Faculty Profiles - NAGANAWA, Shinji

Papers - NAGANAWA, Shinji

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Contrast enhanced MR imaging of the brain using T1-FLAIR with BLADE compared with conventional spin echo sequence

S.Naganawa,H.Kawai,and H.Fukatsu

Proc.Intl.Soc.Mag.Reson.Med Vol. 15 page： 2110 2007

拡散テンソル画像を用いた多系統萎縮症とパーキンソン病の錐体路評価

伊藤瑞規, 熱田直樹, 川合圭成, 渡邉宏久, 祖父江元, 長縄慎二, 深津博, 石垣武男

臨床神経学 Vol. 46 page： 1084 2007

Parry-Romberg syndrome with a clinically silent white matter lesion. Reviewed

Okumura A, Ikuta T, Tsuji T, Kato T, Fukatsu H, Naganawa S, Kato K, Watanabe K

AJNR Am J Neuroradiol Vol. 27 ( 8 ) page： 1729-1731 2006.9

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

We performed a detailed neuroimaging study in a patient with Parry-Romberg syndrome. Proton MR spectroscopy demonstrated normal spectral patterns, though conventional MR imaging revealed high-intensity areas in the entire white matter in the left hemisphere. Single-photon emission tomography showed increased perfusion in the cortex of the affected hemisphere. Pyramidal tracts and optic radiations were preserved on diffusion tensor tractography. We will correlate these neuroimaging findings with normal psychomotor development in our patient.

Prompt contrast enhancement of cerebrospinal fluid space in the fundus of the internal auditory canal: observations in patients with meningeal diseases on 3D-FLAIR images at 3 Tesla. Reviewed

Naganawa S, Sugiura M, Kawamura M, Fukatsu H, Nakashima T, Maruyama K

Magn Reson Med Sci Vol. 5 ( 3 ) page： 151-155 2006

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

We speculated that meningeal pathologies might facilitate the permeability of cranial nerves at the fundus of the internal auditory canal (IAC), causing prompt enhancement after administration of Gd-DTPA. Using a 3D- fluid-attenuated inversion recovery (FLAIR) sequence, we evaluated the enhancement of the cerebrospinal fluid (CSF) space in the IAC fundus 10 min after Gd-DTPA administration in patients with meningeal diseases. Twenty patients (aged 22 to 79 years) were divided into 2 groups, a group with meningeal disease comprising 9 patients with meningeal abnormalities (6, tumor dissemination; 3, infection) and a control group of 11 patients with unilateral IAC pathology whose healthy sides were included as controls. Six of the 9 patients in the group with meningeal disease showed bilateral enhancement; one showed unilateral enhancement. None of the control group showed enhancement in the healthy side. One patient with Ramsay-Hunt syndrome showed only ipsilateral enhancement. Enhancement in the IAC fundus was frequently observed in patients with meningeal disease, even just 10 min after administration of contrast agent. This enhancement in the IAC fundus was never visible on T1-weighted 3D-FLASH images.

*Observation of contrast enhancement in the cochlear fluid space of healthy subjects using a 3D-FLAIR sequence at 3 Tesla. Reviewed

Naganawa S, Komada T, Fukatsu H, Ishigaki T, Takizawa O

Eur Radiol Vol. 16 ( 3 ) page： 733-737 2006

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

In animals, the enhancement of perilymph in the cochlea has been reported using 1.25 mmol/kg of Gd-DTPA, allowing the separate visualisation of perilymph and endolymph for the diagnosis of Meniere's disease. The purpose of this study was three-fold: (1) to determine the optimal timing for detecting cochlear fluid enhancement using 3D-FLAIR (fluid-attenuated inversion recovery) after intravenous administration of 0.1 mmol/kg of Gd-DTPA in healthy human subjects; (2) to examine the reliability of enhancement in multiple healthy subjects; and (3) to investigate whether endolymph and perilymph space can be visually discriminated. In two healthy subjects, 3D-FLAIR images were obtained before, immediately after and 2 h, 4 h and 6 h after the injection. Three more healthy subjects were scanned before and 4 h after the injection. In all four ears of the initial two subjects, cochlear fluid was found to be most intensely enhanced 4 h after the injection. In all of the additional three subjects, the cochlear fluid signal had increased after 4 h from injection. However, visual differentiation of endolymph and perilymph fluid could not be achieved. Using 3D-FLAIR and Gd-DTPA, cochlear fluid enhancement can be observed in healthy human ears, even with a single dose of contrast-medium injection.

Relationship between CT densitometry with a slice thickness of 0.5 mm and audiometry in otosclerosis. Reviewed

Kawase S, Naganawa S, Sone M, Ikeda M, Ishigaki T

Eur Radiol Vol. 16 ( 6 ) page： 1367-1373 2006

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

The appropriate cutoff Hounsfield unit (HU) value for the diagnosis of otosclerosis was determined and the correlation between the bone conduction threshold and the findings of computed tomography (CT) densitometry investigated. CT images, 0.5-mm thick, were evaluated in 24 ears with otosclerosis and 19 control ears. Eight regions of interest were set around the otic capsule. The mean HU values in the area anterior to the oval window (A-OW) and anterior to the internal auditory canal (A-IAC) were significantly lower in otosclerosis than in controls. Based on receiver operating characteristic (ROC) analysis, the cutoff HU value in A-OW was determined to be 2,187.3 HU. The mean HU value in retrofenestral otosclerosis was significantly lower in the area A-OW, A-IAC and around the cochlea than in controls. Based on ROC analysis, the cutoff HU value in the latter was determined to be 2,045 HU. A statistically significant correlation was found between the density of the area A-OW and the hearing level at 500 and 1,000 Hz, and between the density of the area around the cochlea and the hearing level at most frequencies. These results suggest the semi-automated diagnosis of otosclerosis may be possible.

Blood flow to the promontory in cochlear otosclerosis. Reviewed

Nakashima T, Sone M, Fujii H, Teranishi M, Yamamoto H, Otake H, Sugiura M, Naganawa S

Clin Otolaryngol Vol. 31 ( 2 ) page： 110-115 2006

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

OBJECTIVE: To investigate Schwartze sign with measurements of blood flow to the promontory in patients with cochlear otosclerosis. DESIGN: Prospective clinical study. SETTING: Tertiary referral centre. PARTICIPANTS: Five patients with cochlear otosclerosis and five control subjects. Significant decalcification around the cochlea was observed by computed tomography (CT) in patients with cochlear otosclerosis. However, no recognizable lesion was observed at the oval window in two patients. One patient had mixed hearing loss and four patients had sensorineural hearing loss without an air-bone gap. Main outcome measures: The relationship between CT findings and the presence or absence of Schwartze sign was investigated. Blood flow to the promontory was measured through the tympanic membrane using laser speckle flowgraphy and laser Doppler flowmetry. Results: The Schwartze sign correlated significantly with otosclerotic lesions invading the promontory. Patients with otosclerosis exhibited elevated and pulsating blood flow to the promontory with the Schwartze sign. CONCLUSIONS: Computed tomography demonstrated that cochlear otosclerosis can exist without the oval window lesion. Schwartze sign can be used as a sign of the otosclerotic invasion to the promontory. The reddening of the Schwartze sign is likely due to increased blood flow.

Visualization of a high protein concentration in the cochlea of a patient with a large endolymphatic duct and sac, using three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging. Reviewed

Sugiura M, Naganawa S, Sato E, Nakashima T

J Laryngol Otol Vol. 120 ( 120 ) page： 1084-1086 2006

Inner ear hemorrhage in systemic lupus erythematosus. Reviewed

Sugiura M, Naganawa S, Teranishi M, Sato E, Kojima S, Nakashima T

Laryngoscope Vol. 116 ( 5 ) page： 826-828 2006

Publishing type：Research paper (scientific journal)

A 33-year-old man had systemic lupus erythematosus (SLE) with anticardiolipin antibody. At the age of 40 years, he experienced bilateral hearing deterioration. The three-dimensional fluid-attenuated inversion recovery of magnetic resonance imaging showed high signals bilaterally in the cochlea and vestibule. He was diagnosed with bilateral inner ear hemorrhage on the basis of the presence of anticardiolipin antibody. This is the first published case of inner ear hemorrhage in a patient with SLE. Our findings suggest that inner ear hemorrhage is associated with hearing deterioration in some patients with SLE.

Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging findings in patients with sudden sensorineural hearing loss. Reviewed

Sugiura M, Naganawa S, Teranishi M, Nakashima T

Laryngoscope Vol. 116 ( 8 ) page： 1451-1454 2006

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

OBJECTIVE: To evaluate the inner ear in sudden sensorineural hearing loss (SNHL) using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) at 3 Tesla (T). BACKGROUND: 3D-FLAIR MRI has recently been developed to detect high concentrations of protein or hemorrhage. Application of this method to sudden SNHL has not been described. METHODS: We used 3D-FLAIR at 3 T with and without gadolinium enhancement to evaluate eight patients with sudden SNHL. RESULTS: In four of eight ears with idiopathic sudden SNHL, high precontrast signals were observed within the inner ear on 3D-FLAIR. The high-signal areas observed on 3D-FLAIR were not detected by T1- or T2-weighted MRI in any of these patients. In one of these four ears, significant gadolinium enhancement was observed on 3D-FLAIR. CONCLUSION: Half the patients with sudden SNHL examined had high signals in the SNHL-affected ear on 3D-FLAIR at 3 T. High precontrast signals in the inner-ear fluid space may reflect minor hemorrhage, or an increased concentration of protein that had passed through blood vessels with increased permeability, or had originated from disrupted cells in the inner ear. Gadolinium enhancement in one ear suggested the breakdown of the blood-labyrinth barrier. 3D-FLAIR MRI should contribute markedly to the elucidation of pathologic conditions in the inner ears of patients with idiopathic sudden SNHL.

Lateral semicircular canal and vertigo in patients with large vestibular aqueduct syndrome. Reviewed

Ishida IM, Sugiura M, Nakashima T, Naganawa S, Sato E, Sugiura J, Yoshino T

Otol Neurotol Vol. 27 ( 6 ) page： 788-792 2006

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

OBJECTIVE: To evaluate the hypothesis that there are differences in the morphology of the lateral semicircular canal (LSCC) between patients with large vestibular aqueduct syndrome (LVAS) and control subjects and to investigate the clinical implications of these differences. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Nine patients (two male patients and seven female patients; age range, 8-54 yr) with LVAS (one patient had unilateral LVAS, and eight patients had bilateral LVAS). Five patients had vertigo, and four patients, including the one with unilateral LVAS, did not have vertigo. MAIN OUTCOME MEASURES: The area of the LSCC was traced on the magnetic resonance imaging console and compared between LVAS patients and 12 control subjects who did not have sensorineural hearing loss. The LSCC fluid-containing area was divided by the sum of the LSCC inner area and the LSCC fluid-containing area for evaluation of the degree of the LSCC dysplasia. RESULTS: The LSCC fluid-containing ratio was significantly larger in LVAS patients than in control subjects. Moreover, the LSCC fluid-containing ratio was significantly larger in the eight ears with vertigo than in the nine ears without vertigo. There was no relationship between hearing level and the LSCC fluid-containing ratio. CONCLUSION: Patients with LVAS may have disturbed morphogenesis of both membranous and bony labyrinths. Our results reveal that the morphology of semicircular canals is clinically associated with vertigo.

3D-FLAIR magnetic resonance imaging in the evaluation of mumps deafness. Reviewed

Otake H, Sugiura M, Naganawa S, Nakashima T

Int J Pediatr Otorhinolaryngol Vol. 70 ( 12 ) page： 2115-2117 2006

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

A 6-year-old boy suffered acute profound right side deafness after his classmates had mumps. Although his salivary glands were not swollen, he had high levels of anti-mumps IgM and IgG antibodies. The three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) procedure applied to magnetic resonance imaging (MRI) showed high signals in the right cochlea and vestibule. This indicated hemorrhage or a high concentration of protein in the right inner ear. This is the first case demonstrating a high 3D-FLAIR MRI signal of the inner ear in a patient with mumps deafness. Our findings suggest that 3D-FLAIR MRI may help to identify and define labyrinthitis in mumps deafness.

【超音波画像診断の最新技術と臨床活用　最新技術をキーワードで斬る】 RVS　RVS(Real-time Virtual Sonography)技術の乳腺領域への臨床応用

佐竹弘子, 澤木明子, 長縄慎二, 三竹毅, 荒井修

Vol. 6 page： 56-59 2006

拡散テンソル画像を用いた多系統萎縮症の錐体路評価

伊藤瑞規, 熱田直樹, 渡邉宏久, 祖父江元, 長縄慎二, 深津博, 石垣武男

臨床神経学 Vol. 46 page： 110 2006

非造影検査でどこまで診断に迫れるか?　高磁場MRI

長縄慎二

断層映像研究会雑誌 Vol. 33 page： 20-21 2006

3Teslaにおける3D-FLAIRを用いた蝸牛リンパ液の造影効果の観察

長縄慎二, 深津博, 石垣武男

日本医学放射線学会雑誌 page： 263 2006

【脊髄小脳変性症研究の最近の進歩】　孤発性脊髄小脳変性症　多系統萎縮症のMRI画像

渡辺宏久, 伊藤瑞規, 熱田直樹, 長縄慎二, 深津博, 祖父江元

神経研究の進歩 Vol. 50 page： 397-407 2006

【ここまで進歩した3D画像システム】　臨床での効果が大きい3D画像診断　画像診断機器の進歩でもたらされた3D画像の有用性　3テスラMRIを中心に

長縄慎二

新医療 Vol. 33 page： 102-104 2006

【3D-SPACEの臨床応用】さまざまなコントラストのisotropic data撮像

長縄慎二

Vol. 21 page： 02-04 2006

【64列CTがもたらした影響を検証する】 CTがもたらした診療・経営への効果　64スライスCTの普及がもたらす画像診断の進歩と機器運用の変化

長縄慎二

新医療 Vol. 33 page： 56-59 2006

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