• Nuclear Medicine and Molecular Imaging
• /
• 제42권2호
• /
• pp.153-163
• /
• 2008

다중영상기기는 1990년대 초에 처음 개발되어 현재 주요 영상 장비 회사에서 상품으로 개발되어 판매되고 있다. 단순한 소프트웨어적인 정합과 융합을 통해 해부학적 영상과 기능적 영상의 상호 보완하는 단계에서 발전하여 하드웨어적으로 정합하는 하드웨어의 개발은 새로운 연구의 시작이다. 다중영상기기의 발전 이전에는 해부학적 구조를 보여주는 영상 장비와 기능적 영상을 표현하는 장비가 각각 고 분해능과 고 해상도로 많은 발전을 이루어 왔다. 현재는 각 영상 장비의 특징을 살려 효과적으로 결합시킨 다중영상기기의 개발이 활발하게 이루어지고 있다. 다중영상기기는 단순하게 두 장비를 결합시키는 개념에서 기능적 영상에서 필요한 감쇠 보정을 하면서 동시에 해부학적 위치를 융합 영상 형태로 표현하는 새로운 영상 장비로 발전하고 있다 다중영상기기의 특징을 살릴 수 있는 프로토콜이 개발되고 하드웨어적으로도 상호 보완적으로 결합되고 있다. 실제로 PET/CT와 같은 다중영상기기는 임상적으로 중요한 역할을 하고 있으며 PET 영상기기를 대체하고 있다. PET/CT 스캐너는 PET에서 나오는 기능적 영상과 CT에서 나오는 해부학적 영상뿐만 아니라 융합 영상을 함께 보여 주므로 임상적으로 유용한 정보를 제공하고 있다. 현재 SPECT/CT는 아직 보급이 많이 되지 않았으나 PET/CT와 같이 임상적으로 유용한 SPECT와 CT 장비가 결합된 상품들이 나오고 있어 그 시장이 점점 성장할 것으로 기대된다. 다중영상기기는 각각의 단독 영상장비에서 갖고 있는 문제뿐만 아니라 두 영상 장비를 결합시키므로 인해 새로운 문제들이 발생하고 있다. 대표적으로 호흡에 의한 움직임, 조영제의 영향, 금속 물질의 영향과 환자의 피폭에 관한 문제가 있다. 이를 해결하기 위해 새로운 프로토콜과 프로세싱 방법이 개발되고 있다. 뇌를 동시에 촬영할 수 있는 PET/MR의 개발은 뇌 과학에 많은 발전을 줄 것으로 기대된다. PET/MR의 개발은 PET/CT 에서 촬영한 영상의 일부분을 대체할 것으로 예상된다. MR 영상이 CT 영상보다 우수한 분해능을 보이는 분야에서는 PET/MR을 이용한 검사와 연구가 활발하게 진행될 것으로 보인다. 해부학적 영상과 기능적 영상을 결합시킨 융합 영상을 함께 제공하는 다중영상기기는 환자의 질병을 진단뿐만 아니라 치료 후의 효과를 보는데 있어서 중요한 역할을 할 것으로 기대된다. 또 앞으로 검사 목적에 맞는 다양한 다중영상기기의 개발이 이루어질 것으로 기대된다.

• Clinical and Experimental Pediatrics
• /
• 제50권11호
• /
• pp.1055-1060
• /
• 2007

Right-sided heart failure is a major problem among patients with congenital heart diseases, due to the prevalence of congenital heart defects and the association of pulmonary hypertension. More attention is focused on the structure of the right heart particularly in association with congenital heart defects and chronic lung disease. The right ventricle (RV) may support the pulmonary circulation, and sometimes the systemic circulation (systemic RV) in congenital heart defects. Despite major progress being made, assessing the RV remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and cineangiography). Evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. While there is extensive literature on the pathophysiology and treatment of left heart failure, the data for right-sided heart failure is scarce. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. An understanding of RV physiology and hemodynamics will lead to a better understanding of current and future treatment strategies for right heart failure. This will review right-sided heart failure with the implications of volume and pressure loading of the RV in congenital heart diseases.

• Journal of Yeungnam Medical Science
• /
• 제40권4호
• /
• pp.321-327
• /
• 2023

Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using "diabetic foot [MeSH]" and "osteomyelitis [MeSH]" or "diagnosis" was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.

• 대한영상의학회지
• /
• 제85권3호
• /
• pp.643-648
• /
• 2024

선방세포암은 침샘에서 발생하는 종양 중 약 2%-3%를 차지하는 드문 악성 종양이다. 유방에서 발생한 선방세포암은 매우 드물어 현재까지 약 70예 정도만 보고되었고, 대부분 병리학적 소견을 위주로 기술되었다. 이에 저자들은 33세 여성에서 발생한 유방 선방세포암의 증례와 영상의학적 소견에 대해 보고하고자 한다.

• Investigative Magnetic Resonance Imaging
• /
• 제13권2호
• /
• pp.117-126
• /
• 2009

목적: 수치해석적인 방법을 통해 핵자기공명 분광기법에서의 다중양자 필터를 디자인하는 방법을 소개하고 이를 뇌의 중요한 대사체인 myo-inositol의 생체 내 검출에 이용하였다. 대상 및 방법 : 이를 위해 우선적으로 myo-inositol의 분광학적 성질을 조사 한 후 다중양자 필터의 echo time, mixing time 그리고 세번째 $9^{\circ}$ 펄스의 flip angle과 offset frequency같은 시퀀스 파라미터들을 최적화 하였다. 최적화된 필터는 우선적으로 실험 팬텀에서 테스트 한 후 최종적으로 인간의 두뇌에서 그 성능을 검증하였다. 결과: 실험결과를 토대로, 본 연구에서 제안하는 다중양자 필터를 사용하여 신호의 순수도가 크게 개선된 타겟 대사체의 신호를 얻을 수 있음을 알 수 있다. 결론: 수치해석적인 방법을 통하여 핵자기공명 분광기법에서의 다중양자 필터를 디자인함으로써 특히, 복잡한 스핀계를 갖는 타겟대사체의 신호의 순수도를 크게 강화할 수 있다.

• 방사선산업학회지
• /
• 제12권4호
• /
• pp.325-332
• /
• 2018

Carotid angiography covering the aortic arch includes contrast-enhanced magnetic resonance angiography (CEA), which is applied to a large region and usually employs contrast media. However, the use of contrast media can be dangerous in infants, pregnant women, and patients with chronic renal failure (CRF). Follow-up patients informed of a lesion may also want to avoid constant exposure to contrast media. We aimed to apply time-of-flight (TOF) angiography to a large region and compare its usefulness with that of CEA. Ten patients (mean age, 58 years; range, 45~75 years) who visited our hospital for magnetic resonance angiography (MRA) participated in this study. A 3.0 Tesla Achieva magnetic resonance imaging (MRI) system (Philips, Netherland) and the SENSE NeuroVascular 16-channel coil were employed for both methods. Both methods were applied simultaneously to the same patient. Three TOF stacks were connected to cover the aortic arch through the circle of Willis, and CEA was applied in the same manner. For the quantitative assessment, the acquired images were used to set the regions of interest (ROIs) in the common carotid artery (CCA) bifurcation, internal carotid artery, external carotid artery, middle cerebral artery, and vertebral artery, and to obtain the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) for the soft tissues. Three radiologists and one radiological resident performed the qualitative assessment on a 5-point scale - 1 point, "very bad"; 2 points, "bad"; 3 points, "average"; 4 points, "good"; and 5 points, "very good" - with regard to 4 items: (1) sharpness, (2) distortion, (3) vein contamination, and (4) expression of peripheral vessels. For the quantitative assessment, we estimated the mean SNR and CNR in each of the 5 ROIs. In general, the mean SNR was higher in TOF angiography (166.1, 205.2, 154.39, 172.23, and 161.95) than in CEA(92.05, 95.43, 84.76, 73.69, and 88.3). Both methods had a similar mean CNR: 67.62, 106.71, 55.9, 73.74, and 63.46 for TOF angiography, and 67.82, 71.19, 60.52, 49.45, and 64.07 for CEA. In all ROIs, the mean SNR was statistically significant (p<0.05), whereas the mean CNR was insignificant (p>0.05). The mean values of TOF angiography and CEA for each item in the qualitative assessment were 4.2 and 4.28, respectively for item 1; 2.93 and 4.55, respectively, for item 2; 4.6 and 3.13, respectively, for item 3; and 2.88 and 4.65, respectively, for item 4. Therefore, TOF angiography had a higher mean for item 3, and CEA had a higher mean for items 2 and 4; there was no significant difference between the two methods for item 1. The results for item 1 were statistically insignificant (p>0.05), whereas the results for items 2~4 were statistically significant (p<0.05). Both methods have advantages and disadvantages and they complement each other. However, CEA is usually applied to a large region covering the aortic arch. Time-of-flight angiography may be useful for people such as infants, pregnant women, CRF patients, and followup patients for whom the use of contrast media can be dangerous or unnecessary, depending on the circumstance.

• Radiation Oncology Journal
• /
• 제35권4호
• /
• pp.340-348
• /
• 2017

Purpose: To evaluate the diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) in predicting pelvic lymph node (LN) metastases in patients with cervical cancer. Materials and Methods: From January 2009 to March 2015, 114 patients with FIGO stage IA1-IIB uterine cervical cancer who underwent hysterectomy with pelvic lymphadenectomy and took CT, MRI, and PET/CT before surgery were enrolled in this study. The criteria for LN metastases were a LN diameter ${\geq}1.0cm$ and/or the presence of central necrosis on CT, a LN diameter ${\geq}1.0cm$ on MRI, and a focally increased FDG uptake on PET/CT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for pelvic LN metastases were estimated. Results: The sensitivity, specificity, PPV, NPV, and accuracy for detection of pelvic LN metastases were 51.4%, 85.9%, 41.3%, 90.1%, and 80.3% for CT; 24.3%, 96.3%, 56.3%, 86.8%, and 84.6% for MRI; and 48.6%, 89.5%, 47.4%, 90.0%, and 82.9% for PET/CT, respectively. The sensitivity of PET/CT and CT was higher than that of MRI (p=0.004 and p= 0.013, respectively). The specificity of MRI was higher than those of PET/CT and CT (p=0.002 and p=0.001, respectively). The difference of specificity between PET/CT and CT was not statistically significant (p=0.167). Conclusion: These results indicate that preoperative CT, MRI, and PET/CT showed low to moderate sensitivity and PPV, and moderate to high specificity, NPV, and accuracy. More efforts are necessary to improve sensitivity of imaging modalities in order to predict pelvic LN metastases.

• Journal of Ginseng Research
• /
• 제22권2호
• /
• pp.96-101
• /
• 1998

This paper describes the determination of bulk density and the discrimination of internal structure of red ginseng by nuclear magnetic resonance (NMR). The 102 red ginseng roots were tested for bulk density. The NMR properties measured by NMR parameters such as spin-lattice relaxation time ($T_1$) and spin-spin relaxation time ($T_2$) were determined using the low field proton NMR analyzer. Bulk density of red ginseng root showed a highly negative significant correlation (r=-0.8934) with the value of $T_1$, but a highly positive significant correlation (r=0.7672 and 0.5909) with the value of T21 (short T2) and T22 (long T2), respectively. Multiple regression equation, Y=-0.0069.$T_1$+0.3044.$T_{21}$-0.0156.$T_{22}$-0.6368, using the MNR parameter values of 80 red ginseng roots can effectively predict the bulk density of 22 red ginseng roots with the correlation coefficient of 0.9396 and the standard error of 0.086. The differences in the internal structure of normal and inside white part of red ginseng were easily found by the signal intensity of NMR image based on magnetic properties of proton nucleus.

• Investigative Magnetic Resonance Imaging
• /
• 제7권2호
• /
• pp.100-107
• /
• 2003

목적 : 급성심근경색을 진단하는데 있어 심장자기공명영상의 유용성을 알아보고, 생존심근을 평가하는데 있어 Tl-201 심근관류 SPECT와 비교하고자 하였다. 대상 및 방법 : 흉통 및 호흡곤란이 있는 환자 중 심장자기공명영상과 Tl-201 SPECT를 시행한 17명을 후향적으로 조사하였다. 심장자기공명영상에서는 T2강조영상에서 심벽의 고신호 강도 유무, 영화영상에서 심벽 운동, Gd-DTPA 조영 증강 후 좌심실 벽의 관류 결손 및 주입 15분 후의 지연조영증강 유무를 평가하였다. T1-201 SPECT에서는 아데노신 부하 영상과 휴식기 영상을 얻어 관류 결손 유무와 관류 결손시 가역성 여부를 평가하였다. 결과 심장자기공명영상과 T1-201 SPECT 모두 급성심근경색을 진단하는데 통계적으로 의미가 있었고, T2강조영상, T1-201 SPECT, 지연조영증강 및 심벽운동 순으로 연관성이 있는 것으로 나타났고, 관류 결손은 통계적 유의성이 없었다. 생존심근 평가에 있어서는 두 검사간 유의한 차이가 없었으며, T2강조영상과 관류영상에서 T1-201 SPECT와 높은 일치율, 지연조영증강 및 심벽운동은 낮은 일치율을 보였다. 결론 : 심장자기공명영상은 급성심근경색을 진단하는데 매우 유의한 진단율을 보였고, 생존 심근여부의 판단에 있어 SPECT와 높은 일치율을 보였다. 그러나 각 검사별 판독 기준과 방법에서 많은 연구가 필요할 것으로 생각된다.

• Investigative Magnetic Resonance Imaging
• /
• 제3권2호
• /
• pp.159-166
• /
• 1999

Purpose : To evaluate the effect of rotational correlation time (${\tau}_R$) and the possible related changes of other parameters, ${\tau}_M,{\;}{\tau}_S,{\;}and{\;}(\tau}_V$ of gadolinium (Gd) chelate on T1 relaxation enhancement in two pool model. Materials and Methods : The NMRD (Nuclear Magnetic Relaxation Dispersion) profiles were simulated from 0.02 MHz to 800 MHz proton Larmor frequency for different values of rotational correlation times based on Solomon-Bloembergen equation for inner-sphere relaxation enhancement. To include both unbound pool (pool A) and bound pool (pool B), the relaxivity was divided by contribution from unbound pool and bound pool. The rotational correlation time for pool A was fixed at the value of 0.1 ns, which is a typical value for low molecular weight complexes such as Gd-DTPA in solution and ${\tau}_R$ for pool B was changed from 0.1 ns to 20 ns to allow the slower rotation by binding to macromolecule. The fractional factor of was also adjusted from 0 to 1.0 to simulate different binding ratios to macromolecule. Since the binding of Gd-chelate to macromolecule cab alter the electronic environment of Gd ion and also the degree of bulk water access to hydration site of Gd-chelate, the effects of these parameters were also included. Results : The result shows that low field profiles, ranged from 0.02 to 40 MHz, and dominated by contribution from bound pool, which is bound to macromolecule regardless of binding ratios. In addition, as more Gd-chelate bound to macromolecule, sharp increase of relaxivity at higher field occurs. The NMRD profiles for different values of ${\tau}_S$ show the enormous increase of low field profile whereas relaxivity at high field is not affected by ${\tau}_S$. On the other hand, the change in ${\tau}$V does not affect low field profile but strongly in fluences on both inflection fie이 and the maximum relaxivity value. The results shows a fluences on both inflection field and the maximum relaxivity value. The results shows a parabolic dependence of relaxivity on ${\tau}_M$. Conclusion : Binding of Gd-chelate to a macromolecule causes slower rotational tumbling of Gd-chelate and would result in relaxation enhancement, especially in clinical imaging field. However, binding to macromolecule can change water enchange rate (${\tau}_M$) and electronic relaxation ($T_le$) vis structural deformation of electron environment and the access of bulk water to hydration site of metal-chelate. The clinical utilities of Gd-chelate bound to macromolecule are the less dose requirement, the tissue specificity, and the better perfusion and intravascular agents.