• Investigative Magnetic Resonance Imaging
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• v.3 no.1
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• pp.66-72
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• 1999

Purpose : To evaluate the usefulness of Dual Echo in Steady State(DESS) image in the diagnosis of chondromalacia of the knee compared with turbo spin-echo MR images Materials and Methods : We included 26 patients with chondromalacia of the knee. MR imaging was obtained with a 1.5T imager. Sagittal and coronal double echo T2 weighted images(TR/TE 3000-4200/16-96msec, FOV $140-160{\times}140-160mm$, matrix size $180{\times}256$, slice thickness 4.0mm, interslice gap 0.5mm), and sagittal DESS image(TR/TE 25.4/9.0msec, flip angle $35-45^{\circ}$, FOV $150-160{\times}150-160mm,{\;}matrix{\;}size{\;}192{\times}256$, effective slice thickness 1.5mm) were obtained. Cartilage lesions were staged according to a modified scheme proposed by Outerbirdge: grade 0, normal; grade 1, softening or/and swelling; grade 2, mild surface fibrillation or/and less than 50% of cartilage thickness; grade 3, severe surface fibrillation or/and loss of more than 50% of cartilage thickness but without exposure of subchondral bone; and grade 4, complete loss of cartilage with subchondral bone exposure. Gradings were determined by two readers with consensus, and patellofemoral, medial and lateral tibiofemoral compartments were evaluated. Results : Arthroscopic findings revealed grade 1 in seven cases, grade 2 in 21 cases, grade 3 in six cases, and grade 4 in 18 cases. Sensitivity of turbo spin-echo MR image was as follows; 0%, 14%, 0%, 61% in each grade, and sensitivity of DESS image was as follows; 0%, 33%, 50%, 67%, in each grade(p=0.001). In the detection of chondromalacic lesions regardless of gradings, sensitivity, specificity and accuracy of conventional MR image were 59.6% 88.6% 78.8%, and of DESS image, 73.1% 88.4%, 82.2%(p=0.007). Conclusion : For chondromalacia of knee joints, DESS images showed higher sensitivity than turbo spin-echo MR images. Therefore, DESS images will be helpful for diagnosis of chondromalacia of knee joints.

• Journal of radiological science and technology
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• v.32 no.1
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• pp.95-99
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• 2009

The purpose of this research is to seek SPAIR's reversal time (TI) which satisfies two conditions ; maintaining the suppression ability of fat tissue and simultaneously minimizing the inhomogeneity of fat tissue in T2 high-speed spin echo 3.0T magnetic resonance image (MRI) of the brain, and to compare SPAIR with STIR which is fat-suppression technique. The reversal times (TI) of SPAIR protocol are set to 1/2, 1/3, 1/6 and 1/12 of SPAIR TR (420 msec), namely 210 msec (8 people), 140 msec (26 people), 70 msec (26 people) and 35 msec (18 people) and STIR TI is set with 250 msec (26 people). With these parameter sets, we acquired the axis direction 104 images of the brain. In ROI ($50\;mm^2$) of output image, signal intensities of the fatty tissue, the muscular tissue, and the background were measured and the CNRs of fatty tissue and the muscular tissue were calculated. The inhomogeneity of the fatty tissue is SD/mean, where SD is the standard deviation and 'mean' is a average fatty tissue signal. Consequently, SPAIR TI is determined on either 1/3 or 1/6 of TR (420 ms) ; 140 ms or 70 ms. Because the difference of statistics in fat-suppression ability and inhomogeneity of fatty tissue is very small (p < 0.001), Selecting 140 ms seems to be better choice for the image quality. Meanwhile, Comparing SPAIR (TI : 140 ms) with STIR, the fat-suppression is not able to be considered statistically (p < 0.252), but the image quality is able to be considered statistically (p < 0.01). In conclusion, SPAIR is better than STIR in the image quality.

• The KIPS Transactions:PartB
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• v.10B no.3
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• pp.339-346
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• 2003

In this paper, we propose a new method in which interpolation images are created by using a small number of axiai T2-weighted images instead of using many sectional images for 3D visualization of brain MR images. For image Interpolation, an important part of this process, we first segment a region of interest (ROI) that we wish to apply 3D reconstruction and extract the boundaries of segmented ROIs and MBR information. After the image size of interpolation layer is determined according to the changing rate of MBR size between top slice and bottom slice of segmented ROI, we find the corresponding pixels in segmented ROI images. Then we calculate a pixel's intensity of interpolation image by assigning to each pixel intensity weights detected by cube interpolation method. Finally, 3D reconstruction is accomplished by exploiting feature points and 3D voxels in the created interpolation images.

• Journal of the Korean Society of Radiology
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• v.12 no.5
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• pp.699-706
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• 2018

In this study, we measured signal intensities according to array coil position changes to provide reference data of coil directions and the distances as it deters image quality unless the coils are aligned properly. The multi-purpose MRI phantom was placed in body array coils, and it was moved to the top, bottom, left, and right directions by 2 cm from the center to 10 cm. After obtaining images, signal intensities were measured and compared. The results of this study were as follows: Except for the upward direction, the signal intensities of the reference signal was not significantly different from that of the reference signal intensity within 2cm in both T1 and T2-weighted images. In conclusion, in clinical circumstances which various challenges exist to align the coils exactly on the same lines, array coils should be positioned at least within 2 cm from the center except for the upward direction, on the same line to prevent the image qualities are lowered.

• Journal of Korean Neurosurgical Society
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• v.49 no.3
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• pp.178-181
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• 2011

Congenital anomalies in arches of the atlas are rare, and are usually discovered incidentally. However, a very rare subgroup of patients with unique radiographic features is predisposed to transient quadriparesis after minor cervical or head trauma, A 46-year-old male presented with a 2-month history of tremor and hyperesthesia of the lower extremities after experiencing a minor head trauma. He said that he had been quadriplegic for about 2 weeks after that trauma. Radiographs of his cervical spine revealed bilateral bony defects of the lateral aspects of the posterior arch of C1 and a midline cleft within the anterior arch of the atlas. A magnetic resonance imaging revealed an increased cord signal at the C2 level on the T2-weighted sagittal image. A posterior, suboccipital midline approach for excision of the remnant posterior tubercle was performed. The patient showed significant improvement of his motor and sensory functions. Since major neurologic deficits can be produced by a minor trauma, it is crucial to recognize this anomaly.

• Imaging Science in Dentistry
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• v.47 no.4
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• Investigative Magnetic Resonance Imaging
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• v.18 no.3
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• pp.193-199
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• 2014

Purpose : To evaluate the relationship between superior labral dimension of the glenohumeral joint on direct MRA and presence of SLAP lesion. Materials and Methods: IRB approval was obtained and informed consent was waived for this retrospective study. Direct MRA studies of the shoulder in 296 patients (300 shoulders) with arthroscopic surgery were analyzed by two radiologists blinded to the arthroscopic results, which were used as gold standard. One of the radiologists reviewed the images twice (session 1 and 2) for the evaluation of intra-observer variability. Transverse and longitudinal dimensions of superior labrum on coronal T1-weighted images were measured as base and height of the inverted triangular-shaped superior labrum and compared between patients with SLAP lesions vs. non-SLAP patients. Presence of meniscoid labrum was noted. Statistical analysis was done using unpaired t-test. Results: Among 279 patients (283 shoulders), 122 patients (43.1%) had SLAP lesions. The mean base/height of superior labrum in SLAP and non-SLAP patients measured on T1-weighted MR image were 8.8 mm / 5.2 mm, 8.5 mm / 4.9 mm for reader 1; 8.2 mm / 4.9 mm, 8.1 mm / 4.5 mm for session 1 of reader 2; 8.0 mm / 4.8 mm, 7.6 mm / 4.3 mm for session 2 of reader 2. In SLAP group, the mean labral height was larger than non-SLAP group with statistically significant difference (p<0.05). Fifteen patients (5.3%) had meniscoid labrum according to operation records. Conclusion: In patients with SLAP lesion, the height of the superior glenoid labrum on oblique coronal image of MRA was slightly larger than non-SLAP patients. A larger height of superior glenoid labrum may be associated with SLAP lesions.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.71-81
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• 2017

Purpose: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. Materials and Methods: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. Results: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). Conclusion: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.

• Progress in Medical Physics
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• v.12 no.2
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• pp.113-124
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• 2001

For veterinary imaging diagnosis, we obtained MR images of the canine brain, spine, kidney and pelvis from 3T MRI system which was equipped with the world first 3T active shield magnet. Spin echo (SE) and fast Spin Echo (FSE) images were obtained from the canine brain, spine, kidney and pelvis of normal and sick dogs using a homemade birdcage and transverse electromagnetic (TEM) resonators operating in quadrature and tuned to 128 MHz. In addition, we employed a homemade saddle shaped RF coil. Typical common acquisition parameters were as follows: matrix=512$\times$512, field of view (FOV)=20cm, slice thickness=3 w, number of excitations (NEX)=1. For T1-weighted MR images, we used TR=500 ms, TE=10 or 17.4 ms. For T2-weighted MR images, we used TR=4000 ms, TE=108 ms. Signal to noise ratio (SNR) of 3T system was measured 2.7 times greater than that of prevalent 1.57 system. The high resolution images acquired in this study represent more than a 4-fold increase in in-plane resolution relative to conventional images obtained with a 20 cm field of view and a 5 mm slice thickness. MR images obtained from 3T system revealed numerous small venous structures throughout the image plane and provided reasonable delineation between gray and white matter The present results demonstrate that the MR images from 3T system could provide better diagnostic quality of resolution and sensitivity than those of 1.5T system. The elevated SNR observed in the 3T high field magnetic resonance imaging can be utilized to acquire images with a level of resolution approaching the microscopic structural level under in vivo conditions. These images represent a significant advance in our ability to examine small anatomical features with noninvasive imaging methods. Moreover, MRI technique could begin to apply for veterinary medicine in Korea.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.98-107
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• 2006

Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.