• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2010년도 춘계학술발표대회
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• pp.381-384
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• 2010

심장질환을 예방하기 위하여 정기적인 검진을 통한 심장 운동기능 분석과 관찰이 중요하며, 심장 기능의 분석은 좌심실의 수동윤곽분할을 통하여 혈류량과 심박구출률 계산을 통해 이루어진다. 본 논문에서는 심장단축 자기공명영상에서 좌심실을 자동분할하기 위한 연구에 대하여 설명한다. 관측자의 간섭을 최소화하고 심장기능 분석을 자동화하기 위한 자동 초기점을 추출한 후에, 그래프 탐색을 통하여 복잡한 심장 구조와 다양한 촬영환경에 적용할 수 있는 좌심실 분할 알고리즘을 제안한다. 실험 결과에 따르면 자동 초기점 추출 알고리즘의 성능은 86.8%로 나타났고, 진행 중인 그래프 탐색 알고리즘도 유용한 결과를 나타내고 있다.

• Korean Journal of Radiology
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• 제23권9호
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• pp.935-935
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• 2022

• Korean Journal of Radiology
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• 제22권10호
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• pp.1609-1618
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• 2021

Objective: Arrhythmogenic mitral valve prolapse (MVP) is an important cause of sudden cardiac death characterized by fibrosis of the papillary muscles or left ventricle (LV) wall, and an association between late gadolinium enhancement (LGE) of the LV papillary muscles and ventricular arrhythmia in MVP has been reported. However, LGE of the papillary muscles may be observed in other causes of mitral regurgitation, and it is not limited to patients with MVP. This study was to evaluate the association of LGE of the LV papillary muscles or ventricular wall on cardiac magnetic resonance imaging (CMR) and ventricular arrhythmia in patients with mitral regurgitation. Materials and Methods: This study included 88 patients (mean age ± standard deviation, 58.3 ± 12.0 years; male, 42%) with mitral regurgitation who underwent CMR. They were allocated to the MVP (n = 43) and non-MVP (n = 45) groups, and their LGE images on CMR, clinical characteristics, echocardiographic findings, and presence of arrhythmia were compared. Results: LV myocardial wall enhancement was more frequent in the MVP group than in the non-MVP group (28% vs. 11%, p = 0.046). Papillary muscle enhancement was observed in 7 (7.9%) patients. Of the 43 patients with MVP, 15 (34.8%) showed LGE in the papillary muscles or LV myocardium, including 12 (27.9%) with LV myocardial wall enhancement and 4 (9.3%) with papillary muscle enhancement. One patient with bilateral diffuse papillary muscle enhancement experienced sudden cardiac arrest due to ventricular fibrillation. Univariable logistic regression analysis showed that high systolic blood pressure (BP; odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; p = 0.027) and ventricular arrhythmia (OR, 6.84; 95% CI, 1.29-36.19; p = 0.024) were significantly associated with LGE of the papillary muscles. Conclusion: LGE of the papillary muscles was present not only in patients with MVP, but also in patients with other etiologies of mitral regurgitation, and it was associated with high systolic BP and ventricular arrhythmia. Papillary muscle enhancement on CMR should not be overlooked.

• Korean Journal of Radiology
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• 제22권3호
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• pp.324-333
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• 2021

Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1634-1641
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• 2000

Objective : The cerebrospinal fluid(CSF) pulsates within the craniospinal axis in response to rhythmic cerebral blood volume variation during the cardiac cycle. The aim of this study is to characterize the normal and abnormal CSF flow and its waveforms in the cervical spinal subarachnoid space. Methods : The magnetic resonance(MR) images were obtained with 1.5 T(GE Signa, GE Medical Systems, Milwaukee, USA) unit using the 2 dimensional cine PC(phase contrast) sequence with cardiac gating and gradient recalled echo imaging. This pulse sequence yielded 16 quantitative flow-encoded images per cardiac cycle. Sagittal and axial images of the cervical spinal CSF space were obtained, and target sites were analyzed for characteristic CSF flow (TR=50ms, TE=12.5-15ms). The region of interest(ROI) was 1mm 3 in volume. Twenty six persons were included in this study : 10 healthy volunteers and 16 patients with cervical myelopathy. The post-operative cine MR study were also done in five patients. Results : The normal CSF pulsation dynamics in the cervical spine showed discrete systolic and diastolic components. The CSF flow revealed a sine wave pattern, in which the systolic phase was shorter than the diastolic phase(ratio=2 : 3). The patient group revealed decreased amplitudes of the CSF flow and irregularly distored flow waves. The systolic phase was elongated in the ROI above the stenotic level, whereas the diastolic phase was lengthened below the level. In the postoperative images, the abnormal pattern and amplitude were found to be corrected. Conclusion : From these results, the authors believe that the CSF flow study provides valuable informations regarding the extent of cervical stenosis and may be useful for the surgical planning and post-operative evaluation.

• Journal of Yeungnam Medical Science
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• 제4권1호
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• pp.1-15
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• 1987

Magnetic Resonance (M.R.) is rapidly emerging technique that provides high quality images and potentially provides much more diagnostic information than do conventional imaging modalities. M.R.I. is conceptually quite different from currently used imaging methods. The complex nature of M.R.I. allows a great deal of flexibility in image product ion and available information, and key points are as follows. 1. M.R.I. offers a non-invasive technique with which to gene rate in vivo human images without ionizing radiation and with no known adverse biological effects. 2. Imaging mechanism of M.R.I. is quite different from conventional imaging modality and for more accurate diagnostic application, It is necessary for physician to understand imaging mechanism of M.R.I. 3. M.R. makes available basic chemical parameters that may provide to be useful for diagnostic medical imaging and more specific pathophysiologic information which are not available by alternate techniques. 4. M.R. can be produced by number of different methods. This flexibility allows the imaging technique to be applicated for particular clinical purpose. Multiplanar and three dimensional imaging may extend the imaging process beyond the single section available with current CT. 5. Future directions include efforts to; a. Further development of hard ware b. More fasternning scan time c. Respiratory and cardiac gated imaging d. Imaging of additional nuclei except hydrogen e. Further development of contrast media f. M.R. in vivo spectroscopy g. Real time M.R. imaging.

• 대한방사선기술학회지:방사선기술과학
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• 제25권1호
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• pp.55-62
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• 2002

Aneurysm-mimicking findings were frequently visualized due to hemodynamical causes of dephasing effects around area of A-com artery during magnetic resonance angiography(MRA) and these kind of phenomena have not been clearly known yet. We investigated the hemodynamical patterns of dephasing effect around area of the A-com artery that might be a cause of false intracranial aneurysms on MRA. For experimental study, We used hand-made silicon phantoms of the asymmetric A-com artery as like a bifurcation configuration. In a closed circulatory system with UHDC computer driven cardiac pump system. MRA and fast digital subfraction angiography(DSA) involved the use of these phantoms. Flow patterns were evaluated with axial and coronal imaging of MRA(2D-TOF, 3D-TOF) and DSA of Phantoms constructed from an automated closed-type circulatory system filled with glycerol solution [circulation fluid(glycerol:water = 1:1.4)]. These findings were then compared with those obtained from computational fluid dynamic(CFD) for inter-experimental correlation study. Imaging findings of MRA, DSA and CFD on inflow zone according to the following: a) MRA demonstrated high signal intensity zone as inflow zone on silicon phantom; b) Patterns of DSA were well matched with MRA on trajectory of inflow zone; and c) CFD were well matched with MRA on the pattern of main flow. Imaging findings of MRA. DSA and CFD on turbulent flow zone according to the following: a) MRA demonstrated hyposignal intensity zone at shoulder and axillar zone of main inflow; b) DSA delineated prominent vortex flow at the same area. The hemodynamical causes of signal defect, which could Induce the false aneurysm on MRA, turned out to be dephasing effects at axilla area of bifurcation from turbulent flow as the results of MRA, DSA and CFD.

• Investigative Magnetic Resonance Imaging
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• 제23권1호
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• pp.38-45
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• 2019

Purpose: To demonstrate the high-resolution numerical simulation of the respiration-induced dynamic $B_0$ shift in the head using generalized susceptibility voxel convolution (gSVC). Materials and Methods: Previous dynamic $B_0$ simulation research has been limited to low-resolution numerical models due to the large computational demands of conventional Fourier-based $B_0$ calculation methods. Here, we show that a recently-proposed gSVC method can simulate dynamic $B_0$ maps from a realistic breathing human body model with high spatiotemporal resolution in a time-efficient manner. For a human body model, we used the Extended Cardiac And Torso (XCAT) phantom originally developed for computed tomography. The spatial resolution (voxel size) was kept isotropic and varied from 1 to 10 mm. We calculated $B_0$ maps in the brain of the model at 10 equally spaced points in a respiration cycle and analyzed the spatial gradients of each of them. The results were compared with experimental measurements in the literature. Results: The simulation predicted a maximum temporal variation of the $B_0$ shift in the brain of about 7 Hz at 7T. The magnitudes of the respiration-induced $B_0$ gradient in the x (right/left), y (anterior/posterior), and z (head/feet) directions determined by volumetric linear fitting, were < 0.01 Hz/cm, 0.18 Hz/cm, and 0.26 Hz/cm, respectively. These compared favorably with previous reports. We found that simulation voxel sizes greater than 5 mm can produce unreliable results. Conclusion: We have presented an efficient simulation framework for respiration-induced $B_0$ variation in the head. The method can be used to predict $B_0$ shifts with high spatiotemporal resolution under different breathing conditions and aid in the design of dynamic $B_0$ compensation strategies.

• Investigative Magnetic Resonance Imaging
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• 제5권1호
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• pp.38-42
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• 2001

2D TOF혈관조영술에서 presaturation RF펄스를 사용하여 정맥피에서 나오는 MR신호를 제거하고 얻은 동맥 angiogram에는 band형태로 동맥이 끊어져 나타나는 현상이 자주 보인다. 일부 동맥에서 피의 흐름은 한 심장 주기 동안에 3번의 펄스를 갖는데, 이 중 가운데 펄스는 짧은 기간 동안 역류를 한다. 이 역류하는 동맥피는 정맥피와 같은 방향이기 때문에 presaturation RF펄스에 의해 정맥피 처럼 saturation이 되어서 imaging slice로 흘러 들어가게 될 수 있다. 특히 이러한 경우가 phase encoding step의 dc 부근에서 발생하게 되면 그 때의 단면 영상에서 동맥이 강조가 될 수 없게 되어, 결과적으로 angiogram에는 그 단면을 지나는 동맥의 신호가 없어서 band 형태로 핏줄이 끊어져 나타나게 된다. Imaging slice와 saturation band와의 간격을 변화 시켜 가면서 angiogram을 얻어 봄으로서 이러한 현상을 실험적으로 확인하였다 나아가 saturation band를 rectangle형태에서 ramp 형태로 변경함으로써 이러한 artifacts를 제거 할 수 있는 방법을 제시하였다

• Korean Journal of Radiology
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• 제22권4호
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• pp.535-546
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• 2021

Objective: To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). Materials and Methods: This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. Results: A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility. Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002). Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). Conclusion: The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.