受賞区分：学会誌・学術雑誌による顕彰  受賞国：日本国

受賞区分：国内学会・会議・シンポジウム等の賞  受賞国：日本国

受賞区分：国際学会・会議・シンポジウム等の賞  受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

受賞国：日本国

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER SOC NEURORADIOLOGY  

PURPOSE: Our aim was to determine whether diffusion anisotropy and diffusivity of white matter tracts of the temporal stem in patients with Alzheimer (AD) can be evaluated independently by using diffusion tensor tractography.
MATERIALS AND METHODS: Subjects included 15 patients with AD (11 women and 4 men; mean age, 74 years) and 15 age-matched control subjects (11 women and 4 men; mean age, 72 years). Diffusion tensor images were acquired by using echo-planar imaging. We drew tractographies of the uncinate fasciculus, inferior occipitofrontal fasciculus, and Meyer's loop, with diffusion tensor analysis software. We measured diffusion anisotropy, diffusivity, and the number of voxels along the "tracts of interest" and used the Sludent t test to compare results between patients with AD and controls.
RESULTS: Values of diffusion anisotropy of the bilateral uncinate fasciculus and left inferior occipitofrontal fasciculus were significantly lower for patients with AD than for controls. Also, values of diffusivity in the bilateral uncinate fasciculus were significantly greater for patients with AD than for controls. There was no significant difference in diffusion anisotropy or diffusivity along Meyer's loop between the 2 groups. There was no significant difference in the number of voxels included in all constructed tracts between patients with AD and controls.
CONCLUSION: White matter tracts of the temporal stem can be evaluated independently by using diffusion tensor tractography, which appears to be a promising technique for determining changes in white matter in degenerative diseases.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Investigative Radiology  

The concept of the glymphatic system was proposed more than a decade ago as a mechanism for interstitial fluid flow and waste removal in the central nervous system. The function of the glymphatic system has been shown to be particularly activated during sleep. Dysfunction of the glymphatic system has been implicated in several neurodegenerative diseases. Noninvasive in vivo imaging of the glymphatic system is expected to be useful in elucidating the pathophysiology of these diseases. Currently, magnetic resonance imaging is the most commonly used technique to evaluate the glymphatic system in humans, and a large number of studies have been reported. This review provides a comprehensive overview of investigations of the human glymphatic system function using magnetic resonance imaging. The studies can be divided into 3 categories, including imaging without gadolinium-based contrast agents (GBCAs), imaging with intrathecal administration of GBCAs, and imaging with intravenous administration of GBCAs. The purpose of these studies has been to examine not only the interstitial fluid movement in the brain parenchyma, but also the fluid dynamics in the perivascular and subarachnoid spaces, as well as the parasagittal dura and meningeal lymphatics. Recent research has even extended to include the glymphatic system of the eye and the inner ear. This review serves as an important update and a useful guide for future research directions.

DOI： 10.1097/RLI.0000000000000969

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Sleep and Biological Rhythms  

Disruption of the circadian rhythm and sleep–wake cycles is a consequence of aging and is associated with the cognitive decline and many neurodegenerative conditions. We investigated the bedtime, wake-up time, sleep timing (midpoint between bedtime and wake-up time), and sleep timing standard deviation (SD) using the actigraphy among 80 consecutive volunteers aged ≥ 60 years. Global cognitive function and executive function of detailed cognitive domains were evaluated using the mini-mental state examination (MMSE) and Wisconsin card sorting test (WCST) and subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The category achievement (CA), total errors (TE), perseverative errors of Nelson (PEN), non-perseverative errors (NPE), and difficulties in maintaining set (DMS) on the WCST were significantly correlated with sleep timing SD (CA: r = − 0.276, p = 0.013, TE: r = 0.311, p = 0.005, PEN: r = 0.241, p = 0.032, NPE: r = 0.250, p = 0.025, DMS: r = 0.235, p = 0.036), but not with the MMSE score. Multiple regression analyses with the stepwise forward selection method including age, ESS score, bedtime, sleep timing, and sleep timing SD, revealed that the ESS score, and sleep timing SD were significant factors related to CA on the WCST (ESS score: β = − 0.322, p = 0.004; sleep timing SD: β = − 0.250, p = 0.022). Assessment of sleep–wake rhythms, daytime sleepiness, and cognitive function using the MMSE and WCST is valuable for the prediction of cognitive decline in the geriatric population.

DOI： 10.1007/s41105-023-00491-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical Neurology and Neurosurgery  

Objective: This study aimed to analyze whether the development of donor vessels after combined revascularization surgery for moyamoya disease (MMD) is related to cerebral blood flow (CBF) changes. Methods: We retrospectively reviewed the charts of 11 adult (12 hemispheres) and 13 pediatric (19 hemispheres) patients who underwent combined revascularization in our department. The total vessel cross-sectional area (TVA) was the sum of the cross-sectional areas of the superficial temporal, middle meningeal, and deep temporal arteries imaged using time-of-flight magnetic resonance angiography. The ipsilateral relative CBF (RCBF) on the brain surface in the craniotomy area was calculated by single-photon emission computed tomography. ΔTVA and ΔRCBF were defined as the preoperative and postoperative ratios of TVA and RCBF, and their correlations were analyzed in adult and pediatric patients. Results: The TVA and RCBF showed a significant increase after surgery, regardless of the age group. However, there was no significant correlation between ΔTVA and ΔRCBF in either the adult or pediatric groups. While the adult group exhibited significantly higher ΔRCBF values compared to the pediatric group (p < 0.01, r = −0.44), the ΔTVA values were higher in the pediatric group compared to the adult group (p = 0.06). Conclusions: In the chronic phase after combined revascularization surgery for MMD, the development of measurable TVA of donor vessels does not necessarily correlate with an increase in CBF around the craniotomy area.

DOI： 10.1016/j.clineuro.2023.108110

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: Impaired glymphatic function has been suggested to be implicated in the pathophysiology of MS and aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorder. This study aimed to investigate the interstitial fluid dynamics in the brain in patients with myelin oligodendrocyte glycoprotein antibody disorders (MOGAD), another demyelinating disorder, using a noninvasive imaging technique called the diffusivity along the perivascular space (ALPS) index. MATERIALS AND METHODS: A prospective study was conducted on 16 patients with MOGAD in remission and 22 age- and sexmatched healthy control subjects. MR imaging was performed using a 3T scanner, and the ALPS index was calculated using diffusion MR imaging data with a b-value of 1000 s/mm2. The ALPS index and gray matter volumes were compared between the 2 groups, and these parameters were correlated with the Expanded Disability Status Scale. RESULTS: The mean ALPS index of patients with MOGAD was significantly lower than that of healthy controls (Cohen d 0.93, false discovery rate-corrected P .02). The lower mean ALPS index was significantly associated with a worse Expanded Disability Status Scale score (Spearman r _0.51; 95% CI, _0.85 to _0.02; P .03). However, cortical volume and deep gray matter volume were not significantly different between the 2 groups, and they were not correlated with the Expanded Disability Status Scale. CONCLUSIONS: This study suggests that patients with MOGAD may have impaired glymphatic function, as measured by the ALPS index, which is associated with patient disability. Further study is warranted with a larger sample size.

DOI： 10.3174/ajnr.A8066

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers in Aging Neuroscience  

Background and purpose: Glymphatic system in type 2 diabetes mellitus (T2DM) but not in the prodrome, prediabetes (Pre-DM) was investigated using diffusion tensor image analysis along the perivascular space (DTI-ALPS). Association between glymphatic system and insulin resistance of prominent characteristic in T2DM and Pre-DM between is yet elucidated. Therefore, this study delves into the interstitial fluid dynamics using the DTI-ALPS in both Pre-DM and T2DM and association with insulin resistance. Materials and methods: In our cross-sectional study, we assessed 70 elderly individuals from the Bunkyo Health Study, which included 22 with Pre-DM, 18 with T2DM, and 33 healthy controls with normal glucose metabolism (NGM). We utilized the general linear model (GLM) to evaluate the ALPS index based on DTI-ALPS across these groups, considering variables like sex, age, intracranial volume, years of education, anamnesis of hypertension and hyperlipidemia, and the total Fazekas scale. Furthermore, we have explored the relationship between the ALPS index and insulin resistance, as measured by the homeostasis model assessment of insulin resistance (HOMA-IR) using GLM and the same set of covariates. Results: In the T2DM group, the ALPS index demonstrated a reduction compared with the NGM group [family-wise error (FWE)-corrected p < 0.001; Cohen's d = −1.32]. Similarly, the Pre-DM group had a lower ALPS index than the NGM group (FWE-corrected p < 0.001; Cohen's d = −1.04). However, there was no significant disparity between the T2DM and Pre-DM groups (FWE-corrected p = 1.00; Cohen's d = −0.63). A negative correlation was observed between the ALPS index and HOMA-IR in the combined T2DM and Pre-DM groups (partial correlation coefficient r = −0.35, p < 0.005). Conclusion: The ALPS index significantly decreased in both the pre-DM and T2DM groups and showed a correlated with insulin resistance. This indicated that changes in interstitial fluid dynamics are associated with insulin resistance.

DOI： 10.3389/fnagi.2024.1362457

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.2147/NSS.S448871

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: This study aimed to evaluate the relationship between sleep quality as assessed using the Pittsburgh Sleep Quality Index (PSQI) and the index of diffusivity along the perivascular space (ALPS index), a possible indirect indicator of glymphatic system activity. Materials and methods: This study included the diffusion magnetic resonance imaging (MRI) data of 317 people with sleep disruption and 515 healthy controls (HCs) from the Human Connectome Project (WU-MINN HCP 1200). The ALPS index was calculated automatically based on diffusion tensor image analysis (DTI)-ALPS of diffusion MRI. The ALPS index of the sleep disruption and HC groups was compared using general linear model (GLM) analysis with covariates, such as age, sex, level of education, and intracranial volume. In addition, to confirm the relationship between sleep quality and the ALPS index in the sleep disruption group as well as evaluate the effect of each PSQI component on the ALPS index, correlation analyses between the ALPS indices and PSQI scores of all the components and between the ALPS index and each PSQI component was performed using GLM analysis with the abovementioned covariates, respectively. Results: The ALPS index was significantly lower in the sleep disruption group than in the HC group (p = 0.001). Moreover, the ALPS indices showed significant negative correlations with the PSQI scores of all the components (false discovery rate [FDR]-corrected p < 0.001). Two significant negative correlations were also found between the ALPS index and PSQI component 2 (sleep latency, FDR-corrected p < 0.001) and 6 (the use of sleep medication, FDR-corrected p < 0.001). Conclusion: Our findings suggest that glymphatic system impairment contributes to sleep disruption in young adults.

DOI： 10.1007/s11604-023-01463-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

We aimed to compare longitudinal brain atrophy in patients with neuromyelitis optica spectrum disorder (NMOSD) with healthy controls (HCs). The atrophy rate in patients with anti-aquaporin-4 antibody-positive NMOSD (AQP4 + NMOSD) was compared with age-sex-matched HCs recruited from the Japanese Alzheimer’s Disease Neuroimaging Initiative study and another study performed at Chiba University. Twenty-nine patients with AQP4 + NMOSD and 29 HCs were enrolled in the study. The time between magnetic resonance imaging (MRI) scans was longer in the AQP4 + NMOSD group compared with the HCs (median; 3.2 vs. 2.9 years, P = 0.009). The annualized normalized white matter volume (NWV) atrophy rate was higher in the AQP4 + NMOSD group compared with the HCs (median; 0.37 vs. − 0.14, P = 0.018). The maximum spinal cord lesion length negatively correlated with NWV at baseline MRI in patients with AQP4 + NMOSD (Spearman’s rho = − 0.41, P = 0.027). The annualized NWV atrophy rate negatively correlated with the time between initiation of persistent prednisolone usage and baseline MRI in patients with AQP4 + NMOSD (Spearman’s rho = − 0.43, P = 0.019). Patients with AQP4 + NMOSD had a greater annualized NWV atrophy rate than HCs. Suppressing disease activity may prevent brain atrophy in patients with AQP4 + NMOSD.

DOI： 10.1038/s41598-023-38893-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本磁気共鳴医学会  

DOI： 10.2463/mrms.bc.2023-0122

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.21203/rs.3.rs-3411760/v1

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: This multisite study aimed to use the COMBined Association Test (COMBAT), a harmonization technique that uses regression of covariates with an empirical Bayesian framework, to harmonize diffusion tensor image analysis along the perivascular space (DTI-ALPS) variations caused by scanner, site, and protocol differences. Materials and methods: This study included multisite diffusion magnetic resonance imaging (dMRI) data of 45 patients with Alzheimer’s disease (AD) and 82 cognitively normal (CN) participants from the AD neuroimaging initiative database. The dMRI data were obtained with two b values (0 and 1000 s/mm2) from 27 institutions and three different 3-Tesla MRI scanners (two vendors). The ALPS index was calculated from multisite dMRI data, and COMBAT was used to harmonize the factors causing site variations. Welch’s t test was used, Cohen’s d was calculated to compare the difference in the ALPS index between AD and CN before and after harmonization, and Pearson’s correlation coefficient was calculated to assess the relationships between the ALPS index and the cognitive score, [18F] fluorodeoxyglucose (FDG)-positron emission tomography (PET), and [18F] florbetapir (AV45)-PET standardized uptake value ratios (SUVRs). Results: COMBAT harmonized scanner differences and increased Cohen’s d of the left and right ALPS indexes between AD and CN from 0.288 to 0.438 and 0.328 to 0.480, respectively. The ALPS indexes were significantly different between AD and CN after harmonization (P < 0.05) but not before it. Moreover, Pearson’s correlation coefficients between the ALPS index and cognitive score, FDG-PET, and AV45-PET SUVRs were higher after harmonization than before it. Conclusion: This study demonstrates the application of COMBAT harmonization to eliminate between-scanner, site, and protocol variations in the ALPS index calculated from DTI-ALPS using dMRI and possibly facilitate the use of the ALPS index in multi-center studies.

DOI： 10.1007/s11604-023-01432-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NMR in Biomedicine  

In the current study, we assessed changes in interstitial fluid dynamics resulting after whole-brain radiotherapy using the diffusion-weighted image analysis along the perivascular space (DWI-ALPS) method, which is a simplified variation of the diffusion tensor image ALPS (DTI-ALPS) method using diffusion-weighted imaging (DWI) with orthogonal motion-probing gradients (MPGs). This retrospective study included 47 image sets from 22 patients who underwent whole-brain radiotherapy for brain tumors. The data for the normal control group comprised 105 image sets from 105 participants with no pathological changes. DWI was performed with the three MPGs applied in an orthogonal direction to the imaging plane, and apparent diffusion coefficient images for the x-, y-, and z-axes were retrospectively generated. The ALPS index was calculated to quantify interstitial fluid dynamics. The independent t-test was used to compare the ALPS index between normal controls and patients who underwent whole-brain radiotherapy. Patients were compared in all age groups and individual age groups (20–39, 40–59, and 60–84 years). We also examined the correlation between biologically equivalent doses (BEDs) and the ALPS index, as well as the correlation between white matter hyperintensity and the ALPS index. In the comparison of all age groups, the ALPS index was significantly lower (p < 0.001) in the postradiation group (1.32 ± 0.16) than in the control group (1.44 ± 0.17), suggesting that interstitial fluid dynamics were altered in patients following whole-brain radiotherapy. Significant age group differences were found (40–59 years: p < 0.01; 60–84 years: p < 0.001), along with a weak negative correlation between BEDs (r = −0.19) and significant correlations between white matter hyperintensity and the ALPS index (r = −0.46 for periventricular white matter, r = −0.38 for deep white matter). It was concluded that the ALPS method using DWI with orthogonal MPGs suggest alteration in interstitial fluid dynamics in patients after whole-brain radiotherapy. Further systematic prospective studies are required to investigate their association with cognitive symptoms.

DOI： 10.1002/nbm.5030

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

DOI： 10.1007/s11604-023-01431-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

DOI： 10.1007/s11604-023-01412-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiology  

MRI plays a central role in the diagnosis of multiple sclerosis (MS) and in the monitoring of disease course and treatment response. Advanced MRI techniques have shed light on MS biology and facilitated the search for neuroimaging markers that may be applicable in clinical practice. MRI has led to improvements in the accuracy of MS diagnosis and a deeper understanding of disease progression. This has also resulted in a plethora of potential MRI markers, the importance and validity of which remain to be proven. Here, five recent emerging perspectives arising from the use of MRI in MS, from pathophysiology to clinical application, will be discussed. These are the feasibility of noninvasive MRI-based approaches to measure glymphatic function and its impairment; T1-weighted to T2-weighted intensity ratio to quantify myelin content; classification of MS phenotypes based on their MRI features rather than on their clinical features; clinical relevance of gray matter atrophy versus white matter atrophy; and time-varying versus static resting-state functional connectivity in evaluating brain functional organization. These topics are critically discussed, which may guide future applications in the field.

DOI： 10.1148/radiol.221512

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本磁気共鳴医学会  

DOI： 10.2463/jjmrm.2022-1783

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本磁気共鳴医学会  

DOI： 10.2463/jjmrm.2022-1774

CiNii Research

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本磁気共鳴医学会  

もやもや病のGlymphatic system(GS)について、DTI analysis along the perivascular space(DTI-ALPS index)を用いて検討した。成人もやもや病患者46名(男性13名、女性33名、平均38.4歳)と年齢、性別の合致した健常人34名(男性7名、女性27名、平均40.1歳)を対象とし、3T機でEPIシーケンスによる拡散MRIとMPRAGE法による3DT1強調像を撮影した。患者全例で認知機能検査としてTrail Making Test(TMT)を行った。もやもや病のDTI-ALPS indexは健常人より有意に低く、脳実質水成分と負の相関を示した。DTI-ALPS indexはPETのパラメータのうち、脳灌流圧の逆波である平均通過時間(MTT)と有意な負の相関を示した。遂行機能障害が強いほど点数が高くなるTMT-Bは左半球のDTI-ALPS indexと有意な負の相関を示した。もやもや病では脳循環不全の程度に応じてGS機能不全が存在し、脳実質の水成分増加を生じ、認知機能障害と関連する可能性があると考えられた。

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neurology  

Background: Studies of glymphatic dysfunction in Parkinson’s disease (PD) patients have attracted much attention in recent years. However, the relationships between glymphatic dysfunction and clinical symptoms remains unclear. Objectives: To determine whether the diffusion tensor image analysis along the perivascular space (DTI-ALPS) affect the severity and types of motor and non-motor symptoms in PD patients. Methods: De novo PD patients and controls who performed both DTI and 123I-DaTscan single photon emission computed tomography (SPECT) scanning were retrieved from the international multicenter Parkinson’s Progression Marker Initiative (PPMI) cohort. Glymphatic system was evaluated by the DTI-ALPS. Motor symptoms were assessed by Movement Disorders Society Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS-III). The influence of glymphatic activity on motor and non-motor symptoms was explored by multivariate linear regression models. Results: A total of 153 PD patients (mean age 60.97 ± 9.47 years; 99 male) and 67 normal controls (mean age 60.10 ± 10.562 years; 43 male) were included. The DTI-ALPS index of PD patients was significantly lower than normal controls (Z = − 2.160, p = 0.031). MDS-UPDRS III score (r = − 0.213, p = 0.008) and subscore for rigidity (r = − 0.177, p = 0.029) were negatively correlated with DTI-ALPS index. The DTI-ALPS index was significantly associated with MDS-UPDRS-III score (β = − 0.160, p = 0.048) and subscore for rigidity (β = − 0.170, p = 0.041) after adjusting for putamen dopamine transporter availability and clinical factors. Conclusions: Our results showed distinct relationships between glymphatic dysfunction and the severity and types of PD motor symptoms, suggesting the potential of DTI-ALPS index as a biomarker for PD motor symptoms.

DOI： 10.1007/s00415-023-11594-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：メジカルビュー社  

DOI： 10.18885/ci.0000001254

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers in Neurology  

Background and purpose: Exposure to contact sports in youth causes brain health problems later in life. For instance, the repetitive head impacts in contact sports might contribute to glymphatic clearance impairment and cognitive decline. This study aimed to assess the effect of contact sports participation in youth on glymphatic function in old age and the relationship between glymphatic function and cognitive status using the analysis along the perivascular space (ALPS) index. Materials and methods: A total of 52 Japanese older male subjects were included in the study, including 12 who played heavy-contact sports (mean age, 71.2 years), 15 who played semicontact sports (mean age, 73.1 years), and 25 who played noncontact sports (mean age, 71.3 years) in their youth. All brain diffusion-weighted images (DWIs) of the subjects were acquired using a 3T MRI scanner. The ALPS indices were calculated using a validated semiautomated pipeline. The ALPS indices from the left and right hemispheres were compared between groups using a general linear model, including age and years of education. Furthermore, partial Spearman's rank correlation tests were performed to assess the correlation between the ALPS indices and cognitive scores (Mini-Mental State Examination and the Japanese version of the Montreal Cognitive Assessment [MoCA-J]) after adjusting for age years of education and HbA1c. Results: The left ALPS index was significantly lower in the heavy-contact and semicontact groups than that in the noncontact group. Although no significant differences were observed in the left ALPS index between the heavy-contact and semicontact groups and in the right ALPS index among groups, a trend toward lower was found in the right ALPS index in individuals with semicontact and heavy-contact compared to the noncontact group. Both sides' ALPS indices were significantly positively correlated with the MoCA-J scores. Conclusion: The findings indicated the potential adverse effect of contact sports experience in youth on the glymphatic system function in old age associated with cognitive decline.

DOI： 10.3389/fneur.2023.1100736

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neurobiology of Disease  

Objective: The glymphatic system is a glial-based perivascular network that promotes brain metabolic waste clearance. Reduced glymphatic flow has been observed in rat models of type 2 diabetes and hypertension, indicating the role of vascular risk factors in the glymphatic system. However, little is known about how vascular risk factors affect the human glymphatic system. The present study aims to assess the relationships between metabolic syndrome (MetS), a cluster of vascular risk factors, and the glymphatic system function using diffusion magnetic resonance imaging (MRI)-based measures of water diffusivity in the glymphatic compartments, including the brain interstitial space and perivascular spaces around the deep medullary vein. We hypothesized that vascular risk factors are associated with glymphatic dysfunction, leading to cognitive impairment in older adults. Methods: This cross-sectional study assessed 61 older adults (age range, 65–82 years) who had participated in the Bunkyo Health Study, including 15 healthy controls (mean age, 70.87 ± 4.90 years) and 46 individuals with MetS (mean age, 71.76 ± 4.61 years). Fractional volume of extracellular-free water (FW) and an index of diffusion tensor imaging along the perivascular space (DTI-ALPS) were used as indirect indicators of water diffusivity in the interstitial extracellular and perivenous spaces of white matter, respectively. Results: After adjusting for age, sex, years of education, total Fazekas scale, Pittsburgh sleep quality index (PSQI) score, and intracranial volume (ICV), a significantly (P = 0.030; Cohen's d = 1.01) higher FW was observed in individuals with MetS than in the healthy controls. Furthermore, individuals with MetS had a significantly (P = 0.031; Cohen's d = 0.86) lower ALPS index than the healthy controls, with age, sex, years of education, total Fazekas scale, PSQI score, ICV, fractional anisotropy, and mean diffusivity included as confounding factors. Higher FW was significantly associated with lower ALPS index (r = −0.37; P = 0.004). Multiple linear regression (MLR) with backward elimination analyses showed that higher diastolic blood pressure (BP; standardized β = 0.33, P = 0.005) was independently associated with higher FW, whereas higher fasting plasma glucose levels (standardized β = −0.63, P = 0.002) or higher Brinkman index of cigarette consumption cumulative amount (standardized β = −0.27, P = 0.022) were associated with lower ALPS index. The lower ALPS index (standardized β, 0.28; P = 0.040) was associated with poorer global cognitive performance, which was determined using the Japanese version of the Montreal Cognitive Assessment (MOCA-J) scores. Finally, partial correlation analyses showed a significant correlation between higher FW and lower MOCA-J scores (r = −0.35; P = 0.025) and between higher FW and higher diastolic BP (r = 0.32, P = 0.044). Conclusion: The present study shows the changes in diffusion MRI-based measures reflected by the higher FW and lower ALPS index in older adults with MetS, possibly due to the adverse effect of vascular risk factors on the glymphatic system. Our findings also indicate the associations between the diffusion MRI-based measures and elevated diastolic BP, hyperglycemia, smoking habit, and poorer cognitive performance. However, owing to the limitations of this study, the results should be cautiously interpreted.

DOI： 10.1016/j.nbd.2023.105990

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To investigate the characteristics of the putative meningeal lymphatics located at the posterior wall of the sigmoid sinus (PML-PSS) in human subjects imaged before and after intravenous administration (IV) of a gadolinium-based contrast agent (GBCA). The appearance of the PML-PSS and the enhancement of the perivascular space of the basal ganglia (PVS-BG) were analyzed for an association with gender, age, and clearance of the GBCA from the cerebrospinal fluid (CSF). Methods: Forty-two patients with suspected endolymphatic hydrops were included. Heavily T2-weighted 3D-fluid attenuated inversion recovery (hT2w-3D-FLAIR) and 3D-real inversion recovery (IR) images were obtained at pre-administration, immediately post-administration, and at 4 and 24 hours after IV-GBCA. The appearance of the PML-PSS and the presence of enhancement in the PVS-BG were analyzed for a relationship with age, gender, contrast enhancement of the CSF at 4 hours after IV-GBCA, and the washout ratio of the GBCA in the CSF from 4 to 24 hours after IV-GBCA. Results: The PML-PSS and PVS-BG were seen in 23 of 42 and 21 of 42 cases, respectively, at 4 hours after IV-GBCA. In all PML-PSS positive cases, hT2w-3D-FLAIR signal enhancement was highest at 4 hours after IV-GBCA. A multivariate analysis between gender, age, CSF signal elevation at 4 hours, and washout ratio indicated that only the washout ratio was independently associated with the enhancement of the PML-PSS or PVS-BG. The odds ratios (95% CIs; P value) were 4.09 × 10–5 (2.39 × 10–8 – 0.07; 0.0078) for the PML-PSS and 1.7 × 10–4 (1.66 × 10–7 – 0.174; 0.014) for the PVS-BG. Conclusion: The PML-PSS had the highest signal enhancement at 4 hours after IV-GBCA. When the PML-PSS was seen, there was also often enhancement of the PVS-BG at 4 hours after IV-GBCA. Both observed enhancements were associated with delayed GBCA excretion from the CSF.

DOI： 10.2463/mrms.mp.2022-0110

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To determine whether T2-contrast enhancement techniques can be used to diagnose endolym-phatic hydrops, we compared fluid signal artifacts with and without T2-contrast enhancement techniques in 3D fluid-attenuated inversion recovery (3D-FLAIR). Methods: We prepared a custom-made phantom consisting of eight tubes half-filled with saline. Images were obtained using four 3D-FLAIR: without T2-contrast enhancement (Normal), with non-selective T2-inversion recovery (T2-IR), and two with non-selective T2 preparation IR (T2-prep). Scans were performed with and without rice covering the phantom to simulate minimal and severe B0-inhomogeneity conditions. The average signal intensity (SI) values of eight saline tubes were compared between the four sequences and between each other. Comparisons were performed for all measurement slices and the central 10 slices. The images using T2-contrast enhancement technique were obtained from a volunteer and a patient suspected of Meniere’sdisease. Results: The Normal sequence SI for all slices was significantly lower than that for the other sequences, with smaller standard deviation (SD) and no outliers. Several outliers were detected in the other sequences. The SDs and outliers were larger without rice than with rice. When the central 10 slices with rice, the T2-IR had a significantly higher SI with more outliers compared with the Normal sequence. The T2-prep had no outliers and SIs that were comparable to those of the Normal sequence. However, without rice, the T2-IR and T2-prep sequences had significantly higher SIs with outliers and larger SDs compared to the Normal sequence. In the corresponding images, the Normal sequence achieved excellent fluid suppression, whereas the T2-IR and T2-prep sequences showed high-signal artifacts. Imperfect fluid suppressions were observed in the volunteer image and the endolymphatic hydrops on the post-gadolinium image differed in size and shape in the non-injected T2-IR in the patient image. Conclusion: T2-contrast enhancement techniques should be used with caution in 3D-FLAIR for diagnosing endolymphatic hydrops.

DOI： 10.2463/mrms.mp.2022-0017

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: The effect of temporal sampling rate (TSR) on perfusion parameters has not been fully investigated in Moyamoya disease (MMD); therefore, this study evaluated the influence of different TSRs on perfusion parameters quantitatively and qualitatively by applying simultaneous multi-slice (SMS) dynamic susceptibility contrast-enhanced MR imaging (DSC-MRI). Methods: DSC-MRI datasets were acquired from 28 patients with MMD with a TSR of 0.5 s. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and time to maximum tissue residue function (Tmax) were calculated for eight TSRs ranging from 0.5 to 4.0 s in 0.5-s increments that were subsampled from a TSR of 0.5 s datasets. Perfusion measurements and volume for chronic ischemic (Tmax ≥ 2 s) and non-ischemic (Tmax < 2 s) areas for each TSR were compared to measurements with a TSR of 0.5 s, as was visual perfusion map analysis. Results: CBF, CBV, and Tmax values tended to be underestimated, whereas MTT and TTP values were less influenced, with a longer TSR. Although Tmax values were overestimated in the TSR of 1.0 s in non-ischemic areas, differences in perfusion measurements between the TSRs of 0.5 and 1.0 s were generally minimal. The volumes of the chronic ischemic areas with a TSR ≥ 3.0 s were significantly underestimated. In CBF and CBV maps, no significant deterioration was noted in image quality up to 3.0 and 2.5 s, respectively. The image quality of MTT, TTP, and Tmax maps for the TSR of 1.0 s was similar to that for the TSR of 0.5 s but was significantly deteriorated for the TSRs of ≥ 1.5 s. Conclusion: In the assessment of MMD by SMS DSC-MRI, application of TSRs of ≥ 1.5 s may lead to deterioration of the perfusion measurements; however, that was less influenced in TSRs of ≤ 1.0 s.

DOI： 10.2463/mrms.mp.2021-0162

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

It has been reported that perivenous cystic structures near the parasagittal dura are associated with the leakage of gadolinium-based contrast agents at 4 hours after intravenous administration. The origin of such cystic structures remains unknown. While reading many cases of MR cisternography, we noticed that some of the cystic structures appeared to connect to the perivenous subpial space. This new imaging finding might facilitate future research of the waste clearance system for the central nervous system.

DOI： 10.2463/mrms.bc.2021-0141

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: Peripheral retinal leakage (PRL) of contrast medium from the ora serrata (i.e., the peripheral part of the retina) was recently reported in normal eyes using ultra-widefield fluorescein angiography. We occasionally see PRL of gadolinium-based contrast agents (GBCAs) in the vitreous from the temporal and inferior sides of the ora serrata on MR images of subjects without ophthalmic disease. In this study, we retrospectively evaluated these MR images to determine if PRL was associated with aging. We also evaluated whether the initial leakage appeared in the temporal and inferior sides, and whether there was uniform distribution within the vitreous after 24 hours. Methods: In 127 subjects (9 volunteers, 85 patients with sudden deafness, and 33 patients with a suspicion of endolymphatic hydrops), pre-and post-contrast-enhanced heavily T2-weighted 3D-fluid attenuated inversion recovery (FLAIR) images were obtained. The presence or absence of PRL was subjectively evaluated. For patients with a suspicion of endolymphatic hydrops, 3D-real inversion recovery (IR) images were also obtained at pre-, 10 mins, 4 hours, and 24 hours after intravenous administration (IV) of GBCA. Four circular ROIs were placed in the vitreous humor and the signal intensity was measured. Results: In the cases with PRL (n = 88) and without PRL (n = 47), the median age was 59 and 47 years, respectively (P = 0.001). At 4 hours after IV-GBCA, the mean signal increase in the inferior temporal ROI was greater than all the other ROIs. At 24 hours after IV-GBCA, no significant difference in signal intensity was observed for the four ROIs. Conclusion: PRL of GBCA is age-dependent and occurs mainly from the inferior temporal side of the ora serrata. The contrast effect was uniformly distributed at 24 hours after IV-GBCA. Future observations in a variety of diseases will determine the clinical significance of these findings.

DOI： 10.2463/mrms.mp.2021-0100

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neurology  

Background and Objectives The glymphatic system is a whole-brain perivascular network, which promotes CSF/interstitial fluid exchange. Alterations to this system may play a pivotal role in amyloid β (Aβ) accumulation. However, its involvement in Alzheimer disease (AD) pathogenesis is not fully understood. Here, we investigated the changes in noninvasive MRI measurements related to the perivascular network in patients with mild cognitive impairment (MCI) and AD. Additionally, we explored the associations of MRI measures with neuropsychological score, PET standardized uptake value ratio (SUVR), and Aβ deposition. Methods MRI measures, including perivascular space (PVS) volume fraction (PVSVF), fractional volume of free water in white matter (FW-WM), and index of diffusivity along the perivascular space (ALPS index) of patients with MCI, those with AD, and healthy controls from the Alzheimer's Disease Neuroimaging Initiative database were compared. MRI measures were also correlated with the levels of CSF biomarkers, PET SUVR, and cognitive score in the combined subcohort of patients with MCI and AD. Statistical analyses were performed with age, sex, years of education, and APOE status as confounding factors. Results In total, 36 patients with AD, 44 patients with MCI, and 31 healthy controls were analyzed. Patients with AD had significantly higher total, WM, and basal ganglia PVSVF (Cohen d = 1.15-1.48; p < 0.001) and FW-WM (Cohen d = 0.73; p < 0.05) and a lower ALPS index (Cohen d = 0.63; p < 0.05) than healthy controls. Meanwhile, the MCI group only showed significantly higher total (Cohen d = 0.99; p < 0.05) and WM (Cohen d = 0.91; p < 0.05) PVSVF. Low ALPS index was associated with lower CSF Aβ42 (rs = 0.41, pfdr = 0.026), FDG-PET uptake (rs = 0.54, pfdr < 0.001), and worse multiple cognitive domain deficits. High FW-WM was also associated with lower CSF Aβ42 (rs = −0.47, pfdr = 0.021) and worse cognitive performances. Discussion Our study indicates that changes in PVS-related MRI parameters occur in MCI and AD, possibly due to impairment of the glymphatic system. We also report the associations between MRI parameters and Aβ deposition, neuronal change, and cognitive impairment in AD.

DOI： 10.1212/WNL.0000000000201300

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Interest in interstitial fluid dynamics has increased since the proposal of the glymphatic system hypothesis. Abnormal dynamics of the interstitial fluid have been pointed out to be an important factor in various pathological statuses. In this article, we propose the concept of central nervous system interstitial fluido-pathy as a disease or condition in which abnormal interstitial fluid dynamics is one of the important factors for the development of a pathological condition. We discuss the aspects of interstitial fluidopathy in various diseases, including Alzheimer’s disease, Parkinson’s disease, normal pressure hydrocephalus, and cerebral small vessel disease. We also discuss a method called “diffusion tensor image analysis along the perivascular space” using MR diffusion images, which is used to evaluate the degree of interstitial fluidopathy or the activity of the glymphatic system.

DOI： 10.2463/mrms.rev.2022-0012

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: The purpose of this study was to investigate whether the changes in apparent diffusion coefficients (ADCs) due to differences in diffusion time reflect tissue properties in actual measurements of phantoms. Materials and methods: Various n-alkane phantoms and sucrose/collagen phantoms with various collagen densities were set up with and without polyvinyl alcohol (PVA) foam with an average pore diameter of 300 μm. Thus, n-alkanes or sucrose/collagen represented substrate viscosity and the presence of PVA foam represented tissue structure with septum. Diffusion-weighted images with various diffusion times (7.71–60 ms) were acquired using pulsed-gradient spin-echo (PGSE) and oscillating-gradient spin-echo (OGSE) sequences. The ADCs of the phantoms with and without PVA foam were calculated. Results: The ADCs of some of the phantoms without PVA decreased with diffusion times decreased. In the n-alkane phantoms, only C8H18 showed significantly different ADCs depending on the use of PVA foam in the OGSE sequence. On the other hand, sucrose/collagen phantoms showed significant differences according to diffusion time. The ADCs of the phantoms decreased as the molecular size of the n-alkanes or collagen density of the sucrose/collagen phantom increased. Compared to phantoms without PVA foam, the ADC of the phantoms with PVA foam decreased as the diffusion time increased. Conclusion: Changes in ADCs due to differences in diffusion time reflect tissue properties in actual measurements of phantoms. These changes in ADCs can be used for tissue characterization in vivo.

DOI： 10.1007/s11604-022-01281-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Magnetic Resonance Imaging  

While contrast-enhanced fluid-attenuated inversion recovery (FLAIR) has long been regarded as an adjunct sequence to evaluate leptomeningeal disease in addition to contrast-enhanced T1-weighted imaging, it is gradually being used for more diverse pathologies beyond leptomeningeal disease. Contrast-enhanced FLAIR is known to be highly sensitive to low concentrations of gadolinium within the fluid. Accordingly, recent research has suggested the potential utility of contrast-enhanced FLAIR in various kinds of disease, such as Meniere's disease, seizure, stroke, traumatic brain injury, and brain metastasis, in addition to being used for visualizing glymphatic dysfunction. However, its potential applications have been reported sporadically in an unorganized manner. Furthermore, the exact mechanism for its superior sensitivity to low concentrations of gadolinium has not been fully understood. Rapidly developing magnetic resonance technology and unoptimized parameters for FLAIR may challenge its accurate application in clinical practice. This review provides the fundamental mechanism of contrast-enhanced FLAIR, systematically describes its current and potential clinical application, and elaborates on technical considerations for its optimization. Level of Evidence: 3. Technical Efficacy Stage: 5.

DOI： 10.1002/jmri.28117

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Perivascular spaces are fluid-filled spaces that surround the perforating vessels of the brain and are normal findings on brain imaging. These are usually asymptomatic and are considered a manifestation of aging. Perivascular spaces occasionally undergo significant enlargement and are referred to as tumefactive perivascular spaces, which are often indistinguishable from neoplastic lesions. Spontaneous regression of tumefactive perivascular spaces during follow-up is rare. We report the imaging findings and clinical course of a patient who showed spontaneous regression of tumefactive perivascular spaces in the anterior temporal lobe, together with a literature review and discussion regarding the characteristics and pathogenesis of spontaneous regression of tumefactive perivascular spaces. Most studies in the available literature report tumefactive perivascular spaces in the anterior temporal lobe; in our view, the characteristics of anterior temporal lobe tumefactive perivascular spaces may differ from those of tumefactive perivascular spaces that occur at other locations.

DOI： 10.18999/nagjms.84.3.678

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiologia Medica  

DOI： 10.1007/s11547-022-01486-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Physica Medica  

Purpose: Gold fiducial markers are used to guide liver stereotactic body radiation therapy (SBRT) and are hard to detect by magnetic resonance imaging (MRI). In this study, the parameters of the three-dimensional T1-weighted turbo gradient-echo (3D T1W-GRE) sequence were optimized for gold marker detection without degrading tumor delineation. Methods: Custom-made phantoms mimicking tumor and normal liver parenchyma were prepared and embedded with a gold marker. The 3D T1W-GRE was scanned by varying echo time (TE), bandwidth (BW), flip angle (FA), and base matrix size. The signal-to-noise ratio (SNR), contrast ratio (CR), and relative standard deviation (RSD) of the signal intensity in the area including the gold marker were evaluated, and the parameters were optimized accordingly. The modified 3D T1W-GRE (called HYBRID) was compared with the conventional T1W-GRE- and T2*-sequences in both phantom and clinical studies. In the clinical study of six patients with primary liver tumors, two observers visually assessed marker detection, tumor delineation, and overall image quality on a four-point scale. Results: In the phantom study, HYBRID showed significantly higher SNR and RSD than those of conventional T1W-GRE (P < 0.001). In the clinical study, HYBRID yielded significantly higher scores than conventional T1W-GRE did in terms of marker detection (P < 0.001). The scores of both sequences were not statistically different in terms of tumor delineation and overall image quality (P = 0.56 and P = 0.32). Conclusions: The proposed HYBRID sequence improved gold fiducial marker detection without degrading tumor delineation in MRI for SBRT of primary liver tumor.

DOI： 10.1016/j.ejmp.2022.01.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3389/fneur.2022.843883

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

We propose two methods to evaluate system-related distortion in magnetic resonance imaging (MRI)in radiation therapy treatment planning (RTP) and demonstrate the importance of three-dimensional (3D)distortion correction (DC) by quantitatively measuring the distortion magnitude. First, a small pin phantomwas scanned at multiple positions using an external laser guide for accurate phantom placement andcombined into one image encompassing a large area. Direct plane images were used for evaluating in-planedistortion and multiplanar reconstruction images for through-plane distortion with no DC, two-dimensional(2D) DC, and 3D DC. Second, a large grid sheet was scanned as the direct plane of the phantom placement.The distortion magnitude was determined by measuring the displacement between the MRI and referencecoordinates. The measured distortions were compared between in and through-plane when applying DCand between the two methods. The small pin phantom method can be used to evaluate a wide range ofdistortions, whereas data from the entire plane can be obtained with a single scan using the grid sheetwithout a laser guide. The mean distortion magnitudes differed between the methods. Furthermore, the 3DDC reduced in and through-plane distortions. In conclusion, the small pin phantom method can be usedto evaluate a wide range of distortions by creating a combined image, whereas the grid sheet methodis simpler, accurate, repeatable, and does not require a special-order phantom or laser guide. As 3D DCreduces both in and through-plane distortions, it can be used to improve RTP quality

DOI： 10.18999/nagjms.84.1.29

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gz.0000002650

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gz.0000002657

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Breast Cancer  

Purpose: The purpose of the study is to evaluate the associations between intratumoral or peritumoral textural features derived from pretreatment magnetic resonance imaging (MRI) and recurrence-free survival (RFS) in triple-negative breast cancer (TNBC) patients. Methods: Forty-three patients with TNBC who underwent preoperative MRI between February 2008 and March 2014 were included. We performed two-dimensional texture analysis on the intratumoral or peritumoral region of interest (ROI) on axial of T2-weighted image (T2WI), dynamic contrast-enhanced (DCE)-MRI and DCE-MRI subtraction images. We also analyzed histopathological data. Cox proportional hazards models were used to investigate associations with survival outcomes. Results: Twelve of the 43 patients (27.9%) had recurrence disease, at a median of 32.5 months follow-up (1.4–61.5 months). In univariate analysis, nine texture features in T2WI and DCE-MRI subtraction images were significantly associated with RFS. In multivariate analysis, intratumoral difference entropy in DCE-MRI subtraction images in the initial phase (hazard ratio 11.71; 95% confidence interval (CI) [1.41, 97.00]; p value 0.023) and, peritumoral difference variance in DCE-MRI subtraction images in the delayed phase (hazard ratio 9.60; 95% CI [1.98, 46.51]; p value 0.005), were both independently associated with RFS. Moreover, multivariate analysis revealed the presence of lymphovascular invasion as independently associated with RFS (hazard ratio 8.13; 95% CI [2.16, 30.30]; p value 0.002). Conclusions: At pretreatment MRI, an intratumoral and peritumoral quantitative approach using texture analysis has the potential to serve as a prognostic marker in patients with TNBC.

DOI： 10.1007/s12282-021-01294-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: Hypertension may be related to alterations of the glymphatic system, a waste metabolite drainage system in the brain. We aimed to investigate analysis along the perivascular space index changes in elderly subjects with hypertension. MATERIALS AND METHODS: Diffusion-weighted images were acquired from 126 subjects, including 63 subjects with hypertension (25 men and 38 women; mean age, 72.45 years) and 63 age- and sex-matched controls (25 men and 38 women; mean age, 72.16 years). We calculated the analysis along the perivascular space index as a ratio of the mean of x-axis diffusivities in the projection and association areas to the mean of y-axis diffusivity in the projection area and z-axis diffusivity in the association area. The left, right, and mean analysis along the perivascular space indices of both hemispheres were compared between the hypertension and control groups using a Mann-Whitney U test. The Spearman correlation coefficient was used to assess the correlation between the left, right, and mean ALPS indices and blood pressure and pulse pressure. RESULTS: The left (P =.011) and mean (P =.024) analysis along the perivascular space indices of the hypertension group were significantly lower than that of the control group. The left, right, and mean analysis along the perivascular space indices of all subjects were significantly negatively correlated with blood pressure values (r = -0.200 to -0.278, P =.002-0.046) and pulse pressure values (r = -0.221 to -0.245, P =.006-0.013). CONCLUSIONS: Our results are consistent with a model in which hypertension causes glymphatic dysfunction.

DOI： 10.3174/ajnr.A7334

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Thecentralnervoussystem(CNS)waspreviouslythoughttobetheonlyorgansystemlackinglymphatic vessels to remove waste products from the interstitial space. Recently, based on the results from animal experiments, the glymphatic system was hypothesized. In this hypothesis, cerebrospinal fluid (CSF) enters the periarterial spaces, enters the interstitial space of the brain parenchyma via aquaporin-4 (AQP4) channels in the astrocyte end feet, and then exits through the perivenous space, thereby clearing waste products. From the perivenous space, the interstitial fluid drains into the subarachnoid space and meningeal lymphatics of the parasagittal dura. It has been reported that the glymphatic system is particularly active during sleep. Impairment of glymphatic system function might be a cause of various neurodegenerative diseases such as Alzheimer’s disease, normal pressure hydrocephalus, glaucoma, and others. Meningeal lymphatics regulate immunity in the CNS. Many researchers have attempted to visualize the function and structure of the glymphatic system and meningeal lymphatics in vivo using MR imaging. In this review, we aim to summarize these in vivo MR imaging studies and discuss the significance, current limitations, and future directions. We also discuss the significance of the perivenous cyst formation along the superior sagittal sinus, which is recently discovered in the downstream of the glymphatic system.

DOI： 10.2463/mrms.rev.2020-0122

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

In this study, we present images acquired by a fast-imaging method for the evaluation of endolymphatic hydrops after intravenous administration of a single dose of gadolinium-based contrast agent. We utilized the hybrid of reversed image of MR cisternography and a positive perilymph signal by heavily T2-weighted 3D-fluid attenuated inversion recovery-multiplied by T2 (HYDROPS2-Mi2) method combined with deep learning reconstruction denoising. The scan time for the fast protocol was approximately 5 mins, which is far shorter than previously reported scan times. The fast acquisition provides similar image quality and less motion artifacts compared to the longer method.

DOI： 10.2463/mrms.ici.2021-0022

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To evaluate the relationship between the size of the venous structures related to the inner ear and the degree of endolymphatic hydrops (EH). Methods: Thirty-four patients with a suspicion of EH underwent whole brain MR imaging including the inner ear. Images were obtained pre-and post-administration, and at 4 and 24 hours after the intravenous administration of a gadolinium-based contrast agent (IV-GBCA). The cross-sectional areas (CSA) of the internal jugular vein (IJV), superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) were measured on the magnetization prepared rapid acquisition of gradient echo (MPRAGE) images obtained immediately after the IV-GBCA. The grade of EH was determined on the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images obtained at 4 hours after IV-GBCA as no, mild, and significant EH according to the previously proposed grading system for the cochlea and vestibule, respectively. The ipsilateral CSA was compared between groups with each level of EH grade. P < 0.05 was considered statistically significant. Results: There were no statistically significant differences between EH grades for the CSA of the IJV or that of the IPS in either the cochlea or the vestibule. The CSA of the SPS in the groups with significant EH was significantly smaller than that in the group with no EH, for both the cochlea (P < 0.01) and the vestibule (P < 0.05). In an ROC analysis to predict significant EH, the cut-off CSA value in the SPS was 3.905 mm2 for the cochlea (AUC: 0.8762, 95% confidence interval [CI]: 0.7952‒0.9572) and 3.805 mm2 for the vestibule (AUC: 0.7727, 95% CI: 0.6539‒0.8916). Conclusion: In the ears with significant EH in the cochlea or vestibule, the CSA of the ipsilateral SPS was smaller than in the ears without EH.

DOI： 10.2463/mrms.mp.2021-0010

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gz.0000002588

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMJ Open  

Introduction Bidirectional associations have been reported between sleep disturbance and both cognitive impairment, including Alzheimer’s disease and amyloid beta-peptide (Aβ) accumulation. These relationships can be explained by the glymphatic system, which acts as a garbage drainage system in the brain. As interstitial fluid dynamics are suggested to increase during sleep, clearance of Aβ can be influenced by sleep disturbance or deprivation. We hypothesised that using lemborexant, an orexin receptor antagonist, to improve sleep quality would also improve the function of the glymphatic system. We plan to examine the effect of lemborexant on sleep quality and the glymphatic system among patients with insomnia disorder. Methods and analysis This pilot study is designed as an open-label, single-arm, single-centre trial. Thirty patients aged 50 years and over with insomnia will be recruited. The participants will take lemborexant (5 mg) at bedtime for 12 weeks and undergo a home-based sleep study at baseline and weeks 4 and 12, as well as MRI examinations to evaluate the glymphatic system at baseline and week 12. The primary outcome will be changes in objective sleep parameters as evaluated using a sleep monitoring system. The secondary outcomes will be changes in subjective sleep parameters. The relationships between changes in sleep parameters and the glymphatic system will be evaluated using diffusion tensor image analysis along the perivascular space, which is called the ALPS-index. Sleep parameters and the ALPS-index will be analysed using a paired t-test or Pearson’s correlation coefficient. Ethics and dissemination The study protocol was approved by Nagoya University Certified Review Board. The findings from this research will be published in peer-reviewed journals and be presented at local, national and international conferences.

DOI： 10.1136/bmjopen-2021-054885

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods: The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results: V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion: The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.

DOI： 10.1007/s11604-021-01137-1

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その他リンク： https://link.springer.com/article/10.1007/s11604-021-01137-1/fulltext.html

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neurologia Medico-Chirurgica  

Moyamoya disease (MMD) causes intracranial arterial stenosis progression. The progression of intracranial arterial stenosis will increase the risk of ischemic cerebrovascular events. This study aims to investigate the relationship between intracranial arterial stenosis progression, vessel wall enhancement (VWE), and the recent neurological symptoms. A total of 39 MMD patients (12 male 37.6 ± 18.0 years old) were registered in this study analysis between April 2016 and July 2018. All patients received MRI at registration and 6, 12, and 24 months post-registration. The incidence of ischemic cerebrovascular events (transit ischemic attacks or cerebral infarction) was checked until December 2018. We evaluated the relationship between the intensity of VWE, intracranial arterial stenosis, and the recent neurological symptoms. During the mean follow-up period of 13.8 ± 5.5 months, the changes in VWE were observed in 33 hemispheres (42.3%), stenosis progression was observed in 21 hemispheres (26.9%), and recent neurological symptoms occurred in 10 hemispheres (12.8%). Stenosis progression was observed in 11 hemispheres (33.3%) in the VWE(+) group and ten hemispheres (22.2%) in the VWE(-) group (p = 0.310). The recent neurological symptoms were observed in eight hemispheres (21.2%) in the VWE(+) group and two hemispheres (4.44%) in the VWE(-) group (odds ratio 6.88, 95% confidence interval 1.35-34.98, p = 0.015). The intensity of VWE sometimes changes. The changes in VWE were significantly associated with the recent neurological symptoms but not with stenosis progression.

DOI： 10.2176/nmc.oa.2021-0058

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance Imaging Clinics of North America  

DOI： 10.1016/j.mric.2021.01.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oxidative Medicine and Cellular Longevity  

Background. Parkinson's disease (PD) is a common neurodegenerative disease associated with accumulation of misfolding proteins and increased neuroinflammation, which may further impair the glymphatic system. The purpose of this study was to utilize diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate glymphatic system activity and its relationship with systemic oxidative stress status in PD patients. Methods. Magnetic resonance imaging and neuropsychological tests were conducted on 25 PD patients with normal cognition (PDN), 25 PD patients with mild cognitive impairment (PD-MCI), 38 PD patients with dementia (PDD), and 47 normal controls (NC). Oxidative stress status was assessed by plasma DNA level. Differences in ALPS-index among the subgroups were assessed and further correlated with cognitive functions and plasma DNA levels. Results. The PD-MCI and PDD groups showed significantly lower ALPS-index compared to normal controls. The ALPS-index was inversely correlated with plasma nuclear DNA, mitochondrial DNA levels, and cognitive scores. Conclusions. Lower diffusivity along the perivascular space, represented by lower ALPS-index, indicates impairment of the glymphatic system in PD patients. The correlation between elevated plasma nuclear DNA levels and lower ALPS-index supports the notion that PD patients may exhibit increased oxidative stress associated with glymphatic system microstructural alterations.

DOI： 10.1155/2021/4034509

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本磁気共鳴医学会  

<p>　2020年8月にウェブ開催されたISMRM（国際磁気共鳴医学会）において，京都大学の富樫かおり先生がGold Medalを受賞され，名古屋大学の長縄慎二先生がSenior Fellowに選出されました．同じ年の大会で日本人が同時に2名選出されることは初めてのことであり，MRI研究における日本の大きなプレゼンスを示す出来事でもありました．</p><p>　この度，この快挙を記念して，お二人とご縁の深い先生方からの特別寄稿をいただきましたので，ここに掲載させて頂きます．</p>

DOI： 10.2463/jjmrm.2020-1724

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: Decrease in signal of the cerebrospinal fluid (CSF) on low b-value diffusion weighted image (DWI) due to non-uniform flow can provide additional information regarding CSF motion. The purpose of the current study was to evaluate whether arterial pulsations constitute the driving force of CSF motion. Methods: We evaluated the CSF signals within the Sylvian fissure on low b-value DWI in 19 patients with unilateral middle cerebral artery (MCA) occlusion. DWI with b-value of 500 s/mm2 was evaluated for a decrease in CSF signal within the Sylvian fissure including the Sylvian vallecula and lower, middle, and higher Sylvian fissures and graded as follows: the same as contralateral side; smaller signal decrease than that on contralateral side; and no signal decrease. MR angiography (MRA) findings of MCA were graded as follows: the same as contralateral, lower signal than contralateral signal, and no signal. In 15 patients, regional cerebral blood flow (rCBF) was evaluated using single-photon emission computed tomography (SPECT) studies and graded as > 90%, 90%–70%, and < 70% rCBF compared to contralateral. The correlations between the gradings were evaluated using G likelihood-ratio test. Results: There was no statistically significant correlation between the MRA and low b-value DWI gradings of CSF in all areas. There were statistically significant correlations between the decreases in CBF on SPECT and CSF signals in the middle Sylvian fissure. Conclusion: The driving force of CSF pulsation in the Sylvian sinus may be related to the pulsations of the cerebral hemisphere rather than direct arterial pulsations.

DOI： 10.2463/mrms.mp.2020-0121

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To investigate the association between signal changes over time in perivenous cystic structures near the superior sagittal sinus and leakage of a gadolinium-based contrast agent (GBCA) into the subarachnoid space in patients with suspected endolymphatic hydrops. Methods: Fifty-one cystic structures in 27 cases were evaluated. The signal intensity of the cystic structures was measured on 3D real inversion recovery (3D-real IR) images obtained at pre-, and at 10 min, 4 hrs and 24 hrs post-intravenous administration (IV) of GBCA. Signal enhancement of the cystic structures from the pre-contrast images at each time point was compared in subjects with leakage (positive) versus those without leakage (negative) using an ANOVA. Fisher’s exact probability test was used to compare the maximum contrast-enhanced time point between positive and negative groups. We used 5% as a threshold to determine statistical significance. Results: In leakage positive subjects, mean signal enhancement of the cysts was significantly greater at 4 and 24 hrs compared to 10 min. However, although there was a trend of an increase from 4 to 24 hrs, the difference was not significant. In the leakage negative group, mean signal enhancement of the cysts was significantly higher at 4 hrs compared to 10 min and 24 hrs. There was no significant difference between 10 min and 24 hrs. In the positive group, the maximum signal increase was found in 10/38 and 28/38 cysts at 4 and 24 hrs after IV-GBCA, respectively. In the leakage negative group, the maximum signal increase was found in 10/13 and 3/13 cysts at 4 and 24 hrs, respectively (P = 0.0019). Conclusion: There was an association between signal changes over time after IV-GBCA in perivenous cystic structures and leakage of GBCA. Further research to clarify the impact of cystic structures on the function of the waste clearance system of the brain is warranted.

DOI： 10.2463/mrms.mp.2020-0138

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: The purpose of this retrospective study was to investigate the relationship between the number and size of cystic structures around the cortical veins near the superior sagittal sinus and the leakage of gadolinium-based contrast agent (GBCA) around the cortical veins. Methods: Of 190 patients (91 male and 99 female), that were scanned at 4 h after an intravenous injection of GBCA as a diagnostic examination for endolymphatic hydrops, 6 patients with GBCA leakage were younger than the previously proposed threshold age of 37.3 years for leakage. Six age-matched patients without leakage were also included for reference. In addition, we included 8 cases without leakage that were older than the hypothesized threshold of 37.3 years, as well as 8 age-matched patients with GBCA leakage into the cerebrospinal fluid space. The number of cysts was counted and the sizes were measured in these 28 patients (age: 32–60 years old, 13 men and 15 women). Results: The mean number of cysts surrounding the cortical veins in the parasagittal region was 4.29 ± 1.77 vs. 1.79 ± 1.05 (P = 0.0001) in the subjects with and without GBCA leakage, respectively. The mean size of the largest cysts was at 8.89 ± 3.49 mm vs. 5.69 ± 2.29 (P = 0.009) in the subjects with and without GBCA leakage, respectively. Conclusion: The number and size of the perivenous cystic structures near the superior sagittal sinus is greater in subjects with GBCA leakage into the subarachnoid space compared with those without leakage. Future research regarding the histological and functional details of these parasagittal cystic structures is needed.

DOI： 10.2463/mrms.mp.2020-0062

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To evaluate the feasibility for the detection of slight contrast effects after intravenous administration of single dose gadolinium-based contrast agent (IV-SD-GBCA), the time course of the GBCA distribution up to 24 h was examined in various fluid spaces and brain parenchyma using 3D-real IR imaging and MR fingerprinting (MRF). Methods: Twenty-four patients with a suspicion of endolymphatic hydrops were scanned at pre-administration and at 10 min, 4 and 24 h post-IV-SD-GBCA. 3D-real IR images and MRF at the level of the internal auditory canal were obtained. The signal intensity on the 3D-real IR image of the cerebrospinal fluid (CSF) in the cerebellopontine angle cistern (CPA), Sylvian fissure (Syl), lateral ventricle (LV), and cochlear perilymph (CPL) was measured. The T1 and T2 values of cerebellar gray (GM) and white matter (WM) were measured using MRF. Each averaged value at the various time points was compared using an analysis of variance. Results: The signal intensity on the 3D-real IR image in each CSF region peaked at 4 h, and was decreased significantly by 24 h (P < 0.05). All patients had a maximum signal intensity at 4 h in the CPA, and Syl. The mean CPL signal intensity peaked at 4 h and decreased significantly by 24 h (P < 0.05). All patients but two had a maximum signal intensity at 4 h. Regarding the T1 value in the cerebellar WM and GM, the T1 value at 10 min post-IV-GBCA was significantly decreased compared to the pre-contrast scan, but no significant difference was observed at the other time points. There was no significant change in T2 in the gray or white matter at any of the time points. Conclusion: Time course of GBCA after IV-SD-GBCA could be evaluated by 3D-real IR imaging in CSF spaces and in the brain by MRF.

DOI： 10.2463/mrms.mp.2020-0030

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cerebral Cortex  

In autism spectrum disorder (ASD), the complexity-specific hypothesis explains that atypical visual processing is attributable to selective functional changes in visual pathways. We investigated dendritic microstructures and their associations with functional connectivity (FC). Participants included 28 individuals with ASD and 29 typically developed persons. We explored changes in neurite orientation dispersion and density imaging (NODDI) and brain areas whose FC was significantly correlated with NODDI parameters in the explored regions of interests. Individuals with ASD showed significantly higher orientation dispersion index (ODI) values in the left occipital gyrus (OG) corresponding to the secondary visual cortex (V2). FC values between the left OG and the left middle temporal gyrus (MTG) were significantly negatively correlated with mean ODI values. The mean ODI values in the left OG were significantly positively associated with low registration of the visual quadrants of the Adolescent/Adult Sensory Profile (AASP), resulting in a significant positive correlation with passive behavioral responses of the AASP visual quadrants; additionally, the FC values between the left OG and the left MTG were significantly negatively associated with reciprocal social interaction. Our results suggest that abnormal V2 dendritic arborization is associated with atypical visual processing by altered intermediation in the ventral visual pathway.

DOI： 10.1093/cercor/bhaa121

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Korean Journal of Radiology  

The glymphatic system hypothesis is a concept describing the clearance of waste products from the brain. The term “glymphatic system” combines the glial and lymphatic systems and is typically described as follows. The perivascular space functions as a conduit that drains cerebrospinal fluid (CSF) into the brain parenchyma. CSF guided to the perivascular space around the arteries enters the interstitium of brain tissue via aquaporin-4 water channels to clear waste proteins into the perivascular space around the veins before being drained from the brain. In this review, we introduce the glymphatic system hypothesis and its association with fluid dynamics, sleep, and disease. We also discuss imaging methods to evaluate the glymphatic system.

DOI： 10.3348/kjr.2020.0042

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers in Aging Neuroscience  

Recent studies have demonstrated that connector hubs, regions considered critical for the flow of information across neural systems, are mostly involved in neurodegenerative dementia. Considering that aging can significantly affect the brain’s intrinsic connectivity, identifying aging’s impact on these regions’ overall connection strength is important to differentiate changes associated with healthy aging from neurodegenerative disorders. Using resting state functional magnetic resonance imaging data from a carefully selected cohort of 175 healthy volunteers aging from 21 to 86 years old, we computed an intrinsic connectivity contrast (ICC) metric, which quantifies a region’s overall connectivity strength, for whole brain, short-range, and long-range connections and examined age-related changes of this metric over the adult lifespan. We have identified a limited number of hub regions with ICC values that showed significant negative relationship with age. These include the medial precentral/midcingulate gyri and insula with both their short-range and long-range (and thus whole-brain) ICC values negatively associated with age, and the angular, middle frontal, and posterior cingulate gyri with their long-range ICC values mainly involved. Seed-based connectivity analyses further confirmed that these regions are connector hubs with connectivity profile that strongly overlapped with multiple large-scale brain networks. General cognitive performance was not associated with these hubs’ ICC values. These findings suggest that even healthy aging could negatively impact the efficiency of regions critical for facilitating information transfer among different functional brain networks. The extent of the regions involved, however, was limited.

DOI： 10.3389/fnagi.2020.592469

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Pediatric Neurology  

Background: Advances in hematopoietic stem cell transplantation have improved the survival rate of malignant diseases and congenital immunodeficiencies. It has become important to assess long-term complications in survivors. To assess neurological abnormalities in children treated by transplantation, diffusion tensor imaging was performed. Methods: Forty children who underwent head diffusion tensor imaging before and after their first transplantation were enrolled. Patients with brain lesions on conventional MRI were excluded. Fractional anisotropy and mean diffusivity were compared between patients and 28 control subjects using tract-based spatial statistics. The Strengths and Difficulties Questionnaire was administered as a behavioral evaluation after transplantation, and diffusion tensor images of patients with and without behavioral abnormalities were compared. Results: The age of patients and controls was 0 to 19 years and 0 to 16 years, respectively. The date of diffusion tensor imaging was 10 to 57 days before and 40 to 153 days after transplantation. Tract-based spatial statistics showed fractional anisotropy reduction in widespread white matter in patients before and after transplantation. Mean diffusivity was high before transplantation and normalized after transplantation. Analysis comparing before and after hematopoietic stem cell transplantation shows no difference in fractional anisotropy and significantly high mean diffusivity before hematopoietic stem cell transplantation. In patients with behavioral abnormalities, low fractional anisotropy and high mean diffusivity remained after transplantation. Conclusions: Longitudinal diffusion tensor imaging showed white matter abnormalities in children without conventional MRI abnormalities, which were related to behavioral problems after transplantation. Diffusion tensor imaging is useful for behavioral assessment in children undergoing transplantation.

DOI： 10.1016/j.pediatrneurol.2020.06.008

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gz.0000001857

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Human Brain Mapping  

White matter (WM) fiber bundles change dynamically with age. These changes could be driven by alterations in axonal diameter, axonal density, and myelin content. In this study, we applied a novel fixel-based analysis (FBA) framework to examine these changes throughout the adult lifespan. Using diffusion-weighted images from a cohort of 293 healthy volunteers (89 males/204 females) from ages 21 to 86 years old, we performed FBA to analyze age-related changes in microscopic fiber density (FD) and macroscopic fiber morphology (fiber cross section [FC]). Our results showed significant and widespread age-related alterations in FD and FC across the whole brain. Interestingly, some fiber bundles such as the anterior thalamic radiation, corpus callosum, and superior longitudinal fasciculus only showed significant negative relationship with age in FD values, but not in FC. On the other hand, some segments of the cerebello-thalamo-cortical pathway only showed significant negative relationship with age in FC, but not in FD. Analysis at the tract-level also showed that major fiber tract groups predominantly distributed in the frontal lobe (cingulum, forceps minor) exhibited greater vulnerability to the aging process than the others. Differences in FC and the combined measure of FD and cross section values observed between sexes were mostly driven by differences in brain sizes although male participants tended to exhibit steeper negative linear relationship with age in FD as compared to female participants. Overall, these findings provide further insights into the structural changes the brain's WM undergoes due to the aging process.

DOI： 10.1002/hbm.25008

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical Neurology and Neurosurgery  

DOI： 10.1016/j.clineuro.2020.105764

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

Neurite orientation dispersion and density imaging (NODDI) is a novel diffusion method for evaluating tissue microstructure, and may provide additional information over conventional diffusion tensor imaging (DTI). We evaluated NODDI and DTI parameters in cases of tuberous sclerosis (TS) to assess microstructural changes in the white matter. Eleven cases of tuberous sclerosis and eight age-matched controls underwent NODDI and DTI. We performed qualitative analysis and tract-based spatial statistics (TBSS) analysis of the NODDI parameters (Ficv: intracellular volume fraction, Fiso: isotropic fraction, ODI: orientation dispersion index) as well as DTI parameters (MD: mean diffusivity, FA: fractional anisotropy). We also performed a correlation analysis between clinical symptoms and parameters. The qualitative analysis indicated that the Ficv had a lower value in TS cases particularly in the tubers adjacent to the white matter. The TBSS analysis showed that the TS cases had decreased Ficv in a greater area compared to the other parameters including MD. In particular, the Ficv was decreased in deep white matter, such as the superior longitudinal fascicles (SLF). The application of NODDI to TS cases revealed tissue microstructural changes, and particularly the Ficv could detect more widespread abnormalities in white matter structure compared to DTI parameters.

DOI： 10.1038/s41598-019-57306-w

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Magnetic Resonance Imaging  

In recent years, the existence of a mass transport system in the brain via cerebrospinal fluid (CSF) or interstitial fluid (ISF) has been suggested by many studies. The glymphatic system is hypothesized to be a waste clearance system of the CSF through the perivascular and interstitial spaces in the brain. Tracer studies have primarily been used to visualize or evaluate the waste clearance system in the brain, and evidence for this system has accumulated. The initial study that identified the glymphatic system was an in vivo tracer study in mice. In that study, fluorescent tracers were injected into the cisterna magna and visualized by two-photon microscopy. MRI has also been used to evaluate glymphatic function primarily with gadolinium-based contrast agents (GBCAs) as tracers. A number of GBCA studies evaluating glymphatic function have been conducted using either intrathecal or intravenous injections. Stable isotopes, such as 17O-labeled water, may also be used as tracers since they can be detected by MRI. In addition to tracer studies, several other approaches have been used to evaluate ISF dynamics within the brain, including diffusion imaging. Phase contrast evaluation is a powerful method for visualizing flow within the CSF space. In order to evaluate the movement of water within tissue, diffusion-weighted MRI represents another promising technique, and several studies have utilized diffusion techniques for the evaluation of the glymphatic system. This review will discuss the findings of these diffusion studies. Level of Evidence: 5. Technical Efficacy: Stage 3. J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2020;51:11–24.

DOI： 10.1002/jmri.26892

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: This study aimed to evaluate comprehensively; accuracy, repeatability and reproducibility of T1 and T2 relaxation times measured by magnetic resonance fingerprinting using B+1-corrected fast imaging with steady-state precession (FISP–MRF). Methods: The International Society of Magnetic Resonance in Medicine/National Institute of Standards and Technology (ISMRM/NIST) phantom was scanned for 100 days, and six healthy volunteers for 5 days using a FISP–MRF prototype sequence. Accuracy was evaluated on the phantom by comparing relaxation times measured by FISP–MRF with the reference values provided by the phantom manufacturer. Daily repeatability was characterized as the coefficient of variation (CV) of the measurements over 100 days for the phantom and over 5 days for volunteers. In addition, the cross-scanner reproducibility was evaluated in volunteers. Results: In the phantom study, T1 and T2 values from FISP–MRF showed a strong linear correlation with the reference values of the phantom (R2 = 0.9963 for T1; R2 = 0.9966 for T2). CVs were <1.0% for T1 values larger than 300 ms, and <3.0% for T2 values across a wide range. In the volunteer study, CVs for both T1 and T2 values were <5.0%, except for one subject. In addition, all T2 values estimated by FISP–MRF in vivo were lower than those measured with conventional mapping sequences reported in previous studies. The cross-scanner variation of T1 and T2 showed good agreement between two different scanners in the volunteers. Conclusion: B+1-corrected FISP-MRF showed an acceptable accuracy, repeatability and reproducibility in the phantom and volunteer studies.

DOI： 10.2463/mrms.mp.2019-0016

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

We currently obtain pre-and post-contrast enhanced whole brain 3D-real inversion recovery images for the evaluation of endolymphatic hydrops. We noticed that the space between the pial sheath surrounding the cortical veins and the cortical venous wall is enhanced and this enhancement seems to connect to the meningeal lymphatics along superior sagittal sinus. This new anatomical concept regarding the outflow from the glymphatic system might be important for the future research in neuroscience.

DOI： 10.2463/mrms.bc.2019-0099

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: It has been reported that leakage of intravenously administered gadolinium-based contrast agents (IV-GBCAs) into the cerebrospinal fluid (CSF) from the cortical veins even in healthy subjects can be detected using a highly sensitive pulse sequence such as heavily T2-weighted 3D fluid-attenuated inversion recovery and 3D-real inversion recovery (IR). The purpose of this study was to evaluate the feasibility of MR fingerprinting to detect GBCA leakage from the cortical veins after IV-GBCA. Materials: Fourteen patients with suspected endolymphatic hydrops (EH) who received a single dose of IV-GBCA (39–79 years old) were included. The real IR images as well as MR fingerprinting images were obtained at 4 h after IV-GBCA. T1 and T2 values were obtained using MR fingerprinting and analyzed in ROIs covering intense GBCA leakage, and non-leakage areas of the CSF as determined on real IR images. The scan time for real IR imaging was 10 min and that for MR fingerprinting was 41 s. Results: The mean T1 value of the ROI in the area of GBCA leakage was 2422 ± 261 ms and that in the non-leakage area was 3851 ± 235 ms (P < 0.01). There was no overlap between the T1 values in the area of GBCA leakage and those in the non-leakage area. The mean T2 value in the area of GBCA leakage was 319 ± 90 ms and that in the non-leakage area was 670 ± 166 ms (P < 0.01). There was some overlap between the T2 values in the area of GBCA leakage and those in the non-leakage area. Conclusion: Leaked GBCA from the cortical veins into the surrounding CSF can be detected using MR fingerprinting obtained in <1 min.

DOI： 10.2463/mrms.mp.2019-0048

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: It has been reported previously that intravenously administered gadolinium-based contrast agent (GBCA) leaks into the subarachnoid space around the cortical veins at 4 h after injection in all old people over 37 years, but not in younger people up to 37 years of age in 3D-real IR images. The purpose of this study was to investigate whether there was a strict threshold of 37 years of age for the leakage of the GBCA into the subarachnoid space. Methods: The subjects included 190 patients, that were scanned for 3D-real IR images at 4 hours after intravenous injection of GBCA as a diagnostic test for endolymphatic hydrops. The patient’s age ranged from 14 to 81 years. Two experienced neuroradiologists evaluated the images to determine whether the GBCA leakage around the cortical veins was positive or negative. Any discrepancies between the two observers were discussed and a consensus was obtained. A Mann–Whitney U test and receiver operating characteristic (ROC) curve analysis were used to compare the positive and the negative group and to set the age cut-off value for the prediction of GBCA leakage. Results: The GBCA leakage around the cortical veins was negative in 35 patients and positive in 155 patients. The average age was 33 ± 11 years in the negative group, and 55 ± 12 years in the positive group (P < 0.01). In the ROC analysis for the age and leakage of the GBCA, an area under the curve was 0.905 and the cut-off age was 37.317 years (sensitivity of 0.942 and specificity of 0.771). Conclusion: Intravenously administered GBCA leaks into the subarachnoid space around the cortical veins in most patients over 37 years of age. However, it should be noted that it can be found occasionally in patients under 37 years of age.

DOI： 10.2463/mrms.mp.2019-0182

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Psychiatry Research - Neuroimaging  

Previous studies have reported that cognitive remediation therapy (CRT) improves cognitive deficits in patents with schizophrenia. However, few studies have focused on the underlying structural alterations in the brain following Vocational Cognitive Ability Training by the Japanese Cognitive Rehabilitation Program for Schizophrenia (VCAT-J). In this study, we analyzed changes in diffusion tensor imaging parameters in 31 patients with schizophrenia after 12 weeks of intervention consisting of standard treatment alone or standard treatment plus VCAT-J, in order to determine the effect of the latter on white matter microstructural plasticity. Cognitive function was evaluated using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J) scale. The CRT group exhibited significant improvements in verbal fluency and composite BACS-J scores, relative to the treatment-as-usual (TAU) group. In addition, the CRT group exhibited significantly increased fractional anisotropy (FA) values, along with significantly decreased radial (RD) and mean diffusivity (MD) values, in the posterior lobe of the left cerebellum. Changes in RD and MD values were negatively correlated with changes in BACS-J composite scores. These suggest that VCAT-J might mediate improvements in myelin sheath composition in the posterior lobe of the left cerebellum, which may have been associated with improvements in cognitive function.

DOI： 10.1016/j.pscychresns.2019.09.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

Healthy aging is associated with structural and functional changes in the brain even in individuals who are free of neurodegenerative diseases. Using resting state functional magnetic resonance imaging data from a carefully selected cohort of participants, we examined cross sectional changes in the functional organization of several large-scale brain networks over the adult lifespan and its potential association with general cognitive performance. Converging results from multiple analyses at the voxel, node, and network levels showed widespread reorganization of functional brain networks with increasing age. Specifically, the primary processing (visual and sensorimotor) and visuospatial (dorsal attention) networks showed diminished network integrity, while the so-called core neurocognitive (executive control, salience, and default mode) and basal ganglia networks exhibited relatively preserved between-network connections. The visuospatial and precuneus networks also showed significantly more widespread increased connectivity with other networks. Graph analysis suggested that this reorganization progressed towards a more integrated network topology. General cognitive performance, assessed by Addenbrooke’s Cognitive Examination-Revised total score, was positively correlated with between-network connectivity among the core neurocognitive and basal ganglia networks and the integrity of the primary processing and visuospatial networks. Mediation analyses further indicated that the observed association between aging and relative decline in cognitive performance could be mediated by changes in relevant functional connectivity measures. Overall, these findings provided further evidence supporting widespread age-related brain network reorganization and its potential association with general cognitive performance during healthy aging.

DOI： 10.1038/s41598-019-47922-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: To apply for detecting low-concentration gadolinium contrast agent (Gd), such as those in the perilymph and cerebrospinal fluid (CSF) at 4 h after intravenous administrations (IV), we tried to clarify the degree of increased signal intensity (SI) of low-concentration Gd by longer repetition time (TR) in heavily T 2 -weighed 3D-FLAIR. Materials and methods: A phantom was designed using Gd diluted with saline at 0.250–0.008 mM and obtained images by varying the TR from 9000 to 16,000. We measured the SI of five slices for each concentration and compared the mean SI (SI mean ) values. Normalized SI (SI norm ) values, defined as the SI mean value of each TR divided by the SI mean value of 9000-ms TR for each concentration were compared. Results: Longer TR increased the SI mean values in all solutions. In the 0.250 mM solution, the SI mean value of 16,000-ms TR was 1.07-times greater than that of 9000-ms TR. In contrast, the SI mean value of 16,000-ms TR was 1.67-times greater than that of 9000-ms TR in 0.008 mM solution. Conclusion: SI increased with longer TR and lower Gd concentration. Thus, longer TR was useful in detecting low-concentration Gd, such as those in the perilymph and CSF at 4 h after IV.

DOI： 10.1007/s11604-019-00828-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)メジカルビュー社  

DOI： 10.18885/j01843.2019184029

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)メジカルビュー社  

DOI： 10.18885/j01843.2019184045

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)メジカルビュー社  

DOI： 10.18885/j01843.2019184046

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: We aimed to investigate whether low b value diffusion-weighted imaging (DWI) can show the change of cerebrospinal fluid (CSF) dynamics. Materials and methods: The subjects of this retrospective study consisted of patients with ventricular dilatation (n = 50) and controls (n = 50). The CSF signal intensity on the b = 500 s/mm 2 DWI was evaluated by a scoring method in the lateral, 3rd and 4th ventricles, the cerebral sulci and the Sylvian fissure. The signal void findings adjacent to the septum pellucidum were also evaluated. Results: The CSF signal intensities were significantly less in lateral ventricle and 3rd ventricle of the ventricular dilatation subjects. In controls, the score for the signal void in the Sylvian fissure showed a significant positive correlation with age. However, other areas did not show a significant correlation with age. The appearance of the characteristic signal void adjacent to the septum pellucidum showed a significant correlation with ventricular dilatation. Conclusion: Our current study suggests that the CSF signal intensity on the b = 500 s/mm 2 DWI may show the changes in CSF dynamics and might be useful to evaluate the overlook of CSF dynamics.

DOI： 10.1007/s11604-018-0790-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: It has been reported that intravenously administered gadolinium-based contrast agents (IV-GBCAs) leak into the cerebrospinal fluid (CSF) even in healthy subjects. The purpose of this study was to evaluate GBCA leakage from the cortical veins in patients with delayed imaging after IV-GBCA. Materials and Methods: There are two parts of retrospective study. In the first part, we reviewed six patients with suspected endolymphatic hydrops (EH) who received a single dose of IV-GBCA (37–58 years old). The 3D-real inversion recovery images were obtained prior to the contrast administration as well as 5 min and 4 h after IV-GBCA. Leakage from the cortical veins to the CSF was graded as positive if enhancement around the cortical veins at 5 min was observed and had further spread into the CSF at 4 h after IV-GBCA. In the second part of this study, we reviewed 21 patients with suspected EH (17–69 years old). Images were obtained only at 4 h after IV-GBCA. The number of slices (NOS) with a positive GBCA leakage from the cortical veins was counted. The correlation of the NOS with age, gender, and degree of EH was evaluated by Spearman’s rank correlation coefficient. Results: In the first part of the study, the GBCA leakage from the cortical veins was positive in all patients. In the second part of the study, the GBCA leakage from the cortical veins was seen in all older patients (above 37 years old), but not in the five younger patients (younger than 37 years old). The NOS correlated significantly only with age (r = 0.755, P < 0.01), but not with gender or degree of EH. Conclusion: IV-GBCA leaks from the cortical veins into the surrounding CSF. The leakiness of the cortical veins significantly correlated with age, but not with gender or degree of EH.

DOI： 10.2463/mrms.mp.2018-0053

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: Gadobutrol is a gadolinium-based contrast material (GBCM) with a high concentration of gadolinium and high relaxivity. Our purpose was to evaluate the signal intensity profiles in brain tissue for the bolus width and degree of signal change after bolus injection using an echo planar dynamic susceptibility contrast (DSC) sequence. We compared gadobutrol to gadoteridol using various injection speeds and saline flush volumes. Methods: We studied 97 patients who underwent brain MRI. Datasets for perfusion studies were acquired using a 3T scanner with an echo planar imaging (EPI) sequence. The injection protocols were set up with combinations of injection speed and saline flush volume for both gadobutrol and gadoteridol. The full width at half maximum (FWHM) and the maximum signal change ratio (SCR max ) of the time intensity curves were measured. Results: The FWHM did not show a statistically significant difference according to injection speed, flush volume, or type of GBCM. The SCR max showed a greater change with a faster injection speed, larger saline flush, and gadobutrol administration. The difference between gadobutrol and gadoteridol became smaller with a faster injection speed and a larger saline flush. Conclusion: The maximum signal drop was larger with gadobutrol when the injection speed was slow and the saline flush was small. Thus, gadobutrol may be useful to obtain a better profile for DSC perfusion MRI in conditions requiring a slower injection speed and/or a smaller volume of saline flush.

DOI： 10.2463/mrms.mp.2017-0172

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

DOI： 10.2463/mrms.bc.2017-0158

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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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Investigative Radiology  

Objectives The glymphatic system is a recently hypothesized waste clearance system of the brain in which perivascular space constitutes a pathway similar to the lymphatic system in other body regions. Sleep and anesthesia are reported to influence the activity of the glymphatic system. Because rats are nocturnal animals, the glymphatic system is expected to be more active during the day. We attempted to elucidate the influence of the glymphatic system for intravenously injected gadodiamide in the rat brain by 2 experiments. One was a magnetic resonance imaging (MRI) experiment to evaluate the short-term dynamics of signal intensity changes after gadodiamide administration. The other was a quantification experiment to evaluate the concentration of retained gadolinium within the rat brain after repeated intravenous administration of gadodiamide at different times of day and levels of anesthesia. Materials and Methods The imaging experiment was performed on 6 rats that received an intravenous injection of gadodiamide (1 mmol/kg) and dynamic MRI for 3 hours at 2.4-minute intervals. The time course of the signal intensity changes was evaluated for different brain structures. The tissue quantification experiment was performed on 24 rats divided into 4 groups by injection time (morning, late afternoon) and anesthesia (none, short, long) during administration. All animals received gadodiamide (1.8 mmol/kg, 8 times over 2 weeks). Gadolinium concentration of dissected brain tissues was quantified 5 weeks after the last administration by inductively coupled plasma mass spectrometry. Results In the imaging experiment, muscle and the fourth ventricle showed an instantaneous signal intensity increase immediately after gadodiamide injection. The signal curve of the cerebral cortex and deep cerebellar nuclei reached the peak signal intensity later than the fourth ventricle but earlier than that of the prepontine cistern. In the gadolinium quantification experiment, the concentration in the group with the morning injection showed a significantly lower concentration than the late afternoon injection group. The lowest tissue gadolinium concentrations were found in the groups injected in the morning during long anesthesia. Conclusions Instantaneous transition of gadodiamide from blood to cerebrospinal fluid was indicated by dynamic MRI. The gadodiamide distribution to the cerebral cortex and deep cerebellar nuclei seemed to depend on both blood flow and cerebrospinal fluid. This confirms previous studies indicating that the cerebrospinal fluid is one potential pathway of gadolinium-based contrast agent entry into the brain. For the distribution and clearance of the gadodiamide from brain tissue, involvement of the glymphatic system seemed to be indicated in terms of the influence of sleep and anesthesia.

DOI： 10.1097/RLI.0000000000000473

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neurology  

Objective: We examined the anatomical involvement related to cognitive impairment in patients with multiple system atrophy (MSA). Methods: We examined 30 patients with probable MSA and 15 healthy controls. All MSA patients were assessed by the Unified MSA-Rating scale and Addenbrooke’s Cognitive Examination-Revised (ACE-R). We classified 15 MSA patients with ACE-R scores > 88 as having normal cognition (MSA–NC) and 15 with scores ≤ 88 as having cognitive impairment (MSA–CI). All subjects underwent 3 T MRI scanning and were investigated using voxel-based morphometry and diffusion tensor imaging. Results: Both the MSA–NC and MSA–CI patients exhibited cerebellar but not cerebral atrophy in voxel-based morphometry compared to controls. In contrast, tract-based spatial statistics revealed widespread and significantly decreased fractional anisotropy (FA) values, as well as increased mean diffusivity, radial diffusivity, and axial diffusivity in both the cerebrum and cerebellum in MSA–CI patients compared to controls. MSA–NC patients also exhibited similar involvement of the cerebellum but less extensive involvement of the cerebrum compared with the MSA–CI patients. In particular, FA values in MSA–CI patients were significantly decreased in the anterior part of the left corpus callosum compared with those in MSA–NC patients. The mean FA values in the left anterior part of the corpus callosum were significantly correlated with total ACE-R scores and subscores (memory, fluency, and language) in MSA patients. Conclusions: Decreased FA values in the anterior corpus callosum showed a significant correlation with cognitive impairment in MSA.

DOI： 10.1007/s00415-018-8923-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：World Neurosurgery  

Objective: Moyamoya vasculopathy (MMV) is characterized by progressive stenosis of the intracranial arteries. MMV currently has no curative treatments, and cerebral ischemia and hemorrhage are the major outcomes. Evaluation of the stroke risk of each patient resulting from the progression of intracranial arterial stenosis is clinically important. Methods: We prospectively reviewed patients with intracranial arterial stenosis and already diagnosed MMV. High-resolution magnetic resonance imaging using contrast agent is the novel vessel wall imaging (VWI) technique for directly evaluating vascular walls and intracranial artery disease. All patients underwent high-resolution vessel wall imaging and magnetic resonance angiography at the time of registration, and they underwent follow-up magnetic resonance angiography. The Fisher exact test was used to assess associations between the degrees of wall enhancement and between stable and progressive intracranial arterial stenosis. Results: A total of 24 patients (17 female; mean age, 36.1 ± 16.8 years; range 3–67 years) with MMV were consecutively recruited to this study. Progression of stenosis was shown in 6 lesions (66.6%) on strong enhancement, 2 lesions (12.5%) on mild enhancement, and 1 lesion (4.3%) on lack of enhancement. Arterial vessel wall enhancement in MMV patients correlated closely with progression of intracranial arterial stenosis (P = 0.002). Conclusions: Arterial vessel wall enhancement in MMV patients was closely related to progression of intracranial arterial stenosis. Strong enhancement of the intracranial vessel wall was associated with intracranial arterial stenosis progression, and lack of enhancement correlated with the stability of intracranial arterial stenosis.

DOI： 10.1016/j.wneu.2018.05.181

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：{SAGE} Publications  

For brain magnetic resonance (MR) examination, three-dimensional imaging is commonly performed. Radiologists need to know the appropriate imaging angle for viewing. We present six imaging angles for the axial images. Each angle is determined by the reference line. The landmarks on the midsagittal MR image to determine the angle of the reference lines are as follows: the supraorbito-meatal line (the center of the mammillary body and the fastigium of the fourth ventricle), the orbito-meatal (OM) line (the center of the mammillary body and the most posterior point of the cerebellar tentorium), the Talairach anterior commissure (AC)-posterior commissure (PC) line (the superior edge of the AC and the inferior edge of the PC), the Schaltenbrand AC-PC line (the center of the AC and the center of the PC), the subcallosal line (the inferior border of the genu and the inferior border of the splenium of the corpus callosum), Reid’s baseline (the center of the pituitary gland and the most posterior point of the cerebellar tentorium) and the brainstem vertical line (the line perpendicular to the posterior border of the brainstem). The AC-PC line is most commonly used in MR examination. The OM line is most commonly used in computed tomography examination. The supraorbito-meatal line is recommended for avoiding irradiation to the orbit. In cases of multiple sclerosis, the subcallosal line is recommended in the guidelines. For lesions in the orbital cavity, paranasal cavity or skull base, Reid’s baseline is useful. For cases of brainstem lesions, the brainstem vertical line is useful.

DOI： 10.1177/1971400918769911

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Society of Neuroradiology ({ASNR})  

DOI： 10.3174/ajnr.A5663

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)メジカルビュー社  

DOI： 10.18885/j01843.2018192368

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Psychiatry  

Background: Cognitive remediation therapy (CRT) effectively reduces neurocognitive impairment in patients with schizophrenia, but few studies have used structural neuroimaging methods to assess its neuroanatomical effects. We investigated these effects, as well as the association between changes in cortical volume and neurocognitive performance. Method: Between August 2013 and September 2016, we performed a randomized controlled study comprising a CRT group (16 individuals) and a treatment-as-usual (TAU) group (15 individuals) of patients with schizophrenia. CRT participants engaged in twice-weekly computer-assisted CRT sessions and weekly group meetings for 12 weeks. T1-weighted magnetic resonance imaging was performed before and after the intervention period, and whole-brain voxel-based morphometric analysis was used to detect significant cortical gray matter volume changes. We also assessed the correlation between cortical volume changes and CRT-derived neurocognitive improvements. Results: The CRT group exhibited significantly greater improvements than the TAU group in verbal fluency (P = 0.012) and global cognitive scores (P = 0.049). The CRT group also exhibited significantly greater increases in right hippocampal volume than the TAU group (P < 0.001). Changes in verbal fluency scores and right hippocampal volumes were positively correlated (r = 0.53, P = 0.001). Conclusion: We found that CRT significantly increased right hippocampal volumes and that these enhancements were positively correlated with changes in verbal fluency scores. Our results indicate that CRT induces cognitive improvement through hippocampal plasticity.

DOI： 10.1186/s12888-018-1667-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gz.0000000419

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gz.0000000353

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: Circumventricular organs (CVOs) lack a blood brain barrier and are also called “brain windows”. Among CVOs, the organum vasculosum of the lamina terminalis (OVLT) is an osmotic regulator involved in the release of vasopressin. In a previous study of healthy subjects, it was reported that contrast enhancement in the OVLT can be recognized in only 34% of 3 Tesla thin slice contrast-enhanced T1-weighted images. The purpose of this study was to evaluate the leakage of gadolinium contrast from the OVLT in healthy subjects using heavily T2-weighted three dimensional-fluid attenuated inversion recovery (3D-FLAIR) (HF) imaging. Methods: Eight healthy male subjects were included in this study. A standard dose (0.1 mmol/kg) of gadoteridol was intravenously administered. Magnetic resonance cisternography (MRC) and HF were obtained before and 0.5, 1.5, 3, 4.5 and 6 h after the injection. Enhancement of the OVLT including the surrounding cerebral spinal fluid (CSF) was measured by manually drawing a rectangular ROI centered on the OVLT. The ROI was copied to the HF image and the signal intensity was measured. The signal intensity ratio (SIR) was obtained by dividing the signal intensity value of the OVLT ROI by that of the midbrain. Results: The differences between the mean SIR at pre-contrast and those at 0.5, 1.5, 3, 4.5, and 6 h were significant (P < 0.05). The mean SIR at 0.5 h was higher than those at all other time points (P < 0.05). Conclusion: Using HF imaging, enhancement around the OVLT was observed in all subjects at 0.5 h after intravenous administration of single dose gadoteridol.

DOI： 10.2463/mrms.mp.2017-0088

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

After Kanda’s first report in 2014 on gadolinium (Gd) deposition in brain tissue, a considerable number of studies have investigated the explanation for the observation. Gd deposition in brain tissue after repeated administration of gadolinium-based contrast medium (GBCM) has been histologically proven, and chelate stability has been shown to affect the deposition. However, the mechanism for this deposition has not been fully elucidated. Recently, a hypothesis was introduced that involves the ‘glymphatic system’, which is a coined word that combines ‘gl’ for glia cell and ‘lymphatic’ system. According to this hypothesis, the perivascular space functions as a conduit for cerebrospinal fluid to flow into the brain parenchyma. The perivascular space around the arteries allows cerebrospinal fluid to enter the interstitial space of the brain tissue through water channels controlled by aquaporin 4. The cerebrospinal fluid entering the interstitial space clears waste proteins from the tissue. It then flows into the perivascular space around the vein and is discharged outside the brain. In addition to the hypothesis regarding the glymphatic system, some reports have described that after GBCM administration, some of the GBCM distributes through systemic blood circulation and remains in other compartments including the cerebrospinal fluid. It is thought that the GBCM distributed into the cerebrospinal fluid cavity via the glymphatic system may remain in brain tissue for a longer duration compared to the GBCM in systemic circulation. Glymphatic system may of course act as a clearance system for GBCM from brain tissue. Based on these findings, the mechanism for Gd deposition in the brain will be discussed in this review. The authors speculate that the glymphatic system may be the major contributory factor to the deposition and clearance of gadolinium in brain tissue.

DOI： 10.2463/mrms.rev.2017-0116

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To elucidate differences between the perivascular space (PVS) in the basal ganglia (BG) versus that found in white matter (WM) using heavily T2-weighted FLAIR (hT2-FL) in terms of 1) signal intensity on non-contrast enhanced images, and 2) the degree of contrast enhancement by intravenous single dose administration of gadolinium based contrast agent (IV-SD-GBCA). Materials and Methods: Eight healthy men and 13 patients with suspected endolymphatic hydrops were included. No subjects had renal insufficiency. All subjects received IV-SD-GBCA. MR cisternography (MRC) and hT2-FL images were obtained prior to and 4 h after IV-SD-GBCA. The signal intensity of the PVS in the BG, subinsular WM, and the cerebrospinal fluid (CSF) in Ambient cistern (CSFAC) and CSF in Sylvian fissure (CSFSyl) was measured as well as that of the thalamus. The signal intensity ratio (SIR) was calculated by dividing the intensity by that of the thalamus. We used 5% as a threshold to determine the significance of the statistical test. Results: In the pre-contrast scan, the SIR of the PVS in WM (Mean ± standard deviation, 1.83 ± 0.46) was significantly higher than that of the PVS in the BG (1.05 ± 0.154), CSFSyl (1.03 ± 0.15) and the CSFAC (0.97 ± 0.29). There was no significant difference between the SIR of the PVS in the BG compared to the CSFAC and CSFSyl. For the evaluation of the contrast enhancement effect, significant enhancement was observed in the PVS in the BG, the CSFAC and the CSFSyl compared to the pre-contrast scan. No significant contrast enhancement was observed in the PVS in WM. Conclusion: The signal intensity difference between the PVS in the BG versus WM on pre-contrast images suggests that the fluid composition might be different between these PVSs. The difference in the contrast enhancement between the PVSs in the BG versus WM suggests a difference in drainage function.

DOI： 10.2463/mrms.mp.2017-0137

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society for Neuroendovascular Therapy  

DOI： 10.5797/jnet.oa.2017-0017

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)メジカルビュー社  

DOI： 10.18885/j01843.2018048070

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

Background Facial paralysis remains as one of the major morbidities of surgery of cerebellopontine angle tumors. The preoperative standard Magnetic Resonance Image does not identify, with precision, the path of the facial nerve. Case description The authors describe a case of a 56 years-old female with a cerebellopontine angle meningioma, submitted to preoperative Diffusion Tensor Tractography to identification of the course of the facial nerve, and correlate its position with the intraoperative findings. There was an accurate correlation between the path of the facial nerve revealed by preoperative DTT and the route of the nerve identified during surgery. Conclusion The preoperative identification of the facial nerve seems to be possible by tractography in meningiomas of the cerebellopontine angle. It is possible that this technique may have utility in larger tumors, where the intraoperative identification of the facial path can be more difficult.

DOI： 10.1016/j.inat.2017.03.010

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)メジカルビュー社  

DOI： 10.18885/j01843.2017276845

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Materials Science: Materials in Medicine  

Abstract: The objective of this study is to evaluate the efficacy and safety of non-suture dural closure using a novel dural substitute (GM111) consisting of polyglycolic acid felt with a fibrin-glue-coated area commensurate in size with the dural defect. This was a non-controlled, open-label, multicenter clinical trial. The efficacy evaluation endpoints were (1) GM111’s intra-operative capability to close dural defects and (2) prevention of cerebrospinal fluid (CSF) leakage and subcutaneous CSF retention throughout the postoperative period (evaluated by diagnostic imaging). Patients meeting the following three preoperative and two intra-operative selection criteria were enrolled: (1) between 12 and <75 years of age; (2) the dura is surmised to be defective and in need of reconstruction; (3) informed written consent was obtained from the patient; (4) the surgical wound is class 1; and (5) the size of duraplasty is ≥0.2 cm2 to <100 cm2. Sixty patients were enrolled. The craniotomy site was supratentorial in 77.2%, infratentorial in 12.3% and sellar in 10.5%. The GM111 prosthesis size ranged from 0.24 to 42 cm2. To evaluate the efficacy, intra-operative closure was confirmed by Valsalva’s maneuver, water infusion, etc., in all patients. CSF leakage and subcutaneous CSF retention throughout the postoperative period were found in four patients. Adverse events for which a causal relationship with GM111 could not be ruled out occurred in 8.8% of the patients. There were no instances of postoperative infection due to GM111. GM111 showed good closure capability and safety when used for non-suture dural closure. Graphical Abstract: [InlineMediaObject not available: see fulltext.]

DOI： 10.1007/s10856-017-5877-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JACC: Cardiovascular Interventions  

Objectives This study sought to clarify the incidence and prognosis of PP in carotid artery stenting (CAS). Background Projections thought to be plaque may be observed inside the stent on angiography or intravascular ultrasound (IVUS) during CAS. Known as plaque protrusion (PP), the incidence and prognosis of this complication are unclear. Methods A total of 354 consecutive carotid atherosclerotic stenoses in 328 patients (285 men, 43 women; age range 51 to 97 years [mean age 73.6 years]; 158 symptomatic cases; stenosis rate, 50% to 99% [mean 81.0%]) who underwent CAS under IVUS between October 2007 and March 2016 were retrospectively analyzed. PP was defined as plaque seen inside the stent lumen on both digital subtraction angiography and IVUS. The incidence and prognosis (rate of stroke within 30 post-operative days) of PP and the rate of ischemic lesions on the treated side on diffusion-weighted imaging performed within 48 post-operative hours within the PP group were investigated. Results PP was observed in 9 cases (2.6%). Ischemic stroke occurred in 6 of 9 PP cases (66.7%; 1 major, 5 minor). Ischemic lesions were observed on diffusion-weighted imaging in 8 of 9 cases (88.9%). PP was strongly associated with perioperative ischemic stroke. A significant increase in PP susceptibility was observed with open-cell stent use and unstable plaque. Conclusions The incidence of PP in CAS was 2.6%, with a high risk of ischemic complications if PP was observed. The present findings indicate the necessity of appropriate device selection to avoid PP.

DOI： 10.1016/j.jcin.2017.01.029

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/gzj.0000002997

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiographics  

Deep medullary veins drain into subependymal veins with four convergence zones and show parallel distribution patterns adjacent to the body or inferior horn and a radial pattern in the frontal horn or trigon of the lateral ventricle. As white matter imaging develops such as diffusion tensor imaging or susceptibility-weighted imaging, requirements for understanding of white matter structures are increasing, not only for understanding of neuronal tracts but also for that of other structures including the fine anatomy of white matter vessels. Some disorders are related to deep medullary veins and show characteristic distributions of the lesions indicating the relationship to the medullary veins. When lesions show a parallel or radial distribution pattern in the certebral deep white matter, disorders related to deep medullary veins should be considered for differential diagnosis. In this review, we discuss disorders related to deep medullary veins, including (a) anomalies of the medullary veins, (b) hemorrhagic disorders related to the medullary veins (diffuse vascular injury due to high-energy trauma, deep medullary vein engorgement/thrombosis in neonates), (c) inflammatory changes that spread along the medullary veins, (d) neoplasms within the medullary veins, and (e) metabolic changes that lead to altered visualization of medullary veins. Understanding the anatomic structure of medullary veins in the cerebral hemisphere and becoming familiar with disorders in which the medullary veins play a major role in disease development may be helpful in the interpretation of brain images.

DOI： 10.1148/rg.2017160061

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Roentgenology  

OBJECTIVE. Advanced stroke imaging has generated much excitement for the early diagnosis of acute ischemic stroke (AIS) and facilitation of intervention. However, its therapeutic impact has not matched its diagnostic utility; most notably, lacking significant contributions to recent major AIS clinical trials. It is time to reexamine the fundamental hypotheses from the enormous body of imaging research on which clinical practices are based and reassess the current standard clinical and imaging strategies, or golden rules, established over decades for AIS. In this article, we will investigate a possible new window of opportunity in managing AIS through a better understanding of the following: first, the potential limitations of the golden rules; second, the significance of imaging-based parenchymal hypoperfusion (i.e., lower-Thannormal relative cerebral blood flow [rCBF] may not be indicative of ischemia); third, the other critical factors (e.g., rCBF, collateral circulation, variable therapeutic window, chronicity of occlusion) that reflect more individual ischemic injury for optimal treatment selection; and, fourth, the need for penumbra validation in successfully reperfused patients (not in untreated patients). CONCLUSION. Individual variations in the therapeutic window, ischemic injury (rCBF), and chronicity of vascular lesion development have not been comprehensively incorporated in the standard algorithms used to manage AIS. The current established imaging parameters have not been consistently validated with successfully reperfused patients and rCBF to quantitatively distinguish between oligemia and ischemia and between penumbra and infarct core within ischemic tissue. A novel paradigm incorporating rCBF values or indirectly incorporating relative rCBF values with higher statistically powered imaging studies to more reliably assess the severity of ischemic injury and differentiate reversibility from viability within the area of imagingbased parenchymal hypoperfusion may provide a more personalized approach to treatment, including no treatment of infarction core, to further enhance outcomes.

DOI： 10.2214/AJR.16.16557

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: To evaluate the visualization of middle ear ossicles by ultra-short echo time magnetic resonance (MR) imaging at 3T in subjects over 50 years old. Materials and Methods: Sixty ears from 30 elder patients that underwent surgical or interventional treatment for neurovascular diseases were included (ages: 50–82, median age: 65; 10 men, 20 women). Patients received follow-up MR imaging including routine T1- and T2-weighted images, time-of-flight MR angiography, and ultra-short echo time imaging (PETRA, pointwise encoding time reduction with radial acquisition). All patients underwent computed tomography (CT) angiography before treatment. Thin-section source CT images were correlated with PETRA images. Scan parameters for PETRA were: TR 3.13, TE 0.07, flip angle 6 degrees, 0.83 × 0.83 × 0.83 mm resolution, 3 min 43 s scan time. Two radiologists retrospectively evaluated the visibility of each ossicular structure as positive or negative using PETRA images. The structures evaluated included the head of the malleus, manubrium of the malleus, body of the incus, long process of the incus, and the stapes. Signal intensity of the ossicles was classified as: between labyrinthine fluid and air, similar to labyrinthine fluid, between labyrinthine fluid and cerebellar parenchyma, or higher than cerebellar parenchyma. Results: In all ears, the body of the incus was visible. The head of the malleus was visualized in 36/60 ears. The manubrium of the malleus and long process of the incus was visualized in 1/60 and 4/60 ears, respectively. The stapes were not visualized in any ear. Signal intensity of the visible structures was between labyrinthine fluid and air in all ears. Conclusion: The body of the incus was consistently visualized with intensity between air and labyrinthine fluid on PETRA images in aged subjects. Poor visualization of the manubrium of the malleus, long process of the incus, and the stapes limits clinical significance of middle ear imaging with current PETRA methods.

DOI： 10.2463/mrms.mp.2015-0171

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: In textbooks, the perivascular space (PVS) is described as non-enhancing after the intravenous administration of gadolinium-based contrast agent (IV-GBCA). We noticed that the PVS sometimes has high signal intensity (SI) on heavily T2-weighted 3D-FLAIR (hT2-FL) images obtained 4 h after IV-GBCA. The purpose of this study was to retrospectively evaluate the contrast enhancement of the PVS. Materials and Methods: In 8 healthy subjects and 19 patients with suspected endolymphatic hydrops, magnetic resonance cisternography (MRC) and hT2-FL images were obtained before and 4 h after a single dose of IV-GBCA. No subjects had renal insufficiency. On axial MRC at the level of the anterior commissure (AC)-posterior commissure (PC) line, 1 cm circular regions of interest (ROIs) were drawn centering on the PVS in the bilateral basal ganglia and thalami. Three-millimeter diameter ROIs were set in the cerebrospinal fluid (CSF) of the bilateral ambient cistern. The ROIs on MRC were copied onto the hT2-FL images and the SI was measured. The SI ratio (SIR) was defined as SIRPVS = SI of PVS/SI of the thalami, and SIRCSF = SI of CSF/SI of the thalami. The average of the bilateral values was used for the calculation. The SIRCSF, SIRPVS, and SI of the thalami were compared between before and 4 h after IV-GBCA. Results: The SIR was increased significantly from 1.02 ± 0.37 to 2.65 ± 0.82 in the CSF (P < 0.01) and from 1.20 ± 0.35 to 2.13 ± 1.23 in the PVS at 4 h after IV-GBCA (P < 0.01). The SI of the thalami showed no significant difference. Conclusion: The enhancement of the PVS at 4 h after IV-GBCA was confirmed even in subjects without renal insufficiency. It is possible that the GBCA in the blood vessels might have permeated into the cerebrospinal fluid (CSF) space and the PVS. This might be a first step in the imaging evaluation of the glymphatic system (waste clearance system) of the brain.

DOI： 10.2463/mrms.mp.2016-0039

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

DOI： 10.2463/mrms.ci.2016-0114

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

To improve the imaging protocol for the evaluation of endolymphatic hydrops after intravenous administration of a gadolinium-based contrast agent, we modified our previously reported hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) method. Although the scan time of the new protocol was half that of the previous one, there were no significant differences between two protocols in the mean contrast noise ratio between the endolymph and perilymph and the area ratio of the endolymph size values in nine patients.

DOI： 10.2463/mrms.tn.2016-0126

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: Although the neonatal and infantile brain typically shows sequential T1 shortening according to gestational age as a result of myelination, several structures do not follow this rule. We evaluated the relationship between the signal intensity of various structures in the neonatal and infantile brain on T1-weighted imaging (T1WI) and either postnatal or gestational age. Materials and Methods: We examined magnetic resonance images from 120 newborns and infants without any abnormalities in the central nervous system. Written informed consent was obtained from all parents and the institutional review board approved the study. Gestational age at examination ranged from 35 weeks, 3 days to 46 weeks, 6 days, and postnatal age ranged from 7 days to 127 days. Signal intensity on T1WI was evaluated on a scale from Grade 1 (indistinguishable from surrounding structures) to Grade 4 (higher than cortex and close to fat). We evaluated relationships between the T1 signal grades of various structures in the neonatal brain and postnatal or gestational age using Spearman’s correlation analysis. Results: Significant positive correlations were identified between T1 signal grade and gestational age in the pyramidal tract (P < 0.001). Conversely, significant negative correlations were evident between T1 signal grade and postnatal age (P < 0.001), in structures including the stria medullaris thalami, fornix cerebellar vermis, dentate nucleus and anterior pituitary gland. Conclusion: Significant negative correlations exist between signal intensity on T1WI and postnatal age in some structures of the neonatal and infantile brain. Some mechanisms other than myelination might play roles in the course of signal appearance.

DOI： 10.2463/mrms.mp.2015-0168

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer, Tokyo  

While there are huge number of reports in the gray matter changes in Alzheimer's disease (AD), there are also increasing number of reports on white matter changes in the cases of AD due to the development of diffusion tensor methods. This report summarizes the recent knowledge about white matter lesions in Alzheimer's disease.

DOI： 10.1007/978-4-431-55133-1_5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/j00235.2017019946

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance Imaging  

Purpose: The "K2" value is a factor that represents the vascular permeability of tumors and can be calculated from datasets obtained with the dynamic susceptibility contrast (DSC) method. The purpose of the current study was to correlate K2 with Ktrans, which is a well-established permeability parameter obtained with the dynamic contrast enhance (DCE) method, and determine the usefulness of K2 for glioma grading with histogram analysis. Methods: The subjects were 22 glioma patients (Grade II: 5, III: 6, IV: 11) who underwent DSC studies, including eight patients in which both DSC and DCE studies were performed on separate days within 10 days. We performed histogram analysis of regions of interest of the tumors and acquired 20th percentile values for leakage-corrected cerebral blood volume (rCBV20%ile), K2 (K220%ile), and for patients who underwent a DCE study, Ktrans (Ktrans20%ile). We evaluated the correlation between K220%ile and Ktrans20%ile and the statistical difference between rCBV20%ile and K220%ile. Results: We found a statistically significant correlation between K220%ile and Ktrans20%ile (r = 0.717, p < 0.05). rCBV20%ile showed a significant difference between Grades II and III and between Grades II and IV, whereas K220%ile showed a statistically significant (p < 0.05) difference between Grades II and IV and between Grades III and IV. Conclusions: The K2 value calculated from the DSC dataset, which can be obtained with a short acquisition time, showed a correlation with Ktrans obtained with the DCE method and may be useful for glioma grading when analyzed with histogram analysis.

DOI： 10.1016/j.mri.2016.04.020

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Georg Thieme Verlag {KG}  

DOI： 10.1055/s-0036-1592566

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SpringerPlus  

Purpose: The purpose of the current study was to assess the feasibility of diffusion tensor imaging (DTI) parameters for determining the prognosis of Alzheimer’s disease (AD). We also analyzed the correlation among DTI, voxel-based morphometry (VBM), and results of the mini-mental state examination (MMSE). Methods: The subjects of this prospective study were patients with AD and mild cognitive impairment. We performed annual follow-ups with DTI, VBM, and MMSE for 2 or 3 years. On DTI, the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the uncinate fascicles were measured. VBM was performed to provide a z-score for the parahippocampal gyrus. The correlations among these factors were evaluated in the same period and the next period of the follow-up study. Results: For evaluation of the same period, both DTI parameters and z-scores showed statistically significant correlations with the MMSE score. Also for evaluation of the next period, both DTI parameters and z-scores showed statistically significant correlations with the MMSE score of the next period. We observed a statistically significant correlation between the ADC value of the uncinate fascicles and the z-score of the next period. Conclusions: Diffusion tensor parameters (ADC and FA) of the uncinate fascicles correlated well with cognitive function in the next year and seemed to be feasible for use as biomarkers for predicting the progression of AD. In addition, the white matter changes observed in the ADC seemed to precede changes in the gray matter volume of the parahippocampal gyrus that were represented by z-scores of VBM.

DOI： 10.1186/s40064-016-2692-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Computer Assisted Tomography  

Objective This study aimed to assess the utility of dural thickening of the internal auditory canal (IAC) in patients with spontaneous intracranial hypotension (SIH) syndrome and determined the sensitivity and specificity of this image finding. Methods Magnetic resonance images were evaluated for 22 cases of definite SIH and 16 cases of unlikely SIH. On contrast-enhanced magnetic resonance imaging, pachymeningeal enhancement and dural thickening of the IAC were assessed. Results Pachymeningeal enhancement was observed in 21 of 22 patients in the definite SIH group and 1 of 16 patients in the unlikely SIH group (sensitivity, 95.5%; specificity, 93.8%). Dural thickening of the IAC was observed in 15 of 22 patients in the definite SIH group and 0 of 16 patients in the unlikely SIH group (sensitivity, 68.2%; specificity, 100%). Conclusions Dural thickening of the IAC showed 100% specificity for SIH syndrome and can increase the accuracy of diagnosis of SIH syndrome.

DOI： 10.1097/RCT.0000000000000342

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その他リンク： http://orcid.org/0000-0001-9227-0240

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Stroke and Cerebrovascular Diseases  

Objective To evaluate the relationship between fiber bundle direction and changes in diffusion kurtosis, we evaluated the apparent diffusion kurtosis coefficients (AKCs) that were perpendicular to and parallel to the principal diffusion tensor eigenvector. Materials and Methods Adult male Wistar rats were subjected to 30 or 60 minutes of middle cerebral artery occlusion and imaged with a 7T Magnetic Resonance Imager System (Varian MRI System 7T/210: Agilent Technologies, CA). Diffusion kurtosis images were obtained before middle cerebral artery (MCA) reperfusion and 3, 6, and 24 hours after reperfusion to generate the apparent diffusion coefficient (ADC), fractional anisotropy (FA), mean apparent diffusion kurtosis coefficient (mAKC), AKC axial to the eigenvector (axAKC), and AKC radial to the eigenvector (radAKC) images. The time course of the region/normal ratio was evaluated for the above parameters in the caudoputamen and white matter. Results Relative FA and relative ADC values decreased 3 hours after MCA reperfusion and remained decreased until 24 hours. Relative mAKC, axAKC, and radAKC values were increased 3 hours after MCA reperfusion, peaked after 6 hours, and slightly decreased after 24 hours. In the white matter, axAKC showed larger changes than radAKC. Conclusion The time course of the diffusion kurtosis value showed earlier pseudonormalization than the ADC value of the lesions. For white matter lesions, the increase in axAKC was larger than that in radAKC, suggesting that the tissue changes after infarction mainly produce reduced diffusivity along the fibers and lead to increased inhomogeneity of the diffusion.

DOI： 10.1016/j.jstrokecerebrovasdis.2015.11.028

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その他リンク： http://orcid.org/0000-0001-9227-0240

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society for Magnetic Resonance in Medicine  

PURPOSE: To compare the signal increase in cochlear lymph fluid on three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) in patients with sudden sensorineural hearing loss (SNHL) between regular contrast 3D-FLAIR (FL) and heavily T2-weighted 3D-FLAIR (HF). METHODS: Twenty-five patients with unilateral sudden SNHL and eight healthy volunteers were included. Patients were divided into two groups: the mild group consisted of 9 patients, with an average hearing level of 60 dB or less; the severe group consisted of 16 patients, with an average hearing level of more than 60 dB. All patients and healthy volunteers underwent magnetic resonance (MR) cisternography for anatomical reference of the fluid space with FL and HF at 3 T. The region of interest (ROI) was manually drawn on the mid-modiolar section of the MR cisternography around the cochlea. The ROI for noise was drawn within the air space. ROIs were copied onto the FL and HF images. The contrast-to-noise ratio (CNR) between the affected and non-affected ear was measured in the patient group and the CNR between the right and left ear was also measured in the control group. Differences in the CNR on FL and HF images among t

DOI： 10.2463/mrms.mp.2015-0065

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

PURPOSE: Increased cochlear lymph fluid signals on three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) images obtained several minutes after intravenous administration of a single dose of gadolinium-based contrast agent (IV-SD-GBCA) in a patient with severe retrofenestral type otosclerosis had been reported. This increase was thought to represent breakdown of the blood-labyrinthine barrier. The purpose of this study was to evaluate cochlear lymph signal on heavily T2-weighted 3D-FLAIR (HF) images obtained 4 hours after IV-SD-GBCA in patients with otosclerosis, Meniere&#039;s disease, and healthy subjects. MATERIALS AND METHODS: Twenty-two ears from 12 patients with otosclerotic plaques determined by computed tomography (CT), 16 ears from 8 healthy volunteers, and 10 ears from 9 Meniere&#039;s disease patients with significant endolymphatic hydrops on magnetic resonance (MR) images were retrospectively analyzed. Images were obtained 4 hours after IV-SD-GBCA. Patients and healthy volunteers underwent MR cisternography (MRC) for anatomical reference of the fluid space and HF at 3T. The region of interest (ROI) was manually drawn on MRC images around the scala tympani in the basal c

DOI： 10.2463/mrms.mp.2015-0121

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Neurosurgery  

Diffusion of water is based on the principle that water molecules show random motion. In diffusion studies on magnetic resonance imaging using a motion proving gradient, a signal decrease which is caused by molecular diffusion in the tissue provides information about tissue structure and physiological status. Diffusion-weighted images play a very important role in brain related diagnosis, especially for acute infarctions, and have become an essential tool in clinical practice. Diffusion tensor imaging using the Gaussian distribution model also has made strides in evaluating anisotropic water diffusion in the white matter in which water diffusion is restricted by macromolecules, membrane, and myelin. Diffusion tensor imaging is based on a mathematical model of an ellipsoid. Thus principal directions of diffusion and the magnitude of diffusion along those directions can be calculated. Diffusion tensor tractography is an innovative application of the diffusion tensor method which can access the pathways of neuronal fibers. However, neuronal tissue is a highly heterogeneous structure on various scales and the Gaussian distribution has only been adapted for free diffusion in a fluid that is uniform and sufficiently large. Complicated wall structures exist in the neuronal tissue, and the Gaussian distribution model does not reflect the existence of a large number of compartments and nerve tracts, particularly in the central nervous system. Therefore, instead of a simple Gaussian distribution model, measurement of the probability distribution of a detailed water molecule is necessary. One method is q-space imaging (QSI). QSI is performed by measuring a large amount of diffusion encoding and can provide the probability density function of individual water molecules. Although QSI is theoretically superior to conventional Gaussian distribution analysis, one limitation of QSI is the long acquisition time due to the large sampling number. The concept of kurtosis is another method to evaluate non-Gaussianity. Kurtosis is a quantity that reflects a gap between the diffusion distribution of a water molecule in vivo and the Gaussian distribution, and can be calculated from datasets of relatively few diffusion encoding elements compared to QSI. Thus, a rather short acquisition time is required for kurtosis. Recently, other innovative applications of non-Gaussian diffusion have been introduced including neurite orientation dispersion and density imaging (NODDI) which is a model-based diffusion technique that allows for the quantification of specific microstructural features directly related to neuronal morphology. These novel techniques will provide useful information on tissue microstructure not only in the scientific research but also in the clinical practice.

DOI： 10.7887/jcns.25.402

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society for Neuroendovascular Therapy  

DOI： 10.5797/jnet.oa.2016-0052

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jstrokecerebrovasdis.2015.11.028.

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本神経学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Medical Imaging  

Background: Bacterial meningitis is a fatal infectious disease of the central nervous system complicating intravascular involvements. Multiple microbleeds are rarely identified as complications because of the limited detection threshold of conventional imaging modalities. We report the first case of meningococcal meningitis with successful identification of multiple microbleeds in the cerebellum by susceptibility-weighted imaging. Case presentation: A 19-year-old Japanese female was brought to our emergency department because of fever and coma. A spinal tap was performed and turbid yellow fluid was collected. A diagnosis of bacterial meningitis was established and the patient was admitted to an intensive care unit. Dexamethasone and Antibiotics were administered and Neisseria meningitides was cultured from the spinal fluid. On day 10, postcontrast magnetic resonance imaging identified enhanced subarachnoid space in the cerebellum. Susceptibility-weighted imaging showed spotty low-intensity signals in the cerebellar tissue, indicating microbleeds. The patient made a full recovery from coma and was discharged without neurological sequelae on day 24. Conclusion: Meningococcal meningitis can cause multiple microbleeds in the cerebellum. In this report, we successfully identified microbleeds by susceptibility-weighed imaging. Using this imaging modality, further investigations will clarify its clinical incidence and significance.

DOI： 10.1186/s12880-015-0090-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.nmd.2015.06.312

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Stroke and Cerebrovascular Diseases  

Background Medial longitudinal fasciculus (MLF) syndrome refers to a gaze disorder characterized by impaired adduction on the ipsilateral side to the injured MLF, with dissociated nystagmus of the contralateral abducting eye. The most common cause of the MLF syndrome is ischemic stroke. However, acute ischemic change in the MLF may be undetectable even on diffusion-weighted magnetic resonance imaging (DW-MRI) partly because of its small size and specific brainstem location. Case Report Herein, we present the first reported case of MLF syndrome in which, compared with the standard-b-value DWI, a higher b-value DWI revealed more clearly a small infarction in the dorsal pons in the acute stage. Conclusions We suggest that high-b-value DWI can be a useful diagnostic method for patients with MLF syndrome caused by possible brainstem ischemia and thus supportive for deciding the optimal treatment for such patients.

DOI： 10.1016/j.jstrokecerebrovasdis.2015.03.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1371/journal.pone.0125051.

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: To investigate morphological changes of the superior and middle cerebellar peduncles (SCP, MCP) in spinocerebellar degeneration (SCD) by observing “cerebellar peduncle quarter notes”. Materials and Methods: We examined 21 patients with SCD, including nine patients with multiple system atrophy cerebellar type (MSA-C), and 24 controls. We measured SCP angle and performed diffusion tensor analysis to quantify the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the MCP. We quantified the relationship between SCP angle and the ADC and FA of the MCP, and compared these variables between MSA-C patients and controls. Results: There was statistically significant negative correlation between SCP angle and FA of the MCP, and a positive correlation between SCP angle and the ADC of the MCP. Mean SCP angle was larger among MSA-C patients than among normal controls. Conclusions: SCP angle tended to be larger among patients with severe degeneration of the MCP. The SCP angle, quantified by observing “cerebellar peduncle quarter notes”, may be a simple index for evaluation of degeneration of the MCP.

DOI： 10.1007/s11604-015-0409-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Stroke  

Patients with a history of ischemic stroke are known to develop new ischemic stroke. While asymptomatic, the presence and progression of silent brain infarcts and white matter lesions on magnetic resonance imaging are associated with an increased risk of future strokes. Both angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are recommended for the primary and secondary prevention of stroke, but there are no direct comparisons of angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers regarding their cerebroprotective effects, including their effect on asymptomatic cerebral lesions detected by magnetic resonance imaging. Methods: Elderly (65 years or older) patients with essential hypertension who underwent cerebral magnetic resonance imaging and were found to have any cerebral ischemic lesions, such as cerebral infarction, silent brain infarct, or white matter lesion, were enrolled in this CEREBRAL study. Patients who agreed to participate were enrolled in the randomized controlled trial portion. Patients who did not agree to participate in the randomized controlled trial were enrolled in the cohort study portion. After two-years of angiotensin-converting enzyme inhibitor or angiotensin II receptor blockers treatment, follow-up magnetic resonance imaging examination will be performed. The primary end-point is the composite of (1) occurrence of a fatal or nonfatal cerebrovascular event or (2) progression of cerebrovascular lesions as evaluated by magnetic resonance imaging, including white matter lesions or silent brain infarcts. After enrollment, cognitive function was evaluated, if possible, using the Mini-Mental State Examination. Conclusions: Our study will clarify whether angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers are more effective for preventing primary and recurrence of ischemic stroke, including the progression of asymptomatic cerebral lesions on magnetic resonance imaging, in elderly hypertensive patients.

DOI： 10.1111/ijs.12085

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：学研メディカル秀潤社  

DOI： 10.15105/j00235.2015188395

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：World Neurosurgery  

Objective We examined the effectiveness of a newly developed magnetic resonance imaging (MRI) technique, brain surface motion imaging (BSMI), in the preoperative evaluation of tumor-brain adhesion in meningioma surgery. Methods Cine phase-contrast MRI was used to measure cerebrospinal fluid (CSF) pulsations and heart rates at 2 different time points to create a subtraction image in meningioma patients who underwent BSMI. With no tumor-brain adhesion, a gap was observed in the tumor-brain movements, resulting in an outline of the tumor in BSMI. If adhesion was evident, no outline was observed. Cases were evaluated as exact if the presence or absence of edema in T2-weighted MRI, BSMI findings, and intraoperative findings all matched; as effected when only BSMI findings and intraoperative images matched; and as false when BSMI findings and intraoperative findings did not match. Results BSMI judged 27 patients as adhesion (+) and 33 as adhesion (-), whereas surgical findings evaluated 22 as adhesion (+) and 38 as adhesion (-). The sensitivity and specificity were both high, at 95.5% and 84.2%, respectively. Forty-one of 60 patients were evaluated as exact, 12 as effected, and 7 as false. World Health Organization tumor grade assessment of effected subjects included 16.7% in grade 1 and 36.4% in grade 2. Conclusions BSMI was shown to be effective in evaluating adhesion between the meningioma and the brain, allowing safe and effective removal planning to be carried out preoperatively.

DOI： 10.1016/j.wneu.2013.02.015

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PLoS ONE  

The objective of our study was to evaluate the relation between muscle MRI findings and upper limb weakness with grip myotonia in patients with myotonic dystrophy type 1 (DM1). Seventeen patients with DM1 were evaluated by manual muscle strength testing and muscle MRI of the upper limbs. Many DM1 patients presenting with decreased grasping power frequently showed high intensity signals in the flexor digitorum profundus (FDP) muscles on T1-weighted imaging. Patients presenting with upper limb weakness frequently also showed high intensity signals in the flexor pollicis longus, abductor pollicis longus, and extensor pollicis muscles. Disturbances of the distal muscles of the upper limbs were predominant in all DM1 patients. Some DM1 patients with a prolonged disease duration showed involvement of not only distal muscles but also proximal muscles in the upper limbs. Muscle involvement of the upper limbs on MRI strongly correlated positively with the disease duration or the numbers of CTG repeats. To our knowledge, this is the first study to provide a detailed description of the distribution and severity of affected muscles of the upper limbs on MRI in patients with DM1.We conclude that muscle MRI findings are very useful for identifying affected muscles and predicting the risk of muscle weakness in the upper limbs of DM1 patients.

DOI： 10.1371/journal.pone.0125051

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: Diffusion kurtosis is a statistical measure for quantifying the deviation of the water diffusion profile from a Gaussian distribution. The current study evaluated the time course of diffusion kurtosis in patients with cerebral infarctions, including perforator, white matter, cortical, and watershed infarctions. MATERIALS AND METHODS: Subjects were 31 patients, representing 52 observations of lesions. The duration between the onset and imaging ranged from 3 hours to 122 days. Lesions were categorized into 4 groups listed above. Diffusion kurtosis images were acquired with b-values of 0, 1000, and 2000 s/mm2 applied in 30 directions; variables including DWI signal, ADC, fractional anisotropy, radial diffusivity, axial diffusivity, radial kurtosis, and axial kurtosis, were obtained. The time courses of the relative values (lesion versus contralateral) for these variables were evaluated, and the pseudonormalization period was calculated. RESULTS: Diffusion kurtosis was highest immediately after the onset of infarction. Trend curves showed that kurtosis decreased with time after onset. Pseudonormalization for radial/axial kurtosis occurred at 13.2/59.9 days for perforator infarctions, 33.1/40.6 days for white matter infarctions, 34.8/35.9 days for cortical infarctions, and 34.1/28.2 days after watershed infarctions. For perforator infarctions, pseudonormalization occurred in the following order: radial kurtosis, ADC, axial kurtosis, and DWI. CONCLUSIONS: Diffusion kurtosis variables in lesions increased early after infarction and decreased with time. Information provided by diffusion kurtosis imaging, including axial and radial kurtosis, seems helpful in conducting a detailed evaluation of the age of infarction, in combination with T2WI, DWI, and ADC.

DOI： 10.3174/ajnr.A3908

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical Neurology and Neurosurgery  

Objectives The 2010 revisions to the McDonald criteria for the diagnosis of multiple sclerosis (MS) were recently published. One objective of the revision was to simplify the MRI criteria. The MRI criteria do not specify magnetic field strength. We studied whether there was any difference in diagnosis between brain 3.0-T and 1.5-T MRI according to the 2010 revisions of the McDonald criteria. Patients and methods We prospectively studied brain 3.0-T and 1.5-T MRI in 22 patients with MS. 1.5-T MRI was performed 24 h after 3.0-T MRI, and the scanning protocol included contiguous axial sections of T2-weighted images (T2WI), T1WI, and enhanced T1WI. These two different MRI and neurological assessments were scheduled to be repeated 3 and 6 months after study entry. Results The regions where MS lesions were better visualized on 3.0-T MRI tended to be in deep white matter on T2WI. Dissemination of lesions in space and time was similar for 3.0-T and 1.5-T MRI. Conclusion Our study found no difference between brain 3.0-T and 1.5-T MRI. There was no apparent impact of brain 3.0-T MRI on the diagnosis of MS according to the 2010 version of the MRI criteria. © 2014 Elsevier B.V.

DOI： 10.1016/j.clineuro.2014.03.018

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.15274/NRJ-2014-10023

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology Journal  

The objective of this study was to determine long-term outcomes after stent placement for subclavian artery (SA) obstructive lesions assisted by intraoperative intravascular ultrasound (IVUS). The study included 25 lesions in 24 patients who underwent stent placement assisted by intraoperative IVUS for subclavian artery stenosis or obstruction at our hospital between January 2003 and August 2010. Outcome was evaluated based on the results within 30 postoperative days (technical success rate, improvement in upper extremity ischemia, steal syndrome, left-right blood pressure difference, and perioperative complications) and the results after 30 postoperative days (incidence of vertebrobasilar artery territory infarction and restenosis). Stent placement and vessel dilatation were successful in all patients, without perioperative complications. Upper extremity ischemia, steal syndrome, and left-right blood pressure difference disappeared in all cases. During follow-up observation (6-96 months; median 51 months), no restenosis occurred at the stent placement site in any patient. In one case, four years after initial treatment, stenosis was noted proximal to the stent placement site. Satisfactory long-term as well as short-term outcomes were achieved after stent placement for SA obstructive lesions assisted by intraoperative IVUS evaluation.

DOI： 10.15274/NRJ-2014-10023

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical Neurology and Neurosurgery  

Objectives: Some patients with progressive supranuclear palsy (PSP) present with cerebellar dysfunction. Severe degeneration of the cerebellar dentate nucleus (CDN) was evident in these patients. We evaluated signal intensity on MRI in the CDN of PSP patients with or without cerebellar ataxia. Patients and methods: We reviewed the clinical histories and brain MRI studies of 28 patients with clinically probable PSP. Three disease control groups were studied: a group of 28 sex- and age-matched patients with Parkinson's disease (PD), a group of 15 patients with multiple system atrophy with predominant parkinsonian features (MSA-P), and 15 control subjects. Turbo spin-echo sequences for T2-weighted images were used using a 1.5 T magnetic resonance imager. Results: Eight patients with PSP (28%) and one patient with MSA-P (6%) had heterogeneous regions in the CDN. This finding was not evident in the patients with PD or controls. Three out of four PSP patients with cerebellar ataxia had heterogeneous regions in the CDN and other one patient with cerebellar ataxia as the initial and principal symptoms had no heterogeneous regions in the CDN. Conclusion: Heterogeneous regions in the CDN on MRI do not always reflect cerebellar ataxia in PSP patients, and this finding might be an additional marker to support a probable diagnosis of PSP. © 2014 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.clineuro.2013.12.011

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Brain and Cognition  

Patients with traumatic brain injury (TBI) were reported to have difficulty making advantageous decisions, but the underlying deficits of the network of brain areas involved in this process were not directly examined. We report a patient with TBI who demonstrated problematic behavior in situations of risk and complexity after cerebral injury from a traffic accident. The Iowa gambling task (IGT) was used to reveal his deficits in the decision-making process. To examine underlying deficits of the network of brain areas, we examined T1-weighted structural MRI, diffusion tensor imaging (DTI) and Tc-ECD SPECT in this patient. The patient showed abnormality in IGT. DTI-MRI results showed a significant decrease in fractional anisotropy (FA) in the fasciculus between the brain stem and cortical regions via the thalamus. He showed significant decrease in gray matter volumes in the bilateral insular cortex, hypothalamus, and posterior cingulate cortex, possibly reflecting Wallerian degeneration secondary to the fasciculus abnormalities. SPECT showed significant blood flow decrease in the broad cortical areas including the ventromedial prefrontal cortex (VM). Our study showed that the patient had dysfunctional decision-making process. Microstructural abnormality in the fasciculus, likely from the traffic accident, caused reduced afferent feedback to the brain, resulting in less efficient decision-making. Our findings support the somatic-marker hypothesis (SMH), where somatic feedback to the brain influences the decision-making process. © 2013 Elsevier Inc.

DOI： 10.1016/j.bandc.2013.11.005

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PLoS ONE  

Subjective cognitive impairment may be a very early at-risk period of the continuum of dementia. However, it is difficult to discriminate at-risk states from normal aging. Thus, detection of the early pathological changes in the subjective cognitive impairment period is needed. To elucidate these changes, we employed diffusion tensor imaging and volumetry analysis, and compared subjective cognitive impairment with normal, mild cognitive impairment and Alzheimer's disease. The subjects in this study were 39 Alzheimer's disease, 43 mild cognitive impairment, 28 subjective cognitive impairment and 41 normal controls. There were no statistically significant differences between the normal control and subjective cognitive impairment groups in all measures. Alzheimer's disease and mild cognitive impairment had the same extent of brain atrophy and diffusion changes. These results are consistent with the hypothetical model of the dynamic biomarkers of Alzheimer's disease. © 2014 Kiuchi et al.

DOI： 10.1371/journal.pone.0104007

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本磁気共鳴医学会  

Purpose: As stereotactic radiotherapy (SRT) becomes widespread, precise information including number, location, and margin of lesions is required when magnetic resonance (MR) imaging of brain metastasis is performed. We compare methods using 2 separate injections and a single injection for the administration of a double dose of contrast medium for contrastenhanced MR imaging.

DOI： 10.2463/mrms.2013-0068

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：特定非営利活動法人 日本脳神経血管内治療学会  

【目的】紡錘状動脈瘤に対するコイル塞栓術は，通常親血管と動脈瘤を分離できない場合が多いため，親血管を温存した瘤内塞栓術は難しい．ステントを併用したコイル塞栓術で，親血管の内腔を短軸像で確認できる“down-the-barrel view（DBV）”が取れれば，親血管を温存した瘤内塞栓術が可能であったとの報告例がある．紡錘状動脈瘤に対してステントを併用したコイル塞栓術でDBV による追加ステント留置術で親血管を温存して瘤内塞栓術が可能であった1 例を経験したので報告する．【症例】60 歳女性．約1 年前に右椎骨動脈紡錘状動脈瘤を指摘され外来で経過観察されていたが瘤の増大が認められたため，Enterprise stent（EP）を用いたコイル塞栓術を施行した．最初にマイクロカテーテルを瘤内に挿入し，動脈瘤を十分覆うようにEP を留置した後，瘤内塞栓術を施行した．術中親血管へコイルが逸脱しているかどうかの判断が困難となったため，DBV で造影したところステント内腔にコイルの逸脱が認められた．そのためstent-in-stent で新たにEP を追加留置したところ，EP 内のコイル逸脱は消失した．術後合併症は認められなかった．3 カ月後の血管造影で動脈瘤の完全閉塞が認められ，親血管は開存していた．【結論】紡錘状動脈瘤に対するステント併用コイル塞栓術において，DBV による追加ステント留置を行うことで良好な治療効果が得られる例があることが示唆された．

DOI： 10.5797/jnet.cr.13050

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Stroke and Cerebrovascular Diseases  

Susceptibility-weighted imaging (SWI) has recently attracted attention for its ability to investigate acute stroke pathophysiology. SWI detects an increased ratio of deoxyhemoglobin to oxyhemoglobin in cerebral venous compartments, which can illustrate cerebral misery perfusion with a compensatory increase of oxygen extraction fraction in the hypoperfused brain. In this study we make the first case report of blunt cervical trauma leading to a stroke, demonstrating the disparity between diffusion-weighted imaging (DWI) and SWI changes, or DWI-SWI mismatch, in the acute ischemic brain. The area of mismatch between a smaller DWI cytotoxic edema and a larger SWI misery perfusion in our patient matured into a complete infarction with time. The DWI-SWI mismatch may signify the presence of an ischemic penumbra, and provide information about viability of the brain tissue at risk of potential infarction if without early reperfusion. © 2013 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.jstrokecerebrovasdis.2012.12.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neurologia Medico-Chirurgica  

Isolated oculomotor nerve palsy is well known as a symptom of microvascular infarction and intracranial aneurysm, but unilateral oculomotor nerve palsy as an initial manifestation of chronic subdural hematoma (CSDH) is a rare clinical condition. We report a rare case of an 84-year-old woman with bilateral CSDH who presented with unilateral oculomotor nerve palsy as the initial symptom. The patient, who had a medical history of minor head injury 3 weeks prior, presented with left ptosis, diplopia, and vomiting. She had taken an antiplatelet drug for lacunar cerebral infarction. Computed tomography (CT) of the head showed bilateral CSDH with a slight midline shift to the left side. She underwent an urgent evacuation through bilateral frontal burr holes. Magnetic resonance angiography (MRA) after evacuation revealed no intracranial aneurysms, but constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) revealed that the left posterior cerebral artery (PCA) ran much more anteriorly and inferiorly compared with the right PCA and the left oculomotor nerve passed very closely between the left PCA and the left superior cerebellar artery (SCA). There is the possibility that the strong compression to the left uncus, the left PCA, and the left SCA due to the bilateral CSDH resulted in left oculomotor nerve palsy with an initial manifestation without unconsciousness. Unilateral oculomotor nerve palsy as an initial presentation caused by bilateral CSDH without unconsciousness is a rare clinical condition, but this situation is very important as a differential diagnosis of unilateral oculomotor nerve palsy. © 2013 by The Japan Neurosurgical Society.

DOI： 10.2176/nmc.cr2012-0339

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN NEUROSURGICAL SOC  

Isolated oculomotor nerve palsy is well known as a symptom of microvascular infarction and intracranial aneurysm, but unilateral oculomotor nerve palsy as an initial manifestation of chronic subdural hematoma (CSDH) is a rare clinical condition. We report a rare case of an 84-year-old woman with bilateral CSDH who presented with unilateral oculomotor nerve palsy as the initial symptom. The patient, who had a medical history of minor head injury 3 weeks prior, presented with left ptosis, diplopia, and vomiting. She had taken an antiplatelet drug for lacunar cerebral infarction. Computed tomography (CT) of the head showed bilateral CSDH with a slight midline shift to the left side. She underwent an urgent evacuation through bilateral frontal burr holes. Magnetic resonance angiography (MRA) after evacuation revealed no intracranial aneurysms, but constructive interference in steady-state (CISS) magnetic resonance imaging (MM) revealed that the left posterior cerebral artery (PCA) ran much more anteriorly and inferiorly compared with the right PCA and the left oculomotor nerve passed very closely between the left PCA and the left superior cerebellar artery (SCA). There is the possibility that the strong compression to the left uncus, the left PCA, and the left SCA due to the bilateral CSDH resulted in left oculomotor nerve palsy with an initial manifestation without unconsciousness. Unilateral oculomotor nerve palsy as an initial presentation caused by bilateral CSDH without unconsciousness is a rare clinical condition, but this situation is very important as a differential diagnosis of unilateral oculomotor nerve palsy.

DOI： 10.2176/nmc.cr2012-0339

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Brain Research  

Alzheimer's disease (AD) classically presents with gray matter atrophy, as well as feature significant white matter abnormalities. Previous evidence indicates the overall burden of these pathological changes continues to advance as the disease progresses. The aim of this study was to investigate whether pathological alterations of white matter tracts correlate with the course of AD disease progression. 35 AD patients and 29 normal controls were recruited to the study and administered baseline magnetic resonance diffusion tensor imaging (DTI) acquisition and a cognitive function assessment at the time of initial evaluation. Subjects were re-evaluated with secondary DTI scan and cognitive function assessment at intervals of about 1.5 years on average. For the DTI acquired scans, we calculated diffusion tensor parameters, fractional anisotropy (FA), apparent diffusion coefficient (ADC), radial diffusivity (DR), and axial diffusivity (DA) along with the uncinate fasciculus (UNC), the inferior longitudinal fasciculus (ILF), and the inferior occipitofrontal fasciculus (IOFF). Compared to baseline, a significant mean FA reduction of the bilateral UNC, as well as a significant mean DR increase of the left UNC, was evident in AD patients at follow-up. Compared with normal controls, AD patients exhibited significant diffusion parameter abnormalities in their UNC, ILF, and IOFF. Taken together, these results indicate that progressive pathological white matter alterations can be quantified using the DTI parameters utilized here and may prove to be a useful biological marker for monitoring the pathophysiological course of AD. © 2013 Elsevier B.V.

DOI： 10.1016/j.brainres.2013.03.052

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuro-Ophthalmology  

Optic nerve hypoplasia is diagnosed by the ophthalmoscopic appearance of the fundus of the eye and by standard magnetic resonance imaging of the brain. The ability to study eyes with optic nerve hypoplasia by magnetic resonance diffusion tensor imaging has improved the evaluation of the optic pathways. The authors report a case of unilateral optic nerve hypoplasia with hypoplasia of the contralateral optic pathway. The entire visual pathway of this patient was examined by magnetic resonance and magnetic resonance diffusion tensor imaging. The images show a decrease of the volume of the optic radiation contralateral to the optic nerve abnormality and also pre- and post-chiasmal abnormalities. © Informa Healthcare USA, Inc.

DOI： 10.3109/01658107.2013.785572

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本インターベンショナルラジオロジー学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Geriatric Imaging  

This chapter reviews disorders that show movement dysfunction. Although these diseases have various mechanisms and include a number of categories, the role of imaging has become increasingly important in clinical practice in the diagnostic assessment of all movement disorders. In addition to standard morphological images, functional images using MRI, diffusion tensor images illustrating white matter structure, and other methods are becoming increasingly important in initial diagnosis as well as ongoing monitoring and assessment during treatment. In addition to the importance of imaging, information about genetics is also important for characterizing disease subtypes and for correct diagnosis. In this chapter, clinical, genetic, and pathological findings, as well as imaging findings, are discussed for each disorder. These sections are followed by more recent imaging findings to further evaluate each of the disorders.

DOI： 10.1007/978-3-642-35579-0_25

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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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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(公社)日本医学放射線学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neurosurgery  

BACKGROUND:: Retrograde leptomeningeal venous drainage (RLVD) in dural arteriovenous fistulas (DAVFs) is associated with intracerebral hemorrhage and nonhemorrhagic neurological deficits or death. Angiographic evidence of RLVD is a definite indication for treatment, but less invasive methods of identifying RLVD are required. OBJECTIVE:: To evaluate the efficacy of susceptibility- weighted magnetic resonance imaging (SWI) in detecting RLVD in DAVFs. METHODS:: We retrospectively identified 17 DAVF patients who had angiographic evidence of RLVD and received treatment. Conventional angiography and SWI were assessed at pretreatment and posttreatment time points. The presence of RLVD on SWI was defined as cortical venous hyperintensity, and the presence of venous congestion on SWI venograms was defined as increased caliber of cortical or medullary veins. RESULTS:: Cortical venous hyperintensity was identified in pretreatment SWI of 15 patients. Cortical venous hyperintensity was absent in early posttreatment SWI, consistent with the absence of RLVD in posttreatment angiography, in all but one of these patients. In 2 patients, cortical venous hyperintensity was identified during follow-up, indicating the recurrence of RLVD. Cortical venous hyperintensity was not identified in the pretreatment SWI of 2 patients despite angiographic evidence of RLVD. Venous congestion was identified in pretreatment SWI venograms of 11 patients and had an appearance similar to that identified from angiography. Venous congestive signs improved over the follow-up period. CONCLUSION:: The presence of SWI hyperintensity within the venous structure could be a useful indicator of RLVD in DAVF patients. Thus, SWI offers a noninvasive alternative to angiography for the identification of RLVD in pretreated and posttreated DAVF patients. Copyright © 2012 by the Congress of Neurological Surgeons.

DOI： 10.1227/NEU.0b013e318276f7cc

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SpringerPlus  

Purpose: The present study aimed to identify the types of curved lesions that are difficult to place Carotid Wallstent (CWS). Materials and methods: The study targeted 31 consecutive carotid artery (CA) stenosis underwent carotid artery stenting using CWS. CWS placement success rate, stenosis location, lesion tortuosity, and relationship with stent placement failures were investigated. Lesion tortuosity was defined as the angle formed by 2 tangential lines between internal CA and common CA from the inflection point (IP) was defined as the center of lesion curvature. Stenosed lesions were classified into type A or B. Type A was defined as if the distal end of the stenosis was located proximal to the IP at a distance ≥0.5 of a vertebral body based on the posterior height of the 3rd vertebral body, otherwise was type B. Results: The stent placement success rate was 93.5% (29/31). The 2 unsuccessfully stented lesions, both lesions were significantly different from other lesions by having a lesion tortuosity less than 90° and by belonging to type B. Conclusion: Since CWS placement is difficult in patients with CA stenosis located close to the IP at a lesion tortuosity ≤90°, open-cell stents should be considered as an alternative. © 2013 Myouchin et al.

DOI： 10.1186/2193-1801-2-468

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SpringerPlus  

Objective: To elucidate the key points for safe performance of transradial angiography. Conclusions: Transradial angiography can be performed safely if attention is paid to the following points from after radial artery puncture to reaching the aortic arch: resistance during guide wire operation for sheath insertion after puncture; confirmation of the superficial brachial artery; guide wire resistance while guiding the catheter to the aortic arch; and aortic arch anomalies. © 2013 Iwasaki et al.

DOI： 10.1186/2193-1801-2-365

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本脳神経外科学会  

DOI： 10.2176/nmc.cr2012-0339

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：European Society of Radiology  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction: The presence of adhesions between the brain and the meningioma is an important factor that determines the success of total surgical removal. Brain surface motion imaging enables assessment of the dynamics of brain surface motion. A subtraction image of pulse-gated heavily T2-weighted images in different phases of the cardiac cycle provides a stripe pattern on the surface of the pulsating brain. Thus, the lack of a stripe pattern on the surface of extraaxial tumor indicates the presence of tumor-brain adhesion. The purpose of the present experiment was to evaluate the accuracy of predicting tumor-brain adhesion using the original double acquisition method and the improved single acquisition method. Methods: The subjects were 67 meningioma cases patients who were surgically treated after brain surface motion imaging. Thirty-three cases were evaluated using the double acquisition method and 34 cases were evaluated with the single acquisition method. In the double acquisition method, the two sets of images are acquired as two independent scans, and in the single acquisition method, the images are acquired serially as a single scan. Results: The findings for the double acquisition method agreed with the surgical findings in 23 cases (69.7 %), while findings from the single acquisition method agreed with the surgical findings in 26 cases (76.5 %). Conclusion: Pre-surgical evaluation for tumor-brain adhesion by brain surface motion imaging provides helpful information for meningioma surgery, especially when using the single acquisition method. © 2012 Springer-Verlag.

DOI： 10.1007/s00234-012-1054-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: Restenosis after CAS is a postoperative problem, with a reported frequency of approximately 2%-8%. However differences in stent design, procedure, and the anti-platelet agent appear to affect the incidence of restenosis. We assessed the frequency of restenosis and the effect of the antiplatelet agent CLZ in preventing restenosis after CAS by the standard procedure using the CWS. MATERIALS AND METHODS: Between May 2010 and October 2011, 62 lesions in 60 consecutive patients underwent CAS using the CWS at 4 medical institutions, and all patients were followed clinically and assessed by sonography, 3D-CTA, or angiography at 3 and 6 months postoperatively. Restenosis was defined as ≥50% stenosis. The incidence of restenosis and the variation in the incidence of restenosis by the difference in type of antiplatelet agent between the CLZ group (n = 30; aspirin, 100 mg, and CLZ, 200 mg) and the non-CLZ group (n = 32; aspirin, 100 mg, and clopidogrel, 75 mg [n = 29]; or ticlopidine, 100 mg [n = 2] or 200 mg [n = 1]) were retrospectively investigated. Two antiplatelet agents were given starting 1 week preoperatively until at least 3 months postoperatively. RESULTS: Restenosis occurred in 5 patients (8.3%), but all were cases of asymptomatic lesions in the follow-up period. All 5 patients with restenosis were in the non-CLZ group, with no cases of restenosis in the CLZ group; the difference was significant (P = .0239). CONCLUSIONS: The restenosis rate after CAS by using the CWS was 8.3%. CLZ was associated with significant inhibition of restenosis.

DOI： 10.3174/ajnr.A3127

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Recently, non-Gaussian diffusion-weighted imaging (DWI) techniques, including qspace imaging (QSI) and diffusional kurtosis imaging (DKI), have emerged as advanced methods to evaluate tissue microstructure in vivo using water diffusion. QSI and DKI have shown promising results in clinical applications, such as in the evaluation of brain tumors (e.g., grading gliomas), degenerative diseases (e.g., specific diagnosis of Parkinson disease), demyelinating diseases (e.g., assessment of normal-appearing tissue of multiple sclerosis), and cerebrovascular diseases (e.g., assessment of the microstructural environment of fresh infarctions). Representative metrics in clinical use are the full width at half maximum, also known as the mean displacement of the probability density function curve, which is derived from QSI, and diffusional kurtosis, which is derived from DKI. These new metrics may provide information on tissue structure in addition to that provided by conventional Gaussian DWI investigations that use the apparent diffusion coefficient and fractional anisotropy, recognized indices for evaluating disease and normal development in the brain and spine. In some clinical situations, sensitivity for detecting pathological conditions is higher using QSI and DKI than conventional DWI and diffusion tensor imaging (DTI) because DWI and DTI calculations are based on the assumption that water molecules follow a Gaussian distribution, whereas hindrance of the distribution of water molecules by complex and restricted structures in actual neural tissues produces distributions that are far from Gaussian. We review the technical aspects and clinical applications of QSI and DKI, focusing on clinical use and in vivo studies and highlighting differences from conventional diffusional metrics.

DOI： 10.2463/mrms.11.221

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Psychiatry  

Background: Polydipsia frequently occurs in schizophrenia patients. The excessive water loading in polydipsia occasionally induces a hyponatremic state and leads to water intoxication. Whether polydipsia in schizophrenic patients correlates with neuropsychological impairments or structural brain changes is not clear and remains controversial.Methods: Eight polydipsic schizophrenia patients, eight nonpolydipsic schizophrenia patients, and eight healthy controls were recruited. All subjects underwent magnetic resonance imaging (MRI) and neuropsychological testing. Structural abnormalities were analyzed using a voxel-based morphometry (VBM) approach, and patients' neuropsychological function was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J).Results: No significant differences were found between the two patient groups with respect to the clinical characteristics. Compared with healthy controls, polydipsic patients showed widespread brain volume reduction and neuropsychological impairment. Furthermore, the left insula was significantly reduced in polydipsic patients compared with nonpolydipsic patients. These nonpolydipsic patients performed intermediate to the other two groups in the neuropsychological function test.Conclusions: It is possible that polydipsia or the secondary hyponatremia might induce left insula volume reduction. Furthermore, this structural brain change may indirectly induce more severe neuropsychological impairments in polydipsic patients. Thus, we suggest that insula abnormalities might contribute to the pathophysiology of polydipsic patients. © 2012 Nagashima et al.; licensee BioMed Central Ltd.

DOI： 10.1186/1471-244X-12-210

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction: The current study evaluated the signal characteristics of susceptibility weighted imaging (SWI) of arteriovenous malformation (AVM), especially for draining veins. For this purpose, we identified the draining veins of the AVM on angiography and evaluated the signal on magnitude image for SWI (SWI-mag) and minimum intensity projection image (SWI-minIP). Methods: Subjects were 14 cases with angiographically proven AVM. SWI-mag, SWI-minIP, and time-of-flight (TOF) magnetic resonance angiography were acquired. For the draining veins of the AVM identified on angiography, we analyzed signal intensity on the images listed above, and classified it into hyperintensity (hyper), mixed intensity (mixed), hypointensity (hypo), and no visualization. Results: On the analysis of 27 angiographically proven draining veins, 19 draining veins were classified as hyper, 3 as mixed, 0 as hypo, and 6 as no visualization on SWI-mag. On TOF images, 21 draining veins were classified as hyper, 2 as mixed, 0 as hypo, and 4 as no visualization, while 6 draining veins did not show hyperintensity on TOF, and SWI-mag visualized 3 of these 6 veins as hyper. Conclusion: SWI-mag depicted most draining veins of AVM as hyperintensity. We speculate that this is mainly due to the higher concentration of oxygenated hemoglobin (oxy-Hb) and inflow effect of the draining vein. SWI-mag seems to be useful in the analysis and follow-up for AVM as the signal on the image may reflect physiological status. © 2012 Springer-Verlag.

DOI： 10.1007/s00234-012-1029-5

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose We hypothesized that the pattern of branching of the lenticulostriate arteries (LSAs) is involved in the variation of the distribution of the infarction within the LSA region. Our purpose was to evaluate the visibility of LSAs in 3D time-of-fiight (TOF) MR angiography (MRA) with a 3.0 T scanner and to investigate the branching patterns of LSAs. Materials and methods We performed 3D TOF MRA at 3.0 T for 100 healthy subjects. We assessed the number of LSAs and the number of branches arising from each LSA by evaluating MRA source images. Results In 200 hemispheres, 330 LSAs were visualized (mean = 1.65/hemisphere). In 3.5% of all hemispheres, no LSA was depicted; one LSA was depicted in 39%, two in 46.5%, and three in 11%. The maximum number of depicted LSA branches was five in 2% of all subjects, four in 7%, three in 26%, and two in 49% (mean = 2.3/subject). A large LSA trunk with three or more branches was found in 35% of subjects. Conclusion Visualization of LSAs was possible in 96.5% of subjects by use of 3.0 T MRA. LSA branching patterns were variable, and a large LSA trunk with three or more branches was common. © 2012 Japan Radiological Society.

DOI： 10.1007/s11604-012-0058-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction: Susceptibility-weighted image (SWI) is one of the most sensitive methods for detect microbleeding and useful for evaluation of traumatic brain damage. The purpose of this study is to delineate the characteristics and importance of supratentorial deep white matter hemorrhages detected by SWI in cases of traumatic brain damage. Methods: Twenty-one consecutive cases with severe traumatic head injury were included in the current study. MRI examinations were made within 1 month after injury. We evaluated the degree and distribution of the supratentorial hemorrhages on SWI retrospectively. We classified the degree of bleeding into four grades: "small hemorrhage," "single bead-like hemorrhage," "convergent-type hemorrhage," and "massive hemorrhage." We then correlated the degree and distribution of the hemorrhage to clinical outcomes. We also evaluated the apparent diffusion coefficient (ADC) image of lobes with "convergent-type hemorrhage." Results: Existence of "massive hemorrhage" correlated with a poor outcome, that is, worse than "severely disabled" on the Glasgow Outcome Scale. The number of lobes affected by "convergent-type hemorrhage" also correlated with poor outcome. There were 45 lobes with "convergent-type hemorrhage" and 27 of them showed increased diffusivity on ADC images. Conclusion: Supratentorial massive hemorrhages and supratentorial convergent-type multiple hemorrhages were associated with poor prognosis after traumatic brain injury. The increased diffusivity in lobes with convergent-type hemorrhages may indicate that congestion of the proximal medullary vein may play some role for these hemorrhages. © Springer-Verlag 2011.

DOI： 10.1007/s00234-011-0892-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Spine  

Study Design: A retrospective observational study. Objective: To compare the usefulness of radioisotope cisternography (RIC) and computed tomography myelography (CTM) for the detection of cerebrospinal fluid (CSF) leakage in spontaneous intracranial hypotension (SIH). Summary of Background Data: CSF leakage sites have been generally identified by RIC in patients with SIH. Although a number of reports have recently indicated the usefulness of CTM, whether RIC or CTM more reliably detects leakage sites has not been decided because the 2 tests have not been directly compared. Methods: Both RIC and CTM were performed, and the findings were compared in 12 patients with SIH strictly meeting the second edition of the International Classification of Headache Disorders diagnostic criteria. Results: On RIC, the detection rate of leakage including indirect signs, an early vesicular radioisotope (RI) accumulation and delayed ascent of the RI to the cerebral convexity, was observed in 100%, but that of the direct sign, paraspinal RI accumulation, was in 8 patients (67%). On CTM, the epidural collection of intraspinally administered contrast medium was demonstrated in all patients (100%), and the collection site was located in the cervical and thoracic vertebral regions in most cases. When RIC and CTM findings were collated, paraspinal accumulation in the cervical and thoracic regions on RIC corresponded to the entire or a part of the findings on CTM. In contrast, in 4 of 5 patients with paraspinal accumulation in the lumbosacral region, epidural collection was not noted in this region on CTM. Conclusion: In patients with SIH, epidural collection on CTM may more accurately demonstrate CSF leakage compared with paraspinal RI accumulation on RIC. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

DOI： 10.1097/BRS.0b013e31822e606a

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(公社)日本医学放射線学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本磁気共鳴医学会  

DOI： 10.2463/mrms.11.221

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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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance in Medical Sciences  

Purpose: We assessed the signal of the globus pallidus (GP) in cases of hepatic in-sufficiency, especially to evaluate the degree of discrepancy in paramagnetic effects on shortening of T 1 and T 2* using susceptibility-weighted images (SWI). Materials and Methods: Seven patients with hepatic insufficiency underwent magnetic resonance (MR) examinations that included T 1-weighted images (T 1WI), T 2-weighted images (T 2WI), and SWI on a 1.5-tesla MR imager, and we compared their results to those of controls. On T 1WI and T 2WI, we measured signal intensity in the GP and posterior segment of the putamen (Put) to obtain a signal ratio (GP/Put ratio), and on SWI, we classified signal intensity into 4 grades: A, higher than the cortex; B, lower than the cortex and higher than the cerebrospinal fluid (CSF); C, lower than the CSF and higher than the red nucleus; and D, lower than the red nucleus. Results: In the 7 patients with hepatic insufficiency, the mean GP/Put ratio was significantly higher on T 1WI and T 2WI than those values in controls. On SWI, we classified 2 cases each as Grade A, Grade B, and Grade C, and one as Grade D. Although the signal of the GP was elevated on T 1WI, there was no decrease in signal on T 2WI. On SWI, we obtained no low signal intensity. Conclusion: In patients with hepatic insufficiency, the globus pallidus did not show low signal intensity on either T 2WI or SWI. Hyperintensity of the GP on T 1WI without hypoin-tensity on T 2WI, or even SWI, suggests a discrepancy between paramagnetic effect on T 1 and T 2 shortening that reflects the accumulation of manganese and the presence of hepatic insufficiency.

DOI： 10.2463/mrms.10.79

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本神経学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Research Notes  

Background: Hemispherical asymmetry, sex differences and age-related changes have been reported for the human brain. Meanwhile it was still unclear the presence of the asymmetry or sex differences in the human brain occurred whether as a normal development or as consequences of any pathological changes. The aim of this study was to investigate hemispherical asymmetry, sex differences and age-related changes by using a tract-based analysis in the nerve bundles. Methods. 40 healthy elderly subjects underwent magnetic resonance diffusion tensor imaging, and we calculated fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values along the major white matter bundles. Results: We identified hemispherical asymmetry in the ADC values for the cingulate fasciculus in the total subject set and in males, and a sex difference in the FA values for the right uncinate fasciculus. For age-related changes, we demonstrated a significant increase in ADC values with advancing age in the right cingulum, left temporal white matter, and a significant decrease in FA values in the right superior longitudinal fasciculus. Conclusion: In this study, we found hemispherical asymmetry, sex differences and age-related changes in particular regions of the white matter in the healthy elderly. Our results suggest considering these differences can be important in imaging studies. © 2010 Kitamura et al; licensee BioMed Central Ltd.

DOI： 10.1186/1756-0500-4-378

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その他リンク： http://orcid.org/0000-0001-9227-0240

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本神経感染症学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Computer Assisted Tomography  

Objective: The aim of this study was to determine the feasibility and usefulness of contrast-enhanced magnetic resonance angiography (CE-MRA) and 3-dimensional (3D) time-of-flight (TOF) MRA for follow-up of intracranial aneurysms treated using the Enterprise stent. Methods: Five aneurysm cases using the Enterprise stent were prospectively analyzed and were followed up with CE-MRA, 3D TOF MRA, and digital subtraction angiography (DSA). Depictions of parent artery lumen and the aneurysm neck with 3D TOF MRA and CE-MRA were compared with those of DSA. Results: In all cases, on 3D TOF MRA, it was difficult to evaluate the parent artery lumen and aneurysm neck owing to the significant artifacts from the stent. Contrast-enhanced MRA sufficiently demonstrated parent artery lumen and aneurysm neck distinctly and as clear as DSA did in all cases. Conclusions: For follow-up after coiling with an Enterprise stent, CE-MRA may be necessary to avoid susceptibility artifacts caused by the stent. Copyright © 2011 by Lippincott Williams & Wilkins.

DOI： 10.1097/RCT.0b013e31822bd498

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Psychiatric Research  

Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) are different types of dementia. However, their clinical symptoms partially overlap and differential diagnosis is occasionally difficult. There is need for additional diagnostic criteria to reliably differentiate between these two conditions. Meanwhile, several imaging studies have showed inconsistent results between DLB and AD. The aim of this study was to use a tractography-based analysis to elucidate white matter alterations in subjects with DLB compared to those with AD and to controls. An understanding of the white matter connectivity differences between AD, DLB and controls will be helpful for differential diagnosis and an understanding of the pathophysiology. Twenty-six subjects with DLB, 26 with AD and 26 controls underwent magnetic resonance diffusion tensor imaging and neuropsychological assessment. Diffusion tensors were computed and fiber-tract maps were created using "dTV II" software. We measured mean fractional anisotropy (FA) values along the uncinate fasciculus (UNC), the inferior occipitofrontal fasciculus (IOFF) and the inferior longitudinal fasciculus (ILF). Both subjects with DLB and AD had lower FA values for the bilateral UNC than controls. Subjects with DLB exhibited significantly lower FA values on both sides of the IOFF and the left side of the ILF than those of controls. Although there were no significant differences between subjects with DLB and AD for any measurements, those with DLB exhibited lower FA values especially in visual-related white matter. These different changes in white matter tracts among groups could be helpful for differential diagnosis and an understanding of the pathophysiology. © 2011 Elsevier Ltd.

DOI： 10.1016/j.jpsychires.2011.01.011

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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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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: In the brains of newborns, changes in signal intensity in most structures can be explained by the development of myelination. However, there are some structures for which signal intensity changes cannot be accounted for by myelination alone. We examined the STN and globus pallidus signal intensities and tried to determine whether a relationship exists between the signal intensity and the postnatal age or the gestational age at the examination. MATERIALS AND METHODS: We examined T1WI and T2WI obtained from 79 neonates who showed normal development at their 2-year follow-up examinations. We performed both qualitative and quantitative (signal intensity ratio to the thalamus) evaluation of the STN and globus pallidus signals, and we examined the correlation between signal intensity changes and the age of neonates. RESULTS: With increasing postnatal age at examination, the high signal intensity on the T1WI for both STN and globus pallidus diminished. Although the disappearance of this hyperintensity was well correlated with the postnatal age at examination for both the qualitative and quantitative studies, there was no correlation with gestational age at examination. For the T2WI, there was no correlation with either the postnatal age or the gestational age at examination. CONCLUSIONS: Signal intensity on T1WI in the STN and globus pallidus is not related to the gestational age at examination; instead, signal intensities on T1WI seem to be more dependent upon the postnatal age at examination.

DOI： 10.3174/ajnr.A2451

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neuroimaging  

BACKGROUND AND PURPOSE: Features of tumefactive demyelinating lesion (TDL) on magnetic resonance imaging (MRI) can facilitate the differential diagnosis of TDL and neoplastic lesions, but vary considerably among patients. The larger TDL grows, the more difficult it becomes to differentiate TDL from neoplastic lesions. The purpose of this study was to elucidate typical MRI features in 12 patients with large TDL (>30 mm in diameter). METHODS: We identified 12 patients with large TDL (six men, six women; age range 17-64 years, median age 27 years) and studied the clinical histories and the results of laboratory and various radiological studies in these patients. All cases of clinically definite multiple sclerosis were diagnosed in accordance with McDonald's revised criteria. RESULTS: Common MRI features of large TDLs included variable degrees of mass effect (71%) and edema (100%), a T2 hypointense rim (79%), venular enhancement (57%), and peripheral restriction on diffusion-weighted images (50%). Ring enhancement (38%), open-ring enhancement (31%), or decreased N-acetylaspartate ratios on magnetic resonance spectroscopy (22%) were less frequently observed. Brain angiography demonstrated venous dilatations on and around the TDL. CONCLUSIONS: The diagnosis of large TDL is challenging. Our findings suggest that multiple venous dilatations on and around TDLs on angiography can facilitate diagnosis. © 2010 by the American Society of Neuroimaging.

DOI： 10.1111/j.1552-6569.2010.00502.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

Purpose: The Carotid WALLSTENT (CWS) and Filter-Wire EZ (FWEZ) embolic protection devices for use in carotid arterial stenting (CAS) were newly approved for national health insurance coverage in Japan in April 2010. This article describes our initial experience of CAS using the CWS and FWEZ. Material and methods: A group of 14 patients (12 men, 2 women; mean age 70.1 years, range 59-83 years) with 15 carotid artery stenoses at high risk for carotid endarterectomy were treated by CAS using the CWS and FWEZ. Of these stenoses, 5 were symptomatic with ≥50% stenosis of the common or internal carotid artery (ICA), and 10 were asymptomatic with ≥80% stenosis. The rates of technical success, ICA flow impairment during filter protection, periprocedural ischemic stroke, 30-day major adverse events (MAEs) (stroke, death, myocardial infarction), and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed. Results: CAS was successful in all cases. There was no ICA flow impairment, periprocedural ischemic stroke, or MAEs. DWI showed new ipsilateral ischemic lesions in only one patient (6.7%). Conclusion: Our initial clinical experience using the CWS and FEWZ for CAS was generally excellent, and the incidence of postprocedural ischemic lesions was low. © 2011 Japan Radiological Society.

DOI： 10.1007/s11604-010-0518-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of neuroimaging : official journal of the American Society of Neuroimaging  

Tolosa-Hunt syndrome (THS) is a very rare, relapsing, and remitting painful ophthalmoplegia caused by nonspecific granulomatous inflammation in the cavernous sinus. To our knowledge, bilateral complete, simultaneous palsies of all 3 cranial nerves associated with extraocular movement have not been reported. We describe the first such patient with bilateral THS that responded quickly to corticosteroid therapy. A 54-year-old man presented with a periorbital and frontal headache with acute bilateral severe blepharoptosis and fixed eyes, which dramatically responded to corticosteroid therapy. He had diabetes mellitus type II. Brain MRI showed granulomatous inflammation in both cavernous sinuses and thickening of the surrounding dura mater of the cranial base, suggesting the coexistence of focal hypertrophic cranial pachymeningitis. Our experience indicates that steroid therapy with strict control of blood sugar should be considered in patients with THS complicated by diabetes. MRI is a valuable tool for serially monitoring the response of lesions to treatment in THS.

DOI： 10.1111/j.1552-6569.2009.00381.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiology  

Purpose: To assess the frequency of hyperintensity in the dentate nucleus on T1-weighted magnetic resonance (MR) images and to establish correlations between such hyperintensity and clinical factors, including a history of brain irradiation. Materials and Methods: This study was approved by the institutional review board, and each patient provided written informed consent. Three hundred sixty-two patients (164 men, 198 women; mean age, 62 years) were evaluated. Unenhanced T1-weighted MR images were obtained by using a spin-echo sequence at 3.0 T. Two neuroradiologists, who were blinded to clinical data, independently evaluated the signal intensity of the dentate nucleus compared with the signal intensity of the central white matter of the cerebellum by using a four-point graded response scale (grade 4 indicated prominent hyperintensity; grade 3, faint hyperintensity; grade 2, isointensity; and grade 1, hypointensity). Backward stepwise regression analysis was used to evaluate the relationship between signal intensity grades and the following clinical factors: sex, age, the interaction between age and sex, hypertension, dyslipidemia, diabetes mellitus, liver dysfunction, brain infarction, brain tumor, spinocerebellar degeneration, multiple sclerosis, a history of chemotherapy, and a history of brain irradiation. Results: T1-hyperintense dentate nuclei were present in 41 (11%) of the 362 patients. Of these 41 patients, 31 (76%) had a history of brain irradiation. Signal intensity grade of the dentate nucleus on T1-weighted MR images correlated significantly with a history of brain irradiation (P <.001) but no other clinical factor. Conclusion: A hyperintense dentate nucleus may be seen on unenhanced T1-weighted MR images in some patients and may be associated with a history of brain irradiation. © RSNA, 2010.

DOI： 10.1148/radiol.10100508

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.2463/mrms.10.79

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society for Magnetic Resonance in Medicine  

Purpose: We assessed the signal of the globus pallidus (GP) in cases of hepatic insufficiency, especially to evaluate the degree of discrepancy in paramagnetic effects on shortening of T₁ and T₂* using susceptibility-weighted images (SWI).<br> Materials and Methods: Seven patients with hepatic insufficiency underwent magnetic resonance (MR) examinations that included T₁-weighted images (T₁WI), T₂-weighted images (T₂WI), and SWI on a 1.5-tesla MR imager, and we compared their results to those of controls. On T₁WI and T₂WI, we measured signal intensity in the GP and posterior segment of the putamen (Put) to obtain a signal ratio (GP/Put ratio), and on SWI, we classified signal intensity into 4 grades: A, higher than the cortex; B, lower than the cortex and higher than the cerebrospinal fluid (CSF); C, lower than the CSF and higher than the red nucleus; and D, lower than the red nucleus.<br> Results: In the 7 patients with hepatic insufficiency, the mean GP/Put ratio was significantly higher on T₁WI and T₂WI than those values in controls. On SWI, we classified 2 cases each as Grade A, Grade B, and Grade C, and one as Grade D. Although the signal of the GP was elevated on T₁WI, there was no decrease in signal on T₂WI. On SWI, we obtained no low signal intensity.<br> Conclusion: In patients with hepatic insufficiency, the globus pallidus did not show low signal intensity on either T₂WI or SWI. Hyperintensity of the GP on T₁WI without hypointensity on T₂WI, or even SWI, suggests a discrepancy between paramagnetic effect on T₁ and T₂ shortening that reflects the accumulation of manganese and the presence of hepatic insufficiency.<br>

DOI： 10.2463/mrms.10.79

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.neures.2011.07.1263

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ijdevneu.2010.07.204

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction "Brain surface motion imaging" (BSMI) is the subtraction of pulse-gated, 3D, heavily T2-weighted image of two different phases of cerebrospinal fluid (CSF) pulsation, which enables the assessment of the dynamics of brain surface pulsatile motion. The purpose of this study was to evaluate the feasibility of this imaging method for providing presurgical information about adhesions between meningiomas and the brain surface. Methods Eighteen cases with surgically resected meningioma in whom BSMI was presurgically obtained were studied. BSMI consisted of two sets of pulse-gated, 3D, heavily T2-weighted, fast spin echo scans. Images of the systolic phase and the diastolic phase were obtained, and subtraction was performed with 3D motion correction. We analyzed the presence of band-like texture surrounding the tumor and judged the degree of motion discrepancy as "total," "partial," or "none." The correlation between BSMI and surgical findings was evaluated. For cases with partial adhesions, agreements in the locations of the adhesions were also evaluated. Results On presurgical BSMI, no motion discrepancy was seen in eight cases, partial in six cases, and total in four cases. These presurgical predictions about adhesions and surgical findings agreed in 13 cases (72.2%). The locations of adhesions agreed in five of six cases with partial adhesions. Conclusion In the current study, BSMI could predict brain and meningioma adhesions correctly in 72.2% of cases, and adhesion location could also be predicted. This imaging method appears to provide presurgical information about brain/meningioma adhesions. © Springer-Verlag 2010.

DOI： 10.1007/s00234-010-0671-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Folia Japonica de Ophthalmologica Clinica  

We encountered a patient who showed optic disc edema and was finally diagnosed with IgG4-related disease. An 81-year-old male with cataract was referred to our department for surgery. At the time of the initial consultation, edema was observed in the bilateral optic discs. Brain magnetic resonance imaging revealed hypophysitis and hypertrophic cranial pachymeningitis. Close examination of the entire body showed interstitial nephritis and a lung lesion. In addition, since the IgG4 level was high, a final diagnosis of IgG4-related disease was made. In recent years, IgG4-related disease has attracted attention as a systemic disease. In the future, when optic disc edema is observed, hypertrophic cranial pachymeningitis and IgG4-related disease should also be taken into consideration, and close examination of the entire body in cooperation with other departments may also be necessary.

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neuro-Oncology  

Brainstem encephalitis is not a classic paraneoplastic syndrome and usually involves monophasic neurological deterioration and has negative magnetic resonance imaging (MRI) findings. We describe a patient with brainstem encephalitis who had elevated anti-Ri antibody levels and double-step neurological deterioration associated with different abnormal lesions on MRI. Immunosuppression with steroids and intravenous immune globulin combined with aggressive treatment of the tumor successfully led to the resolution of brainstem symptoms and MRI lesions. In patients with unusual signs and symptoms of paraneoplastic encephalitis mimicking multiple sclerosis, onconeural antibody studies are recommended. © 2010 Springer Science+Business Media, LLC.

DOI： 10.1007/s11060-010-0135-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Academic Radiology  

Rationale and Objectives: The torcular herophili, or " confluence of the sinuses," shows various configurations with other venous sinuses, as revealed by angiography. The aims of this study were to evaluate anatomic variations of this confluence and to assess their clinical relevance using three-dimensional (3D) computed tomographic (CT) venography. Materials and Methods: The torcular herophili and its relevant venous sinuses were analyzed using 3D CT venography in 120 adults, consisting of 76 patients who were proven to have aneurysms and 44 patients who were proven to have no vascular malformations or aneurysms after the examinations. Three-dimensional CT venography was performed following the arterial phase of 3D CT angiography without any additional injection of contrast material. Three-dimensional volume-rendered venous images were reconstructed on a workstation and reviewed. Results: The superior sagittal sinus (SSS) drained into the transverse sinus (TS) in four patterns: the SSS reached the centrally located confluence, where it divided into the bilateral TS (20.0%); the SSS was prematurely duplicated into the right and left limbs and drained into the same side TS (26.7%); the SSS drained exclusively into the right TS (44.2%); or the SSS drained exclusively into the left TS (9.2%). The draining pattern of the straight sinus was also classified into four types. The right TS was larger than the left TS. The right TS were higher compared to the left TS. Persistent occipital sinuses were recognized in 57.5% of the subjects. Finally, persistent falcial sinuses were seen in 2.5% of the subjects. A septum in the SSS and complicated venous channels in the confluence were each seen in only one case. Conclusion: Three-dimensional CT venography is useful as a noninvasive method to evaluate the confluence and its relevant dural sinuses and can provide useful information for surgical intervention. © 2010 AUR.

DOI： 10.1016/j.acra.2010.04.020

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Skeletal Radiology  

We report a case of hepatocellular carcinoma of the iliac bone in which the primary tumor was not detected. No malignant primary lesions such as hepatocellular carcinoma or hepatoid carcinoma were detected at the time or during 10 years' follow-up. In this case, transcatheter arterial chemoembolization and radiation therapy resulted in complete regression of the iliac bone tumor and in long-term survival. We focus in particular on the clinical, histological, and therapeutic aspects of the presented case, as well as the imaging and diagnostic aspects. © ISS 2010.

DOI： 10.1007/s00256-010-0891-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neuroimaging  

Rotational vertebral artery (VA) occlusion can cause ischemic strokes due to hemodynamic insufficiency and possibly artery-to-artery (A-to-A) embolism. The former is known as bow hunter's stroke. The latter has been proposed only from indirect evidence. We have described a 7-year-old boy with cerebral infarction associated with A-to-A embolism due to repetitive rotational VA occlusion. He had a mobile mural thrombus at the VA occlusion site on head rotation. Surgical treatment may effectively prevent recurrences. © 2008 by the American Society of Neuroimaging.

DOI： 10.1111/j.1552-6569.2008.00309.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction The purpose is to investigate the feasibility of magnetic resonance (MR) plaque imaging in predicting the marterial flow impairment (slow-flow phenomenon) during carotid artery stenting (CAS) using a filter-type protection device. Methods Thirty-one carotid artery stenotic lesions in 30 patients (28 men and two women; mean age, 71.8 years) were evaluated by MR plaque imaging with black blood T1- and T2-weighted and time-of-flight sequences before CAS. Main plaque components were classified as vulnerable (intraplaque hemorrhage and lipid-rich/necrotic core) or stable (fibrous tissue and dense calcification) from the signal pattern. The plaque classification was statistically compared with the occurrence of slow-flow phenomenon. Results The slow-flow phenomenon was observed in ten CAS procedures (five flow arrests and five flow reductions). Flow arrests consisted of four vulnerable and one stable plaque, and flow reductions consisted of four vulnerable and one stable plaque. The slow-flow phenomenon occurred significantly (P<0.01) more frequently in patients with vulnerable plaque. Conclusions Vulnerable carotid plaques have a significantly higher risk of slow-flow phenomenon than stable plaques. The occurrence of the slow-flow phenomenon can be predicted by MR plaque imaging before CAS © Springer-Verlag 2009.

DOI： 10.1007/s00234-009-0623-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Psychogeriatrics  

Background: Neuroimaging studies show increased diffusivity and decreased anisotropy in Alzheimer's disease (AD) patients by diffusion tensor imaging (DTI). Previous reports have analyzed a correlation with cognitive function and DTI parameters, but their results are inconsistent. A reason for this might be a region of interest (ROI) method, used to calculate parameters for DTI, because this method has various usages of how to place a ROI and includes summations of values for various neuronal fiber tracts, resulting in contamination of unintended fibers. To improve the instability with ROI placement, a tractography-based method might be useful. Our coworker reported decreased fractional anisotropy (FA) and increased apparent diffusion coefficient (ADC) of uncinate fasciculus (UF) in patients with AD by tractography. To confirm whether DTI parameter values are related to severity of cognitive function in patients with AD, we measured mean diffusion anisotropy and diffusivity of coregistered voxels along the tracking lines (i.e. tract of interest) of UF. Methods: The subjects were 30 patients with probable AD (NINCDSADRDA criteria). Assessment of cognitive function was carried out according to the Mini-Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale-cognitive component-Japanese version (ADAS-Jcog). A 1.5-T clinical magnetic resonance unit was used to obtain diffusion tensor images. Diffusion tensors were computed and fiber-tract maps were created using 'dTV II' DTI software developed by Masutani et al. We measured mean FA and ADC values along the bilateral UF. Results: FA values were positively correlated with MMSE score (r = 0.67) and were negatively correlated with ADAS-Jcog score (r = -0.62), while ADC values were negatively correlated with MMSE score (r = -0.58) and were positively correlated with ADAS-Jcog score (r = 0.59). Conclusion: FA and ADC values might reflect the severity of cognitive dysfunction. The tract-of-interest method might be a useful tool for objectively evaluating DTI parameters in AD. © 2010 The Authors Journal compilation © 2010 Japanese Psychogeriatric Society.

DOI： 10.1111/j.1479-8301.2010.00312.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Computer Assisted Tomography  

Objective: The purpose of this study was to evaluate the feasibility of magnetic resonance angiography (MRA) with midsagittal saturation for depiction of superficial temporal artery-to-middle cerebral artery bypass flow. Methods: Eleven patients undergoing bypass surgery in 13 regions were examined by external carotid artery angiography (ECAG) and 3-dimensional time-of-flight MRA with saturation pulse applied to the midsagittal plane covering the internal carotid arteries. We classified the extent of visualization of bypass flow into 4 types and examined the agreement of findings between them. Results: The MRA revealed types of bypass flow in agreement with those observed on ECAG in 10 of the 13 regions. The MRA underestimated bypass flow in 2 regions and overestimated it in 1 region. Conclusions: The MRA with midsagittal saturation demonstrated bypass flow in agreement with ECAG in most cases. Application of MRA with midsagittal saturation permits noninvasive assessment of physiological flow from superficial temporal artery-to-middle cerebral artery bypass for a postoperative follow-up. Copyright © 2010 by Lippincott Williams & Wilkins.

DOI： 10.1097/RCT.0b013e3181ac914e

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：{SAGE} Publications  

DOI： 10.4137/ccrep.s3555

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

その他リンク： http://orcid.org/0000-0001-9227-0240

記述言語：英語   掲載種別：論文集(書籍)内論文   出版者・発行元：Neurovascular Imaging: MRI and Microangiography  

The carotid bifurcation is a frequent site for atheromatous diseases, and severe stenosis or occlusion of the bifurcation leads to hypoperfusion of the brain [5]. Progression of carotid artery disease relates closely to future cerebral or coronary infarction; stability of the carotid plaque and degree of carotid stenosis are important factors in disease development and assessment. Diagnosis of unstable plaque (vulnerable plaque) is important because its presence may lead to embolic diseases in the brain. Both the size and composition of plaque influence its stability [13]. Histological characteristics of unstable plaque include a large necrotic core that contains a large amount of cholesterol ester, intraplaque hemorrhage, and/or infiltration by inflammatory cells. Diagnosis of carotid plaque should be aimed at evaluating the degree of fibrosis, thrombosis, existence of lipid or calcification, and degree of stenosis or plaque thickness. In addition, the Rotterdam Study of more than 4,000 neurologically asymptomatic subjects aged 55 years or older associated carotid plaque with increased risk of stroke, irrespective of plaque location. Study results suggest that carotid plaque in such subjects is a marker of generalized atherosclerosis and a source of thrombotic emboli [20]. © 2011 Springer-Verlag London Limited.

DOI： 10.1007/978-1-84882-134-7_11

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

その他リンク： http://orcid.org/0000-0001-9227-0240

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Clinical Medicine Insights: Case Reports  

Bow hunter's stroke (BHS) is a cerebrovascular disease caused by occlusion of the vertebral artery (VA) on head rotation. BHS is generally associated with hemodynamic changes, often leading to vertebrobasilar insufficiency symptoms, such as vertigo and faintness. Although artery-to-artery embolism has also been proposed as an underlying mechanism, it remains controversial. This report documents a case of BHS without hemodynamic changes. We describe a 26-year-old male patient who had VA occlusion on head rotation and repetitive infarction of thalami. He had an anomalous bypass of the VA and therefore no symptomatic hemodynamic changes. Thus, non-hemodynamic BHS should be considered in juvenile patients with vertebrobasilar stroke. © the authors, publisher and licensee Libertas Academica Ltd.

DOI： 10.4137/ccrep.s3555

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Radiology  

A 77-year-old man presented with transient motor weakness of the left hand. Cerebral angiography showed 90% stenosis at the origin of the right internal carotid artery. Carotid artery stenting (CAS) was performed 3 weeks later, and a large intraluminal thrombus was found during the procedure. The blood around the thrombus was aspirated using an aspiration catheter under distal protection with a filter wire protection device, and CAS was successfully performed without complications. Although this patient was treated by CAS without complications, carotid stenosis associated with intraluminal thrombus-because it has a high risk of distal embolism-should be carefully diagnosed immediately before CAS. © 2009 Japan Radiological Society.

DOI： 10.1007/s11604-009-0348-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society for Lymphoreticular Tissue Research  

The assessment of residual tumors after treatment of malignant lymphoma (ML) is often difficult. Here we report a case of non-Hodgkin's lymphoma with a huge sacral tumor. After chemotherapy and following radiation therapy, a residual mass was detected on magnetic resonance imaging (MRI). However, a hypermetabolic lesion in the sacrum disappeared on <SUP>18</SUP>F-fluorodeoxyglucose positron emission tomography (<SUP>18</SUP>F-FDG-PET) and clinically the patient was considered to achieve complete remission. Seven months after the completion of radiation therapy, a new tumor-like lesion in the sacrum developed on MRI, but hypermetabolic lesions were not detected on <SUP>18</SUP>F-FDG-PET. Recurrence of lymphoma was denied by open biopsy of the lesion. <SUP>18</SUP>F-FDG-PET has been of widespread use not only for staging but for post-treatment assessment of ML. Although MRI is a standard imaging tool for the assessment of bone involvement of ML, there have been few reports documenting the results of comparative studies on the usefulness of <SUP>18</SUP>F-FDG-PET and MRI for the evaluation of residual mass in bone involvement of ML. The present case suggests that <SUP>18</SUP>F-FDG-PET is superior to MRI not only in the evaluation of a residual mass but in the judgment of recurrence after treatment of such patients. [<I>J Clin Exp Hematopathol 49(2) : 109-115, 2009</I>]

DOI： 10.3960/jslrt.49.109

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CiNii Books

その他リンク： http://search.jamas.or.jp/link/ui/2010112585

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Computer Assisted Tomography  

Our purpose was to produce a prototype of a foot-controlled image-scrolling device that will prevent work-related upper extremity complaints by radiologists. After foot-controlled image-scrolling devices were added to a picture archiving and communication system, 15 (83%) of 18 radiologists indicated that fatigue and pain in their upper extremities were diminished. Upon further production and implementation of this image-scrolling device in radiology clinics, the new interface may help to prevent work-related injuries in radiologists. Copyright © 2009 by Lippincott Williams & Wilkins.

DOI： 10.1097/RCT.0b013e31819d98da

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(NPO)日本脳神経血管内治療学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: Tract-based analysis can be used to investigate required tracts extracted from other fiber tracts. However, the fractional anisotropy (FA) threshold influences tractography analysis. The current study evaluated the influence of the FA threshold in measuring diffusion tensor parameters for tract-based analysis of the uncinate fasciculus in subjects with Alzheimer disease (AD). MATERIALS AND METHODS: Subjects included 30 patients with AD and 10 healthy controls. We acquired tractographies of the uncinate fasciculus by using different FA thresholds. We measured mean FA and the apparent diffusion coefficient (ADC) along the uncinate fasciculus for different FA thresholds and evaluated the correlation between diffusion tensor parameters (FA, ADC) and the Mini-Mental State Examination (MMSE) scores. RESULTS: The uncinate fasciculus showed lower mean FA and higher mean ADC values in cases with more severe AD. A higher FA threshold led to a lower mean ADC value and a higher mean FA value along the uncinate fasciculus, whereas the relative order of measured values according to the severity of AD was not influenced by the FA threshold. An FA threshold of 0.2 showed higher correlation between mean ADC values and MMSE scores. FA thresholds of 0.15 and 0.20 showed higher correlation between mean FA values and MMSE scores. CONCLUSIONS: Appropriate selection of the FA threshold leads to higher correlation between diffusion tensor parameters and the severity of AD. For tract-based analysis of degenerative diseases such as AD, appropriate selection of the FA threshold for tractography is important.

DOI： 10.3174/ajnr.A1698

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Brain Research  

Mild cognitive impairment (MCI) is considered the transitional stage between normal cognition and dementia. The aim of this study was to use tractography based analysis to elucidate alterations in subjects with MCI compared with subjects with early Alzheimer's disease (AD) and controls. Seventeen subjects with early AD, 16 with MCI and 16 controls underwent magnetic resonance diffusion tensor imaging (DTI) and neuropsychological assessment. Diffusion tensor tractographies were computed and fiber-tract maps were generated using "dTV II" DTI software. We measured mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values along the uncinate fasciculus (UNC), posterior cingulate fasciculus (PCF) and corticospinal tract (CST). There were statistically significant differences in the FA and ADC values of the UNC and PCF between subjects with early AD and controls. Subjects with MCI exhibited significantly lower FA values on both sides of the PCF relative to controls. However, there were no significant differences between subjects with early AD and MCI for any measurement. Our results suggest that alterations in the PCF precede the onset of dementia. © 2009 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.brainres.2009.06.052

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Neuroimaging  

OBJECTIVE Contrast-enhanced magnetic resonance imaging (MRI) with fluid-attenuated inversion recovery (contrast FLAIR) is particularly useful for the detection of meningeal lesions. However, whether contrast FLAIR is useful in multiple sclerosis (MS) remains uncertain. This study evaluated the usefulness of contrast FLAIR in MS. PATIENTS AND METHODS We prospectively studied the clinical histories and brain MRI studies of 6 patients with clinically definite MS diagnosed according to the new McDonald criteria. Contrast FLAIR (repetition time [TR] 9,000 ms; echo time [TE] 120 ms; inversion time [TI] 2,200 ms; 5-mm slice thickness, with a 1-mm interslice gap) was obtained with the use of a bolus of gadolinium diethylenetriamine pentaacetic acid. RESULTS Three enhancing plaques located in the periventricular or juxtacortical areas showed higher intensity on contrast FLAIR than on other MR sequences. In contrast, 8 enhancing plaques in the deep white matter or infratentorial areas showed no increased signals on contrast FLAIR. CONCLUSION Our findings suggest that early contrast-enhanced imaging with FLAIR may be helpful for the further detection of MS plaques, particularly those located in periventricular and juxtacortical lesions. J Neuroimaging 2009;19:246-249. © 2008 by the American Society of Neuroimaging.

DOI： 10.1111/j.1552-6569.2008.00315.x

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Society for Equilibrium Research  

CT and MRI are indispensable for routine medical examination of neurovascular disorders. This article describes the imaging findings in acute infarction and carotid plaques, knowledge of which is essential for clinics of equilibrium disorders. Diffusion-weighted images are indispensable for detecting acute infarction, and perfusion MRI also yields important information about the ischemic status. Carotid bifurcation is one of the frequent sites of involvement in atheromatous diseases. A variety of imaging modalities are available for the evaluation of carotid plaques, including conventional contrast angiography, CT, ultrasound, and MRI. MRI is a non-invasive imaging method that reflects the chemical composition, concentration, water content or physical status of the tissues examined.

DOI： 10.3757/jser.68.113

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その他リンク： http://search.jamas.or.jp/link/ui/2009271709

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Movement Disorders  

DOI： 10.1002/mds.22167

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Thieme Publishing Group  

DOI： 10.1055/s-2009-1222351

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction: The purpose of this study was to assess the usefulness of signs ("Sukeroku sign" and "dent internal-capsule sign") for the recognition of subthalamic nucleus (STN). Materials and methods: Five Parkinson's disease cases in which there was a successful placement of deep brain stimulation (DBS) electrodes at the STN were retrospectively reviewed. Five radiologists who were not engaged in localization of STNs in clinical practice were asked to locate the STNs before and after instructions on the signs. We evaluated the deviation between the reader-located points and the location of the DBS electrode for which there had been a successful installation. Results: After instruction, there was a significant reduction in the deviation between the reader-located points and the DBS electrode. The time required for localization was also reduced after the instructions. Conclusion: Sukeroku sign and dent internal-capsule sign are feasible indicators of STN and seem to be useful in helping to identify the STN. © 2008 Springer-Verlag.

DOI： 10.1007/s00234-008-0451-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Internal Medicine  

We report a patient who had cerebral infarction associated with heparin-induced thrombocytopenia (HIT) during treatment of aseptic encephalitis. In patients with intracranial inflammation, such as ours, the possibility of HIT has to be considered when heparin is used, since inflammatory cerebral lesions often cause vascular damage, which is an aggravating factor for HIT-associated thrombosis. © 2009 The Japanese Society of Internal Medicine.

DOI： 10.2169/internalmedicine.48.1486

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本めまい平衡医学会  

シリーズ教育講座「画像検査で脳を探る」2. CT・MRI 文献1) を訂正します。

DOI： 10.3757/jser.68.183

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society for Lymphoreticular Tissue Research  

The assessment of residual tumors after treatment of malignant lymphoma (ML) is often difficult. Here we report a case of non-Hodgkin's lymphoma with a huge sacral tumor. After chemotherapy and following radiation therapy, a residual mass was detected on magnetic resonance imaging (MRI). However, a hypermetabolic lesion in the sacrum disappeared on <SUP>18</SUP>F-fluorodeoxyglucose positron emission tomography (<SUP>18</SUP>F-FDG-PET) and clinically the patient was considered to achieve complete remission. Seven months after the completion of radiation therapy, a new tumor-like lesion in the sacrum developed on MRI, but hypermetabolic lesions were not detected on <SUP>18</SUP>F-FDG-PET. Recurrence of lymphoma was denied by open biopsy of the lesion. <SUP>18</SUP>F-FDG-PET has been of widespread use not only for staging but for post-treatment assessment of ML. Although MRI is a standard imaging tool for the assessment of bone involvement of ML, there have been few reports documenting the results of comparative studies on the usefulness of <SUP>18</SUP>F-FDG-PET and MRI for the evaluation of residual mass in bone involvement of ML. The present case suggests that <SUP>18</SUP>F-FDG-PET is superior to MRI not only in the evaluation of a residual mass but in the judgment of recurrence after treatment of such patients. [<I>J Clin Exp Hematopathol 49(2) : 109-115, 2009</I>]

DOI： 10.3960/jslrt.49.109

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Magnetic Resonance Imaging  

Purpose: This study discusses prominent signal intensity of T1/T2 prolongation of subcortical white matter within the anterior temporal region in premature infant brains that radiologists may encounter when interpreting conventional screening MRIs. Materials and Methods: T1- and T2-weighted images of 69 preterm and term infants with no neurological abnormalities or developmental delays were evaluated retrospectively for areas of prominent signal intensity of T1/T2 prolongation in white matter. We measured signal intensities of anterior temporal white matter, deep temporal white matter, frontopolar white matter and subcortical white matter of the precentral gyrus. We accessed chronological changes in signal intensity in the anterior and deep temporal white matter. We also analyzed variance tests among the signal intensity ratios to the ipsilateral thalamus of white matter areas by gestational age. Results: There was high frequency of prominent signal intensity of T1/T2 prolongation in the temporal tip, particularly at a gestational age of 36-38 weeks. Signal intensity ratio of the anterior temporal white matter was lower on T1-weighted images and higher on T2-weighted images, and the finding became less prominent with increasing gestational age. The signal intensity ratios of anterior temporal white matter at a gestational age of 36-37 weeks and 38-39 weeks were significantly different from other regions. Conclusion: Prominent signal intensity of T1/T2 prolongation of subcortical white matter of the anterior temporal region is seen in normal premature infants, especially those at 36-39 gestational weeks. Although it is a prominent finding, radiologists should understand that these findings do not represent a pathological condition. © 2008 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.mri.2008.04.014

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiation Medicine - Medical Imaging and Radiation Oncology  

DOI： 10.1007/s11604-008-0283-2

Scopus

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s11604-008-0283-2

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s11604-008-0283-2

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s11604-008-0283-2

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Neuroradiology  

Introduction: We attempted to determine the most appropriate combination of magnetic resonance (MR) images that can accurately detect and discriminate between asymptomatic infarction and deep white matter hyperintensity (DWMH); these lesions have different clinical implications and are occasionally confused. Materials and methods: We performed an observer performance analysis using cerebral MR images of 45 individuals with or without asymptomatic small white matter infarction and/or mild DWMH who participated in a physical checkup program at four institutions. Six observers interpreted whether infarction and/or DWMH existed in combinations of two or three image types of the T1-weighted images (T1WI), T2-weighted images (T2WI), and fluid-attenuated inversion recovery (FLAIR) images. The observers' performance was evaluated with a receiver operating characteristic (ROC) analysis. Results: The averaged area under the ROC curve (Az) for detecting a infarction was significantly larger in the combination of all the three image types (0.95) than that in any combinations of the two image types (T1WI and FLAIR images, 0.87; T2WI and FLAIR images, 0.85; T1WI and T2WI, 0.86). The Az for detecting DWMH was significantly smaller in the combination of T1WI and T2WI (0.79) than that in other image combinations (T1WI and FLAIR, 0.89; T2WI and FLAIR, 0.91; T1WI, T2WI, and FLAIR, 0.90). Conclusion: The combination of T1WI, T2WI, and FLAIR images is required to accurately detect both small white matter infarction and mild DWMH. © 2008 Springer-Verlag.

DOI： 10.1007/s00234-008-0406-6

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Neuroradiology  

BACKGROUND AND PURPOSE: Visual field defects sometimes occur after temporal resection surgery. Our purpose was to evaluate the correlation between visual field defects caused by temporal lobe resection and the degree of resection of the Meyer loop, as assessed by diffusion tensor tractography. MATERIALS AND METHODS: We examined 14 patients who underwent temporal resection for temporal lobe epilepsy. We obtained presurgical tractographies and then measured the distance between the temporal tip and the anterior limit of the Meyer loop (T-M distance). The degree of resection of the Meyer loop was defined as the distance from the anterior limit of the Meyer loop to the posterior limit of the temporal lobe resection (M-R distance). This was calculated by subtracting the T-M distance from the measured distance between the temporal tip and the posterior limit of the resection (T-R distance). RESULTS: The mean T-M distance was 36.6 mm. The interindividual variation of the distance ranged from 30.0 to 43.2 mm. Although there was no statistically significant correlation between the extent of the visual field defect and the T-R distance, there was a statistically significant correlation between the degree of the visual field defect and the M-R distance. CONCLUSION: The range of interindividual variation for the position of the Meyer loop was rather large, indicating that this variation is the key factor in visual field defects after temporal lobectomy, and the visual field defect appears to be predicted by presurgical tractography. Evaluation of the Meyer loop through the use of tractography seems to be a feasible method, which can be used to predict the visual field defect after temporal lobe resection.

DOI： 10.3174/ajnr.A1101

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiation Medicine - Medical Imaging and Radiation Oncology  

Purpose. No filter protection devices for carotid artery stenting (CAS) have been formally approved for use in Japan; however, as of April 2008, the Angioguard XP (AGXP) was approved. This article describes our initial results using the AGXP during CAS for the treatment of carotid artery stenosis. Material and methods. A group of 15 patients (14 men) with a mean age of 72.3 years (range 53-81 years) were treated by CAS using the AGXP. Among them, 10 were symptomatic with >50% stenosis of the common or internal carotid artery (ICA), and 5 were asymptomatic with >70% stenosis. The rates of technical success, periprocedural stroke, ICA flow impairment, filter movement, and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed. Results. CAS using the AGXP was successful in all cases. There was one minor stroke, and flow impairment occurred in six patients. Filter movement averaged 1.9 vertebral bodies. DWI showed new ipsilateral ischemic lesions in eight of the patients. Conclusion. Initial clinical experience using the AGXP for CAS has been generally sufficient. However, attention must be paid to three problems when using the AGXP: the filter may move after placement; the filter may disturb blood flow in the ICA; and debris may pass around the filter. © 2008 Japan Radiological Society.

DOI： 10.1007/s11604-008-0239-6

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Radiation Medicine - Medical Imaging and Radiation Oncology  

The cerebrovascular complications of Takayasu arteritis are primarily related to the presence of occlusive lesions. Cerebral aneurysms rarely occur as complications; only 18 cases have been reported thus far. The use of coil embolization to treat cerebral aneurysms occurring as a complication of Takayasu arteritis has not been previously reported. We report a case of Takayasu arteritis with a basilar tip aneurysm and a P1 segment aneurysm of the left posterior cerebral artery that were successfully treated with coil embolization. Because coil embolization for cerebral aneurysms associated with Takayasu arteritis requires the use of limited access routes that have extremely curved and tortuous courses, catheter navigation was difficult. The guide catheter, microcatheter, and guidewire must be selected and navigated with greater care than is usually required for common aneurysm embolization. © 2008 Japan Radiological Society.

DOI： 10.1007/s11604-007-0184-9

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