• Investigative Magnetic Resonance Imaging
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• v.17 no.3
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• pp.200-206
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• 2013

Purpose : To assess the effect of applying an automated heart model based measurements of left ventricle (LV) and compare with manual and semi-automated measurements at Cardiovascular MR Imaging. Materials and Methods: Sixty-two patients who underwent cardiac 1.5T MR imaging were included. Steady state free precession cine images of 20 phases per cardiac cycle were obtained in short axis views and both 2-chamber and 4-chamber views. Epicardial and endocardial contours were drawn in manual, automated, and semi-automated ways. Based on these acquired contour sets, the end-diastolic (ED) and end-systolic (ES) volumes, ejection fraction (EF), systolic volume (SV) and LV mass were calculated and compared. Results: In EDV and ESV, the differences among three measurement methods were not statistically significant (P = .399 and .145, respectively). However, in EF, SV, and LV mass, the differences were statistically significant (P=.001, <001, <001, respectively) and the measured value from automated method tend to be consistently higher than the values from other two methods. Conclusion: An automatic heart model-based method grossly overestimate EF, SV and LV mass compared with manual or semi-automated methods. Even though the method saves a considerable amount of efforts, further manual adjustment should be considered in critical clinical cases.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.10-20
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• 2010

Purpose : Recently, the Recon Challenge at the 2009 ISMRM workshop on Data Sampling and Image Reconstruction at Sedona, Arizona was held to evaluate feasibility of highly accelerated acquisition of time resolved contrast enhanced MR angiography. This paper provides the step-by-step description of the winning results of k-t FOCUSS in this competition. Materials and Methods : In previous works, we proved that k-t FOCUSS algorithm successfully solves the compressed sensing problem even for less sparse cardiac cine applications. Therefore, using k-t FOCUSS, very accurate time resolved contrast enhanced MR angiography can be reconstructed. Accelerated radial trajectory data were synthetized from X-ray cerebral angiography images and provided by the organizing committee, and radiologists double blindly evaluated each reconstruction result with respect to the ground-truth data. Results : The reconstructed results at various acceleration factors demonstrate that each components of compressed sensing, such as sparsifying transform and incoherent sampling patterns, etc can have profound effects on the final reconstruction results. Conclusion : From reconstructed results, we see that the compressed sensing dynamic MR imaging algorithm, k-t FOCUSS enables high resolution time resolved contrast enhanced MR angiography.

• Proceedings of the KIEE Conference
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• 2011.07a
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• pp.2039-2040
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• 2011

자기공명영상에서 심장의 기능을 진단에 필요한 심장 영상을 얻기 위해서는 심장의 움직임을 모니터 할 수 있는 ECG나 pulse oximeter 등의 장비로 동기를 맞추어 주기위한 트리거 신호가 필요하다. 본 논문은 심장의 움직임을 다른 장비의 도움 없이 동기화하여 자기공명 심장 영상을 재구성하는 새로운 방법을 나선주사영상기법에 적용하여 제안하였다.

• Proceedings of the Korean Society of Medical Physics Conference
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• 1999.11a
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• pp.425-426
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• 1999

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1253-1265
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• 2021

Objective: To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR). Materials and Methods: The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51-66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality. Results: For the median follow-up duration of 5.4 years (interquartile range, 1.2-6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m², p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m² RVMI = 1.75, p < 0.001). After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005). Conclusion: RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.

• Progress in Medical Physics
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• v.10 no.3
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• pp.159-168
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• 1999

Cardiac disease is one of the leading causes of death in Korea. In quantitative analysis of cardiac function and morphological information by three-dimensional reconstruction of magnetic resonance images, left ventricle provides an important role functionally and physiologically. However, existing procedures mostly rely on the extensive human interaction and are seldom evaluated on clinical applications. In this study, we developed a system which could perform automatic extraction of enpicardial and endocardial contour and analysis of cardiac function to evaluate reliability and stability of each system comparing with the result of ARGUS system offered 1.5T Siemens MRI system and manual method performed by clinicians. For various aspects, we investigated reliability of each system by compared with left ventricular contour, end-diastolic volume (EDV), end-systolic volume (ESV), stock volume (SV), ejection fraction (EF), cardiac output (CO) and wall thickness (WT). When comparing with manual method, extracted results of developed process using minimum error threshold (MET) method that automatically extracts contour from cardiac MR images and ARGUS system were demonstrated as successful rate 90% of the contour extraction. When calculating cardiac function parameters using MET and comparing with using correlation coefficients analysis method, the process extracts endocardial and epicardial contour using MET, values from automatic and ARGUS method agreed with manual values within :t 3% average error. It was successfully demonstrated that automatic method using threshold technique could provide high potential for assessing of each parameters with relatively high reliability compared with manual method. In this study, the method developed in this study could reduce processing time compared with ARGUS and manual method due to a simple threshold technique. This method is useful for diagnosis of cardiac disease, simulating physiological function and amount of blood flow of left ventricle. In addition, this method could be valuable in developing automatic systems in order to apply to other deformable image models.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.613-616
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• 1997

We present a case of 58-year-old (tamale with dilated cardiomyopathy(DCMP) in whom we performed left ventricular(LV) remodeling surgery(Batista operation) to reduce the left ventricle diameter and improve left ventricular unction. The patient was admitted September 1996 with heart failure NYHA class IV. There was severe orthopnea and peripheral edema. 2-D echocardiography(Echo) showed DCMP with the ejection fraction(EF) I5%, LV end diastolic dimension(LVEDD) 80mm, mitral regurgitation(MR) grade IV, tricuspid regurgitation ('m) grade ll. Preoperative cardiac output(CO) was 1.5/L/min and cardiac index(Cl) was 1.0 L/min/m2. We proceeded with LV remodeling surgery by resection a part of LV lateral wall between both papillary muscle, from the mitral annulus to the LV apex. Size of resected LV wall was 90 $\times$ 100 $\times$ 15 mm. At the mean time, mitral valve and tricuspid valve were repaired. Postoperative 2-D Echo showed the EF 37%, LVEDD 50 mna, trivial MR, no TR. CO was 3.SL/min and Cl was 2.3 L/min/m2. Her fuctional NYHA class was 1.

• Investigative Magnetic Resonance Imaging
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• v.7 no.1
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• pp.22-30
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• 2003

Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.594-600
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• 2019

With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.549-552
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• 2006

In the mitral regurgitation (MR) accompanied with a serious ischemic cardiomyopathy (ICMP), coronary revascularization to viable myocardium, LV reduction and mitral reconstruction become the main surgery under the bad conditions that the cardiac transplantation is not so easy. The MR in ischemic cardiomyopathy appears as various pathologic factors, among them, the papillary muscle displacement in addition to the annular dilatation is pointed out as the important cause. Our hospital would like to report the experience of the surgery about coronary revascularization to the left main with 3-vessel coronary disease, severe ICMP patients accompanied with the MR, posterior mitral annuloplasty and papillary muscle plication through the LVtomy.