• Investigative Magnetic Resonance Imaging
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• 제22권2호
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• pp.131-134
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• 2018

Susceptibility-weighted imaging (SWI) is well known for detecting the presence of hemorrhagic transformation, microbleeds and the susceptibility of vessel signs in acute ischemic stroke. But in some cases, it can provide the tissue perfusion state as well. We describe a case of a patient with hyperacute ischemic infarction that had a slightly hypodense, patchy lesion at the left thalamus on the initial SWI, with a left proximal posterior cerebral artery occlusion on a magnetic resonance (MR) angiography and delayed time-to-peak on an MR perfusion performed two hours after symptom onset. No obvious abnormal signals at any intensity were found on the initial diffusion-weighted imaging (DWI). On a follow-up MR image (MRI), an acute ischemic infarction was seen on DWI, which is the same location as the lesion on SWI. The hypointensity on the initial SWI reflects the susceptibility artifact caused by an increased deoxyhemoglobin in the affected tissue and vessels, which reflects the hypoperfusion state due to decreasing arterial flow. It precedes the signal change on DWI that reflects a cytotoxic edema. This case highlights that, in some hyperacute stages of ischemic stroke, hypointensity on an SWI may be a finding before the hyperintensity is seen on a DWI.

• Annals of Clinical Neurophysiology
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• 제15권2호
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• pp.42-47
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• 2013

Background: Diffusion-weighted image (DWI) might be useful to predict the prognosis of acute hypoxic encephalopathy. The aim of our study was to test whether the early change and extent of DWI abnormalities can be an indicator of the clinical outcome of hypoxic encephalopathy. Methods: Forty-four patients who were diagnosed as hypoxic encephalopathy due to the cardiorespiratory arrest were retrospectively identified. Clinical variables were determined, and the DWI abnormalities were counted by four areas: cortex, subcortical white matter, cerebellum and deep grey matter, and were divided into three groups by the extent of lesions. Prognosis was classified as 'poor' (Glasgow coma scale (GSC) at 30 days after arrest <9 or death) and 'good' (GSC at 30 days after arrest ${\geq}9$). Results: GCS at day 3 (p<0.001), presence of seizure (p=0.01), and presence of lesion (p<0.001) were significantly different in prognosis, but statistically there is no association with the extent of lesions and prognosis (p=0.26). Conclusions: Presence of early DWI changes could predict the clinical outcome of hypoxic encephalopathy after cardiorespiratory arrest.

• Investigative Magnetic Resonance Imaging
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• 제20권4호
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• pp.241-249
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• 2016

Purpose: To evaluate the added value of diffusion weighted imaging (DWI) to computed tomography (CT) for detecting pancreatic abnormality in patients with clinically suspected acute pancreatitis (AP). Materials and Methods: 203 patients who underwent abdomen CT and subsequent DWI to do a workup for epigastric pain were analyzed. Two blinded radiologists independently performed an interval reading based on CT image sets first, then based on combined CT and DWI image sets. The diagnostic criterion on DWI was the increased signal intensity in the pancreas to that of the spleen. For quantitative analysis, the third radiologist measured ADC value of the pancreas in each patient. Results: For AP (n = 43), the sensitivity for detecting pancreatic abnormality increased, from 42% to 70% for reader 1 (P < 0.05) and from 44% to 72% for reader 2 (P < 0.05). For borderline pancreatitis (n = 42), the sensitivity also increased, from 10% to 26% for reader 1 (P < 0.05) and from 7% to 29% for reader 2 (P < 0.05). The mean ADC values (unit, ${\times}10^{-3}mm^2/s$) were significantly different among the three groups (for AP, $1.09{\pm}0.16$; for borderline pancreatitis, $1.28{\pm}0.2$; for control, $1.46{\pm}0.15$, P < 0.05). Conclusion: Sensitivity for detecting pancreatic abnormality increased significantly after adding DWI to CT in patients with clinically suspected AP.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제12권10호
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• pp.4976-4994
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• 2018

The diffusion-based salient object detection methods have shown excellent detection results and more efficient computation in recent years. However, the current diffusion-based salient object detection methods still have disadvantage of detecting the object appearing at the image boundaries and different scales. To address the above mentioned issues, this paper proposes a multi-scale diffusion-based salient object detection algorithm with background and objectness seeds. In specific, the image is firstly over-segmented at several scales. Secondly, the background and objectness saliency of each superpixel is then calculated and fused in each scale. Thirdly, manifold ranking method is chosen to propagate the Bayessian fusion of background and objectness saliency to the whole image. Finally, the pixel-level saliency map is constructed by weighted summation of saliency values under different scales. We evaluate our salient object detection algorithm with other 24 state-of-the-art methods on four public benchmark datasets, i.e., ASD, SED1, SED2 and SOD. The results show that the proposed method performs favorably against 24 state-of-the-art salient object detection approaches in term of popular measures of PR curve and F-measure. And the visual comparison results also show that our method highlights the salient objects more effectively.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회.한국자기공명학회 2005년도 공동학술대회
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• pp.27-27
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• 2005

• 한국의학물리학회지:의학물리
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• 제21권1호
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• pp.52-59
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• 2010

요추 압박 골절이 있는 환자를 대상으로 1.5 T MR 기기에서 b value의 변화를 이용한 확산강조영상에서 압박 골절이 있는 요추의 신호대 잡음비와 현성 확산 계수가 어떤 변화를 나타내는지 알아보고자 하였다. 2008년 1월부터 2009년 11월까지 요추 MRI를 촬영한 환자 중에서 만성 골다공증으로 척추 압박 골절을 보였던 환자 30명을 대상으로 1.5T MR scanner를 이용하여 b value를 400, 600, 800, 1000, $1200\;s/mm^2$으로 점차 증가시켜가면서 확산강조영상을 각각 획득하였다. 각각의 b value로 획득한 확산강조영상에서 1~5번의 요추체중 척추 압박 골절이 있는 부위와 골절이 있는 부위의 위, 아래 추간판등 세 부위에서 신호대 잡음비를 측정하였고 각각의 b value로 획득한 ADC map 영상에서는 세 부위의 신호대 잡음비와 현성 확산 계수를 측정 하였다. 정량적 분석방법으로 b value $400\;s/mm^2$으로 획득한 확산강조영상과 ADC map영상을 기준으로 각각의 b value로 획득한 영상과 비교하였다. 정성적인 분석방법은 b value $400\;s/mm^2$ 확산강조영상과 ADC map영상의 1~5번의 요추체중 척추 압박 골절이 있는 부위의의 신호강도를 분석하여 이를 기준으로 각각의 b value를 증가시켰을 때의 확산강조영상과 ADC map영상에서 신호강도가 상대적으로 어떻게 변화하는지 알아보았다. 영상의 정량적 분석에서는 확산강조영상에서 b value가 증가함에 따라 척추 압박 골절이 있는 부위와 골절이 있는 부위의 위, 아래 추간판등 세 부위 모두 신호대 잡음비가 상대적으로 감소했다. ADC map영상에서는 b value가 증가함에 따라 척추 압박 골절이 있는 부위와 골절이 있는 부위의 위, 아래 추간판등 세 부위 모두 신호대 잡음비가 상대적으로 감소했다. ADC map영상에서 b value에 따른 관심영역의 현성 확산 계수는 b value가 증가함에 따라 척추 압박 골절이 있는 부위와 골절이 있는 부위의 위, 아래 추간판등 세 부위 모두 현성 확산 계수가 상대적으로 감소했다. 영상의 정성적 분석에서 b value를 $400\;s/mm^2$ 이상으로 증가시킴에 따라 척추 압박 골절이 있는 부위와 골절이 있는 부위의 위, 아래 추간판등 세 부위 모두 신호강도가 점차 감소하였고 b value를 $1,000\;s/mm^2$ 이상으로 했을 때에는 세 부위 모두 영상의 잡음이 매우 심했다. 또한 척추 압박 골절이 있는 부위는 상대적으로 위, 아래 추간판 보다 높은 신호강도를 보였다. 확산강조영상에서 b value를 증가시킴에 따라 척추 압박 골절이 있는 부위와 골절이 있는 부위의 위, 아래 추간판 등 세부위 모두 신호대 잡음비와 현성확산계수가 점차 감소하는 결과를 얻었고 향후 확산강조영상 검사 시 Multi b value를 사용하여 신호의 변화를 인지함으로서 여러 가지 척추질환으로의 적용에 도움을 줄 것이라 사료된다.

• Investigative Magnetic Resonance Imaging
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• 제17권4호
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• pp.312-315
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• 2013

발작을 동반한 급성 뇌경색이 의심되는 환자에서 대뇌피질에 고신호 강도의 병변이 확산강조영상에서 보일 때 뇌경색에 의한 병변인지 발작에 동반된 이차적 병변인지 구분하는 것은 혈전용해제의 치료방침과 관련하여 대단히 중요하다. 발작을 동반한 뇌경색이 의심되는 환자에서 관류 MR영상을 이용하여 뇌경색과 감별이 가능하였던 발작에 동반된 대뇌피질의 고신호 강도를 보였던 1예를 보고하고자 한다.

• 대한의생명과학회지
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• 제10권2호
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• pp.115-120
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• 2004

To investigate the correlation between the magnetic resonance imaging (MRI) of cerebral fat embolism that is induced by injecting oleic acid into 10 cats, and a pathologic diagnosis. Using a microcatheter, 30 ${mu}ell$ of oleic acid was injected into the internal carotid artery of 10 cats. MR T2-weighted image (T2WI), diffusion-weighted image (DWI) and Gadolinium-enhanced T1-weighted image (Gd-enhanced T1WI) were obtained after 30 minutes and 2 hours of embolization. After 30 minutes of the embolization, lesions of very high signal intensity were detected by T2WI in 6 cats, and of slightly high signal intensity in 2 cats; in the remaining 2 cats, signal intensity was normal. DWI showed lesions of very high intensity in 9 cats and of slightly high intensity in one cat. According to the findings of light microscopic examination, infarcted lesions mainly involved the gray matter, but also some white matter. A magnetic resonance imaging diagnosis for cerebral fat embolism that was induced by oleic acid through the internal carotid artery in cats showed high signal intensity on the T2WI and the DWI within an initial 2 hours, and with a well enhancement on the Gd-enhanced T1WI. Considering cellular edema, cerebrovascular injury and extracellular space widening, we assumed pathologically that cytotoxic and vasogenic edema exists at the same time.

• Investigative Magnetic Resonance Imaging
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• 제15권2호
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• pp.102-109
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• 2011

목적 : 수술 전 축내 뇌종양의 경도를 평가하는데 확산강조영상 및 현성확산계수영상과 고식적 MR 영상의 유용성을 알아보고자 하였다. 대상 및 방법: 축내 뇌종양으로 수술을 받은 23명의 환자를 대상으로 T1, T2, 확산강조영상 소견을 후향적으로 분석하였다. 다양한 MR영상에서의 신호강도와 수술에서 평가한 종양의 경도를 정량적, 정성적으로 비교 분석하였다. 수술소견에서 종양의 경도는 낭성, 젤리같은, 쉽게 부서지는, 부드러운, 단단한, 딱딱한 정도로 나눴다. 세 명의 환자에서는 낭성 부분과 고형성 부분이 함께 있어서 각각에 대해서 평가하였다. 결과: 종양이 단단할수록 현성확산계수와 T2강조영상에서의 신호강도의 비는 더 낮았다 (p = 0.002, p = 0.01). 종양의 경도와 현성확산계수가 가장 강한 선형상관관계를 보였다 (r = -0.586, p = 0.002). 정성적 분석에서는 단단할수록 T2강조영상에서 정성적 신호강도 등급이 낮았다 (p = 0.018). 그 외 다른 MR소견은 통계분석에서 종 양의 경도와 유의한 상관관계를 보이지 않았다. 결론: 축내 뇌종양의 현성확산계수, T2강조영상에서 신호강도의 비와 정성적 신호강도 등급은 종양의 경도와 상관관계가 있었고 이는 수술 전 전략 수립에 많은 도움이 될 것으로 생각된다.

• Investigative Magnetic Resonance Imaging
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• 제25권2호
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• pp.118-128
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• 2021

Purpose: To investigate the value of MR textural analysis, including use of diffusion-weighted imaging (DWI) to differentiate malignant from benign soft-tissue tumors on 3T MRI. Materials and Methods: We enrolled 69 patients (25 men, 44 women, ages 18 to 84 years) with pathologically confirmed soft-tissue tumors (29 benign, 40 malignant) who underwent pre-treatment 3T-MRI. We calculated MR texture, including mean, standard deviation (SD), skewness, kurtosis, mean of positive pixels (MPP), and entropy, according to different spatial-scale factors (SSF, 0, 2, 4, 6) on axial T1- and T2-weighted images (T1WI, T2WI), contrast-enhanced T1WI (CE-T1WI), high b-value DWI (800 sec/mm²), and apparent diffusion coefficient (ADC) map. We used the Mann-Whitney U test, logistic regression, and area under the receiver operating characteristic curve (AUC) for statistical analysis. Results: Malignant soft-tissue tumors had significantly lower mean values of DWI, ADC, T2WI and CE-T1WI, MPP of ADC, and CE-T1WI, but significantly higher kurtosis of DWI, T1WI, and CE-T1WI, and entropy of DWI, ADC, and T2WI than did benign tumors (P < 0.050). In multivariate logistic regression, the mean ADC value (SSF, 6) and kurtosis of CE-T1WI (SSF, 4) were independently associated with malignancy (P ≤ 0.009). A multivariate model of MR features worked well for diagnosis of malignant soft-tissue tumors (AUC, 0.909). Conclusion: Accurate diagnosis could be obtained using MR textural analysis with DWI and CE-T1WI in differentiating benign from malignant soft-tissue tumors.