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- 저자 : 원종진 ( Gang Deuk Kim (검색결과 2 건)
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Tc-99m-MAA 를 이용한 간세포암의 경동맥 관류스캔
김강득,손광준,민경윤,권영미,김창근,노병석,원종진 ( Gang Deuk Kim,Kwang Joon Sohn,Kyung Yoon Min,Young Mi Kwon,Chang Guhn Kim,Byung Suk Noh,Jong Jin Won ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3
Puryose : Hepatic arterial perfusion scintigraphy with Tc 99m macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma(HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and usefullness of HAPS, Materials and Methods : HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4 5 mCi of MAA mixed with 2ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1ml/sec. We anatysed 21 HCCs over 2cm in diameter(average diameter : 6.4cm) and 17 of 21 HCCs were over 4cm in diameter(Table 1). CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Results : Three different pattern of tumor perfusion were observed in 16 pat.ients with HCC (Table 2), 1) diffuse increased perfusion in 16 of 21(76%)(Fig. 1) 2) increased peripheral perfusion in 4 of 21(19%)(Fig. 2) 3) diffuse decreased perfusion in 1 of 21(5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16(56% ) (Fig. 4). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16(13%). There was no accumulation of radioactivity on RRC blood pool scan in all six patients with HCC examined (Fig. 1). Conclusion : HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.
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김창근,김강득,최시성,정선관,노병석,원종진 圓光大學校 醫科學硏究所 1994 圓光醫科學 Vol.10 No.1-2
In order to evaluate CT findings with time and to confirm the capsular structure correlating with its histopathologic findings, we experimentally induced ischemic necrosis of liver in 20 rabbits. Incision of the abdomen was performed under anesthesia. Ligation of hepatic artery, portal vein and hepatic duct of right inferior posterior lobe of the liver after injection of macroaggregated albumin into right inferior posterior portal vein in order to prevent from developing collateral circulation as possible. Precontrast and postcontrast enhanced CT images were obtained at 1. 2. 4 days and 1, 2. 4. 6 weeks after induction of ischemic necrosis. Necrotic area in the liver showed homogeneous low density compared to normal liver, and no contrast enhancement after contrast material administration, and marked volume loss with time. CT attenuation value of necrotic area at 1 day(36.7±6.4 M±SD, Hounsfield unit) approached to two third of that of normal liver(56.3±7.3) and showed no significant change until two weeks but increased significantly after four weeks. On contrast enhanced CT images, capsular structure was obsereved as a high density rim along the liver surface of the necortic area in 8 of 15 cases. From the first day on, homogenous ischemic or coagulation necrosis was observed but rarely findings of edema, hemorrhage and cystic change were observed on histopathologic specimen. In all of the histologic samples taken from 10 cases during th 2nd to 6th week, fibrous thickening with rich vascularity was observed along the surface of the necrotic area. In conclusion, ischemic necrosis of the liver showed homogeneous low density and no contrast enhancement. CT attenuation value of necrotic area increased significantly with time associated with markedly decrease in volume. Capsular structure attributed to the hypertrophy of the liver capsule and rich vascularity within it.
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