Su Young Yun;Hye Jung Choo;Hae Woong Jeong;Sun Joo Lee
Journal of the Korean Society of Radiology
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v.83
no.5
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pp.1071-1080
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2022
Purpose To compare the MR findings of septic and acute gouty arthritis of the knee joint. Materials and Methods This retrospective study included patients who underwent knee MRI for septic or gouty arthritis at our hospital between October 2012 and October 2018. The MR findings were analyzed for the presence of bone marrow edema, soft tissue edema, abscess, pattern of synovial thickening (frondlike, lamellated, diffuse linear), maximum thickness of the synovium, and joint effusion volume. The gouty (n = 5) and septic arthritis (n = 10) groups were compared using the Wilcoxon rank-sum test and Fisher's exact test. Results No statistically significant differences were observed for each item. One patient in the gouty arthritis group and seven in the septic arthritis group had bone marrow edema. Soft tissue abscess formation was only observed in the septic group. The incidence of each synovial thickening pattern was as follows: 100% (diffuse linear) in the gouty arthritis group and 20% (frondlike), 50% (lamellated), and 30% (diffuse linear) in the septic arthritis group. Conclusion Differentiation of gouty arthritis and septic arthritis based on imaging findings is difficult. However, lamellated synovial thickening patterns, bone marrow edema, and soft tissue abscess formation are more commonly observed in patients with septic arthritis than in those with gouty arthritis.
Ji Young Lee;Ji Eun Park;Mi Sun Chung;Se Won Oh;Won-Jin Moon;Aging and Neurodegeneration Imaging (ANDI) Study Group, Korean Society of Neuroradiology (KSNR)
Journal of the Korean Society of Radiology
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v.82
no.5
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pp.1124-1139
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2021
The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.
Purpose To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability. Materials and Methods We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann-Whitney and Fisher's exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression. Results We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31-84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression. Conclusion Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.
For identifying the pathological findings in magnetic resonance images (MRIs), normal anatomical structures in MRIs should be identified in advance. For studying the anatomical structures in MRIs, a learning tool that includes the followings is necessary. First, MRIs of the entire body; second, horizontal, coronal, and sagittal MRIs; third, segmented images corresponding to the MRIs; fourth, three dimensional (3D) images of the anatomical structures in the MRIs; fifth, software incorporating the MRIs, segmented images, and 3D images. Such a learning tool, however, is hard to obtain. Therefore, in this research, such a learning tool which helps medical students and doctors study the normal anatomical structures in MRIs was made as follows. A healthy young Korean male adult with standard body shape was selected. Six hundred thirteen MRIs of the entire body were scanned (slice thickness 3 mm, interslice gap 0 mm, field of view 480 mm${\times}$480 mm, resolution 512${\times}$512, T1 weighted), and transferred to the personal computer. Sixty anatomical structures in the MRIs were segmented to make segmented images. Coronal, sagittal MRIs and coronal, sagittal segmented images were made. On the basis of the segmented images, forty-seven anatomical structures 3D images were made by manual surface reconstruction method. Software incorporating the MRIs, segmented images, and 3D images was composed. This learning tool that includes horizontal, coronal, sagittal MRIs of the entire body, corresponding segmented images, 3D images of the anatomical structures in the MRIs, and software is expected to help medical students and doctors study the normal anatomical structures in MRIs. This learning tool will be presented worldwide through Internet or CD titles.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.11
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pp.5299-5304
/
2012
MRI signals are significantly reduced by the magnetic field inhomogenity result from human body itself being consisted of various materials like air, fat, muscle, bone and blood vessels. In this study we used silicon which is tissue equivalent to compensate wound body shapes. Objects were eight adults who do not have any special symptoms. Feet were scanned because of their complicated structures and consequently signal reduction occurs a lot. Thirty images were acquired from the middle of arcus pedis longitudinalis including five distal phalanges parallel to the line connecting metatarsal bone and phalanges. SNR data from bones and soft tissues were compared before and after sticking silion between toes and paired t test was performed. It was came out that SNR data from bone and soft tissue were both significantly higher after applying silicon on both T1 and T2 weighted images and it was statistically meaningful having positive corelation. As a result, this study dramatically increases SNR without affecting object by increasing the object volume inside the surface coil.
Purpose: To get a 3-D coordinates of intracranial target position was investicated in axial, sagittal and coronal magnetic resonance imaging with a preliminary experimented target localizer. Material and methods : In preliminal experiments, the localizer is made of engineering plastic to avoid the distrubance of magnetic field during the MR image scan. The MR localizer displayed the 9 points in three different axial tomogram. The bright signal of localizer was obtjained from 0.1~0.3% of paramagnetic gadolinium/DTPA solution in T1WI or T2WI. In this study, the 3-D position of virtual targets were examined from three different axial MR images and the streotactic position was compared to that of BRW stereotactic system in CT scan with same targets. Results: This study provided the actual target position could be obtained from single scan with MRI localizer which has inverse N-typed 9 bars. This experiment was accomplished with shimming test for detection of image distortion in MR image. However we have not found the image distortion in axial scan. The maximum error of target positions showed 1.0 mm in axial, 1.3 mm for sagittal and 1.7 mm for coronal image, respectivelly. The target localization in MR localizer was investicated with spherical virtual target in skull cadaver. Furthermore, the target position was confirmed with CRW stereotactic system showed a 1.3 mm in discrepancy. Summary : The intracranial target position was determined within 1.7 mm of discrepancy with designed MR localizer. We found the target position from axial image has more small discrepancy than that of sagittal and coronal image.
Sung-wook Hong;Yongmin Chang;Moon-jung Hwang;Il-su Rhee;Duk-Sik Kang
Investigative Magnetic Resonance Imaging
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v.4
no.1
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pp.27-33
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2000
Purpose: To determine the electronic spin relaxation times, $T_{le}$, of three commercially available Gd-chelated MR contrast agents, Gd-DTPA, Gd-DTPA-BMA and Gd-DOTA, using Electron Paramagnetic Resonance(EPR) technique. Material and Methods: The paramagnetic MR contrast agents, Gd-DTFA(Magnevist) , Gd-DTFA-BMA(OMNISCAN) and Gd-DOTA(Dotarem), were used for this study, The EPR spectra of these contrast agents, which were prepared 2:1 methanol/water solution, were obtained at low temperatures, from $-160^{\circ}C~20^{\circ}C$. The glassy-state EPR spectra for these contrast agents were then fitted by the simulation spectra generated with different zero-field splitting (ZFS) parameters by a computer simulation program 'GEN', which generates the EPR powder spectrum using a given ZFS in $3{\times}3$ tensor. Finally, the spin relaxation times of the contrast agents were then determined from the $T_{2e}$, D, and E values of the best simulation spectra using the McLachlan's theory of average relaxation rate. Results: The electronic transverse spin relaxation times, $T_{2e}'s$, of Gd-DTPA, Gd-DTPA-BMA and Gd-DOTA were 0.113ns, 0.147ns and 1.81ns respectively. The g-values were 1.9737, 1.9735 and 1.9830 and the electronic spin relaxation times, $T_{1e}'s$, were 18.70ns, 33.40ns and $1.66{\mu}s$, respectively. Conclusion: The results of these studies reconfirm that the paramagnetic MR contrast agents with larger ZFS parameters should have shorter $T_{1e}'s$. Among three contrast agents used for this study, Gd-DOTA chelated with cyclic ligand structure shows better electronic property then the others with linear structure. Thus, it is concluded that the exact determination of ZFS parameters is the important factor in evaluating relaxation enhancement effect of the agents and in developing new contrast agents.
Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.
The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.
Previous studies could not offer available guideline to decide size of balloon and grade of injury before induction of spinal cord injury (SCI) because grade of SCI was assessed after inserting a catheter and each experimental animal were different in body size and weight as well as in species. This study was performed to provide guideline for standardized SCI model. Eight healthy adult beagle dogs that had 8 mm of spinal canal height were assigned to four groups according to the diameter of balloon and compression time: 4 mm/3hrs, 4 mm/6hrs, 4 mm/12hrs and 6 mm/3hrs group. Radiography was performed to standardize between experimental animal and balloon before selecting balloon diameter to induce SCI. Behaviors outcomes, somatosensory evoked potentials (SEPs), magnetic resonance imaging (MRI) and histopathological examination were evaluated. Behaviors outcomes and SEPs were not available to assess grade of SCI and those only indicate SCI. The damaged area was revealed clear hyperintensity on STIR image and T2WI after induction of SCI. The hyperintense area on MRI was cranially and caudally expanded with increasing of the diameter of balloon or the compression time. Well corresponded to expanding of hyperintense area on MRI, the damaged region and the numbers of caspase-3 and PARP immunoreactive cells were increased on histopathological findings. Therefore, these results will be considered fundamental data to induce standardized SCI model in experimental animal that has various weight and size.
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