2025/03/18 更新

写真a

ホリグチ リョウタ
堀口 瞭太
HORIGUCHI Ryota
所属
医学部附属病院 放射線科 病院助教
職名
病院助教

学位 1

  1. 医学博士 ( 2023年   名古屋大学 ) 

研究分野 1

  1. ライフサイエンス / 放射線科学

 

論文 5

  1. Evaluation of 4D Flow MRI-Derived Relative Residence Time as a Marker for Cirrhosis Associated Portal Vein Thrombosis

    Hyodo, R; Takehara, Y; Ishizu, Y; Nishida, K; Mizuno, T; Ichikawa, K; Horiguchi, R; Kurata, N; Ogura, Y; Yokoyama, S; Naganawa, S; Jin, N; Ichiba, Y

    JOURNAL OF MAGNETIC RESONANCE IMAGING   60 巻 ( 6 ) 頁: 2592 - 2601   2024年12月

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

    Background: Portal vein thrombosis (PVT) is thought to arise from stagnant blood flow, yet conclusive evidence is lacking. Relative residence time (RRT) assessed using 4D Flow MRI may offer insight into portal flow stagnation. Purpose: To explore the relationship between RRT values and the presence of PVT in cirrhotic participants. Study Type: Prospective. Population: Forty-eight participants with liver cirrhosis (27 males, median age 67 years [IQR: 57–73]) and 20 healthy control participants (12 males, median age 45 years [IQR: 40–54]). Field Strength/Sequence: 3 T/4D Flow MRI. Assessment: Laboratory (liver and kidney function test results and platelet count) and clinical data (presence of tumors and other imaging findings), and portal hemodynamics derived from 4D Flow MRI (spatiotemporally averaged RRT [RRT-mean], flow velocity, and flow rate) were analyzed. Statistical Tests: We used multivariable logistic regression, adjusted by selected covariates through the Lasso method, to explore whether RRT-mean is an independent risk factor for PVT. The area under the ROC curve (AUC) was also calculated to assess the model's discriminative ability. P < 0.05 indicated statistical significance. Results: The liver cirrhosis group consisted of 16 participants with PVT and 32 without PVT. Higher RRT-mean values (odds ratio [OR] 11.4 [95% CI: 2.19, 118]) and lower platelet count (OR 0.98 per 1000 μL [95% CI: 0.96, 0.99]) were independent risk factors for PVT. The incorporation of RRT-mean (AUC, 0.77) alongside platelet count (AUC, 0.75) resulted in an AUC of 0.84. When including healthy control participants, RRT-mean had an adjusted OR of 12.4 and the AUC of the combined model (RRT-mean and platelet count) was 0.90. Data Conclusion: Prolonged RRT values and low platelet count were significantly associated with the presence of PVT in cirrhotic participants. RRT values derived from 4D Flow MRI may have potential clinical relevance in the management of PVT. Evidence Level: 2. Technical Efficacy: Stage 2.

    DOI: 10.1002/jmri.29357

    Web of Science

    Scopus

    PubMed

  2. The immediate post-operative impact of infrarenal aortic endografts on renal arterial flow dynamics: Insights from four-dimensional flow magnetic resonance imaging analysis

    Sugimoto, M; Horiguchi, R; Ikeda, S; Kawai, Y; Niimi, K; Hyodo, R; Banno, H

    VASCULAR     頁: 17085381241277651   2024年8月

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    記述言語:英語   出版者・発行元:Vascular  

    Objectives: This study aims to quantify changes in renal blood flow before and after endovascular aneurysm repair (EVAR) using four-dimensional (4D) flow magnetic resonance imaging (MRI) and evaluate its correlation with renal impairment. Methods: In this retrospective analysis, 18 patients underwent elective EVAR for infrarenal fusiform abdominal aortic aneurysms using Excluder or Endurant endografts. 4D flow MRI scans were conducted before and 1–4 days after EVAR. Hemodynamics were quantified at the suprarenal aorta (SupAo), bilateral renal arteries (RRA and LRA), and infrarenal aorta (InfAo). Cardiac phase-resolved blood flow values (BFVs), relative flow distribution (RFD), and flow change rates (FCRs) were assessed. Estimated glomerular filtration rate (eGFR) was measured pre- and postoperatively. Results: A total of 16 patients were analyzed after excluding two outliers. Pre-EVAR BFVs were 23.1 ± 8.3, 3.7 ± 1.3, 3.4 ± 1.2, and 15.1 ± 5.9 mL/cycle, while post-EVAR BFVs were 20.9 ± 6.9, 3.8 ± 1.1, 3.2 ± 0.9, and 12.1 ± 4.3 mL/cycle in SupAo, RRA, LRA, and InfAo, respectively. Comparing Excluder (N = 8) and Endurant (N = 8), the total renal FCR was 121.8% [106.6–144.7] versus 101.3% [63.8–121.8] (p = 0.110), suggesting a potential improvement in renal blood flow with the Excluder, although not statistically significant. A significant correlation was found between the total renal FCR and the relative eGFR at 6 months (Spearman correlation coefficient, 0.789; p < 0.001). Conclusions: The endografts, particularly the Excluder, showed potential in improving renal artery blood flow in some patients. The significant correlation between the total renal FCR and the relative eGFR at 6 months suggests that acute hemodynamic alterations induced by EVAR may impact post-operative renal function. Further research is needed to confirm these findings and assess their clinical implications.

    DOI: 10.1177/17085381241277651

    Web of Science

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  3. Four-dimensional Flow MRI Assessment of Portal Hemodynamics and Hepatic Regeneration after Portal Vein Embolization

    Hyodo, R; Takehara, Y; Mizuno, T; Ichikawa, K; Horiguchi, R; Kawakatsu, S; Mizuno, T; Ebata, T; Naganawa, S; Jin, N; Ichiba, Y

    RADIOLOGY   308 巻 ( 3 ) 頁: e230709   2023年9月

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    記述言語:英語   出版者・発行元:Radiology  

    Background: Percutaneous transhepatic portal vein (PV) embolization (PVE) is a standard preoperative procedure for advanced biliary cancer when the future liver remnant (FLR) is insufficient, yet the effect of this procedure on portal hemodynamics is still unclear. Purpose: To assess whether four-dimensional (4D) MRI flowmetry can be used to estimate FLR volume and to identify the optimal time for this measurement. Materials and Methods: This prospective single-center study enrolled consecutive adult patients with biliary cancer who underwent percutaneous transhepatic PVE for the right liver between June 2020 and November 2022. Portal hemodynamics were assessed using 4D flow MRI before PVE and within 1 day (0-day group) or 3-4 days (3-day group) after PVE. FLR volume was measured using CT before PVE and after PVE but before surgery. Blood flow changes were analyzed with the Wilcoxon signed rank test, and correlations with Spearman rank correlation. Results: The 0-day group included 24 participants (median age, 72 years [IQR, 69-77 years]; 17 male participants), and the 3-day group included 13 participants (median age, 71 years [IQR, 68-78 years]; eight male participants). Both groups showed increased left PV (LPV) flow rate after PVE (0-day group: from median 3.72 mL/sec [IQR, 2.83-4.55 mL/sec] to 9.48 mL/sec [IQR, 8.12-10.7 mL/sec], P < .001; 3-day group: from median 3.65 mL/sec [IQR, 2.14-3.79 mL/sec] to 8.16 mL/sec [IQR, 6.82-8.98 mL/sec], P < .001). LPV flow change correlated with FLR volume change relative to the number of days from PVE to presurgery CT only in the 3-day group (ρ = 0.62, P = .02; 0-day group, P = .11). The output of the regression equation for estimating presurgery FLR volume correlated with CT-measured volume (ρ = 0.78; P = .002). Conclusion: Four-dimensional flow MRI demonstrated increased blood flow in residual portal branches 3-4 days after PVE, offering insights for estimating presurgery FLR volume.

    DOI: 10.1148/radiol.230709

    Web of Science

    Scopus

    PubMed

  4. Postendovascular Aneurysmal Repair Increase in Local Energy Loss for Fusiform Abdominal Aortic Aneurysm: Assessments With 4D flow MRI Open Access

    Horiguchi, R; Takehara, Y; Sugiyama, M; Hyodo, R; Komada, T; Matsushima, M; Naganawa, S; Mizuno, T; Sakurai, Y; Sugimoto, M; Banno, H; Komori, K; Itatani, K

    JOURNAL OF MAGNETIC RESONANCE IMAGING   57 巻 ( 4 ) 頁: 1199 - 1211   2023年4月

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

    Background: Although endovascular aneurysmal repair (EVAR) is a preferred treatment for abdominal aortic aneurysm (AAA) owing to its low invasiveness, its impact on the local hemodynamics has not been fully assessed. Purpose: To elucidate how EVAR affects the local hemodynamics in terms of energy loss (EL). Study Type: Prospective single-arm study. Field Strength/Sequence: A 3.0 T/4D flow MRI using a phase-contrast three-dimensional cine-gradient-echo sequence. Population: A total of 13 consecutive patients (median [interquartile range] age: 77.0 [73.0, 78.8] years, 11 male) scheduled for EVAR as an initial treatment for fusiform AAA. Assessment: 4D flow MRI covering the abdominal aorta and bilateral common iliac arteries and the corresponding stent-graft (SG) lumen was performed before and after EVAR. Plasma brain natriuretic peptide (BNP) was measured within 1 week before and 1 month after EVAR. The hemodynamic data, including mean velocity and the local EL, were compared pre-/post-EVAR. EL was correlated with AAA neck angle and with BNP. Patients were subdivided into deformed (N = 5) and undeformed SG subgroups (N = 8) and pre-/post-EVAR BNP compared in each. Statistics: Parametric or nonparametric methods. Spearman's rank correlation coefficients (r). The interobserver/intraobserver variabilities with Bland–Altman plots. A P value < 0.05 is considered significant. Results: The mean velocity (cm/sec) at the AAA was five times greater after EVAR: 4.79 ± 0.32 vs. 0.91 ± 0.02. The total EL (mW) increased by 1.7 times after EVAR: 0.487 (0.420, 0.706) vs. 0.292 (0.192, 0.420). The total EL was proportional to the AAA neck angle pre-EVAR (r = 0.691) and post-EVAR (r = 0.718). BNP (pg/mL) was proportional to the total EL post-EVAR (r = 0.773). In the deformed SG group, EL (0.349 [0.261, 0.416]) increased 2.4-fold to 0.848 (0.597, 1.13), and the BNP 90.3 (53.6, 105) to 100 (67.2, 123) post-EVAR. Conclusion: The local EL showed a 1.7-fold increase after EVAR. The larger increase in the EL in the deformed SG group might be a potential concern for frail patients. Evidence Level: 1. Technical Efficacy: Stage 2.

    DOI: 10.1002/jmri.28359

    Open Access

    Web of Science

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    PubMed

  5. A case of intraductal tubulopapillary neoplasm of the pancreas originating from the branch duct: cast in the mold sign

    Horiguchi, R; Ogawa, H; Nagai, N; Takehara, Y; Naganawa, S; Yokoyama, Y; Shimoyama, Y

    NAGOYA JOURNAL OF MEDICAL SCIENCE   83 巻 ( 4 ) 頁: 869 - 875   2021年11月

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    記述言語:英語   出版者・発行元:Nagoya Journal of Medical Science  

    A 59-year-old man with jaundice and lower common bile duct stenosis was referred to our institution for diagnosis and treatment. Computed tomography and magnetic resonance imaging showed a well-circumscribed smoothly marginated solid mass lesion in the pancreatic head. He underwent pyloric preserving pancreatoduodenectomy. Histopathological specimen revealed that the mass was located in the dilated branch duct of the pancreatic head, and an intraductal tubulopapillary neoplasm originating from the branch pancreatic duct was diagnosed. On magnetic resonance cholangiopancreatography, the mass within the dilated duct branch in the pancreatic head was similar to a “cast in the mold” image, which we retrospectively deemed, might be reflecting the nature of this tumor.

    DOI: 10.18999/nagjms.83.4.869

    Web of Science

    Scopus

    PubMed

講演・口頭発表等 2

  1. 巨大肝内門脈肝静脈シャントを Coil-in plug 法で塞栓し、治療効果評価に 4D Flow MRI が有用であっ た一例

    堀口 瞭太

    第53回日本 IVR 学会総会  2024年5月23日  第53回日本IVR学会総会運営事務局

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    開催年月日: 2024年5月

    記述言語:英語   会議種別:口頭発表(一般)  

  2. 巨大肝内門脈肝静脈シャントをCoil-in plug法で安全に塞栓できた一例

    堀口 瞭太

    第73回 中部IVR研究会  2024年2月17日  愛知医科大学放射線科

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    開催年月日: 2024年2月

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:名古屋国際会議場   国名:日本国  

 

担当経験のある科目 (本学) 1

  1. PBL

    2024