• Title/Summary/Keyword: CT, MRI

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Spinal Presentation of Spontaneous Intracranial Hypotension (자발두개내압저하의 척추 자기공명영상 소견)

  • Hye Jin Yoo
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.24-35
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    • 2024
  • Spontaneous intracranial hypotension (SIH), which generally presents as orthostatic headache, is increasingly being identified due to improved imaging technologies and heightened awareness. Many prior studies have reported the characteristic brain MRI findings of SIH. However, recently, focus has shifted to spinal MRI, as SIH is believed to be caused by leakage of cerebrospinal fluid from the spinal dural sac. Advanced techniques such as ultrafast CT myelography and digital subtraction myelography have emerged as useful technique to identify the site of cerebrospinal fluid leakage. In this review, we discuss the diagnosis, spinal MRI findings, imaging techniques, and treatment of SIH.

When We Consider Neurolymphomatosis in Patient with Lumbosacral Plexopathy with an Extreme Leg Pain? (통증을 동반한 신경총병증에서 언제 신경림프종증을 고려해야 하는가?)

  • Ahn, Jun Young;Seok, Hyun;Kim, Sang-Hyun;Kim, Hyun Jung;Cho, Yeon Hee;Oh, Back Min;Lee, Seung Yeol
    • Clinical Pain
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    • v.20 no.1
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    • pp.53-57
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    • 2021
  • We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.

A Systematic Review of MRI, Scintigraphy, FDG-PET and PET/CT for Diagnosis of Multiple Myeloma Related Bone Disease - Which is Best?

  • Weng, Wan-Wen;Dong, Meng-Jie;Zhang, Jun;Yang, Jun;Xu, Qin;Zhu, Yang-Jun;Liu, Ning-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9879-9884
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    • 2014
  • Aim: The purpose of the current study was to conduct a systematic review of the published literature to evaluate the diagnostic accuracy of FDG-PET, PTE/CT, MRI and scintigraphy for multiple myeloma related bone disease. Methods: Through a search of PubMed, EMBASE, and the Cochrane Library, two reviewers independently assessed the methodological quality of each study. We estimated pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and two sample Z-tests were conducted to evaluate for differences in sensitivity, specificity, area under the curve (AUC), and the $Q^*$ index between any two diagnostic modalities. Results: A total of 17 studies were reviewed. The MRI had a pooled sensitivity of 0.88, specificity of 0.68, AUC of 0.897, and $Q^*$ index of 0.828, whereas for MIBI, the corresponding values were 0.98, 0.90, 0.991, and 0.962, respectively, and for bone scan, they were 066, 0.83, 0.805, and 0.740, respectively. The corresponding values of MIBI were 0.98, 0.90, 0.991, and 0.962, respectively. For PET and PET/CT, the values were 0.91, 0.69, 0.927 and 0.861, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC, and $Q^*$ index between MRI, scintigraphy, FDG-PET and PET/CT. Conclusions: On the condition that X ray is taken as a reference in our study, we suggested that FDG-PET, PTE/CT, MRI and scintigraphy are all associated with high detection rate of bone disease in patients with MM. Thus, in clinical practice, it is recommended that we could choose these tests according to the condition of the patient.

Medical Image Denoising using Wavelet Transform-Based CNN Model

  • Seoyun Jang;Dong Hoon Lim
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.10
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    • pp.21-34
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    • 2024
  • In medical images such as MRI(Magnetic Resonance Imaging) and CT(Computed Tomography) images, noise removal has a significant impact on the performance of medical imaging systems. Recently, the introduction of deep learning in image processing technology has improved the performance of noise removal methods. However, there is a limit to removing only noise while preserving details in the image domain. In this paper, we propose a wavelet transform-based CNN(Convolutional Neural Network) model, namely the WT-DnCNN(Wavelet Transform-Denoising Convolutional Neural Network) model, to improve noise removal performance. This model first removes noise by dividing the noisy image into frequency bands using wavelet transform, and then applies the existing DnCNN model to the corresponding frequency bands to finally remove noise. In order to evaluate the performance of the WT-DnCNN model proposed in this paper, experiments were conducted on MRI and CT images damaged by various noises, namely Gaussian noise, Poisson noise, and speckle noise. The performance experiment results show that the WT-DnCNN model is superior to the traditional filter, i.e., the BM3D(Block-Matching and 3D Filtering) filter, as well as the existing deep learning models, DnCNN and CDAE(Convolution Denoising AutoEncoder) model in qualitative comparison, and in quantitative comparison, the PSNR(Peak Signal-to-Noise Ratio) and SSIM(Structural Similarity Index Measure) values were 36~43 and 0.93~0.98 for MRI images and 38~43 and 0.95~0.98 for CT images, respectively. In addition, in the comparison of the execution speed of the models, the DnCNN model was much less than the BM3D model, but it took a long time due to the addition of the wavelet transform in the comparison with the DnCNN model.

Evaluation of Traumatic Intracranial Hemorrhage Using Computed Tomography and Magnetic Resonance Imaging in Four Dogs (개에서 컴퓨터단층촬영술과 자기공명영상을 이용한 창상성 두개관내 출혈의 평가)

  • Choi Ho-Jung;Lee Ki-Ja;Kang Sang-Kyu;Lee Hee-Chun;Chang Dong-Woo;Lee Ki-Chang;Jeong Seong-Mok;Cho Sung-Whan;Lee Young-Won
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.96-101
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    • 2006
  • Four dogs with neurologic dysfunction resulted from intracranial hemorrhage by head trauma were referred to Veterinary Medical Teaching Hospital, Chungnam National University. There were no remarkable findings in survey radiography in four cases. CT and MRI scans were diagnostic in these cases. Three dogs underwent CT scanning. On CT images, the lesion was hyperdense and was not enhanced after intravenous contrast administration in dog 1 and dog 2. On CT of dog 4, there was no significant finding. All of four dogs were verified by dorsal, sagittal, and transverse T1-weighted (T1W) and T2-weighted (T2W) images. Appearance of the lesions in dog 1 and dog 2 was isointense (dog 2) or isointense with hyperintense rim (dog 1) on T1W images and hyperintense on T2W images. In dog 3 and dog 4, there were hypointense and hyperintense lesions on T1Wand T2W images respectively. The lesions in four dogs were located in the left intracerebral region, intracerebral and cerebellovestibular region, subdural space, and right cerebral hemisphere, respectively.

Feasibility of the Threshold-Based Quantification of Myocardial Fibrosis on Cardiac CT as a Prognostic Marker in Nonischemic Dilated Cardiomyopathy

  • Na Young Kim;Dong Jin Im;Yoo Jin Hong;Byoung Wook Choi;Seok-Min Kang;Jong-Chan Youn;Hye-Jeong Lee
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.540-549
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    • 2024
  • Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

Clinical Application of $^{18}F-FDG$ PET and PET-CT in Adrenal Tumor (부신종양에서 $^{18}F-FDG$ PET 및 PET-CT의 임상 이용)

  • Hwang, Kyung-Hoon;Choi, Duck-Joo;Lee, Min-Kyung;Choe, Won-Sick
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.130-133
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    • 2008
  • Adrenal tumors are increasingly detected by widespread use of anatomical imaging such as a, MRI, etc. For these adrenal tumors, differentiation between malignancy and benignancy is very important. In diagnostic assessment of adrenal tumor, $^{18}F-FDG$ PET and PET-CT have been reported to have high diagnostic performance, especially, very excellent performance in evaluation of adrenal metastasis in the oncologic patient. In cases of adrenal incidentalomas, $^{18}F-FDG$ PET or PET-CT is helpful if a or chemical-shift MRI is inconclusive. $^{18}F-FDG$ PET and PET-CT may be applied to the patients with MIBG-negative pheochromocytomas. In summary, $^{18}F-FDG$ PET and PET-CT are expected to be effective diagnostic tools in the management of adrenal tumor.

Bone scintigraphy in patients with pain

  • Shin, Seung Hyeon;Kim, Seong Jang
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.165-175
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    • 2017
  • Nuclear medicine imaging is widely used in pain medicine. Low back pain is commonly encountered by physicians, with its prevalence from 49% to 70%. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually used to evaluate the cause of low back pain, however, these findings from these scans could also be observed in asymptomatic patients. Bone scintigraphy has an additional value in patients with low back pain. Complex regional pain syndrome (CRPS) is defined as a painful disorder of the extremities, which is characterized by sensory, autonomic, vasomotor, and trophic disturbances. To assist the diagnosis of CRPS, three-phase bone scintigraphy is thought to be superior compared to other modalities, and could be used to rule out CRPS due to its high specificity. Studies regarding the effect of bone scintigraphy in patients with extremity pain have not been widely conducted. Ultrasound, CT and MRI are widely used imaging modalities for evaluating extremity pain. However, SPECT/CT has an additional role in assessing pain in the extremities.