Pyridoxine responsive sideroblastic anemia in a boy with mitral valve prolapse / 소아과

Sideroblastic anemia is a rare, heterogeneous group of disorders characterized by hyperferremia, microcytic hypochromic anemia, and bone marrow erythroid hyperplasia with the presence of numerous ringed sideroblasts. We describe herewith the case of a rare coincidence of sideroblastic anemia and mitral valve prolapse with resultant regurgitation in a 2-year-old boy. In addition to the inherent propensity for the development of cardiac dysfunction in sideroblastic anemia due to transfusion-associated myocardial iron overload and chronic anemia, a coincidence of MVP will further increase the likelihood of the morbidity or mortality of th patient. in this patient. After response to pyridoxine, the patient remains in good condition with stable hemoglobin levels.

Hepatic Veno-occlusive Disease Following Hematopoietic Stem Cell Transplantation in Children: Retrospective Analysis in a Single Institution / 대한소아혈액종양학회지

PURPOSE: Hepatic veno-occlusive disease (VOD) is a life-threatening complication occurring early after stem cell transplantation (SCT). Early diagnosis and effective treatment has not been established in severe VOD. Because there are few reports on VOD in Korean children, we evaluated the clinical characteristics of VOD following SCT in children. METHODS: We retrospectively reviewed the chart of all patients (n=116) receiving SCTs in CNUH Pediatric BMT center between May, 1991 and June, 2004. RESULTS: VOD developed in 11 patients (9.5%) (median age, 9.8 years; range, 2 to 13.9). Underlying diagnoses were ALL (n=3), severe aplastic anemia (n=3), AML (n=2), acute biphenotypic leukemia (n=1), neuroblastoma (n=1), and myelodysplastic syndrome (n=1). The median day of onset of VOD was D+9 (range, D-3 to D+19). VOD was classified as moderate in 5 and severe in 6 cases. Maximum level of serum total bilirubin was 2.9 mg/dL (range, 2.1 to 9.2) in moderate VOD and 7.3 mg/dL in severe VOD (range, 2.0 to 24.2) at D+18 (range, D-5 to D+59). We successfully treated VOD with various combinations including tPA and heparin (2/5, 40%), ursodeoxycholic acid (2/5, 40%), N-acetylcysteine (3/5, 60%), and defibrotide (1/2, 50%). All of 5 patients with moderate VOD survived at D+100 (range, 5.5+ to 66.6+ months). Five of 6 (83%) patients with severe VOD died within first 19 day from complications of VOD. CONCLUSION: This retrospective study showed that the incidence of VOD was 9.5%, and the mortality of severe VOD was still high which would necessitate early diagnosis, effective prevention and treatment.

Hemodynamic Infarction Associated with Coil Embolization of Intracranial Aneurysm / 대한뇌혈관외과학회지

We report a case of borderzone infarction which was developed after the coil embolization of unruptured internal carotid-posterior communicating artery aneurysm. Post-procedural angiography and brain computerized tomographic scan did not reveal any abnormality. However, brain magnetic resonance image (MRI) showed a wedge-shaped borderzone cerebral infarction between left middle cerebral artery and left anterior cerebral artery territory. It was suspected to be a manifestation of hypoperfusion in the internal carotid artery territory, caused by hemodynamic instability during the procedure. In order to prevent this unexpected serious complication, using the continuous hemodynamic monitoring during aneurysmal coil embolization, such as transcranial doppler ultrasonography, should be considered.

Functional MR Imaging of the Motor Cortex in Active and Passive Movement: Qualitative and Quantitative Changes

PURPOSE: To compare functional MR imaging of the motor cortex during active and passive movement. MATERIALS AND METHODS: Seven healthy, right-handed volunteers (M:F=6:1; age:25-30 years) were included in this study. A 1.5-T whole body scanner and the multislice EPI BOLD method were used. The motor paradigm was flexion-extension of a thumb against rest. In the active motion task, the thumb was flexed voluntarily once a second, while in the passive task, it was tied with a thread and pulled to flex and extend passively at the same interval and with the same intensity as in the active task. For image postprocessing, an SPM 96 program was used. The sites, numbers, and signal intensity of the activated pixels were determined, and the threshold for significance was set at p<0.001 to p<0.01. RESULTS: In the active motion task, strong activation at the contralateral side of the primary sensorimotor cortex and supplementary motor cortex occurred in all 14 examples in all seven volunteers. Additionally, the ipsilateral primary sensorimotor cortex and supplementary motor area were activated in 12/14 and 11/14 such tasks, respectively. During passive motion tasks, on the other hand, weak activation occurred at the contralateral side of the primary sensorimotor cortex in all cases, but in the contralateral supplementary motor cortex in only three. In the ipsilateral primary sensorimotor cortex and supplementary motor area, there was no activation. CONCLUSION: Compared with the active motion task, activation occurring in the contralateral primary sensorimotor cortex and supplementary cortex was weaker and less frequent during the passive task, and during this latter, the ipsilateral motor cortex remained inactive. These results may be useful for the clinical application of functional MR imaging in unconscious patients or in animal studies.

The Analysis of Pathogenesis in the Hypertensive Encephalopathy using Diffusion-Weighted MR Imaging

PURPOSE: To investigate the nature of edematous lesions seen on MR images during acute episodes of hypertensive encephalopathy(HTE) with particular attention to the findings of diffusion-weighted imaging (DWI). MATERIALS AND METHODS: A total of 17 MR examinations in fourteen patients with hypertensive encephalopathy were performed. The diagnoses were idiopathic HTE in eight cases, eclampsia in three, and cyclosporin-induced HTE in three. The apparent diffusion coefficients(ADCs) of edematous lesions and normal white matter revealed by DWI were assessed and compared, and the changes observed at follow-up MR imaging were analysed. RESULTS: DWI obtained within one week of the appearance of acute neurological symptoms revealed the edema as iso-intense in all patients with eclampsia and cyclosporin-induced HTE, and in five of eight patients with idiopathic HTE. In the other three patients with idiopathic HTE, DWI demonstrated slightly hyperintense edema. The ADCs of edematous lesion in patients with idiopathic HTE, eclampsia and cyclosporin-induced HTE were 1.21 +/-0.34, 1.08 +/-0.28, and 1.28 +/-0.22 mm 2 /ms, respectively, while for normal white matter the corresponding figures were 0.77 +/-0.25, 0.71 +/-0.22, and 0.68 +/-0.27mm 2 /ms The differences in ADCs between edema and normal white matter were thus significantly different between the three patient groups (p<0.05), while the ADCs of edematous lesions showed no sisgnificant variation between these groups (p<0.05). Follow-up MRI revealed that in three cases, edematous lesions were reversible and there were no residual signal changes. CONCLUSION: Vasogenic rather than cytotoxic edema is present during the acute stage of HTE.

Comparison of Magnetization Transfer Ratios of Various Cerebral Edemas

PURPOSE: To compare magnetization transfer ratios (MTR) among various cerebral edemas with different pathophysiologic processes. MATERIALS AND METHODS: Cerebral edemas seen on MR images in 45 patients were classified as one of three types: vasogenic (n=22; tumor[n=9], contusion[n=3], hemangioma[n=4], hemorrhage[n=4], others[2]); cytotoxic (n=18; all acute infarction), and interstitial edema (n=5). In all cases, both T2-weighted images with and without magnetization transfer were obtained using off-set pulses of 600Hz. MTRs in each cerebral edema were measured and compared. RESULTS: The mean MTRs of vasogenic edema, cytotoxic edema and interstitial edema were 22 +/- 5%, 26 +/- 4 % and 19 +/- 2%, respectively. There was no statistically significant difference among the three types (p>0.05). CONCLUSION: Mean MTR was highest in cytotoxic edema and lowest in interstitial edema, but the differences were not significant.

Surgical Application of Magnetic Resonance Imaging Anatomy for Temporal Lobe Epilepsy Surgery

Anterior temporal lobectomy is the most popular surgical method for mesiobasal temporal lobe epilepsy. The key point in anterior temporal lobectomy is to resect lateral neocortex as little as possible, and mesiobasal structures as much as possible without surgical complication. We analyzed surgical anatomy on MRI scans of 20 persons to evaluate the relationships of anatomical structures related with surgical steps in anterior temporal lobectomy. On the oblique axial scan, the distance from temporal pole to anterior margin of hippocampus was 29.8+/-1.5mm. The length of hippocampus to the level of posterior margin of cerebral peduncle was 25.6+/-2.4mm. On the oblique coronal image through hippocampal head, the distance between the surface of superior temporal sulcus and lateral margin of temporal horn roof was 32.5+/-2.2mm. The angle between middle fossa base line and the line connecting superior temporal sulcus and lateral margin of temporal horn roof was 33.6+/-5.2 degree. The distance between lateral temporal surface and brain stem, and that between lateral temporal surface and collateral sulcus was 49.9+/-1.9mm and 40.6+/-3.3mm, respectively. The distance between collateral sulcus and lateral margin of temporal horn roof was 14.2+/-1.8mm, and the angle between middle fossa base line and the line connecting lateral margin of temporal horn roof and collateral sulcus was 60.4+/-7.4 degree. On the sagittal image, the angle between superior temporal sulcus and hippocampal axis was 18.8+/-1.1 degree. In conclusion, surgical complication of anterior temporal lobectomy can be reduced by careful consideration of anatomical relationships between anatomical structures encountered in each surgical steps in anterior temporal lobectomy.

Practical Role of Three-Dimensional Computed Tomographic Angiography in Planning the Surgery for Intracranial Aneurysm

OBJECTIVES: The aim of this study is to evaluate the practical role of 3D-CTA in planning the surgery for intracranial aneurysm from a viewpoint of operator. METHODS: Since May 1997 to April 1998, a total of 65 patients who were suspected to have intracranial aneurysms were studied with 3D-CTA using a General Electric Hispeed Advantage helical scanner. Conventional intraarterial digital subtraction angiographies(IA-DSAs) were performed in all patients except four who were in urgent situation. With the images obtained from the 3D-CTA, we performed preoperative assessments for the targeted aneurysms and evaluated its usefulness for planning the aneurysm surgery. RESULTS: 3D-CTA revealed 69 intracranial aneurysms in 55 patients and the size of aneurysms detected were 2-17mm in diameter. The sensitivity of 3D-CTA(95.8%) which was based on the comparison with IA-DSA and supplemented by microsurgical finding was similar to that of IA-DSA(94.1%) and its specificity(81.8%) was lower than that of IA-DSA(100%). Time consuming for getting images from 3D-CTA was no more than 20 minutes and this rapidity was very useful in the emergent situation such as cases of large intracerebral hematoma or massive intraventricular hemorrhage. 3D-CTA proffered various perspective views including surgical view, which were valuable to estimate the degree of head rotation and the direction of clip insertion and to determine the permanent clip type preoperatively. Careful reviewing of 3D-CTA made it possible to minimize surgical procedures. We could omit routine rectus gyrus resection in twelve of 16 surgeries for A-com aneurysm and could operate sixteen of 19 ICA aneurysms successfully without routine extracranial carotid artery preparation. On the basis of 3D-CTA, we could select the appropriate surgical approach in cases of ophthalmic aneurysm or posterior circulation aneurysm. Moreover, in cases of bilateral multiple aneurysms, 3D-CTA was helpful for evaluating the possibility of visualizing contralateral aneurysm through unilateral approach. The extent of bone work could be determined preoperatively through reviewing the 3D-CTA images and possible rupture of MCA aneurysm during bone work could be avoidable. However, 3D-CTA had some limitations for the describing fine vascular architecture such as the teat of aneurysm, a clue for the ruptured aneurysm in multiple aneurysms and most of fine caliber vessels such as hypoplastic posterior communicating artery or anterior choroidal artery was missed on the 3D-CTA. 3D-CTA lacked description for the hemodynamics of cerebral circulation. CONCLUSIONS: Although the 3D-CTA is still insufficient to be the complete substitute for conventional intraarterial digital subtraction angiography, it may be excellent adjunctive tool in planning the surgery of intracranial aneurysm considering that understanding the exact relationship of aneurysm with surrounding structure is mandatory for minimizing the possible risk during surgery.

Diagnostic Usefulness of CT-guided Pe rcutaneous Biopsy of the Spine

PURPOSE: To evaluate the diagnostic value of CT-guided percutaneous biopsy of inflammatory and tumorous lesions of the spine and paraspinal soft tissue. MATERIALS AND METHODS: Twenty-three patients underwent CT-guided percutaneous biopsy of the spine and paraspinal soft tissue. Tentative clinical diagnoses determined before biopsy were tuberculous spondylitis (n=5), pyogenic spondylitis (n=4), butterfly vertebra (n=1), old compression fracture (n=3), discitis (n=1), hemangioma (n=1), metastasis (n=7) and multiple myeloma (n=1). Biopsy was performed at the following levels: cervical-(n=1), thoracic-(n=9), and lumbar-spine(n=13). The approach to biopsy of the spine and paraspinal soft tissue lesions was posterolateral (n=11), posterior (n=2), or transpedicular (n=10). RESULTS: Tissue considered adequate by the pathologist involved was obtained in 21 (91%) of the 23 cases. In 19 cases, pathologic findings supported the clinical diagnoses determined before biopsy. In two cases, pathologic and clinical diagnoses differed. Complications such as severe pain, bleeding, infection, neurologic deficit or damage to internal organs were detected neither during or after the procedure. CONCLUSION: CT-guided percutaneous biopsy is a safe and reliable method of obtaining a diagnosis in many cases involving different spinal and paraspinal lesions.

CT of Normal Variations of the Minute Central Skull Base Foramina

PURPOSE: To evaluate the CT appearance of normal variations in the minute central skull base foramina in infants and children. MATERIALS AND METHODS: One hundred and fourteen children under the age of 17 years without skull base abnormality underwent CT scanning. A high spatial frequency algorithm was used, and contiguous axial scanning parallel to the orbitomeatal line was performed from the foramen magnum to the orbital roof, with a 1-mm slice thickness. The presence or absence of eight foramina, pseudoforamina, or ossification centers including anterior presphenoidal foramen, posterior presphenoidal foramen, rostro-orbital pseudoforamen, intralateromedial postsphenoidal pseudoforamen, intrapostsphenoidal pseudoforamen, spheno-occipital pseudo-foramen, canalis basilaris medianus and intrasynchondral ossified bodies was analysed according to age. The presence of foramina or pseudoforamina was indicated if a ring-shaped structure was seen on two or more CT scans at the location anatomically predicted, and intrasynchondral ossified bodies were indicated if linear or dot-like structures with high attenuation accompanied spheno-occipital synchondrosis. RESULTS: CT indicated that within a certain age range, various kinds of foramina, pseudoforamina, and ossification centers were frequent. The anterior presphenoidal foramen was most commonly seen in infants aged 1-12 months (16/17, 94 %); the posterior presphenoidal foramen in children less than 2 years old(27/37, 73 % ) ; the rostro-orbital pseudoforamen in children aged 2 -5 years (9/17, 53%); intrapostsphenoidal pseudoforamen in children 6 -12 years old(20/37, 54%) and spheno-occipital pseudoforamen and intrasynchondral ossified bodies in children aged 13 -16 years. The canalis basilaris medianus was identified in about 20 % of all subjects regardless of age. CONCLUSION: Development of the minute central skull base foramina varied greatly according to age. Knowledge of the CT appearances of such embryologic variants of the central skull base should not only help Provide an understanding of complex skull base anatomy but also identify abnormal skull base development.

Magnetic Resonance Imaging Anatomy for Surgical Application in Subtemporal Selective Amygdalohippocampectomy

Although subtemporal amygdalohippocampectomy is the ideal approach for pure mesial temporal lobe epilepsy from the view point that it can resect amygdala, hippocampusis, and parahippocampal gyrus selectively, this approach has not gained wide popularity due to shortcomings such as temporal lobe retraction and possible injury to temporal lobe draining veins. We analized surgical anatomy on MRI scan of 20 persons for the purpose of modifing the subtemporal approach to overcome the inherent shortcomings. The distance from temporal pole to anterior margin of temporal horn was 29.8+/-5mm(range, 28.5-31mm). Anterior margin of hippocampus was located 1.8+/-9mm(range, 1-3mm) anterior to dorsum sella. The length of hippocampus to the level of posterior margin of cerebral peduncle was 25.6+/-4mm. External auditary meatus divided the hippocampus, from anterior to the level of posterior margin of cerebral peduncle, in the ratio of 1.52: 1. On the coronal image through interpeduncular cistern, the distance between lateral margin of temporal lobe and collateral sulcus was 40.6+/-.3mm(37-45mm). On the coronal image through interpeduncular cistern and through the external auditary meatus, the height from temporal base to the choroidal fissure was 30.0+/-.7mm and 21.3+/-.5mm, respectively, and the angle between temporal base line and a line from collateral sulcus to choroidal fissure was 45.7+/-.6 degree and 33.2+/-.9 degree, respectively. In conclusion, our results indicate that external auditary meatus(EAM) is anatomical landmark for subtemporal amygdalohippocampectomy, and skull base approach focused on either EAM or anterior to EAM is necessary to minimize morbidity due to temporal lobe retraction and draining vein injury.

Breath-Hold Gadolinium-enhanced MRA: Clinical Application

PURPOSE: To compare breath-hold gadolinium enhanced MR angiography(MRA) with digital subtraction angiography. MATERIALS AND METHODS: Ten patients underwent angiography and breath-hold gadolinium enhanced MRA;the latterperformed at 1.5T with 3D FSPGR after a bolus injection of gadopentetate dimeglumine(0.4mmol/kg) RESULTS: Sevenof ten pathologic conditions(70%) evaluated by both techniques had a similar appearance. The conditions examinedwere as follows : the artery feeding renal cell carcinoma(n=2): renal artery stenosis(n=2); pulmonaryAVM(n=2);abdominal aortic aneurysm(n=1); atheromatous plaque in the lower abdominal aorta(n=1);an enlargedbronchial artery(n=1); and an aberrant renal artery(n=1). For evaluating an anatomic relationship, a reconstructed3D image obtained by MRA is more advantageous. CONCLUSION: Breath hold contrast enhanced MRA is a potentiallyuseful noninvasive screening method for detecting vascular abnormality of the aorta and its branches.

Magnetization Transfer on T2-weighted Image: Magnetization Transfer Ratios in Normal Brain and CerebralLesions

PURPOSE: To evaluate the magnetization transfer ratio(MTR) of various normal structures and pathologiclesions, as seen on magnetization transfer T2-weighted images (MT+T2WI). MATERIALS AND METHODS: In ten normalvolunteers, T2-weighted images without MT (MT-T2WI) and with MT(MT+T2WI) were obtained. Off-set pulses used inMT+T2WI were 400, 600, 1000, 1500, and 2000Hz. In 60 clinical cases infarction(n=10), brain tumors(n=5), traumatichematomas(n=5), other hematomas(n=3) vascular malformation(n=2) white matter disease(n=2) normal(n=31) andothers(n=2), both MT-T2WI and MT+T2WI images were obtained using an off-set pulse of 600 Hz. In all volunteers andpatients, MTR in various normal brain parenchyma and abnormal areas was measured. RESULT: The MTRs of white andgray matter were 48% and 45% respectively at 400 Hz, 26% and 22% at 600Hz, 12% and 11% of 1000Hz, 10% and 9% 1500HZ, and 9% and 8% at 2000Hz of RF. The MTR of CSF was 43% at 400 Hz of off-resonance RF, while the contrastresolution of T2WI was poor. An off-resonance of 600Hz appeared to be the optimal frequency. In diseased areas,MTRs varied but were usually similar to or lower than those of brain parenchyma. CONCLUSION: The optimaloff-resonance RF on MT+T2WI appears to be 600 Hz for relatively high MTR of brain parenchyma and low MTR of CSF,in which MTRs of white and gray matter were 26% and 22%, respectively, of 600Hz off-set pulse. The MTRs ofcerebral lesions varied and further studies of various cerebral lesions are needed.

1H MR Spectroscopy of the Normal Human Brains: Comparison of Automated Prescan Method with Manual Method

PURPOSE: To evaluate regional differences in relative metabolite ratios in the normal human brain by 1H MRspectroscopy (MRS), and compare the spectral quality obtained by the automated prescan method (PROBE) and themanual method. MATERIALS AND METHODS: Localized 1H MRS was performed on a GE 1.5T SIGNA MRI/MRS system (version5.5) with active shielded gradients. For 20 normal volunteers aged 8-47 years, spectral parameters were adjustedby the auto-prescan routine provided by a PROBE package(N=34)and manually (N=33). Five regions of the human brainwere examined (N=PROBE,manual): frontal white matter(N=6,10), parietal white matter(N=8,9), basal ganglia(N=6,5),thalamus(N=4,5), and cerebellum(N=4,4). For all spectra, a STEAM localization sequence with three-pulse CHESS H2Osuppression was used, with the following acquisition parameters: TR=3.0 sec, TE=30 msec, TM=13,7 msec, SW=2500Hz,SI=2048 pts, AVG=48, and NEX=2. RESULTS: A total of 61 reliable spectra were obtained by PROBE (28/34=82%success) and by the manual method (33/33=100% success). Regional differences in the spectral patterns of the fiveregions were clearly demonstrated by both PROBE and the manual methods. For prescanning, the manual method tookslightly longer than PROBE (3-5 mins and 2 mins,respectively). There were no significant differences in spectralpatterns and relative metabolic ratios between the two methods. However, auto-prescan by PROBE seemed to be veryvulnerable to slight movement by patients, and in three cases, an acceptable spectrum was thus not obtained. CONCLUSION: PROBE is a highly practical and reliable method for single voxel 1H MRS of the human brain; the twomethods of prescanning do not result in significantly different spectral patterns and the relative metaboliteratios. PROBE, however, is vulnerable to slight movement by patients, and if the success rate for obtainingquality spectra is to be increased, regardless of the patient's condition and the region of the brain, it must beused in conjunction with the manual method.

Physical Property and MR Imaging of Self-expandable Metallic Stents

PURPOSE: In order to furnish basic information prior to their use, the physical properties of variousself-expandable metallic stents and their MR characteristics were evaluated. MATERIALS AND METHODS: Fourcommercially available self-expandable metallic stents - Gianturco-the R sch, Hanaro, Memotherm, and Wallstent -were used in this study. For evaluation of the physical properties of each, hoop strengths and changes in radiiaccording to the degrees of longitudinal flexion were compared. Stent characteristics seen on MR images wereevaluated by measuring magnetic torque and by comparing images obtained in the vascular phantom using SE T1WI, FSET2WI, and FMPSPGR sequences. These images were analyzed with special emphasis on artifact size and the apparantshepe of the stent. RESULTS: Hoop strength was greatest in the Gianturco-R sch stent, followed by the Memotherm,Hanaro, and Wallstent. When flexed in the longitudinal axis, the radius of the Hanaro and Memotherm stentdecreased slightly as a larger flexion angle was applied. When this was 90degree, however, the connection of theGianturco-R sch stent collapsed. In contrast, the radius of the Wallstent became larger as a larger flexion anglewas applied. At the portal of the MR imaging unit, neither the Memotherm nor Wallstent showed deflection ; exceptfor a thin hyperintense rim at both ends, their images were excellent, and the lumina of these stents were alsoclearly seen. In contrast, the Gianturco-R sch and Hanaro stent demonstrated large deflexion and showed a severeblack-hole artifact. As a result, visualization of the stents themselves and their lumina was impossible. CONCLUSION: The Gianturco-R sch stent showed greater hoop strength than the others. The Wallstent showed goodlongitudinal flexibility and was thought to be effective in tortuous vessels. For follow-up after placement,especially when the nonferromagnetic Memotherm and Wallstent are used, MR imaging appears to be safe and useful.

New Device for Dilatation of Percutaneous Biliary Tract

PURPOSE: To evaluate the usefulness of percutaneous transhepatic biliary drainage (PTBD) tract dilatation using a Nipro set. MATERIALS AND METHODS: We dilated 28 percutaneous biliary drainage tracts up to 18F ; 26 procedures involved PTBD, and two, cholecystostomy. A Nipro set was used for dilatation, the purposes of which were stone removal (n=18) and choledochoscopic biposy (n=10). For dilatation, local anesthesia was used in all cases. RESULTS: In all patients, tract dilatation was successful. In 21 of 28 cases, dilatation of the right PTBD tract was involved, and in five of 28, dilatation of the left tract. In two cases, tract dilatation was done in cholecystostomy tracts. Complications encountered were pain (n=17), bradycardia (n=2), hemobilia (n=2), bleeding (n=1)and fever (n=1). CONCLUSION: In choledocoscopy, tract dilatation using a Nipro set is safe and simple.

Imaging with Magnetization Transfer Technique on the Intracranial Tumors

PURPOSE: To measure the magnetization transfer ratio(MTR) of intracranial tumors and to evaluate the difference of the character and the border of tumors on magnetization transfer image. MATERIALS AND METHODS: We prospectively reviewed magnetization transfer imaging(MTI) findings of intracranial tumors of 13 patients. 1.0T MRI machine was used. T1 weighted image(TRITE=700/14) and T1 weighted magnetization transfer image were obtained. The offset and bandwidth of magnetization transfer pulse were 1000 Hz and 250Hz, respectively. Postcontrast images were also obtained. MTR was measured at lesion area. RESULTS: The mean of normal MTR of white matter and gray matter in 7 normal volunteers were 37% and 29%, respectively. The MTR of each tumor was as follows;metastatic tumors(mean 16.3%), meningioma(mean 27.3%), oligodendroglioma(mean 20.2%), glomus jugulare tumor(mean 17.3%), gliomatosis cerebri(mean 27. 0%). The contrast of lesions were better at magnetization transfer image than at T1 weighted image. CONCLUSION: The MTR of the intracranial tumors is lower than normal tissue. Measurement of MTR at muirpie areas within the tumor can be useful for evaluation of indistinct border of the tumor.

The Morphometric Study of the Pons and Cerebellum in Korean using MRI

PURPOSE: To evaluate the size of normal pons and cerebellum in vivo and the change in size according to age, and to compare those with measurement of the diseased pons and cerebellum. MATERIALS AND METHODS: 121 normal adults(M:F=54:67), 5 patients with OPCD and 19 patients with WallerJan degeneration were studied. The normal group was divided into 5 subgroups according to the age (ranged from 20 to 72 years). 1.5T GE Signa MR unit was used. On axial plane, the AP(A) and transverse(B) diameters of the pons, the size of the middle cerebellar peduncle(C), and transverse diameter of the posterior fossa(D) and the cerebellum(E) were measured. On midsagittal plane, the longitudinal(F) and AP(G) diameters of the basis pontis were measured. The ratios of E/D and F/G were calculated. The student t test was used for statistical analysis. RESULTS: C, E and F/G were 15.5mm+/-1.3, 99.8mm+/-4.3 and 1.63+/-.10, respectively. F/G, H/I, and H/J were larger in male(p<.01). All data of the pons showed no statistically significant differences among age groups. E of the seventh decades was shorter than that of the third decades(p<.05). C(12.7 mm+/-1.4) in OPCD and F/G(1. 81+/-.10) in Wallerian degeneration(p<.01) showed the most significant differences when they were compared to the normal. CONCLUSION: Although the cerebellum decreased in size with age, the pons maintained its size up to eighth' decades. The measurement of middle cerebellar peduncle on axial plane (C) and the ratio of basis pontis on midsagittal plane (F/G) were important in the evaluation of OPCD and WallerJan degeneration, respectively.

Clinical review of 874 patients with gastric cancer

No abstract available.

Cystic disease of pancreas

No abstract available.