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        Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology

        김매란,황재연,이연주,김용우,변신연,이윤진,염정아,전웅배,추기석,남경진,Storm Nicholas Shaun Reid 대한영상의학회 2020 대한영상의학회지 Vol.81 No.6

        Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion- weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion- restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

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        Acoustic radiation force impulse imaging of biopsy-proven Kikuchi disease: initial experiences for evaluating feasibility in pediatric patients

        이정민,황재연,배지연,김매란,김용우,박수은,염정아,노지은 대한초음파의학회 2019 ULTRASONOGRAPHY Vol.38 No.1

        Purpose: This study evaluated the feasibility of acoustic radiation force impulse (ARFI) elastography and characterized the sonographic features of lymph nodes (LNs) with Kikuchi disease in pediatric patients. Methods: Seventy-six cervical LN biopsies were performed for the diagnosis of cervical lymphadenopathy. ARFI imaging was performed, and the characteristic ultrasound features of the biopsied LNs and the contralateral LNs were analyzed. We also reviewed clinical and conventional ultrasonographic findings. Results: On histology, 56 patients were diagnosed with Kikuchi disease. These LNs were large and elongated, with increased perinodal echogenicity and capsular thickening. In 38 of them, ARFI elastography was performed, and the median shear wave velocity (SWV) of the biopsied LNs with Kikuchi disease (2.19 m/sec; range, 1.45 to 4.57 m/sec) was higher than of the contralateral LNs (1.72 m/sec; range, 0.95 to 2.65 m/sec; P<0.001). In patients with reactive hyperplasia, the mean SWV of the biopsied LNs (2.00 m/sec; range, 1.49 to 2.26 m/sec) was higher than that of the contralateral LNs (1.55 m/sec; range, 1.21 to 2.32 m/sec; P=0.031). Conclusion: The SWV of LNs with Kikuchi disease was significantly higher than that of the contralateral LNs. Morphologically, LNs with Kikuchi disease showed an enlarged, elongated, and oval shape, increased perinodal echogenicity, and capsular thickening. In addition to the conventional ultrasonographic findings, the application of ARFI is feasible even in pediatric patients for the evaluation of cervical lymphadenopathy

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        The Relationship between Neural Foraminal Stenosis and Imaging Features of Lumbar Spine MRI in Patients Older Than 60 Years with Lumbar Radiculopathy

        이계영,정희석,박찬규,김매란,류화성,노지은,염정아,김진혁,김태언,전창호 대한영상의학회 2021 대한영상의학회지 Vol.82 No.4

        Purpose To investigate the MRI features associated with neural foraminal stenosis (NFS) in patients older than 60 years with lumbar (L) radiculopathy. Materials and Methods This study included 133 retrospectively selected patients older than 60 years with lumbar radiculopathy who had undergone a lumbar spine MRI (from January 2018 to April 2018). For L4/L5 and L5/sacral (S)1 levels, NFS was reviewed blindly by two radiologists. Spondylolisthesis, retrolisthesis, disc height loss, disc bulging/herniation/central canal stenosis, ligamentum flavum thickening, and facet hypertrophy were evaluated separately for the NFS and non-NFS groups, and they were compared using univariate and multivariate analyses. Results The univariate analysis revealed that disc height loss (p = 0.006) was associated with NFS for L4/L5. For L5/S1, both spondylolisthesis (p = 0.005) and facet hypertrophy (p = 0.006) were associated with NFS. The multivariate logistic analysis revealed that disc height loss was associated with NFS for L4/L5 [odds ratio (OR) = 4.272; 95% confidence interval (CI) 1.736– 10.514]. For L5/S1, spondylolisthesis (OR = 3.696; 95% CI 1.297–10.530) and facet hypertrophy (OR = 6.468; 95% CI 1.283–32.617) were associated with NFS. Conclusion Disc height loss was associated with NFS for L4/L5 and spondylolisthesis and facet hypertrophy were associated with NFS for L5/S1.

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