소아 급성 신우신염에서 출력 도플러 초음파검사

이승주,이선화,Lee Seung-Joo,Lee Sun-Wha 대한소아신장학회 2002 Childhood kidney diseases Vol.6 No.2

목적: 소아의 급성 신우신염에서 신실질병소의 발견에 대한 출력도플러초음파의 진단적 유용성을 평가하고자하였다. 대상 및 방법: 임상적으로 상부요로감염으로 진단된 80명의 소아에서 회색도초음파, 출력도플러초음파 및 $^{Tc-99m}DMSA$ 신티그라피를 시행하였고 각 검사간의 시간 간격은 4일 이내였다. 급성 신우신염의 신실질병소에 대한 진단 기준은 신티그라피에 관찰되는 방사능축적이 감소되거나 결손된 부위였고, 출력도플러초음파에서는 삼각형의 신장내 관류가 저하되거나 없는 부위였다. 급성 신우신염에 대한 객관적인 참조기준은 신티그라피 소견이었고 이를 출력도플러초음파와 회색도초음파 결과와 비교분석하였다. 결과: 신티그라피에서 급성 신우신염의 병소가 발견된 47명중 40명(85%)은 출력도플러초음파에서도 관류의 이상이 관찰되는 양성소견을 보였다. 출력도플러 초음파 소견이 위음성인 경우가 7명, 위양성인 경우가 3명 있었다. 회색도초음파경우 신티그라피에서 병소가 발견된 47명중 23명(49%)에서 이상소견을 관찰할 수 있었다. 결론: 출력도플러초음파는 소아의 급성 신우신염의 진단에 있어 신티그라피보다는 민감하지 않으나 회색도초음파에 비해서는 매우 민감하였다. 출력도플러 초음파는 급성 신우신염을 의심하는 소아에서 신장으로의 관류이상을 평가할 수 있는 비침해적인 검사로 진단적 가치가 있다. Purpose: The purpose of this study is to assess the ability of power Doppler sonography in the detection of acute pyelonephritis. Materials and Methods: We performed gray scale sonography, power Doppler sonography, and $^{Tc-99m}DMSA$ scintigraphy of the kidney in 80 patients with symptoms suggesting upper urinary tract infection. All imaging studies were obtained within 4 days. On $^{Tc-99m}DMSA$ scintigraphy, decreased radioactivity or photopenic lesions were considered indicative of acute pyelonephritis. Triangular areas of decreased perfusion identified on power Doppler sonography were considered as parenchymal lesions of acute pyelonephritis. The results of gray scale sonography and power Doppler sonography were retrospectively analysed and compared with those of $^{Tc-99m}DMSA$ scintigraphy which was given as the standards of reference. Results: For 40(85%) of the 47 patients with scintigraphy-proven acute pyelonephritis, power Doppler sonography diagnosed this condition on the correct side. The acute pyelonephritis which was not revealed by power Doppler sonography was observed in seven patients. Also, in three patients, false-positive indication of pyelonephritis was given by power Doppler sonography. Gray scale sonography showed positive findings in 23(49%) of 47 patients with positive findings on scintigraphy. Conclusion: Power Doppler sonography seems to be less sensitive than $^{Tc-99m}DMSA$ DMSA scintigraphy but significantly more sensitive than gray scale sonography for the detection of acute pyelonephritis in children. Power Doppler sonography shows promise as a noninvasive means of assessing renal cortical perfusion in children with clinically suspected acute pyelonephritis.

Usefulness of Bedside Sonographic Monitoring of Critical Neurosurgical Patients

김용찬,오창완,방재승,권오기,김정은,임소향 대한뇌혈관외과학회 2010 Journal of Cerebrovascular and Endovascular Neuros Vol.12 No.3

Objective : Sonography is a noninvasive and safe bedside imaging modality that provides rapid and repeatable real-time radiological evaluations without a radiation hazard. However, sonography has not gained widespread acceptance as a diagnostic tool in adult brain disease because of limited imaging resolution through the bony window. We investigated the diagnostic potential and clinical usefulness of bedside brain sonography through surgical bone defects in neurosurgical patients. Methods : We evaluated twelve patients, each of whom had undergone a decompressive craniectomy, via bedside sonography. and performed comparison CT or MRI for all patients. Results : We obtained reliable information regarding anatomical structure displacement, ventricle systems, intracranial fluid collection, presence and distribution of cerebral infarctions, and hemorrhages. We performed several interventional trials under sonography guidance, including aspiration of entrapped fluid collection and insertion of an external ventricular drainage catheter into a collapsed and displaced ventricle cavity. Conclusion : Bedside sonography through surgically created bone defects is a non-invasive method that physicians can repeat as required with no radiation hazard, and it is of particular value in emergent and critical situations when conventional neuroimages are unobtainable. Bedside sonography can be a first-line monitoring tool, in lieu of CT, for critically ill patients with surgical cranial defects. (Kor J Cerebrovascular Surgery 12(3):177-181, 2010)

Predictive Factors for Extrathyroidal Extension of Papillary Thyroid Carcinoma Based on Preoperative Sonography

Lee, Chang Yoon,Kim, Soo Jin,Ko, Kyung Ran,Chung, Ki-Wook,Lee, Joo-Hyuk American Institute of Ultrasound in Medicine 2014 Journal of ultrasound in medicine Vol.33 No.2

<P><B>Objectives—</B></P><P>The purpose of this study was to evaluate the diagnostic performance and predictive factors of extrathyroidal extension of papillary thyroid carcinoma based on preoperative sonography.</P><P><B>Methods—</B></P><P>Preoperative sonography was performed for 568 patients who underwent surgery for papillary thyroid cancer between May 2009 and December 2010. Patients’ T stages based on preoperative sonography were compared with their T stages based on pathologic examination, and we statistically analyzed the discriminatory performance of sonography. Among the 568 patients enrolled in this study, we selected 320 patients in whom extrathyroidal extension was suspected on sonography. We analyzed several predictive factors for extrathyroidal extension.</P><P><B>Results—</B></P><P>Two hundred seventy-five of the 568 patients were proven to have pathologic extrathyroidal extension of papillary thyroid cancer after surgery (75.9% diagnostic accuracy, 83.3% sensitivity, 68.9% specificity, 71.6% positive predictive value, and 81.5% negative predictive value). Of 320 patients with sonographically suspected extrathyroidal extension, a larger lesion size (<I>P</I> < .001) and a higher lymph node stage on sonography (<I>P</I> = .004) were the best predictors of extrathyroidal extension among the features that we measured. There were no significant differences in terms of the lesion site or thyroid parenchymal background echogenicity. Thyroid capsular protrusion had a higher predictive value than the abutting ratio (<I>P</I> = .001). However, increasing the abutting ratio enabled the prediction of extrathyroidal extension on sonography (<I>P</I> = .009).</P><P><B>Conclusions—</B></P><P>Preoperative sonography is a helpful tool for predicting pathologic extrathyroidal extension of papillary thyroid cancer. In particular, clinicians should focus on the lesion size, nodal stage, and abutment or capsular protrusion of the lesion while performing sonography because these are the most useful predictive factors for extrathyroidal extension.</P>

Correlation between the Pressure Pain Threshold and Sonography and Spontaneous Electrical Activity in Myofascial Trigger Points

김현진,김명훈,김수현,오석,최지호,김태열 대한물리치료학회 2010 대한물리치료학회지 Vol.22 No.3

Purpose: This study was designed to investigate possibilities for quantitative analysis using the electromyography and sonography. For better understanding, we evaluated the correlation between the pressure pain threshold and sonography, spontaneous electrical activity in trigger points located in the upper trapezius muscle. Methods: Thirty three active subjects volunteered to participate in this study (n=33). They had a palpable taut band, exquisite spot tenderness of a nodule in a taut band, spontaneous pain, referred pain, jump sign, local twitch response, and a painful limit to full stretch range of motion. We measured Pressure pain threshold, density, white area index, root mean square, and reaction. Pearson’s correlation coefficient was calculated to estimate the relationship between the pressure pain threshold and other variables including density, white area index, root mean square, and reaction time. Results: There were significant correlations between pressure pain threshold and density (r=‑0.75, p<0.01), and between pressure pain threshold and white area index (r=‑0.74, p<0.01). A significant correlations between pressure pain threshold and root mean square (r=‑0.59, p<0.01). The significant correlation was found between pressure pain threshold and reaction time (r=‑0.64, p<0.01). Conclusion: These should indicate whether quantitative analysis can be done using the characteristics of electromyography and sonography Purpose: This study was designed to investigate possibilities for quantitative analysis using the electromyography and sonography. For better understanding, we evaluated the correlation between the pressure pain threshold and sonography, spontaneous electrical activity in trigger points located in the upper trapezius muscle. Methods: Thirty three active subjects volunteered to participate in this study (n=33). They had a palpable taut band, exquisite spot tenderness of a nodule in a taut band, spontaneous pain, referred pain, jump sign, local twitch response, and a painful limit to full stretch range of motion. We measured Pressure pain threshold, density, white area index, root mean square, and reaction. Pearson’s correlation coefficient was calculated to estimate the relationship between the pressure pain threshold and other variables including density, white area index, root mean square, and reaction time. Results: There were significant correlations between pressure pain threshold and density (r=‑0.75, p<0.01), and between pressure pain threshold and white area index (r=‑0.74, p<0.01). A significant correlations between pressure pain threshold and root mean square (r=‑0.59, p<0.01). The significant correlation was found between pressure pain threshold and reaction time (r=‑0.64, p<0.01). Conclusion: These should indicate whether quantitative analysis can be done using the characteristics of electromyography and sonography

비정상 자궁 출혈 환자의 진단에 있어서 경질식 초음파 , 식염수 주입 자궁 조영술 및 자궁경술의 진단적 효용성에 관한 연구

이지영(Ji Young Lee),김유곤(You Kon Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

Objective: To evaluate prospectively the efficacy and accuracy of transvaginal sonography(TVS), saline infusion sonohysterography(SIS) and hysteroscopy in the exploration of the uterine cavity. Methods: 71 consecutive patients were evaluated with SIS who showed abnormal TVS findings, using saline instilled through endocervically placed balloon catheter with concurrent vaginal sonography. Among them, 41 patients also underwent hysteroscopy and surgery. Transvaginal sonography, sonohysterography, hysteroscopy were compaired with pathologic reports. Results: Fifty-five of 71 sonohysterogram(77.5%) showed abnormal findings, Among them 41 patients have done hysteroscopy and biopsy. According to pathologic reports, sixteen patients were noted to have myoma(39.0%), twelve patients had polyps (21.3%), and both showed most frequent lesions. TVS, SIS, and hysteroscopy had a sensitivity of 94.4%, 91.1%, 94.4%, and a specificity of 40%, 42.8%, 60.0%, respectively and showed not so much different in detection rate. In case of submucosal myoma and polyps, hysteroscopy showed 100% sensitivity, and 92% specificity and showed much higher detection rate compared with SIS (81.2%, 92.0%). Conclusion: Transvaginal sonography and sonohysterography are good office diagnostic test in case of detecting variable gynecologic intrauterine abnormalities.

이중초음파에서 드물게 관찰되는 목 부위의 혈관질환: 3례

한민호 ( Minho Han ),서강식 ( Kangsik Seo ),최정혜 ( Junghye Choi ) 대한임상검사과학회 2021 대한임상검사과학회지(KJCLS) Vol.53 No.1

이중초음파는 반복적으로 검사를 실시할 수 있고, 비교적 저렴하기 때문에 다양한 진료분야에서 널리 이용되고 있다. 그중, 목동맥이중초음파는 뇌혈관질환을 진단하고 예후를 예측하는데 매우 유용한 비침습적 검사이다. 임상에서 목동맥이중초음파의 소요시간을 줄이고 결과의 정확성을 높이는 것은 매우 중요한 작업이다. 일반적으로 환자의 정보를 미리 숙지하는 것만으로도 신속히 정확한 검사를 수행할 수 있다. 하지만 예상과 달리 새롭게 발견되는 목 혈관질환으로 인해 검사하는데 종종 어려움을 겪기도 한다. 따라서 목 부위에서 발생할 수 있는 다양한 증례들을 숙지하는 것은 신속히 정확한 검사결과를 산출하는데 큰 도움이 될 것이다. 이러한 맥락에서, 본 연구는 목동맥이중초음파를 시행하던 중 예기치 않게 발견된 목 혈관질환 증례 3가지를 소개하고자 한다. 증례1. 속목동맥 폐색과 바깥목동맥으로부터 분지된 대뇌혈관; 증례 2. 속목정맥에서 관찰된 혈전; 증례 3. 척추동맥에서 관찰된 미세색전. Duplex sonography is used widely in various medical fields because of its repeatability and low cost. In particular, the carotid duplex sonography is a useful non-invasive test for diagnosing cerebrovascular disease and predicting the prognosis. In clinical practice, it is very important to reduce the test time and improve accuracy. The patient's clinical information must be known in advance to perform carotid duplex sonography quickly and accurately. Despite this, there are often difficulties finding new cervical vascular diseases that are not mentioned in the clinical information. Therefore, knowing a variety of cases can lead to fast and accurate results. In this context, this paper reports three cases of cervical vascular disease discovered unexpectedly during carotid duplex sonography: CASE 1, internal carotid artery occlusion and cerebral arteries branched from the external carotid artery; CASE 2, internal jugular vein thrombosis; CASE 3, microembolism observed in the vertebral artery. Copyright Ⓒ 2021 The Korean Society for Clinical Laboratory Science. All rights reserved.

Sonazoid를 이용한 간 내 종양의 Contrast Harmonic Sonography의 유용성에 관한 연구

윤영주,진미경,이원홍 대한초음파의료영상학회 2014 대한초음파의료영상학회지 Vol.5 No.1

목적:CT 또는 MRI 검사로 확인된 간 내 종양은 초음파 유도 하에 조직검사나 고주파 치료술을 시행하는 경우가 있다. 하지만 간 내 종양이 B-mode 초음파로 분명하게 보이지 않는 경우가 있으며, Navigation 초음파로도 진단을 할 수 없는 경우가 있다. 본 저자는 초음파 검사 시 간 내 종양의 진단에 있어 Sonazoid를 이용한 Contrast Harmonic Sonography의 유용성과 임상적 의의를 알아보고자 한다. 대상 및 방법:2013년 3월부터 5월까지 간 내 종양을 평가하기 위해 본원을 내원하여 초음파 검사를 시행한 환자 10명을 대상으로 하였으며, B-mode 초음파를 시행한 후 명확하게 구분이 되지 않는 환자에 대하여 Navigation 초음파 유도 하 Sonazoid를 이용한 Contrast Harmonic Sonography를 시행한 결과를 분석하고 영상을 평가하였다. 결과:10개 병변을 대상으로 Contrast Harmonic Sonography를 시행한 결과 8개의 병변이 확인 되었으며 2개의 병변은 확인되지 않았다. 명확하게 확인된 병변 8개중 5개가 쿠퍼기 영상에서 결손부위로 보였고, 3개가 동맥기에서 조영 증강된 영상으로 확인되었다. 결론 및 고찰:Sonazoid를 이용한 Contrast Harmonic Sonography는 B-mode 초음파 검사로 간 내 종양의 진단이 어려울 경우 조금 더 명확하게 구별하는데 도움을 주며, Sonazoid 조영제의 지속 시간이 길어 쿠퍼기 영상을 획득할 수 있어 초음파 유도 하에 조직검사 또는 고주파 치료를 시행하는데 유용성 및 임상적인 의의가 있을 것으로 사료된다.

궤양성 대장염 질병 활동성 평가에서 도플러 초음파의 유용성

오유석 ( You Suk Oh ),정우철 ( Woo Chul Chung ),황성수 ( Sung Su Hwang ),이강문 ( Kang Moon Lee ),백창렬 ( Chang Nyol Paik ),조영석 ( Young Seok Cho ),이보인 ( Bo In Lee ),최규용 ( Gyu Yong Choi ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.6

Background/Aims: Disease activity in ulcerative colitis (UC) is generally assessed using symptoms, laboratory data, endoscopic findings, and histology of the biopsy specimens. In this study, we compared disease activity of UC as determined by clinical features and endoscopic findings, and aimed to assess the clinical usefulness of Doppler sonography. Methods: The duplex Doppler sonography of superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) of 10 patients with clinically inactive UC and 20 patients with active UC were evaluated by one radiologist who was blinded to clinical information. Peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI) of the SMA and IMA were evaluated. All patients underwent biochemical and endoscopic evaluations thereafter. Correlation between disease activity by the Truelove-Witts classification and the Mayo scoring system was measured, and we compared hemodynamic parameters between active and inactive UC. Results: Correlation rate of disease activity between these two scoring systems was 93.3%. Flow velocities (PSV, p<0.001 and EDV, p=0.03) and PI (p=0.03) were significantly higher in patients with active UC than inactive UC. PSVs of the SMA and IMA were also significantly correlated with disease severity. The active UC could be accurately diagnosed using Doppler sonography (AUC=0.83; 95% confidence interval 0.68-0.99). Conclusions: In patients with UC, clinical stage was well matched with endoscopic disease activity. Doppler sonography was a readily available method, and PSV of SMA would be clinically useful in predicting of disease activity and severity. (Korean J Gastroenterol 2010;56:346-352)

Case Report : A Case of Occipital Neuralgia in the Greater and Lesser Occipital Nerves Treated with Neurectomy by Using Transcranial Doppler Sonography: Technical Aspects

( Sang Jin Jung ),( Seong Keun Moon ),( Tae Young Kim ),( Ki Seong Eom ) 대한통증학회 2011 The Korean Journal of Pain Vol.24 No.1

Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient`s headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief. (Korean J Pain 2011; 24: 48-52)

유두 분비물을 원인으로 하여 시행한 Galactography의 유용성에 관한 고찰 : Mammography, Breast sonography와 비교

조희정(Hee Jeong Jo),전해경(Hae Kyeong Jeon),김서현(Seo Hyeon Kim),최진희(Jin Hee Choi),권순안(Soon An Kwon),민관홍(Kwan Hong Min),김성룡(Seong Ryong Kim) 대한영상의학기술학회 2009 대한영상의학기술학회 논문지 Vol.2009 No.-

Purpose : To evaluate the usefulness of galactography compared with mammography and breast sonography in patients with nipple discharge. Materials and methods : This study was retrospectively conducted in 79 patients with nipple discharge who underwent galactography in our hospital from April in 2004 to July in 2008. Telebrix was used as a contrast medium There were digital mammography (GE Senography TM 2000D) and sono medical system (Philips Medical system, Bothwll, WA / HDl-5000, iU22) as a device for this study. First of all, we accessed Galactography, Mammography and breast sonography using BI-RADS classification and analyze pathology from surgery and biopsy over BI-RADS C3 lesion. The last, we find out the availability of galactography compared with pathology and analyzed the result of galactography. Results : Among 79 patients who underwent galactography, 55 were revealed as over BI-RADS C3 lesion. In mammography, 20 of that 55 were normal as Bl-RADS C1 or C2 lesion, other 12 were diagnosed as BI-RADS C1 or C2 lesion, then recommended further study. In breast sonography, 43 of 55 were consistent with BI-RADS C3 lesion. 9 were not found the lesion in mammography and breast sonography, but found the suspicious lesion in galactography. Conclusion : Galactography is useful for the patient with nipple discharge diagnosed breast disease, especially intraductal papilloma (IDP).