• Title/Summary/Keyword: resonance test

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Endocrinological Results of the Transsphenoidal Microsurgery for Cushing's Disease (쿠싱병에 대한 경접형동접근법의 내분비학적 결과)

  • Kim, Joon Soo;Kim, Chang Jin;Ha, Sang Soo;Kim, Jung Hoon;Lee, Jung Gyo;Kwun, Byung Duk;Hong, Sung Kwan;Lee, Ki Up;Lee, Bong Jae;Kim, Yong Jae;Choi, Choong Kon;Lee, Ho Gyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.611-621
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    • 2001
  • Objective : We analyzed the clinical and endocrinological results of the transsphenoidal microsurgery for ACTH secreting pituitary adenomas. Marerials and Methods : From October 1995 to August 2000, 18 patients underwent transsphenoidal microsurgery for Cushing's disease. We analyzed the surgical results of 17 patients, one patient who was previously operated from other hospital was excluded. Age of the patients were 18 to 61 years old(mean 37.7), male to female ratio was 1 : 3.3, and follow-up period was 3 to 50 months(mean 20.3). The selection of candidates for transsphenoidal exploration was based on endocrinologic criteria. Magnetic resonance imaging was the preferred radiologic test. Selective inferior petrosal sinus sampling of adrenocorticotropic hormone futher refined the diagnosis when endocrinologic and radiologic procedures were not definitive. Results : Results of the preoperative endocrinological test were : level of serum ACTH 29.4 to $225{\mu}g/dL$(mean $93.88{\mu}g/dL$) ; serum cortisol 11.9 to $47.5{\mu}g/dL$(mean $27.49{\mu}g/dL$) ; 24-hour urine free cortisol 235 to $1019{\mu}g/day$(mean $571.0{\mu}g/day$). Inferior petrosal sinus sampling for ACTH was performed in 11 patients and all were confirmed by Cushing's disease and we could predict the laterality of the tumor in 9 of 11 patients. We performed transsphenoidal selective adenomectomy in 5 patients, adenomectomy and subtotal hypophysectomy in 2 patients, adenomectomy and partial hypophysectomy in 9 patients, and in the remaining one patient, hemihypophysectomy followed by total hypophysectomy due to remission failure. Fifteen of 17 patients(88.2%) showed endocrinological remission. Glucocorticoid replacement therapy was performed in all the patients who showed remission for 1 to 24 months(mean 5.9 months), and 6 patients received steroid over 6 months. Conclusion : We conclude that the direct demonstration of a tumor in the pituitary gland by MRI is the most important and definitive diagnostic tool and the location of a mass should be confirmed with increased level of ACTH by the inferior petrosal sinus sampling. Transsphenoidal microsurgery is effective treatment modality for Cushing's disease and the immediate postoperative evaluation of the surgical resection of the tumor is very important. The patients should show hypocortisolism, decreased, subnormal serum ACTH and cortisol levels and 24-hours urine free cortisol. We performed 18 transsphenoidal microsurgery for Cushing's disease in 17 patients and 15 patients(88.2%) showed endocrinological remission.

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Cerebral Activity by Motor Task in Welders Exposed to Manganese through fMRI (fMRI를 이용한 망간 노출 용접공의 운동수행에 따른 뇌 활성도 평가)

  • Choi, Jae-Ho;Jang, Bong-Ki;Lee, Jong-Wha;Hong, Eun-Ju;Lee, Myeong-Ju;Ji, Dong-Ha
    • Journal of Environmental Health Sciences
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    • v.37 no.2
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    • pp.102-112
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    • 2011
  • Objectives: The purpose of this study is to analyze the effects of chronic exposure by welders to manganese (Mn) through an analysis of the degree of brain activity in different activities such as cognition and motor activities using the neuroimaging technique of functional magnetic resonance imaging (fMRI). The neurotoxic effect that Mn has on the brain was examined as well as changes in the neuro-network in motor areas, and the usefulness of fMRI was evaluated as a tool to determine changes in brain function from occupational exposure to Mn. Methods: A survey was carried out from July 2010 to October 2010 targeting by means of a questionnaire 160 workers from the shipbuilding and other manufacturing industries. Among them, 14 welders with more than ten years of job-related exposure to Mn were recruited on a voluntary basis as an exposure group, and 13 workers from other manufacturing industries with corresponding gender and age were recruited as a control group. A questionnaire survey, a blood test, and an fMRI test were carried out with the study group as target. Results: Of 27 fMRI targets, blood Mn concentration of the exposure group was significantly higher than that of the control group (p<0.001), and Pallidal Index (PI) of the welder group was also significantly higher than that of the control group (p<0.001). As a result of the survey, the score of the exposure group in self-awareness of abnormal nerve symptoms and abnormal musculoskeletal symptoms was higher than those of the control group, and there was a significant difference between the two groups (p<0.05, respectively). In the correlation between PI and the results of blood tests, the correlation coefficient with blood Mn concentration was 0.893, revealing a significant amount of correlation (p<0.001). As for brain activity area within the control group, the right and the left areas of the superior frontal cortex showed significant activity, and the right area of superior parietal cortex, the left area of occipital cortex and cerebellum showed significant activity. Unlike the control group, the exposure group showed significant activity selectively on the right area of premotor cortex, at the center of supplementary motor area, and on the left side of superior temporal cortex. In the comparison of brain activity areas between the two groups, the exposure group showed a significantly higher activation state than did the control group in such areas as the right and the left superior parietal cortex, superior temporal cortex, and cerebellum including superior frontal cortex and the right area of premotor cortex. However, in nowhere did the control group show a more activated area than did the exposure group. Conclusions: Chronic exposure to Mn increased brain activity during implementation of hand motor tasks. In an identical task, activation increased in the premotor cortex, superior temporal cortex, and supplementary motor area. It was also discovered that brain activity increase in the frontal area and occipital area was more pronounced in the exposure group than in the control group. This result suggests that chronic exposure to Mn in the work environment affects brain activation neuro-networks.

Development and Usefulness of Acrylic Needle for Percutaneous Bone Biopsy (경피적 골생검용 아크릴 바늘의 제작과 유용성)

  • Kim, Tae-Hyung;Shin, Myung-Jin;Shin, Ji-Hoon;Lim, Jin-Oh;Ryu, Ji-Yeon;Oh, Jae-Seon;Woo, Chul-Woong;Nam, Jeung-Hee
    • Journal of radiological science and technology
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    • v.33 no.1
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    • pp.25-29
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    • 2010
  • To evaluate the usefulness of newly designed percutaneous bone biopsy needle for pumpkin's specimen collection. We manufactured three types of biopsy needle with different internal processing which were made of 10 mm-diameter acrylic material. We made the conventional type (Ct) similar to the clinical type then compared the test group. The type a (Ta) made 1 cm-length internal processing from the distal, type b (Tb) made taper, and type c (Tc) made internal processing like spiral configuration. We performed 20 times biopsy to get an 10 mm length specimen from pumpkin's surface and evaluated the success rate of the biopsy, length of the specimen, and determine internal processing type of the most suitable biopsy needle (ANOVA test). Success rates of Ct, Ta, Tb, and Tc were 55%, 80%, 90%, and 100%, respectively. The lengths of the specimen of Ct, Ta, Tb, and Tc were $5.6{\pm}1.1\;mm$, $5.9{\pm}0.87\;mm$, $3.9{\pm}0.77\;mm$, and $9.4{\pm}0.54\;mm$, respectively. All groups were statistically significant (p < 0.05) except the group between Ct and Ta (p = 0.28). Newly designed bone biopsy needle seems to be useful for obtaining enough specimen. Tc may be more effective than other types.

The influence of implant diameter, length and design changes on implant stability quotient (ISQ) value in artificial bone (임플란트의 직경, 길이 및 디자인변화가 임플란트 안정성지수(ISQ)에 미치는 영향)

  • Lee, Jeong-Yol;Lee, Won-Chang;Kim, Min-Soo;Kim, Jong-Eun;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.292-298
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    • 2012
  • Purpose: The purpose of this study is to ascertain the stability of the implant by comparing the effects of the change of implant diameter, length and design on implant stability quotient. Materials and methods: To remove the variable due to the difference of bone quality, the uniform density (0.48 g/$cm^3$) Polyuretane foam blocks (Sawbones$^{(R)}$, Pacific Research Laboratories Inc, Vashon, Washington) were used. Implants (Implantium$^{(R)}$, Dentium, Seoul, Korea) were placed with varying diameters (${\phi}3.8$, ${\phi}4.3$ and ${\phi}4.8$) and length (8 mm, 10 mm and 12 mm), to assess the effect on implant stability index (ISQ). Also the influence of the design of the submerged and the non-submerged (SimplelineII$^{(R)}$, Dentium, Seoul, Korea) on ISQ was evaluated. To exclude the influence of insertion torque, a total of 60 implants (n = 10) were placed with same torque to 35 N. Using Osstell$^{TM}$ mentor (Integration Diagnostic AB, Sweden) ISQ values were recorded after measuring the resonant frequency, one-way ANOVA and Tukey HSD test results were analyzed. (${\alpha}$=0.05). Results: 1. The change of the diameter of the implant did not affect the ISQ (P>.05), but the increase of implant length increased the ISQ(P<.001). 2. The change in implant design were correlated with the ISQ, and the ISQ of submerged design was significantly higher than that of the non-submerged design(P<.05). Conclusion: In order to increase implant stability, the longer implant is better to be selected, and on the same length of implant, submerged design is thought to be able to get a higher ISQ than the non-submerged.

Comparison of mDixon, T2 TSE, and T2 SPIR Images in Magnetic Resonance Imaging of Lumbar Sagittal Plane (요추 시상면 자기공명 영상검사에서 mDixon과 T2 TSE, T2 SPIR 영상의 비교 연구)

  • Jung, Da-Bin;Lee, Hae-Kag;Heo, Yeong-Cheol
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.927-933
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    • 2021
  • The purpose of this study was to compare and analyze the differences in scan time, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the third lumbar vertebral region including the back fat, spinal cord, and cerebrospinal fluid using the mDixon, T2 TSE, and T2 spectral pre-saturation with inversion-recovery (SPIR) techniques. With the factors affecting the SNR fixed, the lumbar sagittal plane images of 30 adults were compared on mDixon, T2 TSE, and T2 SPIR imaging tests. The test times for mDixon, T2 TSE, and T2 SPIR were 115 seconds, 60 seconds, and 60 seconds, respectively. The mDixon T2 images showed higher SNR than the T2 TSE images at the third lumbar vertebral region (p<0.05), lower SNR in the back fat and cerebrospinal fluid (p<0.05) areas, and comparable SNR in the spinal cord (p>0.05). The CNR between the third lumbar vertebral area and back fat was higher in the mDixon T2 images, and the CNR of the cerebrospinal fluid and spinal cord images was higher in the T2 TSE images (p<0.05). The mDixon T2 FS images CNR was lower for the 3rd lumbar vertebral body region and back fat than the T2 SPIR images, and higher for the spinal cord and cerebrospinal fluid images (p<0.05). The CNR between the third lumbar body and back fat areas was higher in the mDixon T2 FS images (p<0.05), and there was no difference in the CNR in the images of the cerebrospinal fluid and the spinal cord (p>0.05). It is difficult to determine whether the mDixon technique is superior to the conventional T2 TSE and T2 SPIR techniques in terms of test time, SNR, and CNR. This study was confined to patients with simple lower back pain and was limited by controlled experimental conditions. Studies using clinically applied protocols are warranted in the future.

Quantitative Evaluation of Liver Fibrosis on T1 Relaxometry in Comparison with Fibroscan (Fibroscan과 비교를 통한 T1 MR Relaxometry를 이용한 간섬유화의 정량적 평가)

  • Byeong Hak Sim;Suk Hee Heo;Sang Soo Shin;Seong Beom Cho;Yong Yeon Jeong
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.365-378
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    • 2020
  • Purpose This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

Correlation Analysis between Fat Fraction and Bone Mineral Density Using the DIXON Method for Fat Dominant Tissue in Knee Joint MRI: A Preliminary Study (지방우세 딕슨기법을 이용한 슬관절 자기공명영상 지방신호분율과 골밀도 간의 상관관계 분석: 예비 연구)

  • Sung Hyun An;Kyu-Sung Kwack;Sunghoon Park;Jae Sung Yun;Bumhee Park;Ji Su Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.427-440
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    • 2023
  • Purpose This study aimed to investigate the correlation between the fat signal fraction (FF) of the fat-dominant bone tissue of the knee joint, measured using the MRI Dixon method (DIXON) technique, and bone mineral density (BMD). Materials and Methods Among the patients who underwent knee DIXON imaging at our institute, we retrospectively analyzed 93 patients who also underwent dual energy X-ray absorptiometry within 1 year. The FFs of the distal femur metaphyseal (Fm) and proximal tibia metaphyseal (Tm) were calculated from the DIXON images, and the correlation between FF and BMD was analyzed. Patients were grouped based on BMD of lumbar spine (L), femoral neck (FN), and common femur (FT) respectively, and the Kruskal-Wallis H test was performed for FF. Results We identified a significant negative correlation between TmFF and FN-BMD in the entire patient group (r = -0.26, p < 0.05). In female patients, TmFF showed a negative correlation with FN-BMD, FT-BMD, and L-BMD (r = -0.38, 0.28 and -0.27, p < 0.05). In male patients, FmFF was negatively correlated with only FN-BMD and FT-BMD (r = -0.58 and -0.42, p < 0.05). There was a significant difference in the TmFF between female patients grouped by BMD (p < 0.05). In male patients, there was a significant difference in FmFF (p < 0.05). Conclusion Overall, we found that FF and BMD around the knee joints showed a negative correlation. This suggests the potential of FF measurement using DIXON for BMD screening.

Evaluation of the Neural Fiber Tractography Associated with Aging in the Normal Corpus Callosum Using the Diffusion Tensor Imaging (DTI) (확산텐서영상(Diffusion Tensor Imaging)을 이용한 정상 뇌량에서의 연령대별 신경섬유로의 변화)

  • Im, In-Chul;Goo, Eun-Hoe;Lee, Jae-Seung
    • Journal of the Korean Society of Radiology
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    • v.5 no.4
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    • pp.189-194
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    • 2011
  • This study used magnetic resonance diffusion tensor imaging (DTI) to quantitatively analyze the neural fiber tractography according to the age of normal corpus callosum and to evaluate of usefulness. The research was intended for the applicants of 60 persons that was in a good state of health with not brain or other disease. The test parameters were TR: 6650 ms, TE: 66 ms, FA: $90^{\circ}$, NEX: 2, thickness: 2 mm, no gap, FOV: 220 mm, b-value: $800s/mm^2$, sense factor: 2, acquisition matrix size: $2{\times}2{\times}2mm^3$, and the test time was 3 minutes 46 seconds. The evaluation method was constructed the color-cored FA map include to the skull vertex from the skull base in scan range. We set up the five ROI of corpus callosum of genu, anterior-mid body, posterior-mid body, isthmus, and splenium, tracking, respectively, and to quantitatively measured the length of neural fiber. As a result, the length of neural fiber, for the corpus callosum of genu was 20's: $61.8{\pm}6.8$, 30's: $63.9{\pm}3.8$, 40's: $65.5{\pm}6.4$, 50's: $57.8{\pm}6.0$, 60's: $58.9{\pm}4.5$, more than 70's: $54.1{\pm}8.1mm$, for the anterior-mid body was 20's: $54.8{\pm}8.8$, 30's: $58.5{\pm}7.9$, 40's: $54.8{\pm}7.8$, 50's: $56.1{\pm}10.2$, 60's: $48.5{\pm}6.2$, more than 70's: $48.6{\pm}8.3mm$, for the posterior-mid body was 20's: $72.7{\pm}9.1$, 30's: $61.6{\pm}9.1$, 40's: $60.9{\pm}10.5$, 50's: $61.4{\pm}11.7$, 60's: $54.9{\pm}10.0$, more than 70's: $53.1{\pm}10.5mm$, for the isthmus was 20's: $71.5{\pm}17.4$, 30's: $74.1{\pm}14.9$, 40's: $73.6{\pm}14.2$, 50's: $66.3{\pm}12.9$, 60's: $56.5{\pm}11.2$, more than 70's: $56.8{\pm}11.3mm$, and for the splenium was 20's: $82.6{\pm}6.8$, 30's: $86.9{\pm}6.4$, 40's: $83.1{\pm}7.1$, 50's: $81.5{\pm}7.4$, 60's: $78.6{\pm}6.0$, more than 70's: $80.55{\pm}8.6mm$. The length of neural fiber for normal corpus callosum were statistically significant in the genu(P=0.001), posterior-mid body(P=0.009), and istumus(P=0.012) of corpus callosum. In order of age, the length of neural fiber increased from 30s to 40s, as one grows older tended to decrease. For this reason, the nerve cells of brain could be confirmed through the neural fiber tractography to progress actively in middle age.

Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.441-447
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    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

Usefulness of High-B-value Diffusion - Weighted MR Imaging for the Pre-operative Detection of Rectal Cancers (B-values 변환 자기공명영상: 국소 직장암 수술 전 검출을 위한 적합한 b-value 유용성)

  • Lee, Jae-Seung;Goo, Eun-Hoe;Lee, Sun-Yeob;Park, Cheol-Soo;Choi, Ji-Won
    • The Journal of the Korea Contents Association
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    • v.9 no.12
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    • pp.683-690
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    • 2009
  • The purpose of this study is to evaluate the usefulness of high-b-values diffusion weighted magnetic resonance imaging for the preoperative detection of focal rectum cancers. 60patients with diffusion weighted imaging were evaluated for the presence of rectal cancers. Forty were male and twenty were female, and their ages ranged from 38 to 71 (mean, 56) years. Used equipment was 1.5Tesla MRI((GE, General Electric Medical System, Excite HD). Examination protocols were used the fast spin echo T2, T1 weighted imaging. All examination protocols were performed by the same location with diffusion weighted imaging for accuracy detection. The b-values used in DWI were 250, 500, 750, 1000. 1500, 2000$(s/mm^2)$. The rectum, bladder to tumor contrast-to-noise ratio (CNR) of MR images were quantitativlely analyzed using GE software Functool tool, four experienced radiologists and three radiotechnologists qualitatively evaluated image quality in terms of image artifacts, lesion conspicuity and rectal wall. These data were analysed by using ANOVA and Freedman test with each b-value(p<0.05). Contrast to noise ratio of rectum, bladder and tumor in b-value 1000 were 27.21, 24.44, respectively(p<0.05) and aADC value was $0.73\times10^{-3}$. As a qualitative analysis, the conspicuity and discrimination from the rectal wall of lesions were high results as $4.0\pm0.14$, $4.4\pm0.16$ on b-value 1000(p<0.05), image artifacts were high results as $4.8\pm0.25$ on b-value 2000(p<0.05). In conclusion, DWI was provided useful information with depicting the pre-operative detection of rectal cancers, High-b-value 1000 image was the most excellent DWI value.