• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 1997년도 제2차 추계학술대회 초록집
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• pp.27-27
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• 1997

• Korean Journal of Radiology
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• 제24권8호
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• pp.784-794
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• 2023

Objective: To determine whether dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) can be used to evaluate posterior cerebral circulation in pediatric patients with moyamoya disease (MMD) who underwent anterior revascularization. Materials and Methods: This study retrospectively included 73 patients with MMD who underwent DSC perfusion MRI (age, 12.2 ± 6.1 years) between January 2016 and December 2020, owing to recent-onset clinical symptoms during the follow-up period after completion of anterior revascularization. DSC perfusion images were analyzed using a dedicated software package (NordicICE; Nordic NeuroLab) for the middle cerebral artery (MCA), posterior cerebral artery (PCA), and posterior border zone between the two regions (PCA-MCA). Patients were divided into two groups; the PCA stenosis group included 30 patients with newly confirmed PCA involvement, while the no PCA stenosis group included 43 patients without PCA involvement. The relationship between DSC perfusion parameters and PCA stenosis, as well as the performance of the parameters in discriminating between groups, were analyzed. Results: In the PCA stenosis group, the mean follow-up duration was 5.3 years after anterior revascularization, and visual disturbances were a common symptom. Normalized cerebral blood volume was increased, and both the normalized time-topeak (nTTP) and mean transit time values were significantly delayed in the PCA stenosis group compared with those in the no PCA stenosis group in the PCA and PCA-MCA border zones. TTP_PCA (odds ratio [OR] = 6.745; 95% confidence interval [CI] = 2.665-17.074; P < 0.001) and CBV_PCA-MCA (OR = 1.567; 95% CI = 1.021-2.406; P = 0.040) were independently associated with PCA stenosis. TTP_PCA showed the highest receiver operating characteristic curve area in discriminating for PCA stenosis (0.895; 95% CI = 0.803-0.986). Conclusion: nTTP can be used to effectively diagnose PCA stenosis. Therefore, DSC perfusion MRI may be a valuable tool for monitoring PCA stenosis in patients with MMD.

• 대한한의학회지
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• 제30권1호
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• pp.64-75
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• 2009

Objective: This study was designed to investigate the effect of Samultang (SMT) under hippocampus cells ischemia both in vitro and in vivo. Methods: In the in vitro study, HT22 cells, predominantly detected in the cytoplasm, which coincides with the location of the mitochondria, were used as indicators. In the in vivo study, permanent middle cerebral artery occlusion (MCAO) was induced on rats. SMT was given orally 2 h before induction of permanent focal brain ischemic injury. Result: In the in vitro study, SMT had protective effects in glutamate-induced cytotoxicity, which was revealed as apoptosis characterized by chromatic condensation and the loss of mitochondrial membrane potential in HT22 cells. In the in vivo study, TTC (2,3,5-triphenyltetrazolium chloride) staining showed a marked ischemic injury in blood supply territory of the middle cerebral artery (MCA) such as the cerebral cortex and striatum. However, treatment with SMT significantly reduced infarcted volume. SMT increased marked survival of HT22 cells against glutamate-induced cytotoxicity in MTT assay. Conclusion: These results suggest that water extract of SMT provides neuroprotection against ischemic or oxidative injury by inhibition of apoptotic cell death.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1998년도 추계학술대회
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• pp.281-282
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• 1998

Recently, there has been growing interest in the assessment of physiological parameters on brain perfusion that provide more information than pure morphologic diagnosis. Quantification of parameters that characterize cerebral micro-circulation with magnetic resonance imaging is of great relevance for clinical application. We determine the local tissue concentration by exponential relationship between the relative signal reduction S(t)/$S_0$ and local tissue concentration of contrast material $C_m(t)$ in dynamic susceptibility contrast enhanced MR imaging. And then we made relative regional blood volume map by calculating the area under the measured concentration-time curves $C_m(t)$ during first pass of paramagnetic contrast material as a preliminary step for perfusion map. These images make it possible to compare the rCBV in different brain regions in one individual at a time. We have it in contemplation to obtain arterial and brain signal time curves simultaneously to make absolute rCBV and perfusion (rCBF) map. These maps may provide the method of comparative investigations of different patients having strong variation in AIF.

• 한국임상수의학회지
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• 제41권3호
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• pp.178-182
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• 2024

A 10-year-old spayed female Poodle was referred for blindness. On ophthalmic examination, loss of bilateral ocular pupil light reflex, visual loss, and right retinal detachment were confirmed at a local hospital. Magnetic resonance imaging (MRI) of the brain was performed to identify the optic nerve, optic chiasm, and brain disease. A sessile mass centered on the region of the optic chiasm was identified. The mass had iso- to hypointense on fluid-attenuated inversion recovery and T2-weighted images and mildly hypointense on T1-weighted images compared to the gray matter, with strong contrast enhancement. Peripheral edema was also identified. Computed tomography (CT) brain perfusion was performed to obtain additional hemodynamic information about the patient using a multislice CT. CT perfusion showed that the cerebral blood volume in the left temporal lobe region (13.4 ± 1.6 mL/100 g) was decreased relative to the contralateral region (19.9 ± 0.3 mL/100 g). The patient showed decreased appetite and consciousness one week after the CT scan with clinical symptoms worsened. The patient had seizure, tetraparesis, and loss of consciousness. It was euthanized one month later at the request of the owner. This report suggests that CT brain perfusion can provide additional hemodynamic information such as insufficient brain perfusion in sellar region tumor which can help assess potential complications and prognosis and plan treatment.

• 대한임상검사과학회지
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• 제42권3호
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• pp.155-160
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• 2010

Transcranial Doppler ultrasonography (TCD) allows measurement of blood flow velocity to be made from the basal intracerebral vessels. Blood flow velocity in TCD is highly affected not only by blood vessel diameter, blood flow volume, blood viscosity, but also age and sex. Therefore, the study is focused on the correlation between TCD measurement index and sex/age. Subjects were 214 (male 147, famale 67) who had TCD for headache and stroke evaluations at Dongguk University Ilsan Hospital neurology department from December 2009 to April 2010. Sex did not show significant differences with mean flow velocity (MFV), peak systolic flow velocity (PSFV), end diastolic flow velocity (EDFV), pulsatility index (PI) and resistance index (RI) in middle cerebral artery (MCA). Although age also did not show significant differences with MFV and PSFV, EDFV has statistically decreased with age, and PI and RI has statistically increased with age. In addition, age showed significant correlation with MFV, EDFV, PI and RI, but not with PSFV. Therefore, TCD is definitely correlated with age and sex, so that those influencial factors must be considered when being tested.

• Annals of Clinical Neurophysiology
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• 제4권1호
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• pp.38-43
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• 2002

Background & Purpose : Dynamic susceptibility contrast MR imaging, one method of perfusion MRI, was developed to define cerebral hemodynamic status with good anatomical resolution. The authors investigated hemodynamic parameters using this imaging method, in an effort to identify hemodynamic changes on the remote crossed cerebellum of patients with a supratentorial infarct. Methods : Dynamic susceptibility contrast MR imaging was performed in 15 patients with only unilateral supratentorial infarcts. Imaging was obtained at the anatomic level of the cerebellum. rCBF, rCBV, MTT and TP were determined over both cerebellar hemispheres of interest. Results : The rCBF and rCBV values of the contralateral cerebellar hemisphere were significantly more decreased than those of the ipsilateral cerebellar hemisphere in 12 patients(p=0.028, 0.033). MTT and TP values of the contralateral and ipsilateral cerebellar hemispheres didn't reveal any differences(p=0.130, 0.121). Conclusions : The results of this work suggest that the region which are remote from the ischemic brain lesion shows no changes of MTT or TP but show decrease of rCBF and rCBV, mean to diaschisis, it also demonstrates that perfusion MRI is an easily available method to evaluate the hemodynamic status of the brain.

• Journal of Korean Neurosurgical Society
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• 제39권5호
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• pp.347-354
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• 2006

Objective : We evaluate the role of multislice computerized tomographic angiography[MCTA] in the diagnosis of intracranial vasospasm following subarachnoid hemorrhage[SAH] in patients suspected of having vasospasm on clinical ground. Methods : Between October 2003 and June 2005, patients with ruptured cerebral aneurysms of the anterior circulation clipped within 3 days of the onset were included. We performed follow-up MCTAs in patients who were suspected to have vasospasm on transcranial doppler sonography[TCD] findings and clinical grounds. Based on the clinical presentation of symptomatic vasospasm, we investigated the correlation between clinical, TCD, and MCTA signs of vasospasm and evaluated the role of MCTA in vasospasm. Results : One hundred one patients met the inclusion criteria and symptomatic vasospasm developed in 25 patients [24.8%]. We performed follow-up MCTAs in 28 patients. MCTA revealed spasm in the vessels of 26 patients. The sensitivity of MCTA was 100%. Among the 26 patients with MCTA evidence of vasospasm, 3 patients had TCD signs of vasospasm after symptomatic vasospasm presentation. Another 3 patients with symptomatic vasospasm had no TCD signs of vasospasm in daily serial recordings. Six other patients without symptomatic vasospasm showed MCTA evidence of vasospasm [false positive result] but these patients had also positive TCD signs of vasospasm. Volume rendering[VR] images tended to show significantly more exaggerated vasospasm than maximum intensity projection[MIP] images. The mean cerebral blood flow velocity of both proximal segment of the middle cerebral artery [M1] was significantly correlated with each reduced M1 diameter on MCTA [P<005]. Conclusion : MCTA could be a useful tool for evaluation and planning management of critically ill patients suspected of having vasospasm; however, more randomized controlled trials are necessary to assess these points definitively.

• 동의생리병리학회지
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• 제23권4호
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• pp.866-871
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• 2009

Brain edema is a major importance in the pathophysiology of CNS injuries including stroke. Ischemic brain edema results from both cytotoxic edema, which is severe in astrocytes at early stage, and vasogenic edema caused by excessive blood-brain barrier (BBB) permeability. The present study was performed to determine the effect of Rhei Rhizoma on brain edema induced by middle cerebral artery occlusion (MCAO) in the rats. The neurological symptom, total infarct volume and edema index caused by MCAO were measured. The changes of Matrix Metalloproteinase-9 (MMP-9) and inducible nitric oxide synthase (iNOS) immunoreactivities were also observed. We found that Rhei Rhizoma extract improved the neurological symptom and attenuated the total infarct volume and brain edema caused by ischemic insult. Rhei Rhizoma extract also attenuated the expression of MMP-9 and iNOS. This results suggest that Rhei Rhizoma has a protective effect on the brain edema caused by ischemic insult.

• 대한한의학회지
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• 제21권2호
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• pp.68-78
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• 2000

Objective : This research was performed to investigate protective effects of Sophora subprostrata, against ischemic brain damage after a middle cerebral artery(MCA) occlusion. The effect was estimated using histological test, neurobehavioural test, and biochemical test. Methods : Rats(Sprague-Dawley) were divided into four groups: Sham operated group, MCA occluded group, Sophora subprostrata administrated group after MCA occlusion, and Normal group. The MCA was occluded by intraluminal method. Sophora subprostrata was administrated orally twice(l and 4 hours) after middle cerebral artery occlusion. The neurobeavioural test was performed at 3 hours, 6 hours, 9 hours and 24 hours after the surgery by posture reflex test and swimming behavioural test. All groups were sacrificed at 24 hours after the surgery. The brain tissue was stained with 2% triphenyl tetrazolium chioride(TTC) or 1 % cresyl violet solution, to examine effect of Sophora subprostrata on ischemic brain tissue. The blood samples were obtained from the heart of rats. Tumor necrosis factor-a level was measured from sera using Enzyme-Linked Immunoabsorbent Assay(ELISA). Results : The results showed that (1) Sophora subprostrata reduced infarct size and total infarct volume by 54.8% compared to the control group, (2) that neuronal death, which was shown by decrease in cell number and size, was attenuated significantly in the boundary area of the infarction, (3) that serum $TNF-{\alpha}$ㆍlevel was reduced significantly, and finally, there was significant recovery of motor deficit at 3 hours after MCA occluded by Swimming behavioural test. Conclusions :In conclusion, Sophora subprostrata has protective effects against ischemic brain damage at the early stage of ischemia.