• Proceedings of the KSMRM Conference
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• 2002.11a
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• pp.84-84
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• 2002

목적： 야간성 전두협 발작 (Nocturnal frontal lobe epilepsy NFLE)은 임상적으로 특징적인 야간성 운동성 발작으로 잘 알려져 있지만 일반적인 MR 영상에서는 대부분에서는 특이한 소견을 보이지 않아 확산 텐서 영상 (DTI)에서의 이상 소견 발현 유무를 알아보고자 한다. 대상 및 방법： 임상적 소견과, EEG 소견으로 진단된 NFLE 환자 6명을 대상으로 DTI 영상을 촬영하였다. 남자 2명, 여자 4명으로 평균연령은 32세 이었다. DTI영상은 single shot spin echo EPI 펄스 열을 사용하였고 사용한 영상 변수는 b value는 0, 1000 s/$\textrm{mm}^2$, TR 10000 msec, TE 71.8/72.3 msec, matrix 128$\times$128 (256 reconstruction), FOV 23cm, 5mm thickness, 2mm interstice gap, NEX 1. 19 slices, time은 4min 21sec (25방향) 이었다. 대조군으로 정상 성인 10명 (평균연령 31세)에서 동일한 방법으로 DTI 영상을 시행하여 분할 비등방도 (fractional anisotropy) 영상을 얻고 전두엽 백질에서 분할 비등방도 값을 측정하여 NFLE 환자군과 비교하였다.

• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.60-67
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• 2018

Background Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors. Methods We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. There were 44 operations (27 tumor resections, 17 biopsies). DTI was employed in 17 cases, neuro-navigation in 23 cases and IOM in 14 cases. All diagnoses were revised according to the 2016 World Health Organization Classification of Tumors of the Central Nervous System. Progression-free survival (PFS) and overall survival (OS) rates were calculated, and relevant prognostic factors were analyzed. The median follow-up duration was 19 months. Results Fifteen cases were gross total resections (GTR), 6 subtotal resections (STR), and 6 partial resections (PR). Neurological status did not worsen after 22 tumor resections. There were statistically significant differences in terms of the extent of resection between the groups with DTI, neuro-navigation and IOM (n=12, GTR or STR=12) and the group without at least one of the three techniques (n= 15, GTR or STR=9, p=0.020). The mean PFS was $87.2{\pm}38.0$ months, and the mean OS $90.7{\pm}36.1$ months. The 5-year PFS was 37%, and the 5-year OS 47%. The histological grade ($p{\leq}0.001$) and adjuvant therapy (done vs. not done, p=0.016) were significantly related to longer PFS. The histological grade (p=0.002) and the extent of removal (GTR/STR vs. PR/biopsy, p=0.047) were significantly related to longer OS. Conclusion Maximal surgical resection was achieved with acceptable morbidity in children with thalamic tumors by employing DTI, neuro-navigation and IOM. Maximal tumor resection was a relevant clinical factor affecting OS; therefore, it should be considered the initial therapeutic option for pediatric thalamic tumors.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.106-111
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• 2018

Transcranial magnetic stimulation (TMS) has been a gold standard for investigating central motor pathways in humans. Diffusion tensor imaging with fiber tractography (DTI FT) is known for its usefulness in detecting white matter lesion in vivo. We investigated the clinical usefulness of elucidating the integrity and continuity of corticospinal tract (CST) by combined use of TMS and DTI FT in this study. We report two cases who have presented with left hemiparesis and evaluated by both TMS and DTI FT; 10-year-old boy with Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episode syndrome and 20-year-old woman with traumatic brain injury. Combined use of TMS and DTI FT successfully led to localize the brain lesion that might cause motor impairment in patients with abnormal signal intensities in MRI. The results of this study suggest that TMS and DTI FT might provide the detailed information between function and anatomy of the CST, complementarily.

• Annual Conference of KIPS
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• 2013.05a
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• pp.747-750
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• 2013

알츠하이머병은 치매의 주요 원인 중 하나로 기억, 판단, 언어 등의 지적 기능의 감퇴뿐만 아니라 인격, 행동양상 장애 등을 동반하며 결국은 환자를 죽음에 이르게 하는 위험한 병이다. 본 연구는 뇌 백질의 비등방성을 잘 보여줄 수 있는 확산 텐서 영상 (diffusion tensor imaging; DTI) 데이터로 부터 신경섬유 경로를 생성하고, 알츠하이머병 환자와 정상인의 신경섬유 경로의 특징을 비교 분석 하였다. FSL 프로그램을 사용하여 생성한 신경섬유 경로에서 알츠하이머 환자와 정상인 집단간의 신경섬유 경로는 부피와 밝기에 커다란 차이를 보인다. 특히, 신경섬유 경로의 부피에서 현저한 차이가 있다는 점은 알츠하이머의 조기 진단에 유용하게 사용될 수 있다.

• Progress in Medical Physics
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• v.18 no.2
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• pp.65-72
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• 2007

An echo planar imaging (EPI)-based spin-echo sequence Is often used to obtain diffusion tensor imaging (DTI) data on most of the clinical MRI systems, However, this sequence is confounded with the susceptibility artifacts, especially on the temporal lobe in the human brain. Therefore, the objective of this study was to design a pulse sequence that relatively immunizes the susceptibility artifacts, but can map diffusion tensor components in a single-shot mode. A multi-slice multi-echo pulsed-gradient spin-echo (MePGSE) sequence with eight echoes wasdeveloped with selective refocusing pulses for all slices to map the full tensor. The first seven echoes in the train were diffusion-weighted allowing for the observation of diffusion in several different directions in a single experiment and the last echo was for crusher of the residual magnetization. All components of diffusion tensor were measured by a single shot experiment. The sequence was applied in diffusive phantoms. The preliminary experimental verification of the sequence was illustrated by measuring the apparent diffusion coefficient (ADC) for tap water and by measuring diffusion tensor components for watermelon. The ADC values in the series of the water phantom were reliable. The MePGSE sequence, therefore, may be useful in human brain studies.

• Journal of Biomedical Engineering Research
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• v.25 no.1
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• pp.43-47
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• 2004

Interests in human brain functionality and its connectivity have much frown up. DTI (Diffusion tensor imaging) has been known as a non-invasive MR) technique capable of providing information on water diffusion in tissues and the organization of white matter tract. Thus. It can provide us the information on the direction of brain fiber tract and the connectivity among many important cortical regions which can not be examined by other anatomical or functional MRI techniques. In this study. was used the 24 bit color coding scheme on the IDL platform in the windows environment to visualize the orientation of major fiber tracts of brain such as main association, projection, commissural fibers and corticospinal tracts. We additionally implemented a color coding scheme for each directional component and FA (fractional anisotropy), and used various color tables for them to be visualized more definitely. Consequently we implemented a fancy and basic technique to visualize the directional information of fiber tracts efficiently and we confirmed the feasibility of the 24 bit color coding scheme in DTI by visualizing main fiber tracts.

• Investigative Magnetic Resonance Imaging
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• v.17 no.2
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• pp.123-132
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• 2013

Purpose : We report the results of the various parameters of diffusion tensor imaging (DTI) and CSF flow study of the cervical spinal cord using magnetic resonance (MR) imaging techniques. Materials and Methods: Intramedullary FA and MD were measured in the gray matter and posterior cord of the white matter and both lateral cords of the white matter at the C2-3, C4-5, C5-6 spinal levels. For the CSF flow study, velocity encoding was obtained at the C2-3, C4-5, C5-6 spinal levels. Results: There was a significant difference of the FA and MD between the white matter and gray matter (p < 0.05). The FA of the gray matter was significantly different according to the cervical spinal cord levels (p < 0.05). Otherwise, the FA and MD parameters were not significantly different (p > 0.05). The mean peak systolic velocity and mean peak diastolic velocity were $5.18{\pm}2.00cm/sec$ and $-7.32{\pm}3.18cm/sec$, respectively from C2 to C6 spinal cords. There was no significant difference in these velocities among the cervical spinal cord (p > 0.05). Conclusion: This basic information about DTI and CSF dynamics of the cervical spinal cord may be useful for assessing cervical spinal cord abnormalities using MR imaging.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.49-53
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• 2003

확산텐서영상(Diffusion Tensor Imaging)의 개념은 1980년대 중반 확산강조영상(Diffusion Weighted Imaging)의 개념이 도입되면서 거의 동시에 도입되었지만 MR 장비의 기계적 한계등으로 인해 최근에야 임상적으로 사용되기 시작했다. 확산텐서영상(DTI)과 확산강조영상(DWI)의 방법론적인 차이점은 단순히 확산강조영상의 경우 세 개의 다른방향 (X-, Y-, Z-축)으로 확산측정용 경사자장을 가하는 반면 확산텐서영상의 경우 이보다 많은 방향 (최소한 6 방향)으로 확산측정용 경사자장을 가한다는 점이다. 이러한 차이로부터 금방 알 수 있는 점은 확산강조영상은 확산텐서영상의 일부라는 점이다. 즉, 확산텐서영상의 경우 더 많은 방향으로 확산측정용 경사자장을 가했으므로 더 많은 정보를 획득할 수 있고 이중 세 개의 방향 (주로 X,Y,Z)에 대한 정보만을 이용하게 되면 확산강조영상이다. 이러한 이유로 확산텐서영상을 획득하면 확산강조영상에서 얻게 되는 방향별 확산강조영상, 등방성(isotropic) 확산강조영상, ADC (Apparent Diffusion Coefficient) map등도 기본적으로 얻게 되므로 추가로 확산강조영상을 획득할 필요가 없다. 본 강의에서는 이러한 확산(텐서)영상의 물리적 원리를 복잡한 수학적 설명보다는 개념 위주로 설명해 보고자 한다.

• Journal of radiological science and technology
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• v.43 no.6
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• pp.475-480
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• 2020

The purpose of this study was to reconstruct diffusion tensor tractography (DTT) using stem of garlic and asparagus for in vitro phantom of diffusion tensor imaging (DTI), and to compare and evaluate the fractional anisotropy (FA) value and the apparent diffusion coefficient (ADC) value to determine whether it can be used as materials for in vitro phantoms. Among various plant fibers such as stem of garlic, palmae, cotton, asparagus, etc., stem of garlic and asparagus, which are considered to be the most suitable for making phantoms, and whose shape is considered to be the most suitable for making phantoms, were selected and tests were conducted. Holes were made in a plastic bucket at an angle of 0°, 30°, 60°, 90°, and 120°, then tubes were inserted. In the tube, asparagus and stem of garlic were inserted as far in as possible, and the inserted tube was inserted into the center of the heat bathed gelatin to harden. We were able to reproduce DTT images in asparagus and stem of garlic. Fiber tissues of asparagus and stem of garlic did not show complete connectivity, but the reconstructed images of DTT showed good connectivity. The FA values of asparagus in the tubes were 0.198 at 0° (straight), 0.207 at 30°, 0.187 at 60°, 0.231 at 90°, and 0.204 at 120°. In addition, the FA values of stem of garlic in the tubes were 0.235 at 0°, 0.236 at 30°, 0.216 at 60°, 0.218 at 90°, and 0.257 at 120°. The ADC values of asparagus in the tubes were 1.545 at 0°, 1.677 at 30°, 1.629 at 60°, 1.535 at 90°, and 1.725 at 120°. In addition, the ADC values of stem of garlic in the tubes were 1.252 at 0°, 1.396 at 30°, 1.698 at 60°, 1.756 at 90°, and 1.466 at 120°. For the best expressed DTT reconstruction image, it showed the longest connectivity in the straight line as we hypothesized. In addition, when comparing the FA values and ADC values of fiber tissues of stem of garlic and asparagus, FA value was generally higher in stem of garlic and ADC value was slightly higher in asparagus.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.35-35
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• 2006