Evaluating the Degree of Conformity of Papillary Carcinoma and Follicular Carcinoma to the Reported Ultrasonographic Findings of Malignant Thyroid Tumor

제수경,So Lyung Jung,김범수,Yoen Soo Lee 대한영상의학회 2007 Korean Journal of Radiology Vol.8 No.3

Comparison of the Diagnostic Performance of Response Evaluation Criteria in Solid Tumor 1.0 with Response Evaluation Criteria in Solid Tumor 1.1 on MRI in Advanced Breast Cancer Response Evaluation to Neoadjuvant Chemotherapy

제수경,김성헌,강봉주 대한영상의학회 2013 Korean Journal of Radiology Vol.14 No.1

Objective: To compare the diagnostic performance in evaluating the response of neoadjuvant chemotherapy (NAC), between the response evaluation criteria in solid tumor (RECIST) 1.0 and RECIST 1.1, on magnetic resonance imaging (MRI) for advance breast cancer patients. Materials and Methods: Breast cancer patients, who underwent NAC between 2005 and 2010, were included. Both prechemotherapy and post-chemotherapy MRIs were performed within 1-4 weeks before and after NAC. Only the patients with subsequent surgery were included. The response to NAC was assessed by using RECIST 1.0 and RECIST 1.1. Patients with a complete or partial response on MRI were considered as responders, and those with stable or progressive disease were considered as non-responders. Tumor necrosis > 50% on pathology was defined as responders and necrosis < 50% was defined as non-responders. The diagnostic accuracy of both RECIST 1.0 and RECIST 1.1 was analyzed and compared by receiver operating characteristic curve analysis. Results: Seventy-nine females (mean age 51.0 ± 9.3 years) were included. Pathology showed 45 responders and 34 nonresponders.There were 49 responders and 30 non-responders on RECIST 1.0, and in 55 patients, RECIST 1.0 results agreed with pathologic results (69.6%). RECIST 1.1 showed 52 responders and 27 non-responders. In 60 patients, RECIST 1.1 results were in accordance with pathology results (75.9%). The area under the ROC curve was 0.809 for RECIST 1.0 and 0.853 for RECIST 1.1. Conclusion: RECIST 1.1 showed better diagnostic performance than RECIST 1.0, although there was no statistically significant difference between the two.

Myoid Hamartoma of the Breast: A Case Report

제수경,강봉주,김성헌,차은숙,김태정 대한영상의학회 2010 대한영상의학회지 Vol.63 No.2

Myoid (muscular) hamartoma is a rare subtype of hamartoma and is characterized by the presence of smooth muscle cells. We report a case of myoid hamartoma presenting as a large palpable mass in a 28-year-old patient, which was confirmed by surgical excision and pathologic diagnosis.

Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Steno-occlusive Disease of the Supraaortic Arteries: Comparison with Computed Tomography Angiography and Digital Subtraction Angiography

제수경,김범수,정소령,안국진,신용삼,이관성,김영인,이광수 대한자기공명의과학회 2009 Investigative Magnetic Resonance Imaging Vol.13 No.2

Purpose : To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. Materials and Methods : Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: 0.66×0.66×1.1 or 1.2 mm3), and CTA on 64-slice CT scanners (voxel dimension: 0.42×0.42×0.63 mm3). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. Results : A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n=19) and intracranial (n=15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity, specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1% on CTA, with DSA as the standard of reference. Conclusion : Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.

외음부의 공격성 혈관점액종(Aggressive Angiomyxoma): 증례 보고

제수경,구영미,황인용,김기태 대한영상의학회 2005 대한영상의학회지 Vol.52 No.3

공격성 혈관점액종(aggressive angiomyxoma)는 여성의 골반의 결체 조직에서 주로 발생하는 양성 종양이다. 저자들은 외음부에 커다란 돌출성 종괴 형태로 발생한 공격성 혈관점액종 1예를 경험하였기에, 특징적인 영상소견을 문헌고찰과 함께 보고하고자 한다. Aggressive angiomyxoma is a rare benign tumor that originates in the pelvic or perineal organs of women. We report a case of an aggressive angiomyxoma as a huge vulvar mass, and present its clinical and image characteristics with a review of the literatures.

Radiologic Imaging Findings of Bilateral Infiltrating Pseudoangiomatous Stromal Hyperplasia of the Breasts: A Case Report

고희선,제수경 대한영상의학회 2013 대한영상의학회지 Vol.68 No.4

Pseudoangiomatous stromal hyperplasia (PASH), first described by Vuitch et al., is a rare benign lesion, shows the proliferation of the breast stromal tissue. We experienced a case of a 19-year-old woman with bilateral PASH manifesting as marked enlargement of the breasts for a duration of several months. Morphologic evaluation of imaging modalities was done, including ultrasound, computed tomography and magnetic resonance images. Here, we describe bilateral PASH in a young girl presenting as bilateral breast gigantism from a main point of radiologic image finding.

유방 관상피내암에 있어서 병변의 범위와 예후 결정을 위한 수술 전 자기공명영상의 역할

정유승,이연수,제수경,송병주,김정수,전해명,정상설,박우찬 한국유방암학회 2009 Journal of breast cancer Vol.12 No.2

Purpose: Magnetic Resonance Imaging (MRI) is widely used for the preoperative staging of breast cancer. In this study, we investigated a role of preoperative breast MRI for detecting the extent of disease and predicting the prognosis of ductal carcinoma in situ (DCIS). Methods: From January 2002 to April 2008, preoperative MRI was performed for evaluating the extent of disease in 26 patients with DCIS. The MRI findings, the modified Van Nuys scores and the clinicopathological results were reviewed. The accuracy of breast MRI was analyzed with respect to the detection of tumor multiplicity and disease extending into the nipple, and this was compared with that of mammography. Results: For detecting multiple lesions, the sensitivity and specificity of breast MRI were 25.0% and 86.4%, respectively, and the results of mammography were 0.0% and 86.4%, respectively. The accuracy of breast MRI was 76.9% and that of mammography was 73.1%. For detecting tumor extension into the nipple, the sensitivity and specificity of breast MRI was 100.0% and 80.0%, respectively, and that for mammography was 0.0% and 92.0%. respectively. The accuracy of MRI was 80.8% and that for mammography was 88.5%. The MRI final assessment was not associated with the modified Van Nuys score (p=0.474). Conclusion: For detecting the disease extent of DCIS, preoperative breast MRI is not superior to mammography due to the low specificity and accuracy of MRI. MRI did not show a definite ability to predict the prognosis of DCIS in this study.

양성 표재성 연조직 종양의 변형탄성초음파: 영상소견에 영향을 미치는 요소

이소연,박희진,제수경 대한초음파의학회 2013 ULTRASONOGRAPHY Vol.32 No.1

목적: 표재성 연조직 종양의 변형탄성초음파 영상소견에 영향을 미치는 요소를 알아보고자 하였다. 대상 및 방법: 임상적으로 촉지된 종괴가 있어 초음파검사와 초음파 탄성영상을 시행하고 양성 표재성 연조직 종양으로 진단된 38명의 환자들을 대상으로 하였다. 회색조영상과 변형탄성초음파 영상을 두 명의 영상의학과 의사가 후향적으로 분석하였다. 변형탄성초음파 영상은 등급이높을수록 단단하고 등급이 낮을수록 부드럽게 1등급에서3등급으로 구분하였다. 탄성도 등급이 병변의 높이, 너비,깊이, 뼈로부터의 거리와 관련이 있는지를 알아보기 위해Kruskal-Wallis test를 이용하였다. 결과: 관찰자 1은 11, 8, 19개의 병변을 각각 1, 2, 3 등급으로 평가하였다. 관찰자 2는 11, 9, 18개의 병변을 각각 1, 2, 3 등급으로 평가하였다. 병변과 뼈와의 거리는 탄성도 1, 2, 3등급에서 0.78 ± 0.75cm, 1.56 ± 0.68 cm,1.77 ± 0.63 cm (관찰자 1), 0.86 ± 0.79 cm, 1.55 ±0.72 cm, 1.74 ± 0.65 cm (관찰자2)으로 유의한 차이가있었다 (관찰자 1, P = .006; 관찰자 2, P = .016). 탄성도 등급과 병변의 높이, 너비, 깊이와는 유의한 상관관계가없었다. 결론: 표재성으로 위치한 양성 종양에서 종양이 뼈에 가까울수록 부드럽게 보였다. Purpose: The purpose of this study is to investigate factors influencing strain sonoelastography findings in evaluation of subcutaneous tumors. Materials and Methods: Retrospective analysis of sonoelastography findings performed by two radiologists in 38 consecutive patients with 38 pathologically confirmed benign subcutaneous tumors was performed. Elastographic finding of the lesions was graded from 1 (softer) to 3 (harder) according to stiffness. Analysis of correlations between elastographic findings and height, width and depth of the lesion, and the distance from bone was performed using the Kruskal-Wallis test. Results: By reviewer 1, 11 lesions were grade 1 on sonoelastography, eight were grade 2, and 19 were grade 3, respectively. By reviewer 2, 11 lesions were grade 1 on sonoelastography, nine were grade 2, and 18 were grade 3, respectively. The distance from bone differed significantly among the three grades groups for both reviewers;grade 1, 2, and 3, 0.78 ±0.75 cm, 1.56 ± 0.68 cm, and 1.77 ±0.63 cm, for reviewer 1 (P = .006) and 0.86± 0.79 cm, 1.55 ± 0.72 cm, and 1.74±0.65 cm for reviewer 2 (P = .016). No significant difference in height, width, and depth of the lesion was observed among the three groups. Conclusion: Distance from bone showed a significant association with strain sonoelastographic findings of benign subcutaneous tumors.

2008년도 서울시 정신보건심판위원회의 계속입원심사 및퇴원청구심사 현황

나리지(Riji Na),제수경(Sukyung Je),이명수(Myung-Soo Lee),이광자(Kwang-Ja Lee),권정화(Junghwa Kwon),홍진표(Jin Pyo Hong) 대한사회정신의학회 2011 사회정신의학 Vol.16 No.1

연구목적 : 본 연구의 목적은 2008년에 서울시 정신보건심판위원회에 청구된 계속입원심사와 퇴원청구심사의 특성과 심사 결과를 살펴봄으 로써 향후 서울시 정신보건정책을 수립하기 위한 정책자료를 수집하는 것을 목적으로 하였다. 방 법 : 2008년 1월 1일부터 12월 31일까지 서울시 정신보건심판위원회에 신청된 계속입원심사 및 퇴원청구심사 서류에 나와 있는 자료를 기술분석 하였다. 결 과 : 연구 기간 동안 서울시 정신보건심판위원회에 청구된 계속입원심사는 1213건으로 803명의 환자에서 심사가 청구되었다. 퇴원청 구심사는 73건으로 73명의 환자에서 심사가 있었다. 계속입원심사를 청구한 환자들의 대부분은 의료급여 1종이었다. 또 803명의 환자들 중 44.5%가 구청장을 보호자로 두고 있었으며 85.7%에서 정신분열증이나 분열정동장애가 1차 진단명이었다. 퇴원청구심사를 시행한 환자들의 경우에는 대부분 의료급여를 제외한 일반 건강보험가입자였다. 심판위원회의 심사 이후 퇴원이 결정된 비율은 계속입원심사의 경우 4.9%, 퇴원청구심사의 경우에는 12.0%였다. 결 론 : 계속입원심사를 청구하는 것과 관계가 있는 것으로 보이는 요인들은 의료급여 1종, 정신분열증이나 분열정동장애 진단, 구청장이 보호자로 있는 경우 등이었다. 반면에 퇴원청구심사를 청구한 환자들은 대부분 의료급여를 제외한 일반 건강보험가입자들이었다. 의학적으로 반드시 필요한 경우를 제외한 장기 입원을 줄이고 환자들의 인권을 보호하기 위해서는 지지체계가 약하고 만성적인 질환을 가지고 있는 환자들을 대상으로 한 정책이 필요하다. Objectives : The purpose of this study was to evaluate the current situation about requested judgments of the proprieties for extension on hospitalization and discharge on Seoul Mental Health Review Board and the results of them. Methods : The data was collected from cases had been examined by Seoul Mental Health Review Board from Jan. 1 to Dec. 31 of 2008. Results : 1213 cases to judge the proprieties for extension on hospitalization and 75 cases for discharge were examined. Most patients requested judgments of the proprieties for extension on hospitalization had Medicaid type I. Guardian of 44.5% of patients requested judgments of the proprieties for extension on hospitalization was head of a gu and diagnosis of 85.7% of these patients was diagnosed as schizophrenia or schizoaffective disorder. Most patients requested discharge corresponded to Medical insurance. 4.9% of cases for judgments of the proprieties for extension on hospitalization and 12.0% of cases for discharge were ordered to discharge. Conclusion : Factors related to requested judgments of the proprieties for extension on hospitalization are Medicaid type I, diagnosis of schizophrenia or schizoaffective disorder, guardian of head of a gu. More than half of the patients requested discharge participated in medical insurance. To reduce the period of hospitalization, there should be active policies for the patients with weak support system and chronic and severe mental disorders.

자기공명영상을 이용한 두개인두종과 뇌하수체 거대선종의 감별

김현수,안국진,김지영,이정휘,제수경,박해관,이경진,한성태 대한영상의학회 2006 대한영상의학회지 Vol.55 No.1

목적: 방사선학적으로 감별이 어려운 경우의 두개인두종(craniopharyngioma)과 뇌하수체 거대선종(pituitary macroadenoma)의 감별에 유용한 자기공명영상 소견을 알아보고자 한다. 대상과 방법: 수술 후 조직 병리학적으로 확진된 두개인두종 27명(남자 17명, 여자 10명, 평균 나이 35세)과 뇌하수체 거대선종 24명(남자 8명, 여자 16명, 평균나이 46세)을 대상으로 자기공명영상에서의 종괴의 위치(터키안내, 터키안 상부), 윤곽(분엽상 모양의 유무), T1-강조영상에서 고신호강도의 존재유무, 종괴의 상부 및 하부에서 크기의 차이, 조영증강되는 조직의 두께 차이(< 2 mm 혹은 > 2 mm), 뇌하수체와 종괴와의 구별 여부, 중뇌에 닿거나 누르는 소견의 존재유무 등을 후향적으로 분석하였다. 결과: 두개인두종은 뇌하수체 거대선종에 비하여 터키안 상부에 선택적인 발생을 보였으며, T1 강조영상에서 고신호강도를 보였고, 터키안 상부의 부분이 더 컸으며, 조영증강 후 뇌하수체가 분리되어 보였다. 또한, 중뇌에 닿아 압박하는 소견을 보였다. 뇌하수체 거대선종은 두개인두종에 비하여 터키안 하부 부분이 더 크고, 조영증강 후 두꺼운 벽 조영증강을 보였다. 결론: 터키안 및 터키안 상부에 생긴 두개인두종과 뇌하수체 거대선종을 감별하는데 있어 종괴의 위치, T1-강조영상에서 높은 신호강도의 유무, 조영증강되는 낭성 벽의 두께, 그리고 뇌하수체와의 구별 여부가 많은 도움을 줄 것으로 생각된다. 그러나 종괴가 커서 상기의 소견들이 불분명할 때 종괴가 중뇌에 닿거나 압박하는 소견과 종괴의 상, 하부 크기 비교는 두개인두종을 뇌하수체 거대선종으로부터 진단하는데 큰 역할을 할 것으로 생각된다. Purpose: We wanted to determine the differential points between craniopharyngioma and pituitary macroadenoma on MRI. Materials and Methods: The MRI findings in twenty seven patients (age range: 14-67 years, mean age: 46 years, 17 males and 10 females) with pathologically proven craniopharyngioma and twenty four patients (age range: 23-64 years, mean age: 54 years, 8 males and 16 females) with pathologically proven pituitary macroadenoma were analyzed retrospectively by two radiologists. We analyzed the location, the contour of the mass, the presence of high signal intensity on the T1 weighted images, the thickness of the enhancing wall, separation between the mass and the pituitary gland, and the presence of attachment or compression to the midbrain. Results: On MRI, craniopharyngiomas showed a suprasellar location, high signal intensity on the T1 weighted images and a larger suprasellar portion. After contrast enhancement, the separation of the mass from the pituitary gland is more distinct than that of the pituitary macroadenomas. The craniopharyngiomas showed the presence of attachment or compression to the midbrain. The pituitary macroadenomas had a larger intra- or infrasellar portion than that of the craniopharyngiomas, and they also showed a thicker enhancing wall after contrast enhancement. Conclusion: The location, contour of the mass, presence of high signal intensity on T1 weighted images, thickness of the enhancing wall, separation of the mass from the pituitary gland and the presence of attachment or compression to midbrain are useful differential points between craniophayngioma and pituitary macroadenoma on MRI.