• 대한영상의학회지
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• 제82권5호
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• pp.1287-1291
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• 2021

고환 림프종은 무통성 종괴를 주소로 내원하는 드문 고환 종양이다. 일반적으로 고환 림프종은 칼라 도플러 초음파에서 고혈관성을 보이며, 컴퓨터단층촬영이나 자기공명영상에서 조영증강을 보인다. 저자들은 우측 고환 종대를 주소로 내원한 67세 환자에서 초음파 검사상 크기가 커진 고환 내 혈류가 보이지 않아 계류염전으로 진단하였으나, 전산화단층촬영에서는 주변부에 일부 조영증강을 보이는 종괴로 관찰되었고, 수술 이후 림프종이 진단된 증례를 경험하여 보고하고자 한다.

• 한국방사선학회논문지
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• 제17권5호
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• pp.751-759
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• 2023

유방 초음파 검사는 지방형 유방에서 영상화가 어렵고 미세 석회화를 찾는 데 어려움이 있지만, 미세 석회화의 발견은 유방암 선별 검사에 매우 중요하다. 초음파의 컬러 도플러 허상 중 반짝 허상은 영상에서 주로 결석이나 석회화 같은 강한 반사체에 발생되며 이를 이용한 평가 방법이 임상적으로 사용 중이다. 본 연구는 유방 석회화 중 가장 많이 차지하는 인산칼슘을 이용한 유방 모의 팬텀을 제작하여 초음파 장비의 컬러 도플러 설정 변수인 펄스 반복 주파수, 앙상블, 퍼시스트, 월 필터, 평활화, 선밀도, 임계값에 대해 실험을 진행했고 이를 통해 유방 초음파 검사에서 반짝 허상의 대조도를 개선하는 조건과 임상에서 이를 최대한 활용하기 위한 방안을 연구하고자 하였다. 그 결과 펄스 반복 주파수가 3.6 kHz ~ 7.2 kHz 범위에서 반짝 허상이 발생하며 10.5 kHz 이상에서는 발생하지 않았다. 앙상블의 경우 낮은 조건에서는 모든 크기의 석회화에 반짝 허상이 발생하였고 임계값 설정에서는 80에서 100 조건에서만 반짝 허상이 조금 증가했으며 1 mm 크기의 석회화에서는 발생하지 않았다. 퍼시스트, 월 필터, 평활화, 선밀도 설정은 반짝 허상이 발생하긴 했으나 조건별로 증가하지는 않아 설정 변수에 큰 의미가 없었으며 반짝 허상에 가장 큰 영향을 미친 것은 펄스 반복 주파수, 앙상블, 임계값으로 나타났다. 본 연구는 검사자가 컬러 도플러 설정을 조절하여 반짝 허상을 효과적으로 증가시키는 최적의 조건을 선택하는 데 도움이 될 것으로 사료된다.

• 대한임상검사과학회지
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• 제56권3호
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• pp.228-235
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• 2024

경두개 초음파(transcranial doppler ultrasonography, TCD)를 이용한 난원공 개존증(patent foramen ovale)의 이상 유무를 측정하는 방법은 경식도 심장초음파검사(transesophageal echocardiography, TEE)에 비해 간단하고 비용이 저렴하며 비침습적이기 때문에 보다 효과적인 방법이다. 특이도 및 양성 예측도도 높기 때문에 TEE를 시행하기 어렵거나 합병증 고위험군인 경우 좋은 대체 검사가 될 수 있다. 그래서 본 연구에서는 TCD를 통해 보다 효과적이고 정확한 검사결과를 얻기 위한 방법으로 blood 사용 유무와 환자 자세에 따른 실증적 결과 비교를 통해 적절한 방법을 제안함으로써 진단에 도움을 주고자 한다. Blood 사용 여부와 환자 자세에 따른 결과를 비교하였고, 양쪽 중간대뇌동맥(middle cerebral artery)이 모두 관찰된 환자를 대상으로 하였다. 그리고 측두부창이 불량인 경우는 뇌바닥동맥(basilar artery)으로 대체해서 비교하였다. Blood를 혼합했을 때 positive가 더 많은 것으로 나타났다. Resting과 supine position using valsalva maneuver (VM) 보다 sitting position using VM에서 positive가 더 많은 것으로 나타났고 정확도도 더 높은 것으로 나타났다. 이에 blood를 혼합한 상태에서 sitting position using VM 방법이 가능하다면 시행하는 것이 좋을 것으로 생각된다.

• Journal of Animal Science and Technology
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• 제65권2호
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• pp.365-376
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• 2023

Pig breeding management directly contributes to the profitability of pig farms, and pregnancy diagnosis is an important factor in breeding management. Therefore, the need to diagnose pregnancy in sows is emphasized, and various studies have been conducted in this area. We propose a computer-aided diagnosis system to assist livestock farmers to diagnose sow pregnancy through ultrasound. Methods for diagnosing pregnancy in sows through ultrasound include the Doppler method, which measures the heart rate and pulse status, and the echo method, which diagnoses by amplitude depth technique. We propose a method that uses deep learning algorithms on ultrasonography, which is part of the echo method. As deep learning-based classification algorithms, Inception-v4, Xception, and EfficientNetV2 were used and compared to find the optimal algorithm for pregnancy diagnosis in sows. Gaussian and speckle noises were added to the ultrasound images according to the characteristics of the ultrasonography, which is easily affected by noise from the surrounding environments. Both the original and noise added ultrasound images of sows were tested together to determine the suitability of the proposed method on farms. The pregnancy diagnosis performance on the original ultrasound images achieved 0.99 in accuracy in the highest case and on the ultrasound images with noises, the performance achieved 0.98 in accuracy. The diagnosis performance achieved 0.96 in accuracy even when the intensity of noise was strong, proving its robustness against noise.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2507-2511
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• 2016

Purpose: To study the diagnostic accuracies of serum human epididymis protein 4 (HE-4) levels, virtual organ computer-aided analysis (VOCAL) parameters and endometrial volume in endometrial cancer cases. Materials and Methods: One hundred and seven patients (37 with endometrial cancer and 70 with benign endometrial pathology) were included in this study. VOCAL parameters and serum HE-4 levels were compared between the groups. Results: Area under the curve (AUC) values were 0.702, 0.658, 0.706 for vascularization index (VI), the flow index (FI) and the vascularization flow index (VFI), respectively. A cut off value of 0.568 for VI demonstrated 70% sensitivity, 72% specificity, 56% positive predictive value (PPV) and a81% negative predictive value (NPV). A cut off value of 25.8 for showed a senitivith of 70% and a specificity of 58% with aPPV of 46% and NPV of 78%, and with a cut off value of 0.12 for VFI 70%, 69%, 54% and 81%, respectively. The area under the curve for HE-4 was 0.814. A cut off value of 458 pmol/L was predictive of malignancy with 86% sensitivity and 63% specificity. Conclusions: VOCAL parameters and serum HE-4 levels were statistically significantly higher in the endometrial cancer patients. Serum HE-4 levels provided a greater sensitivity compared to power doppler angiography for predicting malignancy or benign endometrial pathology.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.179-185
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• 2007

결론적으로 출력 도플러 신초음파는 급성신우신염의 병변을 찾는데에 특이도나 민감도가 그리 높지 않았으나 하부요로감염과 급성신우신염을 감별하는데에 어느 정도 유용하였으며, 특히 DMSA 스캔을 같이 실시하는 경우에는 신손상을 찾는데 더 도움이 될 수 있었다. 소아들의 상부요로감염의 진단을 위하여 출력 도플러 신초음파가 DMSA 스캔을 대체하는 영상검사로서는 한계가 있어 향후 보다 많은 시술로 진단을 위한 검사의 질을 높이는 방법을 찾아보아야 할 것이다.

• 대한임상검사과학회지
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• 제36권1호
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• pp.43-48
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• 2004

Cerebral vasoreactivity is an index of autoregulation of cerebral perfusion, and can be measured using functional images such as Xe CT, SPECT and PET in reponse to hypercapneic stimulus. In order to measure cerebral $CO_2$ vasoreactivity in routine TCD study conveniently and reliably, we devised a method of rebreathing into closed volume of reservoir bag as a hypercapneic stimulus, and applied it to 44 healthy volunteers. As a hypercapneic stimulus, we applied fitting mask connected with closed reservoir bag for about 90 seconds, and mean blood flow velocity(MBFV) and pulsatility index(PI) were evaluated at proximal middle cerebral arteries(MCA) of 50-55 mm depth, before and after the hypercapneic stimulus. Age affected the MFV and PI value showed significant and the MFV was 56.45(SD=9.75)cm/sec, while PI was 0.406(SD=0.089). As age increases the flow velocity decreased significantly whereas PI value increased(P<0.05). The vasoreactvity significantly decreased with age(P<0.05). The decrease of cerebral blood flow quantity and cerebral blood flow velocity is not only because of increase of diameter of cerebrovascular resulting from aging, but the resistance increase of small blood vessel resulting from the increase of PI & RI value is regarded. We suppose that the rebreathing method is a reliable and convenient technique as a hypercapneic stimulus in determining cerebral $CO_2$ vasoreactivity. The rebreathing method could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied to the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

• Journal of Chest Surgery
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• 제49권1호
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• pp.22-28
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• 2016

Background: Carotid endarterectomy (CEA) with selective shunting is the surgical method currently used to treat patients with carotid artery disease. We evaluated the incidence of major postoperative complications in patients who underwent CEA with selective shunting under transcranial Doppler (TCD) at our institution. Methods: The records of 45 patients who underwent CEA with TCD-based selective shunting under general anesthesia from November 2009 to June 2015 were reviewed. The risk factors for postoperative complications were analyzed using univariate and multivariate analysis. Results: Preoperative atrial fibrillation was observed in three patients. Plaque ulceration was detected in 10 patients (22.2%) by preoperative computed tomography imaging. High-level stenosis was observed in 16 patients (35.5%), and 18 patients had contralateral stenosis. Twenty patients (44.4%) required shunt placement due to reduced TCD flow or a poor temporal window. The 30-day mortality rate was 2.2%. No cases of major stroke were observed in the 30 days after surgery, but four cases of minor stroke were noted. Univariate analysis showed that preoperative atrial fibrillation (odds ratio [OR], 40; p=0.018) and ex-smoker status (OR, 17.5; p=0.021) were statistically significant risk factors for a minor stroke in the 30-day postoperative period. Analogously, multivariate analysis also found that atrial fibrillation (p<0.001) and ex-smoker status (p=0.002) were significant risk factors for a minor stroke in the 30-day postoperative period. No variables were identified as risk factors for 30-day major stroke or death. No wound complications were found, although one (2.2%) of the patients suffered from a hypoglossal nerve injury. Conclusion: TCD-based CEA is a safe and reliable method to treat patients with carotid artery disease. Preoperative atrial fibrillation and ex-smoker status were found to increase the postoperative risk of a small embolism leading to a minor neurologic deficit.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권1호
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• pp.23-29
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• 2024

Objective: Flow diverting stents (FDS) are increasingly used for the treatment of intracranial aneurysms. While FDS can provide flow diversion of parent vessels, their high metal surface coverage can cause thromboembolism. Transcranial Doppler (TCD) emboli monitoring can be used to identify subclinical embolic phenomena after neurovascular procedures. Limited data exists regarding the use of TCDs for emboli monitoring in the periprocedural period after FDS placement. We evaluated the rate of positive TCDs microembolic signals and stroke after FDS deployment at our institution. Methods: We retrospectively evaluated 105 patients who underwent FDS treatment between 2012 and 2016 using the Pipeline stent (Medtronic, Minneapolis, MN, USA). Patients were pretreated with aspirin and clopidogrel. All patients were therapeutic on clopidogrel pre-operatively. TCD emboli monitoring was performed immediately after the procedure. Microembolic signals (mES) were classified as "positive" (<15 mES/hour) and "strongly positive" (>15 mES/hour). Clinical stroke rates were determined at 2-week and 6-month post-operatively. Results: A total of 132 intracranial aneurysms were treated in 105 patients. TCD emboli monitoring was "positive" in 11.4% (n=12) post-operatively and "strongly positive" in 4.8% (n=5). These positive cases were treated with heparin drips or modification of the antiplatelet regimen, and TCDs were repeated. Following medical management modifications, normalization of mES was achieved in 92% of cases. The overall stroke rates at 2-week and 6-months were 3.8% and 4.8%, respectively. Conclusions: TCD emboli monitoring may help early in the identification of thromboembolic events after flow diversion stenting. This allows for modification of medical therapy and, potentially, preventionf of escalation into post-operative strokes.

• 동의생리병리학회지
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• 제23권6호
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• pp.1491-1496
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• 2009

Stroke is usually associated with the cerebral blood flow of the central nervous system. However, studies concerning the effects of neurologic sysmptoms induced from stroke on the peripheral blood flow has not taken place sufficiently. To ascertain the feasibility of a blood flow meter adopting to use doppler ultrasonogrphy, under the prospect that hemiparesis induced from stroke may have effect on the peripheral blood flow, the peripheral blood flow velocity was observed. The control group made up of healthy people without any factors capable of effecting the peripheral blood flow velocity, and patient group which consist of hemiparetic people induced from stroke, were recruited. Volumes of recruitment are 21 persons in the patient group, and 29 persons in the control group, but the final numbers of people are 17 and 21 respectively because of the inconsistancy in the method of the test. The non-invasive method of Doppler effect of Ultrasound was used to measure the blood flow velocity. The blood flow velocity in the peripheral part of left and right fourth fingers:dorsal branches of proper palmar digital artery to dorsum of distal phalanges, was measured in the control group and patient group through Doppler Ultrasound. In comparison of the control group and the patient group, the systolic blood flow velocity from the peripheral part of the upper extremity was lower in the patient group than that of the control group. According to such results, it is concluded that hemiparesis induces the reduction of the peripheral blood flow velocity in the systolic phase.