• Journal of Biomedical Engineering Research
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• v.20 no.2
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• pp.165-172
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• 1999

An enhancement technique for phase dependent image contrast in MRI(Manetic Resonance Imaging) is proposed. Because the method can enhance inherent phase contrast it is suited for susceptibility imaging and flow imaging where intravoxel phase is a source of image contrast. In this paper, applying external phase in the voxel enhances phase contrast. The external phase is generated by a tailored RF pulse so that one can control the phase contrast and even produces phase only contrast. Signal intensity due to both inherent phase and external phase is analyzed and the proposed technique is applied to a susceptibility effect only imaging and a flow effect only imaging. To verify the proposed technique, computer simulations are performed and their results are given.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.109-109
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• 2001

Purpose： To assess the feasibility of sequential administration of ferumoxides and mangafodi trisodium in the same imaging protocols. Method： Thirty patients underwent double-contrast enhanced MR imaging of liver usi ferumoxides (Fe-MRI) and mangafodipir trisodium (Mn-MRI) on 1.5T GE Horizon system. In twenty patients, Mn-MRI was immediately followed by Fe-MRI. In ten patients, Fe-MR was performed first, then Mn-MRI was performed immediately, In all cases, precontras T1-weighted in-phase and opposed-phase spoiled gradient echo (GRE) images an T2-weighted fast spin-echo images (TR 4000ms, TE 102ms, ETL 8-12) were obtained Fe-MRI was performed with FSE and steady state GRE (TE 10 msec, flip angle 30 sequences. Mn-MRI was performed with in-phase and opposed-phase spoiled GR sequences. The SNR changes after the use of each contrast agents were calculated.

• Investigative Magnetic Resonance Imaging
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• v.23 no.1
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• pp.1-16
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• 2019

Dynamic contrast enhanced (DCE) magnetic resonance (MR) imaging plays an important role in non-invasive detection and characterization of primary and metastatic lesions in the liver. Recently, efforts have been made to improve spatial and temporal resolution of DCE liver MRI for arterial phase imaging. Review of recent publications related to arterial phase imaging of the liver indicates that there exist primarily two approaches: breath-hold and free-breathing. For breath-hold imaging, acquiring multiple arterial phase images in a breath-hold is the preferred approach over conventional single-phase imaging. For free-breathing imaging, a combination of three-dimensional (3D) stack-of-stars golden-angle sampling and compressed sensing parallel imaging reconstruction is one of emerging techniques. Self-gating can be used to decrease respiratory motion artifact. This article introduces recent MRI technologies relevant to hepatic arterial phase imaging, including differential subsampling with Cartesian ordering (DISCO), golden-angle radial sparse parallel (GRASP), and X-D GRASP. This article also describes techniques related to dynamic 3D image reconstruction of the liver from golden-angle stack-of-stars data.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.127-130
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• 1997

Phase-contrast(PC) methods have been used for quantitative measurements of velocity and volume flow rate. In addition, phase contrast cine magnetic resonance imaging (MRI) combines the flow dependent contrast of PC MRI with the ability of cardiac cine imaging to produce images throughout the cardiac cycle. In this method, the through-plane velocity has been encoded generally. However, the accuracy of the flow data can be reduced by the effect of flow direction, finite slice thickness, resolution, pulsatile flow pattern, and so on. In this study we calculated the error caused by misalignment of tomographic plane and flow directon. To reduce this error and encode the velocity for more complex flow, we suggested 3 directional velocity encoding method.

• 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.

• Korean Journal of Radiology
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• v.22 no.5
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• pp.725-734
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• 2021

Objective: To intraindividually compare hepatocellular carcinoma (HCC) washout between MRIs using hepatobiliary agent (HBA) and extracellular agent (ECA). Materials and Methods: This study included 114 prospectively enrolled patients with chronic liver disease (mean age, 55 ± 9 years; 94 men) who underwent both HBA-MRI and ECA-MRI before surgical resection for HCC between November 2016 and May 2019. For 114 HCCs, the lesion-to-liver visual signal intensity ratio (SIR) using a 5-point scale (-2 to +2) was evaluated in each phase. Washout was defined as negative visual SIR with temporal reduction of visual SIR from the arterial phase. Illusional washout (IW) was defined as a visual SIR of 0 with an enhancing capsule. The frequency of washout and MRI sensitivity for HCC using LR-5 or its modifications were compared between HBA-MRI and ECA-MRI. Subgroup analysis was performed according to lesion size (< 20 mm or ≥ 20 mm). Results: The frequency of portal venous phase (PP) washout with HBA-MRI was comparable to that of delayed phase (DP) washout with ECA-MRI (77.2% [88/114] vs. 68.4% [78/114]; p = 0.134). The frequencies were also comparable when IW was allowed (79.8% [91/114] for HBA-MRI vs. 81.6% [93/114] for ECA-MRI; p = 0.845). The sensitivities for HCC of LR-5 (using PP or DP washout) were comparable between HBA-MRI and ECA-MRI (78.1% [89/114] vs. 73.7% [84/114]; p = 0.458). In HCCs < 20 mm, the sensitivity of LR-5 was higher on HBA-MRI than on ECA-MRI (70.8% [34/48] vs. 50.0% [24/48]; p = 0.034). The sensitivity was similar to each other if IW was added to LR-5 (72.9% [35/48] for HBA-MRI vs. 70.8% [34/48] for ECA-MRI; p > 0.999). Conclusion: Extracellular phase washout for HCC diagnosis was comparable between MRIs with both contrast agents, except for tumors < 20 mm. Adding IW could improve the sensitivity for HCC on ECA-MRI in tumors < 20 mm.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.354-365
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• 2021

Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar's test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion: The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

• Korean Journal of Radiology
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• v.20 no.1
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• pp.102-113
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• 2019

Objective: To assess the accuracy and potential bias of computed tomography (CT) ventricular volumetry using semiautomatic three-dimensional (3D) threshold-based segmentation in repaired tetralogy of Fallot, and to compare them to those of two-dimensional (2D) magnetic resonance imaging (MRI). Materials and Methods: This retrospective study evaluated 32 patients with repaired tetralogy of Fallot who had undergone both cardiac CT and MRI within 3 years. For ventricular volumetry, semiautomatic 3D threshold-based segmentation was used in CT, while a manual simplified contouring 2D method was used in MRI. The indexed ventricular volumes were compared between CT and MRI. The indexed ventricular stroke volumes were compared with the indexed arterial stroke volumes measured using phase-contrast MRI. The mean differences and degrees of agreement in the indexed ventricular and stroke volumes were evaluated using Bland-Altman analysis. Results: The indexed end-systolic (ES) volumes showed no significant difference between CT and MRI (p > 0.05), while the indexed end-diastolic (ED) volumes were significantly larger on CT than on MRI (93.6 ± 17.5 mL/m² vs. 87.3 ± 15.5 mL/m² for the left ventricle [p < 0.001] and 177.2 ± 39.5 mL/m² vs. 161.7 ± 33.1 mL/m² for the right ventricle [p < 0.001], respectively). The mean differences between CT and MRI were smaller for the indexed ES volumes (2.0-2.5 mL/m²) than for the indexed ED volumes (6.3-15.5 mL/m²). CT overestimated the stroke volumes by 14-16%. With phase-contrast MRI as a reference, CT (7.2-14.3 mL/m²) showed greater mean differences in the indexed stroke volumes than did MRI (0.8-3.3 mL/m²; p < 0.005). Conclusion: Compared to 2D MRI, CT ventricular volumetry using semiautomatic 3D threshold-based segmentation provides comparable ES volumes, but overestimates the ED and stroke volumes in patients with repaired tetralogy of Fallot.

• Investigative Magnetic Resonance Imaging
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• v.26 no.1
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• pp.60-65
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• 2022

Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has been widely used to detect and characterize focal hepatic lesions. Because gadoxetic acid is a hepatocyte-specific contrast agent, its patterns during hepatobiliary phase enhancement provide useful information for differential diagnoses of focal hepatic lesions. Hepatic angiomyolipoma (AML) is a rare mesenchymal hepatic neoplasm composed of blood vessels, epithelioid cells, and varying amounts of adipose tissue components. Hepatic AMLs usually show marked hypointensity during the hepatobiliary phase of gadoxetic acid-enhanced MRI as hepatic AMLs are devoid of hepatocytes and fibrotic components. The present study describes a patient with hepatic AML and an atypical imaging feature. This tumor showed hyperintensity during the hepatobiliary phase of gadoxetic acid-enhanced MRI, mimicking hepatocellular tumors such as hepatocellular adenoma. The hepatobiliary hyperintensity of this lesion was likely due to multifocal entrapped hepatocytes resulting from an intrasinusoidal growth pattern of tumor cells and insufficient hepatic parenchymal enhancement during the hepatobiliary phase of gadoxetic acid-enhanced MRI.

• Journal of the Korean Magnetics Society
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• v.26 no.4
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• pp.142-148
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• 2016

To evaluate the effect of flip angle on flow rate measurements obtained with phase contrast MRI according to the flip angle degree in ascending aorta and velocity encoding (VENC) was (150 m/s). 1.5T MRI in patients 17 (female: 8, male: 9, mean age $57.9{\pm}15.4$) as a target by applying a non-breath holding techniques to flip angle VENC (150 cm/s) in each of the ascending aorta was measured by changing $20^{\circ}$, $30^{\circ}$ and $40^{\circ}$. Blood was obtained a peak velocity, average velocity, net forward volume, net forward volume/body surface area. Ascending aorta from average velocity (AV) measured the average value of the flip angle $20^{\circ}$ (9.87 cm/s), $30^{\circ}$ (9.6 cm/s) and $40^{\circ}$ (10.05 cm/s). Blood flow VENC in was blood flow change in flip angle change was high most blood flow measurement when the flip angle $30^{\circ}$ in VENC, crouching each blood flow is also proportional to the increases in the $20^{\circ}$ to $40^{\circ}$ and was increased, the deviation of the peak velocity and the average velocity is the smallest deviation from the flip angle $30^{\circ}$. Flip angle $20^{\circ}$, $30^{\circ}$ and $40^{\circ}$ in peak velocity, average velocity, net forward volume, net forward volume/body surface area was no statistically significant difference (p > .05). Blood flow velocity and blood flow is measured by applying to adjust the flip angle accurately calculate the blood flow is important information for diagnosis and treatment of cardiovascular diseases, and can help in the examination on the blood flow measurement.