• Proceedings of the Korean Information Science Society Conference
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• 2012.06c
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• pp.359-361
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• 2012

본 논문은 T2강조 MR 영상과 확산강조 MR 영상의 강체 정합을 통해 크기, 위치, 회전 변환 왜곡을 보정하여 자궁내막암의 위치를 자동으로 찾는 방법을 제안한다. 영상해상도와 밝기값 분포가 서로 다른 두 영상간 정합의 정확성을 향상시키기 위해 잡음을 제거하고 두 영상의 밝기값 신호 분포의 유사성을 강화시킨다. 유사성이 향상된 두 영상의 크기, 위치, 회전 변환 왜곡을 보정하기 위해 정규화 상호정보를 최대화 하는 강체 정합을 반복적으로 수행한다. 정합된 영상에서 악성 종양을 쉽게 판별 할 수 있도록 현상확상계수지도를 컬러맵으로 생성하여 T2강조 MR 영상에서 얻은 종양의 후보군에 매핑하여 T2강조 MR 영상과 융합한다. 실험을 위하여 최적화 반복 과정에 따른 정규화 상호정보 수치 수렴 과정을 확인하고, 융합 후 종양 영역이 매핑되는 것을 육안평가를 통해 분석하였다. 제안방법을 통하여 T2강조 MR 영상과 확산강조 MR 영상을 융합함으로써 종양의 위치를 자동으로 파악하고 자궁내막암의 병기를 확정하는 용도로 활용할 수 있다.

• Investigative Magnetic Resonance Imaging
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• v.9 no.1
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• pp.2-8
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• 2005

Purpose : The purpose of this study was to implement a software to visualize tumor and its surrounding fiber tracts simultaneously using diffusion tensor imaging and examine the feasibility of our software for investigating the influence of tumor on its surrounding fiber connectivity. Material and Methods : MR examination including T1-weigted and diffusion tensor images of a patient with brain tumor was performed on a 3.0 T MRI unit. We used the skull-striped brain and segmented tumor images for volume/surface rendering and anatomical information from contrast-enhanced T1-weighted images. Diffusion tensor images for the white matter fiber-tractography were acquired using a SE-EPI with a diffusion scheme of 25 directions. Fiber-tractography was performed using the streamline and tensorline methods. To correct a spatial mismatch between T1-weighted and diffusion tensor images, they were coregistered using a SPM. Our software was implemented under window-based PC system. Results : We successfully implemented the integrated visualization of the fiber tracts with tube-like surfaces, cortical surface and the tumor with volume/surface renderings in a patient with brain tumor. Conclusion : Our result showed the feasibility of the integrated visualization of brain tumor and its surrounding fiber tracts. In addition, our implementation for integrated visualization can be utilized to navigate the brain for the quantitative analysis of fractional anisotropy to assess changes in the white matter tract integrity of edematic and peri-edematic regions in a number of tumor patients.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.165-169
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• 2011

Cardiac myxoma is the most common benign tumor of the heart. However, low incidence of recurrence and metastasis has been reported. A 49-year-old female patient was admitted in the hospital due to sudden onset of left side weakness. Magnetic resonance imaging (MRI) of brain showed multifocal areas of diffusion restriction on diffusion weighted images. Echocardiography was performed to evaluate the cause of embolic brain infarction and cardiac myxoma was found in the left atrium. The patient underwent complete excision of the mass. One year later, the patient was readmitted with symptoms of dysarthria. Brain MRI showed newly developed multiple hemorrhagic metastatic lesions. The patient underwent radiotherapy of the metastatic lesions. Although rare, cardiac myxoma can cause delayed metastasis. We report a rare case of delayed multiple cerebral metastases from the completely resected cardiac myxoma.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.457-460
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• 2014

This case study describes the magnetic resonance characteristics of brain infarction in three dogs. Locations of the brain infarcts were cerebella, thalamus, and multifocal. The infarcts were sharply demarcated from adjacent brain parenchyma, homogeneous, T1-hypointense, T2-hyperintense with/without contrast enhancement, and minimal or no mass effect. Diffusion-weighted imaging (DWI) sequences were available in a dog and the infarcts were hyperintense on DWI and were hypointense on the apparent diffusion coefficient map.

• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.1-7
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• 2013

Purpose : The purpose of this study is to correlate the imaging findings and the clinical findings in patients with transient splenial lesions (TSL). Materials and Methods: Total of 7 patients (M: F = 4: 3; age range 11 - 38 years, mean age 25.5 years) were studied between November 2006 and April 2011. The MRI findings and clinical findings in all patients were retrospectively reviewed. The location, MR signal intensity, restricted diffusion, enhancement pattern and reversibility from the follow up images were reviewed. Clinical features were reviewed with respect to the presented symptoms, signs, treatment and outcome. Results: The lesions were located in the splenium of corpus callosum in all patients. All lesions showed high signal intensity on diffusion weighted imaging (DWI), and six patients showed restricted diffusion on the apparent diffusion coefficient (ADC) map. ADC map was not available in one patient. All lesions (n = 7) showed high signal intensity on the T2 weighted image (T2WI). Five of the patients (71.4%) with follow up images (range 7 - 34 days) showed complete resolution of focal high signal intensity on DWI, with recovery of ADC values as well as T2WI. After contrast media administration, none of the lesions showed any enhancements. All lesions with various etiologies including TB medication were developed in younger age patients and showed reversibility after the acceptable period of minimum 7 days with conservative treatment. Conclusion: All TSL showed nonspecific imaging findings, including restricted diffusion on DWI and ADC map on the initial images. However, reversibility of the lesions and the young age preference can be a characteristic finding of TSL with acceptable period of minimum 7 days. In addition, to keep it in mind that various etiologies including TB medication may cause TSL, is important for radiologists as well as clinicians.

• Korean Journal of Digital Imaging in Medicine
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• v.17 no.1
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• pp.33-41
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• 2015

This study attempts to examine the clinical usefulness of High b-value DWI (diffusion weighted imaging) for brain tumors with an edema. Subjects were seven patients selected from 65 patients who received an MRI scan for suspected encephalopathy and confirmed diagnosis at our hospital from February to July 2015 (male: 7, average age : 66 years old). As test equipment, 3.0T MR System (ACHIEVA Release, Philips, Best, The Netherlands) and 8Channel SENSE Head Coill were used. DWI checks on the use of the variable TR 5460ms, TE 132ms, Slice Thickness 4mm, gap 1mm, Slice number 29 is, 3D T1WI is TR 8.4ms, TE 3.9ms, matrix size $240{\times}240$, Slice can set 180 piecesIt was. b value of 0, 1,000, 2,000 s/mm2 with DWI acquisition and 3D T1WI enhancement five minutes after the Slice Thickness 3mm, gap 0mm to reconstruct the upper face axis (MPR TRA CE) was. As for the experiment, in b-value 1,000 and 2,000 images, SNR and the lesion at the lesion site and CNR in the normal site opposite to the lesion are measured. WW(window width) and WL(window level) are made equal in MRICro software, and the volume of the lesion is measured from each of b-value and MPR TRA CE image. Using SPSS ver. 1.8.0.0 Mann Whitney-test was analyzed for SNR and CNR, while Kruskal-Wallis test was analyzed for volume.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.170-170
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• 2001

Purpose： To evaluate the relationship between reperfusion hyperemia in reversible cerebral ischem and the degree of programmed cell death. Method： We produced the animal models of reversible cerebral ischemia in 10 cats by mean of middle cerebral artery (MCA) occlusion with transorbital approach. MCA was occluded b microvascular clamp for an hour. MR imaging was performed at 0, 1, 2 days after ischemi and reperfusion. Perfusion (PWI) [Contrast enhanced GRE EPI, TR/TE= 1500/40, 40 Phases, 128 matrix, 12 cm FOV] and diffusion (DWI) (SE EPI, b=0, 500, 1000) weighted images were obtained using Philips Intera 1.57 system. rCBV and ADC maps were calculated wi IDL based postprocessing program. Tissue slices were obtained after the last MR imagin TUNEL, Calbin and Acid-Fuscin staining were done for corresponding slices as MR imagin We investigated the differences of degree of apoptosis in the area of reperfusion hyperemia.

• Annals of Clinical Neurophysiology
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• v.7 no.1
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• pp.31-33
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• 2005

Segmental zoster paresis (SZP) is a clinically rare complication of herpes zoster. But it has not been reported that acute cerebral motor cortical infarction coincidentally occurred in SZP. A 86-year-old woman was admitted due to pain, tingling sensation, and weakness of left arm. She had an acute onset of pain and tingling sensation in left arm at first day, shoulder weakness at second day, and multifocal vesicles at fourth day. Deep tendon reflexes of left arm were decreased than right. Electromyography showed an axonal polyneuropathy at superior trunk level of left brachial plexus. Median and ulnar sensory evoked potential tests were normal. Brain MRI showed a high signal in right primary motor cortex on diffusion weighted image. We report a case of acute cerebral motor cortical infarction coincidentally occurred in SZP.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1065-1076
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• 2020

Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion: mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.

• Investigative Magnetic Resonance Imaging
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• v.18 no.2
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• pp.120-132
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• 2014

Purpose : To compare dynamic susceptibility contrast imaging, diffusion-weighted imaging, and susceptibility-weighted imaging (SWI) for the differentiation of tumor recurrence and delayed radiation therapy (RT)-related changes in patients treated with RT for primary brain tumors. Materials and Methods: We enrolled 24 patients treated with RT for various primary brain tumors, who showed newly appearing enhancing lesions more than one year after completion of RT on follow-up MRI. The enhancing-lesions were confirmed as recurrences (n=14) or RT-changes (n=10). We calculated the mean values of normalized cerebral blood volume (nCBV), apparent diffusion coefficient (ADC), and proportion of dark signal intensity on SWI (proSWI) for the enhancing-lesions. All the values between the two groups were compared using t-test. A multivariable logistic regression model was used to determine the best predictor of differential diagnosis. The cutoff value of the best predictor obtained from receiver-operating characteristic curve analysis was applied to calculate the sensitivity, specificity, and accuracy for the diagnosis. Results: The mean nCBV value was significantly higher in the recurrence group than in the RT-change group (P=.004), and the mean proSWI was significantly lower in the recurrence group (P<.001). However, no significant difference was observed in the mean ADC values between the two groups. A multivariable logistic regression analysis showed that proSWI was the only independent variable for the differentiation; the sensitivity, specificity, and accuracy were 78.6% (11 of 14), 100% (10 of 10), and 87.5% (21 of 24), respectively. Conclusion: The proSWI was the most promising parameter for the differentiation of newly developed enhancing-lesions more than one year after RT completion in brain tumor patients.