관류 자기공명영상의 원리 및 기술
Principles and Technical Aspects of Perfusion Magnetic Resonance Imaging
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관류 자기공명영상은 크게 외인성과 내인성 조영제를 사용하는 방법으로 나눌 수 있고, 외인성조영제를 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. 그 예로 급성 뇌졸중 환자의 경우 매우 빠른영상획득이 최우선적인 인자이므로 DSC 가 주로 이용되고 있고, 뇌종양 환자의 경우 여러 물리적 인자를 고려한 DSC 혹은 DCE 스캔이 필요하다. 또한 소아나 가임여성 및 신장병질환이 있는 경우는 ASL 을 이용되고 있다. 관류 자기공명영상 기술은 방사성 물질을 전혀 사용하지 않아약물효과의 평가와 기타 치료 효과를 이해하는데 많은 응용이 있을 것으로 생각된다
Abstract
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 pMRM method which is arterial spin labeling (ASL) use diffusible blood in body. In order to scan pMRI in human, technical optimizations are very important according to disease conditions. For examples,DSC is popularly used in patients with acute stroke due to its short scan time, while DSC or DCE provides the various perfusion indices for patients with tumor. ASL is useful for children, women who are expected to be pregnant, and in patients with kidney diseases which are problematic in nephrogenic systemic fibrosis (NSF). Perfusion MRI does not require any injection of radioisotopes. We expect that demand for perfusion MRI will be higher in evaluating drug efficacy and other treatment effects.
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