• 한국정밀공학회지
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• 제22권1호
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• pp.183-192
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• 2005

This study compared cerebral lateralization index based on the area of neural activation with that based on the intensity of neural activation. For this purpose, 8 right-handed male college students (the mean age - 23.5 years) and 10 right-handed male college students (the mean age - 25.1 years) participated respectively in researches on visuospatial and verbal task brain function. Functional brain images were taken from 3T MRI using the single-shot EPI method. The result of measuring cerebral lateralization index based on the area of neural activation suggested that the right hemisphere is dominant in visuospatial tasks and the left one is in verbal tasks. However, the dominance is not sufficient to locate the exact part of the brain for these tasks. When cerebral lateralization index was computed based on the intensity of neural activation, it was derived that the area of cerebral lateralization closely related to visuospatial tasks is the superior parietal lobe, and the area of cerebral lateralization closely related to verbal tasks is the inferior and middle frontal lobes. Thus, cerebral lateralization index by area based on the intensity of neural activation as proposed by this study can determine the dominance of the cerebrum by area, so is helpful for accurate and quantitative determination of cerebral lateralization.

• Journal of Genetic Medicine
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• 제9권2호
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• pp.84-88
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• 2012

Purpose: Neurofibromatosis type 1 (NF1), which is caused by mutations of the NF1 gene, is the most frequent single gene disorder to affect the nervous system. Unidentified bright objects (UBOs) are commonly observed on brain magnetic resonance imaging (MRI) in patients with NF1. However, their clinical and pathologic significance is not well understood. The purpose of this study was to investigate the correlation between UBOs and cerebral glucose metabolism measured by $^{18}F$-2-Fluoro-2-deoxy-D-glucose ($^{18}F$-FDG) positron emission tomography (PET) in Korean patients with NF1. Materials and Methods: Medical records of 75 patients (34 males and 41 females) with NF1 who underwent brain MRI and PET between 2005 and 2011 were evaluated retrospectively. Clinical data including demographics, neurological symptoms, and brain MRI and PET findings, were reviewed. Results: UBOs were detected in the brain MRI scans of 31 patients (41%). The region most frequently affected by UBOs was the basal ganglia. The most frequent brain PET finding was thalamic glucose hypometabolism (45/75, 60%). Of the 31 patients with UBOs, 26 had thalamic glucose hypometabolism on brain PET, but the other 5 had normal brain PET findings. Conversely, of the 45 patients with thalamic glucose hypometabolism on brain PET, 26 showed UBOs on their brain MRI scans, but 19 had normal findings on brain MRI scans. Conclusion: UBOs on brain MRI scans and thalamic glucose hypometabolism on PET appear to be 2 distinctive features of NF1 rather than correlated symptoms. Because the clinical significance of these abnormal imaging findings remains unclear, a longitudinal follow-up study of changes in clinical manifestations and imaging findings is necessary.

• 대한한방내과학회지
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• 제19권1호
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• pp.134-143
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• 1998

Background : The purpose of this study was to investigate the prodromal of cerebral infarction in attacked patients and to prove the traditional hypothesis that some symptoms were to be prodromes of cerebral infarction in the oriental medicine. Methods : The questionnaire which was based on symptoms of traditional hypothesis was distributed cerebral infarction patients who were confirmed by Brain CT or MRI.. Results : Fifty-six patients(93.3%) felt some symptoms within three years before onset. Most common prodromal symptoms was dizziness(50%), failure of memory(45%), numbness of arm(45%). Conclusion : This results suggest that the prodromal symptoms before cerebral infarction can be regarded as predicting sign. and we think that these research may contributed to preventing stroke and relapse.

• Clinical and Experimental Pediatrics
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• 제59권6호
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• pp.280-284
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• 2016

Cerebral cavernous malformation (CCM) is a vascular malformation characterized by abnormally enlarged capillary cavities without any intervening neural tissue. We report 2 cases of familial CCMs diagnosed with the CCM1 mutation by using a genetic assay. A 5-year-old boy presented with headache, vomiting, and seizure-like movements. Brain magnetic resonance imaging (MRI) revealed multiple CCM lesions in the cerebral hemispheres. Subsequent mutation analysis of his father and other family members revealed c.940_943 del (p.Val314 Asn315delinsThrfsX3) mutations of the CCM1 gene. A 10-month-old boy who presented with seizure-like movements was reported to have had no perinatal event. His aunt was diagnosed with cerebral angioma. Brain and spine MRI revealed multiple angiomas in the cerebral hemisphere and thoracic spinal cord. Mutation analysis of his father was normal, although that of the patient and his mother revealed c.535C>T (p.Arg179X) mutations of the CCM1 gene. Based on these studies, we suggest that when a child with a familial history of CCMs exhibits neurological symptoms, the physician should suspect familial CCMs and consider brain imaging or a genetic assay.

• 대한핵의학회지
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• 제37권1호
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• pp.63-72
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• 2003

Functional MRI (fMRI) provides an indirect mapping of cerebral activity, based on the detection of the local blood flow and oxygenation changes following neuronal activity (Blood Oxygenation Level Dependent). fMRI allows us to study noninvasively the normal and pathological aspects of functional cortical organization. Each fMRI study compares two different states of activity. Echo-Planar Imaging is the technique that makes it possible to study the whole brain at a rapid pace. Activation maps are calculated from a statistical analysis of the local signal changes. fMRI is now becoming an essential tool in the neurofunctional evaluation of normal volunteers and many neurological patients as well as the reference method to image normal or pathologic functional brain organization.

• 한국임상수의학회지
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• 제26권1호
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• pp.104-108
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• 2009

Global cerebral ischemia occurs commonly in patients who have a variety of clinical conditions including cardiac arrest and shock. Cerebral ischemia results in a rapid depletion of energy stores that triggers resulting in excitotoxic death. Imaging studies of the brain with computed tomography(CT) or magnetic resonance imaging(MRI) are necessary to confirm the clinical neurolocalization, identify any associated mass effect, and rule out other causes of focal brain disorders. Cardiopulmonary arrest was occurred by propofol anesthesia in a 1 year old, intact female Beagle dog. After successful cardiopulmonary resuscitation was performed within 5 minutes, clinical signs such as vocalization, paddling, opisthotonus and seizure were represented. At the 12th day, CT and MRI examinations of the brain were performed to evaluate the brain. After euthanasia, histopathologic examination was performed. On transverse image of CT, lesions appeared as a hypodense in the right dorsal surface of the frontal lobe and level of optic canal, and dorsomedial surface of occipital lobe of cerebrum. No contrast enhancement was represented following intravenous contrast administration. On MR images of brain, the lesions were seen as a hyperintense on T2-weighted(T2W) images and a isointense or mild hypointense on T1-weighted(T1W) images. Hyperintense lesions both T2W and T1W images were observed at the surrounding cerebral sulcus. There was no significant signal changes on contrast T1WI. Histopathologic examination after euthanasia revealed that the lesion was necrosis of the cerebral cortex caused by cerebral ischemia.

• 한국방사선학회논문지
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• 제8권4호
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• pp.163-170
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• 2014

본 연구는 경도인지장애가 동반된 환자를 대상으로 뇌 자기공명영상에서 인지 영역에 대한 대뇌 피질 두께를 측정하고 신경심리검사 결과와 비교하여 신경해부학적 상관관계를 규명하고자 하였다. 이를 위하여 파킨슨병으로 최초 진단 받고 신경심리검사를 시행한 78명(경도인지장애군: 39명; 비인지장애군: 39명)과 정상인 그룹 32명을 선정하였다. 신경심리검사에서 경도인지장애군과 비인지장애군의 상관관계와 신경심리검사와 뇌 자기공명영상에서 대뇌 피질 두께의 상관관계는 독립표본 T 검증 또는 피어슨 상관분석을 실시하였으며 수집된 자료의 유의 수준은 p<0.05에서 검증하였다. 결론적으로 경도인지장애를 동반한 파킨슨병 환자는 뇌 자기공명영상에서 양측 쐐기압소엽과 우하측두엽의 대뇌 피질 두께가 통계적으로 유의하게 감소하였으며 인지 기능 평가를 위한 신경심리검사에서 시공간 기능, 언어 및 시각 기억력 기능이 저하되었다. 특히 언어 및 시각 기억력 영역에 대한 신경심리검사와 신경해부학적으로 좌측 쐐기앞소엽에서 상관관계가 있었다.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.51-57
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• 2018

Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

• Korean Journal of Radiology
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• 제23권4호
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• pp.446-454
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• 2022

Objective: To evaluate whether hyperoxia-induced ΔR₁ (hyperO₂ΔR₁) can accurately identify histological infarction in an acute cerebral stroke model. Materials and Methods: In 18 rats, MRI parameters, including hyperO₂ΔR₁, apparent diffusion coefficient (ADC), cerebral blood flow and volume, and ¹⁸F-fluorodeoxyglucose uptake on PET were measured 2.5, 4.5, and 6.5 hours after a 60-minutes occlusion of the right middle cerebral artery. Histological examination of the brain was performed immediately following the imaging studies. MRI and PET images were co-registered with digitized histological images. The ipsilateral hemisphere was divided into histological infarct (histological cell death), non-infarct ischemic (no cell death but ADC decrease), and nonischemic (no cell death or ADC decrease) areas for comparisons of imaging parameters. The levels of hyperO₂ΔR₁ and ADC were measured voxel-wise from the infarct core to the non-ischemic region. The correlation between areas of hyperO₂ΔR₁-derived infarction and histological cell death was evaluated. Results: HyperO₂ΔR₁ increased only in the infarct area (p ≤ 0.046) compared to the other areas. ADC decreased stepwise from non-ischemic to infarct areas (p = 0.002 at all time points). The other parameters did not show consistent differences among the three areas across the three time points. HyperO₂ΔR₁ sharply declined from the core to the border of the infarct areas, whereas there was no change within the non-infarct areas. A hyperO₂ΔR₁ value of 0.04 s^-1 was considered the criterion to identify histological infarction. ADC increased gradually from the infarct core to the periphery, without a pronounced difference at the border between the infarct and non-infarct areas. Areas of hyperO₂ΔR₁ higher than 0.04 s^-1 on MRI were strongly positively correlated with histological cell death (r = 0.862; p < 0.001). Conclusion: HyperO₂ΔR₁ may be used as an accurate and early (2.5 hours after onset) indicator of histological infarction in acute stroke.

• Korean Journal of Radiology
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• 제22권2호
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• pp.233-242
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• 2021

Objective: To evaluate the association of MRI features with the major genomic profiles and prognosis of World Health Organization grade III (G3) gliomas compared with those of glioblastomas (GBMs). Materials and Methods: We enrolled 76 G3 glioma and 155 GBM patients with pathologically confirmed disease who had pretreatment brain MRI and major genetic information of tumors. Qualitative and quantitative imaging features, including volumetrics and histogram parameters, such as normalized cerebral blood volume (nCBV), cerebral blood flow (nCBF), and apparent diffusion coefficient (nADC) were evaluated. The G3 gliomas were divided into three groups for the analysis: with this isocitrate dehydrogenase (IDH)-mutation, IDH mutation and a chromosome arm 1p/19q-codeleted (IDHmut1p/19qdel), IDH mutation, 1p/19q-nondeleted (IDHmut1p/19qnondel), and IDH wildtype (IDHwt). A prediction model for the genetic profiles of G3 gliomas was developed and validated on a separate cohort. Both the quantitative and qualitative imaging parameters and progression-free survival (PFS) of G3 gliomas were compared and survival analysis was performed. Moreover, the imaging parameters and PFS between IDHwt G3 gliomas and GBMs were compared. Results: IDHmut G3 gliomas showed a larger volume (p = 0.017), lower nCBF (p = 0.048), and higher nADC (p = 0.007) than IDHwt. Between the IDHmut tumors, IDHmut1p/19qdel G3 gliomas had higher nCBV (p = 0.024) and lower nADC (p = 0.002) than IDHmut1p/19qnondel G3 gliomas. Moreover, IDHmut1p/19qdel tumors had the best prognosis and IDHwt tumors had the worst prognosis among G3 gliomas (p < 0.001). PFS was significantly associated with the 95th percentile values of nCBV and nCBF in G3 gliomas. There was no significant difference in neither PFS nor imaging features between IDHwt G3 gliomas and IDHwt GBMs. Conclusion: We found significant differences in MRI features, including volumetrics, CBV, and ADC, in G3 gliomas, according to IDH mutation and 1p/19q codeletion status, which can be utilized for the prediction of genomic profiles and the prognosis of G3 glioma patients. The MRI signatures and prognosis of IDHwt G3 gliomas tend to follow those of IDHwt GBMs.