• Investigative Magnetic Resonance Imaging
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• 제25권1호
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• pp.23-34
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• 2021

Purpose: Differentiating between glioblastoma and solitary metastasis is very important for the planning of further workup and treatment. We assessed the ability of various morphological parameters using conventional MRI and diffusion-based techniques to distinguish between glioblastomas and solitary metastases in tumoral and peritumoral regions. Materials and Methods: We included 38 patients with solitary brain tumors (21 glioblastomas, 17 solitary metastases). To find out if there were differences in the morphologic parameters of enhancing tumors, we analyzed their shape, margins, and enhancement patterns on postcontrast T1-weighted images. During analyses of peritumoral regions, we assessed the extent of peritumoral non-enhancing lesion on T2- and postcontrast T1-weighted images. We also aimed to detect peritumoral neoplastic cell infiltration by visual assessment of T2-weighted and diffusion-based images, including DWI, ADC maps, and exponential DWI, and evaluated which sequence depicted peritumoral neoplastic cell infiltration most clearly. Results: The shapes, margins, and enhancement patterns of tumors all significantly differentiated glioblastomas from metastases. Glioblastomas had an irregular shape, ill-defined margins, and a heterogeneous enhancement pattern; on the other hand, metastases had an ovoid or round shape, well-defined margins, and homogeneous enhancement. Metastases had significantly more extensive peritumoral T2 high signal intensity than glioblastomas had. In visual assessment of peritumoral neoplastic cell infiltration using T2-weighted and diffusion-based images, all sequences differed significantly between the two groups. Exponential DWI had the highest sensitivity for the diagnosis of both glioblastoma (100%) and metastasis (70.6%). A combination of exponential DWI and ADC maps was optimal for the depiction of peritumoral neoplastic cell infiltration in glioblastoma. Conclusion: In the differentiation of glioblastoma from solitary metastatic lesions, visual morphologic assessment of tumoral and peritumoral regions using conventional MRI and diffusion-based techniques can also offer diagnostic information.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1303-1306
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• 2004

We developed a symmetrical upper limb motion trainer for chronic hemiparetic subjects. This trainer enabled the practice of a forearm pronatio $n^ination and wrist flexion/extension. In this study, we have used functional magnetic resonance imaging(fMRI) with the developed symmetrical upper limb motion device, to compare brain activation patterns elicited by flexion/extension wrist movements of control and hemiparetic subject group. In control group, contralateral somatosensory cortex(SMC) and bilateral cerebellum were activated by dominant hand movement(Task 1), while bilateral movements by dominant hand(Task 2) activated the SMC in both cerebral hemispheres and ipsilateral cerebellum. However, in hemiparetic subject group, contralateral supplymentary motor area(SMA) was activated by unaffected hand movement(Task 1), while the activation of bilateral movements by unaffected hand(Task 2) showed only SMA in the undamaged hemisphere. This study, demonstrating the ability to accurately measure activation in both sensory and motor cortex, is currently being extended to patients in clinical applications such as the recovery of motor function after stroke.ke.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.205-209
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• 2009

Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. Result : Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). Conclusion : Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.

• Investigative Magnetic Resonance Imaging
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• 제19권3호
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• pp.168-177
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• 2015

Purpose: Brain surface intensity model (BSIM)-based cortical thickness analysis does not require complicated 3D segmentation of brain gray/white matters. Instead, this technique uses the local intensity profile to compute cortical thickness. The aim of the present study was to evaluate intra-rater and inter-rater reliability of BSIM-based cortical thickness analysis using images from elderly participants. Materials and Methods: Fifteen healthy elderly participants (ages, 55-84 years) were included in this study. High-resolution 3D T1-spoiled gradient recalled-echo (SPGR) images were obtained using 3T MRI. BSIM-based processing steps included an inhomogeneity correction, intensity normalization, skull stripping, atlas registration, extraction of intensity profiles, and calculation of cortical thickness. Processing steps were automatic, with the exception of semiautomatic skull stripping. Individual cortical thicknesses were compared to a database indicating mean cortical thickness of healthy adults, in order to produce Z-score thinning maps. Intra-class correlation coefficients (ICCs) were calculated in order to evaluate inter-rater and intra-rater reliabilities. Results: ICCs for intra-rater reliability were excellent, ranging from 0.751-0.940 in brain regions except the right occipital, left anterior cingulate, and left and right cerebellum (ICCs = 0.65-0.741). Although ICCs for inter-rater reliability were fair to excellent in most regions, poor inter-rater correlations were observed for the cingulate and occipital regions. Processing time, including manual skull stripping, was $17.07{\pm}3.43min$. Z-score maps for all participants indicated that cortical thicknesses were not significantly different from those in the comparison databases of healthy adults. Conclusion: BSIM-based cortical thickness measurements provide acceptable intra-rater and inter-rater reliability. We therefore suggest BSIM-based cortical thickness analysis as an adjunct clinical tool to detect cortical atrophy.

• Investigative Magnetic Resonance Imaging
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• 제19권1호
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• pp.1-9
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• 2015

Purpose: Several morphometric studies have been performed to investigate brain abnormalities in congenitally deaf people. But no report exists concerning structural brain abnormalities in congenitally deaf adolescents. We evaluated the regional volume changes in gray matter (GM) using voxel-based morphometry (VBM) in congenitally deaf adolescents. Materials and Methods: A VBM8 methodology was applied to the T1-weighted magnetic resonance imaging (MRI) scans of eight congenitally deaf adolescents (mean age, 15.6 years) and nine adolescents with normal hearing. All MRI scans were normalized to a template and then segmented, modulated, and smoothed. Smoothed GM data were tested statistically using analysis of covariance (controlled for age, gender, and intracranial cavity volume). Results: The mean values of age, gender, total volumes of GM, and total intracranial volume did not differ between the two groups. In the auditory centers, the left anterior Heschl's gyrus and both inferior colliculi showed decreased regional GM volume in the congenitally deaf adolescents. The GM volumes of the lingual gyri, nuclei accumbens, and left posterior thalamic reticular nucleus in the midbrain were also decreased. Conclusions: The results of the present study suggest that early deprivation of auditory stimulation in congenitally deaf adolescents might have caused significant underdevelopment of the auditory cortex (left Heschl's gyrus), subcortical auditory structures (inferior colliculi), auditory gain controllers (nucleus accumbens and thalamic reticular nucleus), and multisensory integration areas (inferior colliculi and lingual gyri). These defects might be related to the absence of general auditory perception, the auditory gating system of thalamocortical transmission, and failure in the maturation of the auditory-to-limbic connection and the auditorysomatosensory-visual interconnection.

• Investigative Magnetic Resonance Imaging
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• 제7권2호
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• pp.93-99
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• 2003

문자와 그림을 인식하는데 있어 인식패턴의 반구차이는 인지심리학적으로 널리 연구되어왔고 또 증명되어졌다. 일반적으로 그림을 인식하는 있어서는 우반구 우세를 문자를 인식하는 있어는 좌반구 우세를 이야기하는데 본 논문에서는 그 사실을 바탕으로 fMRI 연구를 진행하였다. 동양문화권에서 문자로 사용되고 있는 한자 역시 그림으로 인식한다는 견해가 있다는 것이다. 한자의 인지가 좌반구 또는 우반구 우세라는 엇갈린 견해들이 있다. 그래서 본 논문에서는 한자와 그림의 인식패턴에 대한 반구차이 및 활성화되는 두뇌의 영역을 규명하기 위해 비교 실험하였다. 자극으로 사용되어진 그림은 한자와 동일한 의미를 가진 단순화된 것이다. 실험 디자인은 일반적으로 사용되는 블록디자인을 사용하였고 SPM을 사용하여 분석하였다. 결론으로 한자와 그림 인식패턴 모두 반구우세성을 이야길 할 경우 시각영역인 후두엽 및 측두엽 부분에서는 우반구 우세가 보이지만 일반적으로 반구우세성을 이야기하기는 무리가 있는 것 같다.

• 한국방사선학회논문지
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• 제10권8호
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• pp.629-635
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• 2016

자기공명영상 장치의 정도관리를 위한 ACR 팬텀은 팬텀내의 여러 구조물을 통하여 자기공명영상 화질을 평가할 수 있다. 본 연구는 3.0T 장비에서 Head coil에서 ACR 팬텀을 이용하여 임플란트와 치아 교정용 철사를 부착하여 영상의 고스트 신호 백분율과 절편 두께 정확도를 분석할 수 있었다. T1강조영상 첫 번째 절편과 열한 번째 절편의 임플란트 보철에서 절편위치 정확도는 수신대역폭이 230에서 좋게 나타났으며, 교정용 철사가 부착했을 때는 수신대역폭이 130일 때가 좋았다. 고스트 신호 백분율은 SE T1강조영상 일곱번째 절편에서 임플란트 보철에 추가된 교정용 철사의 경우에는 수신대역폭 230이 좋게 나타났다. 자기공명영상 검사에서 임플란트 보철 환자의 경우에 적절한 수신대역폭을 선택하여 영상의 왜곡과 신소 소실이 감소된 영상을 획득할 수 있을 것으로 사료된다.

• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.37-49
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• 2018

Purpose: The effect of global inhomogeneity on quantitative susceptibility mapping (QSM) was investigated. A technique referred to as Simultaneous Unwrapping Phase with Error Recovery from inhomogeneity (SUPER) is suggested as a preprocessing to QSM to remove global field inhomogeneity-induced phase by polynomial fitting. Materials and Methods: The effect of global inhomogeneity on QSM was investigated by numerical simulations. Three types of global inhomogeneity were added to the tissue susceptibility phase, and the root mean square error (RMSE) in the susceptibility map was evaluated. In-vivo QSM imaging with volunteers was carried out for 3.0T and 7.0T MRI systems to demonstrate the efficacy of the proposed method. Results: The SUPER technique removed harmonic and non-harmonic global phases. Previously only the harmonic phase was removed by the background phase removal method. The global phase contained a non-harmonic phase due to various experimental and physiological causes, which degraded a susceptibility map. The RMSE in the susceptibility map increased under the influence of global inhomogeneity; while the error was consistent, irrespective of the global inhomogeneity, if the inhomogeneity was corrected by the SUPER technique. In-vivo QSM imaging with volunteers at 3.0T and 7.0T MRI systems showed better definition in small vascular structures and reduced fluctuation and non-uniformity in the frontal lobes, where field inhomogeneity was more severe. Conclusion: Correcting global inhomogeneity using the SUPER technique is an effective way to obtain an accurate susceptibility map on QSM method. Since the susceptibility variations are small quantities in the brain tissue, correction of the inhomogeneity is an essential element for obtaining an accurate QSM.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.195-197
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• 2015

Artifacts can seriously degrade the quality of computed tomography (CT) images, sometimes to the point of making them diagnostically unusable. Here, we report an unusual CT artifact that could have resulted in the misdiagnosis of a hyperdense hemorrhagic lesion in a 55-year-old man. The author recommend that when hemorrhagic lesion in posterior fossa is suggested on CT, the physician should carefully consider all patient-related clinical data prior to considering surgical intervention or a biopsy. Cranial magnetic resonance imaging (MRI) can help in preventing the misdiagnosis as hemorrhage of CT scan.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.405-409
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• 2016

Meningiomas are typically diagnosed by their characteristic appearance on conventional magnetic resonance imaging (MRI). However, detailed image findings regarding peri- and intra-tumoral anatomical structures, tumor consistency and vascularity are very important in pre-surgical planning and surgical outcomes. At the 7.0 T MRI achieving ultra-high resolution, it could be possible to obtain more useful information in surgical strategy. Four patients who were radiologically diagnosed with intracranial meningioma in 1.5 T MRI underwent a 7.0 T MRI. Three of them underwent surgery afterwards, and one received gamma knife radiosurgery. In our study, the advantages of 7.0 T MRI over 1.5 T MRI were a more detailed depiction of the peri- and intra-tumoral vasculature and a clear delineation of tumor-brain interface. In the safety issues, all patients received 7.0 T MRI without any adverse event. One disadvantage of 7.0 T MRI was the reduced image quality of skull base lesions. 7.0 T MRI in patients with meningiomas could provide useful information in surgical strategy, such as the peri-tumoral vasculature and the tumor-brain interface.