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Kawabata K, Hosono M, Mori Y, Tsukamoto S, Ito S, Ando S, Kanagaki M. Steroids May Be Associated With Extensive Skeletal Muscle Uptake of 18 F-FDG. Clin Nucl Med 2023; 48:1015-1020. [PMID: 37756474 DOI: 10.1097/rlu.0000000000004856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
PURPOSE The possibility of steroid administration inducing the extensive skeletal muscle uptake (ESMU) of FDG in PET scans was investigated. METHODS From 8923 consecutive 18 F-FDG PET/CT scans taken at our hospital, 23 scans (15 patients) met adult age and ESMU-positive inclusion criteria. Among the 15 patients, 13 with both ESMU-positive and -negative scans were examined for association with steroid administration. RESULTS Extensive skeletal muscle uptake was associated with a history of steroid administration ( χ2 test: P = 0.001). Notably, 20 ESMU-positive scans and 11 ESMU-negative scans were significantly different, with 0 to 95 days (median, 18.5 days) and 0 to 708 days (median, 319.0 days) since the last steroid administration, respectively (Mann-Whitney U test, P = 0.003). A significant correlation was observed between mean skeletal muscle SUV max and the number of days since the last steroid administration (Spearman rank correlation coefficient, ρ = -0.501, P = 0.004). Specifically, the degree of ESMU tended to decrease over time, after steroid administration. From multiple regression analysis, the number of days since the last steroid administration was significantly associated with mean SUV max ( P = 0.007), but the blood glucose level was not significant ( P = 0.204), revealing that the number of days since the last steroid administration was an independent risk factor. Multicollinearity was low (the variance inflation factor was 1.007 for both the number of days since the last steroid administration and blood glucose levels). CONCLUSIONS Steroid administration within months before PET may be one cause of ESMU.
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Affiliation(s)
- Kazuna Kawabata
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Makoto Hosono
- Department of Radiology, Kindai University Faculty of Medicine, Osaka
| | - Yukiko Mori
- Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Suzune Tsukamoto
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Shunsuke Ito
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Saya Ando
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Mitsunori Kanagaki
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
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2
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Umehana M, Hosono M, Hijikata Y, Takahashi M, Kanagaki M. Pembrolizumab-Associated Pneumonitis Resembling Lymphangitic Carcinomatosis in a Melanoma Patient. Clin Nucl Med 2023; 48:e529-e531. [PMID: 37793162 DOI: 10.1097/rlu.0000000000004845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
ABSTRACT In recent years, many articles have described the adverse events associated with immune checkpoint inhibitors. We report the case of a 63-year-old woman with bilateral lung shadows after 1-year pembrolizumab immunotherapy following surgery for the right-foot melanoma because of positive sentinel lymph nodes. Follow-up 18 F-FDG PET/CT demonstrated bilateral diffuse mass-like peribronchovascular opacities with marked FDG uptake. Clinically, melanoma metastases with lymphangitic spread were suspected, and bronchoscopy was performed, although no evidence of malignancy was found. The lung shadow was mostly resolved after steroid treatment. Pembrolizumab-induced pneumonitis can be a mimicker of melanoma metastasis with lymphangitic spread.
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Affiliation(s)
- Masaki Umehana
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Makoto Hosono
- Department of Radiology, Kindai University Faculty of Medicine, Osaka
| | - Yoichiro Hijikata
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Mina Takahashi
- Department of Plastic and Reconstructive Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Mitsunori Kanagaki
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
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3
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Ando S, Ito S, Kawabata K, Kanagaki M, Hijikata Y, Kiso M, Tsuzuki S, Kimura H. Dynamic contrast-enhanced MRI and sequential CT findings of metaplastic breast carcinoma in neurofibromatosis type 1: A case report. Radiol Case Rep 2023; 18:2224-2228. [PMID: 37123039 PMCID: PMC10139865 DOI: 10.1016/j.radcr.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/02/2023] Open
Abstract
Metaplastic breast carcinoma in neurofibromatosis type 1 is extremely rare. There are few reports about dynamic contrast-enhanced MRI findings and sequential CT findings of metaplastic breast carcinoma in neurofibromatosis type 1. Herein, we report imaging findings, including dynamic contrast-enhanced MRI and sequential CT, of metaplastic breast carcinoma in an 82-year-old woman with neurofibromatosis type 1. Short tau inversion recovery image revealed an oval mass with a circumscribed margin that exhibited moderate intensity with partially hyperintense area inside, and T1-weighted imaging revealed a spotty hyperintense area. The solid component of the mass showed heterogeneous enhancement and the time-intensity curve had a fast/washout pattern with restricted diffusion. In addition, multiple neurofibromas were observed. Sequential CT revealed that the diameter of the mass doubled in 3 months without apparent lymph node metastasis. Because detection of metaplastic breast carcinoma in neurofibromatosis type 1 tends to be delayed due to multiple neurofibromas, characteristic MRI findings suggestive of metaplastic breast carcinoma and sequential CT findings are important for early treatment of metaplastic breast carcinoma in patients with neurofibromatosis type 1.
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Affiliation(s)
- Saya Ando
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
- Corresponding author.
| | - Shuichi Ito
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuna Kawabata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
| | - Yoichiro Hijikata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
| | - Marina Kiso
- Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Sadatoshi Tsuzuki
- Department of Pathology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Higashinaniwa-cho 2-17-77, Amagasaki 660-8550, Hyogo, Japan
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4
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Ito S, Kanagaki M, Yoshimoto N, Hijikata Y, Shimizu M, Kimura H. Cerebral proliferative angiopathy depicted by four-dimensional computed tomographic angiography: A case report. Radiol Case Rep 2022; 17:2332-2336. [PMID: 35570862 PMCID: PMC9095649 DOI: 10.1016/j.radcr.2022.03.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
Cerebral proliferative angiopathy is a rare cerebrovascular disorder characterized by diffuse abnormal vessels with intermingled brain parenchyma fed by many arteries and draining into many veins without high-flow arteriovenous shunts, which is usually confirmed by conventional digital subtraction angiography. However, dilution of the contrast medium due to the markedly increased blood flow and volume in cerebral proliferative angiopathy leads to low-contrast angiography. We report a 53-year-old man with cerebral proliferative angiopathy who underwent CT, MR imaging, MR angiography, digital subtraction angiography and 4D-CTA. The 4D-CTA exhibited abnormal vessels without early venous filling between the atrophic brain parenchyma in higher contrast than the angiography due to high spatial and time resolution, whereas the left external carotid angiography visualized the characteristic transdural supply more clearly than the 4D-CTA due to high vascular selectivity. Therefore, novel 4D-CTA and conventional angiography plays a complementary role in the accurate diagnosis of cerebral proliferative angiopathy. Taking invasiveness into account, 4D-CTA may be advantageous for the diagnosis of cerebral proliferative angiopathy based on the characteristic imaging findings.
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Matsubara N, Kanagaki M, Ito S, Matsushima C, Ide M, Kitamura R, Nishida Y, Akasaka Y. Neonatal subpial hemorrhage along the medial side of the temporal lobe: Two case reports. Radiol Case Rep 2022; 17:1881-1886. [PMID: 35401889 PMCID: PMC8990035 DOI: 10.1016/j.radcr.2022.03.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 10/25/2022] Open
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Kawabata K, Hosono M, Tanaka H, Hyuga M, Kanagaki M. Granulocyte Colony-Stimulating Factor Administration at 1 Hour Before 18F-FDG PET Does Not Increase Bone Marrow FDG Accumulation. Clin Nucl Med 2021; 46:770-771. [PMID: 33883491 DOI: 10.1097/rlu.0000000000003649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT A 74-year-old man with diffuse large B-cell lymphoma underwent 18F-FDG PET/CT to evaluate the response to chemotherapy. Although granulocyte colony-stimulating factor was incidentally administered 1 hour before FDG administration, bone marrow FDG accumulation did not increase compared with the previous 18F-FDG PET/CT examination without granulocyte colony-stimulating factor administration. The mean SUVmax of 12 thoracic and 5 lumbar vertebrae was 2.55 (range, 2.14-3.36) and 3.19 (range, 2.49-4.28) in the present and previous examinations, respectively.
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Affiliation(s)
- Kazuna Kawabata
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Makoto Hosono
- Department of Radiology, Kindai University Faculty of Medicine, Osaka
| | - Hiroki Tanaka
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
| | - Mizuki Hyuga
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Mitsunori Kanagaki
- From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo
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Onishi Y, Kimura H, Shimizu M, Oka S, Umeda M, Kimura T, Kanagaki M. Transportal embolization for pancreatic arteriovenous malformation via a recanalized paraumbilical vein: A case report. Radiol Case Rep 2021; 16:1708-1711. [PMID: 34007388 PMCID: PMC8111454 DOI: 10.1016/j.radcr.2021.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022] Open
Abstract
A 62-year-old man with liver cirrhosis presented with deterioration of liver function. Imaging studies revealed an arteriovenous malformation (AVM), with a dilated venous space, at the pancreatic head. Transarterial embolization of the AVM, using microcoils, was performed, although many feeding arteries remained. As the transarterial embolization was incomplete, further liver function deterioration was a possibility. In fact, 1 year after the procedure, the patient was referred back to our hospital for treatment of massive ascites and liver function deterioration. Transportal embolization of the dilated venous space was performed, using microcoils via the recanalized paraumbilical vein, with no enhancement of the AVM. No complications occurred. Based on our experience, we propose transportal embolization as an effective treatment option for pancreatic AVM.
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Affiliation(s)
- Yasuyuki Onishi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Marina Shimizu
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shojiro Oka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Makoto Umeda
- Department of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Toshiyuki Kimura
- Department of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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Matsubara N, Akasaka Y, Kanagaki M, Okamoto S. A case report of fetus in fetu with an aorta-like structure visualized by contrast-enhanced CT. Radiol Case Rep 2020; 15:2645-2648. [PMID: 33088380 PMCID: PMC7567927 DOI: 10.1016/j.radcr.2020.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/02/2020] [Accepted: 10/02/2020] [Indexed: 12/26/2022] Open
Abstract
Fetus in fetu (FIF) is a rare congenital anomaly resulting from abnormal embyogenesis in monochorionic diamniotic twins and appears as a cystic mass containing fetus-like structures mainly in the retroperitoneum of infants. Although there is a theory that FIF is a highly differentiated teratoma, it is commonly distinguished from teratoma as a mass containing a vertebral axis with appropriate arrangement of limbs or other organs around this axis. Here we present a case of FIF with aorta-like structure visualized by contrast-enhanced computed tomography. A 5-day-old girl was pointed out a cystic mass in the abdomen by ultrasound examination. Abdominal contrast-enhanced computed tomography revealed a retroperitoneal cystic mass with spine- and limb-like bone structures and blood vessel-like elongated structures and it was confirmed as FIF by surgery. The presence of major vascular structures along the skeletal axis is clearly different from teratoma and suggests that it occurred as an embryo and underwent some stage of development. Our findings strongly support the monozygotic twin theory.
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Affiliation(s)
- Naoko Matsubara
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashi-Naniwa-Cho, Amagasaki-shi, Hyogo, 660-8550, Japan
- Corresponding author.
| | - Yoshinobu Akasaka
- Department of Diagnostic Radiology, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashi-Naniwa-Cho, Amagasaki-shi, Hyogo, 660-8550, Japan
| | - Shinya Okamoto
- Department of Pediatric Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
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9
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Fukumoto G, Kanagaki M, Ishimoto T, Kitazumi K, Hara A, Kimura H. Identification of a Dural Defect with Cine Phase Contrast MR Imaging. Magn Reson Med Sci 2020; 19:89-91. [PMID: 31217398 PMCID: PMC7232035 DOI: 10.2463/mrms.ci.2019-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Genki Fukumoto
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Takeshi Ishimoto
- Division of Clinical Radiology Service, Hyogo Prefectural Amagasaki General Medical Center
| | - Kazuya Kitazumi
- Division of Clinical Radiology Service, Hyogo Prefectural Amagasaki General Medical Center
| | - Atsushi Hara
- Department of Neurology, Hyogo Prefectural Amagasaki General Medical Center
| | - Hiroaki Kimura
- Department of Orthopedic Surgery, Hyogo Prefectural Amagasaki General Medical Center
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10
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Fukumoto G, Kimura H, Kanagaki M, Oka S, Tanaka H, Wang Y, Tanaka H, Yamauchi Y, Kimura T. Intraabdominal Hemorrhage from Ruptured Ectopic Varices Treated by Antegrade Embolization via a Recanalized Paraumbilical Vein. Cardiovasc Intervent Radiol 2019; 42:1204-1207. [PMID: 31073821 DOI: 10.1007/s00270-019-02235-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/25/2019] [Indexed: 12/17/2022]
Abstract
A 49-year-old man with alcoholic liver cirrhosis was admitted to our hospital with abdominal pain. Contrast-enhanced CT demonstrated massive hemorrhagic ascites and ectopic varices fed by right colic and ileocolic veins. The varices were treated with selective embolization via a recanalized paraumbilical vein using N-butyl cyanoacrylate. Currently, no complications and rebleeding have occurred for 7 months. Antegrade embolization via a recanalized paraumbilical vein is feasible and less-invasive in a patient with massive ascites. Flow reduction may be effective for intraabdominal hemorrhage from ruptured ectopic varices. LEVEL OF EVIDENCE: Level 5, case report.
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Affiliation(s)
- Genki Fukumoto
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan.
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Shojiro Oka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Hiroki Tanaka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Yang Wang
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Hiroaki Tanaka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77, Higashinaniwa-cho, Amagasaki, Hyogo, Japan
| | - Yuki Yamauchi
- Department of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Toshiyuki Kimura
- Department of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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Onishi Y, Kimura H, Kanagaki M, Oka S, Fukumoto G, Otani T, Matsubara N, Kawabata K. Placement of a Viabahn stent-graft for hepatic artery pseudoaneurysm complicated by arterial dissection caused by a guiding sheath. Radiol Case Rep 2019; 14:711-713. [PMID: 30988861 PMCID: PMC6447732 DOI: 10.1016/j.radcr.2019.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 11/24/2022] Open
Abstract
A 69-year-old man was transferred to our hospital for massive hemorrhage from a right hepatic artery pseudoaneurysm 5 months after surgery for gastric cancer. Stent-graft placement was planned to avoid fatal hepatic infarction, and a guiding sheath was advanced deeply into the tortuous and stenotic right hepatic artery beyond the pseudoaneurysm for safe deployment of a stent-graft. However, this advancement caused arterial dissection of the right hepatic artery. After the guiding sheath was pulled back, a Viabahn stent-graft was successfully advanced over a guidewire to exclude the pseudoaneurysm. We consider that a Viabahn stent-graft is more flexible than a guiding sheath and that advancing a Viabahn stent-graft directly from a proximally placed guiding sheath is safer than advancing a guiding sheath into a tortuous and stenotic abdominal artery.
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Affiliation(s)
- Yasuyuki Onishi
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Shojiro Oka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Genki Fukumoto
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Tomoaki Otani
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Naoko Matsubara
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
| | - Kazuna Kawabata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, Amagasaki 660-8550, Japan
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12
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Onishi Y, Kimura H, Kanagaki M, Oka S, Fukumoto G, Otani T, Matsubara N, Kawabata K, Matsumoto M, Suzuki T. Loop formation by an aortic occlusion balloon catheter during resuscitative endovascular balloon occlusion of the aorta (REBOA). Radiol Case Rep 2018; 14:184-186. [PMID: 30425770 PMCID: PMC6226620 DOI: 10.1016/j.radcr.2018.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 11/25/2022] Open
Abstract
A 77-year-old man was transferred to our hospital for endoscopically uncontrollable active bleeding from a duodenal ulcer. Soon after his arrival, he became hemodynamically unstable and resuscitative endovascular balloon occlusion of the aorta was performed using a 7-F aortic occlusion balloon catheter (Rescue Balloon; Tokai Medical Products, Aichi, Japan). He became hemodynamically stable and was transferred to the CT room. CT demonstrated that the distal part of the catheter shaft had made a loop in the aorta and the balloon was located at the level of the upper abdomen. We consider the low-profile occlusion balloon catheter to be less rigid than large ones, and care should be taken to prevent balloon migration and catheter shaft bending.
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Affiliation(s)
- Yasuyuki Onishi
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Shojiro Oka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Genki Fukumoto
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Tomoaki Otani
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Naoko Matsubara
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Kazuna Kawabata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Masaru Matsumoto
- Department of Emergency and Critical Care Medicine, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
| | - Takao Suzuki
- Department of Emergency and Critical Care Medicine, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashimaniwa-cho, Amagasaki, Hyogo 660-8550, Japan
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13
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Onishi Y, Kimura H, Kanagaki M, Oka S, Fukumoto G, Otani T, Matsubara N, Kawabata K, Namikawa M, Kimura T. Usefulness of a distal access catheter in embolization of a short gastric artery pseudoaneurysm. Radiol Case Rep 2018; 14:69-71. [PMID: 30364845 PMCID: PMC6199761 DOI: 10.1016/j.radcr.2018.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/30/2018] [Indexed: 11/05/2022] Open
Abstract
A 59-year-old man was admitted to our hospital for hematemesis. A hematoma was found in the posterior wall of the stomach, but the source of bleeding was not identified. One month later, contrast-enhanced computed tomography revealed a pseudoaneurysm in the short gastric artery. Embolization of the pseudoaneurysm was difficult due to vessel tortuosity. Usage of a distal access catheter improved catheter stability and enabled successful embolization. We consider a distal access catheter to be useful for embolization of an aneurysm beyond a tortuous artery.
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Affiliation(s)
- Yasuyuki Onishi
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Shojiro Oka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Genki Fukumoto
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Tomoaki Otani
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Naoko Matsubara
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Kazuna Kawabata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki, Japan
| | - Mio Namikawa
- Department of Gastroenterology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki , Japan
| | - Toshiyuki Kimura
- Department of Gastroenterology, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa-cho, 660-8550 Amagasaki , Japan
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Onishi Y, Kimura H, Kanagaki M, Oka S, Fukumoto G, Otani T, Matsubara N, Kawabata K, Yasufuku T, Yamada Y. Successful embolization of ileal conduit stomal varices with N-butyl cyanoacrylate via a recanalized paraumbilical vein. Radiol Case Rep 2018; 13:1130-1132. [PMID: 30233743 PMCID: PMC6140417 DOI: 10.1016/j.radcr.2018.07.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 12/12/2022] Open
Abstract
A 77-year-old woman with liver cirrhosis was admitted to our hospital for marked hemorrhage in her ileal conduit stoma. She had a history of cystectomy and urinary diversion for bladder carcinoma 2 years ago. Contrast-enhanced CT demonstrated varices in the ileal conduit stoma. We accessed the varices via a recanalized paraumbilical vein to avoid pain from the transhepatic approach, and selectively embolized the varices with N-butyl cyanoacrylate (NBCA). We consider antegrade embolization of ileal conduit stomal varices with NBCA to be effective and feasible. Access via a paraumbilical vein is a useful alternative to the transhepatic approach.
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Affiliation(s)
- Yasuyuki Onishi
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hiroyuki Kimura
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shojiro Oka
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Genki Fukumoto
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Tomoaki Otani
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Naoko Matsubara
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kazuna Kawabata
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Tomihiko Yasufuku
- Department of Urology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Yuji Yamada
- Department of Urology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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Takemura T, Kataoka Y, Iki R, Nishioka Y, Matsubara N, Kanagaki M, Yasumizu Y. Possibility of Interstitial Lung Disease as a Phlebosclerotic Colitis Manifestation. Case Rep Gastroenterol 2018; 12:182-188. [PMID: 29805364 PMCID: PMC5968274 DOI: 10.1159/000488525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 03/14/2018] [Indexed: 12/24/2022] Open
Abstract
Phlebosclerotic colitis presents with ischemic bowels and calcification of the mesenteric veins. Owing to its rarity, we have little information on the complications of this disease. Herein, we report on a 77-year-old woman with phlebosclerotic colitis and interstitial lung disease. She was diagnosed as having phlebosclerotic colitis by CT and colonoscopy. At the same time, chest CT also showed interstitial lung disease. After 4 years, she experienced exacerbation of interstitial lung disease. She recovered without treatment. The occurrence of interstitial lung disease may have been associated with her phlebosclerotic colitis.
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Affiliation(s)
- Tomoyasu Takemura
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Reika Iki
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Yasuyuki Nishioka
- Department of Gastroenterology Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Naoko Matsubara
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Yoshitomo Yasumizu
- Department of Diagnostic Pathology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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16
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Fushimi Y, Okada T, Okuchi S, Yamamoto A, Kanagaki M, Fujimoto K, Togashi K. Jugular venous reflux on magnetic resonance angiography and radionuclide venography. Acta Radiol Open 2016; 5:2058460116681209. [PMID: 27994882 PMCID: PMC5152933 DOI: 10.1177/2058460116681209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/05/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The relationship between the signal from retrograde venous flow on magnetic resonance angiography (MRA) and retrograde upward flow from the left brachiocephalic vein has not been explored. PURPOSE To reveal the frequency of jugular venous reflux using MRA and nuclear venography in patients being evaluated for cerebral volume and blood flow. MATERIAL AND METHODS A total of 229 patients with cognitive disturbance who had undergone brain magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) on the same day to evaluate cerebral blood flow were evaluated. Jugular venous reflux was measured on MRA and nuclear venography, which was conducted just after injection of N-isopropyl-123I-p-iodoamphetamine for the SPECT study. RESULTS MRA showed jugular reflux in seven patients on the right side, and in 22 on the left. Nuclear venography showed jugular reflux in six patients on the right side, and in 20 on the left. CONCLUSION Jugular venous reflux was observed mostly on the left side. Retrograde flow was observed on both MRA and nuclear venography in half of the cases, with the rest only on one of the modalities.
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Affiliation(s)
- Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohisa Okada
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Fujimoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Mehemed TM, Fushimi Y, Okada T, Kanagaki M, Yamamoto A, Okada T, Takakuwa T, Yamada S, Togashi K. MR Imaging of the Pituitary Gland and Postsphenoid Ossification in Fetal Specimens. AJNR Am J Neuroradiol 2016; 37:1523-7. [PMID: 27127005 DOI: 10.3174/ajnr.a4808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 01/20/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A thorough knowledge of fetal growth and development is key to understanding both the normal and abnormal fetal MR imaging findings. We investigated the size and signal intensity of the normal pituitary gland and the intrasphenoidal ossification around the Rathke pouch in formalin-fixed fetuses on MR imaging. MATERIALS AND METHODS Thirty-two fetuses with undamaged brains were included in this study (mean age, 19.93 weeks; age range, 12-31 weeks). Visual inspection of the pituitary and ossification around the Rathke pouch in the sphenoid bone or the postsphenoid ossification was conducted. The extent of pituitary and postsphenoid ossification, pituitary/pons signal ratio, and postsphenoidal ossification/sphenoid bone signal ratio was compared according to gestational age. RESULTS The pituitary gland was identified as a hyperintense intrasellar structure in all cases, and postsphenoid ossification was identified as an intrasphenoidal hyperintense area in 27 of the 32 cases (84%). The mean pituitary/pons signal ratio was 1.13 ± 0.18 and correlated weakly with gestational age (R(2) = 0.243), while the mean postsphenoid ossification/sphenoid bone signal ratio was 2.14 ± 0.56 and did not show any increase with gestational age (R(2) = 0.05). No apparent change in the size of pituitary hyperintensity was seen with gestational age (R(2) = 0.001). Postsphenoid ossification showed an increase in size with gestational age (R(2) = 0.307). CONCLUSIONS The fetal pituitary gland was hyperintense on T1-weighted images and the pituitary/pons ratio and extent of postsphenoid ossification correlated weakly with gestational age.
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Affiliation(s)
- T M Mehemed
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
| | - Y Fushimi
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
| | - T Okada
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
| | - M Kanagaki
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
| | - A Yamamoto
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
| | - T Okada
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
| | | | - S Yamada
- Human Health Science (T.T., S.Y.) Congenital Anomaly Research Center (S.Y.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Togashi
- From the Department of Diagnostic Imaging and Nuclear Medicine (T.M.M., Y.F., Tomohisa Okada, M.K., A.Y., Tsutomu Okada, K.T.)
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18
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Yamada H, Yamamoto A, Okada T, Kanagaki M, Fushimi Y, Porter DA, Tanji M, Hojo M, Miyamoto S, Togashi K. Diffusion tensor imaging of the optic chiasm in patients with intra- or parasellar tumor using readout-segmented echo-planar. Magn Reson Imaging 2016; 34:654-61. [PMID: 26806681 DOI: 10.1016/j.mri.2016.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the impact of surgery on the optic pathway of patients with intra- or parasellar mass lesions, as evidenced by readout-segmented DTI. MATERIALS AND METHODS Twenty-four patients with intra- or parasellar mass lesions were included in the study. Readout-segmented DTI and T2WI were obtained before and after surgery. The ROIs were set on the optic chiasm as well as the anterior and posterior optic tracts. For each ROI, axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), and ADC values were calculated. DTI parameters in preoperative studies of all patients were compared and related to the presence of tumor compression. In patients who underwent surgery, pre- and postoperative DTI parameters were compared. The correlation between DTI parameters and visual function was determined. RESULTS In the preoperative studies, the optic chiasm of patients with tumor compression showed significant lower AD and RD values. The optic chiasm of patients with visual field disorder showed significantly lower AD and RD values compared to patients without the disorder. There was a negative correlation with a trend toward significance between FA values and visual field disorder scores. The comparative analysis of patients in pre- and postoperative studies showed that the optic chiasm of patients with tumor compression presented a significant lower FA (0.41 versus 0.30, p=0.0068) and higher RD values after surgery. CONCLUSIONS DTI is a useful tool to assess the impact of surgery on the optic chiasm and nerve.
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Affiliation(s)
- Hirofumi Yamada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - David A Porter
- Fraunhofer MEVIS, Universitätsallee 29, 28359, Bremen, Germany
| | - Masahiro Tanji
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masato Hojo
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
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Nakajima S, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Okada T, Arakawa Y, Takagi Y, Miyamoto S, Togashi K. Differentiation between primary central nervous system lymphoma and glioblastoma: a comparative study of parameters derived from dynamic susceptibility contrast-enhanced perfusion-weighted MRI. Clin Radiol 2015; 70:1393-9. [DOI: 10.1016/j.crad.2015.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 06/06/2015] [Accepted: 08/10/2015] [Indexed: 11/17/2022]
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20
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Okubo G, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Okada T, Murata K, Togashi K. MP2RAGE for deep gray matter measurement of the brain: A comparative study with MPRAGE. J Magn Reson Imaging 2015; 43:55-62. [DOI: 10.1002/jmri.24960] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/15/2015] [Indexed: 12/25/2022] Open
Affiliation(s)
- Gosuke Okubo
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Tsutomu Okada
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | | | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
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21
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Nakajima S, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Okada T, Arakawa Y, Takagi Y, Miyamoto S, Togashi K. Primary central nervous system lymphoma and glioblastoma: differentiation using dynamic susceptibility-contrast perfusion-weighted imaging, diffusion-weighted imaging, and 18F-fluorodeoxyglucose positron emission tomography. Clin Imaging 2015; 39:390-5. [DOI: 10.1016/j.clinimag.2014.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/19/2014] [Accepted: 12/06/2014] [Indexed: 02/08/2023]
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22
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Sakata A, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Dodo T, Arakawa Y, Takahashi JC, Miyamoto S, Togashi K. Primary central nervous system lymphoma: is absence of intratumoral hemorrhage a characteristic finding on MRI? Radiol Oncol 2015; 49:128-34. [PMID: 26029023 PMCID: PMC4387988 DOI: 10.1515/raon-2015-0007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/06/2015] [Indexed: 12/15/2022] Open
Abstract
Background. Previous studies have shown that intratumoral hemorrhage is a common finding in glioblastoma multi-forme, but is rarely observed in primary central nervous system lymphoma. Our aim was to reevaluate whether intratumoral hemorrhage observed on T2-weighted imaging (T2WI) as gross intratumoral hemorrhage and on susceptibility-weighted imaging as intratumoral susceptibility signal can differentiate primary central nervous system lymphoma from glioblastoma multiforme. Patients and methods. A retrospective cohort of brain tumors from August 2008 to March 2013 was searched, and 58 patients (19 with primary central nervous system lymphoma, 39 with glioblastoma multiforme) satisfied the inclusion criteria. Absence of gross intratumoral hemorrhage was examined on T2WI, and an intratumoral susceptibility signal was graded using a 3-point scale on susceptibility-weighted imaging. Results were compared between primary central nervous system lymphoma and glioblastoma multiforme, and values of P < 0.05 were considered significant. Results. Gross intratumoral hemorrhage on T2WI was absent in 15 patients (79%) with primary central nervous system lymphoma and 23 patients (59%) with glioblastoma multiforme. Absence of gross intratumoral hemorrhage could not differentiate between the two disorders (P = 0.20). However, intratumoral susceptibility signal grade 1 or 2 was diagnostic of primary central nervous system lymphoma with 78.9% sensitivity and 66.7% specificity (P < 0.001), irrespective of gross intratumoral hemorrhage. Conclusions. Low intratumoral susceptibility signal grades can differentiate primary central nervous system lymphoma from glioblastoma multiforme. However, specificity in this study was relatively low, and primary central nervous system lymphoma cannot be excluded based solely on the presence of an intratumoral susceptibility signal.
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Affiliation(s)
- Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Correspondence to: Tomohisa Okada, M.D., Ph.D., Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto, 606–8507, Japan. Phone: +81 75 751 4215; Fax: +81 75 751 4216; E-mail:
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshiki Dodo
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jun C Takahashi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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23
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Okuchi S, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Okada T, Yamauchi M, Kataoka M, Arakawa Y, Takahashi JC, Minamiguchi S, Miyamoto S, Togashi K. Grading meningioma: a comparative study of thallium-SPECT and FDG-PET. Medicine (Baltimore) 2015; 94:e549. [PMID: 25674763 PMCID: PMC4602750 DOI: 10.1097/md.0000000000000549] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose was to compare capability of fluorine-18 fluorodeoxyglucose (FDG)-PET and thallium-201 (Tl)-SPECT for grading meningioma.This retrospective study was conducted as a case-control study under approval by the institutional review board. In the hospital information system, 67 patients (22 men and 45 women) who had both FDG-PET and Tl-SPECT preoperative examinations were found with histopathologic diagnosis of meningioma. The maximum FDG uptake values of the tumors were measured, and they were standardized to the whole body (SUVmax) and normalized as gray matter ratio (SUVRmax). Mean and maximum Tl uptake ratios (TURmean and TURmax, respectively) of the tumors were measured and normalized as ratios to those of the contralateral normal brain. Receiver-operating characteristic curve analyses of the 4 indexes were conducted for differentiation between low- and high-grade meningiomas, and areas under the curves (AUCs) were compared. Correlation coefficients were calculated between these indexes and Ki-67.Fifty-six meningiomas were classified as grade I (low grade), and 11 were grade II or III (high grade). In all 4 indexes, a significant difference was observed between low- and high-grade meningiomas (P < 0.05). AUCs were 0.817 (SUVmax), 0.781 (SUVRmax), 0.810 (TURmean), and 0.831 (TURmax), and no significant difference was observed among the indexes. Their sensitivity and specificity were 72.7% to 90.9% and 71.4% to 87.5%, respectively. Correlation of the 4 indexes to Ki-67 was statistically significant, but coefficients were relatively low (0.273-0.355).Tl-SPECT, which can be used at hospitals without a cyclotron or an FDG distribution network, has high diagnostic capability of meningioma grades comparable to FDG-PET.
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Affiliation(s)
- Sachi Okuchi
- From the Department of Diagnostic Imaging and Nuclear Medicine (SO, TO, AY, MK, YF, TO, MY, MK, KT); Department of Neurosurgery (YA, JCT, SM); and Department of Clinical Pathology (SM), Kyoto University Graduate School of Medicine, Kyoto, JAPAN
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Sakata A, Okada T, Yamamoto A, Kanagaki M, Fushimi Y, Okada T, Dodo T, Arakawa Y, Schmitt B, Miyamoto S, Togashi K. Grading glial tumors with amide proton transfer MR imaging: different analytical approaches. J Neurooncol 2015; 122:339-48. [PMID: 25559689 DOI: 10.1007/s11060-014-1715-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 12/29/2014] [Indexed: 11/24/2022]
Abstract
Amide proton transfer (APT) magnetic resonance imaging is gaining attention for its capability for grading glial tumors. Usually, a representative slice is analyzed. Different definitions of tumor areas have been employed in previous studies. We hypothesized that the accuracy of APT imaging for brain tumor grading may depend upon the analytical methodology used, such as selection of regions of interest (ROIs), single or multiple tumor slices, and whether or not there is normalization to the contralateral white matter. This study was approved by the institutional review board, and written informed consent was waived. Twenty-six patients with histologically proven glial tumors underwent preoperative APT imaging with a three-dimensional gradient-echo sequence. Two neuroradiologists independently analyzed APT asymmetry (APTasym) images by placing ROIs on both a single representative slice (RS) and all slices including tumor (i.e. whole tumor: WT). ROIs indicating tumor extent were separately defined on both FLAIR and, if applicable, contrast-enhanced T1-weighted images (CE-T1WI), yielding four mean APTasym values (RS-FLAIR, WT-FLAIR, RS-CE-T1WI, and WT-CE-T1WI). The maximum values were also measured using small ROIs, and their differences among grades were evaluated. Receiver operating characteristic (ROC) curve analysis was also conducted on mean and maximum values. Intra-class correlation coefficients for inter-observer agreement were excellent. Significant differences were observed between high- and low-grade gliomas for all five methods (P < 0.01). ROC curve analysis found no statistically significant difference among them. This study clarifies that single-slice APT analysis is robust despite tumor heterogeneity, and can grade glial tumors with or without the use of contrast material.
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Affiliation(s)
- Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Sakamoto R, Okada T, Kanagaki M, Yamamoto A, Fushimi Y, Kakigi T, Arakawa Y, Takahashi JC, Mikami Y, Togashi K. Estimation of proliferative potentiality of central neurocytoma: correlational analysis of minimum ADC and maximum SUV with MIB-1 labeling index. Acta Radiol 2015; 56:114-20. [PMID: 24477268 DOI: 10.1177/0284185114521187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Central neurocytoma was initially believed to be benign tumor type, although atypical cases with more aggressive behavior have been reported. Preoperative estimation for proliferating activity of central neurocytoma is one of the most important considerations for determining tumor management. PURPOSE To investigate predictive values of image characteristics and quantitative measurements of minimum apparent diffusion coefficient (ADCmin) and maximum standardized uptake value (SUVmax) for proliferative activity of central neurocytoma measured by MIB-1 labeling index (LI). MATERIAL AND METHODS Twelve cases of central neurocytoma including one recurrence from January 2001 to December 2011 were included. Preoperative scans were conducted in 11, nine, and five patients for computed tomography (CT), diffusion-weighted imaging (DWI), and fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET), respectively, and ADCmin and SUVmax of the tumors were measured. Image characteristics were investigated using CT, T2-weighted (T2W) imaging and contrast-enhanced T1-weighted (T1W) imaging, and their differences were examined using the Fisher's exact test between cases with MIB-1 LI below and above 2%, which is recognized as typical and atypical central neurocytoma, respectively. Correlational analysis was conducted for ADCmin and SUVmax with MIB-1 LI. A P value <0.05 was considered significant. RESULTS Morphological appearances had large variety, and there was no significant correlation with MIB-1 LI except a tendency that strong enhancement was observed in central neurocytomas with higher MIB-1 LI (P = 0.061). High linearity with MIB-1 LI was observed in ADCmin and SUVmax (r = -0.91 and 0.74, respectively), but only ADCmin was statistically significant (P = 0.0006). CONCLUSION Central neurocytoma had a wide variety of image appearance, and assessment of proliferative potential was considered difficult only by morphological aspects. ADCmin was recognized as a potential marker for differentiation of atypical central neurocytomas from the typical ones.
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Affiliation(s)
- Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahide Kakigi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jun C Takahashi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Mikami
- Department of Clinical Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Mehemed TM, Yamamoto A, Okada T, Kanagaki M, Sawada T, Morimoto E, Takahashi JC, Miyamoto S, Togashi K. Analysis of susceptibility-weighted images of cortico-medullary junction. Magn Reson Med Sci 2014; 13:231-8. [PMID: 25167876 DOI: 10.2463/mrms.2013-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE We qualitatively evaluated the differences among susceptibility-weighted (SWI), magnitude (MAG), and high pass filtered phase (PHA) images in depicting interlobar differences in the appearance of the signal of the corticomedullary junction (CMJ). We conducted quantitative evaluation to validate the qualitative results. MATERIALS AND METHODS We obtained SWI images from 25 preoperative brain tumor patients (12 men, 13 women, aged 19 to 82 years, mean, 52 years). Two trained neuroradiologists evaluated MAG, PHA, and SWI images. Qualitative evaluation of the CMJ signal and quantitative calculation of the relative signal ratio (RSR) percentages between the CMJ and deep white matter (WM) were conducted at 3 different slice levels of the brain independently for 4 different lobes (frontal, parietal, temporal, and occipital) and compared among MAG, PHA, and SWI. The extent of the area of the CMJ signal was graded on a 4-point scale (Grade 3, >75%; Grade 2, 50 to 75%; Grade 1, 25 to 50%; Grade 0, <25%). Data were statistically analyzed using a nonparametric Friedman test. RESULTS The Kappa coefficients between the qualitative and quantitative grades were 0.002 for MAG, 0.0047 for PHA, and 0.050 for SWI. Qualitatively, on the PHA images and SWI, grades of the occipital lobes were significantly higher than those of the other lobes (P < 0.005). Quantitatively, PHA images showed statistically significant interlobar differences in RSR percentage values of the CMJ (P = 0.025). CONCLUSION Qualitatively, the appearance of the CMJ differed significantly among the different lobes of the brain on SWI and underlying PHA images but not on MAG images. Quantitatively, only PHA images showed significant interlobar differences in the RSR. PHA images are most sensitive to the CMJ signal contrast due to local paramagnetic iron content.
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Affiliation(s)
- Taha M Mehemed
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University
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Fushimi Y, Okada T, Kanagaki M, Yamamoto A, Kanda Y, Sakamoto R, Hojo M, Takahashi JC, Miyamoto S, Togashi K. 3D dynamic pituitary MR imaging with CAIPIRINHA: initial experience and comparison with 2D dynamic MR imaging. Eur J Radiol 2014; 83:1900-6. [PMID: 25037932 DOI: 10.1016/j.ejrad.2014.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 06/24/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the validity of 3D dynamic pituitary MR imaging with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA), with special emphasis on demarcation of pituitary posterior lobe and stalk. METHODS Participants comprised 32 patients who underwent dynamic pituitary MR imaging due to pituitary or parasellar lesions. 3D dynamic MR with CAIPIRINHA was performed at 3T with 20-s-interval, precontrast, 1st to 5th dynamic images. Normalized values and enhanced ratios (dynamic postcontrast image values divided by precontrast ones) were compared between 3D and 2D dynamic MR imaging for patients with visual identification of posterior lobe and stalk. RESULTS In 3D, stalk was identified in 29 patients and unidentified in 3, and posterior lobe was identified in 28 and unidentified in 4. In 2D, stalk was identified in 26 patients and unidentified in 6 patients, and posterior lobe was identified in 15 and unidentified in 17. Normalized values of pituitary posterior lobe and stalk were higher in 3D than 2D (P<0.001). No significant difference in enhancement ratio was seen between 3D and 2D. CONCLUSIONS 3D dynamic pituitary MR provided better identification and higher normalized values of pituitary posterior lobe and stalk than 2D.
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Affiliation(s)
- Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Yumiko Kanda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Masato Hojo
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Jun C Takahashi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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Mehemed TM, Fushimi Y, Okada T, Yamamoto A, Kanagaki M, Kido A, Fujimoto K, Sakashita N, Togashi K. Dynamic oxygen-enhanced MRI of cerebrospinal fluid. PLoS One 2014; 9:e100723. [PMID: 24956198 PMCID: PMC4067336 DOI: 10.1371/journal.pone.0100723] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/29/2014] [Indexed: 11/18/2022] Open
Abstract
Oxygen causes an increase in the longitudinal relaxation rate of tissues through its T1-shortening effect owing to its paramagnetic properties. Due to such effects, MRI has been used to study oxygen-related signal intensity changes in various body parts including cerebrospinal fluid (CSF) space. Oxygen enhancement of CSF has been mainly studied using MRI sequences with relatively longer time resolution such as FLAIR, and T1 value calculation. In this study, fifteen healthy volunteers were scanned using fast advanced spin echo MRI sequence with and without inversion recovery pulse in order to dynamically track oxygen enhancement of CSF. We also focused on the differences of oxygen enhancement at sulcal and ventricular CSF. Our results revealed that CSF signal after administration of oxygen shows rapid signal increase in both sulcal CSF and ventricular CSF on both sequences, with statistically significant predominant increase in sulcal CSF compared with ventricular CSF. CSF is traditionally thought to mainly form from the choroid plexus in the ventricles and is absorbed at the arachnoid villi, however, it is also believed that cerebral arterioles contribute to the production and absorption of CSF, and controversy remains in terms of the precise mechanism. Our results demonstrated rapid oxygen enhancement in sulcal CSF, which may suggest inhaled oxygen may diffuse into sulcal CSF space rapidly probably due to the abundance of pial arterioles on the brain sulci.
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Affiliation(s)
- Taha M. Mehemed
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- * E-mail:
| | - Tomohisa Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Fujimoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naotaka Sakashita
- Toshiba Medical Systems Corporation, MRI Systems Development Department Otawara-shi, Tochigi, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Kakigi T, Okada T, Kanagaki M, Yamamoto A, Fushimi Y, Sakamoto R, Arakawa Y, Mikami Y, Shimono T, Takahashi JC, Togashi K. Quantitative imaging values of CT, MR, and FDG-PET to differentiate pineal parenchymal tumors and germinomas: are they useful? Neuroradiology 2014; 56:297-303. [PMID: 24510202 DOI: 10.1007/s00234-014-1334-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/22/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Quantitative values of CT attenuation, apparent diffusion coefficient (ADC), and standardized uptake value (SUV) were investigated for differentiation between pineal parenchymal tumors (PPTs) and germinomas. Differences in age, sex, and calcification pattern were also evaluated. METHODS Twenty-three patients with PPTs and germinomas in 20 years were retrospectively enrolled under the approval of the institutional review board. CT attenuation, ADC, and SUV (20, 13, and 10 patients, respectively) were statistically compared between the two tumors. Differences in sex and patterns of calcification ("exploded" or "engulfed") were also examined. Mean patient ages were compared among three groups of pineoblastoma, pineal parenchymal tumor of intermediate differentiation, (PPTID) and pineocytoma and germinoma. RESULTS None of the quantitative values of CT attenuation, ADC, and SUV showed significant differences between PPTs and germinomas (p > .05). However, there was a significant difference in age (p < .05) among the three groups of pineoblastoma (mean age ± standard deviation 7.0 ± 8.7 years), PPTID, and pineocytoma (53.7 ± 11.4 years) and germinoma (19.1 ± 8.1 years). Sex also showed significant differences between PPTs and germinomas (p = .039). Exploded pattern of calcification was found in 9 of 11 PPT patients and engulfed pattern in 7 of 9 patients with germinomas. No reverse pattern was observed, and the patterns of calcification were considered highly specific of tumor types. CONCLUSIONS None of the quantitative imaging values could differentiate PPTs from germinomas. Age, sex, and calcification patterns were confirmed useful in differentiating these tumors to some degree.
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Affiliation(s)
- Takahide Kakigi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Fushimi Y, Okada T, Yamamoto A, Kanagaki M, Fujimoto K, Togashi K. Timing dependence of peripheral pulse-wave-triggered pulsed arterial spin labeling. NMR Biomed 2013; 26:1527-1533. [PMID: 23784975 DOI: 10.1002/nbm.2986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 05/07/2013] [Accepted: 05/14/2013] [Indexed: 06/02/2023]
Abstract
Arterial spin labeling (ASL) has been developed into a useful technique that is capable of quantifying noninvasively local cerebral blood flow (CBF) using the water molecules in arterial blood as diffusible tracers. Pulsed ASL (PASL) is more strongly affected than continuous ASL (CASL) by cardiac pulsation, because the tag bolus is shorter than the cardiac cycle in most cases. No reports have yet clarified the effects of multiple cardiac phases on the quantification of CBF in PASL when triggering is used. Fourteen subjects participated in this study. Peripheral pulse-wave-triggered (PPWT)-ASL was performed at various time points at the carotid artery (delay 0 ms, second point, foot, peak and tail) and compared with nontriggered (NT)-ASL. Regions of interest (ROIs) were applied based on the anterior, middle and posterior cerebral artery (ACA, MCA, PCA) territories, and CBFs were compared among different time points and ROIs. PPWT-ASL strongly affects CBF values compared with NT-ASL in ACA and MCA territories, especially when measured at the foot of the carotid artery flow phase. CBF_NT was assumed to lie approximately between the minimum and maximum CBFs, with clear statistical significance in several ROIs at several time points of PPWT-ASL, and CBF_NT was assumed to resemble 'randomly triggered' PPWT-ASL. In conclusion, PPWT-ASL strongly affects CBF values compared with NT-ASL, particularly at the foot of the carotid artery flow in ACA and MCA territories.
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Affiliation(s)
- Yasutaka Fushimi
- Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Morimoto E, Okada T, Kanagaki M, Yamamoto A, Fushimi Y, Matsumoto R, Takaya S, Ikeda A, Kunieda T, Kikuchi T, Paul D, Miyamoto S, Takahashi R, Togashi K. Evaluation of focus laterality in temporal lobe epilepsy: A quantitative study comparing double inversion-recovery MR imaging at 3T with FDG-PET. Epilepsia 2013; 54:2174-83. [DOI: 10.1111/epi.12396] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Emiko Morimoto
- Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Tomohisa Okada
- Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Mitsunori Kanagaki
- Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Akira Yamamoto
- Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Yasutaka Fushimi
- Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Riki Matsumoto
- Neurology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Shigetoshi Takaya
- Human Brain Research Center; Kyoto University Graduate School of Medicine; Kyoto Japan
- Radioisotope Research Center; Kyoto University; Kyoto Japan
- Athinoula A. Martinos Center for Biomedical Imaging; Harvard Medical School; Massachusetts General Hospital; Charlestown Massachusetts U.S.A
| | - Akio Ikeda
- Neurology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takeharu Kunieda
- Neurosurgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takayuki Kikuchi
- Neurosurgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | | | - Susumu Miyamoto
- Neurosurgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Ryosuke Takahashi
- Neurology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Kaori Togashi
- Diagnostic Imaging and Nuclear Medicine; Kyoto University Graduate School of Medicine; Kyoto Japan
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Okuchi S, Okada T, Ihara M, Gotoh K, Kido A, Fujimoto K, Yamamoto A, Kanagaki M, Tanaka S, Takahashi R, Togashi K. Visualization of lenticulostriate arteries by flow-sensitive black-blood MR angiography on a 1.5 T MRI system: a comparative study between subjects with and without stroke. AJNR Am J Neuroradiol 2012; 34:780-4. [PMID: 23064597 DOI: 10.3174/ajnr.a3310] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The branches of the LSA are the main causative arteries for lacunar infarction, though the vascular changes are largely unknown. Herein, we examined the correlation of LSA imaging findings in patients with lacunar infarction compared with controls by using FSBB-MRA. MATERIALS AND METHODS Fifteen patients (9 men, 6 women; mean age, 73 years) with infarction at the basal ganglia and/or its vicinity were prospectively enrolled, and 12 aged-matched control subjects (6 men, 6 women; mean age, 68 years) were examined by using FSBB-MRA on a 1.5T MR imaging system. Total number and length of visualized LSA branches were compared by a 2-tailed 2-sample t test. Stepwise multiple regression analyses were performed, including hypertension, hyperlipidemia, smoking history, and diabetes mellitus after evaluation of their colinearity. P<.05 after correction for multiple comparisons was considered significant. RESULTS Patients with stroke had significantly fewer LSA branches (average, 6.3; 95% CI, 5.4-7.1) than controls (8.7; 95% CI, 7.8-9.5) (P=.0003). The total LSA lengths were 117 mm (95% CI, 96-138 mm) for patients with stroke and 162 mm (95% CI, 133-91 mm) for control subjects (P=.01). In stepwise multiple regression analysis, only the LSA branch numbers were significantly related to infarction (P=.0003), while only hypertension was significantly related to total LSA length (P=.0085). CONCLUSIONS Using FSBB-MRA to visualize LSA branches, we found a significant reduction in the numbers of LSA branches in patients with stroke, and hypertension was inversely related to total LSA length. FSBB is a promising method to investigate the LSA by using 1.5T MR imaging.
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Affiliation(s)
- S Okuchi
- Department of Diagnostic Radiology, Translational Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Tourdias T, Roggerone S, Filippi M, Kanagaki M, Rovaris M, Miller DH, Petry KG, Brochet B, Pruvo JP, Radüe EW, Dousset V. Assessment of disease activity in multiple sclerosis phenotypes with combined gadolinium- and superparamagnetic iron oxide-enhanced MR imaging. Radiology 2012; 264:225-33. [PMID: 22723563 DOI: 10.1148/radiol.12111416] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare magnetic resonance (MR) imaging features of multiple sclerosis (MS) lesions after the administration of a gadolinium-based contrast agent and ultrasmall superparamagnetic iron oxide (USPIO) particles among the clinical phenotypes of MS and over time. MATERIALS AND METHODS This study was approved by the local ethics committee, and written informed consent was obtained from all patients. Twenty-four patients with MS (10 with relapsing and 14 with progressive forms) underwent clinical and gadolinium- and USPIO-enhanced MR examinations at baseline and 6-month follow-up. The number of lesions that enhanced with gadolinium alone, USPIO alone, or both was compared with the Pearson χ2 or Fisher exact test, and lesion sizes were compared with the Wilcoxon Mann-Whitney U test. At 6-month follow-up, the lesion signal intensity on precontrast T1-weighted images and the enhancement after repeat injection of the contrast agent were compared with the baseline postcontrast imaging features by using the McNemar test. RESULTS Fifty-six lesions were considered active owing to contrast enhancement at baseline; 37 lesions (66%) in 10 patients enhanced with gadolinium. The use of USPIO helped detect 19 additional lesions (34%), and two additional patients were classified as having active disease. Thus, the use of both agents enabled detection of 51% (19 of 37 lesions) more lesions than with gadolinium alone. Enhanced lesions were more frequently observed in the relapsing compared with the progressive forms of MS (P<.0001). USPIO enhancement, in the form of ringlike patterns, could also be observed on T1-weighted images in patients with progressive MS, enabling the detection of five lesions in addition to the five detected with gadolinium in this phenotype. Lesions that enhanced with both contrast agents at baseline were larger (mean size, 6.5 mm±3.8; P=.001) and were more likely to persistently enhance at 6-month follow-up (seven of 27 lesions, P<.0001) compared with those that enhanced only with gadolinium (mean size, 4.9 mm±2.2; one of nine lesions) or USPIO (mean size, 3.5 mm±1.5; 0 of 17 lesions). CONCLUSION The combination of gadolinium and USPIO in patients with MS can help identify additional active lesions compared with the current standard, the gadolinium-only approach, even in progressive forms of MS. Lesions that enhance with both agents may exhibit a more aggressive evolution than those that enhance with only one contrast agent.
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Affiliation(s)
- Thomas Tourdias
- Department of Neuroradiology and INSERM U1049, CHU de Bordeaux, Université Bordeaux Segalen, Bordeaux, France.
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Moriya S, Miki Y, Kamishima T, Kanagaki M, Yokobayashi T, Ishikawa M. Fat-suppressed MR images of both hands obtained using CHESS can be improved by rice pads. Eur J Radiol 2012; 81:2318-22. [DOI: 10.1016/j.ejrad.2011.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 06/01/2011] [Indexed: 10/18/2022]
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Iima M, Yamamoto A, Brion V, Okada T, Kanagaki M, Togashi K, Le Bihan D. Reduced-distortion diffusion MRI of the craniovertebral junction. AJNR Am J Neuroradiol 2012; 33:1321-5. [PMID: 22383239 DOI: 10.3174/ajnr.a2969] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE CVJ lesion suffers from a high sensitivity to susceptibility and distortion artifacts, which sometimes makes diffusion image difficult to interpret. Our purpose was to evaluate the potential for diffusion MR imaging using RS-EPI compared with SS-EPI in the assessment of the CVJ. MATERIALS AND METHODS RS-EPI and SS-EPI DTI images were acquired from 10 healthy volunteers using 3T MRI with a 32-channel head coil. For both sequences, the following parameters were used: 1-mm(2) in-plane resolution; 3-mm section thickness; TR = 5200 ms; 1 acquisition at b = 0 and 12 different encoding directions at b = 1000 seconds/mm(2). The RS-EPI sequence scan time was 9.44 minutes (1 average). The SS-EPI sequence was 9.37 minutes (8 averages). Diffusion tensor calculation and image analysis were performed using DTIStudio software. Diffusion trace images and color-coded fiber orientation maps were evaluated by 2 independent readers for distortion and delineation of fine structure using a semiquantitative scale in selected landmark locations. The absolute distances between the temporal base and the cerebellar contour between the T2-weighted images and the diffusion trace images obtained with RS-EPI and SS-EPI were also compared. RESULTS The contours of the temporal lobe and cerebellum were better delineated and distortion artifacts were clearly reduced with the RS-EPI sequence. More fine structures were also visible in the brain stem and cerebellum with the RS-EPI sequence. The amount of distortion was significantly reduced with RS-EPI compared with SS-EPI (P < .01). CONCLUSIONS The RS-EPI DTI sequence was less prone to geometric distortion than the SS-EPI sequence and allowed a better delineation of CVJ internal structure. Although the acquisition time is still relatively long, the RS-EPI appears as a promising approach to perform DTI studies in CVJ lesions, such as brain stem ischemia, neurodegenerative diseases, brain and skull base tumors, or inflammation.
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Affiliation(s)
- M Iima
- Department of Diagnostic Imaging and Nuclear Medicine and Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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Fushimi Y, Okada T, Yamamoto A, Kanagaki M, Imai H, Togashi K. Estimation of the timing of carotid artery flow using peripheral pulse wave-gated MRI. J Magn Reson Imaging 2012; 36:454-8. [PMID: 22517508 DOI: 10.1002/jmri.23665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 03/07/2012] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To investigate the relationship between peripheral pulse wave (PPW)-gating and the carotid systolic pulse wave in a large clinical patient cohort, and to establish a process for correct estimation of delay time from PPW-gating to foot (ie, beginning) or peak times of carotid systolic pulse waves. MATERIALS AND METHODS Subjects comprised 209 patients scanned using 3T magnetic resonance imaging (MRI) for PPW-gated phase contrast images at the common carotid artery. Stepwise multiple regression analysis was conducted for the relationship between foot or peak times and the following factors after excluding correlated factors with coefficients ≥0.5: pulse rate (PR); systolic blood pressure; diastolic blood pressure; height; body weight; body mass index; Brinkman index; diabetes mellitus; hypertension; and hyperlipidemia. RESULTS PR showed significant correlation with foot (r = -0.86, P < 0.001) and peak (r = -0.87, P < 0.001) times. The following equations were derived: foot time (msec) = -8.55 × PR + 993.1 and peak time (msec) = -9.21 × PR + 1142.3. No other factors showed significant correlations. CONCLUSION PR was the only factor showing significant relationships to foot and peak times of carotid artery flow. The derived equations will facilitate various kinds of noncontrast MR acquisition with simple PPW-gating.
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Affiliation(s)
- Yasutaka Fushimi
- Department of Radiology, Ichinomiyanishi Hospital, Ichinomiya, Japan.
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Sawada T, Yamamoto A, Miki Y, Kikuta KI, Okada T, Kanagaki M, Kasahara S, Miyamoto S, Takahashi JC, Fukuyama H, Togashi K. Diagnosis of moyamoya disease using 3-T MRI and MRA: value of cisternal moyamoya vessels. Neuroradiology 2012; 54:1089-97. [DOI: 10.1007/s00234-012-1020-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 02/07/2012] [Indexed: 12/01/2022]
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Kasahara S, Miki Y, Kanagaki M, Kondo T, Yamamoto A, Morimoto E, Okada T, Ito H, Takahashi R, Togashi K. "Hot cross bun" sign in multiple system atrophy with predominant cerebellar ataxia: a comparison between proton density-weighted imaging and T2-weighted imaging. Eur J Radiol 2011; 81:2848-52. [PMID: 22209432 DOI: 10.1016/j.ejrad.2011.12.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 12/06/2011] [Accepted: 12/08/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate whether proton density-weighted imaging can detect the "hot cross bun" sign in the pons in multiple system atrophy with predominant cerebellar ataxia significantly better than T2-weighted imaging at 3T. METHODS Sixteen consecutive patients with multiple system atrophy with predominant cerebellar ataxia according to the Consensus Criteria were reviewed. Axial unenhanced proton density-weighted imaging and T2-weighted imaging were obtained using a dual-echo fast spin-echo sequence at 3T. Two neuroradiologists independently evaluated visualisation of the abnormal pontine signal using a 4-point visual grade from Grade 0 (no "hot cross bun" sign) to Grade 3 (prominent "hot cross bun" sign on two or more sequential slices). Differences in grade between proton density-weighted imaging and T2-weighted imaging were statistically analysed using the Wilcoxon signed-rank test. RESULTS In 11 patients (69%), a higher grade was given for proton density-weighted imaging than T2-weighted imaging. In 1 patient (6%), grades were the same (Grade 3) on both images. In the remaining 4 patients (25%), signal abnormalities were not detected on either image (Grade 0). The "hot cross bun" sign was thus observed significantly better on proton density-weighted imaging than on T2-weighted imaging (P=0.001). CONCLUSIONS The "hot cross bun" sign considered diagnostic for multiple system atrophy with predominant cerebellar ataxia is significantly better visualised on proton density-weighted imaging than on T2-weighted imaging at 3T.
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Affiliation(s)
- Seiko Kasahara
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.
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Moriya S, Miki Y, Kanagaki M, Yamamoto A, Okudaira S, Nakamura S, Yokobayashi T, Ishikawa M. Evaluation of cartilage surface injuries using 3D-double echo steady state (3D-DESS): effect of changing flip angle from 40° to 90°. Acta Radiol 2011; 52:1138-42. [PMID: 22042983 DOI: 10.1258/ar.2011.110275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND In magnetic resonance imaging (MRI) with 3D-double-echo steady-state (3D-DESS) sequences, the cartilage-synovial fluid contrast is reported to be better with a flip angle of 90° than with the conventional flip angle of 40°, and the detection rate of knee cartilage injury may be improved. PURPOSE To compare the diagnostic performance and certainty of diagnosis with 3D-DESS images made using two flip angle settings, 40° and 90°, for knee cartilage surface lesions of Grade 2 or above confirmed by arthroscopy. MATERIAL AND METHODS Images were obtained with 3D-DESS flip angles of 40° and 90° at 1.0T in 13 consecutive patients (2 men, 11 women, age range 18-68 years) evaluated for superficial cartilage injury by arthroscopy. Two radiologists classified the presence or absence of cartilage damage of ≥Grade 2 as 'positive (p)' or 'negative (n)', respectively. The rate of agreement with arthroscopic diagnosis was then examined, and the diagnostic performance compared. Diagnostic confidence was assessed scoring the presence or absence of cartilage damage into three categories: 3 = can diagnose with absolute confidence; 2 = can diagnose with a level of certainty as probably present or probably absent; and 1 = cannot make a diagnosis. RESULTS In a comparison of the rate of agreement between diagnosis by 3D-DESS images and arthroscopy, the rate of agreement was significantly higher and diagnostic performance was better in 90° images for the medial femoral condyle only. Diagnostic confidence was significantly better with 90° flip angle images than with 40° flip angle images for all six cartilage surfaces. CONCLUSION In evaluating knee cartilage surface lesions with 3D-DESS sequences, a flip angle setting of 90° is more effective than the conventional setting of 40°.
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Affiliation(s)
| | - Yukio Miki
- Department of Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Shuzo Okudaira
- Department of Orthopaedics, Kyoto Police Hospital, Kyoto, Japan
| | - Shinichiro Nakamura
- Center for Musculoskeletal Research, University of Tennessee, Knoxville, TN, USA
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Moriya S, Miki Y, Yokobayashi T, Yamamoto A, Kanagaki M, Komori Y, Fujimoto K, Ishikawa M. Optimization of the number of selectable channels for spine phased array coils for transverse imaging. Jpn J Radiol 2011; 29:166-70. [PMID: 21519989 DOI: 10.1007/s11604-010-0532-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 10/11/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to investigate whether the signal-to-noise ratio (SNR) in transverse images acquired from spine phased array coils is improved by deactivating coils distant from the imaging region and to identify the optimum coil settings. MATERIALS AND METHODS Ten healthy volunteers (five men, five women; average age 38 years) underwent transverse magnetic resonance imaging (MRI) of the cervical spine using four to one channels of a four-channel phased array coil for cervical imaging. The SNR of cerebrospinal fluid (CSF), spinal cord, muscle tissue, intervertebral disc, vertebral body, and prevertebral soft tissue was measured for each coil combination. RESULTS In all measured regions, the SNR was the highest for images acquired using two coils; the SNR was significantly higher for two coils than for four coils in CSF, spinal cord, muscle tissue, intervertebral disc, vertebral body, and prevertebral soft tissue (P < 0.001, P = 0.019, P < 0.0001, P = 0.014, P = 0.010, P < 0.001). CONCLUSION Deactivating two of the four coils used for sagittal sections, meaning that two coils are active, resulted in improved SNR for transverse images. Selecting the optimum number and combination of coils for each imaging cross section may enable acquisition of images with a better SNR.
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Affiliation(s)
- Susumu Moriya
- Ishikawa Clinic, 46-1 Shimokamo-Umenoki-cho, Sakyo-ku, Kyoto 606-0851, Japan.
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Kasahara S, Miki Y, Kanagaki M, Yamamoto A, Mori N, Sawada T, Taoka T, Okada T, Togashi K. Hyperintense Dentate Nucleus on Unenhanced T1-weighted MR Images Is Associated with a History of Brain Irradiation. Radiology 2011; 258:222-8. [DOI: 10.1148/radiol.10100508] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Moriya S, Miki Y, Yokobayashi T, Yamamoto A, Kanagaki M, Komori Y, Ishikawa M. Rice and perfluorocarbon liquid pads: comparison of fat suppression effects. Acta Radiol 2010; 51:534-8. [PMID: 20235744 DOI: 10.3109/02841851003645744] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND With the chemical shift selective (CHESS) method, lingering fat signals remain because of the effects of nonuniformity in the magnetic field. One method to reduce this phenomenon is the use of pads filled with rice (rice pad), but the improvement in fat suppression effects with rice pads, as compared with conventional perfluorocarbon liquid pads, remains unclear. PURPOSE To investigate whether rice pads are superior to perfluorocarbon liquid pads in improving fat suppression effects in magnetic resonance imaging (MRI) examination of the knee. MATERIAL AND METHODS Subjects were 10 healthy volunteers (5 men, 5 women; aged 20-45 years), from whom images taken using the CHESS methods were collected. Two images were taken for each subject; one with a rice pad placed under the knee and the knee flexed, and the other with a perfluorocarbon liquid pad placed under the knee and the knee flexed. Images were visually assessed by one radiologist and one radiologic technologist. Kendall's W and Wilcoxon signed rank test were used for statistical comparisons. RESULTS Of the 20 evaluations made by the 2 observers, scores for images obtained with the rice pad were higher than those with the perfluorocarbon liquid pad in 18 cases, while the scores were equal in 2 cases. Images with the rice pad were not inferior in any cases. The mean score for visual assessment was 4.65 for the rice pad and 3.0 for the perfluorocarbon liquid pad. The rice pad was thus confirmed to be superior to the perfluorocarbon liquid pad (P=0.0039). CONCLUSION The rice pad exhibited better performance in improving the fat suppression effect. Thus, the rice pad is a superior product that is inexpensive and simple to use.
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Affiliation(s)
| | - Yukio Miki
- Department of Radiology, Osaka City University Graduate School of Medicine, Osaka
| | | | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Japan
| | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Japan
| | - Yoshiaki Komori
- Biomedical Engineering Lab, Department of Systems Science, Graduate School of Informatics, Kyoto University, Japan
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Moriya S, Miki Y, Yokobayashi T, Yamamoto A, Kanagaki M, Komori Y, Fujimoto K, Ishikawa M. Improved CHESS imaging with the use of rice pads: Investigation in the neck, shoulder, and elbow. J Magn Reson Imaging 2010; 31:1504-7. [DOI: 10.1002/jmri.22189] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Abstract
BACKGROUND In magnetic resonance imaging (MRI) of the knee joint, when imaging the knee in a flexed position using the chemical-shift-selective (CHESS) method, lingering fat signals in the popliteal region are sometimes seen. PURPOSE To investigate whether a pad filled with rice (rice pad) placed in the popliteal space is effective in eliminating the lingering fat signals in MR images of the flexed knee, based on the hypothesis that the use of a rice pad would improve the fat suppression effect. MATERIAL AND METHODS Subjects were 10 healthy volunteers (five males, five females; age, 20-45 years) from whom images were taken using CHESS. Images were obtained with: 1) the knee extended and nothing placed underneath; 2) the knee bent with a sponge placed underneath; and 3) the knee bent with a rice pad placed underneath. The effectiveness of suppressing fat signals was visually assessed by one radiologist and one radiological technologist. RESULTS The fat suppression effect in images obtained with the knee extended was good. In contrast, the images made with a sponge under the knee had conspicuous lingering fat signals for nearly all subjects. In the images made with a rice pad under the knee, a uniformly good fat signal suppression effect was seen in all patients, and the assessment score was far higher than that with the sponge pillow (P<0.001). CONCLUSION Lingering fat signals were suppressed with the use of a rice pad, and fat-suppressed images of the knee joint using CHESS were found to be improved.
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Affiliation(s)
| | - Yukio Miki
- Department of Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Mitsunori Kanagaki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Yoshiaki Komori
- Biomedical Engineering Lab, Department of Systems Science, Graduate School of Informatics, Kyoto University, Kyoto, Japan
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Miki Y, Kanagaki M, Takahashi JA, Ishizu K, Nakagawa M, Yamamoto A, Fushimi Y, Okada T, Mikuni N, Kikuta KI, Hashimoto N, Togashi K. Evaluation of pituitary macroadenomas with multidetector-row CT (MDCT): comparison with MR imaging. Neuroradiology 2007; 49:327-33. [PMID: 17200863 DOI: 10.1007/s00234-006-0194-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Accepted: 11/22/2006] [Indexed: 01/07/2023]
Abstract
INTRODUCTION It is important to have information on cavernous sinus extension and bony destruction in pituitary macroadenomas before surgery, but magnetic resonance (MR) imaging cannot always depict them. In the present study we sought to determine whether multidetector-row computed tomography (MDCT) could provide preoperative information in addition to that provided by MR imaging in pituitary macroadenoma. METHODS The subjects comprised 33 consecutive patients (15 women, 18 men; mean age 50 years) with surgically proven macroadenoma. For MDCT, using the soft-tissue window and bone window, three orthogonal multiplanar reconstruction images were generated from venous-phase contrast-enhanced 0.5-mm isotropic voxel data. MDCT and MR images were evaluated with regard to: (1) clarity of tumor margins; (2) identification of the normal pituitary gland; (3) identification of erosion or destruction of the sellar floor; and (4) visualization of the adjacent optic pathways. RESULTS MDCT more clearly demonstrated the lateral tumor margin than MR imaging (P = 0.002). No significant differences in visualization of the normal pituitary gland were noted between MDCT and dynamic MR imaging (P = 0.7). MDCT more clearly demonstrated sellar floor erosion or destruction at the sphenoid sinus than MR imaging (P < 0.001). MR imaging was superior to MDCT for visualizing the adjacent optic pathways (P < 0.001). CONCLUSION MDCT is superior to MR imaging for assessing lateral tumor margin and the sellar floor at the sphenoid sinus. MDCT offers useful preoperative information in addition to that obtained from MR imaging.
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Affiliation(s)
- Yukio Miki
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
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Okada T, Mikuni N, Miki Y, Kikuta KI, Urayama SI, Hanakawa T, Fushimi Y, Yamamoto A, Kanagaki M, Fukuyama H, Hashimoto N, Togashi K. Corticospinal Tract Localization: Integration of Diffusion-Tensor Tractography at 3-T MR Imaging with Intraoperative White Matter Stimulation Mapping—Preliminary Results. Radiology 2006; 240:849-57. [PMID: 16857980 DOI: 10.1148/radiol.2403050916] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Institutional review board approval and written informed consent were obtained. The purpose of this study was to prospectively validate usefulness of diffusion-tensor (DT) fiber tractography of the corticospinal tract at 3-T magnetic resonance imaging, in combination with the subcortical motor-evoked potential (MEP) technique, as a tool for tractography-guided neurosurgery. DT imaging and corticospinal tractography were performed at 3 T in eight patients (four men, four women; mean age, 41 years; age range, 23-58 years) with intracranial space-occupying lesions. Tractography data were transferred to a neuronavigation system, and tractography-guided neurosurgery was performed. During lesion resection, subcortical MEPs were recorded. Positive MEP response was observed in four patients. No patients developed new motor weakness postoperatively. Complementary use of tractography and MEP may be useful for intraoperative depiction of corticospinal tracts.
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Affiliation(s)
- Tsutomu Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Fushimi Y, Miki Y, Kikuta KI, Okada T, Kanagaki M, Yamamoto A, Nozaki K, Hashimoto N, Hanakawa T, Fukuyama H, Togashi K. Comparison of 3.0- and 1.5-T Three-dimensional Time-of-Flight MR Angiography in Moyamoya Disease: Preliminary Experience. Radiology 2006; 239:232-7. [PMID: 16467209 DOI: 10.1148/radiol.2383042020] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively compare 3.0- and 1.5-T three-dimensional (3D) time-of-flight (TOF) magnetic resonance (MR) angiography in patients with moyamoya disease, with special emphasis on the visualization of abnormal netlike vessels (moyamoya vessels). MATERIALS AND METHODS Study protocols were approved by the local ethics committee; written informed consent was obtained from all patients. The study included 24 consecutive patients with moyamoya disease (four male and 20 female patients). Patients ranged in age from 17 to 66 years (mean age, 41 years). Moyamoya disease had been diagnosed in all patients before they were entered into the study. All patients underwent 3D TOF MR angiography at both 3.0 and 1.5 T; imaging examinations were performed within 14 days of each other. Maximum intensity projections (MIPs) obtained with MR angiography performed at both 3.0 and 1.5 T were evaluated by two neuroradiologists; the visualization of moyamoya vessels was graded according to a 4-point scale. For both 3.0- and 1.5-T imaging, the number of high-signal-intensity areas and the summation of cross-sectional areas of high signal intensity on source images obtained at the same level of MR angiography were compared quantitatively by using the Wilcoxon matched-pair signed-rank test. RESULTS Moyamoya vessels were better visualized on MIPs obtained with 3.0-T imaging than on MIPs obtained with 1.5-T imaging (P < .001). At the identical level of the source image, 3.0-T imaging depicted more high-signal-intensity areas than did 1.5-T imaging. Wider cross-sectional areas of moyamoya vessels were visualized with 3.0-T imaging than with 1.5-T imaging (P < .001). CONCLUSION Moyamoya vessels are better depicted with MR angiography at 3.0 T than at 1.5 T.
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Affiliation(s)
- Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Department of Neurosurgery, and Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
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Molinier S, Kanagaki M, Brochet B, Caille JM, Petry KG, Dousset V. CO-34 - Imagerie de diffusion, uspio et gadolinium dans la caractérisation de l’inflammation au cours de la sclérose en plaques. J Neuroradiol 2006. [DOI: 10.1016/s0150-9861(06)77154-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Okada T, Miki Y, Fushimi Y, Hanakawa T, Kanagaki M, Yamamoto A, Urayama SI, Fukuyama H, Hiraoka M, Togashi K. Diffusion-tensor fiber tractography: intraindividual comparison of 3.0-T and 1.5-T MR imaging. Radiology 2006; 238:668-78. [PMID: 16396839 DOI: 10.1148/radiol.2382042192] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively evaluate the depiction of brain fiber tracts at 3.0- versus 1.5-T diffusion-tensor (DT) fiber tractography performed with parallel imaging. MATERIALS AND METHODS Institutional review board approval was obtained, and each subject provided written informed consent. Subjects were 30 healthy volunteers (15 men, 15 women; mean age, 28 years; age range, 21-46 years). Single-shot spin-echo echo-planar magnetic resonance (MR) sequences with parallel imaging were applied. Four fiber tracts were reconstructed: corticospinal tract (CST), superior longitudinal fasciculus (SLF), corpus callosum (CC), and fornix. Two neuroradiologists compared 3.0- and 1.5-T tractography in terms of fiber tract depiction by using five depiction scores (scores 0-4) and numbers of reconstructed tract fibers and in terms of lateral asymmetry in the CST by using numbers of reconstructed fibers. The Wilcoxon signed rank test was applied for statistical analysis. RESULTS Visual scores for both CST hemispheres (P < .001), the right SLF (P = .005), the CC (P = .01), and the right fornix (P = .04) were higher at 3.0-T DT tractography. Larger numbers of CST (right, P = .008; left, P < .001), SLF (right, P = .001; left, P = .02), and fornix (bilaterally, P = .02) tract fibers were depicted at 3.0 T. The asymmetry index for the CST was lower (P < .001) at 3.0 T. Visual scores for the left SLF and the left fornix and numbers of CC tract fibers were not significantly different. CONCLUSION Depiction of most fiber tracts was improved at 3.0-T DT tractography compared with depiction at 1.5-T tractography.
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Affiliation(s)
- Tsutomu Okada
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, and Human Brain Research Center, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi, Kyoto 606-8507, Japan
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Yamamoto A, Miki Y, Adachi S, Kanagaki M, Fushimi Y, Okada T, Kobayashi M, Hiramatsu H, Umeda K, Nakahata T, van Buchem MA, Togashi K. Whole brain magnetization transfer histogram analysis of pediatric acute lymphoblastic leukemia patients receiving intrathecal methotrexate therapy. Eur J Radiol 2005; 57:423-7. [PMID: 16314063 DOI: 10.1016/j.ejrad.2005.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Revised: 08/04/2005] [Accepted: 09/30/2005] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this prospective study was to evaluate the hypothesis that magnetization transfer ratio (MTR) histogram analysis of the whole brain could detect early and subtle brain changes nonapparent on conventional magnetic resonance imaging (MRI) in children with acute lymphoblastic leukemia (ALL) receiving methotrexate (MTX) therapy. MATERIALS AND METHODS Subjects in this prospective study comprised 10 children with ALL (mean age, 6 years; range, 0-16 years). In addition to conventional MRI, magnetization transfer images were obtained before and after intrathecal and intravenous MTX therapy. MTR values were calculated and plotted as a histogram, and peak height and location were calculated. Differences in peak height and location between pre- and post-MTX therapy scans were statistically analyzed. Conventional MRI was evaluated for abnormal signal area in white matter. RESULTS MTR peak height was significantly lower on post-MTX therapy scans than on pre-MTX therapy scans (p = 0.002). No significant differences in peak location were identified between pre- and post-chemotherapy imaging. No abnormal signals were noted in white matter on either pre- or post-MTX therapy conventional MRI. CONCLUSIONS This study demonstrates that MTR histogram analysis allows better detection of early and subtle brain changes in ALL patients who receive MTX therapy than conventional MRI.
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Affiliation(s)
- Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507, Japan.
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