• Title/Summary/Keyword: 자기공명 조영술

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MR Arthrography of the Labral-Capsular-Ligamentous Complex: Normal Variations and Pitfalls (관절와순낭인대(Labral-Capsular-Ligamentous) 복합체의 자기공명관절 조영술 : 정상변이 및 진단시 주의점)

  • Han Sung Ho;Yang Bo Kyu;Kim Chi Hong;Ahn Tae Won;Chu Wu Jun
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1997.05a
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    • pp.164-166
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    • 1997
  • MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex(LOLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalis in image interpretation related to evaluation of the LOLC. MR Arthrogram of 56 shoulders in 41 asymptomatic young, active volunteers were prospectively reviewed to evaluate the labral shapes. capsular insertions and images which may mimic the lesions of glenohumoral instability. The anterior and posterior parts of the labra. respectively. varied in shape: triangular$(72\%,\; 36\%)$. round $(13\%,\; 35\%)$. cleaved$(8\%,\; 1\%)$. notched$(2\%,\; 0\%)$. flat$(5\%,\; 24\%)$ and absent$(0\%,\; 4\%)$. The anterior and posterior capsular insertions. respectively. varied in sites: Mosely and Oevergaard type I$(82\%,\;62\%)$, type II$(13\%,\; 3\%)$ and type III $(5\%,\; 2\%)$. A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum$(29\%)$ and middle glenohumoral ligament in proximity to anterior labrum $(5\%)$ simulated a labral tear. Joint fluid interposed in the central. superior portion of the sublabral sulci$(25\%)$ simulated a SLAP lesion. Synovial fold$(38\%)$ in axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral capsular - ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.

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Popliteal Artery Entrapment Syndrome -One case report - (슬와동맥 포착증후군 - 1예 보고 -)

  • Oh Jae-Yun;Lee Seock-Yeol;Lee Chol-Sae;Lee Seung-Jin
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.791-794
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    • 2006
  • Popliteal artery entrapment syndrome is a rare disorder and lead to claudication and disturbance of blood flow from the results of an abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in a young male population. The specific diagnosis is difficult, In most cases, surgical treatment provides a definitive diagnosis of the lesion and is necessary for the patient's recovery. A 34-years-old male was admitted complaining of claudication and pain on left leg. Ankle-brachial index, vascular sonography, CT-angiogram and MRI revealed an occlusion of proximal popliteal artery of left leg. The patient was confirmed as a popliteal artery entrapment syndrome (type IV) that the popliteal artery was entrapped by a fibrous band around the popliteus muscle in the operative fold. Completely occluded fibrotic popliteal artery was removed, and interposition with ipsilateral greater saphenous vein graft was done. After surgery, symptoms of the patient have improved.

Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas (악성 연부조직 종양에 대한 무계획적 절제술 후 잔여 종양의 영상학적 진단의 정확성과 임상적 위험인자)

  • Oh, Eunsun;Seo, Sung Wook;Jeong, Jeonghwan
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.150-156
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    • 2019
  • Purpose: This study examined the diagnostic accuracy of an imaging study to find the factors that affect the presence of residual tumors after an unplanned excision of sarcomas. Materials and Methods: Ninety-eight patients, who underwent a re-excision after unplanned surgery between January 2008 and December 2014, were enrolled in this study. Magnetic resonance imaging (MRI) was performed before reoperation in all patients. Positron emission tomography (PET)-computed tomography was performed on 54 patients. A wide re-excision and histology diagnosis were performed in all cases. The clinical variables were evaluated using univariate logistic regression and multivariate logistic regression. Results: The presence of a deep-seated tumor increases the risk of remnant tumors (odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25-8.30). The sensitivity for detecting residual tumors is high in MRI (sensitivity 0.79). Conclusion: Deep-seated tumors have a significantly higher risk of remnant tumors. Because the negative predictive value of MRI and PET scans is very low, reoperation should be performed regardless of a negative result.

Usefulness of MRCP in the Diagnosis of Common Bile Duct Dilatation caused by Non-stone or Non-tumorous Conditions (비결석, 비종양성 총담관 확장의 진단에 있어서 자기공명담췌관조영술(MRCP)의 유용성)

  • 정재준;양희철;김명진;김주희;이종태;유형식
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.129-136
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    • 2002
  • Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

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Central Nervous System Complications of Coronary Artery Bypass Grafting - Comparison Between Off-Pump CABG and Conventional CABG (관상동맥 우회술 후의 중추신경계 합병증 - 심폐바이패스를 사용하지 않은 관상동맥 우회술과 기존의 관상동맥 우회술의 비교)

  • Chang, Ji-Min;Lee, Jeong-Sang;Kim, Ki-Bong;Ahn, Hyuk;Yoon, Byung-Woo;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.941-947
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    • 2000
  • Background: Central nervous system complication after coronary artery bypass grafting(CABG) is one of the major prognostic determinants and the use of the cardiopulmonary bypass(CPB) may increase the incidence of this devastating complication. In this study, the outcomes after off-pump CABG were studied and compared with those following the conventional CABG using CPB. Material and Method: Among the consecutive isolated CABG's performed in SNUH during Feb. 1995 and Jun. 1999, 338 coronary artery bypass grafting were divided into two groups. 223 patients underwent CABG using the CPB(Group I), and 115 patients underwent CABG without CPB(OPCAB)(Group II). All patients enrolled in this study received extensive preoperative examinations including thorough neurologic examination before and after surgery, transcranial doppler study, carotid duplex ultrasonography, and magnetic resonance angiography if necessary. Central nervous system(CNS) complications were defined as stroke, seizure, metabolic or hypoxic encephalopathy and transient delirium after surgery. Result: There were 61 cases(27.3%) who developed postoperative CNS complication in Group I, whereas 8 cases(7.0%) of CNS complications developed postoperatively in group II(p<0.05). Statistically significant predictors of postoperative CNS complications in group I were age and the use of cardiac assist devices perioperatively. Conclusion: This study suggested that omitting the use of CPB in CABG resulted in significant decrease of the postoperative CNS complications. OPCAB should be more widely applied especially to the elderly who have preexisting cerebrovascular disease.

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Postnatal Management of Antenatally Diagnosed Patent Urachus with Bladder Prolapse

  • Choi, Hyun-Shin;Kim, Hae-Eun;Kim, Eun-Sun;Oh, Soo-Young;Chang, Yun-Sil;Seo, Jeong-Meen;Park, Won-Soon
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.262-264
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    • 2010
  • A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

Evaluation of Image Quality for Compressed SENSE(CS) Method in Cerebrovascular MRI: Comparison with SENSE Method (뇌혈관자기공영영상에서 Compressed SENSE(CS) 기법에 대한 영상의 질 평가: SENSE 기법과 비교)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.999-1005
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    • 2021
  • The object of this research is CS, which increases resolution while shortening inspection time, is applied to MRA to compare the quality of images for SENSE and CS techniques and to evaluate SNR and CNR to find out the optimal techniques and to provide them as clinical basic data based on this information. Data were analyzed on 32 patients who performed TOF MRA tests at a university hospital in Chung cheong-do (15 males, 17 females), ICA stenosis:10, M1 Aneurysm:10, and average age 53 ± 4.15). In the inspection, the inspection equipment was Ingenia CX 3.0T, Archieva 3.0T, and 32 channel head coil and 3D gradient echo as a method for equipment data. SNR and CNR of each image were measured by quantitative analysis, and the quality of the image was evaluated by dividing the observer's observation into 5 grades for qualitative evaluation. Imaging evaluation is described as being significant when the p-value is 0.05 or less when the paired T-test and Wilcoxon test are performed. Quantitative analysis of SNR and CNR in TOF MRA images Compared to the SENSE method, the CS method is a method measurement method (p <0.05). As an observer's evaluation, the sharpness of blood vessels: CS (4.45 ± 0.41), overall image quality: CS (4.77 ± 0.18), background suppression of images: CS (4.57 ± 0.18) all resulted in high CS technique (p = 0.000). In conclusion, the Compressed SENSE TOF MRA technique shows superior results when comparing and evaluating the SENSE and Compressed SENSE techniques in increased flow rate magnetic resonance angiography. The results are thought to be the clinical basis material in the 3D TOF MRA examination for brain disease.

The effects of labeling gap and susceptibility artifacts in pCASL perfusion MRI (pCASL 관류 영상에서 표지 간격과 자화감수성 인공물이 영상에 미치는 영향)

  • Kim, Seong-Hu
    • Journal of the Korean Society of Radiology
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    • v.9 no.4
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    • pp.213-217
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    • 2015
  • To report problems found in a patient who has implemented stent implantation and then conducted a perfusion MRI using ASL(Arterial Spin Labeling), in order to suggest a solution to them. The perfusion MRI was conducted, using pCASL among ASL methods. Data from pCASL(Pseudo Continuous Arterial Spin Labeling) was acquired together with the structural image simply by changing position(labeling gap 15 mm, 170 mm) of the labeling pulse to avoid stent. Data was processed through the ASLtbx. When perfusion MRI was acquired using pCASL, it showed that the position of the conventional labeling pulse (labeling gap 24 mm) was overlapped with that of stent, which made signal intensity in right brain tissue appear as if it were void. When the labeling pulse was positioned (labeling gap 15 mm) to avoid stent, high signal intensity images were acquired. In labeling pulse (labeling gap 170 mm), the signal intensity was more reduced due to relaxation before labeled blood arrived at the imaging slice. pCASL can be stably repeated measurements because it does not use a contrast agent. And it should be selected with the appropriate image acquisition parameters for the high quality image.

Osteoblastoma of the Distal Fibula - A Case Report - (비골 원위부 골아세포종 - 증례보고 -)

  • Park, Hye-Rim;Min, Soo-Kee;Cho, Hyun-Deuk;Koh, Sung-Hye;Kwon, Bong-Chul;Park, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.34-38
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    • 2004
  • We report an unusual case of osteoblastoma in the distal fibula in a 32-year-old man. Radiographs showed a ballooning lesion with internal trabeculation. MR images demonstrated a lobulated expanding lesion of central heterogeneous low signal intensity with enhancement. Curettage specimen was composed of abundant thick, pink osteoid without mineralization. The osteoid seams were lined by plump osteoblasts and a few giant cells. Focally, a fine unmineralized lace-like osteoid was seen.

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Intracranial Magnetic Resonance Angiography-Its Role in the Approach to Ischemic Stroke (허혈성 뇌혈관질환에서 자기공명혈관조영술의 가치에 대한 임상연구)

  • Lim, Dong-Jun;Cho, Tae-Hyoung;Chung, Yong-Gu;Kim, Baek-Hyun;Kim, Keun-Hoe;Kim, Se-Hoon;Kwon, Taek-Hyun;Chung, Heung-Seob;Park, Jung-Yul;Park, Youn-Kwan;Lee, Hoon-Kap;Lee, Ki-Chan;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1063-1068
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    • 2000
  • Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.

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