研究者詳細 - 田岡　俊昭

Effect of Cilostazol in Preventing Restenosis after Carotid Artery Stenting Using the Carotid Wallstent: A Multicenter Retrospective Study Open Access

Takayama, K; Taoka, T; Nakagawa, H; Myouchin, K; Wada, T; Sakamoto, M; Furuichi, K; Iwasaki, S; Kurokawa, S; Kichikawa, K

AMERICAN JOURNAL OF NEURORADIOLOGY 33 巻 ( 11 ) 頁： 2167 - 2170 2012年12月

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

Visualizing non-Gaussian diffusion: Clinical application of q-space imaging and diffusional kurtosis imaging of the brain and spine Open Access

Hori M., Fukunaga I., Masutani Y., Taoka T., Kamagata K., Suzuki Y., Aoki S.

Magnetic Resonance in Medical Sciences 11 巻 ( 4 ) 頁： 221 - 233 2012年12月

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

Open Access

Application of susceptibility weighted imaging (SWI) for evaluation of draining veins of arteriovenous malformation: utility of magnitude images.

Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia. Open Access

Nagashima T, Inoue M, Kitamura S, Kiuchi K, Kosaka J, Okada K, Kishimoto N, Taoka T, Kichikawa K, Kishimoto T

BMC psychiatry 12 巻 ( 1 ) 頁： 210 2012年11月

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

Miyasaka T, Taoka T, Nakagawa H, Wada T, Takayama K, Myochin K, Sakamoto M, Ochi T, Akashi T, Kichikawa K

Neuroradiology 54 巻 ( 11 ) 頁： 1221 - 7 2012年11月

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

頭蓋内静脈逆流を伴う硬膜動静脈瘻におけるSusceptibility-Weighted Imagingの有用性治療前後での頭蓋内静脈逆流と静脈うっ血の評価

中川一郎, 和田敬, 中川裕之, 西村文彦, 弘中康雄, 本山靖, 朴永銖, 田岡俊昭, 吉川公彦, 中瀬裕之

JNET: Journal of Neuroendovascular Therapy 6 巻 ( 5 ) 頁： 233 - 233 2012年11月

Investigation of donepezil effect to the prevention of hippocamal volume loss in alzheimer's disease 査読有り

Kitamura, S; Kiuchi, K; Taoka, T; Morikawa, M; Inoue, M; Kosaka, J; Hashimoto, K; Nagashima, T; Matsuoka, K; Kichikawa, K; Kishimoto, T

INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY 15 巻頁： 172 - 173 2012年6月

Branching pattern of lenticulostriate arteries observed by MR angiography at 3.0 T.

Akashi T, Taoka T, Ochi T, Miyasaka T, Wada T, Sakamoto M, Takewa M, Kichikawa K

Japanese journal of radiology 30 巻 ( 4 ) 頁： 331 - 5 2012年5月

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

Diffuse vascular injury: convergent-type hemorrhage in the supratentorial white matter on susceptibility-weighted image in cases of severe traumatic brain damage.

Iwamura A, Taoka T, Fukusumi A, Sakamoto M, Miyasaka T, Ochi T, Akashi T, Okuchi K, Kichikawa K

Neuroradiology 54 巻 ( 4 ) 頁： 335 - 43 2012年4月

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

Comparison of computed tomography myelography and radioisotope cisternography to detect cerebrospinal fluid leakage in spontaneous intracranial hypotension.

Hashizume K, Watanabe K, Kawaguchi M, Taoka T, Shinkai T, Furuya H

Spine 37 巻 ( 4 ) 頁： E237 - 42 2012年2月

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