• Korean Journal of Radiology
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• 제22권9호
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• pp.1537-1546
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• 2021

Objective: To assess the role of arterial spin-labeling (ASL) perfusion MRI in identifying cerebral perfusion changes after indirect revascularization in children with moyamoya disease. Materials and Methods: We included pre- and postoperative perfusion MRI data of 30 children with moyamoya disease (13 boys and 17 girls; mean age ± standard deviation, 6.3± 3.0 years) who underwent indirect revascularization between June 2016 and August 2017. Relative cerebral blood flow (rCBF) and qualitative perfusion scores for arterial transit time (ATT) effects were evaluated in the middle cerebral artery (MCA) territory on ASL perfusion MRI. The rCBF and relative time-to-peak (rTTP) values were also measured using dynamic susceptibility contrast (DSC) perfusion MRI. Each perfusion change on ASL and DSC perfusion MRI was analyzed using the paired t test. We analyzed the correlation between perfusion changes on ASL and DSC images using Spearman's correlation coefficient. Results: The ASL rCBF values improved at both the ganglionic and supraganglionic levels of the MCA territory after surgery (p = 0.040 and p = 0.003, respectively). The ATT perfusion scores also improved at both levels (p < 0.001 and p < 0.001, respectively). The rCBF and rTTP values on DSC MRI showed significant improvement at both levels of the MCA territory of the operated side (all p < 0.05). There was no significant correlation between the improvements in rCBF values on the two perfusion images (r = 0.195, p = 0.303); however, there was a correlation between the change in perfusion scores on ASL and rTTP on DSC MRI (r = 0.701, p < 0.001). Conclusion: Recognizing the effects of ATT on ASL perfusion MRI may help monitor cerebral perfusion changes and complement quantitative rCBF assessment using ASL perfusion MRI in patients with moyamoya disease after indirect revascularization.

• 한국의학물리학회지:의학물리
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• 제21권4호
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• pp.348-353
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• 2010

임상적용 전 단계에서 마우스와 같은 작은 설치류를 이용한 신경학적 실험의 필요성이 높아지면서 임상용 3T MRI를 이용한 마우스 뇌 영상의 요구가 높아지고 있다. 본 연구에서는 임상용 3T MRI를 이용한 마우스 뇌 영상의 가능성과 기술적인 적용과 최적화에 대해 알아보고자 하였다. 20~25g 체중 마우스 3마리에서 임상용 3T MRI를 이용하여 T1 강조영상(T1WI), T2 강조영상(T2WI), FLAIR (Fluid Attenuated Inversion Recovery) 영상, 가돌리늄 조영 T1 강조영상(Gd-T1WI), 확산 강조영상(DWI)을 시행하였다. 대상이 되었던 마우스 1마리는 뇌 경색을 유발시키지 않았으며 2마리는 우측 중대뇌동맥을 결찰하여 일측 뇌경색을 유발하고 1시간, 24시간, 72시간에 각각의 MRI 영상을 시행하였으며 각 영상에서 마우스 뇌의 striatum, 뇌실, 대뇌 피질의 해부학적 구별, 뇌 경색 부위의 진단 가능성 등을 분석하였다. T2WI에서 마우스 뇌의 striatum, 뇌실, 대뇌 피질의 해부학적 구별이 모두 가능하였고 T1WI, FLAIR, DWI 영상에서는 위의 해부학적 경계부위의 해상도는 감소하였다. 뇌경색 부위는 경색 후 1시간, 24시간, 72시간 영상 모두에서 발견되었고 T2WI, FLAIR에서는 24시간, 72시간에서만 구분되었다. 임상용 3T MRI를 이용한 마우스 뇌 영상에서 해부학적 부위의 구별이 가능하였고 특히 DWI를 이용하여 급성기 뇌 경색의 진단이 가능하였다. 앞으로 기술적인 적용과 최적화를 위한 노력이 계속 진행된다면 임상 실험에 큰 도움을 줄 수 있을 것이라 생각된다.

• Annals of Clinical Neurophysiology
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• 제7권1호
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• pp.34-36
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• 2005

Two hemiplegic cerebral palsy patients were studied to investigate the cortical mechanisms underlying preserved somatosensory capacity, using functional MRI(fMRI). Tactile stimulation was performed by brushing of palm, during fMRI study. By the affected hand stimulation, contralateral primary somatosensory cortex was activated in patient 1 and cortical area anterior to the lesion site was activated in patient 2. We suggest that reorganization of the somatosensory cortex after brain injury can be induced by recruitment of undamaged areas adjacent to lesion site.

• 한국방사선학회논문지
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• 제6권1호
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• pp.19-26
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• 2012

급성 뇌졸중의 경우 빠른 시간 내의 진단과 치료가 예후에 큰 영향을 미친다. 본 연구에서는 초급성기 뇌경색 환자에서 관류CT와 확산강조MRI의 영상을 비교하여 허혈 부위와 경색부위에 나타나는 차이점을 알아보고자 하였다. 뇌관류 CT와 확산강조 자기공명영상(diffusion weighted MR imaging, DW-MRI)을 시행한 12명의 급성뇌경색 환자를 대상으로 병변부위와 정상부위에서 각각의 CBF, CBV, MTT, TTP지도와 DW-MRI의 신호강도 값을 비교하고, 관류CT와 DW-MRI에서 병변의 크기 비교를 해보았다. CBF, CBV, MTT, TTP는 모두 관류결손을 보였고, 관류 결손이 인지되는 부위에서 MTT와 TTP시간의 현저한 지연이 있었다. 뿐만 아니라, MTT와 TTP 지도의 결손부위 면적은 DW-MRI 보다 크게 나타나 허혈성 반음영을 추측할 수 있었고, 일부 DW-MRI에서 경색부위를 나타내지 못하는 경우도 있었다. 결론적으로 관류 CT의 지도를 이용하면 뇌경색의 조기 진단뿐만 아니라 허혈 중심부, 그리고 허혈성 반음영을 예측하여 관류결손 부위의 혈류 역학적 상태를 평가 할 수 있어 보다 효과적인 치료계획을 세울 수 있다.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.388-391
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• 2011

A lesion that is hyperintense on diffusion-weighted imaging (DWI) and hypointense on the apparent diffusion coefficient (ADC) map is a characteristic magnetic resonance imaging (MRI) finding in acute ischemic infarction. In some cases, however, these findings can persist for a few months after infarct onset. It is thought that these finding reflect the different evolution speeds of the infarcted tissue. We report a patient with a right middle cerebral artery territory infarction with persistent hyperintensity on DWI and hypointensity on the ADC map for over 8 months. To our knowledge, this is the most persistent case of hyperintensity lesion on DWI and the serial MRI images of this patient provide important information on the evolution of infarcted tissue.

• 대한디지털의료영상학회논문지
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• 제13권2호
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• pp.55-58
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• 2011

It is important to study using experimental animals for research about stroke. Magnetic Resonance Imaging(MRI) is avaluable diagnosticmethods for stroke diagnosis. The purpose of this research is to know the Magnetic Resonance Imaging(MRI) and histopathological characteristics findings after induction of photothrombotic cerebral infarction in rat brain. Male Sprague-Dawley rats were anesthetized, Rose Bengal dye(20 mg/kg) was intravenously injected. The right sensonrimotor cortex of rat brain was exposed to cold light of 7 mm diameter at a position of 1 mm anterior and 3.5 mm lateral to bregma for 20 min. The post-infarction effects were monitored by T1 weighted and T2 weighted images of brain MRI. Histopathological changes were observed after Hematoxylin & Eosin staining. The lesion appeared clearly high signal intensity area on T2 weighted images(the major axis $7.04{\pm}0.11$ mm, the minor axis $3.08{\pm}0.04$ mm) and also H&E staining was same result. In conclusion, MRI was avaluable diagnostic methods for diagnosis and serial changes of stroke.

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.295-345
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• 2003

This study investigated activation of cerebral cortex in patients with hemiplegia that was caused by neural damage. Key-point control movement therapy of Bobath was performed for 9 weeks in 3 subjects with hemiplegia and fMRI was used to compare and analyze activated degree of cerebral cortex in these subjects. fMRI was conducted using the blood oxygen level-dependent(BOLD) technique at 3.0T MR scanner with a standard head coil. The motor activation task consisted of finger flexion-extension exercise in six cycles(one half-cycles = 8 scans = $3\;sec{\times}\;8\;=\;24\;sec$). Subjects performed this task according to visual stimulus that sign of right hand or left hand twinkled(500ms on, 500ms off). After mapping activation of cerebral motor cortex on hand motor function, below results were obtained. 1. Activation decreased in primary motor area, whereas it increased in supplementary motor area and visual association area(p<.001). 2. Activation was observed in bilateral medial frontal gyrus, middle frontal gyrus of left cerebrum, inferior frontal gyrus, inter-hemispheric, fusiform gyrus of right cerebrum, superior parietal lobule of parietal lobe and precuneus in subjedt 1, parahippocampal gyrus of limbic lobe and cingulate gyrus in subject 2, and inferior frontal gyrus of right frontal lobe, middle frontal gyrus, and inferior parietal lobule of left cerebrum in subject 3 (p<.001). 3. Activation cluster extended in declive of right cellebellum posterior lobe in subject 1, culmen of anterior lobe and declive of posterior lobe in subject 2, and dentate gyrus of anterior lobe, culmen and tuber of posterior lobe in subject 3 (p<.001). In conclusion, these data showed that Key-point control movement therapy of Bobath after stroke affect cerebral cortex activation by increasing efficiency of cortical networks. Therefore mapping of brain neural network activation is useful for plasticity and reorganization of cerebral cortex and cortico-spinal tract of motor recovery mechanisms after stroke.

• Korean Journal of Radiology
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• 제24권8호
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• pp.784-794
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• 2023

Objective: To determine whether dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) can be used to evaluate posterior cerebral circulation in pediatric patients with moyamoya disease (MMD) who underwent anterior revascularization. Materials and Methods: This study retrospectively included 73 patients with MMD who underwent DSC perfusion MRI (age, 12.2 ± 6.1 years) between January 2016 and December 2020, owing to recent-onset clinical symptoms during the follow-up period after completion of anterior revascularization. DSC perfusion images were analyzed using a dedicated software package (NordicICE; Nordic NeuroLab) for the middle cerebral artery (MCA), posterior cerebral artery (PCA), and posterior border zone between the two regions (PCA-MCA). Patients were divided into two groups; the PCA stenosis group included 30 patients with newly confirmed PCA involvement, while the no PCA stenosis group included 43 patients without PCA involvement. The relationship between DSC perfusion parameters and PCA stenosis, as well as the performance of the parameters in discriminating between groups, were analyzed. Results: In the PCA stenosis group, the mean follow-up duration was 5.3 years after anterior revascularization, and visual disturbances were a common symptom. Normalized cerebral blood volume was increased, and both the normalized time-topeak (nTTP) and mean transit time values were significantly delayed in the PCA stenosis group compared with those in the no PCA stenosis group in the PCA and PCA-MCA border zones. TTP_PCA (odds ratio [OR] = 6.745; 95% confidence interval [CI] = 2.665-17.074; P < 0.001) and CBV_PCA-MCA (OR = 1.567; 95% CI = 1.021-2.406; P = 0.040) were independently associated with PCA stenosis. TTP_PCA showed the highest receiver operating characteristic curve area in discriminating for PCA stenosis (0.895; 95% CI = 0.803-0.986). Conclusion: nTTP can be used to effectively diagnose PCA stenosis. Therefore, DSC perfusion MRI may be a valuable tool for monitoring PCA stenosis in patients with MMD.

• 영재교육연구
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• 제23권3호
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• pp.421-434
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• 2013

청소년들의 뇌는 급속한 변화를 겪는다. 그동안 신경해부학적 특성과 일반지능(IQ)과의 관련성을 알아보기 위한 연구가 지속적으로 이뤄져 왔으나 대부분 단편적이었다. 본 연구는 단순히 대뇌 피질 두께를 한 번 측정한 것이 아니고, 대뇌 피질 두께의 변화를 추적하여 일반지능과 그 변화 간의 관련성을 추정하였다. 건강한 청소년 75명(M=16세 4개월)을 5단계의 지능범주별로 나눈 뒤 6개월의 간격을 두고 MRI 촬영을 두 번씩 하여 대뇌 피질 두께 변화를 알아냈다. 그 결과 일반지능 범주별로 대뇌 피질 두께 변화에 차이가 크게 나타났다. 일반지능이 120 이상인 세 그룹은 관찰 대상인 11개 뇌 영역의 대뇌 피질 두께가 모두 감소했으나, 그 이하의 두 개 그룹에서는 지능이 낮을수록 늘어나는 영역이 5~8개나 됐다. 이는 일반지능이 낮을수록 대뇌피질의 성숙이 늦어지는 것으로 추정할 수 있다.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.365-369
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• 2009

Objective : Susceptibility-weighted image (SWI) is a sensitive magnetic resonance image (MRI) technique to detect cerebral microbleeds (MBLs). which would not be detected by conventional MRI. We performed SWI to detect MBLs and investigated its usefulness in the evaluation of mild traumatic brain injury (MTBI) patients. Methods : From December 2006 to June 2007, twenty-one MTBI patients without any parenchymal hemorrhage on conventional MRI were selected. Forty-two patients without trauma were selected for control group. According to the presence of MBLs, we divided the MTBI group into MBLs positive [SWI (+)] and negative [SWI (-)] group. Regional distribution of MBLs and clinical factors were compared between groups. Results : Fifty-one MBLs appeared in 16 patients of SWI (+) group and 16 MBLs in 10 patients of control group [control (+)], respectively. In SWI (+) group, MBLs were located more frequently in white matters than in deep nucleus different from the control (+) group (p<0.05). Nine patients (56.3%) of SW (+) group had various neurological deficits (disorientation in 4, visual field defect in 2, hearing difficulty in 2 and Parkinson syndrome in 1). Initial Glasgow Coma Scale (GCS)/mean Glasgow Outcome Scale (GOS) were $13.9{\pm}1.5/4.7{\pm}0.8$ and $15.0{\pm}0.0/5.0{\pm}0.0$ in SWI (+) and SWI (-) groups, respectively (p<0.05). Conclusion : Traumatic cerebral MBLs showed characteristic regional distribution, and seemed to have an importance on the initial neurological status and the prognosis. SWI is useful for detection of traumatic cerebral MBLs, and can provide etiologic evidences for some post-traumatic neurologic deficits which were unexplainable with conventional MRI.