• 한국방사선학회논문지
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• 제13권7호
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• pp.1025-1033
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• 2019

뇌 질환과 두경부 검사에서 전산화단층촬영의 선속 경화현상이 없는 자기공명영상이 조직의 높은 대조도와 우수한 분해능의 영상을 획득하는 검사 방법으로 인식되고 있지만 구강 내 금속 이식물이 있는 경우는 자화율 인공물(magnetic susceptibility artifact)이 발생되어 영상 진단에 장해 요소가 된다. 따라서 본 연구는 자기공명영상에서 치아 임플란트와 보철에 의한 인공물 감소 방안을 강구하고자 한다. 자기공명영상에서 임플란트에 의한 인공물 발생은 GE 기법에서 TE가 짧을수록 신호 크기가 증가하였고, 물의 온도 변화에서는 일관성이 없게 나타났다. SE 기법에서도 공기보다 물의 신호 크기가 전반적으로 높았지만, 신호대 잡음비는 공기와 온도에 의한 차이가 없었다. EPI 기법에서는 공기보다 물이 있을 때 정량적, 정성적으로 인공물이 적게 발생한 영상을 얻을 수 있었고, 특히 물 온도 20°와 30°에서 신호 대 잡음비가 가장 높게 측정되었다. 결론적으로 EPI 기법에서 물 온도 20°와 30°의 물주머니를 이용하여 뇌 확산강조영상을 획득하면 임플란트와 보철물에 의한 자화율인공물이 감소되어 보다 진단적 가치가 있는 영상을 획득할 수 있을 것으로 사료된다.

• Investigative Magnetic Resonance Imaging
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• 제6권2호
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• pp.166-172
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• 2002

목적: 척수경색의 진단에서 현성확산계수 값의 측정을 포함한 확산강조자기공명영상의 유용성을 평가하고자하였다. 대상 및 방법: 척수 경색으로 진단받은 6명의 환자를 대상으로 후향적으로 분석하였다. 경색증상 발현 후 평균 5.4일이 지난 후에 1.5 T 초전도체 자기공명영상 기기를 이용하여 자기공명영상을 얻었다. 확산강조자기공명영상은 고식적인 b값($1000s/\textrm{mm}^2$)으로 하여 multi-shot echo planar imaging 기법을 이용하여 영상을 획득하였으며 개인용 컴퓨터로 옮겨져 현성확산계수 지도를 얻어 정상부위와 병변부위의 현성확산계수 값을 측정하였다. 자기공명영상에서 병변의 위치와 T1 과 T2 강조영상, 그리고 확산강조자기공명영상에서 나타나는 각각의 신호강도를 알아 보았고, 병변부위와 정상부위에서 측정한 현성확산계수 값을 비교하였다. 결과: T1강조영상에서 6예 중 4예에서 등신호강도를, 2예에서 저신호 강도를 보였고, T2강조 영상에서 6예 모두 고신호강도를 보였다. 또한 확산강조자기공명영상에서 6예 모두 고신호강도를 보였다. 현성확산계수 지도는 6예 전예에서 성공적으로 얻을 수 있었다. 현성확산계수 지도에서 6예 모두 정상과 뚜렷한 차이를 보이는 색조변화를 보였으며, 6예 모두 병변부위의 현성확산계수 값은 정상 부위의 현성확산계수의 값보다 더 낮았으며 통계적으로 유의하였다 (p＜0.05 ). 결론: 척수경색 환자에서 척수병변의 확산강조자기공명영상과 현성확산계수 값의 측정이 가능하였다. 따라서 확산강조자기공명영상은 척수경색의 조기진단과 국재화(localization)에 유용하리라 보여진다.

• 대한예방한의학회지
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• 제7권2호
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• pp.121-130
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• 2003

The Musculoskeletal Disease has been ignored or turned away due to the difficulty of diagnosis and the vagueness of judgement up to now. Contrary to other diseases, there were many cases where the character of the Musculoskeletal Disease wasn't revealed through the objective inspection. And that's because the Musculoskeletal Disease appears for the most part due to muscular defect so it is impossible to diagnose the muscle by X-ray diagnosing the bone and it is also impossible to diagnose the fine damage of the muscle or tendon even by advanced device like MRI. As the nervous blood vessels or acupunctures pass through or are next to the muscle, the tension of the muscle put pressure on these so can become the direct or indirect causes of various kinds of pains or intern diseases. But in spite of that, for lack of proper equipment diagnosing the state of the muscle(Shortened.. Relaxed... or Hardened...) the muscle has been disregarded or neglected intentionally or unintentionally. While many people think themselves to be a muscular expert, if they don't see the shape of the muscle, that is just like blind treatment. But as now the equipment diagnosing the state of the muscle is developed, it seems that this problem can be settled. It was attempted in this study that the muscle or skeleton of the Musculoskeletal disease patients was diagno the treatment order and method were decided by a questionnaire survey and simple inspection, and the Musculoskeletal correction exercise using the muscle management and sling system made them escape from the Musculoskeletal disease, turning their muscle into more flexible and stronger muscle. As a result notwithstanding the limited treatment period '12 times', the improvement rate was as high as 74%, which showed that the muscle management and Musculoskeletal correction exercise had a great effect on the symptom improvement of the patients. If the treatment times had increased, the improvement rate also would have increased more.

• 대한디지털의료영상학회논문지
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• 제15권1호
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• pp.1-7
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• 2013

Purpose : The Carotid Angio inspection including Aortic arch applied to wide area is conducted as the Contrast Enhance MR Angiography(CEA) which is using a contrast medium. However it is a burden not only for someone such as infants, pregnant women and patients suffering from kidney failure but continuous use of contrast medium also can be a burden for patients who has been taken follow up inspection since diagnose lesion already. The purpose of this study is to estimate a usefulness of the Time of Flight (TOF) by comparing with CEA. Materials and methods : 10 patients with an average age of 58 (from 45 to 75) who had MRA inspection in our hospital were studied using 3.0 Tesla Aachieva (Philips, Netherland) MRI system and Sense Neuro-Vascular 16 Channels Coil. The same patient was inspected both TOF and CEA simultaneously. The TOF inspection included from Aortic arch to Willis Circle by connecting 3 TOF stacks and so did CEA inspection. The quantitative analysis was conducted through signal to noise ratio(SNR) and contrast to noise ratio(CNR) with soft tissue by setting up an area of interest on CCA bifurcatoin, ICA, ECA, MCA and VA concerning obtained image. In case of qualitative analysis, 3 radiological technologists and 1 radiologist evaluated 4 items (1: Visibility of the blood vessel, 2: Image distortion measure, 3: Overlapping measure with vein, 4: Peripheral blood vessel description measure) into five points scale (1: Very bad, 2: Bad, 3: Normal 4: Good, 5: Very good). Results : Results for the quantitative analysis was obtained by calculating the average of 5 ROIs in case of SNR and CNR separately. Results of SNR, TOF were generally measured higher than CEA (In case of TOF were 166.1, 205.2, 154.39, 172.23, 161.95, and CEA were 92.05, 95.43, 84.76, 73.69, 88.3). But according to the result of CNR, both TOF and CEA were measured similarly as 67.62, 106.71, 55.9, 73.74, 63.46 for TOF and 67.82, 71.19, 60.52, 49.45, 64.07 for CEA. Throughout every results of each ROI, SNR showed statistically meaningful consequence (0.050.05). In case of qualitative analysis the average of each evaluated item was 4.2points and 4.28points in the item1, 2.93points and 4.55points in the item2, 4.6points and 3.13points in the item3, 2.88points and 4.6points in the item4. According to the results TOF was measured higher in the item3 while in the item2 and item4 CEA was higher and in case of the item1, both CEA and TOF were similar. To sum up statistically meaningful results (p<0.05) were shown in the item2, item3 and item4 but not in the item1 (p>0.05). Conclusions : Both TOF and CEA are complementary because each inspection has pros and cons, but when inspect wide area including Aortic arch normally CEA is conducted. But TOF inspection also can be considered as alternative in terms of patients who has difficulty in the contrast medium such as infants, pregnant women and patients suffering from kidney failure and patients during follow up.

• Investigative Magnetic Resonance Imaging
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• 제19권2호
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• pp.88-98
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• 2015

Purpose: To compare the interobserver and intraobserver reliability of mean apparent diffusion coefficient (ADC) values using contrast-enhanced (CE) T1 weighted image (WI) and T2WI as structural images between manual and semiautomatic segmentation methods. Materials and Methods: Between January 2011 and May 2013, 28 patients who underwent brain MR with diffusion weighted image (DWI) and were pathologically confirmed as having glioblastoma participated in our study. The ADC values were measured twice in manual and semiautomatic segmentation methods using CE-T1WI and T2WI as structural images to obtain interobserver and intraobserver reliability. Moreover, intraobserver reliabilities of the different segmentation methods were assessed after subgrouping of the patients based on the MR findings. Results: Interobserver and intraobserver reliabilities were high in both manual and semiautomatic segmentation methods on CE-T1WI-based evaluation, while interobserver reliability on T2WI-based evaluation was not high enough to be used in a clinical context. The intraobserver reliability was particularly lower with the T2WI-based semiautomatic segmentation method in the subgroups with involved $lobes{\leq}2$, with partially demarcated tumor borders, poorly demarcated inner margins of the necrotic portion, and with perilesional edema. Conclusion: Both the manual and semiautomatic segmentation methods on CE-T1WI-based evaluation were clinically acceptable in the measurement of mean ADC values with high interobserver and intraobserver reliabilities.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.81-87
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• 2016

Purpose: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow. Materials and Methods: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis. Results: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve. Conclusion: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.

• 대한한의진단학회지
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• 제10권2호
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• pp.121-131
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• 2006

Background : As each human has a look in the face of oneself, he or she has a look of him or herself in the shape of the body also. And for the shape of the body which gives a big clue in diagnosis in musculoskeletal disorders. Therefor many means are used and developed for diagnosis through body shape or posture analysis for musculoskeletal disorders. X-ray, CT, MRI has been used for diagnosis through image in this way to tell about the inside of the human body. On the other side, moire topography was used for information about the exterior of the human body, but yet only minimal information such as the number of contour lines in each side was available. Therefor there were a few studies to use moire topography or other methods to get information about the surface of the human body in numeric values. The instrument used in this study which is a laser projection moire, is another trial to get numeric data about the surface of the human body. The instrument is composed of laser projector and a computer software to recompose and analyse the image data into depth, height, angle and length. Objectives : The study was focused on whether the instrument is reliable for clinic use, and to seek the proper environment and posture for the examination, and among the data the software provides, which items are more reliable and useful. Methods : For reproductivity and repeatability, 4 testers tested 2 persons. And to how if the body shape changes according to the posture and which posture gives the most reliable data, the test was performed in 6 different positions. Results : Result, the instrument showed sufficient repeatability and reproductivity for clinical use. And among the items the software provides, the length of the back, the angle of the back in the sagittal and coronal plane showed reliable results. And there was difference in the results according to the posture, and Therefor, in following studies using this instrument or similar type of posture analysing instruments, the length of the back, the angle of the back in the sagittal and coronal plane could be reliable item to use.

• 대한영상의학회지
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• 제82권5호
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• pp.1124-1139
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• 2021

치매를 비롯한 퇴행성 신경 질환의 초기 진단에 자기공명영상을 이용한 뇌 위축 평가와 정량적 용적 분석이 중요하다. 뇌 위축의 시각적 평가는 주관적으로 평가자에 따라 다른 결과를 보여주기 때문에, 객관적인 결과를 제공하면서 임상 적용도 가능한 소프트웨어의 수요와 개발이 늘어나고 있다. 이러한 임상용 소프트웨어의 실제 임상 적용은 영상 검사의 표준화가 선행되어야 하고, 개발된 소프트웨어의 검증이 반드시 필요하다. 따라서 대한신경두경부영상의학회는 뇌용적 분석 임상용 소프트웨어의 임상적 활용에 대한 의견을 제시하기 위해 전문위원회를 구성하고 현재까지 발표된 연구를 정리하였다. 그리고, 정량화 분석을 위한 영상 검사의 표준화 및 소프트웨어의 임상 적용에 대한 전문가 의견을 제시하기 위하여 공동 작업을 수행하였다. 본 종설에서는 뇌 자기공명영상의 정량화 분석의 필요성 및 배경, 정량화 분석을 위한 임상용 소프트웨어의 소개 및 기존의 표준품(reference standard)과의 진단능 비교, 영상 획득의 표준화, 분석 및 평가의 표준화, 소프트웨어의 임상 적용에 대한 전문가 의견, 제한점 및 대처 방법 등 대한신경두경부영상의학회의 전문가 권고안을 소개하는 것이 목적이다.

• 대한디지털의료영상학회논문지
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• 제16권1호
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• pp.13-19
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• 2014

Purpose: FLAIR image is beneficial for the diagnosis of various bran diseases including ischemic CVS, brain tumors and infections. However the border between the legion of brain metastasis and surrounding edema may not be clear. Therefore, this study aims to investigate the practical benefits of delayed imaging by comparing the image from a patient with brain metastasis before a contrast enhancement and the image 10 minutes after a contrast enhancement. Materials and methods: Of the 92 people who underwent MRI brain metastases in suspected patients 13 people in three patients there is no video to target the 37 people confirmed cases, and motion artifacts brain metastases in our hospital June-December 2013, 18 people measurement position except for the three incorrect patient (male: 11 people, female: 7 people, average age: 60 years) in the target, test equipment, 3.0T MR System (ACHIEVA Release, Philips, I was 8ChannelSENSE Head Coil use Best, and the Netherlands). TR 11000 ms, TE 125 ms, TI2800 ms, Slice Thickness 5 mm, gap 5 mm, is a Slice number 21, the parameters of the 3D FFE, T2 FLAIR variable that was used to test, TR 8.1 ms, TE 3.7 ms, Slice number 240 I set to. The experiment was conducted by acquiring the FLAIR prior to contrast enhancement (heretofore referred to as Pre FLAIR), and acquiring the 3D FFE CE five minutes after the contrast enhancement, and recomposing the images in an axial plane of S/T 3mm, G 0mm (heretofore referred to as MPR TRA CE). Using the FLAIR 10 minutes after the contrast enhancement (heretofore referred to as Post FLAIR) and Pi-View, a retrospective study was conducted. Using MRIcro on the image of a patient confirmed for his diagnosis, the images before and after the contrast media, as well as the CNR and SNR of the MPR TRA CE images of the lesion and the site absent of lesion were compared and analyzed using a one-way analysis of variance. Results: CNR for Pre FLAIR and Post FLAIR were 34.35 and 60.13, respectively, with MPR TRA CE at 23.77 showing no significant difference (p<0.050). Post-experiment analysis shows a difference between Pre FLAIR and Post FLAIR in terms of CNR (p<0.050), but no difference in CNR between Post FLAIR and MPR TRA CE (p>0.050), indicating that the contrast media had an effect only on Pre FLAIR and Post FLAIR. The SNR for the normal site Pre FLAIR was 106.43, and for the lesion site 140.79. Post FLAIR for the normal site was 107.79, and for the lesion site 167.91. MPR TRA CE for the normal site was 140.23 and for the lesion site 183.19, showing significant difference (p<0.050), and post-experiment analysis shows that there was a difference in SNR only on the lesion sites for Pre FLAIR and Post FLAIR (p<0.050). There was no difference in SNR between the normal site and lesion site for Post FLAIR and MPR TRA CE, indicating no effect from the contrast media (p>0.050). Conclusions: This experiment shows that Post FLAIR has a higher contrast than Pre FLAIR, and a higher SNR for lesions, It was not not statistically significant and MPR TRA CE but CNR came out high. Inspection of post-contrast which is used in a high magnetic field is frequently used images of 3D T1 but, since the signal of the contrast medium and the blood flow is included, this method can be diagnostic accuracy is reduced, it is believed that when used in combination with Post FLAIR, and that can provide video information added to the diagnosis of brain metastases.

• 한국자기학회지
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• 제26권6호
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• pp.219-225
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• 2016

퇴행성 슬관절 연골 질환의 평가를 위하여 지방 신호 억제 3D SPGR 기법과 지방 신호 억제 3D $T2^*$ weighted 기법을 이용하여 자기공명영상을 획득하였다. 정량적 평가를 위해서 슬관절 연골을 내측대퇴연골(medial femoral cartilage, MFC), 내측경골연골(medial tibial cartilage, MTC), 외측대퇴연골(lateral femoral cartilage, LFC), 외측경골연골(lateral femoral cartilage, LFC), 슬개연골(patella cartilage, Pat) 구역으로 분류하여 관심영역을 설정한 후 각각의 신호강도, 신호 대 잡음비, 대조도 대 잡음비를 측정하였다. 측정된 값은 Mann-Whitney U-검정을 이용 두 기법간의 통계적 유의성을 검증하였다. 정성적 평가를 위해서 각각의 영상을 2명의 영상의학의가 관찰한 후 영상 내 인공음영, 연골의 경계, 조직 간 대조도, 병소의 묘사정도를 4점 척도(1점: 나쁨, 2점: 적당함, 3점: 좋음, 4점: 매우 좋음)로 평가하고, 그 결과를 바탕으로 Kappa-value 검정을 통해 통계적 유의성을 검증하였다. 영상획득에 사용된 장비는 3.0T MR system과 HD T/R 8ch knee array coil을 사용하였다. 정량적 분석결과, SNR 측정값을 토대로 한 두 기법 간의 통계적 유의성 검증 결과 MFC, LFC, LTC, Pat에서는 통계적으로 유의한 결과(p < 0.05)를 보였으나, MTC에서는 유의하지 않은 결과(p > 0.05)를 보였다. CNR 측정값의 통계적 유의성 검증 결과 MFC, LFC, Pat에서는 통계적으로 유의한 결과(p < 0.05)를 보였으나, MTC, LTC에서는 유의하지 않은 결과(p > 0.05)를 보였다. 정성적 분석결과, 영상의 평가항목별 결과 값의 평균을 비교해 보면 3D $T2^*$ weighted 영상에서 조금 높은 결과를 보였고, Kappa-value test를 이용한 두 관찰자간의 일치성 검증에서는 모든 평가항목에서 통계적으로 의미 있는 결과(p < 0.05)를 보였다. 결론적으로 3D $T2^*$ weighted 영상 기법은 3D SPGR 영상기법과의 비교에서 슬관절 연골의 묘사와 주변 조직 간의 대조도 및 병소의 묘사 등 영상의 평가에서 동등 및 그 이상의 진단적 가치를 낼 수 있다.