• Annals of Clinical Neurophysiology
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• 제14권1호
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• pp.36-40
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• 2012

Nephrogenic systemic fibrosis (NSF) is a systemic disease that affects the skin and other tissues in patients with renal insufficiency and exposure to gadolinium-containing contrast. A 55-year-old woman with end-stage renal disease on hemodialysis was consulted for progressive general weakness. After she had undergone multiple MRIs with gadolinium-containing contrast media, muscle weakness and skin lesions were developed. Her skin and muscle biopsy specimens showed CD34+ fibroblast entrapping collagen bundles. There are few reports of NSF with myopathy.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.209-217
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• 2021

Magnetic resonance angiography (MRA) plays an important role in accurate diagnosis and appropriate treatment planning for patients with arterial disease. Contrast-enhanced (CE) MRA is fast and robust, offering hemodynamic information of arterial flow, but involves the risk of a side effect called nephrogenic systemic fibrosis. Various non-contrast-enhanced (NCE) MRA techniques have been developed by utilizing the fact that arterial blood is moving fast compared to background tissues. NCE MRA is completely free of any safety issues, but has different drawbacks for various approaches. This review article describes basic principles of CE and NCE MRA techniques with a focus on how to generate angiographic image contrast from a pulse sequence perspective. Advantages, pitfalls, and key applications are also discussed for each MRA method.

• Korean Journal of Radiology
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• 제20권1호
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• pp.134-147
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• 2019

Gadolinium-based contrast agents (GBCAs) are commonly used for enhancement in MR imaging and have long been considered safe when administered at recommended doses. However, since the report that nephrogenic systemic fibrosis is linked to the use of GBCAs in subjects with severe renal diseases, accumulating evidence has suggested that GBCAs are not cleared entirely from our bodies; some GBCAs are deposited in our tissues, including the brain. GBCA deposition in the brain is mostly linked to the specific chelate structure of the GBCA: linear GBCAs were responsible for brain deposition in almost all reported studies. This review aimed to summarize the current knowledge about GBCA brain deposition and discuss its clinical implications.

• Investigative Magnetic Resonance Imaging
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• 제23권1호
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• pp.34-37
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• 2019

Gadolinium contrast agents (CAs) are integral components of clinical magnetic resonance imaging (MRI). However, safety concerns have arisen regarding the use of gadolinium CAs, due to their association with nephrogenic systemic fibrosis (NSF). Furthermore, recently the long-term retention of $Gd^{3+}-based$ CAs in brains patients with normal renal function raised another possible safety issue. The safety concerns of $Gd^{3+}-based$ CAs have been based on the ligand structure of $Gd^{3+}-based$ CAs, and findings that $Gd^{3+}-based$ CAs with linear ligand structures showed much higher incidences of NSF and brain retention of CAs than $Gd^{3+}-based$ CAs with macrocyclic ligand structure. In the current study, we report the in vivo biodistribution profile of a new highly stable multifunctional $Gd^{3+}-based$ CA, with macrocyclic ligand structure (HNP-2006). MR imaging using HNP-2006 demonstrated a significant contrast enhancement in many different organs. Furthermore, the contrast enhanced tumor imaging using HNP-2006 confirmed that this new macrocyclic CA can be used for detecting tumor in the central nervous system. Therefore, this new multifunctional HNP-2006 with macrocyclic ligand structure shows great promise for whole-body clinical application.

• Investigative Magnetic Resonance Imaging
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• 제15권2호
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• pp.91-101
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• 2011

관류 자기공명영상은 크게 외인성과 내인성 조영제를 사용하는 방법으로 나눌 수 있고, 외인성 조영제를 사용하는 방법으로는 DSC 와 DCE 방법이 있으며, 내인성 조영제를 사용하는 방법으로는 ASL 이 있다. 이들 관류 자기공명영상 방법들은 환자의 상태와 나타내고자 하는 영상인자에 따라 선별적으로 최적화되어 사용되어야 한다. 그 예로 급성 뇌졸중 환자의 경우 매우 빠른 영상획득이 최우선적인 인자이므로 DSC 가 주로 이용되고 있고, 뇌종양 환자의 경우 여러 물리적 인자를 고려한 DSC 혹은 DCE 스캔이 필요하다. 또한 소아나 가임여성 및 신장병질환이 있는 경우는 ASL 을 이용되고 있다. 관류 자기공명영상 기술은 방사성 물질을 전혀 사용하지 않아 약물효과의 평가와 기타 치료 효과를 이해하는데 많은 응용이 있을 것으로 생각된다.