Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

腹部救急領域における経カテーテル的動脈塞栓術(transcatheter arterial embolization:以下,TAE)へのニーズは,機器の進歩に伴って近年ますます高まっている。腹部救急領域で用いられる塞栓物質としては,固形材料であるゼラチンスポンジと金属コイル,シアノアクリレート系液体接着剤であるn-butyl-2-cyanoacrylate(以下,NBCA)の使用頻度が高い。ゼラチンスポンジは汎用性の高い一時的塞栓物質であり,血流を停滞させて血栓化を促進する。この塞栓メカニズムには凝固能が大きく関与するため,症例によっては凝固能への依存が少ないNBCAが適する。金属コイルは留置部位において強い塞栓効果を発揮するため,限局的な血管閉鎖を求める場合に効果的である。最良のTAEを行うためには,塞栓物質の特徴を理解し,病変の形態や血行動態,患者背景に応じて適切な塞栓物質を選択する必要がある。本稿では,代表的な塞栓物質の特徴と使用方法について概説する。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: This study aimed to illustrate the utility of our original system to deliver vascular plugs into aortic side branches during endovascular aneurysm repair (EVAR). TECHNIQUE: Our device, which we named "System-F," consists of a 14 Fr sheath, a 12 Fr long sheath with a side hole, a stiff guidewire as a shaft, and a parallelly-inserted delivery catheter navigated through the side hole into the aneurysm sac. Vertical motion and horizontal rotation of the side hole allow multidimensional movement of the delivery catheter within the aneurysm. This system was applied in 7 cases undergoing EVAR; 4 inferior mesenteric arteries and 14 lumbar arteries were embolized using vascular plugs. Type II endoleak (T2EL) was not observed in the follow-up survey of any case. Conclusion: The applicability of System-F for vascular plug placement in the side branches of abdominal aortic aneurysms has the potential to achieve high delivery capability and be widely applied for the prevention of T2EL. CLINICAL IMPACT: System-F has potential to change the strategies of pre-EVAR embolization.

DOI： 10.1177/15266028231179422

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PURPOSE: Completely occlusive acute-subacute portal and mesenteric vein thrombosis (PVMVT) with severe complications is fatal. Endovascular treatments (EVTs) of acute-subacute PVMVT are not standardized. Thrombectomy combined with continuous catheter-directed thrombolysis is considered an effective treatment. Here, we aimed to evaluate the outcome of EVTs of completely occlusive acute-subacute PVMVT with severe complications in patients without cirrhosis. MATERIALS AND METHODS: Nineteen patients (nine men and 10 women; age, 60.1 ± 16.8 years) with completely occlusive acute-subacute PVMVT were retrospectively assessed. Acute-subacute PVMVT was defined as symptom onset within 40 days, with no cavernous transformation observed on contrast-enhanced computed tomography. The patients were treated with EVTs, a combination of thrombectomy (including aspiration thrombectomy, plain old balloon angioplasty, single injection of thrombolytic agents, and stent placement) and continuous catheter-directed thrombolysis. Kaplan-Meier analyses were performed to assess all-cause mortality, acute-subacute PVMVT-related mortality, and portal vein (PV) patency. The degree of recanalization and patency of PV, complications, factors related to acute-subacute PVMVT-related mortality, and factors related to patency of PV were also evaluated. RESULTS: The all-cause and acute-subacute PVMVT-related mortality rates were 36.8% (7/19) and 31.6% (6/19), respectively. Seven (36.8%) and 11 (57.9%) patients achieved complete and partial recanalization, respectively. Among the 18 patients who achieved recanalization, follow-up images after 608.7 ± 889.5 days confirmed recanalization in 83.3% (15/18) patients, and 53.3% (8/15) of these patients achieved patency of PV. Seven patients (36.8%) developed complications, and two (10.5%) required interventional treatment for complications. Deterioration of liver function significantly worsened the prognosis (P = 0.046), while anticoagulation therapy significantly maintained portal patency (P = 0.03). CONCLUSION: This endovascular method for acute-subacute PVMVT, which combines thrombectomy and continuous catheter-directed thrombolysis EVT approach was effective for thrombus resolution. However, further studies must define conditions that improve patient prognosis.

DOI： 10.1007/s11604-022-01377-9

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Standard non-invasive methods for diagnosing and selecting the best treatment for osteomyelitis in patients with multiple chronic conditions remain to be established. We aimed to evaluate the ability of quantitative 67 Ga-citrate single-photon emission computed tomography (Ga-SPECT/CT) to determine the indication for either non-surgical treatment or osteotomy in patients with lower-limb osteomyelitis (LLOM) associated with diabetes mellitus and lower-extremity ischemia, based on monitoring of inflammatory activity in bone tissue. This single-center prospective study conducted from January 2012 to July 2017 included 90 consecutive patients with suspected LLOM. Regions of interest were drawn on SPECT images during quantification of Ga accumulation. Subsequently, the inflammation-to-background ratio (IBR) was calculated by dividing the maximal accumulated lesion number by the mean number for the distal femur bone marrow of the unaffected side. Osteotomy was performed in 28 of 90 patients (31%). The osteotomy rate was higher for patients with IBR > 8.4 (71.4%) than for those with IBR ≤ 8.4 (5.5%) (p < 0.001, sensitivity: 0.89, specificity: 0.84). In the multivariate Cox regression analysis, IBR > 8.4 was an independent risk factor for osteotomy (hazard ratio [HR]: 19.0, 95% confident interval [CI]: 5.6-63.9, p < 0.001). Transcutaneous oxygen tension (TcPO2 ) was identified as an independent risk factor for lower-limb amputation (HR: 0.96, 95%CI: 0.92-0.99, p=0.01). The current results indicate that quantitative Ga-SPECT/CT is useful for distinguishing patients with LLOM likely to require osteotomy.

DOI： 10.1111/wrr.13075

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Radiographic detection of the Adamkiewicz artery (AKA) before aortic surgery helps to avoid spinal cord ischemia (SCI). We applied magnetic resonance angiography (MRA) using gadolinium enhancement (Gd-MRA) by means of the slow-infusion method with sequential k-space filling and compared AKA detectability with that of computed tomography angiography (CTA). METHODS: A total of 63 patients with thoracic or thoracoabdominal aortic disease (30 with aortic dissection [AD] and 33 with aortic aneurysm) who underwent both CTA and Gd-MRA to detect AKA were evaluated. The detectability of the AKA using Gd-MRA and CTA were compared among all patients and subgroups based on anatomical features. RESULTS: The detection rates of the AKAs using Gd-MRA and CTA were higher in all 63 patients (92.1% vs. 71.4%, P = 0.003). In AD cases, the detection rates using Gd-MRA and CTA were higher in all 30 patients (93.3% vs. 66.7%, P = 0.01) as well as in 7 patients whose AKA originated from false lumens (100% vs. 0%). In aneurysm cases, the detection rates using Gd-MRA and CTA were higher in 22 patients whose AKA originated from the nonaneurysmal parts (100% vs. 81.8%, P = 0.03). In clinical, SCI was observed in 1.8% of cases after open or endovascular repair. CONCLUSIONS: Despite the longer examination time and more complicated imaging techniques compared to those of CTA, the high spatial resolution of slow-infusion MRA may be preferable for detecting AKA before performing various thoracic and thoracoabdominal aortic surgeries.

DOI： 10.1016/j.avsg.2023.02.027

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Perineural spread (PNS) from pelvic carcinoma has been regarded as a pathway to muscle and bone metastasis. However, few cases have been reported, especially in patients with bladder carcinoma. In the present report, we discuss a case of diffuse cancer involvement in the muscle 5 years after radical cystectomy for advanced bladder carcinoma. Careful observation of temporal changes on medical images confirmed PNS as the pathway to muscle metastasis (i.e., primary PNS). Our report presents early and post-treatment CT, MRI and FDG-PET/CT findings of PNS from the bladder carcinoma.

DOI： 10.1272/jnms.JNMS.2024_91-301

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: The turbulent kinetic energy (TKE) estimation based on 4D flow MRI has been currently developed and can be used to estimate the pressure gradient. The objective of this study was to validate the clinical value of 4D flow-based TKE measurement in patients with hypertrophic cardiomyopathy (HCM). METHODS: From April 2018 to March 2019, we recruited 28 patients with HCM. Based on echocardiography, they were divided into obstructed HCM (HOCM) and non-obstructed HCM (HNCM). Triple-velocity encoding 4D flow MRI was performed. The volume-of-interest from the left ventricle to the aortic arch was drawn semi-automatically. We defined peak turbulent kinetic energy (TKEpeak) as the highest TKE phase in all cardiac phases. RESULTS: TKEpeak was significantly higher in HOCM than in HNCM (14.83 ± 3.91 vs. 7.11 ± 3.60 mJ, P < 0.001). TKEpeak was significantly higher in patients with systolic anterior movement (SAM) than in those without SAM (15.60 ± 3.96 vs. 7.44 ± 3.29 mJ, P < 0.001). Left ventricular (LV) mass increased proportionally with TKEpeak (P = 0.012, r = 0.466). When only the asymptomatic patients were extracted, a stronger correlation was observed (P = 0.001, r = 0.842). CONCLUSION: TKE measurement based on 4D flow MRI can detect the flow alteration induced by systolic flow jet and LV outflow tract geometry, such as SAM in patients with HOCM. The elevated TKE is correlated with increasing LV mass. This indicates that increasing cardiac load, by pressure loss due to turbulence, induces progression of LV hypertrophy, which leads to a worse prognosis.

DOI： 10.2463/mrms.mp.2022-0051

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Patients with lower-limb osteomyelitis (LLOM) may experience major adverse events, such as lower-leg amputations or death; therefore, early diagnosis and risk stratification are essential to improve outcomes. Ga-scintigraphy is commonly used for diagnosing inflammatory diseases. Although the diagnostic performance of planar and SPECT imaging for localized lesions is limited, SPECT/CT, which simultaneously acquires functional and anatomical definition, has resulted in significant improvements to diagnostic confidence. While quantitative Ga-SPECT/CT is an emerging approach to improve diagnoses, its diagnostic performance has not been sufficiently evaluated to date. Therefore, this study aimed to evaluate the diagnostic performance of Ga-SPECT/CT with quantitative analyses for patients with LLOM.

Methods

A total of 103 consecutive patients suspected of LLOM between April 2012 and October 2016 were analyzed. All patients underwent Ga-scintigraphy with SPECT/CT imaging. Findings were assessed visually, with higher than background accumulation considered positive, and quantitatively, using Ga-SPECT/CT images to calculate the lesion-to-background ratio (LBR), the maximum standardized uptake value (SUVmax), and total lesion uptake (TLU). Diagnoses were confirmed using pathological examinations and patient outcomes, and diagnostic performances of planar, SPECT, and SPECT/CT images were compared. To evaluate prognostic performance, all patients were observed for 5 years for occurrences of major adverse events (MAE), defined as recurrence of osteomyelitis, major leg amputation, or fatal event. Multivariate Cox regression was performed to evaluate outcome factors.

Results

The overall diagnoses indicated that 54 out of 103 patients had LLOM. LBR, SUVmax, and TLU were significantly higher in patients with LLOM (12.23 vs. 1.00, 4.85 vs. 1.34, and 68.77 vs. 8.63, respectively; p &lt; 0.001). Sensitivity and specificity were 91% and 96% for SPECT/CT with LBR, 89% and 94% for SPECT/CT with SUVmax, and 91% and 92% for SPECT/CT with TLU, respectively. MAE occurred in 23 of 54 LLOM patients (43%). TLU was found to be an independent prognostic factor (p = 0.047).

Conclusions

Ga-SPECT/CT using quantitative parameters, namely LBR and TLU, had better diagnostic and prognostic performances for patients with LLOM compared to conventional imaging. The results suggest that Ga-SPECT/CT is a good alternative for diagnosing LLOM in countries where FDG-PET/CT is not commonly available.

DOI： 10.1186/s41824-022-00148-z

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Other Link： https://link.springer.com/article/10.1186/s41824-022-00148-z/fulltext.html

Language：Japanese   Publisher：(一社)日本集中治療医学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本心臓病学会  

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Language：Japanese   Publisher：(一社)日本心臓病学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本人間ドック・予防医療学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Most cardiac diseases cause a non-physiological blood flow pattern known as turbulence around the heart and great vessels, which further worsen the disease itself. However, there is no consensus on how blood flow can be defined in disease conditions. Especially, in the left atrium, the fact that vortex flow already exists makes this debate more complicated. 3D time-resolved phase-contrast (4D flow) MRI is expected to be able to capture blood flow patterns from multiple aspects, such as blood flow velocity, stasis, and vortex quantification. Previous studies have confirmed that physiological vortex flow is predominantly induced by the higher-volume flow from the superior left pulmonary vein. In atrial fibrillation, 4D flow MRI reveals a non-physiological blood flow pattern, which information may add value to well-established clinical risk factors. Currently, the research target of LA analysis has also widened to lung surgeons, pulmonary vein stump thrombosis after left upper lobectomy. 4D flow MRI is expected to be utilized for many more variable diseases that are currently unimaginable.

DOI： 10.2463/mrms.rev.2021-0137

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English  

BACKGROUND: Acute portal vein thrombosis (PVT) with bowel necrosis is a fatal condition with a 50%-75% mortality rate. This report describes the successful endovascular treatment (EVT) of two patients with severe PVT. CASE SUMMARY: The first patient was a 22-year-old man who presented with abdominal pain lasting 3 d. The second patient was a 48-year-old man who presented with acute abdominal pain. Following contrast-enhanced computed tomography, both patients were diagnosed with massive PVT extending to the splenic and superior mesenteric veins. Hybrid treatment (simultaneous necrotic bowel resection and EVT) was performed in a hybrid operating room (OR). EVTs, including aspiration thrombectomy, catheter-directed thrombolysis (CDT), and continuous CDT, were performed via the ileocolic vein under laparotomy. The portal veins were patent 4 and 6 mo posttreatment in the 22-year-old and 48-year-old patients, respectively. CONCLUSION: Hybrid necrotic bowel resection and transileocolic EVT performed in a hybrid OR is effective and safe.

DOI： 10.12998/wjcc.v10.i6.1876

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BACKGROUND: A congenital intrahepatic portosystemic shunt (IPSVS) is a rare vascular abnormality that is characterized by an anomalous intrahepatic venous tract that connects the intrahepatic portal vein with the hepatic venous system. Hepatic encephalopathy is an indication for IPSVS embolization, which is technically challenging because rapid blood flow through shunts can induce the migration of embolization material to systemic veins. This case report discusses the efficacy of percutaneous balloon-occluded retrograde transvenous obliteration for treating patients with IPSVSs. CASE SUMMARY: A 75-year-old woman presented with a six-month history of repeated hepatic encephalopathy due to an IPSVS without liver cirrhosis. We successfully embolized the IPSVS using percutaneous balloon-occluded retrograde transvenous obliteration with interlocking detachable coils. After the procedure, the patient exhibited no symptoms of hepatic encephalopathy for 14 mo. CONCLUSION: Balloon-occluded retrograde transvenous obliteration with detachable coils can be effective for the endovascular treatment of an IPSVS.

DOI： 10.12998/wjcc.v10.i6.2023

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Coronary peripheral circulatory disturbances in the remote stage of Kawasaki disease have been reported. In this study, of the 50 patients in the remote stage of Kawasaki disease who underwent coronary perfusion evaluation using adenosine-loaded 13N-ammonia positron emission tomography, 28 patients who did not have stenosis of ≥75% in the left coronary artery underwent an evaluation for myocardial flow reserve (MFR) of the left anterior descending artery (LAD) and left circumflex artery (LCx). Clinical findings were compared between patients with normal (≥2.0) and abnormal (<2.0) MFRs. In the group with an abnormal MFR in the LAD, the responsiveness of the coronary vascular resistance to adenosine stress decreased even in the LCx (3.50 ± 1.23 vs. 2.39 ± 0.25, p = 0.0100). In the group with an abnormal MFR in the LCx, the responsiveness of the coronary vascular resistance in the LAD also decreased (3.27 ± 1.39 vs. 2.03 ± 0.25, p = 0.0105), and the age of onset of Kawasaki disease tended to be younger in the group with abnormal MFR in the LAD and LCx. We found that the peripheral coronary circulation was extensively impaired in the remote stage of Kawasaki disease, suggesting that an early onset of Kawasaki disease may affect the peripheral coronary circulation in later years.

DOI： 10.3390/jcm11041134

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Sustained ventricular tachycardia (sVT), leading to sudden cardiac death, is one of the common manifestations in cardiac sarcoidosis (CS). Although late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) has been reported to be associated with sVT, the relationships of its localization to sVT have not been fully evaluated.To evaluate the localization of LGE and its relationships to sVT in patients with CS, we reviewed medical record of consecutive 31 patients with CS who underwent CMR. The localization of LGE was divided into four categories: Left ventricular (LV) septum, LV free wall, right ventricular (RV) septum, and RV free wall. We investigated the association of sVT with localization of LGE and other parameters including serum biomarkers LV ejection fraction on echocardiography and Fluorine-18-fluorodeoxyglucose (FDG) accumulation on positron emission tomography (PET) -CT.Of the studied population, 8 patients (25.8%) were known to present with sVT among 31 CS patients. LGE was observed in the RV free wall in 6 patients with sVT, whereas it was in 5 patients without sVT (75.0% versus 21.7%, P = 0.022). Univariate analysis showed that only LGE in the RV free wall was associated with sVT (odds ratio [OR]: 10.80; 95% confidence interval [CI]: 1.64-70.93, P = 0.013).LGE in the RV free wall was associated with sVT in patients with CS.

DOI： 10.1536/ihj.21-635

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Purpose: To investigate the reproducibility of tracer uptake measurements, including volume metrics, such as metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) obtained by TOF-PET-CT and TOF-PET-MR. Materials and Methods: Eighty consecutive patients with different oncologic diagnoses underwent TOF-PET-CT (Discovery 690; GE Healthcare) and TOF-PET-MR (SIGNA PET-MR; GE Healthcare) on the same day with single dose-18F-FDG injection. The scan order, PET-CT following or followed by PET-MR, was randomly assigned. A spherical volume of interest (VOI) of 30 mm was placed on the liver in accordance with the PERCIST criteria. For liver, the maximum and mean standard uptake value for body weight (SUV) and lean body mass (SUL) were obtained. For tumor delineation, VOI with a threshold of 40 and 50% of SUVmax was used (VOI40 and VOI50). The SUVmax, SUVmean, SUVpeak, MTV and TLG were calculated. The measurements were compared between the two scanners. Results: In total, 80 tumor lesions from 35 patients were evaluated. There was no statistical difference observed in liver regions, whereas in tumor lesions, SUVmax, SUV mean, and SUVpeak of PET-MR were significantly underestimated (p < 0.001) in both VOI40 and VOI50. Among volume metrics, there was no statistical difference observed except TLG on VOI50 (p = 0.03). Correlation between PET-CT and PET-MR of each metrics were calculated. There was a moderate correlation of the liver SUV and SUL metrics (r = 0.63-0.78). In tumor lesions, SUVmax and SUVmean had a stronger correlation with underestimation in PET-MR on VOI 40 (SUVmax and SUVmean; r = 0.92 and 0.91 with slope = 0.71 and 0.72, respectively). In the evaluation of MTV and TLG, the stronger correlations were observed both on VOI40 (MTV and TLG; r = 0.75 and 0.92) and VOI50 (MTV and TLG; r = 0.88 and 0.95) between PET-CT and PET-MR. Conclusion: PET metrics on TOF-PET-MR showed a good correlation with that of TOF-PET-CT. SUVmax and SUVpeak of tumor lesions were underestimated by 16% on PET-MRI. MTV with % threshold can be regarded as identical volumetric markers for both TOF-PET-CT and TOF-PET-MR.

DOI： 10.3389/fmed.2022.796085

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DOI： 10.1007/s12149-021-01707-3

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BACKGROUND: A Viabahn stent graft (SG) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system. This study aimed to evaluate the short-term efficacy and safety of emergency endovascular treatment (EVT) using a Viabahn SG for upper and lower extremity arterial bleeding (ULEAB). METHODS: Consecutive patients with ULEAB who underwent emergency EVT using the Viabahn SG between January 2017 and August 2021 were retrospectively reviewed. The indications for EVT, location of artery, technical success, clinical success, limb ischemia, periprocedural complications, bleeding-related mortality, 30-day mortality, diameter of the target artery, diameter of the SG, neck length, rebleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. RESULTS: EVT using the Viabahn SG was performed in 22 patients (mean age, 72.0 ± 13.0 years; 11 men) and 23 arteries (upper, 6; lower, 17). The indications for EVT were pseudoaneurysm (n = 13, 59.1%), extravasation (n = 9, 39.1%), and inadvertent arterial cannulation (n = 1, 4.3%). The anatomical locations of the 23 ULEAB injuries were the brachiocephalic (1 [4.3%]), subclavian (3 [13.0%]), axillary (1 [4.3%]), brachial (1 [4.3%]), common iliac (4 [17.4%]), external iliac (8 [34.8%]), common femoral (2 [8.7%]), superficial femoral (2 [8.7%]), and popliteal (1 [4.3%]) arteries. The technical and clinical success rates were 100%. The rates of limb ischemia, periprocedural complications, and bleeding-related mortality were 0%, whereas the 30-day mortality rate was 22.7%. The mean diameters of the arteries and SGs were 7.7 ± 2.2 and 8.9 ± 2.3 mm, respectively. The mean neck length was 20.4 ± 11.3 mm. No endoleaks or rebleeding occurred during the follow-up period (mean, 169 ± 177 days). Two SG occlusions without limb ischemia occurred in the external iliac and brachial arteries after 1 and 4 months, respectively. Subsequently, cumulative SG patency was confirmed after 1, 3, 6, and 12 months in 91.7%, 91.7%, 81.5%, and 81.5% of patients, respectively. CONCLUSIONS: Emergency EVT using the Viabahn SG for ULEAB was effective and safe according to short-term outcomes. Appropriate size selection and neck length are important for successful treatment. SG patency was good after 1, 3, 6, and 12 months.

DOI： 10.1186/s42155-021-00273-z

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BACKGROUND: The goals of neoadjuvant systemic therapy (NST) are to reduce tumor volume and to provide a prognostic indicator in assessing treatment response. Digital breast tomosynthesis (DBT) was developed and has increased interest in clinical settings due to its higher sensitivity for breast cancer detection compared to full-field digital mammography (FFDM). PURPOSE: To evaluate the accuracy of DBT in assessing response to NST compared to FFDM, ultrasound (US), and magnetic resonance imaging (MRI) in breast cancer patients. MATERIAL AND METHODS: In this retrospective study, 95 stages II-III breast cancer patients undergoing NST and subsequent surgeries were enrolled. After NST, the longest diameter of residual tumor measured by DBT, FFDM, US, and MRI was compared with pathology. Agreements and correlations of tumor size were assessed, and the diagnostic performance for predicting pathologic complete response (pCR) was evaluated. RESULTS: Mean residual tumor size after NST was 19.9 mm for DBT, 18.7 mm for FFDM, 16.0 mm for US, and 18.4 mm for MRI, compared with 17.9 mm on pathology. DBT and MRI correlated better with pathology than that of FFDM and US. The ICC values were 0.85, 0.87, 0.74, and 0.77, respectively. Twenty-five patients (26.3%) achieved pCR after NST. For predicting pCR, area under the receiver operating characteristic (ROC) curve for DBT, FFDM, US, and MRI were 0.79, 0.66, 0.68, and 0.77, respectively. CONCLUSION: DBT has good correlation with histopathology for measuring residual tumor size after NST. DBT was comparable to MRI in assessing tumor response after completion of NST.

DOI： 10.1177/20584601211063746

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OBJECTIVE: Myocardial ischemia is known to suppress fatty acid metabolism and favor glucose metabolism. However, changes in myocardial metabolism after coronary revascularization are not fully elucidated. METHODS: Thirty-eight patients with coronary artery disease were retrospectively enrolled. These patients had undergone stress perfusion single photon emission computed tomography (SPECT) and 123I-BMIPP SPECT in both the short-term (6.4 ± 4.7 months) and mid-term (29.9 ± 7.2 months) after isolated coronary artery bypass grafting. Tracer uptake was graded using a 17-segment, 5-point scoring model. Serial changes in SRS (summed rest score), SDS (summed difference score), the BMIPP score (total defect score of BMIPP), and the mismatch score (BMIPP score-SRS) were evaluated. In addition, persistent perfusion-metabolism mismatch (PM) was defined as mismatch score minus SDS of 3 or more during the mid-term postoperative period. The clinical parameters associated with PM were examined. RESULTS: From short- to mid-term postoperative period, the extent of infarcted myocardium (SRS) did not change significantly (7.8 ± 8.0 to 7.1 ± 7.0, P = 0.117). The extent of ischemic myocardium (SDS), the BMIPP score and the mismatch score, which reflects perfusion-metabolism mismatch, were significantly improved (2.0 ± 2.8 to 0.7 ± 1.0, P = 0.010; 12.2 ± 9.0 to 9.5 ± 7.9, P < 0.001; 4.4 ± 3.7 to 2.5 ± 2.6, P < 0.001; respectively). Remarkably, perfusion-metabolism mismatch persisted in 13 patients (34%) even in the mid-term postoperative period. eGFR and SYNTAX score were independent predictors of persistent perfusion-metabolic mismatch in multivariable analysis (OR = 0.951, 95% CI 0.898-0.985, P = 0.010 and OR = 1.126, 95% CI 1.011-1.254, P = 0.031, respectively). The mismatch score both in the short- and mid-term significantly correlated with SYNTAX score (r = 0.400 and r = 0.472, respectively). CONCLUSIONS: Fatty acid metabolism disturbance improved from short- to mid-term postoperative period in patients with successful reperfusion by coronary artery bypass grafting. However, in patients with severe atherosclerosis, impaired fatty acid metabolism was sustained until the mid-term postoperative period, even though ischemia had resolved.

DOI： 10.1007/s12149-021-01696-3

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BACKGROUND: Although the high-attenuating crescent (HAC) sign can indicate aortic aneurysm (AA) impending rupture, the relation of its computed tomography (CT) value to the aneurysmal status remains unclear. This study compared the HAC sign CT-attenuation values among rupture, impending rupture, and non-rupture AA cases.Methods and Results:This included 76 patients (mean age: 77.0 years) diagnosed with HAC sign-associated AA between January 2005 and July 2015. The CT-attenuation values of the HAC sign (H) and aortic lumen (A) using region-of-interest methodology were measured and the H/A ratio was calculated. The study classified patients into the rupture group (R-G, n=36), impending rupture group (IR-G, n=16), and non-rupture group (NR-G, n=24); the H and the H/A ratio were compared among them. Additionally, the H and the H/A ratio cut-offs between the IR-G and NR-G groups were evaluated. The H and the H/A ratio were significantly higher in the R-G and IR-G than in the NR-G (both P<0.001); the H/A ratio was significantly higher in the R-G than in the IR-G (P=0.038). The optimal cut-off for H between the IR-G and NR-G was 50.3 Hounsfield units (area under the curve [AUC]=0.875; sensitivity=87.5%; specificity=87.5%), and that for the H/A ratio was 1.3 (AUC=0.909; sensitivity=91.7%; specificity=87.5%). CONCLUSIONS: Among patients with AA, the H and the H/A ratio were significantly higher in cases of rupture and impending rupture than in those of non-rupture.

DOI： 10.1253/circj.CJ-21-0541

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BACKGROUND: The hemodynamic changes after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery are unclear. OBJECTIVE: To clarify the hemodynamics by comparing flow parameters obtained by 4-dimensional (4D) flow magnetic resonance imaging (MRI) and intraoperative MCA pressure measurement. METHODS: We recruited 23 patients who underwent STA-MCA bypass surgery for internal carotid artery (ICA) or MCA stenosis. We monitored intraoperative MCA, STA, and radial artery (RA) pressure. All patients underwent 4D flow MRI preoperatively and 3 wk after surgery to quantify the blood flow volume (BFV) of the ipsilateral ICA (BFViICA), contralateral ICA (BFVcICA), basilar artery (BFVBA), ipsilateral STA (BFViSTA), and contralateral STA (BFVcSTA). The sum of intracranial BFV was defined as BFVtotal. We compared BFV parameters and intraoperative pressure. RESULTS: BFViSTA significantly increased after surgery (P < .001). BFViICA and BFVBA significantly decreased after surgery (BFViICAP = .005; BFVBAP = .02). No significant difference was observed between BFVcICA before and after surgery. As a result, BFVtotal postoperatively increased by 6.8%; however, no significant difference was observed. Flow direction at M1 changed from antegrade to unclear after surgery in 5 patients. Intraoperative MCA pressure and MCA/RA pressure ratio significantly increased after surgery (P < .001). We found a stronger positive correlation between MCA pressure increase ratio and BFVtotal increase ratio in patients with lower pre-MCA pressure (r = 0.907, P < .001). CONCLUSION: The visual and quantitative assessment of 4D flow MRI revealed that intracranial blood flow changes complementarily after STA-MCA bypass surgery. 4D flow MRI may detect the improvement of cerebral perfusion pressure.

DOI： 10.1093/neuros/nyab305

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：English   Publisher：(一社)日本核医学会  

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Despite the recent technical developments, surgery on the thoracic aorta remains challenging and is associated with significant mortality and morbidity. Decisions about when and if to operate are based on a balance between surgical risk and the hazard of aortic rupture. These decisions are sometimes difficult in elective cases of thoracic aortic diseases, including aneurysms and dissections. Abnormal wall stress derived from flow alterations influences disease progression. Therefore, a better understanding of the complex hemodynamic environment inside the aortic lumen will facilitate patient-specific risk assessments of complications, which enable clinicians to provide timely prophylactic interventions. Time-resolved 3D phase-contrast (4D flow) MRI has many advantages for the in vivo assessment of flow dynamics. Recent developments in 4D flow imaging techniques has led to significant advances in our understanding of physiological flow dynamics in healthy subjects and patients with thoracic aortic diseases. In this clinically focused review of thoracic aortic diseases, we demonstrate the clinical advances acquired with 4D flow MRI from published studies. We provide a systematic overview of key evidences and considerations regarding normal thoracic aortas, thoracic aortic aneurysms, aortic dissections, and thoracic aortas with prosthetic graft replacement.

DOI： 10.2463/mrms.rev.2021-0046

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PURPOSE: The purpose of the study is to evaluate the initial and midterm efficacy and safety of endovascular treatment (EVT) using Viabahn stent-graft (SG) for arterial injury and bleeding (AIB) at the visceral arteries. MATERIALS AND METHODS: Consecutive patients with visceral AIB who underwent EVT using Viabahn between January 2017 and February 2021 were retrospectively reviewed. Technical success, clinical success, peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, 30-day mortality, neck length, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. RESULTS: EVT using Viabahn was performed in 14 patients (mean age: 68.6 years; 12 males) and 15 arteries. The technical and clinical success rates were 100%. The rates of peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, and 30-day mortality were all 0%. The mean neck length was 9.9 mm. No endoleaks or re-bleeding occurred during the follow-up (mean: 732 days). The SG patency was confirmed after 1, 3, 6, and 12 months in 78.6%, 78.6%, 78.6%, and 56.1% of the patients, respectively. CONCLUSION: EVT using Viabahn for AIB at the visceral arteries was safe and effective. SG occlusions without ischemia often occurred after 12 months.

DOI： 10.1007/s11604-021-01192-8

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Purpose</title>
The purpose of the study is to evaluate the initial and midterm efficacy and safety of endovascular treatment (EVT) using Viabahn stent-graft (SG) for arterial injury and bleeding (AIB) at the visceral arteries.


</sec><sec>
<title>Materials and methods</title>
Consecutive patients with visceral AIB who underwent EVT using Viabahn between January 2017 and February 2021 were retrospectively reviewed. Technical success, clinical success, peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, 30-day mortality, neck length, re-bleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated.


</sec><sec>
<title>Results</title>
EVT using Viabahn was performed in 14 patients (mean age: 68.6 years; 12 males) and 15 arteries. The technical and clinical success rates were 100%. The rates of peripheral organ ischemia, peri-procedural complications, bleeding-related mortality, and 30-day mortality were all 0%. The mean neck length was 9.9 mm. No endoleaks or re-bleeding occurred during the follow-up (mean: 732 days). The SG patency was confirmed after 1, 3, 6, and 12 months in 78.6%, 78.6%, 78.6%, and 56.1% of the patients, respectively.


</sec><sec>
<title>Conclusion</title>
EVT using Viabahn for AIB at the visceral arteries was safe and effective. SG occlusions without ischemia often occurred after 12 months.


</sec>

DOI： 10.1007/s11604-021-01192-8

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Other Link： https://link.springer.com/article/10.1007/s11604-021-01192-8/fulltext.html

Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: To evaluate outcomes of endovascular treatment (EVT) using a combination of multiple endovascular techniques for acute lower limb ischemia (ALLI) and to compare outcomes based on vessel type and artery location. METHODS: A total of 95 consecutive patients with ALLI (mean age, 72.0 years; 65 males; 104 lower limbs) who received emergency EVT using a combination of multiple endovascular techniques including thrombolysis, aspiration thrombectomy, stenting, and balloon angioplasty with or without surgical thromboembolectomy, between January 2005 and December 2017 were included. Vessel type was classified into native artery occlusion (native occlusion) and bypass graft occlusion (graft occlusion), including prosthetic and vein graft. Additionally, native arteries were categorized into below-knee occlusion and non-below-knee occlusion. Technical success, perioperative death (POD), ALLI-related death, amputation, amputation-free survival (AFS), and complications were compared according to vessel type (native occlusion vs. graft occlusion) and artery location (below-knee occlusion vs. non-below-knee occlusion). RESULTS: Of all patients with ALLI, 16.8% underwent a single endovascular technique, whereas 83.2% underwent a combination of multiple endovascular techniques. The technicalsuccess, POD, and ALLI-related death rates in the total number of patients were 94.7%, 11.6%, and 4.2%, respectively. A total of 67 patients (75 limbs) and 28 patients (29 limbs) were classified as having native occlusion and graft occlusion (prosthetic, 24 limbs; vein, 5 limbs), respectively. No significant differences in technical success (native occlusion: 92.5% vs. graft occlusion: 100%), POD (14.9% vs. 3.6%), and ALLI-related death (6.0% vs. 0%) were noted between native occlusion and graft occlusion. However, the 30-day AFS rate of native occlusion was significantly lower than that of graft occlusion (75.2% vs. 96.3%, P=0.01). The amputation rate (P=0.03) and AFS rate (P=0.03) of below-knee occlusion were significantly worse for below-knee occlusion patients than for non-below-knee occlusion patients. CONCLUSIONS: EVT using multiple endovascular techniques for ALLI is effective and safe. A combination of multiple endovascular techniques is crucial for successful treatment. However, native occlusion may have a lower AFS rate than graft occlusion, and below-knee occlusion may have a higher risk of amputation than non-below-knee occlusion.

DOI： 10.1016/j.avsg.2021.02.023

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Publishing type：Research paper (scientific journal)   Publisher：The Editorial Committee of Annals of Vascular Diseases  

DOI： 10.3400/avd.cr.20-00144

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Temperature alteration can modify the polymerization of n-butyl cyanoacrylate (NBCA)-iodized oil mixtures during vascular embolization; its effects on viscosity, polymerization time, and intra-arterial distribution of the NBCA-iodized oil mixture were investigated. MATERIALS AND METHODS: In vitro, the viscosities of NBCA, iodized oil, and NBCA-iodized oil mixtures (ratio, 1:1-8) were measured at 4-60 ºC using a rotational rheometer. The polymerization times (from contact with blood plasma to stasis) were recorded at 0-60 ºC using a high-speed video camera. In vivo, the 1:2 mixture was injected into rabbit renal arteries at 0, 20, and 60 ºC; intra-arterial distribution of the mixture was pathologically evaluated. RESULTS: The mixtures' viscosities decreased as temperature increased; those at 60 ºC were almost four to five times lower than those at 4 ºC. The polymerization time of NBCA and the 1:1-4 mixtures increased as temperature decreased in the 0-30 ºC range; the degree of time prolongation increased as the percentage of iodized oil decreased. The 0 ºC group demonstrated distributions of the mixture within more peripheral arterial branches than the 20 and 60 ºC groups. CONCLUSION: Warming reduces the mixture's viscosity; cooling prolongs polymerization. Both can be potential factors to improve the handling of NBCA-iodized oil mixtures for lesions requiring peripheral delivery. Temperature alteration influences the polymerization time, viscosity, and intra-arterial distribution of NBCA-iodized oil mixtures. Warming reduces the viscosity of the mixture, while cooling prolongs polymerization.

DOI： 10.1007/s11604-021-01143-3

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Language：Japanese   Publisher：医学図書出版(株)  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: This study aimed to explore the flow dynamics factors affecting turbulence formation in the false lumen (FL) of aortic dissection using four-dimensional flow magnetic resonance imaging (4D flow MRI). This study also aimed to uncover risk factors affecting late complications of aortic dissection. METHODS: Thirty-three aortic dissection patients were examined using 4D flow MRI for quantitative flow dynamics (gross flow, velocity and regurgitant fraction) and turbulence visualization (helix and vortex with three-point visual grading) in the FL. The incidence of late complications (rupture or prophylactic intervention) was also obtained prospectively. RESULTS: The helix grade was correlated with FL gross flow (rS = 0.55, P < 0.001) and FL velocity (rS = 0.45, P = 0.008). The vortex grade was also correlated with FL gross flow (rS = 0.70, P < 0.001) and FL velocity (rS = 0.67, P < 0.001). Comparative analysis of patients with complications and stable patients revealed that patients with complications exhibited higher FL gross flow [41.7 (interquartile range, IQR 29.1-59.7) vs 17.7 (IQR 9.0-42.0) ml/s; P = 0.01], higher helix grade [2 (IQR 1.25-2) vs 0 (IQR 0-1); P = 0.001] and higher vortex grade [2 (IQR 1-2) vs 0 (IQR 0-2); P = 0.01]. CONCLUSIONS: Using 4D flow MRI analysis, we showed that turbulence formation depends on flow volume and velocity in the FL. Patients with high-volume turbulent flow in their FL are at higher risk of late complications; therefore, close follow-up and aggressive prophylactic intervention may improve their survival. CLINICAL TRIAL REGISTRATION NUMBER: Nippon Medical School Hospital Institutional Review Board approved this observational study in September 2018 (No. 30-08-986).

DOI： 10.1093/ejcts/ezab201

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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BACKGROUND: Spontaneous isolated visceral artery dissection is rarely encountered. Endovascular intervention with good outcomes has become popular for patients with persistent symptoms or developing ischemia. We could perform life-saving treatment for a spontaneous isolated superior mesenteric artery dissection with a unique endovascular intervention. CASE PRESENTATION: We describe the case of an 80-year-old man who presented with acute abdominal pain and a spontaneous isolated superior mesenteric artery dissection measuring 35 mm in major diameter and 6.6 mm in minor diameter on abdominal contrast-enhanced computed tomography. After admission, abdominal pain was progressive, and a repeated scan revealed progression of the dissection. As an endovascular intervention, via the bilateral femoral approach, detachable coils were placed in the false lumen of the superior mesenteric artery dissection through the false lumen under the micro-balloon occlusion at the point of re-entry and entry through the true lumen to prevent coil migration. Technical and clinical success was achieved without serious adverse events. CONCLUSION: Coil embolization using micro-balloon assistance combined with the double-catheter technique for a large entry and re-entry false lumen of a spontaneous isolated superior mesenteric artery dissection was useful and feasible.

DOI： 10.1186/s42155-021-00225-7

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: The purpose of the current study was to clarify the blood flow pattern in the left atrium (LA), potentially causing the formation of thrombosis after left upper lobectomy (LUL). The blood flow in the LA was evaluated and compared between LUL patients with and without thrombosis. For the evaluation, we applied highly accelerated 4D flow MRI with dual-velocity encoding (VENC) scheme, which was expected to be able to capture slow flow components in the LA accurately. METHODS: Eight volunteers and 18 patients subjected to LUL underwent dual-VENC 4D Flow MRI. Eight patients had a history of thrombosis. We measured the blood flow velocity and stasis ratio (proportion in the volume that did not exceed 10 cm/s in any cardiac phase) in the LA and left superior pulmonary vein (LSPV) stump. For visual assessment, the presence of each collision of the blood flow from pulmonary veins and vortex flow in the LA were evaluated. Each acquired value was compared between healthy participants and LUL patients, and in LUL patients with and without thrombosis. RESULTS: In LUL patients, blood flow velocity near the inflow part of the left superior pulmonary vein (Lt Upp) and mean velocity in the LA were lower, and stasis ratio in the LA was higher compared with healthy volunteers (Lt Upp 9.10 ± 3.09 vs.13.23 ± 14.19 cm/s, mean velocity in the LA 9.81 ± 2.49 vs. 11.40 ± 1.15 cm/s, and stasis ratio 25.28 ± 18.64 vs. 4.71 ± 3.03%, P = 0.008, 0.037, and < 0.001). There was no significant difference in any quantification values between LUL patients with and without thrombosis. For visual assessment, the thrombus formation was associated with no collision pattern (62.5% vs. 10%, P = 0.019) and not with vortex flow pattern (50% vs. 30%, P = 0.751). CONCLUSION: The net blood flow velocity was not associated with the thrombus formation. In contrast, a specific blood flow pattern, the absence of blood flow collision from pulmonary veins, correlates to the thrombus formation in the LA.

DOI： 10.2463/mrms.mp.2020-0170

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DOI： 10.1253/circj.CJ-19-1131

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Isolated internal iliac artery aneurysms are rare, and there are no reports of human immunodeficiency virus (HIV)-related vasculitis in Japan. We report our experience with a 51-year-old man diagnosed with acquired immunodeficiency syndrome, discovered during the postoperative course when the patient exhibited remittent fever and susceptibility to infection after emergency interventional radiology therapy for a right isolated internal iliac artery aneurysm. The patient had positive treponema pallidum particle agglutination test result before admission, and tests for sexually transmitted disease showed positive results for HIV H-1 antibodies. The repeated fevers were attributed to HIV infection-related susceptibility.

DOI： 10.3400/avd.cr.20-00139

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English  

In the present report, we have described the case of a 79-year-old woman who presented with acute right lower limb ischemia and was diagnosed with bilateral persistent sciatic arteries and a right persistent sciatic artery aneurysm. Concomitant widespread thrombotic occlusion was present, extending from the orifice of the right internal and external iliac arteries to the below-the-knee popliteal artery. These complicated lesions were successfully treated using only percutaneous endovascular procedures, including stent-graft placement, bare metal stent implantation, and thrombolysis. Our report illustrates how a combination of techniques can achieve total endovascular repair of a persistent sciatic artery aneurysm accompanied by occlusion of the internal and external iliac arteries.

DOI： 10.1016/j.jvscit.2020.09.012

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.21037/jtd-20-3229

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Aims: This study aimed to analyze the performance of multi-atlas MRI-based parcellation for 123I-FP-CIT SPECT (DAT-SPECT) in healthy volunteers. The proposed method was compared with the SPECT-atlas-based and Bolt methods. 18F-FE-PE2I-PET (DAT-PET) was used as a reference. Methods: Thirty healthy subjects underwent DAT-SPECT, DAT-PET, and 3D-T1WI-MRI. We calculated the striatum uptake ratio (SUR/SBR), caudate uptake ratio (CUR), and putamen uptake ratio (PUR) for DAT-SPECT using the multi-atlas MRI-based method, SPECT-atlas-based method, and Bolt method. In the multi-atlas MRI-based method, the cerebellum, occipital cortex, and whole-brain were used as reference regions. The correlation of age with DAT-SPECT activity and the correlations of SUR/SBR, CUR, and PUR between DAT-SPECT and DAT-PET were calculated by each of the three methods. Results: The correlation between age and SUR/SBR for DAT-SPECT based on the multi-atlas MRI-based method was comparable to that based on the SPECT-atlas-based method (r = -0.441 to -0.496 vs. -0.488). The highest correlation between DAT-SPECT and DAT-PET was observed using the multi-atlas MRI-based method with the occipital lobe defined as the reference region compared with the SPECT-atlas-based and Bolt methods (SUR, CUR, and PUR: 0.687, 0.723, and 0.676 vs. 0.698, 0.660, and 0.616 vs. 0.655). Conclusion: Multi-atlas MRI-based parcellation with the occipital lobe defined as the reference region was at least comparable to the clinical methods.

DOI： 10.3389/fmed.2021.662233

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Language：English   Publishing type：Research paper (scientific journal)  

Objective Computed tomography (CT) can be used for visualizing acute intracerebral hemorrhages (ICHs) as distinct hyperdense areas and cerebral edema as perihematomal low-density areas (LDAs). We observed a perihematomal LDA on CT, which appeared to be part of a hemorrhage on magnetic resonance imaging (MRI) in acute ICH. We named this "CT perihematomal rim" and evaluated its characteristics and clinical significance. Methods We stratified patients with acute ICH according to the presence or absence of a CT perihematomal rim and then compared their radiologic findings. Logistic regression analyses were performed to assess whether the CT findings can predict the presence of a CT perihematomal rim. Patients Patients within 24 hours of ICH onset who were admitted between September 1, 2014, and October 31, 2018, were registered. Results Overall, 139 patients (91 men; mean age, 66 years) were investigated. CT perihematomal rims were observed in 40 patients (29%). ICH volumes on CT were 30% smaller than those on MRI in patients with CT perihematomal rims. On a multivariate analysis, the presence of a CT perihematomal rim was independently associated with the maximum diameter of the perihematomal LDA. According to a receiver operating characteristic analysis, the maximum LDA diameter threshold was 7.5 mm (sensitivity, 85%; specificity, 83%). Conclusion CT perihematomal rims were observed in 29% of the patients with acute ICH. A perihematomal LDA (>7.5 mm) in acute ICH cases should be considered a CT perihematomal rim. Clinicians should be aware that the ICH volume on CT may be underestimated by 30%.

DOI： 10.2169/internalmedicine.6653-20

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1186/s42155-020-00132-3

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Other Link： http://link.springer.com/article/10.1186/s42155-020-00132-3/fulltext.html

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: MRI-based risk stratification should be established to identify patients with internal carotid artery stenosis (ICS) who require further PET or SPECT evaluation. This study assessed whether multiparametric flow analysis using time-resolved 3D phase-contrast (4D flow) MRI can detect cerebral hemodynamic impairment in patients with ICS. METHODS: This retrospective study analyzed 26 consecutive patients with unilateral ICS (21 men; mean age, 71 years) who underwent 4D flow MRI and acetazolamide-stress brain perfusion SPECT. Collateral flow via the Willis ring was visually evaluated. Temporal mean flow volume rate (Net), pulsatile flow volume (ΔV), and pulsatility index (PI) at the middle cerebral artery were measured. Cerebral vascular reserve (CVR) was calculated from the SPECT dataset. Patients were assigned to the misery perfusion group if the CVR was < 10% and to the nonmisery perfusion group if the CVR was ≥ 10%. Parameters showing a significant difference in both groups were statistically evaluated. RESULTS: Affected side ΔV, ratio of affected to contralateral side Net (rNet), and ratio of affected to contralateral side ΔV were significantly correlated to CVR (p = 0.030, p = 0.010, p = 0.015, respectively). Absence of retrograde flow at the posterior communicating artery was observed in the misery perfusion group (p = 0.020). Combined cut-off values of the affected side ΔV (0.18 ml) and rNet (0.64) showed a sensitivity and specificity of 100% and 77.8%, respectively. CONCLUSION: Multiparametric flow analysis using 4D flow MRI can detect misery perfusion by comprehensively assessing blood flow data, including blood flow volume, pulsation, and collateral flow.

DOI： 10.1007/s00234-020-02464-2

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Language：Japanese   Publisher：(株)メジカルビュー社  

＜文献概要＞シャントトラブルの診断は,理学所見と超音波検査や血管造影などの画像検査を組み合わせて行われる。治療の中心はIVR治療であり,良好な成績が報告されているが,外科的治療を要する場合がある。透析患者にとってシャント機能の維持は生命にかかわる重要な課題であり,正確な診断および適切な治療が大切である。

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01843&link_issn=&doc_id=20201006140007&doc_link_id=%2Fap4ringc%2F2020%2F003610%2F006%2F1112-1124%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fap4ringc%2F2020%2F003610%2F006%2F1112-1124%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Delayed vascular injury (DVI) with a hemodialysis catheter is a rare but potentially life-threatening complication. However, the appropriate treatment for DVI has not yet been established. A 44-year-old man underwent placement of a hemodialysis catheter via the left internal jugular vein, and the first leukapheresis procedure was performed without complications. However, 3 days after the insertion of the hemodialysis catheter, the patient developed sudden dyspnea. Chest radiographs and contrast-enhanced computed tomography revealed that the catheter tip had migrated and was located outside the left brachiocephalic vein. DVI with catheter migration was diagnosed. To perform safe and reliable hemostasis, we successfully performed transvenous balloon-assisted tract embolization with n-butyl cyanoacrylate and the catheter was removed. To our knowledge, there has been no previous report of the treatment of balloon-assisted tract embolization with n-butyl cyanoacrylate for DVI caused by a hemodialysis catheter. Our treatment approach may be safe and effective for DVI.

DOI： 10.1016/j.radcr.2020.05.077

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：English  

We present a case of an 85-year-old woman with bilateral limb-threatening ischemia caused by acute-on-chronic occlusion of the infrarenal aorta. The patient once underwent endovascular recanalization using nitinol and stainless-steel bare-metal stent implantation; however, the stainless-steel stent collapsed 3 months later. In the second endovascular therapy, "Squid-Capture" modified in situ stent-graft fenestration technique followed by stent-in-stent implantation with stent graft and bare-metal stent was successfully applied, and it can be regarded as a promising treatment option for the repair of abdominal aortic occlusive disease in some limited anatomical conditions.

DOI： 10.1016/j.avsg.2019.12.021

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: We examined the diagnostic value of brain perfusion single-photon emission computed tomography (SPECT) using voxel-based statistical analysis with CT-based attenuation correction (CT-AC) by comparing it to that with Chang's AC in mild cognitive impairment (MCI) patients and attempted to locate brain areas that are good indicators predicting the progression of MCI. METHODS: Twenty-six individuals matched for age, educational background and initial Mini-Mental State Examination (MMSE) score of more than 24 underwent SPECT with N-isopropyl-4-[123I]iodoamphetamine and were assigned to 2 groups: the stable MCI (S-MCI) group comprising 11 subjects who maintained their MMSE score (mean 27.0) during at least a 1-year follow-up period (mean 37.2 months) and the progressive MCI (P-MCI) group comprising 15 subjects whose MMSE scores decreased by 3 or more points (from 26.4 to 21.4, mean). The diagnostic values of the two AC methods for discriminating P-MCI from S-MCI were compared using voxel-based statistical analysis in the lobe (Level 2) and lobule/gyrus levels (Level 3). RESULTS: Receiver operating characteristic analysis revealed that the area under the curve (AUC) was higher with CT-AC than with Chang's AC in the left temporal and limbic lobes in Level 2. In Level 3, the AUC in the left middle temporal gyrus was higher with CT-AC (0.852) than with Chang's AC (0.827). There were differences between the gyri/lobules that showed higher AUCs with CT-AC and those that showed higher AUCs with Chang's AC. When the gyri with the 4 highest AUCs were combined, AUC (0.897) and accuracy (84.6%) were better with CT-AC than with Chang's AC (0.806 and 80.8%). Surprisingly, the AUCs in the posterior cingulate gyrus and precuneus, excluding the AUC in the right precuneus with Chang's AC (0.715), were no more than 0.70 and less useful. CONCLUSIONS: CT-AC may allow brain perfusion SPECT to reflect more exact neuropathic changes in MCI that would cause progression of early AD. CT-AC in conjunction with voxel-based statistical analysis could possess higher diagnostic accuracy for exacerbation of disease implying early Alzheimer changes in MCI patients, with decreases in cerebral perfusion in the left temporal and limbic lobes representing good indicators.

DOI： 10.1007/s12149-020-01477-4

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: We aimed to illustrate the benefits of using warmed glue for viscosity reduction via the triaxial microballoon system for the treatment of various vascular disorders. METHODS: Seven patients who underwent 10 treatment sessions for hemoptysis, type II endoleak, post-pancreatic surgical bleeding, spontaneous retroperitoneal bleeding, or ovarian tumor bleeding were evaluated based on technical and clinical outcomes. In the procedure, the triaxial system, consisting of a 4.5-Fr guiding catheter, a 2.8-Fr microballoon catheter, and a 1.9-Fr no-taper microcatheter, was advanced into the target lesion. Glue (33% n-butyl cyanoacrylate mixed with Lipiodol) warmed to 40°C was injected under balloon occlusion. RESULTS: The common hepatic, right bronchial, intercostals, internal mammary, costocervical, lateral thoracic, superior thoracic, thoracoacromial, inferior thyroid, iliolumbar, lumbar, internal pudendal arteries, and branch of the inferior mesenteric artery were successfully embolized; 100% technical success and 100% clinical success were obtained after each session. CONCLUSION: Our modified balloon-occluded glue embolization may lead to better handling with more distal glue penetration capability.

DOI： 10.5152/dir.2019.19285

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: There is increasing evidence that a proportion of patients with cardiac sarcoidosis (CS) have atrial arrhythmias (AA). Although 18F-fluorodeoxy-glucose (FDG) uptake in the ventricle on positron emission tomography/computed tomography (PET/CT) is well studied, FDG uptake in the atrium has not been elucidated in detail. OBJECTIVES: To evaluate FDG uptake in the atrium and its relationship with AA in patients with CS. METHODS: We retrospectively investigated 62 CS patients. All patients underwent echocardiography and PET/CT. Serum angiotensin converting enzyme (ACE) and soluble IL-2 receptor (sIL-2R) levels, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations were also evaluated. ECG, Holter monitoring and device interrogations were used to detect AA. RESULTS: Of the studied population, 25 patients (40.3%) had AA, of which 2 patients had atrial tachycardia (AT) and 23 patients had atrial fibrillation (AF). Eighteen patients with AA had atrial FDG uptake on PET/CT, whereas 14 patients without AA had atrial FDG uptake (72.0% vs 37.8%, P = 0.017). Multivariate analysis revealed a significant association between AA and age (odds ratio [OR]: 1.15; 95% confidence interval [CI]: 1.01-1.31, P = 0.040), atrial FDG uptake (odds ratio [OR]: 7.23; 95% confidence interval [CI]: 1.91-27.36, P = 0.004), and left atrial diameter (OR: 1.08; 95% CI: 1.01-1.16, P = 0.027). Meanwhile, gender, serum ACE and BNP levels, and left ventricular ejection fraction were not associated with AA. CONCLUSIONS: Atrial FDG uptake was common in patients with CS and strongly associated with AA.

DOI： 10.1016/j.ijcard.2020.04.041

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Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

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Language：Japanese   Publisher：(一社)日本磁気共鳴医学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J02090&link_issn=&doc_id=20200319090009&doc_link_id=10.2463%2Fjjmrm.2019-1700&url=https%3A%2F%2Fdoi.org%2F10.2463%2Fjjmrm.2019-1700&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To compare observer performance between synthetic mammography (2DSM) and full-field digital mammography (FFDM) for breast cancer detection and visibility. METHOD: A retrospective analysis was conducted on 136 histopathologically proven cases of breast cancer in patients who underwent FFDM and digital breast tomosynthesis (DBT). 2DSM images were reconstructed from DBT data, and 2DSM and FFDM images were reviewed and evaluated for mammographic features, probability of malignancy (BI-RADS classification), and lesion conspicuity. DBT images were not reviewed. Statistical differences in cancer detection rates between 2DSM and FFDM images were analyzed using the McNemar test, agreement on BI-RADS assessment between 2DSM and FFDM was assessed using Cohen's kappa test, and the Wilcoxon's signed rank test was used to compare visibility scores. RESULTS: Mean cancer detection rates with 2DSM and FFDM images were 84.6 % and 87.8 %, respectively. In subgroup analyses, differences in breast density, tumor size, and presence of calcifications were not statistically significant. Agreement between 2DSM and FFDM images for BI-RADS classification was graded as good with Cohen's k-coefficient of 0.78 ± 0.05. Visibility scores in both modalities of images were similar for all lesions combined; however, 2DSM had significantly better visibility scores for calcified cancers (p < 0.01), and in dense breast tissue (p < 0.01). CONCLUSIONS: Diagnostic performances of 2DSM and FFDM images were comparable for detecting breast cancers, and it is possible that 2DSM may eliminate the need for additional FFDM during DBT-based imaging due to advances in image reconstruction methods.

DOI： 10.1016/j.ejro.2019.12.001

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1093/ejcts/ezz152

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Language：Japanese   Publisher：日本医科大学医学会  

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Language：English   Publisher：(一社)日本核医学会  

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Language：English   Publisher：(一社)日本核医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Objective: To determine if there are changes in the aortic wall before acute aortic dissection (AD) that can be observed on contrast-enhanced computed tomography (CECT). Materials and Methods: Twenty-two patients with AD who underwent CECT before developing AD were retrospectively identified and enrolled as the AD group. Twenty-five consecutive patients who underwent CECT and did not develop AD were enrolled as the control group. In the AD group, the site of entry tear was detected on CECT images; the aortic wall thickness at this site, defined as the dissection-related wall thickness (D-T), was then measured on CECT images acquired before AD. Moreover, the mean thickness of the ascending, thoracic descending, and abdominal aortic walls before AD was defined as the non-dissection-related wall thickness (non-D-T). In the control group, the aortic wall thickness was measured similarly and defined as the control wall thickness (C-T). The D-T, non-D-T, and C-T values were compared using one-way analysis of variance with the Games-Howell pairwise comparison test. Results: The D-T (2.17±0.75 mm) was significantly greater than the non-D-T (1.58±0.22 mm; P<.01) and C-T (1.53±0.15 mm; P<.01). Conclusion: The aortic wall may have become thicker prior to the onset of AD.

DOI： 10.3400/avd.oa.19-00051

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本門脈圧亢進症学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(株)学研メディカル秀潤社  

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Language：Japanese   Publisher：(一社)日本心臓病学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞ポイント ・FDG-PET/CTは前立腺癌,腎癌の病期診断,悪性度評価,治療効果判定,再発診断に有効である.・PSMA-PET/CTは前立腺癌,腎癌の病変検出能がFDG-PET/CTに比し高い.・半導体PET/CT装置は従来のアナログ装置に比し空間分解能,S/N比,コントラスト分解能が高く,病変検出能,腫瘍活性評価能が高い.

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01561&link_issn=&doc_id=20190902070006&doc_link_id=10.11477%2Fmf.1413206691&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1413206691&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The hemodynamic changes that occur after high-flow (extracranial-intracranial) EC-IC bypass surgery with internal carotid artery (ICA) ligation are not well known. OBJECTIVE: To assess blood flow changes after high-flow EC-IC bypass with ICA ligation by time-resolved 3-dimensional phase-contrast (4D Flow) magnetic resonance imaging (MRI). METHODS: We enrolled 11 patients who underwent high-flow EC-IC bypass. 4D Flow MRI was performed before and after surgery to quantify the blood flow volume (BFV) of the ipsilateral ICA (BFViICA), bypass artery (BFVbypass), contralateral ICA (BFVcICA), and basilar artery (BFVBA). Subsequently, we calculated the total BFV (BFVtotal = BFViICA + BFVcICA + BFVBA [before surgery], BFVcICA + BFVBA + BFVbypass [after surgery]). The BFV changes after bypass was statistically analyzed. RESULTS: BFVbypass was slightly lower than BFViICA, but the difference was not statistically significant (3.84 ± 0.94 vs 4.42 ± 1.38 mL/s). The BFVcICA and BFVBA significantly increased after bypass surgery (BFVcICA 5.89 ± 1.44 vs 7.22 ± 1.37 mL/s [P = .0018], BFVBA 3.06 ± 0.41 vs 4.12 ± 0.38 mL/s [P < .001]). The BFVtotal significantly increased after surgery (13.37 ± 2.58 vs 15.18 ± 1.77 mL/s [P = .015]). There was no evidence of hyperperfusion syndrome in any cases. CONCLUSION: After high-flow EC-IC bypass with permanent ICA ligation, the bypass artery could partially compensate for the loss of BFV of the sacrificed ICA. The increased flow of the contralateral ICA and BA supply collateral blood flow. Clinically irrelevant hyperperfusion was observed.

DOI： 10.1093/neuros/nyy192

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DOI： 10.1007/s12350-019-01755-3

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(株)メディカルアイ  

動脈損傷に対するゴアバイアバーンステントグラフトを用いた血管内治療は末梢臓器血流を維持したまま止血を行うことが可能な理想的な治療法である。2016年12月に血管損傷に対する適応が保険認可されて以来、急速に普及してきている。本稿では、本デバイスの特徴・適応などの基本事項および実際に使用する上での注意点や問題点について解説する。(著者抄録)

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PURPOSE: To report an unusual case of an abdominal aortic aneurysm (AAA) rupture caused by migration of a Zenith stent-graft main body years after its separation from the suprarenal stent. CASE REPORT: A 72-year-old man underwent endovascular aneurysm repair with a Zenith stent-graft for an infrarenal AAA in year 2000. At that time, a femorofemoral bypass was performed because the left external iliac and common femoral arteries were dissected during treatment. In 2013, follow-up computed tomography (CT) showed disconnection of the uncovered proximal stent, which led to a type Ia endoleak. An additional Zenith main body and Large Palmaz XL balloon-expandable stent were deployed; the endoleak disappeared. In 2016, the patient had abdominal pain, and emergency CT showed AAA rupture caused by migration of the first main body deployed in 2000 under the distal edge of the contralateral (left) leg of the additional main body from 2013, which led to a type IIIa endoleak between the 2 main bodies. A converter and iliac legs were deployed to successfully seal the type IIIa endoleak. The patient remains well 18 months after the second repair; CT scans document stable stent-grafts and no endoleak. CONCLUSION: Physicians should be aware of the potential risk for AAA rupture caused by late main body migration after treatment for suprarenal stent separation from a Zenith stent-graft.

DOI： 10.1177/1526602819830979

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：日本心臓核医学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J03644&link_issn=&doc_id=20190305470006&doc_link_id=10.14951%2Fjsnc.21.01.20&url=https%3A%2F%2Fdoi.org%2F10.14951%2Fjsnc.21.01.20&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：日本心臓核医学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J03644&link_issn=&doc_id=20190305470007&doc_link_id=10.14951%2Fjsnc.21-001&url=https%3A%2F%2Fdoi.org%2F10.14951%2Fjsnc.21-001&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：English   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media B.V.  

Background: The diagnostic performance of SPECT-only imaging for takotsubo cardiomyopathy (TC) is limited due to the lack of coronary artery distribution information. The aim of this study was to evaluate the diagnostic performance of hybrid cardiac SPECT/CT for patients with TC or acute coronary syndrome (ACS). Methods: Twenty-two patients with apical ballooning left ventricular (LV) dysfunction who underwent cardiac perfusion SPECT using 99mTc-methoxy-isobutyl-isonitrile (MIBI), cardiac fatty-acid metabolism SPECT using 123I–beta-methyl-P-iodophenyl-pentadecanoic acid (BMIPP), cardiac CT, and hybrid cardiac SPECT/CT imaging were analyzed. On the SPECT images, MIBI and BMIPP defects were quantified using a 17-segment model with a 5-point grading system and a summed MIBI defect score (SMDS), summed BMIPP defect score (SBDS), and summed mismatch score (SMS) were calculated. Furthermore, apical and non-apical MDS, BDS, and mismatch scores (A- and NA-MDS, A- and NA-BDS, and A- and NA-MS) were calculated. These quantitative scores were compared between the TC (n = 11) and ACS (n = 11) groups, and the diagnostic performances of SPECT-only imaging and hybrid SPECT/CT imaging were compared. For all patients, the diagnoses of both SPECT-only and SPECT/CT imaging were categorized as TC: SPECT accumulation defects around apical LV wall deviated from the actual coronary artery territories, equivocal: unclear relationship of accumulation defects and the coronary artery territories, or non-TC: accumulation defects coincided with the coronary artery territories. Results: SMDS and SBDS did not significantly differ between TC and ACS patients [SMDS: 5 (3–7) vs. 8 (4–16), p = 0.216
SBDS: 10 (8–12) vs. 18 (9–24), p = 0.354]. While A-MDS and A-BDS did not significantly differ between patients with TC and ACS (p = 0.567 and p = 0.386, respectively), NA-MDS and NA-BDS were significantly lower for patients with TC (p = 0.022 and p = 0.022, respectively). Compared with SPECT-only imaging (sensitivity: 30% and specificity: 81%), hybrid SPECT/CT imaging showed a higher accuracy (sensitivity: 90% and specificity: 100%) for the diagnosis of TC. Conclusions: Hybrid cardiac SPECT/CT imaging may have superior diagnostic performance compared with SPECT-only imaging for patients with TC.

DOI： 10.1186/s41824-017-0023-x

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Language：English   Publisher：(一社)日本核医学会  

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Language：English   Publisher：(一社)日本核医学会  

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Language：English   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：日本医科大学医学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Society for Vascular Surgery  

Pseudoaneurysm of the superior mesenteric artery (SMA) is rare and associated with the risk of massive fatal hemorrhage and acute mesenteric ischemia. We describe a 43-year-old man with acute pancreatitis who presented with an SMA pseudoaneurysm measuring 13 × 12 cm in diameter. The pseudoaneurysm originated between the first and second jejunal arteries and drained into the mesenteric vein. The SMA trunk between the first and second jejunal arteries was embolized with detachable coils using microballoon assistance. After coil placement, arteriography showed the collateral circulation and no perfusion delay of the distal SMA. This technique was useful for isolation of the SMA pseudoaneurysm.

DOI： 10.1016/j.jvscit.2018.02.009

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Language：Japanese   Publisher：日本骨髄腫学会  

J-GLOBAL

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Tokyo  

T1 mapping using cardiac magnetic resonance (CMR) is useful for myocardial assessment. However, its prognostic value is not well defined. The aim of this study was to determine whether T1 mapping with CMR can predict reverse cardiac remodeling in patients with non-ischemic dilated cardiomyopathy (NIDCM). We also investigated the predictive prognostic value of T1 mapping with CMR in these patients. We included 33 patients with NIDCM admitted to Nippon Medical School Hospital between February 2012 and October 2015. All patients underwent CMR and echocardiography for clinical assessment within 1 month of admission (13 ± 16 days). Follow-up echocardiography was performed no sooner than 6 months after the initial echocardiogram (536 ± 304 days). We evaluated the correlations between native and post-contrast T1 values/extracellular volume fraction (ECV) and the difference in left ventricular ejection fraction (ΔLVEF) determined at baseline and follow-up echocardiography. No correlation was noted between ΔLVEF and native (p = 0.150, r = − 0.256) or post-contrast T1 values (p = 0.956, r = − 0.010). However, a significant and substantial correlation was found between ΔLVEF and ECV (p = 0.043, r = − 0.355). Four patients were hospitalized for heart failure (HF), but no cardiovascular-related deaths occurred over a median follow-up period of 34 months (interquartile range 25–49 months). Kaplan–Meier curves stratified by the median value of ECV were created. The higher ECV groups experienced a significantly higher incidence of HF-related hospitalization (p = 0.0159). ECV measured by CMR can predict improvements in LVEF in patients with NIDCM. In addition, ECV may be a predictive factor for HF-related hospitalization.

DOI： 10.1007/s00380-018-1154-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Netherlands  

Quantification of myocardial flow reserve (MFR) provides diagnostic value for detection of cardiovascular artery disease. However, the common calculation method for MFR requires dynamic acquisition and specific software. The study aimed to predict coronary artery disease by simpler calculation of myocardial count without the use of dynamic data from 13N-ammonia myocardial perfusion positron emission tomography (MP-PET). This study included 40 consecutive patients suspected of ischemic heart disease and 7 healthy controls (34 men and 13 women, 66 ± 12 years). All participants underwent adenosine stress and rest 13N-ammonia MP-PET. From the dynamic images, the MFR in the entire left ventricular myocardium (ELV) and the three-vessel area was calculated by dividing stress myocardial blood flow (MBF) by rest MBF. From the static images, the myocardium-to-background ratio (MBR) was calculated by dividing each area’s counts/pixel by background counts in the upper thoracic aorta/pixel in both stress and rest images. The MBR-increasing rate (MBR-IR) was calculated by dividing stress MBR by rest MBR. The relationship between MFR and MBR-IR in each area was examined. The cutoff diagnostic value of MBR-IR corresponding to that of MFR for detection of cardiovascular artery disease was calculated. Each MBR-IR was closely correlated with each MFR (r = 0.830 in ELV, r = 0.864 in LAD, r = 0.829 in LCX, r = 0.757 in RCA). The cutoff values of MBR-IR were 1.45 in ELV, 1.46 in LAD, 1.41 in LCX, and 1.45 in RCA, respectively. This study demonstrated that quantification of MBR-IR may provide diagnostic value for detection of coronary artery disease as well as MFR.

DOI： 10.1007/s10554-018-1335-z

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Language：English   Publisher：(一社)日本循環器学会  

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Language：Japanese   Publisher：金原出版(株)  

DOI： 10.18888/rp.0000000368

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01565&link_issn=&doc_id=20180322180008&doc_link_id=10.18888%2Frp.0000000368&url=https%3A%2F%2Fdoi.org%2F10.18888%2Frp.0000000368&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：English   Publisher：(一社)日本循環器学会  

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PURPOSE: We sought to use non-contrast-enhanced T1 mapping to determine the native T1 values required to identify myocardial fibrosis in patients with dilated cardiomyopathy (DCM). METHODS: A total of 25 patients with DCM and 15 healthy controls were enrolled. All subjects underwent T1 mapping using modified look-locker inversion recovery, and the patients underwent late gadolinium-enhancement (LGE) imaging. Basal and mid-ventricular levels were divided into eight segments and the T1 value was measured in each segment. The T1 values of septal segments with LGE were compared with those of the septal segments without LGE, the minimum T1 value of each patient, and the T1 values of the normal septal myocardium. RESULTS: Late gadolinium-enhancement was present in 12 septal segments (24.0%) from 10 patients (40.0%). T1 values were significantly higher in septal segments with LGE than in those without (1373.7 vs. 1288.0 ms; P = 0.035) or in normal septal myocardium (1209.1 ms; P < 0.01). A receiver operating characteristic analysis revealed the appropriate cutoff value of 1349.4 ms for identifying LGE with a sensitivity of 75% and specificity of 92.1%. When the minimum T1 value + 1.2 standard deviation (SD) was used as the threshold, the sensitivity was 75% and specificity was 89.5%. CONCLUSION: Non-contrast-enhanced T1 mapping can be used for assessment of myocardial fibrosis associated with DCM by using the appropriate threshold.

DOI： 10.2463/mrms.mp.2017-0136

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Background A novel strategy to combine conventional transcatheter arterial chemoembolization (TACE) and TACE during portal vein occlusion (TACE-PVO) in the presence of high-flow arterioportal shunt (APS) has been developed to treat hepatocellular carcinoma (HCC) with portal invasion. Purpose To evaluate the efficacy of this strategy. Material and Methods Twenty-five cases of HCC with portal invasion, treated between April 2006 and December 2015, were evaluated. Balloon occlusion of the portal venous outlet was performed in eight cases of high-flow APS when performing TACE. Conventional TACE was performed in the other 17 cases. The primary endpoint was overall survival. Adverse events and deterioration of liver function were also evaluated. Results The median survival time (MST) was 12 months. One-, two-, and three-year survival rates were 48.0%, 39.3%, and 26.2%, respectively. Subgroup analysis and multivariate analysis revealed the CLIP score as prognostic factor. MST was 2.5 months in the subgroup with CLIP score ≥4 and 26.0 months in the subgroup with CLIP score ≤3 (hazard ratio = 7.7, 95% confidence interval = 2.3-25.8). Transient elevations of the levels of transaminase and bilirubin were observed; however, deterioration of liver function was infrequent; upgrading of Child-Pugh class in 9.1% of cases. Conclusion A novel strategy, combining conventional TACE and TACE-PVO, is effective for HCC with portal invasion. The CLIP score may be useful for considering treatment indication.

DOI： 10.1177/0284185117717762

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DOI： 10.1200/JCO.2018.36.6_suppl.142

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Language：Japanese   Publisher：(NPO)日本心臓血管外科学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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BACKGROUND AND PURPOSE: To assess the clinical feasibility of time-resolved 3D phase contrast (4D Flow) MRI assessment of the ophthalmic artery (OphA) flow in patients with internal carotid artery stenosis (ICS). MATERIALS AND METHODS: Twenty-one consecutive patients with unilateral ICS were recruited. 4D Flow MRI and acetazolamide-stress brain perfusion single photon emission computed tomography (SPECT) were performed. The flow direction on the affected-side OphA was categorized into native flow (anterograde or unclear) and non-native flow (retrograde flow) based on 4D Flow MRI. In the affected-side middle cerebral artery (MCA) territory, the ratio of rest cerebral blood flow to normal control (RCBFMCA) and cerebral vascular reserve (CVRMCA) were calculated from SPECT dataset. High-risk patients were defined based on the previous large cohort study (RCBFMCA < 80% and CVRMCA < 10%). RESULTS: Eleven patients had native OphA flow (4 anterograde, 7 unclear) and the remaining 10 had non-native OphA flow. RCBFMCA and CVRMCA each were significantly lower in non-native flow group (84.9 ± 18.9% vs. 69.8 ± 7.3%, P < 0.05; 36.4 ± 20.6% vs. 17.0 ± 15.0%, P < 0.05). Four patients in the non-native flow group and none in the native flow group were confirmed as high-risk (Sensitivity/Specificity, 1.00/0.65). CONCLUSION: The 6 min standard 4D Flow MRI assessment of OphA in patients with ICS can predict intracranial hemodynamic impairment.

DOI： 10.2463/mrms.mp.2016-0074

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OBJECTIVE: To examine the additional prognostic value of coronary CT angiography (CTA) over myocardial perfusion imaging (MPI) in patients with suspected or known coronary artery disease. METHODS: A series of 157 patients (mean age 69 ± 9 years; 76% male; median follow-up 49 months; range 12-82 months) underwent stress MPI with SPECT and coronary CTA within a 6-month interval. Summed stress score (SSS) and summed difference score (SDS) of stress MPI, number of vessels with stenosis, and presence of left main trunk stenosis and high-risk plaques on coronary CTA were examined. Primary endpoints were cardiac death, acute myocardial infarction, or unstable angina requiring revascularization. Secondary endpoints were revascularization > 60 days after the latter imaging test. All patients were followed up for at least 1 year (mean 45 ± 19 months; range 12-82 months). RESULTS: Nine (6%) patients reached primary endpoints. Cardiac death occurred in 1 (0.6%) patient, myocardial infarction in 5 (3%), and unstable angina requiring hospitalization in 3 (2%). Elective revascularization within 60 days was performed in 31 (20%) patients. Sixteen (10%) patients required revascularization after > 60 days. Primary endpoint event-free survival rates were significantly lower in patients with myocardial ischemia (SDS ≥ 2) and high-risk plaques (HRP), and secondary endpoint event-free survival rates in patients with SSS ≥ 4 and 3VD. In multivariate analysis, Cox proportional hazards regression analysis revealed HRP (HR = 8.02; P = 0.006) and myocardial ischemia (HR = 11.487; P = 0.025) were significant predictors of primary endpoints, and 3VD of secondary endpoints (HR = 4.981; P = 0.008). Combined ischemia and HRP resulted in the significant increase of the model Chi square in prediction of primary end points from ischemia or HRP alone (17.4 vs. 9.41; P = 0.005, 17.4 vs. 9.39; P = 0.005, respectively). CONCLUSION: Coronary CT angiography may provide additional prognostic information over MPI.

DOI： 10.1007/s12149-017-1214-z

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Language：English   Publisher：Japanese Society for Magnetic Resonance in Medicine  

Hypertrophic cardiomyopathy (HCM) is a relatively common myocardial genetic disease having a wide variety of symptoms and prognoses. The most serious complications of HCM are sudden cardiac death induced by ventricular arrhythmia or inappropriate changes in blood pressure, and heart failure. Cardiac MR imaging is a valuable imaging method for detecting HCM because of its accurate measurement of wall thickness and myocardial mass without limited view and the unique ability of late gadolinium enhancement (LGE) to identify myocardial fibrosis related to the prognosis of HCM. Tagging and T1 or T2 mapping MR imaging techniques have emerged as quantitative methods for the evaluation of disease severity. In this review, we introduce the MR imaging techniques applied to HCM and demonstrate the typical phenotypes and some morphological characteristics of HCM. In addition, we discuss the clinical relevance of MR imaging for risk stratification and management of HCM.

DOI： 10.2463/mrms.rev.2017-0145

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

Background
The purposes of this study were to assess the usefulness of myocardial F-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET)/computed tomography (CT) for evaluating myocardial metabolic status in hypertrophic cardiomyopathy (HCM) and the therapeutic efficacy of alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy (HOCM).
Methods
Thirty HCM patients (64.4 +/- 10.5 years, 14 male, 12 hypertrophic non-obstructive cardiomyopathy [HNCM], 16 HOCM, and 2 dilated phase of HCM) underwent F-18-FDG-PET/CT. (18)FFDG uptake was semi-quantitatively evaluated using an uptake score in each 17 segment and the entire LV or regional standardized uptake value (SUV).
Results
F-18-FDG uptake was observed mostly in a hypertrophied myocardium in HNCM patients, whereas F-18-FDG was extensively accumulated beyond the hypertrophied myocardium in HOCM patients. There was a positive correlation between the summed uptake score of (18)FFDG and high-sensitive troponin T level in HNCM patients (r = 0.603, p = 0.049), whereas the score was positively correlated with brain natriuretic peptide level (r = 0.614, p = 0.011) in HOCM patients. In 10 patients who received ASA, the maximum SUV of the entire LV was significantly reduced from 5.6 +/- 2.6 to 3.2 +/- 2.1 (p = 0.040) after ASA. Reduction of that maximum SUV was particularly significant in the lateral region (from 5.5 +/- 2.6 to 2.9 +/- 2.2, p = 0.024) but not significant in the anteroseptal region (from 4.5 +/- 2.6 to 2.9 +/- 1.6, p = 0.12).
Conclusion
Extensive F-18-FDG uptake beyond the hypertrophied myocardium was observed in HOCM. ASA attenuates F-18-FDG uptake in a remote lateral myocardium.

DOI： 10.1371/journal.pone.0188479

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：English   Publisher：(一社)日本核医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Objective: This study aimed to determine the relationship between the extent and the location of late gadolinium enhancement (LGE) and ventricular tachyarrhythmia or implantable cardioverter defibrillator (ICD) in hypertrophic cardiomyopathy (HCM).
Methods: We enrolled 115 patients with HCMand LGE. The location of LGEwas divided into septal and nonseptal segments. Clinical backgrounds and LGE were compared in patients between with and without the arrhythmia or consequent ICD installation.
Results: Therewere significant differences in the number of riskmarkers, left ventricular ejection fraction, extent of global LGE, and extent of nonseptal LGE between the groups (P &lt; 0.01). Multivariate analysis revealed that the number of risk markers and extent of nonseptal LGE contributed to ventricular tachyarrhythmia or ICD installation (P &lt; 0.01).
Conclusions: The nonseptal LGE is related to ventricular tachyarrhythmia or ICD installation. We should be vigilant for nonseptal LGE when applying LGE to risk stratification for HCM.

DOI： 10.1097/RCT.0000000000000599

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BAISHIDENG PUBLISHING GROUP INC  

AIM
To evaluate the relationship between the location of hepatocellular carcinoma (HCC) and the efficacy of transarterial chemoembolization (TACE).
METHODS
We evaluated 115 patients (127 nodules), excluding recurrent nodules, treated with TACE between January 2011 and June 2014. TACE efficacy was evaluated according to mRECIST. The HCC location coefficient was calculated as the distance from the central portal portion to the HCC center (mm)/liver diameter (mm) on multiplanar reconstruction images rendered (MPR) to visualize bifurcation of the right and left branches of the portal vein and HCC center. The HCC location coefficient was compared between complete response (CR) and non-CR groups in Child-Pugh grade A and B patients.
RESULTS
The median location coefficient of HCC among all nodules, the right lobe, and the medial segment was significantly higher in the CR group than in the non-CR group in the Child-Pugh grade A patients (0.82 vs 0.62, P &lt; 0.001; 0.71 vs 0.59, P &lt; 0.01; 0.81 vs 0.49, P &lt; 0.05, respectively). However, there was no significant difference in the median location coefficient of the HCC in the lateral segment between in the CR and in the non-CR groups (0.67 vs 0.65, P &gt; 0.05). On the other hand, in the Child-Pugh grade B patients, the HCC median location coefficient in each lobe and segment was not significantly different between in the CR and in the non-CR groups.
CONCLUSION
Improved TACE efficacy may be obtained for HCC in the peripheral zone of the right lobe and the medial segment in Child-Pugh grade A patients. (C) The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

DOI： 10.3748/wjg.v23.i35.6437

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Background. Motion artifact and partial volume effect caused underestimation of coronary plaque inflammation. This study evaluated the high matrix acquisition technique using time-off-light (TOF) positron emission tomography/computed tomography for imaging of atherosclerotic plaque inflammation with fluorine-18 fluorodeoxyglucose in small and moving phantoms.
Methods and Results. All images were reconstructed using a conventional algorithm without TOF (4 x 4 x 4 mm(3) voxel size) and a high matrix algorithm with TOF (2 x 2 x 2 mm(3) voxel size). Microsphere phantoms of 10, 7.9, 6.2, 5.0, and 4.0 mm diameters were acquired in 3-dimensional list-mode for 30 minutes. A heart phantom mimicking cardiac motion consisted of a hot spot simulating a plaque (phi 4 mm, phi 2 mm) on the outside of the left ventricle. In the microsphere and heart phantom study, visual discrimination, maximum activity, and target-to-background ratio using the high matrix algorithm with TOF were better than those using the conventional algorithm without TOF.
Conclusion. The high matrix algorithm with TOF improves detection of small targets in phantoms.

DOI： 10.1007/s12350-016-0510-7

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Purpose To evaluate the usefulness and safety of endovascular treatments for acute upper limb ischemia (AULI) by using multiple techniques, and to compare catheter-directed thrombolysis (CDT) and percutaneous aspiration thromboembolectomy (PAT) as initial procedures.
Materials and Methods The study included 18 patients (4 men and 14 women) with AULI, who underwent a total of 20 sessions of endovascular treatment using various endovascular techniques between January 2005 and April 2016. The patients were initially treated with CDT [n = 9, CDT-based group (C-G)], PAT [n = 6, PAT-based group (P-G)], or angioplasty (n = 3). In case of residual emboli, we performed additional endovascular techniques. We assessed technical success, clinical success, and complications. Additionally, we compared the urokinase dosage between the groups.
Results The mean patient age was 74.4 years. Technical and clinical success was obtained in all patients. Among the 18 patients, 1 underwent CDT only, 2 underwent PAT only, 1 underwent angioplasty only, and 14 underwent multiple techniques. Two patients from the C-G experienced major complications (cerebellar hemorrhage 1; pseudo-aneurysm in a branch of the ulnar artery 1). The mean urokinase dosage was lower in the P-G than in the C-G (40,000 vs. 246,667 IU; Mann-Whitney U test, P = 0.004).
Conclusion Endovascular treatment is effective and safe for AULI. A combination of multiple endovascular techniques is important for successful treatment. PAT is suggested as an initial procedure among endovascular techniques, in terms of a lower dosage of urokinase and a lower complication rate.

DOI： 10.1007/s00270-017-1599-z

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC  

We evaluated a cohort of patients treated with alcohol septal ablation (ASA) to identify predictive factors for repeat ASA. We compared 15 patients who underwent repeat ASA procedures (group R) with 69 patients not requiring repeat procedures (group S) in terms of clinical parameters and morphologic cardiac magnetic resonance. Group R showed higher number of hypertrophic segments (thickness &gt;= 15 mm) in the basal left ventricular level (2.8 +/- 1.7 vs 1.7 +/- 0.8, p = 0.009) than group S. In the multivariate analysis, diuretics use (adjusted odds ratio 5.8, 95% confidential interval [CI] 1.04 to 32.2, p = 0.045) and the number of non anteroseptal extended hypertrophy segments at the basal level were independent predictors of a repeat ASA procedure (adjusted odds ratio 3.64/segment, 95% CI 1.40 to 9.4, p = 0.008). One repeat ASA among 21 patients without non anteroseptal hypertrophy and 1 repeat ASA among 29 patients without posteroseptal hypertrophy were observed; however, 7 of the 14 patients with &gt;= 2 segments of non anteroseptal hypertrophy received repeat ASA. In conclusion, cardiac magnetic resonance based cross-sectional investigation elucidated non anteroseptal hypertrophy segments) to be a crucial predictor of repeat ASA. ASA is useful for patients with regional hypertrophy in the basal anteroseptal, but not posteroseptal region, and without heart failure requiring diuretics. (C) 2017 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.amjcard.2017.03.248

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER HEIDELBERG  

A better understanding of the standardized uptake value (SUV) ranges of fludeoxyglucose positron emission tomography (FDG-PET) is crucial for radiologists. We have developed a statistical image analysis method for FDG-PET imaging of the torso, based on comparisons with normal data. The purpose of this study was to verify the accuracy of the normal model and usefulness of the statistical image analysis method by using typical cancer cases in the liver, lungs, and abdomen.
Our study and the data collection (49 normal and 34 abnormal cases, in terms of PET/CT findings) were approved by the institutional review board. Our scheme consisted of the following steps: (1) normal model construction, (2) anatomical standardization of patient images, and (3) Z-score calculation to show the results of the statistical image analysis. To validate the Z-score index, we sampled 3603 and 1270 voxels in normal organs and abnormal regions, respectively, from the liver, lungs, and the abdomen. We then obtained the SUV and Z-score for each region. A receiver operating characteristics (ROC) analysis-based method was performed to evaluate the discrimination performances of the SUV and Z-score.
The discrimination performances of the SUV and Z-score for the objective regions of interest (ROIs) were evaluated by the areas under the ROC curves (AUCs). As a result of the ROC analysis and statistical tests, all AUCs were found to be larger than 0.98. When the ROIs in the objective regions were combined, the mean AUCs of the Z-score and SUV were 0.99 and 0.98, respectively, the difference being statistically significant ().
The results suggested the possibility of applying a quantitative image reading method for torso FDG-PET imaging. Furthermore, a combination of the SUV and Z-score may provide increased accuracy of the determination methods, such as computer-aided detection and diagnosis.

DOI： 10.1007/s11548-017-1526-4

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To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion.
Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver.
In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group.
Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion.
aEuro cent Hepatic artery occlusion causes haemodynamic changes in hepatocellular carcinoma and liver.
aEuro cent Segmental occlusion decreased rate of change in hepatocellular carcinoma-to-liver attenuation ratio.
aEuro cent Subsegmental occlusion increased rate of change in hepatocellular carcinoma-to-liver attenuation ratio.
aEuro cent Hepatic artery occlusion decreased enhancement volume of hepatocellular carcinoma and liver.
aEuro cent Hepatic artery occlusion causes perfusion defects in hepatocellular carcinoma.

DOI： 10.1007/s00330-016-4573-2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Objective: The aim of this study was to evaluate the usefulness of T2 mapping for detecting myocardial injuries in patients with hypertrophic cardiomyopathy (HCM).
Methods: Twenty-one HCM patients and 7 healthy volunteers were examined. The T2 values were measured at hyperintense areas (high-T2 areas) identified with T2 mapping, at late gadolinium enhancement (LGE) areas, and in nullified myocardium of the HCM patients. The associations between T2 values and laboratory data or LGE areas were assessed.
Results: High-T2 areas had significantly greater T2 values than LGE areas (P &lt; 0.05) and nullified areas (P &lt; 0.01) of HCM and normal myocardium (P &lt; 0.01). The presence of high-T2 areas was associated with an increase in troponin T levels (P = 0.02), and T2 values correlated with the levels of brain natriuretic peptide (P = 0.036, r = 0.86).
Conclusions: T2 mapping identified myocardial injuries suggested by the laboratory data in HCM.

DOI： 10.1097/RCT.0000000000000521

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(公社)日本医師会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本循環器学会  

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Traumatic chopstick injury is very rare, especially in the vascular system. We present an unusual case of a 19-year-old man who presented at the emergency department after being stabbed with a chopstick by his elder brother. Computed tomography revealed a left subclavian artery pseudoaneurysm, which increased from 4 mm to 7 mm in diameter within 47 days. We successfully deployed a Niti-S stent graft for the increasing aneurysm, thereby avoiding a surgical operation. Balloon angioplasty was added for re-stenosis 8 months after the first intervention.

DOI： 10.1272/jnms.84.41

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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The purpose of this study was to estimate the severity of the participants' lower limb ischemia by calculating the lower limb muscle-to-background ratio (LMBR) using lower limb perfusion single-photon emission computed tomography-computed tomography (SPECT/CT) and to evaluate the prognostic value of LMBR in peripheral artery disease (PAD) patients.
This retrospective study consists of 38 patients with PAD (70 +/- 12 years) and observed over 1 year who were included in the analysis. All participants underwent lower limb perfusion SPECT/CT. LMBR was calculated by dividing counts/volume in lower limb muscle by mean counts/volume of background. All patients were divided into two groups based on their LMBR value and observed for the occurrence of a major adverse event (MAE).
The high and low LMBR groups consisted of 26 and 12 patients, respectively. The median LMBR in the high group was 9.59 (6.11-11.87) while that in the low group was 4.35 (3.85-4.99). A significantly higher number of patients in the low LMBR group experienced MAE than in the high LMBR group (7 of 12 vs. 1 of 26, p &lt; 0.001).
This study demonstrated that the LMBR derived from lower limb perfusion SPECT/CT may have a high prognostic value in patients with PAD.

DOI： 10.1007/s11604-016-0602-y

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Language：Japanese   Publisher：(株)メジカルビュー社  

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Language：English   Publisher：JPN SOC MAGNETIC RESONANCE MEDICINE  

Three-dimensional (3D) cardiac magnetic resonance (MR) imaging has several advantages, including the easy coverage of the entire heart without misregistration, reduction of breath-holding times, and availability for postprocessing reconstruction. These advantages are associated with some techniques such as breath-hold or navigator gating and parallel imaging. However, the image quality of 3D cardiac MR images is compromised by the use of a shorter repetition time and parallel imaging. Thus, a steady-state free precession sequence, contrast agent administration, and presaturation pulses are used to maintain the image quality. In this review, we introduce the MR imaging techniques used in 3D cardiac MR imaging and demonstrate the typical 3D cardiac MR images, followed by discussion about their advantages and disadvantages.

DOI： 10.2463/mrms.rev.2016-0116

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Inc  

Introduction The plasma concentration of beta-amyloid (Aβ) has been considered another biomarker of Alzheimer's disease and was reportedly associated with cortical Aβ accumulation. Methods We analyzed 28 subjects with apolipoprotein E4 (ApoE4
E4 group) and 89 subjects without ApoE4 (non-E4 group) to determine the association between cortical Aβ accumulation by standard uptake value ratio with [18F]florbetapir positron emission tomography and plasma Aβ1–40 and Aβ1–42. Results Aβ1–42/Aβ1–40 correlated significantly with mean regional [18F]florbetapir standard uptake value ratio in the non-E4 group (R2 = 0.06, P =.02) but not in the E4 group, and receiver operating characteristic curve analysis for Aβ1–42/Aβ1–40 in the non-E4 group showed sensitivity (92.9%) and specificity (45.9%) with a cutoff value of 0.150 for Aβ positivity. Discussion We verified that the correlation between Aβ1–42/Aβ1–40 and Aβ accumulation differed according to ApoE phenotype. The high sensitivity of plasma Aβ1–42/Aβ1–40 for Aβ positivity in non-E4 subjects indicated a possible role of plasma Aβ1–42/Aβ1–40 as a screening biomarker before amyloid positron emission tomography in clinical settings.

DOI： 10.1016/j.dadm.2017.08.002

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

In the present report, we describe a case of a patient with an asymptomatic aneurysm in the arc of Bahler (AOB), which was successfully treated by transcatheter arterial embolization. The patient presented with severe stenosis of the celiac trunk, which was suspected to be due to median arcuate ligament syndrome. Arteriography of the superior mesenteric artery indicated a rapid stream in an aneurysm in the AOB. Hence, embolization was carefully performed using detachable coils and microcoils. An arteriography performed after embolization did not show any aneurysm, and the hepatic artery and splenic artery could be detected via the pancreatic arcade, originating from the superior mesenteric artery. The AOB is a persistent embryonic ventral anastomosis present between the superior mesenteric artery and the celiac artery. This anastomotic artery is independent of the gastroduodenal artery and the dorsal pancreatic artery, and is extremely rare, with an incidence of &lt;4%. Aneurysms of the AOB are even more uncommon, and such cases have been reported in association with stenosis or occlusion of the celiac trunk. Open surgical aneurysmectomy, with or without reconstruction, is the conventional treatment for such aneurysms. However, rapid advances in interventional radiology have enabled the safe and effective treatment of visceral aneurysms via transcatheter arterial embolization. Based on the current findings, we believe that transcatheter arterial embolization is a minimally invasive and valuable method that may serve as an initial treatment option for aneurysms of the AOB.

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Language：Japanese   Publisher：日本心臓血管内視鏡学会  

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Language：English   Publisher：Tottori University Faculty of Medicine  

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DOI： 10.1007/s12350-015-0074-y

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Language：Japanese   Publisher：大道学館出版部  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J01556&link_issn=&doc_id=20160706450012&doc_link_id=%2Fam3daidc%2F2016%2F009306%2F012%2F0831-0837%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fam3daidc%2F2016%2F009306%2F012%2F0831-0837%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To evaluate the feasibility of a novel embolization technique, the Amplatzer vascular plug (AVP) anchoring technique, to stabilize the delivery system for microcoil embolization.
Three patients were enrolled in this study, including two cases of internal iliac artery aneurysms and one case of internal iliac arterial occlusion prior to endovascular aortic repair. An AVP was used in each case for embolization of one target artery, and the AVP was left in place. The AVP detachment wire was then used as an anchor to stabilize the delivery system for microcoil embolization to embolize the second target artery adjacent to the first target artery. The microcatheter for the microcoils was inserted parallel to the AVP detachment wire in the guiding sheath or catheter used for the AVP.
The AVP anchoring technique was achieved and the microcatheter was easily advanced to the second target artery in all three cases.
The AVP anchoring technique was found to be feasible to advance the microcatheter into the neighboring artery of an AVP-embolized artery.

DOI： 10.1007/s00270-015-1248-3

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Background Dilated cardiomyopathy (DCM) is often associated with progressive heart failure or ventricular arrhythmia. Look-Locker magnetic resonance imaging (MRI) allows quantitative evaluation of interstitial fibrosis by measuring the myocardial T1 value, and delayed enhancement (DE) MRI visualizes myocardial scar.
Purpose To determine the relationship of postcontrast myocardial T1 value or DE to reduced cardiac function or sustained ventricular tachycardia (SVT) in DCM patients with a left ventricular ejection fraction (LVEF) &lt;35%.
Material and Methods We enrolled 41 patients with DCM. Correlations between the cardiac function parameters and postcontrast myocardial T1 value or extent of DE were evaluated. The relationship between SVT and the T1 values or extent of DE was assessed. The correlation between the extent of DE and the T1 value was also examined.
Results The postcontrast myocardial T1 value was significantly correlated with the LVEF (P&lt;0.05; r=0.31) and end-diastolic volume (P&lt;0.01; r=-0.40) in 40 patients with LVEF &lt;35%. DE was not correlated with the cardiac function, but provided a high negative predictive value of 94.7% for SVT. No correlation was found between the myocardial T1 value and extent of DE.
Conclusion In DCM patients with LVEF &lt;35%, the postcontrast myocardial T1 value correlated with the severity of cardiac dysfunction, and the absence of DE indicated the low risk of SVT. Both MRI parameters should be estimated because they may reflect discrete forms of myocardial damages in patients with DCM.

DOI： 10.1177/0284185115580840

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Language：Japanese   Publisher：(株)メディカルレビュー社  

CT検査は比較的簡便で侵襲が低く、かつ短時間で広範囲の領域を客観的に評価できることから、脈管疾患における日常診療において必要不可欠な検査である。その目的はスクリーニングに始まり、血管解剖や破格の評価、瘤、解離、狭窄、閉塞などの脈管疾患の診断やその程度に基づく治療適応・治療方針の決定、合併症の評価、治療後のフォローアップなど多岐にわたる。本稿では、脈管疾患におけるCT検査の役割に関して、脈管部位および代表的な疾患(頸動脈、冠動脈、大動脈瘤、大動脈解離、静脈血栓塞栓症、末梢動脈疾患(PAD)ごとに分類して概説する。(著者抄録)

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Language：Japanese   Publisher：(株)日本臨床社  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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DOI： 10.2967/jnumed.115.162420

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DOI： 10.1007/s00234-015-1626-1

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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DOI： 10.2967/jnumed.115.160937

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Language：Japanese   Publisher：日本医科大学医学会  

DOI： 10.1272/manms.12.6

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Other Link： http://search.jamas.or.jp/link/ui/2016193368

Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2967/jnumed.115.160937

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Language：English  

Portal vein thrombosis (PVT) is a rare complication of liver transplantation which can lead to graft failure and patient death. Treatment can be difficult, especially in cases of PVT from the intrahepatic portal vein to the proximal jejunal veins. A 55-year-old woman had undergone living-donor liver transplantation with splenectomy for end-stage liver cirrhosis due to hepatitis C with hepatocellular carcinoma. Ten months after transplantation, massive ascites and slight abdominal pain developed, and computed tomography revealed a PVT between the intrahepatic portal vein and the superior mesenteric vein. Repeated interventional radiology procedures were used in combination with thrombolysis, thrombectomy, and metallic stent replacement to obtain favorable portal flow to the graft. Five years after being treated, the patient is well, with favorable portal flow having been confirmed. In conclusion, repeated and assiduous interventional radiological treatment combined with thrombolytic therapy, thrombectomy, and metallic stent replacement could be important for severe PVT.

DOI： 10.1272/jnms.83.206

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JPN SOC MAGNETIC RESONANCE IN MEDICINE  

Purpose: We evaluated the feasibility of contrast-enhanced steady-state free precession (ceSSFP) in the assessment of myocardial injury and obstruction of the left ventricular outflow tract (LVOT) in patients with hypertrophic obstructive cardiomyopathy (HOCM) after alcohol septal ablation (ASA).
Methods: Twelve patients with HOCM underwent 16 magnetic resonance (MR) examinations following ASA. Precontrast SSFP, ceSSFP and late gadolinium enhancement (LGE) imaging were performed with a 1.5-tesla imager. ceSSFP was performed 3 to 7 min after gadolinium injection. We visually and quantitatively evaluated the signal patterns of the myocardium after ASA on SSFP and LGE MR imaging. We observed the LVOT using ceSSFP in the 3-chamber view.
Results: We could visualize ASA-induced myocardial infarction (MI) in all 16 studies by LGE and ceSSFP but in only 6 studies (37.5%) by precontrast SSFP. Contrast was higher between MI and remote myocardium with LGE than ceSSFP (P &lt; 0.01). ASA-induced hypointense regions were well visualized by the 2 sequences after contrast in the 7 patients who underwent MR imaging within 7 weeks of ASA and in a few patients after 80 weeks from ASA. The ceSSFP allowed comparable visualization of the jet flow crossing the LVOT to that derived from echocardiographic data.
Conclusion: Contrast-enhanced steady-state free precession allows assessment of myocardial injury as well as of the left ventricular outflow tract after alcohol septal ablation in a single scan without penalty in scan time and cine imaging contrast.

DOI： 10.2463/mrms.2015-0037

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DOI： 10.1155/2016/3749489

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Language：English   Publisher：The Medical Association of Nippon Medical School  

We report on a rare case of blunt traumatic hepatic arteriovenous fistula arising from a pseudoaneurysm in a 35-year-old woman. Transarterial embolization was performed with n-butyl-2-cyanoacrylate, under inflow control with loose coil packing within the pseudoaneurysm and outflow control by balloon occlusion of the hepatic vein. A promising therapeutic outcome was achieved without any serious adverse events. Thus, the combination of these techniques to control inflow and outflow was successfully used to treat this rare hepatic vascular injury.

DOI： 10.1272/jnms.83.27

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Other Link： http://search.jamas.or.jp/link/ui/2017010064

Language：Japanese   Publisher：(株)メジカルビュー社  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE PUBLICATIONS LTD  

Background: The clinical significance of microvascular obstruction (MO) in hypertrophic cardiomyopathy (HOCM) after percutaneous transluminal septal myocardial ablation (PTSMA) remains unknown.
Purpose: To assess the relationship between the location of MO and the improvement in symptoms and pressure gradient after PTSMA in patients with HOCM.
Material and Methods: Twenty-three patients with HOCM underwent MRI within 24 weeks after PTSMA. The MO was defined visually as the hypointense region adjacent to the left or right ventricular cavity, which was surrounded by myocardial infarction. The location of MO and improvement in clinical symptoms and pressure gradient at 3-6 months follow-up were assessed.
Results: MO was observed in 16 patients who underwent MRI within 7 weeks after PTSMA. Left-sided MO was observed in 12 patients, and right-sided MO was observed in four patients. Improvement in clinical symptoms and reduction in the pressure gradient were not sufficient in the patients with right-sided MO, while PTSMA was effective in the patients with the left-sided MO.
Conclusion: The location of MO identified by MRI may be related to the effectiveness of PTSMA at the short-term follow-up. The left-sided MO is related to complete improvement in clinical symptoms and pressure gradients.

DOI： 10.1177/0284185114559871

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Language：Japanese   Publisher：(一社)日本耳鼻咽喉科学会  

自己骨髄細胞を用いた血管再生医療は、難病指定疾患であるBuerger病と閉塞性動脈硬化症(ASO)の治療抵抗性症例に対して、安全性に優れ有効性も証明され、わが国再生医療初の高度先進医療(当時)として承認され、現在も第2項先進医療技術【先進医療A】に承認されている。さらに末梢血単核球細胞、末梢血幹細胞を使用した血管再生治療も先進医療技術Aに追加承認された。血管再生治療(先進医療承認)は、末梢動脈疾患(PAD)に対する経皮的血管形成術(PTA)、末梢血管バイパス手術に次ぐ第3の治療法として認識されつつあり(Beyond TASC II)、さらに厚生労働省難治性疾患克服研究事業の一つとして、膠原病の中でも難治性潰瘍・壊疽を合併することが最も多い全身性強皮症(PSS)に対して研究班で多施設共同研究を実施し、安全性と有効性を証明した。さらに進化させた次世代型血管再生療法として、血管形成に不可欠な塩基性線維芽細胞増殖因子(b-FGF)をゼラチンハイドロゲルと混入し、患肢筋肉内に注射するだけで血管再生可能な「DDS(薬物伝送システム)徐放化b-FGF蛋白による血管再生療法(2008年内閣府スーパー医療特区分担研究課題)」の臨床研究を実施して安全性と有効性を報告した。また最近では、現在泌尿器科、消化器外科等で実施されている結石破砕術の約10分の1の低出力(約0.09mJ/mm2)の衝撃波(shock wave)を虚血患肢に当てるだけで血流増加を可能にする新治療法である低出力体外衝撃波治療による血管再生治療を臨床応用し、これも安全性および有意な下肢血流増加効果を証明した。このように血管再生治療は治療抵抗性PADに対して、各種の臨床研究を通じて徐々に安全性と有効性が一般に認識され、PTAやバイパス術が不可能な難治性症例の最後に考慮され得るべき最新治療となりつつある。(著者抄録)

DOI： 10.3950/jibiinkoka.118.1281

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Other Link： https://jlc.jst.go.jp/DN/JLC/20018517994?from=CiNii

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Objective The aim of this study was to evaluate distribution and clinical significance of high signal intensity of the myocardium on T2-weighted images (T2-HI) in 2 phenotypes of hypertrophic cardiomyopathy (HCM).
Methods Thirty-six patients with asymmetrical septal HCM (ASH) and 18 patients with apical HCM (APH) and their 864 myocardial segments were investigated. The distribution of T2-HI was compared with that of late gadolinium enhancement (LGE), and the relationships between T2-HI and clinical risk markers were evaluated. T2 values of the T2-HI were estimated with T2 mapping.
Results The T2-HI was observed in 18 segments (3.1%) in 13 patients with ASH (36.1%) and in 12 segments (4.2%) in 8 patients with APH (44.4%). It was often localized outside LGE. The presence of T2-HI was related to syncope in ASH (P = 0.016). Furthermore, it had higher T2 values (61.1 milliseconds) than the reference myocardium (47.3 milliseconds).
Conclusions High signal intensity of the myocardium on T2-weighted images often locates outside LGE and reflects myocardial damage, which is related to syncope in ASH.

DOI： 10.1097/RCT.0000000000000296

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DOI： 10.1245/s10434-015-4494-3

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Language：Japanese   Publisher：(一社)日本脈管学会  

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DOI： 10.1007/s12350-014-0037-8

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Language：Japanese   Publisher：(一社)日本脈管学会  

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Splenic arteriovenous fistulas (SAVFs) with splenic vein aneurysms are extremely rare entities. There have been no prior reports of SAVFs developing after laparoscopic pancreatectomy. Here, we report the first case. A 40-year-old man underwent a laparoscopic, spleen-preserving, distal pancreatectomy for an endocrine neoplasm of the pancreatic tail. Three months after surgery, a computed tomography (CT) scan demonstrated an SAVF with a dilated splenic vein. The SAVF, together with the splenic vein aneurysm, was successfully treated using percutaneous transarterial coil embolization of the splenic artery, including the SAVF and drainage vein. After the endovascular treatment, the patient's recovery was uneventful. He was discharged on postoperative day 6 and continues to be well 3 mo after discharge. An abdominal CT scan performed at his 3-mo follow-up demonstrated complete thrombosis of the splenic vein aneurysm, which had decreased to a 40 mm diameter. This is the first reported case of SAVF following a laparoscopic pancreatectomy and demonstrates the usefulness of endovascular treatment for this type of complication.

DOI： 10.3748/wjg.v21.i25.7907

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DOI： 10.1148/radiol.15141596

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/gps.4215

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DOI： 10.1007/s10554-015-0654-6

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Language：Japanese   Publisher：先端医療技術研究所  

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DOI： 10.1007/s00330-014-3558-2

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Language：Japanese   Publisher：日本外科系連合学会  

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DOI： 10.1097/GOX.0000000000000375

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1002/gps.4173

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Language：Japanese   Publisher：日本外科系連合学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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DOI： 10.1016/j.jccase.2014.11.006

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Language：Japanese   Publisher：金原出版(株)  

当院で副腎静脈サンプリングを施行した145例を対象に、血管造影画像に基づく副腎静脈の吻合様式について検討した。その結果、副腎静脈において吻合血管が描出されたのは右側で128例(88.3%)、左側で136例(93.8%)であった。右副腎静脈との吻合血管の種類と頻度は、それぞれ腎被膜静脈80.7%、後腹膜静脈33.1%、下横隔静脈11.0%、肝静脈5.5%、門脈5.5%、腎盂尿管静脈1.4%であった。右下肝静脈と右副腎静脈の共通幹形成は4.1%で認められた。左副腎静脈との吻合血管は、腎被膜静脈56.6%、後胃静脈9.7%、後腹膜静脈7.6%、腎盂尿管静脈1.4%、腰静脈0.7%であった。左下横隔静脈との共通幹形成は89.7%と高頻度にみられた。

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPANESE CIRCULATION SOC  

Background: The severity of impaired fatty acid utilization in the myocardium can predict cardiac death in asymptomatic patients on hemodialysis. However, interpretive variability and its impact on the prognostic value of myocardial fatty acid imaging are unknown.
Methods and Results: A total of 677 patients who received hemodialysis for &gt;= 20 years and had one or more cardiovascular risk factors underwent I-123-labeled beta-methyl iodophenyl-pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) at 48 hospitals across Japan. SPECT images were interpreted by experts at the nuclear core laboratory and by readers with varying skill levels at clinical centers, based on the standard 17-segment model and 5-point scoring systems, independently. The. values only reached fair agreement both for overall impression (kappa=0.298, normal vs. abnormal) and for categorical impression (kappa=0.244, normal vs. mildly abnormal vs. severely abnormal). The normalcy rate was lower in readers at the clinical centers (60.9%) than in experts (69.9%). In contrast to the results assessed by experts, a Kaplan-Meier analysis based on the interpretation by readers at the clinical centers failed to distinguish the risk of events in patients with normal scans from that of patients with mildly abnormal scans.
Conclusions: Considerable variability and its impact on prognostic value were observed in the visual interpretation of BMIPP SPECT images between experts and readers at the clinical centers.

DOI： 10.1253/circj.CJ-14-0646

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DOI： 10.1272/jnms.82.76

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DOI： 10.2463/mrms.2014-0044

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DOI： 10.1272/jnms.82.166

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Kanehara Shuppan Co. Ltd  

We evaluated the anastomotic variations of adrenal veins in 145 adrenal venous sampling cases. Right adrenal veins communicated with renal capsular (80.7%), retroperitoneal (33.1%), inferior phrenic (11.0%), hepatic (5.5%), portal (5.5%), renal pelvis and ureteric veins (1.4%), respectively. There were 6 cases with common trunk of right adrenal vein and inferior hepatic vein. Left adrenal veins communicated with renal capsular (56.6%), posterior gastric (9.7%), retroperitoneal (7.6%), renal pelvis and ureteric (1.4%), and lumbar veins (0.7%), respectively. Majority of adrenal veins anastomosed to renal capsular veins. Knowledge of adrenal venous anatomical variations is mandatory for accurate AVS.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Background and purpose: The aim of this study was to compare the accumulation of 4-borono-2-F-18-fluoro-phenylalanine (F-18-BPA) with that of F-18-fluorodeoxyglucose (F-18-FDG) in head and neck cancers, and to assess the usefulness of F-18-FDG PET for screening candidates for boron neutron capture therapy (BNCT).
Material and methods: Twenty patients with pathologically proven malignant tumors of the head and neck were recruited from March 2012 to January 2014. All patients underwent both whole-body F-18-BPA PET/CF and F-18-FDG PET/CT within 2 weeks of each other. The uptakes of F-18-BPA and F-18-FDG at 1 h after injection were evaluated using the maximum standardized uptake value (SUVmax).
Results: The accumulation of F-18-FDG was significantly correlated with that of F-18-BPA. The SUVmax of F-18-FDG &gt;= 5.0 is considered to be suggestive of high F-18-BPA accumulation.
Conclusions: F-18-FDG PET might be an effective screening method performed prior to F-18-BPA for selecting patients with head and neck cancer for treatment with BNCT. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.radonc.2014.11.001

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Language：Japanese   Publisher：(株)学研メディカル秀潤社  

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Language：English   Publisher：BAISHIDENG PUBLISHING GROUP INC  

Hepatocellular carcinoma (HCC) is the sixth most common cancer and third leading cause of cancer-related death in the world. The Barcelona clinic liver cancer classification is the current standard classification system for the clinical management of patients with HCC and suggests that patients with intermediate-stage HCC benefit from transcatheter arterial chemoembolization (TACE). Interventional treatments such as TACE, balloon-occluded TACE, drug-eluting bead embolization, radioembolization, and combined therapies including TACE and radiofrequency ablation, continue to evolve, resulting in improved patient prognosis. However, patients with advanced-stage HCC typically receive only chemotherapy with sorafenib, a multi-kinase inhibitor, or palliative and conservative therapy. Most patients receive palliative or conservative therapy only, and approximately 50% of patients with HCC are candidates for systemic therapy. However, these patients require therapy that is more effective than sorafenib or conservative treatment. Several researchers try to perform more effective therapies, such as combined therapies (TACE with radiotherapy and sorafenib with TACE), modified TACE for HCC with arterioportal or arteriohepatic vein shunts, TACE based on hepatic hemodynamics, and isolated hepatic perfusion. This review summarizes the published data and data on important ongoing studies concerning interventional treatments for unresectable HCC and discusses the technical improvements in these interventions, particularly for advanced-stage HCC. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

DOI： 10.3748/wjg.v20.i37.13453

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE PUBLICATIONS LTD  

Background: Drug leakage and lack of a drug-removal system have prevented clinical application of isolated pelvic perfusion (IPP). These barriers were overcome with negative-balance IPP (NIPP) in experimental pig models. Here, a phase 1 clinical study of NIPP was performed in patients with incurable symptomatic rectal cancer.
Purpose: To establish a safe regimen of high-dose regional chemotherapy with NIPP using cisplatin in patients with incurable rectal cancer.
Material and Methods: Between June 2004 and January 2007, NIPP therapy was performed for 23 patients (11 women, 12 men; mean age, 58 years). NIPP was routinely performed twice over a 4-week interval. Dose-limiting toxicities (DLTs) were defined using a 5+3 design, and cisplatin doses were escalated from 170 mg/m(2), with a fixed 5-fluorouracil dose of 1000 mg/m(2). The grade of adverse events (AEs) at the first and second sessions of NIPP therapy, pharmacokinetics, and antitumor response were evaluated.
Results: No DLTs were observed during the first session of NIPP. However, at the second session, two patients experienced the DLT of neuropathy after administration of 200 mg/m(2) cisplatin. Therefore, 190 mg/m(2) cisplatin was indicated as the maximum tolerated dose (MTD). The plasma pelvic-to-systemic exposure ratio was 18.4 based on the maximum concentration and 19.0 based on the concentration-time curve. Solid tumor responses included complete response in two patients, partial response in five patients, stable disease in 15 patients, and progressive disease in one patient.
Conclusion: NIPP may offer the safe delivery of high-dose regional chemotherapy (MTD of 190 mg/m(2) cisplatin) with negligible AEs and effective control of tumor growth in patients with incurable rectal cancer.

DOI： 10.1177/0284185113507253

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Purpose: To evaluate the distribution and extent of myocardial fibrosis identified by either contrast-enhanced Look-Locker or late gadolinium enhancement magnetic resonance imaging (LGE MRI) and their relationships between ventricular tachyarrhythmia or risk factors in apical hypertrophic cardiomyopathy (APH).
Materials and Methods: Twenty-five APH patients were examined using a 3.0 T or 1.5 T instrument. We used MRI to evaluate myocardial T1 values and scar. We compared the myocardial fibrosis assessed by contrast-enhanced Look-Locker or LGE MRI with ventricular tachyarrhythmia or risk factors for hypertrophic cardiomyopathy.
Results: Myocardial scar was present in 17 of the 25 patients with APH. Myocardial scar was distributed predominantly in the apical myocardium (P &lt; 0.01), whereas myocardial T1 values did not differ between the apical, midventricular, and basal septum. The extent of myocardial scar according to 16-segment model and ejection fraction were related to ventricular tachyarrhythmia or risk factors in APH (P &lt; 0.05 for both). The myocardial T1 value was not associated with the tachyarrhythmia or risk factors.
Conclusion: In APH, the extent of myocardial scar on LGE MRI is associated with ventricular tachyarrhythmia and risk factors. Quantification of the myocardial T1 value is not necessary for its risk stratification.

DOI： 10.1002/jmri.24357

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DOI： 10.1007/s12149-014-0859-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Background and Aim: To retrospectively evaluate proper hepatic artery embolization, with respect to the development of extrahepatic collaterals.
Methods: Proper hepatic artery embolization was performed in 18 patients with hemorrhagic arterial lesions in the hepatic hilum. Post-procedural development of extrahepatic collaterals was evaluated by computed tomography or angiography. Embolization data and liver function tests were assessed. The correlation of outcomes with portal venous stenosis, hepatic failure prior to embolization, elevation of prothrombin time, and insufficient collateral development were analyzed.
Results: Postoperative bleeding occurred in 17/18 patients, and one was treated for an idiopathic aneurysm of the proper hepatic artery; all treatments achieved technical success. Extrahepatic collaterals were confirmed in 13 patients. Elevations of liver function test values were transient and returned to baseline within 14 days in patients with collateral development (n = 13), but were unimproved in patients without collaterals (n = 5) (P &lt; 0.001). Portal venous stenosis; prior hepatic failure; unrecovered, elevation of prothrombin time; and insufficient collateral development were significantly correlated with poor outcomes (P &lt; 0.05, respectively).
Conclusions: Proper hepatic artery embolization is effective for hemostasis, and extrahepatic collateral development is expected. Therefore, this is a safe treatment without prolonged hepatic ischemic damage, especially in patients without severe portal venous stenosis or prior hepatic failure.

DOI： 10.1111/jgh.12571

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DOI： 10.1177/1742271X14524571

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：English   Publisher：SAGE PUBLICATIONS LTD  

DOI： 10.1177/0284185113514162

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DOI： 10.1530/EJE-13-0741

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROYAL SOC MEDICINE PRESS LTD  

Background: Renal arteriovenous malformations (AVMs) are rare vascular malformations that cause hematuria. Treatment for renal AVMs has evolved from open nephrectomy to transcatheter arterial embolization (TAE).
Purpose: To retrospectively evaluate efficacy and adverse events of TAE for renal AVMs.
Material and Methods: We examined 12 patients (three men, nine women; mean age, 56 years) with renal AVM with gross hematuria, who underwent 14 sessions of treatment, using various embolization materials (liquid embolization agents, gelatin sponge, and coils). Among the 12 patients, 10 had cirsoid AVMs, eight of which were high-flow lesions. The remaining two patients had aneurismal AVMs. We assessed technical and clinical success, and also complications. All patients were followed for 7-92 months (mean, 48 months).
Results: Technical success was obtained in all patients. Primary clinical success was obtained in all patients; however, recurrence was observed in two patients who were treated with coils alone. A second session of TAE led to the sustained relief of symptoms. Clinical success rate was significant better (P = 0.045) when coils combined with other agents or liquid agents were used, than when only coils were used. No major complications occurred in any of patients; post-embolization syndrome and deterioration of renal function were not observed.
Conclusion: TAE treatment was safe, effective, and provided a good outcome, except when only coils were used as the embolization agent.

DOI： 10.1177/0284185113493085

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Language：Japanese   Publisher：金原出版(株)  

症例は40歳代女性で、2年前CTで右傍胸椎腫瘤および左副腎腫瘤を指摘され、経過観察された。右傍胸椎腫瘤が増大したため、精査のため受診した。造影CTでTh9レベルの右傍椎体領域に楕円形で17×26×28mm大、境界明瞭な軟部腫瘤を認めた。また左副腎領域や右副腎前方〜腹部大動脈側にも2〜3cm大の腫瘤が散見され、傍胸椎病変と同様の造影所見であった。造影MRIで腫瘤はT1強調像低信号、T2強調像、拡散強調像で高信号を呈し、腫瘤は強い増強効果を示した。FDG-PET/CTで胸椎右側の腫瘤、左副腎、右副腎腹側〜大動脈腹側病変、左傍咽頭領域に高集積腫瘤を認めた。123I-MIBG SPECT/CTで腫瘤の殆どにMIBG高集積が確認されたが腹部大動脈腹側病変の一部や脾臓病変では集積を認めなかった。MIBG強陽性を呈した左副腎領域病変に対し腹腔鏡下左副腎切除術が施行された。腫瘤組織は類円形〜やや紡錘形の核を有する細胞が小型胞巣を形成しながら索状あるいは密に増生し有糸核分裂は目立たず、出血・壊死は認めなかった。S-100、シナプトフィシン、クロモグラニンAは陽性で、副腎外褐色細胞腫と診断された。

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Objective This study aimed to determine the relationship between delayed enhancement magnetic resonance imaging (DE MRI) and ventricular tachyarrhythmia in patients with hypertrophic cardiomyopathy (HCM) with basal septal hypertrophy and preserved ejection fraction (EF). Methods One hundred seven patients with HCM with basal septal hypertrophy and EF greater than 50% underwent cine and DE MRI. Myocardial scar was identified with DE MRI. We assessed whether patient,s background, cine MRI findings, presence of myocardial scar, or number of scarred myocardial segments was related to the occurrence of ventricular tachyarrhythmia. Results Patient,s age, family history of HCM, and number of scarred segments differed between the patients with and without the arrhythmia. A family history of HCM and number of scarred segments were significantly related to ventricular tachyarrhythmia (P &lt; 0.01). Conclusions The number of scarred segments is the significant DE MRI parameter related to ventricular tachyarrhythmia in HCM with basal septal hypertrophy and preserved EF.

DOI： 10.1097/RCT.0b013e3182a2fb01

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DOI： 10.1177/2047981613518772

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Language：English   Publisher：The Medical Association of Nippon Medical School  

Patients with acute type B aortic dissection (ABAD) are often treated medically. However, ABAD is a potentially serious emergency if complicated by acute organ ischemia. The therapeutic strategy for ABAD with visceral malperfusion remains controversial. Because emergent surgery has a high mortality rate, emergent endovascular treatment can be performed instead. We report a case of endovascular fenestration with stenting for visceral malperfusion in ABAD. One stent was inserted across the intimal flap to keep the fenestrated site open, and another stent was placed into the narrowed true lumen. This therapeutic strategy may be feasible for ABAD with acute malperfusion.

DOI： 10.1272/jnms.81.340

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Other Link： http://search.jamas.or.jp/link/ui/2015260981

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JPN SOC MAGNETIC RESONANCE IN MEDICINE  

Purpose: A drawback of time-resolved 3-dimensional phase contrast magnetic resonance (4D Flow MR) imaging is its lengthy scan time for clinical application in the brain. We assessed the feasibility for flow measurement and visualization of 4D Flow MR imaging using Cartesian y-z radial sampling and that using k-t sensitivity encoding (k-t SENSE) by comparison with the standard scan using SENSE.
Materials and Methods: Sixteen volunteers underwent 3 types of 4D Flow MR imaging of the brain using a 3.0-tesla scanner. As the standard scan, 4D Flow MR imaging with SENSE was performed first and then followed by 2 types of acceleration scan with Cartesian y-z radial sampling and with k-t SENSE. We measured peak systolic velocity (PSV) and blood flow volume (BFV) in 9 arteries, and the percentage of particles arriving from the emitter plane at the target plane in 3 arteries, visually graded image quality in 9 arteries, and compared these quantitative and visual data between the standard scan and each acceleration scan.
Results: 4D Flow MR imaging examinations were completed in all but one volunteer, who did not undergo the last examination because of headache. Each acceleration scan reduced scan time by 50% compared with the standard scan. The k-t SENSE imaging underestimated PSV and BFV (P &lt; 0.05). There were significant correlations for PSV and BFV between the standard scan and each acceleration scan (P &lt; 0.01). The percentage of particles reaching the target plane did not differ between the standard scan and each acceleration scan. For visual assessment, y-z radial sampling deteriorated the image quality of the 3 arteries.
Conclusion: Cartesian y-z radial sampling is feasible for measuring flow, and k-t SENSE offers sufficient flow visualization; both allow acquisition of 4D Flow MR imaging with shorter scan time.

DOI： 10.2463/mrms.2013-0008

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：HINDAWI PUBLISHING CORPORATION  

Purpose. To investigate the liver volume change and the potential of early evaluation by contrast-enhanced magnetic resonance imaging (MRI) using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) after portal vein embolization (PVE). Materials and Methods. Retrospective evaluations of computed tomography (CT) volumetry of total liver and nonembolized areas were performed before and 3 weeks after PVE in 37 cases. The percentage of future liver remnant (%FLR) and the change ratio of %FLR (%FLR ratio) were calculated. Prospective evaluation of signal intensities (SIs) was performed to estimate the role of Gd-EOB-DTPA-enhanced MRI as a predictor of hypertrophy in 16 cases. The SI contrast between embolized and nonembolized areas was calculated 1 week after PVE. The change in SI contrast before and after PVE (SI ratio) was also calculated in 11 cases. Results. %FLR ratio significantly increased, and SI ratio significantly decreased (both P &lt; 0.01). There were significant negative correlations between %FLR and SI contrast and between %FLR and SI ratio (both P &lt; 0.01). Conclusion. Hypertrophy in the nonembolized area after PVE was indicated by CT volumetry, and measurement of SI contrast and SI ratio in Gd-EOB-DTPA-enhanced MRI early after PVE may be useful to predict the potential for hepatic hypertrophy.

DOI： 10.1155/2014/684754

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：HINDAWI PUBLISHING CORPORATION  

The aim of this study was to evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) using warmed and nonwarmed miriplatin for hepatocellular carcinoma. Eighty patients (117 nodules), treated between January 2010 and June 2013, were evaluated. Thirty-two and 85 nodules were treated with nonwarmed and warmed miriplatin, respectively. The efficacy of TACE was evaluated on a per nodule basis according to treatment effect (TE). Adverse events were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.0. TE grades were significantly improved in the warmed group compared to the nonwarmed group (nonwarmed: TE 4, 12.5%; TE 3, 0%; TE 2, 15.6%; TE 1, 71.9%; warmed: TE 4, 34.1%; TE 3, 5.9%; TE 2, 9.4%; TE 1, 50.6%; P = 0.017). Multivariate analysis revealed significant impact of warming miriplatin on objective response rate (odds ratio, 12.35; 95% confidence interval, 2.90-90.0; P = 0.0028). CTCAE grades of elevated aspartate and alanine transaminase after TACE were significantly higher in the warmed group (P = 0.0083 and 0.0068, resp.); however, all adverse events were only transient. The use of warmed miriplatin in TACE significantly improved TE without causing serious complications.

DOI： 10.1155/2014/359296

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Kanehara Shuppan Co. Ltd  

We reported two cases of pancreatic neuroendocrine tumor with marked fibrosis : insulinoma and serotonin producing tumor. CT showed typical intense enhancement of the tumors, which reflected hypervascularity. The tumors showed low intensity on the T2-weighted images, which reflected marked fibrosis or amyloid deposits. The serotonin producing tumor showed dilatation of the main pancreatic duct on MRCP. CT may be useful for diagnosing pancreatic neuroendocrine tumor, and MRI reflected the marked fibrosis in the tumor. MRCP indicated the serotonin producing tumor.

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Kanehara Shuppan Co. Ltd  

We report a 40's female with multiple extra-adrenal pheochromocytoma. Contrast enhanced CT showed highly-enhanced tumors at extra-adrenal organs with high affinity of 123I-MIBG. FDG-PET/CT revealed increased density of paravertebral and retroperitoneal fat tissues with high FDG accumulation. The pathological examination confirmed the diagnosis as pheochromocytoma, and the fat tissues were defined as brown adipose tissue with slight lipid droplets. The findings were well accorded with those of CT and FDG-PET/CT of high activity and increased density.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

PurposeTo assess relationship between nonscarred myocardial T1 value measured using contrast-enhanced Look-Locker MRI and cardiac function in dilated cardiomyopathy (DCM) at 1.5 Tesla (T) and 3.0T MRI.
Materials and MethodsContrast-enhanced Look-Locker MRI was performed in 35 DCM patients. Nonscarred myocardial and blood T1 values were calculated from the signal intensity values and the delay time obtained on Look-Locker MRI. We assessed the correlation between the myocardial T1 value or myocardial T1 minus blood T1 value and cardiac function estimated using cine MRI (e.g., end-diastolic volume: EDV, left ventricular ejection fraction: LVEF) or brain natriuretic peptide (BNP).
ResultsWith 1.5T MRI (n=16), the myocardial T1 value correlated negatively with the EDV(r=-0.66) and end-systolic volume (ESV; r=-0.68), and positively with the LVEF (r=0.51); the myocardial T1 minus blood T1 value correlated inversely with EDV (r=-0.70), ESV (r=-0.62), and brain natriuretic peptide (BNP; r=-0.56). With 3.0T MRI (n=17), the myocardial T1 value correlated negatively with ESV (r=-0.44), septal thickness (r=-0.60), and BNP (r=-0.51), and positively with LVEF (r=0.61); the myocardial T1 minus blood T1 value negatively correlated with BNP (r=-0.50) and positively with LVEF (r=0.54).
ConclusionThe nonscarred myocardial T1 value measured with either 1.5T or 3.0T contrast-enhanced Look-Locker MRI is significantly related to cardiac dysfunction in DCM.

DOI： 10.1002/jmri.24131

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Kobayashi Y, Kumita S, Fukushima Y, Ishihara K, Suda M, Sakurai M, Journal of cardiology, 2013, vol. 62, no. 5, pp. 314-319

DOI： 10.1016/j.jjcc.2013.05.004

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Other Link： http://orcid.org/0000-0001-6224-4914

Language：Japanese   Publisher：THE JAPANESE UROLOGICAL ASSOCIATION  

(Purpose) We evaluated usefulness of transcatheter arterial embolization (TAE) for deep renal injury, and investigated whether there is any difference in outcomes for transcatheter arterial embolization (TAE) performed for deep renal injury in a large-sized hospital (university hospital) in comparison with a middle-sized hospital (local hospital). (Methods) We retrospectively reviewed the outcomes of 42 patients with renal injury who were transported to the critical care center of Nippon Medical School (NMS) Hospital in Tokyo from April 2001 to April 2011 and 33 patients of renal injury transported to the critical care center of Ohtawara Red Cross (ORC) Hospital in Tochigi prefecture from April 2001 to April 2009. Therefore, a total of 75 patients, which is the sum of the patients presenting to both the hospitals for renal injury were reevaluated according to the guidelines developed by the Japanese Association for the Surgery of Trauma (JAST) and published in 2008. (Results) Forty-two patients in NMS hospital included 6 women and 36 men who were 16 to 88 years old (mean 41.6), and they were divided into Type I (16), Type II (11), and Type III (15) and were treated with bedrest (30), TAE (7), or laparotomy (5). Five patients died, but no one succumbed solely due to the renal injury. On the other hand, 33 Patients in ORC Hospital included 8 women and 25 men who were 16 to 87 years old (mean 46.6). They were divided into Type I (9), Type II (12), and Type III (12) and were treated with bedrest (24) or TAE (9). Eight patients died, but no one succumbed solely due to the renal injury. Sixteen patients were treated successfully with TAE in the 2 hospitals, and 15 of these 16 patients were divided into type III renal injury. Therefore, we believe that nephrectomy should be avoided in such patients because of the benefits offered by TAE. (Conclusion) TAE was found to be useful for the treatment of type III renal injury in both institutions, irrespective of the size of a hospital.

DOI： 10.5980/jpnjurol.104.688

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Other Link： https://jlc.jst.go.jp/DN/JALC/10026610213?from=CiNii

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To evaluate the capability of MRI to differentiate cardiac amyloidosis (CA), end-stage hypertrophic cardiomyopathy (HCM), and hypertensive heart disease (HHD), which are important etiologies of left ventricular hypertrophy (LVH) and heart failure.
We enrolled 26 patients presenting with both LVH and heart failure: six with CA, nine with end-stage HCM, and 11 with HHD. Cardiac function, presence of pericardial or pleural effusion, and the extent and patterns of late gadolinium enhancement (LGE) were compared among the three diseases.
Myocardial LGE was observed in all six CA patients, eight end-stage HCM patients, and six HHD patients. The number of LGE segments was significantly greater in CA than in HCM or HHD (p = 0.02 for both), and all patients with CA showed a global endocardial pattern of LGE. There were significant differences among CA, HCM, and HHD in ejection fraction and end-diastolic and end-systolic volume indices (p &lt; 0.05 for all). Pericardial effusion was observed more frequently in CA than in HCM or HHD (p = 0.04 or 0.01, respectively).
MRI is valuable for distinguishing among CA, end-stage HCM, and HHD, all of which present with LVH and heart failure.

DOI： 10.1007/s11604-013-0238-0

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DOI： 10.1016/j.clineuro.2013.05.022

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Language：Japanese   Publisher：(公財)日本心臓財団  

DOI： 10.11281/shinzo.45.1229

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT.
Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48-72 h after contrast administration.
Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P=.027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0-20.5, P=.046).
Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ejrad.2013.06.004

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DOI： 10.1111/hepr.12212

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1177/0284185113484644

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

A study was conducted to evaluate the sensitivity of computer-aided detection (CAD) with full-field digital mammography in detection of breast cancer, based on mammographic appearance and histopathology. Retrospectively, CAD sensitivity was assessed in total group of 152 cases for subgroups based on breast density, mammographic presentation, lesion size, and results of histopathological examination. The overall sensitivity of CAD was 91 % (139 of 152 cases). CAD detected 100 % (47/47) of cancers manifested as microcalcifications; 98 % (62/63) of those manifested as non-calcified masses; 100 % (15/15) of those manifested as mixed masses and microcalcifications; 75 % (12/16) of those manifested as architectural distortions, and 69 % (18/26) of those manifested as focal asymmetry. CAD sensitivity was 83 % (10/12) for cancers measuring 1-10 mm, 92 % (37/40) for those measuring 11-20 mm, and 92 % (92/100) for those measuring &gt;20 mm. There was no significant difference in CAD detection efficiency between cancers in dense breasts (88 %; 69/78) and those in non-dense breasts (95 %; 70/74). CAD showed a high sensitivity of 91 % (139/152) for the mammographic appearance of cancer and 100 % sensitivity for identifying cancers manifested as microcalcifications. Sensitivity was not influenced by breast density or lesion size. CAD should be effective for helping radiologists detect breast cancer at an earlier stage.

DOI： 10.1007/s10278-012-9564-5

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

The aim of the present study is to quantify the degree of the error as a function of the left ventricular (LV) wall thickness, in calculation of the ejection fraction (EF) using gated single-photon emission computed tomography (SPECT). The essential error of quantitative gated SPECT (QGS) software in patients with myocardial hypertrophy has not been quantitatively estimated.
Forty-six patients with known or suspected hypertrophic cardiomyopathy underwent gated myocardial perfusion SPECT and cardiac magnetic resonance (MR) imaging. The EF value was automatically calculated from gated SPECT using the QGS software. Twelve points of regional LV wall thickness and the EF value were estimated from MR images.
Only a fair correlation was found between the QGS-EF and the MR-EF values (r = 0.48, y = 0.49x + 26.80, p &lt; 0.01), and the QGS-EF was underestimated (r = 0.25, y = 0.90x) in 30 patients with myocardial hypertrophy (mean wall thickness &gt; 12 mm). The magnitude of the error of the EF quantification from gated SPECT showed a significant negative correlation with the mean 12-point LV wall thickness in all 46 patients (r = -0.67, y = -4.12x + 40.44, p &lt; 0.0001). The degree of the error of the ESV and that of the EDV showed positive correlation with the mean LV wall thickness (r = 0.55, y = 5.46x - 56.13, p &lt; 0.0001; r = 0.31, y = 4.20x - 55.28, p &lt; 0.05, respectively).
The underestimation of EF increases with the degree of myocardial hypertrophy, because of the overestimation of the LV cavity especially in the end-systolic phase.

DOI： 10.1007/s12149-013-0713-9

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Kuwako T, Mizumura S, Murakami R, Yoshida T, Shiiba M, Sato H, Fukushima Y, Teramoto A, Kumita S, Annals of nuclear medicine, 2013, vol. 27, no. 6, pp. 493-501

DOI： 10.1007/s12149-013-0711-y

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Other Link： http://orcid.org/0000-0001-6224-4914

Language：Japanese   Publisher：日本心臓核医学会  

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DOI： 10.1016/j.cardfail.2013.05.009

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Many SPECT/PET tracers have been developed on the basis of molecules in athrosclerosis. However, molecular imaging of vulnerable plaques at the coronary arteries remains a challenging issue because of the small size of the target. The integration of anatomical and physiological information using high-resolution PET/CT with new specific target tracers may provide useful information for the evaluation of the vulnerable plaques.

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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DOI： 10.1016/j.jvsv.2012.09.003

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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DOI： 10.1097/JCP.0b013e3182825bce

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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DOI： 10.1093/eurheartj/ehs272

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROYAL SOC MEDICINE PRESS LTD  

Background: Two-dimensional (2D) Look-Locker MRI technique can identify myocardial fibrosis, but cannot cover the whole left ventricle during a single scan.
Purpose: To develop breath-hold three-dimensional (3D) Look-Locker MRI for the evaluation of postcontrast myocardial and blood T1 values and myocardial scarring in the left ventricle.
Material and Methods: A phantom and 24 patients with myocardial diseases underwent gadolinium-enhanced 2D and 3D Look-Locker MRI using a 1.5-T unit. We compared the T1 value of the phantom and the values of the myocardium and blood in the patients between the two Look-Locker MRI sequences. In the patient study, the scan ordering of the two Look-Locker MRI was selected randomly. We also assessed the ability of the 3D imaging to detect myocardial scarring that was confirmed by late gadolinium enhancement MRI.
Results: The phantom study showed a good agreement for the T1 value between 2D and 3D Look-Locker MRI. There were no significant differences in the myocardial T1 values after contrast between 2D and 3D Look-Locker MRI or in the T1 values between the two imaging slices on the 3D Look-Locker MRI (P &gt; 0.10). A better agreement for the myocardial T1 values was found when the 3D Look-Locker imaging was performed first. The T1 values for blood were affected by the scan order (P &lt; 0.05). The 3D Look-Locker MRI showed myocardial scarring with a shorter T1 value (290.4 +/- 62.7 ms) than those for unscarred myocardium (360.8 +/- 30.3 ms).
Conclusion: Three-dimensional Look-Locker MRI may precisely estimate the postcontrast myocardial and blood T1 values for the entire left ventricle during a single scan.

DOI： 10.1258/ar.2012.120378

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Language：Japanese   Publisher：(一社)日本腹部救急医学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：金原出版(株)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Risk stratification for ischemic heart disease using SPECT is a well-established method and widely accepted. On the other hand, other non-invasive imaging modalities are available nowadays according to the aggressive development of technology. Coronary CT angiography can't depict only luminological stenoses as invasive coronary angiography does, but also subclinical atherosclerosis of coronary artery wall. Though the correlation between myocardial ischemia depicted by SPECT and prognosis is well reported so far, SPECT can't describe subclinical coronary atherosclerosis before the symptom or myocardial ischemia occurs. Combined or fused SPECT and CT imaging is expected being a powerful and exact method to evaluate prognosis in patients with ischemic heart disease.

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Language：Japanese   Publisher：日本医科大学医学会  

J-GLOBAL

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Language：English   Publishing type：Research paper (international conference proceedings)  

DOI： 10.1117/12.2007886

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Language：English   Publisher：The Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.80.2

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Language：English   Publisher：The Medical Association of Nippon Medical School  

Background: Preoperative ingestion of only clear fluids until 2 hours before induction of anesthesia is a common preoperative fasting regimen. Gastric emptying times, however, vary among clear fluids. We therefore investigated the gastric emptying of 2 clear glucose-electrolyte drinks.<br> Method: A 2-way crossover study was performed in 10 healthy volunteers. After fasting, the volunteers drank 500 mL of either OS-1^®, an oral rehydration solution, or Pocari Sweat^®, a popular sports drink, over 3 minutes in a standing position. Magnetic resonance imaging was performed before, immediately after, and 30 minutes after the drinking of each test fluid. The difference in gastric emptying between OS-1^® and Pocari Sweat^® was evaluated by comparing gastric fluid volume, flow rate, and residual ratio. We also compared the flow rates of sodium, potassium, carbohydrates, and osmotically active particles in the 2 test fluids.<br> Results: Gastric fluid volume 30 minutes after drinking was significantly smaller for OS-1^® (76.0 ± 57.0 mL) than for Pocari Sweat^® (158.1 ± 73.5 mL, p<0.01), although the volumes did not differ before or immediately after drinking. The flow rate was significantly faster for OS-1^® (10.66 ± 3.34 mL) than for Pocari Sweat^® (8.68 ± 3.02 mL/min, p<0.05), and the residual ratio was significantly smaller for OS-1^® (21 ± 14% than for Pocari Sweat^® (41 ± 19%, p<0.01). The flow rates of sodium, potassium, and glucose differed significantly between OS-1^® and Pocari Sweat^®, whereas the flow rate of osmotically active particles did not.<br> Conclusions: Gastric emptying is significantly faster for OS-1^® than for Pocari Sweat^®.<br>

DOI： 10.1272/jnms.80.342

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Other Link： http://search.jamas.or.jp/link/ui/2014299203