2021/07/08 更新

写真a

タケハラ ヤスオ
竹原 康雄
TAKEHARA Yasuo
所属
大学院医学系研究科 新規低侵襲画像診断法基盤開発研究寄附講座 特任教授
職名
特任教授

学位 1

  1. 博士(医学) ( 1994年12月   浜松医科大学 ) 

研究キーワード 6

  1. 造影剤

  2. 血流解析

  3. 胆膵疾患

  4. 磁気共鳴医学

  5. 画像診断

  6. Diagnostic Imaging

研究分野 1

  1. ライフサイエンス / 放射線科学

経歴 13

  1. 名古屋大学大学院医学系研究科新規低侵襲画像診断法基盤開発研究寄附講座教授

    2016年10月 - 現在

  2. 浜松医科大学医学部附属病院病院教授

    2011年1月

  3. 浜松医科大学附属病院放射線部助教授

    2001年10月

  4. - Associate professor and Vice-chairman of Radiology, Hamamatsu University Hospital

    2001年

  5. 浜松医科大学附属病院放射線科講師

    1995年7月

  6. 聖隷三方原病院放射線科医長、診療科長

    1991年4月

  7. 浜松医科大学

    1989年10月

  8. 米国カリフォルニア大学サンフランシスコ校 (UCSF)

    1988年7月

  9. Department of Radiology, MRI division, 客員研究員(国際ロータリー財団奨学金)

    1988年7月

  10. 社会福祉法人聖隷三方原病院放射線科 医員

    1987年4月

  11. 同 助手

    1986年7月

  12. 浜松医科大学附属病院放射線科医員

    1986年5月

  13. 浜松医科大学附属病院放射線科医員(研修医)

    1984年5月

▼全件表示

所属学協会 12

  1. 日本脈管学会

  2. 日本胆道学会

  3. 日本磁気共鳴医学会

  4. 日本消化器病学会

  5. 日本核医学会

  6. 日本医学放射線学会

  7. 国際磁気共鳴医学会日本支部

  8. 日本腹部放射線学会

  9. Radiological Society of North America

  10. International Society for Magnetic Resonance in Medicine

  11. 日本血管造形・インターベンショナルラジオロジー学会

  12. 日本膵臓学会

▼全件表示

委員歴 12

  1. 4D Flow研究会   会長  

    2019年 - 現在   

  2. 国際磁気共鳴医学会日本支部支部長   ISMRM Japanese Chapter Chairperson  

    2018年 - 2019年   

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    団体区分:学協会

  3. 日本医学放射線学会   造影剤安全性委員会委員  

    2016年3月   

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    団体区分:学協会

  4. 日本消化器画像診断研究会   世話人  

    2016年 - 現在   

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    団体区分:学協会

  5. Advanced Medical Imaging研究会(SAMI)   世話人  

    2016年 - 現在   

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    団体区分:学協会

  6. European Congress of Radiology, 学会誌European Radiology編集委員(欧州連合)  

    2002年   

  7. Editor of “Japanese Journal of Radiology” (official Journal of Japanese Radiological Society)  

  8. 日本磁気共鳴医学会   理事 学会誌Magnetic Resonance in Medical Sciences編集委員  

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    団体区分:学協会

  9. 日本腹部放射線学会   理事  

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    団体区分:学協会

  10. 日本放射線科医会・専門医会 理事  

  11. 日本医学放射線学会 代議員  

  12. 日本医学放射線学会   学会誌Japanese Journal of Radiology編集委員  

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    団体区分:学協会

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論文 27

  1. Time-resolved 3D cine phase-contrast magnetic resonance imaging (4D-flow MRI) can quantitatively assess portosystemic shunt severity and confirm normalization of portal flow after embolization of large portosystemic shunts

    Hyodo Ryota, Takehara Yasuo, Mizuno Takashi, Ichikawa Kazushige, Ishizu Yoji, Sugiyama Masataka, Naganawa Shinji

    HEPATOLOGY RESEARCH   51 巻 ( 3 ) 頁: 343 - 349   2021年3月

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    記述言語:日本語  

    DOI: 10.1111/hepr.13616

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  2. Daikenchuto increases blood flow in the superior mesenteric artery in humans: A comparison study between four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction magnetic resonance imaging and Doppler ultrasound.

    Suzuki K, Takehara Y, Sakata M, Kawate M, Ohishi N, Sugiyama K, Akai T, Suzuki Y, Sugiyama M, Kawamura T, Morita Y, Kikuchi H, Hiramatsu Y, Yamamoto M, Nasu H, Johnson K, Wieben O, Kurachi K, Takeuchi H

    PloS one   16 巻 ( 1 ) 頁: e0245878   2021年

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    記述言語:英語   出版者・発行元:PLoS ONE  

    Respiratory-gated four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction (4D PC-VIPR) is magnetic resonance (MR) imaging technique that enables analysis of vascular morphology and hemodynamics in a single examination using cardiac phase resolved 3D phase-contrast magnetic resonance imaging. The present study aimed to assess the usefulness of 4D PC-VIPR for the superior mesenteric artery (SMA) flowmetry before and after flow increase was induced by the herbal medicine Daikenchuto (TJ-100) by comparing it with Doppler ultrasound (DUS) as a current standard. Twenty healthy volunteers were enrolled in this prospective single-arm study. The peak cross-sectionally averaged velocity was measured by 4D PC-VIPR, peak velocity was measured by DUS, and flow volume (FV) of SMA and aorta were measured by 4D PC-VIPR and DUS 25 min before and after the peroral administration of TJ-100. The peak cross-sectionally averaged velocity, peak velocity, and FV of SMA measured by 4D PC-VIPR and DUS significantly increased after administration of TJ-100 (4D PC-VIPR: the peak cross-sectionally averaged velocity; p = 0.004, FV; p = 0.035, DUS: the peak velocity; p = 0.003, FV; p = 0.010). Furthermore, 4D PC-VIPR can analyze multiple blood vessels simultaneously. The ratio of the SMA FV to the aorta, before and after oral administration on the 4D PC-VIPR test also increased (p = 0.015). The rate of change assessed by 4D PC-VIPR and DUS were significantly correlated (the peak cross-sectionally averaged velocity and peak velocity: r = 0.650; p = 0.005, FV: r = 0.659; p = 0.004). Retrospective 4D PC-VIPR was a useful modality for morphological and hemodynamic analysis of SMA.

    DOI: 10.1371/journal.pone.0245878

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  3. Three Dimensional Ultra-short Echo Time MRI Can Depict Cholesterol Components of Gallstones Bright.

    Takahashi M, Takehara Y, Fujisaki K, Okuaki T, Fukuma Y, Tooyama N, Ichijo K, Amano T, Goshima S, Naganawa S

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine     2020年12月

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    <p>Purpose: Non-calcified cholesterol stones that are small in size are hard to be depicted on CT or magnetic resonance cholangiopancreatography. This institutional review board (IRB)-approved retrospective <i>in vitro</i> study aims to characterize contrast behaviors of 3 main components of the gallstones, i.e., cholesterol component (CC), bilirubin calcium component (BC) and CaCO<sub>3</sub> (CO) on 3D radial scan with ultrashort TE (UTE) MRI, and to test the capability of depicting CC of gallstones as bright signals as compared to background saline.</p><p>Methods: Fourteen representative gallstones from 14 patients, including 15 CC, 6 BC and 4 CO, were enrolled. The gallstones underwent MRI including fat-saturated T1-weighted image (fs-T1WI) and UTE MRI with dual echoes. The contrast-to-noise ratio (CNR) and the chemical analysis for the 25 portions of the stones were compared.</p><p>Results: BC was bright on fs-T1WI, which did not change dramatically on UTE MRI and the signal did not remain on UTE subtraction image between dual echoes. Whereas the CC was negative or faintly positive signal on fs-T1WI, bright signal on UTE MRI and the contrast remained even higher on the UTE subtraction, which reflected their short T2 values. Median CNRs and standard errors of the segments on each imaging were as follows: on fs-T1WI, −10.2 ± 4.2 for CC, 149.7 ± 27.6 for BC and 37.9 ± 14.3 for CO; on UTE MRI first echo, 16.7 ± 3.3 for CC, 74.9 ± 21.3 for BC and 17.7 ± 8.4 for CO; on UTE subtraction image, 30.2 ±2.0 for CC, −11.2 ± 5.4 for BC and 17.8 ± 10.7 for CO. Linear correlations between CNRs and cholesterol concentrations were observed on fs-T1WI with r = −0.885, (P < 0.0001), UTE MRI first echo r = −0.524 (<i>P</i> = 0.0072) and UTE subtraction with r = 0.598 (<i>P</i> = 0.0016).</p><p>Conclusion: UTE MRI and UTE subtraction can depict CC bright.</p>

    DOI: 10.2463/mrms.mp.2020-0009

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  4. Assessing the Risk of Intracranial Aneurysm Rupture Using Morphological and Hemodynamic Biomarkers Evaluated from Magnetic Resonance Fluid Dynamics and Computational Fluid Dynamics. 査読有り

    Perera R, Isoda H, Ishiguro K, Mizuno T, Takehara Y, Terada M, Tanoi C, Naito T, Sakahara H, Hiramatsu H, Namba H, Izumi T, Wakabayashi T, Kosugi T, Onishi Y, Alley M, Komori Y, Ikeda M, Naganawa S

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   19 巻 ( 4 ) 頁: 333 - 344   2020年12月

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    <p>Purpose: Evaluate <i>in vivo</i> hemodynamic and morphological biomarkers of intracranial aneurysms, using magnetic resonance fluid dynamics (MRFD) and MR-based patient specific computational fluid dynamics (CFD) in order to assess the risk of rupture.</p><p>Methods: Forty-eight intracranial aneurysms (10 ruptured, 38 unruptured) were scrutinized for six morphological and 10 hemodynamic biomarkers. Morphological biomarkers were calculated based on 3D time-of-flight magnetic resonance angiography (3D TOF MRA) in MRFD analysis. Hemodynamic biomarkers were assessed using both MRFD and CFD analyses. MRFD was performed using 3D TOF MRA and 3D cine phase-contrast magnetic resonance imaging (3D cine PC MRI). CFD was performed utilizing patient specific inflow–outflow boundary conditions derived from 3D cine PC MRI. Univariate analysis was carried out to identify statistically significant biomarkers for aneurysm rupture and receiver operating characteristic (ROC) analysis was performed for the significant biomarkers. Binary logistic regression was performed to identify independent predictive biomarkers.</p><p>Results: Morphological biomarker analysis revealed that aneurysm size [<i>P</i> = 0.021], volume [<i>P</i> = 0.035] and size ratio [<i>P</i> = 0.039] were statistically significantly different between the two groups. In hemodynamic biomarker analysis, MRFD results indicated that ruptured aneurysms had higher oscillatory shear index (OSI) [OSI.max, <i>P</i> = 0.037] and higher relative residence time (RRT) [RRT.ave, <i>P</i> = 0.035] compared with unruptured aneurysms. Correspondingly CFD analysis demonstrated significant differences for both average and maximum OSI [OSI.ave, <i>P</i> = 0.008; OSI.max, <i>P</i> = 0.01] and maximum RRT [RRT.max, <i>P</i> = 0.045]. ROC analysis revealed AUC values greater than 0.7 for all significant biomarkers. Aneurysm volume [AUC, 0.718; 95% CI, 0.491–0.946] and average OSI obtained from CFD [AUC, 0.774; 95% CI, 0.586–0.961] were retained in the respective logistic regression models.</p><p>Conclusion: Both morphological and hemodynamic biomarkers have significant influence on intracranial aneurysm rupture. Aneurysm size, volume, size ratio, OSI and RRT could be potential biomarkers to assess aneurysm rupture risk.</p>

    DOI: 10.2463/mrms.mp.2019-0107

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  5. Optimal Plane Selection for Measuring Post-prandial Blood Flow Increase within the Superior Mesenteric Artery: Analysis Using 4D Flow and Computational Fluid Dynamics. 査読有り

    Sugiyama M, Takehara Y, Kawate M, Ooishi N, Terada M, Isoda H, Sakahara H, Naganawa S, Johnson KM, Wieben O, Wakayama T, Nozaki A, Kabasawa H

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   19 巻 ( 4 ) 頁: 366 - 374   2020年12月

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    <p>Purpose: 2D cine phase contrast (PC)-MRI is a standard velocimetry for the superior mesenteric artery (SMA); however, the optimal localization of the measurement plane has never been fully discussed previously. The purpose of this Institutional Review Board approved prospective and single arm study is to test whether flow velocimetry of the SMA with combined use of 2D cine PC-MRI and meal challenge is dependent on the localizations of the measurement planes and to seek optimal section for velocimetry.</p><p>Methods: Seven healthy volunteers underwent cardiac phase resolved ECG gated 2D cine PC-MRI pre- and 30 min post-meal challenge at three measurement planes: proximal, curved mid section and distal straight section of the SMA at 3T. 4D Flow using 3D cine PC-MRI with vastly undersampled isotropic projection imaging (PC VIPR) was also performed right after 2D cine PC-MRI to delineate the flow dynamics within the SMA using streamline analysis. Two radiologists measured flow velocities, and rated the appearances of the abnormal flow in the SMA on streamlines derived from the 4D Flow and the computational fluid dynamics (CFD).</p><p>Results: 2D cine PC-MRI measured increased temporally averaged flow velocity (mm/s) after the meal challenge only in the proximal (129.3 vs. 97.8, <i>P</i> = 0.0313) and distal section (166.9 vs. 96.2, <i>P</i> = 0.0313), not in the curved mid section (113.1 vs. 85.5, <i>P</i> = 0.0625). The average velocities were highest and their standard errors (8.5–26.5) were smallest at the distal straight section both before and after the meal challenge as compared with other sections. The streamline analysis depicted more frequent appearances of vertical or helical flow in the curved mid section both on 4D Flow and CFD (<i>κ</i>: 0.27–0.68).</p><p>Conclusion: SMA velocimetry with 2D cine PC-MRI was dependent on the localization of the measurement planes. Distal straight section, not in the curved mid section is recommended for MR velocimetry.</p>

    DOI: 10.2463/mrms.mp.2019-0089

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  6. Consensus-Based Technical Recommendations for Clinical Translation of Renal Phase Contrast MRI.

    de Boer A, Villa G, Bane O, Bock M, Cox EF, Dekkers IA, Eckerbom P, Fernández-Seara MA, Francis ST, Haddock B, Hall ME, Hall Barrientos P, Hermann I, Hockings PD, Lamb HJ, Laustsen C, Lim RP, Morris DM, Ringgaard S, Serai SD, Sharma K, Sourbron S, Takehara Y, Wentland AL, Wolf M, Zöllner FG, Nery F, Caroli A

    Journal of magnetic resonance imaging : JMRI     2020年11月

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    記述言語:英語   出版者・発行元:Journal of Magnetic Resonance Imaging  

    Background: Phase-contrast (PC) MRI is a feasible and valid noninvasive technique to measure renal artery blood flow, showing potential to support diagnosis and monitoring of renal diseases. However, the variability in measured renal blood flow values across studies is large, most likely due to differences in PC-MRI acquisition and processing. Standardized acquisition and processing protocols are therefore needed to minimize this variability and maximize the potential of renal PC-MRI as a clinically useful tool. Purpose: To build technical recommendations for the acquisition, processing, and analysis of renal 2D PC-MRI data in human subjects to promote standardization of renal blood flow measurements and facilitate the comparability of results across scanners and in multicenter clinical studies. Study Type: Systematic consensus process using a modified Delphi method. Population: Not applicable. Sequence Field/Strength: Renal fast gradient echo-based 2D PC-MRI. Assessment: An international panel of 27 experts from Europe, the USA, Australia, and Japan with 6 (interquartile range 4–10) years of experience in 2D PC-MRI formulated consensus statements on renal 2D PC-MRI in two rounds of surveys. Starting from a recently published systematic review article, literature-based and data-driven statements regarding patient preparation, hardware, acquisition protocol, analysis steps, and data reporting were formulated. Statistical Tests: Consensus was defined as ≥75% unanimity in response, and a clear preference was defined as 60–74% agreement among the experts. Results: Among 60 statements, 57 (95%) achieved consensus after the second-round survey, while the remaining three showed a clear preference. Consensus statements resulted in specific recommendations for subject preparation, 2D renal PC-MRI data acquisition, processing, and reporting. Data Conclusion: These recommendations might promote a widespread adoption of renal PC-MRI, and may help foster the set-up of multicenter studies aimed at defining reference values and building larger and more definitive evidence, and will facilitate clinical translation of PC-MRI. Level of Evidence: 1. Technical Efficacy Stage: 1.

    DOI: 10.1002/jmri.27419

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  7. 4D Flow when and how?

    Takehara Y

    La Radiologia medica   125 巻 ( 9 ) 頁: 838 - 850   2020年9月

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    記述言語:英語   出版者・発行元:Radiologia Medica  

    4D Flow is an emerging MR technique enabling three-dimensional and cardiac phase-resolved flowmetry with ECG-gated phase-contrast MRI that increased the speed of data acquisitions, accuracy and robustness. The method is promoting researches in areas that have not been fully addressed before in the cardiovascular system, such as flowmetry of the bloodstream across the valves, within the heart chambers, complexed flow dynamics such as vortex, helical or retrograde. Wall shear stress and other potential biomarkers derived from 4D Flow are known to be related to vascular wall diseases such as atherosclerosis. In this review, fundamental concepts of 4D Flow technique and post-processing, benefits and limitations as well as its clinical applications are discussed, and the importance of quality control and validation of the method is emphasized. New ideas inspired by 4D Flow can help clinicians and MR scientists further understand the role of flow dynamics in health sciences, diseases and various aspects of cardiovascular physiology.

    DOI: 10.1007/s11547-020-01249-0

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  8. Portal Vein Stenosis Following Liver Transplantation Hemodynamically Assessed with 4D-flow MRI before and after Portal Vein Stenting.

    Hyodo R, Takehara Y, Mizuno T, Ichikawa K, Ogura Y, Naganawa S

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine     2020年8月

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    <p>We present a case of a patient who underwent portal vein (PV) stenting for PV stenosis after a living-donor liver transplantation. A pretreatment 3D cine phase-contrast (4D-flow) MRI showed decreased, though hepatopetal, blood flow in the PV. After stenting, 4D-flow MRI confirmed an improvement in PV flow, with a more homogeneous flow distribution to each hepatic segment. 4D-flow MRI are valuable for understanding the hemodynamics of this area, planning for treatments, and evaluating the outcome of the interventions.</p>

    DOI: 10.2463/mrms.ici.2020-0057

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  9. Abnormal Flow Dynamics Result in Low Wall Shear Stress and High Oscillatory Shear Index in Abdominal Aortic Dilatation: Initial in vivo Assessment with 4D-flow MRI. 査読有り

    Takehara Y, Isoda H, Takahashi M, Unno N, Shiiya N, Ushio T, Goshima S, Naganawa S, Alley M, Wakayama T, Nozaki A

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   19 巻 ( 3 ) 頁: 235 - 246   2020年8月

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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  

    <p>Purpose: To characterize the non-laminar flow dynamics and resultant decreased wall shear stress (WSS) and high oscillatory shear index (OSI) of the infrarenal abdominal aortic dilatation, cardiac phase-resolved 3D phase-contrast MRI (4D-flow MRI) was performed.</p><p>Methods: The prospective single-arm study was approved by the Institutional Review Board and included 18 subjects (median 67.5 years) with the dilated infrarenal aorta (median diameter 35 mm). 4D-flow MRI was conducted on a 1.5T MRI system. On 3D streamline images, laminar and non-laminar (i.e., vortex or helical) flow patterns were visually assessed both for the dilated aorta and for the undilated upstream aorta. Cardiac phase-resolved flow velocities, WSS and OSI, were also measured for the dilated aorta and the upstream undilated aorta.</p><p>Results: Non-laminar flow represented by vortex or helical flow was more frequent and overt in the dilated aorta than in the undilated upstream aorta (<i>P</i> < 0.0156) with a very good interobserver agreement (weighted kappa: 0.82–1.0). The WSS was lower, and the OSI was higher on the dilated aortic wall compared with the proximal undilated segments. In mid-systole, mean spatially-averaged WSS was 0.20 ± 0.016 Pa for the dilated aorta vs. 0.68 ± 0.071 Pa for undilated upstream aorta (<i>P</i> < 0.0001), and OSI on the dilated aortic wall was 0.093 ± 0.010 vs. 0.041 ± 0.0089 (<i>P</i> = 0.013). The maximum values and the amplitudes of the WSS at the dilated aorta were inversely proportional to the ratio of dilated/undilated aortic diameter (<i>r</i> = −0.694, <i>P</i> = 0.0014).</p><p>Conclusion: 4D-flow can characterize abnormal non-laminar flow dynamics within the dilated aorta <i>in vivo</i>. The wall of the infrarenal aortic dilatation is continuously and increasingly affected by atherogenic stimuli due to the flow disturbances represented by vortex or helical flow, which is reflected by lower WSS and higher OSI.</p>

    DOI: 10.2463/mrms.mp.2019-0188

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  10. Intravoxel incoherent motion magnetic resonance imaging for predicting the long-term efficacy of immune checkpoint inhibitors in patients with non-small-cell lung cancer. 査読有り 国際誌

    Karayama M, Yoshizawa N, Sugiyama M, Mori K, Yasui H, Hozumi H, Suzuki Y, Furuhashi K, Fujisawa T, Enomoto N, Nakamura Y, Inui N, Goshima S, Suda T, Takehara Y

    Lung cancer (Amsterdam, Netherlands)   143 巻   頁: 47 - 54   2020年5月

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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:Lung Cancer  

    Objectives: Conventional evaluation of anti-tumor activity on the basis of tumor size is inadequate for immune checkpoint inhibitors (ICIs). We therefore aimed to assess the usefulness of intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) for evaluation of the therapeutic efficacy of ICIs. Materials and methods: A chest IVIM-MRI was performed before and 2, 4, and 8 weeks after administration of ICIs in patients with advanced non-small-cell lung cancer. Apparent diffusion coefficient (ADC), skewness of ADC (ADCskew), kurtosis of ADC (ADCkurt), true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) were evaluated at each evaluation point and changes from the baseline (Δ). Results: Twenty patients were enrolled in this study. An increased ADC 8 weeks and decreased ADCkurt and ΔADCkurt 4 weeks after ICIs was associated with objective responses and longer progression-free survival (PFS). A decreased ΔADCskew at 4 weeks was associated with objective responses, disease control, and longer PFS and overall survival. There was no correlation between the efficacy of ICIs and D, D* and f. All of three patients who had pseudoprogression had decreased ΔADCskew at 4 weeks and two of them had decreased ΔADCkurt at 4 weeks. Inversely, all five patients who had progressive disease (PD) did not have increased ΔADCskew at 4 weeks and only one of them had decreased ΔADCkurt at 4 weeks. Conclusions: Changes in histograms of ADC may be useful for predicting long-term efficacy and distinguishing between pseudoprogression and actual PD after ICIs.

    DOI: 10.1016/j.lungcan.2020.03.013

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  11. Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol.

    Umakoshi H, Nihashi T, Shimamoto H, Yamada T, Ishiguchi H, Takada A, Hirasawa N, Ishihara S, Takehara Y, Naganawa S, Davenport M, Terasawa T

    BMJ open   10 巻 ( 3 ) 頁: e033023   2020年3月

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    記述言語:英語   出版者・発行元:BMJ Open  

    Introduction: Iodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions. Methods and analysis: We will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate. Ethics and dissemination: Ethics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal. PROSPERO registration number CRD42019134003.

    DOI: 10.1136/bmjopen-2019-033023

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  12. Motion and solution in hepatobiliary agent-enhanced dynamic MRI: solid evidence and unanswered question.

    Motosugi U, Takehara Y

    Japanese journal of radiology   38 巻 ( 2 ) 頁: 99 - 100   2020年2月

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    記述言語:英語   出版者・発行元:Japanese Journal of Radiology  

    DOI: 10.1007/s11604-019-00900-9

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  13. Accuracy of the Flow Velocity and Three-directional Velocity Profile Measured with Three-dimensional Cine Phase-contrast MR Imaging: Verification on Scanners from Different Manufacturers.

    Watanabe T, Isoda H, Fukuyama A, Takahashi M, Amano T, Takehara Y, Oishi N, Kawate M, Terada M, Kosugi T, Komori Y, Fukuma Y, Alley M

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   18 巻 ( 4 ) 頁: 265 - 271   2019年10月

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    記述言語:英語   出版者・発行元:日本磁気共鳴医学会  

    <p>Purpose: The accuracy of flow velocity and three-directional velocity components are important for the precise visualization of hemodynamics by 3D cine phase-contrast MRI (3D cine PC MRI, also referred to as 4D-flow). The aim of this study was to verify the accuracy of these measurements of prototype or commercially available 3D cine PC MRI obtained by three different manufactures' MR scanners.</p><p>Methods: The verification of the accuracy of flow velocity in 3D cine PC MRI was performed by circulating blood mimicking fluid through a straight-tube phantom in a slanting position, such that the three-directional velocity components were simultaneously measurable, using three 3T MR scanners from different manufacturers. The data obtained were processed by phase correction, and the velocity and three-directional velocity components in the center of the tube on the central cross section of a slab were calculated. The velocity profile in each three directions and the composite velocity profiles were compared with the calculated reference values, using the Hagen–Poiseuille equation. In addition, velocity profiles and the spatially time-averaged velocity perpendicular to the tube were compared with the theoretical values and measured values by a flowmeter, respectively.</p><p>Results: An underestimation of the maximum velocity in the center of the tube and an overestimation of the velocity near the tube wall due to partial volume effects were observed in all three scanners. A roughening and flattening of profiles in the center of the tube were observed in one scanner, due, presumably, to the low signal-to-noise ratio. However, the spatially time-averaged velocities corresponded well with the measured values by the flowmeter in all three scanners.</p><p>Conclusion: In this study, we have demonstrated that the accuracy of flow velocity and three-directional velocity components in 3D cine PC MRI was satisfactory in all three MR scanners.</p>

    DOI: 10.2463/mrms.mp.2018-0063

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    CiNii Article

  14. Mechanical haemolytic anaemia assessed with four-dimensional flow cardiac magnetic resonance.

    Uchida W, Tokuda Y, Takehara Y, Usui A

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery   56 巻 ( 4 ) 頁: 813 - 814   2019年10月

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    記述言語:英語   出版者・発行元:European Journal of Cardio-thoracic Surgery  

    A 66-year-old woman developed marked haemolytic anaemia 2 years after total aortic arch replacement using a branched Dacron graft. Echocardiography confirmed bicuspid aortic valve stenosis. A four-dimensional flow magnetic resonance imaging revealed a jet flow arising from the aortic valve along with the vortex and turbulent flow inside the kinked prosthetic graft at the ascending aorta. She underwent a reoperation to replace the aortic valve and correct the kinking. The estimated energy loss after intervention was relieved to 2.9 mJ/cardiac cycle from 4.3 mJ/cardiac cycle before intervention. The patient's anaemia resolved immediately after the reoperation.

    DOI: 10.1093/ejcts/ezz031

    Web of Science

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    PubMed

  15. Flow dynamics of type II endoleaks can determine sac expansion after endovascular aneurysm repair using four-dimensional flow-sensitive magnetic resonance imaging analysis. 査読有り 国際誌

    Katahashi K, Sano M, Takehara Y, Inuzuka K, Sugiyama M, Alley MT, Takeuchi H, Unno N

    Journal of vascular surgery   70 巻 ( 1 ) 頁: 107 - 116.e1   2019年7月

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    記述言語:英語   出版者・発行元:Journal of Vascular Surgery  

    Objective: The objective of this study was to investigate the hemodynamic parameters of type II endoleaks (T2ELs) to predict sac expansion using four-dimensional flow-sensitive magnetic resonance imaging (4D-flow MRI) analysis. Methods: Patients who underwent endovascular aneurysm repair (EVAR) and were diagnosed with a T2EL were included in the study. Using 4D-flow MRI at 7 days, the peak flow velocity and amplitude of dynamics of blood flow per minute were measured in each T2EL vessel. The peak flow velocity was defined as the maximum of the absolute value of the blood flow velocity. The amplitude of dynamics of blood flow in the tributary arteries was defined as the sum of the absolute values of the inflow and outflow volume in each vessel. The amplitude of dynamics of blood flow in the tributary arteries per sac was calculated in each sac. The aneurysm sac diameter was measured by computed tomography (CT) at 1 year. The patients were divided into two groups according to the presence or absence of sac expansion. Results: Of 155 patients who underwent EVAR, both CT angiography and 4D-flow MRI were performed in 107 patients at 7 days after EVAR. Among them, 39 (36.4%) were found to have a T2EL, of whom 28 were re-evaluated with CT angiography and 4D-flow at 1 year; 7 patients had expanding sacs (expanding group), whereas 21 had nonexpanding sacs (not-expanding group). At 7 days, 28 patients had 80 T2EL vessels detected by 4D-flow MRI, of which 39 vessels (48.8%) had stopped flowing at 1 year (transient vessels); 41 vessels (51.3%) had sustained flow (persistent vessels). The persistent vessels had significantly larger peak flow velocity and amplitude of dynamics of blood flow. The comprehensive analysis of T2EL vessels per sac identified that the amplitude of dynamics of blood flow in the tributary arteries per sac was significantly higher in the expanding group than in the not-expanding group. A receiver operating characteristic curve analysis revealed that the sensitivity and specificity of sac enlargement at a cutoff value of 3750 mm3/min were 85.7% and 76.2%, respectively. Conclusions: The fate of aneurysm sacs with T2ELs after EVAR has remained difficult to predict. A comprehensive analysis of concurrent multiple T2EL vessels using 4D-flow MRI analysis may enable prediction of the sac expansion after EVAR.

    DOI: 10.1016/j.jvs.2018.09.048

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  16. A case of human pancreatic eurytremiasis. 国際誌

    Ogawa H, Takehara Y, Naganawa S, Yamaguchi J, Nakaguro M

    Abdominal radiology (New York)   44 巻 ( 4 ) 頁: 1213 - 1216   2019年4月

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    記述言語:英語   出版者・発行元:Abdominal Radiology  

    This study provides the first comprehensive imaging report of human pancreatic eurytremiasis. A 43-year-old man with obstructive jaundice and a pancreatic tumor was referred for diagnosis and treatment. Serum aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase were elevated. Computed tomography (CT) revealed a multilocular cystic lesion with delayed enhanced area in the pancreas head. On magnetic resonance imaging, the tumor was hyperintense on diffusion-weighted image, and the apparent diffusion coefficient value of the tumor was lower than that of the normal pancreatic parenchyma. Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography ( 18 F-FDG PET/CT) revealed abnormally increased uptake of 18 F-FDG in the tumor. A subtotal stomach-preserving pancreaticoduodenectomy was performed on the preoperative diagnosis of pancreatic carcinoma accompanied by branch duct-type intraductal papillary mucinous neoplasm. Multifocal granulomatous lesions with necrotic areas including many parasite eggs were seen on the histology. The final diagnosis was pancreatic eurytremiasis.

    DOI: 10.1007/s00261-019-01925-4

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    PubMed

  17. Hemodynamic vascular biomarkers for initiation of paraclinoid internal carotid artery aneurysms using patient-specific computational fluid dynamic simulation based on magnetic resonance imaging.

    Watanabe T, Isoda H, Takehara Y, Terada M, Naito T, Kosugi T, Onishi Y, Tanoi C, Izumi T

    Neuroradiology   60 巻 ( 5 ) 頁: 545 - 555   2018年5月

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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  

    Purpose: We performed computational fluid dynamics (CFD) for patients with and without paraclinoid internal carotid artery (ICA) aneurysms to evaluate the distribution of vascular biomarkers at the aneurysm initiation sites of the paraclinoid ICA. Methods: This study included 35 patients who were followed up for aneurysms using 3D time of flight (TOF) magnetic resonance angiography (MRA) and 3D cine phase-contrast MR imaging. Fifteen affected ICAs were included in group A with the 15 unaffected contralateral ICAs in group B. Thirty-three out of 40 paraclinoid ICAs free of aneurysms and arteriosclerotic lesions were included in group C. We deleted the aneurysms in group A based on the 3D TOF MRA dataset. We performed CFD based on MR data set and obtained wall shear stress (WSS), its derivatives, and streamlines. We qualitatively evaluated their distributions at and near the intracranial aneurysm initiation site among three groups. We also calculated and compared the normalized highest (nh-) WSS and nh-spatial WSS gradient (SWSSG) around the paraclinoid ICA among three groups. Results: High WSS and SWSSG distribution were observed at and near the aneurysm initiation site in group A. High WSS and SWSSG were also observed at similar locations in group B and group C. However, nh-WSS and nh-SWSSG were significantly higher in group A than in group C, and nh-SWSSG was significantly higher in group A than in group B. Conclusion: Our findings indicated that nh-WSS and nh-SWSSG were good biomarkers for aneurysm initiation in the paraclinoid ICA.

    DOI: 10.1007/s00234-018-2002-8

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  18. 【大動脈疾患の画像診断:画像所見・画像からみた自然史・治療効果判定】 大動脈疾患のMRI. 査読有り

    竹原 康雄

    臨床画像   34 巻 ( 1 ) 頁: 40-52   2018年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  19. Four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction (4D PC-VIPR) MR evaluation of the renal arteries in transplant recipients: Preliminary results. 査読有り

    Motoyama D, Ishii Y, Takehara Y, Sugiyama M, Yang W, Nasu H, Ushio T, Hirose Y, Ohishi N, Wakayama T, Kabasawa H, Johnson K, Wieben O, Sakahara H, Ozono S

    Journal of magnetic resonance imaging : JMRI   46 巻 ( 2 ) 頁: 595 - 603   2017年8月

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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  

    Purpose: To assess the performance of four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction (4D PC-VIPR) at 3.0T in depicting intrarenal arteries compared with computed tomography angiography (CTA), and its correlation with arterial flowmetry in comparison with Doppler ultrasonography (DUS). Materials and Methods: In our prospective single-arm study, subjects were 25 patients who underwent renal transplant-related surgery at our hospital between July 2011 and June 2015. In the morphological study, depictions of renal artery branches delineated by magnetic resonance angiography (MRA)/4D PC-VIPR without gadolinium contrast agent were compared in seven living transplant recipients with the same kidney delineated by CTA in seven living transplant donors. In the flowmetric study, flow velocities in the renal (main stem), segmental, and interlobar arteries during systole and diastole were measured in 12 recipients using noncontrast MRA/4D PC-VIPR, and were compared with those obtained from DUS. Results: Concerning MRA, average confidence levels of delineation rated by six observers for secondary to third level renal artery branches were 82.9–100% and for the fourth to fifth branches were 60.8–89.7% (average kappa value of 0.588 [95% confidence interval: 0.522–0.653]). Total flow velocities measured using 4D PC-VIPR and DUS demonstrated significant correlations during both systole and diastole with acceptable bias (r = 0.902; P < 0.001 in systole and r = 0.734; P < 0.001 in diastole). Conclusion: 4D PC-VIPR was useful in generating both morphological and hemodynamic information for evaluation of transplant intrarenal arteries without the need for contrast media. Level of Evidence: 2. Technical Efficacy: Stage 2. J. MAGN. RESON. IMAGING 2017;46:595–603.

    DOI: 10.1002/jmri.25607

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  20. Validation of numerical simulation methods in aortic arch using 4D Flow MRI. 査読有り

    Miyazaki S, Itatani K, Furusawa T, Nishino T, Sugiyama M, Takehara Y, Yasukochi S

    Heart and vessels   32 巻 ( 8 ) 頁: 1032 - 1044   2017年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00380-017-0979-2

    Web of Science

    PubMed

  21. Characterizing saccular aortic arch aneurysms from the geometry-flow dynamics relationship.

    Natsume K, Shiiya N, Takehara Y, Sugiyama M, Satoh H, Yamashita K, Washiyama N.

    J Thorac Cardiovasc Surg.   153 巻 ( 6 ) 頁: 1413-1420   2017年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  22. Characterizing saccular aortic arch aneurysms from the geometry-flow dynamics relationship. 査読有り

    Natsume K, Shiiya N, Takehara Y, Sugiyama M, Satoh H, Yamashita K, Washiyama N

    The Journal of thoracic and cardiovascular surgery   153 巻 ( 6 ) 頁: 1413 - 1420.e1   2017年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.jtcvs.2016.11.032

    Web of Science

    PubMed

  23. 【最新分類に基づく画像による悪性腫瘍の病期診断2017】 膵癌. 査読有り

    牛尾 貴輔, 阪原 晴海, 竹原 康雄

    臨床画像   33 巻 ( 4月増刊 ) 頁: 140-8   2017年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  24. 【圧縮センシングの旅-MRI高速化を探る-】 圧縮センシング(Cs)の現状 臨床MRIの知見と有用性. 査読有り

    寺田 理希, 松芳 圭吾, 小板橋 実夏, 安澤 千奈, 大杉 正典, 内藤 眞明, 沓掛 康道, 岩倉 岳史, 山中 典子, 吉原 和代, 吉原 修, 礒田 治夫, 竹原 康雄

    Rad Fan   15 巻 ( 15 ) 頁: 43-7   2017年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  25. 【局所進行膵癌の治療限界に挑む】 局所進行膵癌の術前治療後の画像診断. 査読有り

    小川 浩, 鈴木 耕次郎, 竹原 康雄, 長縄 慎二

    胆と膵   38 巻 ( 11 ) 頁: 1255-60   2017年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  26. Validation of numerical simulation methods in aortic arch using 4D Flow MRI. 査読有り

    Miyazaki S, Itatani K, Furusawa T, Nishino T, Sugiyama M, Takehara Y, Yasukochi S.

    Heart Vessels.   32 巻 ( 8 ) 頁: 1032-1044   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  27. Intra-left ventricular flow dynamics in patients with preserved and impaired left ventricular function: Analysis with 3D cine phase contrast MRI (4D-Flow). 査読有り

    Suwa K, Saitoh T, Takehara Y, Sano M, Saotome M, Urushida T, Katoh H, Satoh H, Sugiyama M, Wakayama T, Alley M, Sakahara H, Hayashi H.

    J Magn Reson Imaging.   44 巻 ( 6 ) 頁: 1493-1503   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

▼全件表示

書籍等出版物 1

  1. シンプル薬理学

    野村 隆英, 石川 直久, 梅村 和夫, 天ヶ瀬 紀久子, 野元 正弘, 岡田 尚志郎, 植田 真一郎, 近藤 一直, 松野 浩之, 西尾 眞友, 三鴨 廣繁, 丹羽 雅之, 竹原 康雄, 新井 信

    南江堂  2020年  ( ISBN:9784524246588

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    記述言語:日本語

    CiNii Books

MISC 1

  1. 腹部大動脈瘤ステントグラフト内挿術後2型エンドリーク症例の動脈瘤分枝血管に対する4D-flow MRIを用いた血行動態学的解析

    片橋 一人, 海野 直樹, 竹原 康雄, 山本 尚人, 犬塚 和徳, 佐野 真規, 斉藤 貴明, 杉澤 良太, 矢田 達朗, 嘉山 貴文, 今野 弘之  

    日本外科学会定期学術集会抄録集117回 巻   頁: SF - 6   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

Works(作品等) 7

  1. ジーイー横河メディカルシステム株式会社 多コイル感度エンコーディング法による超高速撮像法の実用化

    2003年

  2. 日本シェーリング株式会社 新しい組織・病変特異性MR造影剤の研究

    2003年

  3. 光ケミカル研究所(岡山)“金属ポルフィリンMR造影剤の開発”

  4. 静岡大学工学部(浜松)“デンドリマー型MR造影剤研究”

  5. 聖隷三方原病院消化器病センター(浜松)“MRCPによる慢性膵炎診断能”

  6. 聖隷三方原病院放射線科,循環器科(浜松)“循環器MR臨床研究”

  7. 産業技術総合研究所ライフエレクトロニクス研究ラボ医用ビジョングループ(大阪)“磁気共鳴 画像法を用いた小動物の画像化の研究”

▼全件表示

科研費 5

  1. 流体構造連成解析による大動脈瘤成長・破裂のリスク予測システムの開発

    研究課題/研究課題番号:21H02868  2021年4月 - 2024年3月

    竹原 康雄

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    担当区分:研究代表者 

    配分額:17420000円 ( 直接経費:13400000円 、 間接経費:4020000円 )

  2. 腹部大動脈瘤ステントグラフト内挿術後の諸問題解決を目指すMRIの新戦略

    研究課題/研究課題番号:17K10398  2017年4月 - 2020年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    竹原 康雄

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    担当区分:研究代表者 

    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    腹部大動脈瘤に対するEVAR後に最も頻度が高く瘤破裂という重大な結果を生ずる可能性のある問題点にエンドリークがある。これをMRIを用いて早期に正確に診断する方法を確立することが本研究の目的である。本研究により、type IIエンドリーク(EL2)のうち、分枝動脈内血流の流速の振幅が大きいほうが、瘤の増大と関係することが突き止められた。
    また、type Iエンドリーク(EL1), type IIIエンドリーク(EL3) では、瘤内の流線解析で、検出できる可能性が示唆された。また、造影MR angiography上で瘤内への造影剤の漏出の検出感度が、造影CTやX線DSAに勝っていることが確認された。
    高齢化が加速する本邦にあって、低侵襲治療であるEVARは今後も増加してゆく可能性が高いが、そのトレンドにあって、瘤破裂につながりかねないEVAR後のエンドリークの問題解決は焦眉の急と考えられる。本研究では、侵襲性の低い造影MR angiographyや4D Flow MRIといった新しい方法で従来法よりも高い感度でエンドリークを診断できる可能性が示された。流れという従来あまり利用されてこなかった学術的にも新規な方法論によって、腹部大動脈瘤の自然史解明につながる知見が得られた意義は大きい。

  3. 腹部大動脈瘤ステントグラフト内挿術後の諸問題解決を目指すMRIの新戦略

    2017年 - 2020年

    文部科学省  科学研究費補助金(基盤研究C) 

    竹原 康雄

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    担当区分:研究代表者  資金種別:競争的資金

  4. 腹部大動脈瘤術後2型エンドリークに対する血行動態学的予後予測因子の探索的研究

    研究課題/研究課題番号:16K15629  2016年4月 - 2019年3月

    日本学術振興会  科学研究費助成事業 挑戦的萌芽研究  挑戦的萌芽研究

    海野 直樹, 犬塚 和徳, 山本 尚人, 竹原 康雄

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    腹部大動脈瘤ステントグラフト内挿術 (EVAR) 後の2型エンドリーク (T2EL) が問題である。待機的EVAR症例に対して術後7日目のCT と4dimensional flow-sensitive MRI (4D-flow MRI) を用いて1年後のT2EL遺残の血行動態学的予後指標を探索した。1年後のEL遷延血管群ではEL消失群に比し、毎分あたりの血流量絶対値が有意に高かった。また瘤径増大群は非増大群に比して個々の瘤に属するT2EL血管の血流量絶対値の総和が有意に高かった。以上から4D-flow MRIによるT2ELの血行動態解析は、EL血管の血流遺残と1年後の瘤径増大予測に有用である。

  5. 核磁気共鳴エラストグラフィーによる頭蓋内腫瘍の弾性率の解析

    研究課題/研究課題番号:15K10359  2015年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    酒井 直人

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    担当区分:研究分担者 

    脳神経外科手術において頭蓋内腫瘍の硬さは手術の難易度を左右する。核磁気共鳴エラストグラフィー(MRE)は非侵襲的に生体内に組織の弾性率、すなわち硬さを測定することができる画期的な方法である。我々は、MREを用いて代表的な4つの頭蓋内腫瘍:髄膜腫、下垂体腺腫、前庭神経鞘腫、グリオーマに対してMREを用いて術前に弾性率を評価し術中の硬さとの相関について研究を行った。その結果、術前のMREの弾性率と術中の腫瘍の硬さは相関した。MREは術前に硬い腫瘍を鑑別するのに有用と考えた。

 

担当経験のある科目 (本学以外) 10

  1. (1) 先端医学特論Ⅲ 病期診断・画像診断(大学院博士過程)(90分1コマ)

    浜松医科大学医学部大学院)

  2. 臨床医学入門講義 単純Ⅹ線診断(医学部医学科5年生)90分1コマ

    浜松医科大学医学部医学科)

  3. 胸部画像診断(医学部医学科6年生)(90分1コマ)

    浜松医科大学医学部医学科)

  4. 看護学科放射線医学講義 X線検査(医学部看護学科3年生)(90分1コマ)

    浜松医科大学医学部看護学科)

  5. 看護学科放射線医学講義 MRI検査(医学部看護学科3年生)(90分1コマ)

    浜松医科大学医学部看護学科)

  6. ユニット8 消化器系講義Ⅰ肝胆道の画像診断(医学部医学科4年生)90分1コマ

    浜松医科大学医学部医学科)

  7. ユニット3 腹部画像診断(医学部医学科3年生)90分1コマ

    浜松医科大学医学部医学科)

  8. ユニット3 胸部画像診断(医学部医学科3年生)90分1コマ

    浜松医科大学医学部医学科)

  9. ユニット10呼吸器外科画像診断Ⅱ(医学部医学科4年生)(90分1コマ)

    浜松医科大学医学部医学科)

  10. プライマリ・ケアの実践講 胸腹部単純X線、CT、MRIの見方(50分1コマ)

    浜松医科大学)

▼全件表示