• Title/Summary/Keyword: Contrast correction

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Free-Breathing Motion-Corrected Single-Shot Phase-Sensitive Inversion Recovery Late-Gadolinium-Enhancement Imaging: A Prospective Study of Image Quality in Patients with Hypertrophic Cardiomyopathy

  • Min Jae Cha;Iksung Cho;Joonhwa Hong;Sang-Wook Kim;Seung Yong Shin;Mun Young Paek;Xiaoming Bi;Sung Mok Kim
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1044-1053
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    • 2021
  • Objective: Motion-corrected averaging with a single-shot technique was introduced for faster acquisition of late-gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging while free-breathing. We aimed to evaluate the image quality (IQ) of free-breathing motion-corrected single-shot LGE (moco-ss-LGE) in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: Between April and December 2019, 30 patients (23 men; median age, 48.5; interquartile range [IQR], 36.5-61.3) with HCM were prospectively enrolled. Breath-held single-shot LGE (bh-ss-LGE) and free-breathing moco-ss-LGE images were acquired in random order on a 3T MR system. Semi-quantitative IQ scores, contrast-to-noise ratios (CNRs), and quantitative size of myocardial scar were assessed on pairs of bh-ss-LGE and moco-ss-LGE. The mean ± standard deviation of the parameters was obtained. The results were compared using the Wilcoxon signed-rank test. Results: The moco-ss-LGE images had better IQ scores than the bh-ss-LGE images (4.55 ± 0.55 vs. 3.68 ± 0.45, p < 0.001). The CNR of the scar to the remote myocardium (34.46 ± 11.85 vs. 26.13 ± 10.04, p < 0.001), scar to left ventricle (LV) cavity (13.09 ± 7.95 vs. 9.84 ± 6.65, p = 0.030), and LV cavity to remote myocardium (33.12 ± 15.53 vs. 22.69 ± 11.27, p < 0.001) were consistently greater for moco-ss-LGE images than for bh-ss-LGE images. Measurements of scar size did not differ significantly between LGE pairs using the following three different quantification methods: 1) full width at half-maximum method; 23.84 ± 12.88% vs. 24.05 ± 12.81% (p = 0.820), 2) 6-standard deviation method, 15.14 ± 10.78% vs. 15.99 ± 10.99% (p = 0.186), and 3) 3-standard deviation method; 36.51 ± 17.60% vs. 37.50 ± 17.90% (p = 0.785). Conclusion: Motion-corrected averaging may allow for superior IQ and CNRs with free-breathing in single-shot LGE imaging, with a herald of free-breathing moco-ss-LGE as the scar imaging technique of choice for clinical practice.

Analysis on the Snow Cover Variations at Mt. Kilimanjaro Using Landsat Satellite Images (Landsat 위성영상을 이용한 킬리만자로 만년설 변화 분석)

  • Park, Sung-Hwan;Lee, Moung-Jin;Jung, Hyung-Sup
    • Korean Journal of Remote Sensing
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    • v.28 no.4
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    • pp.409-420
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    • 2012
  • Since the Industrial Revolution, CO2 levels have been increasing with climate change. In this study, Analyze time-series changes in snow cover quantitatively and predict the vanishing point of snow cover statistically using remote sensing. The study area is Mt. Kilimanjaro, Tanzania. 23 image data of Landsat-5 TM and Landsat-7 ETM+, spanning the 27 years from June 1984 to July 2011, were acquired. For this study, first, atmospheric correction was performed on each image using the COST atmospheric correction model. Second, the snow cover area was extracted using the NDSI (Normalized Difference Snow Index) algorithm. Third, the minimum height of snow cover was determined using SRTM DEM. Finally, the vanishing point of snow cover was predicted using the trend line of a linear function. Analysis was divided using a total of 23 images and 17 images during the dry season. Results show that snow cover area decreased by approximately $6.47km^2$ from $9.01km^2$ to $2.54km^2$, equivalent to a 73% reduction. The minimum height of snow cover increased by approximately 290 m, from 4,603 m to 4,893 m. Using the trend line result shows that the snow cover area decreased by approximately $0.342km^2$ in the dry season and $0.421km^2$ overall each year. In contrast, the annual increase in the minimum height of snow cover was approximately 9.848 m in the dry season and 11.251 m overall. Based on this analysis of vanishing point, there will be no snow cover 2020 at 95% confidence interval. This study can be used to monitor global climate change by providing the change in snow cover area and reference data when studying this area or similar areas in future research.

Correlation Analysis of Diffusion Metrics (FA and ADC) Values Derived from Diffusion Tensor Magnetic Resonance Imaging in Breast Cancer (유방암의 확산텐서 자기공명 영상에서 유도된 확산 지표(FA, ADC) 값의 연관성 분석)

  • Lee, Jae-Heun;Lee, Hyo-Yeong
    • Journal of the Korean Society of Radiology
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    • v.12 no.6
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    • pp.755-762
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    • 2018
  • The purpose of this study was to compare the FA(faractional anisotropy) and ADC(apparent diffusion coefficient) values, which were derived from diffusion tensor imaging in breast cancer patients. The diffusion gradient used in this study was derived from quantitative diffusion indices using 20 directions(b-value, 0 and $1,000s/mm^2$). Quantitative analysis was analyzed using Pearson's correction and qualitative analysis using for correction coefficients. As a result, $FA_{min}$, $FA_{mean}$ and $FA_{max}$ were $0.098{\pm}0.065$, $0.302{\pm}0.142$ and $0.634{\pm}0.236$, respectively(p > 0.05). The $ADC_{min}$, $ADC_{mean}$ and $ADC_{max}$ were $0.741{\pm}0.403$, $1.095{\pm}0.394$ and $1.530{\pm}0.447$, respectively(p > 0.05). The $FA_{min}$, $FA_{mean}$, and $FA_{max}$ mean values were $0.132{\pm}0.050$, $0.418{\pm}0.094$, and $0.770{\pm}0.164$ for Category 6 and Kinetic Curve Pattern III, respectively. $ADC_{min}$, $ADC_{mean}$, and $ADC_{max}$ were $0.753{\pm}0.189$, $1.120{\pm}0.236$, and $1.615{\pm}0.372$, respectively. Quantitative analysis showed negative correlation between $ADC_{mean}-FA_{mean}$ and $ADC_{max}-FA_{max}$(p = 0.001, 0.003). The qalitative analysis showed ADC 0.628(p = 0.001), FA 0.620(p = 0.001) in the internal evaluations, ADC 0.677(p = 0.001), FA 0.695(p = 0.001) in external evaluations. In conclusion, based on the morphological examination, time to signal intensity graph is the form of wash-out(pattern III) in the dynamic contrast enhance examination, As a result, the $ADC_{mean}$ $1.120{\pm}0.236$ and $FA_{mean}$ values were $0.032{\pm}0.142$ with a negative correlation (Y=1.44-1.12X). Therefore, If we understand the shape of time to signal intensity graph and the relationship between ADC and FA, It will be a criterion for distinguishing malignant diseases in breast cancer.

Consideration of Standardized Uptake Value (SUV) According to the Change of Volume Size through the Application of Astonish TF Reconstruction Method (Astonish TF 재구성 기법의 적용을 통한 체적 크기의 변화에 따른 표준섭취계수(SUV)에 관한 고찰)

  • Lee, Juyoung;Nam-Kung, Sik;Kim, Ji-Hyeon;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.115-121
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    • 2014
  • Purpose: In addition to improving the quality of the PET image, through much research, the development of various programs are performed. Astonish TF reconstruction techniques by Philips can confirm the improved contrast of the lesion. Also, It's image reconstruction of 2 mm is possible with rapid reconstruction rate than conventional. In this study, we compared and evaluated Standardized Uptake Value (SUV) in accordance with the 2 mm reconstruction techniques and traditional 4 mm from the $^{18}F-FDG$ PET whole body image. Materials and Methods: In the phantom experiment, NEMA IEC body phantom (sphere: 10, 13, 17, 22, 28, 37 mm) was used to obtain images by using GEMINI TF 64 PET/CT (Philips, Cleveland, USA). Also, In the clinical images, we performed $^{18}F-FDG$ PET/CT examination to 30 women (age: $55.1{\pm}11.3$, BMI: $24.1{\pm}2.9$) with a diagnosis of breast cancer. After that, we reconstructed images in 2 mm and 4 mm respectively. The region of interest was drawn to acquired images. Since then, we measured SUV and statistically analyzed with SPSS ver.18 by using EBW (Extended Brilliance Workstation) NM ver.1.0. Results: After analyzing the result of the phantom study, there was a tendency that the bigger hot sphere size, the higher SUV. If you compared the 2 mm reconstruction techniques to 4 mm, it increased 95.78% in 10 mm, 50.60% in 13 mm, 25.00% in 17 mm, 30.04% in 22 mm, 31.81% in 28 mm, and 27.84% in 37 mm. Through the result of the analysis of the 2 mm reconstruction techniques and 4 mm in clinical images, it appeared that SUV of 2 mm was higher than that of 4 mm. Also the smaller the volume was, the more the change rate increased. Conclusion: After analyzing the result of the clinical picture and phantom experiments applied by Astonish TF reconstruction techniques, as the size of the volume was small, the change rate of the SUV increased. Therefore, it was necessary to further research about the SUV correction for accurate and active utilization of 2 mm reconstruction techniques which had excellent lesion discrimination ability and contrast in clinic.

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Analysis of the Eyeglasses Supply System for Ametropes in ROK Military (한국군 비정시자용 안경의 보급체계 분석)

  • Jin, Yong-Gab;Koo, Bon-Yeop;Lee, Woo-Chul;Yoon, Moon-Soo;Park, Jin-Tae;Lee, Hang-Seok;Lee, Kyo-Eun;Leem, Hyun-Sung;Jang, Jae-Young;Mah, Ki-Choong
    • The Korean Journal of Vision Science
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    • v.20 no.4
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    • pp.579-588
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    • 2018
  • Purpose : To analyze the eyeglasses supply system for ametropic soldiers in ROK military. Methods : We investigated and analyzed the supply system of eyeglasses for the ametropic soldiers provided by the Korean military. The refractive powers and corrected visual acuity were measured for 37 ametropic soldiers who wear insert glasses for ballistic protective and gas-masks supplied by the military based on their habitual prescriptions. Full correction of refractive error was prescribed for subjects having less than 1.0 of distance visual acuity, and comparison was held for inspecting the changes in corrected visual acuity. Suggestions were provided for solving the issues regarding current supplying system, and this study investigated the applicabilities for utilizing professional optometric manpower. Results : The new glasses supplied by army for ametropic soldiers were duplicated from the glasses they worn when entering the army. The spherical equivalent refractive powers of the conventional, ballistic protective and gas-mask insert glasses supplied for 37 ametropic soldiers were $-3.47{\pm}1.69D$, $-3.52{\pm}1.66D$ and $-3.55{\pm}1.63D$, respectively, and the spherical equivalent refractive power of full corrected glasses was $-3.79{\pm}1.66D$, which showed a significant difference(p<0.05). The distant corrected visual acuity measured at high and low contrast(logMAR) of conventional, ballistic protective and gas-mask insert glasses were $0.06{\pm}0.80$, $0.21{\pm}0.82$, $0.15{\pm}0.74$, $0.34{\pm}0.89$, $0.10{\pm}0.70$ and $0.22{\pm}0.27$, respectively, while the corrected visual acuity by full corrected glasses were increased to $0.02{\pm}1.05$, $0.10{\pm}0.07$, $0.09{\pm}0.92$, $0.26{\pm}0.10$, $0.04{\pm}1.00$ and $0.19{\pm}1.00$, respectively. There was a significant difference(p<0.05) except for the case of the low contrast corrected visual acuity of the conventional and gas-mask insert glasses. The procedure for ordering, dispensing, and supplying military glasses consists of 5 steps, and it was found that approximately two weeks or more are required to supply from the initial examination. Conclusion : The procedure of supplying the military glasses showed three issues: 1) a lack of refraction for prescription system, 2) relatively long length of time required for supplying the glasses, 3) an inaccurate power of supplied glasses. In order to solve those issues, in the short term, education is necessarily required for soldiers on the measurement of the refractive powers, and in the near future, further standard procedures for prescription of glasses as well as the securement of optometric manpower are expected.

Variation on Estimated Values of Radioactivity Concentration According to the Change of the Acquisition Time of SPECT/CT (SPECT/CT의 획득시간 증감에 따른 방사능농도 추정치의 변화)

  • Kim, Ji-Hyeon;Lee, Jooyoung;Son, Hyeon-Soo;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.2
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    • pp.15-24
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    • 2021
  • Purpose SPECT/CT was noted for its excellent correction method and qualitative functions based on fusion images in the early stages of dissemination, and interest in and utilization of quantitative functions has been increasing with the recent introduction of companion diagnostic therapy(Theranostics). Unlike PET/CT, various conditions like the type of collimator and detector rotation are a challenging factor for image acquisition and reconstruction methods at absolute quantification of SPECT/CT. Therefore, in this study, We want to find out the effect on the radioactivity concentration estimate by the increase or decrease of the total acquisition time according to the number of projections and the acquisition time per projection among SPECT/CT imaging conditions. Materials and Methods After filling the 9,293 ml cylindrical phantom with sterile water and diluting 99mTc 91.76 MBq, the standard image was taken with a total acquisition time of 600 sec (10 sec/frame × 120 frames, matrix size 128 × 128) and also volume sensitivity and the calibration factor was verified. Based on the standard image, the comparative images were obtained by increasing or decreasing the total acquisition time. namely 60 (-90%), 150 (-75%), 300 (-50%), 450 (-25%), 900 (+50%), and 1200 (+100%) sec. For each image detail, the acquisition time(sec/frame) per projection was set to 1.0, 2.5, 5.0, 7.5, 15.0 and 20.0 sec (fixed number of projections: 120 frame) and the number of projection images was set to 12, 30, 60, 90, 180 and 240 frames(fixed time per projection:10 sec). Based on the coefficients measured through the volume of interest in each acquired image, the percentage of variation about the contrast to noise ratio (CNR) was determined as a qualitative assessment, and the quantitative assessment was conducted through the percentage of variation of the radioactivity concentration estimate. At this time, the relationship between the radioactivity concentration estimate (cps/ml) and the actual radioactivity concentration (Bq/ml) was compared and analyzed using the recovery coefficient (RC_Recovery Coefficients) as an indicator. Results The results [CNR, radioactivity Concentration, RC] by the change in the number of projections for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.5%, +3.90%, 1.04] at -90%, [-77.9%, +2.71%, 1.03] at -75%, [-55.6%, +1.85%, 1.02] at -50%, [-33.6%, +1.37%, 1.01] at -25%, [-33.7%, +0.71%, 1.01] at +50%, [+93.2%, +0.32%, 1.00] at +100%. and also The results [CNR, radioactivity Concentration, RC] by the acquisition time change for each increase or decrease rate (-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.3%, -3.55%, 0.96] at - 90%, [-73.4%, -0.17%, 1.00] at -75%, [-49.6%, -0.34%, 1.00] at -50%, [-24.9%, 0.03%, 1.00] at -25%, [+49.3%, -0.04%, 1.00] at +50%, [+99.0%, +0.11%, 1.00] at +100%. Conclusion In SPECT/CT, the total coefficient obtained according to the increase or decrease of the total acquisition time and the resulting image quality (CNR) showed a pattern that changed proportionally. On the other hand, quantitative evaluations through absolute quantification showed a change of less than 5% (-3.55 to +3.90%) under all experimental conditions, maintaining quantitative accuracy (RC 0.96 to 1.04). Considering the reduction of the total acquisition time rather than the increasing of the image acquiring time, The reduction in total acquisition time is applicable to quantitative analysis without significant loss and is judged to be clinically effective. This study shows that when increasing or decreasing of total acquisition time, changes in acquisition time per projection have fewer fluctuations that occur in qualitative and quantitative condition changes than the change in the number of projections under the same scanning time conditions.

Evaluation of Retro recon for SRS planning correction according to the error of recognize to coordinate (SRS의 좌표 인식 오류 시 Retro recon을 이용한 수정 방법에 관한 평가)

  • Moon, hyeon seok;Jeong, deok yang;Do, gyeong min;Lee, yeong cheol;Kim, sun myung;Kim, young bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.101-108
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    • 2016
  • Purpose : The purpose of this study was to evaluate the Retro recon in SRS planning using BranLAB when stereotactic location error occurs by metal artifact. Materials and Methods : By CT simulator, image were acquired from head phantom(CIRS, PTW, USA). To observe stereotactic location recognizing and beam hardening, CT image were approved by SRS planning system(BrainLAB, Feldkirchen, Germany). In addition, we compared acquisition image(1.25mm slice thickness) and Retro recon image(using for 2.5 mm, 5mm slice thickness). To evaluate these three images quality, the test were performed by AAPM phantom study. In patient, it was verified stereotactic location error. Results : All the location recognizing error did not occur in scanned image of phantom. AAPM phantom scan images all showed the same trend. Contrast resolution and Spatial resolution are under 6.4 mm, 1.0 mm. In case of noise and uniformity, under 11, 5 of HU were measured. In patient, the stereotactic location error was not occurred at reconstructive image. Conclusion : For BrainLAB planning, using Retro recon were corrected stereotactic error at beam hardening. Retro recon may be the preferred modality for radiation treatment planning and approving image quality.

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Abosrbed Dose Measurements and Phantom Image Ecaluation at Minimum CT Dose for Pediatric SPECT/CT Scan (소아 SPECT/CT 검사를 위한 최저조건에서의 피폭선량측정 및 팬텀의 영상평가)

  • Park, Chan Rok;Choi, Jin Wook;Cho, Seong Wook;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.82-88
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    • 2014
  • Purpose: The purpose of study was to evaluate radiation dose for pediatric patients by changing tube voltage (kVp) and tube current (mA) at minimum conditions. By evaluating radiation dose, we want to provide dose reduction for pediatric patients and maintain good quality of SPECT/CT images. Materials and Methods: Discovery NM/CT 670 Scanne was used as SPECT/CT. Tube voltages are 80 and 100 kvP. Tube currents are 10, 15, 20, 25 mA. Using PMMA (Polymethyl methacrylate) Phantom, radiation dose which were calculated at center and peripheral dose and SNRD (Signal to Noise Ratio Dose) were evaluated. Using the CT performance phantom, spatial resolution was evaluated as the MTF (Modulation Transfer Function) graph. Jaszczak phantom was used for SPECT image evaluation by CNR (Contrast to Noise to Ratio). Results: Radiation dose using the PMMA phantom was higher peripheral dose than center dose about 7%. SNRD were 7.8, 8.2, 8.3, 8.8, 8.8, 9.9, 9.8, 9.6 for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA. We can distinguish 35, 45, 70, 71, 52, 58, 90, 110 linepair for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA at resolution with MTF. CNR of SPECT images using CT attenuation map were 57.8, 57.7, 57.1, 56.7, 56.6, 56.7, 56.7, 56.7% for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA. Conclusion: In this study, radiation dose for pediatric patients showed decreased low dose condition. And SNRD value was similar in all condition. Resolution showed higher value at 100kVp than 80kVp. for CNR, there was no significant difference. we should take additional study to prove better quality and dose reduction.

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Errors in Net Ecosystem Exchanges of CO2, Water Vapor, and Heat Caused by Storage Fluxes Calculated by Single-level Scalar Measurements Over a Rice Paddy (단일 높이에서 관측된 저장 플럭스를 사용할 때 발생하는 논의 이산화탄소, 수증기, 현열의 순생태계교환량 오차)

  • Moon, Minkyu;Kang, Minseok;Thakuri, Bindu Malla;Lee, Jung-Hoon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.17 no.3
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    • pp.227-235
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    • 2015
  • Using eddy covariance method, net ecosystem exchange (NEE) of $CO_2$ ($F_{CO_2}$), $H_2O$ (LE), and sensible heat (H) can be approximated as the sum of eddy flux ($F_c$) and storage flux term ($F_s$). Depending on strength and distribution of sink/source of scalars and magnitude of vertical turbulence mixing, the rates of changes in scalars are different with height. In order to calculate $F_s$ accurately, the differences should be considered using scalar profile measurement. However, most of flux sites for agricultural lands in Asia do not operate profile system and estimate $F_s$ using single-level scalars from eddy covariance system under the assumption that the rates of changes in scalars are constant regardless of the height. In this study, we measured $F_c$ and $F_s$ of $CO_2$, $H_2O$, and air temperature ($T_a$) using eddy covariance and profile system (i.e., the multi-level measurement system in scalars from eddy covariance measurement height to the land surface) at the Chengmicheon farmland site in Korea (CFK) in order to quantify the differences between $F_s$ calculated by single-level measurements ($F_s_{-single}$ i.e., $F_s$ from scalars measured by profile system only at eddy covariance system measurement height) and $F_s$ calculated by profile measurements and verify the errors of NEE caused by $F_s_{-single}$. The rate of change in $CO_2$, $H_2O$, and Ta were varied with height depending on the magnitudes and distribution of sink and source and the stability in the atmospheric boundary layer. Thus, $F_s_{-single}$ underestimated or overestimated $F_s$ (especially 21% underestimation in $F_s$ of $CO_2$ around sunrise and sunset (0430-0800 h and 1630-2000 h)). For $F_{CO_2}$, the errors in $F_s_{-single}$ generated 3% and 2% underestimation of $F_{CO_2}$ during nighttime (2030-0400 h) and around sunrise and sunset, respectively. In the process of nighttime correction and partitioning of $F_{CO_2}$, these differences would cause an underestimation in carbon balance at the rice paddy. In contrast, there were little differences at the errors in LE and H caused by the error in $F_s_{-single}$, irrespective of time.

The Study on the investigation of oriental medical theraphy(oriental medical theraphy by symptoms and signs and Sasang constitutional medicine)and the each effect of oriental medicine, occidental medicine and both joint control (뇌졸중(腦卒中)에 대(大)한 한방치료법(韓方治療法) 연구(硏究)(증치의학(證治醫學)과 사상의학(四象醫學)) 및 한방(韓方), 양방(洋方), 양(洋)·한방(韓方) 협진치료(協診治療) 효과(效果)에 관(關)한 연구(硏究))

  • Kim, Jong-won;Kim, Young-kyun;Kim, Beob-young;Lee, In-seon;Lee, In-seon;Jang, Kyung-jeon;Gwon, Jeong-Nam;Lee, Won-oe;Song, Chang-won;Park, Dong-il
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.2
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    • pp.351-429
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    • 1998
  • The Purpose of Study 1. Inspection of clinical application on TCD to CVA 2. Objective Comparement and analysis about treatment effect of Western-Medicine, Korean Medicine, Cooperative consultation of Korean and Western medicice for CVA The Subject of Study We intended for the eighty six patient of CVA who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. I to 1998. 7. 31 1. View of CT, MRI : the patient of Cb infarction 2. Attack Time : The patient who coming hospital falling ill within the early one week The method of study 1. Treat four group of Korean medicine, Constitution medicine, Western medicine, cooperative consultation of Korean medicine and Western medicine. 2. Application of TCD Check the result for three times, immediatly after the attack, two months later, four months later 3. Comparative analysis of each treatment effect by clinical symptoms and pathologic examination 4. The Judgement of the patient The Result From 8/1/1997 to 7/31/1998, We have the following result by clinical analysis intended for CVA 86 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. 1 to 1998. 7. 31 in 1. Analysis according to Age The first stage of thirties, forties, seventies is heavier than forties, fifties in improvement and Index of improvement of symptom 2. Analysis according to sex We have no special relation in an average of symptom and improvement, Index improvement 3. Analysis according to Family History We have the better result in first stage and improvement, index improvement when no family history. 4. Analysis according to Past History We have no special relation in past history like hypertension, DM, heart problem 5. Analysis devided two group, above group and under group on the basis of the average in first stage of all patient. We have the better result when the first stage is light, that the first score of barthel index and CNS is high. 6. Analysis of the effect of treatment about Korean medical treatment, Western medical treatment, cooperative treatment. In this study, the highest group of rate of treatment at four contrast groups (Korean medicine, Constitution medicine, Western medicine, cooperative treatment according to dyagnosis and range of treatment was the patient group of doing dyagnosis and method of treatment based on constitution medicine theory. This is that of doing demostation, A-Tx, po-herb-medication according to dyagnosis and treat method of constitution of Lee Je-ma In case of left, the case of dyagnosis any disease according to doctor view but, normal in TCDwas 22-beginning of attack, 20- two weeks later, 11 case-four weeks later in case of right, 15-beginning of attack, 12-two weeks later, 9 case four weeks later. So left vessel compares to right vessel is more interference, in fact more than a 1/2 of the patients of MCA disease can't do dyagnosis. In rate of imparement, the state of pacient improved but there isn't the improved case of result in TCD. 7. In TCD dyagnosis, between the case of inconsus the doctor view specially MCA in brain blood vessel is in large numbers and in total 86's patient, impossible case of dyagnosis according to interferiance of temporal is 21 case. 7. Result study about application of Kreaan medical treatment 1) The impossible patient of observation MCA blood vescular for interference temporal bone happened in large numbers. 2) There is the case having difference result to CT,MRI, MRA result. 3) Because individual difference is large, excluding to ananalogy of symptom. This is normal numerical value that has possibility of being checked as abnormal numerical value 4) there are a lot of cases that the speed of normal part is as similarly measured as that of abnormal part. It means that we cannot judge the disease by this measure 5) It is rare that this measure represent degree of improvement in patient's condition of disease. When we observe patient's condition become better, but we have no case that the result of TCD test better. 6) The result could be appear differently by the technique of the tester or by the experience of the tester 7) In the TCD test, abnormal symptoms is checked at 0 week, but at 2th week, normal symptoms is checked, again at 4th week abnormal is checked. According to the above result, CVA diagnosis is difficult only with TCD, as it appear in diagnosis error check which is suggested in the problem connected to project, for the aged persons who have the worst hardening of part of the cranium (1998. 5. 26 77 of 83 patients is 50s) there is a lot of cases that the measurement is impossible by TCD and the correction of measurement numerical value is decreased, as the age of cerebral infarction is high, TCD is inappropriate to diagnosis equipment through this study.

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