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소아의 수아세포종양 수술후 자기공명영상소견 뇌수막 조영증강의 중요성
최충곤 대한영상의학회 1993 대한영상의학회지 Vol.29 No.2
To differentiate the postoperative changes from the recurrence of tumor and to evaluate MR imaging of early postoperative leptomeningeal seeding in medulloblastoma, we have retrospectively analysed 34 cases of MR images of 17 patients who were confirmed as medulloblastoma by histopaghology, Noncontrast and postcontrast T1 weighted MR images were obtained in all patients. In 11 patients follow-up MR was done more than once (average:1.5 times) and average interval of MR imaging was 6 months. The timing of 34 MR images was as follow : 6case within 2 months, 9cases between 2 months and 1 year, 19 cases more than 1 year after surgery respectively. MR images within 2 month after surgery revealed contrast enhancement at operation site and adjacent meninges, hemorrhage, residual tumor, in pateints who had no evidence of tumor recurrence, these early postoperative changes were markedly decreased within 6 month after sugery. MR images obtained more than 1 year after surgery showed no abnormal contrast enhancement or mild focal dural enhancement at operation site. Diffuse moderate dural enhancement was noted in one patient who had the history of post-surgical subdural hemorrhage. In six patients with tumor recurrences which were detected from as early as 9 months to 6 years after surgery, the findings of recurrence included leptomeningeal nodules, linear or irregular sulcus obliterating enhancing lesions, enhancing mass at primary or metastatic site. We have concluded that leptomeningeal enhancement detected after 6 months of surgery is an important MR finding suggesting the possibility of tumor recurrence. Small nodular and linear enhancement of leptomeninges at brainstem or cerebellar surfance is considered as the early manifestation of intracranial tumor seeding.
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최충곤 대한영상의학회 1995 대한영상의학회지 Vol.33 No.4
Purpose : The purpose of this study is to find helpful MR findings for predicting anaplasticoligodendrogliomas. Materials and Methods : Retrospective analysis of 46 MR images and 37 CT scans was performedfor 46 patients with pathologically-proven cerebral oligodendrogliomas. A neuropathologist graded the tumors asone of low-grade (n=16), intermediate-grade (n=12), or anaplastic oligodendroglioma (n=18). MR imaging featureswere retrospectively analysed with respect to histologic grading of the tumors. Results : Contrast enhancement wasobserved always in anaplastic group (17/17), in a portion of intermediate-grade group (4/10) but not in low-gradegroup (0/14). Peritumoral edema was observed infrequently in anaplastic group (4/18) or intermediate-grade group(1/12). Cystic changes (25/46) or calcifications on CT Scans (14/37) were not related with histologic grading.Grossly identifiable hemorrhage was rare in this series (2/46). Among the various imaging features, only tumorenhancement and peritumoral edema were statistically significant for trend test (p<0.05). Conclusion : Whenconsidering the diagnosis of oligodendrogliomas, the presence of contrast enhancement or peritumoral edema is ahelpful features suggesting anaplastic oligodendrogliomas.
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최충곤 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.2
The limbic system plays an important role in attention, memory, and the emotions. The limbic lobe comprises four C-shaped arches stretching from the medial surface of frontal lobe to the temporal pole. These structures are limbic gyrus (subcallosal area-cingulated gyrus-parahippocampal gyrus-uncus), Broca's intralimbic gyrus (paraterminal gyrus-supracallosal gyrushippocampal tail, body, head), hippocampal and callosal sulcus, and fimbria/fornix. These gross anatomical relationships can be clearly demonstrated by high-resolution MR imaging.
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최충곤 대한뇌졸중학회 2000 Journal of stroke Vol.2 No.1
Proton MR Spectroscopy란 ?자기공명분광 기법은 원래 핵자기공명(nuclear magnetic resonance; NMR) 현상을 이용하는 물질분석의 도구로 자기공명영상(magnetic resonance imaging; MRI)이 개발되기 이전부터 물리화학분야에서 널리 이용되고 있었다. 그러나 이 기법의 생체 및 인체에 대한 적용은 비교적 최근에 이르러서야 가능하게 되었는데 초기에는 인 자기공명분광법(Phosphorous MR Spectroscopy; 31PMRS)를 이용한 연구가 많이 진행되었으나 이 기법은 시간이 오래 걸리고 해상도가 매우 낮아 지금은 일부 동물실험이나 연구소에서만 이용되고 임상적으로는 거의 이용되지 않고 있다. 이후에 양성자 자기공명분광법(Proton MR Spectroscopy; 1H MRS)나 탄소 자기공명분광법(Carbon MR Spectroscopy, 13C MRS)이 개발되었는데 이중 양성자 즉 수소원자핵을 이용한 자기공명분광법(1H MRS)이 임상적으로 가장 널리 이용되고 있다. 따라서 본고에서는1H MRS만을 다루기로 한다. Korean Journal of Stroke 2000;2(1): 8~13
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사지에 생긴 신경섬유초종의 자기공명영상 : 병리조직소견과의 비교
최충곤 대한영상의학회 1993 대한영상의학회지 Vol.29 No.4
Neuilemmomas of the extremities are nerve sheath tumors involving peripheral nerves of the extremities. We analyzed MR images of 16 surgically proved tumors in 12 patients and compared the MR images with gross pathologic specimens in two tumors (2/16) Spin echo T1-weighted images were obtained in all the patients but T2-weighted images were obtained in six patients with a gratients (15/16) Signal on T1-weighted images was iso or slightly higher than that of the adjacent muscles. Siganl on T2-weighted images ranged from homogenous high to heterogeneous. After Gadolinium injection, all the 15 tumors showed enhancement. Small sized tumors were enhanced homogeneously but there was a tendency to be enhanced heterogeneously to the central portion with peripheral rim enhancement as the size of the tumors increasesd. Pathologically, the enhanced protion with correlated the with solid portion of the tumors. Also encapsulation of the mass (12/16) suspended nerve strings (9/16) and bony erosion (1/16) were detected. MR characteristics of neurilemmoma include heterogeniety on enhanced T1 and T2 weighted images. encapsulation, and suspended nerve strings. Signal heterogeneity on enhanced T1 and T2 weignted images may be attributed to the variable cellularity, cystic changes, vascularity and focal hemorrhage of the tumors.
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