• Korean Journal of Radiology
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• 제21권1호
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• pp.77-87
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• 2020

Objective: To assess the feasibility of simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) of the rectum in comparison with conventional DWI (C-DWI) in rectal cancer patients. Materials and Methods: This study included 65 patients with initially-diagnosed rectal cancer. All patients underwent C-DWI and SMS-DWI with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) using a 3T scanner. Acquisition times of the three DWI sequences were measured. Image quality in the three DWI sequences was reviewed by two independent radiologists using a 4-point Likert scale and subsequently compared using the Friedman test. Apparent diffusion coefficient (ADC) values for rectal cancer and the normal rectal wall were compared among the three sequences using repeated measures analysis of variance. Results: Acquisition times using C-DWI, SMS2-DWI, and SMS3-DWI were 173 seconds, 107 seconds, (38.2% shorter than C-DWI), and 77 seconds (55.5% shorter than C-DWI), respectively. For all image quality parameters other than distortion (margin sharpness, artifact, lesion conspicuity, and overall image quality), C-DWI and SMS2-DWI yielded better results than did SMS3-DWI (Ps < 0.001), with no significant differences observed between C-DWI and SMS2-DWI (Ps ≥ 0.054). ADC values of rectal cancer (p = 0.943) and normal rectal wall (p = 0.360) were not significantly different among C-DWI, SMS2-DWI, and SMS3-DWI. Conclusion: SMS-DWI using an acceleration factor of 2 is feasible for rectal MRI resulting in substantial reductions in acquisition time while maintaining diagnostic image quality and similar ADC values to those of C-DWI.

• 한국방사선학회논문지
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• 제12권5호
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• pp.631-636
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• 2018

기존의 자기공명영상검사에서 문제점으로 지적되어 왔던 위상부호화 방향에서의 긴 판독시간과 낮은 대역폭과 함께 기하학적 왜곡의 경향이 있어 이러한 영상왜곡을 감소하기 위한 여러 방법 중 FOCUS-DWI가 있다. 본 논문은 선택적인 위상 방향 및 슬라이스를 이용하는 FOCUS-DWI가 자기장 내 중심축에서 거리변화에 따른 인공물, 균일도를 기존의 Conventional-DWI와 비교하여 그에 대한 유용성을 확인하고자 하였다. 인공물 발생에 대한 결과는 Conventional-DWI 기법에서 불규칙적인 줄무늬 인공물이 발생하였는데 중심축에서 인공물의 발생이 심하게 나타났고, 영상의 겹침 정도가 급격하게 증가하였다. 하지만 FOCUS-DWI 기법은 줄무늬 모양의 인공물 발생이 나타나지 않았고 영상의 겹침 정도도 적게 나타났으며, 영역별 신호측정에 대한 균일도 결과는 중심축에서 거리의 변화에 관계없이 FOCUS-DWI가 훨씬 우수한 기법으로 나타났다. 결론적으로 FOCUS-DWI 기법은 인공물, 영상의 겹침 정도, 균일도 측정에서 Conventional-DWI 기법보다 우수한 결과를 보였고, 거리의 변화에 따른 두 기법에서는 차이가 없게 나타났다. 따라서 FOCUS-DWI 기법은 영상의 왜곡 정도가 적고 화질이 우수하여 임상에서 활용도가 높을 것이라 사료된다.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1036-1044
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• 2020

Objective: To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patients with breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventional diffusion-weighted imaging (cDWI). Materials and Methods: Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm² (cDWI₈₀₀ and cDWI₁₅₀₀) and sDWI at b-values of 1000 and 1500 s/mm² (sDWI₁₀₀₀ and sDWI₁₅₀₀). Qualitative analysis (normal glandular tissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI sets and the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI set in 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test, one-way analysis of variance, and Cochran's Q test. Results: All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasing b-values, regardless of the type of imaging (synthetic or conventional) (p < 0.001). Additionally, sDWI₁₅₀₀ provided better lesion conspicuity than cDWI₁₅₀₀ (3.52 ± 0.92 vs. 3.39 ± 0.90, p < 0.05). Although cDWI₁₅₀₀ showed better normal glandular tissue suppression and overall image quality than sDWI₁₅₀₀ (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively; p < 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater in sDWI₁₅₀₀ than in cDWI₁₅₀₀ (0.63 ± 0.17 vs. 0.55 ± 0.18, p < 0.001). Conclusion: sDWI₁₅₀₀ can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity, better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI₁₅₀₀.

• 대한교통학회지
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• 제29권3호
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• pp.21-29
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• 2011

본 연구는 음주운전을 억제시키기 위한 정책 중, 유인정책으로 제시되고 있는 교통안전교육의 음주운전 억제효과를 분석하였다. 본 연구를 위하여 2003년 경기도 성남시에서 음주운전으로 단속되어 운전면허 정지처분을 받은 운전자의 처분이후 5년간의 운전행태를 추적한 자료를 대상으로 하였다. 교통안전교육 이수 및 교육종류에 따른 음주운전 재범발생횟수와 음주운전 준수기간을 효과척도로 하여 공분산분석을 실시하였으며, 집단 간 조정평균으로써 음주운전 억제효과를 비교하였다. 분석결과 교통안전교육은 음주운전 재범발생이 적었고 음주운전 준수기간도 길어 음주운전 억제효과가 있었다. 특히 교육형태별로 체험식 토론식 교육이 강의식교육에 비하여 재범발생은 12% 감소하였고, 준수기간은 5.7% 증가하여 효과가 더 큰 것으로 나타났다.

• Journal of Korean Neurosurgical Society
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• 제64권3호
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• pp.418-426
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• 2021

Objective : A role of diffusion-weighted imaging (DWI) in the diagnosis of cerebral venous thrombosis (CVT) is not well-understood. This study evaluates the effectiveness of DWI in the diagnosis of CVT. Methods : Literature search was conducted in electronic databases for the identification of studies which reported the outcomes of patients subjected to DWI for CVT diagnosis. Random-effects meta-analyses were performed to achieve overall estimates of important diagnostic efficiency indices including hyperintense signal rate, the sensitivity and specificity of DWI in diagnosing CVT, and the apparent diffusion coefficient (ADC) of DWI signal areas and surrounding tissue. Results : Nineteen studies (443 patients with 856 CVTs; age 40 years [95% confidence interval (CI), 33 to 43]; 28% males [95% CI, 18 to 38]; symptom onset to DWI time 4.6 days [95% CI, 2.3 to 6.9]) were included. Hyperintense signals on DWI were detected in 40% (95% CI, 26 to 55) of the cases. The sensitivity of DWI for detecting CVT was 22% (95% CI, 11 to 34) but specificity was 98% (95% CI, 95 to 100). ADC values were quite heterogenous in DWI signal areas. However, generally the ADC values were lower in DWI signal areas than in surrounding normal areas (mean difference-0.33×10-3 ㎟/s [95% CI, -0.44 to -0.23]; p<0.00001). Conclusion : DWI has a low sensitivity in detecting CVT and thus has a high risk of missing many CVT cases. However, because of its high specificity, it may have supporting and exploratory roles in CVT diagnosis.

• 방사선산업학회지
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• 제10권4호
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• pp.227-230
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• 2016

DWI of biological effects are independent of magnetic field strength in various regions. High field strength, however, does affect the signal to noise ratio (SNR) and artifacts of diffusion weighted imaging (DWI) images, which ultimately will influence the quantitative of diffusion imaging. In this study, the effects of field strength on DWI are reviewed. The effects of the diseases also are discussed. Comparing DWI in cerebellum, WM, GM, Hyperacute region measurements both as a function of field strength (1.5T and 3.0T). Overall, the SNR of the DWI roughly doubled going from 1.5 T to 3.0 T. In summary, DWI studies at 3.0 T is provided significantly improved DWI measurements relative to studies at 1.5T.

• Investigative Magnetic Resonance Imaging
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• 제12권1호
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• pp.49-54
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• 2008

목적 : 저산소성-허혈성 뇌증(HIE)의 확산강조영상(DWI) 소견을 알아보고자 하였다. 대상 및 방법 : 심폐기능 정지에 의한 뇌손상으로 심폐소생술을 통하여 소생된 6명의 환자를 대상으로 하였으며 뇌손상 후 MR검사까지의 시간 간격은 4일에서부터 32일까지 평균 11.8일 이었다. 전 예에서 T1 및 T2강조영상, FLAIR, DWI 및 현성확산계수영상을 얻었다. 병변의 분포, 각 영상에서의 신호 강도를 분석하였으며, T2 및 FLAIR영상과 비교한 DWI에서의 병변의 명확도를 분석하였다. 결과 : 전 예에서 T2, FLAIR 및 DWI에서 기저핵에 양측으로 대칭적인 고신호 강도의 병변을 볼 수 있었다. 현성확산계수영상에서는 이중 4예가 저신호 강도를, 2예는 동등신호 강도를 보였다. 병변의 명확도는 6예 중 4예에서 T2 및 FLAIR영상과 비교하여 DWI에서 뚜렷한 고신호 강도를 보였고, 2예에서는 비슷하였다. 대뇌 피질과 피질하 백질의 경우 6예 중 5예에서 T2, FLAIR 및 DWI에서 양측으로 대칭적인 고신호 강도를 보였고, 그 중 3예에서는 T2 및 FLAIR 영상과 비교하여 DWI에서 명확하게 보였다. 현성확산계수영상에서는 3예가 저신호 강도를, 나머지는 동등신호 강도를 보였다. 대뇌 심부백질의 경우 6예 중 4예에서 T2, FLAIR 및 DWI에서 양측으로 대칭적인 고신호 강도를 보였고, 그 중 1예에서만 T2 및 FLAIR 영상과 비교하여 DWI에서 명확하게 보였다. 결론 : HIE의 DWI 소견은 기저핵 및 대뇌 피질과 백질의 대칭적인 고신호 강도가 특징이며, T2 및 FLAIR영상보다 명확하였다.

• 한국작물학회지
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• 제49권6호
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• pp.441-446
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• 2004

효율적인 물 관리방식 개발의 기초 자료를 얻고자 논의 물 관리 차이가 벼의 생육과 수확량에 미치는 영향을 2002년부터 2003년까지 조사한 결과는 다음과 같다. 1. 물 관리 방법별 벼 생육 및 수량은 DWI는 VSII에 비해 출수기의 초장이 길었고, 경수가 적었으나 유효경 비율은 약간 높았고, VSII의 등숙비율은 다른 물 관리에 비해 $1\%$ 낮아 쌀 수량은 $2.1\%$ 적었으나 통계적 유의성은 없었다. 2. 관개량과 유효강우량 등 총 물 공급량은 DWI에서 777.2mm로 가장 많았고, VS팀에서 527mm로 가장 적어, SII에서는 DWI에 비해 약 $15.9\%$, VSII에서는 $32.2\%$정도의 물 절약효과가 있었다. 3. 절간장은 N3, N4절은 관수심이 깊을수록 길었으며, 간벽두께, 간기중, 줄기직경은 DWI에서 감소하였으나, 좌절중, Pushing resistance는 VSII가 DWI에 비해 매우 높고 도복지수가 낮았다. 4. VSII의 성숙기 근장은 27cm로 DWI보다 깊게 내려갔으며, 토양 표면으로부터 10cm이상 깊이에서는 VSII의 뿌리 발생량이 많았으나, 토양 표면으로부터 10cm까지는 DWI의 뿌리분포가 많았다. 5. 물 관리 차이에 따른 잡초 발생양상은 최고 분얼기에는 VSII가 DWI에 비해 일년생 잡초와 다년생 잡초 모두 본수가 2배 이상 많았으며, 출수기에는 일년생 잡초 본수는 물 관리 차이에 관계없이 비슷하였으나, 다년생 잡초 본수는 VSII에서 DWI에 비해 3배 이상 많았다. 이상의 결과에서 담수심을 얕게 하여 용수를 절약하여도 관행 심수 관개 방식에 비해 벼 생육 및 수량에는 차이가 없었고, 오히려 내도복성을 향상시킬 수 있었으므로 최적 용수 공급량 산출의 기초 자료로 활용할 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.19-24
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• 2013

Objective : The purpose of this study was to retrospectively evaluate and compare the incidence of diffusion-weighted image (DWI) lesions between the Guglielmi detachable coil (GDC) and the Target coil for treating unruptured intracranial aneurysm. Methods : From 2010 to 2011, consecutive 222 patients with an intracranial aneurysm underwent coil embolization. Inclusion criterias were : 1) unruptured intracranial aneurysm, 2) one or more GDC or Target coils used with or without other coils, 3) DWI examination within 24 hours after coiling, and 4) coiling performed without a balloon or stent. Results : Ninety patients (92 cases) met the inclusion criteria. DWI lesions were detected in 55 (61.1%) of 90 patients. In the GDC group (n=44), DWI lesions were detected in 31 (70.5%). The average number of DWI lesions was $5.0{\pm}8.7$ (mean${\pm}$SD; range, 1-40) in aneurysm-related territory. In the Target coil group (n=48), DWI lesions were detected in 24 (50.0%). The number of DWI lesion was $2.1{\pm}5.4$ (range, 1-32) in aneurysm-related territory. There was no significant correlation between a number of coils and DWI lesions. No significant differences were also observed in the number of DWI lesions in each group. Conclusion : The GDC and Target coils, which have an electrolytic detachable system, showed no differences in the incidence of DWI lesion.

• Korean Journal of Radiology
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• 제22권10호
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• pp.1680-1689
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• 2021

Objective: To investigate the diagnostic yield of diffusion-weighted imaging (DWI) in patients with transient global amnesia (TGA) and identify significant parameters affecting diagnostic yield. Materials and Methods: A systematic literature search of the MEDLINE and EMBASE databases was conducted to identify studies that assessed the diagnostic yield of DWI in patients with TGA. The pooled diagnostic yield of DWI in patients with TGA was calculated using the DerSimonian-Laird random-effects model. Subgroup analyses were also performed of slice thickness, magnetic field strength, and interval between symptom onset and DWI. Results: Twenty-two original articles (1732 patients) were included. The pooled incidence of right, left, and bilateral hippocampal lesions was 37% (95% confidence interval [CI], 30-44%), 42% (95% CI, 39-46%), and 25% (95% CI, 20-30%) of all lesions, respectively. The pooled diagnostic yield of DWI in patients with TGA was 39% (95% CI, 27-52%). The Higgins I² statistic showed significant heterogeneity (I² = 95%). DWI with a slice thickness ≤ 3 mm showed a higher diagnostic yield than DWI with a slice thickness > 3 mm (pooled diagnostic yield: 63% [95% CI, 53-72%] vs. 26% [95% CI, 16-40%], p < 0.01). DWI performed at an interval between 24 and 96 hours after symptom onset showed a higher diagnostic yield (68% [95% CI, 57-78%], p < 0.01) than DWI performed within 24 hours (16% [95% CI, 7-34%]) or later than 96 hours (15% [95% CI, 8-26%]). There was no difference in the diagnostic yield between DWI performed using 3T vs. 1.5T (pooled diagnostic yield, 31% [95% CI, 25-38%] vs. 24% [95% CI, 14-37%], p = 0.31). Conclusion: The pooled diagnostic yield of DWI in TGA patients was 39%. DWI obtained with a slice thickness ≤ 3 mm or an interval between symptom onset and DWI of > 24 to 96 hours could increase the diagnostic yield.