• Investigative Magnetic Resonance Imaging
• /
• v.24 no.1
• /
• pp.55-60
• /
• 2020

Tietze's syndrome is an inflammatory condition associated with painful swelling of the costochondral, costosternal, and sternoclavicular joints. Tietze's syndrome has been mostly attributed to microtrauma until now; however, this etiology is currently disputed. The diagnosis is based on clinical findings, although a few studies suggest the advantages of imaging. We report a case of Tietze's syndrome with a review of radiological findings, especially magnetic resonance imaging (MRI) with dynamic contrast enhancement.

• Journal of Yeungnam Medical Science
• /
• v.22 no.1
• /
• pp.43-51
• /
• 2005

Background: To examine the ultrasonographic and magnetic resonance (MRI) imaging findings of a cervical mass type cervical pregnancy. Materials and Methods: The ultrasonographic and MRI findings of 5 patients pathologically confirmed as having a cervical pregnancy were analyzed retrospectively. On ultrasonography, the size and echo pattern of the uterine cervix, the shape and echo pattern of the lesion, the degree and the pattern of blood flow on the color Doppler study and the spectral Doppler pattern were analyzed. The shape, signal intensity, and degree and pattern of enhancement of the lesion were evaluated on MRI. Results: The uterine cervix was enlarged and the size of the lesion was 6.1 to 7.1 (average, 6.5) cm. The endocervical canal was irregularly dilated and showed heterogeneous echogenicity in all 5 cases. Four of the 5 lesions were heterogeneously hyper- or mixed echoic and remaining one was relatively homogeneous echogenic. Doppler ultrasonography revealed an increased vascularity of the peritrophoblastic flow pattern. In all 4 cases where MRI performed, the lesion was irregular in shape and the margin was not sharply demarcated. The T2-weighed image showed that the lesions were mixed signal intensity. Three of the 4 lesions contained high signal intensity nodular portions and a low signal intensity rim was observed along the margin of the nodular portions. The T1-weighted image revealed multiple signal voids along the periphery of the lesions and high signal intensity portions as a result of hemorrhage were noted. The dynamic enhanced study showed that the high signal intensity portions on the T2-weighted image were strongly enhanced similar to the vessels on the early phase and the contrast enhancement gradually decreased with time. Conclusion: A cervical mass type cervical pregnancy can be correctly diagnosed using the patient's clinical symptom, the elevation in the serum ${\beta}$-HCG level, and characteristic ultrasonographic and MRI findings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.2
• /
• pp.134-140
• /
• 2010

Synovial condromatosis of the temporomandibular joint (TMJ) is characterized by the presence of loose bodies (joint mices). It can be confused with temporomandibular disorder clinically, and be with chondrosarcoma histologically. The purpose of this clinical report was to review the clinical, radiological, arthroscopic findings, histological feature and the results of surgical treatment of TMJ synovial chondromatosis. Four patients presented with pain of TMJ and limited mouth opening. The dynamic magnetic resonance imaging (MRI) disclosed a characteristic morphologic changes and displacement of the meniscus with limited translation of the condyle head. Bone scans showed progressive resorptive changes with hot-uptake of the radioisotope. The synovial loose bodies in the joint spaces were removed and sent to pathology for diagnosis as the synovial chondromatosis. The follow-up examination with computed tomography (CT) and MRI revealed no evidence of recurrence and good in function until postoperative 18 months. Diagnostically, the distension of the lateral capsule and fluid findings in the joint on the MRI are very suggestive tool for this synovial chondromatosis, but they are not always detected on the preoperative MRI. Arthroscopic approaches are very useful to inspect the joint spaces and to remove the loose bodies without interruption of the whole synovial membranes.

• Journal of the Korean Society of Radiology
• /
• v.82 no.4
• /
• pp.889-902
• /
• 2021

Purpose To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for additional MR-detected enhancing lesions and to determine whether or not kinetic pattern results comparable to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can be obtained using the quantitative analysis of CEUS. Materials and Methods In this single-center prospective study, a total of 71 additional MR-detected breast lesions were included. CEUS examination was performed, and lesions were categorized according to the Breast Imaging-Reporting and Data System (BI-RADS). The sensitivity, specificity, and diagnostic accuracy of CEUS were calculated by comparing the BI-RADS category to the final pathology results. The degree of agreement between CEUS and DCE-MRI kinetic patterns was evaluated using weighted kappa. Results On CEUS, 46 lesions were assigned as BI-RADS category 4B, 4C, or 5, while 25 lesions category 3 or 4A. The diagnostic performance of CEUS for enhancing lesions on DCE-MRI was excellent, with 84.9% sensitivity, 94.4% specificity, and 97.8% positive predictive value. A total of 57/71 (80%) lesions had correlating kinetic patterns and showed good agreement (weighted kappa = 0.66) between CEUS and DCE-MRI. Benign lesions showed excellent agreement (weighted kappa = 0.84), and invasive ductal carcinoma (IDC) showed good agreement (weighted kappa = 0.69). Conclusion The diagnostic performance of CEUS for additional MR-detected breast lesions was excellent. Accurate kinetic pattern assessment, fairly comparable to DCE-MRI, can be obtained for benign and IDC lesions using CEUS.

• Investigative Magnetic Resonance Imaging
• /
• v.6 no.2
• /
• pp.129-136
• /
• 2002

Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

• Korean Journal of Radiology
• /
• v.22 no.4
• /
• pp.559-567
• /
• 2021

Objective: To evaluate the impact of multiparametric magnetic resonance imaging (mpMRI) before confirmatory prostate biopsy in patients under active surveillance (AS). Materials and Methods: This retrospective study included 170 patients with Gleason grade 6 prostate cancer initially enrolled in an AS program between 2011 and 2019. Prostate mpMRI was performed using a 1.5 tesla (T) magnetic resonance imaging system with a 16-channel phased-array body coil. The protocol included T1-weighted, T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging sequences. Uroradiology reports generated by a specialist were based on prostate imaging-reporting and data system (PI-RADS) version 2. Univariate and multivariate analyses were performed based on regression models. Results: The reclassification rate at confirmatory biopsy was higher in patients with suspicious lesions on mpMRI (PI-RADS score ≥ 3) (n = 47) than in patients with non-suspicious mpMRIs (n = 61) and who did not undergo mpMRIs (n = 62) (66%, 26.2%, and 24.2%, respectively; p < 0.001). On multivariate analysis, presence of a suspicious mpMRI finding (PI-RADS score ≥ 3) was associated (adjusted odds ratio: 4.72) with the risk of reclassification at confirmatory biopsy after adjusting for the main variables (age, prostate-specific antigen density, number of positive cores, number of previous biopsies, and clinical stage). Presence of a suspicious mpMRI finding (adjusted hazard ratio: 2.62) was also associated with the risk of progression to active treatment during the follow-up. Conclusion: Inclusion of mpMRI before the confirmatory biopsy is useful to stratify the risk of reclassification during the biopsy as well as to evaluate the risk of progression to active treatment during follow-up.

• Korean Journal of Radiology
• /
• v.23 no.6
• /
• pp.674-687
• /
• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• Proceedings of the KSMRM Conference
• /
• 2002.11a
• /
• pp.75-75
• /
• 2002

목적： 고자장 자기공명영상 시스템 등으로 신호대잡음비가 향상됨에 따라 데이터 측정에서 analog-to-digital converter (ADC)의 quantization noise 가 중요한 시스템 사양으로 부각되고 있다. 특히 자기공명영상은 공간주파수 영역에서 데이터를 측정하기 때문에 dc와 ac간의 신호 차이가 매우 크며, 이러한 dynmic range는 3-D 영상에서 더욱 커진다. 본 연구에서는 다양한 자기총명 영상기법 및 실험 파라미터에 따른 신호의 dynamic range와 ADC의 bit 수에 따른 quantization noise를 살펴봄으로써, 주어진 시스템에 적합한 ADC의 bit 수를 분석하고자 한다. 대상 및 방법： 펄스 시퀀스의 종류, 파라미터, 2D/3D 등에 따른 각 신호의 크기를 수학적으로 모델링하여 신호의 크기를 예측하였다. 또한 whole body MRI 시스템에서 실험을 통하여 신호의 크기를 비교하였다. ADC의 quantization noise를 실험과 시뮬레이션을 통하여 살펴보았다. 시뮬레이션은 test 영상을 Inverse FFT 하여 spatial frequency domain data를 만든 후, 다양한 bit 수의 ADC로 quantization을 한 후 다시 영상을 재구성하였다. 재구성된 영상과 원영상 간의 error가 quantization noise가 된다. 또한 이러한 error가 주파수 영역에서의 error 값과 일치하는지를 확인하였다.

• Investigative Magnetic Resonance Imaging
• /
• v.23 no.1
• /
• pp.38-45
• /
• 2019

Purpose: To demonstrate the high-resolution numerical simulation of the respiration-induced dynamic $B_0$ shift in the head using generalized susceptibility voxel convolution (gSVC). Materials and Methods: Previous dynamic $B_0$ simulation research has been limited to low-resolution numerical models due to the large computational demands of conventional Fourier-based $B_0$ calculation methods. Here, we show that a recently-proposed gSVC method can simulate dynamic $B_0$ maps from a realistic breathing human body model with high spatiotemporal resolution in a time-efficient manner. For a human body model, we used the Extended Cardiac And Torso (XCAT) phantom originally developed for computed tomography. The spatial resolution (voxel size) was kept isotropic and varied from 1 to 10 mm. We calculated $B_0$ maps in the brain of the model at 10 equally spaced points in a respiration cycle and analyzed the spatial gradients of each of them. The results were compared with experimental measurements in the literature. Results: The simulation predicted a maximum temporal variation of the $B_0$ shift in the brain of about 7 Hz at 7T. The magnitudes of the respiration-induced $B_0$ gradient in the x (right/left), y (anterior/posterior), and z (head/feet) directions determined by volumetric linear fitting, were < 0.01 Hz/cm, 0.18 Hz/cm, and 0.26 Hz/cm, respectively. These compared favorably with previous reports. We found that simulation voxel sizes greater than 5 mm can produce unreliable results. Conclusion: We have presented an efficient simulation framework for respiration-induced $B_0$ variation in the head. The method can be used to predict $B_0$ shifts with high spatiotemporal resolution under different breathing conditions and aid in the design of dynamic $B_0$ compensation strategies.

• Annals of Clinical Neurophysiology
• /
• v.4 no.1
• /
• pp.21-27
• /
• 2002

Background : Spatial analysis of EEG is a phenomenal assessment and not so informative for phase space and dynamic aspect of EEG data. In contrast, nonlinear EEG analysis attempts to characterize the dynamics of neural networks in the brain. We have analyzed the features of EEG nonlinearly in subjects with white matter change on brain MRI and compared the results with cognitive function in each. Methods : Digital EEG data were taken for 30 seconds in 9 subjects with white matter degeneration and in 5 healthy normal controls without white matter change on MRI. Then we analyzed them nonlinearly to calculate the correlation dimension(D2) using the MATLAB software. The cognitive function was assessed by 3MS(modified mini-mental state examination). The severity of white matter change was assessed by Scheltens scale. Results : The mean D2 value of normal control was greater than that of white matter degeneration group. The D2s of some channels were correlative with 3MS and degree of white matter degeneration significantly. Conclusions : nonlinear analysis of EEG can be used as one of adjuvant functional studies for prediction of cognitive impairment in subjects with white matter degeneration and subcortical white matter change can be influential on cognitive function and correlation dimension of EEG.