• Title/Summary/Keyword: T2 강조영상

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Cerebral Hemodynamic Analysis in Pediatric Moyamoya Patients using Perfusion Weighted MRI (관류 강조 자기공명 영상을 이용한 소아 모야모야 환아의 뇌 혈역학 분석)

  • Chang, Won-Seok;Kim, Tae-Gon;Lee, Seung-Koo;Choi, Jung-Uhn;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.207-212
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    • 2005
  • Objective: Classically, single photon emission tomography is known to be the reference standard for evaluating the hemodynamic status of patients with moyamoya disease. Recently, T2-weighted perfusion magnetic resonance(MR) imaging has been found to be effective in estimating cerebral hemodynamics in moyamoya disease. We aim to assess the utility of perfusion-weighted MR imaging for evaluating hemodynamic status of moyamoya disease. Methods: The subjects were fourteen moyamoya patients(mean age: 7.21 yrs) who were admitted at our hospital between Sep. 2001 to Sep 2003. Four normal children were used for control group. Perfusion MR imaging was performed before any treatment by using a T2-weighted contrast material-enhanced technique. Relative cerebral blood volume(rCBV) and time to peak enhancement(TTP) maps were calculated. Relative ratios of rCBV and TTP in the anterior cerebral artery(ACA), middle cerebral artery(MCA) and basal ganglia were measured and compared with those of the posterior cerebral artery(PCA) in each cerebral hemispheres. Using this data, we analysed the hemodynamic aspect of pediatric moyamoya disease patients in regarding to the age, Suzuki stage, signal change in FLAIR MR imaging, and hemispheres inducing symptoms. Results: The mean rCBV ratio of ACA, MCA did not differ between normal children and moyamoya patients. However the significant TTP delay was observed at ACA, MCA territories (mean = 2.3071 sec, 1.2089 see, respectively, p < 0.0001). As the Suzuki stage of patients is advanced, rCBV ratio is decreased and TTP differences increased. Conclusion: Perfusion MR can be applied for evaluating preoperative cerebral hemodynamic status of moyamoya patients. Furthermore, perfusion MR imaging can be used for determine which hemisphere should be treated, first.

Transient Abnormalities on Magnetic Resonance Imaging after Absence Seizures (결신발작 이후 확인된 일시적인 자기공명영상 이상 1예)

  • Yoo, Hye Won;Yoon, Lira;Kim, Hye Young;Kwak, Min Jung;Park, Kyung Hee;Bae, Mi Hye;Lee, Yunjin;Nam, Sang Ook;Kim, Young Mi
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.280-283
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    • 2018
  • Magnetic resonance imaging (MRI) is recommended for patients with epileptic seizures to rule out an underlying focal lesion. However, abnormalities in idiopathic generalized epilepsy, including childhood absence epilepsy, cannot usually be identified using brain imaging modalities such as MRI. Peri-ictal MRI abnormalities have been most commonly reported secondary to status epilepticus and are rarely observed in patients with focal seizures and generalized tonic-clonic seizures. Transient peri-ictal MRI abnormalities in absence epilepsy are extremely rare. A five-year-old girl presented with a three-day history of absence seizures that persisted despite continued treatment with sodium valproate. Electroencephalography showed bursts of generalized 3-Hz spike-and-wave discharges, during and after hyperventilation. Abnormal cortex thickening in the left perisylvian region was detected on T2-weighted brain MRI, and cortical dysplasia or a tumor was suspected. The patient started treatment with lamotrigine and was seizure-free after one month. The abnormal MRI lesion was completely resolved at the two-month follow-up. We report on a patient with childhood absence epilepsy and reversible brain MRI abnormalities in the perisylvian region. To our knowledge, this is the first report of transient MRI abnormalities after absence seizures. Transient peri-ictal MRI abnormalities should be considered for differential diagnosis in patients with absence seizures and a focal abnormality on brain MRI.

Clinical Experience of LINAC-based Stereotactic Radiosurgery for Angiographically Occult Vascular Malformations (혈관조영상 잠재혈관기형에 대한 선형가속기형 정위방사선수술의 임상경험)

  • Kim Dae Yong;Ahn Yong Chan;Lee Jung Il;Nam Do-Hyun;Lim Do Hoon;Lee Jeong Eun;Yeo Inhwan;Huh Seung Jae;Noh Young Joo;Shin Seong Soo;Hong Seung-Chyul;Kim Jong Hyun
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.1-9
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    • 2001
  • Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

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The effect of steroid for fibrous dysplasia of the humerus combined with multiple cystic lesion (낭종성 병변을 동반한 상완골의 섬유성 골이형성증에서 steroid의 효과 - 증례 보고 -)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bo-Hyun;Won, Jung-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.20-26
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    • 2002
  • Fibrous dysplasia is a benign pathologic condition in which the normal cancellous bone is replaced by the fibro-osseous tissue. It is found mostly in the femur, tibia, skull, rib, and humerus. Clinically it may develops pain, progressive deformity, and pathologic fracture. Curettage with bone graft has been the most popular treatment method thesedays. A 17-year-old female who had fibrous dysplasia of the humerus combined with multiple cystic lesion was treated by intralesional steroid injection into the lesion total 2 times. The follow-up plain X-ray which was taken 11 months after steroid injection reveals decrease in size and increase in bone density and cortex thickness. The follow-up MRI reveals significant decrease in size and signal intensity. The signal intensity was decreased to that of normal bone marrow in T2 weighted image. She complains no pain and lives symptom free in last follow-up at 2 years and 8 months after steroid injection.

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Positional Change of the Uterus during Definitive Radiotherapy for Cervix Cancer (자궁경부암의 방사선치료 시 자궁의 크기와 위치 변화)

  • Park, Won;Huh, Seung-Jae;Lee, Jeung-Eun
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.135-142
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    • 2003
  • Purpose: The purpose of this study was to investigate the positional change of the uterus during radiotherapy. Materials and Methods: Between 1997 and 2001, 47 patients received definitive radiotherapy for cervical cancer at the Samsung Medical Center. For each patient, two MRI scans were taken; one before and the other 3$\~$4 weeks after the radiotherapy treatment. In T2 weighted MRI images, the positional change of the uterine was quantified by measuring six quantities; the distance from the cervix os to the isthmus of the uterus (Dcx), the maximum length from the isthmus of the uterus to the uterine fundus (Dco), the maximum vertical distance of the uterine body (Dco-per), the angle between the vertical line and the cervical canal in the sagittal images (Acx), the angle of the uterine corpus from the vertical line in the sagittal plan (Aco-ap), and the relative angle of the uterine corpus from a fixed anatomical landmark in the axial images (Aco-axi). Results: The mean Dcx values, before and during the treatment, were 36.7 and 27.8 mm, respectively. The Dco deviated by more than 10 mm in 14 cases (29.8$\%$). The change in the Acx ranged from 0.1 to 67.8$^{\circ}$ (mean 13.2$^{\circ}$). The Aco-ap changed by a maximum of 84.8$^{\circ}$ (mean 16.9$^{\circ}$). The differences in the Dcx plus the Dco in the smaller (<4 cm) and larger ($geq$4 cm) tumors were 5.3 and 19.4 mm, respectively. With patients less than 60 years old, or with a tumor size larger than 4 cm, the difference in the Acx was statistically significant. Conclusion: The positional changes of the uterus, during radiation treatment, should be considered in the 3DCRT or IMRT treatment planning, particularly in patients under 60 years of age or in those with a tumor size greater than 4 cm in maximum diameter.

Smart IoT Service Users' Compliance with Personal Information Protection Behavior: An Empirical Study on the Message Design Features to Induce Installation of Software Updates (스마트 IoT 서비스 사용자의 개인정보 보호 행동 준수: 소프트웨어 업데이트 유도를 위한 메세지 디자인 특성에 관한 실증 연구)

  • Lee, Ho-Jin;Kim, Hyung-Jin;Lee, Ho-Geun
    • Informatization Policy
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    • v.31 no.2
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    • pp.82-104
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    • 2024
  • Smart home services are growing rapidly as the development of the Internet of Things (IoT) opens the era of the so-called "Connected Living." Although personal information leaks through smart home cameras are increasing, however, users-while concerned-tend to take passive measures to protect their personal information. This study theoretically explained and verified how to design effective software update notification messages for smart home cameras to ensure that users comply with the recommended security behavior (i.e., update installation). In a survey experiment participated in by 120 actual users, the effectiveness of both emotional appeals (i.e., security breach warning images for fear appeals) and rational appeals (i.e., loss-framed messages emphasizing the negative consequences of not installing the updates) were confirmed. The results of this study provide theoretical interpretations and practical guidelines on the message design features that are effective for threat appraisals (i.e., severity, vulnerability) of smart home camera users and their protection motivation.

Correlation of the Speed of Enhancement of Hepatic Hemangiomas with Intravoxel Incoherent Motion MR Imaging (간혈관종의 조영증강속도와 복셀내비결집운동 MR영상과의 상관관계)

  • Yang, Dal Mo;Jahng, Geon-Ho;Kim, Hyun Cheol;Kim, Sang Won;Kim, Hyug-Gi
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.208-218
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    • 2014
  • Purpose : To evaluate the relationship between the speed of enhancement of hepatic hemangiomas on gadolinium-enhanced MRI and ADC values by using various parameters, including the D, f, $D^*$ and $ADC_{fit}$ on intravoxel incoherent motion (IVIM) MR Imaging. Materials and Methods: The institutional review board approved this retrospective study. A total of 47 hepatic hemangiomas from 39 patients were included (20 men and 19 women). The hemangiomas were classified into three types according to the enhancement speed of the hepatic hemangiomas on gadolinium-enhanced dynamic T1-weighted images: rapid (Type A), intermediate (Type B), and slow (Type C) enhancement. The D, f, $D^*$ and $ADC_{fit}$ values were calculated using IVIM MR imaging. The diffusion/perfusion parameters and ADC values were compared among the three types of hemangiomas. Results: Both the $ADC_{fit}$ and D values of type C were significantly lower than those of type A (P = 0.0022, P = 0.0085). However, for the f and $D^*$, there were no significant differences among the three types. On DWI with all b values (50, 200, 500 and $800sec/mm^2$), the ADC values of type C were significantly lower than those of the type A (P < 0.012). For b values with $800sec/mm^2$, the $ADC_{800}$ values of the type C hemangiomas were significantly lower than those of type B (P = 0.0021). We found a negative correlation between hepatic hemangioma enhancement type and $ADC_{50}$ (${\rho}=-0.357$, P = 0.014), $ADC_{200}$ (${\rho}=-0.537$, P = 0.0001), $ADC_{500}$ (${\rho}=-0.614$, P = 0.0001), and $ADC_{800}$ (${\rho}=-0.607$, P = 0.0001). Therefore, four ADC values of $ADC_{50}$, $ADC_{200}$, $ADC_{500}$, and $ADC_{800}$ were decreased with decreasing enhancement speed. Conclusion: Hepatic hemangiomas had variable ADCs according to the type of enhancement, and the reduced ADCs in slowly enhancing hemangiomas may be related to the reduced pure molecular diffusion (D).

Quantification of the Elastic Property of Normal Thigh Muscles Using MR Elastography: Our Initial Experience (자기 공명 탄성 검사를 이용한 대퇴 근육의 탄성도의 정량화: 초기 경험)

  • Junghoon Kim;Jeong Ah Ryu;Juhan Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1556-1564
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    • 2021
  • Purpose This study aimed to apply MR elastography (MRE) to achieve in vivo evaluation of the elastic properties of thigh muscles and validate the feasibility of quantifying the elasticity of normal thigh muscles using MRE. Materials and Methods This prospective study included 10 volunteer subjects [mean age, 32.5 years, (range, 23-45 years)] who reported normal activities of daily living and underwent both T2-weighted axial images and MRE of thigh muscles on the same day. A sequence with a motion-encoding gradient was used in the MRE to map the propagating shear waves in the muscle. Elastic properties were quantified as the shear modulus of the following four thigh muscles at rest; the vastus medialis, vastus lateralis, adductor magnus, and biceps femoris. Results The mean shear modulus was 0.98 ± 0.32 kPa and 1.00 ± 0.33 kPa for the vastus medialis, 1.10 ± 0.46 kPa and 1.07 ± 0.43 kPa for the vastus lateralis, 0.91 ± 0.41 kPa and 0.93 ± 0.47 kPa for the adductor magnus, and 0.99 ± 0.37 kPa and 0.94 ± 0.32 kPa for the biceps femoris, with reader 1 and 2, respectively. No significant difference was observed in the shear modulus based on sex (p < 0.05). Aging consistently showed a statistically significant negative correlation (p < 0.05) with the shear modulus of the thigh muscles, except for the vastus medialis (p = 0.194 for reader 1 and p = 0.355 for reader 2). Conclusion MRE is a quantitative technique used to measure the elastic properties of individual muscles with excellent inter-observer agreement. Age was consistently significantly negatively correlated with the shear stiffness of muscles, except for the vastus medialis.

Clinical Correlates of Subcortical Hyperintensities on Magnetic Resonance Imaging in Patients with Bipolar Disorder : Preliminary Study (양극성장애 환자의 뇌자기공명영상에서 보이는 피질하 고신호광도의 임상적 상관변수에 관한 예비적 연구)

  • Yoon, Dae Hyun;Kwon, Jun Soo;Han, Moon Hee;Chang, Kee Hyun
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.60-66
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    • 1997
  • Objective : Accumulating evidence suggests a greater number of subcortical hyperintensities in the brain of patients with bipolar disorder. We studied the Clinical correlates of subcortical hyperintensities on magnetic resonance imaging in patients with Bipolar Disorder : Methods : Magnetic resonance images of the brain were obtained for 32 patients with bipolar disorder. The presence and location of hyperintensities were assessed. We compared clinical variables between patients with subcortical hyperintensities and patients without them. Results : Seven patients(21.8%) had subcortical hyperintensities, but among 8 patients who were 40 years or older, 5 patients(62%) had them. Age and age at onset of patients with subcortical hyperintensities were significantly older than patients without them. Psychotic symptoms were more frequent in patients with hyperintensities. Patients without hyperintensities had more familial loadings. Conclusion : Given the limitations of the study, our results should be seen as preliminary. This study, however, provides preliminary evidence supporting the notion that the onset, clinical feature and course of some bipolar disorders of late onset may be determined by underlying subcortical abnormalities, with such abnormalities being the consequence of factors related to aging or neurodegeneration(such as impaired cerebral circulation) rather than genetic factors which predispose to early-onset bipolar disorders.

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Morphometric Analysis of Distances between Sacral Hiatus and Conus Medullaris Using Magnetic Resonance Image in Korean Adult (자기공명영상을 이용한 한국 성인의 엉치뼈틈새와 척수원뿔 사이 거리 연구)

  • Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
    • Anatomy & Biological Anthropology
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    • v.29 no.4
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    • pp.145-154
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    • 2016
  • The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.