• Title/Summary/Keyword: CT조영제

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Colon Cancer Mimicking Physiologic FDG Uptake : with Using of Negative Oral Contrast (네거티브 경구 조영제를 이용한 PET/CT 촬영시 나타난 종양성 섭취와 유사한 생리적 장관 섭취)

  • Jeong, Young-Jin;Kang, Do-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.186-187
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    • 2006
  • A 64-year-old female with glioblastoma multiforme (GBM) was assigned to our department for whole body PET/CT scan. She ingested 1 liter of pure water as negative oral contrast just before PET/CT examination. FDG-PET/CT images showed a very intense hypermetabolic, focal lesion in the abdominal cavity around descending colon. The SUVmax of the lesion was 17.2. But there was no abnormal lesion corresponded to the area of PET scan in the combined contrast enhanced CT scan. We suggested considering a malignant lesion due to very intense glycolytic activity. Conventional abdominal CT scan & colonoscopy were accomplished within one week after PET/CT evaluation. There was no abnormality in both examinations. We executed follow-up PET/CT evaluation after 1 month and couldn't find any abnormality around the corresponding area. So we concluded the hypermetabolism was colonic physiologic uptake. A colonic physiologic uptake is a well known cause of false positive finding. Nuclear physicians should be considered the possibility of malignancy when interpret focal colonic uptake, especially incidental finding. There are a few reports that using of negative oral contrast is able to reduce gastrointestinal physiologic uptakes. But as we can see in this case, although we used negative oral contrast, intense physiologic uptake is detected and maxSUV is able to up to 17.2. So, it is important to keep a fact in mind. Even though there is a colonic physiologic uptake in PET/CT image, it may be able to show very intense hypermetabolism regardless of using negative oral contrast.

Pediatric Neuro-MRI : Techniques and Methods

  • 윤혜경
    • Proceedings of the KSMRM Conference
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    • 1999.04a
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    • pp.81-86
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    • 1999
  • MR은 높은 조직 대조도와 축상, 시상 및 관상면 등의 multiplanar capability의 커다란 장점을 갖고 있어 뇌 신경계질환 진단에 필수적이며, 특히 ionizing radiation이 아니고 요오드계 IV 조영제를 사용하지 않는다는 점이 CT에 비해 더욱 유리하다. 소아에서의 뇌신경계 질환은 선천성 기형이나 대사성 질환이 많은 등 성인과는 다른 질환분포를 보인다. 따라서 성인에서와 같은 protocol을 그대로 적용하였을 때 좋은 질의 영상을 얻기 힘든 경우가 있으며, 연령 또는 질환에 따라 촬영기법도 다양하게 하여야 하므로 routine protocol을 정하지 않고 매 환아 마다 적절한 기법을 선택하고 있다. 또한 움직임을 억제하기 위하여 진정 (sedation)이 필요한 예가 대부분이며 적절한 잠재우기는 좋은 질의 영상을 얻기 위해 필수적이므로 이에 대한 지식을 필요로 한다.

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Radiological Evaluation of CT Contrast Medium Extravasation (CT 조영제 혈관외유출의 방사선학적 고찰)

  • Kweon, Dae-Cheol;Park, Chang-Hee;Jeong, Jae-Ho;Kang, Hui-Doo;Song, Woon-Heung
    • Korean Journal of Digital Imaging in Medicine
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    • v.10 no.2
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    • pp.39-49
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    • 2008
  • Extravasation of contrast material is a not infrequent complication of enhanced imaging studies and large volume extravasation may result in severe damage. Subcutaneous extravasation of the radiographic contrast medium is one of the complications of the contrast medium-enhanced procedures. Automated power injectors enable the contrast material to be delivered at a uniform high-flow-rate and as a nonfragmented bolus, and this is essential for many contrast material enhanced CT(computed tomography) applications. The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of CT contrast material can produce the compartment syndrome. Selection of the nonionic contrast material after careful evaluation of the intravenous administration site and monitoring of the patient during the use of a mechanical power injector may help minimize or prevent extravasation injuries. Early identification is important and conservative management is effective in most cases. Prevention of these injuries with the education of radiological technologist remains the ultimate aim.

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Analysis of Attenuation Differences According to Radiolucent and Radiopague Materials : Based on DECT (Dual Energy Computed Tomography) (방사선 투과 및 불투과성 물질에 따른 감약 차이의 분석 : DECT 검사 중심으로)

  • Jang, Hyon-Chol;Kim, Yoon-Shin;Kim, Hyeon-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1584-1589
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    • 2014
  • This study analyzed CT values of radiolucent and radiopaque materials by energy region after selecting radiolucent and radiopaque materials at random using GE's DECT((Dual Energy Com-puted Tomography) at S University Hospital located in Gyeonggi-province from July through August in 2013. Besides, it drew out the most analogous energy region to the value of 120kVp CT, which is applied to existing SECT(Single Energy Computed Tomography), by utilizing the analysis method of CT values and tried to find out the most useful and appropriate materials when contrast was applied within visible area in clinical application. As a result, there was little decrease of CT value after 90KeV in the case of materials with low density and high moisture content such as normal saline, methyl-cellulose and gels used in ultra-sonic waves test; energy does not influence much on materials with extremely low or high density such as air and contrast medium; methyl-cellulose and gels used in ultra-sonic waves test are considered to be the most useful materials for clinical applications.

The Clinical Usefulness Evaluation of Normal Saline Injection in Coronary Artery Computed Tomography Angiography(Coronary CTA) (관상동맥 전산화단층촬영 조영검사에서 생리식염수 투여를 통한 임상 유용성 평가)

  • Jung, Kang-Kyo;Lee, Mi-Hwa;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.307-313
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    • 2014
  • The purpose of this study is that in coronary artery angiography computed tomography (coronary CTA), to gain high quality of image and to use low dose radiation by administrating normal saline and converting the mode of scanning heart rate (HR) characteristics before infusing contrast media. All patients data (total specimens: 200, male: 108, female: 92) were measured by using appropriate mode of scanning the heart rate (HR) after injection of saline. in addition we measured radiation dose (CTDIvol, effective dose) in all examinations. CT number and noise, and blurring of coronary artery (proximal RCA, middle RCA, proximal LCA) were measured and compared. The result of this study after injection of saline, mean heart rate was decreased about $4.8{\pm}0.3bpm$ (beats per minute). 33 patients (13%) got converting scan mode due to reducing heart rate (HR). In prospective gating mode, radiation dose were measured less $6.0{\pm}1.0mSv$ (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.

Segmentation of Liver on MDCT Image (MDCT 영상에서 간의 추출)

  • Seo Jeongjoo;Ryu Gangmin;Fei Yang;Park Jongwon
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.07b
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    • pp.802-804
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    • 2005
  • 제안된 연구에서는 기존의 일반 CT(Computerized tomography) 영상이 아닌 MDCT(Multi Detector CT) 영상을 이용하여 장기 추출에 관한 연구를 진행하였다. 조영제를 이용한 복부 MDCT 영상으로부터 모폴로지(morphology) 기법을 통해 간에 근접한 노이즈를 제거하고, 기존의 Otsu threshold를 개선하여 간의 명암값 분포를 구분할 수 있는 임계치를 구하였다. 찾아진 임계치를 이용하여 영상을 이진화하고, 최종적으로 위치정보를 이용하여 간에 해당하는 부분들을 추출하였다. 이러한 방식은 명암값과 위치정보를 이용하여 간을 추출한 후 다시 노이즈 문제를 해결하는 기존의 알고리즘과 비교했을 때, 처리 방식이 단순해지고 속도가 향상되었다. 추출된 간은 간 이식술이나 절제술에 필요한 간 내부의 혈관 인식과 간의 부분체적 계산 연구에 중요한 정보로 사용될 수 있을 것이다.

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Optimization of the Empirical Method to the Enhancement Image of the Four Chambers at the Same Time in the Pediatric Cardiac Computed Tomography (소아 심장 전산화단층촬영 검사에서 4 chamber의 동시 조영증강 영상에 대한 최적화 방안)

  • Park, Chanhyuk;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.6
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    • pp.279-285
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    • 2014
  • This study is to have dose reduction and minimization of excessive use of contrast medium in the pediatric cardiac computed tomography and to suggest the optimization plan to acquire the enhancement image of the 4 chambers at the same time by formulating scan delay time in empirical method with considering variables such as contrast medium injection velocity and cardiac approaching time. Quantitative, qualitative and dose assessment were carried out for 30 pediatric patients who had taken the cardiac examination. In conclusion, image enhancement in 4 chambers of the cardiac shows over 300 HU which is proper to pediatric cardiac reading by applying the empirical method with calculating scan delay time according to weight and contrast medium volume and injection velocity. Qualitative image assessments in confidence sharpness and noise have excellence qualitatively. Exposure dose to pediatrics also decreases precisely. Therefore this study is judged to take a important role of making optimization images with advantages of dose reduction and less side effects caused by it's excessive use in clinic.

Comparison of the Efficacy of Diluted Polyethylene Glycol and Low-Density (0.1% w/v) Barium Sulfate Suspension for CT Enterography (전산화단층촬영 소장조영술을 위한 희석된 폴리에틸렌 글리콜과 저밀도(0.1% w/v) 바륨 현탁액의 유용성 비교)

  • Yeon Jung Kim;Seung Ho Kim;Tae Wook Baek;Hyungin Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.911-922
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    • 2023
  • Purpose To compare small bowel distension and side effects between a diluted polyethylene glycol (PEG) solution and a low-density (0.1% w/v) barium sulfate suspension (LDBSS) for CT enterography (CTE) preparation. Materials and Methods Total 173 consecutive patients who underwent CTE were enrolled in this study. The LDBSS (1 L) was used in 50 patients, and the diluted iso-osmotic PEG solution (1 L) was used in 123 patients. Two blinded radiologists independently scored jejunal and ileal distensions on a 5-point scale. To compare side effects between the two groups, the patients reported whether they had immediate complications after the administration of the oral contrast media. Results For ileal and jejunal distension, the diluted PEG solution showed no difference from the LDBSS for either reader (ileum: reader 1, median, 4; 4, interquartile range, 3-4; 3-4, p = 0.997; reader 2, median, 4; 4, interquartile range, 3.3-4.0; 3-4, p = 0.064; jejunum: reader 1, median, 2; 2, interquartile range, 2-3; 2-3, p = 0.560; reader 2, median, 3; 2, interquartile range, 2-3; 2-3, p = 0.192). None of the patients complained of immediate complications following administration of either of the oral contrast media. Conclusion The diluted PEG solution showed comparable bowel distension compared to LDBSS and no immediate side effects; thus, it can be a useful alternative.

Signal Change of Iodinated Contrast Agents in MR Imaging (요오드화 조영제가 MR영상에 미치는 신호 변화)

  • Jeong, HK;Kim, Seongho;Kang, Chunghwan;Lee, Suho;Yi, Yun;Kim, Mingi;Kim, Hochul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.131-138
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    • 2016
  • In this study, we tried to analyze the influence of ICM(Iodinated Contrast Media) in MR imaging compare to GBCA(Gadolinium Based Contrast Agent), and as this result we discussed whether resonable or not the protocol which is MRI scan after enhanced CT scan without proper time interval in clinical field. For this research, we assembled two phantoms. which one was iodine and another one was gadolinium. We did test two phantoms in conventional MRI scan which is T1, T2, T2 FLAIR and 3D angio. After that, quantitative analysis was progressed. The results of study were as follow : SSI(Saline's Signal Intensity) was shown as each sequences 175, 1231, 333, 37 [a.u] at iodine. and 1297, 123, 757, 232 [a.u] was recorded at gadolinium. BDEPS(the Biggest Difference of EPS) was shown as each sequences 1297, 123, 757, 232 [a.u] at iodine and 793, 6, 1495, 365 [a.u] was recorded at gadolinium. At this time, EPS(Enhancement Percentage to Saline) was shown 641.1, -90.0, 127.3, 527% at iodine and 685.1, 99.4, 365.7, 1077.4% was recorded at gadolinium. BP(BDEPS's point) was shown 900, 900, 477, 900 mmol at iodine and 4, 0.2, 0.2, 40 mmol was recorded at gadolinium. CPSS(Change Point of SI to SSI) was shown 63, 423, 63, 29 mmol at iodine and each [50, 30], [4, 0.2], [4, 1], 0.2 mmol was recorded at gadolinium. According to this research, we could not only discover the fact that was iodine could effect on MR signal, but also the pattern is different as various sequences compare to gadolinium. Therefore, we expect useful diagnostic MR image in clinical field with this quantitative data for deciding protocol regarding MRI and CT scan order.

Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography (관절경적 2열 고정 회전근개 복원술 후의 임상 결과 및 CT 관절조영술을 이용한 건의 치유 평가)

  • Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.