2022/03/30 更新

写真a

ナカミチ レイ
中道 玲瑛
NAKAMICHI Rei
所属
医学部附属病院 放射線科 助教
大学院担当
大学院医学系研究科
職名
助教

学位 1

  1. 医学博士 ( 2014年3月   名古屋大学 ) 

研究キーワード 2

  1. 放射線医学

  2. 画像診断

現在の研究課題とSDGs 1

  1. MRIを用いた髄膜リンパ管の評価

経歴 1

  1. 名古屋大学   医学部附属病院 放射線科   助教

    2018年7月 - 現在

所属学協会 2

  1. 日本医学放射線学会

  2. 日本磁気共鳴医学会

 

論文 10

  1. Magnetic resonance cisternography imaging findings related to the leakage of Gadolinium into the subarachnoid space 査読有り 国際誌

    Nakamichi Rei, Taoka Toshiaki, Kawai Hisashi, Yoshida Tadao, Sone Michihiko, Naganawa Shinji

    JAPANESE JOURNAL OF RADIOLOGY   39 巻 ( 10 ) 頁: 927 - 937   2021年10月

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    担当区分:筆頭著者, 責任著者   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

    Web of Science

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    PubMed

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

  2. Reproducibility of diffusion tensor image analysis along the perivascular space (DTI-ALPS) for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment (CHAMONIX) study 査読有り 国際誌

    Taoka Toshiaki, Ito Rintaro, Nakamichi Rei, Kamagata Koji, Sakai Mayuko, Kawai Hisashi, Nakane Toshiki, Abe Takashi, Ichikawa Kazushige, Kikuta Junko, Aoki Shigeki, Naganawa Shinji

    JAPANESE JOURNAL OF RADIOLOGY   40 巻 ( 2 ) 頁: 147 - 158   2022年2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:Japanese Journal of Radiology  

    Purpose: The diffusion tensor image analysis along the perivascular space (DTI-ALPS) method was developed to evaluate the brain’s glymphatic function or interstitial fluid dynamics. This study aimed to evaluate the reproducibility of the DTI-ALPS method and the effect of modifications in the imaging method and data evaluation. Materials and methods: Seven healthy volunteers were enrolled in this study. Image acquisition was performed for this test–retest study using a fixed imaging sequence and modified imaging methods which included the placement of region of interest (ROI), imaging plane, head position, averaging, number of motion-proving gradients, echo time (TE), and a different scanner. The ALPS-index values were evaluated for the change of conditions listed above. Results: This test–retest study by a fixed imaging sequence showed very high reproducibility (intraclass coefficient = 0.828) for the ALPS-index value. The bilateral ROI placement showed higher reproducibility. The number of averaging and the difference of the scanner did not influence the ALPS-index values. However, modification of the imaging plane and head position impaired reproducibility, and the number of motion-proving gradients affected the ALPS-index value. The ALPS-index values from 12-axis DTI and 3-axis diffusion-weighted image (DWI) showed good correlation (r = 0.86). Also, a shorter TE resulted in a larger value of the ALPS-index. Conclusion: ALPS index was robust under the fixed imaging method even when different scanners were used. ALPS index was influenced by the imaging plane, the number of motion-proving gradient axes, and TE in the imaging sequence. These factors should be uniformed in the planning ALPS method studies. The possibility to develop a 3-axis DWI-ALPS method using three axes of the motion-proving gradient was also suggested.

    DOI: 10.1007/s11604-021-01187-5

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  3. Relationship between Time-dependent Signal Changes in Parasagittal Perivenous Cysts and Leakage of Gadolinium-based Contrast Agents into the Subarachnoid Space. 査読有り 国際誌

    Naganawa S, Ito R, Nakamichi R, Kawamura M, Taoka T, Yoshida T, Sone M

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   20 巻 ( 4 ) 頁: 378 - 384   2021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)   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

  4. Evaluating the Effect of Arterial Pulsation on Cerebrospinal Fluid Motion in the Sylvian Fissure of Patients with Middle Cerebral Artery Occlusion Using Low b-value Diffusion-weighted Imaging. 査読有り 国際誌

    Taoka T, Kawai H, Nakane T, Abe T, Nakamichi R, Ito R, Sasaki Y, Nishida A, Naganawa S

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   20 巻 ( 4 ) 頁: 371 - 377   2021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)   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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  5. Relationship between Parasagittal Perivenous Cysts and Leakage of Gadolinium-based Contrast Agents into the Subarachnoid Space around the Cortical Veins after Intravenous Administration 査読有り 国際誌

    Naganawa Shinji, Ito Rintaro, Nakamichi Rei, Kawamura Mariko, Kawai Hisashi, Taoka Toshiaki, Yoshida Tadao, Sone Michihiko

    MAGNETIC RESONANCE IN MEDICAL SCIENCES   20 巻 ( 3 ) 頁: 245 - 252   2021年9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: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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  6. MR Imaging of Endolymphatic Hydrops: Utility of iHYDROPS-Mi2 Combined with Deep Learning Reconstruction Denoising 査読有り 国際誌

    Naganawa Shinji, Nakamichi Rei, Ichikawa Kazushige, Kawamura Mariko, Kawai Hisashi, Yoshida Tadao, Sone Michihiko

    MAGNETIC RESONANCE IN MEDICAL SCIENCES   20 巻 ( 3 ) 頁: 272 - 279   2021年9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:Magnetic Resonance in Medical Sciences  

    Purpose: MRI of endolymphatic hydrops (EH) 4 h after intravenous administration of a single dose of gadolinium-based contrast agent is used for clinical examination in some institutions; however, further improvement in image quality would be valuable for wider clinical utility. Denoising using deep learning reconstruction (Advanced Intelligent Clear-IQ Engine [AiCE]) has been reported for CT and MR. The purpose of this study was to compare the contrast-to-noise ratio of endolymph to perilymph (CNREP) between the improved hybrid of reversed image of the positive endolymph signal and the native image of the perilymph signal multiplied with the heavily T2-weighted MR cisternography (iHYDROPS-Mi2) images, which used AiCE for the three source images (i.e. positive endolymph image [PEI], positive perilymph image [PPI], MR cisternography [MRC]) to those that did not use AiCE. We also examined if there was a difference between iHYDROPS-Mi2 images with and without AiCE for degree of visual grading of EH and in endolymphatic area [EL] ratios. Methods: Nine patients with suspicion of EH were imaged on a 3T MR scanner. iHYDROPS images were generated by subtraction of PEI images from PPI images. iHYDROPS-Mi2 images were then generated by multiplying MRC with iHYDROPS images. The CNREP and EL ratio were measured on the iHYDROPS-Mi2 images. Degree of radiologist visual grading for EH was evaluated. Results: Mean CNREP ± standard deviation was 1681.8 ± 845.2 without AiCE and 7738.6 ± 5149.2 with AiCE (P = 0.00002). There was no significant difference in EL ratio for images with and without AiCE. Radiologist grading for EH agreed completely between the 2 image types in both the cochlea and vestibule. Conclusion: The CNREP of iHYDROPS-Mi2 images with AiCE had more than a fourfold increase compared with that without AiCE. Use of AiCE did not adversely affect radiologist grading of EH.

    DOI: 10.2463/mrms.mp.2020-0082

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  7. Diffusion analysis of fluid dynamics with incremental strength of motion proving gradient (DANDYISM) to evaluate cerebrospinal fluid dynamics 査読有り 国際誌

    Taoka Toshiaki, Kawai Hisashi, Nakane Toshiki, Abe Takashi, Nakamichi Rei, Ito Rintaro, Sato Yuki, Sakai Mayuko, Naganawa Shinji

    JAPANESE JOURNAL OF RADIOLOGY   39 巻 ( 4 ) 頁: 315 - 323   2021年4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:Japanese Journal of Radiology  

    Purpose: To visualize and analyze the dynamics of cerebrospinal fluid (CSF) motion in the cranium, we evaluated the distribution of motion-related signal dephasing by CSF on Diffusion ANalysis of fluid DYnamics with Incremental Strength of Motion proving gradient (DANDYISM) method, a composite imaging method using various low b values. Materials and methods: This study examined ten subjects aged 25–58. We acquired DWIs on a 3T clinical scanner with b values 0, 50, 100, 200, 300, 500, 700, and 1000 s/mm2 in total imaging time of 4 min. We constructed DANDYISM images and evaluated the CSF area distribution with decreased motion-dephasing signal using a scoring method. Results: The DANDYISM images showed statistically significant higher CSF scores in the ventral posterior fossa, suprasellar cistern, and Sylvian vallecula compared to the lateral ventricle and frontal and parietal CSF spaces, indicating greater CSF movement in the former areas. Conclusion: The results indicated prominent CSF motions in the ventral portion of the posterior fossa, suprasellar cistern, and Sylvian fissure but smaller motions in the lateral ventricles and parietal subarachnoid space. This method may provide information of CSF dynamics in the clinical settings within short imaging time.

    DOI: 10.1007/s11604-020-01075-4

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    その他リンク: http://link.springer.com/article/10.1007/s11604-020-01075-4/fulltext.html

  8. A case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm (IPMN). 査読有り

    Kawai Y, Nakamichi R, Kamata N, Miyake H, Fujino M, Itoh S

    Abdominal imaging   40 巻 ( 3 ) 頁: 466-470   2015年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

  9. Establishing normal diameter range of the cochlear and facial nerves with 3D-CISS at 3T. 査読有り

    Nakamichi R, Yamazaki M, Ikeda M, Isoda H, Kawai H, Sone M, Nakashima T, Naganawa S

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   12 巻 ( 4 ) 頁: 241-247   2013年12月

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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)  

  10. Semi-quantification of endolymphatic size on MR imaging after intravenous injection of single-dose gadodiamide: comparison between two types of processing strategies. 査読有り

    Naganawa S, Suzuki K, Nakamichi R, Bokura K, Yoshida T, Sone M, Homann G, Nakashima T, Ikeda M

    Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine   12 巻 ( 4 ) 頁: 261-269   2013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)  

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MISC 7

  1. 放射線治療を施行した骨転移患者の予後-10年前との比較-

    石原俊一, 高田章, 中道玲瑛, 石口裕章, 山田剛大, 吉原永武  

    日本整形外科学会雑誌92 巻 ( 6 ) 頁: S1435   2018年6月

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    記述言語:日本語  

  2. 生検を要した小児tumefactive demyelinationの1例

    若林健一, 真島久和, 伊藤剛, 中道玲瑛, 前多松喜, 芝良樹, 清水浩之, 奥村衣里子, 原口健一, 雄山博文  

    小児の脳神経41 巻 ( 1 ) 頁: 105   2016年5月

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    記述言語:日本語  

  3. 悪性腫瘍との鑑別を要した頭蓋内アスペルギルス症の1例

    中道玲瑛, 河合雄一, 鎌田憲子, 伊藤茂樹, 岩味健一郎  

      34 巻 ( Supplement ) 頁: 28   2016年2月

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    担当区分:筆頭著者   記述言語:日本語  

  4. 腹腔内出血を生じた卵巣Strumal carcinoidの1例

    伊藤茂樹, 中道玲瑛, 河合雄一, 水野公雄, 藤野雅彦  

      34 巻 ( Supplement ) 頁: 28   2016年2月

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    記述言語:日本語  

  5. 主膵管型IPMNと鑑別を要した膵癌の2例

    河合雄一, 中道玲瑛, 鎌田憲子, 伊藤茂樹, 永井英雅, 三宅秀夫, 藤野雅彦  

      34 巻 ( Supplement ) 頁: 27   2016年2月

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    記述言語:日本語  

  6. Oncocytic papillary renal cell carcinomaの2例

    河合雄一 , 中道玲瑛 , 鎌田憲子 , 伊藤茂樹  

      33 巻 ( Supplement ) 頁: 59   2015年2月

  7. 著明なステンドグラス様所見を呈した膵のmucinous cystic neoplasmの1例 査読有り

    伊藤茂樹, 中道玲瑛, 河合雄一, 春田純一, 服部正興, 藤野雅彦, 渡辺緑子  

    臨床放射線59 巻 ( 4 ) 頁: 593-597   2014年4月

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    記述言語:日本語  

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講演・口頭発表等 2

  1. 9歳児の右被殻を主座とするtumefactive demyelinating lesionの一例

    中道玲瑛, 高田章, 伊藤剛, 若林健一, 前多松喜

    第45回 日本神経放射線学会 

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    開催年月日: 2016年2月

    記述言語:日本語   会議種別:ポスター発表  

    国名:日本国  

  2. Normal diameters of the Cochlear Nerve and Facial Nerve on 3D-CISS at 3T 国際会議

    Rei Nakamichi, Masashi Yamazaki, Hideki Kawai, Shinji Naganawa

    European Congress of Radiology 2012 

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    開催年月日: 2012年3月

    記述言語:英語   会議種別:ポスター発表  

    開催地:Austria Center Vienna   国名:オーストリア共和国  

科研費 1

  1. 強T2強調3D-FLAIR画像を用いた髄膜リンパ管の評価および神経疾患の病態解明

    研究課題/研究課題番号:20K16697  2020年4月 - 2023年3月

    科学研究費助成事業  若手研究

    中道 玲瑛

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    担当区分:研究代表者 

    配分額:4030000円 ( 直接経費:3100000円 、 間接経費:930000円 )

    従来リンパ系は頭蓋内には存在しないものとされてきたが、近年髄膜にリンパ管が存在することが報告された。脳脊髄液から頭蓋外への物質や免疫細胞の輸送に大きな役割を果たしているとされ、様々な神経疾患との関連も報告されている。髄膜リンパ管をMRIで評価することが可能となれば、アルツハイマー病や多発性硬化症などの神経疾患の病態解明にも繋がると考えられる。本研究では髄膜リンパ管をMRIのheavily T2-weighted 3D-FLAIR (hT2-FL)画像を用いて描出可能とし、加齢や神経疾患などにおける髄膜リンパ管の役割を明らかにすることにより、脳神経医学のさらなる発展を目指す。
    髄膜リンパ管は、頭蓋内から老廃物を排泄する経路として複数存在するPost-glymphatic clearance pathwaysの1つとされており、上矢状静脈洞の近傍などに存在することが報告されている。これをMRIのhT2-FL画像を用いて描出するため、まず過去に当教室において3T MRIで撮像されたhT2-FL画像を用いて検討を行った。検討項目は多岐にわたり、画像撮像時のパラメータとしてはエコー時間、繰り返し時間、反転時間、フリップアングルの程度、GRAPPA (GeneRalized Autocalibrating Partial Parallel Acquisition)のacceleration factor、励起回数などが挙げられる。描出する対象に合わせた撮像範囲、解像度なども検討が必要となる。これらの検討結果から髄膜リンパ管を直接的ないしは間接的に描出するためのhT2-FL画像における詳細な撮像方法の候補を決定し、健常ボランティアを用いて実際に髄膜リンパ管が描出できるかどうか検討していくことになる。
    近年アルツハイマー病などの神経疾患において、発症前の段階における評価によって発症予防に結びつけるようなバイオマーカーが求められるようになってきている。髄膜リンパ管の障害はアミロイドβタンパク質の脳実質への蓄積などに関わると考えられており、その他のバイオマーカーに先行して障害が生じると予想される。Post-glymphatic clearance pathwaysの1つである髄膜リンパ管の評価をMRIで非侵襲的に行うことができれば、アミロイドイメージングなどで確認できるよりも早期に病勢を検知できるバイオマーカーとして利用できる可能性がある。また、得られた画像所見から新たな概念に基づく神経疾患の発症機序解明や予防・治療薬の創薬研究の基礎となる可能性もある。
    当初の予定通りに初年度の課題としてhT2-FL画像における詳細な撮像方法についての検討を進めたが、シーケンスパラメータや撮像範囲などの候補の選定にやや時間がかかっている。髄膜リンパ管のサイズが小さく、評価に必要なコントラストを得られるように描出するためのパラメータや撮像範囲などを推定することが困難であることなどが原因として挙げられる。
    検討する過去のhT2-FL画像を増やし、できるだけ早期にシーケンスパラメータや撮像範囲などの候補の選定を行い、健常ボランティアでの撮像へと移行する。これと並行し、hT2-FL画像以外のMRIシーケンスにおいても髄膜リンパ管の描出が可能かどうかの検討も行う。