• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.84-91
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• 1995

Many clinical and laboratory tests have been employed to evaluate disease activity in rheumatioid arthritis. $^{99m}Tc$-labelled polyclonal IgG(HIG) has been demonstrated to accumulate in focal sites of infection or inflammation in both animals and human subjects. The purpose of this study was to distinguish arthritis with active inflammation from those without active inflammation and to correlate relative intensities of $^{99m}Tc$-labelled HIG uptake of the rheumatoid arthritis with clinical and MR indices of the joint inflammation. This study included twelve patients with active rheumatoid arthritis, two with ankylosing spondylitis and one with degenerative osteoarthritis without active inflammation. A Whole-body and spot images were obtained 4 hours after intravenous injection of 20mCi of $^{99m}Tc$-labelled HIG. Scintigrams were assessed visually by 3 experienced radiologists, and graded as normal or mildly and markedly increased uptake within the joints, and the degree of uptake was compared with clinical and radiologic severity of synovial inflammation. MRI studies were done on the involved joints consisted of wrist(n = 11), knee(n = 2) and hip joint(n= 2). Active synovitis was defined when marked elevation of ESR and gadolinium enhancement of synovium on MRI were demonstrated. Markedly increased radiotracer uptake was seen in 10 of 11 rheumatoid arthritic patients with active synovitis whereas normal or mildly increased uptakes were noted in others, including rheumatoid arthritic patient(n=1) and non-rheumatoid patients(n = 3) without active synovitis. This study showed that the localization of involved joints in rheumatoid arthritis could be detected with $^{99m}Tc$-labelled HIG and that the degree of uptake correlated well with the degree and activity of inflammation. In conclusion, $^{99m}Tc$-labelled HIG scan is a useful method in the evaluation of active inflammation in rheumatoid arthritis.

• Progress in Medical Physics
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• v.23 no.2
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• pp.71-80
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• 2012

In order to verify exact dose distributions in the state-of-the-art radiation techniques, a newly designed three-dimensional dosimeter and technique has been took strongly into consideration. The main purpose of our study is to verify the optimized parameters of polymer gel as a real volumetric dosimeter in terms of the various study of MRI. We prepared a gel dosimeter by combing 8% of gelatin, 8% of MAA, and 10 mM of THPC. We used a Co-60 gamma-ray teletherapy unit and delivered doses of 0, 2, 4, 6, 8, 10, 12, and 14 Gy to each polymer gel with a solid phantom. We used a fast spin-echo pulse to acquire the characterized T2 time of MRI. The signal noise ratio (SNR) of the head & neck coil was a relatively lower sensitivity than the body coil; therefore the dose uncertainty of head & neck coil would be lower than body coil's. But the dose uncertainty and resolution of the head & neck coil were superior to the body coil in this study. The TR time between 1,500 ms and 2,000 ms showed no significant difference in the dose resolution, but TR of 1,500 ms showed less dose uncertainty. For the slice thickness of 2.5 mm, less dose uncertainty of TE times was at 4 Gy, as well, it was the lowest result over 4 Gy at TE of 12 ms. The dose uncertainty was not critical up to 6 Gy, but the best dose resolution was obtained at 20 ms up to 8 Gy. The dose resolution shows the lowest value was over 20 ms and was an excellent result in the number of excitation (NEX) of three. The NEX of two was the highest dose resolution. We concluded that the better result of slice thickness versus NEX was related to the NEX increment and thin slice thickness.

• The Korean Journal of Nuclear Medicine
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• v.36 no.4
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• pp.232-243
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• 2002

Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.473-476
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• 1994

This is a case report on the lipoma of the parotid gland. Lipomas are common soft tissue neoplasms found only rarely in the region of the parotid gland, and therefore often not considered in the initial differential diagnosis of a mass presenting in this region. Clinically they can be confused with other being lesions and there was no reliable methods to make a preoperative diagnosis of the lipoma until 1980's; however, CT allows a specific diagnosis to be made in virtually all case. We experienced that CT imaging permit the preoperative diagnosis of the lipoma, so could remove it preserving the parotid gland.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.63-65
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• 2008

We treated a 37-year-old male with traumatic hematoma in the suprapatellar bursa that had developed in the form of persistent swelling on suprapatellar area of left knee after blunt trauma. Though there were no obvious abnormal findings on plain roentgenographs, an isolated suprapatellar cystic lesion with fluid-fluid level on T2-weighted sagittal image of MRI was noted. We found the suprapatellar plica with complete septum and no synovitis in the knee joint proper by arthroscopy. We incised the plica and found leakage of blood-stained fluid from the suprapatellar bursa. There were no findings of pigmented villonodular synovitis or other tumorous lesions. At 6 months after surgery, the patient felt symptom-free and there was no recurrence.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.64-68
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• 2010

Brain aspergillosis has been increasing remarkably. They are known to occur commonly in immunocompromised individuals by hematogenous spread from other primary sites or by direct extension from adjacent structures to central nervous system. We report a rare case of a 29-year-old male without any known medical history, who had isolated brain lesion and the pathology from stereotactic biopsy confirmed cerebral aspergillosis.

• Investigative Magnetic Resonance Imaging
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• v.18 no.3
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• pp.258-262
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• 2014

Hypertensive encephalopathy and basal ganglia intracerebral hemorrhage (ICH) are a medical emergency caused by a sudden elevation of systemic blood pressure. Although the relationship between hypertensive encephalopathy and large ICH has not been clarified yet, Cushing reflex in acute elevations of ICP due to large ICH may induce or aggravate hypertensive encephalopathy. We report a rare case of isolated hypertensive brainstem encephalopathy combined with hypertensive ICH.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.220-230
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• 1991

Internuclear ophthalmoplegia is a conjugated gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the other abducting eye. Six patients with INO(who had clinical cerebrovascular diseases) underwent MR imaging and the results were as follows : 1. The MLF lesions were identified by MR imaging in 5 cases 2. The ratio of unilateral INO to bilateral INO was 5:1 3. The nature of lesions was infarction in 4 cases and hemorrhage in 1 case 4. The sites of MLF lesion were in the midbrain in 4 cases and in the pons in 1 case 5. All 5 cases of INO identified by MR imaging had other lesion sites in addition to MLF lesion.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.161-164
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• 2009

Irreducible knee dislocation is a rare injury and often need an open procedure with ligaments reconstruction. This report describes a case of arthroscopic treatment of a patient with traumatic knee dislocation unable to reduce in a closed method. MRI revealed incarceration of the medial collateral ligament and capsule in the medial compartment. And arthroscopic examination confirmed incarcerated medial capsuloligamentous structures which prevented the knee from reduction. Arthroscopic procedure without ligaments reconstruction was complete when the medial condyle was well visualized and the knee reduced. After 4 weeks of immobilization in extension, range of motion exercise and gradual increases in weight bearing was allowed. At the 3- year follow-up, mild laxity was remained but the patient did not have any discomfort of doing ADL activity and showed full range of motion of the knee.

• Investigative Magnetic Resonance Imaging
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• v.2 no.1
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• pp.96-103
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• 1998

Purpose : To assess the clinical utility of turbo contrast-enhanced magnetic resonance angiography(CE MRA) in the evaluation of the aortic arch and its major branches and to compare the image quality of CE MRA among different coils used. Materials and Methods : Turbo three-phase dynamic CE MRA encompassing aortic arch and its major branches was prospectively performed after manual bolus IV injection of contrast material in 29 patients with suspected cerebrovascular diseases at 1.0T MR unit. the raw data were obtained with 3-D FISH sequence (TR 5.4ms, TE 2.3ms, flip angle 30, slab thickness 80nm, effective slice thickness 4.0mm, matrix size $100{\times}256$, FOV 280mm). Total data acquisition time was 4. to 60 seconds. We subjectively evaluated the imge quality with three-rating scheme : "good" for unequivocal normal finding, "fair" for relatively satisfactory quality to diagnose 'normal' despite intravascular low signal, and "poor" for equivocal diagnosis or non-visualization of the origin or segment of the vessels due to low signal or artifacts which needs catheter angiography. At the level of the carotid bifurcation, it was compared with conventional 2D-TOF MRA image. Overall image quality was also compared visually and quantitatively by measuring signal-to-noise ratios (SNRs) of the ascending aorta, the innominate artery and both common carotid arteries among the three different coils used(CP body array(n=12), CP neck array(n=9), and head-and-neck(n=8). Results : Demonstration of the aortic arch and its major branches was rated as "good" in 55% (16/29) and "fair" in 34%(10/29). At the level of the carotid bifurcation, image quality of turbo CE MRA was same as or better than conventional 2D-TOF MRA in 65% (17/26). Overall image quality and SNR were significantlygreater with CP body array coil than with CP neck array or head-and-neck coil. Conclusions : Turbo CE MRA can be used as a screening exam in the evaluation of the major branches of the aortic arch from their origin to the skull base. Overall imagequality appears to be better with CP body array coil than with CP neck array coil or head-and-neck coil.