• Title/Summary/Keyword: Magnetic resonance (MR), contrast media

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Magnetic Resonance Imaging in Thoracic Disease (흉부질환의 자기공명영상)

  • Song, Koun-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.345-352
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    • 1993
  • The role of magnetic resonance(MR) imaging in the evaluation of thoracic disease has been limited Nontheless, MR has inherent properties of better contrast resolution than CT allowing tissue-specific diagnosis. MR has capability of direct imaging in sagittal, coronal, and oblique planes which provide better anatomic information than axial images of CT such as lesions in the pulmonary apex, aorticopulmonary window, peridiaphragmatic region, and subcarinal region. MR is sensitive to blood flow making it an ideal imaging modality for the evaluation of cardiovascular system of the thorax without the need for intravenous contrast media. Technical developments and better control of motion artifacts have resulted in improved image quality, and clinical applications of MR imaging in thoracic diseases have been expanded. Although MR imaging is considered as a problem-solving tool in patients with equivocal CT findings, MR should be used as the primary imaging modality in the following situations: 1) Evaluation of the cardiovascular abnormalities of the thorax 2) Evaluation of the superior sulcus tumors 3) Evaluation of the chest wall invasion or mediastinal invasion by tumor 4) Evaluation of the posterior mediastinal mass, especially neurogenic tumor 5) Differentiation of fibrosis and residual or recurrent tumor, especially in lymphoma 6) Evaluation of brachial plexopathy With technical developments and fast scan capabilities, clinical indications for MR imaging in thorax will increase in the area of pulmonary parenchymal and pulmonary vascular imaging.

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Emerging Role of Hepatobiliary Magnetic Resonance Contrast Media and Contrast-Enhanced Ultrasound for Noninvasive Diagnosis of Hepatocellular Carcinoma: Emphasis on Recent Updates in Major Guidelines

  • Tae-Hyung Kim;Jeong Hee Yoon;Jeong Min Lee
    • Korean Journal of Radiology
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    • v.20 no.6
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    • pp.863-879
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    • 2019
  • Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.

Influence of Iodinated Contrast Media and Paramagnetic Contrast Media on Changes in Uptake Counts of 99mTc

  • Cho, Jae-Hwan;Lee, Jin-Hyeok;Park, Cheol-Soo;Lee, Sun-Yeob;Lee, Jin;Moon, Deog-Hwan;Lee, Hae-Kag
    • Journal of Magnetics
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    • v.19 no.3
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    • pp.248-254
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    • 2014
  • The purpose of this study is to figure out how uptake counts of technetium ($^{99m}Tc$) among radioisotopes in the human body are affected if computed tomography (CT), magnetic resonance imaging (MRI) and isotope examination are performed consecutively. $^{99m}Tc$ isotope material, iodinated contrast media for CT and paramagnetic contrast media for magnetic resonance (MR) were used as experimental materials. First, $^{99m}Tc$ was added to 4 cc normal saline in a test tube. Then, 2 cc of CT contrast media such as $Iopamidol^{(R)}$ and $Dotarem^{(R)}$ were diluted with 2 cc normal saline, and 2cc of MRI contrast media such as $Primovist^{(R)}$ and $Gadovist^{(R)}$ were diluted with 2 cc normal saline. Each distributed contrast media was a total of 4 cc and included 10m Ci of $^{99m}Tc$. A gamma camera, a LEHR (Low energy high resolution) collimator and a pin-hole collimator were used for image acquisition. Image acquisition was repeated a total of 6 times and 120 frames were obtained and uptake counts of $^{99m}Tc$ were measured (from this procedure). In this study, as a result of measuring the uptake counts of $^{99m}Tc$ using the LEHR collimator, the uptake counts were less measured in all contrast media than normal saline as a reference. In particular, the lowest uptake counts were measured when $Gadovist^{(R)}$, contrast media for MRI, was used. However, the result of measuring the uptake counts of $^{99m}Tc$ using the pin-hole collimator showed higher uptake counts in all contrast media, except for $Iopamidol^{(R)}$, than normal saline as a reference. The highest uptake counts were measured particularly when $Primovist^{(R)}$, contrast media for MRI, was used. In performing the gamma camera examination using contrast media and $^{99m}Tc$, it is considered significant to check the changes in the uptake counts to improve various diagnosis values.

Syringe Reuse Issues in Automated Contrast Injection System in Dynamic Magnetic Resonance Imaging (조영제 자동주입기를 활용한 자기공명영상 동적검사 시 실린지 재사용의 문제)

  • Son, Soon-Yong
    • The Journal of the Korea Contents Association
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    • v.19 no.11
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    • pp.445-450
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    • 2019
  • This study proves that syringe reuse of automated injection system entails a risk of contrast media reflux and saline solution contamination which are pumped by a piston into the patients' venous cannula in the dynamic MR images, we will be aware of the serious problem. To quantify the contrast media contamination effect on the saline solution, identical volume of the saline solution was collected before and after the contrast injection to the patients' venous cannula following T1 weighted image scanning to verify whether signal intensities differences are observed. The signal intensity of saline solution after the contrast injection was significantly higher than that of saline before injection by 523.43%. This result is due to the backflow that contaminates the saline solution on the opposite side when the contrast agent is injected. In conclusion, the syringe used to inject contrast medium. causes cross-contamination due to contrast reflux. Therefore, even if the same patient's examination is used for quantitative analysis, the error should be avoided by changing the acquisition sequence or replacing the syringe.

Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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Signal Change of Normal Saline by Oxygen Injection in FLAIR Image (산소주입에 의한 FLAIR 영상에서 생리식염수의 신호 변화)

  • Shin, Woon-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.55-63
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    • 2019
  • It was reported that there were some cases in which signal was not inhibited but high signal appeared in cerebrospinal fluid on FLAIR(fluid attenuated inversion recovery) of MRI(Magnetic Resonance Imaging) in case a person inhales high-concentration oxygen. This study was to prepare basic database. We produced a phantom fixed with agar gel and by using it, obtained the images of the signals of normal saline into which oxygen was injected and normal saline diluted with contrast media by changing the TI(Inversion Time) of FLAIR technique and analyzed them. In the result of FLAIR technique of MRI using Philips Achieva MR 3.0T in Busan P Hospital, the SNR(Signal to Noise Ratio) of normal saline into which oxygen was injected was higher than the SNR of normal saline into which oxygen was not injected. However, it was not higher than the SNR of normal saline diluted with contrast media. In the TI 1,800ms, we could obtain the images which do not have the rise of the signal due to oxygen. In the CNR(Contrast to Noise Ratio) of normal saline into which oxygen was injected and normal saline diluted with contrast media as well, it was higher in the TI 1,800ms than in the TI 2,800ms that is mainly used clinically. It is thought that the result of this study could be basic database for studies on change of signal of cerebrospinal fluid as a result of injection of oxygen in FLAIR technique of MRI.

Detection of Malignant Primary Hepatic Neoplasms with Gadobenate Dimeglumine (Gd-BOPTA) Enhanced T1-Weighted Hepatocyte Phase MR Imaging: Results of Off-site Blinded Review in a Phase-II Multicenter Trial

  • Constantino S. Pena;Sanjay Saini;Richard L. Baron;Bernd A. Hamm;Giovanni Morana;Roberto Caudana;Andrea Giovagnoni;Andrea Villa;Alessandro Carriero;Didier Mathieu;Michael W. Bourne;Miles A. Kirchin;Gianpaolo Pirovano;Alberto Spinazzi
    • Korean Journal of Radiology
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    • v.2 no.4
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    • pp.210-215
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    • 2001
  • Objective: To investigate the efficacy of gadobenate dimeglumine (GdBOPTA) enhanced MR imaging for the detection of liver lesions in patients with primary malignant hepatic neoplasms. Materials and Methods: Thirty-one patients with histologically proven primary malignancy of the liver were evaluated before and after administration of GdBOPTA at dose 0.05 or 0.10 mmol/kg. T1-weighted spin echo (T1W-SE) and gradient echo (T1W-GRE) images were evaluated for lesion number, location, size and confidence by three off-site independent reviewers and the findings were compared to reference standard imaging (intraoperative ultrasound, computed tomography during arterial portography or lipiodol computed tomography). Results were analyzed for significance using a two-sided McNemar's test. Results: More lesions were identified on Gd-BOPTA enhanced images than on unenhanced images and there was no significant difference in lesion detection between either concentration. The largest benefit was in detection of lesions under 1 cm in size (7 to 21, 9 to 15, 16 to 18 for reviewers A, B, C respectively). In 68% of the patients with more than one lesion, Gd-BOPTA increased the number of lesions detected. Conclusion: Liver MR imaging after Gd-BOPTA increases the detection of liver lesions in patients with primary malignant hepatic neoplasm.

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