Location of Primary Motor Cortex Function in Cerebral Migration Disorder

PURPOSE: The purpose of this study was to demonstrate by functional MRI (MRI) the location of the primarymotor cortex in patients with schizencephaly. MATERIALS AND METHODS: fMRI was performed in four patients withschizencephaly who complained of seizures;three were right handed and one was ambidex trous. Associated lesionswere agenesis of the corpus callosum in one patient and absence of the septum pellucidum in another. fMRI employedthe single sliced FLASH BOLD technique using a 1.5-T MR imager with a standard head coil, and was obtained in theaxial plane. Thirty consecutive images were obtained on finger movements of each hand were obtained;the motor taskconsisted of repetitive finger to thumb opposition. Percentage change in primary motor cortex signal intensity wascalculated, and ipsilateral activation index was compared betweenthe affected and unaffected hemispheres. RESULTS: Percentage change in signal intensity increase in the activated area of the unaffected hemisphere ranged from4.8% +/-0.9% to 9.2+/-1.2%(mean:5.6%+/-1.5%) of the baseline value. The ipsilateral activation index of the affectedhemisphere was 0-0.38 and that of the unaffected hemisphere was 15.4-Infinity;in patients with schizencephalysignificantly different(p<0.01). CONCLUSION: Our results suggest that increased activation in the unaffectedhemisphere reflect functional reorganization of the primary motor cortex.

Functional MRI of The Supplementary Motor Area in Hand Motor Task: Comparison Study with The Primary Motor Area

PURPOSE: To investigate the localization and functional lateralization of the supplementary motor area (SMA) in motor activation tests in comparison to that of the primary motor area. MATERIALS AND METHODS: Seven healthy volunteers obtained echoplanar imaging blood oxygen level dependent technique. This study was carried on 1.5T Siemens Magneton Vision system with the standard head coil. Parameters of EPI were followed as ; TR/TE; 1.0/66.0 msec. flip angle : 90degree, field of view : 22cmx22cm, matrix : 128x128, slice number/slice thickness/gap : 10/4mm/0.8mm with fat suppression technique. Motor task as finger opposition in each hand consisted of 3 sets of alternative rest and activation periods. Postprocessing were done on Stimulate 5.0 by using cross-correlation statistics. To compare the functional lateralization of the SMA in the right and left hand tests, each examination was evaluation for the percent change of signal intensity and the number of activated voxels both in the SMA and in the primary motor area. Hemispheric asymmetry was defined as difference of summation of the activated yokels between each hemisphere. RESULTS: Percent change of signal intensity in the SMA (2.49-3.06%) is lower than that of primary motor area(4.4-7.23%). Percent change of signal intensity including activated voxels were observed almost equally in the right and left SMA. As for summation of activated voxels primary motor area had significant difference between each hemisphere but not did the SMA. CONCLUSION: Preferred contralateral dominant hemisphere and hemispheric asymmetry were detected in the primary motor area but not in the SMA.

Analysis of Papers in Radiological Journals in Recent Years: A Comparison of Journal of Korean Radiologic Society and Radiology

PURPOSE: The purpose of this study was to determine current trends and the mode of future development in the field of medical radiology and to promote research among the nation's radiologists by analyzing the contents of the Korean Radiologic Society(JKRS) and Radiology. MATERIALS AND METHODS: The number of articles published in JKRS each year between 1990 and 1994 was counted. The research articles in JKRS(n=740) and in Radiology(n=1748) between 1992 and 1994 were categorized according to the objective, type, topic, materials, and radiologic techniques of their contents on the basis of predetermined criteria. Domestic Masters theses(n=126) and doctoral dissertations(n=75) accepted between 1990 and 1994, and domestic materials published in international journals(n=416) between 1986 and 1994 were also categorized using the same criteria. RESULTS: The greatest increase in the number of articles published in JKRS was seen during 1994. The majority of these aimed to retrospectively analyse the findings of diseases while the majority of articles published in Radiology dealt prospectively with the development and/or evaluation of diagnostic methods. More variety of topics and issues was seen in Radiology than in JKRS. The number of articles of domestic materials published in international journals increased from1986 to 1994, while the number of articles of foreign materials published in korea was relatively stationary. A significant number of theses and dissertations dealt, mostly prospectively, with studies of pathophysiologic and/or pharmacologic mechanisms using animal models. CONCLUSION: In order to understand both current trends and the direction and mode of future developments in the field of radiology, and to be able to actively deal with challenges at the forefront of radiologic development, it is essential to review research articles published in radiology-related journals.

Radiology of Islet Cell Tumor of Pancreas: Diagnostic Usefulness of Spiral CT

PURPOSE: To analysis the radiologic characteristics of a pancreatic islet cell tumor, and to assess the usefulness of spiral CT scanning in the detection of a small tumor. MATERIALS AND METHODS: We retrospectively reviewed the clinical, pathologic, and imaging features of 12 cases of pathologically-proven islet cell tumors of the pancreas occurring between 1989 and 1995. Imaging study included conventional CT (n=9), spiral CT (n=3), ultrasonography (n=5), MRI (n=4), and angiography (n=6). RESULTS: Among 12 patients, eight (67%) were diagnosed as suffering from functioning islet cell tumor, and four (33%) as nonfunctioning tumors cases. Of the former, four were insulinoma and one was glucagonoma. Their average diameter was 2.4cm, whereas that of nonfunctioning tumors was 5cm. The average diameter of islet cell tumors was 1.3cm. Using conventional CT (4), spiral CT (3), ultrasonography (3), MRI (1), and angiography (3) preoperative localization was possible. Dynamic spiral CT scans with 5mm slice thickeness were performed in the three cases of smaller tumor (2cm) showded 100% sensitivity. CONCLUSION: Since nonfunctioning islet cell tumors tend to be large, it is usually possible to detect a tumor by using only ultrasonography or conventional CT scan. In the case of functioning islet cell tumors, however, localization of the lesion requires more complicated imaging studies. Our results show that thin slice spiral CT was valuable in the defection of small functioning tumors and can be the modality of choice for preoperative localization of a pancreatic islet cell tumor.

CT Features of Lung Cancer Associated with Idiopathic Pulmonary Fibrosis

PURPOSE: It is well known that the incidence of lung cancer is high in patients with idiopathic pulmonary fibrosis(IPF). We analyzed the CT features of lung cancer associated with IPF. MATERIALS AND METHODS: Retrospective analysis was performed in 23 patients with lung cancer(24 lung cancers) associated with IPF. The diagnosis of IPF was made by clinical and CT findings, and lung cancer was confirmed pathologically. We dividedthe location of lung cancer by lobar distribution and central or peripheral lung zone, and measured the size ofmass. We classified the mediastinal lymph node enlargement by American Thoracic Society(ATS) mapping scheme. We evaluated the CT pattern of IPF. RESULTS: The subjects consisted of 6 cases of small cell carcinoma and 18 cases of non-small cell lung cancer. Non-small cell lung cancer included 8 cases of squamous cell carcinoma, 4 cases of adenocarcinoma, 2 cases of large cell carcinoma, 3 cases of poorly differenciated carcinoma, and 1 case of unclassified malignant neoplosm. The lung cancers were located in the right upper lobe in 5 cases, left upper lobein 6 cases, right middle lobe in 1 case, right lower lobe in 9 cases, and left lower lobe in 3 cases. Twenty cancers(85%) were located in the peripheral lung zone. Eighteen cancers(73%) were surrounded by fibrotic lung. The size of the mass ranged from 1 to 12cm, and in 12 cases it was below 3cm in diameter. Mediastinal lymph nodes were enlarged in 22 cases(92%) and classified as N2 or N3 in 15 cases out of 18 non-small cell lung cancers. CT patterns of underlying IPF were honey-combing in 18 patients(78%) and mixed honey-combing and ground-glassopacity in 5 patients(22%). CONCLUSION: The lung cancer associated with IPF shows variable cell types. Most ofthe lung cancers were located peripherally, surrounded by end-stage fibrosis, and were associated with mediastinallymph node enlargement.

Localized Single Voxel 1H MR Spectroscopy Toward Routine Clinical Use

PURPOSE: To evaluate the utomated 1H magnetic resonance spectroscopy (1H-MRS) method for a routine clinical use, various regions of the normal human brain were examined for regional variations, the reproducibility, and thequality control of the spectral data. MATERIALS AND METHODS: Localized 1H-MRS was performed in a GE 1.5T SIGNAMRI/MRS system using the automated method(PROton brain Exam : PROBE). Six regions of the human brain from normal volunteers (N=25, age=23-65) were examined : Occipital gray matter, parietal white matter, frontal white matter, pons, cerebellum, and basal ganglia regions. STEAM was used as the localization method with the following parameters : TE=30 msec, TR=3.0 sec, AVG=48 AVG, NEX=2, Spectral Width (SW)=2500 Hz, Size (SI)=2048 points (2K),and the size of voxel=7-9 ml, The reproducibility and the quality control of the spectral date were evaluated. RESULTS: For the 6 regions, the regional variation by the spectral patterns and the metabolites ratios relative to creatine was well demonstrated. Rates of the auto prescan success and the percentages of obtaining the acceptable quality spectra were high in the parietal white matter, occipital gray matter, and basal gangliaregions, and low in the frontal white matter and pons regions. CONCLUSION: PROBE is a highly practical as well asreliable method to produce reproducible quality spectra that represent the regional metabolic variations in the human brain, PROBE can be used as a single spectroscopic exam or as an additional series to a routine brain MRI exam, which takes less than 10 minutes for acquiaition of one spectrum. In order to obtain good quality spectra, agood quality control scheme of the MR instrument is mandatory.