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자발생 두개내 저압 환자의 방사성 동위원소 뇌조조영술 소견
문대혁(Dae Hyuk Moon),이희경(Hee Kyung Lee),류진숙(Jin Sook Ryu),신중우(Jung Woo Shin),정동진(Dong Jin Jung),김재승(Jae Seung Kim),임주혁(Joo Hyuk Im),이명종(Myoung Chong Lee),정선주(Sun Joo Jung) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.6
N/A Purpose: Radionuclide cisternography may be helpful in understanding pathophysiology of postural headache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. Materials and Methods: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 1/2 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. Results: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30 min (6/10) and 2 hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30 min. Epidural blood patch was done in 11 patients and headache was improved in all cases. Conclusion: The characterstic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.
신경내분비종양 진단에 있어서 I - 123 MIBG 조기 평면 영상과 SPECT 영상의 임상적 유용성
양승오(Seoung Oh Yang),최윤영(Yun Young Choi),이희경(Hee Kyung Lee),원경숙(Kyoung Sook Won),류진숙(Jin Sook Ryu),서용섭(Yong Sup Suh),신중우(Jung Woo Shin),김희중(Hee Jung Kim) 대한핵의학회 1996 핵의학 분자영상 Vol.30 No.4
N/A The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(l adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), l false positive(hepatocellular carcinoma) and 3 false negatives(l recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.
서로 다른 이중에너지 방사선흡수기계 기종 (Hologic QDR 4500-A 와 Lunar EXPERT-XL)간의 골밀도 교차 보정
문대혁,김기수,이희경,김재승,신중우,조진만,김상욱 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.3
Purpose: A cross-calibration equation is needed to compare bone mineral density measured by different dual X-ray absoptiometry systems. We performed this study to establish appropriate cross-calibration equations between two different dual X-ray absorptiometry systems. Materials and Methods: Bone mineral density of anterior-posterior lumbar spine (L2-4 level) and femoral neck were measured in 109 women (55±11yr) using two different dual X-ray absorptiometry systems (Lunar EXPERT-XL) and Hologic QDR 4500-A). Bone mineral density values measured by two systems, including area, bone mass content, bone mineral density and percentile of young normals were compared and cross-calibration equations between two systems derived. Results: The bone mineral density values of 109 women measured by Lunar system were 0.958±0.17 g/cm2 at L2-4 and 0.768±0.131 g/cm2 at femur neck, which were significantly higher (13±6% at L2-4 and 19±7% at femur neck, p<0.001) than those (0.851±0.144 g/cm2 at L2-4 and 0.649±0.108 g/cm2 a neck) by Hologic system. Bone mineral content and percentile of young normals measured by Lunar system were also significantly higher than those by Hologic system (p<0.001), whereas there was no difference in area (p>0.05). There was a high correlation between bone mineral density values of L2-4 and femoral neck obtained with both dual X-ray absortiometry systems (r=0.96 and 0.95, respectively). Cross-calibration equations relating the bone mineral density were Lunar=1.1287×Hologic-0.0027 for L2-4 and Lunar=l.1556×Hologic+0.0l82 for femoral neck. Conclusion: We obtained cross-calibration equations of bone mineral density between Lunar EXPERT-XL and Hologic QDR 4500-A. These equations can be useful in comparing bone mineral density obtained by different dual X-ray absorptiometry systems.
부갑상선기능항진증 환자에서 Tc-99m MIBI 부갑상선 신티그라피를 이용한 병소 국소화
문대혁,류진숙,이희경,김재승,홍승모,홍석준,신중우,공경엽 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.2
Purpose: This study was performed to evaluate the diagnostic usefulness of double-phase Tc-99m MIBI parathyroidism scintigraphy with single photon emission computed tomography (SPECT) in patients with hyperparathyroidism. We also evaluated the relationship between Tc-99m MIBI uptake and oxyphil cell contents in parathyroid glands. Materials and Methods: The subjects were 28 parathyroid glands of 10 patients who underwent Tc-99m MIBI parathyroid scintigraphy and parathyroidectomy for clinically suspected hyperparathyroidism. Early and delayed pinhole images were obtained at 15 minutes and 2 hours after injection of Tc-99m MIBI, and SPECT images were followed. The weight and oxyphil cell contents of parathyroid of tissue were obtained from pathologic specimen, and the scintigraphic findings were compared with histopathology. Results: In surgical histopathology, 6 parathyroid adenomas and 9 parathyroid hyperplasias were confirmed. The sensitivity, specificity, and positive predictive value of early and delayed images were 46.7% (7/15), 76.9% (10/13), 70% (7/10) and 667% (10/15), 92.3% (12/13), 90.9% (10/11), respectively. SPECT image detected an additional small hyperplasia. The sensitivity, specificity, and positive predictive value of combined interpretation of early and delayed images with SPECT were 733% f11/15), 100% (13/13), 100% (11/11). The sensitivity was 100% (6/6) for aenoma, whereas that was 555% (5/9) for hyperplasia. Both adenomas and hyperplasias showed significantly increased oxyphil cell contents compared with normal parathyroid glands (p<0.0001), but the oxyphil cell content and weight were not significantly different between adenomas and hyperplasias. Conclusion: Double-phase Tc-99m MIBI parathyroid scintigraphy with SPECT is useful for lesion localization m patients with hyperparathyroidism. Although both adenoma and hyperplasia have increased oxyphil cell content, the sensitivity is high in adenoma, but low in hyperplasia.