폐기종의 연무흡입 폐환기스캔 소견

박용휘(Yong Whee Bahk),정수교(Soo Kyo Chung),박영하(Young Ha Park),전정수(jeong Su Jeon) 대한핵의학회 1990 핵의학 분자영상 Vol.24 No.2

N/A Perfusion and ventilaion imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonary emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebulizer with 15 mCi of Tc- 99m-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to l0-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with Tc-99m-MAA was performed in 12 patients. In five patients, we performed fo1low-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was diffuse (6/21), discrete(6/21), intermediate (3/21), or combined (6/21). In 12 patients studied also with perfusion scans, perfusion defects matched closely with ventilation defects in location and configuration. But the size of the ventilation defects was generally larger than the perfusion defects. In all four patients treated with bronchodilators, the follow-up study demonstrated decrease in abnormal of radioaerosol deposition in the central airway with improvement of ventilation defects. RII was useful technique for the evaluation of regional ventilatory abnormality and the effects of treatment with bronchodilators in pulmonary emphysema.

B형 간염 백신 접종 후 일시적으로 관찰된 (99m)Tc-MDP의 미만성 간 섭취

김현진 ( Hyun Jin Kim ),박영하 ( Young Ha Park ),황성수 ( Seong Su Hwang ),김상흠 ( Sang Heum Kim ),정수교 ( Soo Kyo Chung ) 대한핵의학회 2006 핵의학 분자영상 Vol.40 No.1

내과적 질환에 병발된 반사성 교감신경계 위축 증후군 20 예의 분석

송소향(So Hyang Song),이정득(Jeong Deuk Lee),이상헌(Sang Heon Lee),홍연식(Yeon Sik Hong),조철수(Chul Su Cho),박동준(Dong Joon Park),정수교(Soo Kyo Chung),김호연(Ho Yun Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Reflex sympathetic dystrophy syndrome (RSDS) is an distinct symptom complex characterized by diffuse distal-limb pain, edema, vasomotor skin change and dystrophic skin change. It has been associated with limb-trauma, acute stoke, myocardial ischemia, peripheral neuropathy, phamacological agents such as phenobarbital and antituberculosis agents and malignancy. We report the clinical and radiological features of 20 patients who were diagnosed of RSDS at Kangnam Saint Mary's Hospital between January 198S and May 1991. The results were as fo1lows: 1)According to Kozin's criteria, seven (35%) are diagnosed of definite RSDS, eight (40%) of probable RSDS, and five (25%) of doubtful RSDS. 2) Disorders associated with RSDS were cerebrovascular disease (7 patients), malignancy (4 patients), myocardial ischemia (4 patients) and antituberculosis drug (2 patients). The remaining 6 padtients (30%) had no specific precipitating events. 3) Review of the Three phase bone scitigraphy (TPBS) for 20 patients indicated that nineteen of twenty patients (95%) has asymmetric and abnormal blood flow in TPBS. 4) Most patients were diagnosed early, therefore, had symptomatic relief without sequele such as flexion contracture of skin or subcutaneous atrophy by analgesics, steroid, calcitonin and physical therapy. In summary, the TPBS is a potentially sensitive and specific test to corroborate the diagnosis of RSDS and we can expect to have symptomatic relief without sequence if this disorder could be diagnased and treated, early.

99mTc - HSA 신티그램을 이용한 쯔쯔가무시병에서의 장내단백소실 진단

박용휘(Yong Whee Bahk),김춘열(Choon Yul Kim),양우진(Woo Jin Yang),손형선(Hyung Sun Sohn),김성훈(Sung Hun Kim),신경섭(Kyung Sub Shin),김윤희(Yoon Hee Kim),정수교(Su Kyo Chung) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.1

N/A N/A

급성 요로감염 환아의 신장 반흔 예측요인

백준현,박영하,황성수,전정수,김성훈,이성용,정수교 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.4

목적 : 본 연구는 요로 감염 환아의 추적 ^(99m)Tc DMSA신 피질 스캔으로 신장 반흔을 진단하고, 감염 초기 스캔 소견, 요관 역류, 신장 섭취율, 연령, 성 등 관련 요인들이 신장 반흔에 미치는 영향을 분석하고자 하였다. 대상 및 방법 : 임상증상, 소변 검사 및 뇨 배양 검사로 요로 감염으로 진단된 14세 이하의 환자 83명을 대상으로 하였다. 남아 50명, 여아가 33명이었고 평균 연령은 33.7개월 이었다. 치료 시작 일주일 이내에 DMSA스캔과 배뇨성 방광 요도술을 시행하였으며, 적절한 항생제 치료 후 6개월 이후에 추적 스캔을 하였다. 추적 스캔에서 감염 초기 보였던 피질 결손이 회복되지 않은 경우를 신 반흔으로 진단하였으며, 피질 결손을 1; 신장상부나 하부의 큰 결손으로 신장 의연은 불분명하나 변형은 없는 경우. 2 ; 작은 결손으로 신장 외연의 뚜렷한 변형이 없는 경우. 3 ; 단일 결손으로 신장 외연의 국소적인 변형을 일으킨 경우. 4 ; 정상 혹은 작은 크기의 신장으로 외연의 변형이 있는 경우. 5 ; 다발성 피질 결손이 있는 경우. 6 ; 국소적인 이상 소견 없이 미만성으로 신장 섭취가 감소한 경우로 분류하였다. 배뇨성 방광 요도술에서 요관 역류는 5단계로 분류하였다. 결과 : 166개의 신장 중 감염 초기 신 피질 스캔에서 결손을 보인 신장은 115개(69.3%) 이었고, 추적 검사에서 신장 반흔으로 진단된 신장은 65개(56.5%)였다. 신 피질 스캔에서 3, 4, 5 형태 결손의 75%, 77%, 78%에서 신장 반흔이 발생된 반면, 1, 2, 6 형태 결손의 65%, 77%, 50%에서 결손이 회복되었다. 회복이 어려운 3, 4, 5 형태 결손으로 신장 반흔을 진단할 경우 DMSA스캔의 민감도, 특이도, 정확도는 각각 76.9%, 85.1%, 81.9%였다. 요관 역류는 감염 초기 스캔에서 3, 4, 5 형태의 결손을 보인 경우 역류 유무 및 정도가 신장 반흔과 유의한 연관성을 보인 반면, 1, 2, 6 형태의 결손을 보인 경우 신장 반흔과의 연관성은 유의하지 않았다. 로지스틱 분석에서 감염 초기 DMSA 스캔에서 회복 가능성이 적은 3, 4, 5 형태의 결손이 있을 경우 그렇지 않을 경우에 비해 신장 반흔을 일으킬 19.1배였다. 경한 요관 역류 나 증증 역류가 있을 경우 신장 반흔을 일으킬 위험이 각각 3.5배, 14.4배 였다. 신장 섭취율도 신장 반흔과 연관성이 있었으나 신장 반흔 위험도는 유의하지 않았다. 연령 및 성별은 신반흔과 유의한 연관성이 없었다. 결론 : 요로 감염 초기 ^(99m)Tc DMSA 스캔에서 결손이 신장 외연의 변형을 일으키거나 다발성일 경우, 신장 반흔으로 진행될 가능성이 높으며, 적극적인 치료가 필요하다. Purpose : The purpose of this study was to evaluate the usefulness of ^(99m)Tc DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infection. Materials and Methods : Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of sympton, urinalysis and urine culture. ^(99m)Tc DMSA scintigraphy and voiding cystoureterography were performed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s ; 1 ; a large hypoactive upper or lower pole, 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the cutlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow up scr, the lesion was defined as containing a scar. Results : One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1%%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion : In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.