목적:출혈성 뇌졸중 환자에서 뇌출혈의 각 시기별 혈색소 상태에 따른 고식적 T1,T2 강조영상의 신호강도를 근거로 하여 뇌출혈의 확산강조영상(diffusion weighted image ;DWI)에 서 신호강도변화를 알아보고자 하였다. 대상과 방법:출혈성 뇌졸중 환자 중 발병시기가 확실하고 DWI와 고식적 자기공명영상(MRI)을 시행한 34명의 환자를 대상으로 하였다.환자의 시기적 분류는 뇌졸중의 증상발현시간과 MRI시행과의 간격에 따라 급성기 (3일 이내)8예,초기 아급성기 (7일 이내)10예,후기 아급성기 (4주 이내)7예,초기 만성기(3개월 이내)4예,그리고 후기 만성기(3개월 이후)5예로 구분하였다.MRI는 1.5T 초전도 기기를 사용하였고,T1 강조영상(T1WI)과 고속스핀에코 T2 강조영상(T2WI)을 얻은 후 단발포에코평면영상기법을 사용하여 DWI를 얻었다.T1WI, T2WI와 DWI에서 뇌출혈병변 중심부의 육안적 신호강도를 알아보았고,각 영상에서 병변 중심부-정상 신호강도비(SIR)를 구하였다. 결과:병변 중심부의 신호강도는 급성기 8예중 5예(24 시간이내)에서 등 또는 고/고/고 (T1WI/T2WI/DWI)신호강도로 보였고,3예(72 시간이내)에서 저/저/저 신호강도를 보였으며 초기 아급성기 10예 모두에서 고/저/저 신호강도를,후기 아급성기 7예 모두에서 고/고/고 신호강도를,초기 만성기 4예 모두에서 고/고/고 신호강도를,그리고 후기 만성기 5예 모두에서 저/고/저 신호강도를 보였다.병변 중심부-정상 신호강도비는 급성기 중 T1WI에서 등 또는 고신호강도로 보인 5예에서 각각 1.42 $\pm$0.78/2.58 $\pm$0.84/1.35 $\pm$0.08 (T1WI/T2WI/ DWI),나머지 3예에서는 각각 0.94 $\pm$0.18/0.63 $\pm$0.16/0.27 $\pm$0.10,초기 아급성기에서는 각각 1.35 $\pm$0.01/0.97 $\pm$0.21/0.86 $\pm$0.22,후기 아급성기에서는 각각 1.58 $\pm$0.04/1.54 $\pm$0.09/1.44 $\pm$0.14, 초기 만성기에서는 각각 1.26 $\pm$0.11/1.06 $\pm$0.14/0.97 $\pm$0.12,그리고 후기 만성기에서는 각각 0.65 $\pm$2.23/1.51 $\pm$0.12/0.23 $\pm$0.18을 보였다. 결론:두개내 혈종은 DWI에서 T2WI를 반영하는 양상으로 관찰되었고 DWI에서 뇌출혈을 시 기에 따라 잘 이해를 하면 출혈성 뇌졸중환자에서 DWI를 해석하는 데 많은 도움이 되리라 생 각된다.
Purpose: To determine changes in the signal intensity of intracerebral hemorrhagic lesions according to the time interval, between the onset of symptoms and MR imaging in the T1-weighted (T1W1), T2-weighted (T2W1) and diffusion-weighted modes. Materials and Methods: Thirty-four patients with hemorrhagic stroke who underwent DWI and conventional MRI were involved in this study. Hemorrhagic phase was determined according to the time interval between the onset of symptoms and MR scanning, and was as follows: acute (3 days or less): eight patients); early subacute (7 days or less): ten patients; late subacute (4 weeks or less): seven patients; early chronic (3 months or less) : four patients); and late chronic (more than 3 months): five patients. Using a 1.5T MR imager and the single-shot echo-planar imaging technique, T1-weighted, fast spin-echo T2-weighted, and diffusion-weighted were obtained. In all cases qualitative signal intensity (SI) at the center of a lesion was recorded, and the ratio between this and normal brain parenchyma was calculated. Results: SI at the center of a lesion was found to be iso or high/high/high (T1WI/T2WI/DWI) in five of eight acute-phase cases (interval of 24 hours or less) and low/low/low in the remaining three (interval of 72 hours or less). Other signal intensities were as follows: early subacute phase: high/low/low (all ten cases); late subacute phase: high/high/high (all seven cases); early chronic phase: high/high/high (all four cases); late chronic phase: low/high/low (all five cases). Mean SIRs were as follows: in the five acute-phase cases in which SI was iso or high: 1.42${\pm}$0.78 / 2.58${\pm}$0.84 / 1.35${\pm}$0.08 (T1WI / T2WI / DWI); in the remaining three acute-phase cases: 0.94 ${\pm}$0.18 / 0.63${\pm}$0.16 / 0.27${\pm}$0.10; in the early subacute phase, 1.35${\pm}$0.01 / 0.97${\pm}$0.21 / 0.86${\pm}$0.22 in early subacute phase, 1.58${\pm}$0.04 / 1.54${\pm}$0.09 / 1.44${\pm}$0.14; in the early chronic phase: 1.26${\pm}$0.11 / 1.06${\pm}$0.14 / 0.97${\pm}$0.12; and in the late chronic phase: 0.65${\pm}$2.23 / 1.51${\pm}$0.12 / 0.23${\pm}$0.18. Conclusion: The DWI findings of intracerebral hemorrhage reflect the findings of T2WI. When interpreting the DWI findings in patients with intracerebral hemorrhage, an understanding of the temporal evolution of this is very helpful . The no-show rate, patient distribution, chief complaint, type and number of additional radiologic examinations, patient compliance rate, biopsy result, rate of cancer detection, and staging of cancers were determined. The merits and demerits of the clinic were also assessed. Results: A total of 671 patients attended, with a no-show rate of 13.2%. Referrals from the Health Promation Centre accounted for 90.4% of patient visits. The most frequent complaint was a suspicious nodule at mammography. One additional radiologic examination was performed in 429 patients, two examinations in 70, and three or more examations in five. The most frequent type of examination was ultrasonography, followed by magnification compression view, mammography, and ultrasound-guided aspiration biopsy. An additional radiologic examination was recommended in 81.2% of patients and compliance rate was 96.7%. Primary breast cancer was diagnosed in 16 patients (2.1%), and was found to be stage 0 and 1 in 64.3% of these. No significant demerits were apparent. Conclusion: Radiologic examinations play a very important role in the detection of early-stage breast cancer, and the establishment of an early detection clinic lead by a radiologist is a very effective and recommendable approach to screening.',PY = '2002-00-00',RF = '5',BN = '