• Progress in Medical Physics
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• v.7 no.2
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• pp.67-77
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• 1996

Purpose: To get a 3-D coordinates of intracranial target position was investicated in axial, sagittal and coronal magnetic resonance imaging with a preliminary experimented target localizer. Material and methods : In preliminal experiments, the localizer is made of engineering plastic to avoid the distrubance of magnetic field during the MR image scan. The MR localizer displayed the 9 points in three different axial tomogram. The bright signal of localizer was obtjained from 0.1～0.3％ of paramagnetic gadolinium/DTPA solution in T1WI or T2WI. In this study, the 3-D position of virtual targets were examined from three different axial MR images and the streotactic position was compared to that of BRW stereotactic system in CT scan with same targets. Results: This study provided the actual target position could be obtained from single scan with MRI localizer which has inverse N-typed 9 bars. This experiment was accomplished with shimming test for detection of image distortion in MR image. However we have not found the image distortion in axial scan. The maximum error of target positions showed 1.0 mm in axial, 1.3 mm for sagittal and 1.7 mm for coronal image, respectivelly. The target localization in MR localizer was investicated with spherical virtual target in skull cadaver. Furthermore, the target position was confirmed with CRW stereotactic system showed a 1.3 mm in discrepancy. Summary : The intracranial target position was determined within 1.7 mm of discrepancy with designed MR localizer. We found the target position from axial image has more small discrepancy than that of sagittal and coronal image.

• Korean Journal of Biological Psychiatry
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• v.21 no.3
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• pp.81-86
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• 2014

Objectives Total intracranial volume (TIV) is a major nuisance of neuroimaging research for interindividual differences of brain structure and function. Authors intended to prove the reliability of the atlas scaling factor (ASF) method for TIV estimation in FreeSurfer by comparing it with the results of manual tracing as reference method. Methods The TIVs of 26 normal children and 26 children with attention-deficit hyperactivity disorder (ADHD) were obtained by using FreeSurfer reconstruction and manual tracing with T1-weighted images. Manual tracing performed in every 10th slice of MRI dataset from midline of sagittal plane by one researcher who was blinded from clinical data. Another reseacher performed manual tracing independently for randomly selected 20 dataset to verify interrater reliability. Results The interrater reliability was excellent (intraclass coefficient = 0.91, p < 7.1e-07). There were no significant differences of age and gender distribution between normal and ADHD groups. No significant differences were found between TIVs from ASF method and manual tracing. Strong correlation between TIVs from 2 different methods were shown (r = 0.90, p < 2.2e-16). Conclusions The ASF method for TIV estimation by using FreeSurfer showed good agreement with the reference method. We can use the TIV from ASF method for correction in analysis of structural and functional neuroimaging studies with not only elderly subjects but also children, even with ADHD.

• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.33-40
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• 2013

Purpose : To evaluate late gadolinium enhancement (LGE) pattern of left ventricular (LV) myocardium and presence or absence of LGE in other regions of the heart on cardiac magnetic resonance (CMR) imaging in patients diagnosed with cardiac amyloidosis. Materials and Methods: From 2009 to 2011, 9 patients who were suspected cardiac amyloidosis underwent CMR. We retrospectively analyzed the presence or absence of LGE and enhancement pattern in LV myocardium, and the presence or absence of LGE in other chambers as well. Also we measured interatrial septal thickness (IST), relative signal intensities of atrial septum and epicardial fat over the left atrial (LA) cavity on delayed enhanced images. MRI parameters in these patients were compared to those of control group of patients with ischemic heart disease by Wilcoxon rank sum test. Results: Of nine patients, LGE were found in 8; subendocardial circumferential pattern in 4 and diffuse pattern in 4. LGE in right ventricle was observed in 7. IST was significantly increased in patients with cardiac amyloidosis (P = 0.02). Ratio of atrial septum to LA cavity and ratio of epicardial fat to LA cavity showed a significant difference (P = 0.0002 and P = 0.0006, respectively). Conclusion: In LGE CMR, subendocardial or diffuse enhancement pattern is a typical finding for patients with cardiac amyloidosis. Atrial septum and epicardial fat show relatively increased signal intensities over LA blood cavity.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1606-1611
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• 2000

Objective : To obtain more reliable sample in stereotactic biopsy, authors adopted proton chemical shift imaging ($^1H$-CSI)-directed biopsy. Until now, proton single voxel spectroscopy($^1H$-SVS) technique has been reported as a technique using metabolic information in stereotactic biopsy. The authors performed $^1H$-CSI with a stereotactic headframe in place and evaluated the pathologic results obtained from local metabolic information through $^1H$-CSI. Methods : $^1H$ CSI-directed stereotactic biopsy was performed in four patients. $^1H$-CSI and conventional Gd-enhancement stereotactic MRI was done simultaneously after application of the stereotatic frame. After reconstruction of metabolic maps of NAA/Cr, Cho/Cr, and Lactate/Cr ratios, the focal areas of increased Cho/Cr ratios and decreased NAA/Cr ratios were selected for target sites in the MR images Results : There was no difficulty in performing $^1H$-CSI with the stereotactic headframe in place. In pathologic examinations, the samples taken in area of increased Cho/Cr ratios and decreased NAA/Cr ratios showed the features of increased cellularity, mitoses and cellular atypism, thus facilitated the diagnosis. The pathologic samples taken from the area of increased Lactate/Cr ratios showed prominent feature of necrosis. Conclusion : $^1H$-CSI was feasible with stereotactic head frame in place. The final pathologic results obtained in our samples were concordant with the local metabolic informations from $^1H$-CSI. Authors believe that $^1H$ CSI-directed stereotactic biopsy may provide us advantages in obtaining more reliable tissue specimen in stereotactic biopsy.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.82-89
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• 2010

Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

• Journal of the Korean Society of Radiology
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• v.10 no.4
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• pp.279-284
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• 2016

Single-shot echo planar imaging(SS-EPI) is well established as high sensitivity for ischemic stroke. However, it is prone to susceptibility artifact in brain stem that diminish the image quality. single-shot turbo spin echo(SS-TSE) is a new DWI technique that can reduce susceptibility artifact. Thus, this research was conducted so as to reduce geometric distortion in brain stem by using single-shot turbo spin echo technique. Thirty patients without brain disease underwent diffusion MR on a 3T scanner with SS-EPI and SS-TSE. Obtained images with both sequences were analyzed for geometric distortion and error percentage as well. Image quality in terms of geometric distortion of SS-TSE were found to be significantly better than those for SS-EPI. And error percentage was considerably reduced for 2.4% of b0 image(from 11.1% to 8.7%), 1.2% of b1000 image(from 11.4% to 10.1%), respectively. In summary, diffusion MR using SS-TSE significantly reduce geometric distortion compared to SS-EPI in brain stem and may provide improved diagnostic performance.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.22-30
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• 1994

Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with $^{99m}Tc$-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade I to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal lobes being the most frequently involved site. $4{\times}4$ pixel sized ROIs were applied on the frontotemporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as: PI (%)=average F-T activity/average cerebellar activity${\times}100$ Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean: $74.3{\pm}17%$) and increased significantly after operation ($81.4{\pm}17%$, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement (${\Delta}CI$) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70-89) showed a significantly higher ${\Delta}CI$ (3.3) compared to group I (PI< 70, 1.57) or group III (PI >90, 0.5) (P< 0.001). The amount of perfusion improvement (${\Delta}PI$) showed significant correlation with ${\Delta}CI$ (r=0.42, p=0.04). ${\Delta}PI$ did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

• Investigative Magnetic Resonance Imaging
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• v.17 no.3
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• pp.200-206
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• 2013

Purpose : To assess the effect of applying an automated heart model based measurements of left ventricle (LV) and compare with manual and semi-automated measurements at Cardiovascular MR Imaging. Materials and Methods: Sixty-two patients who underwent cardiac 1.5T MR imaging were included. Steady state free precession cine images of 20 phases per cardiac cycle were obtained in short axis views and both 2-chamber and 4-chamber views. Epicardial and endocardial contours were drawn in manual, automated, and semi-automated ways. Based on these acquired contour sets, the end-diastolic (ED) and end-systolic (ES) volumes, ejection fraction (EF), systolic volume (SV) and LV mass were calculated and compared. Results: In EDV and ESV, the differences among three measurement methods were not statistically significant (P = .399 and .145, respectively). However, in EF, SV, and LV mass, the differences were statistically significant (P=.001, <001, <001, respectively) and the measured value from automated method tend to be consistently higher than the values from other two methods. Conclusion: An automatic heart model-based method grossly overestimate EF, SV and LV mass compared with manual or semi-automated methods. Even though the method saves a considerable amount of efforts, further manual adjustment should be considered in critical clinical cases.

• Journal of Magnetics
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• v.22 no.1
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• pp.146-149
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• 2017

In this study, we compared the standardized value of each signal intensity, the apparent diffusion coefficient (ADC) that digitizes the diffusion of water molecules, and the signal to noise ratio (SNR) using b value 0 400, 1400 ($s/mm^2$). From March 2013 to December 2013, patients with suspicion of simple compound fracture and metastatic spine cancer were included in the MR readout. We used a 1.5 Tesla Achieva MRI system and a Syn-Spine Coil. Sequence is a DWI SE-EPI sagittal (diffusion weighted imaging spin echo-echo planar imaging sagittal) image with b-factor ($s/mm^2$) 0, 400, 1400 were used. Data analysis showed ROI (Region of Interest) in diseased area with high SI (signal intensity) in diffusion-weighted image b value 0 ($s/mm^2$) Using the MRIcro program, each SI was calculated with images of b-value 0, 400, and 1400 ($s/mm^2$), ADC map was obtained using Metlab Software with each image of b-value, The ADC is obtained by applying the ROI to the same position. The standardized values ($SI_{400}/SI_0$, $SI_{400}/SI_0$) of simple compression fractures were $0.47{\pm}0.04$ and $0.23{\pm}0.03$ and the standardized values ($SI_{400}/SI_0$, $SI_{400}/SI_0$) of the metastatic spine were $0.57{\pm}0.07$ and $0.32{\pm}0.08$ And the standardized values of the two diseases were statistically significant (p < 0.05). The ADC ($mm^2/s$) for b value 400 ($s/mm^2$) and 1400 ($s/mm^2$) of the simple compression fracture disease site were $1.70{\pm}0.16$ and $0.93{\pm}0.28$ and $1.24{\pm}0.21$ and $0.80{\pm}0.15$ for the metastatic spine. The ADC ($mm^2/s$) for b value 400($s/mm^2$) was statistically significant (p < 0.05) but the ADC ($mm^2/s$) for b value 1400 (p > 0.05). In conclusion, multi - b value recognition of signal changes in diffusion - weighted imaging is very important for the diagnosis of various spinal diseases.

• Advances in nano research
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• v.1 no.3
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• pp.159-169
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• 2013

A preparation method for gadolinium compound (GdC) nanoparticles coated with silica ($GdC/SiO_2$) is proposed. GdC nanoparticles were prepared with a homogeneous precipitation method at $80^{\circ}C$ using $1.0{\times}10^{-3}$ M $Gd(NO_3)_3$, 0.5 M urea and $0-3.0{\times}10^{-4}$ M ethylenediarinnetetraacetic acid disodium salt dihydrate (ETDA) in water. As a result of preparation at various EDTA concentrations, GdC nanoparticles with a size as small as $40.5{\pm}6.2$ nm, which were colloidally stable, were prepared at an EDTA concentration of $2.0{\times}10^{-4}$ M. Silica-coating of the GdC nanoparticles was performed by a St$\ddot{o}$ber method at $35^{\circ}C$ using $1.0-10.0{\times}10^{-3}$ M tetraethylorthosilicate (TEOS), 11 M $H_2O$ and $1.5{\times}10^{-3}$ M NaOH in ethanol in the presence of $1.0{\times}10^{-3}$ M GdC nanoparticles. Performance of preparation at various TEOS concentrations resulted in production of $GdC/SiO_2$ particles with an average size of $106.1{\pm}11.2$ nm at a TEOS concentration of $5.0{\times}10^{-3}$ M. The gadolinium (Gd) concentration of $1.0{\times}10^{-3}$ M in the as-prepared $GdC/SiO_2$ particle colloid solution was increased up to a Gd concentration of 0.2 M by concentrating with centrifugation. The core-shell structure of $GdC/SiO_2$ particles was undamaged, and the colloid solution was still colloidally stable, even after the concentrating process. The concentrated $GdC/SiO_2$ colloid solution showed images of X-ray and magnetic resonance with contrast as high as commercial Gd complex contrast agents.