• 한국노년학
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• 제31권4호
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• pp.969-983
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• 2011

본 연구의 목적은 고혈압노인의 식사시간 별 혈압변화와 식후저혈압(PPH: Postprandial hypotension) 발생을 파악하기 위해 아침, 점심, 저녁 세 끼 식사 전후의 혈압을 측정하였다. 노인 복지시설에 거주하는 고혈압 노인 187명으로부터 서면동의를 받은 후 시행되었다. 혈압측정 도구는 휴대용 혈압모니터(ABPM)를 사용하여 아침, 점심, 저녁의 식전 30분부터 식후 2시간까지 15분 간격으로 측정하였다. 수집된 자료는 SPSS Win 14.0 program으로 빈도와 백분율, 평균과 표준편차, ANOVA와 Scheffé 사후검정을 이용하여 분석하였으며, 연구결과는 다음과 같다. • 수축기혈압과 이완기혈압의 하강 정도는 아침 식후가 점심이나 저녁 식후 보다 유의하게 더 많았다. • PPH 발생률은 아침 식후에는 73.4%, 점심 식후에는 54.2%, 저녁에는 50.2%이었다. • PPH가 가장 많이 발생한 시점은 아침과 점심 저녁 모두 식사 시작 후 90분이었다. • 식후 혈압을 8회 측정한 것을 기준했을 때, 평균 PPH 발생 횟수는 아침 식후가 평균 3.0±2.7회로 점심 평균 2.1±2.5회와 저녁 평균 1.9±2.4회 보다 더 많았다. 고혈압노인의 간호에서는 점심이나 저녁 식사에서보다는 아침식사 후에 PPH 발생이 더 많다는 점을 고려하여야 할 것이다. 또한 식사 시작 후 1시간에서 2시간 동안은 PPH로 인한 건강문제가 발생하지 않도록 주의 관찰과 간호관리가 이루어져야 한다. 아울러 고혈압노인의 PPH를 조절할 수 있는 간호중재를 개발하기 위한 추후연구가 활성화되어야 한다.

• Korean Journal of Radiology
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• 제23권7호
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• pp.720-731
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• 2022

Objective: We aimed to develop and test a deep learning algorithm (DLA) for fully automated measurement of the volume and signal intensity (SI) of the liver and spleen using gadoxetic acid-enhanced hepatobiliary phase (HBP)-magnetic resonance imaging (MRI) and to evaluate the clinical utility of DLA-assisted assessment of functional liver capacity. Materials and Methods: The DLA was developed using HBP-MRI data from 1014 patients. Using an independent test dataset (110 internal and 90 external MRI data), the segmentation performance of the DLA was measured using the Dice similarity score (DSS), and the agreement between the DLA and the ground truth for the volume and SI measurements was assessed with a Bland-Altman 95% limit of agreement (LOA). In 276 separate patients (male:female, 191:85; mean age ± standard deviation, 40 ± 15 years) who underwent hepatic resection, we evaluated the correlations between various DLA-based MRI indices, including liver volume normalized by body surface area (LV_BSA), liver-to-spleen SI ratio (LSSR), MRI parameter-adjusted LSSR (aLSSR), LSSR × LV_BSA, and aLSSR × LV_BSA, and the indocyanine green retention rate at 15 minutes (ICG-R15), and determined the diagnostic performance of the DLA-based MRI indices to detect ICG-R15 ≥ 20%. Results: In the test dataset, the mean DSS was 0.977 for liver segmentation and 0.946 for spleen segmentation. The Bland-Altman 95% LOAs were 0.08% ± 3.70% for the liver volume, 0.20% ± 7.89% for the spleen volume, -0.02% ± 1.28% for the liver SI, and -0.01% ± 1.70% for the spleen SI. Among DLA-based MRI indices, aLSSR × LV_BSA showed the strongest correlation with ICG-R15 (r = -0.54, p < 0.001), with area under receiver operating characteristic curve of 0.932 (95% confidence interval, 0.895-0.959) to diagnose ICG-R15 ≥ 20%. Conclusion: Our DLA can accurately measure the volume and SI of the liver and spleen and may be useful for assessing functional liver capacity using gadoxetic acid-enhanced HBP-MRI.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1093-1101
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• 2023

Objective: Cine magnetic resonance imaging (MRI) has emerged as a noninvasive method to quantitatively assess bowel motility. However, its accuracy in measuring various degrees of small bowel motility has not been extensively evaluated. We aimed to draw a quantitative small bowel motility score from cine MRI and evaluate its performance in a population with varying degrees of small bowel motility. Materials and Methods: A total of 174 participants (28.5 ± 7.6 years; 135 males) underwent a 22-second-long cine MRI sequence (2-dimensional balanced turbo-field echo; 0.5 seconds per image) approximately 5 minutes after being intravenously administered 10 mg of scopolamine-N-butyl bromide to deliberately create diverse degrees of small bowel motility. In a manually segmented area of the small bowel, motility was automatically quantified using a nonrigid registration and calculated as a quantitative motility score. The mean value (MV) of motility grades visually assessed by two radiologists was used as a reference standard. The quantitative motility score's correlation (Spearman's ρ) with the reference standard and performance (area under the receiver operating characteristics curve [AUROC], sensitivity, and specificity) for diagnosing adynamic small bowel (MV of 1) were evaluated. Results: For the MV of the quantitative motility scores at grades 1, 1.5, 2, 2.5, and 3, the mean ± standard deviation values were 0.019 ± 0.003, 0.027 ± 0.010, 0.033 ± 0.008, 0.032 ± 0.009, and 0.043 ± 0.013, respectively. There was a significant positive correlation between the quantitative motility score and the MV (ρ = 0.531, P < 0.001). The AUROC value for diagnosing a MV of 1 (i.e., adynamic small bowel) was 0.953 (95% confidence interval, 0.923-0.984). Moreover, the optimal cutoff for the quantitative motility score was 0.024, with a sensitivity of 100% (15/15) and specificity of 89.9% (143/159). Conclusion: The quantitative motility score calculated from a cine MRI enables diagnosis of an adynamic small bowel, and potentially discerns various degrees of bowel motility.

• Korean Journal of Radiology
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• 제23권12호
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• pp.1260-1268
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• 2022

Objective: To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard. Materials and Methods: A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity > 90% and specificity > 90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set. Results: Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%). Conclusion: In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.

• 핵의학기술
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• 제28권1호
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• pp.57-69
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• 2024

Purpose: Quantitative analysis through count measurement in nuclear medicine planar images is limited by analysis techniques that are useful for obtaining various clinical information or by organ overlap or artifacts in actual clinical practice. On the other hand, the use of SPECT tomography images is quantitative analysis using volume rather than planar, which is not only free from problems such as projection overlap, but also has excellent quantitative accuracy. In the use of developing SPECT quantitative analysis technology, this study aims to compare the accuracy of quantitative analysis between ROI of the conventional planar images and VOI of the SPECT tomographic images in evaluating the count change happened by the volume change of the source. Materials and Methods: A ^99mTcO₄^- source(200.17 MBq) was filled with sterilized water in the syringe to create a phantom with an inner diameter volume of 60 cc, and a planar image and a SPECT image were obtained by reducing the volume by 15 cc (25%) respectively. ROI and VOI(threshold: 1~45%, 5% interval) were set for each image obtained to estimate true count and measure the total count, and compared with the preseted volumetric change rate(%). Results: When volume changes of 25%, 50%, and 75% occurred in the initial volume of 60 cc(100%) of the phantom, the average count changes of the measured planar image were 26.8%, 53.2%, 77.5%, and the average count changes of the SPECT image were 24.4%, 50.9%, and 76.8%. In this case, the VOI size(cm³) set showed an average change rate of 25.4%, 51.1%, and 76.6%. The highest threshold value for the accuracy of radioactive concentration by VOI size (average error -1.03%) was 35%, and the VOI size of the same threshold had an error of -17.1% on average compared to the actual volume. Conclusion: On average, the count-based volumetric change rate in nuclear medicine images was able to track changes more accurately using VOI than ROI, but there was no significant difference with relatively similar value. However, the accuracy of radioactive concentration according to individual VOI sizes did not match, but it is considered that a relatively accurate quantitative analysis can be expected when the size of VOI is set smaller than the actual volume.

• 한국지반공학회논문집
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• 제40권3호
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• pp.41-54
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• 2024

건설된 지반구조물을 안전하게 유지하기 위해 정기적인 모니터링은 매우 중요하다. 현재 유지관리를 위해 센서를 기반으로 하는 가속도, 변위계, 이미지를 기반으로 하는 레이저 혹은 드론 영상 촬영 등 지반구조물에 영향을 최소화할 수 있는 비파괴방식이 활용되고 있다. 해당 기술들은 표면의 변화를 관찰할 수 있지만, 내부 물성값 변화 파악에는 어려움이 있다. 지반구조물의 내부 물성값 변화를 모니터링하기 위해 현장 지반조사법이 도입될 수 있으며, 이를 위해 활용될 수 있는 비파괴시험에는 지오폰을 활용한 Spectral-Anlysis-of-Surface-Wave(SASW) 시험이 있다. SASW 시험은 비파괴시험이지만, 데이터 해석에 드는 시간과 분석에 어려움으로 인해 잦은 관찰을 요구하는 유지관리 모니터링의 용도로 활용이 어렵다. 하지만, 전단파 속도를 도출하는 복잡한 SASW 최종 해석이 아닌 분산곡선을 도출하는 1단계 해석만으로도 모니터링에 적용할 수 있다. 따라서, 본 논문에서는 SASW 시험을 모니터링에 활용하기 위해 분산곡선 도출에 필요한 위상각차 데이터에 관한 기초 연구를 수행하였다. 위상각차 구간별 신뢰도에 대해 검토하여 데이터 모니터링에 활용이 가능한 범위에 관하여 확인하였다. 이를 위해 단일 층으로 구성된 균질한 지반 현장에서 지오폰을 활용하여 계측한 위상각차 데이터들을 활용하였다. 본 연구를 통해 활용할 수 있는 위상각차 데이터 구간을 파악해 모니터링의 활용성을 높일 것으로 기대된다.

• Korean Journal of Radiology
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• 제22권5호
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• pp.688-698
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• 2021

Objective: To compare the lumen parameters measured by the location-adaptive threshold method (LATM), in which the inter- and intra-scan attenuation variabilities of coronary computed tomographic angiography (CCTA) were corrected, and the scan-adaptive threshold method (SATM), in which only the inter-scan variability was corrected, with the reference standard measurement by intravascular ultrasonography (IVUS). Materials and Methods: The Hounsfield unit (HU) values of whole voxels and the centerline in each of the cross-sections of the 22 target coronary artery segments were obtained from 15 patients between March 2009 and June 2010, in addition to the corresponding voxel size. Lumen volume was calculated mathematically as the voxel volume multiplied by the number of voxels with HU within a given range, defined as the lumen for each method, and compared with the IVUS-derived reference standard. Subgroup analysis of the lumen area was performed to investigate the effect of lumen size on the studied methods. Bland-Altman plots were used to evaluate the agreement between the measurements. Results: Lumen volumes measured by SATM was significantly smaller than that measured by IVUS (mean difference, 14.6 mm³; 95% confidence interval [CI], 4.9-24.3 mm³); the lumen volumes measured by LATM and IVUS were not significantly different (mean difference, -0.7 mm³; 95% CI, -9.1-7.7 mm³). The lumen area measured by SATM was significantly smaller than that measured by LATM in the smaller lumen area group (mean of difference, 1.07 mm²; 95% CI, 0.89-1.25 mm²) but not in the larger lumen area group (mean of difference, -0.07 mm²; 95% CI, -0.22-0.08 mm²). In the smaller lumen group, the mean difference was lower in the Bland-Altman plot of IVUS and LATM (0.46 mm²; 95% CI, 0.27-0.65 mm²) than in that of IVUS and SATM (1.53 mm²; 95% CI, 1.27-1.79 mm²). Conclusion: SATM underestimated the lumen parameters for computed lumen segmentation in CCTA, and this may be overcome by using LATM.

• 한국지리정보학회지
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• 제27권2호
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• pp.1-18
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• 2024

본 연구는 서울시에서 도로 방향과 가로수 식재형태가 여름철 도시 열환경에 미치는 영향을 분석하여 최적의 식재방식을 찾는 것을 목표로 하였다. 컴퓨터 시뮬레이션 프로그램 ENVI-met을 이용하여, 도로 4방향과 가로수 식재형태에 따라 68가지 시나리오를 수행하였다. 그 결과, 수목 식재 시 기온, 평균복사온도, 인간 열환경지수가 개선되는 것으로 나타났다. 평균복사온도의 감소는 도로와 접한 건물에 의한 태양 복사에너지 차단과 수목의 그늘효과에 기인하였으며, 도로방향은 풍속 감소에 영향을 주는 것으로 나타났다. 모든 시나리오에서 낮은 수고(6m), 넓은 수관폭(9m), 높은 엽면적 지수(3.0), 좁은 식재간격(8m)일 때 가장 큰 열환경 개선효과를 보였다. 도로 방향은 동-서 방향의 북측 보도에서 열환경이 가장 크게 개선되었다. 본 연구는 컴퓨터 시뮬레이션을 이용해 현실도시공간과의 차이를 감안해야 하고, 현장 실측과 더 많은 변수 고려를 통한 추가연구가 필요하다.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1077-1086
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• 2021

Objective: To investigate the diagnostic performance of quantitative ultrasound (US) parameters for the assessment of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Materials and Methods: In this single-center prospective study, 120 patients with clinically suspected NAFLD were enrolled between March 2019 and January 2020. The participants underwent US examination for radiofrequency (RF) data acquisition and chemical shift-encoded liver MRI for PDFF measurement. Using the RF data analysis, the attenuation coefficient (AC) based on tissue attenuation imaging (TAI) (AC-TAI) and scatter-distribution coefficient (SC) based on tissue scatter-distribution imaging (TSI) (SC-TSI) were measured. The correlations between the quantitative US parameters (AC and SC) and MRI-PDFF were evaluated using Pearson correlation coefficients. The diagnostic performance of AC-TAI and SC-TSI for detecting hepatic fat contents of ≥ 5% (MRI-PDFF ≥ 5%) and ≥ 10% (MRI-PDFF ≥ 10%) were assessed using receiver operating characteristic (ROC) analysis. The significant clinical or imaging factors associated with AC and SC were analyzed using linear regression analysis. Results: The participants were classified based on MRI-PDFF: < 5% (n = 38), 5-10% (n = 23), and ≥ 10% (n = 59). AC-TAI and SC-TSI were significantly correlated with MRI-PDFF (r = 0.659 and 0.727, p < 0.001 for both). For detecting hepatic fat contents of ≥ 5% and ≥ 10%, the areas under the ROC curves of AC-TAI were 0.861 (95% confidence interval [CI]: 0.786-0.918) and 0.835 (95% CI: 0.757-0.897), and those of SC-TSI were 0.964 (95% CI: 0.913-0.989) and 0.935 (95% CI: 0.875-0.972), respectively. Multivariable linear regression analysis showed that MRI-PDFF was an independent determinant of AC-TAI and SC-TSI. Conclusion: AC-TAI and SC-TSI derived from quantitative US RF data analysis yielded a good correlation with MRI-PDFF and provided good performance for detecting hepatic steatosis and assessing its severity in NAFLD.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1266-1278
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• 2021

Objective: We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique. Materials and Methods: We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation. Results: The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm², 0.82 ± 0.34 cm², and 0.80 ± 0.26 cm², respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94-0.97) and 0.87 (95% CI, 0.82-0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96-0.98) and 0.98 (95% CI, 0.97-0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89-0.94) and 0.91 (95% CI, 0.88-0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82-0.91) vs. 0.85 (95% CI, 0.79-0.89). Conclusion: High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.