• Title/Summary/Keyword: clinical MR

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Diagnosis of Graft-Versus-Host Disease after Bone Marrow Transplantation by in vivo Proton MR Spectroscopy of the Liver: Correlation with Pathologic Results

  • Cho, Soon-Gu;Lee, Moon-Hee;Suh, Chang-Hae
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.135-135
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    • 2001
  • Purpose: To know the differences of the proton MR spectroscopic features of the liver between th patients with graft-versus-host disease (GVHD) and without GVHD (non-GVHD) after to marrow transplantation (BMT), and to evaluate the possibility to discriminate GVHD fro non-GVHD by analysis of the in vivo proton MR spectra. Method: We evaluated the in vivo proton MR spectra from the livers of 37 patients wh underwent BMT. Our series included 14 cases with GVHD and 23 without GVHD in the liver. Nineteen men and 18 women were included in our series. All cases of GVHD and 2 o non-GVHD were confirmed by liver biopsy and remaining of non-GVHD by evaluation clinical follow up. Proton MR spectroscopy (1H-MRS) was performed at 1.5T GE Sign Horizon (GE Medical System, Milwaukee, USA) system using localized proton STEAM sequence and body coil in all cases with subjects were located in supine position. N respiratory interruption was required during the spectroscopic signal acquisition. Paramete using in MRS were: TR = over 3000ms, TE = 30ms, number of scans = 128, voxel size = ($2{\times}2{\times}2$)$cm^3$, and one NEX. We evaluated the spectra with an attention to the differences o patterns of the peaks between GVHD and non-GVHD groups. The ratio of peak area of peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P(1.6-4.1ppm)/P(0.9-1.6ppm)] was calculated in GVHD and non-GVHD group, and compared the results between these groups. We als evaluated the sensitivity and specificity for discriminating GVHD from non-GVHD by anal of 1H-MRS.

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Evaluation of Knee Joint after Double-Bundle ACL Reconstruction with Three-Dimensional Isotropic MRI

  • Jung, Min ju;Jeong, Yu Mi;Lee, Beom Goo;Sim, Jae Ang;Choi, Hye-Young;Kim, Jeong Ho;Lee, Sheen-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.95-104
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    • 2016
  • Purpose: To evaluate the knee joint after double-bundle anterior cruciate ligament (ACL) reconstruction with three-dimensional (3D) isotropic magnetic resonance (MR) image, and to directly compare the ACL graft findings on 3D MR with the clinical results. Materials and Methods: From January 2009 to December 2014, we retrospectively reviewed MRIs of 39 patients who had reconstructed ACL with double bundle technique. The subjects were examined using 3D isotropic proton-density sequence and routine two-dimensional (2D) sequence on 3.0T scanner. The MR images were qualitatively evaluated for the intraarticular curvature, graft tear, bony impingement, intraosseous tunnel cyst, and synovitis of anteromedial and posterolateral bundles (AMB, PLB). In addition anterior tibial translation, PCL angle, PCL ratio were quantitatively measured. KT arthrometric values were reviewed for anterior tibial translation as positive or negative. The second look arthroscopy results including tear and laxity were reviewed. Results: Significant correlations were found between an AMB tear on 3D-isotropic proton density MR images and arthroscopic proven AMB tear or laxity (P < 0.05). Also, a significant correlation was observed between increased PCL ratio on 3D isotropic MRI and the arthroscopic findings such as tear, laxities of grafts (P < 0.05). KT arthrometric results were found to be significantly correlated with AMB tears (P < 0.05) and tibial tunnel cysts (P < 0.05). Conclusion: An AMB tear on 3D-isotropic MRI was correlated with arthroscopic results qualitatively and quantitatively. 3D isotropic MRI findings can aid the evaluation of ACL grafts after double bundle reconstruction.

A Study for Normal Development of the Posterior Cranial Fossa in the Chick Embryos (gestation 14-20 days) with MR Images and Histopathology (정상 닭배자(배양14-20일)의 후두와 발생과정에 대한 연구 : 자기공명영상 및 해부병리학적 소견)

  • Sim Ki Bum;Lee Chang Sub;Shin Tae Kyun
    • Environmental Mutagens and Carcinogens
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    • v.25 no.1
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    • pp.25-31
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    • 2005
  • The objective was to use MR imaging to provide a template of posterior fossa development during the late stages in the chick embryos. The MR findings were then correlated with histological data. Fourteen normal formalin-fixed embryonic specimens with a gestational age of 14 to 20 days were examined with 1.5 Tesla unit MRl using a conventional clinical magnet and pulse sequences. The MR findings were correlated with the whole-mount histological specimens. Resolution of the morphological features of posterior fossa development in embryos greater than 14 days gestational age was possible. Development of cerebellum, brain stem, 4th ventricle and bony posterior fossa was documented. In the 14-day-old embryos, a premordial cerebellum was visualized in the enlarged bony posterior fossa, and it covered the the roof of the primitive fourth ventricle. The bony posterior fossa grows at the same rate along the supratentorial skull. The supratentorial skull and the rostral part of the brain grows at the same rate. The cerebellum begins to grow later than the rostral part of the brain. In the 19- to 20-day-old embryos, MRl revealed the rapid development of the cerebellar hemispheres, along with an increase in volume manifested by the more typical mushroom-shaped configuration observed in the newly hatched. At this stage, the cerebellum almost completely filled the posterior fossa and covered the entire fourth ventricle. The brain stem grew steadily, but the volume change was too subtle to evaluate. Features of cerebellar histogeneis were beyond the resolution of MRl. However, there were lots of artifacts in the features of the bony posterior fossa. An MR template of normal posterior fossa development would be useful to avoid confusion of normal development with abnormal development and to identify the expected developmental features when provided the estimated gestational age of a embryo.

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Human in-vivo 31P MR Spectroscopy of Benign and Malignant Breast Tumors

  • Jeong Mi Park;Jae Hyung Park
    • Korean Journal of Radiology
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    • v.2 no.2
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    • pp.80-86
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    • 2001
  • Objective: To assess the potential clinical utility of in-vivo 31P magnetic resonance spectroscopy (MRS) in patients with various malignant and benign breast lesions. Materials and Methods: Seventeen patients with untreated primary malignant breast lesions (group I), eight patients with untreated benign breast lesions (group II) and seven normal breasts (group III) were included in this study. In-vivo 31P MRS was performed using a 1.5 Tesla MR scanner. Because of the characteristics of the coil, the volume of the tumor had to exceed 12 cc (3×2×2 cm), with a superoinferior diameter at least 3 cm. Mean and standard deviations of each metabolite were calculated and metabolite ratios, such as PME/PCr, PDE/PCr, T-ATP/PCr and PCr/T-ATP were calculated and statistically analyzed. Results: Significant differences in PME were noted between groups I and III (p=0.0213), and between groups II and III (p=0.0213). The metabolite ratios which showed significant differences were PME/PCr (between groups II and III) (p=0.0201), PDE/PCr (between groups I and III, and between groups II and III) (p=0.0172), T-ATP/PCr (between groups II and III) (p=0.0287), and PCr/T-ATP (between groups II and III) (p=0.0287). There were no significant parameters between groups I and II. Conclusion: In-vivo 31P MRS is not helpful for establishing a differential diagnosis between benign and malignant breast lesions, at least with relatively large lesions greater than 3 cm in one or more dimensions.

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Carotid Intraplaque Hemorrhage Imaging: Diagnostic Value of High Signal Intensity Time-of-Flight MR Angiography Compared with Magnetization-Prepared Rapid Acquisition with Gradient-Echo Sequencing

  • Ahn, Ji-eun;Kwak, Hyo Sung;Chung, Gyung Ho;Hwang, Seung Bae
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.2
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    • pp.94-101
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    • 2018
  • Purpose: To determine the value of the appearance of the high signal intensity halo sign for detecting carotid intraplaque hemorrhage (IPH) on maximum intensity projection (MIP) of time-of-flight (TOF) MR angiography (MRA), based on high signal intensity on magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) sequencing. Materials and Methods: A total of 78 carotid arteries in 65 patients with magnetization-prepared rapid acquisition gradient-echo (MPRAGE) positive on carotid plaque MR imaging were included in this study. High-resolution MR imaging was performed on a 3.0-T scanner prior to carotid endarterectomy or carotid artery stenting. Fast spin-echo T1- and T2-weighted axial imaging, TOF, and MPRAGE sequences were obtained. Carotid plaques with high signal intensity on MPRAGE > 200% that of adjacent muscle on at least two consecutive slices were defined as showing IPH. Halo sign of high signal intensity around the carotid artery was found on MIP from TOF MRA. Continuous and categorical variables were compared among groups using the Mann-Whitney test and Fisher's exact tests. Results: Of these 78 carotid arteries, 53 appeared as a halo sign on the TOF MRA. The total IPH volume of patients with a positive halo sign was significantly higher than that of patients without a halo sign ($75.0{\pm}86.8$ vs. $16.3{\pm}18.2$, P = 0.001). The maximum IPH axial wall area in patients with a positive halo sign was significantly higher than that of patients without a halo sign ($11.3{\pm}9.9$ vs. $3.7{\pm}3.6$, P = 0.000). Conclusion: High signal intensity halo of IPH on MIP of TOF MRA is associated with total volume and maximal axial wall area of IPH.

Quantitative Feasibility Evaluation of 11C-Methionine Positron Emission Tomography Images in Gamma Knife Radiosurgery : Phantom-Based Study and Clinical Application

  • Lim, Sa-Hoe;Jung, Tae-Young;Jung, Shin;Kim, In-Young;Moon, Kyung-Sub;Kwon, Seong-Young;Jang, Woo-Youl
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.476-486
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    • 2019
  • Objective : The functional information of $^{11}C$-methionine positron emission tomography (MET-PET) images can be applied for Gamma knife radiosurgery (GKR) and its image quality may affect defining the tumor. This study conducted the phantom-based evaluation for geometric accuracy and functional characteristic of diagnostic MET-PET image co-registered with stereotactic image in Leksell $GammaPlan^{(R)}$ (LGP) and also investigated clinical application of these images in metastatic brain tumors. Methods : Two types of cylindrical acrylic phantoms fabricated in-house were used for this study : the phantom with an array-shaped axial rod insert and the phantom with different sized tube indicators. The phantoms were mounted on the stereotactic frame and scanned using computed tomography (CT), magnetic resonance imaging (MRI), and PET system. Three-dimensional coordinate values on co-registered MET-PET images were compared with those on stereotactic CT image in LGP. MET uptake values of different sized indicators inside phantom were evaluated. We also evaluated the CT and MRI co-registered stereotactic MET-PET images with MR-enhancing volume and PET-metabolic tumor volume (MTV) in 14 metastatic brain tumors. Results : Imaging distortion of MET-PET was maintained stable at less than approximately 3% on mean value. There was no statistical difference in the geometric accuracy according to co-registered reference stereotactic images. In functional characteristic study for MET-PET image, the indicator on the lateral side of the phantom exhibited higher uptake than that on the medial side. This effect decreased as the size of the object increased. In 14 metastatic tumors, the median matching percentage between MR-enhancing volume and PET-MTV was 36.8% on PET/MR fusion images and 39.9% on PET/CT fusion images. Conclusion : The geometric accuracy of the diagnostic MET-PET co-registered with stereotactic MR in LGP is acceptable on phantom-based study. However, the MET-PET images could the limitations in providing exact stereotactic information in clinical study.

Prognostic Impact of Left Atrial Strain After Mitral Valve Repair Surgery in Patients With Severe Mitral Regurgitation

  • Jin Kyung Oh;Yong-Hoon Yoon;Jae-Hyung Roh;Minsu Kim;Byung Joo Sun;Sung-Ho Jung;Jae Hwan Lee;Jae Won Lee;Dae-Hee Kim;Jae-Hyeong Park
    • Korean Circulation Journal
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    • v.52 no.3
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    • pp.205-217
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    • 2022
  • Background and Objectives: The prognostic value of left atrial (LA) function in terms of long-term clinical outcomes after mitral regurgitation (MR) surgery remains unclear. Therefore, we investigated the impact of preoperative LA global longitudinal strain (LAGLS) on the long-term postoperative clinical outcomes in chronic severe MR patients who underwent mitral valve (MV) repair surgery. Methods: From January 2012 to December 2017, we analyzed 338 patients (mean age, 51.9±12.5 years; 218 males [64.5%]) treated with MV repair surgery for severe MR. The primary outcome was cardiovascular events, defined as the composite of all-cause death, newly developed atrial fibrillation (AF), and re-hospitalization for cardiovascular causes. Results: During a median follow-up of 45 months (interquartile range, 26-65), 30 (8.9%) cardiovascular events, 5 (1.5%) all-cause death, 8 (2.4%) newly developed AF, and 26 (7.7%) re-hospitalizations occurred. On multivariable analysis, baseline LAGLS was an independent predictor of cardiovascular events (adjusted hazard ratio [HR], 0.91; 95% confidential interval [CI], 0.85-0.97; p=0.004) and re-hospitalization (adjusted HR, 0.93; 95% CI, 0.86-1.00; p=0.037). According to the optimal cutoff value of LAGLS, patients with low LAGLS (<23.6%) had a significantly higher risk of cardiovascular events (adjusted HR, 2.70; 95% CI, 1.04-7.00; p=0.041) than those with high LAGLS (≥23.6%). In a subgroup analysis, patients with high LAGLS had better clinical outcomes regardless of whether the patient had a LA volume index <60 mL/m2. Conclusions: In patients with chronic severe MR who received successful MV repair surgery, preoperative LAGLS is an independent predictor of long-term postoperative outcomes.

Noninvasive Rx of Breast Cancer by MR-guided High Intensity Focused Ultrasound

  • Moonen, Chrit
    • Proceedings of the KSMRM Conference
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    • 2005.09a
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    • pp.77-78
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    • 2005
  • A specific FUS-MRI platform was designed for breast cancer treatment. phased array technologies, sideways FUS transmission, and spatio-temporal temperature control in the complete region of interest, were combined for a novel therapy approach with enhanced safety and afficacy. A phase I clinical trial will start soon.

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