Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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High-Resolution Contrast-Enhanced 3D-Spoiled Gradient-Recalled Imaging for Evaluation of Intracranial Vertebral Artery and Posterior Inferior Cerebellar Artery in Lateral Medullary Infarction

고해상도 조영증강 삼차원 회손기울기 회상 영상을 이용한 측면연수경색 환자의 두개내 척추동맥 및 뒤아래소뇌동맥 평가

  • Yoon, Youngno (Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine) ;
  • Ahn, Sung Jun (Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine) ;
  • Suh, Sang Hyun (Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine) ;
  • Park, Ah Young (Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine) ;
  • Chung, Tae-Sub (Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine)
  • 윤영노 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 안성준 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 서상현 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 박아영 (연세대학교 의과대학 강남세브란스병원 영상의학과) ;
  • 정태섭 (연세대학교 의과대학 강남세브란스병원 영상의학과)
  • Received : 2013.12.19
  • Accepted : 2014.03.14
  • Published : 2014.03.30
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Abstract

Purpose : To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). Materials and Methods: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. Results: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). Conclusion: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

목적: 측면연수경색 환자의 두개내 척추동맥 및 뒤아래소뇌동맥 평가에 있어 고해상도 조영증강 삼차원 회손기울기에 코 회상영상의 역할 규명하고자 한다. 대상과 방법: 임상시험심사위원회에서 승인한 측면연수경색으로 확진된 25명의 환자를 대상으로 하였다. 모든 환자는 3T 자기공명 영상을 이용한 고해상도 조영증강 삼차원 회손기울기에코 회상영상과 조영증강 자기공명 혈관조영술을 받았다. 두 명의 영상의학과 의사는 환자의 임상정보와 확산강조영상 없이 두개내 척추동맥 및 뒤아래소뇌동맥에 있는 동맥병변을 평가하였다. 두개내 척추동맥과 뒤아래소뇌동맥의 병변 동반유무에 따라 임상정보와 측면연수경색의 넓이, 소뇌경색 동반여부를 비교하였다. 결과: 총 25명의 환자 중 22명의 환자가 고해상도 조영증강 삼차원 회손기울기에코 회상영상으로 두개내 척추동맥 및 뒤아래소뇌동맥에서 박리, 죽종, 혈전색전증을 보였다. 그러나 그 중 12개의 뒤아래소뇌동맥의 병변은 조영증강 자기공명 혈관조영술에서 보이지 않았다. 추가적인 소뇌경색은 두개내 척추동맥과 뒤아래소뇌동맥에 병변이 있을 경우 두개내 척추동맥에만 병변이 있는 경우보다 빈번하게 나타났다. 결론: 고해상도 조영증강 삼차원 회손기울기에코 회상영상은 측면연수경색 환자의 두개내 척추동맥 및 뒤아래소뇌동맥의 병변평가에 도움을 줄 수 있다.

Keywords

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