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윤수웅 대한영상의학회 1999 대한영상의학회지 Vol.40 No.1
Purpose : To assess the value of computed tomography (CT) in the preoperative staging of transitional cellcarcinoma (TCC) of the renal pelvis. Materials and Methods : We retrospectively evaluated the CT TNM staging of 38patients with TCC of the renal pelvis who had undergone preoperative abdominal CT examination between January 1990and January 1998. In CT staging for differentiation between early-stage (TO-2) and advanced-stage disease (T3-T4),three criteria were used, namely the presence or obliteration of the renal sinus fat layer, the smoothness orirregularity of margin between the tumor and renal parenchyma, and the presence or absence of hydronephrosisproximal to the tumor. CT staging was performed by two genitourinary radiologists blinded to the pathologicresults, and was compared with pathologic staging. Results : Pathologic results revealed 19 cases of early stagedisease (TO=8, T1=9, T2=2) and 19 of advanced stage (T3=12, T4=7). Overall CT staging accuracy was 82%(31/38);fourcases were overstaged and three were understaged. In early-stage disease, sensitivity and specificity were 79%,and 84%, and in advanced stage disease were 83% and 80%. Three of four overstaged cases showed hydronephrosisproximal to the tumor. In the second CT staging, using proximal hydronephrosis of the tumor as a criterion forearly-stage disease, the sensitivity and specificity of early-stage disease were 95% and 75%, respectively, andthe specificity of advanced-stage disease was 95%. Conclusion : When hydronephrosis proximal to a tumor wasconsidered to be a sign of early stage disease, the CT staging of renal pelvic TCC was highly accurate.
바륨현탁액 투여후 메틸셀룰로스를 사용한 개조형 소장 바륨추적검사 : 전통적 바륨추적검사와의 비교
신지훈,하현권,박성태,윤수웅,김호성,김선미,정융기,김표년,이문규 대한영상의학회 1998 대한영상의학회지 Vol.39 No.1
Purpose : To compare modified small bowel follow-through (SBFT) using methylcellulose after the administration of barium suspension with a conventional series. Materials and Methods : In order to evaluate small bowel pathology, modified SBFT was performed in 155 patients during a 15 month period. All patients received 600mL of methylcellulose ; 98 had taken 250mL of 40% wt/vol barium suspension and 57 had taken 150mL of 70% barium. For the group of 98, the barium suspension was prepared by mixing barium powder with water (n=46) or with methylcellulose in(n=52). For comparison with a modified series, 49 patients who underwent conventional SBFT using 500mL of 40% wt/vol barium were also included. Image quality was rated by three radiologists as "poor", "fair", "good", or"excellent". We analyzed the relationship between image quality, transit time and small bowel pathology; the sensitivity and specificity of each technique was also determined. Results : Among the four techniques, modified SBFT with 250mL of 40% wt/vol barium suspension, prepared by mixing barium powder with methylcellulose, showed the best image quality ["excellent" result in 33 of the 52 patients (63%)] and shortest transit time to the cecum. The high image quality of this technique was not affected by the presence of small bowel pathology; its use resulted in the lowest incidence and slowest development of flocculation. The sensitivity (91-95%) of the three modified SBFT procedures was superior to that of a conventional series(76%), but there was no difference in specificity. Conclusion : Modified SBFT using methylcellulose after administering barium suspension with barium powder as a mixing agent is a simple technique. Its use easily improves the image quality and diagnostic accuracy of peroral SBFT.e quality and diagnostic accuracy of peroral SBFT.