건강검진 수진자의 복부 초음파 검사 시 선별 검사용 흉부 저선량 전산화단층촬영의 추가적인 가치 = Added Value of Screening Low Dose Computed Tomography of the Chest for the Evaluation of Abdominal Solid Organs by Ultrasound in Physical Check-up Patients

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to assess the added value of screening low-dose computed tomography of the chest (LDCT) covering the abdomen in evaluating abdominal solid organs to the screening abdominal ultrasonography (US).
Materials and Methods: We prospectively enrolled a consecutive series of 393physical check-up patients, who underwent screening abdominal US and LDCT of the chest from January to February, 2008. LDCT covered the lungs, liver, pancreas, gallbladder,spleen, and both kidneys. The 1st screening abdominal US were performed without information from the LDCT, and then abdominal images covered by LDCT were immediately evaluated. Then a 2nd US session was done with additional information from LDCT and US examination was focused to the findings of LDCT. Perpatient and per-lesion analyses were performed.
Results: In per-patient analysis, additional focal lesions were found in 20 patients (5.1%) for liver and 9 patients (2.3%) for kidneys in the 2nd US sessions. In per-lesion analysis, 154 and 73 focal lesions were found in liver and kidneys, respectively, in the 1st US sessions. On the 2nd US session, 186 and 86 lesions were found in liver and kidneys, respectively. 20.8% and 17.8% of focal lesions were additionally found on 2nd US session in liver and kidneys, respectively. Most (62.5%) of the additional lesions detected in liver were located in segment 7 and 8, the hepatic dome.
Conclusion: Previewing LDCT of the chest and abdominal solid organs before performing screening abdominal US can enhance the diagnostic performance of US in physical check-up patients.

국문 초록 (Abstract)

목적: 본 연구의 목적은 복부 장기를 포함하는 흉부 저선량전산화단층촬영이, 복부 초음파 검사의 진단 능력 향상에 도움이 되는 지 알아보는 것이다.
재료 및 방법: 2008년 1월에서 2월 사이에 복부 초음파검사와 흉부 저선량전산화단층촬영을 포함한 건강 검진을시행한 393명의 수진자(남자 227명, 여자 166명, 평균연령 50.0세)에서 전향적인 연구가 시행되었다. 저선량전산화단층촬영은 간, 췌장, 담낭, 비장, 신장 등의 복부 장기를포함하여 촬영이 이루어졌다. 먼저 저선량전산화단층촬영을 시행 후, 그 영상을 보지 않은 상태에서 복부 초음파 검사가 1차로 시행되었으며, 이후 저선량전산화단층촬영 영상 정보를 참고하여 2차 초음파 검사가 시행되었다. 1차및 2차 초음파 검사에서 각 복부 장기에서 발견된 병변들을 수진자별, 병변별로 분석하였다.
결과: 수진자별 분석에서, 간의 경우 20명(5.1%), 신장의 경우 9명(2.3%)에서 추가적인 국소 병변이 2차 초음파검사에서 발견되었다. 병변별 분석에서 간과 신장에서는 1차 초음파 검사에서 각각 154개, 73개, 2차 초음파 검사에서 각각 186개와 86개의 국소 병변이 발견되었으며 각각20.8%와 17.8%의 국소 병변이 추가적으로 발견되었다.
간에서 추가로 발견된 병변의 62.5%는 간지붕부인 7번 및8번 분절에서 발견되었다.
결론: 건강검진 수검자에서, 흉부 저선량전산화단층촬영에 포함된 복부 장기의 소견을 복부 초음파 검사 전에 미리 확인하는 것은 초음파 검사의 진단 능력 향상에 도움이될 것으로 생각된다.

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