• Investigative Magnetic Resonance Imaging
• /
• 제13권2호
• /
• pp.213-217
• /
• 2009

간에 생기는 단발성 괴사성 결절은 매우 드문 양성 질환으로 대개 아무 증상 없이 우연히 발견되고, 간에서 생길 수 있는 여러 가지 단발성 병변과의 감별을 필요로 하며, 특히 악성 종양의 병기 결정에 있어서 간내 전이암과 구별하는 것은 매우 중요하다고 알려져 있다. 영상의학적으로 간의 단발성 괴사성 결절은 조영증강이 얼거나 미약한 주변부 조영증강을 보이는 경계가 좋은 간내 결절로 보고되고 있다. 하지만 단발성 괴사성 결절이 영상에서 과녁 모양으로 보이는 경우는 지금까지 보고된 바 없으며, 특히 고자장의 자기 공명 영상과 양성자 방출 단층 촬영 소견이 보고된 경우도 전무하다. 이에 저자들은 조기 위암 환자에서 과녁 모양으로 보여 전이암과 감별이 어려웠던 간내 단발성 결절을 경험하여 이의 다양한 영상 소견을 보고하고자 하며, 병리학적 소견과 이에 대한 문헌 고찰을 통해 원인을 알아 보고자 하였다.

• Investigative Magnetic Resonance Imaging
• /
• 제22권1호
• /
• pp.1-9
• /
• 2018

Purpose: This study was designed to optimize the flip angle (FA) and scan timing of the hepatobiliary phase (HBP) using the 3D T1-weighted, gradient-echo (GRE) imaging with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) technique on gadoxetic acid-enhanced 3T liver MR imaging. Materials and Methods: Sixty-two patients who underwent gadoxetic acid-enhanced 3T liver MR imaging were included in this study. Four 3D T1-weighted GRE imaging studies using the CAIPIRINHA technique and FAs of $9^{\circ}$ and $13^{\circ}$ were acquired during HBP at 15 and 20 min after intravenous injection of gadoxetic acid. Two abdominal radiologists, who were blinded to the FA and the timing of image acquisition, assessed the sharpness of liver edge, hepatic vessel clarity, lesion conspicuity, artifact severity, and overall image quality using a five-point scale. Quantitative analysis was performed by another radiologist to estimate the relative liver enhancement (RLE) and the signal-to-noise ratio (SNR). Statistical analyses were performed using the Wilcoxon signed rank test and one-way analysis of variance. Results: The scores of the HBP with an FA of $13^{\circ}$ during the same delayed time were significantly higher than those of the HBP with an FA of $9^{\circ}$ in all the assessment items (P < 0.01). In terms of the delay time, images at the same FA obtained with a 20-min-HBP showed better quality than those obtained with a 15-min-HBP. There was no significant difference in qualitative scores between the 20-min-HBP and the 15-min-HBP images in the non-liver cirrhosis (LC) group except for the hepatic vessel clarity score with $9^{\circ}$ FA. In the quantitative analysis, a statistically significant difference was found in the degree of RLE in the four HBP images (P = 0.012). However, in the subgroup analysis, no significant difference in RLE was found in the four HBP images in either the LC or the non-LC groups. The SNR did not differ significantly in the four HBP images. In the subgroup analysis, 20-min-HBP imaging with a $13^{\circ}$ FA showed the highest SNR value in the LC-group, whereas 15-min-HBP imaging with a $13^{\circ}$ FA showed the best value of SNR in the non-LC group. Conclusion: The use of a moderately high FA improves the image quality and lesion conspicuity on 3D, T1-weighted GRE imaging using the CAIPIRINHA technique on gadoxetic acid, 3T liver MR imaging. In patients with normal liver function, the 15-min-HBP with a $13^{\circ}$ FA represents a feasible option without a significant decrease in image quality.

• Nuclear Medicine and Molecular Imaging
• /
• 제40권5호
• /
• pp.243-248
• /
• 2006

목적: 다른 기관들에 비해 간에서는 상대적으로 FDG 섭취 양상이 매우 불규칙하며, 악성 병변이 없는 간에서 비정상적으로 FDG 섭취가 증가하기도 한다. 하지만, 이제까지 이러한 다양한 간의 FDG 섭취를 간의 다른 양성 질환과 연관시킨 연구가 없어, 저자들은 이 연구에서 간에서의 FDG 섭취 양상과 지방간, 간 기능 검사, 지질 프로필을 포함하는 다양한 임상 요인과의 관계를 밝히고자 하였다. 대상 및 방법: 건강검진 목적으로 $^{18}F-FDG$ PET/CT를 시행한 188명 (남/여: 120/68, 평균나이: $50{\pm}9$세)을 대상으로 분석하였다. 간의 FDG 섭취에 영향을 줄 수 있는 당뇨 및 내당증 장애 환자, 심한 간질환이나 오랜 약물 복용의 기왕력이 있는 환자는 연구대상에서 제외하였다. PET/CT의 횡단면에서 간의 5번 분절에 해당하는 부위에 관심영역을 설정하고 이 부위의 평균 SUV를 구하여, 지방간이 있는 군과 없는 군 사이의 차이를 분석하였다. 또한 혈중 간 기능(ALT, AST), 알코올성 간질환(${\gamma}-GT$), 총 콜레스테롤, 중성지방 수치와 간의 FDC 섭취와의 관계를 알아보았다. 지방간 환자들의 체질량지수, 음주력을 조사하여 이 인자들이 간의 FDG 섭취에 미치는 영향도 분석하였다 결과 지방간이 있는 군의 평균 SUV가 지방간이 없는 군보다 통계적으로 유의하게 높았다(p<0.05). 혈중 총 콜레스테롤과 중성지방 수치는 간의 FDG 섭취와 유의한 상관관계를 보인 반면, 다른 요인들은 상관관계를 보이지 않았다. 또한, 지방간 환자에서 음주나 체질량 지수의 위험군과 비위험군 사이에 간의 FDG 섭취 정도는 차이는 보이지 않았다. 다변량 분석 결과, 지방간의 유무와 혈중 중성지방 수치가 간의 평균 SUV에 영향을 주는 유의한 독립 인자였다. 결론: 결론적으로 간의 FDG 섭취 정도는 지방간의 유무에 영향을 받으며, 중성지방 수치와 유의한 상관관계를 보였다.

• Investigative Magnetic Resonance Imaging
• /
• 제1권1호
• /
• pp.142-147
• /
• 1997

목적: 호흡정지 간 자기공영상에서 국소 간 병변을 발견함에 있어 동위상(inphase) 방식과 역위상(opposed-phase) 방식의 fast multiplanar spoiled gradient recalled(FMPSPGR) 영상간의 효율성을 비교하고자 하였다. 대상 및 방법: 다른 검사를 통해 국소 간 병변이 발견되었거나 의심되었던 45명의 환자의 78개의 병변에 대한 고속경사에코대열의 동위상과 역위상 영상을 비교하였다. 병변 발견률을 평가하기 위해 세 명의 사전 정보 없는 판독의가 독립적으로 영상을 검토하였다. 간의 신호대잡음비, 병변과 간의 대조대잡음비 및 간과 비장 간 대조대잡음비를 비교하였다. 세 명의 동의에 의해 어느 대열에서 영상의 질이 더 나은지 결정하였다. 결과: 역위상 영상에서 판독의 1, 2, 3이 각각 61(78%), 61(78%), 및 63(89%)개의 병변을 정확히 발견하였다. 동위상 영상에서 각 판독의가 66(85%), 65(83%) 및 65(93%)개의 병변을 발견하였다. 두 영상을 조합하였을 때, 71(91%), 69(88%) 및 76(97%)개의 병변이 각각 발견되었다. 간세포암이 증례에서 간-병변간 대조대잡음비는 역위상 영상에서 더 컸으나(p<0.05), 다른 병변에서의 의미 있는 차이는 보이지 않았다. 간-비장간 대조잡음비는 역위상 영상에서 높았으나(p<0.1), 간의 신호대잡음비는 동위상 영상에서 더 높았다. 결론: 국소적 간 병변을 놓치지 않고 발견 하기 위새서는 동위상 영상과 역위상 영상을 모두 이용하는 것이 바람직하다.

• Korean Journal of Radiology
• /
• 제23권7호
• /
• pp.697-719
• /
• 2022

Gadoxetate magnetic resonance imaging (MRI) is widely used in clinical practice for liver imaging. For optimal use, we must understand both its advantages and limitations. This article is the outcome of an online advisory board meeting and subsequent discussions by a multidisciplinary group of experts on liver diseases across the Asia-Pacific region, first held on September 28, 2020. Here, we review the technical considerations for the use of gadoxetate, its current role in the management of patients with hepatocellular carcinoma (HCC), and its relevance in consensus guidelines for HCC imaging diagnosis. In the latter part of this review, we examine recent evidence evaluating the impact of gadoxetate on clinical outcomes on a continuum from diagnosis to treatment decision-making and follow-up. In conclusion, we outline the potential future roles of gadoxetate MRI based on an evolving understanding of the clinical utility of this contrast agent in the management of patients at risk of, or with, HCC.

• Parasites, Hosts and Diseases
• /
• 제50권1호
• /
• pp.23-27
• /
• 2012

The aim of this study is to ascertain the relationship between ingestion of raw cow liver and $Toxocara$ $canis$ infection. A total of 150 apparently healthy adults were divided into 2 groups; 1 group consisted of 86 adults with positive results of Toxocara ELISA, and the other group of 64 adults with negative results. One researcher collected the history of ingestion of raw cow liver within 1 year and recent history of keeping dogs. Among 86 seropositive adults for $T.$ $canis$, 68 (79.1%) had a recent history of ingestion of raw cow liver. Multivariate statistical analysis showed that a recent ingestion of raw cow liver and keeping dogs were related to an increased risk of toxocariasis (odds ratios, 4.4 and 3.7; and 95% confidence intervals, 1.9-10.2 and 1.2-11.6, respectively). A recent history of ingestion of raw cow liver and keeping dogs was significantly associated with toxocariasis.

• Natural Product Sciences
• /
• 제27권3호
• /
• pp.201-207
• /
• 2021

We have previously reported that Acer tegmentosum extract, which is traditionally used in Korea to reduce alcohol-related liver injury, suppresses liver inflammation caused by excessive alcohol consumption and might improve metabolism. The active ingredient, 6-O-galloylsalidroside (GAL), was isolated from A. tegmentosum, and we hypothesized that GAL could provide desirable pharmacological benefits by ameliorating physiological conditions caused by alcohol abuse. Therefore, this study focused on whether GAL could ameliorate alcoholic fat accumulation and repair liver injury in mice. During chronic alcohol consumption plus binge feeding in mice, GAL was administered orally once per day for 11 days. Intrahepatic lipid accumulation was measured in vivo using a noninvasive method, ¹H magnetic resonance imaging, and confirmed by staining with hematoxylin and eosin and Oil Red O. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured using a Konelab system, and the triglyceride content was measured in liver homogenates using an enzymatic peroxide assay. The results suggested that GAL alleviated alcohol-induced steatosis,e as indicated by decreased hepatic and serum triglyceride levels in ethanol-fed mice. GAL treatment also correlated with a decrease in the Cd36 mRNA expression, thus potentially inhibiting the development of alcoholic steatosis via the hepatic de novo lipogenesis pathway. Furthermore, treatment with GAL inhibited the expression of cytochrome P450 2E1 and attenuated hepatocellular damage, as reflected by a reduction in ALT and AST levels. These findings suggest that GAL extracted from A. tegmentosum has the potential to serve as a bioactive agent for the treatment of alcoholic fatty liver and liver damage.

• Korean Journal of Radiology
• /
• 제20권6호
• /
• pp.863-879
• /
• 2019

Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.

• Korean Journal of Radiology
• /
• 제22권7호
• /
• pp.1077-1086
• /
• 2021

Objective: To investigate the diagnostic performance of quantitative ultrasound (US) parameters for the assessment of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Materials and Methods: In this single-center prospective study, 120 patients with clinically suspected NAFLD were enrolled between March 2019 and January 2020. The participants underwent US examination for radiofrequency (RF) data acquisition and chemical shift-encoded liver MRI for PDFF measurement. Using the RF data analysis, the attenuation coefficient (AC) based on tissue attenuation imaging (TAI) (AC-TAI) and scatter-distribution coefficient (SC) based on tissue scatter-distribution imaging (TSI) (SC-TSI) were measured. The correlations between the quantitative US parameters (AC and SC) and MRI-PDFF were evaluated using Pearson correlation coefficients. The diagnostic performance of AC-TAI and SC-TSI for detecting hepatic fat contents of ≥ 5% (MRI-PDFF ≥ 5%) and ≥ 10% (MRI-PDFF ≥ 10%) were assessed using receiver operating characteristic (ROC) analysis. The significant clinical or imaging factors associated with AC and SC were analyzed using linear regression analysis. Results: The participants were classified based on MRI-PDFF: < 5% (n = 38), 5-10% (n = 23), and ≥ 10% (n = 59). AC-TAI and SC-TSI were significantly correlated with MRI-PDFF (r = 0.659 and 0.727, p < 0.001 for both). For detecting hepatic fat contents of ≥ 5% and ≥ 10%, the areas under the ROC curves of AC-TAI were 0.861 (95% confidence interval [CI]: 0.786-0.918) and 0.835 (95% CI: 0.757-0.897), and those of SC-TSI were 0.964 (95% CI: 0.913-0.989) and 0.935 (95% CI: 0.875-0.972), respectively. Multivariable linear regression analysis showed that MRI-PDFF was an independent determinant of AC-TAI and SC-TSI. Conclusion: AC-TAI and SC-TSI derived from quantitative US RF data analysis yielded a good correlation with MRI-PDFF and provided good performance for detecting hepatic steatosis and assessing its severity in NAFLD.

• 한국정보처리학회:학술대회논문집
• /
• 한국정보처리학회 2015년도 추계학술발표대회
• /
• pp.1446-1447
• /
• 2015

In this paper, we developed the quantification software for evaluating the voxel-based cellular heterogeneity of gadoxetic acid-enhanced magnetic resonance imaging (MRI) in the liver. Our software is clinically applied to accurately quantify and interpret the alterations of liver functions in patients with hepatocellular carcinoma.