두경부에 발생한 횡문근육종 : 5예 보고 및 문헌고찰

차성숙 인제대학교 1985 仁濟醫學 Vol.6 No.2

1982년부터 1984년까지 인제대학 부속 부산 백병원에 입원하여 확진된 두경부에 발생한 횡문근육종 5예에 대하여 임상 및 방사선학적 소견을 분석하고 문헌 고찰과 함께 보고하고자 한다. Rhabdomyosarcoma, malignant tumor of striate muscle, is common soft tissue sarcoma of head and neck in the children. Recently, the computed tomography is most useful modality in detecting accurate location and extent of tumor with bone erosion, and digital subtraction angiography, polytomography, RI brain and bone scintigraphy are also useful modality in diagnosis and decision of treatment technique. Author reviewed 5 cases of rhabdomyosarcoma in head and neck at Inje Medical College Hospital from 1982 to 1984. The results were as follows: 1.The age distribution was below 10 year-old in all cases, and 4 cases were male and 1 case was female. 2.The tumor involved soft tissue in 2 cases, eyelid in 1 case, middle ear in 1 case, and nasopharynx in 1 case, and the chief complaints were palpable soft tissue mass in 3 cases, facial palsy in 2 cases, headache, decreased visual acuity, and ear bleeding. 3.The computed tomography performed in 3 cases, the findings were noted as soft tissue mass and/or isodense mass in the brain with bonydestruction of skull on precontrast scan, and relative moderate enhancement on postcontrast scan. The computed gomography is important study for reveal accurate location and extent of tumor. 4.Although the digitar subtraction angiography was performed in 1 case, good visualization of faint tumor stain by small amount of contrast media in nasopharyngeal region, which was not clearly visualiged by conventional angiography because of overlapped bony shadows. 5.The pathological findings were embryonal rhabdomyosarcoma in 2 case, and unclassified rhabdomyosarcoma in 3 cases, and the stage of tumor were group III in 2 cases and group IV in 3 cases, and the three combined therapy was performed in only 1 case. Therefore, more multiple diagnostic modality and active treatment are recommended.

신경아세포종의 방사선학적 고찰

차성숙 대한영상의학회 1989 대한영상의학회지 Vol.25 No.3

Neuroblastoma is one of common malignacy in children and originates from the primitive sympathetic neuroblasts of the embryonic neural crest. Because of the patient have disseminated disease at the time of diagnosis the prognosis will not be good. Nowadays we will have more accurate information for dianosing and staging by applica-tions of modern imaging modalities. the authors analyzed radiological findings of 21 cases of pathologically proven neuroblasto-ma at Inje University pusan paik Hospital. the results were as follows: 1. The mean age was 4 year-old and male to female ration was 11:10 2. The most common clinical finding was palpable abdominal mass(10 cases) and the most common originating site was abdomen(17 cases) the diagnosis could be done in 9 cases by clinical impression, 3. Neuroblastoma was in 19 cases and ganglioneuroblastoma was in 2 cases pathologically. stage I was and the others (20 cases) were more than stage III. 4. Among 19 cases plain film and IVP showed renal abnormality in 16 cases calcification in 6 cases and bone metastases in 10 cases 5, Among 19 cases plain film and IVP showed renal abnormality in 16 cases calcification in 6 cases and bone metastases in 10 cases 5. Among 13 cases ultrasonography showed irregularly marginated heterogenous mass in 12 cases calcification in 8 cases renal abnormality in 9 cases and lymph node metastases in 10 cases 6. Among 12 cases CT finding showed irregular margined soft tissue mass in 11 cases calcification in 9 cases renal abnormality in 9 cases lymph node metastases in 11 cases and bone metastases in 4 cases 7. Among 15 cases bone scintigraphy showed bone metastases in 11 cases and bone metastases in 4 cases. 7. Among 15 cases bone scintigraphy showed bone metastases in 11 cases renal abnormality in 9 cases and primary site uptake in 9 cases

한국인의 시신경관에 관한 방사선학적 고찰

차성숙 대한영상의학회 1982 대한영상의학회지 Vol.18 No.3

Various methods of taking of optic foramen view and avalabilities have been studied by many foreign ivestigators, but those in Korea have not been reported yet. The authors have measured and examined the size and shapes of optic foramina of optic foramen views in 111 Korean checked at Inje Medical College Hospital during about 3 years from June 1979 to March 1982. The cases were divided into two groups, A and B, for the convenience of study. Group A consisted of 50 normal Korea 5 to 55 years of age with no visual symptoms and signs. Group B included 69 patients 3 to 75 years of age with visual symptoms and signs. The results were as follows: 1. Mean value of actual diameter of optic foramen measured by Goalwin's method in Group A : Right : A diamenter ; 4.21mm, B diameter ; 4.32mm, Left : A diameter ; 4.29mm, B diameter ; 4.30mm. 2. Absolute symmetry of the greatest diameters of both optic foramina in Group A ; 36%, difference of 0.5 or less ; 28%, from 0.5 to 1.0mm ; 18%, from 1.0 to 1.5mm ; 8%, umcomparable cases ; 10%. The greatest difference was 1.4mm. 3. The shapes of optic foramen in Group A : oval shape ; 65%, circular ; 29%, keyhole or double foramen; 6%. 4. In Group B, the peak age group was second decade (31%), the most common clinical cause of examination of optic foramen view was optic nerve atrophy (30%), and the pathologic findings were only 4 cases (7%). 5. The technique of optic foramen view by modified Pfeiffer's method delineated the outline of optic foramen more clearly than ordinary Rhese's method in our experience.

부갑상선 선종에 의한 원발성 부갑상선 기능항진증 -2례보고 및 문헌고찰-

차성숙 대한영상의학회 1985 대한영상의학회지 Vol.21 No.1

The primary hyperparathyroidism is a complex endocrine disease caused by neoplasm or diffuse hyperplasia of parathyroid gland in which excessive paratyroid hormon is secreted. This results in chemical abnormalities of serum, and exerts major influences on the bone, kidney and gastrointestinal tract. The authors report 2 cases of primary hyperparathyroidism with review of the literature.

영아 간혈관내피종의 영상소견

차성숙,장승국 인제대학교 1999 仁濟醫學 Vol.20 No.1

영아에서 발생하는 간헐관내피종은 자연적으로 크기가 감소되는 양성 종양으로 영상소견과 추적검사가 매우 중요하다. 최근 4년간 부산백병원에서 수술로 확진된 3예와 임상 및 영상소견으로 진단이 가능하였던 1예를 포함한 4예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Infantile hepatic hemangioendothelloma is a benign vascular tumor of the liver in infant. Since spontaneous regression usually starts within several months, imaging findings and follow-up studies are very important. Imaging findings of four cases of infantile hepatic hemangioendothelioma were reviewed, which were surgically proved(3 cases) and diagnosed by the clinical and imaging findings(1 case).

역동적 전산화 단층촬영법에 의한 정상 신장의 시간-밀도 곡선 분석

차성숙 인제대학교 1991 仁濟醫學 Vol.12 No.3

최근 3년동안 부산백병원 방사선과에서 신장질환이 없는 20명에서 40개의 정상 신장을 대상으로 역동적 전산화단층촬영법을 시행하여 신장의 구조 및 시간-밀도 곡선을 평가분석하여 그 결과를 보고하는 바이다. The 40 normal kidneys were evaluated by dynamic renal computed tomography. The results were as follows : 1.The cortical densities were differentiated from medullary densities within 1 minute after rapid injection of contrast media, and the mean cortical thickness was 5.2 mm. 2.The medullary densities were slightly higher than cortical densities within 1-3 minutes, and the pelvic densities were opacified after 2 minutes after rapid injection of contrast media. 3.The time-density curves were reconstructed, and the mean corticomedullary junction time was about 74 second and the mean corticopelvic junction time was about 106 second.

Iopamidol을 이용한 척수조영술의 임상적 연구

차성숙 인제대학교 1988 仁濟醫學 Vol.9 No.1

Iopamidol을 이용하여 1986년 5월부터 1987년 6월까지 본원 방사선과에서 척수조영술을 시행한 133명을 대상으로 조영상 및 부작용을 분석하여 그 결과를 보고하는 바이다. Iopamidol is a new water soluble, non-ionic myelographic contrast media, and is less expensive and has fewer side effects than Metrizamide. The author studied the film quality and side effect in 133 patients with Iopamidol (Iodine 300 mg/ml) myelography in the department of Radiology of Inje Medical College, Pusan Paik Hospltal, from May, 1986 to June 1987. The results were as follows ; 1.The film qualities were good or excellent in 100% of lumbar region, 75% of thoracic region, and 71% of cervical region by using the dye less than 10ml. By using 11-20ml, the film qualities were better in cervical and thoracicregion. 2.The total incidence of side effects was 35.7%, and the most common side effect was headache(22.9%). 3.The cervical legion was the most frequent site of sloe effects(57.1%). 4.The incidences of sloe effects according to dose of contras media were 35% by using less than 10ml, and 40% by using 11-20ml. 5.Except for 1 case of seizure, most of the side effects were mild and disappeared within 48 hous.

담석환자에서 수술 전 검사로서 자기공명담도조영술

차성숙,최석진 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Purpose : To evaluate the usefulness of magnetic resonance cholangiography(MRC) before biliary surgery in patients with cholelithiasis on ultrasonography. Material and Methods : Seventy four patients with cholelithiasis on ultrasonography underwent MRC before biliary surgery(laparoscopic cholecystectomy:27, cholecystectomy with T-tube drainage:26, cholecystectomy and lobectomy or segmentectomy with T-tube drainage:10, lobectomy or segmentectomy with T-tube drainage:5, lobectomy and cholecystectomy:2, lobectomy or segmentectomy with T-tube drainage:2, T-tube drainage:1, open cholecystectomy:1). For MR imaging, two 1.5T units were used, and single section fast spin echo sequence image, multisection fast spin echo source coronal images(2D or 3D), and maximum intensity projection(MIP) images were obtained. Images were evaluated in detection of stone in GB, intra-hepatic bile duct (IHBD), and extrahepatic bile duct(EHBD) by a consensus of two radiologists. Results : Ultrasonography and MRC showed GB stones in 50(100%) of 5O patients and IHBD stones in 18(100%) of 18 patients. Ultrasonography and MRC showed EHBD stones in 23 (74%) and 30(97%) of 31 patients, respectively. By the detection of EHBD stone on MRC, the surgical methods were changed in 7 patients(16%) of 43 patients in whom ultrasonography showed only GB stones. Stones were detected on MRC in 2 patients in whom ultrasonography showed EHBD dilatation without definite cause. Conclusion : MRC is considered as an excellent imaging modality for detection of stones of GB and bile duct. Therefore we suggest that MRC is a routine study before biliary surgery in patients with cholelithiasis on ultrasonography.

장막하 자궁근종 : 다른 종양과 감별이 어려운 예를 중심으로

차성숙,전제량 인제대학교 1998 仁濟醫學 Vol.19 No.2

장막하 자궁근종은 외측으로 크게 자라거나 경을 가지고 있는 경우에 난소종양을 포함한 다른 종양과 감별이 어려운 경우가 있다. 최근 3년간 부산백병원에서 복강 및 골반강내 고형성 종괴로 자궁과 인접하고 있었으나 자궁은 정상으로 보여 다른 종양과 감별이 어려웠던 수술로 확진된 장막하 자궁근종 8예의 방사선학적 소견을 분석하였다. 종괴의 크기는 직경이 10∼25cm였으며 외측으로 크게 자란 경우가 4예, 인대내 자궁근종이 2예, 경을 가진 경우가 2예였고, 전 예에서 고형성으로 보였으며 1예를 제외하고는 변성을 보인 부분이 섞여 있었고, 종괴는 1예를 제외하고 자궁과 인접하고 있었으며 자궁은 전 예에서 정상으로 보였다. 6예에서는 난소종양을, 전산화 단층촬영만 시행한 1예는 복강내 간염조직종양을 먼저 생각하였으며, 자기공명영상을 시행한 1예는 자궁근종을 먼저 생각하였으나 난소섬유종과 감별이 어려웠다. 가임기 여성에서 복강 및 골반강내 고형성 종괴가 있을 때 자궁이 정상으로 보여도 장막하 자궁근종을 감별 진단에 포함시켜야 할 것으로 생각된다. Pedunculated or large exophytic subserosal leiomyoma can be confused with other solid mass including ovarian tumor. The radiological findings of eight patients, misdiagnosed as other tumors, were reviewed. The masses ranged in size from 10 to 25cm. The leiomyomas were exophytic in four cases, intraligamentous in two cases, and peduculated in two cases. Masses were solid in all cases, all except one case were degenerated, and all had contact with uteri except one case, but uterine abonrmality was not seen in all cases. Diagnoses of solid ovarian tumor we highly likely in six cases. One mass using CT scan was misdiagnosed as peritoneal mesenchymal tumor, and it was difficult to distinguish leiomyoma from ovarian fibroma in a MR imaging. Although the uterus is normal, subserosal leiomyoma should be included in differential diagnosis of abdominal or pelvic solid masses in women during reproductive years.

항문직장에서 발생한 악성 흑색종 : CT 및 MR 소견 CT and MR findings

차성숙,윤정희 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Objective : Anorectal malignant melanoma is a rare malignant tumor. the purpose of this study is to describe the CT and MR findings of anorectal malignant melanoma. Methods and Materials : CT scans of two patients who had confirmed malignant melanoma in rectum and MR scan of one patient who had confirmed anorectal malignant melanoma were reviewed. Results : CT scan showed diffuse wall thickening in rectum and multiple metastases of the liver in one case, and a hypervascular polyp and perirectal mass in one case. MR images showed ill-defined soft tissue mass in anorectal portion at previous hemorrhoidectomy site with small enlarged perirectal lymph node in one case. and follow-up chest and abdominal CT showed multiple metastases of the lung and liver. Conclusion : CT and MR imaging modalities are very useful for the evaluation of primary malignant melanoma in anorectal portion.