Analysis of 1H Magnetic Resonance Spectroscopy Pattern in Invasive Ductal Carcinoma of Breast / 의학물리

To evaluate the potential value of 1H Magnetic resonance spectroscopy (MRS) for detecting and characterizing invasive ductal carcinoma of breast. We conducted 1H Magnetic resonance spectroscopy (MRS), using a 3.0T MR scanner, on 40 patients who were histologically diagnosed to have invasive ductal carcinoma (IDC); tumor areas of the patients were designated as experimental samples, and non-tumor areas as control samples. The peak at 3.2 ppm is characteristically intense and observed in 34 cases of the total 40 invasive ductal carcinoma (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). In constrast peak at 1.3 ppm is characteristically intense and observed in normal breast (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). The study shows that 1H MRS can effectively discriminate invasive ductal carcinoma from normal breast in most cases. It also demonstrates the feasibility of localized in vivo 1H MRS technique as a new diagnostic modality in the detection of breast tumor.

SNR and ADC Changes at Increasing b Values among Patients with Lumbar Vertebral Compression Fracture on 1.5T MR Diffusion Weighted Images / 의학물리

To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to 1,200 s/mm2. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of 400 s/mm2 (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of 400 s/mm2, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC values were relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than 400 s/mm2, the signal intensity gradually decreased at all the sites, while at the levels of more than 1,000 s/mm2, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.

A Study on Usefulness of Specific Agents with Liver Disease at MRI Imaging: Comparison with Ferucarbotran and Gd-EOB-DTPA Contrast Agents / 의학물리

The purpose of this experiment is to know the relation of the detection and characterization of liver's diseases as comparison of finding at MR imaging using a Ferucarbotran (SPIO) and Gd-EOB-DTPA (Primovist) agents in diffuse liver disease. A total of 50 patients (25 men and 25 women, mean age: 50 years) with liver diseases were investigated at 3.0T machine (GE, General Electric Medical System, Excite HD) "with 8 Ch body coil for comparison of diseases and contrast's uptake relation, which used the LAVA, MGRE." All images were performed on the same location with before and after Ferucarbotran and Gd-EOB-DTPA administrations (p<0.05). Contrast to noise ratio of Ferucarbotran and Gd-EOB-DTPA in the HCC were 3.08+/-0.12 and 7.00+/-0.27 with MGRE and LAVA pulse sequence, 3.62+/-0.13 and 2.60+/-0.23 in the hyper-plastic nodule, 1.70+/-0.09 and 2.60+/-0.23 in the meta, 2.12+/-0.28 and 5.86+/-0.28 in the FNH, 4.45+/-0.28 and 1.73+/-0.02 in the abscess and ANOVA test was used to evaluate the diagnostic performance of each disease (p<0.05). In conclusions, two techniques were well demonstrated with the relation of the detection and characterization of liver's diseases.

A Study on Compensation for Imaging Qualities Having Artifact with the Change of the Center Frequency Adjustment and Transmission Gain Values at 1.5 Tesla MRI / 의학물리

The purpose of this study is to compensate for susceptibility and a ferromagnetic body artifact using CFA and TGV on MR Imaging. A total of 30 patients (15 men and 15 women, mean age: 45 years) were performed on head and neck diseases. MR Unit used a 1.5T superconducting magnet (GE medical system, High Density). This study have investigated by changing with CFA and TGV (70, 90, 110, 130, 150) searching for compensation values about susceptibility and a ferromagnetic body artifact in 60 kg standards of body weight (p<0.05). As a quality results, Image qualities were obtained at different score from CFA and TGV (70, 90, 110, 130, 150=3.23+/-0.35, 4.31+/-0.02 4.23+/-0.21, 5.12+/-0.25, 7.13+/-0.72, 8.31+/-0.01, 5.21+/-0.15, 6.14+/-0.08, 5.23+/-0.72, 5.91+/-0.06, p<0.05). Absolute CNRs (TG, CNRpre, CNRpost) were acquired with (70:-1.44+/-0.11, -2.7+/-0.04, 90:-2.18+/-0.42, -4.41+/-0.43, 110:-2.89+/-0.43, -5.23+/-0.02, 130:-2.34+/-0.05, -5.26+/-0.01, 150: -2.09+/-0.08, -3.87+/-0.12, p<0.05). In conclusions, this study could be compensated for metal and flow artifacts surrounding the tissues having artifact by changing CFA and TGV.

MR T2 Map Technique: How to Assess Changes in Cartilage of Patients with Osteoarthritis of the Knee / 의학물리

By using the MR T2 map technique, this study intends, first, to measure the change of T2 values of cartilage between healthy people and patients with osteoarthritis and, second, to assess the form and the damage of cartilage in the knee-joint, through which this study would consider the utility of the T2 map technique. Thirty healthy people were selected based on their clinical history and current status and another thirty patients with osteoarthritis of the knee who were screened by simple X-ray from November 2007 to December 2008 were selected. Their T2 Spin Echo (SE hereafter) images for the cartilage of the knee joint were collected by using the T2 SE sequence, one of the multi-echo methods (TR: 1,000 ms; TE values: 6.5, 13, 19.5, 26, 32.5. 40, 45.5, 52). Based on these images, the changes in the signal intensity (SI hereafter) for each section of the cartilage of the knee joint were measured, which yielded average values of T2 through the Origin 7.0 Professional (Northampton, MA 01060 USA). With these T2s, the independent samples T-test was performed by SPSS Window version 12.0 to run the quantitative analysis and to test the statistical significance between the healthy group and the patient group. Closely looking at T2 values for each anterior and lateral articular cartilage of the sagittal plane and the coronal plane, in the sagittal plane, the average T2 of the femoral cartilage in the patient group with arthritis of the knee (42.22+/-2.91) was higher than the average T2 of the healthy group (36.26+/-5.01). Also, the average T2 of the tibial cartilage in the patient group (43.83+/-1.43) was higher than the average T2 in the healthy group (36.45+/-3.15). In the case of the coronal plane, the average T2 of the medial femoral cartilage in the patient group (45.65+/-7.10) was higher than the healthy group (36.49+/-8.41) and so did the average T2 of the anterior tibial cartilage (i.e., 44.46+/-3.44 for the patient group vs. 37.61+/-1.97 for the healthy group). As for the lateral femoral cartilage in the coronal plane, the patient group displayed the higher T2 (43.41+/-4.99) than the healthy group did (37.64+/-4.02) and this tendency was similar in the lateral tibial cartilage (i.e., 43.78+/-8.08 for the patient group vs. 36.62+/-7.81 for the healthy group). Along with the morphological MR imaging technique previously used, the T2 map technique seems to help patients with cartilage problems, in particular, those with the arthritis of the knee for early diagnosis by quantitatively analyzing the structural and functional changes of the cartilage.

Relationship between Homocysteine Level, White Matter Lesion and Cognitive Decline

BACKGROUND: Hyperhomocysteinemia increase the risk of vascular disease, dementia and cognitive impairment. The effect of homocysteine on cognitive function may be as a consequence of direct neurotoxicity or indirectly through cerebrovascular disease. Thus we examined the association between homocysteine levels and cognitive function, and assess whether this may be mediated by cerebral white matter lesions. METHODS: Non-dementic participants were recruited from March to December 2005, and underwent brain MRI. White matter hyperintensities(WMH) were rated visually by 4-class WMH grades. Informations of age, gender, education and vascular risk factor were obtained from interview. Cognitive function were assessed by using K-MMSE and HDS-R. The cross-sectional relationship between homocysteine level and cognitive test score was assessed by multiple regression analysis. RESULTS: Severe WMH groups more exposed to vascular risk factor such as age, hypertension and higher levels of homocyteine. More severe WMH grades also had lower K-MMSE and HDS-R score. Higher group of homocysteine concentration were significantly related to poorer performances on K-MMSE and HDS-R tests. In multiple linear regression analyses for the relationship between homocysteine and cognitive performances, higher homocysteine level was also related to lower cognitive performances. Adding cerebral WMH changes to the level of homocysteine did not significantly change the effect of homocysteine on cognitive ability, and cerebral WMH had a separate and additive effect with homocysteine. CONCLUSIONS: Elevated homocysteine level is associated decreased cognitive score and cerebral white matter lesion on MRI is independent association to the cognitive abilities.