• Investigative Magnetic Resonance Imaging
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• v.9 no.2
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• pp.109-116
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• 2005

Purpose : To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. Materials and Methods : Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm<, 1-2 cm, and >2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. Results : In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p=0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm<, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28%, p=0.023). Conclusion : Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (<2 cm) and could improve detection of the small hepatic metastases (<1 cm) from colorectal carcinoma.

• Journal of the Korean Society of Radiology
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• v.15 no.1
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• pp.9-14
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• 2021

Recently, magnetic resonance imaging (MRI), which can acquire images with good contrast without exposure to radiation, has been widely used for diagnosis. However, noise that reduces the accuracy of diagnosis is essentially generated when acquiring the MR images, and by adjusting the parameters, the noise problem can be solved to obtain an image with excellent characteristics. Among the parameters, the number of excitation (NEX) can acquire images with excellent characteristics without additional degradation of image characteristics. In contrast, appropriate NEX setting is required since the scan time increases and motion artifacts may occur. Therefore, in this study, after fixing all MRI parameters through the MRiLab simulation program, we tried to evaluate the tendency of image characteristics according to changing NEX through quantitative evaluation of brain T2 weighted images acquired by adjusting only NEX. To evaluate the noise level and similarity of the acquired image, signal to noise ratio (SNR), contrast to noise ratio (CNR), root mean square error (RMSE) and peak signal to noise ratio (PSNR) were calculated. As a result, both noise level and similarity evaluation factors showed improved values as NEX increased, while the increasing width gradually decreased. In conclusion, we demonstrated that an appropriate NEX setting is important because an excessively large NEX does not affect image characteristics improvement and cause motion artifacts due to a long scan.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.372-385
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• 2023

Breast cancer is one of the most common cancers and causes several complications in females. Currently, MRI is a necessary method for preoperative studies in patients with breast cancer. A high frequency of breast MRI can lead to an increase in the number of incidental extramammary findings. Moreover, it can provide accurate preoperative workup; therefore, the prognosis of patients can be improved. Herein, we provide several extramammary findings, including the mediastinum, lung, upper abdomen, bone, and soft tissue, correlating with US, chest CT, liver MRI, PET-CT, and bone scan.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.26-32
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• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.108-116
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• 2006

Purpose : High-resolution spiral-scan imaging is performed at 3 Tesla MRI system. Since the gradient waveforms for the spiral-scan imaging have lower slopes than those for the Echo Planar Imaging (EPI), they can be implemented with the gradient systems having lower slew rates. The spiral-scan imaging also involves less eddy currents due to the smooth gradient waveforms. The spiral-scan imaging method does not suffer from high specific absorption rate (SAR), which is one of the main obstacles in high field imaging for rf echo-based fast imaging methods such as fast spin echo techniques. Thus, the spiral-scan imaging has a great potential for the high-speed imaging in high magnetic fields. In this paper, we presented various high-resolution images obtained by the spiral-scan methods at 3T MRI system for various applications. Materials and Methods : High-resolution spiral-scan imaging technique is implemented at 3T whole body MRI system. An efficient and fast higher-order shimming technique is developed to reduce the inhomogeneity, and the single-shot and interleaved spiral-scan imaging methods are developed. Spin-echo and gradient-echo based spiral-scan imaging methods are implemented, and image contrast and signal-tonoise ratio are controlled by the echo time, repetition time, and the rf flip angles. Results : Spiral-scan images having various resolutions are obtained at 3T MRI system. Since the absolute magnitude of the inhomogeneity is increasing in higher magnetic fields, higher order shimming to reduce the inhomogeneity becomes more important. A fast shimming technique in which axial, sagittal, and coronal sectional inhomogeneity maps are obtained in one scan is developed, and the shimming method based on the analysis of spherical harmonics of the inhomogeneity map is applied. For phantom and invivo head imaging, image matrix size of about $100{\times}100$ is obtained by a single-shot spiral-scan imaging, and a matrix size of $256{\times}256$ is obtained by the interleaved spiral-scan imaging with the number of interleaves of from 6 to 12. Conclusion : High field imaging becomes increasingly important due to the improved signal-to-noise ratio, larger spectral separation, and the higher BOLD-based contrast. The increasing SAR is, however, a limiting factor in high field imaging. Since the spiral-scan imaging has a very low SAR, and lower hardware requirements for the implementation of the technique compared to EPI, it is suitable for a rapid imaging in high fields. In this paper, the spiral-scan imaging with various resolutions from $100{\times}100$ to $256{\times}256$ by controlling the number of interleaves are developed for the high-speed imaging in high magnetic fields.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.206-213
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• 1994

We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.

• The Korean Journal of Nuclear Medicine
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• v.29 no.4
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• pp.504-510
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• 1995

Avascular necrosis(AVN) of bone can be resulted from various causes that distrub vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was deter-mined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivacal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip Joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be perfomed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

• Journal of the Korean Society of Radiology
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• v.5 no.4
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• pp.161-169
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• 2011

This research experimented on the change of the multiple colleague scan angle facing one scan object facet to many directions of the form of 3D about the visual angle nervous system forming the cubic distribution with the gradient magnetic field of the mri system and considered the existing basic angle oblique direction test coverage and comparison. MR system can freely select various pulse sequence and image slice. To oblique imaging for optic nerve viewing, we have studied the variation of scan angle between typical oblique scan method (sagittal-coronal plane) and multi directional angles oblique scan method (sagittal-coronal-axial plane) using gradient of MR system. In this study, the subjects of the experiment were normal adults in our country. As a result, we confirmed that multi directional angles oblique scan method can display anatomical information of more wider area than typical oblique scan method. In addition, to clearly display optic nerve, we also confirmed that image slice thickness and pulse sequence have effect on it.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1570-1576
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• 2000

Objective : To evaluate objectively the sites of injury in patients with posttraumatic olfactory deficits and to suggest the diagnostic procedure for evaluation of posttraumatic anosmia. Methods : Ten patients with posttraumatic olfactory dysfunction were examined by means of olfactory testing, sinoscopy, contrast filled paranasal sinus computed tomography(contrast filled PNS CT) and magnetic resonance imaging(MRI). Five normal persons without olfactory dysfunction were also evauluated. The aerodynamic patency of olfactory cleft was examined by contrast filled PNS CT. The olfactory system(oflactory bulbs, olfactory tracts, inferior frontal region, hippocampi, or temporal lobes) was investigated in detail with MRI. The difference in the size of the olfactory bulb between normal volunteers and anosmic patients was evaluated by Student's t test. Results : Contrast filled dynamic CT scan was useful method for the evaluation of dynamic patency of the olfactory cleft. Paranasal CT scan of the all anosmic patients showed dynamic reflux of contrast media in olfactory cleft on valsalva maneuver. For the largest cross-sectional area and great height, the difference in olfactory bulb size between normal volunteers and patients was statistically significant(p<0.001) in MRI study. Conclusion : Posttraumatic anosmia was completely evaluated by olfactory testing, sinoscopy, and contrast filled CT scan for differentiation between conductive type and neurogenic type. Neurogenic anosmia was confirmed by perfect localization with MRI study.

• Journal of the Korean Society of Radiology
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• v.12 no.4
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• pp.475-480
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• 2018

In lower abdominal MRI scan, patients have been tested by physically contacting with the body array coil. In this study, we have designed the acrylic assistant equipment (ACR) which allows the contactless scan of the patient to the coil and evaluated the feasibility by comparing the acquired images with ACR to those obtained without ACR. We tested 10 cases (F: 5, m: 5) by using the Ingenia $3.0T^{TM}$ MR system and dStreamTM torso coil (Philips Healthcare, Netherlands). We implemented T1 AX TSE and eTHRIVE (GRE) techniques. The scanned images were quantitatively and qualitatively assessed. In qualitatively, the TSE shows 4.44 and 4.56 mean values with and without the ACR and 4.34 and 4.28 at the GRE, respectively. In quantitatively, the TSE shows 12.15 CNR, 17.95 SNR and 12.71 CNR, 18.96 SNR with and without the ACR. And GRE shows 17.72 CNR, 22.59 SNR and 18.26 CNR, 24.47 SNR with and without the ACR, respectively. We have designed and implemented the acrylic assistant equipment to lower abdominal patients. Our data indicate that it is possible to obtain similar image qualities to current lower abdominal MRI scan without the physical contact to the patient.