Objective : This is prospective study of clinical outcomes of percutaneous plasma disc coagulation Therapy (PDCT) in patients with herniated lumbar disc disease (HLD) to evaluate the safety and efficacy in its clinical application and usefulness as a reliable alternative to microscopic discectomy. Methods : Forty-six patients were enrolled in this study from April 2006 to June 2010. All patients had one-level HLD. Disc degeneration was graded on routine T2-weighted magnetic resonance Image (MRI) using the Pfirrmann's grading system and all index levels were grade 3 and grade 4. Indications for surgery were radiculopathy caused by disc protrusion with soft consistency. MRI was done at one month after the procedure in all patients to check post-PDCT change. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. Results : This study was approved by the Institutional Review Board of our institution. The age of the study population ranged from 16 to 59 years with a mean age of 37.2 years. There were 29 males and 17 females in this study. The mean period of clinical follow-up was 21 months. The average preoperative VAS score for radiculopathy was $7.4{\pm}1.4$, while the final follow-up VAS score was $1.4{\pm}0.7$ (p<0.001). In MacNab's criteria, 41 patients (89.1%) had achieved favorable improvement (excellent and good) until later follow-up. There were one patient from infection and two patients who needed to convert to open discectomy. Conclusion : PDCT is a safe and efficient treatment modality in a selective patient with HLD.
Kim, Sung-Chul;Kim, Yu-Chan;Seok, Hyun-Kwang;Yang, Seok-Jo;Shon, In-Jin;Lee, Kang-Sik;Lee, Jae-Chul
Korean Journal of Metals and Materials
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v.50
no.5
/
pp.401-406
/
2012
When viewed using a magnetic resonance imaging (MRI) system, invasive materials inside the human body, in many cases, severely distort the MR image of human tissues. The degree of the MR image distortion increases in proportion not only to the difference in the susceptibility between the invasive material and the human tissue, but also to the intensity of the magnetic field induced by the MRI system. In this study, by blending paramagnetic Ti particles with diamagnetic graphite, we synthesized $Ti_{100-x}C_x$ composites that can reduce the artifact in the MR image under the high-strength magnetic field. Of the developed composites, $Ti_{70}C_{30}$ showed the magnetic susceptibility of ${\chi}=67.6{\times}10^{-6}$, which corresponds to 30% of those of commercially available Ti alloys, the lowest reported in the literature. The level of the MR image distortion in the vicinity of the $Ti_{70}C_{30}$ composite insert was nearly negligible even under the high magnetic field of 4.7 T. In this paper, we reported on a methodology of designing new structural materials for bio-applications, their synthesis, experimental confirmation and measurement of MR images.
Purpose: To analyze contrast-enhancement pattern of stomach cancer on dynamic MRI and to verify the efficacy of intravenous contrast agent in the evaluation of stomach cancer. Materials and Methods: Twelve patients with proven stomach cancer underwent dynamic MRI. By using l.OT scanner, we obtained precontrast FLASH images, and 30, 60, 90 second delay FLASH images after intravenous contrast injection. All patients ingested one liter of water and had intramuscular injection of Buscopan just before MR study. For quantitative analysis we measured signal to noise ratio (SiN) of stomach cancer on each image, and signal difference to noise ratio (SD/N) between cancer and intraluminal fluid, cancer and the pancreas. For qualitative analysis two radiologists evaluated lesion conspicuity on each image by grading system(grade 0, 1, 2, 3: poor, fair, good, excellent). Results: SiN of stomach cancer increased gradually by time(precontrast, 30, 60, 90 second delay: 38.7, 42.5, 57.4, 65.7). SD/N between cancer and intraluminal fluid significantly increased after contrast enhancement(l.24, 25.01, 39.30, 45.89). SD/Ns between cancer and the pancreas were 10.5, 9.33, 9.99, 10.66, respectively. In qualitative analysis, precontrast images were better than postcontrast images for delineation of stomach cancer. Postcontrast images showed clear endo-Iuminal side of stomach cancer, but outer margin of stomach cancer was more distinct on precontrast images. Conclusion: Precontrast MR images are better than postcontrast MR images in the depiction of stomach cancer. Intravenous contrast agent is not imperative in the evaluation of stomach cancer.
Purpose: The purpose of this study was to design and build an optimized birdcage resonator configuration with a low pass filter, which would facilitate the acquisition of high-resolution 3D-image of small animals at 3T MRI system. Methods and Materials: The birdcage resonator with 12-element structures was built, in order to ensure B1 homogeneity over the image volume and maximum filling factor, and hence to maximize the signal to noise ratio (SNR) and resolution of the 3-dimensional images. The diameter and length of each element of a birdcage resonator were as follows: (1) diameter 13 cm, length 22 cm, (2) diameter 15 cm, length 22 cm, (3) diameter 17 cm, length 25 cm. Spin echo pulse sequence and fast spin echo pulse sequence were employed in obtaining MR images. The quality of the manufactured birdcage resonators wes evaluated on the basis of the return loss following matching and tuning process. Results: The experimental MR image of phantoms by the various manufactured birdcage resonators were obtained to compare the SNR in accordance with the size of objects. The size of an object to that of coil was identified by parameters that were estimated from the image of a phantom. First, the diameter of the birdcage resonator was 15cm, and the ratio of the tangerine to the birdcage resonator accounted for approximately 27%. The Q factor was 53.2 and the SNR was 150.7. Second, at the same birdcage resonator, the ratio of the orange was approximately 53%. The SNR and the Q parameter was 212.8 and 91.2, respectively. Conclusion: The present study demonstrated that if birdcage resonators have the same forms, SNR could be different depending on the size of an object, especially when the size of an object to that of coil is approximately 40~80%, the former is bigger than the latter. Therefore, when the size of an object to be observed is smaller than that of coil, the coil should be manufactured in accordance with the size of an object in order to obtain much more excellent images.
In this paper, we have reported two interesting flow effects arising in the TRFGE sequence using water flow phantom. First, we have shown that the TRFGE sequence is indeed not affected by "in-flow" effect from the unsaturated spins flowing into the imaging slice. Second, the enhancement of "in-plane flow" signal in the readout gradient direction was observed when the TRFGE sequence was used without flow compensation. These two results have many interesting applications in MR imaging other than fMRI. Results obtained were also compared with the results obtained by the conventional gradient echo(CGE) imaging. Experiments were performed at 4.7T MRI/S animal system (Biospec, BRUKER, Switzerland). A cylindrical phantom was made using acryl and a vinyl tube was inserted at the center(Fig. 1). The whole cylinder was filled with water doped with $MnCl_2$ and the center tube was filled with saline which flows in parallel to the main magnetic field along the tube. Tailored RF pulse was designed to have quadratic ($z^2$) phase distribution in slice direction(z). Imaging parameters were TR/TE = 55~85/10msec, flip angle = $30^{\circ}$, slice thickness = 2mm, matrix size = 256${\times}$256, and FOV= 10cm. In-flow effect : Axial images were obtained with and without flow using the CGE and TRFGE sequences, respectively. The flow direction was perpendicular to the image slice. In-plane flow : Sagittal images were obtained with and without flow using the TRGE sequence. The readout gradient was applied in parallel to the flow direction. We have observed that the "in-flow" effect did not affect the TRFGE image, while "in-plane flow" running along the readout gradient direction enhanced the signal in the TRFGE sequence when flow compensation gradient scheme was not used.
Purpose: To get a 3-D coordinates of intracranial target position was investicated in axial, sagittal and coronal magnetic resonance imaging with a preliminary experimented target localizer. Material and methods : In preliminal experiments, the localizer is made of engineering plastic to avoid the distrubance of magnetic field during the MR image scan. The MR localizer displayed the 9 points in three different axial tomogram. The bright signal of localizer was obtjained from 0.1~0.3% of paramagnetic gadolinium/DTPA solution in T1WI or T2WI. In this study, the 3-D position of virtual targets were examined from three different axial MR images and the streotactic position was compared to that of BRW stereotactic system in CT scan with same targets. Results: This study provided the actual target position could be obtained from single scan with MRI localizer which has inverse N-typed 9 bars. This experiment was accomplished with shimming test for detection of image distortion in MR image. However we have not found the image distortion in axial scan. The maximum error of target positions showed 1.0 mm in axial, 1.3 mm for sagittal and 1.7 mm for coronal image, respectivelly. The target localization in MR localizer was investicated with spherical virtual target in skull cadaver. Furthermore, the target position was confirmed with CRW stereotactic system showed a 1.3 mm in discrepancy. Summary : The intracranial target position was determined within 1.7 mm of discrepancy with designed MR localizer. We found the target position from axial image has more small discrepancy than that of sagittal and coronal image.
Background: The size of a hepatic neoplasm is critical for staging, prognosis and selection of appropriate treatment. Our study aimed to compare the radiological size of solid hepatocellular carcinoma (HCC) masses on magnetic resonance imaging (MRI) with the pathological size in a Chinese population, and to elucidate discrepancies. Materials and Methods: A total of 178 consecutive patients diagnosed with HCC who underwent curative hepatic resection after enhanced MRI between July 2010 and October 2013 were retrospectively identified and analyzed. Pathological data of the whole removed tumors wereassessed and differences between radiological and pathological tumor size were identified. All patients were restaged using a modified Tumor-Node-Metastasis (TNM) staging system postoperatively according to the maximum diameter alteration. The lesions were classified as hypo-staged, iso-staged or hyper-staged for qualitative assessment. In the quantitative analysis, the relative pre and postoperative tumor size contrast ratio ($%{\Delta}size$) was also computed according to size intervals. In addition, the relationship between radiological and pathological tumor diameter variation and histologic grade was analyzed. Results: Pathological examination showed 85 (47.8%) patients were overestimated, 82 (46.1%) patients underestimated, while accurate measurement by MRI was found in 11 (6.2%) patients. Among the total subjects, 14 (7.9%) patients were hypo-staged and 15 (8.4%) were hyper-staged post-operatively. Accuracy of MRI for calculation and characterized staging was related to the lesion size, ranging from 83.1% to 87.4% (<2cm to ${\geq}5cm$, p=0.328) and from 62.5% to 89.1% (cT1 to cT4, p=0.006), respectively. Overall, MRI misjudged pathological size by 6.0 mm (p=0.588 ), and the greatest difference was observed in tumors <2cm (3.6 mm, $%{\Delta}size=16.9%$, p=0.028). No statistically significant difference was observed for moderately differentiated HCC (5.5mm, p=0.781). However, for well differentiated and poorly differentiated cases, radiographic tumor maximum diameter was significantly larger than the pathological maximum diameter by 3.15 mm and underestimated by 4.51 mm, respectively (p=0.034 and 0.020). Conclusions: A preoperative HCC tumor size measurement using MRI can provide relatively acceptable accuracy but may give rise to discrepancy in tumors in a certain size range or histologic grade. In pathological well differentiated subjects, the pathological tumor size was significantly overestimated, but underestimated in poorly differentiated HCC. The difference between radiological and pathological tumor size was greatest for tumors <2 cm. For some HCC patients, the size difference may have implications for the decision of resection, transplantation, ablation, or arterially directed therapy, and should be considered in staging or selecting the appropriate treatment tactics.
Increased external rotation and decreased internal rotation have been noted to occur progressively in the throwing shoulders of baseball pitchers. The purpose of this study was to provide descriptive data for terminal range eccentric antagonist/concentric agonist shoulder muscle strength in collegiate baseball pitchers with humeral head retroversion diagnosed through MRI. The dominant and non-dominant shoulders of 9 asymptomatic baseball pitchers were tested through a range of 20 degrees of external rotation to 90 degrees of internal rotation using the Biodex system 3 isokinetic dynamometer at speeds of $90^{\circ}/s$ and $180^{\circ}/s$. Differences between the dominant and non-dominant shoulders were assessed using the paired samples t-test. Total range of motion, measured at $90^{\circ}$ of glenohumeral abduction, was $180.1^{\circ}$ for dominant shoulders and $183.7^{\circ}$ for non-dominant shoulders. Humeral head retroversion measured $47.6{\pm}6.1^{\circ}$ in dominant and $37.8{\pm}5.3^{\circ}$ in non-dominant extremities. The mean internal rotator concentric contraction (IR-Con) showed a significant difference compared to $31.5{\pm}5.1$ (Nm) in dominant and $38.7{\pm}5.2$ (Nm) in non-dominant shoulders at $180^{\circ}/s$ (p<0.05). The mean external rotator eccentric contraction (ER-Ecc) showed a significant difference compared to $20.3{\pm}4.7$ (Nm) in dominant and $25.1{\pm}3.7$ (Nm) in non-dominant shoulders at $90^{\circ}/s$ (p<0.05). There is a pattern of increased external rotation and decreased internal rotation in the dominant extremity that significantly correlates with an increase in humeral retroversion.
Y. Wenjing;T. Yuhan;Y. Zhiang;T. Shanhui;L. Shijun;M. Sharaf
Advances in nano research
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v.15
no.5
/
pp.451-466
/
2023
Gastrointestinal cancer (GC) is a prevalent malignant tumor of the digestive system that poses a severe health risk to humans. Due to the specific organ structure of the gastrointestinal system, both endoscopic and MRI diagnoses of GIC have limited sensitivity. The primary factors influencing curative efficacy in GIC patients are drug inefficacy and high recurrence rates in surgical and pharmacological therapy. Due to its unique optical features, good biocompatibility, surface effects, and small size effects, nanotechnology is a developing and advanced area of study for the detection and treatment of cancer. Because of its deep location and complex surgery, diagnosing and treating gastrointestinal cancer is very difficult. The early diagnosis and urgent treatment of gastrointestinal illness are enabled by nanotechnology. As diagnostic and therapeutic tools, nanoparticles directly target tumor cells, allowing their detection and removal. XGBoost was used as a classification method known for achieving numerous winning solutions in data analysis competitions, to capture nonlinear relations among many input variables and outcomes using the boosting approach to machine learning. The research sample included 300 GC patients, comprising 190 males (72.2% of the sample) and 110 women (27.8%). Using convolutional neural networks (CNN) and artificial neural networks (ANN)-EXtreme Gradient Boosting (XGBoost), the patients mean± SD age was 50.42 ± 13.06. High-risk behaviors (P = 0.070), age at diagnosis (P = 0.037), distant metastasis (P = 0.004), and tumor stage (P = 0.015) were shown to have a statistically significant link with GC patient survival. AUC was 0.92, sensitivity was 81.5%, specificity was 90.5%, and accuracy was 84.7 when analyzing stomach picture.
Kim, Jin-tae;Byun, Jae-Hu;Park, Yong-Seong;Lee, Rae-Gon;Hwang, Seon-Kwang
Korean Journal of Digital Imaging in Medicine
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v.17
no.1
/
pp.33-41
/
2015
This study attempts to examine the clinical usefulness of High b-value DWI (diffusion weighted imaging) for brain tumors with an edema. Subjects were seven patients selected from 65 patients who received an MRI scan for suspected encephalopathy and confirmed diagnosis at our hospital from February to July 2015 (male: 7, average age : 66 years old). As test equipment, 3.0T MR System (ACHIEVA Release, Philips, Best, The Netherlands) and 8Channel SENSE Head Coill were used. DWI checks on the use of the variable TR 5460ms, TE 132ms, Slice Thickness 4mm, gap 1mm, Slice number 29 is, 3D T1WI is TR 8.4ms, TE 3.9ms, matrix size $240{\times}240$, Slice can set 180 piecesIt was. b value of 0, 1,000, 2,000 s/mm2 with DWI acquisition and 3D T1WI enhancement five minutes after the Slice Thickness 3mm, gap 0mm to reconstruct the upper face axis (MPR TRA CE) was. As for the experiment, in b-value 1,000 and 2,000 images, SNR and the lesion at the lesion site and CNR in the normal site opposite to the lesion are measured. WW(window width) and WL(window level) are made equal in MRICro software, and the volume of the lesion is measured from each of b-value and MPR TRA CE image. Using SPSS ver. 1.8.0.0 Mann Whitney-test was analyzed for SNR and CNR, while Kruskal-Wallis test was analyzed for volume.
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