• Journal of radiological science and technology
• /
• v.32 no.4
• /
• pp.461-469
• /
• 2009

To predict the tumor grading, various imaging modalities have been applied clinically. This study determines clinical usefulness of perfusion MRI, using relative cerebral blood volume in grading of the gliomas. We did a retrospective review of 17 patients (mean age, 57.5 years; 11 male, 6 female) who underwent perfusion MR and conventional MRI, and then correlated pathologically after operation. Statistical analysis of regional cerebral blood volume and relative cerebral blood volume(rCBV) was performed by using softwares such as PAT by SIEMENS and Xmap ver 2.0 developed by ourselves. Six patients out of 13 were low-grade gliomas while eleven patients were the high-grade gliomas. Mean relative CBV (m_rCBV/white matter) in the low-grade gliomas was 1.62, and mean relative CBV(m_rCBV/cortex) was 0.12. In the high-grade gliomas, mean relative CBV(m_rCBV/white matter) and mean relative CBV(m_rCBV/cortex) were 33.53 and 0.96. Mean relative CBV of gliomas were elevated with a statistical difference(P<.05), compared with contralateral white matter(P=.019) or cortex(P=.025). Furthermore mean relative CBV(m_rCBV/white matter) was much higher than mean relative CBV(m_rCBV/cortex). Perfusion MRI using regional cerebral blood volume and rCBV is very useful imaging modality for grading the glioma.

• Clinical and Experimental Pediatrics
• /
• v.51 no.12
• /
• pp.1342-1345
• /
• 2008

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare white matter disorder, first described in the early 1990s. The brain in patients with MLC appears swollen on MRI, with diffuse white matter abnormalities; in addition, there is an invariable presence of subcortical cysts, primarily in the anterior temporal region sparing the deep white matter, basal ganglia, thalami, and cerebellum. Patients with MLC present with macrocephaly and neurological abnormalities such as motor deterioration, ataxia, spasticity, and cognitive deficits. We report a twenty-month-old boy who presented with seizures and macrocephaly, delay in development, and abnormal brain MRI findings compatible with the diagnosis of MLC. The brain MRI revealed bilateral hypersignal intense subcortical white matter regions in the frontal, temporal, and parietal lobes on T2-weighted images, which were not yet associated with cystic changes. During follow-up, the frequency of seizures decreased after anticonvulsant medication was started, but the head circumference remained above the 97th percentile, and the patient continued to have developmental delay.

• Clinical and Experimental Pediatrics
• /
• v.51 no.11
• /
• pp.1205-1210
• /
• 2008

Purpose : The development of the corpus callosum occupies the entire period of cerebral formation. The myelination pattern on magnetic resonance imaging (MRI) is very useful to evaluate neurologic development and to predict neurologic outcome in high risk infants. The thickness of the corpus callosum is believed to depend on the myelination process. It is possible to calculate the length and thickness of the corpus callosum on MRI. Thus, we can quantitatively evaluate the development of the corpus callosum. We investigated the clinical significance of measuring various portions of the corpus callosum in neonate with neurologic disorders such as hypoxic brain damage and seizure disorder. Methods : Forty-two neonates were evaluated by brain MRI. We measured the size of the genu, body, transitional zone, splenium, and length of the corpus callosum. Each measurement was divided by the total length of the corpus callosum to obtain its corrected size. The ratio of corpus callosal length and the anteroposterior diameter of the brain was also measured. Results : There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy. Conclusion : The abnormal size of the corpus callosum showed a good correlation with periventricular leukomalacia and hypoxic ischemic encephalopathy in neonates. We can predict clinical neurological problems by estimation of the corpus callosum in the neonatal period.

• Clinical and Experimental Pediatrics
• /
• v.50 no.9
• /
• pp.901-904
• /
• 2007

Purpose : Reversible posterior leukoencephalopathy syndrome is a complex disorder with characteristic clinical and radiologic findings that mainly involve the white/gray matter of the parieto-occipital lobes. The purpose of this study was to determine its clinical and radiological characteristics. Methods : A total of 15 pateints were involved in the study. Their medical records and radiological features of brain MRI were retrospectively reviewed and analyzed. Results : Fifteen pateints were involved. (9 males and 5 females). The patients' ages ranged from 2-20 years (mean age : 10 years). The brain MRI revealed fairly symmetric areas of increased T2 signal involving both white and gray matter of parieto-occipital regions. The condition seemed to be associated with cyclosporin A and steroid therapy or a variety of other conditions in which blood pressure rises acutely. Conclusion : Reversible posterior leukoencephalopathy syndrome is a complicated neurological condition, but a better understanding of this complex syndrome may obviate unnecessary investigations and lead to prompt and appropriate management of the associated problems.

• Clinical and Experimental Pediatrics
• /
• v.46 no.10
• /
• pp.966-971
• /
• 2003

Purpose : It is now well established that infection and inflammation play an important role in the pathogenesis of ischemic brain damage. The loss of neutrophils from systemic circulation is an associated finding in injury mediated by granulocyte. Periventricular leukomalacia(PVL) caused by ischemia is the principal form of brain injury in premature infants. This study was conducted to evaluate whether the low neutrophil count is associated with periventricular leukomalacia(PVL) in premature infants. Methods : Retrospective review of medical records was undertaken. Subjects were premature infants with a birth weight of less than 1,500 gm, admitted to the Neonatal Intensive Care Unit of Kyungpook University Hospital. A complete blood count of peripheral blood was done within the 1st hour of life. Neutropenia was defined as absolute neutrophil count < $1,500/mm^3$, PVL as increased periventricular echodensities followed by cyst formation on ultrasonography or corresponding signs on brain MRI. Results : Thirteen infants out of a total population of 37 revealed neutropenia. Respiratory distress syndrome and requirement for respiratory support were not different between infants with neutropenia( neutropenia group) and infants without neutropenia(control group). Intraventricular hemorrhage (IVH) and grade 3 and 4 IVH were more frequent in neutropenia group(P<0.05). There was no statistically significant increase of PVL in neutropenia group. The neutrophil count was $18,760.0{\pm}10,266.1/mm^3$, $7,272.0{\pm}7,435.0/mm^3$ infants with PVL and $11,131.7{\pm}3,386.5/mm^3$, $2,407.5{\pm}1,933.1/mm^3$ in infants without PVL, respectively. The frequency of mechanical ventilation and artificial surfactant therapy was higher in infants with PVL compared with infants without PVL, but statistical analysis was not performed due to small number of subjects. Conclusion : A low number of neutrophils in the systemic circulation was not associated with an increased risk of PVL in premature infants.

• Proceedings of the Korea Multimedia Society Conference
• /
• 2001.06a
• /
• pp.185-188
• /
• 2001

의료 영상 처리 기술은 질병의 진단 및 치료를 위한 계획이나 방법을 결정하는데 있어 매우 중요한 역할을 하고 있다. 뇌 MR 영상에서의 질병 진단을 위한 전처리 단계로서 필수적으로 이루어져야 하는 단계가 영상 분할 단계이다. 본 논문에서는 뇌의 질병 진단에 사용할 수 있는 자료를 제공하기 위한 뇌 영상 분할 방법을 제시한다. T2 강조 영상의 반전된 영상에서 원본 영상을 뺀 차이 영상의 결과로 회백질·뇌척수액·비정상 영역이 두드러지게 나타나는 점을 이용해 회백질 뇌척수액·비정상 영역과 백질 영역을 분리하는 방법을 제안한다. 또한 뇌척수액 영역의 위치 정보와 몇 가지 특징들을 정의하여 분할되어진 회백질·뇌척수액· 비정상 영역에서 뇌척수액 영역만을 분할하는 방법을 제시한다. 600 여 개의 T2 강조 영상에 대해서 실험을 행하러 비교적 정확한 분할 결과를 유도할 수 있었음을 확인하였다.

• Progress in Medical Physics
• /
• v.24 no.2
• /
• pp.108-118
• /
• 2013

Currently, an arterial spin labeling (ASL) magnetic resonance imaging (MRI) technique does not routinely used in clinical studies to measure perfusion in brain because optimization of imaging protocol is required to obtain optimal perfusion signals. Therefore, the objective of this study was to investigate changes of perfusion-weighed signal intensities with varying several parameters on a pulsed arterial spin labeling MRI technique obtained from a 3T MRI system. We especially evaluated alternations of ASL-MRI signal intensities on special brain areas, including in brain tissues and lobes. The signal targeting with alternating radiofrequency (STAR) pulsed ASL method was scanned on five normal subjects (mean age: 36 years, range: 29~41 years) on a 3T MRI system. Four parameters were evaluated with varying: 1) the labeling gap, 2) the labeling delay time, 3) the labeling thickness, and 4) the slice scan order. Signal intensities were obtained from the perfusion-weighted imaging on the gray and white matters and brain lobes of the frontal, parietal, temporal, and occipital areas. The results of this study were summarized: 1) Perfusion-weighted signal intensities were decreased with increasing the labeling gap in the bilateral gray matter areas and were least affected on the parietal lobe, but most affected on the occipital lobe. 2) Perfusion-weighted signal intensities were decreased with increasing the labeling delay time until 400 ms, but increased up to 1,000 ms in the bilateral gray matter areas. 3) Perfusion-weighted signal intensities were increased with increasing the labeling thickness until 120 mm in both the gray and white matter. 4) Perfusion-weighted signal intensities were higher descending scans than asending scans in both the gray and white matter. We investigated changes of perfusion-weighted signal intensities with varying several parameters in the STAR ASL method. It should require having protocol optimization processing before applying in patients. It has limitations to apply the ASL method in the white matter on a 3T MRI system.

• Journal of the Korean Society of Radiology
• /
• v.14 no.7
• /
• pp.947-956
• /
• 2020

The human body becomes vulnerable to various diseases due to deterioration in structure and function as it ages. In particular, changes in brain structure weaken the immune system against diseases such as vascular and metabolic neuropsychiatric diseases. In this study, we used a magnetic resonance imaging technique that allows non-invasive observation of brain structures and measurement of how the volumes of the brain, gray matter, white matter, and subcortical regions changes with aging in women aged 65 to 85 years. As a result of our investigation, we observed a significant linear decrease in subcortical regions with age. These results suggest that the changes due to aging in the brain structure area are closely related to neuropsychiatric diseases in old age, and can provide information in understanding the vulnerability of the brain in old age.

• Journal of the Korean Society of Radiology
• /
• v.84 no.3
• /
• pp.638-652
• /
• 2023

Purpose To investigate the MRI markers for the prediction of amyloid β (Aβ)-positivity in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to evaluate the differences in MRI markers between Aβ-positive (Aβ [+]) and -negative groups using the machine learning (ML) method. Materials and Methods This study included 139 patients with MCI and AD who underwent amyloid PET-CT and brain MRI. Patients were divided into Aβ (+) (n = 84) and Aβ-negative (n = 55) groups. Visual analysis was performed with the Fazekas scale of white matter hyperintensity (WMH) and cerebral microbleeds (CMB) scores. The WMH volume and regional brain volume were quantitatively measured. The multivariable logistic regression and ML using support vector machine, and logistic regression were used to identify the best MRI predictors of Aβ-positivity. Results The Fazekas scale of WMH (p = 0.02) and CMB scores (p = 0.04) were higher in Aβ (+). The volumes of hippocampus, entorhinal cortex, and precuneus were smaller in Aβ (+) (p < 0.05). The third ventricle volume was larger in Aβ (+) (p = 0.002). The logistic regression of ML showed a good accuracy (81.1%) with mini-mental state examination (MMSE) and regional brain volumes. Conclusion The application of ML using the MMSE, third ventricle, and hippocampal volume is helpful in predicting Aβ-positivity with a good accuracy.

• Journal of the Korean Society of Radiology
• /
• v.11 no.7
• /
• pp.589-595
• /
• 2017

This study evaluated the effect of gadolinium contrast agents on the spectrum of metabolites during $^1H-MRS$ of brain and to investigate whether the contrast agents injected before MR spectroscopy significantly affect the estimated peaks of MRS. From January to May 2017, brain MR spectroscopy was performed on 30 patients to compare the spectrum before and after contrast injection of the brain white matter tissue. As a result, the spectrum of metabolites decreased after the paramagnetic contrast agents injected. However, it was not statistically significant which indicated that the use of contrast agent did not meaningfully affect the spectrum of metabolites. In conclusion, the use of the paramagnetic contrast before the acquisition of the spectroscopy may aid voxel positioning especially when it is difficult to determine the exact location of the lesion or the contrast is low.