• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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• pp.99-99
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• 2003

To exhibit our clinical experience of diffusion-weighted (DW) MR imaging for various brain pathologies and to determine its role in characterizing brain pathologies in children. DW images in 177 children (M：F＝96：81, mean age, 4.7 years) with various brain pathologies were retrospectively collected over past 3 years. DW images (b value： 1000 s/mm) were reviewed along with corresponding apparent diffusion coefficient (ADC) maps. Brain pathologies included cystic or solid brain tumor (n = 55), cerebral infarct (n = 32), cerebritis with or without brain abscess (n = 21), metabolic or toxic brain disorder (n = 19), demyelinating disease (n = 16), hypoxic-ischemic encephalopathy (n = 16), intracerebral hemorrhage including traumatic brain lesion (n = 15), and posterior reversible leukoencephalopathy (n = 3). We reviewed whether DW images and ADCmaps contribute to further characterization of brain pathologies by defining a chronological age of lesions, the presence of cytotoxic edema in lesions, and the nature of cystic lesions.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1994년도 춘계학술대회
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• pp.9-15
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• 1994

In last few decades, medical imaging techniques have been developed startling progress. Especially in MRI (Magnetic Resonance Imaging), many imaging techniques such as chemical shift imaging, flow imaging, diffusion and perfusion imaging, fast imaging, susceptibility imaging and functional imaging have been studied and many of them were well known as useful diagnostic instruments. In this paper, recently developing techniques, i.e., NMR microscopy, fringe field imaging and functional imaging will be presented.

• Korean Journal of Radiology
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• 제20권1호
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• pp.18-33
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• 2019

In this study, we summarize the clinical role of magnetic resonance imaging (MRI) in the diagnosis of patients with malignant uterine neoplasms, including leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma, uterine carcinosarcoma, and endometrial cancer, with emphasis on the challenges and disadvantages. MRI plays an essential role in patients with uterine malignancy, for the purpose of tumor detection, primary staging, and treatment planning. MRI has advanced in scope beyond the visualization of the many aspects of anatomical structures, including diffusion-weighted imaging, dynamic contrast enhancement-MRI, and magnetic resonance spectroscopy. Emerging technologies coupled with the use of artificial intelligence in MRI are expected to lead to progressive improvement in case management of malignant uterine neoplasms.

• Investigative Magnetic Resonance Imaging
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• 제6권2호
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• pp.158-165
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• 2002

목적: 체내에 주입된 Gd-DTPA가 뇌의 확산강조 자기공명영상 신호강도 및 현성확산계수에 미치는 영향을 알아보았다. 대상 및 방법 : 성숙한 잡견 5마리에 대하여 동맥내 도관삽입에 의한 좌측 내경동맥 색전방법을 이용하여 초급성 뇌경색 동물모델을 만들었다. 색전 후 1시간째 확산강조영상을 시행하고, Gd-DTPA를 주입한 다음 다시 90분까지 11회의 추가 확산강조영상을 얻었다. 관심영역을 설정하여 측정한 초급성 뇌경색부위와 반대측 정상부위의 확산강조영상 신호강도 및 현성확산계수를 분석하였다. 결과: 뇌경색은 색전 후 1시간에 시행한 확산강조 자기공명영상에서 잡견 5마리 모두에서 발견되었다. 확산강조영상에서 초급성 뇌경색부위의 신호강도는 Gd-DTPA 주입 여부와 관계없이 시간이 경과함에 따라 증가하였으나, 관류가 유지된 정상부위의 신호강 도는 Gd-DTPA 주입 후 2분에 시행한 첫 검사에서 오히려 저하된 후, 시간경과에 따라 다시 증가하였다. 현성확산계수는 초급성 뇌경색부위에서 Gd-DTPA주입여부에 관계없이 시간 이 경과함에 따라 지속적으로 감소되었으나, 관류가 유지된 반대측 정상부위에서는 변화하지 않았다. 결론: 체내에 주입된 Gd-DTPA는 초급성 뇌경색부위 및 정상부위의 현성확산계수에 영향을 미치지 않으나, 정상부위에서는 조영제 주입 직후 초기의 자화율효과에 의해 확산강조영상의 신호 강도를 저하시켰다. 조영제 주입 후 시행한 확산강조영상 신호 강도의 정량적인 측정이 필요한 연구 혹은 임상 증례에 대하여는 현성확산계수를 측정함으로써 Gd-DTPA의 자화율효과에 의한 영향을 배제하여야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제43권6호
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• pp.275-280
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• 2008

Objective : In order to assess the incidence of thromboembolic events and their clinical presentations, the present study prospectively examined routine brain magnetic resonance images (MRI) taken within 48 hours after a coil embolization of cerebral aneurysms. Methods : From January 2006 to January 2008, 163 cases of coil embolization of cerebral aneurysm were performed along with routine brain MRI, including diffusion-weighted magnetic resonance (DW-MR) imaging, within 48 hours after the embolization of the aneurysm to detect the silent thromboembolic events regardless of any neurological changes. If any neurological changes were observed, an immediate brain MRI follow-up was performed. High-signal-intensity lesions in the DW-MR images were considered as acute thromboembolic events and the number and locations of the lesions were also recorded. Results : Among the 163 coil embolization cases, 98(60.1%) showed high-signal intensities in the DW-MR imaging follow-up, 66 cases (67.0%) involved the eloquent area and only 6cases (6.0%) showed focal neurological symptoms correlated to the DW-MR findings. The incidence of DW-MR lesions was higher in older patients (${\geq}60$ yrs) when compared to younger patients (<60 yrs) (p=0.002, odd's ratio=1.043). The older patients also showed a higher incidence of abnormal DW-MR signals in aneurysm-unrelated lesions (p=0.0003, odd's ratio=5.078). Conclusion : The incidence of symptomatic thromboembolic attacks after coil embolization of the cerebral aneurysm was found to be lower than that reported in previous studies. While DW-MR imaging revealed a higher number of thromboembolic events, most of these were clinically silent and transient and showed favorable clinical outcomes. However, the incidence of DW-MR abnormalities was higher in older patients, along with unpredictable thromboembolic events on DW-MR images. Thus, in order to provide adequate and timely treatment and to minimize neurological sequelae, a routine DW-MR follow-up after coil embolization of cerebral aneurysms might be helpful, especially in older patients.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.248-260
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• 2020

Objective : To investigate the efficiency of diffusion tensor imaging (DTI) fiber-tracking based neuronavigation and assess its usefulness in the preoperative surgical planning, prognostic prediction, intraoperative course and outcome improvement. Methods : Seventeen patients with cerebral masses adjacent to corticospinal tract (CST) were given standard magnetic resonance imaging and DTI examination. By incorporation of DTI data, the relation between tumor and adjacent white matter tracts was reconstructed and assessed in the neuronavigation system. Distance from tumor border to CST was measured. Results : The sub-portion of CST in closest proximity to tumor was found displaced in all patients. The chief disruptive changes were classified as follows : complete interruption, partial interruption, or simple displacement. Partial interruption was evident in seven patients (41.2%) whose lesions were close to cortex. In the other 10 patients (58.8%), delineated CSTs were intact but distorted. No complete CST interruption was identified. Overall, the mean distance from resection border to CST was 6.12 mm (range, 0-21), as opposed to 8.18 mm (range, 2-21) with simple displacement and 2.33 mm (range, 0-5) with partial interruption. The clinical outcomes were analyzed in groups stratified by intervening distances (close, <5 mm; moderated, 5-10 mm; far, >10 mm). For the primary brain tumor patients, the proportion of completely resected tumors increased progressively from close to far grouping (42.9%, 50%, and 100%, respectively). Five patients out of seven (71.4%) experienced new neurologic deficits postoperatively in the close group. At meantime, motor deterioration was found in six cases in the close group. All patients in the far and moderate groups received excellent (modified Rankin Scale [mRS] score, 0-1) or good (mRS score, 2-3) rankings, but only 57.1% of patients in the close group earned good outcome scores. Conclusion : DTI fiber tracking based neuronavigation has merit in assessing the relation between lesions and adjacent white matter tracts, allowing prediction of patient outcomes based on lesion-CST distance. It has also proven beneficial in formulating surgical strategies.

• 한국멀티미디어학회논문지
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• 제24권5호
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• pp.684-694
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• 2021

Resting-state Functional Magnetic Resonance Imaging(fMRI) data detects the temporal correlations in Blood Oxygen Level Dependent(BOLD) signal and these temporal correlations are regarded to reflect intrinsic cortical connectivity, which is deactivated during attention demanding, non-self referential tasks, called Default Mode Network(DMN). The relationship between fMRI and anatomical connectivity has not been studied in detail, however, the preceded studies have tried to clarify this relationship using Diffusion Tensor Imaging(DTI) and fMRI. These studies use method that fMRI data assists DTI data or vice versa and it is used as guider to perform DTI tractography on the brain image. In this study, we hypothesized that functional connectivity in resting state would reflect anatomical connectivity of DMN and the combined images include information of fMRI and DTI showed visible connection between brain regions related in DMN. In the previous study, functional connectivity was determined by subjective region of interest method. However, in this study, functional connectivity was determined by objective and advanced method through Independent Component Analysis. There was a stronger connection between Posterior Congulate Cortex(PCC) and PHG(Parahippocampa Gyrus) than Anterior Cingulate Cortex(ACC) and PCC. This technique might be used in several clinical field and will be the basis for future studies related to aging and the brain diseases, which are needed to be translated not only functional connectivity, but structural connectivity.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1367-1373
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• 2020

Objective: To assess diffusion tensor imaging (DTI) parameters of the hepatic parenchyma for the differentiation of biliary atresia (BA) from Alagille syndrome (ALGS). Materials and Methods: This study included 32 infants with BA and 12 infants with ALGS groups who had undergone DTI. Fractional anisotropy (FA) and mean diffusivity (MD) of the liver were calculated twice by two separate readers and hepatic tissue was biopsied. Statistical analyses were performed to determine the mean values of the two groups. The optimum cut-off values for DTI differentiation of BA and ALGS were calculated by receiver operating characteristic (ROC) analysis. Results: The mean hepatic MD of BA (1.56 ± 0.20 and 1.63 ± 0.2 × 10^-3 mm²/s) was significantly lower than that of ALGS (1.84 ± 0.04 and 1.79 ± 0.03 × 10^-3 mm²/s) for both readers (r = 0.8, p = 0.001). Hepatic MD values of 1.77 and 1.79 × 10^-3 mm²/s as a threshold for differentiating BA from ALGS showed accuracies of 82 and 79% and area under the curves (AUCs) of 0.90 and 0.91 for both readers, respectively. The mean hepatic FA of BA (0.34 ± 0.04 and 0.36 ± 0.04) was significantly higher (p = 0.01, 0.02) than that of ALGS (0.30 ± 0.06 and 0.31 ± 0.05) for both readers (r = 0.80, p = 0.001). FA values of 0.30 and 0.28 as a threshold for differentiating BA from ALGS showed accuracies of 75% and 82% and AUCs of 0.69 and 0.68 for both readers, respectively. Conclusion: Hepatic DTI parameters are promising quantitative imaging parameters for the detection of hepatic parenchymal changes in BA and ALGS and may be an additional noninvasive imaging tool for the differentiation of BA from ALGS.

• Korean Journal of Radiology
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• 제23권1호
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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.

• 한국산학기술학회논문지
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• 제15권7호
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• pp.4380-4386
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• 2014

본 연구는 갑상선의 확산강조영상 검사 시 조직과 공기 간 자화율차이를 줄임으로서 영상의 뒤틀림을 감소시키고자 하였다. 연구대상은 정상인 23명을 대상으로 하였으며, 공기와 인접해 있고 주변에 후두와 기관이 자리 잡고 있어 뒤틀림이 많이 발생하는 갑상선을 대상으로, 실리콘 적용 전 후 확산강조영상의 뒤틀림과 오차율을 비교평가 하였다. 연구결과 실리콘 적용 전보다 적용 후가 뒤틀림이 감소된 것을 볼 수 있으며, 오차율 또한 30%대에서 10%대로 감소하는 것을 볼 수 있었다. 또한 일원배치분산분석과 Duncan의 사후분석을 통해서도 실리콘 적용 후가 기준영상인 T2 강조영상의 면적과 차이가 없음을 알 수 있었다. 결론적으로 본 연구는 선행연구들의 복잡한 과정 없이 자기공명신호의 대조도에 영향을 주지 않으면서 공기와 맞닿은 굴곡진 부분을 보상함으로써 영상의 뒤틀림을 감소시킬 수 있는 근본적인 개선 방안을 제시하였다는 데에 커다란 의의가 있다.