• Progress in Medical Physics
• /
• v.20 no.4
• /
• pp.235-243
• /
• 2009

The purpose of this experiment is to know the relation of the detection and characterization of liver's diseases as comparison of finding at MR imaging using a Ferucarbotran (SPIO) and Gd-EOB-DTPA (Primovist) agents in diffuse liver disease. A total of 50 patients (25 men and 25 women, mean age: 50 years) with liver diseases were investigated at 3.0T machine (GE, General Electric Medical System, Excite HD) "with 8 Ch body coil for comparison of diseases and contrast's uptake relation, which used the LAVA, MGRE." All images were performed on the same location with before and after Ferucarbotran and Gd-EOB-DTPA administrations (p<0.05). Contrast to noise ratio of Ferucarbotran and Gd-EOB-DTPA in the HCC were $3.08{\pm}0.12$ and $7.00{\pm}0.27$ with MGRE and LAVA pulse sequence, $3.62{\pm}0.13$ and $2.60{\pm}0.23$ in the hyper-plastic nodule, $1.70{\pm}0.09$ and $2.60{\pm}0.23$ in the meta, $2.12{\pm}0.28$ and $5.86{\pm}0.28$ in the FNH, $4.45{\pm}0.28$ and $1.73{\pm}0.02$ in the abscess and ANOVA test was used to evaluate the diagnostic performance of each disease (p<0.05). In conclusions, two techniques were well demonstrated with the relation of the detection and characterization of liver's diseases.

• The KIPS Transactions:PartA
• /
• v.11A no.7 s.91
• /
• pp.555-562
• /
• 2004

Both global volume reduction and local shape changes of hippocampus within the brain indicate their abnormal neurological states. Hippocampal shape analysis consists of two main steps. First, construct a hippocampal shape representation model ; second, compute a shape similarity from this representation. This paper proposes a novel method for the analysis of hippocampal shape using integrated Octree-based representation, containing meshes, voxels, and skeletons. First of all, we create multi-level meshes by applying the Marching Cube algorithm to the hippocampal region segmented from MR images. This model is converted to intermediate binary voxel representation. And we extract the 3D skeleton from these voxels using the slice-based skeletonization method. Then, in order to acquire multiresolutional shape representation, we store hierarchically the meshes, voxels, skeletons comprised in nodes of the Octree, and we extract the sample meshes using the ray-tracing based mesh sampling technique. Finally, as a similarity measure between the shapes, we compute $L_2$ Norm and Hausdorff distance for each sam-pled mesh pair by shooting the rays fired from the extracted skeleton. As we use a mouse picking interface for analyzing a local shape inter-actively, we provide an interaction and multiresolution based analysis for the local shape changes. In this paper, our experiment shows that our approach is robust to the rotation and the scale, especially effective to discriminate the changes between local shapes of hippocampus and more-over to increase the speed of analysis without degrading accuracy by using a hierarchical level-of-detail approach.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.11
• /
• pp.1421-1428
• /
• 2000

Objectives : The aim of this study is to evaluate the sequential metabolic changes in experimental hydrocephalus and the clinical applicability to the diagnosis and prognosis of hydrocephalus using proton MR spectroscopy. Methods : Hydrocephalus was experimentally induced in 30 cats(2-3kg body weight) by injecting 1ml of sterile kaolin suspension(250mg/ml) into the cisterna magna. Proton MRS was performed with a 1.5 T MRI/MRS unit (Vision Plus, Siemens) at pre-treatment and at 1, 3, 7, 14, 21, and 28 days after the kaolin injection. PRESS(TR/TE＝1500/270msec) technique was employed. The major metabolites which include N-acetyl aspartate (NAA), creatine(Cr), choline(Cho), and lactate(Lac) were quantitatively analyzed and the relative concentrations ratios were evaluated. Multislice $T_2$-weighted images were also obtained using fast spin echo sequence(TR/TE＝ 2500/96msec) to monitor the morphologic changes along with progression of hydrocephalus. Results : Hydrocephalus was successfully induced in all 30 cats. Twenty five cats died within 3 days and one at the end of the second week. In all animals, the NAA/Cr ratios initially decreased during the acute stage. In 4 surviving cats, the NAA/Cr ratios initially decreased during the acute stage(<14 days) and then gradually increased to the prekaolin level as follows : pre-kaolin($1.49{\pm}0.04$), day 1($1.11{\pm}0.07$), day 7($1.17{\pm}0.04$), day 14($1.40{\pm}0.03$), day 21 ($1.46{\pm}0.06$), day 28($1.43{\pm}0.03$). These levels were relatively well correlated with the symptomatologic improvement. Lactate peak, which reflects the evidence of ischemia, did not appear throughout the entire period except in one case which expired at the end of the second week. Conclusions : The NAA/Cr ratio of the sequential proton MRS in kaolin-induced hydrocephalic cats reflects a metabolic aspect of the hydrocephalus at each stage. A decreased NAA level at the early stage is from both neuronal and axonal damage which may provide diagnostic information in the acute stage of hydrocephalus. In addition, the initial fall of NAA/Cr ratio and recovery in the late stage, when no lactate peak emerges, may suggest that the main insult of the parenchyma is not to the neuron itself but to the axon, which may be related to a good prognosis. However, emergence of the lactate peak and unrecoverable NAA/Cr at the end of the acute phase may be a poor prognostic factor. In the chronic stage, recovery of NAA/Cr ratio may provide a diagnostic clue for the differentiation between hydrocephalus and cortical atrophy.

• Investigative Magnetic Resonance Imaging
• /
• v.1 no.1
• /
• pp.103-107
• /
• 1997

Purpose: To investigate the localization and functional lateralization of the supplementary motor area (SMA) in motor activation tests in comparison to that of the primary motor area. Materials and Methods: Seven healthy volunteers obtained echoplanar imaging blood oxygen level dependent technique. This study was carried on 1.5T Siemens Magnetom Vision system with the standard head coil. Parameters of EPI were followed as; TR/TE : 1.0/66.0msec, flip angle: $90^{\circ}$, field of view: $22cm{\times}22cm,{\;}matrix:{\;}128{\times}128$, slice number/slice thickness/gap: 1O/4mm/0.8mm with fat suppression technique. Motor task as finger opposition in each hand consisted of 3 sets of alternative rest and activation periods. Postprocessing were done on Stimulate 5.0 by using cross-correlation statistics. To compare the functional lateralization of the SMA in the right and left hand tests, each examination was evaluated for the percent change of signal intensity and the number of activated voxels both in the SMA and in the pri¬mary motor area. Hemispheric asymmetry was defined as difference of summation of the activted voxels between each hemisphere. Results: Percent change of signal intensity in the SMA (2.49 -3.06%) is lower than that of primary motor area(4.4 -7.23%). Percent change of signal intensity including activated voxels were observed almost equally in the right and left SMA. As for summation of activated voxels, primary motor area had significant difference between each hemisphere but not did the SMA. Conclusion: Preferred contralateral dominant hemisphere and hemispheric asymmetry were detected in the primary motor area but not in the SMA.

• Investigative Magnetic Resonance Imaging
• /
• v.6 no.2
• /
• pp.152-157
• /
• 2002

Purpose : The differential diagnosis between Modic type I degenerative spine and infectious spondylitis sometimes is difficult, because the affected bone marrows in both disease show similar signal intensity on conventional MR imaging. We evaluate the usefulness of diffusion-wighted MR imaging for differential diagnosis between Modic type I degenerative spine and infectious spondylitis. Materials and methods : The spin-echo and diffusion-weighted MR images of eight patients with Modic type I degenerative spines and 14 patients with infectious spondylitis diagnosed by clinical findings or CT-guided biopsies we re analyzed. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF). Signal intensity changes of the vertebral bone marrow on conventional spin-echo and diffusion-weighted MR imaging were compared between degenerative spine and infectious spondylitis. Results : On T1-weighte d images, the affeted bone marrow in both disease showed hypointense signals. On T 2-weighted images, all of type I degenerative spine and 11 of infectious spondylitis showed hyperintensity, and three of infectious spondylitis showed heterogeneo us mixed signal intensity. On diffusion-weighted MR images, all of type I degenerative spine were hypointense with peripheral high signal intensity to normal vertebral body, but infectious spondylitis was hyperintense (n = 11) and hypointense (n=3). Conclusion : Diffusion-weighted MR imaging is useful to differentiate Modic type I degenerative spine from infectious spondylitis. On diffusion-weighted images, the high singal intensity of bone marrow suggests infectious spondylitis, whereas the low signal intensity of bone marrow with peripheral focal high signal intensity suggests type I degenerative spine.

• The Korean Journal of Nuclear Medicine
• /
• v.36 no.3
• /
• pp.166-176
• /
• 2002

Purpose: The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of $^{99m}Tc-HMPAO$ (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. Materials and Methods: The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and $^{99m}Tc-HMPAO$ SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the legion of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). Results: The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was $32.50{\pm}5.67%$. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Conclusion: Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

• Korean Journal of Digital Imaging in Medicine
• /
• v.12 no.1
• /
• pp.27-31
• /
• 2010

The purpose of this study was to investigated the usefulness of MR perfusion image comparing with SPECT image. A total of pediatric 30 patients(average age : 7.8) with Moyamoya disease were performed MR Perfusion with 32 channel body coil at 3T from March 01, 2010 to June 10, 2010. The MRI sequences and parameters were as followed : gradient Echo-planar imaging(EPI), TR/TE : 2000ms/50ms, FA : $90^{\circ}$, FOV : $240{\times}240$, Matrix : $128{\times}128$, Thickness : 5mm, Gap : 1.5mm. Images were obtained contrast agent administrated at a rate of 1mL/sec after scan start 10s with a total of slice 1000 images(50 phase/1 slice). It was measured with visual color image and digitize data using MRDx software(IDL version 6.2) and also, it was compared of measurement with values of normal and abnormal ratio to analyze hemodynamic change, and a comparison between perfusion MR with technique using Warm Color at SPECT examination. On MR perfusion examination, the color images from abnormal region to the red collar with rCBV(relative cerebral blood volume) and rCBF(relative cerebral blood flow) caused by increase cerebral blood flow with brain vascular occlusion in surrounding collateral circulation advancement, the blood speed relatively was depicted slowly with blue in MTT(Mean Transit Time) and TTP(Time to Peak) images. The region which was visible abnormally from MR perfusion examination visually were detected as comparison with the same SPECT examination region, would be able to confirm the identical results in MMD(Moyamoya disease)judgments. Hymo-dynamic change in MR perfusion examination produced by increase and delay cerebral blood flow. This change with digitize data and being color imaging makes enable to distinguish between normal and abnormal area. Relatively, MR perfusion examination compared with SPECT examination could bring an excellent image with spatial resolution without radiation expose.

• Advances in pediatric surgery
• /
• v.19 no.2
• /
• pp.81-89
• /
• 2013

The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

• Journal of Acupuncture Research
• /
• v.19 no.6
• /
• pp.80-96
• /
• 2002

Objective : The Purpose of this Study is to Evaluate Clinical Effect of Oriental Medical Treatment Clinically for the HNP by Comparing the Improvement of VAS and Meridian MAX Score Gap between Common Acupuncture with Sa-am Acupuncture Treatment Group and Common Acupuncture Treatment Group. Methods : The 29 patients who had a Diagnosis of HNP by Lumbar CT and MRI, and were Observed from the first June 2000 to the tenth May 2001, were divided into two classes ; the "A"group was 14 cases practised with Acupuncture treatment used Sa-am Acupuncture with Common Acupuncture, the "B" group 15 cases only Common Acupuncture. Then the time of Discharge, The authors compared VAS(Visual Analogue Scale) and Meridian Max score Gap out of these two groups. Results : On the result of the VAS(Visual Analog Scale), Group "A" is $4.14{\pm}2.62$ and Group "B" us $2.27{\pm}1.94$. So Group "A" is thought to be significance.(Independent T-test, P=0.0399). On the result of the Meridian Max Score Gap, Group "A" is $2.13{\pm}7.29$ and Group "B" is $1.43{\pm}8.42$. So Group "A" proceed more excellent result than the Group "B" Conclusions : The Group with Sa-am Acupuncture and Common Acupuncture treatment is more effective than the Group With Common Acupuncture treatment. And the Group of Done Cox is more effective than the Group of None.

• Korean Journal of Biological Psychiatry
• /
• v.21 no.3
• /
• pp.81-86
• /
• 2014

Objectives Total intracranial volume (TIV) is a major nuisance of neuroimaging research for interindividual differences of brain structure and function. Authors intended to prove the reliability of the atlas scaling factor (ASF) method for TIV estimation in FreeSurfer by comparing it with the results of manual tracing as reference method. Methods The TIVs of 26 normal children and 26 children with attention-deficit hyperactivity disorder (ADHD) were obtained by using FreeSurfer reconstruction and manual tracing with T1-weighted images. Manual tracing performed in every 10th slice of MRI dataset from midline of sagittal plane by one researcher who was blinded from clinical data. Another reseacher performed manual tracing independently for randomly selected 20 dataset to verify interrater reliability. Results The interrater reliability was excellent (intraclass coefficient = 0.91, p < 7.1e-07). There were no significant differences of age and gender distribution between normal and ADHD groups. No significant differences were found between TIVs from ASF method and manual tracing. Strong correlation between TIVs from 2 different methods were shown (r = 0.90, p < 2.2e-16). Conclusions The ASF method for TIV estimation by using FreeSurfer showed good agreement with the reference method. We can use the TIV from ASF method for correction in analysis of structural and functional neuroimaging studies with not only elderly subjects but also children, even with ADHD.