PURPOSE: In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. MATERIALS AND METHODS: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. RESULTS: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. CONCLUSION: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.
Antidepressive Agents ; Diagnosis ; Fatigue ; Fibromyalgia* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging* ; Prostaglandins B ; Thalamus ; Pregabalin

PURPOSE: A relative increase in deoxyhemoglobin levels in hypoperfused tissue can cause prominent hypointense signals in the draining veins (PHSV) within areas of impaired perfusion in susceptibility-weighted imaging (SWI). The purpose of this study is to evaluate the usefulness of SWI in patients with acute cerebral infarction by evaluating PHSV within areas of impaired perfusion and to investigate the usefulness of PHSV in predicting prognosis of cerebral infarction. MATERIALS AND METHODS: In 18 patients with acute cerebral infarction who underwent brain MRI with diffusion-weighted imaging and SWI and follow-up brain MRI or CT, we reviewed the presence and location of the PHSV within and adjacent to areas of cerebral infarction qualitatively and measured the signal intensity difference ratio of PHSVs to contralateral normal appearing cortical veins quantitatively on SWI. The relationship between the presence of the PHSV and the change in the extent of infarction in follow-up images was analyzed. RESULTS: Of the 18 patients, 10 patients showed progression of the infarction, and 8 patients showed little change on follow-up imaging. On SWI, of the 10 patients with progression 9 patients showed peripheral PHSV and the newly developed infarctions corresponded well to area with peripheral PHSV on initial SWI. Only one patient without peripheral PHSV showed progression of the infarct. The patients with infarction progression revealed significantly higher presence of peripheral PHSV (p=0.0001) and higher mean signal intensity difference ratio (p=0.006) comparing to the patients with little change. CONCLUSION: SWI can demonstrate a peripheral PHSV as a marker of penumbra and with this finding we can predict the prognosis of acute infarction. The signal intensity difference of PHSV to brain tissue on SWI can be used in predicting prognosis of acute cerebral infarction.
Brain ; Cerebral Infarction ; Follow-Up Studies ; Humans ; Infarction ; Magnetic Resonance Imaging ; Perfusion ; Prognosis* ; Veins*

PURPOSE: To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. MATERIALS AND METHODS: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. RESULTS: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy (6.8 +/- 1.6 cm vs. 5.8 +/- 1.6 cm, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. CONCLUSION: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.
Consensus ; Endoscopy ; Humans ; Rectal Neoplasms* ; Rectum ; Retrospective Studies ; Weights and Measures

PURPOSE: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. METHODS AND RESULTS: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). CONCLUSIONS: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.
Blood Flow Velocity ; Cardiomyopathy, Hypertrophic* ; Diastole ; Echocardiography ; Echocardiography, Doppler ; Female ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging* ; Male ; Mitral Valve* ; Pulmonary Veins*

PURPOSE: In-vivo conductivity reconstruction using transmit field (B1+) information of MRI was proposed. We assessed the accuracy of conductivity reconstruction in the presence of statistical noise in complex B1 + map and provided a parametric model of the conductivity-to-noise ratio value. MATERIALS AND METHODS: The B1+ distribution was simulated for a cylindrical phantom model. By adding complex Gaussian noise to the simulated B1+ map, quantitative conductivity estimation error was evaluated. The quantitative evaluation process was repeated over several different parameters such as Larmor frequency, object radius and SNR of B1+ map. A parametric model for the conductivity-to-noise ratio was developed according to these various parameters. RESULTS: According to the simulation results, conductivity estimation is more sensitive to statistical noise in B1+ phase than to noise in B1+ magnitude. The conductivity estimate of the object of interest does not depend on the external object surrounding it. The conductivity-to-noise ratio is proportional to the signal-to-noise ratio of the B1+ map, Larmor frequency, the conductivity value itself and the number of averaged pixels. To estimate accurate conductivity value of the targeted tissue, SNR of B1+ map and adequate filtering size have to be taken into account for conductivity reconstruction process. In addition, the simulation result was verified at 3T conventional MRI scanner. CONCLUSION: Through all these relationships, quantitative conductivity estimation error due to statistical noise in B1+ map is modeled. By using this model, further issues regarding filtering and reconstruction algorithms can be investigated for MREPT.
Evaluation Studies as Topic ; Magnetic Resonance Imaging ; Noise* ; Radius ; Signal-To-Noise Ratio

PURPOSE: Susceptibility-weighted magnetic resonance (MR) sequence is three-dimensional (3D), spoiled gradient-echo pulse sequences that provide a high sensitivity for the detection of blood degradation products, calcifications, and iron deposits. This pictorial review is aimed at illustrating and discussing its main clinical applications. MATERIALS AND METHODS: SWI is based on high-resolution, 3D, fully velocity-compensated gradient-echo sequences using both magnitude and phase images. To enhance the visibility of the venous structures, the magnitude images are multiplied with a phase mask generated from the filtered phase data, which are displayed at best after post-processing of the 3D dataset with the minimal intensity projection algorithm. A total of 200 patients underwent MR examinations that included SWI on a 3 tesla MR imager were enrolled. RESULTS: SWI is very useful in detecting multiple brain disorders. Among the 200 patients, 80 showed developmental venous anomaly, 22 showed cavernous malformation, 12 showed calcifications in various conditions, 21 showed cerebrovascular accident with susceptibility vessel sign or microbleeds, 52 showed brain tumors, 2 showed diffuse axonal injury, 3 showed arteriovenous malformation, 5 showed dural arteriovenous fistula, 1 showed moyamoya disease, and 2 showed Parkinson's disease. CONCLUSION: SWI is useful in detecting occult low flow vascular lesions, calcification and microbleed and characterising diverse brain disorders.
Arteriovenous Malformations ; Brain ; Brain Diseases ; Brain Neoplasms ; Central Nervous System Vascular Malformations ; Dataset ; Diffuse Axonal Injury ; Humans ; Iron ; Magnetic Resonance Imaging ; Masks ; Moyamoya Disease ; Neuroimaging* ; Parkinson Disease ; Stroke

OBJECTIVE: The aims of this article are to differentiate soft tissue masses showing low signal intensity on T2-weighted images (T2WIs) according to the histopathologic findings. CONCLUSION: To know relatively small numbered soft tissue masses with low signal intensities on T2WIs adding characteristic location, morphology, signal intensities on other sequences might be helpful for differential diagnosis of mostly nonspecific soft tissue tumors on MRI.
Diagnosis, Differential ; Magnetic Resonance Imaging ; Soft Tissue Neoplasms

Hypertensive encephalopathy and basal ganglia intracerebral hemorrhage (ICH) are a medical emergency caused by a sudden elevation of systemic blood pressure. Although the relationship between hypertensive encephalopathy and large ICH has not been clarified yet, Cushing reflex in acute elevations of ICP due to large ICH may induce or aggravate hypertensive encephalopathy. We report a rare case of isolated hypertensive brainstem encephalopathy combined with hypertensive ICH.
Basal Ganglia ; Blood Pressure ; Brain Stem* ; Cerebral Hemorrhage* ; Emergencies ; Hypertension ; Hypertensive Encephalopathy ; Magnetic Resonance Imaging ; Reflex

Wandering spleen is a rare clinical condition caused by lax splenic suspensory ligaments. The laxity of ligaments causes torsion of splenic vascular pedicle. CT scan of a 7-year-old girl with abdominal pain showed a non-enhancing lobular mass in lower abdomen. Small bowel loops were located at the right-sided abdomen and colonic loops at the left-sided abdomen. MRI scan showed non-enhancing heterogeneous mass with twisted vascular pedicle. To our knowledge, only a few cases have been reported about wandering spleen diagnosed on MRI.
Abdomen ; Abdominal Pain ; Child ; Colon ; Female ; Humans ; Infarction* ; Ligaments ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Wandering Spleen*

PURPOSE: We proposed a multi-physiological signals based real-time intelligent triggering system(MITS) for Cardiac MRI. Induced noise of the system was analyzed. MATERIALS AND METHODS: MITS makes cardiac MR imaging sequence synchronize to the cardiac motion using ECG, respiratory signal and second order derivative of SPO2 signal. Abnormal peaks due to arrhythmia or subject's motion are rejected using the average R-R intervals and R-peak values. Induced eddy currents by gradients switching in cardiac MR imaging are analyzed. The induced eddy currents were removed by hardware and software filters. RESULTS: Cardiac MR images that synchronized to the cardiac and respiratory motion are acquired using MITS successfully without artifacts caused by induced eddy currents of gradient switching or subject's motion or arrhythmia. We showed that the second order derivative of the SPO2 signal can be used as a complement to the ECG signals. CONCLUSION: The proposed system performs cardiac and respiratory gating with multi-physiological signals in real time. During the cardiac gating, induced noise caused by eddy currents is removed. False triggers due to subject's motion or arrhythmia are rejected. The cardiac MR imaging with free breathing is obtained using MITS.
Arrhythmias, Cardiac ; Artifacts ; Complement System Proteins ; Electrocardiography ; Magnetic Resonance Imaging* ; Noise ; Respiration