• Title/Summary/Keyword: MRIS

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Analysis of Inadvertent Intradiscal Injections during Lumbar Transforaminal Epidural Injection

  • Hong, Ji Hee;Lee, Sung Mun;Bae, Jin Hong
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.168-173
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    • 2014
  • Background: Recently, there have been several case reports and retrospective studies about the incidence of intradiscal (ID) injection during transforaminal epidural steroid injection (TFESI). Inadvertent ID injection is not a rare complication, and it carries the risk of developing diskitis, although there has been no report of diskitis after TFESI. We prospectively evaluated the incidence of inadvertent ID injection during lumbar TFESI and analyzed the contributing factors. Methods: Ten patients received 2-level TFESI, and the remaining 229 patients received 1-level TFESI. When successful TFESI was performed, 2 ml of contrast dye was injected under real-time fluoroscopy to check for any inadvertent ID spread. A musculoskeletal radiologist analyzed all magnetic resonance images (MRIs) of patients who demonstrated inadvertent ID injection. When reviewing MRIs, the intervertebral foramen level where ID injection occurred was carefully examined, and any anatomical structure which narrowing the foramen was identified. Results: Among the 249 TFESI, we identified 6 ID injections; thus, there was an incidence of 2.4%. Four patients had isthmic spondylolisthesis, and the level of spondylolisthesis coincided with the level of ID injection. We further examined the right or left foramen of the spondylolisthesis level and identified the upward migrated disc material that was narrowing the foramen. Conclusions: Inadvertent ID injection during TFESI is not infrequent, and pain physicians must pay close attention to the type and location of disc herniation.

Evaluation of full-order method for extreme wind effect estimation considering directionality

  • Luo, Ying;Huang, Guoqing;Han, Yan;Cai, C.S.
    • Wind and Structures
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    • v.32 no.3
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    • pp.193-204
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    • 2021
  • The estimation of the extreme wind load (effect) under a mean recurrence interval (MRI) is an important task in the wind-resistant design for the structure. It can be predicted by either first-order method or full-order method, depending on the accuracy and complexity requirement. Although the first-order method with the consideration of wind directionality has been proposed, less work has been done on the full-order method, especially with the wind directionality. In this study, the full-order method considering the wind directionality is proposed based on multivariate joint probability distribution. Meanwhile, considering two wind directions, the difference of the corresponding results based on the first-order method and full-order method is analyzed. Finally, based on the measured wind speed data, the discrepancy between these two methods is investigated. Results show that the difference between two approaches is not obvious under larger MRIs while the underestimation caused by the first-order method can be larger than 15% under smaller MRIs. Overall, the first-order method is sufficient to estimate the extreme wind load (effect).

Development of GIS-based EEZ Marine Resources Information System (GIS를 이용한 배타적 경제수역 해양자원정보시스템의 구현에 관한 연구)

  • Kim, Kye-Hyun;Kim, Sun-Yong;Park, Eun-Ji;Yoo, Hai-Soo
    • Journal of Korea Spatial Information System Society
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    • v.9 no.2
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    • pp.55-66
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    • 2007
  • There has been increasing concerns regarding marine mineral resources as the land energy resources has been depleting from worldwide energy crisis. Also, all the coastal countries around the world are getting into the high competition as EEZ implemented to widen each country's marine autonomy. Especially, the adoption of EEZ in UN's marine regulation agreement at the January of 1996 has aggravated conflicts among coastal countries and eventually resulted in critical agenda to determine the boundaries of EEZ among such countries. It is imperative for us to have negotiation with neighboring countries to determine the boundaries of EEZ. For the preparation of such negotiation, it is essential to have data such as mineral distribution, deep-sea geology, related agreement and marine laws, etc. Therefore, this study mainly concentrates on analyzing existing data of resources exploration and establishing standards for each type of data and manipulating data based on such standards, thereby building a database for more efficient management of EEZ data from marine resources survey. MRIS has also been developed to diversely analyze and visualize graphic and attribute data considering data usage and inter-relationship in the database. This system can provide various spatial analysis and spatial searching techniques to enable easier comparison of cost-benefit analysis and data provision of any area in EEZ thereby facilitating major policy making. In addition, the system can support sustainable management of marine resources of EEZ regions and data supply for systematic management of national marine resources. Furthermore, this will be very useful for negotiating with neighboring countries to determine EEZ boundaries to lead more favorable results.

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Are There Any Additional Benefits to Performing Positron Emission Tomography/Computed Tomography Scans and Brain Magnetic Resonance Imaging on Patients with Ground-Glass Nodules Prior to Surgery?

  • Song, Jae-Uk;Song, Junwhi;Lee, Kyung Jong;Kim, Hojoong;Kwon, O Jung;Choi, Joon Young;Kim, Jhingook;Han, Joungho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.368-376
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    • 2017
  • Background: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. Methods: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. Results: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). Conclusion: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.

Intraindividual Comparison of Hepatocellular Carcinoma Washout between MRIs with Hepatobiliary and Extracellular Contrast Agents

  • Yeun-Yoon Kim;Young Kon Kim;Ji Hye Min;Dong Ik Cha;Jong Man Kim;Gyu-Seong Choi;Soohyun Ahn
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.725-734
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    • 2021
  • Objective: To intraindividually compare hepatocellular carcinoma (HCC) washout between MRIs using hepatobiliary agent (HBA) and extracellular agent (ECA). Materials and Methods: This study included 114 prospectively enrolled patients with chronic liver disease (mean age, 55 ± 9 years; 94 men) who underwent both HBA-MRI and ECA-MRI before surgical resection for HCC between November 2016 and May 2019. For 114 HCCs, the lesion-to-liver visual signal intensity ratio (SIR) using a 5-point scale (-2 to +2) was evaluated in each phase. Washout was defined as negative visual SIR with temporal reduction of visual SIR from the arterial phase. Illusional washout (IW) was defined as a visual SIR of 0 with an enhancing capsule. The frequency of washout and MRI sensitivity for HCC using LR-5 or its modifications were compared between HBA-MRI and ECA-MRI. Subgroup analysis was performed according to lesion size (< 20 mm or ≥ 20 mm). Results: The frequency of portal venous phase (PP) washout with HBA-MRI was comparable to that of delayed phase (DP) washout with ECA-MRI (77.2% [88/114] vs. 68.4% [78/114]; p = 0.134). The frequencies were also comparable when IW was allowed (79.8% [91/114] for HBA-MRI vs. 81.6% [93/114] for ECA-MRI; p = 0.845). The sensitivities for HCC of LR-5 (using PP or DP washout) were comparable between HBA-MRI and ECA-MRI (78.1% [89/114] vs. 73.7% [84/114]; p = 0.458). In HCCs < 20 mm, the sensitivity of LR-5 was higher on HBA-MRI than on ECA-MRI (70.8% [34/48] vs. 50.0% [24/48]; p = 0.034). The sensitivity was similar to each other if IW was added to LR-5 (72.9% [35/48] for HBA-MRI vs. 70.8% [34/48] for ECA-MRI; p > 0.999). Conclusion: Extracellular phase washout for HCC diagnosis was comparable between MRIs with both contrast agents, except for tumors < 20 mm. Adding IW could improve the sensitivity for HCC on ECA-MRI in tumors < 20 mm.

Non-stationary statistical modeling of extreme wind speed series with exposure correction

  • Huang, Mingfeng;Li, Qiang;Xu, Haiwei;Lou, Wenjuan;Lin, Ning
    • Wind and Structures
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    • v.26 no.3
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    • pp.129-146
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    • 2018
  • Extreme wind speed analysis has been carried out conventionally by assuming the extreme series data is stationary. However, time-varying trends of the extreme wind speed series could be detected at many surface meteorological stations in China. Two main reasons, exposure change and climate change, were provided to explain the temporal trends of daily maximum wind speed and annual maximum wind speed series data, recorded at Hangzhou (China) meteorological station. After making a correction on wind speed series for time varying exposure, it is necessary to perform non-stationary statistical modeling on the corrected extreme wind speed data series in addition to the classical extreme value analysis. The generalized extreme value (GEV) distribution with time-dependent location and scale parameters was selected as a non-stationary model to describe the corrected extreme wind speed series. The obtained non-stationary extreme value models were then used to estimate the non-stationary extreme wind speed quantiles with various mean recurrence intervals (MRIs) considering changing climate, and compared to the corresponding stationary ones with various MRIs for the Hangzhou area in China. The results indicate that the non-stationary property or dependence of extreme wind speed data should be carefully evaluated and reflected in the determination of design wind speeds.

Incidence of Tarsal Coalition: An Institutional Magnetic Resonance Imaging Analysis (족근골 유합의 발생 빈도: 단일 기관 자기공명영상 분석)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Chang-Rak;Kim, Young-Jun;Kim, Jeon-Gyo;Lee, Sun-Joo;Lee, Jeong-Han;Park, Jun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.116-120
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    • 2016
  • Purpose: Tarsal coalition results from defects during the developmental stage and produes ankle pain and limitations in the range of motions. Its incidence has been reported to be 1%, but there has not been any reports with respect to Koreans. Therefore, we evaluated the prevalence of tarsal coalition in Koreans. Materials and Methods: Between 2005 and 2014, we analyzed a total of 733 cases of foot and ankle magnetic resonance imaging (MRI) in our hospital. There were 391 men and 342 women. All MRI readings were read by a radiologist in our hospital. We classified the coalitions in accordance with the histological and anatomical characteristics, and calculated the prevalence in each group. Moreover, we tried to determine the prevalence of tarsal coalitions in accordance with sex, age, and proportion of the symptomatic tarsal coalitions. Results: There were a total of 11 MRIs of tarsal coalition - 9 talocalcaneal coalitions, 1 calcaneocuboidal coalition, and 1 calcaneonavicular coalition. Nine tarsal coalitions were observed in men and 2 in women. Conclusion: Through this study, we found that the prevalence of tarsal coalition, including the asymptomatic patients, is similar to the previously known prevalence (1%). By getting more MRIs of the foot and ankle, we could better represent the prevalence of tarsal coalitions in Koreans.

Magnetic resonance imaging-based temporomandibular joint space evaluation in tempormandibular disorders (측두하악관절증에서 자기공명영상을 이용한 측두하악관절의 관절강 평가)

  • Nah, Kyung-Soo
    • Imaging Science in Dentistry
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    • v.37 no.1
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    • pp.15-18
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    • 2007
  • Purpose : Disc and condylar position were observed on MRIs of temporomandibular joint disorder patients and condylar position agreement between MRI and tranascranal radiography was evaluated. Materials and Methods MRI and transcranial radiographs of both TM joints from 67 patients with temporemandibular disorder were used. On MRI, the position and shape of disc and condylar position as anterior, middle, posterior was evaluated at medial, center, and lateral views. On transcranial radiographs, condylar position was evaluated using the shortest distance from condyle to fossa in anterior, superior, and posterior directions. Results. 1. On MRI, 96 joints (71.6%) of 134 had anterior disc dispalcement with reduction and 38 joints (28.4%) without reduction. 2. Fourteen (14.6%) of 96 reducible joints showed anterior condylar position, 19 (19.8%) showed central position, 63 joints (65.6%) showed posterior position. Two joints (5.3%) of 38 non-reducible joints showed anterior condylar position, while 9 (23.7%) showed central position, and 27 (71.1%)-posterior position. 3. In 85 joints (63.4%) of 134, the transcranial condylar position agreed with that of the central MRI view, 10 joints (7.5%) with that of medial, 16 joints (11.9%) with that of lateral, and 23 joints (17.2%) disagreed with that of MRI. Conclusion : On MRT, most oi the reducible and non-reducible joints showed posterior condylar position. Transcranial radiographs taken with machine designed for TMJ had better agreement of condylar position with that of MRI. Extremely narrow joint spaces or very posterior condylar positions observed on transcranial radiographs had a little more than fifty percent agreement with those of MRIs.

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The Retrospective Study on the Correlation between the Multifidus Muscle Atrophy on Low Back Pain Patients and the Magnetic Resonance Images (자기공명영상 (Magnetic Resonance Image)을 통한 요통 환자의 다열근 위축에 대한 후향적 연구)

  • Lee, Kil-Joon;Park, Young-Hoi;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.4
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    • pp.151-163
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    • 2009
  • Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.