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확산강조 뇌자기공명영상에서 대뇌 피질 고영상 병변을 보이는 임상적으로 진단된 크로이츠펠트-야콥병 4예
곽용태,방오영,김옥준,김원주 대한신경과학회 2006 대한신경과학회지 Vol.24 No.6
A high signal in the cerebral cortex and/or basal ganglia on a diffusion-weighted MRI (DWI) has been described as a good diagnostic marker for sporadic Creutzfeldt-Jakob disease (sCJD). We report four cases of sCJD with atypical clinical presentations and ribbon-like areas of high signals in the cerebral cortex on DWI. DWI patterns of asymmetric cortical high signals in the cerebral cortex may offer the means for diagnosis of sCJD early in the course of the illness even when the clinical presentations are atypical.
최영민,김성민,곽동원,이형식,강명구,이동근,허원주 대한방사선종양학회 2018 Radiation Oncology Journal Vol.36 No.2
Purpose: To explore the feasibility of maximum diameter as a response assessment method for vestibular schwannomas (VS) after stereotactic radiosurgery or fractionated stereotactic radiotherapy (RT), we analyzed the concordance of RT responses between maximum diameters and volumetric measurements. Materials and Methods: Forty-two patients receiving curative stereotactic radiosurgery or fractionated stereotactic RT for VS were analyzed retrospectively. Twelve patients were excluded: 4 did not receive follow-up magnetic resonance imaging (MRI) scans and 8 had initial MRI scans with a slice thickness >3 mm. The maximum diameter, tumor volume (TV), and enhanced tumor volume (ETV) were measured in each MRI study. The percent change after RT was evaluated according to the measurement methods and their concordances were calculated with the Pearson correlation. The response classifications were determined by the assessment modalities, and their agreement was analyzed with Cohen kappa statistics. Results: Median follow-up was 31.0 months (range, 3.5 to 86.5 months), and 90 follow-up MRI studies were analyzed. The percent change of maximum diameter correlated strongly with TV and ETV (r(p) = 0.85, 0.63, p = 0.000, respectively). Concordance of responses between the Response Evaluation Criteria in Solid Tumors (RECIST) using the maximum diameters and either TV or ETV were moderate (kappa = 0.58; 95% confidence interval, 0.32-0.85) or fair (kappa = 0.32; 95% confidence interval, 0.05-0.59), respectively. Conclusions: The percent changes in maximum diameter and the responses in RECIST were significantly concordant with those in the volumetric measurements. Therefore, the maximum diameters can be used for the response evaluation of VS following stereotactic RT.