• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1066-1079
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• 2023

Purpose Distinguishing intradural extramedullary (IDEM) spinal ependymoma from myxopapillary ependymoma is challenging due to the location of IDEM spinal ependymoma. This study aimed to investigate the utility of clinical and MR imaging features for differentiating between IDEM spinal and myxopapillary ependymomas. Materials and Methods We compared tumor size, longitudinal/axial location, enhancement degree/pattern, tumor margin, signal intensity (SI) of the tumor on T2-weighted images and T1-weighted image (T1WI), increased cerebrospinal fluid (CSF) SI caudal to the tumor on T1WI, and CSF dissemination of pathologically confirmed 12 IDEM spinal and 10 myxopapillary ependymomas. Furthermore, classification and regression tree (CART) was performed to identify the clinical and MR features for differentiating between IDEM spinal and myxopapillary ependymomas. Results Patients with IDEM spinal ependymomas were older than those with myxopapillary ependymomas (48 years vs. 29.5 years, p < 0.05). A high SI of the tumor on T1W1 was more frequently observed in IDEM spinal ependymomas than in myxopapillary ependymomas (p = 0.02). Conversely, myxopapillary ependymomas show CSF dissemination. Increased CSF SI caudal to the tumor on T1WI was observed more frequently in myxopapillary ependymomas than in IDEM spinal ependymomas (p < 0.05). Dissemination to the CSF space and increased CSF SI caudal to the tumor on T1WI were the most important variables in CART analysis. Conclusion Clinical and radiological variables may help differentiate between IDEM spinal and myxopapillary ependymomas.

• Proceedings of the KOSOMBE Conference
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• v.1992 no.05
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• pp.27-47
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• 1992

Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

• Investigative Magnetic Resonance Imaging
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• v.17 no.4
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• pp.286-293
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• 2013

Purpose : The objective of this study was to analyze the brain volume according to the brain image of healthy adults in the 20s taken with different inversion time (TI). Materials and Methods: Brain images of healthy adults in the 20 s were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) pulse sequence with 1.5 mm thickness of pieces and four inversion times (1100 ms, 1000 ms, 900 ms, 800 ms). The acquired brain images were analyzed to measure the volume of white matter (WM), gray matter (GM), intracranial volume (ICV). The statistical difference according to brain volume and gender was analyzed for each TI. Results: The brain volume calculated using Freesurfer was WM$486.52{\pm}48.64cm^3$ and GM=$646.83{\pm}57.12cm^3$ in mean when adjusted by mean ICV=$1278.94{\pm}154.92cm^3$. Men's brain volume(WM, GM, ICV) was larger than women's brain volume. In the intrarater reliability test, all of the intraclass correlation coefficients were high (0.992 for WM, 0.988 for GM, and 0.997 for ICV). In the repeated measures analysis of variance, GM and ICV did not show a significant difference at each TI (GM p=0.143, ICV p=0.052), but WM showed a significant (p=0.001). In the linear structure relation analysis, all of the Pearson correlation coefficients were high. Conclusion: WM, GM, and ICV indicated high reliability and solid linear structure relations, but WM showed significant differences at each TI. The brain volume of healthy adults in the 20s could be used in comparison with that of patients for reference purposes and to predict the structural change of brain. It would be needed to conduct additional studies to examine the contract, SNR, and lesion detection ability according to variable TI.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.546-552
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• 2010

Previous studies could not offer available guideline to decide size of balloon and grade of injury before induction of spinal cord injury (SCI) because grade of SCI was assessed after inserting a catheter and each experimental animal were different in body size and weight as well as in species. This study was performed to provide guideline for standardized SCI model. Eight healthy adult beagle dogs that had 8 mm of spinal canal height were assigned to four groups according to the diameter of balloon and compression time: 4 mm/3hrs, 4 mm/6hrs, 4 mm/12hrs and 6 mm/3hrs group. Radiography was performed to standardize between experimental animal and balloon before selecting balloon diameter to induce SCI. Behaviors outcomes, somatosensory evoked potentials (SEPs), magnetic resonance imaging (MRI) and histopathological examination were evaluated. Behaviors outcomes and SEPs were not available to assess grade of SCI and those only indicate SCI. The damaged area was revealed clear hyperintensity on STIR image and T2WI after induction of SCI. The hyperintense area on MRI was cranially and caudally expanded with increasing of the diameter of balloon or the compression time. Well corresponded to expanding of hyperintense area on MRI, the damaged region and the numbers of caspase-3 and PARP immunoreactive cells were increased on histopathological findings. Therefore, these results will be considered fundamental data to induce standardized SCI model in experimental animal that has various weight and size.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.32-40
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• 2011

Purpose : The purpose of this study was to investigate the microstructural changes according to aging on the thickness and signal intensity (SI) of the cortical gray matter (GM) and white matter (WM) on the T2-, fluid-attenuated inversion recovery (FLAIR) and T1-weighted MR images in normal subjects. Materials and Methods : The 10, 20, 30, 40, 50, 60, 70, 80 and 90 year age groups of men and women (each 10 individuals) who underwent routine brain MRI, including the T2-, FLAIR and T1-weighted images, were selected for this study. We measured the thickness and the SI of the cortical GM and WM at the postcentral gyrus, which has an even thickness at the level of centrum semiovale, on the axial scans and we calculated the mean values of the thickness ratio of the gray/white matter (TRGW) and the signal intensity ratio of the gray/white matter (SRGW), and we compared the ratios of each age group. Results : On the T2-weighted images, the TRGWs were 0.81 and 0.79 at the age of 10 and they were 0.73 and 0.71 at the age of 90 in the men and women, respectively. So, the GM thickness was decreased more than the WM thickness was with aging. On the FLAIR images, the TRGWs were 1.09 and 1.00 at the age of 10 and they were 1.11 and 0.95 at the age of 70 in the men and women, respectively. On the T1-weighted images, the TRGWs were 0.66 and 0.80 at the age of 10, and the ratio was changed to 0.90 and 0.78 at the age of 90 in the men and women, respectively. On the T2-weighted image, the SRGWs were 1.53 and 1.43 at the age of 10, and they were 1.23 and 1.27 at the age of 90 in the men and women, respectively. On the FLAIR images, the SRGWs were 1.23 and 1.25 at the age of 10 and they were 1.06 and 1.05 at the age of 90 in the men and women, respectively. On the T1-weighted images, the SRGWs were 0.86 and 0.85 at the age of 10, and they were 0.90 and 0.87 at the age of 90 in the men and women, respectively. Conclusion : We suggest that the age-related microstructural changes of the thickness and the SI of the cortical GM and WM on the T2-, FLAIR and T1-weighted images are unique, and so this knowledge will be helpful to differentiate neurodegenerative disease from normal aging of the brain.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.81-88
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• 2006

Purpose : To evaluate the MR imaging findings of bowel wall thickening in patients with minimal to moderate cirrhosis, and analyze their clinical significances comparing with laboratory findings. Materials and Methods : We assessed retrospectively the MRI findings of 123 patients with minimal to moderate cirrhosis, and compared these with the clinical laboratory findings. We evaluated the involved sites and MR image findings of thickened bowel wall, as well as the presence of collateral vessels, ascites, and splenic size. These were compared with serum albumin and bilirubin levels, and prothrombin time. Results : Gastrointestinal wall thickening was detected at 37 sites in 25 patients (20%), and more frequently detected in moderate cirrhosis (29%) than in minimal cirrhosis (17%). Jejunum and ascending colon were the most common sites of bowel wall thickening; each was involved at 22 and 9 sites, respectively. Ascending colonic wall thickening was more commonly detected in moderate cirrhosis than in minimal cirrhosis. The thickened bowel wall showed symmetric contour, high signal intensity on T2-weighted images, mixed iso- and low signal intensity on T1-weighted images, and homogeneous or target-like enhancement. Serum albumin level was significantly lower in patients with bowel wall thickening ($3.3{\pm}0.9$ g/dl vs. $3.9{\pm}0.7$ g/dl; p=0.0024). Serum bilirubin level was significantly higher in patients with bowel wall thickening ($1.7{\pm}1.0$ mg/dl vs. $1.4{\pm}1.2$ mg/dl; p=0.0160). Bowel wall thickening did not significantly correlate with the presence of collateral vessels, ascites, splenic size, and prolongation of prothrombin time. Conclusion : In minimal to moderate cirrhosis, the MR imaging evaluation of bowel wall thickening was useful for estimating the severity of cirrhosis and laboratory findings.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.1-7
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• 2006

Purpose : Recent development of diffusion tensor imaging enables the evaluation of the microstructural characteristics of the brain white matter. However, optimal imaging parameters for diffusion tensor imaging, particularly concerning the number of diffusion gradient direction, have not been studied thoroughly yet. The purpose of this study was to evaluate the influence of the number of diffusion gradient direction on the fiber tracking of the white matter. Materials and methods : 13 healthy volunteers (ten men and three women, mean age 30 years, age range 23-37 years) were included in this study. Diffusion tensor imaging was performed with different numbers of diffusion gradient direction as 6, 15, and 32, keeping the other imaging parameters constant. The imaging field ranged from 1 cm below the pons to 2-3 cm above the lateral ventricle, parallel to the anterior commissure-posterior commissure line. FA (fractional anisotropy) maps were created via image postprocessing, and then FA and its standard deviation were calculated in the genu and the splenium of the corpus callosum on each of FA maps. Fiber tracking of the corticospinal tract in the brain was performed and the number of the reconstructed fibers of the tract was measured. FA, standard deviation of FA and the number of the reconstructed fibers were compared statistically between the different diffusion gradient directions. Results : FA is not statistically significantly different between the different diffusion gradient directions. By increasing the number of diffusion gradient direction, standard deviation of FA decreased significantly, and the number of the reconstructed fibers increased significantly. Conclusion : The higher number of diffusion gradient direction provided better quality of fiber tracking.

• Investigative Magnetic Resonance Imaging
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• v.18 no.3
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• pp.225-231
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• 2014

Purpose : The biceps femoris tendon (BFT) and lateral collateral ligament (LCL) in the knee were formerly known to form a conjoined tendon at the fibular attachment site. However, the BFT and LCL are attached into the fibular head in various patterns. We classified insertion patterns of the BFT and LCL using MR imaging, and analyzed whether the LCL attaches to the fibular head or not. Materials and Methods: A total of 494 consecutive knee MRIs of 470 patients taken between July 2012 and December 2012 were retrospectively reviewed. There were 224 males and 246 females, and patient age varied from 10 to 88 (mean, 48.6). The exclusion criteria were previous surgery and poor image quality. Using 3T fat-suppressed proton density-weighted axial images, the fibular insertion patterns of the BFT and LCL were classified into following types: type I (the LCL passes between the anterior arm and direct arm of the BFT's long head), type II (the LCL joins with anterior arm of the long head of the BFT), type III (the BFT and LCL join to form a conjoined tendon), type IV (the LCL passes laterally around the anterior margin of the BFT), and type V (the LCL passes posteriorly to the direct arm of the BFT's long head). Results: Among the 494 cases of the knee MRI, there were 433 (87.65%) type I cases, 21 (4.25%) type II cases, 2 (0.4%) type III cases, 16 (3.23%) type IV cases, and 22 (4.45%) type V cases. There were 26 cases (5.26%) in which the LCL and BFT were not attached into the fibular head. Conclusion: The fibular attachment pattern of the BFT and LCL shows diverse types in MR imaging. The LCL does not adhere to the head in some patients.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.191-197
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• 2008

Purpose: To evaluate the postoperative magnetic resonance image (MRI) findings of anterior cruciate ligament (ACL) reconstructed with a tension load technique using auto-Achilles tendon, and to compare the results with knees with a native ACL. Materials and Methods: We evaluated 21 postoperative MRI scan of 21 patients (group A) who had undergone ACL reconstruction between January 1995 and November 1996. The control group (group B) consisted of 50 patients whose meniscus tear had been operated by arthroscopy and whose ACL was intact. We measured the orientation of the graft in the sagittal and coronal planes and compared it with that of the native ACL. Results: The mean sagittal angle of the ACL angle in group A ($55.7{\pm}5.6^{\circ}$, range $47.2{\sim}68.8^{\circ}$) was statistically lesser than group B ($58.7{\pm}3.8^{\circ}$, range $50.4{\sim}67.5^{\circ}$) (p=0.036). But there was no statistically significant difference between the two groups with regard to the mean ACL-Blumensaat line angle (group A: $8.1^{\circ}{\pm}4.9^{\circ}$, range $1.7^{\circ}{\sim}22.0^{\circ}$, group B: $8.6^{\circ}{\pm}3.6^{\circ}$, range $2.6^{\circ}-18.1^{\circ}$) and the mean coronal angle of the ACL (group A: $64.9^{\circ}{\pm}9.1^{\circ}$, range $46.9^{\circ}{\sim}76.4^{\circ}$, group B: $65.9^{\circ}{\pm}4.4^{\circ}$, range $57.7^{\circ}{\sim}75.2^{\circ}$)(p=0.88, p= 0.62). In the sagittal plane, the mean center of tibial insertion of the ACL graft in group A ($31.9{\pm}7.1%$, range 22.4-47.9%) was positioned more anteriorly than group B ($37.0{\pm}4.9%$, range $18.5{\sim}44.7%$)(p=0.005). But in the coronal plane, there was no statistically significant difference between the two groups(group A: $46.3{\pm}2.8%$, range $42.1{\sim}52.5%$, group B: $45.7{\pm}2.8%$, range $41.0{\sim}49.1%$)(p=0.392). Conclusion: We performed an ACL reconstruction with the tension load technique using auto-Achilles tendon and we found that the graft orientation in MRI was as good as that of the native ACL.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.99-115
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• 2021

Various sequences have been developed for MRI to aid in the radiologic diagnosis. Among the various MR sequences, susceptibility-weighted imaging (SWI) is a high-spatial-resolution, three-dimensional gradient-echo MR sequence, which is very sensitive in detecting deoxyhemoglobin, ferritin, hemosiderin, and bone minerals through local magnetic field distortion. In this regard, SWI has been used for the diagnosis and treatment of various neurologic disorders, and the improved image quality has enabled to acquire more useful information for radiologists. Here, we explain the principle of various signals on SWI arising in neurological disorders and provide a retrospective review of many cases of clinically or pathologically proven disease or components with distinctive imaging features of various neurological diseases. Additionally, we outline a short and condensed overview of principles of SWI in relation to neurological disorders and describe various cases with characteristic imaging features on SWI. There are many different types diseases involving the brain parenchyma, and they have distinct SWI features. SWI is an effective imaging tool that provides complementary information for the diagnosis of various diseases.