건강검진 수검자를 대상으로 한 단순흉부촬영과 저 선량 나선형 CT와의 비교 분석

최진영,강화원,이강우,이우식,Choi Jin Yeong,Kang Hwa Won,Lee Kang Woo,Lee Woo Sik 대한방사선사협회 2002 대한방사선사협회지 Vol.28 No.1

Purpose : The purpose of this study is to evaluate the usefulness, after we compare and analyze the difference about the location of a lesion and the result of diagnosis on chest radiographs(CR) and low dose computed tomography(LDCT) in subjects for healt

16 MDCT를 이용한 CT Urography의 유용성

김동수(Dong Soo Kim),강화원(Hwa Won Kang),임상묵(Sang Muk Im),구양수(Yang Su Ku),이강우(Kang Woo Lee),최창한(Chang Han Choi) 대한CT영상기술학회 2005 대한CT영상기술학회지 Vol.7 No.1

Purpose To evaluate the usefulness of computed tomography urography with 16-channel multidetecter computed tomography in patients with urinary track disease. Materials and Methods IN 28 patients who underwent CT urography from May 2004 to December 2004. The clinical symptoms of these patients include; renal donors or hematuria, which were clinically suggestive of urinary system disorders. All studies were performed on a siemens sensation 16 scanner with 16mm detectors. CT scans were obtained on a unenhanced, arterial phase, 1,3,5 minites with the following technique : a collimator of 5mm a pitch of 1, and 3d reconstrutions at a thickness of 2mm with intervals of l.5mm. Intravenous administered of the normal saline 50 ml immediately after injecting contrast medium(at a rate of 3 ml/sec). Results Of these 28 patients,(9men and 19 women, age ranged from 20 to 79 years old, mean age 44.8 years)l4 patients(46.7%) were proven to have no 뮤normal disease, 4 patients(13.4%) were with renal stones or hydronephrosis, and there were 10 patients(40.9%) of other urinary system disorders. Conclusion CT urography is a very useful modality to evaluate kidny-transeplatation donors, hematuria and flank pain in the patients with urinary track disease

위암 진단을 위한 복부CT 검사시 자세 변경에 따른 Air+Water 경구조영제 사용의 유용성

이득열(Deuk Real Lee),임상묵(Sang Muk Lim),강화원(Hwa Won Gang),유대준(Dae Jun Yoo),김대현(Dae Hyun Kim) 대한전산화단층기술학회 2013 대한CT영상기술학회지 Vol.15 No.1

목적 : 위암 진단을 위한 복부CT 검사시 경구조영제로서 기존에 사용하던 발포제 2포 대신 발포제 1포와 물을 이용하여 환자의 자세변화에 따른 유용성에 대하여 알아보고자 하였다. 대상 및 방법 : 대상은 실험군(Group A)은 2012년 10월부터 2012년 12월까지 위암 진단을 위해 복부 CT를 시행한 총인원 117명(남자:76명,여자:41명)으로 평균연령은 59.7세 였다. 대조군(Group B)은 2012년 7월부터 2012년 9월까지 위암 진단을 위해 복부 CT를 시행한 총인원 100명(남자:66명,여자:34명)으로 평균연령은 61.2세 였다. 검사장비는 Siemens사의 Sensation 16, Defenition, Defenition AS+장비를 사용하였고 위 확장용 경구조영제는 태준제약의 탑발포지(4g)과 물을 사용하였다. 검사방법은 Group A는 발포제 1포와 물 300ml, Group B는 발포제 2포를 경구조영제로 먹은 후 pre, artery, portal phase는 좌후사위 자세에서 검사하였고 delay phase는 우측와위 자세에서 검사하였다. 두 Group의 위확장정도 비교평가는 10년 이상 경력의 CT전문 방사선사 3명이 PACS를 통해 poor : 1, fair : 2, good : 3, excellent : 4로 평가하였다. 영상의 정성적 평가는 Group B의 위암 판정을 받은 20명을 복부전문 영상의학과 전문의 1명과 위암전문 소화기외과 전문의 1명이 PACS를 통해 후향적으로 물과 공기의 병변과의 대조도 정도를 평가하였고 공기가 좋으면 1, 같으면 2, 물이 좋으면 3으로 3단계로 평가하였다. 결과 : 첫 번째 위확장정도 평가는 Group A에서 poor가 평균 6.3명, fair가 평균 17.7명, good은 49.7명, excellent는 43.3명 이었고 전체평균은 3.11로 나타났다. Group B는 poor가 평균 3명, fair가 평균 14.7명, good은 47.7명, excellent는 34.7명 이었고 전체평균은 3.14으로 나타났다. 두 그룹의 차이는 발포제로만 검사한 Group B가 평균 0.03 높은것으로 나타났으며 T-test를 통한 두 그룹의 차이는 없었다. 두 번째 공기와 물의 병변과의 대조도 차이는 공기가 좋은 경우는 8명으로 전체의 40%로 나타났고, 같은경우는 6명, 물이 좋은 경우는 6명으로 각각 30%로 나타났다. 결론 : 경구조영제로 발포제와 물을 동시에 사용하여 검사하는 방법은 기존 발포제로만 한 검사와 비교해서 좋은 위확장정도는 유지하면서 좌후사위 자세에서는 antrum에 공기로 채워진 영상과 fundus에는 물이 채워진 영상, 우측와위 자세에서는 antrum에 물이 채워진 영상과 fundus에는 공기가 채워진 영상을 얻을 수 있어서 공기와 물의 조영효과를 동시에 평가 할 수 있어서 환자의 병변을 평가하는데 좀 더 도움을 줄 수 있을 것으로 생각된다. Purpose : It was to identify the usefulness of a effervescent granule and water instead of two effervescent granules as oral contrast media in Abdomen CT for diagnosis of Gastric cancer according to positional changes. Material and methods : Experimental group subjects (Group A) were 117 patients (76 males and 41 females) who had Abdomen CT for gastric cancer diagnosis from October to December in 2012. Mean age was 59.7. Control group subjects (Group B) were 100 patients (66 males and 34 females) who had Abdomen CT for gastric cancer diagnosis from July to September in 2012. Mean age was 61.2. For the examination, Sensation 16, Defenition, and Defenition AS+ by Siemens were used, and for oral contrast media to expand stomach Top effervescent-G (4g) by Taejoon Pharm and water were used. Group A had a effervescent granule and 300ml water, and Group B had two effervescent granules as oral contrast media. They were examined in LPO position for pre, artery and portal phase and in Rt decubitus position for delay phase. To compare and evaluate the gastric distension level of two groups, 3 CT radiology technologists with more than 10 years’ experiences were asked to evaluate as poor:1, fair:2, good:3, excellent:4. For the qualitative evaluation of images, a Abdominal specialized radiologist and a stomach cancer specialized digestive surgeon evaluated contrast of water and air with lesions on 20 gastric cancer diagnosed patients in Group B retrospectively through PACS. They marked 1 when water was better, 2 when they were equal, and 3 when water was better. Results : In the first gastric distension level test, Group A had 6.3 as poor, 17.7 as fair, 49.7 as good, and 43.3 as excellent, which made the average 3.11. Group B had 3 as poor, 14.7 as fair, 47.7 as good, and 34.7 as excellent, which made the average 3.14. Group B using effervescent granules only showed 0.03 higher results than Group A but there was no significant difference between two groups through T-test. Second, in the contrast of water and water with lesions, air was better in 8 subjects (40%), equal was 6 (30%) and water was better in 6 (30%). Conclusion : When using effervescent granule and water at the same time as oral contrast media, it maintained gastric distension level and provided various images such as air-fⅢed antrum and water-fⅢed fundus image at LPO position and water-fⅢed antrum and air-fⅢed fundus image at Rt decubitus position. As it allows evaluating the contrast effects of water and air at the same time, it may help to evaluate lesions of patients better.

다양한 비이온성 조영제의 부작용 발생양상 비교분석

김경민(Kyeong-Min Kim),임상묵(Sang-Muk Im),김상균(Sang-Gyun Kim),강화원,오근택(Geun-Taek Oh),이광원(Gwang-Won Lee) 대한CT영상기술학회 2017 대한CT영상기술학회지 Vol.19 No.2

목적 : 현재 사용하는 비이온성 조영제 성분에 따라 나타나는 부작용 발생확률을 비교하고, 부작용의 강도 및 발생 양상 등을 분석하여 그 특징적인 차이점을 제공하고자 한다. 대상 및 방법 : 연구대상은 2014년 1월 1일부터 2016년 12월 31일까지 단일 기관에서 조영제를 사용하는 CT검사를 시행한 93057명 중 조영제 부작용이 발현되어 약물이상반응 보고서가 작성된 592명을 대상으로 하였다. 비교분석에 사용된 약물은 Iobitridol, Iohexol, Iomeprol, Iopamidol, Iodixanol이며, 5가지의 조영제 성분에 따라 약물이상반응 보고서에 기재된 부작용 발생 위험 인자들의 부작용 발생확률을 비교하고, 나타나는 부작용 발생 강도와 양상을 분석하였다. 결과 : 조영제 부작용 발생률은 Iodixanol이 2.9%로 가장 높았으며(p <0.00), 발생 강도는 Iobitridol에서 중등증 72.7%, 중증 6.1%의 비율로 높게 나타났다(p =0.031). 성별에 따른 부작용 발생률의 유의한 차이는 없었고(p =0.808), 연령별 부작용 발생률은 50-69세에서 Iobitridol을 사용하였을 때 72.7%로 가장 높게 나타났다(p =0.005). 기왕력 유무에 따른 부작용 발생률은 성분별로 유의한 차이를 보이지 않았고(p =0.290), 기저질환이 있는 환자에게서 Iodixanol이 60%, Iohexol이 55.4%의 높은 발생률을 보였다(p =0.003). Iopamidol 32.6%가 호흡기계 부작용 발현양상을 보였고, Iobitridol 48.5%와 Iomeprol 54.2%에서 소화기계 부작용 양상이 보고되었다(p =0.019). 결론 : 조영제의 화학적 특성에 따라 분류되는 각각의 성분들은 확률적으로 부작용 발생의 차이점을 보였다. Iodixanol은 조영제 부작용 발생률이 가장 높았지만 경증의 증상이 대부분으로 그 위험성은 상대적으로 낮았다. Iobitridol과 Iomeprol은 사용량 대비 중등증 이상의 발생비율이 높아 사용에 주의가 필요하며, 이들은 소화기계 부작용 양상이 눈에 띄게 높게 나왔다. 조영제의 분자구조, 삼투압 및 친수성 등의 물리화학적 특성이 부작용 발생에 있어서 특징적인 양상을 보이지는 않았으나, 개별적으로 나타나는 발생률의 차이는 성분에 따라 유의한 영향이 있다는 것을 보여준다. 이는 조영제의 안전성에 영향을 미칠 수 있고, 특히 고위험 환자들에게 있어서는 조영제 선택에 대한 주의가 필요하며, 환자의 안전보장과 최적의 사용을 위해 성분과 조영제 부작용 위험인자와의 충분한 고려와 체계적인 감시가 요구된다. Purpose : This study aimed to compare the prevalence of adverse effects of the composition of non-ionic contrast media currently in use and to describe the characteristics of the adverse reactions to the agents based on the examined intensity and manifestation patterns thereof. Materials and Methods : The study involved 592 participants who were among the 93,057 patients who underwent contrast-enhanced computed tomography at a single institution between January 1, 2014 and December 31, 2016. The participants developed adverse reactions to the contrast media and had had reports of adverse drug effects. The drugs used for the comparative analysis were Iobitridol, Iohexol, Iomeprol, Iopamidol, and Iodixanol. Based on the chemical composition of these five agents, the prevalence rates of adverse effects caused by the adverse effect-inducing risk factors listed in the medical reports were compared. Furthermore, the intensities and patterns of the manifested adverse effects were analyzed. Results : The prevalence of adverse effects caused by the contrast agents was found to be highest when 2.9% Iodixanol was used (p <0.00). Regarding the intensity of the adverse effects of Iobitridol, the prevalence of effects that were moderate and seriousness in intensities were high at 72.7% and 6.1%, respectively (p =0.031). No significant differences were found in the prevalence of gender-specific adverse effect (p =0.808). The prevalence of age-specific adverse reactions of Iobitridol was found to be highest (72.7%) in cohorts aged 50-69 years (p =0.005). In terms of medical history, the prevalence of adverse effects did not show any significant differences in terms of the composition of the contrast media (p =0.029), Iodixanol (60%) and Iohexol (55.4%) had the highest prevalence rates of adverse reactions in the patients who had Pre-existing diseases (p =0.003). Iopamidol (32.6%) was found to cause adverse reactions in the respiratory system, while Iobitridol and Iomeprol caused digestive system-related adverse effects at prevalence rates of 48.5% and 54.2%, respectively (p =0.019). Conclusion : Iodixanol had the highest incidence of adverse reactions, but the mild symptoms were the most common and the risk was relatively low. Iobitridol and Iomeprol have a high incidence of moderate to seriousness, so they should be used with caution, and their digestive system side effects are markedly higher. Individual components, categorized according to the chemical properties of the contrast media, showed differences in the probable incidence of adverse effects induced by them. This may influence the safety of the contrast media. Thorough consideration and systematic monitoring of these components, and the risk factors for the adverse effects of contrast media, is required for ensuring patient safety and optimal usage.

조영제와 생리식염수 혼합물을 이용한 표면선량 감소에 관한연구

고주성(Ju seong Ko),임상묵(Sang muk Yim),강화원(Hwawon Gang),김대현(Dae hyeon Kim) 대한전산화단층기술학회 2015 대한CT영상기술학회지 Vol.17 No.2

목적 : 조영제와 생리식염수를 섞어서 조영제 농도를 달리해 차폐물을 제작하여 조영제 농도에 따른 표면선량 차폐효과에 대해 알아보고자 하였다. 대상 및 방법 : CT장비는 SOMATOM Definition(Siemens, Germany)를 사용하였고, 선량의 측정을 위해 Atom Phantom(CIRS)과 형광유리소자(GD-352M:Chiyoda Technol Japan)을 사용하으며, 선량판독기(FDG-1000;AGC, Techno Glass, Shizuoka, Japan)를 이용하였다. 화질평가를 위해 AAPM Phanrom(Model 76-410, Nuclear Associates LTD)을 사용하였다. 기존의 차폐물질인 BISMUTH(F&L Medical Products co, 0.060mmpb equivalent, USA)와조영제와 생리식염수를 혼합하여 제작한 조영제 200 cc+생리식염수 200 cc, 조영제 100 cc+생리식염수 300cc, 조영제 50 cc+ 생리식염수 350cc, 조영제 25 cc+생리식염수 375 cc, 조영제 10cc+생리식염수 390 cc을 비교하였.다 조영제 혼합차폐물을 Atom 팬텀의 흉부위에올려놓고 형광유리선랑계를 양측 유두부 위치와 폐야에 위치시켜서 각각 선량을 측정하였으며, 비교를 위해 BISMUTH 사용했을 때와 차폐체 없을때 와의 선량을 비교 측정하였다. 피사체와차폐물과의 거리를 0 cm, 0.7 cm, 1.4 cm, 2.1 cm으로 변화시켜 거리에 따른 선량변화를 측정하였고 Image Quality를 측정하기 위해 AAPM Phantom을 이용하여 위 실험과 같은 방법으로 노이즈와 균일도를 측정하였다. 결과 : bone plus algorithm을 대조군으로 환자데이터를 분석하였다. soft tissue에서 SD값이 ultra algorithm은 FBP와 ASIR30% 모두 bone plus algorithm과 차이가 없었다. edge algorithm은 SD값이 FBP와 ASIR30% 각각 28.78%, 34.63% 증가했다. bone어|서 SD값이 ultra algorithm은 FBP와 ASIR30% 가각 18.88%, 19.78% 증가했고, edge algorithm은 FBP와 ASIR30% 각각 10%, 9.1% 감소했다. 공간분해능과 선예도 측정결과 bone plus, edge, ultra algorithm의 MTF50% 값은 FBP에서 각각 4.28, 0.62, 5.64였고, ASIR30%는 4.39, -3.77, 6.17이었다. MTF10%값은 FBP에서 6.50, 5.85, 10.01 이었고, ASIR30%는 6.91, 5.74, 21.98이었다. 측정결과 ultra algorithm의 공간분해능과 선예도가 가장 좋았다. 결론 : Ultra algorithm은 기존의 bone plus, edge algorithm과 비교했을 때 저주파영역의 노이즈 증가없이 고주파영역만 강조하면서 영상의 화질 또한 우수하다는 것을 알 수 있었다. 임상 Temporal bone CT검사에서 ultra algorithm은 bone plus algorithm과 비교하여 적절히 사용한다면 매우 유용할 것이라 사료된다. Purpose : The purpose of this study lies in examining the screening effect of surface absorbed dose based on concentration of contrast media by manufacturing a screen with different contrast media concentration by mixing contrast media and physiological saline solution. Materials & Methods : SOMATOM Definition (Siemens, Germany) was used for CT device and Atom Phantom (CIRS) and fluorescent glass element (GD-352M;Chiyoda Technol Japan) were used for measurement of dose. Also, dosimeter (FDG-1000;AGC, Techno Glass, Shizuoka, Japan) was used to measure absorbed dose and AAPM Phantom(Model 76-410, Nuclear Associates LTD) was used for image quality assessment. The comparison was conducted with mixture of previous screen BISMUTH (F&L Medical Products co, 0.060mmpb equivalent, USA) and contrast media 200 cc + normal saline solution 200 cc, contrast media 100 cc + normal saline solution 300cc. contrast media 50 cc + normal saline solution 350 cc. contrast media 25 cc + normal saline solution 375 cc, and contrast media 10 cc + normal saline solution 390 cc manufactured with mixture of contrast media and normal saline solution. The absorbed dose was measured by fluorescent glass dosimeter after placing contrast media mixed screen to the thorax of atom phantom and fluorescent glass dosimeter to the location of both nipples and lung field. Comparative measurement was conducted in order to compare the dose with the use of BISMUTH and without use of screen. The changes in doses accordingly with distance were measured by changing distance between the subject and screen into 0cm. 0.7cm, 1.4cm, and 2.1 cm and noise and uniformity were measured with same method as above experiment using AAPM Phantom for the measurement of image quality. Result : Although reduction effect of surface absorbed dose was greatest with the use of contrast media 200 cc + normal saline solution 200 cc presenting 4.2 mGy, it has exceeded allowable range when measuring the uniformity. Although there was two-fold increase in surface absorbed dose for screen manufactured with made of contrast media 25cc + normal saline solution 375 cc in comparison with contrast media 200 cc+ normal saline solution 200 cc, the uniformity was measured within allowable range presenting the surface absorbed dose of 8.1 mGy. Also, there was surface absorbed dose reduction of 27% compared to surface absorbed dose 11.0 mGy scanned without screen. There were little changes in surface absorbed doses based on changes in distance between contrast media mixed screen and subject. In regards to noise assessment, it was measured to be the lowest presenting 11.7 without screen and the highest presenting 29.3 with the use of contrast media 200 cc+ normal saline solution 200 cc. With the screen, it was measured to be the lowest presenting 14.7 for contrast media 10 cc + normal saline solution 390 cc. Conclusion : Surface absorbed dose reduction effect of 27% could be acquired compared to previous screen BISMUTH and uniform CT number could be obtained with the use of contrast media mixed screen 25 cc + 375 cc. It is believed that contrast media mixed screen wⅢ be of great assistance to surface absorbed dose reduction in case there is no previous screen.

고해상능 전산화단층촬영을 이용한 폐기종 정량분석의 유용성 : 폐기능 검사와의 비교

임상묵(Sang Muk Im),이우식(Woo Sik Lee),구양수(Yang Su Goo),이강우(Kang Woo Lee),조영기(Young Ki Cho),강화원(Hwa Won Kang),최창한(Chang Han Choi),이광원(Kwang Won Lee),김동수(Dong Su Kim) 대한전산화단층기술학회 2006 대한CT영상기술학회지 Vol.8 No.1

Purpose The pathological severity of emphysema can be detected in high resolution CT well. We obtained mean lung density at inspiratory and expiratory, and percentage of emphysema subrange per slice through Quantitative emphysema CT. We tried to know the usability of Quantitative analysis in emphysema CT, the correlation between results of Quantitative emphysema CT and results of pulmonary function test such as forced vital capacity and forced expiratory volume in one second. Materials and Methods For this study, we selected 10 emphysema patients who had been found to have emphysema through high resolution CT and pulmonary function test during the period from june to august 2005, and who did not have accompanying diseases except emphysema. Also we selected 10 normal persons as a control group who did not have any history clinical disease or smoking in the past. In high resolution CT, we scanned the whole lungs on full inspiration and full expiration at slice thickness of 1mm and at intervals of 10mm using Somatom Sensation 16 with exposure conditions of 140kVp, 160mAs and algorithm B70 ultra sharp. In addition, we measured the area of emphysema by summing values obtained from each section through measuring the CT value inside the parenchyma of the lungs using a Quantitative CT software program. And calculated mean lung density and subrange percentage in the control group and the emphysema patient group on full inspiration and full expiration at pulmonary function test, and determined significance among them. Moreover, we compared forced vital capacity, which was an index of pulmonary function test for the emphysema patients, and forced expiratory capacity in one second for the emphysema patient group and analyzed significant differences using SPSS 10.0. Results Mean lung density of the emphysema patient group on full inspiration and that on full expiration were 895.59HU and 861.45HU, respectively, and their subrange percentages were 63% and 50%, respectively. Statistically significant differences were observed between the control group and the emphysema group in mean lung density and subrange percentage on full inspiration and full expiration. According to the result of analyzing the correlation of mean lung density and subrange percentage in the emphysema patient groups with the indexes of pulmonary function test such as forced vital capacity and forced expiratory volume in one second, statistically significant differences were observed in one second forced expiratory volume according to subrange percentage on full expiration. This suggests that quantative CT is a useful test for diagnosing emphysema and it is more effective to examine emphysema patients on full expiration. Conclusion According to the results of quantitative CT on the control group and the emphysema group, significant differences were observed between the groups in pulmonary function test, so the emphysema quantitative CT program appeared useful in analyzing emphysema but it is considered necessary to develop a pulmonary function quantitative CT that can examine patients with maintaining their breathing in a constant state.

전산화 단층촬영에 사용되는 조영제의 부작용 발생에 대한 분석

임상묵(Sang Muk Lim),조영기(Young Ki Cho),구양수(Yang Soo Gu),이강우(Kang Woo Lee),송환수(Hwan Soo Song),강화원(Hwa Won Kang),김영빈(Young Bin Kim),임성훈(Sung Hoon Lim),온상구(Sang Gu On) 대한CT영상기술학회 2008 대한CT영상기술학회지 Vol.10 No.1

Purpose The objective of this article is to analyze the symptom of patients suffering the adverse reaction of contrast medium in CT test and the risk factor mat can cause adverse reaction in order to provide basic materials which contribute to find the method to reduce adverse reaction in advance. Materials and Methods Among the patients visiting university hospital from January to July, 2007, adults over 16 years old to whom contrast medium was applied into vein for CT test were chosen. Then, among them, 92 male and female patients who suffered the adverse reaction of contrast medium were selected as target. Analyzing backwardly the general property of testee recorded in the written consent for test which was received from patients or custodian before CT test and the former history of the adverse reaction of contrast medium, existence/unexistence of disease and the disease, the test result of patients (hypertension, allergy, asthma, medication adverse reaction, kidney disease, diabetes, digestive organ, respiratory organ, circulatory organ, nerve, hematogenesis, lymph, thyroid gland and other unidentified disease), the authors investigated the relation with adverse reaction and analyzed the risk factor of adverse reaction as per tested part, types of contrast, infusion quantity, infusion velocity in accordance with contrast medium applied to the testee. Further, the symptom of adverse reaction was analyzed in each type. Namely, actual number and percentage was analyzed in the division of dermal sensory system, respiratory organ, digestive organ, nerve system, circulatory organ, ophthalmologic system and so on. To analyze the risk factor of adverse reaction of testee after CT test, Chi-square test and simple/multiple regression analysis was adopted to diverse variables so as to analyze significance by using SPSS 10.0 statistical program. Results 1. In the general property, the division of sex was 36 men(39.1%) and 56 women (60.9%), showing no significant difference in the analysis of sex on the symptom of adverse reaction(p=0.132). In the aspect of age, those in 50~59 years old showed the highest rate of adverse reaction -29 persons (31.5%) and those under 19 years old showed the lowest rate of adverse reaction -1 person (1.1%). Thus, the age analysis in the symptom of adverse reaction also showed no statistically significant difference(p=0.204). The occurrence of adverse reaction in each part of body for test also showed no significant difference from the symptom of adverse reaction of contrast medium (p=0.137). 2. In the case of type of contrast medium (p=0.093), infusion quantity (p=0.279), infusion velocity (p=0.314), there was no statistically significant difference from the symptom of adverse re-action of contrast medium. In the product of A-1,54 persons (58.7%), 61 persons (66.3%) in 121-130cc, 37 persons (40.2%) in 2.6-3.0cc/sec, respectively showing the highest distribution, namely, the symptom of adverse reaction. In the former history of the contrast medium, 10 out of 92 persons(10.9%) were analyzed, thereby showing statistically significant difference(p=0.003). 3. In the analysis of adverse reaction of contrast medium as per history of disease, 9 patients(11%) of hypertension showed urticaria and itching, ex 7), 16 patients (19.5%) of allergic asthma showed urticaria and itching, ex 17) and flush, ex 5), 4 patients of medication adverse reaction (5.2%) showed flush, dermal edema, dizziness, ex 3), 3 patients(3.9%) of kidney disease showed urticaria and itching, ex 5), 32 patients(41.6%) of digestive organ disease, the highest distribution showed itching and urticaria, ex 30), flush, ex 11), 1 patient(1.3%) of nerve system disease showed urticaria and itching, dizziness, ex 2), 6 patients(7.8%) of thyroid gland disease showed urticaria and itching, ex 6), dyspnea, ex 2). Thus, the symptom of adverse reaction of contrast medium as per history of disease showed statistically significant difference(p=