๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #1
1/19
ํ™˜์ž ์ •๋ณด: 91 ์„ธ, ์—ฌ์„ฑ
์ ์‘์ฆ: ์ขŒ์ธก ๊ทผ๋ ฅ ์•ฝํ™”

์ฆ๋ก€ #1

์†Œ๊ฒฌ

  • ์šฐ์ธก MCA ์˜์—ญ์˜ ํฐ ํ™•์‚ฐ ์ œํ•œ ์˜์—ญ
  • ์šฐ์ธก ๋Œ€๋‡Œ ๋‡Œ๊ณ ๋ž‘ ์†Œ์‹ค๊ณผ 3 mm ์šฐ์ธก์—์„œ ์ขŒ์ธก์œผ๋กœ์˜ ์ •์ค‘์„  ํŽธ์œ„๋ฅผ ๋™๋ฐ˜ํ•œ ๊ด€๋ จ T2/FLAIR ๊ณผ๊ฐ•๋„ ๋ฐ ์ข…์ฐฝ
  • ๊ธฐ์ € ์ˆ˜์กฐ ๊ฐœ๋ฐฉ
  • ์šฐ์ธก ๋‚ด๊ฒฝ๋™๋งฅ์˜ ๊ตํ†ต ๋ถ„์ ˆ๊ณผ ์šฐ์ธก MCA์˜ M1 ๋ถ„์ ˆ์—์„œ์˜ ๋น„์ •์ƒ์  ํ˜ˆ๋ฅ˜ ๊ด€๋ จ ์‹ ํ˜ธ
  • ์šฐ์ธก ์ „๋‘์—ฝ์˜ ์†Œ์ˆ˜ ์žํ™”์œจ ์ธ๊ณต๋ฌผ ์ดˆ์ 
  • ์œตํ•ฉ์„ฑ ํ”ผ์งˆํ•˜ ๋ฐ ๋‡Œ์‹ค ์ฃผ์œ„ ๋ฐฑ์งˆ T2/FLAIR ๊ณผ๊ฐ•๋„
  • ๋‡Œ๊ต์˜ ์›๊ฒฉ ์—ด๊ณต์„ฑ ๊ฒฝ์ƒ‰
  • ์ „๋ฐ˜์  ๋Œ€๋‡Œ ์šฉ์  ๊ฐ์†Œ
  • ์–‘์ธก ์ธ๊ณต์ˆ˜์ •์ฒด

์ง„๋‹จ

ํ˜ˆ์ „์„ฑ ๊ฒฝ์ƒ‰

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

ํฐ ๊ธ‰์„ฑ/์ดˆ๊ธฐ ์•„๊ธ‰์„ฑ ์šฐ์ธก MCA ์˜์—ญ ๊ฒฝ์ƒ‰. ๊ฒฐ๊ณผ์ ์œผ๋กœ ์šฐ์ธก ๋Œ€๋‡Œ ๋‡Œ๊ณ ๋ž‘ ์†Œ์‹ค๊ณผ 3 mm ์šฐ์ธก์—์„œ ์ขŒ์ธก์œผ๋กœ์˜ ์ •์ค‘์„  ํŽธ์œ„๋ฅผ ๋™๋ฐ˜ํ•œ ๊ด€๋ จ ์„ธํฌ๋…์„ฑ ๋ถ€์ข…. ํƒˆ์ถœ ๋˜๋Š” ์ˆ˜๋‘์ฆ์˜ ์†Œ๊ฒฌ ์—†์Œ.

์šฐ์ธก ์ „๋‘์—ฝ์˜ ์†Œ์ˆ˜ ์žํ™”์œจ ์ธ๊ณต๋ฌผ ์ดˆ์ ์€ ์ ์ƒ ์ถœํ˜ˆ์„ ๋‚˜ํƒ€๋‚ผ ์ˆ˜ ์žˆ์œผ๋‚˜, ์กฐ์งํ™”๋œ ์ถœํ˜ˆ์„ฑ ๋ณ€ํ™˜์˜ ์†Œ๊ฒฌ์€ ์—†์Šต๋‹ˆ๋‹ค.

์šฐ์ธก ๋‚ด๊ฒฝ๋™๋งฅ์˜ ๊ตํ†ต ๋ถ„์ ˆ๊ณผ ์šฐ์ธก MCA์˜ M1 ๋ถ„์ ˆ์—์„œ ๊ฐ์†Œ๋œ/๋Š๋ฆฐ ํ˜ˆ๋ฅ˜ ๋˜๋Š” ํ์ƒ‰์ด ์šฐ๋ ค๋˜๋Š” ๋น„์ •์ƒ์  ํ˜ˆ๋ฅ˜ ๊ด€๋ จ ์‹ ํ˜ธ. CTA ๋˜๋Š” ์นดํ…Œํ„ฐ ํ˜ˆ๊ด€์กฐ์˜๊ณผ์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๊ถŒ๊ณ ํ•ฉ๋‹ˆ๋‹ค.

๋น„ํŠน์ด์ ์ด๋‚˜ ๋งŒ์„ฑ ์†Œํ˜ˆ๊ด€ ์งˆํ™˜๊ณผ ๊ด€๋ จ๋  ๊ฐ€๋Šฅ์„ฑ์ด ๋†’์€ ์œตํ•ฉ์„ฑ ํ”ผ์งˆํ•˜ ๋ฐ ๋‡Œ์‹ค ์ฃผ์œ„ ๋ฐฑ์งˆ T2/FLAIR ๊ณผ๊ฐ•๋„.

๋‡Œ๊ต์˜ ์›๊ฒฉ ์—ด๊ณต์„ฑ ๊ฒฝ์ƒ‰. ์ „๋ฐ˜์  ๋Œ€๋‡Œ ์šฉ์  ๊ฐ์†Œ.

๊ณ ์ฐฐ

  • MRI๋Š” ์ดˆ๊ธฐ ๋Œ€๋‡Œ ๊ฒฝ์ƒ‰ ๊ฐ์ง€์— CT๋ณด๋‹ค ํ›จ์”ฌ ๋ฏผ๊ฐํ•ฉ๋‹ˆ๋‹ค
  • ๋น„์ •์ƒ ์‹ ํ˜ธ๋Š” ํ™•์‚ฐ/ADC์—์„œ ๋จผ์ € ๋‚˜ํƒ€๋‚˜๋ฉฐ, ์ข…์ข… ํ˜ˆ๊ด€ ํ์ƒ‰ ๋ฐœ์ƒ ํ›„ ์ˆ˜ ๋ถ„ ๋‚ด์— ์กด์žฌํ•ฉ๋‹ˆ๋‹ค
  • ADC ์‹ ํ˜ธ๋Š” T2 ํšจ๊ณผ๋กœ ์ธํ•ด ํ™•์‚ฐ ์‹ ํ˜ธ๋ณด๋‹ค ๋” ๋นจ๋ฆฌ ์ •์ƒํ™”๋ฉ๋‹ˆ๋‹ค (์ผ๋ฐ˜์ ์œผ๋กœ 10์ผ๊นŒ์ง€). T2 ํšจ๊ณผ๋Š” ํ™•์‚ฐ ์‹ ํ˜ธ๋ฅผ ์ผ์‹œ์  ๋˜๋Š” ์˜๊ตฌ์ ์œผ๋กœ ์•ฝ๊ฐ„ ์ƒ์Šน์‹œํ‚ฌ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค
  • T2/FLAIR ์‹ ํ˜ธ ์ด์ƒ์€ ๋‹ค์†Œ ๋’ค์ณ์ง€๋ฉฐ, ์ผ๋ฐ˜์ ์œผ๋กœ ํ์ƒ‰ ํ›„ 6-8์‹œ๊ฐ„์— ๋‚˜ํƒ€๋‚˜๊ธฐ ์‹œ์ž‘ํ•ฉ๋‹ˆ๋‹ค
  • ๋‡Œ์กธ์ค‘์—์„œ ๊ด€์ฐฐ๋  ์ˆ˜ ์žˆ๋Š” ์„ธ ๊ฐ€์ง€ ์œ ํ˜•์˜ ์กฐ์˜์ฆ๊ฐ•์ด ์žˆ์Šต๋‹ˆ๋‹ค:
    1. ๋™๋งฅ ์กฐ์˜์ฆ๊ฐ• (๋‡Œ์กธ์ค‘ ํ›„ ์ˆ˜์‹œ๊ฐ„-์ˆ˜์ผ) - ๊ธ‰์„ฑ ํ—ˆํ˜ˆ ์˜์—ญ ๋‚ด ๋™๋งฅ ํ˜ˆ๋ฅ˜ ๊ฐ์†Œ๋กœ ํ˜ˆ๋ฅ˜ ๊ด€๋ จ ์‹ ํ˜ธ ์†Œ์‹ค์ด ๊ฐ์†Œํ•ฉ๋‹ˆ๋‹ค. ์ด ์ฆ๊ฐ€๋œ ๊ณ ์œ  ์‹ ํ˜ธ์™€ ํˆฌ์—ฌ๋œ ์กฐ์˜์ œ์˜ ์‹ ํ˜ธ๊ฐ€ ๊ฒฐํ•ฉ๋˜์–ด ์ด ํ˜ˆ๊ด€๋“ค์ด ์˜ํ–ฅ๋ฐ›์ง€ ์•Š์€ ๋™๋งฅ๋ณด๋‹ค ๋” ๊ณผ๊ฐ•๋„๋กœ ๋ณด์ด๊ฒŒ ํ•ฉ๋‹ˆ๋‹ค
    2. ์ˆ˜๋ง‰ ์กฐ์˜์ฆ๊ฐ• (๋‡Œ์กธ์ค‘ ํ›„ 1-7์ผ) - ๊ฒฝ์ƒ‰ ์œ„์˜ ์ˆ˜๋ง‰์—์„œ ๋ฐ˜์‘์„ฑ ์ถฉํ˜ˆ๋กœ ์ธํ•œ ๊ฒƒ. ๊ฐ€์žฅ ๋“œ๋ฌผ๊ฒŒ ๊ด€์ฐฐ๋˜๋Š” ์กฐ์˜์ฆ๊ฐ• ์œ ํ˜•์ž…๋‹ˆ๋‹ค
    3. ์‹ค์งˆ ์กฐ์˜์ฆ๊ฐ• (1์ฃผ-3๊ฐœ์›”) - ํ˜ˆ๋‡Œ์žฅ๋ฒฝ ํŒŒ๊ดด๋กœ ์ธํ•œ ๊ฒƒ. ์‹ค์งˆ ์กฐ์˜์ฆ๊ฐ•์€ ๋ถˆ์™„์ „ ๊ฒฝ์ƒ‰์—์„œ ๋” ์ผ์ฐ ๋” ๊ฐ•ํ•˜๊ฒŒ ๋‚˜ํƒ€๋‚  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค. ์กฐ์˜์ฆ๊ฐ• ๋ณ‘๋ณ€์ด ๊ฒฝ์ƒ‰์ธ์ง€ ์ข…์–‘์ธ์ง€ ํŒ๋‹จํ•˜๋ ค๋ฉด, ๋ช‡ ๋‹ฌ ํ›„ ์ถ”์  ์˜์ƒ์ด ๋‘˜์„ ๊ฐ๋ณ„ํ•˜๋Š” ๋ฐ ๋„์›€์ด ๋  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค
  • ๋Œ€๋‡Œํ˜ˆ๊ด€ ์‚ฌ๊ณ ์—์„œ MR ์‹ ํ˜ธ์˜ ์ „ํ˜•์  ์ง„ํ–‰์— ๋Œ€ํ•œ ๊ทธ๋ž˜ํ”„ ํ‘œํ˜„์€ ์•„๋ž˜ ๊ทธ๋ฆผ์„ ์ฐธ์กฐํ•˜์‹ญ์‹œ์˜ค

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

Evolution of signal on several MRI sequences in cerebral infarcts. +C = postcontrast imaging.

Evolution of signal on several MRI sequences in cerebral infarcts. +C = postcontrast imaging.

์ฐธ๊ณ ๋ฌธํ—Œ

  • Allen LM, Hasso AN, Handwerker J, Farid H.ย Sequence-specific MR imaging findings that are useful in dating ischemic stroke.ย Radiographics 2012;ย 32: 1285-1297.
  • Karonen JO,ย Partanen PL,ย Vanninen RL,ย Vainio PA,ย Aronen HJ.ย Evolution of MR contrast enhancement patterns during the first week after acute ischemic stroke.ย AJNR Am J Neuroradiolย 2001; 22(1): 103-111.

    • ์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

    ์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

    /5
    ํ”ผ๋“œ๋ฐฑ์„ ๋ณด๋‚ด์ฃผ์…”์„œ ๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค. ์†Œ์ค‘ํžˆ ๋ฐ˜์˜ํ•˜๊ฒ ์Šต๋‹ˆ๋‹ค.