• Title/Summary/Keyword: Cerebral tumor

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Hybrid Two-Dimensional Proton Spectroscopic Imaging of Pediatric Brain: Clinical Application (소아 뇌에서의 혼성 이차원 양성자자기공명분광법의 임상적 응용)

  • Sung Won Youn;Sang Kwon Lee;Yongmin Chang;No Hyuck Park;Jong Min Lee
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.1
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    • pp.64-72
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    • 2002
  • Purpose : To introduce and demonstrate the advantages of the new hybrid two-dimensional (2D) proton spectroscopic imaging (SI) over the single voxel spectroscopy (SVS) and conventional 2D SI in the clinical application of spectroscopy for pediatric cerebral disease. Materials and Methods : Eighty-one hybrid 2D proton spectroscopic imaging was performed in 79 children (36 normal infants and children, 10 with hypoxic-ischemic injury, 20 with toxic-metabolic encephalopathy, seven with brain tumor, three with meningoencephalitis, one with neurofibromatosis, one with Sturge-Weber syndrome and one with lissencephaly) ranging in age from the third day of life to 15 years. In adult volunteers (n=5), all three techniques including hybrid 2D proton SI, SVS using PRESS sequence, and conventional 2D proton SI were performed. Both hybrid 2D proton SI and SVS using PRESS sequence were performed in clinical cases (n=). All measurements were performed with a 1.5-T scanner using standard head quadrature coil. The 16$\times$16 phase encoding steps were set on variable field of view (FOV) depending on the size of the brain. The hybrid volume of interest inside FOV was set as $75{\times}75{\times}15{\;}\textrm{mm}^3$ or smaller to get rid of unwanted fat signal. Point-resolved spectroscopy (TR/TE=1,500 msec/135 or 270msec) was employed with standard chemical shift selective saturation (CHESSI pulses for water suppression. The acquisition time and spectral quality of hybrid 2D proton SI were compared with those of SVS and conventional 2D proton SI. Results : The hybrid 2D proton SI was successfully conducted upon all patients.

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Comparative Analysis of Signal Intensity and Apparent Diffusion Coefficient at Varying b-values in the Brain : Diffusion Weighted-Echo Planar Image ($T_2^*$ and FLAIR) Sequence (뇌의 확산강조 영상에서 b-value의 변화에 따른 신호강도, 현성확산계수에 관한 비교 분석 : 확산강조 에코평면영상($T_2^*$ 및 FLAIR)기법 중심으로)

  • Oh, Jong-Kap;Im, Jung-Yeol
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.313-323
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    • 2009
  • Diffusion-weighted imaging (DWI) has been demonstrated to be a practical method for the diagnosis of various brain diseases such as acute infarction, brain tumor, and white matter disease. In this study, we used two techniques to examine the average signal intensity (SI) and apparent diffusion coefficient (ADC) of the brains of patients who ranged in age from 10 to 60 years. Our results indicated that the average SI was the highest in amygdala (as derived from DWI), whereas that in the cerebrospinal fluid was the lowest. The average ADC was the highest in the cerebrospinal fluid, whereas the lowest measurement was derived from the pons. The average SI and ADC were higher in $T_2^*$-DW-EPI than in FLAIR-DW-EPI. The higher the b-value, the smaller the average difference in both imaging techniques; the lower the b-value, the greater the average difference. Also, comparative analysis of the brains of patients who had experienced cerebral infarction showed no distinct lesion in the general MR image over time. However, there was a high SI in apparent weighted images. Analysis of other brain diseases (e.g., bleeding, acute, subacute, chronic infarction) indicated SI variance in accordance with characteristics of the two techniques. The higher the SI, the lower the ADC. Taken together, the value of SI and ADC in accordance with frequently occurring areas and various brain disease varies based on the b-value and imaging technique. Because they provide additional useful information in the diagnosis and treatment of patients with various brain diseases through signal recognition, the proper imaging technique and b-value are important for the detection and interpretation of subacute stroke and other brain diseases.

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The Role of Radiation Therapy in the Treatment of Intracranial Glioma : Retrospective Analysis of 96 Cases (뇌 교종 96예에 대한 방사선치료 성적의 후향적 분석)

  • Kim Yeon Sil;Kang Ki Mun;Choi Byung Ock;Yoon Sei Chul;Shinn Kyung Sub;Kang Jun Gi
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.249-258
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    • 1993
  • Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months (range: 31~133 months). Of the 96 patients, 60 $(63\%)$ were males and 36 $(37\%)$ were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headeche $(67\%)$ followed by cerebral motor and sensory discrepancy $(54\%),$ nausea and vomiting $(34\%),$ seizure $(19\%),$ mental change $(10\%)$ and memory and calculation impairment $(8\%).$ Eighty five $(88.5\%)$ patients all, except 11 $(11.5\%)$ brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas $(75\%),$ 4 mixed oligoastrocytomas $(5\%),$ and 17 oligodendrogliomas $(20\%).$ Fourty nine patients $(58\%$ were grade I, II histology and 36 $(42\%)$ patients were grade III, IV histology. Of the 96 patients, 64 $(67\%)$ recieved postoperative RT and 32 $(33\%)$ were treated with primary radiotherapy. Gross total resection was peformed in 14 $(16\%)$ patients, subtotal resection En 29 $(34\%),$ partial resection in 21 $(25\%),$ and biopsy only in 21 $(25\%).$ Median survival time was 53 months (range 2~ 133 months), and 2- and, 5-year survival rate were $69\%,49\%$ respectively. 5-year survival rate by histologic grade was grade I, $70\%,$ grade II, $58\%,$ grade III, $28\%,$ and grade IV, $15\%.$ Multivariated analysis demonstrate that age at diagnosis (p=0.0121), Karnofsky performance Status (KPS) (p=0.0002), histologic grade (p=0.0001), postoperative radiation therapy (p=0.0278), surgical extent (p =0.024), cerebellar location of tumor (p=0.0095) were significant prognostic factors influencing on survival.

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