• Title/Summary/Keyword: FLAIR

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Gerstmann-Sträussler-Scheinker Disease: A Case Report (Gerstmann-Sträussler-Scheinker병: 증례 보고)

  • Minji Shin;Donghyun Kim;Young Jin Heo;Jin Wook Baek;Suyoung Yun;Hae Woong Jeong
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.745-749
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    • 2023
  • Gerstmann-Sträussler-Scheinker (GSS) disease is a rare hereditary prion disease which is clinically characterized by a progressive cerebellar ataxia followed by cognitive impairment. We report a rare case of GSS disease in a 39-year-old male patient who complained of a progressive gait disturbance followed by dysarthria with cognitive impairment, after five months from the onset of initial symptom. His brain MRI scan revealed multifocal symmetric diffusion restricted lesions with T2/FLAIR hyperintensities in bilateral cerebral cortices, basal ganglia, and thalami. His family members also manifested similar symptoms in their 40-50s, suggesting the possibility of a genetic disease. Finally, he was genetically diagnosed with GSS disease by real-time quaking-induced conversion and prion protein (PRNP) gene sequencing test.

Diffusion-Weighted MR Imaging of Intracerebral Hemorrhage

  • Bo Kiung Kang;Dong Gyu Na;Jae Wook Ryoo;Hong Sik Byun;Hong Gee Roh;Yong Seon Pyeun
    • Korean Journal of Radiology
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    • v.2 no.4
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    • pp.183-191
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    • 2001
  • Objective: To document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images. Materials and Methods: In our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2* gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images. Results: DWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage. Conclusion: DWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.

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T2 Relaxation Times of the Cingulate Cortex, Amygdaloid Body, Hippocampal Body, and Insular Cortex: Comparison of 1.5 T and 3.0 T (대상회 피질, 편도체, 해마체, 도피질의 T2 이완시간: 1.5테슬러와 3.0테슬러 자기공명영상장치의 비교)

  • Lee, Ho-Joon;Kim, Eung-Yeop
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.67-71
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    • 2011
  • Purpose : To compare T2 relaxation times (T2) in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex between 1.5T and 3.0T MR imagers. Materials and Methods : Twelve healthy volunteers underwent FLAIR and CPMG imaging perpendicular to the hippocampal body at both 3.0T and 1.5T. T2 was measured in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex. The T2 relaxation time ratios of the cingulate cortex, insular cortex, and amygdaloid body to the hippocampal body were compared between 1.5T and 3.0T. Results : The mean T2 of the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex at 1.5T were $109.5{\pm}3.1$, $117.0{\pm}7.1$, $114.7{\pm}2.4$, and $111.3{\pm}2.4$, respectively; $99.7{\pm}3.8$, $100.7{\pm}4.3$, $97.9{\pm}3.4$, and $96.2{\pm}2.0$, respectively, at 3.0T. Percentage changes of T2 in the cingulate cortex, insular cortex, amygdaloid body, and hippocampal body at 3.0T with respect to those at 1.5T were -8.9%, -13.5%, -14.6%, and -13.5%, respectively. The mean T2 ratios of the cingulate gyrus, insular cortex, and amygdaloid body to the hippocampal body at 1.5T and 3.0T were 0.96 and 1.02 (p = 0.003); 1.02 and 1.03 (p>0.05); 0.97 and 0.98 (p>0.05), respectively. Conclusion : T2 decrease in the cingulate cortex was less than the amygdaloid body, insular cortex, and hippocampal body at 3.0T. The mean T2 ratio of the cingulate gyrus to the hippocampal body was significantly different between 1.5T and 3.0T.

Signal Change of Iodinated Contrast Agents in MR Imaging (요오드화 조영제가 MR영상에 미치는 신호 변화)

  • Jeong, HK;Kim, Seongho;Kang, Chunghwan;Lee, Suho;Yi, Yun;Kim, Mingi;Kim, Hochul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.131-138
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    • 2016
  • In this study, we tried to analyze the influence of ICM(Iodinated Contrast Media) in MR imaging compare to GBCA(Gadolinium Based Contrast Agent), and as this result we discussed whether resonable or not the protocol which is MRI scan after enhanced CT scan without proper time interval in clinical field. For this research, we assembled two phantoms. which one was iodine and another one was gadolinium. We did test two phantoms in conventional MRI scan which is T1, T2, T2 FLAIR and 3D angio. After that, quantitative analysis was progressed. The results of study were as follow : SSI(Saline's Signal Intensity) was shown as each sequences 175, 1231, 333, 37 [a.u] at iodine. and 1297, 123, 757, 232 [a.u] was recorded at gadolinium. BDEPS(the Biggest Difference of EPS) was shown as each sequences 1297, 123, 757, 232 [a.u] at iodine and 793, 6, 1495, 365 [a.u] was recorded at gadolinium. At this time, EPS(Enhancement Percentage to Saline) was shown 641.1, -90.0, 127.3, 527% at iodine and 685.1, 99.4, 365.7, 1077.4% was recorded at gadolinium. BP(BDEPS's point) was shown 900, 900, 477, 900 mmol at iodine and 4, 0.2, 0.2, 40 mmol was recorded at gadolinium. CPSS(Change Point of SI to SSI) was shown 63, 423, 63, 29 mmol at iodine and each [50, 30], [4, 0.2], [4, 1], 0.2 mmol was recorded at gadolinium. According to this research, we could not only discover the fact that was iodine could effect on MR signal, but also the pattern is different as various sequences compare to gadolinium. Therefore, we expect useful diagnostic MR image in clinical field with this quantitative data for deciding protocol regarding MRI and CT scan order.

A Case of Paraneoplastic Limbic Encephalitis Associated with Small Cell Lung Cancer

  • Ryu, Ja Young;Lee, Seung Hyeun;Lee, Eun Joo;Min, Kyung Hoon;Hur, Gyu Young;Lee, Sung Yong;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.5
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    • pp.273-277
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    • 2012
  • Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.

Implementation about measurement of the head SAR and variable parameter according to operation control mode in brain MR study with 1.5Tesia (1.57 BRAIN MRI검사에서의 작동제어모드를 통한 두부 SAR측정과 변화인자에 관한 고찰)

  • Lee, Kyu-Su;Sim, Hyun;Moon, Ji-Hoon;Oh, Jae-Cheol
    • Proceedings of the KIEE Conference
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    • 2007.04a
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    • pp.58-60
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    • 2007
  • Magnetic Resonance Imaging(MRI) has become a very widely used medical procedur e. Clo.sed and open systems are typically used with static magnetic fields at or below 2 Tesla. BWhole body SAR(specific absorbsion rate) is the value of SAR averaged over the entire body of the patient over any period of 15 minutes. Head SAR is the value of SAR averaged over the head of the patient for any period of 10 minutes. SAR is a measure of the absorption of electromagnetic energy in the body' (typically in watts per kilogram (W/kg)). The normal operating mode comprises values of head SAR not higher than 3 W/kg. The second level controlled operating mode comprises values higher than 3 W/kg. Current FDA guidance limits the SAR in the whole body. including the head to a range of 1.5 to 4.0 W/kg, depending on the patient's clinical condition. SAR, limit restrictions are incorporated in all MRI systems. and domestic' s guidance limits the SAR in a part body. including the head to 3.2w/kg and less. The purpose of this study is to evaluate on change of head SAR in using MRI pulse sequence and to check if exceed 3.2(w/kg) level in domestic a part exposure through measured head SAR. 23 patient's the average head SAR of pulse sequence is that T2WI sagittal is 0.5375. T2WI axial(FSE) is 0.4817, T1WI axial(SE) is, 0.8179. FLAIR axial is 0.4580. GRE axial is 0.0077, Diffusion is 0.0824w/kg. The head SAR exposed per patient was proved 2.3845w/kg less than the international standard. Coefficient of correlation for the relations body weight and SAR or for the relations ETL(echo train length) and SAR is 1 value. Coefficient of correlation for the relations between TR(time to repeat) and SAR is -0.602 value. so SAR increased relative to weight body and ETL. But the relations between TR and SAR is negative definite.

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A Case of Childhood Cerebral Form Adrenoleukodystrophy with Novel Mutation in the ABCD1 Gene (새로운 ABCD1 유전자의 돌연변이를 가지는 소아 대뇌형 부신백질이영양증 1례)

  • Shin, Young-Lim
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.49-53
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    • 2012
  • X-linked adrenoleukodystrophy (ALD) is a rare inherited metabolic disease which results in impaired peroxisomal ${\beta}$-oxidation and the accumulation of very long chain fatty acids (VLCFA) in the adrenal cortex, the myelin of the central nervous system, and the testes. X-linked ALD is caused by mutations in the ABCD1 gene encoding an ATP-binding cassette transporter superfamily located in the peroxisomal membrane. This disease is characterized by a variety of phenotypes. The classic childhood cerebral ALD is a rapidly progressive demyelinating condition affecting the cerebral white matter before the age of 10 years in boys. We report the case of a 8-year-old with childhood cerebral X-linked ALD who developed inattention, hyperactivity, motor incoordination and hemiparesis. We diagnosed ALD with elevated plasma very long chain fatty acid level and diffuse high signal intensity lesions in both parieto-occipital white matter and cerebellar white matter in brain MRI. We identified a novel c.983delT (p.Met329CysfsX7) mutation of the ABCD1 gene. There is no correlation between X-ALD phenotype and mutations in the ABCD1 gene. Further studies for searching additional non-genetic factor which determine the phenotypic variation will be needed.

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Findings Regarding an Intracranial Hemorrhage on the Phase Image of a Susceptibility-Weighted Image (SWI), According to the Stage, Location, and Size

  • Lee, Yoon Jung;Lee, Song;Jang, Jinhee;Choi, Hyun Seok;Jung, So Lyung;Ahn, Kook-Jin;Kim, Bum-soo;Lee, Kang Hoon
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.2
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    • pp.107-113
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    • 2015
  • Purpose: Susceptibility weighted imaging (SWI) is a new magnetic resonance technique that can exploit the magnetic susceptibility differences of various tissues. Intracranial hemorrhage (ICH) looks a dark blooming on the magnitude images of SWI. However, the pattern of ICH on phase images is not well known. The purpose of this study is to characterize hemorrhagic lesions on the phase images of SWI. Materials and Methods: We retrospectively enrolled patients with ICH, who underwent both SWI and precontrast CT, between 2012 and 2013 (n = 95). An SWI was taken, using the 3-tesla system. A phase map was generated after postprocessing. Cases with an intracranial hemorrhage were reviewed by an experienced neuroradiologist and a trainee radiologist, with 10 years and 3 years of experience, respectively. The types and stages of the hemorrhages were determined in correlation with the precontrast CT, the T1- and T2-weighted images, and the FLAIR images. The size of the hemorrhage was measured by a one- directional axis on a magnitude image of SWI. The phase values of the ICH were qualitatively evaluated: hypo-, iso-, and hyper-intensity. We summarized the imaging features of the intracranial hemorrhage on the phase map of the SWI. Results: Four types of hemorrhage are observed: subdural and epidural; subarachnoid; parenchymal hemorrhage; and microbleed. The stages of the ICH were classified into 4 groups: acute (n = 34); early subacute (n = 11); late subacute (n = 15); chronic (n = 8); stage-unknown microbleeds (n = 27). The acute and early subacute hemorrhage showed heterogeneous mixed hyper-, iso-, and hypo-signal intensity; the late subacute hemorrhage showed homogeneous hyper-intensity, and the chronic hemorrhage showed a shrunken iso-signal intensity with the hyper-signal rim. All acute subarachnoid hemorrhages showed a homogeneous hyper-signal intensity. All parenchymal hemorrhages (> 3 mm) showed a dipole artifact on the phase images; however, microbleeds of less than 3 mm showed no dipole artifact. Larger hematomas showed a heterogeneous mixture of hyper-, iso-, and hypo-signal intensities. Conclusion: The pattern of the phase value of the SWI showed difference, according to the type, stage, and size.

Susceptibility Vessel Sign for the Detection of Hyperacute MCA Occlusion: Evaluation with Susceptibility-weighted MR Imaging

  • Lee, Sangmin;Cho, Soo Bueum;Choi, Dae Seob;Park, Sung Eun;Shin, Hwa Seon;Baek, Hye Jin;Choi, Ho Cheol;Kim, Ji-Eun;Choi, Hye Young;Park, Mi Jung
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.105-113
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    • 2016
  • Purpose: Susceptibility vessel sign (SVS) on gradient echo image, which is caused by MR signal loss due to arterial thrombosis, has been reported in acute middle cerebral artery (MCA) infarction. However, the reported sensitivity and diagnostic accuracy of SVS have been variable. Susceptibility-weighted imaging (SWI) is a newly developed MR sequence. Recent studies have found that SWI may be useful in the field of cerebrovascular diseases, especially for detecting the presence of prominent veins, microbleeds and the SVS. The purpose of this study was to evaluate the diagnostic values of SWI for the detection of hyperacute MCA occlusion. Materials and Methods: Sixty-nine patients (37 males, 32 females; 46-89 years old [mean, 69.1]) with acute stroke involving the MCA territory underwent MR imaging within 6 hours after the symptom onset. MR examination included T2, FLAIR (fluid-attenuated inversion recovery), DWI, SWI, PWI (perfusion-weighted imaging), contrast-enhanced MR angiography (MRA) and contrast-enhanced T1. Of these patients, 28 patients also underwent digital subtraction angiography (DSA) within 2 hours after MR examination. Presence or absence of SVS on SWI was assessed without knowledge of clinical, DSA and other MR imaging findings. Results: On MRA or DSA, 34 patients (49.3%) showed MCA occlusion. Of these patients, SVS was detected in 30 (88.2%) on SWI. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of SWI were 88.2%, 97.1%, 96.8%, 89.5% and 92.8%, respectively. Conclusion: SWI was sensitive, specific and accurate for the detection of hyperacute MCA occlusion.

The Study on the modernism characteristics of melodrama in the 1930s (1930년대 멜로드라마의 모더니즘적 특성 연구)

  • Sim, Sang-gyo
    • (The) Research of the performance art and culture
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    • no.35
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    • pp.203-227
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    • 2017
  • In this thesis, I examined the characteristics of modernism in this work, focusing on the melodrama "Sarang ye soggo donye wulgo(means 'Crying in Love and Crying for Money')", which was popular in the 30s when the consciousness of modernity was overflowing. There has never been an example of a connection between modernism and drama in the 1930s. The characteristic of modernism is clearly embedded in the representative drama of "Sarang ye soggo donye wulgo(means 'Crying in Love and Crying for Money')" at that time. In the title "Sarang ye soggo donye wulgo(means 'Crying in Love and Crying for Money')". 'Don' reveals modern elements. 'Love' can be seen as revealing melodramatic elements. The flair of modern art, which is a background to reveal modern elements, is spread throughout the works. Hongdo fails to complete the relationship with his family, as well as with the couple. It became a person who accepted the modernistic phenomenon by showing the domination of matter. While the typical method of constructing conflicts in the pre-modern narrative works is horizontal and sequential, it can be said that it was in the form of a train station, while the post-modern era of narrative conflict formation from the 30s forms a plurality of conflicts simultaneously, can do. The fear of the ordinary people who see the reality that urban and western values are already rampant by attempting new contents that lead the change of values in "Sarang ye soggo donye wulgo(means 'Crying in Love and Crying for Money')" became a factor to transfer into internal conflict again.