• Journal of Acupuncture Research
• /
• v.21 no.6
• /
• pp.177-186
• /
• 2004

Introduction : Recent studies Suggested that there is a strong correlation between acupuncture stimulation and its related cortical activation. Anther study showed that either positive or negative BOLD effects could be observed depending on anatomical structure in acupuncture stimulation. In ttis study, we investigated a new acupoint $KI_6$ (照海), which was known as motor-related acupoint and obtained an evidence that the stimulation of $KI_6$ resulted in either negative or positive BOLD response to stimulation. Methods & Results : 1. Subjects and paradigms : Two separate stimulation paradigms were performed on five healthy (aged 22-23 yrs) in this study. First, the paradigm of acupuncture stimulation was that the acupuncture needle was inserted in acupoints $KI_6$, which is located in lateral side of the foot and then continuously twisted(補瀉를 除外한 捻轉法) for 70 seconds for 10 cycles of activation. During rest period (70 seconds), the needle was completed removed from acupoint. Total 60 cycles were performed and 10 images were obtained per cycle. Second, nonacupoint was randomly selected and the same paradigm was performed as acupoint stimulation. The stimulation protocol comprised 10 cycles of alternating. activation and rest (10 images per cycle). Total 60 cycles were performed and each cycle take about 1.5 sec for motor task. Subjects take an at least 15 minutes break before starting anther paradigm. 2. fMRI mapping : Multi-slice functional images were obtained on a 1.5T Magnetom Vision MRI scanner (Simens Medical, Erlangen, Germany) equipped with high performance whole-body gradients. The BOLD T2 * - weighted images were acquired with acho planar imaging sequence (TR = 1.2 sec, TE = 60 msec, and flip angle = $90_{\circ}$). The other sequence parameter are : FOV = 210 mm, matrix=$64{\times}128$ or $64{\times}64$, slice number=10 and slice thickness = 5 or 8 mm. the anatomic images were obtained with Spin-echo T1-weighted images. The resulting images were then anaiyzed with STIMULATE (CMRR, U. of Minnesota) to generate functional maps using a student T-test (p < 0.005) and cluster analysis. Both positive and negative response were evaluated. Conclusions : We have observed the activation of the motor cortex by stimulating motor-related acupoint ($KI_6$). Among five subjects, negative BOLD response was shown in four and positive response in one. All subjects showed positive response to conventional finger flexion-extension task. To understand the detailed mechanisms of correlation between acupuncture stimulation and BOLD fMRI changes and two typs of response, further study strongly required.

• Proceedings of the KSMRM Conference
• /
• 2002.11a
• /
• pp.133-133
• /
• 2002

Purpose： The purpose of paper is to implement software to visualize brain fiber tract using a 24-bit color coding scheme and to test its feasibility. Materials and Methods： MR imaging was performed on GE 1.5 T Signa scanner. For diffusion tensor image, we used a single shot spin-echo EPI sequence with 7 non-colinear pulsed-field gradient directions： (x, y, z)：(1,1,0),(-1,1,0),(1,0,1),(-1,0,1),(0,1,1),(0,1,-1) and without diffusion gradient. B-factor was 500 sec/$\textrm{mm}^2$. Acquisition parameters are as follows： TUTE=10000ms/99ms, FOV=240mm, matrix=128${\times}$128, slice thickness/gap=6mm/0mm, total slice number=30. Subjects consisted of 10 normal young volunteers (age：21∼26 yrs, 5 men, 5 women). All DTI images were smoothed with Gaussian kernel with the FWHM of 2 pixels. Color coding schemes for visualization of directional information was as follows. HSV(Hue, Saturation, Value) color system is appropriate for assigning RGB(Red, Green, and Blue) value for every different directions because of its volumetric directional expression. Each of HSV are assigned due to (r,$\theta$,${\Phi}$) in spherical coordinate. HSV calculated by this way can be transformed into RGB color system by general HSV to RGB conversion formula. Symmetry schemes： It is natural to code the antipodal direction to be same color(antipodal symmetry). So even with no symmetry scheme, the antipodal symmetry must be included. With no symmetry scheme, we can assign every different colors for every different orientation.(H =${\Phi}$, S=2$\theta$/$\pi$, V=λw, where λw is anisotropy). But that may assign very discontinuous color even between adjacent yokels. On the other hand, Full symmetry or absolute value scheme includes symmetry for 180$^{\circ}$ rotation about xy-plane of color coordinate (rotational symmetry) and for both hemisphere (mirror symmetry). In absolute value scheme, each of RGB value can be expressed as follows. R=λw｜Vx｜, G=λw｜Vy｜, B=λw｜Vz｜, where (Vx, Vy, Vz) is eigenvector corresponding to the largest eigenvalue of diffusion tensor. With applying full symmetry or absolute value scheme, we can get more continuous color coding at the expense of coding same color for symmetric direction. For better visualization of fiber tract directions, Gamma and brightness correction had done. All of these implementations were done on the IDL 5.4 platform.

• Investigative Magnetic Resonance Imaging
• /
• v.20 no.2
• /
• pp.81-87
• /
• 2016

Purpose: To analyze the feasibility of three-dimensional (3D) diffusion-weighted (DW) PSIF (reversed FISP [fast imaging with steady-state free precession]) sequence in order to evaluate peripheral nerves in the elbow. Materials and Methods: Ten normal, asymptomatic volunteers were enrolled (6 men, 4 women, mean age 27.9 years). The following sequences of magnetic resonance images (MRI) of the elbow were obtained using a 3.0-T machine: 3D DW PSIF, 3D T2 SPACE (sampling perfection with application optimized contrasts using different flip angle evolution) with SPAIR (spectral adiabatic inversion recovery) and 2D T2 TSE (turbo spin echo) with modified Dixon (m-Dixon) sequence. Two observers used a 5-point grading system to analyze the image quality of the ulnar, median, and radial nerves. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each nerve were measured. We compared 3D DW PSIF images with other sequences using the Wilcoxon-signed rank test and Friedman test. Inter-observer agreement was measured using intraclass correlation coefficient (ICC) analysis. Results: The mean 5-point scores of radial, median, and ulnar nerves in 3D DW PSIF (3.9/4.2/4.5, respectively) were higher than those in 3D T2 SPACE SPAIR (1.9/2.8/2.8) and 2D T2 TSE m-Dixon (1.7/2.8/2.9) sequences (P < 0.05). The mean SNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR, but there was no difference between 3D DW PSIF and 2D T2 TSE m-Dixon in all of the three nerves. The mean CNR in 3D DW PSIF was lower than 3D T2 SPACE SPAIR and 2D T2 TSE m-Dixon in the median and ulnar nerves, but no difference among the three sequences in the radial nerve. Conclusion: The three-dimensional DW PSIF sequence may be feasible to evaluate the peripheral nerves around the elbow in MR imaging. However, further optimization of the image quality (SNR, CNR) is required.

• Investigative Magnetic Resonance Imaging
• /
• v.22 no.2
• /
• pp.102-109
• /
• 2018

Purpose: The purpose of this study is to compare the performance of the T1 3D subtraction technique and the conventional 2D dynamic contrast enhancement (DCE) technique in diagnosing Cushing's disease. Materials and Methods: Twelve patients with clinically and biochemically proven Cushing's disease were included in the study. In addition, 23 patients with a Rathke's cleft cyst (RCC) diagnosed on an MRI with normal pituitary hormone levels were included as a control, to prevent non-blinded positive results. Postcontrast T1 3D fast spin echo (FSE) images were acquired after DCE images in 3T MRI and image subtraction of pre- and postcontrast T1 3D FSE images were performed. Inter-observer agreement, interpretation time, multiobserver receiver operating characteristic (ROC), and net benefit analyses were performed to compare 2D DCE and T1 3D subtraction techniques. Results: Inter-observer agreement for a visual scale of contrast enhancement was poor in DCE (${\kappa}=0.57$) and good in T1 3D subtraction images (${\kappa}=0.75$). The time taken for determining contrast-enhancement in pituitary lesions was significantly shorter in the T1 3D subtraction images compared to the DCE sequence (P < 0.05). ROC values demonstrated increased reader confidence range with T1 3D subtraction images (95% confidence interval [CI]: 0.94-1.00) compared with DCE (95% CI: 0.70-0.92) (P < 0.01). The net benefit effect of T1 3D subtraction images over DCE was 0.34 (95% CI: 0.12-0.56). For Cushing's disease, both reviewers misclassified one case as a nonenhancing lesion on the DCE images, while no cases were misclassified on T1 3D subtraction images. Conclusion: The T1 3D subtraction technique shows superior performance for determining the presence of enhancement on pituitary lesions compared with conventional DCE techniques, which may aid in diagnosing Cushing's disease.

• Korean Journal of Digital Imaging in Medicine
• /
• v.10 no.1
• /
• pp.45-50
• /
• 2008

Recently, MR Cholangiography used mainly bu controlling of patient's breathing. There is breathing hold techniques to get images within shopt time and gating technique adjusted to respiration cycle for high resolution image. In this study, the aim of this experiment is to know on clinical usefulness compared with PACE and RTG thchniques. This study's period is from 2006 in November to 2007 in January. A total of 21 patients investigated at MAGNETOM Sonata 1.5T (SIEMENS Erlangen) with use of 12ch body coil. MR acquisition protocol used 3D turbo spin echo coronal sequence. Scan parameters applied to potimal setting in use as gating techniques, respectively. Analysis of consuming timing evaluated with rapidness. As analysis of quantity, the common bile duct, gall bladder measured in signal intensities, then these data were calculated by signal to noise ratio and contrast to noise ratio. Qualitative analysis, experienced 2radiologists and 3 RTs were evaluated into 3groups about artifact, accuracy of lesions, sharpness of the common bile duct or gall bladder. As a result of analysis, when compared to PACE, consuming time of the RTG took less than PACE, On both CNRs and SNRs, PACE technique was slightly high values than RTG(p<0.05). Qualitative analysis' results, discrimination of lesions in the common bile duct, gall bladder get a significance level in both RTG and PACE techniques but presence's artifact of breathing and pulsation highly demonstrate in PACE techniques. In conclusion, both PACE and RTG methods at MRCP provided prominently clinical information for the common bile duct, gall bladder. If machines have not limitation with performance, induction of breathing holding also will help getting diagnistic quality.

• Journal of the Korean Society of Radiology
• /
• v.16 no.7
• /
• pp.835-842
• /
• 2022

This study is aimed to evaluate the effects of a synthetic MR technique in reducing metal artifacts. In the experiment, the in-plane and through-plane images were acquired by applying a synthetic MR technique and a high-speed spin echo technique to a phantom manufactured with screw for spinal surgery. The area of the metal artifact was compared. The metal artifacts were measured by dividing the signal-loss and the signal pile-up areas, and the area of the final artifact was calculated through the sum of the two. As a result, the metal artifacts were relatively reduced when the synthetic MR techniques were applied to both in-plane and through-plane. Comparing by sequence, the in-plane T1 images decreased by 23.45%, T2 images by 20.85%, PD images by 19.67%, and FLAIR images by 22.12%. Also, in the case of the through-plane, the T1 image decreased by 62.95%, the T2 image decreased by 73.93%, the PD image decreased by 74.68%, and the FLAIR image decreased by 66.43%. The cause of this result is that when the synthetic MR technique is applied, the distortion is due to the signal pile-up and does not occur and the size of the entire metal artifact is reduced. Therefore, synthetic MR technique can very effectively reduce metal artifacts, which can help to increase the diagnostic value of images.

• Journal of the Korean Society of Radiology
• /
• v.17 no.7
• /
• pp.1133-1138
• /
• 2023

This study analyzed the relationship between image parameters and specific absorption rate (SAR) in various sequence environments to optimize SAR. For this purpose, image parameters were adjusted for T2, T1, STIR, T1 FLAIR, and T2 FLAIR sequences in a 3.0T MRI, and the whole body (WB) SAR and head SAR calculated by the device were measured. Then, the SAR was evaluated by adjusting the number of images and the flip angle (FA) of the refocusing RF. As a result, SAR increased as the number of image increased in all sequences. T1 and T1 FLAIR had correlation coefficients (r) of 0.876, 0.876 (WB SAR, head SAR), 0.867, 0.867 (WB SAR, head SAR), respectively, and STIR had the highest correlation with 0.898 and 0.899 (WB SAR, head SAR). showed (p<0.05). When applied by increasing the refocusing FA, WB SAR and head SAR increased overall in all sequences. The T1 and T2 sequences showed high correlation with correlation coefficients (r) of 0.897, 0.898 (WB SAR, head SAR) and 0.914, 0.915 (WB SAR, head SAR), respectively, while the sequences to which the inversion recovery technique was applied had relatively low FA, showed less sensitivity to increase. Therefore, in a sequence with a relatively low TR, minimizing the number of image and applying the fast spin echo to reduce the refocusing FA in a sequence with a high duty cycle are effective in reducing SAR.

• Korean Journal of Radiology
• /
• v.22 no.5
• /
• pp.770-781
• /
• 2021

Objective: Chemical exchange-dependent saturation transfer (CEST) MRI is sensitive for detecting solid-like proteins and may detect changes in the levels of mobile proteins and peptides in tissues. The objective of this study was to evaluate the characteristics of chemical exchange proton pools using the CEST MRI technique in patients with dementia. Materials and Methods: Our institutional review board approved this cross-sectional prospective study and informed consent was obtained from all participants. This study included 41 subjects (19 with dementia and 22 without dementia). Complete CEST data of the brain were obtained using a three-dimensional gradient and spin-echo sequence to map CEST indices, such as amide, amine, hydroxyl, and magnetization transfer ratio asymmetry (MTR_asym) values, using six-pool Lorentzian fitting. Statistical analyses of CEST indices were performed to evaluate group comparisons, their correlations with gray matter volume (GMV) and Mini-Mental State Examination (MMSE) scores, and receiver operating characteristic (ROC) curves. Results: Amine signals (0.029 for non-dementia, 0.046 for dementia, p = 0.011 at hippocampus) and MTR_asym values at 3 ppm (0.748 for non-dementia, 1.138 for dementia, p = 0.022 at hippocampus), and 3.5 ppm (0.463 for non-dementia, 0.875 for dementia, p = 0.029 at hippocampus) were significantly higher in the dementia group than in the non-dementia group. Most CEST indices were not significantly correlated with GMV; however, except amide, most indices were significantly correlated with the MMSE scores. The classification power of most CEST indices was lower than that of GMV but adding one of the CEST indices in GMV improved the classification between the subject groups. The largest improvement was seen in the MTR_asym values at 2 ppm in the anterior cingulate (area under the ROC curve = 0.981), with a sensitivity of 100 and a specificity of 90.91. Conclusion: CEST MRI potentially allows noninvasive image alterations in the Alzheimer's disease brain without injecting isotopes for monitoring different disease states and may provide a new imaging biomarker in the future.

• Investigative Magnetic Resonance Imaging
• /
• v.6 no.1
• /
• pp.35-40
• /
• 2002

Purpose : To evaluate the NMR relaxation properties and imaging characteristics of tissue-specificity for a newly developed macromolecular MR agent. Materials and methods : Phthalocyanine (PC) was chelated with paramagnetic ion, Mn.2.01g (5.2 mmol) of Phthalocyanine was mixed with 0.37g (1.4 mmol) of Mn chloride at $310^{\circ}C$ for 36 hours and then purified by chromatography (CHC13/CH3OH 98/2 v/v, Rf, 0.76) to obtain 1.04g (46%) of MnPC (molecular weight= 2000d). The $T1}T2$ relaxivity of MnPC was measured in 1.5T(64 MHz) MR using 0.1 mM MnPC. The MR image characteristics of MnPC was evaluated using spin-echo (TR/TE=500/14 msec) and gradient-echo (FLASH) (TR/TE=80/4 msec, flip angle=60) techniques in 1.57 MR scanner. The images of rabbit liver were obtained every 10 minutes up to 4 hours. To study the effect of concentration on image, 20 mM, 50 mM, 100 mM of MnPC were tested. Results : The relaxivities of MnPC at 1.5T(64MHz) were Rl=7.28 $mM^{-1}S^{-1},{\;}R2=55.56mM^{-1}S^{-1}$. Compared to the values of Gd-DTPA (Rl[=4.8 $mM^{-1}S^{-1})$], R2[=5.2 $mM^{-1}S^{-1}])$]), both T1/T2 relaxivities of MnPC were higher than those of Gd-DTPA. For both of SE and FLASH techniques, the contrast enhancement reached maximum at 10 minutes after bolus injection and the enhancement continued for more than 2 hours. When compared with small molecular weight liver agents such as Gd-EOB-DTPA, Gd-BOPTA and MnDPDP, MnPC was characterized by more prolonged enhancement time. The time course of MR images also revealed biliary excretion of MnPC. Conclusion : We developed a new macromolecular MR agent, MnPC. The relaxivities of MnPC were higher than those of small molecular weight Gd-chelate. Hepatic uptake and biliary excretion of MnPC suggests that this agent is a new liver-specific MR agent.

• Investigative Magnetic Resonance Imaging
• /
• v.5 no.2
• /
• pp.123-129
• /
• 2001

Purpose: The purposes of this study are to evaluate normal MR spectroscopy (MRS) data of the cerebellum and pons, and to evaluate intra-unit and inter-unit differences of the results. Materials and methods: Nine normal volunteers (mean age 23 years) were studied with two 1.5 Tesla MR units (A and B units). A total of four sessions of MRS study were performed with two sessions in ea.ch MR unit in each volunteer. In each session, MRS data were obtained from bilateral cerebellar hemisphere and pons. MRS was performed using spin-echo single voxel technique with repetition time of 2000 ms, echo time of 288ms and 128 averagings. Voxel size was $2{\;}{\times}{\;}2{\;}{\times}{\;}1.5{\;}cm$ in the cerebellum and $1.5{\;}{\times}{\;}1.5{\;}{\times}{\;}1.5{\;}cm$ in the pons. Metabolite ratios of NAA/Cho, NAAcCr, NAAc(Cho+Cr) and Cr/Cho (both peak heights and the peak areas) were compared among the results of four sessions of MRS for evaluation of intra-unit and inter-unit differences. Results: In the cerebellum, mean (SO values of peak height NAA/Cho, NAA/Cr, NAA/(Cho+Cr) and Cr/Cho ratios obtained in the first session of A unit were $1.08{\pm}O.16,{\;}1.44{\pm}O.286,{\;}0.61{\pm}O.09{\;}and{\;}O.76{\pm}0.13$, respectively. Comparing with the results of the second session, intra-unit differences were 3-7%. In B unit intra-unit differences were 1-9%, except for 22% of Cr/Cho ratio. Inter-unit differences between A and B units were 1-26%. In the pons, mean ISD values of peak height NANCho, NANCr, NANICho + Cr) and Cr/Cho ratios obtained in the first session of A unit were $1.51{\pm}O.35,{\;}3.35{\pm}O.78,{\;}1.02{\pm}0.16{\;}and{\;}0.47{\pm}O.14$, respectively. Mean NAAfCho, NANCr and NAAI(Cho+ Cr} ratios of the pons were significantly higher than those of the cerebellum. Intra-unit differences were 2-21 % in A unit and 4-18 % in B unit. Inter-unit differences between A and B units were 1-18%. The mean values obtained by using peak area were generally higher and wider in range than those of peak height in both units. Conclusion: Mean NAAfCho, NAAlCr and NAAf(Cho+Cr) ratios of the cerebellum were significanHy lower than those of the pons. Intra-unit differences of most metabolites ratios were generally not significant, whereas inter-unit differences were greater than intra-unit differences in more metabolite ratios. Therefore, normal MRS data of the cerebellum and the pons should be obtained in every MR unit, before MRS applications in the diseases of the cerebellum and the pons.