• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.56-60
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• 2018

Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.132-135
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• 2016

We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.332-337
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• 2021

Behçet's disease is a chronic inflammatory disorder involving vessels of various sizes and organs, including the skin, joints, gastrointestinal tract, lungs, and cardiovascular system. The etiology of Behçet's disease is unclear, and clinical diagnosis is important in the absence of definitive laboratory or pathological findings diagnostic of Behçet's disease. Cardiac involvement is rare but might present as endocarditis, myocarditis, pericarditis, or intracardiac thrombosis. This report presents a case of Behçet's disease involving the heart in a 22-year-old man with unusual manifestations of right ventricular fibrosis and intracardiac thrombosis. Cardiac magnetic resonance imaging revealed multiple intracardiac thrombi and delayed diffuse subendocardial enhancement involving the right ventricle. No peripheral eosinophilia was detected. Endomyocardial biopsy showed mixed inflammatory cell infiltrates. Based on the patient's clinical history of oral ulcer and arthritis, a diagnosis of Behçet's disease was made considering the clinical, radiological, and histological findings. Intracardiac thrombi and endomyocardial fibrosis are rare manifestations of Behçet's disease, and the diagnosis is often a clinical challenge. Early diagnosis is important for appropriate management. Behçet's disease should be considered in the differential diagnosis of patients with intracardiac thrombosis and endomyocardial fibrosis of the right chamber.

• Investigative Magnetic Resonance Imaging
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• 제22권4호
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• pp.254-259
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• 2018

Application of magnetic resonance imaging (MRI) for assessment of pulmonary disease has been limited, due to susceptibility to cardiac pulsation, respiratory motion, and inhomogeneity of the magnetic field of the lung. With technical advances of MRI and unmet clinical needs for more accurate diagnosis and assessment of the disease, however, the use of MRI for evaluation of the lung has broadened. Herein, we present a case of pneumonic-type lung adenocarcinoma in a patient with history of anaphylactic shock to iodinated contrast medium, in which MRI played a critical role for targeted lung biopsy and cancer staging. Through this paper, we would like to report potential value of MRI in assessment of lung cancer.

• Investigative Magnetic Resonance Imaging
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• 제24권1호
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• pp.1-20
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• 2020

This document is the third part of the guidelines for the interpretation and post-processing of cardiac magnetic resonance (CMR) studies. These consensus recommendations have been developed by a Consensus Committee of the Korean Society of Cardiovascular Imaging (KOSCI) to standardize the requirements for image interpretation and post-processing of CMR. This third part of the recommendations describes tissue characterization modules, including perfusion, late gadolinium enhancement, and T1- and T2 mapping. Additionally, this document provides guidance for visual and quantitative assessment, consisting of "What-to-See," "How-To," and common pitfalls for the analysis of each module. The Consensus Committee hopes that this document will contribute to the standardization of image interpretation and post-processing of CMR studies.

• Tuberculosis and Respiratory Diseases
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• 제56권6호
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• pp.571-584
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• 2004

Magnetic Resonance Imaging (MRI) is one of the most advanced imaging techniques in clinical and research medicine. However, clinical application of MRI to the lung or thorax has been limited due to various drawbacks. Low signal intensity of the lung and cardiac and respiratory movements are the most serious problems with MRI in thorax. Nevertheless, MRI is superior to CT in some selected patients with thoracic diseases. The role of clinical MRI in thoracic disease has been widened with improvement of MR equipments and development of new pulse sequences. Otherwise, functional assessment of lung by MRI has been studied for the last decade. These include perfusion MRI with or without contrast enhancement and ventilation MRI with oxygen-enhancement or hyperpolarized noble gas, $^3He$ and $^{129}Xe$.

• Investigative Magnetic Resonance Imaging
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• 제18권3호
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• pp.244-252
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• 2014

목적 : 멀티 생체신호를 이용한 지능형 실시간 심장과 호흡에 동기화 하는 시스템을 사용하여 심장자기공명영상을 수행하였다. 또한 멀티 생체신호를 측정하는 과정에서 유기될 수 있는 eddy current의 특성을 분석하였다. 대상 및 방법 : 멀티 생체신호 동기화 시스템에서는 심전도 신호와 호흡신호 외에 추가로 $SPO_2$ 정보를 수집하여 심장의 움직임에 동기화 하였다. 심장운동의 동기화는 심전도와 함께 $SPO_2$의 이차미분 신호를 이용할 수 있음을 보였다. 심장 동기화 과정에서 피검자의 움직임과 부정맥에 의해 발생할 수 있는 잘못된 동기신호를 평균 R-R 시간을 이용하여 제거하였다. 심장 영상화를 위한 시퀀스에서 경사자계의 스위칭에 의해 유기될 수 있는 eddy current의 특성을 분석하여 하드웨어 및 소프트웨어 필터로 차단하였다. 결과 : 제안된 동기화 시스템을 이용하여 심장과 호흡 운동에 동기화된 심장자기공명영상을 얻었다. 심전도 신호에서 피검자의 움직임과 부정맥에 의해 발생할 수 있는 동기신호를 차단하였고, 심장 영상화 과정에서 유기될 수 있는 eddy current를 제거하였다. 또한 심전도 신호를 보완하여 $SPO_2$의 이차미분신호를 이용하여 심장 영상이 가능함을 보였다. 결론 : 본 논문에서 제안한 멀티 생체신호 동기화 시스템은 심장자기공명영상을 위해 여러 생체신호 (심전도, $SPO_2$, 호흡)를 이용하여 실시간으로 심장과 호흡 동기화를 수행한다. 심전도에서 피검사자의 움직임과 부정맥에 의해 발생할 수 있는 동기 신호를 차단하였다. 경사자계의 스위칭에 의해 생체신호에 유기될 수 있는 eddy current를 분석하였고, 심장과 호흡 동기를 병행하여 피검사자가 자유롭게 호흡하면서 심장 영상을 얻을 수 있었다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 춘계학술대회
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• pp.127-130
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• 1997

Phase-contrast(PC) methods have been used for quantitative measurements of velocity and volume flow rate. In addition, phase contrast cine magnetic resonance imaging (MRI) combines the flow dependent contrast of PC MRI with the ability of cardiac cine imaging to produce images throughout the cardiac cycle. In this method, the through-plane velocity has been encoded generally. However, the accuracy of the flow data can be reduced by the effect of flow direction, finite slice thickness, resolution, pulsatile flow pattern, and so on. In this study we calculated the error caused by misalignment of tomographic plane and flow directon. To reduce this error and encode the velocity for more complex flow, we suggested 3 directional velocity encoding method.

• Korean Journal of Radiology
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• 제24권10호
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• pp.960-973
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• 2023

The bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Patients with BAV are at higher risk of other congenital cardiovascular malformations and valvular dysfunction, including aortic stenosis/regurgitation and infective endocarditis. BAV may also be related to aortic wall abnormalities such as aortic dilatation, aneurysm, and dissection. The morphology of the BAV varies with the presence and position of the raphe and is associated with the type of valvular dysfunction and aortopathy. Therefore, accurate diagnosis and effective treatment at an early stage are essential to prevent complications in patients with BAV. This pictorial essay highlights the characteristics of BAV and its related congenital cardiovascular malformations, valvular dysfunction, aortopathy, and other rare cardiac complications using multimodal imaging.

• Investigative Magnetic Resonance Imaging
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• 제21권1호
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• pp.20-27
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• 2017

Purpose: To evaluate quantification results of single breath-hold (SBH) magnetic resonance (MR) cine imaging compared to results of conventional multiple breath-hold (MBH) technique for left ventricular (LV) function in patients with cardiac arrhythmia. Materials and Methods: MR images of patients with arrhythmia who underwent MBH and SBH cine imaging at the same time on a 1.5T MR scanner were retrospectively reviewed. Both SBH and MBH cine imaging were performed with balanced steady state free precession. SBH scans were acquired using temporal parallel acquisition technique (TPAT). Fifty patients ($65.4{\pm}12.3years$, 72% men) were included. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial mass, and LV regional wall motion were evaluated. Results: EF, myocardial mass, and regional wall motion were not significantly different between SBH and MBH acquisition techniques (all P-values > 0.05). EDV, ESV, and SV were significant difference between the two techniques. These parameters for SBH cine imaging with TPAT tended to lower than those in MBH. EF and myocardial mass of SBH cine imaging with TPAT showed good correlation with values of MBH cine imaging in Passing-Bablok regression charts and Bland-Altman plots. However, SBH imaging required significantly shorter acquisition time than MBH cine imaging ($15{\pm}7sec$ vs. $293{\pm}104sec$, P < 0.001). Conclusion: SBH cine imaging with TPAT permits shorter acquisition time with assessment results of global and regional LV function comparable to those with MBH cine imaging in patients with arrhythmia.