• 제목/요약/키워드: Ultrasound Diagnosis

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비알코올성 지방간 소견을 보이는 성인에 대한 간 기능 및 hs-CRP 혈액 검사 항목 평가 (Evaluation of Liver Function and Blood Exam including hs-CRP in Adults with Nonalcoholic Fatty Liver Findings)

  • 박정미;서영현;송종남
    • 한국방사선학회논문지
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    • 제16권7호
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    • pp.943-952
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    • 2022
  • 지방간 진단을 위한 검사로, 최근 초음파 검사와 혈액검사를 동시에 병행하여 시행하고 있다. 특히 혈액검사 중 hs-CRP의 경우, 심혈관 질환 뿐 아닌, 인체의 다양한 부위에 대한 염증 수치를 나타내는 지표로 사용되고 있다. 따라서 본 연구를 통해 비알콜성 지방간 정도에 따른 대사증후군 구성 요소와 간 기능 및 hs-CRP수치 등의 연관성을 분석해 지방간 진단 임상 지표로 활용하고자 연구를 진행하였다. 2021년 3월~2021년 8월 한국 건강관리 협회 광주 전남지부에서 복부 초음파 검사를 실시하여 비알콜 지방간이 관찰된 환자 중 대사증후군 구성요소와 간 기능 및 hs-CRP 검사를 모두 실시한 만 20세 이상, 남녀 총 1,139명의 피검사 수치 데이터를 대상으로 하였다. 남녀 전체를 대상으로 분석한 경우 경도 지방간 환자의 간 검사 수치가 AST 30 U/L, ALT 32.1 U/L hs-CRP 0.14 mg/dL로 중등도 지방간 환자의 혈액 검사 수치 AST 38 U/L, ALT 47.6 U/L, 54.9 IU/L, hs-CRP 0.22 mg/dL보다 낮았으며 통계적으로 유의했다(P<0.001). hs-CRP 검사의 경우 경도 지방간 환자보다 중등도 지방간 환자에서 통계적으로 유의할 만큼 높은 수치 차이를 나타낸 것으로 보아 hs-CRP 검사가 지방간 예방과 관리를 위한 임상적 데이터로도 활용될 수 있을 것으로 사료된다.

Delayed Cancer Diagnosis in Thyroid Nodules Initially Treated as Benign With Radiofrequency Ablation: Ultrasound Characteristics and Predictors for Cancer

  • Myoung Kyoung Kim;Jung Hee Shin;Soo Yeon Hahn;Haejung Kim
    • Korean Journal of Radiology
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    • 제24권9호
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    • pp.903-911
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    • 2023
  • Objective: Regrowth after radiofrequency ablation (RFA) of symptomatic large thyroid nodules, initially treated as benign, sometimes turns out to be malignancies. This study aimed to assess the ultrasound (US) characteristics of thyroid nodules initially treated as benign with RFA and later diagnosed as cancers, predictive factors for cancers masquerading as benign, and methods to avoid RFA in these cancers. Materials and Methods: We reviewed the medical records of 134 consecutive patients with 148 nodules who underwent RFA between February 2008 and November 2016 for the debulking of symptomatic thyroid nodules diagnosed as benign using US-guided biopsy. We investigated the pre-RFA characteristics of the thyroid nodules, changes at follow-up after RFA, and the final surgical pathology. Results: Nodule regrowth after RFA was observed in 36 (24.3%) of the 148 benign nodules. Twenty-two of the 36 nodules were surgically removed, and malignancies were confirmed in seven (19.4% of 36). Of the 22 nodules removed surgically, pre-RFA median volume (range) was significantly larger for malignant nodules than for benign nodules: 22.4 (13.9-84.5) vs. 13.4 (7.3-16.8) mL (P = 0.04). There was no significant difference in the regrowth interval between benign and malignant nodules (P = 0.49). The median volume reduction rate (range) at 12 months was significantly lower for malignant nodules than for benign nodules (51.4% [0-57.8] vs. 83.8% [47.9-89.6]) (P = 0.01). The pre-RFA benignity of all seven malignant nodules was confirmed using two US-guided fine-needle aspirations (FNAs), except for one nodule, which was confirmed using US-guided core-needle biopsy (CNB). Regrown malignant nodules were diagnosed as suspicious follicular neoplasms by CNB. Histological examination of the malignant nodules revealed follicular thyroid carcinomas, except for one follicular variant, a papillary thyroid carcinoma. Conclusion: Symptomatic large benign thyroid nodules showing regrowth or suboptimal reduction after RFA may have malignant potential. The confirmation of these nodules is better with CNB than with FNA.

Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran

  • Haghighi, Shirin;Molaei, Mahsa;Foroughi, Forough;Foroutan, Mojgan;Dabiri, Reza;Habibi, Effat;Alizadeh, Amir Houshang Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4537-4540
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    • 2012
  • Background: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow an indolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiological presentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzed clinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghani hospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between 2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors. The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients, cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization of functional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and late stages and cystic lesions were more common in this group.

대화식 의사결정나무를 이용한 보건의료 데이터 질 관리 알고리즘 개발: 당뇨환자의 고혈압 동반을 중심으로 (Development of Healthcare Data Quality Control Algorithm Using Interactive Decision Tree: Focusing on Hypertension in Diabetes Mellitus Patients)

  • 황규연;이은숙;김고원;홍성옥;박정선;곽미숙;이예진;임채혁;박태현;박종호;강성홍
    • 보건의료산업학회지
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    • 제10권3호
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    • pp.63-74
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    • 2016
  • Objectives : There is a need to develop a data quality management algorithm to improve the quality of healthcare data using a data quality management system. In this study, we developed a data quality control algorithms associated with diseases related to hypertension in patients with diabetes mellitus. Methods : To make a data quality algorithm, we extracted the 2011 and 2012 discharge damage survey data from diabetes mellitus patients. Derived variables were created using the primary diagnosis, diagnostic unit, primary surgery and treatment, minor surgery and treatment items. Results : Significant factors in diabetes mellitus patients with hypertension were sex, age, ischemic heart disease, and diagnostic ultrasound of the heart. Depending on the decision tree results, we found four groups with extreme values for diabetes accompanying hypertension patients. Conclusions : There is a need to check the actual data contained in the Outlier (extreme value) groups to improve the quality of the data.

피하 조직에 발생한 나무 이물의 초음파 진단 (Ultrasonographic Diagnosis of Subcutaneous Wooden Foreign Body)

  • 최지혜;계서연;김성수;김혜진;장재영;최희연;윤정희
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.163-172
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    • 2011
  • Subcutaneous foreign body causes recurrent problems such as chronic soft tissue swelling and discharge. Wooden foreign body is one of the most common foreign bodies found in subcutaneous region including face, interdigit, and thoracic or abdominal area. This report demonstrated three dogs with wooden foreign body located in subcutaneous region of thoracic wall, abdominal wall and upper eyelid, respectively. Three dogs showed prominent soft tissue swelling adjacent the foreign body. A sinus or drainage tract was developed in two of these dogs. Ultrasonography revealed that hyperechoic linear structure accompanied acoustic shadow in all dogs, and which was diagnosed as a subcutaneous foreign body. Anechoic or hyperechoic fluid and hypoechoic tissue circumscribed the foreign body. A subcutaneous foreign body in case 3 was removed by clamp under ultrasound-guide with sedation. Sinography was performed in case 1 and clarified that the wooden foreign body did not perforate the thoracic wall and there was no direct communication into thoracic cavity. Ultrasonography and sinography can be used to identify the subcutaneous foreign body and evaluate the inflammatory reaction and relationship between foreign body and adjacent structures.

Comparison of Effectiveness in Differentiating Benign from Malignant Ovarian Masses between IOTA Simple Rules and Subjective Sonographic Assessment

  • Tongsong, Theera;Tinnangwattana, Dangcheewan;Vichak-ururote, Linlada;Tontivuthikul, Paponrad;Charoenratana, Cholaros;Lerthiranwong, Thitikarn
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권9호
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    • pp.4377-4380
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    • 2016
  • Background: To compare diagnostic performance in differentiating benign from malignant ovarian masses between IOTA (the International Ovarian Tumor Analysis) simple rules and subjective sonographic assessment. Materials and Methods: Women scheduled for elective surgery because of ovarian masses were recruited into the study and underwent ultrasound examination within 24 hours of surgery to apply the IOTA simple rules by general gynecologists and to record video clips for subjective assessment by an experienced sonographer. The diagnostic performance of the IOTA rules and subjective assessment for differentiation between benign and malignant masses was compared. The gold standard diagnosis was pathological or operative findings. Results: A total of 150 ovarian masses were covered, comprising 105 (70%) benign and 45 (30%) malignant. Of them, the IOTA simple rules could be applied in 119 (79.3%) and were inconclusive in 31 (20.7%) whereas subjective assessment could be applied in all cases (100%). The sensitivity and the specificity of the IOTA simple rules and subjective assessment were not significantly different, 82.9% vs 86.7% and 94.0% vs 94.3% respectively. The agreement of the two methods in prediction was high with a Kappa index of 0.835. Conclusions: Both techniques had a high diagnostic performance in differentiation between benign and malignant ovarian masses but the IOTA rules had a relatively high rate of inconclusive results. The IOTA rules can be used as an effective screening technique by general gynecologists but when the results are inconclusive they should consult experienced sonographers.

피부학(Dermatology)을 위한 고해상도 초음파 진단 장치에 관한 연구 (A study of the high resolution Ultrasound Diagnostic system for Dermatology)

  • 류점수;임춘성;김영길
    • 전자공학회논문지S
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    • 제35S권6호
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    • pp.66-71
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    • 1998
  • 본 연구에서 피부계통의 진단에 이용될 수 있는 고해상도 영상진단기를 개발하였으며 개발된 영상진단기는 sector scanning 방식으로서 A-mode, B-mode, M-mode의 80${\mu}m$ 축방향, 250${\mu}m$ 축방향 해상도로 $5mm {\times} 5mm$의 인체 단면 영상을 초당 20frame으로 나타낸다. 이 영상장치는 대부분의 피부학(dermatology) 계통의 질환에 그 병리학적인 연구에 이용될 수 있을 뿐만 아니라 안과(ophthalmology)나 치과(odontology) 계통의 병리학적인 판단에도 도움을 줄 수 있다고 생각되며 또한 피부미용(dermato-cosmetology)을 위한 분야에도 응용 가능하다.

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유두상 갑상선 암의 큰 세포 변이(Tall Cell Variant) (Tall Cell Variant of Papillary Thyroid Carcinoma)

  • 강상욱;김태완;남기현;장항석;홍순원;박정수
    • 대한두경부종양학회지
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    • 제20권2호
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    • pp.123-127
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    • 2004
  • Objectives: The tall cell variant is an uncommon variant and has been known as more aggressive form of papillary thyroid carcinoma (PTC). Owing to the rarity of these thyroid cancers, their clinical behavior remains incompletely understood. To elucidate the clinicopathologic characteristics of tall cell variant, we retrospectively reviewed our surgical experience of patients with tall cell variant. Methods: Between August 1993 and July 2004, a total of 11 consecutive patients who were pathologically diagnosed with tall cell variant of papillary thyroid carcinoma were enrolled in this study. All patients underwent total (8 cases) or subtotal thyroidectomy (3 cases) with central compartment node dissections. The lateral neck dissection was added in 6 patients. After the operation, neck ultrasound and serum thyroglobulin were checked regularly during the follow-up period. Results: The mean age of the patients was 56.6years (range, 30-74years) at the time of diagnosis. 3 patients were men, and 8 were women. The mean diameter of tumor was 3.7cm(range, 1.5-6.0cm), and 6 patients had lateral neck node metastasis. Extrathyroidal extension was seen in 5 patients (45%). Loco-regional recurrence was found in 2 patients (18%), and distant metastasis in 1 patient (9%). The 5-year disease free survival rate was 68%. Conclusion: The tall cell variant of papillary thyroid carcinoma is an uncommon disease. Clinicopathologic feature and prognosis of this disease show more aggressive behaviors than ordinary papillary thyroid carcinoma. More aggressive treatment and close follow-up should be undertaken in the tall cell variant of papillary thyroid carcinoma.

온 바닥 쪽 손가락 동맥에서 발생한 동맥류의 치험례 (True Aneurysm of the Common Digital Artery: Case Report)

  • 장준철;정성호;한승규;김우경
    • Archives of Plastic Surgery
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    • 제38권3호
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    • pp.315-318
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    • 2011
  • Purpose: An aneurysm is defined as a permanent, localized dilation of an artery with a 50% increase in diameter over its expected normal diameter. Aneurysms can be classified by cause as traumatic and nontraumatic. Traumatic aneurysms can be divided into true and false aneurysms. Nontraumatic causes of peripheral artery aneurysms include mycotic, atherosclerotic, inflammatory, and idiopathic. In the hand, true aneurysms occurring at the common digital artery have been rarely reported. We present a rare case of a true aneurysm of the common digital artery that was resected and reconstructed using a reversed vein graft. Methods: A 49-year-old male patient was refered to our institution with a $0.73{\times}0.44{\times}1.37cm$ sized pulsating mass between 2nd and 3rd flexor digitorum tendons on Lt. palm area. The mass had been present for 5 years and had increased in size over the previous year. No history of trauma was reported. After a physical examination and ultrasound sonography review, a diagnosis of aneurismal dilatation of common digital artery was made. Surgical treatment by excision of the aneurysm, and a reversed vein graft was performed. Results: Histologic examination of the specimen ($3.4{\times}0.7cm$) showed aneurismal dilatation, with elastin fibers present in the arterial wall. The lesions were healed without any complications and there were no evidence of recurrence. Doppler examination of the reconstruction showed good perfusion. Conclusion: Early excision is recommended to relieve symptoms and avoid neurologic damage. Also, artery reconstruction can be performed by primary end-to-end anastomosis or the placement of a reversed interposition vein graft. Micro surgical repair was the only possible treatment in this case. The authors believe that the vascular anatomy should always be restored as natural as possible.

Primary Splenic Paraganglioma in a Dog

  • An, Su-Jin;Moon, Jong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Sur, Jung-Hyang;Jung, Dong-In
    • 한국임상수의학회지
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    • 제35권4호
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    • pp.155-160
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    • 2018
  • A 6-year-old intact female Shih-tzu dog was referred due to anorexia. Physical examination, complete blood count, serum chemical analysis, radiography, and ultrasonography were evaluated. Physical examination and hematological analysis showed normal findings. Abdominal radiographs and ultrasound revealed well-defined masses in the spleen. Other abdominal organs showed no significant abnormalities. Tissue samples taken via sono-guided fine needle aspiration of the splenic mass showed many bare nuclei, which were variable in size. Results of histopathological and immunohistochemical (IHC) analyses performed after splenectomy were consistent with paraganglioma. Based on these findings, we diagnosed this patient with a paraganglioma of splenic origin. Two months after splenectomy, abdominal ultrasonography revealed a new neoplastic lesion in the liver. The clients refused further management and the patient expired three months after initial diagnosis. Necropsy as well as histopathological and IHC examinations of other systemic organs including the liver, adrenal gland, kidney, brain, urinary bladder, lung, aortic body, carotid body, and pancreas were performed. The neoplastic tissue in the liver also demonstrated features of a paraganglioma, and there were no remarkable findings in all other organs.