• 대한방사선기술학회지:방사선기술과학
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• 제27권4호
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• pp.17-21
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• 2004

최근 의학 영상 기술의 발전과 함께 동적 골반 MRI(Pelvic magnetic resonance imaging)가 소개되었고 이러한 기술을 이용하여 동적 MR 배변조영술이 소개되어 환자의 진단에 도움을 주기 위해 사용되고 있다. 처음에 도입 당시에는 탈장(Enterocele)과 방광탈출증(Cystocele) 등을 진단하기 위하여 사용되었지만, 이후 장기의 탈출증(Prolapse), 또는 다른 골반 장기의 이상에 점점 그 유용성이 증명되어 현재는 기능성변비 등 다른 질환에서도 많은 보고가 있다. 본 논고에서는 골반 MRI 및 동적 MR 배변조영술에 대해서 소개하고 앞으로의 임상적 응용에 대한 전망을 살펴보도록 한다. 최근까지도 Pelvic MRI의 결과들은 앙와위(Supine position)에서 골반의 움직임을 관찰하는데 Yang 등은 26명의 골반 기관의 탈출증(Pelvic organ prolapse)을 가진 환자들을 관찰하고 Pubococcygeal line을 해부학적인 지표로 이용하여 좋은 결과를 얻었다고 보고했다. 이들은 Fast gradient recalled acquisition(fast GRASS)을 이용하여, Cystocoele, Prolapse, Enterocoele 그리고 Rectocoele 등을 증상이 없는 대조군과 비교하여 보고하였다. Kruyt 등은 Posterior compartment를 주로 관찰하여 MRI가 Fluoroscopy에 비하여 더 도움이 된다고 보고하였다. Healy 등은 Fast GRASS sequence를 이용하여 변비를 가진 환자와 변실금을 가진 환자, 그리고 증상이 없는 대조군을 대상으로 하여 동적 MRI 검사를 실시하였다. 이들은 변비나 변실금 증상과 관련되어 환자들의 Posterior compartment에 여러 곳에서 Prolapse을 관찰할 수 있었다. 이후 MRI 기술은 Lienemann 등에 의해서 더욱 발전했는데 그는 Fast T2 weighted turbo spin echo 기술을 이용하여 영상을 좀더 세밀하게 얻을 수 있게 되었다. 지금까지의 앙와위에서의 검사로 진단에 한계가 있었던 Intussusception 등의 질환을 Open MR 등의 방법으로 극복할 수 있다면 장래에는 방사선학적 배변조영술을 대체할 수 있는 검사법으로 발전할 수 있을 것으로 생각된다.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2001년도 제6차 학술대회 초록집
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• pp.111-111
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• 2001

목적： To evaluate the feasibility of the event-related functional MR study using power grip studying the hand motor system 대상 및 방법： Event-related functional MRI was performed on a 1.5T MR unit in seven norm volunteers (man=7, right-handedness=2, left-handedness=5, mean age： 25 years). A single-shot GRE-EPI sequence (TR/TE/flip angle： 1000ms/40ms/90, FOV = 240 mm matrix= 64$\times$64, slice thickness/gap = 5mm/0mm, 7 true axial slices) was used for functiona MR images. A flow-sensitive conventional gradient echo sequence (TR/TE/flip angl 50ms/4ms/60) was used for high-resolution anatomical images. To minimize the gross hea motion, neck-holders (MJ-200, USA) were used. A series of MR images were obtained in axial planes covering motor areas. To exclude motion-corrupted images, all MR images wer surveyed in a movie procedure and evaluated using the estimation of center of mass of ima signal intensities. Power grip task consisted of the powerful grip of all right fingers and hand movement ta used very fast right finger tapping at a speed of 3 per 1 second. All tasks were visual-guid by LCD projector (SHARP, Japan). Two tasks consisted of 134 phases including 7 activatio and 8 rest periods. Active stimulations were performed during 2 seconds and rest period were 15 seconds and total scan time per one task was 2 min 14 sec. Statistical maps we obtained using cross-correlation method. Reference vector was time-shifted by 4 seconds an Gaussian convolution with a FWHM of 4 seconds was applied to it. The threshold in p val for the activation sites was set to be 0.001. All mapping procedures were peformed usin homemade program an IDL (Research Systems Inc., USA) platform. We evaluated the activation patterns of the motor system of power grip compared to hand movement in t event-related functional MRI.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1634-1641
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• 2000

Objective : The cerebrospinal fluid(CSF) pulsates within the craniospinal axis in response to rhythmic cerebral blood volume variation during the cardiac cycle. The aim of this study is to characterize the normal and abnormal CSF flow and its waveforms in the cervical spinal subarachnoid space. Methods : The magnetic resonance(MR) images were obtained with 1.5 T(GE Signa, GE Medical Systems, Milwaukee, USA) unit using the 2 dimensional cine PC(phase contrast) sequence with cardiac gating and gradient recalled echo imaging. This pulse sequence yielded 16 quantitative flow-encoded images per cardiac cycle. Sagittal and axial images of the cervical spinal CSF space were obtained, and target sites were analyzed for characteristic CSF flow (TR=50ms, TE=12.5-15ms). The region of interest(ROI) was 1mm 3 in volume. Twenty six persons were included in this study : 10 healthy volunteers and 16 patients with cervical myelopathy. The post-operative cine MR study were also done in five patients. Results : The normal CSF pulsation dynamics in the cervical spine showed discrete systolic and diastolic components. The CSF flow revealed a sine wave pattern, in which the systolic phase was shorter than the diastolic phase(ratio=2 : 3). The patient group revealed decreased amplitudes of the CSF flow and irregularly distored flow waves. The systolic phase was elongated in the ROI above the stenotic level, whereas the diastolic phase was lengthened below the level. In the postoperative images, the abnormal pattern and amplitude were found to be corrected. Conclusion : From these results, the authors believe that the CSF flow study provides valuable informations regarding the extent of cervical stenosis and may be useful for the surgical planning and post-operative evaluation.

• 한국방사선학회논문지
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• 제10권7호
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• pp.531-537
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• 2016

물과 지방에서 발생하는 화학적 이동의 인공물을 확인하기 위해 다양한 MRI parameter를 적용하여 실험하였다. MRI의 1.5T와 3.0T에서 parameter와 bandwidth 및 부호화 변화에 따른 영상을 스캔하여 SNR, CNR을 비교하였다. MRI 영상에서 물과 기름의 화학적 이동의 인공물의 발생을 확인할 수 있었고, 3.0T보다 1.5T에서의 영상이 인공물이 비교적 줄어드는 것을 확인할 수 있었다. Bandwidth의 폭이 넓어짐에 따라 인공물이 줄어드는 것을 확인할 수 있었다. 따라서 MRI검사에서 화학적 이동의 인공물을 감소하기 위해서는 주 자장의 세기가 약하고, bandwidth의 폭을 넓히는 것이 적절할 것으로 생각된다.

• Investigative Magnetic Resonance Imaging
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• 제16권2호
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• pp.152-158
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• 2012

목적: 뇌내 정맥혈관을 평가하기 위한 조영 증강 자기공명 정맥촬영술의 arterial trigger 와 venous trigger 방법으로 시행한 영상의 차이점을 비교 분석하고자 한다. 대상과 방법: 건강검진을 목적으로 자기공명정맥촬영술을 시행한 41명의 환자들을 대상으로 해면부위의 내경 동맥에서 arterial triggering하여 6초 후에 얻은 영상 (n = 20) 과 상시상 정맥동에서 venous triggering (n = 21) 방법으로 시행한 영상을 후향적으로 분석하였다. 영상은 가돌리늄 조영제 ($Magnevist^{(R)}$, Schering, Germany)를 0.1 mmol/kg 정맥주입하여 시행하였고, 두개강 전반에 대하여 시상영상을 fast spoiled gradiend echo sequence로 시행하였다 (TR/TE 5.2/1.5, matrix $310{\times}310$, 절편수 124 절편, 두께 15 cm). 두 그룹의 영상을 해부학적 정맥 혈관 구조에 따라 17 정맥구역에 대하여 평가하였고, 정맥의 영상품질은 세 단계 (안보임, 일부 보임, 완전히 보임)로 나눠서 평가하였다. 결과: 정맥이 완전히 보인 구역은 arterial triggering 자기공명 정맥 촬영술에서 84% (272/323), venous triggering 자기 공명 정맥촬영술에서 91% (310/340) 이다. Venous triggering 자기공명촬영술과 arterial 자기 공명 정맥촬영술을 비교하였을 때 뇌내 정맥 구조를 평가하는데 있어 venous triggering 방법이 통계적으로 유의하게 높았다 (Fisher exact test, p<0.006). 결론: 조영 증강 자기공명 정맥 촬영술은 정맥 혈관 구조에 대한 고화질의 이미지를 제공하였고 arterial triggering 방법보다 venous triggering 방법이 뇌내 정맥 구조 평가에 우월한 것으로 나타났다.

• 한국방사선학회논문지
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• 제2권2호
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• pp.31-38
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• 2008

0.32 T 자기공명영상시스템에서 선주사영상기법(line scan imaging)을 이용한 확산강조영상(diffusion weighted imaging; DWI) 펄스열(pulse sequence)을 개발하였다. 선주사영상은 단면선택 경사자장과 함께 90도 펄스를 가하여 단면을 선택한 후 y 방향으로 경사자장을 가한 후 180도 라디오파 펄스를 가하여 단면영상의 y-방향 픽셀크기와 같은 너비의 x축에 평행한 띠를 따라 에코가 발생하게 한 뒤 x-방향으로 주파수부호화해서 1차원 k-공간 데이터를 획득하며 이를 1차원 푸리에변환하여 영상을 재구성하였다. 또한 선주사확산강조영상(line scan diffusion weighted image)을 위해서 한 쌍의 사다리꼴모양의 경사자장을 선주사영상기법의 180도 펄스 전후에 대칭으로 배치하였으며 사용된 확산경사자장기울기의 최대값은 G = 15 mT/m 이었고 최대 b 값은 $301.50s/mm^2$이었다. 본 연구에서 개발된 선주사확산강조펄스열을 이용하여 0.32 T 자기공명영상 장비에서 트리아실글리세롤 팬텀(triacylglycerol, TAG) 및 염화나트륨 수용액 (NaCl = 0.1w/v%) 팬텀 영상을 획득하였다. 또한 1.5 T 자기공명영상시스템에서 단일여기에코평면영상화(single shot echo planar imaging)로 동일한 팬텀의 확산강조영상을 구하였다. 선주사확산강조영상은 가장 널리 이용되고 있는 에코평면영상을 이용한 확산강조영상과 비교하여 자화율차이에 의한 영상왜곡이나 화학이동에 의한 허상들이 없음을 확인하였다. 특히 선주사확산강조영상에서 측정한 염화나트륨 수용액 팬텀의 확산계수($963.90{\pm}79.83{\times}10^{-6}mm^2/s$)는 1.5 T에서 계산된 확산계수($956.77{\pm}4.12{\times}10^{-6}mm^2/s$)와 오차범위 내에서 일치하였다.

• Journal of Acupuncture Research
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• 제20권5호
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• pp.133-150
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• 2003

Objective: Recently. many studies have showed the evidences of the effect of the Electro-acupuncture treatment through scientific. Methods : One of these methods is functional MRI. We performed electro-acupuncture on Zusanli(St36) and observed the change of brain activation using fMRI. Zusanli(St36) is located on the lateral side of the lower leg. 3 cun(寸) inferior to the Patella of the lower border. Theoretically and clinically. this point has been considered very important for gynecological disorders. spleen and stomach disorders. and psychological disorders. To see the effects of electro-acupuncture stimulation on Zusanli(St36). the experiment was carried out on twelve healthy volunteers. using the gradient echo sequence with the 3.0T whole-body fMRI system(ISOL). After the needle insertion on right Zusanli(St36). 2 Hz of electric stimulation was given for 30 seconds. repeated five times. with 30 seconds' intervals. The Image analysis including motion correction. talairach transformation, and smoothing was done with SPM99. Results ad conclusion : The electro-acupuncture stimulation on Zusanli(St36) activates Brodmann Area 6, 13, 2, 19, 21, 22, 39, 40, 38, 3which indicates the pathways of the electro-acupuncture stimulation on Zusanli(St36) and the possibility of the relationship of the electro-acupuncture stimulation on Zusanli(St36) with autonomic nervous system, internal organic system.

• Journal of Acupuncture Research
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• 제20권5호
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• pp.208-226
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• 2003

Objective : Recently many studies have showed the evidence of the effect of the acupuncture treatment through scientific methods. One of these methods is functional MRI. We performed electro-acupuncture on St40 and observed the change of brain activation using fMRI. Methods : To see the effects of electro-acupuncture stimulation on Fenglong(St40), the experiment was carried out on six healthy volunteers, using the gradient echo sequence with 3.0T whole-body MRI system(ISOL). after the needle insertion on right Fenglong(St40), 2 Hz of electric stimulation was given for 30 seconds, repeated five times, with 30 seconds' intervals. Results & Conclussion : Electro-acupuncture stimulation on Fenglong(St40) activated Brodmann's Areas of 2, 3, 4, 6, 9, 10, 13, 18, 22, 30, 40, 42, 43 which may be the central pathways of electro-acupuncture stimulation on Fenglong(St40).

• Journal of Acupuncture Research
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• 제20권5호
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• pp.187-207
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• 2003

Objective: Recently, many studies have showed the evidences of the effect of the acupuncture treatment through scientific methods. One of these methods is functional MRI. We performed electro-acupuncture on Liv3 and observed the change of brain activation using fMRI. Methods: To see the effect of electro-acupuncture stimulation on Liv3. the experiment was carried out on 12 healthy volunteers. using the gradient echo sequence with the 3.0T whole-body MRI system(ISOL). After the needle insertion on right Liv3. 2 Hz of electric stimulation was given for 30 seconds. repeated five times. with 30 seconds' intervals. The Image analysis including motion correction, talairach transformation. and smoothing was done with SPM99. Results : 1. Group averaged brain activation induced by bilateral electro-acupuncture stimulation on Liv3 activates Brodman Area 6, 13, 18, 19, 22, 31, 39, 44, 2. Group averaged brain deactivation induced by bilateral Electro-acupuncture stimulation on Liv3 activates Brodman Area 4, 6, 9, 19, 36, 37, 39. 3. Group averaged brain activation induced by unilateral(right side) electro-acupuncture stimulation on Liv3 activates Brodman Area 2, 3, 6, 9, 10, 22, 40, 42, 43. 4. Group averaged brain deactivation induced by unilateral(right side) electro-acupuncture stimulation on Liv3 activates Brodman Area 6, 18, 19, 28, 30, 31, 35, 37. 5. Brain region activated by motor stimulation activates Brodman Area 4, 6, 13, 19, 42.

• Investigative Magnetic Resonance Imaging
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• 제5권1호
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• pp.24-32
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• 2001

Purpose : We investigated the reproducibility of language lateralization by 4 different word generation paradigms or the rest contents in each paradigm using functional magnetic resonance imaging in normal volunteers Materials and Methods Nine normal volunteers with left-handedness (mean age: 25 yrs) were examined on a 1.57 MR unit using a single-shot gradient echo epibold sequence. Four different word generation paradigms of noun, verb, adjective and adverb were used in each normal volunteer for investigating language system. In each paradigm, two different rest contents consisted of only seeing the " +" symbol or reading the meaningless letters. Each task consisted of 96 phases including 3 activations and 6 rests of 2 different contents. Two activation maps in one task were obtained under two different rest contents using the correlation method. We evaluated the detection rates of Broca and Wernicke areas and the differences of language lateralization among four different word generation paradigms, or between the rest contents. Results : The detection rates of Broca and Wernicke areas were over 67 % in 4 different language paradigms and there was no significant difference of them among language paradigms, or between two different rest contents. Language dominances, in all 4 different language paradigms, were shown to be consistent in 66 %, but were contrary with language paradigms in some subjects. The rest contents made no significant effect on dominant language dominance determination, but the success rates of the dominant language dominances determined from 4 language paradigms were higher in reading the meaningless letter (100%, n=9) than in only seeing "+" on screen at the rest task (78%, n=7).