방사선치료와 화학요법을 받은 유방암 환자에서 발생한 발치 후 종창의 진단영상학적 감별 진단

허경회,안병모,김미자,박관수,허민석 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.3

A 60-year-old female, who complained of delayed healing and swelling after extraction of left lower second molar during chemotherapy, visited our department. She had a history of a resection surgery of breast cancer and postoperative radiotherapy. The conventional radiographs showed diffuse permeative bone destruction in posterior mandibular body, which gave the first radiologic impression of osteonecrosis associated with radiotherapy or chemotherapy. And bone metastasis from the breast cancer was also considered in the differential diagnosis. On the enhanced computed tomography (ECT) the posterior mandibular body was occupied by a large expansile lesion showing central low attenuation with peripheral rim enhancement. Magnetic resonance images revealed that the low attenuated area on ECT did not show as high signal intensity as water on T2 weighted image and indicated solid component of a tumor. The final diagnosis was central squamous cell carcinoma. We present the diagnostic imaging features of the patient with special emphasis on the differential diagnosis.

돼지 하악골의 micro-CT 영상에서 추출한 3차원 골미세구조와 골강도 사이의 상관관계

허경회,박무순,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.3

Purpose : To investigate the relationship between three-dimensional (3D) bone imaging parameters and trabecular strength in the mandible. Materials and Methods : Bone specimens were obtained from the mandibles of five male pigs weighing around 110 kg each. Of those, 43 samples were selected for 3D analysis and measured by micro-computed tomography. The five morphometric parameters were trabecular thickness (Tb.Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI) and degree of anisotropy (DA). Through destructive mechanical testing, strength parameters were obtained. Results : BV/TV, SMI, BS/BV, and Tb.Th showed significant correlations with strength parameters. DA did not show any correlation with the other parameters. In multiple linear regression analysis, BV/TV alone explained 43% of the variance in Young’s modulus. By stepwise inclusion of SMI, the variance in the Young’s modulus was better explained up to 52%. Conclusions : Predicting trabecular strength in the mandible through architectural analysis would be possible. Further study is needed to establish the tendency and variety of trabecular architecture and strength according to the locations within the mandible.

상악골 침범 소견을 동반한 선천성 침윤 지방종

허경회,이향옥,이서영,최형길,하병각,문제운,이삼선 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.37 No.2

Infiltrating lipoma is a rare mesenchymal neoplasm that, in spite of benign nature, characteristically infiltrates adjacent tissues and tends to recur after surgery. It has a predilection for the extremities and the trunk and is extremely rare in the head and neck region. We present a case of congenital infiltrating lipoma of the face, describing the intrabony invasion and osseous dystrophy as well as the soft tissue changes seen on plain radiographs and magnetic resonance imaging.

하악과두에 발생한 호산구육아종

최문경,허경회,이원진,오성욱,이삼선 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.1

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

구강악안면영역의 3차원 CT 영상 재형성시 역치 및 불투명도에 대한 연구

최문경,이삼선,허경회,이원진,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.1

Purpose : This study was designed to determine a proper threshold value and opacity in three-dimensional CT volume rendering of oral and maxillofacial area. Materials and Methods : Three-dimensional CT data obtained from 50 persons who were done orthognatic surgery in department of oral and maxillofacial radiology of Seoul National University retrospectively. 12 volume rendering post-processing protocols of combination of threshold (100HU, 150HU, 221HU, 270HU) and opacity (58%, 80%, 90%) were applied. Five observers independently evaluated image quality using a five-point range scale. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa value. And three oromaxillofacial surgeons chose the all images that they thought proper clinically in the all of images. Results : Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. The highest diagnostic accuracy appear with 100HU and 58% opacity. and the lowest diagnostic accuracy appear with 221HU and 58% opacity that are being used protocol in department of oral and maxillofacial radiology of Seoul National University. But, no statistically significant difference was noted between any of the protocols. And the number of proper images clinically that chosen by three oromaxillofacial surgeons is the largest in the cases of protocol 8 (221HU, opacity 80%) and protocol 11 (270HU, opacity 80%) in one after the other. Conclusion : Threshold and opacity in volume rendering can be controled easily and these can be causes of making an diagnostic accuracy. So we need to select proper values of these factors.

방사선사진에서의 골질과 임상적으로 평가한 골질 분류의 상관관계

김현우,허경회,박관수,김정화,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Purpose : To investigate the validity of digital image processing on panoramic radiographs in estimating bone quality before endosseous dental implant installation by correlating bone quality in radiographic images with clinical bone quality classification. Materials and Methods : An experienced surgeon assessed and classified bone quality for implant sites with tactile sensation at the time of implant placement. Including fractal dimension eighteen morphologic features of trabecular pattern were examined in each anatomical sites on panoramic radiographs. Finally bone quality of 67 implant sites were evaluated in 42 patients. Results : Pearson correlation analysis showed that three morphologic parameters had weak linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.276, -0.280, and -0.289, respectively (p<0.05). And other three morphologic parameters had obvious linear negative correlation with clinical bone quality classification showing correlation coefficients of -0.346, -0.488, and -0.343 respectively (p<0.05). Fractal dimension also had a linear correlation with clinical bone quality classification with correlation coefficients -0.506 significantly (p<0.05). Conclusion : This study suggests that fractal and morphometric analysis using digital panoramic radiographs can be used to evaluate bone quality for implant recipient sites. (Korean J Oral Maxillofac Radiol 2006; 36 : 25-32)

CT사진을 이용한 한국인의 C형 치근관의 분포에 대한 연구

전록원,허경회,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.2

Purpose : To investigate the incidence and prevalence of C-shaped root canal using computed tomographic images of head and neck in Korean population. Materials and Methods : Regardless of each examination purpose, randomly selected 268 examples which have serial axial computed tomographic images with 8 normal molars in maxilla and mandible were selected and investigated. Defined C-shaped root canal and we could get 82 proper image examples in view of this definition. These were detected and investigated of incidence and prevalence of C-shaped root canal. Results : C-shaped root canals were found in 82 examples among 268 (30.6%) and 147 teeth. They were only found on molar area, and the highest incidence was 37.41% of left mandibular second molars, and the lowest was 2.04%of right maxillary second molars. On prevalence of tooth position, mandibular second molar was the highest, 65% of C-shaped root canal teeth and maxillary second molar was 6% the lowest. Conclusion : 31% of randomly selected CT images no considering check-up reason have C-shaped root canals. The C-shaped root canals of mandibular second molar are found most frequently and they are also detectable on maxilla. On Korean population, C-shaped root canals are one of conditions that have to concern with dental treatment for it appears at a high prevalence relatively.

디지털 및 일반 측방두부규격방사선사진에서 측정 방법에 따른 계측치의 비교

김미자,허경회,이원진,허민석,이삼선,이진구,안병근,최순철 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.1

Purpose : To compare cephalometric measurement between measuring methods in digital and conventional lateral cephalometric radiograph. Materials and Methods : Twenty digital and conventional lateral cephalometric radiographs were selected. In digital group, cephalometric measurements were performed manually using hardcopies and automatically using VCeph^(TM) program on the monitor. In conventional group, the same measurements were performed manually on conventional films, and for automatic measurement conventional films were digitized by scanner. All measurements were performed twice by 4 observers, and 24 cephalometric variables were calculated and the time spent for each measurement was recorded. The differences in measurements data and the time spent for each measurement were compared within each group. Intra-observer and inter-observer comparisons were performed. Results : In both groups, no statistically significant difference between manual and automatic measurements was observed and most of the variables didn’t show statistically significant differences between methods. The observer with less experience tended to show statistically significant differences of measurements between methods, and differences from other observers. The differences of measurements between methods in digital group were lesser than those of conventional group with statistical significance in 8 variables out of 24. With automatic method and in digital group, the spent time was shorter. Conclusion : With direct digital radiograph, automatic method using manually idenitified landmarks can be preferable in cephalometric analysis.

저작근 공간에서 재발된 치성각화낭

임수연,허경회,이원진,최현배,최순철 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.2

The odontogenic keratocyst (OKC) is a developmental odontogenic cyst typically occurring in the jaws. Since the first description of OKC was published in 1956, the lesion has been of particular interest because of its specific histopathologic features, high recurrence rate, and aggressive behavior. Recurrences most commonly arise within bone at the site of the original cyst. However, as lining cells may find their way into surrounding tissues either from implantation during surgery or from cortical perforation recurrences may arise at a distance from the original cyst. Here, we report a rare case of recurrent OKC which was first developed in mandible and recurred within the masticatory space.

결합조직형성 법랑모세포종의 방사선학적 소견 : 증례보고 3례

최다혜,허경회,문제운,이원진,허민석,이삼선,최순철,박관수 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma. It shows important differences in anatomic distribution, histologic appearance, and radiographic findings compared with the general type of ameloblastoma. It is histologically characterized by an abundance of densely collagenous stroma and radiographically a mixed radiolucent-radiopaque lesion. We present three cases of desmoplastic ameloblastoma. All the patients complained on buccal swelling with or without pain and the sites of occurrence were the anterior and the premolar region. Plain radiographs showed mixed radiopaque-radiolucent lesion with ill-defined or diffuse sclerotic margin and no external root resorption. Additionally, CT scans revealed buccal expansion and relatively well-defined margin of the lesions. The clinical and radiographic features of the presented cases were compared with those of the desmoplastic ameloblastoma in the previous literatures. (Korean J Oral Maxillofac Radiol 2006; 36 : 63-8)