• 한국임상수의학회지
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• 제31권4호
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• pp.337-340
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• 2014

An 11-year-old male Maltese dog was presented with sudden onset of convulsion and right sided circling. On neurological examination, left side proprioception and menace reflexes were delayed. Blood examinations indicated severe thrombocytopenia and increased hepatic enzymes. On brain magnetic resonance imaging, lesions were founded on the left lateral subarachnoid space area. Those lesions showed hyperintense on T1-weighted images, hyperintense on T2-weighted images and hyperintense on fluid attenuated inversion recovery images. Cerebrospinal fluid analysis revealed xanthochromia and erythrophagocytosis. Coagulation test results demonstrated that fibrin degradation product and D-dimer concentrations were higher than normal range. The patient expired few hours after presentation. This case report demonstrates intracranial hemorrhage with disseminated intravascular coagulation in a dog.

• Investigative Magnetic Resonance Imaging
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• 제3권2호
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• pp.167-172
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• 1999

목적 : Echo planar image (EPn와 다론 MR 영상기법에서 2시간 이내의 초급성 출혈의 발견율의 차이를 비교해 보고자 한다. 대상 및 방법 : 인위적으로 뇌출혈을 유발시킨 백서 10마리를 대상으로 EP1, 급속 스핀에코 (FSE) T2 강조영상, Fluid attenuated inversion recovery (FLAIR) 영상, 스펀에코 (SE) Tl 강조영상과 Tl 강조 Gradient echo (GE) 영상을 이용하여, 뇌출혈을 일으킨 2시간 후에 MR 촬영을 하였다. 추가적으로 3마리는 출혈 30분 후에, 6마리는 1시간 후에 각각 EPI와 FSE T2 강조영상을 얻었다. 얻어진 영상에 대한 주관적인 시각적 평가를 하기위하여 세명의 방사선과 의사가 출혈 병변이 어느 MR 영상 기법에서 제일 잘 보이는지를 평가하였다. 정량적인 평가 로는 병변-정상 뇌설질의 대조잡음비(contrast-to-noise ratio, CNR)를 측정하였다. 통계처리는 Wilcoxon-Ranks test를 이용하였다. 결과 : 시각적 평가에서 출혈 병변이 높은 신호강도로 나타난 EP1, FLAIR, FSE T2 영상 중 EPI 영상이 특히 높은 신호강도로 나타나 제일 쉽게 병변이 구별되었다. 정량적인 평가에서 출혈 병 변-정상 뇌설질의 CNR은 EPI와 FLAIR 영상에서 다른 세 영상기법에 비해 통계적으로 유의하게 우월하였다 (p<0.01). 그러나 EPI와 FLAIR 영상간의 CNR은 동계적으로 유의한 차이가 없었다 (p>0.10). 추가적으로 출혈 30분과 1l시간 후 촬영한 모두에서 EPI영상과 FSE T2 강조 영상은 정상에 비해 높은 신호강도를 보여 병변의 구별이 가능하였다. 결론 : 백서에서 유발시킨 초급성기 뇌출혈의 여러 기법의 MR 영상 중 EPI 영상이 영상획득 시간이 가장 빠르면서 시각적 평가와 정량적 평가에서 출혈의 발견율이 가장 높아 출혈의 선속한 진단에 유용할 것으로 생각된다.

• 한국의학물리학회지:의학물리
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• 제21권4호
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• pp.348-353
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• 2010

임상적용 전 단계에서 마우스와 같은 작은 설치류를 이용한 신경학적 실험의 필요성이 높아지면서 임상용 3T MRI를 이용한 마우스 뇌 영상의 요구가 높아지고 있다. 본 연구에서는 임상용 3T MRI를 이용한 마우스 뇌 영상의 가능성과 기술적인 적용과 최적화에 대해 알아보고자 하였다. 20~25g 체중 마우스 3마리에서 임상용 3T MRI를 이용하여 T1 강조영상(T1WI), T2 강조영상(T2WI), FLAIR (Fluid Attenuated Inversion Recovery) 영상, 가돌리늄 조영 T1 강조영상(Gd-T1WI), 확산 강조영상(DWI)을 시행하였다. 대상이 되었던 마우스 1마리는 뇌 경색을 유발시키지 않았으며 2마리는 우측 중대뇌동맥을 결찰하여 일측 뇌경색을 유발하고 1시간, 24시간, 72시간에 각각의 MRI 영상을 시행하였으며 각 영상에서 마우스 뇌의 striatum, 뇌실, 대뇌 피질의 해부학적 구별, 뇌 경색 부위의 진단 가능성 등을 분석하였다. T2WI에서 마우스 뇌의 striatum, 뇌실, 대뇌 피질의 해부학적 구별이 모두 가능하였고 T1WI, FLAIR, DWI 영상에서는 위의 해부학적 경계부위의 해상도는 감소하였다. 뇌경색 부위는 경색 후 1시간, 24시간, 72시간 영상 모두에서 발견되었고 T2WI, FLAIR에서는 24시간, 72시간에서만 구분되었다. 임상용 3T MRI를 이용한 마우스 뇌 영상에서 해부학적 부위의 구별이 가능하였고 특히 DWI를 이용하여 급성기 뇌 경색의 진단이 가능하였다. 앞으로 기술적인 적용과 최적화를 위한 노력이 계속 진행된다면 임상 실험에 큰 도움을 줄 수 있을 것이라 생각된다.

• 한국임상수의학회지
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• 제34권5호
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• pp.377-380
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• 2017

An 8-year-old, shih-tzu female dog was referred due to neurological signs including paraparesis and back pain. On the complete blood count, hematologic analysis showed elevated leukocytosis. Serum biochemical analysis revealed elevated serum alkaline phosphatase concentration and C-reactive protein concentration. On the neurologic exam, the dog was suspected to have thoracolumbar myelopathy. On magnetic resonance imaging, there were masses within the spinal canal at L1-3 intervertebral disc space that were located dorsal to spinal cord. It was hyperintense on T1-, T2-weighted magnetic resonance images, Fluid-attenuated inversion recovery, and fat suppression images. The contrast-enhanced T1-weighted images showed no enhancement. The lesions were well circumscribed. The spinal cord was compressed and displaced ventrally by the mass. After removal of the masses via L1-L3 dorsal laminectomy, pyogranulomatous inflammation was confirmed by histopathological examination. Six months after surgery, the dog recovered uneventfully and remained fully ambulatory with no neurological deficits. This case demonstrates the utility of magnetic resonance imaging for the diagnosis of spinal canal pyogranulomatous inflammation.

• 대한임상독성학회지
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• 제4권2호
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• pp.131-136
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• 2006

Metronidazole is an antimicrobial drug widely used against various types of infectious agents, including protozoa, amoeba, Helicobacter pylori, and anaerobes. Metronidazole may produce some adverse effects on hematologic, immunologic, neurologic and other systems. We report a case of reversible metronidazole-induced encephalopathy. The toxic dose of metronidazole and the onset of encephalopathy were variable. Two patients showed abnormally high signal intensity in the bilateral dentate nucleus of cerebellum, and characteristic abnormalities were detected by brain magnetic resonance imaging (MRI) and T2-weighted images, fluid-attenuated inversion recovery images and/or diffusion weighted imaging (DWI). Discontinuation of metronidazole resulted in the improvement of the neurologic symptoms over a period of two to three weeks. We followed up the brain MRI with DWI in one case following obvious clinical improvement, and the previously detected lesion had disappeared.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.161-164
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• 2009

Plasma cell granuloma is a tumor-like disease characterized by non-neoplastic polyclonal proliferation of plasma cells and other mononuclear cells. This disease occurs most frequently in the lung and upper respiratory tract, while the involvement of the central nervous system is very rare. A 44-year-old female patient presented with nausea and progressive visual disturbance. Brain magnetic resonance imaging (MRI) revealed the mass along the right tentorium with low signal intensity in the T2 weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR) sequence, and an isosignal intensity in T1 weighted image (T1WI), the latter of which was enhanced after administration of gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA). The thickest portion of the tentorium was partially excised via the combined suboccipital and infratentorial approach. The histopathological examination indicated a diagnosis of plasma cell granuloma. Postoperative steroid therapy was administered for remnant tumor control. Although a follow up MRI scan taken 20 months after the operation showed a slight decrease in tumor size, the lesion had extended to the falx and left frontal convexity along with parenchymal edema at 32 months after the operation and the clinical status was aggravated. The mass was removed from the left frontal convexity. Radiation therapy was given, together with steroid administration.

• Investigative Magnetic Resonance Imaging
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• 제22권2호
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• pp.86-93
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• 2018

Purpose: Imaging plays a significant role in diagnosing leptomeningeal metastases. However, the most appropriate sequence for the detection of leptomeningeal metastases has yet to be determined. This study compares the efficacies of contrast-enhanced T2 fluid attenuated inversion recovery (FLAIR) and contrast-enhanced 3D T1 black-blood fast spin echo (FSE) imaging for the detection of leptomeningeal metastases. Materials and Methods: Tube phantoms containing varying concentrations of gadobutrol solution were scanned using T2 FLAIR and 3D T1 black-blood FSE. Additionally, 30 patients with leptomeningeal metastases were retrospectively evaluated to compare conspicuous lesions and the extent of leptomeningeal metastases detected by T2 FLAIR and 3D T1 black-blood FSE. Results: The signal intensities of low-concentration gadobutrol solutions (< 0.5 mmol/L) on T2 FLAIR images were higher than in 3D T1 black-blood FSE. The T2 FLAIR sequences exhibited significantly greater visual conspicuity scores than the 3D T1 black-blood sequence in leptomeningeal metastases of the pial membrane of cistern (P = 0.014). T2 FLAIR images exhibited a greater or equal extent (96.7%) of leptomeningeal metastases than 3D T1 black-blood FSE images. Conclusion: Because of its high sensitivity even at low gadolinium concentrations, contrast-enhanced T2 FLAIR images delineated leptomeningeal metastases in a wider territory than 3D T1 black-blood FSE.

• Journal of Medicine and Life Science
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• 제15권2호
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• pp.89-94
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• 2018

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds(CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

• Investigative Magnetic Resonance Imaging
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• 제25권2호
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• pp.81-92
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• 2021

The role of neuroimaging in patients with acute ischemic stroke has been gradually increasing. The ultimate goal of stroke imaging is to make a streamlined imaging workflow for safe and efficient treatment based on optimized patient selection. In the era of multimodal comprehensive imaging in strokes, imaging based on computed tomography (CT) has been preferred for use in acute ischemic stroke, because, despite the unique strengths of magnetic resonance imaging (MRI), MRI has a longer scan duration than does CT-based imaging. However, recent improvements, such as multicoil technology and novel MRI acceleration techniques, including parallel imaging, simultaneous multi-section imaging, and compressed sensing, highlight the potential of comprehensive MR-based imaging for strokes. In this review, we discuss the role of stroke imaging in acute ischemic stroke management, as well as the strengths and limitations of MR-based imaging. Given these concepts, we review the current MR acceleration techniques that could be applied to stroke imaging and provide an overview of the previous research on each essential sequence: diffusion-weighted imaging, gradient-echo, fluid-attenuated inversion recovery, contrast-enhanced MR angiography, and MR perfusion imaging.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.442-450
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• 2024

Objective : Cerebral hyperperfusion syndrome (CHS) manifests as a collection of symptoms brought on by heightened focal cerebral blood flow (CBF), afflicting nearly 30% of patients who have undergone superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. The aim of this study was to investigate whether the amalgamation of magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) and apparent diffusion coefficient (ADC) imaging via MRI can discern cerebral hyperemia after STA-MCA anastomosis surgery. Methods : A retrospective study was performed of patients who underwent STA-MCA anastomosis due to Moyamoya disease or atherosclerotic steno-occlusive disease. A protocol aimed at preventing CHS was instituted, leveraging the use of MRI FLAIR. Patients underwent MRI diffusion with FLAIR imaging 24 hours after STA-MCA anastomosis. A high signal on FLAIR images signified the presence of hyperemia at the bypass site, triggering a protocol of hyperemia care. All patients underwent hemodynamic evaluations, including perfusion MRI, single-photon emission computed tomography (SPECT), and digital subtraction angiography, both before and after the surgery. If a high signal intensity is observed on MRI FLAIR within 24 hours of the surgery, a repeat MRI is performed to confirm the presence of hyperemia. Patients with confirmed hyperemia are managed according to a protocol aimed at preventing further progression. Results : Out of a total of 162 patients, 24 individuals (comprising 16 women and 8 men) exhibited hyperemia on their MRI FLAIR scans following the procedure. SPECT was conducted on 23 patients, and 11 of them yielded positive results. All 24 patients underwent perfusion MRI, but nine of them showed no significant findings. Among the patients, 10 displayed elevations in both CBF and cerebral blood volume (CBV), three only showed elevation in CBF, and two only showed elevation in CBV. Follow-up MRI FLAIR scans conducted 6 months later on these patients revealed complete normalization of the previously observed high signal intensity, with no evidence of ischemic injury. Conclusion : The study determined that the use of MRI FLAIR and ADC mapping is a competent means of early detection of hyperemia after STA-MCA anastomosis surgery. The protocol established can be adopted by other neurosurgical institutions to enhance patient outcomes and mitigate the hazard of permanent cerebral injury caused by cerebral hyperemia.