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MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman.

Jisun LEE ; Bum Sang CHO ; Yook KIM ; Kyung Sik YI ; Min Ho KANG ; Seung Young LEE ; Sung Jin KIM ; Kil Sun PARK

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):243-248. doi:10.13104/jksmrm.2013.17.3.243

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy. To date, 51 cases have been reported, including 3 in pregnant women. Herein, we report magnetic resonance findings of a 31-year-old Korean woman (15 weeks and 3 days pregnant) with primary retroperitoneal mucinous cystadenocarcinoma. On abdominal magnetic resonance imaging (MRI), a mass was identified in the retroperitoneal area with a nodular lesion showing heterogeneous signal intensity and focal wall thickening on T1- and T2-weighted images. Exploratory laparotomy and tumor excision were performed. Histological examination revealed primary retroperitoneal mucinous cystadenocarcinoma. The patient subsequently underwent total hysterectomy, bilateral salpingo-oophorectomy, and omentectomy for metastatic mucinous cystadenocarcinoma of both ovaries 15 months after her initial surgery.
Adult ; Cystadenocarcinoma, Mucinous ; Female ; Humans ; Hysterectomy ; Laparotomy ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Mucins ; Ovary ; Pregnant Women ; Retroperitoneal Neoplasms

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Anomalous Insertion of the Medial Meniscus into the Anterior Cruciate Ligament: A Case Report.

Ki Hwan KIM ; Jae Chan SHIM ; Kyoung Eun LEE ; Ho Kyun KIM ; Ghi Jai LEE ; Jung Ho SUH

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):239-242. doi:10.13104/jksmrm.2013.17.3.239

Anomalies of the medial meniscus are rare and difficult to diagnose clinically. Among these anomalies, anomalous insertion of the medial meniscus into the anterior cruciate ligament is rare. Most of the reported cases had no relation to clinical symptoms and were found incidentally during arthroscopy. We report a rare case of anomalous insertion of the medial meniscus into the anterior cruciate ligament with a brief review of the literature.
Anterior Cruciate Ligament ; Arthroscopy ; Menisci, Tibial

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Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma.

Eunsol LEE ; Eun Jin CHAE ; Sunji KANG ; Yoo Kyeong YEOM ; Hyun Joo LEE ; Jong Chun PARK ; So Youn SHIN ; Yoon Young CHOI ; Joon Ho CHOI ; Kyung Hyun DO

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):232-238. doi:10.13104/jksmrm.2013.17.3.232

PURPOSE: We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). MATERIALS AND METHODS: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. RESULTS: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. CONCLUSION: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.
Consensus ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Mesothelioma ; Neoplasm Staging ; Retrospective Studies

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Background Parenchymal Enhancement on Breast MRI in Breast Cancer Patients : Impact on Biopsy Rate and Cancer Yield.

Tae Yun KIM ; Sung Hun KIM ; Jee Eun BAIK ; Yun Joo KIM ; Bong Joo KANG

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):224-231. doi:10.13104/jksmrm.2013.17.3.224

PURPOSE: To evaluate the potential effects of background parenchymal enhancement of MR imaging in diagnosed breast cancer patients on the rate of additional biopsy and resultant cancer yield. MATERIALS AND METHODS: 322 patients who were diagnosed with breast cancer and had undergone breast MR imaging were included in this study. Two radiologists reviewed the MRI for degree of background parenchymal enhancement and additional suspicious lesions described as BI-RADS category 4 or 5 on radiologic reports. Biopsy was done for these lesions, pathology reports were reviewed to calculate the cancer yield. RESULTS: Background parenchymal enhancement of MR imaging in a total of 322 patients were classified as minimal degree 47.5%, mild degree 28.9%, moderate degree 12.4% and marked degree 11.2%. Among these 332 patients, MR imaging of 70 patients showed additional suspicious malignant lesions described as BI-RADS category 4 or 5, and consequently, 66 patients underwent biopsy. Biopsy rates in those with minimal or mild background parenchymal enhancement and those with moderate and marked background parenchymal enhancement were 19.9% and 22.3% (p-value 0.77) respectively. Cancer yields in those with minimal or mild background parenchymal enhancement and those with moderate and marked background parenchymal enhancement were 6.5% and 5.2% (p value 0.88) respectively. Both these results did not show stastically significant difference between the two groups. CONCLUSION: The degree of background parenchymal enhancement in MR imaging of breast cancer patients did not significantly impact additional biopsy rates or cancer yields.
Biopsy ; Breast ; Breast Neoplasms ; Humans ; Image-Guided Biopsy ; Magnetic Resonance Imaging

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The Effect of Gd-EOB-DPTA on the Stiffness Value of Magnetic Resonance Elastography in Evaluating Hepatic Fibrosis.

Jeong Eun LEE ; Jeong Min LEE ; Ye Ji LEE ; Jeong Hee YOON ; Kyung Bun LEE ; Joon Koo HAN ; Byung Ihn CHOI

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):215-223. doi:10.13104/jksmrm.2013.17.3.215

PURPOSE: To evaluate the effect of gadoxetic acid on the measurement of the stiffness value of MR elastography (MRE) used to evaluate hepatic fibrosis (HF). MATERIALS AND METHODS: MRE was obtained in 32 patients with clinically suspected chronic liver disease, both before and after injection of gadoxetic acid. Two independent reviewers measured the stiffness values of the liver parenchyma on elastograms. The mean liver stiffness values were compared in the pre- and post-contrast MREs using the paired t-test. Intra-rater and inter-rater correlation was assessed using the intraclass correlation coefficient (ICC). The accuracy, sensitivity, and specificity of both pre- and post-contrast MREs was evaluated for the diagnosis of significant HF (> or = F2) using cut off value of 3.1 kPa. RESULTS: There were no significant differences in the stiffness values of the liver parenchyma on pre- and post-contrast MREs (p = 0.15 and 0.38 for each reader, respectively). Regarding intra-rater correlation, excellent agreement was noted on rater 1(ICC = 0.998) and rater 2 (ICC = 0.996). Excellent correlation regarding the measured stiffness values was noted on both pre- and post-contrast MREs (ICC = 0.988 for pre-contrast, ICC = 0.993 for post-contrast). The accuracy, sensitivity, and specificity of the pre- and post-contrast MREs for differentiating significant HF (> or = F2) from < or = F1 were same as 71%, 60%, and 100%, respectively. CONCLUSION: As there was no significant difference in the stiffness measurements seen on MREs before and after administration of gadoxetic acids, it is therefore acceptable to perform MRE after contrast injection in order to evaluate HF.
Elasticity Imaging Techniques ; Fibrosis ; Gadolinium DTPA ; Humans ; Liver ; Liver Diseases ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Sensitivity and Specificity

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Magnetic Resonance Imaging of Breast Cancer Patients with BRCA Mutation.

Sun Young CHUNG ; Joo Hee CHA ; Hak Hee KIM ; Hee Jung SHIN ; Hyun Ji KIM ; Eun Young CHAE ; Ji Eun SHIN ; Woo Jung CHOI ; Min Ji HONG ; Sei Hyun AHN ; Jong Won LEE ; Kyung Hae JUNG

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):207-214. doi:10.13104/jksmrm.2013.17.3.207

PURPOSE: To evaluate the MRI findings of breast cancer with BRCA mutation. MATERIALS AND METHODS: We collected information of the breast cancer patients who underwent the test for BRCA gene mutation as well as preoperative breast MRI from January 2007 to December 2010. A total of 185 patients were enrolled; 33 of these patients had BRCA mutations and 152 patients did not. Among them, a total of 231 breast cancers were detected. Images of the 47 breast cancers with BRCA mutation and of the 184 breast cancers without mutations were evaluated to compare the morphologic and enhancement features on MRI. RESULTS: With MR imaging, there were no significant difference in morphologic characteristic between two groups. However, enhancement pattern in the group with BRCA mutation were more likely to have persistent enhancement (p < 0.233), and LN metastasis was more common in breast cancers without BRCA mutation. Breast cancers with BRCA 2 mutation tend to show more persistent enhancement pattern than BRCA 1 mutation. CONCLUSION: In breast cancer patients with BRCA mutation, MRI didn't show significant difference in morphologic characteristics, however breast cancers with BRCA gene mutation carriers tend to have benign morphologic features on MRI, such as Type 1 kinetic curve enhancement.
Breast ; Breast Neoplasms ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Neoplasm Metastasis

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Heart-Model-Based Automated Method for Left Ventricular Measurements in Cardiac MR: Comparison with Manual and Semi-automated Methods.

Seung Hoon CHAE ; Whal LEE ; Eun Ah PARK ; Jin Wook CHUNG

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):200-206. doi:10.13104/jksmrm.2013.17.3.200

PURPOSE: To assess the effect of applying an automated heart model based measurements of left ventricle (LV) and compare with manual and semi-automated measurements at Cardiovascular MR Imaging. MATERIALS AND METHODS: Sixty-two patients who underwent cardiac 1.5T MR imaging were included. Steady state free precession cine images of 20 phases per cardiac cycle were obtained in short axis views and both 2-chamber and 4-chamber views. Epicardial and endocardial contours were drawn in manual, automated, and semi-automated ways. Based on these acquired contour sets, the end-diastolic (ED) and end-systolic (ES) volumes, ejection fraction (EF), systolic volume (SV) and LV mass were calculated and compared. RESULTS: In EDV and ESV, the differences among three measurement methods were not statistically significant (P = .399 and .145, respectively). However, in EF, SV, and LV mass, the differences were statistically significant (P=.001, <001, <001, respectively) and the measured value from automated method tend to be consistently higher than the values from other two methods. CONCLUSION: An automatic heart model-based method grossly overestimate EF, SV and LV mass compared with manual or semi-automated methods. Even though the method saves a considerable amount of efforts, further manual adjustment should be considered in critical clinical cases.
Axis, Cervical Vertebra ; Heart ; Heart Ventricles ; Humans

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Dynamic Contrast-Enhanced MR Imaging in Detecting Local Tumor Progression after HIFU Ablation of Localized Prostate Cancer.

Jung Jae PARK ; Chan Kyo KIM ; Hyun Moo LEE ; Byung Kwan PARK ; Sung Yoon PARK

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):192-199. doi:10.13104/jksmrm.2013.17.3.192

PURPOSE: To retrospectively evaluate the diagnostic performance of dynamic contrast-enhanced MR imaging (DCE-MRI) in detecting recurrent prostate cancer after HIFU of clinically localized cancer, as compared with T2-weighted imaging (T2WI). MATERIALS AND METHODS: Twenty-six patients with increased prostate-specific antigen levels after HIFU were included in this study. All MR examinations were performed using T2WI and DCE-MRI, followed by transrectal ultrasound-guided biopsy. MRI and biopsy results were correlated in six prostate sectors. Residual or recurrent cancer after HIFU was defined as local tumor progression if biopsy results showed any cancer foci. Two independent readers interpreted the MR images. RESULTS: Of 156 prostate sectors, 51 (33%) were positive for cancer in 17 patients. For detecting local tumor progression, the sensitivity of DCE-MRI and T2WI was 80% and 57% for reader 1 (P < 0.001) versus 84% and 61% for reader 2 (P < 0.001), respectively. The specificity and overall accuracy between DCE-MRI and T2WI showed no statistical difference in both readers (P > 0.05). Interobserver agreement of DCE-MRI and T2WI was moderate and fair, respectively. CONCLUSION: For detecting local tumor progression of prostate cancer after HIFU, DCE-MRI was more sensitive than T2WI, with less interobserver variability.
Biopsy ; Humans ; Observer Variation ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Retrospective Studies ; Sensitivity and Specificity

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Serial MR Imaging of Magnetically Labeled Humen Umbilical Vein Endothelial Cells in Acute Renal Failure Rat Model.

Sun Joo LEE ; Sang Yong LEE ; Kyung Pyo KANG ; Won KIM ; Sung Kwang PARK

Journal of the Korean Society of Magnetic Resonance in Medicine.2013;17(3):181-191. doi:10.13104/jksmrm.2013.17.3.181

PURPOSE: To evaluate the usefulness of in vivo magnetic resonance (MR) imaging for tracking intravenously injected superparamagnetic iron oxide (SPIO)-labeled human umbilical vein endothelial cells (HUVECs) in an acute renal failure (ARF) rat model. MATERIALS AND METHODS: HUVECs were labeled with SPIO and poly-L-lysine (PLL) complex. Relaxation rates at 1.5-T MR, cell viability, and labeling stability were assessed. HUVECs were injected into the tail vein of ARF rats (labeled cells in 10 rats, unlabeled cells in 2 rats). Follow-up serial T2*-weighted gradient-echo MR imaging was performed at 1, 3, 5 and 7 days after injection, and the MR findings were compared with histologic findings. RESULTS: There was an average of 98.4+/-2.4% Prussian blue stain-positive cells after labeling with SPIO-PLL complex. Relaxation rates (R2*) of all cultured HUVECs at day 3 and 5 were not markedly decreased compared with that at day 1. The stability of SPIO in HUVECs was maintained during the proliferation of HUVECs in culture media. In the presence of left unilateral renal artery ischemia, T2*-weighted MR imaging performed 1 day after the intravenous injection of labeled HUVECs revealed a significant signal intensity (SI) loss exclusively in the left renal outer medulla regions, but not in the right kidney. The MR imaging findings at days 3, 5 and 7 after intravenous injection of HUVECs showed a SI loss in the outer medulla regions of the ischemically injured kidney, but the SI progressively recovered with time and the right kidney did not have a significant change in SI in the same period. Upon histologic analysis, the SI loss on MR images was correspondent to the presence of Prussian blue stained cells, primarily in the renal outer medulla. CONCLUSION: MR imaging appears to be useful for in vivo monitoring of intravenously injected SPIO-labeled HUVECs in an ischemically injured rat kidney.
Acute Kidney Injury ; Animals ; Cell Survival ; Cell Tracking ; Culture Media ; Endothelial Cells ; Ferric Compounds ; Ferrocyanides ; Follow-Up Studies ; Human Umbilical Vein Endothelial Cells ; Injections, Intravenous ; Iron ; Ischemia ; Kidney ; Magnetic Resonance Spectroscopy ; Magnets ; Rats ; Relaxation ; Renal Artery ; Track and Field ; Umbilical Veins ; Veins

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A Preliminary Results of Acoustic Noise Effect due to Gradient Pulsing in Functional MRI.

Sung Taek CHUNG ; In Chan SONG ; Hyun Wook PARK

Journal of the Korean Society of Magnetic Resonance in Medicine.1999;3(3):257-264.

PURPOSE: In functional MRI(fMRI), the acoustic noise effects of gradient pulsing are analyzed with two different combinations of readout and phase-encoding gradients for sagittal-view images. MATERIALS AND METHODS: Series of sagittal-view EPI images for fMRI obtained from five healthy volunteers. In order to show the effect of gradient pulsing noise, this study was duplicated for the Y readout / Z phase-encoding gradients and the Z readout / Y phase-encoding gradients. The first 7 images were obtained with visual stimulation. This sequential paradigm without and with visual stimulation was repeated 4 times, and was followed by the last 7 images being obtained without visual stimulation. In order to compare the visual cortex activation according to the combination of readout and phase-encoding gradients, the number of activated pixels and the average intensities of the activated pixels were analyzed, where the total activation is defined by multiplying the number of activated pixels by the average intensities of the activated pixels. RESULTS: The experimental results show that the combination of Z readout and Y phase-encoding gradients produce larger visual cortex activation than the combination of Y readout and Z phase-encoding gradients when a sagittal-view fMRI is performed. CONCLUSION: This experiment result represents that visual cortex response can be affected by acoustic noise. Therefore, the combination of the Z readout and Y phase encoding gradients is efficient for sagittal view fMRI because it has less acoustic noise.
Acoustics* ; Angiography* ; Healthy Volunteers ; Magnetic Resonance Imaging* ; Noise* ; Photic Stimulation ; Visual Cortex

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