• Title/Summary/Keyword: Dynamic MRI

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Management Principles of Bilateral Vocal Fold Immobility (양측성 성대 마비의 치료 원칙)

  • Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.118-125
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    • 2009
  • Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

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A Design and Implementation of Direct Volume Rendering View Program based on Web (웹 기반의 다이렉트 볼륨 렌더링 View 프로그램의 설계 및 구현)

  • Yoon, Yo-Sup;Yoon, Ga-Rim;Kim, Young-Bong
    • Proceedings of the Korea Contents Association Conference
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    • 2004.11a
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    • pp.402-407
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    • 2004
  • Since the world wide web, simple and convenient tool, has proposed, the Internet became the most simple network resource which provide many informations of the world. Furthermore, various methodologies are developed to support the dynamic service such as 3D View web service. We will propose the volume rendering view program that interactively visualize the 3D data on the web. The 3D Data is obtained by stacking the 2D images along the z-direction. We also employ the COM based OCX control which is a kind of Active component. This web program will contribute the diagnosis of the diseases through the 3D visualization and image analysis functions at remote places.

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Segmentation and Visualization of Head MR Image Based on Structural Approach (구조적인 기법을 이용한 머리 MR 단층 영상의 조직 분류 및 가시화)

  • 권오봉;김민기
    • Journal of Biomedical Engineering Research
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    • v.20 no.3
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    • pp.283-290
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    • 1999
  • Because MR(Magnetic Resonance) slice images have much information of functions about body organs, it is very effeclive for diagnoses lo analyze and visualize MR slice images. A visuahzation process is composed of medical image acquisition, preprocessmg, segmentation, inlerpolation, rendering. Segmentation and interpolation among thenl ,1re currenl hot topics because of MR slice image imperfections. This paper proposes a method for segmentalion, mlerpolation respectively and addresses 3 D-visualizmg of a head. We segmented head tissues uomg otructural knowledge of head studied by clinical experiments sequentially. We improved the dynamic elastic inlerpolation to Utilize in concave conlour. We compared the proposed segmentation method and the interpolation method with other methods.

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Primary Diffuse Large B-Cell Lymphoma of the Seminal Vesicle: a Case Report

  • Kwag, Kyung Su;Jang, Suk Ki;Yeon, Jae Woo;Kwon, Kye-Won;Son, Jeong Hwan;Kim, Hyuk Jung
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.4
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    • pp.259-263
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    • 2016
  • Primary diffuse large B-cell lymphoma of the seminal vesicle is an extremely rare disorder, with only two cases reported in the English literature. Here, we present imaging findings of a case of primary diffuse large B-cell lymphoma of the seminal vesicle. On transrectal ultrasonography, the mass presented as a 3.0-cm-sized heterogeneous, hypoechoic lesion in the right seminal vesicle. Computed tomography (CT) revealed a mass with rim-like enhancement in the right seminal vesicle. On magnetic resonance imaging (MRI), the tumor showed iso-signal intensity on T1-weighted images and heterogeneously intermediate-high signal intensity on T2-weighted images. The tumor showed rim-like and progressive enhancement with non-enhancing portion on dynamic scanning. Diffusion restriction was observed in the mass. On fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) imaging, a high standardized uptake value (maxSUV, 23.5) by the tumor was noted exclusively in the right seminal vesicle.

Dynamic Computed Tomography based on Spatio-temporal Analysis in Acute Stroke: Preliminary Study (급성 뇌졸중 환자의 시공간 분석 기법을 이용한 동적 전산화 단층 검사: 예비 연구)

  • Park, Ha-Young;Pyeon, Do-Yeong;Kim, Da-Hye;Jung, Young-jin
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.543-547
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    • 2016
  • Acute stroke is a one of common disease that require fast diagnosis and treatment to save patients life. however, the acute stroke may cause lifelong disability due to brain damage with no prompt surgical procedure. In order to diagnose the Stroke, brain perfusion CT examination and possible rapid implementation of 3D angiography has been widely used. However, a low-dose technique should be applied for the examination since a lot of radiation exposure to the patient may cause secondary damage for the patients. Therefore, the degradation of the measured CT images may interferes with a clinical check in that blood vessel shapes on the CT image are significantly affected by gaussian noise. In this study, we employed the spatio-temporal technique to analyze dynamic (brain perfusion) CT data to improve an image quality for successful clinical diagnosis. As a results, proposed technique could remove gaussian noise successfully, demonstrated a possibility of new image segmentation technique for CT angiography. Qualitative evaluation was conducted by skilled radiological technologists, indicated significant quality improvement of dynamic CT images. the proposed technique will be useful tools as a clinical application for brain perfusion CT examination.

Prognostic Value of Dynamic Contrast-Enhanced MRI-Derived Pharmacokinetic Variables in Glioblastoma Patients: Analysis of Contrast-Enhancing Lesions and Non-Enhancing T2 High-Signal Intensity Lesions

  • Yeonah Kang;Eun Kyoung Hong;Jung Hyo Rhim;Roh-Eul Yoo;Koung Mi Kang;Tae Jin Yun;Ji-Hoon Kim;Chul-Ho Sohn;Sun-Won Park;Seung Hong Choi
    • Korean Journal of Radiology
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    • v.21 no.6
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    • pp.707-716
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    • 2020
  • Objective: To evaluate pharmacokinetic variables from contrast-enhancing lesions (CELs) and non-enhancing T2 high signal intensity lesions (NE-T2HSILs) on dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging for predicting progression-free survival (PFS) in glioblastoma (GBM) patients. Materials and Methods: Sixty-four GBM patients who had undergone preoperative DCE MR imaging and received standard treatment were retrospectively included. We analyzed the pharmacokinetic variables of the volume transfer constant (Ktrans) and volume fraction of extravascular extracellular space within the CEL and NE-T2HSIL of the entire tumor. Univariate and multivariate Cox regression analyses were performed using preoperative clinical characteristics, pharmacokinetic variables of DCE MR imaging, and postoperative molecular biomarkers to predict PFS. Results: The increased mean Ktrans of the CEL, increased 95th percentile Ktrans of the CELs, and absence of methylated O6-methylguanine-DNA methyltransferase promoter were relevant adverse variables for PFS in the univariate analysis (p = 0.041, p = 0.032, and p = 0.083, respectively). The Kaplan-Meier survival curves demonstrated that PFS was significantly shorter in patients with a mean Ktrans of the CEL > 0.068 and 95th percentile Ktrans of the CEL > 0.223 (log-rank p = 0.038 and p = 0.041, respectively). However, only mean Ktrans of the CEL was significantly associated with PFS (p = 0.024; hazard ratio, 553.08; 95% confidence interval, 2.27-134756.74) in the multivariate Cox proportional hazard analysis. None of the pharmacokinetic variables from NE-T2HSILs were significantly related to PFS. Conclusion: Among the pharmacokinetic variables extracted from CELs and NE-T2HSILs on preoperative DCE MR imaging, the mean Ktrans of CELs exhibits potential as a useful imaging predictor of PFS in GBM patients.

Characteristic of Cross-sectional Area of Lumbar Paraspinal Muscle in Patients of Acute and Chronic LBP (20대와 40대의 급성 및 만성요통환자의 척추주위 근육에 관한 횡단면의 비교)

  • Kim, Dae-Hun;Park, Jin-Kyu;Park, Yun-Jin;Jung, Dae-In;Kim, Seong-Su
    • The Journal of the Korea Contents Association
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    • v.11 no.6
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    • pp.270-278
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    • 2011
  • The purpose of this study was to compare acute and chronic LBP patient in twenties and forties, respectively by size measure paraspinal muscle (cross-sectional area; CSA). CSA of paraspinal muscle (psoas, multifidus, erector muscle) size was measured by free-handling technique of the picture archiving and communication system(PACS) using MRI at the level(lower end-plate of L4) in twenties(9 males, 10 females) and forties(9 males, 8 females) in acute and chronic LBP patient. The results of this study showed no significantly difference between acute and chronic LBP (p>0.05) in twenties patients. However, there was significant difference between acute and chronic LBP (p<0.05) in forties patients. Also, there was significant difference in paraspinal muscle CSA between chronic LBP patients in twenties and chronic LBP patients in forties (p<0.05). This study showed that paraspinal muscle atrophy was observed in forties with various cause, but Not chronic LBP patients in twenties. Accordingly it is required for chronic LBP patients in forties to minimize trunk muscle atrophy through immediate back muscle dynamic exercise and early functional activity.

Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3595-3604
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    • 2015
  • Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

MR Findings of Papillary Neoplasms of the Breast (유두 종양의 자기공명 영상소견)

  • Jo, Yeseul;Kim, Sung Hun;Kang, Bong Joo;Choi, Byung Gil
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.1
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    • pp.43-51
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    • 2014
  • Purpose : To review MR imaging finding of papillary lesion identified as additional suspicious lesion on MR image in women with biopsy-proven breast cancer and to evaluate upgrading rates after subsequent surgical histopathological diagnosis. Materials and Methods: Among 1729 preoperative MR image of women with biopsy proven breast cancer, US-guided CNB-proven 22 papillary lesions from 21 patients, which showed additional suspicious contrast enhancement other than index cancer on MR image, were subjected to the study. Some of these lesions underwent surgery, thus the comparisons between the histopathologic results were able to be compared to the results of US-guided CNB. Also retrospective analysis was done for MR findings of these lesions by BI-RADS MRI lexicon. Results: On MR imaging, 8 mass lesions, 7 non-mass lesions, 7 focus lesions were detected. All of the focus lesion (100%, 7/7) was diagnosed as benign lesion and showed plateau and washout pattern in dynamic MR image. After excisional biopsy, one of 9 benign papilloma (11.1%), 3 of 3 papillary neoplasm with atypia component (100%), 3 of 5 papillary neoplasm (60%) were upgraded to malignancy such as ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC). Conclusion: The MR images of papillary lesions diagnosed by US-guided CNB exhibit no significant differences between malignancy and benign lesion. Also 41.2% of the lesion (7/17) was upgraded after subsequent surgery. Thus all of the papillary lesions require excisional biopsy for definite diagnosis and the MR imaging, it's just not enough by itself.

Primary Colonic Epithelioid Angiosarcoma with Hepatic Metastasis: A Case Report (간전이를 동반한 대장 상피모양혈관육종: 증례 보고)

  • Jiyun Lim;Seong Sook Hong;Jiyoung Hwang;Hyun-joo Kim;So-Young Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.432-438
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    • 2022
  • Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.