• The Korean Journal of Nuclear Medicine Technology
• /
• v.19 no.1
• /
• pp.62-66
• /
• 2015

Purpose Various database comparison methods(DCM) are used for analyzing functional neuro-imaging. It is possible to statistically evaluate decreased or increased metabolism of abnormal patient's brain by comparing with asymptomatic controls in DCM. And results of DCM are additionally used for easily explaining defect region. The aim of this study was to evaluate usefulness of statistical parametric mapping(SPM) and scenium. Materials and Methods Data of 15 patients($62.02{\pm}15.03year$) underwent $^{18}F-FDG$ brain PET/CT were collected and analyzed. Biograph TruePoint 40 with TrueV, (Siemens) was used as a PET/CT scanner. Scenium(version 4.0) in Syngo.via(version VA30A) and SPM99 were applied for statistical evaluation. Consistency between PET reading and result of DCM were evaluated by 5 nuclear medicine physicians through a questionnaire survey. SUV and SD changes were evaluated by changing iteration, gaussian filter and matrix size in scenium. And average required time for generating result of SPM99 and scenium was compared by 3 medical technologists. Results Consistency from the result of SPM99 and scenium showed 84% and 92.4% compare to PET reading. When iteration 4, FWHM 8 and matrix size 168, SUV and SD were decreased by 0.59%, 8.73%, 4.69%, 20.38% and 0.88%, 8.25% respectively compare to routine parameter(iteration 8, FWHM 2 and matrix size 336) of scenium. Average required time of SPM99 and Scenium took 282 seconds and 116 seconds to generate result. Conclusion Results of SPM99 and Scenium showed high consistency compare to PET reading. Various parameters can be controled by user when using SPM. However, normal database needs to be acquired. And it takes significant amount of time and effort for the first set up. On the other hand, Scenium provides normal database even though modifiable parameters are limited. Therefore, more informations could be provided for brain PET/CT if properly understanding and selecting each DCM.

• Korean Journal of Digital Imaging in Medicine
• /
• v.15 no.1
• /
• pp.1-7
• /
• 2013

Purpose : The Carotid Angio inspection including Aortic arch applied to wide area is conducted as the Contrast Enhance MR Angiography(CEA) which is using a contrast medium. However it is a burden not only for someone such as infants, pregnant women and patients suffering from kidney failure but continuous use of contrast medium also can be a burden for patients who has been taken follow up inspection since diagnose lesion already. The purpose of this study is to estimate a usefulness of the Time of Flight (TOF) by comparing with CEA. Materials and methods : 10 patients with an average age of 58 (from 45 to 75) who had MRA inspection in our hospital were studied using 3.0 Tesla Aachieva (Philips, Netherland) MRI system and Sense Neuro-Vascular 16 Channels Coil. The same patient was inspected both TOF and CEA simultaneously. The TOF inspection included from Aortic arch to Willis Circle by connecting 3 TOF stacks and so did CEA inspection. The quantitative analysis was conducted through signal to noise ratio(SNR) and contrast to noise ratio(CNR) with soft tissue by setting up an area of interest on CCA bifurcatoin, ICA, ECA, MCA and VA concerning obtained image. In case of qualitative analysis, 3 radiological technologists and 1 radiologist evaluated 4 items (1: Visibility of the blood vessel, 2: Image distortion measure, 3: Overlapping measure with vein, 4: Peripheral blood vessel description measure) into five points scale (1: Very bad, 2: Bad, 3: Normal 4: Good, 5: Very good). Results : Results for the quantitative analysis was obtained by calculating the average of 5 ROIs in case of SNR and CNR separately. Results of SNR, TOF were generally measured higher than CEA (In case of TOF were 166.1, 205.2, 154.39, 172.23, 161.95, and CEA were 92.05, 95.43, 84.76, 73.69, 88.3). But according to the result of CNR, both TOF and CEA were measured similarly as 67.62, 106.71, 55.9, 73.74, 63.46 for TOF and 67.82, 71.19, 60.52, 49.45, 64.07 for CEA. Throughout every results of each ROI, SNR showed statistically meaningful consequence (0.050.05). In case of qualitative analysis the average of each evaluated item was 4.2points and 4.28points in the item1, 2.93points and 4.55points in the item2, 4.6points and 3.13points in the item3, 2.88points and 4.6points in the item4. According to the results TOF was measured higher in the item3 while in the item2 and item4 CEA was higher and in case of the item1, both CEA and TOF were similar. To sum up statistically meaningful results (p<0.05) were shown in the item2, item3 and item4 but not in the item1 (p>0.05). Conclusions : Both TOF and CEA are complementary because each inspection has pros and cons, but when inspect wide area including Aortic arch normally CEA is conducted. But TOF inspection also can be considered as alternative in terms of patients who has difficulty in the contrast medium such as infants, pregnant women and patients suffering from kidney failure and patients during follow up.

• Journal of radiological science and technology
• /
• v.32 no.2
• /
• pp.183-194
• /
• 2009

Purpose : This study was performed not only to compare the brain activation regions associated with sexual arousal induced by visual stimulation and SP6 acupuncture, but also to evaluate its differential neuro-anatomical mechanism in healthy women using functional magnetic resonance imaging (fMRI) at 3 Tesla (T). Subjects and methods : A total of 21 healthy right-handed female volunteers (mean age 22 years, range 19 to 32) underwent fMRI on a 3T MR scanner. The stimulation paradigm for sexual arousal consisted of two alternating periods of rest and activation. It began with a 1-minute rest period, 3 minutes of stimulation with either of an erotic video film or SP6 acupuncture, followed by 1-minute rest. In addition, a comparative study on the brain activation patterns between an acupoint and a shampoint nearby GB37 was performed. The fMRI data were obtained from 20 slices parallel to the AC-PC line on an axial plane, giving a total of 2,000 images. The mean activation maps were constructed and analyzed by using the statistical parametric mapping (SPM99) software. Results : As comparison with the shampoint, the acupoint showed 5 times and 2 times higher activities in the neocortex and limbic system, respectively. Note that brain activation in response to stimulation with the shampoint was not observed in the regions including the HTHL in the diencephalon, GLO and AMYG in the basal ganglia, and SMG in the parietal lobe. In the comparative study of visual stimulation vs. SP6 acupuncture, the mean activation ratio of stimulus was not significantly different to each other in both the neocortex and the limbic system (p < 0.05). The mean activities induced by both stimuli were not significantly different in the neocortex, whereas the acupunctural stimulation showed higher activity in the limbic system (p < 0.05). Conclusions : This study compared the differential brain activation patterns and the neural mechanisms for sexual arousal, which were induced by visual stimulation and SP6 acupuncture by using 3T fMRI. These findings will be useful to understand the theory of traditional acupuncture and acupoint channel in scientific point of view.

• Progress in Medical Physics
• /
• v.22 no.1
• /
• pp.18-27
• /
• 2011

The purpose of this study was to identify different cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla functional magnetic resonance imaging (fMRI) and further to investigate the human suitability for rural and urban environments. A total of 27 right-handed participants (mean age: $27.3{\pm}3.7$) underwent fMRI study on a 3.0T MR scanner. The brain activation patterns were induced by visual stimulation with each rural and urban sceneries. The participants were divided into two groups as 26 subjects favorable to rural scenery and 14 subjects unfavorable to urban scenery based on their filled-in questionnaire. The differences of the brain activation in response to two extreme types of pictures by the two sample t-test were characterized as follows: the activation areas observed in rural scenery over urban were the insula, middle frontal gyrus, precuneus, caudate nucleus, superior parietal gyrus, superior occipital gyrus, fusiform gyrus, and globus pallidus. In urban scenery over rural, the inferior frontal gyrus, parahippocampal gyrus, postcentral gyrus, superior temporal gyrus, amygdala, and posterior cingulate gyrus were activated. The fMRI patterns also clearly show that rural scenery elevated positive emotion such as happiness and comfort. On the contrary, urban scenery elevated negative emotion, resulting in activation of the amygdala which is the key region for the feelings of fear, anxiety and unpleasantness. This study evaluated differential cerebral areas of the human brain associated with rural and urban picture stimulation using a 3.0 Tesla fMRI. These findings will be useful as an objective evaluation guide to human suitability for ecological environments that are related to brain activation with joy, anger, sorrow and pleasure.

• Journal of Environmental Health Sciences
• /
• v.37 no.2
• /
• pp.102-112
• /
• 2011

Objectives: The purpose of this study is to analyze the effects of chronic exposure by welders to manganese (Mn) through an analysis of the degree of brain activity in different activities such as cognition and motor activities using the neuroimaging technique of functional magnetic resonance imaging (fMRI). The neurotoxic effect that Mn has on the brain was examined as well as changes in the neuro-network in motor areas, and the usefulness of fMRI was evaluated as a tool to determine changes in brain function from occupational exposure to Mn. Methods: A survey was carried out from July 2010 to October 2010 targeting by means of a questionnaire 160 workers from the shipbuilding and other manufacturing industries. Among them, 14 welders with more than ten years of job-related exposure to Mn were recruited on a voluntary basis as an exposure group, and 13 workers from other manufacturing industries with corresponding gender and age were recruited as a control group. A questionnaire survey, a blood test, and an fMRI test were carried out with the study group as target. Results: Of 27 fMRI targets, blood Mn concentration of the exposure group was significantly higher than that of the control group (p<0.001), and Pallidal Index (PI) of the welder group was also significantly higher than that of the control group (p<0.001). As a result of the survey, the score of the exposure group in self-awareness of abnormal nerve symptoms and abnormal musculoskeletal symptoms was higher than those of the control group, and there was a significant difference between the two groups (p<0.05, respectively). In the correlation between PI and the results of blood tests, the correlation coefficient with blood Mn concentration was 0.893, revealing a significant amount of correlation (p<0.001). As for brain activity area within the control group, the right and the left areas of the superior frontal cortex showed significant activity, and the right area of superior parietal cortex, the left area of occipital cortex and cerebellum showed significant activity. Unlike the control group, the exposure group showed significant activity selectively on the right area of premotor cortex, at the center of supplementary motor area, and on the left side of superior temporal cortex. In the comparison of brain activity areas between the two groups, the exposure group showed a significantly higher activation state than did the control group in such areas as the right and the left superior parietal cortex, superior temporal cortex, and cerebellum including superior frontal cortex and the right area of premotor cortex. However, in nowhere did the control group show a more activated area than did the exposure group. Conclusions: Chronic exposure to Mn increased brain activity during implementation of hand motor tasks. In an identical task, activation increased in the premotor cortex, superior temporal cortex, and supplementary motor area. It was also discovered that brain activity increase in the frontal area and occipital area was more pronounced in the exposure group than in the control group. This result suggests that chronic exposure to Mn in the work environment affects brain activation neuro-networks.

• Journal of the Korean Society of Radiology
• /
• v.5 no.2
• /
• pp.81-92
• /
• 2011

This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.20 no.1
• /
• pp.29-35
• /
• 2020

Joubert syndrome (JS) is a rare genetic disorder that is characterized by ataxia, hypotonia, developmental delay, respiratory abnormalities such as apnea-hyperpnea, and abnormal eye movements. The pathognomonic diagnostic finding is the "molar tooth sign" (MTS) on brain magnetic resonance imaging (MRI), described as cerebellar vermis hypoplasia or dysplasia, thick and horizontally oriented superior cerebellar peduncles, and an abnormally deep interpeduncular fossa. JS is characterized by genetic heterogeneity: pathogenic variants in over 30 genes have been identified to date. The CEP290 protein, which is on chromosome 12q21.3, is most frequently mutated in patients with JS, especially with renal involvement. Here, we report a case of JS in a 14-year-old male patient with end-stage renal disease. To the best of our knowledge, this is the first Korean report of a patient with JS due to CEP290 mutation (c.6012-12T> A) whose diagnosis was confirmed after repetitive MRI. We suggest consultation with an experienced neuro-radiologist and follow-up MRI studies to detect a "hidden" MTS if clinical findings suggest a diagnosis of JS. Furthermore, even in the absence of an MTS, whole exome sequencing should be considered.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.2
• /
• pp.77-82
• /
• 2007

Objective : The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients. Methods : Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three Types. The patients were divided into two groups by age : A (51 patients), from birth to 3 years, and B (24 patients), from 3 to 24 years. For prevention of retethering of the cord, a mega-dural sac rebuilding procedure was performed in 15 patients. Results : During a mean postoperative follow-up period of 4 years, the surgical outcome was satisfactory in terms of improved pain and motor weakness, but disappointing with reference to the resolution of bowel and bladder dysfunction. Among these 75 patients with LMMC, preoperative deficits were improved after surgery in 29 (39%), remained stable in 28 (37%), changed slightly in 13 (17%), and worsened in 5 (7%). Patients in group A achieved better outcomes than those in group B. Depending on the type of lesion, patients with types I and II LMMC have better outcomes than those with type III LMMC. Finally, retethering of the cord with neurological deterioration occurred in 4 (5.3%) of the 75 patients, but no retethering was found in the 15 patients who were recently treated with a mega-dural sac rebuilding procedure. Conclusion : Our data continue to support the opinion that early diagnosis and optimal surgery are still essential for the treatment of patients with LMMC, since there is a high likelihood of residual neurological functions that can be preserved. Based on our surgical experience of untethering and decompression of lipomas, a mega-dural sac repair is useful to prevent retethering of the cord.

• Journal of radiological science and technology
• /
• v.39 no.2
• /
• pp.227-236
• /
• 2016

Dynamic positron emission tomography(dPET) is widely used medical imaging modality that can provide both physiological and functional neuro-image for diagnosing various brain disease. However, dPET images have low spatial-resolution and high noise level during spatio-temporal analysis (three-dimensional spatial information + one-dimensional time information), there by limiting clinical utilization. In order to overcome these issues for the spatio-temporal analysis, a novel computational technique was introduced in this paper. The computational technique based on singular value decomposition classifies multiple independent components. Signal components can be distinguished from the classified independent components. The results show that signal to noise ratio was improved up to 30% compared with the original images. We believe that the proposed computational technique in dPET can be useful tool for various clinical / research applications.

• Journal of Radiation Industry
• /
• v.12 no.4
• /
• pp.325-332
• /
• 2018

Carotid angiography covering the aortic arch includes contrast-enhanced magnetic resonance angiography (CEA), which is applied to a large region and usually employs contrast media. However, the use of contrast media can be dangerous in infants, pregnant women, and patients with chronic renal failure (CRF). Follow-up patients informed of a lesion may also want to avoid constant exposure to contrast media. We aimed to apply time-of-flight (TOF) angiography to a large region and compare its usefulness with that of CEA. Ten patients (mean age, 58 years; range, 45~75 years) who visited our hospital for magnetic resonance angiography (MRA) participated in this study. A 3.0 Tesla Achieva magnetic resonance imaging (MRI) system (Philips, Netherland) and the SENSE NeuroVascular 16-channel coil were employed for both methods. Both methods were applied simultaneously to the same patient. Three TOF stacks were connected to cover the aortic arch through the circle of Willis, and CEA was applied in the same manner. For the quantitative assessment, the acquired images were used to set the regions of interest (ROIs) in the common carotid artery (CCA) bifurcation, internal carotid artery, external carotid artery, middle cerebral artery, and vertebral artery, and to obtain the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) for the soft tissues. Three radiologists and one radiological resident performed the qualitative assessment on a 5-point scale - 1 point, "very bad"; 2 points, "bad"; 3 points, "average"; 4 points, "good"; and 5 points, "very good" - with regard to 4 items: (1) sharpness, (2) distortion, (3) vein contamination, and (4) expression of peripheral vessels. For the quantitative assessment, we estimated the mean SNR and CNR in each of the 5 ROIs. In general, the mean SNR was higher in TOF angiography (166.1, 205.2, 154.39, 172.23, and 161.95) than in CEA(92.05, 95.43, 84.76, 73.69, and 88.3). Both methods had a similar mean CNR: 67.62, 106.71, 55.9, 73.74, and 63.46 for TOF angiography, and 67.82, 71.19, 60.52, 49.45, and 64.07 for CEA. In all ROIs, the mean SNR was statistically significant (p<0.05), whereas the mean CNR was insignificant (p>0.05). The mean values of TOF angiography and CEA for each item in the qualitative assessment were 4.2 and 4.28, respectively for item 1; 2.93 and 4.55, respectively, for item 2; 4.6 and 3.13, respectively, for item 3; and 2.88 and 4.65, respectively, for item 4. Therefore, TOF angiography had a higher mean for item 3, and CEA had a higher mean for items 2 and 4; there was no significant difference between the two methods for item 1. The results for item 1 were statistically insignificant (p>0.05), whereas the results for items 2~4 were statistically significant (p<0.05). Both methods have advantages and disadvantages and they complement each other. However, CEA is usually applied to a large region covering the aortic arch. Time-of-flight angiography may be useful for people such as infants, pregnant women, CRF patients, and followup patients for whom the use of contrast media can be dangerous or unnecessary, depending on the circumstance.