• Title/Summary/Keyword: DWI

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Individual approach in the recanalization treatment of the acute ischemic brain stroke according to the various MR findings in hyperacute stage

  • Y. Jang;Lee, D.;Kim, H.;Lee, J.;Park, C.G.;Lee, H.K.;Kim, S.;D. Suh
    • Proceedings of the KSMRM Conference
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    • 2003.10a
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    • pp.98-98
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    • 2003
  • We will present various MR findings of hyperacute ischemic stroke with our own experiences in the management of the patients according to the findings. 대상 및 방법: A total of 441 patients were underwent 'acute stroke MR' imaging protocol between Mar. 2001 and Jun. 2003. The protocol included initial T2-weighted image (WI), diffusion WI (DWI, b=2000), time-of-flight (TOF) MR angiography (MRA), and pefusion WI(PWI), and follow-up T2WI, DWI, TOF MRA, and neck vessel contrast-enhanced MRA obtained three to five days after the insult. Among them, we retrospectively reviewed the MR findings and clinical courses of 193 patients with anterior circulation territorial infarction. Those ICA and MCA lesions were divided into six and five groups respectively according to the level and mechanism of the occlusion. PWI findings can be another factor in the management planning.

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Rapid Regression of White Matter Changes in Hypoglycemic Encephalopathy (저혈당성 뇌병증에서 뇌백질 변화의 빠른 퇴행)

  • Son, Sang-Wook;Lee, Kye-Ho;Yoo, Dong-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.357-361
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    • 2014
  • Purpose : In a previous report, it took several days for white matter lesions to regress in hypoglycemic encephalopathy. We present a case of rapid diffusion-weighted image (DWI) changes in hypoglycemic encephalopathy. Case Report: A 58-year-old male patient was found semi-comatous with the only abnormality in his laboratory tests showing hypoglycemia (44 mg/dL). After rapid correction of glucose level, immediate brain DWI showed bilateral subcortical white matter lesions. After about 5 hours, follow-up DWI showed resolved subcortical white matter lesions, with newly-appeared bilateral fronto-temporo-parietal cortical lesions. Conclusion: Both white matter and cortex involvement in hypoglycemic encephalopathy has been shown in several reports, but rapid regression of white matter changes in hypoglycemic encephalopathy has been rarely reported. It is important to know that MR imaging changes in hypoglycemic encephalopathy can be made as quick as just a few-hour-long.

b0 Dependent Neuronal Activation in the Diffusion-Based Functional MRI

  • Kim, Hyug-Gi;Jahng, Geon-Ho
    • Progress in Medical Physics
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    • v.30 no.1
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    • pp.22-31
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    • 2019
  • Purpose: To develop a new diffusion-based functional MRI (fMRI) sequence to generate apparent diffusion coefficient (ADC) maps in single excitation and evaluate the contribution of b0 signal on neuronal changes. Materials and Methods: A diffusion-based fMRI sequence was designed with single measurement that can acquire images of three directions at a time, obtaining $b=0s/mm^2$ during the first baseline condition (b0_b), followed by 107 diffusion-weighted imaging (DWI) with $b=600s/mm^2$ during the baseline and visual stimulation conditions, and another $b=0s/mm^2$ during the last activation condition (b0_a). ADC was mapped in three different ways: 1) using b0_b (ADC_b) for all time points, 2) using b0_a (ADC_a) for all time points, and 3) using b0_b and b0_a (ADC_ba) for baseline and stimulation scans, respectively. The fMRI studies were conducted on the brains of 16 young healthy volunteers using visual stimulations in a 3T MRI system. In addition, the blood oxygen level dependent (BOLD) fMRI was also acquired to compare it with diffusion-based fMRI. A sample t-test was used to investigate the voxel-wise average between the subjects. Results: The BOLD data consisted of only activated voxels. However, ADC_ba data was observed in both deactivated and activated voxels. There were no statistically significant activated or deactivated voxels for DWI, ADC_b, and ADC_a. Conclusions: With the new sequence, neuronal activations can be mapped with visual stimulation as compared to the baseline condition in several areas in the brain. We showed that ADC should be mapped using both DWI and b0 images acquired with the same conditions.

Imaging Patterns of Bacillus Calmette-Guérin-Related Granulomatous Prostatitis Based on Multiparametric MRI

  • Seungsoo Lee;Young Taik Oh;Hye Min Kim;Dae Chul Jung;Hyesuk Hong
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.60-67
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    • 2022
  • Objective: To categorize multiparametric MRI features of Bacillus Calmette-Guérin (BCG)-related granulomatous prostatitis (GP) and discover potential manifestations for its differential diagnosis from prostate cancer. Materials and Methods: The cases of BCG-related GP in 24 male (mean age ± standard deviation, 66.0 ± 9.4 years; range, 50-88 years) pathologically confirmed between January 2011 and April 2019 were retrospectively reviewed. All patients underwent intravesical BCG therapy followed by a MRI scan. Additional follow-up MRI scans, including diffusion-weighted imaging (DWI), were performed in 19 patients. The BCG-related GP cases were categorized into three: A, B, or C. The lesions with diffusion restriction and homogeneous enhancement were classified as type A. The lesions with diffusion restriction and a poorly enhancing component were classified as type B. A low signal intensity on high b-value DWI (b = 1000 s/mm2) was considered characteristic of type C. Two radiologists independently interpreted the MRI scans before making a consensus about the types. Results: The median lesion size was 22 mm with the interquartile range (IQR) of 18-26 mm as measured using the initial MRI scans. The lesion types were A, B, and C in 7, 15, and 2 patients, respectively. Cohen's kappa value for the inter-reader agreement for the interpretation of the lesion types was 0.837. On the last follow-up MRI scans of 19 patients, the size decreased (median, 5.8 mm; IQR, 3.4-8.5 mm), and the type changed from A or B to C in 11 patients. The lesions resolved in four patients. In five patients who underwent prostatectomy, caseous necrosis on histopathology matched with the non-enhancing components of type B lesions and the entire type C lesions. Conclusion: BCG-related GP demonstrated three imaging patterns on multiparametric MRI. Contrast-enhanced T1-weighted imaging and DWI may play a role in its differential diagnosis from prostate cancer.

In Vivo and In Vitro Studies of the Steady State Free Precession-Diffusion-Weighted MR Imagings on Low b-value : Validation and Application to Bone Marrow Pathology

  • Byun, Woo-Mok
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.119-128
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    • 2007
  • Purpose : The purpose of this study was a phantom study to measure the diffusion properties of water molecules by steady-state free precession diffusion-weighted imaging (SSFP- DWI) with a low b-value and to determine if this sequence might be useful for application to the evaluation of bone marrow pathology. Materials and methods : 1. The phantom study: A phantom study using two diffusion weighted sequences for the evaluation of the diffusion coefficient was performed. Three water-containing cylinders at different temperatures were designed: phantom A was $3^{\circ}C$, B was $23^{\circ}C$ and C was $63^{\circ}C$. Both SSFP and echo planar imaging (EPI) sequences (b-value: $1000s/mm^2$) were performed for comparison of the diffusion properties. The Signal to noise ratios (SNR) and apparent diffusion coefficient (ADC) values of the three phantoms using each diffusion-weighted sequence were assessed. 2. The Clinical study: SSFP-DWI was performed in 28 patients [sacral insufficiency fractures (10), osteoporotic lumbar compression fractures (10), malignant compression fractures (8)]. To measure the ADC maps, a diffusion-weighted single shot stimulated echo-acquisition mode sequence ($650s/mm^2$) was obtained using the same 1.5-T MR imager Results : For the phantom study, the signal intensity on the SSFP as well as the classic EPI-based DWI was decreased as the temperature increased in phantom A to C. The ADC values of the phantoms on EPI-DWI were $0.13{\times}10^{-3}mm^2/s$ in phantom A, $0.22{\times}10^{-3}mm^2/s$ in B and $0.37{\times}10^{-3}mm^2/s$. in C. The SSFP can be regarded as a DWI sequence in view of the series of signal decreases. Conclusion : Bone marrow pathologies with different diffusion coefficients were evaluated by SSFP-DWI. All benign fractures were hypointense compared to the adjacent normal bone marrow where as the malignant fractures were hyperintense compared to the adjacent normal bone marrow.

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Study on Volume Measurement of Cerebral Infarct using SVD and the Bayesian Algorithm (SVD와 Bayesian 알고리즘을 이용한 뇌경색 부피 측정에 관한 연구)

  • Kim, Do-Hun;Lee, Hyo-Young
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.591-602
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    • 2021
  • Acute ischemic stroke(AIS) should be diagnosed within a few hours of onset of cerebral infarction symptoms using diagnostic radiology. In this study, we evaluated the clinical usefulness of SVD and the Bayesian algorithm to measure the volume of cerebral infarction using computed tomography perfusion(CTP) imaging and magnetic resonance diffusion-weighted imaging(MR DWI). We retrospectively included 50 patients (male : female = 33 : 17) who visited the emergency department with symptoms of AIS from September 2017 to September 2020. The cerebral infarct volume measured by SVD and the Bayesian algorithm was analyzed using the Wilcoxon signed rank test and expressed as a median value and an interquartile range of 25 - 75 %. The core volume measured by SVD and the Bayesian algorithm using was CTP imaging was 18.07 (7.76 - 33.98) cc and 47.3 (23.76 - 79.11) cc, respectively, while the penumbra volume was 140.24 (117.8 - 176.89) cc and 105.05 (72.52 - 141.98) cc, respectively. The mismatch ratio was 7.56 % (4.36 - 15.26 %) and 2.08 % (1.68 - 2.77 %) for SVD and the Bayesian algorithm, respectively, and all the measured values had statistically significant differences (p < 0.05). Spearman's correlation analysis showed that the correlation coefficient of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was higher than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (r = 0.915 vs. r = 0.763 ; p < 0.01). Furthermore, the results of the Bland Altman plot analysis demonstrated that the slope of the scatter plot of the cerebral infarct volume measured by the Bayesian algorithm using CTP imaging and MR DWI was more steady than that of the cerebral infarct volume measured by SVD using CTP imaging and MR DWI (y = -0.065 vs. y = -0.749), indicating that the Bayesian algorithm was more reliable than SVD. In conclusion, the Bayesian algorithm is more accurate than SVD in measuring cerebral infarct volume. Therefore, it can be useful in clinical utility.

Development of the National Integrated Daily Weather Index (DWI) Model to Calculate Forest Fire Danger Rating in the Spring and Fall (봄철과 가을철의 기상에 의한 전국 통합 산불발생확률 모형 개발)

  • Won, Myoungsoo;Jang, Keunchang;Yoon, Sukhee
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.20 no.4
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    • pp.348-356
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    • 2018
  • Most of fires were human-caused fires in Korea, but meteorological factors are also big contributors to fire behavior and its spread. Thus, meteorological factors as well as topographical and forest factors were considered in the fire danger rating systems. This study aims to develop an advanced national integrated daily weather index(DWI) using weather data in the spring and fall to support forest fire prevention strategy in South Korea. DWI represents the meteorological characteristics, such as humidity (relative and effective), temperature and wind speed, and we integrated nine logistic regression models of the past into one national model. One national integrated model of the spring and fall is respectively $[1+{\exp}\{-(2.706+(0.088^*T_{mean})-(0.055^*Rh)-(0.023^*Eh)-(0.014^*W_{mean}))\}^{-1}]^{-1}$, $[1+{\exp}\{-(1.099+(0.117^*T_{mean})-(0.069^*Rh)-(0.182^*W_{mean}))\}^{-1}]^{-1}$ and all weather variables significantly (p<0.01) affected the probability of forest fire occurrence in the overall regions. The accuracy of the model in the spring and fall is respectively 71.7% and 86.9%. One integrated national model showed 10% higher accuracy than nine logistic regression models when it is applied weather data with 66 random sampling in forest fire event days. These findings would be necessary for the policy makers in the Republic of Korea for the prevention of forest fires.

Evaluation of the Applicability of Major Domestic and International Forest fire indices: A Case Study in the Eastern Region of the Taebaek Mountain Range (국내외 주요 산불위험지수의 국내 적용성 평가: 태백산맥 동쪽 지역을 대상으로)

  • Jeong-Hyeok Ma;Chulsang Yoo
    • Journal of Wetlands Research
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    • v.26 no.3
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    • pp.204-218
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    • 2024
  • In this study, we evaluate the applicability of domestic and international forest fire indices in Korea. To accomplish this objective, we first compare the structures of widely-used forest fire indices worldwide. Then, the application results of these forest fire indices are evaluated by comparing them with the annual and seasonal variations in actual forest fire occurrences in Korea. Finally, we select indices suitable for domestic application and propose directions to improve their appropriate applicabilities. The considered forest fire indices include MI, KBDI, FFWI, and mFFWI developed in the United States, NI, ZhI, and MNI developed in Russia, and DWI developed in Korea. This study considers the East Coast region as a study area, and the number of forest fire occurrences is referenced from the forestry statistics yearbook provided by the Korea Forest Service. As results, first, most forest fire indices do not adequately reproduce the actual annual forest fire occurrences as its variation is so small. However, most indices are found to effectively represent the monthly variations. Based on the correlation analysis between forest fire indices and actual forest fire occurrences, mFFWI, MI, ZhI, and DWI are selected as suitable indices for the East Coast region. However, these indices are still not satisfactory to adequately represent the forest fire occurrences in Korea, suggesting the need for further improvements. Each index has its own different aspects to be improved and, therefore, evaluation of these indices may be available only after further improvements are completed.

Hyperperfusion in DWI Abnormality in a Patient with Acute Symptomatic Hypoglycemic Encephalopathy

  • Park, Ji Kang
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.2
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    • pp.106-108
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    • 2017
  • The perfusion change in acute symptomatic hypoglycemic encephalopathy (ASHE) is not well known. We present the perfusion-weighted imaging of a patient with ASHE. The area of diffusion-weighted imaging abnormalities and adjacent normal-appearing white matter showed increased cerebral blood volume and flow, and shortening of time-to-peak.