• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.49-53
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• 2003

확산텐서영상(Diffusion Tensor Imaging)의 개념은 1980년대 중반 확산강조영상(Diffusion Weighted Imaging)의 개념이 도입되면서 거의 동시에 도입되었지만 MR 장비의 기계적 한계등으로 인해 최근에야 임상적으로 사용되기 시작했다. 확산텐서영상(DTI)과 확산강조영상(DWI)의 방법론적인 차이점은 단순히 확산강조영상의 경우 세 개의 다른방향 (X-, Y-, Z-축)으로 확산측정용 경사자장을 가하는 반면 확산텐서영상의 경우 이보다 많은 방향 (최소한 6 방향)으로 확산측정용 경사자장을 가한다는 점이다. 이러한 차이로부터 금방 알 수 있는 점은 확산강조영상은 확산텐서영상의 일부라는 점이다. 즉, 확산텐서영상의 경우 더 많은 방향으로 확산측정용 경사자장을 가했으므로 더 많은 정보를 획득할 수 있고 이중 세 개의 방향 (주로 X,Y,Z)에 대한 정보만을 이용하게 되면 확산강조영상이다. 이러한 이유로 확산텐서영상을 획득하면 확산강조영상에서 얻게 되는 방향별 확산강조영상, 등방성(isotropic) 확산강조영상, ADC (Apparent Diffusion Coefficient) map등도 기본적으로 얻게 되므로 추가로 확산강조영상을 획득할 필요가 없다. 본 강의에서는 이러한 확산(텐서)영상의 물리적 원리를 복잡한 수학적 설명보다는 개념 위주로 설명해 보고자 한다.

• Proceedings of the Korea Contents Association Conference
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• 2019.05a
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• pp.231-232
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• 2019

최근 압축감도 부호화라는 새로운 기술의 개발로 인하여 기존보다 더 빠른 검사시간에 자기공명영상 검사가 가능하게 되었다. 감도 부호화를 이용한 터보 스핀 에코 확산강조 자기공명영상과 비교하였을 때, 압축감도 부호화를 사용한 확산강조영상에서 영상평가와 자기공명 신호 분석을 통해 적절한 영상품질을 유지하면서, 검사시간을 줄 일수 있어 확산강조영상에서에 유용하게 사용되리라 사료된다.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.29-48
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• 2021

Diffusion-weighted magnetic resonance imaging (DW MRI) is a fast unenhanced technique that shows promise as a stand-alone modality for cancer screening and characterization. Currently, DW MRI may have lower sensitivity than that of dynamic contrast-enhanced MRI as a standalone modality for breast cancer detection but superior to that of mammography, which may provide a useful alternative for supplemental screening. Standardized acquisition and interpretation of DW MRI can improve the image quality and reduce the variability of the results. Furthermore, high-resolution DW MRI, with advanced techniques and postprocessing, will facilitate better detection and characterization of subcentimeter cancers and reduce false-negatives and false-positives. Future results from ongoing prospective multicenter clinical trials using standardized and optimized protocols will facilitate the use of DW MRI as a stand-alone modality.

• Investigative Magnetic Resonance Imaging
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• v.6 no.2
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• pp.166-172
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• 2002

Purpose : To evaluate the usefulness of diffusion-weighted imaging(DWI) and quantitative apparent diffusion coefficient (ADC) maps in the patients with spinal cord infarction. Materials and methods : We studied 6 patients presented symptoms with spinal cord infarction, retrospectively (3 men and 3 women). We obtained multi-shot echo planar-based, DWI using 1.5T MR scanner at 5.4 mean days after the onset of ischemic symptoms. In six patients, signal intensity was acquired at conventional b value $1000s/\textrm{mm}^2$). The ADC value for the normal spinal cord and for infarcted lesions was measured from the trace ADC maps by using regions of interest positioned over the spinal cord. We analyzed signal intensity of lesion on MRI and DWI, and compared with ADC values in infarcted lesions and normal site. Results : T1-weighted MR image showed isosignal intensity in four of six patients and low signal intensity in two of six. T2-weighted MR image demonstrated high signal intensity in all of six. All DWI were considered to be diagnostic. All of six depicted a bright signal intensity on DWI. ADC values of infarcted lesion were measured lower than that of normal spinal cord on ADC map. The differences in ADC values between infarcted and normal spinal cord were significantly different (p＜0.05). Conclusion : It is possible to obtain DWI and ADC map of the spinal cord and DWI may be useful in the early diagnosis and localization of lesion site in patients with spinal cord infarction.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.22-31
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• 2011

Purpose : To compare free-breathing and respiratory-triggered diffusion-weighted imaging on 1.5-T MR system in the detection of hepatic lesions. Materials and Methods: This single-institution study was approved by our institutional review board. Forty-seven patients (mean 57.9 year; M:F = 25:22) underwent hepatic MR imaging on 1.5-T MR system using both free-breathing and respiratory-triggered diffusion-weighted imaging (DWI) at a single examination. Two radiologists retrospectively reviewed respiratory-triggered and free-breathing sets (B50, B400, B800 diffusion weighted images and ADC map) in random order with a time interval of 2 weeks. Liver SNR and lesion-to-liver CNR of DWI were calculated measuring ROI. Results : Total of 62 lesions (53 benign, 9 malignant) that included 32 cysts, 13 hemangiomas, 7 hepatocellular carcinomas (HCCs), 5 eosinophilic infiltration, 2 metastases, 1 eosinophilic abscess, focal nodular hyperplasia, and pseudolipoma of Glisson's capsule were reviewed by two reviewers. Though not reaching statistical significance, the overall lesion sensitivities were increased in respiratory-triggered DWI [reviewer1: reviewer2, 47/62(75.81%):45/62(72.58%)] than free-breathing DWI [44/62(70.97%):41/62(66.13%)]. Especially for smaller than 1 cm hepatic lesions, sensitivity of respiratory-triggered DWI [24/30(80%):21/30(70%)] was superior to free-breathing DWI [17/30(56.7%):15/30(50%)]. The diagnostic accuracy measuring the area under the ROC curve (Az value) of free-breathing and respiratory-triggered DWI was not statistically different. Liver SNR and lesion-to-liver CNR of respiratory-triggered DWI ($87.6{\pm}41.4$, $41.2{\pm}62.5$) were higher than free-breathing DWI ($38.8:{\pm}13.6$, $24.8{\pm}36.8$) (p value < 0.001, respectively). Conclusion: Respiratory-triggered diffusion-weighted MR imaging seemed to be better than free-breathing diffusion-weighted MR imaging on 1.5-T MR system for the detection of smaller than 1 cm lesions by providing high SNR and CNR.

• Journal of the Korean Society of Radiology
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• v.2 no.2
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• pp.31-38
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• 2008

Line scan diffusion weighted imaging (LSDI) pulse sequence for 0.32 T magnetic resonance imaging (MRI) system was developed. In the LSDI pulse sequence, the imaging volume is formed by the intersection of the two perpendicular planes selected by the two slice-selective $\pi$/2-pulse and $\pi$-pulse and two diffusion sensitizing gradients placed on the both side of the refocusing $\pi$-pulse and the standard frequency encoding readout was followed. Since the maximum gradient amplitude for the MR system was 15 mT/m the maximum b value was $301.50s/mm^2$. Using the developed LSDI pulse sequence, the diffusion weighted images for the aqueous NaCl solution phantom and triacylglycerol solution phantom calculated from the line scan diffusion weighted images gives the same results within the standard error range (mean diffusivities = $963.90{\pm}79.83({\times}10^{-6}mm^2/s)$ at 0.32 T, $956.77{\pm}4.12({\times}10^{-6}mm^2/s)$ at 1.5 T) and the LSDI images were insensitive to the magnetic susceptibility difference and chemical shift.

• Journal of the Korean Society of Radiology
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• v.5 no.3
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• pp.149-154
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• 2011

The purpose of this study was to examine the usefulness of diffusion weighted images in breast MRI by performing a quantitative comparative analysis in patients diagnosed with DCIS. On a 3.0T MR scanner, diffusion weighted images and ADC map images were obtained from 20 patients histologically diagnosed with ductal carcinoma in situ (DCIS). The findings from the quantitative image analysis are the following: The diffusion weighted images showed higher SNR and CNR at the lesion area. In addition, the ADC values were lower at the lesion area.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1059-1070
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• 2022

Purpose To compare the sensitivity of tumor detection and inter-observer agreement between acquired diffusion-weighted imaging (aDWI) b2000 and computed DWI (cDWI) b2000 in patients with prostate cancer (PCa). Materials and Methods Eighty-eight patients diagnosed with PCa by radical prostatectomy and having undergone pre-operative 3 Tesla-MRI, including DWI (b, 0, 100, 1000, 2000 s/mm²), were included in the study. cDWI b2000 was obtained from aDWI b0, b100, and b1000. Two independent reviewers performed a review of the aDWI b2000 and cDWI b2000 images in random order at 4-week intervals. A region of interest was drawn for the largest tumor on each dataset, and a Prostate Imaging-Reporting and Data System (PI-RADS) score based on PI-RADS v2.1 was recorded. Histologic topographic maps served as the reference standard. Results The study population's Gleason scores were 6 (n = 16), 7 (n = 53), 8 (n = 9), and 9 (n = 10). According to the reviewers, the sensitivities of cDWI b2000 and aDWI b2000 showed no significant differences (for reviewer 1, both 94% [83/88]; for reviewer 2, both 90% [79/88]; p = 1.000, respectively). The kappa values of cDWI b2000 and aDWI b2000 for the PI-RADS score were 0.422 (95% confidence interval [CI], 0.240-0.603) and 0.495 (95% CI, 0.308-0.683), respectively. Conclusion cDWI b2000 showed comparable sensitivity with aDWI b2000, in addition to sustained moderate inter-observer agreement, in the detection of PCa.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.119-128
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• 2007

Purpose : The purpose of this study was a phantom study to measure the diffusion properties of water molecules by steady-state free precession diffusion-weighted imaging (SSFP- DWI) with a low b-value and to determine if this sequence might be useful for application to the evaluation of bone marrow pathology. Materials and methods : 1. The phantom study: A phantom study using two diffusion weighted sequences for the evaluation of the diffusion coefficient was performed. Three water-containing cylinders at different temperatures were designed: phantom A was $3^{\circ}C$, B was $23^{\circ}C$ and C was $63^{\circ}C$. Both SSFP and echo planar imaging (EPI) sequences (b-value: $1000s/mm^2$) were performed for comparison of the diffusion properties. The Signal to noise ratios (SNR) and apparent diffusion coefficient (ADC) values of the three phantoms using each diffusion-weighted sequence were assessed. 2. The Clinical study: SSFP-DWI was performed in 28 patients [sacral insufficiency fractures (10), osteoporotic lumbar compression fractures (10), malignant compression fractures (8)]. To measure the ADC maps, a diffusion-weighted single shot stimulated echo-acquisition mode sequence ($650s/mm^2$) was obtained using the same 1.5-T MR imager Results : For the phantom study, the signal intensity on the SSFP as well as the classic EPI-based DWI was decreased as the temperature increased in phantom A to C. The ADC values of the phantoms on EPI-DWI were $0.13{\times}10^{-3}mm^2/s$ in phantom A, $0.22{\times}10^{-3}mm^2/s$ in B and $0.37{\times}10^{-3}mm^2/s$. in C. The SSFP can be regarded as a DWI sequence in view of the series of signal decreases. Conclusion : Bone marrow pathologies with different diffusion coefficients were evaluated by SSFP-DWI. All benign fractures were hypointense compared to the adjacent normal bone marrow where as the malignant fractures were hyperintense compared to the adjacent normal bone marrow.

• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.21-27
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• 2002

Purpose : To evaluate diffusion-weighted imaging findings of intracerebral hematoma according to the time sequence. Materials and methods : Seventeen patients with intracerebral hematoma were studied. Diffusion weighted images using 1.5 tesla MRI machine were obtained with b-value of $1000{\;}sec/\textrm{mm}^2$. The patients were grouped as hyperacute stage(within 12 hours, 5 patients), acute stage(within 3 days, 4 patients), subacute stage(within 3 weeks, 4 patients), and chronic stage(after 3 weeks,4 patients). The signal intensities were analysed as bright, high, iso, low and dark at the central and peripheral portions of the hematoma in each stage, and compared with those of T2 and T1 weighted images. Results : The signal intensities of the central and peripheral portion of the intracerebral hematoma on diffusion-weighted images were high and dark in hyperacute stage, dark and high-bright in acute stage, and high-bright and dark in subacute and chronic stages. The patterns of signal change of hematoma on diffusion-weighted image according to the time sequence were similar to those on T2-weighted image, but changed early and prominently. Conclusion : The intracerebral hematoma on diffusion-weighted image showed unique central and peripheral signal intensity according to the time sequence. Central portions show high to bright signals in hyperacute, subacute and chronic stage, and dark signal in acute stage, and peripheral portions show dark signals in hyperacute, subacute and chronic stage, and high to bright signal in acute stage.