• 제목/요약/키워드: thyroid imaging

검색결과 159건 처리시간 0.031초

갑상선 안병증으로 오인된 비강 내 횡문근육종의 양쪽 외안근 전이: 증례 보고 (Bilateral Extraocular Muscle Metastasis of Nasal Rhabdomyosarcoma Mimicking a Thyroid Associated Orbitopathy: A Case Report)

  • 신진호;이정현;임현경;이하영;박지원;백혜진;최영준;안진희;백정환
    • Investigative Magnetic Resonance Imaging
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    • 제15권2호
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    • pp.176-180
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    • 2011
  • 안와에 발생하는 전이암은 주로 안와 지방이나 뼈에 발생하며 한쪽에 국한되어 발생하고, 양쪽 외안근의 미만성비대 형태로 발생하는 경우는 매우 드물다. 저자들은 코에 생긴 횡문근육종 환자에서 치료 후 추적 관찰 중 발생한 안와의 전이암이 양쪽 외안근의 미만성 비대 형태로 발생하여 갑상선 안병증으로 오인되었던 1예를 보고하고 갑상선 안병증과 감별하는데 도움을 받을 수 있는 소견이 무엇인지에 대해 분석해 보고자 한다.

Conventional Ultrasonography and Real Time Ultrasound Elastography in the Differential Diagnosis of Degenerating Cystic Thyroid Nodules Mimicking Malignancy and Papillary Thyroid Carcinomas

  • Wu, Hong-Xun;Zhang, Bing-Jie;Wang, Jun;Zhu, Bei-Lin;Zang, Ya-Ping;Cao, Yue-Long
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.935-940
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    • 2013
  • Background: To evaluate the diagnostic utility of conventional ultrasonography and real time ultrasound elastography in differentiating degenerating cystic thyroid nodules mimicking malignancy from papillary thyroid carcinoma. Methods: We retrospectively analyzed conventional ultrasonographic and elastographic characteristics of 19 degenerating cystic thyroid nodules mimicking malignancy in 19 patients, with 30 surgically confirmed PTCs as controls. Based on size, the nodules had been grouped into less than 10mm (group A) and greater than 10 mm (group B). We evaluated conventional parameters and elasticity pattern. Color-scaled elastograms were graded as to stiffness of nodules using an elasticity pattern from I (soft) to IV (stiff). Results: Degenerating cystic thyroid nodules were similar to PTCs in conventional ultrasonographic findings, but the former frequently showed oval to round in shape (group A, 69.2% vs 18.8%, P=0.017; group B, 66.7% vs 7.14%, P=0.017) and punctuate hyperechoic foci (group A, 61.5% vs 0, P<0.001; group B, 50% vs 0, P<0.001). On real time ultrasound elastography, 7 of 13 degenerating cystic thyroid nodules in group A were pattern I, 5 were pattern II, 1 was pattern III. One degenerating cystic thyroid nodule in group B was pattern II, 5 were pattern III. The area under the curve for elastography was 0.98 in group A (sensitivity 92.3%, specificity 100%, P = 0.002), and 0.88 in group B (sensitivity 16.7%, specificity 100%, P = 0.014). Conclusions: As a dependable imaging technique, elastography helps increase the performance in differential diagnosis of degenerating cystic thyroid nodule and malignancy.

유방촬영 시 갑상샘의 피폭선량 경감을 위한 Al Face Block 제작 및 유용성에 관한 연구 (The Usefulness of Al Face Block Fabrication for Reducing Exposure Dose of Thyroid Glands in Mammography)

  • 홍은애;이인자
    • 대한방사선기술학회지:방사선기술과학
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    • 제36권1호
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    • pp.11-17
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    • 2013
  • 최근 환자가 안심하고 진료를 받을 수 있도록 의료 환경의 변화에 따라 의료 피폭 저감화 대책이 국내, 국제적으로 추진되고 있다. 연구자는 유방촬영 시 보다 안전하게 검사를 받을 수 있도록 환자의 방사선 피폭에 대한 방어 및 안전 관리가 절실 하다고 생각되어 본 차폐체를 개발하고, 제작하게 되었다. 임상에서 사용 중인 유방촬영 장치로 SID 65 cm, 조건 28 kVp, 63 mAs, 측정기는 Victoreen 6000-529(Fluke Co.)를 이용하여 제작한 Face Block을 사용하여, 환자 30명을 대상으로 실제 갑상샘 위치에 Chamber를 놓고 CC, MLO를 촬영해 Face Block장착 전, 후 선량을 측정하였다. 그 결과 Face Block 장착 후 CC View에서 평균 65.9%의 선량이 감소되었고, MLO View에서는 평균 60.7%의 선량이 감소되었으며, 영상의 질에는 큰 변화가 없었다. 따라서 유방촬영 시 갑상샘의 피폭을 줄이고, 실용적이고, 유용한 실제 Face Block을 개발한 것에 큰 성과가 있었다고 생각되며, 유방촬영 시 환자들의 피폭에 관한 불안감을 해소시켜, 환자 만족도 증대와 함께 환자 피폭선량 경감에 크게 이바지 할 것으로 기대하며, 피폭선량을 줄일 수 있는 방안을 끊임없이 노력해야 할 것이다.

의사결정트리 프로그램 개발 및 갑상선유두암에서 질량분석법을 이용한 단백질 패턴 분석 (Development of Decision Tree Software and Protein Profiling using Surface Enhanced laser Desorption/lonization - Time of Flight - Mass Spectrometry (SELDI-TOF-MS) in Papillary Thyroid Cancer)

  • 윤준기;이준;안영실;박복남;윤석남
    • Nuclear Medicine and Molecular Imaging
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    • 제41권4호
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    • pp.299-308
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    • 2007
  • 본 연구의 목적은 의사결정트리를 생성하는 생물정보학 프로그램을 개발하고, 이를 갑상선유두암 혈청의 질량분석자료로 시험해 보는 것이다. 대상 및 방법: C4.5를 커스터마이징하여 의사결정트리 분석을 수행할 수 있는 'Protein analysis'라는 프로그램을 개발하였다 61개의 혈청시료(갑상선유두암 27, 자가면역성 갑상선염 17, 대조군 17)를 일정 기간 동안 순차적으로 냉동한 후 실온에서 일시에 해동하여 분석에 사용하였다. 모든 시료는 탈지질화 과정을 거쳐 준비한 후, 2종류의 단백질칩(CM10, IMAC3)에 각각 60개, 50개 시료를 적용하였다. 갑상선유두암의 특징적인 단백질 패턴을 찾기 위해 질량분석기를 이용하여 단백질칩을 분석했다. 'Protein analysis' 프로그램을 이용하여 단백질분포 자료로부터 의사결정트리를 작성하고, 생체표지자 후보물질을 검출하였다. CM10칩에서 발견된 생체표지자 후보물질을 무작위 표본추출 방법을 이용하여 검증하였다. 결과: 단백질분포 자료의 훈련과 검증이 가능한 의사결정트리 프로그램이 개발되었으며, 이 프로그램은 트리 구조와 노드 정보, 트리 구성 과정을 표시하는 3개의 창으로 구성되었다. CM10칩을 이용한 분석에서 총 113개의 단백질 피크 중 23개가 3그룹 간에 유의한 차이가 있었으며, IMAC3는 41개의 단백질 피크 중 8개가 3그룹 간에 유의한 차이가 있었다. 3그룹 분석에서 의사결정트리는 CM10칩과 IMAE3의 단백질분포 자료로부터 각각 60개와 50개의 시료를 높은 정확도로 분류하였으며(오차율 = 각각 3.3%, 2.0%), 각각 4개와 7개의 생체표지자 후보물질을 검출하였다. 암시료와 비암시료를 구분하는 2그룹 분석 에서, 의사결정트리는 모든 암시료를 정확히 구분하였으며(모두 오차율 = 0%), CM10칩을 이용한 분석에서는 단일 노드를 사용하고, IMAC3칩을 이용한 분석에서는 여러 개의 노드를 사용하였다. CM10칩의 단백질 분포자료를 5번의 무작위 추출에 의해 시행한 검증에서 암시료와 비암시료를 구분하는데 높은 정확도를 보였으나(정확도 = 98%, 54/55), 3그룹을 구분할 때는 중등도의 정확도를 보였다(정확도 = 65%, 36/55). 결론: 우리가 개발한 프로그램은 질량분석 자료로부터 성공적으로 의사결정트리를 생성하고, 생체표지자 후보물질을 검출할 수 있었다. 따라서 이 프로그램은 혈청 시료를 이용한 생체표지자 발굴 및 갑상선유두암의 추적관찰에 유용하게 사용될 수 있을 것이다.

Psychotic Symptoms of Hashimoto's Encephalopathy: A Diagnostic Challenge

  • Savarimuthu, Monisha K;Tsheringla, Sherab;Mammen, Priya
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제30권1호
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    • pp.42-44
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    • 2019
  • Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

갑상선암 환자에서 관찰된 뇌수막종의 위양성 옥소 섭취 (False-positive I-131 Uptake in Meningioma)

  • 정신영;서지형;배진호;황정현;안병철;이재태;이규보
    • 대한핵의학회지
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    • 제38권3호
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    • pp.272-273
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    • 2004
  • We experienced a case with meningioma showing false positive I-131 uptake. A 55-years old female patient underwent high dose (150 mCi) radioactive iodine therapy to ablate remnant tissue after total thyroidectomy for papillary thyroid cancer. in addition to intense tracer uptake in thyroid bed, there was mild but focal abnormal uptake in left frontal lobe of the brain on post-therapy I-131 whole body scan. Subsequent brain MR imaging showed single mass lesion in left frontal lobe and the mass was resected under the impression of brain metastasis of thyroid carcinoma. Pathologic report confirmed meningioma from the surgical specimen.

Effectiveness of Ultrasonographic Screening for Thyroid Cancer: Round-table Conference in the National Evidence-based Healthcare Collaborating Agency (NECA) in conjunction with the Korean Thyroid Association

  • Shin, Sangjin;Park, Sae Eun;Kim, Soo Young;Hyun, Min Kyung;Kim, Sun Wook;Kwon, Jin Won;Kim, Yeol;Kim, Won Bae;Na, Dong Gyu;Park, Hyun-Ah;Sheen, Seung Soo;Yi, Ka Hee;Chang, Hang-Seok;Cho, Jung Jin;Chung, Jae Hoon
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.5107-5110
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    • 2014
  • Background: The incidence rate of thyroid cancer has been increasing worldwide in recent years, and it is also the most prevalent cancer when it comes to the number of patients among Korean women. With it, ultrasonographic screening test has also become very common. However, there is still controversy over the performance of this screening test. Therefore, the National Evidence-based Healthcare Collaborating Agency (NECA) organized a Round-table Conference on the issues regarding ultrasonographic screening for thyroid cancer in Korea. The objective of the conference was mainly about delivering worthwhile information reflecting social value for the current situation, which was based on evidence surrounding thyroid cancer screening that relevant experts investigated and agreed on. The significance of this Round-table Conference lies in the fact that we reviewed the current evidence, and we were able to discuss the social value and future direction for ultrasonographic screening in Korea.

Sonographic Diagnosis of Cervical Lymph Node Metastasis in Patients with Thyroid Cancer and Comparison of European and Korean Guidelines for Stratifying the Risk of Malignant Lymph Node

  • Sae Rom Chung;Jung Hwan Baek;Yun Hwa Rho;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • 제23권11호
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    • pp.1102-1111
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    • 2022
  • Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.