• Title/Summary/Keyword: MR, perfusion imaging

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Comparative Study between ZOOMit and Conventional Intravoxel Incoherent Motion MRI for Assessing Parotid Gland Abnormalities in Patients with Early- or Mid-Stage Sjögren's Syndrome

  • Qing-Qing Zhou;Wei Zhang;Yu-Sheng Yu;Hong-Yan Li;Liang Wei;Xue-Song Li;Zhen-Zhen He;Hong Zhang
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.455-465
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    • 2022
  • Objective: To compare the reproducibility and performance of quantitative metrics between ZOOMit and conventional intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in the diagnosis of early- and mid-stage Sjögren's syndrome (SS). Materials and Methods: Twenty-two patients (mean age ± standard deviation, 52.0 ± 10.8 years; male:female, 2:20) with early- or mid-stage SS and 20 healthy controls (46.9 ± 14.6 years; male:female, 7:13) were prospectively enrolled in our study. ZOOMit IVIM and conventional IVIM MRI were performed simultaneously in all individuals using a 3T scanner. Quantitative IVIM parameters - including tissue diffusivity (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) - inter- and intra-observer reproducibility in measuring these parameters, and their ability to distinguish patients with SS from healthy individuals were assessed and compared between ZOOMit IVIM and conventional IVIM methods, appropriately. MR gland nodular grade (MRG) was also examined. Results: Inter- and intra-observer reproducibility was better with ZOOMit imaging than with conventional IVIM imaging (ZOOMit vs. conventional, intraclass correlation coefficient of 0.897-0.941 vs. 0.667-0.782 for inter-observer reproducibility and 0.891-0.968 vs. 0.814-0.853 for intra-observer reproducibility). Significant differences in ZOOMit f, ZOOMit D*, D*, conventional D*, and MRG between patients with SS and healthy individuals (all p < 0.05) were observed. ZOOMit D* outperformed conventional D* in diagnosing early- and mid-stage SS (area under receiver operating curve, 0.867 and 0.658, respectively; p = 0.002). The combination of ZOOMit D*, MRG, and ZOOMit f as a new diagnostic index for SS, increased diagnostic area under the curve to 0.961, which was higher than that of any single parameter (all p < 0.01). Conclusion: Considering its better reproducibility and performance, ZOOMit IVIM may be preferred over conventional IVIM MRI, and may subsequently improve the ability to diagnose early- and mid-stage SS.

The Clinical Usefulness of Tc-99m ECD Brain SPECT in Acute Measles Encephalitis (홍역 후 발생된 급성 뇌염 진단시 Tc-99m ECD 뇌혈류 SPECT의 임상적 유용성)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.229-234
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    • 2003
  • Purpose: Since the prognosis of measles encephalitis is poor, early diagnosis and proper management are very important to improve clinical outcomes. We compared Tc-99m ECD brain SPECT (SPECT) with MR imaging (MRI) for the detection of acute measles encephalitis. Materials and Methods: Eleven patients(M : F=4 : 7, age range 18 months-14 yrs) with acute measles encephalitis were enrolled in this studies. All of them underwent both MRI and SPECT. The results of SPECT were scored from 0 (normal) to 3 (most severe defect) according to perfusion state. We compared two image modalities for the detection of brain abnormality in acute measles encephalitis. Results: Seven of 11 patients (63.6%) revealed high signal intensity in the white matter on T2WI of MRI, on the other hand all patients (100%) showed hypoperfusion on SPECT. Severe perfusion deficits above score 2 were located with decreasing frequencies in the frontal lobe (81.8%), temporal lobe (72.7%), occipital lobe (27.3%), basal ganglia (27.3%), and parietal lobe (9.1%). Conclusion: We conclude that SPECT is more useful than MRI for the detection of brain involvement in patients with acute measles encephalitis.

Magnetic Resonance Angiographic Evaluation as a Screening Test for Patients who are Scheduled for Cardiac Surgery (심장수술 대상자에서 선별 검사로서 두경부 MRA)

  • Suh, Jong-Hui;Choi, Si-Young;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.718-723
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    • 2008
  • Background: The advances in surgical techniques, anesthesia management, perfusion methodology and postoperative intensive care have markedly decreased the mortality and cardiac morbidity of patients who undergo heart surgery over the past 2 decades. Nevertheless, it is well recognized that cardiac surgery carries a substantial risk for central nervous system complications. This study was conducted to evaluate the prevalence of subclinical cerebrovascular lesions in the head and neck by performing magnetic resonance angiography (MRA), and we investigated the clinical course of patients who had abnormal lesion seen on head and neck MRA. Material and Method: The subjects were 107 patients (71 men and 36 women ranging in age from 21 to 83 years) who were scheduled for cardiac surgery under nonemergency conditions between October 2005 and June 2008. Informed consent was obtained before the MRA. The carotid arteries, intracranial arteries and brain parenchyme were examined for subclinical cerebrovascular lesions by performing MRA. We reviewed the patients' medical records and MR findings to evaluate the prevalence of neurologically high risk patients and their clinical course. Result: The overall prevalence of neurologically high risk patients was 15.7% (17 patients). Among these patients, 11 patients had ischemic heart disease and 6 patients had valvular heart disease. Only 2 patients had a history of cerebrovascular disease. The clinical courses of 14 patients (13.1%) were changed according to their MRI findings. Conclusion: The prevalence of subclinical cerebrovascular disease in patients who were scheduled for cardiac surgery was higher than was expected. MR angiography was of value to identify these patients.

Comparison of Diagnostic Performance between Interictal F-18-FDG PET and Ictal Tc-99m-HMPAO SPECT in Occipital Lobe Epilepsy (후두엽간질 환자에서 F-18-FDG PET와 발작기 Tc-99m-HMPAO SPECT의 간질원인병소 진단 성능 비교)

  • Kim, Seok-Ki;Lee, Dong-Soo;Yeo, Jeong-Seok;Lee, Sang-Kun;Kim, Joo-Yong;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.262-272
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    • 1999
  • Purpose: Interictal F-18-fluorodeoxyglucose (FDG) PET and ictal Tc-99m-HMPAO SPECT are found to be useful in localizing epileptogenic zones in neocortical lateral temporal or frontal lobe epilepsy. We investigated whether interictal F-18-FDG PET or ictal Tc-99m-HMPAO SPECT was useful to find epileptogenic Bones in occipital lobe epilepsy (OLE). Materials and Methods: We reviewed patterns of hypometabolism in interictal F-18-FDG PET and of hyperperfusion in ictal Tc-99m-HMPAO SPECT in 17 OLE patients (mean age=$27{\pm}6.8$ year, M:F= 10:7, injection time= $30{\pm}17$ sec). OLE was diagnosed based on invasive electroencephalography (EEG) study, surgery and post-surgical outcome (Engel class I in all for average 14 months). Results: Epileptogenic zones were correctly localized in 9 (60%) out of 15 patients by interictal F-18-FDG PET. Epiletogenic hemispheres were correctly lateralized in 14 patients (93%). By ictal Tc-99m-HMPAO SPECT, epileptogenic hemispheres were correctly lateralized in 13 patients (76%), but localization was possible only in 3 patients (18%). Among patients who showed no abnormality with MR imaging and no correct localization with ictal Tc-99m-HMPAO SPECT, interictal F-18-FDG PET was helpful in 2 patients. Conclusion: Ictal Tc-99m-HMPAO SPECT was helpful in lateralization but not in localization in OLE. Interictal F-18-FDG PET was helpful for localization of epileptogenic zones even in patients with ambiguous MR or ictal SPECT findings.

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