• Title/Summary/Keyword: MR Diffusion

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Neuroimaging Application

  • 정경호
    • Proceedings of the KSMRM Conference
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    • 2002.11a
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    • pp.37-44
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    • 2002
  • 신경계의 MR영상은 하드웨어적인 발달과 초고속 영상 기법으로 기존의 MRI가 제공해 줄 수 있는 해부학적 정보 외에 기능적인 정보인 물의 확산, 뇌 혈류 정보, 뇌의 기능적 지도화와 뇌대사물의 농도를 측정할 수 있게 되었다. 반전회복영상(Inversion Recovery), 확산(diffusion), 관류(profusion), 기능적(functional)영상, 뇌의 3차원 뇌표면 rendering 및 곡면재구성영상의 임상적인 의의를 알아보고자 한다.

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Temporal Evolution of a Chronic Expanding Organizing Hematoma on MRI, Including Functional MR Imaging Techniques: a Case Report

  • Lee, Jeonghyun;Lee, Taebum;Oh, Eunsun;Yoon, Young Cheol
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.1
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    • pp.43-50
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    • 2017
  • Chronic expanding organizing hematoma (CEH) occasionally mimics a soft tissue tumor on MRI, which becomes more problematic in patients with a history of surgical resection for musculoskeletal malignancy. Herein, we present a case of CEH which we were able to differentiate from recurrent tumor through MRI follow-up, including diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) imaging. A 66-year-old male visited our institution under suspicion of recurrent leiomyosarcoma of the thigh, 19 months after surgery and radiation therapy. Due to inconclusive results, three US-guided biopsies and 6 MRI examinations were performed over 2 years. In the end, we could diagnose a CEH using conventional and functional MRI techniques, and it was histopathologically confirmed after surgical resection. A CEH may occur remotely after an initiating event, and it may persist and expand over several years. Functional MR sequences, in addition to conventional sequences, are helpful in differentiating CEH from malignant neoplasms.

In Vivo and In Vitro Studies of the Steady State Free Precession-Diffusion-Weighted MR Imagings on Low b-value : Validation and Application to Bone Marrow Pathology

  • Byun, Woo-Mok
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.119-128
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    • 2007
  • Purpose : The purpose of this study was a phantom study to measure the diffusion properties of water molecules by steady-state free precession diffusion-weighted imaging (SSFP- DWI) with a low b-value and to determine if this sequence might be useful for application to the evaluation of bone marrow pathology. Materials and methods : 1. The phantom study: A phantom study using two diffusion weighted sequences for the evaluation of the diffusion coefficient was performed. Three water-containing cylinders at different temperatures were designed: phantom A was $3^{\circ}C$, B was $23^{\circ}C$ and C was $63^{\circ}C$. Both SSFP and echo planar imaging (EPI) sequences (b-value: $1000s/mm^2$) were performed for comparison of the diffusion properties. The Signal to noise ratios (SNR) and apparent diffusion coefficient (ADC) values of the three phantoms using each diffusion-weighted sequence were assessed. 2. The Clinical study: SSFP-DWI was performed in 28 patients [sacral insufficiency fractures (10), osteoporotic lumbar compression fractures (10), malignant compression fractures (8)]. To measure the ADC maps, a diffusion-weighted single shot stimulated echo-acquisition mode sequence ($650s/mm^2$) was obtained using the same 1.5-T MR imager Results : For the phantom study, the signal intensity on the SSFP as well as the classic EPI-based DWI was decreased as the temperature increased in phantom A to C. The ADC values of the phantoms on EPI-DWI were $0.13{\times}10^{-3}mm^2/s$ in phantom A, $0.22{\times}10^{-3}mm^2/s$ in B and $0.37{\times}10^{-3}mm^2/s$. in C. The SSFP can be regarded as a DWI sequence in view of the series of signal decreases. Conclusion : Bone marrow pathologies with different diffusion coefficients were evaluated by SSFP-DWI. All benign fractures were hypointense compared to the adjacent normal bone marrow where as the malignant fractures were hyperintense compared to the adjacent normal bone marrow.

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Interpretation of Complete Tumor Response on MRI Following Chemoradiotherapy of Rectal Cancer: Inter-Reader Agreement and Associated Factors in Multi-Center Clinical Practice

  • Hae Young Kim;Seung Hyun Cho;Jong Keon Jang;Bohyun Kim;Chul-min Lee;Joon Seok Lim;Sung Kyoung Moon;Soon Nam Oh;Nieun Seo;Seong Ho Park
    • Korean Journal of Radiology
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    • v.25 no.4
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    • pp.351-362
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    • 2024
  • Objective: To measure inter-reader agreement and identify associated factors in interpreting complete response (CR) on magnetic resonance imaging (MRI) following chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: This retrospective study involved 10 readers from seven hospitals with experience of 80-10210 cases, and 149 patients who underwent surgery after CRT for rectal cancer. Using MRI-based tumor regression grading (mrTRG) and methods employed in daily practice, the readers independently assessed mrTRG, CR on T2-weighted images (T2WI) denoted as mrCRT2W, and CR on all images including diffusion-weighted images (DWI) denoted as mrCRoverall. The readers described their interpretation patterns and how they utilized DWI. Inter-reader agreement was measured using multi-rater kappa, and associated factors were analyzed using multivariable regression. Correlation between sensitivity and specificity of each reader was analyzed using Spearman coefficient. Results: The mrCRT2W and mrCRoverall rates varied widely among the readers, ranging 18.8%-40.3% and 18.1%-34.9%, respectively. Nine readers used DWI as a supplement sequence, which modified interpretations on T2WI in 2.7% of cases (36/1341 [149 patients × 9 readers]) and mostly (33/36) changed mrCRT2W to non-mrCRoverall. The kappa values for mrTRG, mrCRT2W, and mrCRoverall were 0.56 (95% confidence interval: 0.49, 0.62), 0.55 (0.52, 0.57), and 0.54 (0.51, 0.57), respectively. No use of rectal gel, larger initial tumor size, and higher initial cT stage exhibited significant association with a higher interreader agreement for assessing mrCRoverall (P ≤ 0.042). Strong negative correlations were observed between the sensitivity and specificity of individual readers (coefficient, -0.718 to -0.963; P ≤ 0.019). Conclusion: Inter-reader agreement was moderate for assessing CR on post-CRT MRI. Readers' varying standards on MRI interpretation (i.e., threshold effect), along with the use of rectal gel, initial tumor size, and initial cT stage, were significant factors associated with inter-reader agreement.

The functional imaging to Diagnose Acute Cerebral infarction Comparing between CT Perfusion and MR Diffusion Imaging (급성 뇌경색 진단을 위한 CT관류영상과 MR확산영상의 비교)

  • Kim, Seon-Hee;Eun, Sung-Jong;Rim, Chae-Pyeong
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.19-26
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    • 2012
  • It is very important for early diagnosis and therapy with ischamic cerebral infarction patients. This study was to know the ischemic penumbra lesion which compared CT-perfusion and diffusion weighted MRI(DWMRI) with acute cerebral infarction patients. 12 acute cerebral infarction patients had performed perfusion CT and performed DWMRI. Perfusion images including cerebral blood volume(CBV), cerebral blood flow(CBF), time to peak(TTP) and mean transit time(MTT) maps obtained the values with defect lesion and contralateral normal cerebral hemisphere and DWMRI was measured by signal intensity and compared of lesion size between each perfusion map. All perfusion CT maps showed the perfusion defect lesions in all patients. There were remarkable TTP and MTT delay in perfusion defect lesions. The lesions on CBF map was the most closely correlated with the lesions on DWMRI. The size of perfusion defect lesions on TTP and MTT map was larger than that of lesions on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra, but also hemodynamic status in the perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

Substantia Nigra after Striatal Infarction on T2- Weighted MR Images

  • Park Byung-Rae
    • Biomedical Science Letters
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    • v.11 no.3
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    • pp.307-310
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    • 2005
  • Cerebral ischemia results in neuronal changes in remote areas that have fiber connections with the ischemic area. The aim of this study was to investigate the nigral changes by examining the correlation between the apparent diffusion coefficient (ADC) and the tissue structure. Sprague-Dawley rats were subjected to middle cerebral artery occlusion. Four days after the occlusion, when T2-weighted images revealed the presence of an area of high signal intensity in the ipsilateral substantia nigra, and the ADCs were calculated and imaged. Histopathologic examination by both light and electron microscopy was performed on day 4 after surgery. This finding was consistent with the high signal intensity seen on T2-weighted and diffusion-weighted images, as well as with the ADC reduction, but we did not expect to observe uniform ADC reduction attributable mainly to astrocytic swelling in the perivascular end-feet.

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Bilateral Medial Medullary Infarction Demonstrated by Diffusion-Weighted Imaging : Case Report

  • Jang, Han-Won;Byun, Woo-Mok
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.70-73
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    • 2009
  • A 78-year-old woman presented with weakness of the extremities, dysarthria, dizziness, and sensory impairment. Magnetic resonance imaging showed acute bilateral medial medullary infarction. Contrast enhanced magnetic resonance angiography demonstrated stenosis or occlusion of both intracranial vertebral arteries. We present a rare case of bilateral medullary infarction seen on diffusion-weighted imaging.

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