• Archives of Plastic Surgery
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• v.33 no.2
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• pp.175-180
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• 2006

Preoperative angiography is frequently used in the planning of microsurgical reconstruction for identification of vascular abnormality that influence the planning of operation. But, recently 3D CT angiography is considered as new technique that can provide detailed information about vascular anatomy as well as soft and bony tissue without the risks of invasive angiography. 3D CT angiograms were performed in 19 patients before microsurgical reconstruction for the lower extremity and hand between May of 2003 and Oct of 2004. Sixteen of the studies were of the donor site and all of 19 studies were of the recipient site. No complications were found from the 3D CT angiograms. In one case of the bone exposed open wound, the injury of anterior tibial artery was identified and the zone of injury was adequately demonstrated. With the improvement in quality of CT imaging, 3D CT angiograms may provide a favorable alternative to invasive angiography. It is capable of providing high-resolution, three dimensional vascular imaging without the need for arterial puncture and prolonged post-procedure observation. The relation among blood vessels, bones, and soft tissue is well demonstrated in 3D CT angiogram. Also The acquisition time and examination cost were considerably lower in comparison with invasive angiography. In conclusion, this study demonstrates that 3D CT angiography may provide accurate, safe, and cost-effective preoperative imaging. The 3D CT angiography with relatively low morbidity, low cost, ease of image acquisition can have an broader role in microsurgical reconstructive surgery.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.265-268
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• 2007

Purpose: Superficial temporal artery(STA) aneurysms are very rare and mostly occur as pseudoaneurysms secondary to trauma. Clinical diagnosis of STA pseudoaneurysm is based on a history of trauma or surgery to frontotemporal region, which presents with pulsatile mass. To confirm diagnosis, many imaging strategies can be used such as digital subtraction angiography, sonography, CT and MRI. But, these imaging modalities are invasive or inaccurate or expensive. Thus, we used 3D CT angiography to confirm STA aneurysm and to get accurate information. Methods: We have experienced two cases of pulsatile mass on the temporal area, suspected as STA pseudoaneurysms. On the basis of clinical information, we performed 3D CT angiography to get more accurate information about this pulsatile mass and to confirm diagnosis. On the basis of information from 3D CT angiography, we performed operation. Results: The lesions were diagnosed as pseudoaneurysm of superficial temporal artery by 3D CT angiography, and surgically resected safely without any complication on the basis of information from 3D CT angiography. 3D CT angiography was excellent diagnostic method for detecting STA pseudoaneurysms, and effectively showed many information about pseudoanerysms such as relationship between the aneurysms and surrounding structures, and its size. Conclusion: We could effectively diagnose and treat on the basis of information from 3D CT angiography. We present our cases with a brief review of the literature related to STA traumatic pseudoaneurysms.

• Journal of radiological science and technology
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• v.34 no.2
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• pp.105-116
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• 2011

In this study, we present the measurements of effective dose from CT of head & neck region. A series of dose measurements in anthropomorphic Rando phantom was conducted using a radio photoluminescent glass rod dosimeter to evaluate effective doses of organs of head and neck region from the patient. The experiments were performed with respect to four anatomic regions of head & neck: optic nerve, pons, cerebellum, and thyroid gland. The head & neck CT protocol was used in the single scan (Brain, 3D Facial, Temporal, Brain Angiography and 3D Cervical Spine) and the multiple scan (Brain+Brain Angiography, Brain+3D Facial, Brain+Temporal, Brain+3D Cervical spine, Brain+3D Facial+Temporal, Brain+3D Cervical Spine+Brain Angiography). The largest effective dose was measured at optic nerve in Brain CT and Brain Angiography. The largest effective dose was delivered to the thyroid grand in 3D faical CT and 3D cervical spine, and to the pons in Temporal CT. In multiple scans, the higher effective dose was measured in the thyroid grand in Brain+3D Facial, Brain+3D Cervical Spine, Brain+3D Facial+Temporal and Brain+3D Cervical Spine+Brain Angiography. In addition, the largest effective dose was delivered to the cerebellum in Brain CT+Brain Angiography CT and higher effective dose was delivered to the pons in Brain+Temporal CT. The results indicate that in multiple scan of Brain+3D Cervical Spine+Brain Angiography, effective dose was 2.52 mSv. This is significantly higher dose than the limitation of annual effective dose of 1 mSv. The effective dose to the optic nerve was 0.31 mSv in Brain CT, which shows a possibility of surpassing the limitation of 1 mSv by furthre examination. Therefore, special efforts should be made in clinical practice to reduce dose to the patients.

• Journal of the Korean Society of Radiology
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• v.2 no.1
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• pp.17-21
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• 2008

Because of the reason that the meningioma is enhanced lately, we started the study to maximally enhance the meningioma. we were to know the relation between meningioma and vessels in the skull and compared 3D CT angiography with the conventional angiography. we got the data from 6 patients performed by both 3D CT angiography and there were 5 cases in sphenoidal ridge and 1 case parasagittal sinus. Injecting the contrast media at 3 ml/sec, 120 ml and then the CT number reached 100, we started the study using the medical system Program(smart prep). The scan parameters were HS-Mode(1.25 mm / 7.5 mm) right after being injected all and reconstructed with 0.5 mm interval. We compared the study with the conventional angiography after reconstructing the images required by using 3D-Med software Program(Rapidia). Seeing the consequences, the maximum enhancing time in the menigioma is about 120~180 seconds after injecting the contrast media and we distinguished the relation between vessels and tumors at the time and 1 case showed us the aneurysm with a tumor clearly at the time too. It was very helpful to the operation that the 3D images required by injecting the contrast media to the patients with meningioma distingushed between tumors and vessels dimensionally.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.669-680
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• 1999

Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

• Progress in Medical Physics
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• v.7 no.1
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• pp.3-7
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• 1996

The accuracy in target localization of CT, MR, and digital angiography were investigated for stereotactic radiosurgery. The images using CT and MR were obtained out of geometrical phantom which was designed to produce exact coordinates of several points within a 0.lmm error range. The slice interval was 3mm and FOV was 35cm for CT and 28cm for MR. These images were transferred to treatment planning computer using TCP/IP in forms of GE format. Measured 3-D coordinates of these images from planning computer were compared to known values by geometrical phantom. Anterior-posterior and lateral films were taken by digital angiography for measurement of spatial accuracy. Target localization errors were 1.2${\pm}$0.5mm with CT images, 1.7${\pm}$0.4mm with MR-coronal images, and 2.1${\pm}$0.7mm with MR-sagittal images. But, in case of MR-axial images, the target localization error was 4.7${\pm}$0.9mm. Finally, the target localization error of digital angiography was 0.9${\pm}$0.4mm. The accuracy of diagnostic machines such as CT, MR, and angiography depended on their resolutions and distortions. The target localization error mainly depended on the resolution due to slice interval with CT and the image distortion as well as the resolution with MR However, in case of digital angiography, the target localization error was closely related to the distortion of fiducial markers. The results of our study should be considered when PTV (Planning Target Volume) was determined.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.117-118
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• 1998

The aim of this work is to develop 3-D stereotactic localization system in order to determine the precise shape, size and location of the lesion in the brain in the field of Stereotactic Radiosurgery(SRS) and neurosurgery using CT/MRI/angiography and multi-purpose QA phantom. The algorithms to obtain a 3-D stereotactic coordinates of the target have been developed, and targets on each CT image were superimposed each other on MR/angiography images without distortion corretion. This system was implented in Visual C++ as a PC-based application program.

• Progress in Medical Physics
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• v.9 no.1
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• pp.1-9
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• 1998

In order to provide complementary image data, CT(computed tomography), MR(magnetic resonance) and angiography have been used in the field of Stereotactic Radiosurgery(SRS) and neurosurgery. The aim of this work is to develop 3-D stereotactic localization system in order to determine the precise shape, size and location of the lesion in the brain in the field of Stereotactic Radiosurgery(SRS) and neurosurgery using multi-image modality and multi purpose QA phantom. In order to obtain accurate position of a target, Hitchcoke stereotactic frame and CT/angiography localizers were rigidly attached to the phantom with nine targets dispersed in 3-D space. The algorithms to obtain a 3-D stereotactic coordinates of the target have been developed using the images of the geometrical phantom which were taken by CT/angiography. Positions of targets computed by our algorithms were compared to the absolute position assigned in the phantom. Outlines of targets on each CT image were superimposed each other on angiography images. A spatial mean distance errors were 1.02${\pm}$0.17mm for CT with a 512${\times}$512 matrix and 2mm slice thickness, 0.41${\pm}$0.05mm for angiogra- phy localization. The resulting accuracy in the target localization suggests that the developed system has enough Qualification for Stereotactic Radiosurgery (SRS).

• Journal of International Society for Simulation Surgery
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• v.1 no.1
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• pp.41-44
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• 2014

The aim of this report is showing the case that we could give exact navigation of perigastric vessels for gastrectomy with 3D CTA. A 74-year-old male patient visited hospital with gastric cancer. Early gastric cancer, type IIb was found at stomach antrum great curvature side. Before surgery, he underwent 3D CT angiography. 3D volume rendering images and MIP images were made by post processing. He had replaced Lt. hepatic artery arising from Lt. gastric artery. Surgeon could get patient's specific vascular anatomy before surgery including surgically relevant anatomical distance and direction and could finish gastrectomy within 4 hours and just 53ml blood loss.

• Proceedings of the Korea Society for Simulation Conference
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• 2003.11a
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• pp.201-206
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• 2003

In clinical practice, CT Angiography is a powerful technique for the visualziation of blood flow in arterial vessels throughout the body. However CT Angiography images of blood vessels anywhere in the body may be fuzzy if the patient moves during the exam. In this paper, we propose a novel technique for removing global motion artifacts in the 3D space. The proposed methods are based on the two key ideas as follows. First, the method involves the extraction of a set of feature points by using a 3D edge detection technique based on image gradient of the mask volume where enhanced vessels cannot be expected to appear, Second, the corresponding set of feature points in the contrast volume are determined by correlation-based registration. The proposed method has been successfully applied to pre- and post-contrast CTA brain dataset. Since the registration for motion correction estimates correlation between feature points extracted from skull area in mask and contrast volume, it offers an accelerated technique to accurately visualize blood vessels of the brain.