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대한자기공명의과학회지 = Journal of the Korean society of magnetic resonance in medicine, v.15 no.2, 2011년, pp.91 - 101
장건호 (경희대학교 의과대학 강동경희대학교병원 영상의학과) , 김호성 (울산대학교 의과대학 서울아산병원 영상의학과) , 김선미 (경희대학교 의과대학 강동경희대학교병원 영상의학과) , 류창우 (경희대학교 의과대학 강동경희대학교병원 영상의학과)
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Perfusion magnetic resonance imaging (pMRI) is a special technique for evaluation of blood flow. Exogenous pMRI methods which are dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) use an intravenous bolus injection of paramagnetic contrast agent. In contrast, an endogenous pM...
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| 핵심어 | 질문 | 논문에서 추출한 답변 |
|---|---|---|
| 관류 자기공명영상를 얻기 위해 주로 사용되는 조영제는? | 관류 자기공명영상을 얻기 위해서 주로 사용되는 조영제는 가도리늄 (Gadolinium) 계통의 조영제를 사용한다. 이 조영제는 일반적으로 임상에 사용되고 있는 조영제 중 하나이다. | |
| 외인성 조영제를 사용하는 방법에는 무엇이 있는가? | 관류 자기공명영상은 크게 외인성과 내인성 조영제를 사용하는 방법으로 나눌 수 있고, 외인성 조영제를 사용하는 방법으로는 DSC 와 DCE 방법이 있으며, 내인성 조영제를 사용하는 방법으로는 ASL 이 있다. 이들 관류 자기공명영상 방법들은 환자의 상태와 나타내고자 하는 영상인자에 따라 선별적으로 최적화되어 사용되어야 한다. | |
| 가도리늄 조영제의 효과에는 무엇이 있는가? | 가도리늄 조영제의 효과를 몇 가지 살펴보면 아래와 같다. 첫째, 이 조영제는 물과 혼합되면 T1 이완 값 (T1 relaxation)을 짧게 하여 T1 강조 영상에서 신호 증가를 유발한다. 둘째, 이 조영제는 T2 이완 값(T2 relaxation)을 감소하고, T2 강조 영상이나 T2* 강조 영상에서 신호를 감소시킨다. 그러나 T1 감소 효과 및 T2 감소 효과는 가도리늄이 있는 곳 (혈관내)과 그 주위(혈관외)에서 발생하게 된다. 따라서 모세혈관 외부에서도 자화감수율(magnetic susceptibility) 효과를 잘 관찰 할 수 있어 혈관 내 효과와 더불어 그 주변에서도 가도리늄의 효과를 관찰 할 수 있다. 또한 자화 감수율 효과는 가도리늄이 없는 정맥혈액에서도 관찰할 수 있다. 하지만 내부 자화감수율(intrinsic magnetic susceptibility) 효과의 근본이 되는 혈색소(hemoglobin)의 양은 매우 적어 그 변화가 눈으로 띌 정도로 많지 못하다(< 1~3%)(4). 따라서 자화감수율 효과를 매우 높게 하기 위해서 외부에서 상자성(paramagnetic)물질을 주입하여 자화감수율을 유발시킬 수 있는 조영제가 필요하고, 주로 사용하는 것이 바로 가도리늄이다. 가도리늄을 사용할 경우 신호의 변화를 약 20% 이상 높일 수 있다. 이것이 바로 관류 영상에 조영제를 사용하는 대표적인 이유이다. |
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