• Investigative Magnetic Resonance Imaging
• /
• v.18 no.2
• /
• pp.151-156
• /
• 2014

Purpose : Spin-echo (SE) technique is most commonly used pulse sequence for T1-weighted MR imaging. T1-weighted fluid-attenuated inversion recovery (T1FLAIR) is a relatively new pulse sequence and it provides higher tissue contrast between the gray matter (GM) and white matter (WM) of the brain than T1-weighted SE (T1SE) sequence. However, there has been controversy for the evaluation of enhancing brain tumors with T1FLAIR compared to T1SE. The purpose of this study was to compare T1FLAIR and T1SE sequences for the evaluation of enhancing intracranial tumors. Materials and Methods: Fifty-two patients with enhancing brain tumors were evaluated with contrast-enhanced (CE) T1SE and T1FLAIR imaging. Eight quantitative criteria were calculated: lesion-to-WM contrast ratio (CR) and contrast-to-noise ratio (CNR), lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. For qualitative evaluation, two radiologists assessed lesion conspicuity on CE T1SE and T1FLAIR sequences with three-scale: 1, T1SE superior; 2, sequence equal; T1FLAIR superior. Results: Seventy-nine tumors (31 primaries, 48 metastases) were assessed. For quantitative measurement, the T1FLAIR lesion-to-GM, lesion-to-CSF, WM-to-GM CR and CNR values were comparable and statistically superior to those of the T1SE images (p < 0.001 in all). However, lesion-to-WM CR and CNR were similar on both two sequences without statistically significant difference (p = 0.661, 0.662, respectively). For qualitative evaluation, both radiologists assessed that T1FLAIR images were superior to T1SE images for the evaluation of lesion conspicuity. Conclusion: For the evaluation of enhancing intracranial tumors, T1FLAIR sequence was superior or comparable to T1SE sequence.

• Sleep Medicine and Psychophysiology
• /
• v.27 no.1
• /
• pp.24-31
• /
• 2020

Objectives: Subjective-objective discrepancy of sleep (SODS) is a common symptom and one of the major phenotypes of insomnia. A distorted perception of sleep deficit might be related to abnormal brain reactivity to insomnia-related stimuli. We aimed to investigate differences in brain activation to insomnia-related stimuli vs. general anxiety-inducing stimuli among insomnia patients with SODS, insomnia patients without SODS, and healthy controls (HCs). Methods: All participants were evaluated for subjective sleep status using a sleep diary and questionnaires; occult sleep disorders and objective sleep status were assessed using polysomnography and actigraphy. Task functional magnetic resonance imaging was performed during insomnia-related stimuli (Ins) and general anxiety-inducing stimuli (Gen). Brain reactivity to Ins versus Gen was compared among insomnia with SODS, insomnia without SODS, and HC groups, and a combined insomnia disorder group (ID, insomnia with and without SODS) was also compared with HCs. Results: In the insomnia with SODS group compared to the insomnia without SODS group, the right precuneus and right supplementary motor areas showed significantly increased BOLD signals in response to Ins versus Gen. In the ID group compared to the HC group, the left anterior cingulate cortex showed significantly increased BOLD signals in response to Ins versus Gen. Conclusion: The insomnia with SODS and ID groups showed higher brain activity in response to Ins versus Gen, while this was not observed in the insomnia without SODS and HC groups, respectively. These results suggest that insomnia patients with sleep misperception are more sensitive to sleep-related threats than general anxiety-inducing threats.

• Investigative Magnetic Resonance Imaging
• /
• v.17 no.4
• /
• pp.294-307
• /
• 2013

Purpose : To investigate the correlations between Seoul Neuropsychological Screening Battery (SNSB) scores and the gray matter volumes (GMV) in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and cognitively normal (CN) elderly subjects with correcting the genotypes. Materials and Methods: Total 75 subjects were enrolled with 25 subjects for each group. The apolipoprotein E (APOE) epsilon genotypes, SNSB scores, and the 3D T1-weighted images were obtained from all subjects. Correlations between SNSB scores and GMV were investigated with the multiple regression method for each subject group using both voxel-based and region-of-interest-based analyses with covariates of age, gender, and the genotype. Results: In the AD group, Rey Complex Figure Test (RCFT) delayed recall scores were positively correlated with GMV. In the MCI group, Seoul Verbal Learning Test (SVLT) scores were positively correlated with GMV. In the CN group, GMV negatively correlated with Boston Naming Test (K-BNT) scores and Mini-Mental State Examimation (K-MMSE) scores, but positively correlated with RCFT scores. Conclusion: When we used covariates of age, gender, and the genotype, we found statistically significant correlations between some SNSB scores and GMV at some brain regions. It may be necessary to further investigate a longitudinal study to understand the correlation.

• 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.

• Journal of The Korean Ophthalmological Society
• /
• v.59 no.11
• /
• pp.1087-1090
• /
• 2018

Purpose: To report a case of trochlear nerve palsy caused by quadrigeminal cistern lipoma located in the dorsal midbrain. Case summary: A 65-year-old male visited our clinic for intermittent vertical diplopia over 2-year period. Symptoms of diplopia had worsened over the past two weeks. He had no previous medical history except having had diabetes for 1 month. The best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. Pupillary examination was not remarkable. Extraocular examination showed 4 prism diopters (PD) left hypertropia at distant gaze and 4 PD exotropia at near gaze, with adduction elevation of the left eye. The Bielschowsky head tilt test revealed 6 PD left hypertropia on the left gaze and orthotropia on the right tilt. Fundus examination showed excyclotorsion of the right eye and incyclotorsion of the left eye. Brain magnetic resonance imaging revealed quadrigeminal cistern lipoma. Prism glasses were prescribed to alleviate diplopia, and we followed up the lesions without further treatment. Conclusions: Trochlear nerve palsy can be caused by quadrigeminal cistern lipoma; however, it is uncommon for this condition to be caused by a compressive lesion. Prompt neuroimaging can be helpful to rule out the causes of this condition in patients with atypical symptoms.

• Journal of radiological science and technology
• /
• v.32 no.1
• /
• pp.95-99
• /
• 2009

The purpose of this research is to seek SPAIR's reversal time (TI) which satisfies two conditions ; maintaining the suppression ability of fat tissue and simultaneously minimizing the inhomogeneity of fat tissue in T2 high-speed spin echo 3.0T magnetic resonance image (MRI) of the brain, and to compare SPAIR with STIR which is fat-suppression technique. The reversal times (TI) of SPAIR protocol are set to 1/2, 1/3, 1/6 and 1/12 of SPAIR TR (420 msec), namely 210 msec (8 people), 140 msec (26 people), 70 msec (26 people) and 35 msec (18 people) and STIR TI is set with 250 msec (26 people). With these parameter sets, we acquired the axis direction 104 images of the brain. In ROI ($50\;mm^2$) of output image, signal intensities of the fatty tissue, the muscular tissue, and the background were measured and the CNRs of fatty tissue and the muscular tissue were calculated. The inhomogeneity of the fatty tissue is SD/mean, where SD is the standard deviation and 'mean' is a average fatty tissue signal. Consequently, SPAIR TI is determined on either 1/3 or 1/6 of TR (420 ms) ; 140 ms or 70 ms. Because the difference of statistics in fat-suppression ability and inhomogeneity of fatty tissue is very small (p < 0.001), Selecting 140 ms seems to be better choice for the image quality. Meanwhile, Comparing SPAIR (TI : 140 ms) with STIR, the fat-suppression is not able to be considered statistically (p < 0.252), but the image quality is able to be considered statistically (p < 0.01). In conclusion, SPAIR is better than STIR in the image quality.

• Journal of the Korean Society of Radiology
• /
• v.15 no.7
• /
• pp.991-998
• /
• 2021

The purpose of this study is to investigate the image quality of the SE-EPI and SSH-TSE technique for MR DWI. Datum were analyzed for 35 PACS transmission datum(Normal part: 12 males, 13 females, Cerebral Infarction: 10(5males and 5females), and average age 68±7.32), randomly selected patients who underwent MRDWI tests. The equipment used was Ingenia CX 3.0T, SSH_TSE and SE-EPI pulse sequence and 32 Ch. head coil were used for data acquisition. Image evaluation was performed on the paired t-test and Wilcoxon tests, and was considered significant when the p value was 0.05 or less. As a result of quantitative analysis of SNR for DWI images, the mean and standard deviation values of 4 parts (WM, GM, BG, Cerebellum) in ADC (s/mm2), Diffusion b=0, 1000 images were higher in SE-EPI techniques(ADC: 120.50 ± 40, b=0: 54.50 ± 35.91, b=1000: 91.61 ± 36.63) than in SSH-TSE techniques(ADC: 99.69 ± 31.10, b=0: 43.52 ± 25.00 , b=1000: 60.74 ± 24.85)(p<0.05). The CNR values for GM-WM, BG-WM sites were also higher in SE-EPI technique (ADC: 116.08 ± 43.30, b=0:27.23 ± 09.10, b=1000: 78.50 ± 16.56) than in SSH-TSE(ADC: 101.08 ± 36.81, b=0: 23.96 ± 07.79 , b=1000: 74.30 ± 14.22). As a visual evaluation of observers, ghost artifact, magnetic susceptibility artifacts and overall image quality for SE-TSE and SSH-TSE all yielded high results from SSH-TSE techniques(ADC:3.6 ± 0.1, 2.8 ± 0.2, b=0: 4.3 ± 0.3, 3.4 ± 0.1 b=1000: 4.3 ± 0.2, 3.5 ± 0.2, p=0.000). In conclusion, the SE-EPI technique obtained an superiority in SNR and CNR measurements using SSH-TSE, SE-EPI. In the qualitative analysis, the SSH-TSE pulse sequence was obtained a high result according to the pulse sequence characteristics.

• Korean Journal of Psychosomatic Medicine
• /
• v.9 no.1
• /
• pp.37-48
• /
• 2001

Objectives : The purpose of this study was to evaluate the difference of psychometric analysis among patients with Post-traumatic organic mental disorder according to the lesion of MRI finding of traumatic brain injury. Methods : We divided 35 patients into 4 groups according to the lesion of MRI finding of brain injury. We evaluated the difference of the subscales of MMPI and K-WAIS among 4 groups with Post-traumatic organic mental disorder by ANOVA. Results : We found no significant difference of all subscales of MMPI and K -WAIS among 4 groups by ANOVA. Compared Rt hemispheric injury group with Lt hemispheric injury group by independent t-test, the depression scale in MMPI scored significantly higher in Lt hemispheric injury group, and the block design in K-WAIS scored significantly lower in Rt hemispheric injury group. Conclusion : This study suggests that Lt hemispheric injury be significantly related to depression, and Rt hemispheric injury be significantly related to visuospatial ability.

• Korean Journal of Biological Psychiatry
• /
• v.19 no.2
• /
• pp.77-83
• /
• 2012

Objectives : Although there have been studies that examine sex differences of the brain structures using magnetic resonance imaging, studies that specifically investigate cerebellar structural differences between men and women are scarce. The purpose of current study was to examine sex differences in structures of the cerebellum using cerebellar template and cerebellum analysis methods. Methods : Sixteen men and twenty women were included in the study. A MATLAB based program (MathWorks, Natick, MA, USA), Statistical Parametric Mapping 5 (SPM5) using the spatially unbiased infra-tentorial atlas template (SUIT) as the cerebellum template, was used to analyze the brain imaging data. Results : There was no significant difference in age between men (mean age=28.1) and women (mean age=27.2). Men showed higher gray matter density than women in two left cerebellar areas including the clusters in the lobules IV and V (a cluster located across the lobules IV and V), and the lobule VIIIb (lobules IV and V, t=4.75, p<0.001 ; lobule VIIIb, t=3.08, p=0.004). Conclusions : The current study found differences in cerebellar gray matter density between men and women. The current study holds its significance for applying the template specifically developed for the analysis of cerebellum.

• Childhood Kidney Diseases
• /
• v.11 no.1
• /
• pp.92-99
• /
• 2007

The posterior reversible encephalopathy syndrome(PRES) is characterized clinically by a combination of acute or subacute confusion, lethargy, visual disturbance, and seizures. PRES has been described in various clinical settings, including severe hypertension, chemotherapy, eclampsia, and seizure. We report a case of a 7-year-old girl who had taken cyclosporine for steroid resistant nephrotic syndrome. Twenty one days after the cyclosporine therapy, she was admitted due to generalized tonic clonic seizure and headache. Her blood pressure was 170/90 mmHg. Magnetic resonance(MR) imaging showed necrotic/cystic lesions involving the bilateral parieto-occipital region. After discontinuation of cyclosporine, and control of blood pressure, she had no more seizure and headache. The follow-up MR examination which was performed 6 months later showed the decreased extent of the lesion.