• Title/Summary/Keyword: 심장CT

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Surgical Treatment of Primary Cardiac Tumor -Report of 27 cases - (원발성 심장 종양의 수술적 치료 - 27례 보고-)

  • 박성용;문석환;김치경;조건현;왕영필;이선희;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.787-791
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    • 1998
  • Materials and methods: Between 1979 and 1996, 27 patients with primary cardiac tumor underwent surgery at Catholic University Medical College. Mean age of patient was 45.1${\pm}$3.03 ranging from 21 to 67 years old. Twenty-four cases were myxomas, 2 cases were chondrosarcoma, and remained case was angiosarcoma. Diagnosis was confirmed by echocardiography, cardiac angiography, CT scan, and MRI. The most common site of tumor origin was fossa ovalis limbus area(17cases:63%). A biatrial operative approach was commonly used in 15 cases and the tumor was removed through left atriotomy site. Complete excision of the tumor with a cuff of normal tissue was performed. All heart chambers were carefully explored for evidence of multicentric myxomas or other tumor debris. Most of the patients were improved on postoperative period compared to preoperative NYHA functional class. Results: There was one operative death due to low cardiac output syndrome. Follow up period was 3 months to 17 years. There was 2 late deaths due to local recurrences. Conclusion: complete surgical excion is important for increasing cure rate. Malignancy cannot be ruled out even though preoperative echocardiography suggests benign nature. Chest CT or MRI is effective for further evalution in addition to echocardiography. In suspicious of malignancy, more extensive resection is essential and postoperative chemotheraphy or radiotherapy is useful.

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Left Atrial Rupture with Stable Vital Signs - A case report - (정상인 활력증후를 보인 좌심방 파열 - 1예 보고 -)

  • Jeong, Jae-Han;Cho, Sung-Woo;Shin, Yoon-Cheol;Lee, Hee-Sung;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.633-635
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    • 2008
  • Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.

Reproducibility Evaluation of Deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis during radiation therapy for Left Breast cancer patients (좌측 유방암 환자의 방사선치료 중 환자의 호흡과 심장 위치 분석을 통한 Deep inspiration breath-hold(DIBH) 기법의 재현성 평가)

  • Jo, Jae Young;Bae, Sun Myung;Yoon, In Ha;Lee, Ho Yeon;Kang, Tae Young;Baek, Geum Mun;Bae, Jae Beom
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.297-303
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    • 2014
  • Purpose : The purpose of this study is reproducibility evaluation of deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis in radiation therapy for Left Breast cancer patients. Materials and Methods : Free breathing(FB) Computed Tomography(CT) images and DIBH CT images of three left breast cancer patients were used to evaluate the heart volume and dose during treatment planing system( Eclipse version 10.0, Varian, USA ). The signal of RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, Varian, USA) was used to evaluate respiration stability of DIBH during breast radiation therapy. The images for measurement of heart position were acquired by the Electronic portal imaging device(EPID) cine acquisition mode. The distance of heart at the three measuring points(A, B, C) on each image was measured by Offline Review (ARIA 10, Varian, USA). Results : Significant differences were found between the FB and DIBH plans for mean heart dose (6.82 vs. 1.91 Gy), heart $V_{30}$ (68.57 vs. $8.26cm^3$), $V_{20}$ (76.43 vs. $11.34cm^3$). The standard deviation of DIBH signal of each patient was ${\pm}0.07cm$, ${\pm}0.04cm$, ${\pm}0.13cm$, respectively. The Maximum and Minimum heart distance on EPID images were measured as 0.32 cm and 0.00 cm. Conclusion : Consequently, using the DIBH technique with radiation therapy for left breast cancer patients is very useful to establish the treatment plan and to reduce the heart dose. In addition, it is beneficial to using the Cine acquisition mode of EPID for the reproducibility evaluation of DIBH.

A study on the usefulness of a fusion model designed cloak shield to reduce the radiation exposure of the assistant during CT of severely injured patient (중증외상환자 CT 검사 시 검사보조자의 방사선피폭 경감을 위한 융합적 망토 차폐체의 유용성 연구)

  • Seo, Sun-Youl;Han, Man-Seok;Kim, Chang-Gyu;Jeon, Min-Cheol;Kim, Yong-Kyun;Kim, Gab-Jung
    • Journal of the Korea Convergence Society
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    • v.8 no.9
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    • pp.211-216
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    • 2017
  • The purpose of this study is to evaluate the usefulness of a newly fusion model designed cloak shield to reduce the radiation exposure of the assistant during CT(computed tomography) of severely injured patient. Radiation dose was measured in the heart, both axillary and thyroid areas using newly designed cloak shield and existing shield with head phantom and human phantom under the same conditions as brain vascular CT scan. The newly designed cloak shield was measured higher for radiation shielding rate than the existing shields, 61.9 % for heart, 46.2 % for left axillary, 69.8 % for right axillary and 71.1 % for thyroid gland, respectively. a newly developed fusion model of cloak shields are useful for reducing radiation exposure. It is expected to make a significant contribution to reduction of radiation exposure.

Automatic Extraction of Ascending Aorta and Ostium in Cardiac CT Angiography Images (심장 CT 혈관 조영 영상에서 대동맥 및 심문 자동 검출)

  • Kim, Hye-Ryun;Kang, Mi-Sun;Kim, Myoung-Hee
    • Journal of the Korea Computer Graphics Society
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    • v.23 no.1
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    • pp.49-55
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    • 2017
  • Computed tomographic angiography (CTA) is widely used in the diagnosis and treatment of coronary artery disease because it shows not only the whole anatomical structure of the cardiovascular three-dimensionally but also provides information on the lesion and type of plaque. However, due to the large size of the image, there is a limitation in manually extracting coronary arteries, and related researches are performed to automatically extract coronary arteries accurately. As the coronary artery originate from the ascending aorta, the ascending aorta and ostium should be detected to extract the coronary tree accurately. In this paper, we propose an automatic segmentation for the ostium as a starting structure of coronary artery in CTA. First, the region of the ascending aorta is initially detected by using Hough circle transform based on the relative position and size of the ascending aorta. Second, the volume of interest is defined to reduce the search range based on the initial area. Third, the refined ascending aorta is segmented by using a two-dimensional geodesic active contour. Finally, the two ostia are detected within the region of the refined ascending aorta. For the evaluation of our method, we measured the Euclidean distance between the result and the ground truths annotated manually by medical experts in 20 CTA images. The experimental results showed that the ostia were accurately detected.

PET and PET/CT in Clinical Cardiology (심장 PET과 PET/CT의 임상적 이용)

  • Won, Kyoung-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.124-132
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    • 2005
  • Cardiac PET emerged as a powerful tool that allowed in vivo quantification of physiologic processes including myocardial perfusion and metabolism, as well as neuronal and receptor function for more than 25 years. Wow PET imaging has been playing an important role in the clinical evaluation of patients with known or suspected ischemic heart disease. This important clinical role is expected to grow with the availability of PET/CT scanner that allow a true integration of structure and function. The objective of this review is to provide an update on the current and future role of PET in clinical cardiology with a special eye on the great opportunities now offered by PET/CT.

Contrast Optimization using of Weight-based Injection Protocol in Pediatric Abdomen CT Examination (소아 복부 CT 검사에서 체중에 기반한 조영제 주입 프로토콜 적용에 따른 조영증강의 최적화)

  • Kim, Yung-Kyoon;Han, Dong-Kyoon
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.575-584
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    • 2021
  • The aim of this study was to achieve optimal portal phase while reducing contrast medium by applying weight-based dose protocol compared to standard fixed dose protocol to performing of pediatric abdominal CT examination. Discovery 750HD (General Electric Medical Systems, Milwaukee, USA) was used, and a total of 167 children consisting of 85 men and 82 women under the age of 18 were studied. The group in which the 300 mgI/ml(Xenetix, Guerbet, France) contrast medium was fixedly injected at twice body weight and the group injected with physiological saline while gradually decreasing the injection amount by 10% while applying the weight-based protocol were distinguished. Also, the CT number and SNR of abdominal organs were compared and evaluated while changing the scan delay time. Subjective image quality of enhancement and beam-hardening artifacts of around the heart was assessed with five-point criterion. The group adapted weight-based protocol with 20% reduction in contrast medium was most similar in contrast enhancement in the group with fixed injection at twice body weight. Furthermore, the group with a delay time of 20% had the highest contrast enhancement effect, and the difference in CT attenuation coefficient from the group scanned immediately after injection of the contrast media. Therefore, the appropriate delay time after injection of the contrast agent increased the contrast enhancement of the parenchymal organ. In addition, the weight-based injection protocol with normal saline reduced artifacts around the heart, and the effect of contrast enhancement could be maintained. In conclusion, it is possible to reduce dosage of contrast media through the application of weight-based injection protocols and appropriate latency, and to characterize optimal portal phase imaging on pediatric abdominal CT.