• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.172-172
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• 2001

Purpose： To evaluate compensatory change of opposite hippocampus after temporal lobe surgery in th patient with temporal lobe epilepsy by using single-voxel proton MR spectroscopy. Method： Eighteen patients with intractable temporal lobe epilepsy (TLE) whose MR diagnos was unilateral hippocampal sclerosis (n=11) or localized unilateral anterior temporal lobe lesio (n=7) and who underwent anterior temporal lobectomy were included in the study. Singl proton MRS of opposite hippocampus was carried out on the same day or within 1 week af MR imaging before temporal lobe surgery and after over 1-year post-surgical follow-u Single voxel proton MRS were acquired using GE signa 1.5T scanner and spectrosco system (TR, 1500-2, 000： TE, 136-144). Region of interest (ROI) was placed in a simitar position for all examination to cover the medial temporal lobes including most of the head an body of hippocampus and a part of amygdala, the parahippocampal gyrus. The MR spectr were evaluated with a focus on the metabolite ratio of N-acetylaspartate (NAA choline-containing phospholipids (Cho), creatine (Cr). The metabolite ratios of NAA/ Cr were calculated from the relative peak height measurement. We evaluated change of th intensity ratio NAA/Cr between before and after surgery, to simplify quantification acro patients, because observed decreases in the ratio of NAA/Cr can be interpreted in terms o neuronal or axonal damage.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.135-135
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• 2001

Purpose： To know the differences of the proton MR spectroscopic features of the liver between th patients with graft-versus-host disease (GVHD) and without GVHD (non-GVHD) after to marrow transplantation (BMT), and to evaluate the possibility to discriminate GVHD fro non-GVHD by analysis of the in vivo proton MR spectra. Method： We evaluated the in vivo proton MR spectra from the livers of 37 patients wh underwent BMT. Our series included 14 cases with GVHD and 23 without GVHD in the liver. Nineteen men and 18 women were included in our series. All cases of GVHD and 2 o non-GVHD were confirmed by liver biopsy and remaining of non-GVHD by evaluation clinical follow up. Proton MR spectroscopy (1H-MRS) was performed at 1.5T GE Sign Horizon (GE Medical System, Milwaukee, USA) system using localized proton STEAM sequence and body coil in all cases with subjects were located in supine position. N respiratory interruption was required during the spectroscopic signal acquisition. Paramete using in MRS were： TR = over 3000ms, TE = 30ms, number of scans = 128, voxel size = ($2{\times}2{\times}2$)$cm^3$, and one NEX. We evaluated the spectra with an attention to the differences o patterns of the peaks between GVHD and non-GVHD groups. The ratio of peak area of peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P(1.6-4.1ppm)/P(0.9-1.6ppm)] was calculated in GVHD and non-GVHD group, and compared the results between these groups. We als evaluated the sensitivity and specificity for discriminating GVHD from non-GVHD by anal of 1H-MRS.

• Investigative Magnetic Resonance Imaging
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• v.12 no.1
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• pp.8-19
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• 2008

Purpose : To investigate the 3-bond and spatial connectivity of human brain metabolites by scalar coupling and dipolar nuclear Overhauser effect/enhancement (NOE) interaction through 2D- correlation spectroscopy (COSY) and 2D- NOE spectroscopy (NOESY) techniques. Materials and Methods : All 2D experiments were performed on Bruker Avance 500 (11.8 T) with the zshield gradient triple resonance cryoprobe at 298 K. Human brain metabolites were prepared with 10% $D_2O$. Two-dimensional spectra with 2048 data points contains 320 free induction decay (FID) averaging. Repetition delay was 2 sec. The Top Spin 2.0 software was used for post-processing. Total 7 metabolites such as N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), lutamine (Gln), glutamate (Glu), myo-inositol (Ins), and lactate (Lac) were included for major target metabolites. Results : Symmetrical 2D-COSY and 2D-NOESY pectra were successfully acquired: COSY cross peaks were observed in the only 1.0-4.5 ppm, however, NOESY cross peaks were observed in the 1.0-4.5 ppm and 7.9 ppm. From the result of the 2-D COSY data, cross peaks between the methyl protons ($CH_3$(3)) at 1.33 ppm and methine proton (CH(2)) at 4.11 ppm were observed in Lac. Cross peaks between the methylene protons (CH2(3,$H{\alpha}$)) at 2.50ppm and methylene protons ($CH_2$,(3,$H_B$)) at 2.70 ppm were observed in NAA. Cross peaks between the methine proton (CH(5)) at 3.27 ppm and the methine proton (CH(4,6)) at 3.59 ppm, between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(4,6)) at 3.59 ppm, and between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(2)) at 4.05 ppm were observed in Ins. From the result of 2-D NOESY data, cross peaks between the NH proton at 8.00 ppm and methyl protons ($CH_3$) were observed in NAA. Cross peaks between the methyl protons ($CH_3$(3)) at 1.33 ppm and methine proton (CH(2)) at 4.11 ppm were observed in Lac. Cross peaks between the methyl protons (CH3) at 3.03 ppm and methylene protons (CH2) at 3.93 ppm were observed in Cr. Cross peaks between the methylene protons ($CH_2$(3)) at 2.11 ppm and methylene protons ($CH_2$(4)) at 2.35 ppm, and between the methylene protons($CH_2$ (3)) at 2.11 ppm and methine proton (CH(2)) at 3.76 ppm were observed in Glu. Cross peaks between the methylene protons (CH2 (3)) at 2.14 ppm and methine proton (CH(2)) at 3.79 ppm were observed in Gln. Cross peaks between the methine proton (CH(5)) at 3.27 ppm and the methine proton (CH(4,6)) at 3.59 ppm, and between the methine proton (CH(1,3)) at 3.53 ppm and methine proton (CH(2)) at 4.05 ppm were observed in Ins. Conclusion : The present study demonstrated that in vitro 2D-COSY and NOESY represented the 3-bond and spatial connectivity of human brain metabolites by scalar coupling and dipolar NOE interaction. This study could aid in better understanding the interactions between human brain metabolites in vivo 2DCOSY study.

• Progress in Medical Physics
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• v.19 no.2
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• pp.95-101
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• 2008

In this study, we observed the alteration of choline signal intensity in hippocampus region of the depressive rat model induced by forced swimming test (FST). The purpose of this study was to evaluate the antidepressant efficacy in the depressive animal model using MR spectroscopy. Fourteen experimentally naive male Sprague-Dawley rats weighting $160{\sim}180\;g$ were used as subjects. Drug injection group was exposed to the FST except for control group. The drugs were administered subcutaneously (SC) in a volume equivalent to 2ml/kg. And three injections were administered 23, 5, and 1h before beginning the given test. 1H MR spectra were obtained with use of a point resolved spectroscopy (PRESS) localization sequence performed according to the following parameters: repetition time, 2500 ms; echo time, 144 ms; 512 average; 2048 complex data points; voxel dimensions, $1.5{\times}2.5{\times}2.5\;mm^3$ ; acquisition time, 25min. There were no differences in NAA/Cr and Cho/Cr ratio between the right and the left hippocampus both normal control rats and antidepressant-injected rats. Also, no differences were observed in NAA/Cr and Cho/Cr ratio between the normal control rats and the antidepressant-injected rats both the right and the left hippocampus. In this study, we found the recovery of choline signals in the depressive animal model similar to normal control groups as injecting desipramine-HCl which was antidepressant causing anti-immobility effects. Thus, we demonstrated that MR spectroscopy was able to aid in evaluating the antidepressant effect of desipramine-HCl.

• Investigative Magnetic Resonance Imaging
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• v.5 no.2
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• pp.123-129
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• 2001

Purpose: The purposes of this study are to evaluate normal MR spectroscopy (MRS) data of the cerebellum and pons, and to evaluate intra-unit and inter-unit differences of the results. Materials and methods: Nine normal volunteers (mean age 23 years) were studied with two 1.5 Tesla MR units (A and B units). A total of four sessions of MRS study were performed with two sessions in ea.ch MR unit in each volunteer. In each session, MRS data were obtained from bilateral cerebellar hemisphere and pons. MRS was performed using spin-echo single voxel technique with repetition time of 2000 ms, echo time of 288ms and 128 averagings. Voxel size was $2{\;}{\times}{\;}2{\;}{\times}{\;}1.5{\;}cm$ in the cerebellum and $1.5{\;}{\times}{\;}1.5{\;}{\times}{\;}1.5{\;}cm$ in the pons. Metabolite ratios of NAA/Cho, NAAcCr, NAAc(Cho+Cr) and Cr/Cho (both peak heights and the peak areas) were compared among the results of four sessions of MRS for evaluation of intra-unit and inter-unit differences. Results: In the cerebellum, mean (SO values of peak height NAA/Cho, NAA/Cr, NAA/(Cho+Cr) and Cr/Cho ratios obtained in the first session of A unit were $1.08{\pm}O.16,{\;}1.44{\pm}O.286,{\;}0.61{\pm}O.09{\;}and{\;}O.76{\pm}0.13$, respectively. Comparing with the results of the second session, intra-unit differences were 3-7%. In B unit intra-unit differences were 1-9%, except for 22% of Cr/Cho ratio. Inter-unit differences between A and B units were 1-26%. In the pons, mean ISD values of peak height NANCho, NANCr, NANICho + Cr) and Cr/Cho ratios obtained in the first session of A unit were $1.51{\pm}O.35,{\;}3.35{\pm}O.78,{\;}1.02{\pm}0.16{\;}and{\;}0.47{\pm}O.14$, respectively. Mean NAAfCho, NANCr and NAAI(Cho+ Cr} ratios of the pons were significantly higher than those of the cerebellum. Intra-unit differences were 2-21 % in A unit and 4-18 % in B unit. Inter-unit differences between A and B units were 1-18%. The mean values obtained by using peak area were generally higher and wider in range than those of peak height in both units. Conclusion: Mean NAAfCho, NAAlCr and NAAf(Cho+Cr) ratios of the cerebellum were significanHy lower than those of the pons. Intra-unit differences of most metabolites ratios were generally not significant, whereas inter-unit differences were greater than intra-unit differences in more metabolite ratios. Therefore, normal MRS data of the cerebellum and the pons should be obtained in every MR unit, before MRS applications in the diseases of the cerebellum and the pons.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5085-5088
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• 2015

Background: The aim of this study was to assess the role of the presence of a choline peak in 3 Tesla 1H magnetic resonance spectroscopy (MRS) for differentiating benign from malignant adnexal masses. Materials and Methods: A total of 46 adnexal masses (23 malignant and 23 benign) underwent 1H MRS study prior to surgery to assess the presence of choline peak. Results: A choline peak was detected in 16 malignant masses (69.5%) and was absent in the other 7 (30.5%). A choline peak was only detected in 6 (26%) of the benign adnexal masses. The presence of an MRS choline peak had a sensitivity of 69.5%, a specificity of 74%, a positive predictive value (PPV) of 72.7%, and a negative predictive value (NPV) of 71% for diagnosing malignant adnexal masses. A significant difference between the frequency of mean choline peaks in benign and malignant adnexal masses was observed (P value < 0.01). Conclusions: A 1H MRS choline peak is seen in malignant adnexal masses more frequently than the benign masses, and may be helpful for diagnosing malignant adnexal masses.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.118-124
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• 2017

Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source.

• Journal of the Korean Magnetic Resonance Society
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• v.9 no.1
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• pp.29-37
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• 2005

Intra-cellular drug uptake in Xenopus laevis oocyte has been elucidated using localized MR spectroscopy (MRS) and PFG NMR techniques at a 600 $MH_z$(Bruker, 14.1 T) NMR spectrometer. The localized MRS has been done with a homemade probe, and shows the intra-cellular uptake of nicotinamide. The self-diffusion of the molecule in Xenopus oocyte was obtained by PFG NMR technique. The measured data are well fitted with a linear combination of two exponential functions, which shows that there are two types of drug molecules, intra-and extra-cellular molecules. Diffusion coefficients of intra- and extra-cellular drug molecules are 3.7 $\times$ $10^{-11}$ $\m^{2}/s$and 6.4 $\times$ $10^{-10}$ $\m^{2}/s$, respectively. In the weighting factors there is shown that about 5% of drug molecule is inside the cells. These techniques can be used for drug screening in molecule-, cell-, and tissue-based preclinical test.

• Journal of the Korean Magnetic Resonance Society
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• v.8 no.1
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• pp.28-36
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• 2004

Authors investigated whether there is a lateral effect of $^1$H MRS observable metabolite ratios between the symptomatic and the nonsymptomatic side in the early stage of Parkinson's disease with unilateral symptom. Localized in vivo $^1$H MR spectroscopy (MRS) was used to measure the metabolite levels in the symptomatic and the nonsymptomatic sides of the lentiform nucleus in Parkinson"s disease with unilateral symptom (N=25). The metabolite ratios of NAA/Cr and Cho/Cr in the symptomatic side were compared with those in the nonsymptomatic side. Significant metabolic lateral effect of NAA/(Cho+Cr) ratio was established between the symptomatic and the nonsymptomatic side of lentiform nucleus in Parkinson's disease with unilateral symptom (p<0.05). The ratio of NAA/(Cho+Cr) homolateral to the sympatomatic side of the patient is also lower than that of the control (P<0.05). On the basis of NAA/Cr ratios of lentiform nucleus between the symptomatic and the nonsymptomatic side, the present $^1$H MRS study shows a significant neuronal laterality in Parkinson's disease with unilateral symptom. In vivo $^1$H MRS may provide a diagnostic marker for neuronal dysfunction in Parkinson's disease with unilateral symptom.

• Journal of the Korean Magnetic Resonance Society
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• v.5 no.2
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• pp.99-109
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• 2001

Authors investigated neuronal changes of local cellular metabolism in the cerebral lesions of Parkinsonian symptomatic side between before and after stereotactic neurosurgery by follow-up 1H magnetic resonance spectroscopy (MRS). Patients with Parkinson's disease (PD) (n = 15) and age-matched normal controls (n = 15) underwen MRS examinations using a stimulated echo acquisition mode (STEAM) pulse sequence that provided 2${\times}$2${\times}$2 ㎤ (8ml) volume of interest in the regions of substantia nigra, thalamus, and lentiform nucleus. Spectral parameters were 20 ms TE, 2000 ms TR, 128 averages,2500 Hz spectral width, and 2048 data points. Raw data were processed by the SAGE data analysis package (GE Medical Systems). Peak areas of N-acetylaspartate (NAA), creatine (Cr), choline-containing compounds (Cho), inositols (Ins), and the sum (Glx) of glutamate and GABA were calculated by means of fitting the spectrum to a summation of Lorentzian curves using Marquardt algorithm. After blindly processed, we evaluated neuronal alterations of observable metabolite ratios between before and after stereotactic neurosurgery using Pearson product-moment analysis (SPSS, Ver. 6.0). A significant reduction of NAA/Cho ratio was observed in the cerebral lesion in substantia nigra of PD patient related to the symptomatic side after neurosurgery (P : 0.03). In thalamus, NAA/Cho ratio was also significantly decreased in the cerebral lesion including the electrode-surgical region (P : 0.03). A significant reduction of NAA/Cho ratio in lentiform nucleus was not oberved, but tended toward significant reduction after neurosurgery (P = 0.08). In particular, remarkable lactate signal was noted from the surgical thalamic lesions of 6 among 8 patients and internal segments of globus pallidus of 6 among 7 patients, respectively. Significant metabolic alterations of NAA/Cho ratio might reflect functional changes of neuropathological processes in the lesion of substantia nigra, thalamus, and lentiform nucleus, and could be a valuable finding fur evaluation of Parkinson's disease after neurosurgery. Increase of lactate signals, being remarkable in surgical lesions, could be consistent with a common consequence of neurosurgical necrosis. Thus, IH MRS could be a useful modality to evaluate the diagnostic and prognostic implications fur Parkinsons disease after functional neurosurgery.