• Korean Journal of Radiology
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• v.22 no.8
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• pp.1266-1278
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• 2021

Objective: We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique. Materials and Methods: We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation. Results: The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm², 0.82 ± 0.34 cm², and 0.80 ± 0.26 cm², respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94-0.97) and 0.87 (95% CI, 0.82-0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96-0.98) and 0.98 (95% CI, 0.97-0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89-0.94) and 0.91 (95% CI, 0.88-0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82-0.91) vs. 0.85 (95% CI, 0.79-0.89). Conclusion: High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.

• Investigative Magnetic Resonance Imaging
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• v.4 no.2
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• pp.107-112
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• 2000

Purpose : To evaluate the usefulness of comparison of the signal intensity of uterine septum in the differential diagnosis of bicornuate and septate uterus on magnetic resonance (MR) imaging. Materials and methods : Preoperative MR imaging findings of surgically proven 5 bicornuate and 6 septate uteri were retrospectively analyzed. Because preoperative differential diagnosis of both was possible in all cases in terms of the intercornual distance, external contour of uterine fungus, and divergent angle of two uterine cavities, these criteria were excluded in this study. The signal intensity of uterine septum in patients with bicornuate and septate uterus was analyzed on T1-weighted and fast spin echo T2-weighted images obtained in the axial and coronal planes, using a 1.5-T MR scanner. The signal intensity of uterine septum especially on T2-weighted images was compared with that of myometrium or junctional zone. Results : The signal intensity of uterine septum in patients with bicornuate uterus (n=5) and septate uterus (n=6) was similar to that of myometrium in all cases on T1-weighted images. The septum of bicornuate uterus (n=5) on fast spin echo T2-weighted images was isointense with myometrium in three and hypointense in two cases. The uterine septum of septate uterus (n=6) on T2-weighted images was isointense with myometrium in two, hypointense in two, and isointense with or more hypointense than junctional zone in two cases. No patient showed different signal intensity between upper and lower uterine septum. Conclusion : Because the MR signal intensity of the uterine septum in bicornuate or septate uterus is variable, it should not be used alone in the differential diagnosis of them. In these clinically important differentiation, therefore, comprehensive analysis of MR findings in terms of the external contour of uterine fundus, intercornual distance, divergent angle of two uterine cavities, in addition to the signal intensity of the uterine septum, should be considered.

• Journal of Veterinary Clinics
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• v.40 no.3
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• pp.225-229
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• 2023

In three dogs showing cerebellar ataxia, the onset of clinical signs varied from a young age of five months to age 13 years. Qualitative magnetic resonance imaging (MRI) revealed various degrees of cerebellar atrophy, and a tentative diagnosis of cerebellar cortical degeneration was made. Quantitative analysis using the brainstem to the cerebellar cross-sectional area ratio (BS:CBM ratio) and T2-signal intensity histograms were obtained to perform an objective evaluation. These techniques have the advantage of being easy and fast to evaluate. These quantitative analyses revealed the severity of cerebellar cortical degeneration in the three dogs as mild, moderate, and severe. Dogs 2 and 3 were identified as abnormal on the relative cerebrospinal fluid (CSF) space using T2-signal intensity histograms but were normal on the BS:CBM ratio. This suggests that the T2-signal intensity histograms may have higher sensitivity than BS:CBM ratio.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.791-800
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• 2019

Objective: To compare various models of diffusion-weighted imaging including monoexponential apparent diffusion coefficient (ADC), biexponential (fast diffusion coefficient [D_f], slow diffusion coefficient [D_s], and fraction of fast diffusion), stretched-exponential (distributed diffusion coefficient and anomalous exponent term [α]), and kurtosis (mean diffusivity and mean kurtosis [MK]) models in the differentiation of renal solid masses. Materials and Methods: A total of 81 patients (56 men and 25 women; mean age, 57 years; age range, 30-69 years) with 18 benign and 63 malignant lesions were imaged using 3T diffusion-weighted MRI. Diffusion model selection was investigated in each lesion using the Akaike information criteria. Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. Results: Goodness-of-fit analysis showed that the stretched-exponential model had the highest voxel percentages in benign and malignant lesions (90.7% and 51.4%, respectively). ADC, D_s, and MK showed significant differences between benign and malignant lesions (p < 0.05) and between low- and high-grade clear cell renal cell carcinoma (ccRCC) (p < 0.05). α was significantly lower in the benign group than in the malignant group (p < 0.05). All diffusion measures showed significant differences between ccRCC and non-ccRCC (p < 0.05) except D_f and α (p = 0.143 and 0.112, respectively). α showed the highest diagnostic accuracy in differentiating benign and malignant lesions with an area under the ROC curve of 0.923, but none of the parameters from these advanced models revealed significantly better performance over ADC in discriminating subtypes or grades of renal cell carcinoma (RCC) (p > 0.05). Conclusion: Compared with conventional diffusion parameters, α may provide additional information for differentiating benign and malignant renal masses, while ADC remains the most valuable parameter for differentiation of RCC subtypes and for ccRCC grading.

• Investigative Magnetic Resonance Imaging
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• v.3 no.2
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• pp.167-172
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• 1999

Purpose : To evaluate the detection rate of hyperacute intracerebral hemorrhage in echo planar imaging (EPI) and other MR sequences. materials and Methods : Intracerebral hemorrhage was experimentally induced in ten rats. EPI, fast spin-echo (FSE) T2 weighted images, fluid attenuated inversion recovery (FLAIR), spin-echo (SE) T1 weighted images and gradient echo (GE) T1 weight ed images of rat's brains were obtained 2 hours after onset of intracerebral hemorrhage. EPI and FSE T2 images were additionally obtained 30 min and 1 hour after onset of hemorrhage in 3 and 6 rat, repeatedly, For objective visual assessment, discrimination between the lesion and normal brain parenchyma was evaluated on various MR sequences by three radiologists. For quantitative assessment, contrast-to-noise ratio (CNR) was calculated fro hemorrhage-normal brain parenchyma. Statistical analysis was performed usning the Wilcoxon-Ranks test. Results : EPI, FLAIR, and FSE T2 images showed high signal intensity lesions. The lesion discrimination was easier on EPI than on other sequences, and also EPI showed higher signal intensity for the subjective visual assessment. In quantitative evaluation, CNR of the hemorrhagic lesion versus normal brain parenchyma were higher on EPI and FLAIR images (p<0.01). There was no difference in CNR between EPI and FLAIR (p>0.10). On MR images obtained 30 minutes and 1 hour after the onset of intracerebral hemorrhage, the lesion detection was feasible on both EPI and FSE T2 images showing high signal intensity. Conclusion : EPI showed higher detection rate as compared with other MR sequences and could be useful in early detection and evaluation of intracerebral hemorrhage.

• Investigative Magnetic Resonance Imaging
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• v.6 no.1
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• pp.41-46
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• 2002

The Fourier transform arteriography (FTA) exploits the periodic variation of arterial flow velociety of arterial flow velocity in stnchronized with cardiac cycles. This technique is intrinsically unique compared to other modern techniques. This technique separates the arteries from the veins using the pulsatile arterial flow without using the presaturation RF pulses. Therefore, it has less RF deposition and is free from the dark band artifacts that can arise from retrograde flow and curved arteries. Furthermore, it is free from the artifacts induced by eddy currents. However, there are some drawbacks such as a single projection view and the saturation of arteries at the end of an imaging slab. These drawbacks are circumvented by applying recently developed techniques. The fast gradient switching capability of modern MRI systems enabled us to incorporate dual projection views into the conventional FTA sequence without increasing the repetition time. In addition, signals from the distal arteries were enhanced by use of a ramped RF pulse and therefore the distal arteries were less saturated. By use of the FTA sequence with dual projection views and the ramped RF pulse, we acquired the sagittal and coronal projection views of femoral arteriograms simultaneously with more enhanced signals of distal arteries than the conventional FTA.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.103-105
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• 2003

After fifteen years of development, Magnetic Resonance (MR) technology for human imaging and spectroscopy is reaching a refined state with FDA approved 3T clinical products from Siemens, GE, and Philips. Broker has cleared CE approval with a 4T system. Varian supports a 4T system platform as well. Shielded magnets are standard at 3T from GE, Oxford, Magnex, and IGC. A shielded 4T whole body magnet is available from Oxford. Stronger switched gradients and dynamic shim coils, desired at any field, areespecially useful at higher static magnetic fields B0. In addition to the higher currents required for higher resolution slice or volume selection afforded by higher SNR, whole body gradient coils will be driven at increasing slew rates to meet the needs of new cardiac applications and other requirements. For example 3T and 4T systems are now being equipped with 2kV, 500A gradient coils and amplifiers capable of generating 4G/cm in 200msec, over a 67+/-cm bore diameter. High field EPI applications require oscillation rates at 1 kHz and higher. To achieve a benchmark 0.2 ppm shim over a 30cm sphere in a high field magnet, at least four stages of shimming need to be considered. 1) A good high field magnet will be built to a homogeneity spec. falling in the range of 100 to 150 ppm over this 30cm spherical "sweet spot" 2) Most modern high field magnets will also have superconducting shim coils capable of finding 1.5 ppm by their adjustment during system installation. 3) Passive ferro-magnetic shimming combined with 4) active, high order room temperature shim coils (as many as five orders are now being recommended) will accomplish 0.2 ppm over the 30cm sphere, and 0.1 ppm over a human brain in even the highest field magnets for human studies. Safety concerns for strong, fast gradients at any B0 field include acoustic noise and peripheral nerve stimulation. One or more of the mechanical decoupling methods may lead to quieter gradients. Patient positioning relative to asymmetric or short gradient coils may limit peripheral nerve stimulation at higher slew rates. Gradient designs combining a short coil for local speed and strength with a longer coil for coverage are being developed for 3T systems. Local gradients give another approach to maximizing performance over a limited region while keeping within the physiologically imposed dB0/dt performance limits.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.152-158
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• 2012

Purpose : To compare the arterial and venous detection sites of triggering methods in contrast-enhanced-MR-venography (CE-MRV) for the evaluation of intracranial venous system. Materials and Methods: 41 healthy patients underwent CE-MRV with autotriggering at either the cavernous segment of internal carotid artery with an inserted time-delay of 6 seconds (n = 20) or the superior sagittal sinus without any timedelay (n = 21). 0.1 mmol/kg gadolinium-based contrast material ($Magnevist^{(R)}$, Schering, Germany) was intravenously injected by hand injection. A sagittal fast-spoiled-gradient-echo-sequence ranging from one ear to the other was performed (TR/TE5.2/1.5, Matrix $310{\times}310$, 124 sections in the 15-cm-thick volume). 17 predefined venous structures were evaluated on all venograms by two neuroradiologists and defined as completely visible, partially visible, or none visible. Results: The rate of completely visible structures were 272 out of 323 (84%) in the arterial triggering CE-MRV and 310 out of 340 (91%) in the venous triggering CE-MRV. The venous triggering CE-MRV demonstrated an overall superior visualization of the cerebral veins than the arterial triggering CE-MRV (Fisher exact test, p < 0.006). Conclusion: CE-MRV using venous autotriggering method provides higher-quality images of the intracranial venous structures compared to that of arterial.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.123-130
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• 2008

Purpose : Motion effects in parallel magnetic resonance imaging (MRI) are investigated. Parallel MRI is known to be robust to motion due to its reduced acquisition time. However, if there are some involuntary motions such as heart or respiratory motions involved during the acquisition of the parallel MRI, motion artifacts would be even worse than those in conventional (non-parallel) MRI. In this paper, we defined several types of motions, and their effects in parallel MRI are investigated in comparisons with conventional MRI. Materials and Methods : In order to investigate motion effects in parallel MRI, 5 types of motions are considered. Type-1 and 2 are periodic motions with different amplitudes and periods. Type-3 and 4 are segment-based linear motions, where they are stationary during the segment. Type-5 is a uniform random motion. For the simulation, Cartesian and spiral grid based parallel and non-parallel (conventional) MRI are used. Results : Based on the motions defined, moving artifacts in the parallel and non-parallel MRI are investigated. From the simulation, non-parallel MRI shows smaller root mean square error (RMSE) values than the parallel MRI for the periodic (type-1 and 2) motions. Parallel MRI shows less motion artifacts for linear(type-3 and 4) motions where motions are reduced with shorter acquisition time. Similar motion artifacts are observed for the random motion (type-5). Conclusion : In this paper, we simulate the motion effects in parallel MRI. Parallel MRI is effective in the reduction of motion artifacts when motion is reduced by the shorter acquisition time. However, conventional MRI shows better image quality than the parallel MRI when fast periodic motions are involved.

• Proceedings of the KOSOMBE Conference
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• v.1992 no.05
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• pp.27-47
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• 1992

Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.