Faculty Profiles - NAGANAWA, Shinji

Papers - NAGANAWA, Shinji

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Imaging analysis in cases with inflammation-induced sensorineural hearing loss.

Sone Michiko, Mizuno Terukazu, Naganawa Shinji, Nakashima Tsutomu

Acta Otolaryngol Vol. 8 page： 1-5 2008.8

Focal inflammation in the embryological ventral pancreas: assessment using CT and MRI.

Itoh, S; Suzuki, K; Kawai, H; Naganawa, S

Clin Radiol Vol. 63 page： 433-441 2008.4

Cognitive impairments in multiple system atrophy: MSA-C vs MSA-P.

Kawai, Y; Suenaga, M; Takeda, A; Ito, M; Watanabe, H; Tanaka, F; Kato, K; Fukatsu, H; Naganawa, S; Kato, T; Ito, K; Sobue, G

Neurology Vol. 70 page： 1390-1396 2008.4

Language：English Publishing type：Research paper (scientific journal)

We evaluated comprehensive neuropsychological tests and regional brain blood flow to compare cognitive dysfunction between two types of multiple system atrophy: predominant cerebellar ataxia (MSA-C) and predominant parkinsonism (MSA-P). METHODS: Twenty-one patients with MSA-C, 14 patients with MSA-P, and 21 age- and education-matched control subjects were subjected to neuropsychological tests and SPECT. The neuropsychological tests examined general cognition, verbal and visual memory, working memory, visuospatial and constructional ability, language, executive function, depression, and anxiety, while SPECT analysis examined brain perfusion. RESULTS: Patients with MSA-P showed severe involvement of visuospatial and constructional function, verbal fluency, and executive function compared with control subjects. Patients with MSA-C showed involvement only in visuospatial and constructional function compared with control subjects and a milder degree of involvement compared with patients with MSA-P. Patients with MSA-P tended toward a wide and severe impairment in cognitive function compared with patients with MSA-C. In addition, neuropsychological impairment in patients with MSA-P was significantly correlated with a decrease in prefrontal perfusion. This significant relation was not correlated to other factors such as age, education, and severity of cerebellar ataxia and parkinsonism, which are relevant factors associated with cognitive performance. CONCLUSIONS: Patients with multiple system atrophy-parkinsonism show more severe and more widespread cognitive dysfunctions than patients with multiple system atrophy-cerebellar ataxia. Our results also indicate that cognitive dysfunction in patients with multiple system atrophy-parkinsonism may be associated with prefrontal involvement.

*Separate visualization of endolymphatic space, perilymphatic space and bone by a single pulse sequence; 3D-inversion recovery imaging utilizing real reconstruction after intratympanic Gd-DTPA administration at 3 Tesla.

Naganawa S, Satake H, Kawamura M, Fukatsu H, Sone M, Nakashima T

Eur Radiol Vol. 18 ( 5 ) page： 920-924 2008.3

*Imaging of Endolymphatic and Perilymphatic Fluid at 3T After Intratympanic Administration of Gadolinium-Diethylene-Triamine Pentaacetic Acid.

Naganawa S, Sugiura M, Kawamura M, Fukatsu H, Sone M, Nakashima T

AJNR Am J Neuroradiol Vol. 29 ( 4 ) page： 724-726 2008.1

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

SUMMARY: By optimizing the inversion time of a 3D inversion-recovery turbo spin-echo sequence at 3T, we obtained separate images of endolymphatic and perilymphatic space 24 hours after intratympanic administration of gadolinium contrast material. In patients with Meniere disease, endolymphatic hydrops were detected not only in the cochlea but also in the vestibule. Fusion of the 2 types of images visualized the entire fluid space of the labyrinth and the spatial relationship of the 2 spaces.

Arterial Spin Labeling(syngo ASL) Case Report from Nagoya University

Shinji Naganawa

MAGNETON Flash page： 26-33 2008.1

Neuroendocrine tumor in the breast.

Ogawa H, Nishio A, Satake H, Naganawa S, Imai T, Sawaki M, Yamamoto E, Miyata T.

Radiat Med Vol. 26 ( 1 ) page： 28-32 2008.1

Language：English Publishing type：Research paper (scientific journal)

A 34-year-old woman with a past history of a carcinoid tumor in the right ovary presented with a right breast mass found on contrast-enhanced computed tomography (CT) of the chest. She was asymptomatic, and her blood tests were normal. The mass measured about 2 cm. Mammography showed a lobular, circumscribed, high-density mass without microcalcifications in the upper outer quadrant of the right breast. Ultrasonography showed an irregular mass with both hypoechoic and hyperechoic components with increased vascularity. The mass was well enhanced on contrast-enhanced CT and dynamic magnetic resonance imaging. At the same time, a well-enhanced small nodule was detected in the pouch of Douglas. Both of the tumors were resected, and a primary breast neuroendocrine tumor (solid neuroendocrine carcinoma) and peritoneal dissemination of the ovarian carcinoid tumor were diagnosed.

Development and evaluation of a novel lossless image compression method (AIC: artificial intelligence compression method) using neural networks as artificial intelligence.

Fukatsu, Hiroshi; Naganawa, Shinji; Yumura, Shinnichiro

Radiat Med Vol. 26 page： 120-128 2008

Imaging endolymphatic hydrops at 3 tesla using 3D-FLAIR with intratympanic Gd-DTPA administration.

Naganawa, Shinji; Satake, Hiroko; Iwano, Shingo; Fukatsu, Hiroshi; Sone, Michihiko; Nakashima, Tsutomu

Magn Reson Med Sci Vol. 7 page： 85-91 2008

Intraductal papillary mucinous neoplasm of the pancreas: assessment of the likelihood of invasiveness with multisection CT.

Ogawa, Hiroshi; Itoh, Shigeki; Ikeda, Mitsuru; Suzuki, Kojiro; Naganawa, Shinji

Radiology Vol. 248 page： 876-886 2008

内耳MRIの最前線

長縄慎二

臨床放射線 vol.53 No.11 Vol. 23 ( 11 ) page： 1324-1333 2008

Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging investigation of inner ear disturbances in cases of middle ear cholesteatoma with labyrinthine fistula

Sone M, Mizuno T, Sugiura M, Naganawa S, Nakashima T.

Otol Neurotol. Vol. 28 ( 8 ) page： 1029-33 2007.12

Language：English Publishing type：Research paper (scientific journal)

To investigate the cause of inner ear disturbances in cases of middle ear cholesteatoma with labyrinthine fistula. SETTING: University hospital. STUDY DESIGN: Prospective case study. PATIENTS: Eight patients who were scheduled to undergo surgery for middle ear cholesteatoma with labyrinthine fistula were included in this study. INTERVENTION: Imaging analysis was performed using a 3-dimensional fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging sequence. MAIN OUTCOME MEASURES: Three-dimensional FLAIR findings were compared with clinical symptoms associated with inner ear disturbance and surgical observations of the fistula. RESULTS: Three-dimensional FLAIR in 6 patients revealed areas of high signal intensity in the inner ears on the affected sides and areas with increased signal after the administration of gadolinium, especially in cases accompanied by acute sensorineural hearing loss. These images were considered to be indicative of breakdown of the blood-labyrinth barrier due to middle ear cholesteatoma. This finding was also present in a patient with no clinical symptoms of inner ear disturbances. CONCLUSION: Three-dimensional FLAIR images of the inner ear are valuable in evaluating labyrinthine fistula in patients with cholesteatoma. Future studies are needed to better understand the role of 3-dimensional FLAIR in predicting the severity of inner ear disturbance.

Vestibular aqueduct in sudden sensorineural hearing loss

Sugiura M, Naganawa S, Ishida IM, Teranishi M, Nakata S, Yoshida T, Nakashima T

J Laryngol Otol Vol. 26 page： 1-6 2007.11

Language：English Publishing type：Research paper (scientific journal)

To evaluate the vestibular aqueduct in patients with sudden sensorineural hearing loss.Methods:We evaluated 19 patients (12 men and seven women; age range, 22-79 years) with unilateral sudden sensorineural hearing loss, using computed tomography and magnetic resonance imaging. All these patients had unilateral sudden sensorineural hearing loss. We also evaluated 47 control subjects (22 men and 25 women; age range, 22-79 years).Results:In sensorineural hearing loss affected ears, the width of the vestibular aqueduct at the midpoint and at the operculum was significantly greater than that in contralateral ears or in control ears. The width of the vestibular aqueduct at the midpoint and the operculum did not correlate with the audiometric threshold or the audiogram configuration. Contrast enhancement of the ipsilateral endolymphatic sac was observed in 17 of 19 patients with sudden sensorineural hearing loss (89 per cent). Eleven of these 17 patients also showed enhancement on the contralateral side, but no patient showed enhancement only on the contralateral side. In sensorineural hearing loss affected ears, the width of the vestibular aqueduct did not differ significantly between those patients with and without enhancement.Conclusions:The vestibular aqueducts of sudden sensorineural hearing loss affected ears are wider than those of controls. Precise imaging and evaluation of the inner ear is essential when investigating the pathological conditions responsible for sudden sensorineural hearing loss.

RVS（Real-time Virtual Sonography）技術の乳腺領域への応用

佐竹弘子、西尾明子、石垣聡子、福原理恵子、島本佳寿広、今井常夫、小田高司、菊森豊根、澤木正孝、長縄慎二

乳癌の臨床 Vol. 22 ( 5 ) page： 438(86)-439(87) 2007.10

Comparison of 18F-FDG PET and bone scintigraphy in detection of bone metastasesof thyroid cancer. Reviewed

Ito S, Kato K, Ikeda M, Iwano S, Makino N, Tadokoro M, Abe S, Nakano S,Nishino M, Ishigaki T, Naganawa S.

J Nucl Med. Vol. 48 ( 6 ) page： 889-895 2007.6

Usefulness of FDG PET for diagnosis and radiotherapy of the patient with malignant lymphoma involving bone marrow. Reviewed

Nihashi, Takashi; Hayasaka, Kazumasa; Itou, Toshihide; Sobajima, Takashi; Kato, Rikio; Ito, Kengo; Ito, Yoshiyuki; Ishigaki, Takeo; Naganawa, Shinji

Radiat Med Vol. 25 ( 3 ) page： 130-4 2007.4

Language：English Publishing type：Research paper (scientific journal)

We experienced a case of relapsed malignant lymphoma with multiple bone marrow or bone lesions. The case was diagnosed as follicular lymphoma by cytological biopsy of the right iliac bone, with (67)Ga scintigraphy showing abnormal, intense uptake in multiple bones. After about 10 months of systemic chemotherapy, a relapse was suspected because of pain in the bilateral legs and a high level of lactate dehydrogenase. Assessment of the lesions in the patient was difficult by computed tomography because the affected sites were localized mainly in the bone marrow. (18)F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) was useful for detecting accurately the relapse sites in the bone marrow and enabled us to determine the field for radiotherapy. There are only a few reports of FDG-PET findings for such bone marrow malignant lymphomas. Therefore, we report the findings of FDG-PET for this case and review some of the literature about bone marrow lymphomas.

Usefulness of combined fractional anisotropy and apparent diffusion coefficient values for detection of involvement in multiple system atrophy. Reviewed

Ito, Mizuki; Watanabe, Hirohisa; Kawai, Yoshinari; Atsuta, Naoki; Tanaka, Fumiaki; Naganawa, Shinji; Fukatsu, Hiroshi; Sobue, Gen

J Neurol Neurosurg Psychiatry Vol. 78 page： 722-728 2007.3

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To determine whether apparent diffusion coefficient (ADC) values and fractional anisotropy (FA) values can detect early pathological involvement in multiple system atrophy (MSA), and be used to differentiate MSA-P (multiple system atrophy if parkinsonian features predominate) from Parkinson's disease (PD). METHODS: We compared ADC and FA values in the pons, cerebellum and putamen of 61 subjects (20 probable MSA patients, 21 age matched PD patients and 20 age matched healthy controls) using a 3.0 T magnetic resonance system. RESULTS: ADC values in the pons, cerebellum and putamen were significantly higher, and FA values lower in MSA than in PD or controls. These differences were prominent in MSA lacking dorsolateral putaminal hyperintensity (DPH) or hot cross bun (HCB) sign. In differentiating MSA-P from PD using FA and ADC values, we obtained equal sensitivity (70%) and higher specificity (100%) in the pons than in the putamen and cerebellum. In addition, all patients that had both significant low FA and high ADC values in each of these three areas were MSA-P cases, and those that had both normal FA and ADC values in the pons were all PD cases. Our diagnostic algorithm based on these results accurately diagnosed 90% of patients with MSA-P. CONCLUSION: FA and ADC values detected early pathological involvement prior to magnetic resonance signal changes in MSA. In particular, low FA values in the pons showed high specificity in discriminating MSA-P from PD. In addition, combined analysis of both FA and ADC values in all three areas was more useful than only one.

3D-FLAIR MRI findings in a patient with Ramsay Hunt syndrome. Reviewed

Sugiura M, Naganawa S, Nakata S, Kojima S, Nakashima T

Acta Otolaryngol Vol. 127 ( 5 ) page： 547-549 2007

Language：English Publishing type：Research paper (scientific journal)

Three-dimensional, fluid-attenuated inversion recovery (3D-FLAIR) of magnetic resonance imaging (MRI) has recently been developed to detect hemorrhage or high concentrations of protein. We present a patient with Ramsay Hunt syndrome, in whom high signals in the cochlear and vestibular apparatus were identified with 3D-FLAIR. The high signal areas in 3D-FLAIR were not detected by T1- and T2-weighted MRI in this case. This is the first report of high concentrations of protein in the inner ear in Ramsay Hunt syndrome using 3D-FLAIR, and suggests that high concentrations of protein in the inner ear are associated with hearing deterioration in some patients with Ramsay Hunt syndrome. 3D-FLAIR could be a useful diagnostic tool in the early stages of Ramsay Hunt syndrome.

*Visualization of endolymphatic hydrops in patients with Meniere's disease. Reviewed

Nakashima T, Naganawa S, Sugiura M, Teranishi M, Sone M, Hayashi H, Nakata S, Katayama N, Ishida IM

Laryngoscope Vol. 117 ( 3 ) page： 415-420 2007

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Recently, there have been many reports of intratympanic gentamicin therapy for the treatment of intractable Meniere's disease. Intratympanic administration of steroids has also been used to treat sudden sensorineural hearing loss. We attempted to visualize how the intratympanically administered drug enters the inner ear. METHODS: Gadolinium hydrate diluted eightfold with saline was injected intratympanically through the tympanic membrane using a 23 G needle in nine patients with inner ear diseases. With a 3 Tesla magnetic resonance imaging (MRI) unit, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging was performed. RESULTS: 3D-FLAIR MRI clearly revealed that the gadolinium entered the perilymphatic space and delineated the perilymphatic and endolymphatic spaces of the inner ear. In patients with endolymphatic hydrops, the perilymphatic space surrounding the endolymph was small or had disappeared. Gadolinium appeared first in the scala tympani of the basal turn of the cochlea and the perilymphatic space of the vestibule. One day after the intratympanic injection of gadolinium, the gadolinium was observed in almost all parts of the perilymph. Six days after the intratympanic injection, the gadolinium had almost disappeared from the inner ear. CONCLUSION: We reported the first visualization of endolymphatic hydrops in patients with Meniere's disease. The relationship between the image of the endolymphatic space and functional tests, such as electrocochleography and vestibular-evoked myogenic potential, must be examined in the near future. It is important for the development of intratympanic drug therapies for inner-ear diseases to investigate how the drugs enter and leave the inner ear.

【マルチモダリティによるHead & Neck Imaging 2007　臨床編　日常臨床における戦略と選択】側頭骨・耳(中耳・内耳・外耳)　難聴とめまいにおける画像診断の現状と進歩　名古屋大学医学部附属病院

長縄慎二

INNERVISION Vol. 22 page： 8-11 2007

Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal)

難聴、めまいは病院を訪れる主訴として非常に多い。両者を合併することもある。これらの病態の診断で最も大切なのは、言うまでもなく十分な病歴聴取である。さらに聴力検査、注視眼振検査、頭位眼振検査、温度刺激試験、下位脳神経障害や中耳炎の有無を調べる耳鼻咽喉科的一般所見などの検査で引き続き診断を進め、血液検査や他の部位の画像検査で全身疾患の有無も調べる必要がある。局所つまり側頭骨の画像検査はそれらを補完する意義を持つ。側頭骨画像診断についてはCT,MRIが最も重要な画像検査であるが、本稿では側頭骨におけるCT,MRIの撮像法の原則を述べた後、病態ごとに画像診断のポイント、最近の進歩を述べ、最後に難聴における画像診断の進め方のデシジョンツリーをシェーマとしてまとめることとする。(著者抄録)

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Papers - NAGANAWA, Shinji