• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.188-201
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• 2020

Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

• Journal of Biomedical Engineering Research
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• v.33 no.2
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• pp.72-77
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• 2012

Phase Contrast MR Angiography(PC MRA) is excellent MRA technique for measuring the velocity of vessels in the human body. PC MRA need to at least four images for angiogram reconstruction and it caused longer scan time. Therefore, we used keyhole imaging combined PC MRA to reduce the scan time. However, keyhole imaging can lead the erroneous effects as loss of phase information or frequency discontinuous. In this study, we applied the keyhole imaging combined 2D PC MRA for improving the temporal resolution and also measured the velocity to evaluate the accuracy of phase information. We used 0.32T MRI scanner(Magfinder II, Scimedix, Korea). Using the 2D PC MRA pulse sequence, the vascular images for a human brain targeted on the Superior Sagittal Sinus(SSS) were obtained. We applied tukey window function for keyhole images to minimize the ringing artifact and erroneous factors that are induced frequency discontinuous and phase information loss. We also applied zero-padded algorithm to peripheral missing k-space lines to compare keyhole imaging results and the artifact power(AP) value was measured on the complex difference images to validate the image quality. Consider as based on our results, heavy image distortions and artifacts were shown until using at least 50% keyhole factor. Using above the 50% keyhole factors are shown well reconstructed and matched for magnitude images and velocity information measurements. In conclusion, we confirmed the image quality and velocity information of keyhole technique combined 2D PC MRA. Especially, measured velocity information through the keyhole imaging combination was similar to the velocity information of full sampled k-space image despite of frequency discontinuous and phase information loss in the keyhole imaging reconstruction process. Consequently, the keyhole imaging combined 2D PC MRA will give some clinical usefulness and advantages as improving the temporal resolution and measuring the velocity information via selecting the appropriate keyhole factor at low tesla MRI system.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.161-170
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• 2009

Purpose : A parallel imaging method provides us to improve temporal resolution to obtain three-dimensional (3D) MR images. The objective of this study was to optimize three 3D MRI techniques by adjusting 2D SESNE factors of the parallel imaging method in phantom and human brain. Materials and Methods : With a 3 Tesla MRI system and an 8-channel phase-array sensitivity-encoding (SENSE) coil, three 3D MRI techniques of 3D T1-weighted imaging (3D T1WI), 3D T2-weighted imaging (3D T2WI) and 3D fluid attenuated inversion recovery (3D FLAIR) imaging were optimized with adjusting SESNE factors in a water phantom and three human brains. The 2D SENSE factor was applied on the phase-encoding and the slice-encoding directions. Signal-to-noise ratio(SNR), percent signal reduction rate(%R), and contrast-to-noise ratio(CNR) were calculated by using signal intensities obtained in specific regions-of-interest (ROI). Results : In the phantom study, SENSE factor = 3 was provided in 0.2% reduction of signals against without using SENSE with imaging within 5 minutes for 3D T1WI. SENSE factor = 2 was provided in 0.98% signal reduction against without using SENSE with imaging within 5 minutes for 3D T2WI. SENSE factor = 4 was provided in 0.2% signal reduction against without using SENSE with imaging around 6 minutes for 3D FLAIR. In the human brain study, SNR and CNR were higher with SENSE factors = 3 than 4 for all three imaging techniques. Conclusion : This study was performed to optimize 2D SENSE factors in the three 3D MRI techniques that can be scanned in clinical time limitations with minimizing SNR reductions. Without compromising SNR and CNR, the optimum 2D SENSE factors were 3 and 4, yielding the scan time of about 5 to 6 minutes. Further studies are necessary to optimize 3D MRI techniques in other areas in human body.

• Korean Journal of Radiology
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• v.25 no.1
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• pp.24-32
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• 2024

Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.21-27
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• 2002

Background : Spatial analysis of EEG is a phenomenal assessment and not so informative for phase space and dynamic aspect of EEG data. In contrast, nonlinear EEG analysis attempts to characterize the dynamics of neural networks in the brain. We have analyzed the features of EEG nonlinearly in subjects with white matter change on brain MRI and compared the results with cognitive function in each. Methods : Digital EEG data were taken for 30 seconds in 9 subjects with white matter degeneration and in 5 healthy normal controls without white matter change on MRI. Then we analyzed them nonlinearly to calculate the correlation dimension(D2) using the MATLAB software. The cognitive function was assessed by 3MS(modified mini-mental state examination). The severity of white matter change was assessed by Scheltens scale. Results : The mean D2 value of normal control was greater than that of white matter degeneration group. The D2s of some channels were correlative with 3MS and degree of white matter degeneration significantly. Conclusions : nonlinear analysis of EEG can be used as one of adjuvant functional studies for prediction of cognitive impairment in subjects with white matter degeneration and subcortical white matter change can be influential on cognitive function and correlation dimension of EEG.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.14 no.12
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• pp.4816-4834
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• 2020

This paper proposes transfer learning and fine-tuning techniques for a deep learning model to detect three distinct brain tumors from Magnetic Resonance Imaging (MRI) scans. In this work, the recent YOLOv4 model trained using a collection of 3064 T1-weighted Contrast-Enhanced (CE)-MRI scans that were pre-processed and labeled for the task. This work trained with the partial 29-layer YOLOv4-Tiny and fine-tuned to work optimally and run efficiently in most platforms with reliable performance. With the help of transfer learning, the model had initial leverage to train faster with pre-trained weights from the COCO dataset, generating a robust set of features required for brain tumor detection. The results yielded the highest mean average precision of 93.14%, a 90.34% precision, 88.58% recall, and 89.45% F1-Score outperforming other previous versions of the YOLO detection models and other studies that used bounding box detections for the same task like Faster R-CNN. As concluded, the YOLOv4-Tiny can work efficiently to detect brain tumors automatically at a rapid phase with the help of proper fine-tuning and transfer learning. This work contributes mainly to assist medical experts in the diagnostic process of brain tumors.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4704-4710
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• 2015

The purpose of this study is to obtain a useful diagnostic image by increasing the signal strength of the peripheral artery, was to use a T1 shortening effect of gadolinium contrast agents to improve the disadvantages of the phase image. From october to december 2014 thirty patients were underwent the MRI scanning, except for heart disease. Research method was evaluated comparing the image after gadolinium contrast MR image acquisition step before evaluating the difference between the signal intensity for T1 shortening effect. In frontal lobe 19.45%, temporal lobe 23.09%, occipital lobe 25.45%, parietal lobe 18.82%, cerebellum 20.93% after peripheral arterial signal strength results of gadolinium contrast agent injection was increased significantly after injection of gadolinium both statistically significant. After injecting a contrast agent gadolinium in SWI by increasing the signal strength of the T1 shortening effect can be obtained when using the phase image to give a useful image in diagnosis and treatment.

• Investigative Magnetic Resonance Imaging
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• v.8 no.1
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• pp.17-23
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• 2004

Purpose : To evaluate changes in total cerebral blood flow (tCBF) with aging, parenchymal volume changes and vascular abnormalities, using 2 dimensional (D) phase-contrast magnetic resonance imaging (PC MRI). Materials and Methods : Routine brain MRI including T2 weighted image, time-of-flight (TOF) MR Angiography (MRA) and 2D PC MRI were performed in 73 individuals, including 12 volunteers. Normal subjects (12 volunteers, and 21 individuals with normal MRI and normal MRA) were classified into groups according to age (18-29, 30-49 and 50-66 years). For the group with abnormalities in brain MRIs, cerebral parenchymal volume changes were scored according to the T2 weighted images, and atherosclerotic changes were scored according to the MRA findings. Abnormal groups were classified into 4 groups: (i) mild reduction in volume, (ii) marked reduction in volume by parenchymal volume and atherosclerotic changes, and (iii) increased volume and (iv) Moya-moya disease. Volumetric flow was measured at the internal carotid artery (ICA) and vertebral artery bilaterally using the velocity-flow diagrams from PC MRI, and combined 4 vessel flows and tCBF were compared among all the groups. Results : The age-specific distribution of tCBFs in normal subjects were as follows: $12.0{\pm}2.1ml/sec$ in 18-29 years group, $11.8{\pm}1.9ml/sec$ in 30-49 years group, $10.9{\pm}2.2ml/sec$ in 50-66 years group. The distribution of tCBFs in the different subsets of the abnormal population were as follows: $9.5{\pm}2.5ml/sec$ in the group with mild reduction in volume, $7.6{\pm}2.0ml/sec$ in the group with marked reduction in volume, and $7.3{\pm}1.2ml/sec$ and $7.0{\pm}1.1ml/sec$ in the increased parenchymal volume and Moya-moya disease groups respectively. Conclusion : Total cerebral blood flow decreases with increasing age with a concomitant reduction in parenchymal volumes and increasing atherosclerotic changes. It is also reduced in the presence of increased parenchymal volume and Moya-moya disease.2D PC MRI can be used as a tool to evaluate tCBF with aging and in the presence of various conditions that can affect parenchymal volume and cerebral vasculature.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.43-51
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• 2005

Background: To examine the ultrasonographic and magnetic resonance (MRI) imaging findings of a cervical mass type cervical pregnancy. Materials and Methods: The ultrasonographic and MRI findings of 5 patients pathologically confirmed as having a cervical pregnancy were analyzed retrospectively. On ultrasonography, the size and echo pattern of the uterine cervix, the shape and echo pattern of the lesion, the degree and the pattern of blood flow on the color Doppler study and the spectral Doppler pattern were analyzed. The shape, signal intensity, and degree and pattern of enhancement of the lesion were evaluated on MRI. Results: The uterine cervix was enlarged and the size of the lesion was 6.1 to 7.1 (average, 6.5) cm. The endocervical canal was irregularly dilated and showed heterogeneous echogenicity in all 5 cases. Four of the 5 lesions were heterogeneously hyper- or mixed echoic and remaining one was relatively homogeneous echogenic. Doppler ultrasonography revealed an increased vascularity of the peritrophoblastic flow pattern. In all 4 cases where MRI performed, the lesion was irregular in shape and the margin was not sharply demarcated. The T2-weighed image showed that the lesions were mixed signal intensity. Three of the 4 lesions contained high signal intensity nodular portions and a low signal intensity rim was observed along the margin of the nodular portions. The T1-weighted image revealed multiple signal voids along the periphery of the lesions and high signal intensity portions as a result of hemorrhage were noted. The dynamic enhanced study showed that the high signal intensity portions on the T2-weighted image were strongly enhanced similar to the vessels on the early phase and the contrast enhancement gradually decreased with time. Conclusion: A cervical mass type cervical pregnancy can be correctly diagnosed using the patient's clinical symptom, the elevation in the serum ${\beta}$-HCG level, and characteristic ultrasonographic and MRI findings.

• 한국가시화정보학회:학술대회논문집
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• 2003.11a
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• pp.83-86
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• 2003

Synchrotron X-ray micro imaging technique was employed to non-invasively monitor the water flow inside xylem vessels in a bamboo leaf. The phase contrast X-ray images clearly visualized plant anatomy and the rise of a water front inside the vessels. Consecutive X-ray images taken for 60 seconds revealed water rise kinetics against gravity in the xylem of a cut dry leaf taken from a bamboo tree. For the first time, traces of water rise, variation of contact angle between water and xylem wall as well as the internal structure of xylem were obtained. In xylem vessels, a repeating flow pattern has a typical flow velocity of $30.7{\mu}m/s$ and faster flow is established intermittently. It is concluded that the transmission type of X-ray micro imaging can be used as a powerful tool to investigate the ascent of sap in the xylem vessels at a resolution higher than that of MRI.