• Title/Summary/Keyword: gadolinium

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Non-mass-forming Lymphoma of the Left Ventricle Mimicking Non-ischemic Cardiomyopathy on MR Imaging: A Case Report (MRI에서 비허혈성 심근병증으로 오인된 좌심실의 림프종: 증례 보고)

  • Shin, Won-Seon;Kim, Sung-Mok;Choe, Yeon-Hyeon;Hyeon, Ji-Yeon;Kim, Jung-Sun;Chang, Sung-A
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.189-194
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    • 2012
  • We report a case of cardiac lymphoma in a 40-year-old man, who had a mediastinal mass which was diagnosed as sclerosing mediastinitis pathologically. The mediastinal mass caused right pulmonary arterial stenosis. The patient developed myocardial hypertrophy and echocardiography showed restrictive physiology and severely decreased left ventricle ejection fraction, 6 months later. MRI showed global left ventricular myocardial hypertrophy and diffuse late gadolinium hyperenhancement after administration of contrast material. Thus, non-ischemic cardiomyopathy was suspected on MRI. However, pathology confirmed the myocardial abnormality as lymphoma after myocardial biopsy. Because a basal part of the left ventricle and global subendocardial myocardium were not involved on contrast-enhanced delayed MRI, the MRI abnormalities could be differentiated from amyloidosis and other myocardial diseases. The peculiar non-mass forming diffuse hypertrophy pattern of cardiac lymphoma has not been known in the MRI literature.

Delayed Enhancement Magnetic Resonance Imaging Findings in Cardiac Amyloidosis (심장 아밀로이드증의 지연 조영증강 MR 영상소견)

  • Song, Jin Hwa;Park, Eun-Ah;Lee, Whal;Chung, Jin Wook;Park, Jae Hyung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.33-40
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    • 2013
  • Purpose : To evaluate late gadolinium enhancement (LGE) pattern of left ventricular (LV) myocardium and presence or absence of LGE in other regions of the heart on cardiac magnetic resonance (CMR) imaging in patients diagnosed with cardiac amyloidosis. Materials and Methods: From 2009 to 2011, 9 patients who were suspected cardiac amyloidosis underwent CMR. We retrospectively analyzed the presence or absence of LGE and enhancement pattern in LV myocardium, and the presence or absence of LGE in other chambers as well. Also we measured interatrial septal thickness (IST), relative signal intensities of atrial septum and epicardial fat over the left atrial (LA) cavity on delayed enhanced images. MRI parameters in these patients were compared to those of control group of patients with ischemic heart disease by Wilcoxon rank sum test. Results: Of nine patients, LGE were found in 8; subendocardial circumferential pattern in 4 and diffuse pattern in 4. LGE in right ventricle was observed in 7. IST was significantly increased in patients with cardiac amyloidosis (P = 0.02). Ratio of atrial septum to LA cavity and ratio of epicardial fat to LA cavity showed a significant difference (P = 0.0002 and P = 0.0006, respectively). Conclusion: In LGE CMR, subendocardial or diffuse enhancement pattern is a typical finding for patients with cardiac amyloidosis. Atrial septum and epicardial fat show relatively increased signal intensities over LA blood cavity.

Characteristic MRI Findings of Spinal Metastases from Various Primary Cancers: Retrospective Study of Pathologically-Confirmed Cases (다양한 원발성 암의 척추전이 병변의 특징적인 자기공명영상 소견들: 병리학적으로 확인된 병변들의 후향적인 분석)

  • An, Chansik;Lee, Young Han;Kim, Sungjun;Cho, Hee Woo;Suh, Jin-Suck;Song, Ho-Taek
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.8-18
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    • 2013
  • Purpose : The purpose of this study was to find and categorize the various magnetic resonance imaging (MRI) findings of spinal metastases that correlate with the type of primary cancer. Materials and Methods: We retrospectively reviewed gadolinium-enhanced magnetic resonance images of 30 patients with 169 spinal metastatic lesions from lung cancer (n = 56), breast cancer (n = 29), colorectal cancer (n = 20), hepatocellular carcinoma (HCC) (n = 17), and stomach cancer (n = 47). The size, location, extent of invasion, signal intensity, margin, enhancement pattern, and osteoblastic or osteolytic characteristics of each metastatic tumor were analyzed. Results: The metastatic lesions from HCC were larger than those from the other primary tumors (P < 0.05) except for colorectal cancer (P = 0.268). Well-defined metastatic tumor margins were more frequently seen in lung cancer and breast cancer (P < 0.01). All but HCC showed a tendency to invade the vertebral body rather than the posterior elements (P < 0.02). Colorectal cancer and HCC showed a tendency toward extraosseous invasion without statistical significance. HCC showed a characteristic enhancement pattern of 'worms-in-a-bag'. Rim enhancement with a sclerotic center was only seen in spinal metastases from stomach cancer. Conclusion: Despite many overlapping imaging features, spinal metastases of various primary tumors display some characteristic MRI findings that can help identify the primary cancer.

Phantom-Validated Reference Values of Myocardial Mapping and Extracellular Volume at 3T in Healthy Koreans

  • Lee, Eunjin;Kim, Pan Ki;Choi, Byoung Wook;Jung, Jung Im
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.3
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    • pp.141-153
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    • 2020
  • Purpose: Myocardial T1 and T2 relaxation times are affected by technical factors such as cardiovascular magnetic resonance platform/vendor. We aimed to validate T1 and T2 mapping sequences using a phantom; establish reference T1, T2, and extracellular volume (ECV) measurements using two sequences at 3T in normal Koreans; and compare the protocols and evaluate the differences from previously reported measurements. Materials and Methods: Eleven healthy subjects underwent cardiac magnetic resonance imaging (MRI) using 3T MRI equipment (Verio, Siemens, Erlangen, Germany). We did phantom validation before volunteer scanning: T1 mapping with modified look locker inversion recovery (MOLLI) with 5(3)3 and 4(1)3(1)2 sequences, and T2 mapping with gradient echo (GRE) and TrueFISP sequences. We did T1 and T2 mappings on the volunteers with the same sequences. ECV was also calculated with both sequences after gadolinium enhancement. Results: The phantom study showed no significant differences from the gold standard T1 and T2 values in either sequence. Pre-contrast T1 relaxation times of the 4(1)3(1)2 protocol was 1142.27 ± 36.64 ms and of the 5(3)3 was 1266.03 ± 32.86 ms on the volunteer study. T2 relaxation times of GRE were 40.09 ± 2.45 ms and T2 relaxation times of TrueFISP were 38.20 ± 1.64 ms in each. ECV calculation was 24.42% ± 2.41% and 26.11% ± 2.39% in the 4(1)3(1)2 and 5(3)3 protocols, respectively, and showed no differences at any segment or slice between the sequences. We also calculated ECV from the pre-enhancement T1 relaxation time of MOLLI 5(3)3 and the post-enhancement T1 relaxation time of MOLLI 4(1)3(1)2, with no significant differences between the combinations. Conclusion: Using phantom-validated sequences, we reported the normal myocardial T1, T2, and ECV reference values of healthy Koreans at 3T. There were no statistically significant differences between the sequences, although it has limited statistical value due to the small number of subjects studied. ECV showed no significant differences between calculations based on various pre- and post-mapping combinations.

Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

Effect of Gd-DTPA on Diffusion in Canine Brain with Hyperacute Stroke (초급성 뇌경색을 일으킨 개에서 Gd-조영제의 주입이 뇌의 확산에 미치는 영향)

  • 김범수;정소령;신경섭
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.158-165
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    • 2002
  • Purpose : To evaluate the effect of Gd-DTPA on signal intensity of diffusion-weighted magnetic resonance(MR) image and apparent diffuse coefficient (ADC) in dog brain with hype racute stroke. Materials and methods : Experimental canine model of hyperacute cerebral infarction was made by selective intraarterial embolization with particulate embolic material. Diffusion-weighted MR imaging was performed in five dogs at 1 hour after the embolization of internal carotid artery. After intravenous bolus injection of Gd- DTPA, additional 11 diffusion-weighted MR images were serially obtained from 2 minutes to 90 minutes after injection in each dog. The author evaluated findings of hyperacute cerebral infarction on diffusion-weighted MR imaging, and calculated mean signal intensity and mean ADC in infarcted region and contralateral normal region. Statistical analysis of mean signal intensity, mean ADC and contrast-noise ratio before and after Gd-DTPA injection was performed. Results : Hyperacute cerebral infarction developed in all five dogs on diffusion-weighted MR images obtained 1 hour after embolization. The area of hyperacute infarction had steady increase in signal intensity on diffusion-weighted MR image and decrease in ADC. In normal perfusion area, decrease in signal intensity was observed at 2 minutes the Gd-DTPA injection, whereas ADC did not changed. Conclusion : Intravenous injection of Gd-DTPA had no influence on ADC in both hyperacute infarction and normally perfused are a, but caused initial transient signal reduction in normally perfused area on diffusion-weighted MR image due to susceptibility effect of Gd-DTPA. It is important to calculate ADC in evaluating the effect of diffusion after injection of Gd-DTPA.

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Pharmacokinetics and Bio-distribution of New Gd-complexes of DTPA-bis (amide) (L3) in a Rat Model (쥐를 이용한 새로운 가돌리늄 조영제 Gd-DTPA-bis(amide)(L3)의 약동학 및 생체내 분포 특성에 대한 연구)

  • Yan, Gen;Wu, Renhua;Chang, Yongmin;Kang, Duksik
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.4
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    • pp.259-266
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    • 2013
  • Purpose : To investigate the blood pharmacokinetics and bio-distribution of DTPA-bis-amide (L3) Gd(III) complexes. Materials and Methods: The pharmacokinetics and bio-distribution of Gd $(L3)(H_2O){\cdot}nH_2O$ were investigated in Sprague-Dawley rats after intravenous administration at a dose of 0.1 mmol Gd/kg. The Gd content in the blood, various tissues, and organs was determined by ICP-AES. Blood pharmacokinetic parameters were calculated using a two-compartment model. Results: The half-lives of ${\alpha}$ phase and ${\beta}$ phase Gd $(L3)(H_2O){\cdot}nH_2O$ were $2.286{\pm}0.11$ min and $146.1{\pm}7.5$ min, respectively. The bio-distribution properties reveal that the complex is mainly excreted by the renal pathway, and possibly excreted by the hepatobiliary route. The concentration ratio of Gd (III) was significantly higher in the liver and spleen than in other organs, and small amounts of Gd (III) ion were detected in the blood or other tissues of rats only after 7 days of intravenous administration. Conclusion: The MRI contrast agent Gd $(L3)(H_2O){\cdot}nH_2O$ provides prolonged blood pool retention in the circulation and then clears rapidly with minimal accumulation of Gd(III) ions. The synthesis of gadolinium complexes with well-balanced lipophilicity and hydrophilicity shows promise for their further development as blood pool MRI contrast agents.

Involvement of Kupffer Cell in $CCl_4$ induced Liver Injury: The Role of Calcium (사염화 탄소에 의한 간손상에 있어 Kupffer cell 칼슘의 역할)

  • Yang, Mie-Rha
    • The Korean Journal of Pharmacology
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    • v.32 no.1
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    • pp.75-82
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    • 1996
  • The hypothesis that calcium provoke $O_2^-$ formation by Kupffer cells and may contribute to carbon tetrachloride $(CCl_4)$ induced liver injury was studied in SD rats. In $CCl_4-treated$ animals, hepatic malonaldehyde (nmole/gm liver) and plasma ALT (IU/ml) levels elevated significantly from $119.63{\pm}13.00$ to $268.97{\pm}14.82$ and from $17.3{\pm}0.18$ to $806.08{\pm}37.63$, respectively, compared to those in controls. Activation of Kupffer cells with high dose of retinol (250,000 IU/kg/day, po, for 7 day) significantly enhanced ALT levels, while inactivation of Kupffer cells with gadolinium chloride (7.5 mg/kg/day, ip, for 2 day) attenuated the increase of serum ALT level following $CCl_4$ treatment. Diltiazem (10 mg/kg/day, ip for 2 day) given in combination with retinol led to a marked decrease in ALT levels compare to the level in rats treated only with retinol against $CCl_4$ treatment. In order to determine any alterations in cytochrome P450 activities, the P450 content and the CYP2E1 activity were measured and all $CCl_4-treated$ rats showed significantly lower levels compared to those in controls and vehicle-treated animals. There were significant increases in glutathione peroxidase in all $CCl_4-treated$ rats except diltiazem treated groups. No difference was found among untreated and vehicle-treated rats. It is concluded that Kupffer cells contribute to $CCl_4-induced$ liver injury and that calcium antagonist attenuated the increased $CCl_4-induced$ liver injury due to activation of Kupffer cells.

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A Study on the Luminescence Properties of LiGd9(SiO4)6O2:Ce3+ (LiGd9(SiO4)6O2:Ce3+ 형광 특성 연구)

  • Jin, Seongjin
    • Journal of the Korean Society of Radiology
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    • v.9 no.3
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    • pp.169-174
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    • 2015
  • $LiGd_9(SiO_4)_6O_2:Ce^{3+}$ phosphors were synthesized by solid-state reaction method. The structural characteristic was investigated by X-ray powder diffraction analysis. The emission and excitation spectra of the $Ce^{3+}$ ions doped $LiGd_9(SiO_4)_6O_2$ phosphors were obtained under the UV excitation. The emission spectra of $LiGd_9(SiO_4)_6O_2:Ce^{3+}$ shows the band at 410 nm corresponding to the $^2F_{5/2}$ and $^2F_{7/2}$ states of $Ce^{3+}$. The red shift of $Ce^{3+}$ emission is found as the $Ce^{3+}$ concentration increases, which could be explained by the change in crystal-field symmetry and strength with increasing $Ce^{3+}$ concentration. Fluorescence decay time of $Ce^{3+}$ was about 20 ns. When the concentration of $Ce^{3+}$ increases life time was slightly reduced.

Evaluation of the signal intensity of magnetic resonance angiography in accordance with the dilution rate of the contrast agent (조영제 희석률에 따른 조영증강 자기공명혈관조영검사의 신호강도 평가)

  • Choi, Kwan-Woo;Seo, Sung-Mi;Son, Soon-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5124-5130
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    • 2014
  • Dilution of the contrast agent by analyzing the change in the signal intensity during MR angiography in accordance with the viscosity and osmotic pressure minimizes the side effects, and improves the image quality. The contrast agent molarity changes by the dilution of the contrast agent in the blood, as it is injected, which leads to a change in signal intensity. Based on this principle, a phantom was prepared and experiments were performed. After the phantom experiment, a clinical experiment was conducted using the results of the phantom experiment. From November 2013 to January 2014, a group of patients were classified into diluted contrast agent (30 persons) and undiluted (30 persons), and the signal intensity of the cerebral vessels was compared. The signal intensity of the phantom according to the molarity of the contrast agent increased sharply from 0.0125 mmol, reached a peak at 20 mmol, and achieved equilibrium from 200 mmol. Based on the study results, the signal intensity of the blood vessels in the brain through were compared in a clinical experiment. All the brain vessels in the imaging range with diluting a high content of the gadolinium contrast agent showed high signal intensity. This result supports the phantom experiment and means that using the 500mmol diluted contrast agent is better than using 1000mmol undiluted contrast agent because it is easier to approach the 20mmol level needed to achieve the highest signal intensity. This study has significance in that it can minimize the high viscosity and osmotic pressure, which can cause side effects and improve the image quality using the method of the dilution rate.