MR-histological Correlations of Wallerian Degeneration in Spinal Cord Injury

Cho, Kyoung-Suok,Bunge, Richard P.,Choi, Chang-Rak 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

본 연구의 목적은 척수 손상 후 위 또는 아래 level에서 wallerian degeneration의 MR 소견을 관찰하고, 척수 손상 후 magnetic resonance(MR)에 이상 소견이 나타나는 time interval 관찰하며 그리고 MR 소견과 post mortem histopathology 비교하는데 있다. 척수손상후 사망까지 생존 기간이 8일부터 22년까지 다양한 23명의 척수손상 환자에서 post mortem에 척수를 채취해서 T1과 T2 weighted MR imaging 얻었고, 조직검사는 MR section과 같은 level에서 axon, myelin, connective tissue stain 실시하여 MR 소견과 비교하였다. 결과는 척수손상 후 7주 이후에 사망한 모든 예에서, 손상된 척수 위 level의 dorsal column과 아래 level의 lat, corticospinal tract에서 MR 소견상 increased signal intensity 나타났다. 그리고 손상 후 8일만에 사망한 예에서는 MR 소견상 변화는 없지만, 조직 검사상 wallerian degeneration이 손상의 위 level dorsal column에서는 나타났지만 아래 level의 lat, corticospinal tract에서는 보이지 않았다. 그러나 12일 후 사망한 예에서는 wallerian degeneration이 척수손상 위 dorsal column과 아래 lat, corticospinal tract에서 MR의 이상 소견이 보였다. 결론적으로 척수손상 후 Wallerian degeneration이 나타나지만, 손상 level 위의 dorsal column과 아래의 lat, corticospinal tract의 wallerian degeneration은 최소한 7주 이상이 지나야 MR에서 변화가 보인다. MR로서 wallerian degeneration 관찰함으로 척수손상의 정확한 분석과, epicenter로부터 멀리 떨어진 부위의 MR signal 변화의 설명, 그리고 나아가서는 치료의 평가에도 유용하게 이용될 것으로 생각된다. The purpose of this study were to describe the magnetic resonance(MR) manifestations of wallerian degeneration occurring above and below a spinal cord injury site, to determine the post-injury time interval when the wallerian degeneration becomes evident in MR images, and to correlate the MR findings with post mortem histopathology. Twenty-three postmortem spinal cords, all from patients with cervical (14), thoracic (5), and lumbar (4) cord, injuries, were studied with axial T1- and T2-weighted spin-echo MR imaging. Injury to death intervals varied from 8 days to 22 years. We examined these specimen for abnormal cord contour and alteration of signal above and below the injury site. Histological studies of these cords with axon, myelin, and connective tissue stains were performed at levels equivalent to the MR sections. Studies using plastic embedded sections and antibodies to Glial Fibrillarg Acetic Protein(GF AP) were also performed on some of the above cords. Pathological-imaging correlations were made. MR images of the cord specimen showed increased signal intensity in the dorsal columns above the injury level as well as in the lateral corticospinal tracts below the injury level in all cases in which cord injury had occurred seven or more weeks premortem. In one case where cord injury had occurred eight days prior to death the MR showed no signal abnormalites : histological analysis showed evidence of early wallerian degeneration in the dorsal columns above the lesion but no change was detected in the lateral columns below the lesion. After 12 days, early stage wallerian degeneration was detected by histological examination in both the lateral columns below the lesion and in the dorsal columns above the lesion. Wallerian degeneration in spinal cords, as demonstrated by histological examination, was identified on MR as areas of increased T2 weighted signal intensity site in the dorsal column above the injury site and in the corticospinal tracts below the injury site in all specimen in which the injury-to-death interval was greater than 7 weeks. The ability to recognize wallerian degeneration on MR allows a more comprehensive analysis of the injury, explains abnormal MR signals at sites that are remote from the epicenter of injury, and may be helpful in the assessing of results of therapeutic interventions.

급성 거미막하 출혈의 진단: FLAIR MR영상과 조영전 CT와의 비교

최원진,최대섭,김정혜,김순,이현경,오연희,김승현,이성우,김욱년,이규춘,Choi, Won-Jin,Choi, Dae-Seob,Kim, Joung-Hae,Kim, Soon,Lee, Hyeon-Kyeong,Oh, Yoen-Hee,Kim, Seung-Hyeon,Lee, Sung-Woo,Kim, Wook-Nyeon,Lee, Kyu-Chun 대한자기공명의과학회 2001 Investigative Magnetic Resonance Imaging Vol.5 No.2

목적 : 급성 거미막하 출혈의 진단에 있어 CT와 비교하여 fluid-attenuated inversion-recovery (FLAIR) MR영상의 유용성을 평가하고자 하였다. 대상 및 방법 : 증상 발생 3일 이내에 비조영 CT와 FLAIR MR영상을 모두 얻었던 28명의 급성 지주막하 출혈 환자를 대상으로 하였다. 거미막하 공간을 피질구, 실비우스열구, 기저조, 후두와의 4부위로 나누어 각 부위 별로 CT와 FLAIR영상에서 출혈이 보이는 정도를 0(출혈 없음), 1(출혈 의심), 2(뚜렷한 출혈)의 점수로 구분하여 평가하였다. 또한 이들 28명 환자와 대조군 35명의 FLAIR영상을 비교하여 거미막하 공간의 고신호 강도를 기준으로 출혈의 유무를 판정할 경우, FLAIR영상의 민감도, 특이도 및 진단적 정확도를 평가하였다. 결과 : FLAIR영상에서 급성 거미막하 출혈은 모든 환자에서 뇌척수액이나 뇌 실질보다 고신호 강도를 보여 100%의 발견율을 보였다. CT와 비교하여 피질구($1.11{\pm}0.80$ vs $0.70{\pm}0.83$: p(0.05)와 후두와($1.41{\pm}0.74$ vs $0.78{\pm}0.80$: p(0.05)에서 FLAIR영상이 CT보다 통계적으로 유의하게 우수하였다 FLAIR영상에서 거미막하 공간의 고신호 강도를 기준으로 거미막하 출혈 유무를 평가한 결과에서 100%의 민감도, 특이도 및 진단적 정확도를 보였다. 결론 급성 거미막하 출혈의 진단에 FLAIR MR영상은 매우 유용하며, 특히 출혈의 양이 소량인 경우와 후두와의 출혈을 진단하는데 CT보다 우수하다. Purpose : Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. Materials and methods ; We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. Results : FLAIR MR image was superior to CT in detecting SAH in the posterior fossa ($1.41{\pm}0.74{\;}vs{\;}0.78{\pm}0.80$; p<0.05) and cortical sulci ($1.11{\pm}0.80{\;}vs{\;}0.70{\pm}0.83$; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. Conclusion : FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.

악성흉막중피종의 병기판정에서 자기공명영상의 진단적 유용성 평가

이은솔,채은진,강선지,염유경,이현주,박종천,신소연,최윤영,최준호,도경현 대한자기공명의과학회 2013 Investigative Magnetic Resonance Imaging Vol.17 No.3

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. 목적 : 악성흉막중피종 (이하 MPM)의 임상적 병기판정에 있어 자기공명영상 (이하 MR)의 진단적 유용성을 컴퓨터단층촬영(이하 CT)과 비교하였다. 대상 및 방법 : 1997년부터 2012년까지 MPM으로 확인된 환자 중 진단 시 CT와 MR을 얻은 환자 20명 (남:여=14:6; 평균연령= 53.5세)을 대상으로 하였다. CT 혹은 MR 단독을 이용하여 두 명의 영상의학과 의사가 의견 일치 하에 병기판정을시행하였다. 수술적 병기판정을 받은 환자의 경우 이와 비교하여 CT 단독 및 CT와 MR을 함께 시행하였을 때의 진단적 정확도를 평가하였다. 또 CT 단독과 CT와 MR을 함께 시행하였을 때의 임상병기의 일치도를 비교하였다. 결과 : CT를 이용한 T stage의 정확도는 23.1% (3/13)였고 MR과 함께 시행한 경우 38.5% (5/13)였다. CT 및 MR을함께 시행한 경우 수술 후 수술적 병기에서 5명의 환자는 상위 진단을, 3명의 환자는 하위 진단을 보였다. CT 단독 및 CT와MR을 함께 시행한 병기를 서로 비교하였을 때 85.0% (17/20)의 일치도를 보였고 불일치한 예(3명)에서는 함께 시행한경우 CT 단독보다 상위 진단을 하였다. 결론 : MPM의 병기판정에 있어서 MR을 함께 시행한 경우 CT 단독에 비해 보다 높은 정확도의 병기판정을 제공하여 수술대상이 되는 환자에서 수술 전 검사로서 중요한 역할을 수행할 것으로 기대된다.

급성 뇌실내 출혈의 발견: FLAIR MR영상과 조영전 CT와의 비교

최원진,최대섭 대한영상의학회 2003 대한영상의학회지 Vol.48 No.2

Purpose: To compare the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging with that of unenhanced CT in the detection of acute intraventricular hemorrhage (IVH). Materials and Methods: Thirty-four patients with acute IVH underwent FLAIR MR imaging and unenhanced CT within three days of the onset of symptoms. Except in one patient, all MR studies were performed after CT. The mean time intervals between CT and symptom onset and between CT and MR examinations were six and five hours, respectively. Two radiologists evaluated the detectability and conspicuity of acute IVH at FLAIR MR imaging and unenhanced CT. Positive imaging criteria in the detection of acute IVH were intraventricular hyperintensity at FLAIR MRI and hyperattenuation at CT. Results: Acute IVH was detected in all patients at FLAIR MR imaging and in 30 (88%) of 34 patients at unenhanced CT. In 32 patients (94%), the conspicuity of IVH at FLAIR MR imaging was as good as or better than that at unenhanced CT. Conclusion: FLAIR MR imaging was superior to unenhanced CT in the detection of acute IVH. 목적: 급성 뇌실내 출혈의 발견에 있어 fluid-attenuated inversion recovery(FLAIR) MR영상의 유용성을 평가하고자 하였다. 대상과 방법: 뇌실내 출혈로 진단된 환자 중 3일 이내의 급성기에 비조영 CT와 FLAIR MR영상을 모두 얻었던 34명의 환자를 대상으로 하였다. 1예를 제외한 전 예에서 CT를 먼저 시행하였으며, 증상발현 후 CT검사까지의 시간간격은 평균 6시간이었고, CT와 MR검사 사이의 시간간격은 평균 5시간이었다. CT와 FLAIR MR영상에서 출혈의 존재 유무를 평가하였다. 출혈의 진단기준은 뇌실내에 인접한 뇌실질보다 높은 감쇠 또는 신호강도의 병변이 있을 때로 하였다. 다음으로 CT와 FLAIR MR영상에서 출혈이 보이는 정도(명확도)를 상호 비교 평가하였다. 두 명의 방사선과 의사가 독립적으로 판정하였으며, 판정의 불일치가 있는 예에서는 나중에 합의하여 판정하였다. 결과: 출혈의 존재 유무의 평가에 있어 FLAIR MR영상에서는 전 예에서 뇌실내 출혈을 발견할 수 있었고, CT에서는 34예 중 30예에서 발견할 수 있어 88%의 발견율을 보였다. 병변의 명확성을 상호 비교 평가한 결과에서 17예(50%)에서 FLAIR MR영상이 CT보다 우수하였으며, 15예(44%)에서는 비슷하였고, 2예에서는 CT가 우수하였다. 결론: 급성 뇌실내 출혈의 발견에 FLAIR MR영상은 CT보다 더 유용하였다.

Integrated Whole Body MR/PET: Where Are We?

류혜진,이재성,이정민 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.1

Whole body integrated magnetic resonance imaging (MR)/positron emission tomography (PET) imaging systems have recently become available for clinical use and are currently being used to explore whether the combined anatomic and functional capabilities of MR imaging and the metabolic information of PET provide new insight into disease phenotypes and biology, and provide a better assessment of oncologic diseases at a lower radiation dose than a CT. This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions. Various early clinical applications of integrated MR/PET are also addressed. Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.

Evaluation of the keyhole technique applied to the proton resonance frequency method for magnetic resonance temperature imaging

Han, YongHee,Mun, ChiWoong Wiley Subscription Services, Inc., A Wiley Company 2011 Journal of magnetic resonance imaging Vol.34 No.5

<P><B>Abstract</B></P><P><B>Purpose:</B></P><P>To evaluate the temporal and spatial resolution of magnetic resonance (MR) temperature imaging when using the proton resonance frequency (PRF) method combined with the keyhole technique.</P><P><B>Materials and Methods:</B></P><P>Tissue‐mimicking phantom and swine muscle tissue were microwave‐heated by a coaxial slot antenna. For the sake of MR hardware safety, MR images were sequentially acquired after heating the subjects using a spoiled gradient (SPGR) pulse sequence. Reference raw (<I>k</I>‐space) data were collected before heating the subjects. Keyhole temperature images were reconstructed from full <I>k</I>‐space data synthesized by combining the peripheral phase‐encoding part of the reference raw data and the center phase‐encoding keyhole part of the time sequential raw data. Each keyhole image was analyzed with thermal error, and the signal‐to‐noise ratio (SNR) was compared with the self‐reference (nonkeyhole) images according to the number of keyhole phase‐encoding (keyhole‐data size) portions.</P><P><B>Results:</B></P><P>In applied keyhole temperature images, smaller keyhole‐data sizes led to more temperature error increases, but the SNR did not decreased comparably. Additionally, keyhole images with a keyhole‐data size of <16 had significantly different temperatures compared with fully phase‐encoded self‐reference images (<I>P</I> < 0.05).</P><P><B>Conclusion:</B></P><P>The keyhole technique combined with the PRF method improves temporal resolution and SNR in the measurement of the temperature in the deeper parts of body in real time. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc.</P>

Integrated Whole Body MR/PET: Where Are We?

Yoo, Hye Jin,Lee, Jae Sung,Lee, Jeong Min The Korean Society of Radiology 2015 KOREAN JOURNAL OF RADIOLOGY Vol.16 No.1

<P>Whole body integrated magnetic resonance imaging (MR)/positron emission tomography (PET) imaging systems have recently become available for clinical use and are currently being used to explore whether the combined anatomic and functional capabilities of MR imaging and the metabolic information of PET provide new insight into disease phenotypes and biology, and provide a better assessment of oncologic diseases at a lower radiation dose than a CT. This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions. Various early clinical applications of integrated MR/PET are also addressed. Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.</P>

CycleGan 딥러닝기반 인공CT영상 생성성능에 대한 입력 MR영상의 T1 및 T2 가중방식의 영향

이사무엘,정종훈,김진영,이연수 한국방사선학회 2024 한국방사선학회 논문지 Vol.18 No.1

MR은 우수한 연조직 대비와 기능 정보를 보여줄 수 있지만, 방사선치료에서 정확한 선량 계산을 위해서는 CT영상의 전자밀도 정보가 필요하다. 방사선치료(Radiotherapy) 계획 워크플로우에서 MR영상과 CT영상을 융합하기 위해 환자는 일반적으로 MR과 CT영상 방식 모두에서 스캔된다. 최근에 딥러닝기술 덕분에 MR영상에서 딥러닝 기반의 CT영상 생성이 가능해졌다. 이로 인해 CT 스캔 작업을 할 필요가 없게 된다. 본 연구에서는 MR영상으로부터 CycleGan 딥러닝 기반 CT영상생성을 구현했다. T1가중이나 T2가중 중에 한가지 또는 그 둘다의 MR영상을 가지고 합습한 3가지의 인공지능 CT생성기를 만들었다. 결과에서 우리는 T1가중 MR 영상 기반으로 학습한 생성기가 T1가중 MR영상이 입력될 때 다른 CT생성기보다 더 나은 결과를 생성할 수 있음을 발견했다. 반면, T2가중 MR영상 기반 CT생성기는 T2가중 MR영상을 입력 받을 때, 다른 시퀀스기반 CT생성기보다 더 나은 결과를 생성할 수 있습니다. MR영상을 기반으로 한 CT생성기는 곧 임상현장에 적용될 수 있는 기술이다. 특정 시퀀스 MR영상으로 학습한 머신러닝 CT생성기는 다른 시퀀스 MR영상으로 학습한 생성기보다 더 그 특정 시퀀스와 같은 MR영상을 입력받을 때 더 나은 CT영상을 생성할 수 있음을 보여주었다. Even though MR can reveal excellent soft-tissue contrast and functional information, CT is also required for electron density information for accurate dose calculation in Radiotherapy. For the fusion of MRI and CT images in RT treatment planning workflow, patients are normally scanned on both MRI and CT imaging modalities. Recently deep-learning-based generations of CT images from MR images became possible owing to machine learning technology. This eliminated CT scanning work. This study implemented a CycleGan deep-learning-based CT image generation from MR images. Three CT generators whose learning is based on T1- , T2- , or T1-&T2-weighted MR images were created, respectively. We found that the T1-weighted MR image-based generator can generate better than other CT generators when T1-weighted MR images are input. In contrast, a T2-weighted MR image-based generator can generate better than other CT generators do when T2-weighted MR images are input. The results say that the CT generator from MR images is just outside the practical clinics and the specific weight MR image-based machine-learning generator can generate better CT images than other sequence MR image-based generators do.

The Clinical Feasibility of Using Non-Breath-Hold Real-Time MR-Echo Imaging for the Evaluation of Mediastinal and Chest Wall Tumor Invasion

이창현,구진모,김영태,이현주,박창민,박은아,이호연,강미진,송인찬 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.1

Objective: We wanted to determine the clinical feasibility of using non-breathhold real-time MR-echo imaging for the evaluation of mediastinal and chest wall tumor invasion. Materials and Methods: MR-echo imaging was prospectively applied to 45 structures in 22 patients who had non-small cell lung cancer when the tumor invasion was indeterminate on CT. The static MR imaging alone, and the static MR imaging combined with MR-echo examinations were analyzed. The surgical and pathological findings were compared with using the Wilcoxon-signed rank test and McNemar’s test. Results: The accuracy, sensitivity and specificity of the combined MR-echo examination and static MR imaging for determining the presence of invasion were 84%, 83% and 85%, respectively, for the first reading session and they were 87%, 83% and 87%, respectively, for the second reading session (there was substantial interobserver agreement, k = 0.74). For the static MR imaging alone, these values were 62%, 83% and 59%, respectively, for the first reader and they were 69%, 67% and 74%, respectively, for the second reader (there was moderate interobserver agreement, k = 0.49). The diagnostic confidence for tumor invasion was also higher for the combined MR-echo examination and static MR imaging than that for the static MR imaging alone (p < 0.05). Conclusion: The combined reading of a non-breath-hold real-time MR-echo examination and static MR imaging provides higher specificity and diagnostic confidence than those for the static MR imaging reading alone to determine the presence of mediastinal or chest wall tumor invasion when this was indeterminate on CT scanning. Objective: We wanted to determine the clinical feasibility of using non-breathhold real-time MR-echo imaging for the evaluation of mediastinal and chest wall tumor invasion. Materials and Methods: MR-echo imaging was prospectively applied to 45 structures in 22 patients who had non-small cell lung cancer when the tumor invasion was indeterminate on CT. The static MR imaging alone, and the static MR imaging combined with MR-echo examinations were analyzed. The surgical and pathological findings were compared with using the Wilcoxon-signed rank test and McNemar’s test. Results: The accuracy, sensitivity and specificity of the combined MR-echo examination and static MR imaging for determining the presence of invasion were 84%, 83% and 85%, respectively, for the first reading session and they were 87%, 83% and 87%, respectively, for the second reading session (there was substantial interobserver agreement, k = 0.74). For the static MR imaging alone, these values were 62%, 83% and 59%, respectively, for the first reader and they were 69%, 67% and 74%, respectively, for the second reader (there was moderate interobserver agreement, k = 0.49). The diagnostic confidence for tumor invasion was also higher for the combined MR-echo examination and static MR imaging than that for the static MR imaging alone (p < 0.05). Conclusion: The combined reading of a non-breath-hold real-time MR-echo examination and static MR imaging provides higher specificity and diagnostic confidence than those for the static MR imaging reading alone to determine the presence of mediastinal or chest wall tumor invasion when this was indeterminate on CT scanning.

절제된 정상위벽의 자기공명영상기법에 관한 연구:조직소견과의 비교

서보경,설혜영,이남준,차인호,정규병,김정혁,박철민,이지영,Seo, Bo-Gyeong,Seol, Hye-Yeong,Lee, Nam-Jun,Cha, In-Ho,Jeong, Gyu-Byeong,Kim, Jeong-Hyeok,Park, Cheol-Min,Lee, Ji-Yeong 대한영상의학회 2001 대한영상의학회지 Vol.45 No.5

목적:급속자기공명영상기법을 이용하여 절제된 정상위벽을 관찰하고,이를 조직소견과 비교 연구하여,위벽의 관찰을 위한 최적기법을 찾고자 하였다. 대상과 방법:25명 환자의 모두 41개 절제된 정상위조직을 수술후 수지(polyethylene)통에 넣고,생리식염수로 채워 자기공명영상을 시행하였다.T1강조FLASH,지방억제T1강조FLASH, T2강조TSE와 True-FISP 등 4가지 기법으로 위조직의 영상을 얻었다.자기공명영상에서는 위벽의 층수와 각층의 신호강도를 관찰하였고,이를 조직소견과 비교하였다.자기공명영상소견을 조직소견과 비교한 후 위벽 각층의 명확성과 각층간의 구분,및 전체 영상의 질에 대하여 비교하였다.4가지 기법 중 가장 좋은 방법은 3,가장 나쁜 방법은 0으로 하여 등급을 판정하였다. 결과:자기공명영상에서 위벽의 층수는 T1강조FLASH에서 2층이 41예 중 6예(14.6%),3층 31예(75.6%),및 4층 4예(9.8%)였고,지방억제T1강조FLASH에서 2층 6예(14.6%)와 3층 35예(85.4%),T2강조TSE에서 3층 24예(58.5%),4층 11예(26.8%),및 5층 6예(14.6%)였으며,True-FISP에서 1층 2예(4.9%),2층 8예(19.5%),3층 23예(56.0%),4층은 4예(9.8%), 및 5층 4예(9.8%)이었다.위벽의 신호강도는 T1강조FLASH와 지방억제T1강조FLASH에서 2층으로 보인 예는 위내강으로부터 고-중등도,3층인 경우는 고-저-고/중등도,4층인 예는 고-저-고-중등도신호강도였다.T2강조TSE에서는 3층으로 보인 예는 등도/고-저-중등도,4 층인 경우는 중등도-저-고-중등도/저,5층인 예는 저-고-저-고-저신호강도였다.자기공명 영상소견을 조직소견과 비교하였을 때 위벽이 3층으로 보인 경우 이것은 “점막층-점막하층-근층 ”에 해당하였다.관찰한 3가지 면 모두에서 T1강조FLASH,지방억제T1강조FLASH,T2강조TSE 기법이 True-FISP보다 통계적으로 유의하게 우수하였다(p=0.001).점막층의 명확성에 있어서 가장 우수한 기법은 T1강조FLASH와 지방억제T1강조FLASH이었고(p<0.05),점막하층의 명확성과 점막하층과 근층간의 구분은 T2강조TSE가 가장 우수하였다(p<0.05).전체적인 영상의 질은 T1강조FLASH와 T2강조TSE에서 가장 우수하였다(p<0.05). 결론:자기공명영상은 위벽의 각 층을 구별할 수 있는 우수한 검사로 조직소견과 높은 연관성을 보이며,전체 영상의 질,점막하층의 명확성 및 점막하층과 근층간의 구분이 T2강조TSE에서 가장 우수한다. Purpose: To evaluate normal human gastric wall layers in vitro using magnetic resonance*(MR) imaging, to correlate the results with the histologic findings, and to determine the optimal technique for evaluation of the gastric wall. Materials and Methods: Forty-one normal resected gastric specimens obtained from 25 patients were dissected and placed in a polyethylene tube filled with normal saline. MR imaging with four MR sequences, T1-weighted FLASH*(T1FLASH), fat-saturated T1-weighted FLASH, T2-weighted TSE*(T2TSE), and True-FISP, was performed. The number of gastric wall layers and signal intensity of each layer were determined, and after correlating MR images with the histologic findings, the conspicuity of each layer*(mucosa, submucosa, and muscle), the distinction between each layer, and overall image quality were assessed. results: The gastric wall was shown by TIFLASH to have two (n=6, 14-6%), three (n=31, 75.6%) and four layers (n=4, 9.8%); by fat-saturated TIFLASH to have two (n=6, 14.6%) and three (n=35, 85.4%) ; by T2TSE to have three (n=24, 58.5%), four (n=11, 26.8%), and five (n=6, 14.6%); and by True-FISP to have one (n=2, 4.9%), two (n=8, 19.5%), three (n=23, 56%), four (n=4, 9.8%), and five (n=4, 9.8%) . The signal intensity of each layer at T1FLASH and fat-saturated T1FLASH was high-intermediate from the lumen in two-layer cases, high-low-high/intermediate in three-layer cases, and high-low-high-intermediate in four-layer cases. The signal intensity of each layer at T2TSE was intermediate/high-low-intermediate in three-layer cases, intermediatelow-high-intermediate/low in four-layer cases, and low-high-low-high-low in five-layer cases. Three-layered gastric wall corresponded mostly to mucosa, submucosa, and muscle from the inner to outer layers, respectively. T1FLASH, fat-saturated T1FLASH, and T2TSE were superior to True-FISP in evaluating the gastric wall. T1FLASH and fat-saturated T1FLASH were the best sequences for demonstrating mucosa (p<0.05), and T2TSE was the best for submucosa and the distinction between this and muscle (p<0.05). Both T1FLASH and T2TSE provided the best overall image quality (p<0.05). Conclusion: In-vitro MR imaging is an excellent technique for the evaluation of layers of normal gastric wall. T2TSE is the sequence which best demonstrates the conspicuity of submucosa, the distinction between submucosa and muscle, and overall image quality.