• The Journal of the Korean bone and joint tumor society
• /
• v.15 no.1
• /
• pp.34-43
• /
• 2009

Purpose: Glomus tumors are rare benign vascular tumors, usually located in the skin or soft tissue of extremities. Approximately 30-50% of glomus tumors occur in subungal area, but glomus tumors have been described in every location even where glomus bodies are not or rarely present. The purpose of this study was to identify clinical, histologic and MRI characteristics of soft tissue glomus tumor. Materials and Methods: Between 1993 and 2008, eight patients underwent surgery of soft tissue Glomus tumor at our institution. Exclusion criteria were patients with Glomus tumors in digits, stomach, trachea and glomus tympanicum. We analyzed medical records, interviews, physical examinations, MR findings and histolocial types retrospectively. Results: There were four men and four women. The mean age was fourty-seven years. The mean prevalence time was eight-point-nine years. In the classic triad of symptoms, all eight patients had pain and tenderness. Two patients complained of cold sensitivity. Two showed skin color changes. After surgery, two showed symptom improvement (VAS $9^{\circ}{\rightarrow}8$, $8^{\circ}{\rightarrow}5$) and?six showed complete disappearance of symptoms. Slightly symptom improvemented (VAS $9^{\circ}{\rightarrow}8$) one had additional surgery two times after first surgery due to relapse/remaining Glomus tumor. The mean size was 13.9 mm. In histology, six were 'solid glomus tumor', one was a mixture of 'solid glomus tumor' and 'lomangioma' and one was 'malignant glomus tumor'. MR findings showed isointense signal on T1 image, high signal on T2 image and strong enhancement on the Gadolinium enhanced image. Conclusion: Glomus tumor has low recurrence rate and malignant change, rapid diagnosis and surgical excision is critical in treatment to prevent unnecessary pain of patient.

• Journal of the Korean Society of Radiology
• /
• v.8 no.6
• /
• pp.317-323
• /
• 2014

This study aims to suggest and test methods using an orally inserted guiding device in order to improve a motion artifact by involuntary oral motor such as removing one's dentures and swallowing saliva clinically structured cervical spine scan and to make the optimal image by minimizing motion artifact. A cervical spine test was conducted with 30 patients who wore dentures among those who had a cervical spinal disease from January 1, 2014 through June 30, 2014. As for testing methods, after removing denture, T1-TSE-Sagittal, T2-TSE-Sagittal, T1-TSE-Axial and T2-TSE-Axial were obtained in a normal position and a supine position; the orally inserted guiding device was inserted in patients' mouth; and then T1-TSE-Axial and T2-TSE-Axial were retested. As a result, in SNR, T1-TSE-Axial before inserting an orally inserted guiding device was $22.33{\pm}8.59$; T1-TSE-Axial after inserting the orally inserted guiding device was $25.21{\pm}7.93$; T2-TSE-Axial before inserting the orally inserted guiding device was $14.49{\pm}5.74$; and T2-TSE-Axial after inserting the orally inserted guiding device was $16.61{\pm}6.72$. In CNR, T1-TSE-Axial was measured at $0.23{\pm}0.01$ while T2-TSE-Axial at $0.21{\pm}0.01$. As a result of the qualitative analysis, T1-TSE-Axial before inserting the orally inserted guiding device was $3.49{\pm}0.11$; T1-TSE-Axial after inserting the orally inserted guiding device was $3.95{\pm}0.14$; T2-TSE-Axial before inserting the orally inserted guiding device was $3.25{\pm}0.18$; and T2-TSE-Axial after inserting the orally inserted guiding device was $3.68{\pm}0.09$. As a result of using an orally inserted guiding device, the resolution and contrast of the images improved as the patients' involuntary artifact decreased because of removing dentures and swallowing saliva, and it was found that the interpretation of the images and identification of the diseases improved.

• The Journal of the Korean bone and joint tumor society
• /
• v.6 no.1
• /
• pp.22-29
• /
• 2000

Purpose : The purpose of the current study was to report the results of curettage and en bloc excision as well as to introduce how to excise the nidus percutaneously with Halo-mill. Material and Methods : Twenty patients(14 men and 6 women) were evaluated, who had operative treatments after diagnosed as osteoid osteoma from March 1990 to January 1998. These patients ranged in age from 7 to 42 years(average: 20.8 years). Locations were 9 femurs, 6 tibias, 2 vertebras, 1 ulna, 1 maxilla and 1 skull. Nine femoral lesions included 5 proximal metaphysis, 2 neck and 2 diaphysis, while 5 tibial lesions included 3 diaphysis, 1 proximal metaphysis and 1 distal metaphysis. We used simple radiography, bone scan, CT and MRI for the accurate diagnosis and localization. As for surgical treatments, while excision and curettage had to need open-exposure of lesion, the percutaneous excision of nidus did not need openexposure : guided Halo-mill into K-wire inserted to nidus under image intensifier. Results : Simple radiography showed that 10 cases had typical nidus and others had only cortical sclerosis. Bone scan was performed at 14 cases and all had hot uptake except one case. We used CT in 10 cases and MRI in 4 cases as diagnostic methods, of which 1 case didn't reveal nidus at CT. Surgical treatment consisted of 6 curettages, 11 excisions, 2 percutaneous excisions with halo-mill and 1 total elbow arthroplasty. We used 7mm sized Halo-mill. During the follow-up period, all patient relieved symptoms and there were no recurrences. All had histologically typical findings except one which had hyperostosis without nidus. Conclusion : Complete removal of the nidus is the most important factor in the treatment. We could excise the nidus percutaneously in 2 cases with the minimal injury to surrounding soft tissues. If we could evaluate the precise location, size of nidus and percutaneous acccesibility, the percutaneous excision of nidus with Halo-mill could be an alternative method as a treatment of osteoid osteoma.

• Progress in Medical Physics
• /
• v.18 no.3
• /
• pp.179-185
• /
• 2007

The purpose of this study is to investigate the spectra of a magnetic resonance spectroscopy (MRS) in accordance with the variance of TE and the volumes of metabolites in a localized voxel for the quality assurance using a designed single voxel spectroscopy QA phantom. Because a cone-shade phantom is designed as the volume of metabolite in a localized voxel is changeable, we try to analyze the peaks of each metabolite (NAA, Cr, Cho, Lac, etc.) in accordance with metabolite volume in a localized voxel as well as echo time (TE). All data were obtained using a 3T MRI/MRS machine and analyzed using $jMRUI^{(R)}$. The results of this study show that TE is in inverse proportion to the noise of MRS and the longer TE and the less metabolite volume in the localized voxel, the peak intensities of each metabolite decrease. In case of the lactate, its peak was observed on the all TE only if the greatest metabolite is included in the localized voxel. Then, the intensity of a metabolite is more sensitive to the metabolite volume in the localized voxel than the TE. These obtained in vitro MRS data is provide the guideline that is important for in vivo metabolite quantification. But, in the edge of cone-shape vial air bubbles were observed and spectrum could not obtained. Therefore our cone-shape MRS phantom needs to be modified in order to solve these problems.

• Investigative Magnetic Resonance Imaging
• /
• v.15 no.1
• /
• pp.32-40
• /
• 2011

Purpose : The purpose of this study was to investigate the microstructural changes according to aging on the thickness and signal intensity (SI) of the cortical gray matter (GM) and white matter (WM) on the T2-, fluid-attenuated inversion recovery (FLAIR) and T1-weighted MR images in normal subjects. Materials and Methods : The 10, 20, 30, 40, 50, 60, 70, 80 and 90 year age groups of men and women (each 10 individuals) who underwent routine brain MRI, including the T2-, FLAIR and T1-weighted images, were selected for this study. We measured the thickness and the SI of the cortical GM and WM at the postcentral gyrus, which has an even thickness at the level of centrum semiovale, on the axial scans and we calculated the mean values of the thickness ratio of the gray/white matter (TRGW) and the signal intensity ratio of the gray/white matter (SRGW), and we compared the ratios of each age group. Results : On the T2-weighted images, the TRGWs were 0.81 and 0.79 at the age of 10 and they were 0.73 and 0.71 at the age of 90 in the men and women, respectively. So, the GM thickness was decreased more than the WM thickness was with aging. On the FLAIR images, the TRGWs were 1.09 and 1.00 at the age of 10 and they were 1.11 and 0.95 at the age of 70 in the men and women, respectively. On the T1-weighted images, the TRGWs were 0.66 and 0.80 at the age of 10, and the ratio was changed to 0.90 and 0.78 at the age of 90 in the men and women, respectively. On the T2-weighted image, the SRGWs were 1.53 and 1.43 at the age of 10, and they were 1.23 and 1.27 at the age of 90 in the men and women, respectively. On the FLAIR images, the SRGWs were 1.23 and 1.25 at the age of 10 and they were 1.06 and 1.05 at the age of 90 in the men and women, respectively. On the T1-weighted images, the SRGWs were 0.86 and 0.85 at the age of 10, and they were 0.90 and 0.87 at the age of 90 in the men and women, respectively. Conclusion : We suggest that the age-related microstructural changes of the thickness and the SI of the cortical GM and WM on the T2-, FLAIR and T1-weighted images are unique, and so this knowledge will be helpful to differentiate neurodegenerative disease from normal aging of the brain.

• Investigative Magnetic Resonance Imaging
• /
• v.10 no.2
• /
• pp.81-88
• /
• 2006

Purpose : To evaluate the MR imaging findings of bowel wall thickening in patients with minimal to moderate cirrhosis, and analyze their clinical significances comparing with laboratory findings. Materials and Methods : We assessed retrospectively the MRI findings of 123 patients with minimal to moderate cirrhosis, and compared these with the clinical laboratory findings. We evaluated the involved sites and MR image findings of thickened bowel wall, as well as the presence of collateral vessels, ascites, and splenic size. These were compared with serum albumin and bilirubin levels, and prothrombin time. Results : Gastrointestinal wall thickening was detected at 37 sites in 25 patients (20%), and more frequently detected in moderate cirrhosis (29%) than in minimal cirrhosis (17%). Jejunum and ascending colon were the most common sites of bowel wall thickening; each was involved at 22 and 9 sites, respectively. Ascending colonic wall thickening was more commonly detected in moderate cirrhosis than in minimal cirrhosis. The thickened bowel wall showed symmetric contour, high signal intensity on T2-weighted images, mixed iso- and low signal intensity on T1-weighted images, and homogeneous or target-like enhancement. Serum albumin level was significantly lower in patients with bowel wall thickening ($3.3{\pm}0.9$ g/dl vs. $3.9{\pm}0.7$ g/dl; p=0.0024). Serum bilirubin level was significantly higher in patients with bowel wall thickening ($1.7{\pm}1.0$ mg/dl vs. $1.4{\pm}1.2$ mg/dl; p=0.0160). Bowel wall thickening did not significantly correlate with the presence of collateral vessels, ascites, splenic size, and prolongation of prothrombin time. Conclusion : In minimal to moderate cirrhosis, the MR imaging evaluation of bowel wall thickening was useful for estimating the severity of cirrhosis and laboratory findings.

• Clinics in Shoulder and Elbow
• /
• v.14 no.2
• /
• pp.229-235
• /
• 2011

Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.

• Investigative Magnetic Resonance Imaging
• /
• v.5 no.2
• /
• pp.138-148
• /
• 2001

Purpose : Within a clinically acceptable time frame, we obtained the high resolution MR images of the human brain, knee, foot and wrist from 3T whole-body MRI system which was equipped with the world first 37 active shield magnet. Materials and Methods : Spin echo (SE) and Fast Spin Echo (FSE) images were obtained from the human brain, knee, foot and wrist of normal subjects using a homemade birdcage and transverse electromagnetic (TEM) resonators operating in quadrature and tuned to 128 MHz. For acquisition of MR images of knee, foot and wrist, we employed a homemade saddle shaped RF coil. Topical common acquisition parameters were as follows: matrix=$512{\times}512$, field of view (FOV) =20 cm, slice thickness = 3 mm, number of excitations (NEX)=1. For T1-weighted MR images, we used TR = 500 ms, TE = 10 or 17.4 ms. For T2-weighted MR images, we used TR=4000 ms, TE = 108 ms. Results : Signal to noise ratio (SNR) of 3T system was measured 2.7 times greater than that of prevalent 1.5T system. MR images obtained from 3T system revealed numerous small venous structures throughout the image plane and provided reasonable delineation between gray and white matter. Conclusion The present results demonstrate that the MR images from 3T system could provide better diagnostic quali\ulcorner of resolution and sensitivity than those of 1.5T system. The elevated SNR observed in the 3T high field magnetic resonance imaging can be utilized to acquire images with a level of resolution approaching the microscopic structural level under in vivo conditions. These images represent a significant advance in our ability to examine small anatomical features with noninvasive imaging methods.

• Investigative Magnetic Resonance Imaging
• /
• v.10 no.1
• /
• pp.1-7
• /
• 2006

Purpose : Recent development of diffusion tensor imaging enables the evaluation of the microstructural characteristics of the brain white matter. However, optimal imaging parameters for diffusion tensor imaging, particularly concerning the number of diffusion gradient direction, have not been studied thoroughly yet. The purpose of this study was to evaluate the influence of the number of diffusion gradient direction on the fiber tracking of the white matter. Materials and methods : 13 healthy volunteers (ten men and three women, mean age 30 years, age range 23-37 years) were included in this study. Diffusion tensor imaging was performed with different numbers of diffusion gradient direction as 6, 15, and 32, keeping the other imaging parameters constant. The imaging field ranged from 1 cm below the pons to 2-3 cm above the lateral ventricle, parallel to the anterior commissure-posterior commissure line. FA (fractional anisotropy) maps were created via image postprocessing, and then FA and its standard deviation were calculated in the genu and the splenium of the corpus callosum on each of FA maps. Fiber tracking of the corticospinal tract in the brain was performed and the number of the reconstructed fibers of the tract was measured. FA, standard deviation of FA and the number of the reconstructed fibers were compared statistically between the different diffusion gradient directions. Results : FA is not statistically significantly different between the different diffusion gradient directions. By increasing the number of diffusion gradient direction, standard deviation of FA decreased significantly, and the number of the reconstructed fibers increased significantly. Conclusion : The higher number of diffusion gradient direction provided better quality of fiber tracking.

• Investigative Magnetic Resonance Imaging
• /
• v.17 no.1
• /
• pp.1-7
• /
• 2013

Purpose : The purpose of this study is to correlate the imaging findings and the clinical findings in patients with transient splenial lesions (TSL). Materials and Methods: Total of 7 patients (M: F = 4: 3; age range 11 - 38 years, mean age 25.5 years) were studied between November 2006 and April 2011. The MRI findings and clinical findings in all patients were retrospectively reviewed. The location, MR signal intensity, restricted diffusion, enhancement pattern and reversibility from the follow up images were reviewed. Clinical features were reviewed with respect to the presented symptoms, signs, treatment and outcome. Results: The lesions were located in the splenium of corpus callosum in all patients. All lesions showed high signal intensity on diffusion weighted imaging (DWI), and six patients showed restricted diffusion on the apparent diffusion coefficient (ADC) map. ADC map was not available in one patient. All lesions (n = 7) showed high signal intensity on the T2 weighted image (T2WI). Five of the patients (71.4%) with follow up images (range 7 - 34 days) showed complete resolution of focal high signal intensity on DWI, with recovery of ADC values as well as T2WI. After contrast media administration, none of the lesions showed any enhancements. All lesions with various etiologies including TB medication were developed in younger age patients and showed reversibility after the acceptable period of minimum 7 days with conservative treatment. Conclusion: All TSL showed nonspecific imaging findings, including restricted diffusion on DWI and ADC map on the initial images. However, reversibility of the lesions and the young age preference can be a characteristic finding of TSL with acceptable period of minimum 7 days. In addition, to keep it in mind that various etiologies including TB medication may cause TSL, is important for radiologists as well as clinicians.