• Journal of Radiation Protection and Research
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• 제40권4호
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• pp.277-282
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• 2015

본 연구는 찜질 자극이 국소 통증을 완화시킬 뿐만 아니라 편두통과 같은 만성 질환의 통증 완화에 효과적으로 애용되고 있는 이유에 대한 근거를 혈류 역학적인 측면에서 고찰하고자 한다. 이를 위해 찜질 자극에 의한 자극 부위에서의 국소 혈류 변화가 일어나는 것을 관측하고, 이를 통해 두개 내 외부의 혈액 순환에 어떠한 변화를 야기하는지를 정상인 피험자 (n=8, 평균나이: $32.13{\pm}4.61$) 를 대상으로 자기공명영상 시스템을 이용하여 관측하였다. 국소 혈류변화는 찜질 자극에 의한 피부 색깔 및 온도 변화를 통하여 관측하고자 하였고, 두개 내 외부 혈관의 자극에 따른 변화를 자기공명혈관조영술을 통해 관측하고 영상을 분석하여 비교하고자 하였다. 찜질 자극 전 $36.4^{\circ}C$에서 자극 15분 후 $36.7^{\circ}C$, 그리고 자극 30분 후 $37.1^{\circ}C$ 로 피부온도가 상승한 것으로 나타났으며, 찜질 자극이 시작되는 시점과 자극 30분 후의 혈관 영상 분석 결과를 살펴보면 두개 내부 혈관에서는 유의한 변화를 보이지 않은 반면, 두개 외부 혈관에서는 찜질 자극 후 상당한 혈류 신호의 변화를 보여주었다(+38.8%). 결과에서 보듯이 찜질 자극 부위의 이러한 국소 온도의 변화와 두개 외의 혈류의 변화를 통하여 찜질 자극이 국소적으로는 근육 통증 및 편두통과 같은 만성질환의 통증을 완화시키는 효과를 발휘하고 더 나아가 혈액 순환을 촉진시키는 작용을 통하여 전신에 미치는 결림 현상 및 통증의 완화에 실질적으로 효과를 보일 수 있게 되는 것으로 사료된다.

• Korean Journal of Radiology
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• 제2권1호
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• pp.1-7
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• 2001

Objective: To determine the usefulness of perfusion MR imaging in assessing the histologic grade of cerebral gliomas. Materials and Methods: In order to determine relative cerebral blood volume (rCBV), 22 patients with pathologically proven gliomas (9 glioblastomas, 9 anaplastic gliomas and 4 low-grade gliomas) underwent dynamic contrast-enhanced T2^*-weighted and conventional T1- and T2-weighted imaging. rCBV maps were obtained by fitting a gamma-variate function to the contrast material concentration versus time curve. rCBV ratios between tumor and normal white matter (maximum rCBV of tumor / rCBV of contralateral white matter) were calculated and compared between glioblastomas, anaplastic gliomas and low-grade gliomas. Results: Mean rCBV ratios were 4.90°±1.01 for glioblastomas, 3.97°±0.56 for anaplastic gliomas and 1.75°±1.51 for low-grade gliomas, and were thus significantly different; p < .05 between glioblastomas and anaplastic gliomas, p < .05 between anaplastic gliomas and low-grade gliomas, p < .01 between glioblastomas and low-grade gliomas. The rCBV ratio cutoff value which permitted discrimination between high-grade (glioblastomas and anaplastic gliomas) and low-grade gliomas was 2.60, and the sensitivity and specificity of this value were 100% and 75%, respectively. Conclusion: Perfusion MR imaging is a useful and reliable technique for estimating the histologic grade of gliomas.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.524-527
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• 2010

Temporary disruption of the blood-brain barrier (BBB) after cerebral angiography is presumably caused by nonionic radiographic contrast medium (CM). We hereby report a case of 58-year-old woman who developed decreased mentality, global aphasia and aggravated right hemiparesis after cerebral angiography. Brain CT examination demonstrated gyriform enhancement throughout the left cerebral cortex and thalamus. MR diffusion did not reveal acute infarction. MR angiography did not show any stenosis, spasm or occlusion at the major cerebral vessels. Follow-up CT scan after 1 day did not show any gyriform enhancement. Worsened neurologic signs and symptoms were improved completely after 7 days. In the present study, disruption of the BBB with contrast medium after angiography seems to be the causative factor of transient neurologic deterioration.

• 한국산학기술학회논문지
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• 제15권8호
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• pp.5124-5130
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• 2014

조영제의 희석률 변화에 따른 신호강도를 분석하여 조영증강 자기공명혈관조영검사 시 점도와 삼투압에 따른 부작용을 최소화하고 신호강도를 높여 영상의 질을 향상시키고자 하였다. 연구방법은 조영제가 혈관에 주입되면 혈액과 희석되어 mol 농도가 변화되고, 그에 따라 신호강도의 변화를 일으킴에 착안하여 phantom을 제작하였다. phantom 결과를 바탕으로 임상실험은 2013년 11월부터 2014년 1월까지 조영제를 희석한 군(30명)과 희석하지 않은 군(30명)으로 구분하여 뇌혈관의 신호강도를 비교하였다. 연구결과, 조영제 mol 농도 변화에 따른 phantom의 신호강도는 0.0125mmol부터 급격히 증가하다 20mmol에서 최고점을 이룬 후 200mmol부터 평형을 이루었다. 임상실험에서도 조영제를 희석하여 검사한 영상의 신호강도가 모두 높게 나타나, 1000mmol 조영제 사용에 비해 500mmol로 희석하여 사용함이 최고점인 20mmol에 근접하여 우수함을 알 수 있었다. 결론적으로 조영제를 희석하여 사용함으로써 점도와 삼투압을 저하시키고, 영상의 질을 향상시킬 수 있었으므로 임상적용의 유용성이 높다고 할 수 있다.

• Journal of Korean Neurosurgical Society
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• 제52권1호
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• pp.52-54
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• 2012

A 10-year-old female patient presented with a rapidly growing nodular mass lesion on her right frontal area. On skull radiography and computed tomography (CT) imaging, this mass had a well-demarcated punch-out lesion with a transdiploic, exophytic soft tissue mass nodule on the frontal scalp. Magnetic resonance (MR) imaging revealed the presence of a $1.5{\times}1.2{\times}1$ cm sized calvarial lesion. This lesion was hypointense on T1 and heterogenous hyperintense on T2 weighted MR images, and exhibited heterogeneous enhancement of the soft tissue filling the punch-out lesion after intravenous administration of gadolinium. En block removal of the tumor with resection of the rim of the normal bone was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia (IPEH). After surgery, no recurrence was found for 8 months. IPEH is a rare and benign reactive lesion usually found in thrombosed subcutaneous blood vessels. Involvement of skull bone is rare. In this article, we present a case of IPEH involving the calvarium, in a 10-year-old woman.

• 대한기관식도과학회지
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• 제2권2호
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• pp.194-199
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• 1996

Laser therapy is becoming an accepted procedure for tissue coagulation and ablation and is especially useful in treating tumors. The laser energy is applied to the tissue of interest through various delivery systems which are introduced percutaneously, via blood vessels, through body openings, or during surgical exposure of the tissue. One of the major obstacles to effective application of lasers has been the lack of reliable method to determine the extent of tissue involvement in real time. Several methods have been proposed for monitoring the tissue response and controlling the laser in real time during laser therapy. Among them, magnetic resonance imaging(MRI) has been introduced to monitor laser-tissue interactions because laser irradiation induces changes not only in the thermal motions of the hydrogen protons within the tissue but also in the distribution and mobility of water and lipids. The buttocks of New Zealand rabbits were treated by KTP and $CO_2$laser(power : 10 watts, exposure time:10 seconds). m images were taken at immediately after lasering, 1 week later, 2 weeks later, and at the same time, tissues were harvested for histopathologic study. We analyzed MR images and histopathologic findigs of laser-treated tissues. The MR images taken immediately after laser treatment showed 3 layer pattern and which was correlated with histopathologic changes. We suggest MRI may become a useful monitoring tools for laser-tissue interaction.

• Clinical and Experimental Pediatrics
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• 제45권12호
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• pp.1601-1605
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• 2002

본 저자들은 경련과 의식저하를 보인 알레르기성 자반증 환아에서 신경학적 합병증으로 대뇌 동맥의 혈관염이 발생된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1114-1130
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• 2023

Magnetic resonance neurography (MRN) is increasingly used to visualize peripheral nerves in vivo. However, the implementation and interpretation of MRN in the brachial and lumbosacral plexi are challenging because of the anatomical complexity and technical limitations. The purpose of this article was to review the clinical context of MRN, describe advanced magnetic resonance (MR) techniques for plexus imaging, and list the general categories of utility of MRN with pertinent imaging examples. The selection and optimization of MR sequences are centered on the homogeneous suppression of fat and blood vessels while enhancing the visibility of the plexus and its branches. Standard 2D fast spin-echo sequences are essential to assess morphology and signal intensity of nerves. Moreover, nerve-selective 3D isotropic images allow improved visualization of nerves and multiplanar reconstruction along their course. Diffusion-weighted and diffusion-tensor images offer microscopic and functional insights into peripheral nerves. The interpretation of MRN in the brachial and lumbosacral plexi should be based on a thorough understanding of their anatomy and pathophysiology. Anatomical landmarks assist in identifying brachial and lumbosacral plexus components of interest. Thus, understanding the varying patterns of nerve abnormalities facilitates the interpretation of aberrant findings.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.131-135
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• 2008

Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

• Investigative Magnetic Resonance Imaging
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• 제2권1호
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• pp.96-103
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• 1998

목적 : 고식적인 자기공명혈관조영술 (MR Angiography, MRA) 기법으로는 영상화가 어려웠던 대동맥궁의 주요 분지들의 평가에 있어서 새로운 MR기법인 조영증강 MRA의 임상적 유용성을 알아보고, 그 화질을 사용한 코일의 종류에 따라 비교해 보고자 한다. 대상 및 방법 : 뇌혈관 질환을 의심하여 고식적인 기법으로 뇌 및 경동맥 MRA를 시행한 29명에서 전향적으로 Gd-DAPA 15-20ml를 일시에 손으로 주입한 후 대동맥궁과 그의 주요 분지들에 대해 3시기의 고속 MRA를 시행하여 그 화질을 분석하였다. MRA는 1.0T MR기종에서 3D-FISP기법으로 얻었으며 총 영상 획득 시간은 40-60초였다. 영상 분석은 무명동맥, 양측 총경동맥, 양측 쇄골하동맥과 양측 척추 동맥들의 기시부로부터 전장에 걸쳐 화질을 주관적으로 3등급(good; 명백히 정상소견을 보이는 경우, fair; 약간 낮은 신호를 보이나 정상으로 진단하기에 비교적 만족할 만한 경우, poor; 협착이 모호하거나, 인공물이나 너무 낮은 신호로 혈관을 볼 수 없어 카테터 혈관조영술을 요하는 경우)으로 나누어 평가하였으며, 양측 총경동맥의 분기(bifurcation) 부위에서는 고식적인 기법의 영상과 그 화질을 비교평가하였다. 또한 세가지 사용한 코일의 종류(CP body array 12예, CP neck array 9예, head-and-neck 8예)에 따른 화질 차이를 정성적 및 정량적(신호대 잡음비)으로 분석하였다. 결과 : 대동맥궁 주요 분지들의 전반적인 화질은 55% (16/29)에서 'good', 34%(10/29)에서 'fair'로 평가되어 대부분 고식적인 카테터 혈과조영술이 피요치 않을 정도로 만족할 만한 화질을 보였다. 양측 총경 동맥분지 부위에서는 65%(17/26)에서 고식적인 3D-TOF기법과 같거나 나은 영상을 보였다. CP body array 코일을 사용한 경우가 CP neck array 코일이나 head-and-neck 코일을 사용한 경우보다 정성적 및 정량적으로 유의하게 나은 영상을 보였다(p<0.05). 결론 : 고속 조영증강 MRA기법은 단시간내 (40-60초)에 대동맥구의 주요 분지들을 그 기시부위부터 두개골 저부에 이르기까지 대부분에서 잘 나타내주므로 선별검사로서 임상적으로 유용하리라 생각되며 CP body array 코일을 사용하였을 경우에 CP neck array 코일이나 head-and-neck 코일을 사용한 경우보다 좀더 나은 화질을 얻을 수 있으리라 생각된다.