• Proceedings of the KSMRM Conference
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• 2002.11a
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• pp.82-82
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• 2002

목적： Phase cycling과 fat suppression을 기존 STEAM 펄스시퀀스에 추가 및 최적화함으로써 3.0T 1H MRS 스펙트럼의 quality를 향상시키는 데 그 목적이 있다. 대상 및 방법： 가톨릭의대에 설치된 3.0T MRI를 이용하여 STEAM 펄스시퀀스를 최적화하였다. 우선 CHESS 펄스시퀀스를 이용하여 물 신호를 억제하고, 대사물질의 신호에 영향을 주는 fat 신호를 제거하도록 펄스시퀀스 최적화를 시험하였다. 또한 Phase cycling을 이용하여 Noise 신호를 제거하였다. 스펙트럼을 분석하기 위하여 본 사에서 개발한 MaqSpec 프로그램을 이용하였고, Post-processing을 한 후 펄스시퀀스 변경 전후의 MRS 스펙트럼을 비교하였다.

• The Korean Journal of Nuclear Medicine
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• v.34 no.6
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• pp.465-477
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• 2000

Purpose: Thallim-201 ($^{201}Tl$) brain SPECT and proton ($^1H$) magnetic resonance spectroscopy (MRS) have been used to evaluate tumor grade and viability of glioma. We assessed the correlations between $^{201}Tl$ brain index or spectrum of metabolites of $^1H$ MRS and grade of glioma or histopathologic findings. Materials and Methods: We studied 17 patients (4 astrocytoma, 7 anaplastic astrocytoma and 6 glioblastoma). On $^{201}Tl$ Brain SPECT, $^{201}Tl$ index was measured as the ratio of average counts for region of interest to those for the contralateral normal brain. On $^1H$ MRS, we calculated choline (Cho) /creatine (Cr) ratio and N-acetylaspartate (NAA)/Cr ratio in ROI defined as tumor center. Histopathologic findings were graded by Ki-67 index, cellularity, mitosis, pleomorphism, necrosis and endothelial proliferation. An unpaired t test and statistical correlations were performed to evaluate these data. Results: Tl-index showed the best correlation with Ki-67 index (p<0.01), less correlations with cellularity, mitosis, and endothelial proliferation, but no correlation with results of MRS, pleomorphism, or necrosis. The findings of MRS did not correlate with all of the above. The cases of glioblastoma demonstrated a higher Tl-index, Cho/cr ratio, Ki-67 index and lower NAA/Cr ratio, albeit without statistical significance. Conclusion: Even though $^{201}Tl$ brain SPECT did not correlate directly with grade of malignancy, it may still be useful in determining biological aggressiveness of tumor and prognosis of patients because it correlated well with Ki-67 index, a growth fraction of glioma, cellularity, mitosis and endothelial proliferation.

• Sleep Medicine and Psychophysiology
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• v.28 no.1
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• pp.18-26
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• 2021

Sleep is essential to brain function and mental health. Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders, and are major public health concerns. Proton magnetic resonance spectroscopy (¹H-MRS) is a non-invasive method of quantifying neurometabolite concentrations. Therefore, ¹H-MRS studies on individuals with sleep disorders may enhance our understanding of the pathophysiology of these disorders. In this article, we reviewed ¹H-MRS studies in insomnia and OSA that reported changes in neurometabolite concentrations. Previous studies have consistently reported insomnia-related reductions in γ-aminobutyric acid (GABA) levels in the frontal and occipital regions, which suggest that changes in GABA are important to the etiology of insomnia. These results may support the hyperarousal theory that insomnia is associated with increased cognitive and physiological arousal. In addition, the severity of insomnia was associated with low glutamate and glutamine levels. Previous studies of OSA have consistently reported reduced N-acetylaspartate (NAA) levels in the frontal, parieto-occipital, and temporal regions. In addition, OSA was associated with increased myo-inositol levels. These results may provide evidence that intermittent hypoxia induced by OSA may result in neuronal damage in the brain, which can be related to neurocognitive dysfunction in patients with OSA. The current review summarizes findings related to neurochemical changes in insomnia and OSA. Future well-designed studies using ¹H-MRS have the potential to enhance our understanding of the pathophysiology of sleep disorders including insomnia and OSA.

• Progress in Medical Physics
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• v.11 no.1
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• pp.73-83
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• 2000

In this study, we investigate the effects of poor shimming on quantitative measurement of ratios of metabolite levels by proton magnetic resonance spectroscopy ($^1$H MRS). Coefficient of variation (COV) of metabolite ratios for point resolved spectroscopy (PRESS) and stimulated-echo acquisition mode (STEAM) spectra was evaluated from a phantom containing in vivo levels of metabolites using a conventional whole body 1.5T MR system and conventional acquisition and analysis protocol. A statistical P-value was also calculated from a linear regression for relationship of metabolite ratios. N-acetylaspartate (NAA)/ creatine (Cr) and NAA/ choline (Cho) had low COV values for the long and short TE spectra (29.1 and 27.5%; 23.8 and 12.6 %), whereas Cho/Cr and Cr/Cho had high COV values (50.0 and 68.6 %; 27.5 and 29.3 %). A linear relationship between NAA/Cr and Cho/Cr, and between NAA/Cho and Cr/Cho revealed the statistical significance in the long and short TE spectra, respectively (P < 0.0001 and P < 0.0001; P = 0.015 and P = 0.005). There was no significant relationship between Cho/NAA and Cr/NAA in the measurement (P = 0.159; P = 0.910). The present study suggested that NAA/Cr and NAA/Cho could be useful for data with poor shimming in $^1$H MR spectroscopy. In conclusion, statistical significance of metabolite ratios indicated that the Cr and Cho levels could be interpreted as a significant alteration factor in the long and short TE spectra, and then should be used with care to provide precise metabolite quantification.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1233-1237
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• 2000

Objectives : In order to evaluate the metabolic changes associated with pericontusional edematous area in mild head injury, proton magnetic resonance spectroscopy(1H-MRS) was performed in mild head injury patients (initial GCS score 13-15) with focal brain contusion. Methods : Seven head injury patients with initial GCS 13-15(3 males and 4 females : age range 15-65 years, mean age 33 years) have underwent 1H-MRS evaluations. The patients were examined within 7 days after injury(n=7) and 2 months after injury(n=5). The region of interest(ROI) was selected in the edematous area adjacent to traumatic brain contusion upon T2-weighted MR images and a corresponding region of the contralateral hemisphere (ROC, region of contralateral corresponding hemisphere) was examined as well. The metabolic ratios of NAA/Cr and lactate/Cr were compared between ROIs, ROCs and control values. Results : In initial NAA/Cr ratios, the values of ROIs were significantly lower than those of the controls(p=0.009), but there was no difference either between ROIs and ROCs(p=0.410) or between ROCs of patients and the control (p=0.199). In lactate/Cr ratios, the ROIs in all seven patients and the ROCs in two showed increased lactate signals. The lactate/Cr ratios of the ROIs were significantly elevated as compared to those of the ROCs(p=0.02) and the control(p=0.015). In two months follow-up, lactate signals were absent or significantly reduced(p=0.015). In no patients, clinical or radiological deterioration has been observed. Conclusion : Our 1H-MRS results demonstrate that there are significant ischemic changes in pericontusional edematous areas as indicated by elevated lactate signals in the patients with mild head injury. But there were no consistent neural loss or dysfunction in these area. There findings suggest that pericontusional edematous areas can be vulnerable to secondary brain insults even in the patients with mild head injury.

• Investigative Magnetic Resonance Imaging
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• v.7 no.1
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• pp.31-38
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• 2003

Purpose : To analyze the serial changes of proton magnetic resonance (MR) spectra in the abscess and to determine the effect of the antibiotic treatment on the metabolite patterns. Materials and Methods : MR imaging and MR spectroscopy of an experimentally induced abscess were performed sequentially for four weeks at interval of one week in both the control group (n=5) and the antibiotic treatment group (n=5). On MR imaging, the shape and the size of the abscess were analyzed. On MR spectroscopy, the resonance peaks of metabolites were assigned on the basis of reported peaks in the literature. The metabolite ratios measured by using N-acetyl alanine as an external reference and by using lipid as an internal reference were compared in both the control and treatment g roups. Results : The abscesses were seen as cystic masses on MR imaging. On MR spectroscopy, the variable peaks of acetate, succinate and various amino acids, which are the metabolites of infection, were identified in the control and antibiotic treatment groups. The most frequent peak was that of acetate at 1.92ppm (70%). Both the peak ratios of acetate to lipid and acetate to external reference tended to decrease in the treatment group while the ratios did not change significantly in the control group. Conclusion : MR spectroscopy is useful not only for the diagnosis of abscess but also for monitoring the evolution of the abscess by using the acetate peak.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.135-135
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• 2001

Purpose： To know the differences of the proton MR spectroscopic features of the liver between th patients with graft-versus-host disease (GVHD) and without GVHD (non-GVHD) after to marrow transplantation (BMT), and to evaluate the possibility to discriminate GVHD fro non-GVHD by analysis of the in vivo proton MR spectra. Method： We evaluated the in vivo proton MR spectra from the livers of 37 patients wh underwent BMT. Our series included 14 cases with GVHD and 23 without GVHD in the liver. Nineteen men and 18 women were included in our series. All cases of GVHD and 2 o non-GVHD were confirmed by liver biopsy and remaining of non-GVHD by evaluation clinical follow up. Proton MR spectroscopy (1H-MRS) was performed at 1.5T GE Sign Horizon (GE Medical System, Milwaukee, USA) system using localized proton STEAM sequence and body coil in all cases with subjects were located in supine position. N respiratory interruption was required during the spectroscopic signal acquisition. Paramete using in MRS were： TR = over 3000ms, TE = 30ms, number of scans = 128, voxel size = ($2{\times}2{\times}2$)$cm^3$, and one NEX. We evaluated the spectra with an attention to the differences o patterns of the peaks between GVHD and non-GVHD groups. The ratio of peak area of peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P(1.6-4.1ppm)/P(0.9-1.6ppm)] was calculated in GVHD and non-GVHD group, and compared the results between these groups. We als evaluated the sensitivity and specificity for discriminating GVHD from non-GVHD by anal of 1H-MRS.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.74-74
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• 2003

Purpose: To investigate whether there are significant changes in regional brain metabolism in patients with Parkinson's disease after thalamotomy using proton magnetic resonance spectroscopy (lH MRS). Methods: Fifteen patients with Parkinson's disease of mean age 56.5 years (7 males and 8 females; mean age, 56.5 years) that have treated with levodopa were included. All patients with tremor experienced amelioration of their symptoms on the side contralateral to the thalamotomy. As a single-voxel technique, 1H MR spectra were obtained from the volume of interested regions in thalamus and primary motor cortex. Spectral parameters were: 20 ms TE, 2000 ms TR, 128 averages, 2500 Hz spectral width, and 2048 data points. Results: We found that NAA/Cho ratios showed generally low levels in thalamus in Parkinson's disease patients with clinical improvement following thalamotomy. Conclusions: 1H MRS may be a useful utility for the aid in better understanding the pathophy-siologic process in Parkinson's disease patients on the basis of the variation of NAA/Cho ratio. Acknowledgement: This study was supported by a grant of the Center for Functional and Metabolic Imaging Technology, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV07-0002).

• Investigative Magnetic Resonance Imaging
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• v.8 no.2
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• pp.79-85
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• 2004

Purpose : To evaluate the usefulness and reproducibility of $^1H$ MRS in different 1.5 T MR machines with different coils to compare the SNR, scan time and the spectral patterns in different brain regions in normal volunteers. Materials and Methods : Localized $^1H$ MR spectroscopy ($^1H$ MRS) was performed in a total of 10 normal volunteers (age; 20-45 years) with spectral parameters adjusted by the autoprescan routine (PROBE package). In all volunteers, MRS was performed in a three times using conventional MRS (Signa Horizon) with 1 channel coil and upgraded MRS (Echospeed plus with EXCITE) with both 1 channel and 8 channel coil. Using these three different machines and coils, SNRs of the spectra in both phantom and volunteers and (pre)scan time of MRS were compared. Two regions of the human brain (basal ganglia and deep white matter) were examined and relative metabolite ratios (NAA/Cr, Cho/Cr, and mI/Cr ratios) were measured in all volunteers. For all spectra, a STEAM localization sequence with three-pulse CHESS $H_2O$ suppression was used, with the following acquisition parameters: TR=3.0/2.0 sec, TE=30 msec, TM=13.7 msec, SW=2500 Hz, SI=2048 pts, AVG : 64/128, and NEX=2/8 (Signa/Echospeed). Results : The SNR was about over $30\%$ higher in Echospeed machine and time for prescan and scan was almost same in different machines and coils. Reliable spectra were obtained on both MRS systems and there were no significant differences in spectral patterns and relative metabolite ratios in two brain regions (p>0.05). Conclusion : Both conventional and new MRI systems are highly reliable and reproducible for $^1H$ MR spectroscopic examinations in human brains and there are no significant differences in applications for $^1H$ MRS between two different MRI systems.

• Journal of the Institute of Electronics Engineers of Korea SP
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• v.39 no.5
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• pp.544-555
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• 2002

The aim of this study is to develop the $^1H$-MRS data postprocessing software for both single-voxel and multi-voxel technique, which plays and important role as a diagnostic tool in clinical field. This software is based on graphical user interface(GUI) under windows operating system of personal computer(PC). In case of single-voxel MRS, both of raw data in time-domain and spectrum data in frequency-domain are simultaneously displayed in a screen. Several functions such as DC correction, zero filling, line broadening, Lorentz-Gauss filtering and phase correction, etc. are included to increase the quality of spectrum data. In case of multi-voxel analysis, spectroscopic image reconstructed by 3-D FFT was displayed as a spectral grid and overlapped over previously obtained T1- or T2-weighted image for the spectra to be spatially registered with the image. The analysis of MRS peaks were performed by obtaining the ratio of peak area. In single-voxel method, statistically processed peak-area ratios of MRS data obtained from normal human brain are presented. Using multi-voxel method, MR spectroscopic image and metabolite image acquired from brain tumor are demonstrated.