• Title/Summary/Keyword: Brain magnetic resonance imaging

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Magnetic Resonance-Guided Focused Ultrasound in Neurosurgery: Taking Lessons from the Past to Inform the Future

  • Jung, Na Young;Chang, Jin Woo
    • Journal of Korean Medical Science
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    • v.33 no.44
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    • pp.279.1-279.16
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    • 2018
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is a new emerging neurosurgical procedure applied in a wide range of clinical fields. It can generate high-intensity energy at the focal zone in deep body areas without requiring incision of soft tissues. Although the effectiveness of the focused ultrasound technique had not been recognized because of the skull being a main barrier in the transmission of acoustic energy, the development of hemispheric distribution of ultrasound transducer phased arrays has solved this issue and enabled the performance of true transcranial procedures. Advanced imaging technologies such as magnetic resonance thermometry could enhance the safety of MRgFUS. The current clinical applications of MRgFUS in neurosurgery involve stereotactic ablative treatments for patients with essential tremor, Parkinson's disease, obsessive-compulsive disorder, major depressive disorder, or neuropathic pain. Other potential treatment candidates being examined in ongoing clinical trials include brain tumors, Alzheimer's disease, and epilepsy, based on MRgFUS abilities of thermal ablation and opening the blood-brain barrier. With the development of ultrasound technology to overcome the limitations, MRgFUS is gradually expanding the therapeutic field for intractable neurological disorders and serving as a trail for a promising future in noninvasive and safe neurosurgical care.

Tumor-like Presentation of Tubercular Brain Abscess: Case Report

  • Karki, Dan B.;Gurung, Ghanashyam;Sharma, Mohan R.;Shrestha, Ram K.;Sayami, Gita;Sedain, Gopal;Shrestha, Amina;Ghimire, Ram K.
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.231-236
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    • 2015
  • A 17-year-old girl presented with complaints of headache and decreasing vision of one month's duration, without any history of fever, weight loss, or any evidence of an immuno-compromised state. Her neurological examination was normal, except for papilledema. Laboratory investigations were within normal limits, except for a slightly increased Erythrocyte Sedimentation Rate (ESR). Non-contrast computerized tomography of her head revealed complex mass in left frontal lobe with a concentric, slightly hyperdense, thickened wall, and moderate perilesional edema with mass effect. Differential diagnoses considered in this case were pilocytic astrocytoma, metastasis and abscess. Magnetic resonance imaging (MRI) obtained in 3.0 Tesla (3.0T) scanner revealed a lobulated outline cystic mass in the left frontal lobe with two concentric layers of T2 hypointense wall, with T2 hyperintensity between the concentric ring. Moderate perilesional edema and mass effect were seen. Post gadolinium study showed a markedly enhancing irregular wall with some enhancing nodular solid component. No restricted diffusion was seen in this mass in diffusion weighted imaging (DWI). Magnetic resonance spectroscopy (MRS) showed increased lactate and lipid peaks in the central part of this mass, although some areas at the wall and perilesional T2 hyperintensity showed an increased choline peak without significant decrease in N-acetylaspartate (NAA) level. Arterial spin labelling (ASL) and dynamic susceptibility contrast (DSC) enhanced perfusion study showed decrease in relative cerebral blood volume at this region. These features in MRI were suggestive of brain abscess. The patient underwent craniotomy with excision of a grayish nodular lesion. Abundant acid fast bacilli (AFB) in acid fast staining, and epithelioid cell granulomas, caseation necrosis and Langhans giant cells in histopathology, were conclusive of tubercular abscess. Tubercular brain abscess is a rare manifestation that simulates malignancy and cause diagnostic dilemma. MRI along with MRS and magnetic resonance perfusion studies, are powerful tools to differentiate lesions in such equivocal cases.

Brain MRI Findings of Nitrogen Gas Inhalation for Suicide Attempt: a Case Report

  • Kim, Young-eun;Lee, Donghoon;Kim, Minji;Hwang, Hokyoung
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.4
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    • pp.264-268
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    • 2017
  • South Korea has the highest reported suicide rate among all countries belonging to the Organization for Economic Cooperation and Development. Nitrogen is a colorless, odorless and nontoxic gas. Nitrogen gas has, however, been recently used as a method of attempted suicide, its nontoxity notwithstanding. We herein report on an unusual case involving a 30-year-old male who presented with symptoms after a suicide attempt by nitrogen inhalation. Diffusion-weighted imaging of his brain was showed curvilinear high signal intensity in the bilateral frontal and right occipital cortices, with subtle low apparent diffusion coefficient value. In addition, T2-weighted images and fluid attenuated inversion recovery images revealed subtle high signal intensity in the bilateral frontal cortices, basal ganglia and occipital cortices with contrast enhancement.

Arterial Spin Labeling Magnetic Resonance Imaging in Healthy Adults: Mathematical Model Fitting to Assess Age-Related Perfusion Pattern

  • Ying Hu;Rongbo Liu;Fabao Gao
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1194-1202
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    • 2021
  • Objective: To investigate the age-dependent changes in regional cerebral blood flow (CBF) in healthy adults by fitting mathematical models to imaging data. Materials and Methods: In this prospective study, 90 healthy adults underwent pseudo-continuous arterial spin labeling imaging of the brain. Regional CBF values were extracted from the arterial spin labeling images of each subject. Multivariable regression with the Akaike information criterion, link test, and F test (Ramsey's regression equation specification error test) was performed for 7 models in every brain region to determine the best mathematical model for fitting the relationship between CBF and age. Results: Of all 87 brain regions, 68 brain regions were best fitted by cubic models, 9 brain regions were best fitted by quadratic models, and 10 brain regions were best fitted by linear models. In most brain regions (global gray matter and the other 65 brain regions), CBF decreased nonlinearly with aging, and the rate of CBF reduction decreased with aging, gradually approaching 0 after approximately 60. CBF in some regions of the frontal, parietal, and occipital lobes increased nonlinearly with aging before age 30, approximately, and decreased nonlinearly with aging for the rest of life. Conclusion: In adults, the age-related perfusion patterns in most brain regions were best fitted by the cubic models, and age-dependent CBF changes were nonlinear.

Detecting Deception Using Neuroscience : A Review on Lie Detection Using Functional Magnetic Resonance Imaging (거짓 탐지와 뇌과학 : 기능적 자기공명영상을 활용한 거짓 탐지)

  • Choi, Yera;Kim, Sangjoon;Do, Hyein;Shin, Kyung-Shik;Kim, Jieun E.
    • Korean Journal of Biological Psychiatry
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    • v.22 no.3
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    • pp.109-112
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    • 2015
  • Since the early 2000s, there has been a continued interest in lie detection using functional magnetic resonance imaging (fMRI) in neuroscience and forensic sciences, as well as in newly emerging fields including neuroethics and neurolaw. Related fMRI studies have revealed converging evidence that brain regions including the prefrontal cortex, anterior cingulate cortex, parietal cortex, and anterior insula are associated with deceptive behavior. However, fMRI-based lie detection has thus far not been generally accepted as evidence in court, as methodological shortcomings, generalizability issues, and ethical and legal concerns are yet to be resolved. In the present review, we aim to illustrate these achievements and limitations of fMRI-based lie detection.

Preoperative Assessment of Cystic Brain Lesion : Significance of Diffusion-Weighted Image and ADC (Apparent Diffusion Coefficiency) Values

  • Choi, Hyun-Chul;Lee, Sang-Won;Ji, Cheol
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.371-376
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    • 2007
  • Objective : The aim of this study was to investigate the usefulness of diffusion-weighted imaging [DWI] and apparent diffusion coefficiency [ADC] in distinguishing brain abscesses from cystic or necrotic brain tumors, which are difficult to be differentiated by conventional magnetic resonance imaging techniques. Methods : Seven patients with brain abscesses and ten patients with cystic brain tumors were studied from September 2003 to October 2005. Abscess, subdural empyema and ventriculitis were categorized to the abscess group and cystic or necrotic brain gliomas or metastatic brain tumors into the tumor group. Preoperative magnetic resonance images were performed in all patients and diffusion-weighted images and apparent diffusion coefficiency values of lesions were calculated directly from software of 1.5 tesla MRI [General Electrics, USA]. The ratio of the ADC of the lesion to contralateral regional ADC was also measured [relative ADC, rADC]. Results : The average ADC value of pyogenic abscesses group was $0.82+/-0.14{\times}10^{-3}\;[mean+/-S.D.]\;mm^2/s$ and mean rADC was 0.75. Cystic or necrotic areas had high ADC values [$2.49+/-0.79{\times}10^{-3}\;mm^2/s$, mean rADC=2.14]. ADC and rADC values of abscesses group showed about three times lower values than those of cystic or necrotic tumor group. Conclusion : This study results based on numerical comparison of signal intensities and quantitative analysis to distinguish between brain abscess and cystic or necrotic tumor, DWI and ADC mapping are thought to be very useful diagnostic tools.

The Emerging Role of Fast MR Techniques in Traumatic Brain Injury

  • Yoo, Roh-Eul;Choi, Seung Hong
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.2
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    • pp.76-80
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    • 2021
  • Post-concussion syndrome (PCS) following mild traumatic brain injury (mTBI) is a major factor that contributes to the increased socioeconomic burden caused by TBI. Myelin loss has been implicated in the development of PCS following mTBI. Diffusion tensor imaging (DTI), a traditional imaging modality for the evaluation of axonal and myelin integrity in mTBI, has intrinsic limitations, including its lack of specificity and its time-consuming and labor-intensive post-processing analysis. More recently, various fast MR techniques based on multicomponent relaxometry (MCR), including QRAPMASTER, mcDESPOT, and MDME sequences, have been developed. These MCR-based sequences can provide myelin water fraction/myelin volume fraction, a quantitative parameter more specific to myelin, which might serve as a surrogate marker of myelin volume, in a clinically feasible time. In this review, we summarize the clinical application of the MCR-based fast MR techniques in mTBI patients.

Neuroimaging of Germinal Matrix and Intraventricular Hemorrhage in Premature Infants

  • Sun Kyoung You
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.239-246
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    • 2023
  • Germinal matrix and intraventricular hemorrhage (GM-IVH) are the major causes of intracranial hemorrhage in premature infants. Cranial ultrasound (cUS) is the imaging modality of choice for diagnosing and classifying GM-IVH. Magnetic resonance imaging (MRI), usually performed at term-equivalent age, is more sensitive than cUS in identifying hemorrhage in the brain. Post-hemorrhagic ventricular dilatation is a significant complication of GM-IVH and correlates with adverse neurodevelopmental outcomes. In this review, we discuss the various imaging findings of GM-IVH in premature infants, focusing on the role of cUS and MRI.