• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2011.10a
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• pp.554-556
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• 2011

The occurrence of various vascular diseases due to the need for accurate and rapid diagnosis was emphasized. Several limitations to the presence of pulmonary vascular angiography for chest CT imaging was aware of the need for diversity in medical image processing with Insight Toolkit(ITK) suggested pulmonary vascular division. In this paper, by contrast, based on the value of a two-step partitioning of the lungs and blood vessels to perform the process of splitting. Lung area segmentation of each stage image enhancement, threshold value, resulting in areas of interest cut image acquisition and acquired pulmonary vascular division in lung area obtained by applying the fill area. Partitioned on the basis of pulmonary vascular imaging to obtain three-dimensional visualization image of the pulmonary vascular analysis and diagnosis of a variety of perspectives are considered possible.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.428-434
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• 2020

Background Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes. Methods A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction. Results Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with use of 3D model (CTA vs. 3D, 117.7±14.2 minutes vs. 109.8±11.6 minutes; P=0.001). In addition, there was no change in preoperative decision on type of flap harvested in all cases in 3D print group (0%), compared with 24.1% change in conventional CTA group. Conclusions Use of 3D print model improves accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.352-355
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• 2001

The authors report two cases of familial hemifacial spasm according to the clinical and three dimensional shortrange magnetic resonance angiography(3D-SRMRA) findings. In the family of the first case, there were five patient's with acquired hemifacial spasm in successive generations. Three male and two female patients in successive generations of the same family developed acquired hemifacial spasm. Four patients were on the left side and one was on the right side. In the family of the second case, there were three patient's with acquired hemifacial spasm in successive generations. Two brothers developed left-sided hemifacial spasm. 3D-SRMRA finding of the probands demonstrated that both anterior inferior cerebellar artery in first case and anterior inferior cerebellar artery & vertebral artery in second case offend the 7th cranial nerve respectively. The presence of familial clustering of these rare disorders suggest an underlying genetic predisposition. All family pedigrees suggest that a pattern of autosomal-dominant inheritance with partial penetrance.

• Investigative Magnetic Resonance Imaging
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• v.19 no.2
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• pp.76-87
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• 2015

Purpose: There is an ongoing search for a stent material that produces a reduced susceptibility artifact. This study evaluated the effect of manganese (Mn) content on the MRI susceptibility artifact of ferrous-manganese (Fe-Mn) alloys, and investigated the correlation between MRI findings and measurements of Fe-Mn microstructure on X-ray diffraction (XRD). Materials and Methods: Fe-Mn binary alloys were prepared with Mn contents varying from 10% to 35% by weight (i.e., 10%, 15%, 20%, 25%, 30%, and 35%; designated as Fe-10Mn, Fe-15Mn, Fe-20Mn, Fe-25Mn, Fe-30Mn, and Fe-35Mn, respectively), and their microstructure was evaluated using XRD. Three-dimensional spoiled gradient echo sequences of cylindrical specimens were obtained in parallel and perpendicular to the static magnetic field (B0). In addition, T1-weighted spin echo, T2-weighted fast spin echo, and $T2^*$weighted gradient echo images were obtained. The size of the low-intensity area on MRI was measured for each of the Fe-Mn binary alloys prepared. Results: Three phases of ${\alpha}^{\prime}$-martensite, ${\gamma}$-austenite, and ${\varepsilon}$-martensite were seen on XRD, and their composition changed from ${\alpha}^{\prime}$-martensite to ${\gamma}$-austenite and/or ${\varepsilon}$-martensite, with increasing Mn content. The Fe-10Mn and Fe-15Mn specimens comprised ${\alpha}^{\prime}$-martensite, the Fe-20Mn and Fe-25Mn specimens comprised ${\gamma}+{\varepsilon}$ phases, and the Fe-30Mn and Fe-35Mn specimens exhibited a single ${\gamma}$ phase. The size of the low-intensity areas of Fe-Mn on MRI decreased relative to its microstructure on XRD with increasing Mn content. Conclusion: Based on these findings, proper conditioning of the Mn content in Fe-Mn alloys will improve its visibility on MR angiography, and a Mn content of more than 25% is recommended to reduce the magnetic susceptibility artifacts on MRI. A reduced artifact of Fe-Mn alloys on MRI is closely related to the paramagnetic constitution of ${\gamma}$-austenite and/or ${\varepsilon}$-martensite.

• Journal of Korean Neurosurgical Society
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• v.45 no.1
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• pp.5-10
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• 2009

Objective : Direct surgical clipping of paraclinoid aneurysms poses technical challenges to even very experienced neurosurgeons, making endovascular treatment an alternative treatment modality in many centers. We have therefore retrospectively evaluated the safety and efficacy of endovascular detachable coil embolization of paraclinoid aneurysms. Methods : From June 1997 to June 2007, 65 patients underwent endovascular detachable coiling for 67 paraclinoid aneurysms (of which 9 were ruptured and 58 were unruptured) in our institute. Their medical records, radiological images and readings, and operation records were reviewed retrospectively. Results : After the initial embolization procedure, complete occlusion was achieved in 29 (43.3%) of the aneurysms treated by endovascular detachable coiling. Six aneurysms required retreatment, with two each requiring one, two, or three additional endovascular procedures. Fifty-five (82.1%) aneurysms were measured by three-dimensional time of flight (TOF) magnetic resonance images (MRI) or transfemoral cerebral angiography (TFCA) at a mean follow-up of 29.7 months (range from 4 to 94 months), with 39 aneurysms (70.9%) showing complete occlusion. Thromboembolic events (3.8%) were the most frequent complication. Rupture did not occur during or after any of the procedures. According to the Glasgow Outcome Scale (GOS), 98.4% of the patients treated by coil embolization had a score of 4 or 5. Conclusion : Our results indicate that endovascular detachable coiling is a safe and effective treatment modality in paraclinoid aneurysms.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.653-656
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• 2009

The entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities among young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomic relationships between vascular and musculo-tendinous structures in the popliteal fossa. An 18-year-old male visited our outpatient clinic with the chief complaint of claudication in his right calf. Three dimensional CT angiography showed an occlusion of the popliteal artery and less opacified arteries of the right leg. Intraoperatively, the popliteal artery was compressed by an accessory muscle band arising from the medial head of the gastrocnemius. After release of the muscle band, thrombectomy with endarterectomy was done. Three years after surgery, he is doing well without any problems.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.44-50
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• 2001

Objectives : The objective of this study was to investigate the role of postoperative three dimensional short-range magnetic resonance angiography(3D-TOF MRA) in predicting the clinical outcomes following microvascular decompression(MVD) for the treatment of a hemifacial spasm(HFS). Material and Method : Postoperative magnetic resonance(MR) imaging was performed on 123 patients with a HFS between March 1999 and May 2000. All patients who had postoperative MR imaging were undertaken preoperative MR imaging. Of the 123 patients, 122 patients were included in this retrospective study. The degree of the detachment of vascular contact, and change of the position of offender were determined by pre- and postoperative 3D-TOF MRA. These findings were compared with the surgical findings and clinical outcomes. Results : Of 122 patients who had successful MVD, clear decompression of offenders of the root entry zone(REZ) of facial nerve was found in 106 patients(86.9%), partial decompression in 10 patients(8.2%) and contact of offenders to the REZ of facial nerve in 6 patients(4.9%) by the postoperative 3D-TOF MRA. Our patients demonstrated that the types of offender did not influence with the degree of decompression of REZ of facial nerve and with surgical outcomes(p>0.05). Also, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement of symptoms(p>0.05). Futhermore, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement time (p>0.05). Conclusion : Our data suggests that MVD of facial nerve alone may not be sufficient to resolve the symptoms in all patients with hemifacial spasm. Therefore, another unknown factors besides vascular compression may be involved to cause symptoms in certain patients and it may be necessary to remove these factors with MVD simultaneously to obtain the resolution of symptom.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.813-819
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• 2018

To demonstrate the 3D usefulness of MDCT, a 73-year-old male patient with subclavian thrombosis was obtained 3D images of maximum intensity projection (MIP), volume rendering, and multiplanar reformation (MPR) to clearly detect and locate the subclavian artery. The data will be provided to the patient for diagnosis and treatment. The scan data were acquired as 3D CT images MIP, volume rendering, curved MPR, and virtual endoscopy images. In the 3D program, the ascending aorta was measured as 364.28 HU, the left carotid artery was 413.77 HU, and the left subclavian artery was 15.72 HU. MIP coronal image shows the closure of the subclavian artery in the left side. Three-dimensional volume images were obtained with 100% permeability and 87-1265 HU. The coronal curved MPR and sagittal curved MPR images show the closure of the subclavian artery due to thrombus using 3D image processing. In the case of subclavian arterial occlusion due to thrombosis, the patient is scanned with MDCT and 3D image processing can be used to confirm occlusion of subclavian artery.

• Journal of Cardiovascular Imaging
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• v.31 no.1
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• pp.18-23
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• 2023

BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.1
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• pp.1-10
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• 2024

Objective: Endovascular coil embolization is the primary treatment modality for intracranial aneurysms. However, its long-term durability remains of concern, with a considerable proportion of cases requiring aneurysm reopening and retreatment. Therefore, establishing optimal follow-up imaging protocols is necessary to ensure a durable occlusion. This study aimed to develop guidelines for follow-up imaging strategies after endovascular treatment of intracranial aneurysms. Methods: A committee comprising members of the Korean Neuroendovascular Society and other relevant societies was formed. A literature review and analyses of the major published guidelines were conducted to gather evidence. A panel of 40 experts convened to achieve a consensus on the recommendations using the modified Delphi method. Results: The panel members reached the following consensus: 1. Schedule the initial follow-up imaging within 3-6 months of treatment. 2. Noninvasive imaging modalities, such as three-dimensional time-of-flight magnetic resonance angiography (MRA) or contrast-enhanced MRA, are alternatives to digital subtraction angiography (DSA) during the first follow-up. 3. Schedule mid-term follow-up imaging at 1, 2, 4, and 6 years after the initial treatment. 4. If noninvasive imaging reveals unstable changes in the treated aneurysms, DSA should be considered. 5. Consider late-term follow-up imaging every 3-5 years for lifelong monitoring of patients with unstable changes or at high risk of recurrence. Conclusions: The guidelines aim to provide physicians with the information to make informed decisions and provide patients with high-quality care. However, owing to a lack of specific recommendations and scientific data, these guidelines are based on expert consensus and should be considered in conjunction with individual patient characteristics and circumstances.