• Progress in Medical Physics
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• v.30 no.4
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• pp.139-149
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• 2019

Purpose: With neurodegeneration, the signal intensity of the cerebrospinal fluid (CSF) in the brain increases. The objective of this study was to evaluate chemical exchange saturation transfer (CEST) signals with and without the contribution of CSF signals in elderly human brains using two different 3T magnetic resonance imaging (MRI) sequences Methods: Full CEST signals were acquired in ten subjects (Group I) with a three-dimensional (3D)-segmented gradient-echo echo-planar imaging (EPI) sequence and in ten other subjects (Group II) with a 3D gradient and spin-echo (GRASE) sequence using two different 3T MRI systems. The segmented tissue compartments of gray and white matter were used to mask the CSF signals in the full CEST images. Two sets of magnetization transfer ratio asymmetry (MTR_asym) maps were obtained for each offset frequency in each subject with and without masking the CSF signals (masked and unmasked conditions, respectively) and later compared using paired t-tests. Results: The region-of-interest (ROI)-based analyses showed that the MTR_asym values for both the 3D-segmented gradient-echo EPI and 3D GRASE sequences were altered under the masked condition compared with the unmasked condition at several ROIs and offset frequencies. Conclusions: Depending on the imaging sequence, the MTR_asym values can be overestimated for some areas of the elderly human brain when CSF signals are unmasked. Therefore, it is necessary to develop a method to minimize this overestimation in the case of elderly patients.

• Journal of the Korean Society of Radiology
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• v.13 no.1
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• pp.55-63
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• 2019

It was reported that there were some cases in which signal was not inhibited but high signal appeared in cerebrospinal fluid on FLAIR(fluid attenuated inversion recovery) of MRI(Magnetic Resonance Imaging) in case a person inhales high-concentration oxygen. This study was to prepare basic database. We produced a phantom fixed with agar gel and by using it, obtained the images of the signals of normal saline into which oxygen was injected and normal saline diluted with contrast media by changing the TI(Inversion Time) of FLAIR technique and analyzed them. In the result of FLAIR technique of MRI using Philips Achieva MR 3.0T in Busan P Hospital, the SNR(Signal to Noise Ratio) of normal saline into which oxygen was injected was higher than the SNR of normal saline into which oxygen was not injected. However, it was not higher than the SNR of normal saline diluted with contrast media. In the TI 1,800ms, we could obtain the images which do not have the rise of the signal due to oxygen. In the CNR(Contrast to Noise Ratio) of normal saline into which oxygen was injected and normal saline diluted with contrast media as well, it was higher in the TI 1,800ms than in the TI 2,800ms that is mainly used clinically. It is thought that the result of this study could be basic database for studies on change of signal of cerebrospinal fluid as a result of injection of oxygen in FLAIR technique of MRI.

• Investigative Magnetic Resonance Imaging
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• v.23 no.1
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• pp.65-69
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• 2019

Ramsay Hunt syndrome with the complication of encephalitis or meningoencephalitis is rarely reported and uncommon in immunocompetent patients. The radiological manifestations of such cases usually involve the cerebellum and brainstem or exhibit the absence of any abnormality. We report a case of a 78-year-old immunocompetent man hospitalized with Ramsay Hunt syndrome, who later developed meningoencephalitis. The cerebrospinal fluid-study excluded other causes of meningoencephalitis, and the clinical diagnosis indicated varicella zoster virus meningoencephalitis. Magnetic resonance imaging revealed increased signal intensities in the bilateral temporal lobe, midbrain, and pons on T2-weighted imaging, and T2 fluid attenuated inversion recovery and contralateral asymmetric pachymeningeal enhancement. Contrast-enhanced T1-weighted imaging revealed ipsilateral facial nerve enhancement.

• Journal of the Korean Society of Radiology
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• v.7 no.4
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• pp.265-269
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• 2013

This report aims at picturing out the clinical usefulness by analyzing the signal intensity in choroid plexuses which produce cerebrospinal fluids by diffusion weighted imaging. At first, subjects were chosen among the patients who showed high in signal intensity by diffusion weighted imaging. The subjects were taken another test by fluid attenuated inversion recovery diffusion weighted echo planer image(FLAIR-DW-EPI) the signals of fluid attenuation. And it was found that there are differences between the signal intensities of the two methods, which showed that the signal intensity in FLAIR-DW-EPI is equal to or low than, that in the Brain. By this, it is felt that it is helpful to diagnose the disease in choroid plexus by testing another more with FLAIR-DW-EPI methods the patients who showed high in signal intensity in choroid plexus by $T2^*$ diffusion weighted echo planer image($T2^*$-DW-EPI).

• Journal of Veterinary Clinics
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• v.40 no.3
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• pp.225-229
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• 2023

In three dogs showing cerebellar ataxia, the onset of clinical signs varied from a young age of five months to age 13 years. Qualitative magnetic resonance imaging (MRI) revealed various degrees of cerebellar atrophy, and a tentative diagnosis of cerebellar cortical degeneration was made. Quantitative analysis using the brainstem to the cerebellar cross-sectional area ratio (BS:CBM ratio) and T2-signal intensity histograms were obtained to perform an objective evaluation. These techniques have the advantage of being easy and fast to evaluate. These quantitative analyses revealed the severity of cerebellar cortical degeneration in the three dogs as mild, moderate, and severe. Dogs 2 and 3 were identified as abnormal on the relative cerebrospinal fluid (CSF) space using T2-signal intensity histograms but were normal on the BS:CBM ratio. This suggests that the T2-signal intensity histograms may have higher sensitivity than BS:CBM ratio.

• Journal of the Korean Society of Radiology
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• v.15 no.6
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• pp.927-933
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• 2021

The purpose of this study was to compare and analyze the differences in scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the third lumbar vertebral region including the back fat, spinal cord, and cerebrospinal fluid using the mDixon, T2 TSE, and T2 spectral pre-saturation with inversion-recovery (SPIR) techniques. With the factors affecting the SNR fixed, the lumbar sagittal plane images of 30 adults were compared on mDixon, T2 TSE, and T2 SPIR imaging tests. The test times for mDixon, T2 TSE, and T2 SPIR were 115 seconds, 60 seconds, and 60 seconds, respectively. The mDixon T2 images showed higher SNR than the T2 TSE images at the third lumbar vertebral region (p<0.05), lower SNR in the back fat and cerebrospinal fluid (p<0.05) areas, and comparable SNR in the spinal cord (p>0.05). The CNR between the third lumbar vertebral area and back fat was higher in the mDixon T2 images, and the CNR of the cerebrospinal fluid and spinal cord images was higher in the T2 TSE images (p<0.05). The mDixon T2 FS images CNR was lower for the 3rd lumbar vertebral body region and back fat than the T2 SPIR images, and higher for the spinal cord and cerebrospinal fluid images (p<0.05). The CNR between the third lumbar body and back fat areas was higher in the mDixon T2 FS images (p<0.05), and there was no difference in the CNR in the images of the cerebrospinal fluid and the spinal cord (p>0.05). It is difficult to determine whether the mDixon technique is superior to the conventional T2 TSE and T2 SPIR techniques in terms of test time, SNR, and CNR. This study was confined to patients with simple lower back pain and was limited by controlled experimental conditions. Studies using clinically applied protocols are warranted in the future.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.23-27
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• 2005

Objective : The aim of this study is to assess the significance of an apparent diffusion coefficient[ADC] study for diagnosis of ventriculitis. Methods : Seven patients with ventriculitis were enrolled in this study. Diffusion-weighted[DW] magnetic resonance images[MRI] and ADC maps in the dependent intraventricular collection, periventricular white matter and non-dependent cerebrospinal fluid[CSF] were obtained. The images and ADC data from the different lesions were compared. Results : The DW MRI showed marked hyperintensity in the purulent pus lesion, and the corresponding ADC maps revealed prominent hypointensity and restricted ADC values compared with the non-dependent CSF and normal white matter. Conclusion : The decreased ADC value and increased signal intensity of the dependent intraventricular fluid on the DW MRI show restricted water diffusion in the purulent fluid, which is indicative of a pyogenic ventriculitis diagnosis.

• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.491-494
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• 2012

We report a rare complication of iatrogenic spinal intradural following minimally invasive extradural endoscopic procedues in the lumbo-sacral spines. To our knowledge, intradural cyst following epiduroscopy has not been reported in the literature. A 65-year-old woman with back pain related with previous lumbar disc surgery underwent endoscopic epidural neuroplasty and nerve block, but her back pain much aggravated after this procedure. Postoperative magnetic resonance imaging revealed a large intradural cyst from S1-2 to L2-3 displacing the nerve roots anteriorly. On T1 and T2-weighted image, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent partial laminectomy of L5 and intradural exploration, and fenestration of the cystic wall was accomplished. During operation, the communication between the cyst and subarachnoid space was not identified, and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the pain attenuated immediately. Incidental durotomy which occurred during advancing the endoscope through epidural space may be the cause of formation of the intradural cyst. Intrdural cyst should be considered, if a patient complains of new symptoms such as aggravation of back pain after epiduroscopy. Surgical treatment, simple fenestration of the cyst may lead to improved outcome. All the procedures using epiduroscopy should be performed with caution.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.313-323
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• 2009

Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in $T_2^*$-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.554-556
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• 2015

Primary intracranial malignant melanoma is a very rare and highly aggressive tumor with poor prognosis. A 66-year-old female patient presented a headache that had been slowly progressing for several months. A large benign pigmented skin lesion was found on her back. A brain MRI showed multiple linear signal changes with branching pattern and strong enhancement in the temporal lobe. The cytological and immunohiostochemical cerebrospinal fluid examination confirmed malignant melanoma. A biopsy confirmed that the pigmented skin lesion on the back and the conjunctiva were benign nevi. We report a case of primary intracranial malignant melanoma and review relevant literatures.