• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.118-128
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• 2021

Purpose: To investigate the value of MR textural analysis, including use of diffusion-weighted imaging (DWI) to differentiate malignant from benign soft-tissue tumors on 3T MRI. Materials and Methods: We enrolled 69 patients (25 men, 44 women, ages 18 to 84 years) with pathologically confirmed soft-tissue tumors (29 benign, 40 malignant) who underwent pre-treatment 3T-MRI. We calculated MR texture, including mean, standard deviation (SD), skewness, kurtosis, mean of positive pixels (MPP), and entropy, according to different spatial-scale factors (SSF, 0, 2, 4, 6) on axial T1- and T2-weighted images (T1WI, T2WI), contrast-enhanced T1WI (CE-T1WI), high b-value DWI (800 sec/mm²), and apparent diffusion coefficient (ADC) map. We used the Mann-Whitney U test, logistic regression, and area under the receiver operating characteristic curve (AUC) for statistical analysis. Results: Malignant soft-tissue tumors had significantly lower mean values of DWI, ADC, T2WI and CE-T1WI, MPP of ADC, and CE-T1WI, but significantly higher kurtosis of DWI, T1WI, and CE-T1WI, and entropy of DWI, ADC, and T2WI than did benign tumors (P < 0.050). In multivariate logistic regression, the mean ADC value (SSF, 6) and kurtosis of CE-T1WI (SSF, 4) were independently associated with malignancy (P ≤ 0.009). A multivariate model of MR features worked well for diagnosis of malignant soft-tissue tumors (AUC, 0.909). Conclusion: Accurate diagnosis could be obtained using MR textural analysis with DWI and CE-T1WI in differentiating benign from malignant soft-tissue tumors.

• Investigative Magnetic Resonance Imaging
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• v.23 no.1
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• pp.65-69
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• 2019

Ramsay Hunt syndrome with the complication of encephalitis or meningoencephalitis is rarely reported and uncommon in immunocompetent patients. The radiological manifestations of such cases usually involve the cerebellum and brainstem or exhibit the absence of any abnormality. We report a case of a 78-year-old immunocompetent man hospitalized with Ramsay Hunt syndrome, who later developed meningoencephalitis. The cerebrospinal fluid-study excluded other causes of meningoencephalitis, and the clinical diagnosis indicated varicella zoster virus meningoencephalitis. Magnetic resonance imaging revealed increased signal intensities in the bilateral temporal lobe, midbrain, and pons on T2-weighted imaging, and T2 fluid attenuated inversion recovery and contralateral asymmetric pachymeningeal enhancement. Contrast-enhanced T1-weighted imaging revealed ipsilateral facial nerve enhancement.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.607-617
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• 2024

Purpose Recent studies have demonstrated the usefulness of diffusion-weighted MR neurography (DW MRN) for assessing nerve roots. This study aimed to evaluate the utility of DW MRN with a unidirectional motion-probing gradient (MPG) for the lumbar nerve roots at 1.5T MR. Materials and Methods Sixty-four lumbar spine MRI scans with DW MRN using anteroposterior unidirectional MPG were retrospectively analyzed. Any changes in the 512 lumbar spinal nerve roots from L3 to S1 were evaluated using T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE T1WI), and DW MRN, with agreement and correlation analysis. Results T2WI revealed compression of 78 nerve roots, and CE T1WI revealed 52 instances of nerve root enhancement. Sixty-seven nerve roots showed swelling and hyperintensity on DW MRN. A total of 42 nerve roots showed changes in the CE T1WI and DW MRN sequences. Moderate to substantial agreement and moderate positive correlation were observed between DW MRN and CE T1WI, as well as DW MRN and T2WI (κ = 0.59-0.65, ρ = 0.600-0.653). Conclusion DW MRN with unidirectional anteroposterior MPG can help evaluate neuritisrelated changes in spinal nerve roots and could serve as a sequence capable of complementing or substituting gadolinium CE imaging.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.176-181
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• 2008

Fluid accumulation within the tympanic bulla is an important diagnostic indicator of canine otitis media although its identification can be a challenge using currently available imaging techniques. The purpose of this study was to compare radiography, computed tomography (CT) and magnetic resonance imaging (MRI) in the identification of fluid accumulation within canine tympanic bulla. Unilateral tympanic bulla in 10 beagles were experimentally filled with blood or saline. Quantitative analysis of CT images were obtained by using Hounsfield unit (HU). MR signal intensity was obtained by using region of interesting (ROI) and compared with those of gray matter. On the CT image, the presence of blood or saline produced a fluid opacity occupying the tympanic bulla. On the MR image, the appearance of blood in the tympanic bulla was isointense in T1-weighted images and hyperintense in T2-weighted images. However, the appearance of saline in the tympanic bulla was hypointense in T1-weighted images and hyperintense in T2-weighted images. This study suggest that CT and MR imaging are useful methods for detection and differentiation of fluid in canine tympanic bulla.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.10-15
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• 2016

The purpose of this study was to establish reproducible ischemic infarction model using allogenic blood clot in beagle dogs and identify induced ischemic lesion after middle cerebral artery occlusion using magnetic resonance imaging (MRI) and histopathologic findings. Twenty eight male beagle dogs with no evidence of neurologic disease were experimented. Allogenic embolus was made using a healthy beagle dog. After internal carotid artery (ICA) was exposure, 16G catheter was introduced through the ICA. The dog was administered 0.3 ml blood clot for 15 seconds followed by 3 ml of saline for 15 seconds. MRI scans were performed with 1.5T to evaluate ischemic lesion at 7 days after middle cerebral artery occlusion procedure. Evaluation parameters of MRI include location, distribution, infarction type, margin, shape, mass effect and intensity of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid attenuated inversion recovery (FLAIR) sequence, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC). On MRI, all dogs (28/28) showed focal or multifocal lesion including telencephalon and thalamus lesions, especially caudate nucleus (24/28). These lesions had well-defined margin from adjacent brain parenchyma, none or mild mass effect and various shape. Most of dogs appeared hyperintensity on T1WI, T2WI, FLAIR, and DWI/ADC, corresponding to chronic infarction. These lesions were histopathologically confirmed atrophic changes and unstained lesion. In conclusion, MRI is the useful method to provide information about ischemic infarction in dogs and the best reproducible ischemic infarction model was developed by using allogenic blood clot.

• Investigative Magnetic Resonance Imaging
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• v.22 no.1
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• pp.61-64
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• 2018

Pancreatic lymphoepithelial cysts (LECs) are rare pancreatic cysts with squamous epithelial lining surrounded by dense lymphoid tissue. A preoperative diagnosis of LECs is difficult due to imaging diversity and inadequate documentation because of their rarity. We present a case of surgically confirmed pancreatic LEC with magnetic resonance imaging (MRI) findings as heterogeneous signal intensity on T2-weighted images with multiple septa-like structures, slightly hypo-signal intensity on T1-weighted images, and thin-wall enhancement on dynamic contrast images. LECs are benign lesions without any malignant potential. Therefore, the inclusion of LEC in the differential diagnosis of cystic pancreatic lesions may reduce unnecessary surgical procedures.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.162-170
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• 2017

Purpose: To evaluate the imaging findings of desmoid tumors using various imaging modalities and to evaluate whether diffusion-weighted imaging (DWI) can help differentiate between desmoid and malignant tumors. Materials and Methods: The study included 27 patients with pathologically confirmed desmoid tumors. Two radiologists reviewed 23 computed tomography (CT), 12 magnetic resonance imaging (MRI) and 8 positron emission tomography-computed tomography (PET-CT) scans of desmoid tumors and recorded data regarding the shape, multiplicity, size, location, degree of enhancement, and presence or absence of calcification or hemorrhage. The signal intensity of masses on T1- and T2-weighted imaging and the presence or absence of whirling or band-like low signal intensity on T2-weighted imaging were recorded. The apparent diffusion coefficient (ADC) values of the desmoid tumors in nine patients with DWIs were compared with the ADC values of 32 malignant tumors. The maximum standardized uptake value ($SUV_{max}$) on PET-CT images was measured in 8 patients who underwent a PET-CT. Results: The mean size of the 27 tumors was 6.77 cm (range, 2.5-26 cm) and four tumors exhibited multiplicity. The desmoid tumors were classified by shape as either mass forming (n = 18), infiltrative (n = 4), or combined (n = 5). The location of the tumors was either intra-abdominal (n = 15), within the abdominal wall (n = 8) or extra-abdominal (n = 4). Among the 27 tumors, 21 showed moderate to marked enhancement and 22 showed homogeneous enhancement. Two tumors showed calcifications and one displayed hemorrhage. Eleven of the 12 MR T2-weighted images showed whirling or band-like low signal intensity areas in the mass. The mean ADC value of the desmoid tumors ($1493{\times}10^{-6}mm^2/s$) was significantly higher than the mean of the malignant soft tissue tumors ($873{\times}10^{-6}mm^2/s$, P < 0.001). On the PET-CT images, all tumors exhibited an intermediate $SUV_{max}$ (mean, 3.7; range, 2.3-4.5). Conclusion: Desmoids tumors showed homogenous, moderate to marked enhancement on CT and MRI scans and a characteristic whirling or band-like pattern on T2-weighted images. DWI can be useful for the differentiation of desmoid tumors from malignant soft tissue tumors.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.37-37
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• 2003

To assess the merits and demerits of postcontrast fat-suppressed (FS) brain MR imaging in children in the evaluation of various enhancing lesions, compared with postcontrast conventional or Magnetization Transfer (MT) imaging. 대상 및 방법： We reviewed patients with enhancing lesion on brain MR imaging who underwent both FS imaging and one of conventional or MT imaging as a postcontrast T1-weighted brain MR imaging. Inclusion criteria of our study were as follows： MR studies should be peformed within one-year interval and showed no significant interval change of imaging findings. Thirty-four patients (21 male, 13 female; mean age, 8 years) with 43 enhancing lesions (19 intra-axial, 19 extra-axial, and 5 orbital location) were included in this study, Twenty-one pairs of FS and conventional imaging, and 15 pairs of FS and MT imaging were available. Two radiologists visually assessed the lesion conspicuity and the presence of flow or susceptibility artifacts in a total of 36 pairs of MR imaging by consensus. For 21 measurable lesions (19 pairs of FS and conventional imaging, 5 pairs of FS and MR imaging), contrast ratio between the lesion and the normal brain( ［SIlesion-SIwater］/[SInormal brain-SIwater]) were calculated and compared.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.140-140
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• 2001

We present two cases of surgically proven focal nodular hyperplasia whou underwent tri contrast-enhance MR imaging using gadolinium chelates, mangafodipir trisodium, and ferumoxides After the unehanced MR images were obtained, dynamic gadolinium-enhanced T1-weighted imagi were performed, then mangafodipir enhanced and ferumoxides-enhanced images were obtained. In one case, the mass was isointense on both T1- and T2-weighted images on the unehanced M images, iso and slightly hyperintense on ferumoxides-enhanced FSE and GRE images, strong hyperintense on the mangafodipir enhanced and gadolinium enhanced arterial phase images. In th other case, the mass was isointense on T2-weighted and hypointense on T1-weighted image isointense on ferumoxides-enhanced images, and hyperintense on mangafodipir enhanced an gadolinium enhanced arterial phase images. Triple contrast enhanced MR images were useful correctly diagnose these two cases preoperatively.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.184-188
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• 2012

Anoperineal tuberculosis is a rare extrapulmonary form of the disease and may present as abscess. We report a case of anoperineal tuberculous abscess, which showed low signal intensity on T1-weighted images, high signal intensity on T2-weighted images and diffusion restriction on diffusion weighted images.