• Journal of Korean Neurosurgical Society
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• 제63권3호
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• pp.386-396
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• 2020

Objective : To generate synthetic spine magnetic resonance (MR) images from spine computed tomography (CT) using generative adversarial networks (GANs), as well as to determine the similarities between synthesized and real MR images. Methods : GANs were trained to transform spine CT image slices into spine magnetic resonance T2 weighted (MRT2) axial image slices by combining adversarial loss and voxel-wise loss. Experiments were performed using 280 pairs of lumbar spine CT scans and MRT2 images. The MRT2 images were then synthesized from 15 other spine CT scans. To evaluate whether the synthetic MR images were realistic, two radiologists, two spine surgeons, and two residents blindly classified the real and synthetic MRT2 images. Two experienced radiologists then evaluated the similarities between subdivisions of the real and synthetic MRT2 images. Quantitative analysis of the synthetic MRT2 images was performed using the mean absolute error (MAE) and peak signal-to-noise ratio (PSNR). Results : The mean overall similarity of the synthetic MRT2 images evaluated by radiologists was 80.2%. In the blind classification of the real MRT2 images, the failure rate ranged from 0% to 40%. The MAE value of each image ranged from 13.75 to 34.24 pixels (mean, 21.19 pixels), and the PSNR of each image ranged from 61.96 to 68.16 dB (mean, 64.92 dB). Conclusion : This was the first study to apply GANs to synthesize spine MR images from CT images. Despite the small dataset of 280 pairs, the synthetic MR images were relatively well implemented. Synthesis of medical images using GANs is a new paradigm of artificial intelligence application in medical imaging. We expect that synthesis of MR images from spine CT images using GANs will improve the diagnostic usefulness of CT. To better inform the clinical applications of this technique, further studies are needed involving a large dataset, a variety of pathologies, and other MR sequence of the lumbar spine.

• 대한방사선기술학회지:방사선기술과학
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• 제22권1호
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• pp.27-33
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• 1999

The classification of herniated intervertebral lumbar disc type is clinically important, as treatment method may be slightly different according to the type of herniated intervertebral disc. When 450 patients who suffered from herniated intervertebral lumbar disc were tested with Magnetic Resonance Imaging (MRI) to find out the type of herniated disc, the following findings were given : 1. The age of the patients investigated ranged from 15 to 83, and their mean age was 40. 2. The male patients were twice as many as the female patients, since the ratio of males to females was 300 : 150. 3. 118 patients suffered from a single herniated disc, and 332 patients were attacked with multi-herniated disc. 4. The types of single herniated disc were a protrusion for 50 patients (40%) and an extrusion for 40 patients (34%). The part of being herniated was an intervertebral disc between $L_4-L_5$ for 95 patients(80%) and the same disc between $L_5-S_1$ for 22 patients(19%). 5. The types of multi : -herniated disc were an protrusion for 67 patients(20%) and an extrusion for 70 patients(21%). Besides, 90 patients (28%) were the case that protrusion and extrusion coexisted simultaneously. The parts of being herniated were $L_3-L_4,\;L_4-L_5$ and $L_5-S_1$ for 53 patients(16%), $L_3-L_4$ and $L_4-L_5$ for 57 patients(17%), and $L_4-L_5$ and $L_5-S_1$ for 139 patients(42%).

• Investigative Magnetic Resonance Imaging
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• 제18권3호
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• pp.263-268
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• 2014

신경매독은 스피로헤타(spirochete)인 Treponema pallidum에 의한 뇌와 척수의 드문 감염증이다. 저자들은 53세 남자환자에서 시신경, 삼차신경, 안면신경, 전정와우신경, 중뇌동맥, 후뇌동맥, 척수와 척수막을 침범한 복합적인 수막혈관성, 수막척수염 형태의 신경매독을 경험하여 이를 보고하고자 한다. 본 증례를 통해 뇌수막염과 더불어 뇌신경염, 뇌혈관염이 있고 수막척수염을 동반하는 복합적인 중추신경계 이상 소견이 있어 임상적인 진단이 어려운 경우 신경매독을 감별진단으로 고려하여 영상 소견을 바탕으로 한 빠른 진단이 필요함을 강조하고자 한다.

• 한방재활의학과학회지
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• 제26권4호
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• pp.117-126
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• 2016

Objectives The purpose of this study is to report the effect of Megadose Pharmacoacupuncture combined with conservative Korean medicine treatment on Herniated InterVertebral Disc (HIVD) of lumbar spine patient diagnosed by Magnetic Resonance Imaging (MRI). Methods This study includes 41 patients whose Lumbar Disc Herniations were by MRIbetween 1st Aprill 2011 and 31th March 2016. All of the patients were treated with Megadose Pharmacoacupuncture combined with Korean medicine treatment. The MRI examination was performed on two or more occasions (minimally, pre-treatment and post-treatment). The volume of each herniated disc was measured. For each patient, age, sex, disc migration, morphology, initial LDH size, herniated disc resorption rate were analysed. Results The mean volumes of herniated discs at pre-treatment and post-treatment were $1321.62{\pm}467.53mm^3$ and $648.72{\pm}313.38mm^3$. The volumes of all patients were decreased. The resorption means of each class of the extent of LDH were significantly different (p=0.041). On the other hand, no difference was found in sex, age, level, herniated disc grade. Conclusions The MRI results suggest that Megadose Pharmacoacupuncture combined with Korean medicine treatment can help treat lumbar herniated disc.

• The Korean Journal of Pain
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• 제30권4호
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• pp.281-286
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• 2017

Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015. All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air. Results: The incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later. Conclusions: Pain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine.

• Journal of Acupuncture Research
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• 제36권2호
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• pp.107-112
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• 2019

The aim of this study was to report on the resorption of herniated nucleus pulposus following acupotomy treatment. Two patients were treated with acupotomy which included integrative Korean Medicine treatment, for either cervical, or lumbar herniated nucleus pulposus. Magnetic Resonance Imaging was used to produce images before and after (several months) treatment. The Numerical Rating Scale scores and Range of Motion were used to assess the patients at admission and discharge. In both cases, substantial resorption of the respective herniated disc was observed in the magnetic resonance images, with a decrease in the Numerical Rating Scale score. Range of Motion improved in 1 case. This study shows that acupotomy treatment may be a clinically effective treatment for herniated nucleus pulposus resorption and pain relief.

• Investigative Magnetic Resonance Imaging
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• 제17권2호
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• pp.149-153
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• 2013

척추 수술의 합병증으로 뇌척수액 누출이 발생할 수 있는데 이를 영상학적으로 진단하는 것은 어려움이 있다. 이 연구에서는 자기공명척수조영술을 이용하여 척추 수술 후 뇌척수액 누출을 확인하였던 두 환자의 증례를 보고하고자 한다. 두 환자는 각기 요추 추간판 절제술과 척추 수막종 제거술을 받은 뒤 심한 두통을 호소하였다. 두 환자의 자기공명척수조영영상에서 척추 뇌수막액 누출 부위가 확인되었고, 이에 대해 환자들은 각각 epidural blood patch와 재수술을 받았다. 이 두 사례에서 자기공명척수조영술은 척추 뇌수막액의 누출 부위를 정확히 보여주었고, 척수강과 가성수막류 (pseudomeningocele) 사이의 교통로를 잘 나타내주었다. 척수 수술 후 뇌수막액 누출을 확인하기 위한 검사로 자기공명척수조영술이 유용한 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.137-140
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• 2007

HNP [Herniation of the necleus pulposus] generally occurs at ventral portion of lumbar thecal sac due to the anatomical position. We report two unusual cases of herniated dorsal portion of lumbar thecal sac causing diagnostic difficulties. Two patients with posteriorly migrated epidural disc fragments were evaluated with plain X-ray, and magnetic resonance imaging. These patients responded well to operation with complete relief of symptoms. Definite diagnosis of posteriorly located disc fragments is difficult because the radiological images of disc fragments may mimic those of other more common posterior epidural lesions.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.262-264
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• 2008

Discal cysts are rare lesions that can cause radiating leg pain. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. A 30-year-old male patient presented to our institute with radiating pain in his left leg and mild back pain. Magnetic resonance imaging (MRI) revealed an intraspinal extradural cystic mass with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images at the L5-S1 level. The partial hemilaminectomy and cyst resection were performed. We report a patient with low back pain and radiating leg pain caused by a lumbar discal cyst and discuss the treatment of this cyst.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.320-322
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• 2005

A 45-year-old man presented with lower back pain and pain in the right leg of 3years duration. A plain radiographic examination revealed grade I isthmic spondylolisthesis, with instability at L4-5. Computed tomography and magnetic resonance imaging demonstrated bilateral foraminal stenosis, with soft foraminal disc herniation on the right side at the L4-5 level. He underwent anterior lumbar interbody fusion[ALIF] with percutaneous posterior fixation[PF] at the L4-5 level. Without removing the posterior bony structures, removal of foraminal disc herniation and reduction of spondylolisthesis were successfully performed using ALIF with percutaneous PF. When there is no hard disc herniation or lateral recess stenosis, ALIF with percutaneous PF can be one of the treatment options for isthmic spondylolisthesis, even in the presence of foraminal disc herniation, as in our case.