환자에서 응급으로 시행한 Tc - 99m Sestamibi 심근관류 SPECT와 심전도의 비교
원규장(Kyu Chang Won),이형우(Hyoung Woo Lee),심봉섭(Bong Sup Shim),이현우(Hyun Woo Lee),조인호(Ihn Ho Cho),박종선(Jong Sun Park),도준영(Jun Young Do),신동구(Dong Gu Sin),윤경우(Kyung Woo Yoon),김영조(Young Jo Kim) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.1
N/A We did Tc-99m sestamibi myocardial perfusion SPECT in 36 patients with acute myocardial infarction when they arrived at the emergency room. And we compared myocardial perfusion images with ECG findings. Then we obtained the follows. The myocardial infarction by the obstruction of left coronary descending artery and right coronary artery showed a good concordance in the diagnosis and infarction site between myocardial perfusion images and ECG findings. The 7 patients with myocardial infarction by a left circumflex coronary artery showed a perfusion defect in the lateral wall in myocardial perfusion SPECT images. But 4 patients of them showed ST segment elevation, 2 patients showed ST depression and 1 patient showed normal ECG findings. The diagnostic sensitivity of Tc-99m sestamibi myocardial perfusion SPECT was 100% by a qualified analysis. The perfusion defect site in the myocardial perfusion SPECT were con-responded with the infarct related coronary artery in 31 patients which was diagnosed by coronary angiograpy. The size of perfusion defect in the polar map was 31±18%(M±SD), in the myocardial infarction with left anterior descending coronary arery obstruction, 31±13% (M±SD) in the myocardial infarction with right coronary artery obstruction and 25±5.9%(M±SD) in the myocardial infarction on with left circumflex coronary artery obstruction. We concluded that emergency myocardial perfusion SPECT images are useful in the diagnose of myocardial infarction and it's very useful when we are difficult to diagnose with ECG like as lateral wall infarction or left bundle branch block.
이규보(Kyu Bo Lee),이재태(Jae Tae Lee),이찬우(Chan Woo Lee),원규장(Kyu Chang Won),윤현대(Hyun Dae Yoon),조인호(In Ho Cho),이형우(Hyoung Woo Lee),이현우(Hyun Woo Lee) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2
N/A Abnomalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue, which may occur on the midline in any position from the base of the tongue to the mediastinum. Although ectopic thyroid may be asymptomatic, local obstructive, hemorrhagic or other complication may occur. Radinuclide thyroid scan is confirmatory when the diagnosis is suspected. Hypothyroidism is common in lingual thyroid, and thyroid supplementation is generally required. In order to evaluate the features of ectopic thyroid, we investigated the scintigraphic findings, thyroid function test and clinical symptoms of 19 patients with ectopic thyroid. 1) The frequency of ectopic thyroid was about 5. 3 times more common in female than in male. Then patients were mostly below 30 years old (79%). 2) The frequency of location of ectopic thyroid were as follows: 10 cases in the tongue base, 1 case in suprahyoid, 5 cases in infrahyoid and 3 cases over 2 areas. 3) The thyroid function test was done in 16 cases of the ectopic thyroid patients. The hypothyroidism was detected in 7 cases, subclinical hypothyroidism in 4 cases and normal thyroid function in 5 cases. 4) The rate of hypothyroidism is 90% in the lingual thyroid and 33% in the others. The thyroid dysfunction was related with the location of the ectopic thyroid (p〈0.05). 5) The clinical manifestations include a mass in the tongue base, the foreignbody sensation of a throat and a swallowing difficulty in lingual thyroid. The palpable mass was the chief complaint in the others. 6) We prescribed the thyroid hormone to 10 cases with hypothyroidism. The ectope thyroid was removed in 2 cases with normal thyroid function. The rest is following up through OPD. We must consider the possibility of the ectopic thyroid and take the thyroid scan when the patient has a amass in the tongue base, the sublingual and the prelaryngeal area. Then we have to check the thyroid function and follow up when the ectopic thyroid is diagnosed, because the patient with normal thyroid function can result in the hypothyroidism. Except these, we must mind of the possibility of occurence of the cancer in the ectopic thyroid tissue.
갑상선환자에서의 5분 99mTc - Pertechnetate 섭취율과 방사성옥소섭취율의 상관관계
이찬우(Chan Woo Lee),원규장(Kyu Chang Won),윤현대(Hyun Dae Yoon),조인호(In Ho Cho),김태년(Tae Nyeun Kim),신동구(Dong Gu Shin),이형우(Hyoung Woo Lee),심봉섭(Bong Sup Shim),이현우(Hyun Woo Lee) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2
N/A The 20-minute Tc-99m-pertechnetate uptake became readily available for routine use and it replaced 131I for thyroid imaging. However measuring thyroid uptake during a 5-minute minimizes pertechnetate uptake by the salivary glands and presence of contaminated saliva from those glands in to the pharynx and esophagus. A study was carried out to determine the suitability of the utility of a 5-minute and 20-minute interval from administration of Tc-99m-pertechnetate to imaging and uptake measurement as a replacement for the 24 hour standard originally established with 131I, and to evaluate the relationship between 5-minute Tc-99m-pertechnetate uptake and other thyroid functions. A 5-minute and 20-minute uptake of Tc-99m-pertechnetate were measured in 70 patients with thyroid disease at Yeungnam University Hospital from March 1, 1991 to Feb. 29, 1992. The results were as follows. 1) The 5-minute Tc-99m-pertechnetate uptake in Graves' disease, Hashimoto's thyroiditis, simple goiter non toxic nodular goiter, subacute thyroiditis and euthyroid were 18.2%, 14.6%, 2.8%, 3.2%, 1.2% and 1.1%, respectively. There was a significant difference between the mean of the euthyroid group and the mean of the Graves' disease. So differenciation between them can be easily made. 2) The 5 minute Tc-99m- pertechnetate thyroid uptake was well correlated with 24 hour 131I thyroid uptake (r=0.75, p〈0.001). These data provided an equation for estimating the 24 hour uptake of iodide given the 5 minute pertechnetate uptake: Estimated 24-hour 131I thyroid Uptake = 7.188*ln (5 minute Tc-99m- Pertechnetate uptake)+16.94 3) The 20-minute Tc-99m-pertechnetate thyroid uptake was well correlated with 24-hour 131I uptake (r=0.72, p〈0.001) and 5-minute Tc-99m-pertechnetate thyroid uptake (r=0.96, p〈0.001). 4) In the Graves' disease, The 5-minute Tc-99m-pertechnetate thyroid uptake was well correlated with serum T3-resin uptake (r=0.46, p〈0.01), serum total T3 (r=0.55, p〈0.05), serum total T4 (r=0.46, p〈0.05). These results suggest that 5-minute Tc-99m- pertechnetate thyroid uptake has been found at least as useful as 24-hour 131I uptake for diagnostic confirmation at our hosptial, the logistical advantages of completing the diagnosis. The exam in 5-minutes led us to abandon the 24-hour study in the majority of patients, but the 24-hour 131I uptake is still obtained in patients with planned or potential radioiodine therapy.
림프종 환자에서의 갈륨, Tl-201 그리고 Tc-99m MIBI 섭취의 비교
천경아 ( Kyung Ah Chun ),조인호 ( Ihn Ho Cho ),원규장 ( Kyu Chang Won ),이경희 ( Kyung Hee Lee ),이형우 ( Hyung Woo Lee ),현명수 ( Myung Soo Hyun ),이재태 ( Jae Tae Lee ),이규보 ( Kyu Bo Lee ) 영남대학교 기초/임상의학연구소 2002 Yeungnam University Journal of Medicine Vol.19 No.2
Purpose: Ga-67 scintigraphy has been used for the evaluation of tumors, especially lymphoma. Recently, Tl-201 and Tc-99m MIBI were also used to tumor imaging. Tl-201 and Tc-99m MIBI had better physiologic characteristics than Ga-67, so we studied 32 biopsy proven lymphoma patients (male 24, female 8, mean age 46 years) with Ga-67, Tl-201 or Tc-99m MIBI and compared the scan findings. Materials and Methods: Twenty-three of 32 patients were injected 74-111 MBq (2-3 mCi) of Tl-201, before chemotherapy and imaged with dual-headed SPECT (Prism 2000, Picker, USA) at 30 minutes after injection. Delayed images were obtained after 3 hr in 8 patients. Twenty seven of 32 patients were injected 740 MBq (20 mCi) of Tc-99m MIBI and imaged at 30 minutes after injection. 111-185 MBq (3-5 mCi) of Ga-67 was injected in 12 patients and imaged at 48 and 72 hours after injection. Twenty eight patients were diagnosed as non-Hodgkin`s lymphoma and others were Hodgkin`s lymphoma. Results: Twenty patients were positive on Tl-201 scan and 3 patients showed negative findings. One of these 3 patients, Tc-99m MIBI and Ga-67 scan were positive. Twenty two patients were positive on Tc-99m MIBI scan and 5 patients showed negative findings. One of these 5 patients, Tl-201 was positive and 2 were positive on Ga-67 scan. Ten of 12 patients showed positive findings on Ga-67 scan. The sensitivity of these agents were 83.3%, 87.0% and 81.5% for Ga-67, Tl-201 and Tc-99m MIBI, respectively. The sensitivity was highest in Tl-201 scan, but there were no significant differences among three tests. In this study, there was no significant difference of uptake ratios between early and delayed images of Tl-201. Conclusion: Scintigraphy with Tl-201 and Tc-99m MIBI in lymphoma patients have similar sensitivity with Ga-67.
흥미영상 : (18)F-FDG PET/CT로 진단된 충수 선암종
공은정 ( Eun Jung Kong ),조인호 ( Ihn Ho Cho ),천경아 ( Kyung Ah Chun ),원규장 ( Kyu Chang Won ),이형우 ( Hyung Woo Lee ),김홍진 ( Hong Jin Kim ) 대한핵의학회 2006 핵의학 분자영상 Vol.40 No.3
A 53-year-old man underwent (18)F-FDG whole body PET/CT because of the detected liver mass on abdominal CT. The PET/CT showed a huge liver mass (9×9㎝, SUV: 12.12) in the right lobe and a focally hypermetabolic lesion in the right lower quadrant of abdomen (SUV: 9.12). At first, we suspected that the focal hypermetabolic lesion in RLQ was the physiologic uptake of ureter or a metastatic lesion of small bowel. We repeated the abdominal PET/CT next day. The focally hypermetabolic lesion was identified as the appendiceal mass. He underwent right hemicolectomy and right lobectomy of the liver. It was confirmed that the lesion was appendiceal adenocarcinoma with liver metastasis. Cancer of the appendix is an uncommon disease that is rarely suspected before surgery. But, we suggest that PET/CT is useful to identify the small lesion like appendiceal malignant mass. (Nucl Med Mol Imaging 2006;40(3):188-189)
F-18 FDG PET/CT에서 양성과 악성 근골격 종양의 감별진단-수신자 판단특성곡선을 이용한 maxSUV의 절단값 결정
공은정 ( Eun Jung Kong ),조인호 ( Ihn Ho Cho ),천경아 ( Kyung Ah Chun ),원규장 ( Kyu Chang Won ),이형우 ( Hyung Woo Lee ),최준혁 ( Jun Heok Choi ),신덕섭 ( Duk Seop Shin ) 대한핵의학회 2007 핵의학 분자영상 Vol.41 No.6
목적: F-18 FDG PET은 근골격계 종양에서 양성과 악성병변을 감별하는 유용성에 대하여 다양한 결과가 보고되고 있다. 저자들은 F-18 FDG를 이용한 PET/CT로 근골격계 종양의 maxSUV를 분석하고 비교하여 유용성을 알아보았다. 대상 및 방법: 치료 전 46개 병소(연부 조직 종양 양성/악성 : 11/12, 골종양 양성/악성 : 9/14)에 대하여 F-18 FDG PET/CT를 시행하였으며, 조직학적 검사로 확진하였다. 악성과 양성을 구분하는 maxSUV 절단값은 연부 조직 종양에서는 4.1, 골종양에서는 3.05로 하였다. 결과: 연부 조직 종양에서 양성(n=11; maxSUV 3.4±3.2)과 악성(n=12; maxSUV 14.8±12.2) 간에 maxSUV는 통계학적으로 유의하게( p<0.001) 차이가 있었다. 민감도와 특이도는 각각 83%, 91%였다. 그러나 골종양에서는 양성 종양(n=9; maxSUV 5.4±4.0)과 악성 골종양(n=14; maxSUV 7.3±3.2)간에 통계학적으로 유의한 차이를 보이지 않았다. 연부 조직 종양에서는 결절성 근막염이 위양성으로 나타났고(maxSUV=12.4) 골종양에서는 섬유성 골이형성증과 랑게르한스세포 조직구증식증 2예 및 골모세포종이 있었다. 결론: 연부 조직 종양에서 maxSUV는 양성과 악성을 감별하는데 유용하였다. 그러나 골종양의 경우에는 maxSUV가 낮은 경우에는 악성을 배제할 수 있었으나, maxSUV가 높은 경우에는 조직학적으로 조직구나 섬유모세포 등이 포함된 종양의 감별진단을 고려하여야한다. Purpose: We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Materials and Methods: Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in 0bone tumor by ROC curve. Results: There was a statistically significant difference in maxSUV between benign (n=11; maxSUV 3.4±3.2) and malignant (n=12; maxSUV 14.8±12.2) lesions in soft tissue tumor (p=0.001). Between benign bone tumor (n=9; maxSUV 5.4±4.0) and malignant bone tumor (n=14; maxSUV 7.3±3.2), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n=2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. Conclusion: The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy. (Nucl Med Mol Imaging 2007;41(6):553-560)