2024/03/13 更新

写真a

マツシマ マサヤ
松島 正哉
MATSUSHIMA, Masaya
所属
医学部附属病院 放射線科 病院講師
職名
病院講師

学位 1

  1. 博士(医学) ( 2010年9月   名古屋大学 ) 

 

論文 17

  1. "Speckled Enhancement" on Gd-EOB-DTPA Enhanced MR Imaging of Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma

    Hyodo, R; Takehara, Y; Nishida, A; Matsushima, M; Naganawa, S

    MAGNETIC RESONANCE IN MEDICAL SCIENCES   22 巻 ( 3 ) 頁: 273 - 281   2023年

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    Purpose: To elucidate MRI features of primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma, particularly, the “speckled enhancement” on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI. Methods: The institutional review board approved this retrospective observational study and waived informed consent. Using our picture archiving and communication systems and electronic medical records, five patients histopathologically diagnosed as hepatic MALT lymphoma and clinically confirmed as primary lesions who had undergone dynamic contrast-enhanced (DCE)-CT and DCE-MRI with Gd-EOB-DTPA were identified from September 2009 to December 2020. Two radiologists assessed their CT and MRI data in consensus with a pathologist’s advice. Results: Overall, five lesions in five patients were included in this study. Precontrast CT showed hypoatte-nuation in all lesions. In the arterial phase of DCE-CT, four lesions (80%) showed hyperattenuation, whereas all lesions showed iso-to hypoattenuation in the delayed phase. A vessel penetration sign was also observed in all lesions. On MRI, all lesions showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and restricted diffusion on diffusion-weighted images. Both DCE-CT and DCE-MRI with Gd-EOB-DTPA showed similar enhancement patterns, except for the hepatocyte phase. Notably, how-ever, four out of five lesions showed characteristic “speckled enhancement” that refers to punctate positive enhancements within the low signal lesions on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI pathologically confirmed to be hepatocyte clusters that remained in the tumor. Conclusion: Primary hepatic MALT lymphomas were characterized by arterial phase enhancement, restricted diffusion, vessel penetration sign, and more specifically “speckled enhancement” in the hepato-biliary phase of DCE-MRI with Gd-EOB-DTPA.

    DOI: 10.2463/mrms.mp.2021-0069

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  2. Embolization using patient-specific vascular models created by a 3D printer for difficult cases: a report of two cases

    Komada, T; Kamomae, T; Matsushima, M; Hyodo, R; Naganawa, S

    NAGOYA JOURNAL OF MEDICAL SCIENCE   84 巻 ( 2 ) 頁: 477 - 483   2022年5月

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    記述言語:英語   出版者・発行元:Nagoya Journal of Medical Science  

    With the widespread use of three-dimensional printers, organ models created by these printers are now being used in the medical field for preoperative planning of surgeries. In this article, we report two cases in which embolization was expected to be difficult, and the three-dimensional printer-based vascular modeling was helpful in planning the surgery. The first case involved an aneurysm of the splenic artery. We attempted to embolize the aneurysm but were unable to advance the catheter into the distal artery and discontinued the procedure. The second case was a perianal varicose vein, which was initially treated with percutaneous transhepatic obliteration but was recanalized and required embolization. However, we expected difficulty in selecting the inferior mesenteric vein. In both cases, the vascular models were created using a 3D printer from the patients’ computed tomography images. Preoperative planning, including treatment simulation, was based on these models. The time required to print a three-dimensional vascular model was approximately 12 hours at a cost of less than $10 each. Patient-specific vascular models using a three-dimensional printer can be a simple and inexpensive tool that can increase the success of embolization in difficult cases.

    DOI: 10.18999/nagjms.84.2.477

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  3. A case of stent-graft implantation for postpancreaticoduodenectomy hemorrhage in a patient with a reconstructed gastric tube.

    Komada T, Tachi Y, Nagasaka K, Yamada S, Matsushima M, Sakaki Y, Naganawa S

    Radiology case reports   15 巻 ( 12 ) 頁: 2710 - 2713   2020年12月

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  4. Evaluation of segment 4 portal vein embolization added to right portal vein for right hepatic trisectionectomy: A retrospective propensity score-matched study

    Ito, J; Komada, T; Suzuki, K; Matsushima, M; Nakatochi, M; Kobayashi, Y; Ebata, T; Naganawa, S; Nagino, M

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES   27 巻 ( 6 ) 頁: 299 - 306   2020年6月

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    記述言語:英語   出版者・発行元:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: Adding segment 4 (S4) portal vein embolization (PVE) to right PVE before right hepatic trisectionectomy is controversial. We retrospectively examined the effect of S4 PVE on segments 2 and 3 (S2 + 3) hypertrophy. Methods: We reviewed patients with biliary carcinoma who underwent right PVE with (R3PVE) or without (R2PVE) S4 PVE using gelatin sponge particles and coils (2010-2019). Propensity score matching balanced the cohort for baseline characteristics, including total liver volume and S2 + 3 volume before PVE. We compared the groups regarding the S2 + 3 volume changes after PVE. Results: Of 178 enrolled patients, 38 underwent R3PVE for right hepatic trisectionectomy and 140 underwent R2PVE for right hepatectomy. Twenty-eight patients from each group were respectively matched. The median absolute volume increase in (146 cm3 vs 70 cm3), hypertrophy rate of (52.4% vs 32.3%), and kinetic growth rate of (3.1%/wk vs 2.0%/wk) S2 + 3 were significantly higher in the R3PVE group than in the R2PVE group. In the pre-matched cohort, the rate of posthepatectomy liver failure and postoperative hospital stay did not significantly differ between the patients who underwent right hepatic trisectionectomy and right hepatectomy. Conclusion: R3PVE increased the S2 + 3 volume more effectively than R2PVE in patients with biliary carcinoma.

    DOI: 10.1002/jhbp.723

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  5. Balloon-Occluded Retrograde Transvenous Obliteration for Fundal Gastric Variceal Bleeding in a Small Child

    Komada, T; Suzuki, K; Oshima, K; Matsushima, M; Nagasaka, K; Naganawa, S

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   30 巻 ( 10 ) 頁: 1624 - 1625   2019年10月

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    記述言語:英語   出版者・発行元:Journal of Vascular and Interventional Radiology  

    DOI: 10.1016/j.jvir.2019.06.022

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  6. 画像診断と病理 腎静脈に発生した平滑筋肉腫

    松島 正哉, 林 葉子, 岩野 信吾, 長縄 慎二, 下山 芳江

    画像診断   39 巻 ( 3 ) 頁: 252 - 253   2019年2月

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    出版者・発行元:学研メディカル秀潤社  

    DOI: 10.15105/gz.0000000981

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  7. Successful treatment of esophageal bleeding due to rupture of major aortopulmonary collateral arteries by transcatheter arterial embolization

    Ito Takanori, Ishigami Masatoshi, Ishizu Yoji, Kuzuya Teiji, Honda Takashi, Matsushima Masaya, Kato Taichi, Hirooka Yoshiki

    CLINICAL JOURNAL OF GASTROENTEROLOGY   12 巻 ( 1 ) 頁: 20-24   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s12328-018-0895-8

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  8. Efficacy of percutaneous transhepatic portal vein embolization using gelatin sponge particles and metal coils.

    Komada T, Suzuki K, Mizuno T, Ebata T, Matsushima M, Naganawa S, Nagino M

    Acta radiologica open   7 巻 ( 4 ) 頁: 2058460118769687   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1177/2058460118769687

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  9. 後腹膜大量出血に対する動脈塞栓術後に生じた腹部コンパートメント症候群の1救命例

    鈴木 優美, 佐伯 悟三, 松島 正哉, 平松 聖史, 新井 利幸

    日本腹部救急医学会雑誌   38 巻 ( 1 ) 頁: 105 - 108   2018年1月

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    記述言語:日本語   出版者・発行元:日本腹部救急医学会  

    <p>症例は72歳,女性。近医より後腹膜大量出血による出血性ショックの状態で転院搬送された。緊急血管造影検査で下膵十二指腸動脈からの持続的な出血を認め,塞栓術を施行しすみやかに循環動態は安定した。塞栓術後腹部コンパートメント症候群(abdominal compartment syndrome:以下,ACS) を発症したため緊急開腹血腫除去術を行い,全身状態は改善した。動脈性の大量出血による出血性ショックに対して,血管塞栓術は低侵襲で迅速に止血が得られるため効果的な治療法である。一方,大量の血腫が後腹膜または腹腔内に残存しACS発症のリスクが高いため,大量出血に対する塞栓術後にはACSを念頭に置き,診療にあたることが重要である。</p>

    DOI: 10.11231/jaem.38.105

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  10. Portal Vein Bleeding after Pancreatectomy: Diagnosis and Stent Graft Repair - A Consecutive Case Series

    Suzuki Kojiro, Ebata Tomoki, Komada Tomohiro, Matsushima Masaya, Mizuno Takashi, Igami Tsuyoshi, Sugawara Gen, Yokoyama Yukihiro, Naganawa Shinji, Nagino Masato

    JOURNAL OF THE PANCREAS   18 巻 ( 4 ) 頁: 339-344   2017年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  11. Ex-vivo ultra-high-resolution optical coherence tomography imaging of fine lung structure by use of a high-power Gaussian-like supercontinuum at 0.8-um wavelength.

    Nishizawa N., Ishida S., Ohta T., Itoh K., Kitatsuji M., Ohshima H., Hasegawa Y., Matsushima M., Kawabe T.

    ENDOSCOPIC MICROSCOPY VI   7893 巻   2011年

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    出版者・発行元:Progress in Biomedical Optics and Imaging - Proceedings of SPIE  

    Optical coherence tomography (OCT) is an emerging technology for non-invasive cross-sectional imaging of biological tissue and material with um resolution. Recently, non-invasive high resolution cross-sectional imaging is desired for investigation of diseases in lung in the field of pulmonary medicine. So far, a few works have been reported about OCT imaging of lung. Since the lung consists of alveoli separated by thin wall, ultrahigh resolution (UHR) OCT is supposed to be effective for the imaging of fine structure in lung tissue. In this work, ex vivo cross-sectional imaging of isolated rat lungs was demonstrated using UHR-OCT. A 120 nm-wide, high-power, Gaussian-like supercontinuum (SC) was generated at wavelength of 0.8 um region and it was used as the light source in time domain UHR-OCT. An ultrahigh resolution of 2.1 um in tissue was obtained and the achieved sensitivity was 105 dB. For the UHR-OCT imaging of trachea, the detailed structures of the tracheal cartilage and tracheal mucosa overlying the cartilage were observed clearly. The epithelium and lamina propria were also distinguishable. For the imaging of visceral pleura and alveoli, when saline was instilled into the lung, the penetration depth was improved, and clear images of the fine structure of the lung, including alveoli, were observed owing to the index matching effect. The clear images of up to about 4 alveoli were observed below the visceral pleura. The shape of the alveolar septum was clearly observed, and the alveolar sac was clearly visible. © 2011 SPIE.

    DOI: 10.1117/12.878874

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  12. Diagnostic Value of SPIO-mediated Breath-hold, Black-blood, Fluid-attenuated, Inversion Recovery (BH-BB-FLAIR) Imaging in Patients with Hepatocellular Carcinomas

    Matsushima, M; Naganawa, S; Ikeda, M; Itoh, S; Ogawa, H; Komada, T; Ishigaki, S; Kawai, H; Suzuki, K; Satake, H; Iwano, S

    MAGNETIC RESONANCE IN MEDICAL SCIENCES   9 巻 ( 2 ) 頁: 49 - 58   2010年

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    Purpose: We assessed the value of adding a breath-hold, black-blood, fluid-attenuated, inversion recovery (BH-BB-FLAIR) sequence with a small motion-probing gradient (b=10 s/mm2) using superparamagnetic iron oxide (SPIO) to our present studies that utilize SPIO to detect hepatocellular carcinoma (HCC).We used inversion recovery (IR) in a FLAIR sequence to suppress signals from cysts and a low b-value to suppress vessel signals and provide higher signal to noise than that using high b-value diffusion-weighted imaging. Use of SPIO is expected to reduce the signal in both normal liver parenchyma and in most benign lesions. Materials and Methods: In 19 patients, we reviewed 38 HCC nodules diagnosed by CT arterioportography (CTAP) and CT during hepatic arteriography (CTHA). We divided SPIO-mediated images into sets, those obtained with and without BH-BB-FLAIR. Six radiologists individually interpreted the 2 image sets and sorted them by their confidence levels for the presence of HCC, and we calculated the area under the receiver operating characteristic (ROC) curve (Az) for each image set. Results: On images obtained with BH-BB-FLAIR after SPIO administration, 33 of the 38 HCC nodules appeared as areas of high signal and cyst signal was extinguished. The ROC analysis showed significantly higher Az values in the set with BH-BB-FLAIR (0.89) than in the set without (0.83). Conclusions: Adding BH-BB-FLAIR to existing SPIO-mediated imaging protocols improved detection of HCC nodules and added only 24 s to the scan time.

    DOI: 10.2463/mrms.9.49

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  13. マルチスライスCTによる十二指腸乳頭部近傍領域の診断

    伊藤 茂樹, 松島 正哉, 鈴木 耕次郎, 太田 豊裕, 長縄 慎二

    胆道 = Journal of Japan Biliary Association   23 巻 ( 5 ) 頁: 806 - 815   2009年12月

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    記述言語:日本語  

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  14. 第四回 乳頭部癌 マルチスライスCTによる十二指腸乳頭部近傍領域の診断

    伊藤 茂樹, 松島 正哉, 鈴木 耕次郎, 太田 豊裕, 長縄 慎二

    胆道   23 巻 ( 5 ) 頁: 806 - 815   2009年

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    記述言語:日本語   出版者・発行元:日本胆道学会  

    <b>要旨: </b>十二指腸乳頭部近傍領域のCT診断においては1.25 mm以下の検出器厚による多相造影検査と2-3 mm厚の水平断と高分解能のmultiplanar reformatted imagesの作成が重要である.これらの画像は,主膵管,膵内胆管,膵頭十二指腸動脈などの細かな解剖学的構造の描出を可能とする.また,膵実質相において膵頭部と十二指腸の間に造影効果の低下した領域が描出され,この領域は膵胆管をOddi括約筋が取り巻いている領域に相当すると推定される.膵胆管拡張の原因検索のためCT検査が施行された乳頭部腫瘍の症例において,CTの果たすべき最も重要な役割は膵癌や胆管癌などの他の疾患を除外することである.しかしながら,CTは共通管,Oddi括約筋,十二指腸固有筋層を分離して同定できないため,局所進展度診断におけるその役割は限られる.乳頭部腫瘍は比較的予後が良好であるため,CT検査の施行においては,その被曝や造影剤に伴う副作用にも十分留意すべきである.<br>

    DOI: 10.11210/tando.23.806

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  15. Endovascular Management of Ruptured Pancreaticoduodenal Artery Aneurysms Associated with Celiac Axis Stenosis

    Suzuki, K; Tachi, Y; Ito, S; Maruyama, K; Mori, Y; Komada, T; Matsushima, M; Ota, T; Naganawa, S

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   31 巻 ( 6 ) 頁: 1082 - 1087   2008年11月

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    記述言語:英語   出版者・発行元:CardioVascular and Interventional Radiology  

    The purpose of this study was to assess the efficacy of transcatheter arterial embolization for ruptured pancreaticoduodenal artery (PDA) aneurysms associated with celiac axis stenosis (CS). Seven patients (four men and three women; mean age, 64; range, 43-84) were treated with transcatheter arterial embolization between 2002 and 2007. They were analyzed with regard to the clinical presentation, radiological finding, procedure, and outcome. All patients presented with sudden epigastric pain or abdominal discomfort. Contrast-enhanced CT showed a small aneurysm and retroperitoneal hematoma around the pancreatic head in all patients. The aneurysms ranged from 0.3 to 0.9 cm in size. In one patient, two aneurysms were detected. The aneurysms were located in the pancreaticoduodenal artery (n = 5) and the dorsal pancreatic artery (n = 3). Embolization was performed with microcoils in all aneurysms (n = 8). N-Butyl 2-cyanoacrylate (n = 1) and gelatine particle (n = 1) were also used. Complete occlusion was achieved in four patients. In the other three patients, a significantly reduced flow to the aneurysm remained at final angiography. However, these aneurysms were thrombosed on follow-up CT within 2 weeks. And there was no recurrence of the symptoms and bleeding during follow-up (mean, 28 months; range, 5-65 months) in all patients. In conclusion, transcatheter arterial embolization for PDA aneurysms associated with CS is effective. Significant reduction of the flow to the aneurysm at final angiography may be predictive of future thrombosis. © 2008 Springer Science+Business Media, LLC.

    DOI: 10.1007/s00270-008-9343-3

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  16. Contrast-enhanced MR imaging of metastatic brain tumor at 3 tesla: utility of T(1)-weighted SPACE compared with 2D spin echo and 3D gradient echo sequence.

    Komada T, Naganawa S, Ogawa H, Matsushima M, Kubota S, Kawai H, Fukatsu H, Ikeda M, Kawamura M, Sakurai Y, Maruyama K

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   7 巻 ( 1 ) 頁: 13 - 21   2008年

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    We evaluated the newly developed whole-brain, isotropic, 3-dimensional turbo spin-echo imaging with variable flip angle echo train (SPACE) for contrast-enhanced T1-weighted imaging in detecting brain metastases at 3 tesla (T). Twenty-two patients with suspected brain metastases underwent postcontrast study with SPACE, magnetization-prepared rapid gradient-echo (MP-RAGE), and 2-dimensional T1-weighted spin echo (2D-SE) imaging at 3T. We quantitatively compared SPACE, MP-RAGE, and 2D-SE images by using signal-to-noise ratios (SNRs) for gray matter (GM) and white matter (WM) and contrastto-noise ratios (CNRs) for GM-to-WM, lesion-to-GM, and lesion-to-WM. Two blinded radiologists evaluated the detection of brain metastases by segment-by-segment analysis and continuously-distributed test. The CNR between GM and WM was significantly higher on MP-RAGE images than on SPACE images (P<0.01). The CNRs for lesion-to-GM and lesion-to-WM were significantly higher on SPACE images than on MP-RAGE images (P<0.01). There was no significant difference in each sequence in detection of brain metastases by segment-by-segment analysis and the continuously-distributed test. However, in some cases, the lesions were easier to detect in SPACE images than in other sequences, and also the vascular signals, which sometimes mimic lesions in MP-RAGE and 2D-SE images, were suppressed in SPACE images. In detection of brain metastases at 3T magnetic resonance (MR) imaging, SPACE imaging may provide an effective, alternative approach to MP-RAGE imaging for 3D T1-weighted imaging.

    DOI: 10.2463/mrms.7.13

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  17. 1B1100 神経成長円錐における細胞接着とベシクルの共局在

    辰巳 仁史, 岩井 和子, 松島 正哉, 井上 陽介, 曽我部 正博

    生物物理   40 巻 ( supplement ) 頁: S14   2000年

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    記述言語:日本語   出版者・発行元:一般社団法人 日本生物物理学会  

    DOI: 10.2142/biophys.40.s14_1

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▼全件表示

MISC 1

  1. A case of stent-graft implantation for postpancreaticoduodenectomy hemorrhage in a patient with a reconstructed gastric tube.

    Komada T, Tachi Y, Nagasaka K, Yamada S, Matsushima M, Sakaki Y, Naganawa S  

    Radiology case reports15 巻 ( 12 ) 頁: 2710 - 2713   2020年12月

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    記述言語:英語   出版者・発行元:Radiology Case Reports  

    In patients with a reconstructed gastric tube, the right gastroepiploic artery is a very important feeding artery of the tube, which must be preserved when performing a pancreaticoduodenectomy. A 76-year-old man with a reconstructed gastric tube underwent pancreaticoduodenectomy for distal bile duct carcinoma. On postoperative day 8, he had an arterial hemorrhage from a drain, apparently from a ligation of the anterior superior duodenal artery. He, therefore, underwent stent-graft placement in the gastroduodenal artery. The stent-grafts were temporarily occluded, and the gastric tube was necrotizing. However, thrombolytic therapy allowed the stent-grafts to reopen and prevented gastric tube necrosis. We believe our case of stent-graft implantation in the gastroduodenal artery is the first of this kind to successfully prevent lethal necrosis of the gastric tube.

    DOI: 10.1016/j.radcr.2020.10.021

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科研費 1

  1. 肝内門脈側副路の評価と肝静脈塞栓を組み込んだ拡大肝切除のためのIVRの新戦略

    研究課題/研究課題番号:21K07562  2021年4月 - 2024年3月

    科学研究費助成事業  基盤研究(C)

    駒田 智大, 松島 正哉, 長坂 憲, 馬越 弘泰

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    担当区分:研究分担者 

    門脈塞栓術は、拡大肝切除術前に切除予定部分の肝内門脈を塞栓し、残存予定部分の肝臓を肥大させることで、術後の肝不全を予防するIVRである。
    本研究の目的は、門脈塞栓術の前後で、Dual energy CTを搭載したIVR-CTで、門脈造影による肝実質ヨードマップを作製し、肝実質内のヨード濃度を計測することで、肝内門脈側副路の影響を調べ、残存予定葉の肥大との相関を明らかにすることである。また十分な残肝肥大が得られないと予想される症例に対して、肝静脈塞栓術を追加することで、肝肥大を向上させることができるかを明らかにする。
    門脈塞栓術は、拡大肝切除術前に切除予定部分の肝内門脈を塞栓し、残存予定部分の肝臓を肥大させることで、術後の肝不全を予防するIVRである。我々が門脈塞栓術を行った136症例の残存予定葉の肥大率は、30.7%であったが、ほとんど肥大していない症例もあった。
    残存予定葉の肥大に影響する様々な因子が知られているが、門脈血流そのものを検討した研究はなされていない。近年、Dual energy CTを搭載したIVR-CTで、門脈造影による肝実質ヨードマップを作製することで、肝実質内の門脈血流を客観的に評価できるようになった。
    本研究の目的は、門脈塞栓術の前後で、門脈造影による肝実質ヨードマップを作製し、肝実質内のヨード濃度を計測することで、肝内門脈側副路の影響を調べ、残存予定葉の肥大との相関を明らかにすることである。また十分な残肝肥大が得られないと予想される症例に対して、肝静脈塞栓術を追加することで、肝肥大を向上させることができるかを明らかにする。
    これにより肝癌や胆管癌の手術適応が拡大し、予後の改善が期待できる見込みである。
    まず、研究を始めるにあたり、施設の生命倫理審査委員会に研究の申請を行い、承認を受けた。現在、対象患者さんに対して、インフォームドコンセントを行い、了解を得たのちに、研究に参加していただき、門脈塞栓術時に門脈造影を行いながらDual energy CTの撮影を行い、門脈血流による肝ヨードマップのデータの採取を行っている。
    対象症例が着実に集まっており、データを得ることができている。
    現在、拡大肝切除術前に経皮的門脈塞栓術を行っている患者さんに対して、インフォームドコンセントを行い、署名による同意を得たのちに、門脈造影によるDual energy CTの撮影を行わせていただき、データの蓄積を行っている。
    中間解析を行った結果では、予想と矛盾しない結果であった。さらに症例数を増やして、再検討する予定である。