• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.114-124
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• 2019

Purpose: We investigate biases in the assessments of left ventricular function (LVF), by compressed sensing (CS)-cine magnetic resonance imaging (MRI). Materials and Methods: Cardiovascular cine images with short axis view, were obtained for 8 volunteers without CS. LVFs were assessed with subsampled data, with compression factors (CF) of 2, 3, 4, and 8. A semi-automatic segmentation program was used, for the assessment. The assessments by 3 CS methods (ITSC, FOCUSS, and view sharing (VS)), were compared to those without CS. Bland-Altman analysis and paired t-test were used, for comparison. In addition, real-time CS-cine imaging was also performed, with CF of 2, 3, 4, and 8 for the same volunteers. Assessments of LVF were similarly made, for CS data. A fixed compensation technique is suggested, to reduce the bias. Results: The assessment of LVF by CS-cine, includes bias and random noise. Bias appeared much larger than random noise. Median of end-diastolic volume (EDV) with CS-cine (ITSC or FOCUSS) appeared -1.4% to -7.1% smaller, compared to that of standard cine, depending on CF from (2 to 8). End-systolic volume (ESV) appeared +1.6% to +14.3% larger, stroke volume (SV), -2.4% to -16.4% smaller, and ejection fraction (EF), -1.1% to -9.2% smaller, with P < 0.05. Bias was reduced from -5.6% to -1.8% for EF, by compensation applied to real-time CS-cine (CF = 8). Conclusion: Loss of temporal resolution by adopting missing data from nearby cardiac frames, causes an underestimation for EDV, and an overestimation for ESV, resulting in underestimations for SV and EF. The bias is not random. Thus it should be removed or reduced for better diagnosis. A fixed compensation is suggested, to reduce bias in the assessment of LVF.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.149-156
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• 2016

Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were $96.17{\pm}19.12ml/sec$, $17.04{\pm}4.12cm/sec$ respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of $72.31{\pm}13.27ml$ and $12.32{\pm}3.85$. On the other hand, the average 2NEX blood flow and mean flow velocity is $101.90{\pm}24.09$, $16.84{\pm}4.32$, 3NEX $103.06{\pm}25.49$, $16.88{\pm}4.19$ did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were $76.68{\pm}19.72ml/s$, and $22.23{\pm}4.8$, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.127-130
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• 1997

A 67-year old man with a history of cardiac disease underwent epidural catheterization for pain control of postherpetic neuralgia. Patient had severe back pain and pus discharge at catheter insertion site after dischange from medical part. Patient received anticoagulant therapy with $Aspirin^{(R)}$ and $Coumadin^{(R)}$ prescribed for 15 days in medical part. Magnetic resonance imaging(MRI) showed a diffuse $T_{4-7}$ anterior epidural mass compressing the spinal cord. Emergency surgical exploration revealed a thoracic epidural hematoma without abcess formation. Operation was successful and patient recovered satisfactory without any sequelae.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.130-133
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• 2000

Epiduroscopy is a new imaging and invasive technique that has become increasingly popular in the diagnosis and therapy of spinal pain syndrome. However, the risk of epiduroscopy is a major concern due to its invasiveness. The complications include hematoma, infection, neural damage, cardiac failure and raising of intracranial pressure. We have experienced a case of severe diffuse headache and dizziness following 1 day after epiduroscopy. Emergent brain MRI finding has no remarkable sign. The patient was admitted for 5 days to be treated with bed rest, adequate hydration and pain control with analgesics. After the treatments, she was recovered without residual sequelae and discharged. We need to take greater care of the undesirable effects detected intra- and post epiduroscopy, especially sign of increased intracranial pressure. Therefore, close monitoring of intracranial pressure is necessary during epiduroscopy.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.784-787
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• 1995

A 3-year old female who underwent modified Fontan operation for the double outlet right ventricle with hypoplastic left ventricle at the age of 15 month was admitted with hemoptysis, which was developed 4 days prior to visit. Cardiac catheterization revealed that multiple collaterals from descending thoracic aorta supplied the right lung and drained to the right pulmonary artery. Chest magnetic resonance imaging [MRI showed that the right lung was consolidated by the secondary long-term pulmonary congestion. We decided to perform pneumonectomy because the consolidated right lung and the back-flow from the right pulmonary aretry would worsen the present hemodynamic state of patient. Post-operative course was uneventful, and she could be discharged with good general conditions.

• Proceedings of the KSMRM Conference
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• 1999.04a
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• pp.34-42
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• 1999

의료영상에서 인공물(Artifacts) 이라 함은 영상이 얻어지는 신체부위와 아무런 관련이 없으나 얻어진 영상에는 마치 영상의 일부분으로 나타나는 모든 것을 가리킨다. 따라서 영상에서 이들 인공물들은 실제 조직의 해부학적인 구조를 나타내지 않으므로 영상 판독에 영향을 주어 잘못된 진단을 초래할 수도 있다. 그러나 MR 영상이 가능한 이래로 새로운 여러 종류의 MR 인공물들이 많이 발견 되었으나 다행스럽게도 거의 모든 MR 인공물들은 쉽게 설명이 가능하며, 따라서 이들 인공물들에 의한 진단 오류의 가능성은 매우 희박한 실정이다. 그러나 새로운 영상방법이나 혹은 새로운 펄스대열이 계속 고안됨에 따라 새로운 종류의 인 공물들이 생겨날 가능성은 항상 존재하고 있다. 지금까지 알려진 여러 MR 인공물들은 그 생겨난 원인에 따라 다음과 같이 크게 세 가지로 분류가 가능하다. I. Motion Artifacts 1. Voluntary motion 2. Involuntary motion 1) Bowel Peristalsis 2) Respiration 3) Cardiac and vessel pulsation 4) Swallowing 3. Fluid motion 1) Blood flow 2) Cerebrospinal fluid flow II. Reconstruction Artifacts 1. Aliasing 2. Partial volume averaging 3. Truncation (Ringing) 4. Central point III. Magnetic and RF Field Related Artifacts 1. Chemical shift 1) First kind 2) Second kind 2. Susceptibility 1) Dental 2) Metal 3. Magic angle 4. Zipper 5. Bad data point 6. RF field inhomogeneity 7. Magnetic field inhomogeneity 8. Eddy current 9. slice overlapping 10. Zebra 11. RF overflow

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1194-1201
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• 2006

Purpose : The comatose mentality can be catastrophic, especially if the condition is severe or the duration is prolonged. Therefore, delayed diagnosis can result in a poor outcome or death. The best radiologic modality to differentiate from cerebral lesions in patients suffering from cerebral diseases is magnetic resonance imaging (MRI) rather than computed tomography (CT). Special apparatuses with metal materials such as ventilators, and cardiac pacemakers belonging to patients cannot be located in the magnetic field. We aimed to exhibit the possibility of examining MRI, maintaining ventilation at a relative long distance by means of modified $Ambu^{(R)}$. Methods : Self-inflating bags as a sort of a manual ventilator, connected with relatively long extension tubes instead of mechanical ventilators, were adopted to obtain MRI. PVC (polyvinyl chloride) extension tubes had different lengths and diameters. Lengths were 1, 2, and 3 cm and diameters were 15, and 25 mm. The work of breathing and expiratory changes of expiratory tidal volume (TVe), minute volume of expiration (MVe), peak inspiratory pressure (PIP) were measured by use of the mechanical ventilator, $Servoi^{(R)}$, as the alteration of TVi (inspiratory tidal volume), extension tube lengths and diameters with other values fixed. Results : Measured TVe and MVe by ventilator were the same values with control at every TVi, regardless of extension tube lengths and diameters, but PIP were increased with the rise of TVi, tube lengths, with decline of tube diameters, these were statistically significant. Conclusion : MRI examination can be carried out with a self-inflating bag connected with an extension tube at a long distance in patients who need artificial ventilation.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.880-889
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• 2021

Objective: This study aimed to investigate the regional amyloid burden and myocardial deformation using T1 mapping and strain values in patients with cardiac amyloidosis (CA) according to late gadolinium enhancement (LGE) patterns. Materials and Methods: Forty patients with CA were divided into 2 groups per LGE pattern, and 15 healthy subjects were enrolled. Global and regional native T1 and T2 mapping, extracellular volume (ECV), and cardiac magnetic resonance (CMR)-feature tracking strain values were compared in an intergroup and interregional manner. Results: Of the patients with CA, 32 had diffuse global LGE (group 2), and 8 had focal patchy or no LGE (group 1). Global native T1, T2, and ECV were significantly higher in groups 1 and 2 than in the control group (native T1: 1384.4 ms vs. 1466.8 ms vs. 1230.5 ms; T2: 53.8 ms vs. 54.2 ms vs. 48.9 ms; and ECV: 36.9% vs. 51.4% vs. 26.0%, respectively; all, p < 0.001). Basal ECV (53.7%) was significantly higher than the mid and apical ECVs (50.1% and 50.0%, respectively; p < 0.001) in group 2. Basal and mid peak radial strains (PRSs) and peak circumferential strains (PCSs) were significantly lower than the apical PRS and PCS, respectively (PRS, 15.6% vs. 16.7% vs. 26.9%; and PCS, -9.7% vs. -10.9% vs. -15.0%; all, p < 0.001). Basal ECV and basal strain (2-dimensional PRS) in group 2 showed a significant negative correlation (r = -0.623, p < 0.001). Group 1 showed no regional ECV differences (basal, 37.0%; mid, 35.9%; and apical, 38.3%; p = 0.184). Conclusion: Quantitative T1 mapping parameters such as native T1 and ECV may help diagnose early CA. ECV, in particular, can reflect regional differences in the amyloid deposition in patients with advanced CA, and increased basal ECV is related to decreased basal strain. Therefore, quantitative CMR parameters may help diagnose CA and determine its severity in patients with or without LGE.

• Korean Journal of Radiology
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• v.24 no.7
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• pp.647-659
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• 2023

Objective: The study was conducted to investigate the effect of correct occlusion of the left atrial appendage (LAA) on intracardiac blood flow and thrombus formation in patients with atrial fibrillation (AF) using four-dimensional (4D) flow magnetic resonance imaging (MRI) and three-dimensional (3D)-printed phantoms. Materials and Methods: Three life-sized 3D-printed left atrium (LA) phantoms, including a pre-occlusion (i.e., before the occlusion procedure) model and correctly and incorrectly occluded post-procedural models, were constructed based on cardiac computed tomography images from an 86-year-old male with long-standing persistent AF. A custom-made closed-loop flow circuit was set up, and pulsatile simulated pulmonary venous flow was delivered by a pump. 4D flow MRI was performed using a 3T scanner, and the images were analyzed using MATLAB-based software (R2020b; Mathworks). Flow metrics associated with blood stasis and thrombogenicity, such as the volume of stasis defined by the velocity threshold ($\left|\vec{V}\right|$ < 3 cm/s), surface-and-time-averaged wall shear stress (WSS), and endothelial cell activation potential (ECAP), were analyzed and compared among the three LA phantom models. Results: Different spatial distributions, orientations, and magnitudes of LA flow were directly visualized within the three LA phantoms using 4D flow MRI. The time-averaged volume and its ratio to the corresponding entire volume of LA flow stasis were consistently reduced in the correctly occluded model (70.82 mL and 39.0%, respectively), followed by the incorrectly occluded (73.17 mL and 39.0%, respectively) and pre-occlusion (79.11 mL and 39.7%, respectively) models. The surfaceand-time-averaged WSS and ECAP were also lowest in the correctly occluded model (0.048 Pa and 4.004 Pa^-1, respectively), followed by the incorrectly occluded (0.059 Pa and 4.792 Pa^-1, respectively) and pre-occlusion (0.072 Pa and 5.861 Pa^-1, respectively) models. Conclusion: These findings suggest that a correctly occluded LAA leads to the greatest reduction in LA flow stasis and thrombogenicity, presenting a tentative procedural goal to maximize clinical benefits in patients with AF.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.3
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• pp.1294-1300
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• 2013

The purpose of this study is to increase contrast to noise ratio(CNR) in myocardial viability test by using contrast agent which highly content gadolinium(1mmol/mL) maximizing diagnostic value. This research method that four hundred four patients were underwent the MRI scanning two hundred eighty four of them were injected commercial contrast media which have 0.5mmol/L and the rest of them were injected new contrast media(gadobutrol) which have 1mmol/mL of molarity to study the contrast difference depending on the molarity of the contrast agent signal intensities of normal ventricle and left ventricle were measured to compare and evaluate signal to noise ratio(SNR) and CNR of the images. As result, 1mmol/mL contrast agent showed higher SNR by 25.13% in myocardium and 30.74% in left ventricle. CNR was proved to be better in 1mmol/mL contrast agent by 31.29%. The results above were all statistically meaningful. Therefore, contrast agent contenting more gadolinium which was 1mmol/mL in this study, could more effectively shorten T1 relaxation time, increase the signal intensity and at the same time maximize CNR and diagnostic value. This study firstly report the usefulness of 1mmol/mL contrast agent in patients allegedly suffering cardiac diseases and it is considered to increase diagnostic value.