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급성 심근 경색 환자에서 재관류 후 조기에 시행한 휴식 / 24시간 지연 T1-201 심근 SPECT 의 심근벽 운동 호전 예측능
현인영,권준 ( In Young Hyun,June Kwan ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.3
Purpose: We studied early rest/24 hour delay Tl-201 perfusion SPECT for prediction of wall motion improvement after reperfusion in patients with acute myocardial infarction. Materials and Methods: Among 17 patients (male/female ll/6, age: 59+13) with acute myocardial infarction, 15 patients were treated with percutaneous transcoronary angioplasty (direct:2, delay:11) and intravenous urokinase (2). Spontaneous resolution occurred in infarct-related arteries of 2 patients. We confirmed TIMI 3 flow of infarct-related artery after reperfusion in all patients with coronary angiography. We performed rest Tl-201 perfusion SPECT less then 6 hours after reperfusion and delay Tl-201 perfusion SPECT next day. Tl-201 uptake was visually graded as 4 point score from norrnal (0) to severe defect (3). Rest Tl-201 uptake <2 or combination of rest Tl-201 uptake<2 or late reversibility were considered to be viable. Myocardial wall motion was graded as 5 point score from normal (1) to dyskinesia (5). Myocardial wall motion was considered to be improved when a segment showed an improvement > 1 grade in follow up echo compared with the baseline values. Results: Among 98 segments with wall rnotion abnormality, the severity of myocardial wall motion decrease was as follow: mild hypokinesia: 18/98 (18%), severe hypokinesia: 28/98 (29%), akinesia: 5l/98 (52%), dyskinesia: 1/98 (1%), The wall rnotion improved in 85%. Redistribution (13%), and reverse redistribution (4%) were observed in 24 hour delay SPECT. Positive predictive value (PPV) and negative predictive value (NPV) of combination of late reversibility and rest Tl-201 uptake were 99%, and 54%. PPV and NPV of rest T1-201 uptake were 100% and 52% respectively. Predictive values of combination of rest Tl-201 uptake and late reversibility were not significantly different compared with predictive values of rest Tl-201 uptake only. Conclusion: We conclude that early Tl-201 perfusion SPECT predict myocardial wall motion improvement with excellent positive but relatively low negative predictive values in patients with acute myocardial infarction after reperfusion. (Korean J Nucl Med 1998;32:259-65)
선천성 담도폐쇄증에서 99mTc DISIDA 신티그라피의 진단정확성 ( Diagnostic Accuracy of 99mTc-DISIDA 신티그라피의 진단정확성
현인영,이동수,이경한,김종호,정준기,서정기,이명철,고창순 ( In Young Hyun,Dong Soo Lee,Kyung Han Lee,Jong Ho Kim,June Key Chung,Jung Key Suh,Myung Chul Lee,Chang Soon Koh ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3
We evaluated the diagnostic accuracy of 99mTc-DISIDA scintigraphy as a mean of differentianting biliary tresia from neonatal hepatitis. Tc-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepat,ic retention index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake index was graded visually with 5 minute images using the following scoring scheme :grade 0(normal hepatic uptake), grade 1(decreased hepatic up take), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent int,estinal radioactivity. The results were as follows : l) None of the 30 hiliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity, The sensitivity, specificity, and accuracy of the presence of inlestinal radioactivity .or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patienis with absent intestinal radioactivity the mean hepatic retention index was 1.5+0.6 in the 16 biliary atresia patient,s, and 1.1+0.2 in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary at,resia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake index between biliary atresia and neonatal hepatit.is patients. However t.here were differences in age, total bilirubin, and hepatic uptake index bet.ween neonatal hepatitis patients with and without intestinal radioactivity. The hepatic upt,ake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioact,ivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake index and the hepatic retention index. Thus, we conclude that Tc DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patients age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.
Tc-99m MIBI and Tl-201 Uptake in a Thymic Carcinoma
현인영,Hyun, In-Young The Korea Society of Nuclear Medicine 2003 핵의학 분자영상 Vol.37 No.5
Tc-99m methoxyisobutylisonitrile (MIBI) and Tl-201/technetium subtraction scintigraphy have been used for localization of abnormal parathyroid gland. The uptake mechanism of tracers has been postulated to be increased cellular density and vascularity, or dependent on the presence of mitochondria-rich cells. However, the uptake of these tracers was not specific for abnormal parathyroid gland. The author report a case of thymic carcinoma that would have been mistaken for carcinoma of parathyroid because of Tc-99m MIBI and Tl-201 uptake.
게이트 TI-201 관류 SPECT와 Cedars 소프트웨어를 이용하여 측정한 좌심실 구혈률
현인영(In Young Hyun),김성은(Sung Eun Kim),서정기(Jeong Kee Seo),홍의수(Eui Soo Hong),권준(Jun Kwan),박금수(Keum Soo Park),이우형(Woo Hyung Lee) 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.3
N/A Purpose: We compared estimates of ejection fraction (EF) determined by gated Tl-201 perfusion SPECT (g-TI-SPECT) with those by gated blood pool (GBP) scan. Materials and Methods: Eighteen subjects underwent g-TI-SPECT and GBP scan. After reconstruction of g-TI-SPECT, we measured EF with Cedars software. The comparison of the EF with g-TI-SPECT and GHP scan was assessed by correlation analysis and Bland Altman plot. Results: The estimates of EF were significantly different (p<0.05) with g-TI-SPECT (40%±14%) and GBP scan (43%±14%). There was an excellent correlation of EF between e-TI-SPECT and GBP scan (r=0.94, p<0.001). The mean difference of EF between GRP scan and g-TI- SPECT was +3.2%, Ninety-five percent limits of agreement were +9,8%. EF between g-TI-SPECT and GBP scan were in poor agreement. Conclusion: The estimates of EF by g-TI-SPECT was well correlated with those by GBP scan. However, EF of g-TI-SPECT doesn't agree with EF of GBP scan. EF of g-TI-SPECT cant be used interchangeably with EF of GBP scan. (Korean J Nucl Med 2000;34:222-7)
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 간세포암에 대한 화학색전요법의 항종양 효과
현인영(In Young Hyun),이정애(Jung Ae Lee),고문수(Moon Soo Kih),은진호(Jin Ho Eun),염광섭(Kwang Seoup Yeoum),홍원선(Weon Seon Hong),이진오(Jhin Oh Lee),강태웅(Tae Woong Kang),변홍식(Hong Sik Byun),강숙욱(Sook Wook Kang),김기환(Kie Hwa 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
N/A Eighty-seven TACEs were performed in 38 patients with hepatocellular carcinoma: one in 16 patients; twice in seven patients; three times in seven patients; four times in four patients; and five times in four patients. In all patients, TACE was performed with adriamycin, mitomycin-C and lipiodol. In 21 patients, embolization with gelfoam powders were added following TACE. Six patients had the hepatocellular carcinoma of 4.0~4.9 cm in diameter: 14 patients, 5.0~9.9 cm; and 18 patients, larger than 10 cm. Response rate was evaluated in 33 patients, among whom fifteen patients (45$) achieved response (complete response, 6%; partial response, 33%). The cumulative survival rates at one year and two years for 38 patients were 55.3$ and 23.2%, respectively, with the median survival time of 12.0 months. Sex, ascites, HBsAg, esophageal varix, liver cirrhosis, gelfoam embolization, serum albumin level, size of the tumor, and a-fetoprotein were analyzed to investigate the effect of TACE on survival time, demonstrating that no significant differences in the survival times were observed between these factors except HBsAg. Theses results suggest that TACE is not curable for hepatocellular carcinoma, however prolong the life span in patients with hepatocellular carcinoma.
소영(Young So),이동수(Dong Soo Lee),현인영(In Yong Hyun),강원준(Won Jun Kang),이원우(Won Woo Lee),정준기(June Key Chung),김성권(Suhng Gwon Kim),이명철(Myung Chul Lee),이정상(Jung Sang Lee),고창순(Chang Soon Koh) 대한내과학회 1997 대한내과학회지 Vol.53 No.2
N/A Objectives: It is suggested that frequency of low turnover bone disease is much higher in diabetic renal osteodystrophy. We tried to find out whether bone scan images show less 99mTc-MDP uptake in diabetic renal ostwdystrophy. Methods: We compared bone scan images of renal failure patients with and without diabetes. The number of patients studied was 134 (43 patients had diabetes and 91 patients did not). Two experienced nuclear physicians read Tc-99m-MDP bone scan twice separately and gave the score either 1 or 0 on 6 areas; axial skeleton, long bone, skull & mandible, periarticular areas, costochondral junction and sternum. The means of summed scores were compared using Students t-test. To exclude the effects of sex, age and serum creatinine concentration, we analysed these factors together with the effect of diabetes using analysis of covariance. We also interpreted on bone scan images, as classical renal osteodystrophy, renal failure and normal. Results: The intra- and interobserver variations were very low. Patients of diabetes group showed significantly lower mean of summed score(2.0±0.95) compared to patients of non-DM group(3.3±1.2). Analysis of covariance revealed that lower score of diabetes group was independent of sex, age and serum creatinine level. of diabetes group, 2 nuclear physicians interpreted bone scans as classical renal osteodystrophy in 60% and 56%, However, they interpreted bone scans of non-DM group in 80%, 88%(between-observer k: 0.74). Chi-square test showed that this difference was statistically significant (p<0.05). Conclusion: Bone scan image of diabetic renal osteodystrophy showed less 99mTc-MDP uptake, which meant low osteoblastic activity. This influence of diabetes upon bone uptake was significant after considering other confounding factors.