흉부 질환의 전산화 단층 촬영

최규옥 한국의학사 1986 診斷과治療 Vol.6 No.2

슬관절 간연골 이중조영술

최규옥 대한영상의학회 1978 대한영상의학회지 Vol.14 No.1

Double contrast arthrography of the knee is a safe and technically simple procedure permitting accurate diagnosis of the lesion of menisci. From December 1976 to January 1978 the double contrast arthrography of the knee had been performed in 55 patients in the radiologic department of the Yonsei University. The result: 1. 35 cases of 44 showed normal arthrographic findings, in pathology 18 showed rupture of the menisci and 2 suprapatellar bursitis and synovitis. 2. The definite history of trauma was obtained in 14 cases of 18 meniscal injuries 3. Ruptured location were encountered more frequently in lateral menisci than the medial one. (13 cases, 72.2%) 4. In specific type of injury, bucket handle type was the most frequent type in the lateral meniscal injury. (7 cases, 53.8%) 5. Operations were performed on 13 cases of 18 meniscal injuries and all operated cases were to be correct in arthrographic diagnosis.

의료보험 진료비 심사기준

최규옥,Choe, Gyu-Ok 대한병원협회 1989 대한병원협회지 Vol.18 No.4

수간호원의 업무

최규옥,Choi G. O. 대한간호협회 1977 대한간호 Vol.16 No.3

자기공명영상을 이용한 심장 기능의 평가

최규옥,최병욱 대한자기공명의과학회 2001 Investigative Magnetic Resonance Imaging Vol.5 No.2

전자선 단층 촬영을 이용한 폐종괴의 관류측정$^1$

최규옥,Choe, Gyu-Ok 대한영상의학회 2002 대한영상의학회지 Vol.46 No.2

목적: 전자선단층촬영기를 이용하여 폐종괴의 관류 측정 및 관류 유형을 분석하고 폐종괴의 감별 진단에 도움이 되는지 알아보고자 한다. 대상과 방법: 28개의 폐종괴를 대상으로 하여 전향적 연구를 시행하였다. 남자가 23명이었고 여자가 5명이었으며 평균 연령은 57세였다.Multislice flow mode로 폐관류를 측정하고 관류유형을 분석하였다. 관류 영상은 4기로 이루어졌다. 조영 전 병변의 HU, 병변의 관류량, 최대 조영 증가 HU 및 최대 조영 증가 시기, 지연기에서의 평균 밀도 및 1기 최대치에 대한 %감소율을 구하고 병변의 진단에 따라 비교, 분석하였다. 결과: 19개의 종괴는 악성 종양으로,9개는 양성 병변으로 진단되었고 악성 종양 중 14개의 병변은 원발성 폐암으로 5개의 병변은 폐전이로 진단되었다. 악성 종양이 양성 종괴보다 유의하게 높은 관류량(p<0.001)및 제2기 평균 밀도 (p<0.05)와 유의하게 짧은 최대 조영 증가 시기(p<0.05)를 보였다.원발성 폐암 (n=14)이 양성 종괴보다 유의하게 높은 관류량 (p<0.001) 및 제2기 평균 밀도 (p<0.05)를 보였다. 원발성 폐암과 폐전이는 유의한 관류량 및 관류 유형의 차이를 보이지 않았다. 결론: 전자선단층촬영을 이용한 폐종괴의 관류 측정 및 관류 유형의 분석은 악성 및 양성 폐종양의 감별 진단에 유용한 정보를 제공한다. Purpose: To investigate the perfusion of pulmonary nodules and the flow pattern revealed by electron beam tomography (EBT), and to evaluate their usefulness in the differential diagnosis of pulmonary nodules. Materials and Methods: A prospective perfusion study involving 28 nodules in 23 men and five women (meanage, 57 years) was performed using EBT with the multislice flow mode. There were four phases. Precontrast density (Hounsfield units, HU) in phase 0; perfusion, peak HU and time to peak in phase 1; and mean HU and percentage decrease of HU to peak HU of phase 1 in phases 2 and 3 were measured and compared according Results: Malignancy was diagnased in 19 cases [primary lung cancer (n=14); metastatic nodules (n=5)], while nine nodules were benign. Perfusion was significantly higher in malignant nodules than in benign (P<0.001) and a higher mean delay 1 HU (P<0.05) and a significantly short time to peak (P<0.05) were recorded in malignant nodules. In primary lung cancer cases, perfusion was significantly high compared with benign nodules(P<0.001), and a mean delay 1 HU was observed (P<0.05). There was no significant difference in perfusion Conclusion: Perfusion and flow pattern data measured by EBT can provide the useful information for differentiation between malignant and benign pulmonary nodules.

폐동맥 폐쇄증의 혈관조영상

최규옥 대한영상의학회 1986 대한영상의학회지 Vol.22 No.6

We studied the angiogrpahic findings in 65 patients with congenital pulmonary atresia, ages 4 days to 14 years(mean 3.3yrs). from 1981 to 1986 at Severance hospital Yonsei Univeristy . 1. 6 had pulmonary atresia with an intact interventricular septum, 38 had int with cardiac anomaly Renodynamically simulating TOF, and 21 associated with more complicated cardiac anomalies. 2. In the group with an intact ventricular septum, 5 showed confluent intrapericardial pulmonary artery, all segmental pulmonary arteries connected to intrapericardial artery. 3. In the group simulating TOF, aorta arose form RV with or without overriding in 35. In 27 patients with confluent intrapericardial pulmonary artery, 23 had more than 10 segmental pulmonary arteries connected to intrapericardial artery and 5 had severely hypoplastic hilar pulmonary arteries. In 11 with nonconfluent in trapericaredial pulmonary artery, 4 had more than 10 segmental pulmonary arteries. 4. In the group associated with mor complicated cardiac anomaly, included 8 patients with atrioventricular discordance, 7 with univentricular heart and 6 with tricuspid atresia. In 17 patients with confluent intrapericardial artery, 16 had more than 10 segmental pulmonary arteries connected to intrapericardal artery, one showed severe hypoplasia of hilar pulmonary arteries. In another 4 with nonconfluence, no one showed more than 10 segmental arteries connected to intraperdicardial or hilar pulmonary artery.

관상동맥 석회 수치 검사 - 관동맥경화증의 영상 진단 및 허혈성 심질환의 예방 -

최규옥 中央醫學社 1999 中央醫學 Vol.64 No.3

좌우 심전류에서 폐혈관상의 소견과 혈력학적 변화의 비교

최규옥 대한영상의학회 1975 대한영상의학회지 Vol.11 No.3

It is generally accepted that the plain chest roentgenogram is useful in evaluating the status of pulmonary circulation. But it is conflicting concerning the accuracy of this method for estimating pulmonary blood flow, resistance and pressure. Most studies have been performed in mitral stenosis. However, our present study deals with 97 cases of congenital heart disease with left to right shunt including 22 cases of ASD, 48 cases of VSD and 32 cases of PDA. To determine the accuracy of roentgenologic evaluation of hemodynamic status and localization fo shunt level, the findings of plain chest film are compared with the datas of cardiac catheterization in each case of congenitel heart disease. The results are summarized as follows; 1. When the pulmonary vascular resistance is normal, there is relative correlation between the degree of pulmonary plethora and actual shunt volume, but not well-correlated quantitatively. The degree of correlation is different depending on the diseas entity; with the same volume of shunt the pulmonary plethora is most prominent in VSD, and is least in ASD. The pulmonary plethora itself does not give to assist in determining the location of shunt. 2. when pulmonary vascular resistance is increased, the degree of pulmonary plethora is not correlated at all to the shunt volume. The presence of centralization of pulmonary vascularity in plain chest is a good index of increased pulmonary vascular resistance. Centralization is present in all cases whose pulmonary vascular pattern is detectable in 13 cases among 32 cases of the subjects having increased pulmonary vascular resistance in this study. The detection rate is not apparently different depending on disease entities. This poor result is a big barrier in this study; the cases having increased pulmonary vascular resistance constitutes the major portion of the error in estimating hemodynamic change from the plain film, since the pulmonary plethora is not correlated to shunt volume. 3. Pulmonary arterial pressure is presumptively elevated when the centralization of the pulmonary vascular pattern is present, hewever, in the remainder the radiologic criteria of pressure determination cannot be found. 4. The cross-sectional area of right descending pulmonary artery corrected by body surface area is best correlated with pulmonary blood flow in ASD having within normal range of vascular resistance (Y=0.013X+0.332, r=0.76, p<0.02, X-cross-sectional area of RDPA/BSA, Y=Q'p/Q's). The subjects having increased pulmonary vascular resistance have the right descending pulmonary artery always larger in diameter than those who have not increased pulmonary vascular resistance in the corresponding shunt volume. In PDA the relation is also well correlated but not as well as in the relation in ASD (Y-0.22X+0.224, r=0.717, p<0.01). With increase of pulmonary valscular resistance, the size of the right descending pulmonary artery has no constant relation to those of normal pul onary vascular resistance. There is no statistically significant correlation in this relationship in subjects of VSD (Y=0.003X+1.390, r=0.17, p>0.1).

승모판 협착증의 단순흉부 X-선 사진상의 폐소견에 대한 고찰

최규옥 대한영상의학회 1973 대한영상의학회지 Vol.9 No.1

Mitral stenosis, the most frequent heart disease in adult, showed relatively characteristic pulmonary findings in plain chest X-ray. In recent years the knowledge of the altered physiology of hemodynamics could offer considerable amount of hemodynamic barrier in plain chest. But the value of several parameters was still controversial. In this study a variety of roentgen signs were related to physiologic data and these were acquired by the cardiac catheterization in total of 67 cases of mitral stenosis. 1. Correlation of DPA/DHT ratio (Diameter of pulmonary arterial segment/Diameter of hemithorax$\times$100) to hemodynamic data: The pulmonary arterial segment was dilated by two factors, the one was pulmonary blood flow and the other the blood pressure within it. In mitral stenosis, the cardiac output was decreased to quite uniform level, hence measurement of pulmonary arterial segment might be valuable. The correlation coefficient of DPA/DHT ratio to hemodynamic datas were as follows 0.54 to mean pulmonary artery pressure, 0.32 to pulmonary capillary wedge pressure, -0.37 to mitral valvular area and 0.07 to pulmonary vascular resistence. No significant difference was noted in between pure mitral stenosis and mitral stenosis associated with other valvular disease. 2. Correlation of diameter of right descending pulmonary artery to hemodynamic data: The measurement was made near the first bifurcation of right descending pulmonary artery at its widest point. Pulmonary vascular pattern was best correlated (r=0.71). Another had rough correlation: 0.05 to mean pulmonary artery pressure, 0.31 to pulmonary capillary wedge pressure, -0.44 to mitral valvular area in correlation coefficient. No pulmonary arterial hypertension was observed in the cases diameter of less than 12mm, but all except two cases had pulmonary hypertension in which diameter exceeded 16mm. According to increase of the mean pulmonary arterial pressure, the same increment in pressure increased change pro uced progressively smaller degrees of dilatation of main pulmonary artery and right descending pulmonary artery were enlarged with all degrees of pulmonary arterial segment and right descending pulmonary artery were enlarged with all degrees of pulmonary hypertension and which made enlargement of pulmonary artery as a sign but little value in determining the degrees of pulmonary hypertension. 3. Correlation of pressure of hemosiderosis and intraalveolar edema to hemodynamics: Hemosiderosis was found in 8 cases among 67 cases. No relationship was observed in between the existence of hemosiderosis and the height of pulmonary venous pressure or other hemodynamic factors. Inrraalveolar edema was detected in 7 cases and no significant difference of hemodynamic data was observed whether it is present or not. But the present group all had pulmonary capillary wedge pressure exceeds 19mmHg. 4. Correlation of Kerley's B line to hemodynamic datas: Distinctively present septal line was found in 8 among 65 cases (27.3%): 3 cases in right side, only on case in left side and most of them, 14 cases in both sides. The confirmative factor was not found in distribution of heomdynamic data to the existence itself or detected number of Kerley's B line. But when septal line was found distinctly, pulmonary capillary wedge pressure was all exceeded to 20mmHg except one case. 5. Correlation of pulmonary vascular pattern to hemodynamic data: For the estimation of hemodynamics the above radiographic findings were frequently fraught with overlapping or gave us only limited information. This pulmonary vascular patterns classified in able 1 including peripheral portion as well as central were aimed to compare accordingly with hemodynamic datas. these group showed relative apparent separation in each group especially in mean pulmonary artery pressure: Most of mean pulmonary artery pressure was incluced in the range of below 30 mmHg in group 1, from 25 to 40 mmHg in group 2