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Koike H, Ashizawa K, Tsutsui S, Kurohama H, Okano S, Nagayasu T, Kido S, Uetani M, Toya R. Differentiation Between Heterogeneous GGN and Part-Solid Nodule Using 2 D Grayscale Histogram Analysis of Thin-Section CT Image. Clin Lung Cancer 2023; 24:541-550. [PMID: 37407293 DOI: 10.1016/j.cllc.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION/BACKGROUND To evaluate cases of surgically resected pulmonary adenocarcinoma (Ad) with heterogenous ground-glass nodules (HGGNs) or part-solid nodules (PSNs) and to clarify the differences between them, and between invasive adenocarcinoma (IVA) and minimally invasive adenocarcinoma (MIA) + adenocarcinoma in situ (AIS) using grayscale histogram analysis of thin-section computed tomography (TSCT). MATERIALS AND METHODS 241 patients with pulmonary Ad were retrospectively classified into HGGNs and PSNs on TSCT by three thoracic radiologists. Sixty HGGNs were classified into 17 IVAs, 26 MIAs, and 17 AISs. 181 PSNs were classified into 114 IVAs, 55 MIAs, and 12 AISs. RESULTS We found significant differences in area (P = 0.0024), relative size of solid component (P <0.0001), circumference (P <0.0001), mean CT value (P <0.0001), standard deviation of the CT value (P <0.0001), maximum CT value (P <0.0001), skewness (P <0.0001), kurtosis (P <0.0001), and entropy (P <0.0001) between HGGNs and PSNs. In HGGNs, we found significant differences in relative size of solid component (P <0.0001), mean CT value (P = 0.0005), standard deviation of CT value (P = 0.0071), maximum CT value (P = 0.0237), and skewness (P = 0.0027) between IVAs and MIA+AIS lesions. In PSNs, we found significant differences in area (P = 0.0029), relative size of solid component (P = 0.0003), circumference (P = 0.0004), mean CT value (P = 0.0011), skewness (P = 0.0009), and entropy (P = 0.0002) between IVAs and the MIA+AIS lesions. CONCLUSION Quantitative evaluations using grayscale histogram analysis can clearly distinguish between HGGNs and PSNs, and may be useful for estimating the pathology of such lesions.
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Affiliation(s)
- Hirofumi Koike
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuto Ashizawa
- Departments of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Shin Tsutsui
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirokazu Kurohama
- Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
| | - Shinji Okano
- Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
| | - Takeshi Nagayasu
- Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shoji Kido
- Department of Artificial Intelligence Diagnostic Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masataka Uetani
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Toya
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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He X, Sueyoshi E, Nagayama H, Koike H, Uetani M. The hemodynamics of adrenal veins with four-dimensional computed tomography using quantitative time-density curve: a study based on aldosteronism patients. Sci Rep 2023; 13:14348. [PMID: 37658182 PMCID: PMC10474258 DOI: 10.1038/s41598-023-41414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 08/25/2023] [Indexed: 09/03/2023] Open
Abstract
Present study quantitatively analyzed adrenal venous flow using four-dimensional computed tomography (4D CT). We reviewed 4D CT images of 55 patients [mean age, 52 years ± 11 (standard deviation); 23 females] who underwent adrenal venous sampling between August 2017 and February 2021. Time-density curves were referred for the adrenal venous enhancement. The clinical factors affecting hemodynamics were assessed using uni- and multivariate linear regression analyses. The right and left adrenal veins (RAV and LAV, respectively) were visualized in all cases. Mean peak enhancement values in RAV and LAV were 247 ± 67 and 292 ± 70 Hounsfield units (P < 0.01), and were reached at 44.43 ± 6.86 and 45.39 ± 7.53 s (P < 0.01), respectively. The body mass index (BMI), plasma renin activity and potassium were significant factors influencing the peak enhancement of RAV blood flow [standardized regression coefficients, - 0.327 (P = 0.017), - 0.346 (P = 0.013), 0.426 (P = 0.016), respectively]. A linear relationship between sex and the time-to-peak was observed for RAV [standardized regression coefficient, 0.348 (P = 0.046)]. RAV had a lower contrast effect than LAV and reached its peak faster. BMI, plasma renin activity, and potassium were associated with flow density in RAV. Sex independently influenced the time-to-peak.
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Affiliation(s)
- Xi He
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8521, Japan
| | - Eijun Sueyoshi
- Department of Radiology, Nagasaki Harbor Medical Center, Nagasaki, Japan.
| | - Hiroki Nagayama
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8521, Japan
| | - Hirofumi Koike
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8521, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8521, Japan
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Tamai M, Grundeken V, Arima K, Brinck RT, Mil AHMVDHV, Ohki N, Uetani M, Kawakami A. Predictive Value of Magnetic Resonance Imaging-detected Tenosynovitis of the Metacarpophalangeal and Wrist Joints for the Development of Rheumatoid Arthritis among Patients with Undifferentiated Arthritis. Intern Med 2023; 62:2329-2334. [PMID: 36631087 PMCID: PMC10484776 DOI: 10.2169/internalmedicine.0077-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/24/2022] [Indexed: 01/13/2023] Open
Abstract
Objective The early diagnosis of rheumatoid arthritis (RA) improves disease outcomes. Using bilateral magnetic resonance imaging (MRI), we investigated whether or not tenosynovitis at the level of the metacarpophalangeal (MCP) and wrist joints, as well as non-symmetrical versus symmetrical involvement, predicts RA development in undifferentiated arthritis (UA) patients. Methods We collected the clinical and serological findings as well as bilateral gadolinium-enhanced 1.5-T MRI data of UA patients after 1 year. A multivariate logistic regression analysis was used to determine the association of tenosynovitis in UA with RA development. Ninety-one UA patients from the Nagasaki Early Arthritis Clinic who did not meet the 2010 European League Against Rheumatism/American College of Rheumatology classification criteria for RA were selected. Tenosynovitis at the MCP and wrist joints was scored according to the RA MRI scoring system. Results Of these 91 UA patients, 29 (31.9%) progressed to RA, with a median disease duration of 3 months, despite only 10.9% being positive for anti-cyclic citrullinated peptide antibody (ACPA). A univariate analysis showed higher MCP tenosynovitis scores, MCP flexor tenosynovitis, and symmetrical MCP tenosynovitis in the RA development group than in the non-development group (p<0.05). A multivariate analysis showed that symmetrical MCP tenosynovitis was independently associated with RA development after adjusting for age, gender, swollen joint count, C-reactive protein level, and ACPA positivity (odds ratio: 4.96). The presence of symmetrical MCP tenosynovitis had low sensitivity (35%) but high specificity (87%) for RA development. Conclusion MRI-detected tenosynovitis, especially symmetrical findings at the MCP joint, is predictive of RA development in a UA population with low ACPA positivity.
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Affiliation(s)
- Mami Tamai
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Vincent Grundeken
- Department of Rheumatology, Leiden University Medical Center, The Netherlands
| | - Kazuhiko Arima
- Department of Public Health, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Robin Ten Brinck
- Department of Rheumatology, Leiden University Medical Center, The Netherlands
| | | | - Nozomi Ohki
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Japan
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He X, Sueyoshi E, Tasaki Y, Miyazaki S, Murakami T, Nagayama H, Uetani M. Benefits of adrenal venous sampling with preoperative four-dimensional CT imaging. Acta Radiol 2023; 64:1280-1289. [PMID: 35945822 DOI: 10.1177/02841851221118799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The effects of adrenal venous sampling (AVS) may be limited by the anatomical variants of adrenal veins. PURPOSE To investigate the benefits of AVS for patients who underwent four-dimensional computed tomography (4D CT) before AVS. MATERIAL AND METHODS We reviewed the images of contrast-enhanced four phase three-dimensional (3D) and 4D CT in patients who received AVS between February 2010 and February 2021. A total of 112 patients (59 women; mean age = 55.3 ± 11.8 years) were enrolled. Of the entire population, 49.1% (55/112) underwent 4D CT, whereas 50.9% (57/112) underwent 3D CT. The anatomical features of adrenal veins and procedural data were obtained. Simple linear regression analyses were performed to determine the relationship between imaging protocols and AVS. RESULTS On comparison of the two groups, the 4D cohort had a higher success rate (98.2% vs. 78.9%; P = 0.001), shorter procedure and fluoroscopy time (73.6 ± 37.3 min vs. 110.5 ± 47.9 min; P < 0.001 and 28.7 ± 31.2 min vs. 97.4 ± 251.7 min; P = 0.047, respectively), lower radiation exposure (243.5 ± 315.5 mGycm2 vs. 613.4 ± 674.6 mGycm2; P < 0.001) and less contrast volume (46.2 ± 42.7 ml vs. 68.3 ± 47.4 ml vs; P = 0.014). In simple linear regression analysis, positive and negative identification of right adrenal vein before AVS significantly influenced the success rate (unstandardized coefficients [UC] = 0.304, standardized coefficients [SC] = 0.304; P = 0.001) and operation duration (UC = -46.124, SC = -0.318; P = 0.001). CONCLUSION Pre-procedural 4D CT may facilitate successful AVS. Compared with four-phase 3D CT, this protocol is better to shorten the operation and fluoroscopy time, and to reduce the radiation dose and contrast consumption.
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Affiliation(s)
- Xi He
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Yutaro Tasaki
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Shuhei Miyazaki
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Tomonori Murakami
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Hiroki Nagayama
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, 12961Nagasaki University, Nagasaki, Japan
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Tasaki Y, Ashizawa K, Nakamura D, Mizowaki T, Nagashima S, Fujimoto T, Uetani M. Clinical Outcomes of Stereotactic Body Radiation Therapy for Early-stage Non-small Cell Lung Cancer. Cancer Diagn Progn 2023; 3:201-207. [PMID: 36875300 PMCID: PMC9949538 DOI: 10.21873/cdp.10202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/19/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND/AIM To investigate the clinical outcomes of stereotactic body radiotherapy (SBRT) in patients with early-stage non-small cell lung cancer (NSCLC). PATIENTS AND METHODS Among consecutive patients with early-stage NSCLC who received SBRT between November 2009 and September 2019, those with cT1-2N0M0 staged by the UICC TNM classification and staging system for lung cancer were retrospectively analyzed. RESULTS Fifty-three patients with early-stage NSCLC received SBRT. The median follow-up period was 29 months (range=2-105 months). Twenty-one lung tumors were clinically diagnosed as early-stage primary lung cancers without histological confirmation. Histological examinations revealed adenocarcinoma in 24 patients and squamous cell carcinoma in 8. Two- and 5-year local control, cancer-specific survival, progression-free survival (PFS), and overall survival (OS) rates were 94.4 and 94.4%; 94.6 and 90.8%; 69.0 and 43.3%; and 80.0 and 59.3%, respectively. In a univariate analysis, the T stage, histology, and type of pulmonary nodule correlated with PFS and OS. CONCLUSION Good clinical outcomes were achieved by patients with early-stage NSCLC who received SBRT.
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Affiliation(s)
- Yutaro Tasaki
- Department of Radiology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.,Clinical Oncology Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuto Ashizawa
- Clinical Oncology Center, Nagasaki University Hospital, Nagasaki, Japan.,Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Daisuke Nakamura
- Department of Radiology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Takashi Mizowaki
- Department of Radiology, Sasebo City General Hospital, Nagasaki, Japan
| | - Seiji Nagashima
- Department of Respiratory Medicine, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Toshifumi Fujimoto
- Department of Radiology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Ishimaru H, Ikebe Y, Morikawa M, Ideguchi R, Tateishi Y, Tsujino A, Uetani M. Significance of Low Signal in Intracranial Vertebral Artery Wall Observed on Susceptibility-Weighted Angiography. Cerebrovasc Dis 2023; 52:89-96. [PMID: 35793613 DOI: 10.1159/000524840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023] Open
Abstract
PURPOSE We aimed to investigate the clinical significance of the low signal in the intracranial vertebral artery wall observed on susceptibility-weighted angiography. MATERIALS AND METHODS We retrospectively reviewed susceptibility-weighted angiographies from 200 consecutive patients with acute ischemic stroke in the posterior circulation territory. The presence of eccentric or concentric low signals in the vertebral artery wall was examined and evaluated. The etiology of the low signal was also investigated as much as possible by referring to computed tomography and T1-weighted imaging (T1WI). We also compared its frequency in each stroke subtype. RESULTS A low signal was observed in 128/200 patients (64%). The low signals (58%) corresponded to vessel wall calcification in 74 of 128 patients and to vessel wall thickening showing intermediate to low (n = 8) or high (n = 16) signals on T1WI in 24 (19%) patients. The low signal did not have vessel wall thickening or calcification in 1 patient, and the cause of the low signal could not be verified in 29 patients. According to stroke subtypes, a low signal was observed in 14/14 (100%) vertebral artery dissections, all of which corresponded to intramural hematoma. A low signal was observed in 51/65 (78%) atherothromboses, which were significantly more frequent than cardioembolism (34/66; 52%) and small-artery disease (18/39; 46%) (p < 0.01). In atherothrombosis, calcification was the most common cause of low signal (n = 32; 63%). CONCLUSION Low signals on susceptibility-weighted angiography were frequently observed in vertebral artery dissection and atherothrombosis, reflecting intramural hematoma in all of the former and predominantly calcification in the latter.
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Affiliation(s)
- Hideki Ishimaru
- Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yohei Ikebe
- Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Minoru Morikawa
- Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Reiko Ideguchi
- Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yohei Tateishi
- Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan
| | - Akira Tsujino
- Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan
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Koike H, Ashizawa K, Tsutsui S, Fukuda M, Okano S, Matsumoto K, Nagayasu T, Honda S, Uetani M. Surgically resected lung adenocarcinoma: do heterogeneous GGNs and part-solid nodules on thin-section CT show different prognosis? Jpn J Radiol 2023; 41:164-171. [PMID: 36219310 PMCID: PMC9889431 DOI: 10.1007/s11604-022-01345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/27/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This study aimed to evaluate the clinical courses of patients with surgically resected stage IA pulmonary adenocarcinoma (Ad) who exhibited heterogeneous ground-glass nodules (GGNs) or part-solid nodules on thin-section computed tomography (TSCT) and to clarify the prognostic differences between them. MATERIALS AND METHODS The cases of 242 patients with proven pulmonary Ad with heterogeneous GGN or part-solid nodule who underwent surgical resection were retrospectively reviewed. After surgery, they were examined pathologically. Disease-free survival (DFS) and overall survival (OS) were also investigated. RESULTS There were no cases of recurrent pulmonary Ad or death from the primary disease in the heterogeneous GGN group. In the part-solid nodule group, recurrent pulmonary Ad and death from the primary disease were observed in 12 and 6 of 181 patients, respectively. Heterogeneous GGNs were associated with significantly longer DFS than part-solid nodules (p = 0.042). While, there was no significant difference in OS between the two groups (p = 0.134). Pathological diagnoses were available for all 242 patients. 181 part-solid nodules were classified into 116 invasive Ads, 54 minimally invasive Ads (MIAs), and 11 Ad in situ (AIS) lesions, and 61 heterogeneous GGNs were classified into 18 invasive Ads, 25 MIAs, and 18 AIS lesions. CONCLUSION Heterogeneous GGNs were significantly associated with longer DFS than part-solid nodules. Pathologically, there were significant differences between the heterogeneous GGNs and part-solid nodules.
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Affiliation(s)
- Hirofumi Koike
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kazuto Ashizawa
- Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shin Tsutsui
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Minoru Fukuda
- Clinical Oncology Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shinji Okano
- Depatment of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Keitaro Matsumoto
- Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Takeshi Nagayasu
- Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Sumihisa Honda
- Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nursing, Nagasaki, 852-8501 Japan
| | - Masataka Uetani
- Departments of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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Koike H, Morikawa M, Ishimaru H, Ideguchi R, Uetani M, Hiu T, Matsuo T, Miyoshi M. Amide proton transfer MRI differentiates between progressive multifocal leukoencephalopathy and malignant brain tumors: a pilot study. BMC Med Imaging 2022; 22:227. [PMID: 36572873 PMCID: PMC9793649 DOI: 10.1186/s12880-022-00959-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/22/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nerve system caused by the John Cunningham virus. On MRI, PML may sometimes appear similar to primary central nervous system lymphoma (PCNSL) and glioblastoma multiforme (GBM). The purpose of this pilot study was to evaluate the potential of amide proton transfer (APT) imaging for differentiating PML from PCNSL and GBM. METHODS Patients with PML (n = 4; two men; mean age 52.3 ± 6.1 years), PCNSL (n = 7; four women; mean age 74.4 ± 5.8 years), or GBM (n = 11; 6 men; mean age 65.0 ± 15.2 years) who underwent APT-CEST MRI between January 2021 and September 2022 were retrospectively evaluated. Magnetization transfer ratio asymmetry (MTRasym) values were measured on APT imaging using a region of interest within the lesion. Receiver operating characteristics curve analysis was used to determine diagnostic cutoffs for MTRasym. RESULTS The mean MTRasym values were 0.005 ± 0.005 in the PML group, 0.025 ± 0.005 in the PCNSL group, and 0.025 ± 0.009 in the GBM group. There were significant differences in MTRasym between PML and PCNSL (P = 0.023), and between PML and GBM (P = 0.015). For differentiating PML from PCNSL, an MTRasym threshold of 0.0165 gave diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of 100% (all). For differentiating PML from GBM, an MTRasym threshold of 0.015 gave diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 90.9%, 80.0%, and 100%, respectively. CONCLUSION MTRasym values obtained from APT imaging allowed patients with PML to be clearly discriminated from patients with PCNSL or GBM.
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Affiliation(s)
- Hirofumi Koike
- grid.174567.60000 0000 8902 2273Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Minoru Morikawa
- grid.411873.80000 0004 0616 1585Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Hideki Ishimaru
- grid.411873.80000 0004 0616 1585Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Reiko Ideguchi
- grid.174567.60000 0000 8902 2273Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588 Japan
| | - Masataka Uetani
- grid.174567.60000 0000 8902 2273Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Takeshi Hiu
- grid.174567.60000 0000 8902 2273Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Takayuki Matsuo
- grid.174567.60000 0000 8902 2273Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Mitsuharu Miyoshi
- grid.481637.f0000 0004 0377 9208MR Application and Workflow, GE Healthcare Japan, 4-7-127 Asahigaoka, Hino, Tokyo 191-8503 Japan
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Koike H, Morikawa M, Ishimaru H, Ideguchi R, Uetani M, Hiu T, Matsuo T, Miyoshi M. Quantitative Chemical Exchange Saturation Transfer Imaging of Amide Proton Transfer Differentiates between Cerebellopontine Angle Schwannoma and Meningioma: Preliminary Results. Int J Mol Sci 2022; 23:ijms231710187. [PMID: 36077581 PMCID: PMC9456068 DOI: 10.3390/ijms231710187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/15/2022] [Accepted: 09/04/2022] [Indexed: 11/25/2022] Open
Abstract
Vestibular schwannomas are the most common tumor at the common cerebellopontine angle, followed by meningiomas. Differentiation of these tumors is critical because of the different surgical approaches required for treatment. Recent studies have demonstrated the utility of amide proton transfer (APT)-chemical exchange saturation transfer (CEST) imaging in evaluating malignant brain tumors. However, APT imaging has not been applied in benign tumors. Here, we explored the potential of APT in differentiating between schwannomas and meningiomas at the cerebellopontine angle. We retrospectively evaluated nine patients with schwannoma and nine patients with meningioma who underwent APT-CEST MRI from November 2020 to April 2022 pre-operation. All 18 tumors were histologically diagnosed. There was a significant difference in magnetization transfer ratio asymmetry (MTRasym) values (0.033 ± 0.012 vs. 0.021 ± 0.004; p = 0.007) between the schwannoma and meningioma groups. Receiver operative curve analysis showed that MTRasym values clearly differentiated between the schwannoma and meningioma groups. At an MTRasym value threshold of 0.024, the diagnostic sensitivity, specificity, positive predictive value, and negative predictive values for MTRasym were 88.9%, 77.8%, 80.0%, and 87.5%, respectively. Our results demonstrated the ability of MTRasym values on APT-CEST imaging to discriminate patients with schwannomas from patients with meningiomas.
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Affiliation(s)
- Hirofumi Koike
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Correspondence:
| | - Minoru Morikawa
- Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hideki Ishimaru
- Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Reiko Ideguchi
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Masataka Uetani
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takeshi Hiu
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takayuki Matsuo
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Mitsuharu Miyoshi
- MR Application and Workflow, GE Healthcare Japan, Hino, Tokyo 191-8503, Japan
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Koike H, Ashizawa K, Tsutsui S, Nagayasu T, Uetani M, Kido S. EP13.01-007 Differentiation between heterogeneous GGNs and part solid nodules using histogram on thin-section CT. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Takatani A, Tamai M, Ohki N, Okamoto M, Endo Y, Tsuji S, Shimizu T, Umeda M, Fukui S, Sumiyoshi R, Nishino A, Koga T, Kawashiri SY, Iwamoto N, Igawa T, Ichinose K, Arima K, Nakamura H, Origuchi T, Uetani M, Kawakami A. Prediction of Radiographic Progression During a Treat-to-Target Strategy by the Sequential Application of MRI-Proven Bone Marrow Edema and Power-Doppler Grade ≥2 Articular Synovitis in Rheumatoid Arthritis: Retrospective Observational Study. Mod Rheumatol 2022:6646948. [PMID: 35856575 DOI: 10.1093/mr/roac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/10/2022] [Accepted: 07/20/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To investigate the appropriate timing, useful findings and combination of magnetic resonance imaging (MRI) and ultrasound (US) for predicting the radiographic progression in early rheumatoid arthritis (RA). METHODS Forty-four active RA patients, who examined by both of MRI and US in the symptomatic wrist and finger joints, were recruited in Nagasaki University Hospital from 2010 to 2017 and treated by the T2T therapeutic strategy for 1 year. MRI was evaluated by RA MRI scoring and US by Outcomes Measures in Rheumatology Clinical Trial, respectively. Plain radiographs were assessed by the Genant-modified Sharp score for the symptomatic side in the same manner as MRI and US. Radiographic progression was defined as an annual increase ≥0.75 at 1 year. Factors associated with radiographic progression were analyzed. Also, the optimal combination of MRI and US at each timepoint was considered. RESULTS Logistic regression model revealed that MRI-proven BME at baseline and 6 month and joint counts of PD grade ≥2 articular synovitis at 3 or 6 month were significantly associated with radiographic progression at 1 year. CONCLUSION This study may suggest the favorable timing and combination of MRI and US at each point to predict radiographic progression in patients with early-stage RA.
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Affiliation(s)
- Ayuko Takatani
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Mami Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Nozomi Ohki
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JAPAN
| | - Momoko Okamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Yushiro Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Sousuke Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Shin-Ya Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN.,Department of Community Medicine, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JAPAN
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
| | - Kazuhiko Arima
- Department of Public Health, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JAPAN
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN.,Department of Medicine, Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, JAPAN
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN.,Department of Locomotive and Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JAPAN
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JAPAN
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki-c, Nagasaki, 852-8501, JAPAN
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Miyamura S, Ishimaru H, Oka T, Otsuka T, Yoshimi S, Hidaka M, Miyazoe Y, Uetani M. Combined Transhepatic and Transsplenic Recanalization of Chronic Portal Vein Occlusion to Treat Jejunal Varices: A Report of Two Cases. Interventional Radiology 2022; 7:63-68. [PMID: 36196385 PMCID: PMC9527106 DOI: 10.22575/interventionalradiology.2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 02/02/2022] [Indexed: 11/17/2022]
Abstract
We report two cases of chronic portal vein occlusion with jejunal varices successfully treated using percutaneous intervention with a combined transhepatic and transsplenic approach. Case 1 was a 60-year-old man with uncontrolled jejunal variceal bleeding, and case 2 was a 79-year-old man with anastomotic jejunal variceal bleeding and cholangitis. Single access via the transhepatic or transsplenic route failed to allow catheter advancement through the occlusion. After introducing pull-through access via the transhepatic and transsplenic routes, a metallic stent was could be used to dilate the occluded portal vein. Anastomotic jejunal varices functioning as hepatopetal collaterals were embolized after the establishment of antegrade portal flow. No symptom relapse was observed during the follow-up period (31 months for case 1 and 34 months for case 2).
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Affiliation(s)
| | | | - Taiga Oka
- Department of Radiology, Nagasaki University Hospital
| | | | | | | | - Yuri Miyazoe
- Department of Gastroenterology and Hepatology, Koseikai Hospital
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13
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Koike H, Sueyoshi E, Uetani M. Diagnosis of Chronic Thromboembolic Pulmonary Hypertension Using Quantitative Lung Perfusion Parameters Extracted From Dual-energy Computed Tomography Images. J Thorac Imaging 2022; 37:239-245. [PMID: 35394985 DOI: 10.1097/rti.0000000000000646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate quantified iodine mapping parameters in dual-energy computed tomography in normal patients versus those with chronic thromboembolic pulmonary hypertension (CTEPH) with and without pulmonary thromboembolism. MATERIALS AND METHODS Using automatically quantified iodine mapping in dual-energy computed tomography, we evaluated lung relative average enhancement, standard deviation (SD), and the SD/lung relative average enhancement ratio. We compared the values for these parameters in normal patients versus those with CTEPH. We also performed a receiver operating characteristic curve analysis to determine the diagnostic cutoffs for the parameters. RESULTS Patients constituted 41 patients (10 male [24.4%] and 31 female [75.6%]; mean age [SD]: 70.0 y [13.3]) with CTEPH and 237 (92 male [38.8%] and 145 female [61.2%]; mean age [SD]: 65.9 y [15.9]) normal patients. We found significant differences in lung relative average enhancement (34.9±6.3 vs. 26.9±6.3; P <0.0001), SD (11.6±1.9 vs. 14.7±3.3; P <0.001), and the SD/lung relative average enhancement ratio (33.7±5.0 vs. 55.7±10.4; P <0.001) between the normal and CTEPH groups, respectively. The ROC analyses demonstrated high discriminatory power (area under the curve=0.99) for using the SD/lung relative average enhancement ratio to differentiate between patients in the normal group and CTEPH group. At a threshold for the area under the curve of 44.2, diagnostic sensitivity, specificity, positive predictive value, and negative predictive value for the ratio were 92.7%, 97.5%, 86.5%, and 98.7%, respectively. CONCLUSIONS Patients with CTEPH were well-discriminated from normal patients using the SD/lung relative average enhancement ratio.
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Affiliation(s)
- Hirofumi Koike
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences
- Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Eijun Sueyoshi
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences
- Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences
- Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan
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14
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Shiraishi K, Chiba K, Watanabe K, Oki N, Iwamoto N, Amano S, Yonekura A, Tomita M, Uetani M, Kawakami A, Osaki M. Analysis of bone erosions in rheumatoid arthritis using HR-pQCT: Development of a measurement algorithm and assessment of longitudinal changes. PLoS One 2022; 17:e0265833. [PMID: 35472146 PMCID: PMC9041818 DOI: 10.1371/journal.pone.0265833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/08/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose
The purpose of this study was to establish an algorithm for measuring bone erosions at metacarpophalangeal (MCP) joints using high-resolution peripheral quantitative computed tomography (HR-pQCT), to investigate the precision of measurements, and to assess longitudinal changes in bone erosions among patients with rheumatoid arthritis (RA).
Methods
The 2nd and 3rd MCP joints were scanned at a voxel size of 60.7 μm using second-generation HR-pQCT. Bone erosions on MCP joints were identified using a semi-automated algorithm we developed, and each erosion parameter was measured. Measurement reproducibility was evaluated in 19 healthy subjects using intraclass correlation coefficients (ICCs) and root mean square percent coefficient of variance (RMS%CV). Finally, longitudinal changes in bone erosions over a period of 12 months were assessed in 26 patients with RA based on the calculated least significant change (LSC).
Results
Reproducibilities for measurement parameters regarding bone erosions with our algorithm were good (all ICCs ≥ 0.98; all RMS%CVs < 5%). No erosion parameters showed significant changes after 12 months of treatment in terms of median values in all erosions, while both progression and repair of erosions were observed individually (e.g., erosion volume: progression, 26% (+0.62 mm3); repair, 34% (-0.85 mm3); no change, 40%).
Conclusions
The measurement algorithm developed for bone erosions at MCP joints showed good reproducibility. Both progression and repair of bone erosions were observed in patients with RA even after 12 months of appropriate treatment. Our algorithm may be useful to investigate the etiology of RA and assess drug efficacy.
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Affiliation(s)
- Kazuteru Shiraishi
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ko Chiba
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- * E-mail:
| | - Kounosuke Watanabe
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Nozomi Oki
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Iwamoto
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shoken Amano
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akihiko Yonekura
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masato Tomita
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Division of Advanced Preventive Medical Sciences, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Makoto Osaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Takinoshita S, Ishimaru H, Okano S, Otsuka T, Ishimaru Y, Miyazaki S, Nakagawa J, Koga M, Soyama A, Hidaka M, Fukumoto M, Eguchi S, Uetani M. Hepatic sclerosing haemangioma showing restricted diffusion: A case report with histopathologic correlation. BJR Case Rep 2022; 8:20220029. [DOI: 10.1259/bjrcr.20220029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/23/2022] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
Hepatic sclerosing haemangiomas are rare benign tumours that are often difficult to distinguish from malignant tumours because these tumours do not show the typical imaging features of cavernous haemangiomas. We report a case of a sclerosing haemangioma that showed restricted diffusion and was difficult to differentiate from a malignancy. A 60-year-old female was referred to our hospital for evaluation of a hepatic mass that was incidentally diagnosed after a CT scan for right lower quadrant abdominal pain. Contrast-enhanced dynamic CT showed hepatic capsular retraction, with a small peripheral enhancement of the mass. The lesion appeared homogeneously hypointense on T1-weighted images, heterogeneously hyperintense on T2-weighted images, hyperintense on diffusion-weighted images, and hypointense on apparent diffusion coefficient (ADC) map. The lesion was suspected to be a cholangiocellular carcinoma and was surgically resected, but a final diagnosis of hepatic sclerosing haemangioma was made. Hepatic sclerosing/sclerosed haemangiomas are usually considered to show an increased ADC, which is useful for distinguishing them from malignant tumours. However, in this particular case, most of the lesion contained many obliterated or narrowed vascular channels, which might have acted as septa restricting the diffusion of water molecules in the intervening fibrous and/or hyalinized tissue. Hepatic sclerosing haemangiomas in the process of becoming completely fibrotic may show restricted diffusion, similar to malignant tumours.
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Affiliation(s)
| | - Hideki Ishimaru
- Departments of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Shinji Okano
- Departments of Pathology, Nagasaki University Hospital, Nagasaki, Japan
| | - Tetsuhiro Otsuka
- Departments of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yutaka Ishimaru
- Department of Radiology, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
| | - Shuhei Miyazaki
- Departments of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Jun Nakagawa
- Departments of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Miyuki Koga
- Departments of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masayuki Fukumoto
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Departments of Radiology, Nagasaki University Hospital, Nagasaki, Japan
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Sueyoshi E, Murakami T, He X, Koike H, Nagayama H, Uetani M. CT findings of type A acute aortic dissection that did and did not result in prehospital death. Medicine (Baltimore) 2022; 101:e28657. [PMID: 35089207 PMCID: PMC8797546 DOI: 10.1097/md.0000000000028657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 01/04/2022] [Indexed: 01/05/2023] Open
Abstract
The differences between the pathologies of cases of type A acute aortic dissection (AAD) that did and did not result in prehospital death (PHD) have not been fully elucidated.This study aimed to compare the CT findings and clarify the differences between the pathologies of such cases.Ninety four consecutive type A AAD patients between 2010 and 2020 were enrolled in this study. There were 47 males and 47 females (mean age: 69.0 ± 14.4 years). The patients were divided into those that did (n = 25, 27%) and did not (n = 69, 73%) suffer PHD. We retrospectively evaluated the CT or postmortem CT findings of each case and analyzed the relationships between clinical factors (CT findings and clinical characteristics) and PHD using logistic regression analysis.Bloody pericardial effusion (96% vs 35%, P < .0001), bloody pleural effusion (40% vs 1%, P < .0001), and mediastinal hematomas (88% vs 14%, P < .0001) were significantly more common in the PHD group than in the no PHD group.In the multivariate logistic regression analysis, bloody pericardial effusion and lung consolidation were found to be significant risk factors for PHD (odds ratio: 21.29 [95% confidence intervals {CI}: 1.19-248.29] and 13.72 [95% CI: 1.79-105.06], respectively; P = .014 and P = .012, respectively). AD affecting the abdominal aorta was identified as a significant negative risk factor for PHD (odds ratio: 0.02 [95% CI: 0.01-0.65]; P = .0042).Most PHD due to type A AAD are associated with hemorrhaging. Bleeding into the pericardium and type A AAD confined to the thoracic aorta are significant risk factors for PHD. Secondary respiratory failure might contribute to PHD in such cases.
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17
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Nishimura T, Sueyoshi E, Koike H, Uetani M. Initial experience with intensity distribution analysis of hemodynamic parameters in the thoracic aorta using four-dimensional magnetic resonance imaging: A comparison between groups with different ejection fractions. Medicine (Baltimore) 2022; 101:e28563. [PMID: 35029224 PMCID: PMC8757938 DOI: 10.1097/md.0000000000028563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to investigate whether there were significant differences in the intensity distributions of thoracic aorta hemodynamic parameters between groups with different ejection fractions (EF) using four-dimensional flow magnetic resonance imaging and to investigate the relationships between each parameter.A total of 26 patients, 13 each with EF of >60% and <30%, underwent cardiac four-dimensional flow magnetic resonance imaging (EF >60%: mean age: 54 ± 11.6 years, EF <30%: mean age: 49.2 ± 17.2 years). The thoracic aorta was divided into the proximal and distal ascending aorta (AAo), aortic arch, and the proximal and distal descending aorta, and each section was further divided into the anterior wall, posterior wall, lesser curvature, and greater curvature. The intensity distributions of wall shear stress (WSS), energy loss (EL), and vorticity (Vort) (hemodynamic parameters) and the concordance rates between these distributions were analyzed.The concordance rate between the intensity distributions of EL and Vort was high. Only the intensity distributions of EL and Vort in the distal AAo differed significantly between the groups (P < .001). In the EF >60% group, these intensity distributions showed higher values in the greater curvature of the AAo, whereas in the EF <30% group higher values were seen in the lesser curvature of the AAo.Although there was no significant intergroup difference in the WSS intensity distribution, in the EF <30% group the WSS intensity distribution tended to exhibit higher values in the lesser curvature of the distal AAo, and the WSS intensity distribution values for the greater curvature tended to gradually increase from the arch to the proximal descending aorta.The only significant differences between the EF groups were found in the intensity distributions of EL and Vort in the distal AAo. This suggests that the distributions of atherosclerosis may be EF-dependent.
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He X, Sueyoshi E, Nakaji S, Uetani M. Ulcer-like projections into the dilated false lumen after stent-graft placement for aortic dissection: A case report. Medicine (Baltimore) 2022; 101:e28472. [PMID: 35029894 PMCID: PMC8735798 DOI: 10.1097/md.0000000000028472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/15/2021] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Acute type A aortic dissection and chronic type B aortic dissection (TBAD) occurs simultaneously in rare cases. Although the development of ulcer-like projection (ULP) is associated with an increase in adverse aorta-related events, the false-lumen enlargement caused by the ULP progression is uncommon. PATIENT CONCERNS A 72-year-old female with chronic TBAD was admitted to our unit with back and chest pain. Computed tomography revealed acute type A aortic dissection and a hematoma caused by rupturing of the descending aorta due to chronic TBAD. After endovascular intervention, the false lumen thrombosed and shrunk. DIAGNOSIS After 9 months, a developing ULP, which projected into a dilating false lumen, was found. An impending ruptured descending aortic aneurysm was confirmed. INTERVENTIONS Emergency Total arch replacement and thoracic endovascular aortic repair (TEVAR) was performed. OUTCOMES The procedure was successful. One year later, regular follow-up showed that the false lumen had completely shrunk. LESSONS ULP can arise and cause progressive dilation of false lumen after TEVAR. Careful and regular computed tomography examinations are required for early diagnosis of false lumen becoming thrombosed after TEVAR. Close follow-up and timely intervention, including TEVAR, should be considered in cases of aortic enlargement due to a newly developed ULP.
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Affiliation(s)
- Xi He
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Shun Nakaji
- Department of Cardiovascular Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto, Nagasaki, Japan
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19
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Iwamoto N, Chiba K, Sato S, Shiraishi K, Watanabe K, Oki N, Okada A, Koga T, Kawashiri SY, Tamai M, Hosogaya N, Furuyama M, Kobayashi M, Saito K, Okubo N, Uetani M, Osaki M, Kawakami A. Inhibition of bone erosion, determined by high-resolution peripheral quantitative computed tomography (HR-pQCT), in rheumatoid arthritis patients receiving a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) plus denosumab vs csDMARD therapy alone: an open-label, randomized, parallel-group study. Arthritis Res Ther 2022; 24:264. [PMID: 36476479 PMCID: PMC9727996 DOI: 10.1186/s13075-022-02957-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This exploratory study compared the inhibition of bone erosion progression in rheumatoid arthritis (RA) patients treated with a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) plus denosumab versus csDMARD therapy alone and investigated the effects of denosumab on bone micro-architecture and other bone-related parameters using high-resolution peripheral quantitative computed tomography (HR-pQCT). METHODS In this open-label, randomized, parallel-group study, patients with RA undergoing treatment with a csDMARD were randomly assigned (1:1) to continue csDMARD therapy alone or to continue csDMARDs with denosumab (60-mg subcutaneous injection once every 6 months) for 12 months. The primary endpoint was the change from baseline in the depth of bone erosion, measured by HR-pQCT, in the second and third metacarpal heads at 6 months after starting treatment. Exploratory endpoints were also evaluated, and adverse events (AEs) were monitored for safety. RESULTS In total, 46 patients were enrolled, and 43 were included in the full analysis set (csDMARDs plus denosumab, N = 21; csDMARD therapy alone, N = 22). Most patients were female (88.4%), and the mean age was 65.3 years. The adjusted mean (95% confidence interval) change from baseline in the depth of bone erosion, measured by HR-pQCT, in the 2-3 metacarpal heads at 6 months was - 0.57 mm (- 1.52, 0.39 mm) in the csDMARDs plus denosumab group vs - 0.22 mm (- 0.97, 0.53 mm) in the csDMARD therapy alone group (between-group difference: - 0.35 mm [- 1.00, 0.31]; P = 0.2716). Similar results were shown for the adjusted mean between-group difference in the width and volume of bone erosion of the 2-3 metacarpal heads. Significant improvements in bone micro-architecture parameters were shown. The incidence of AEs and serious AEs was similar between the csDMARDs plus denosumab and the csDMARD therapy alone groups (AEs: 52.2% vs 56.5%; serious AEs: 4.3% vs 8.7%). CONCLUSIONS Although the addition of denosumab to csDMARDs did not find statistically significant improvements in bone erosion after 6 months of treatment, numerical improvements in these parameters suggest that the addition of denosumab to csDMARDs may be effective in inhibiting the progression of bone erosion and improving bone micro-architecture. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry, UMIN000030575. Japan Registry for Clinical Trials, jRCTs071180018.
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Affiliation(s)
- Naoki Iwamoto
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Ko Chiba
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shuntaro Sato
- grid.411873.80000 0004 0616 1585Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kazuteru Shiraishi
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kounosuke Watanabe
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Nozomi Oki
- grid.174567.60000 0000 8902 2273Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Akitomo Okada
- grid.415640.2Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Omura, Nagasaki, 856-8562 Japan
| | - Tomohiro Koga
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Shin-ya Kawashiri
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan ,grid.174567.60000 0000 8902 2273Departments of Community Medicine, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Mami Tamai
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Naoki Hosogaya
- grid.411873.80000 0004 0616 1585Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Masako Furuyama
- Department of Rheumatology, Nagasaki Kita Hospital, 800 Motomurago, Nishisonogigun Togitsucho, Nagasaki, 851-2103 Japan
| | - Makiko Kobayashi
- grid.410844.d0000 0004 4911 4738Primary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd, 3-5-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8426 Japan
| | - Kengo Saito
- grid.410844.d0000 0004 4911 4738Primary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd, 3-5-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8426 Japan
| | - Naoki Okubo
- grid.410844.d0000 0004 4911 4738Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co., Ltd, 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710 Japan
| | - Masataka Uetani
- grid.174567.60000 0000 8902 2273Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Makoto Osaki
- grid.174567.60000 0000 8902 2273Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Atsushi Kawakami
- grid.174567.60000 0000 8902 2273Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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Koike H, Ashizawa K, Tsutsui S, Nagayasu T, Uetani M. P30.04 Clinical Research on Patients With Surgically Resected Lung Adenocarcinoma Lesions: Are Heterogeneous GGNs Different From Part Solid Nodules? J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Yamaguchi S, Soyama A, Ono S, Hamauzu S, Yamada M, Fukuda T, Hidaka M, Tsurumoto T, Uetani M, Eguchi S. Novel Computer-Aided Diagnosis Software for the Prevention of Retained Surgical Items. J Am Coll Surg 2021; 233:686-696. [PMID: 34592404 DOI: 10.1016/j.jamcollsurg.2021.08.689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Retained surgical items are a serious human error. Surgical sponges account for 70% of retained surgical items. To prevent retained surgical sponges, it is important to establish a system that can identify errors and avoid the occurrence of adverse events. To date, no computer-aided diagnosis software specialized for detecting retained surgical sponges has been reported. We developed a software program that enables easy and effective computer-aided diagnosis of retained surgical sponges with high sensitivity and specificity using the technique of deep learning, a subfield of artificial intelligence. STUDY DESIGN In this study, we developed the software by training it through deep learning using a dataset and then validating the software. The dataset consisted of a training set and validation set. We created composite x-rays consisting of normal postoperative x-rays and surgical sponge x-rays for a training set (n = 4,554) and a validation set (n = 470). Phantom x-rays (n = 12) were prepared for software validation. X-rays obtained with surgical sponges inserted into cadavers were used for validation purposes (formalin: Thiel's method = 252:117). In addition, postoperative x-rays without retained surgical sponges were used for the validation of software performance to determine false-positive rates. Sensitivity, specificity, and false positives per image were calculated. RESULTS In the phantom x-rays, both the sensitivity and specificity in software image interpretation were 100%. The software achieved 97.7% sensitivity and 83.8% specificity in the composite x-rays. In the normal postoperative x-rays, 86.6% specificity was achieved. In reading the cadaveric x-rays, the software attained both sensitivity and specificity of >90%. CONCLUSIONS Software with high sensitivity for diagnosis of retained surgical sponges was developed successfully.
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Affiliation(s)
- Shun Yamaguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shinichiro Ono
- Department of Digestive and General Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Shin Hamauzu
- Imaging Technology Center, Research and Development Management Headquarters, FUJIFILM Corporation, Tokyo, Japan
| | - Masahiko Yamada
- Imaging Technology Center, Research and Development Management Headquarters, FUJIFILM Corporation, Tokyo, Japan
| | - Toru Fukuda
- Department of Radiology, Nagasaki University Hospital
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Toshiyuki Tsurumoto
- Department of Macroscopic Anatomy, Nagasaki University Graduate School of Biomedical Sciences
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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22
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Koike H, Morikawa M, Uetani M, Sato C, Tsuda M. A case of intracranial vasospasm in a patient with extensive retropharyngeal cellulitis. Radiol Case Rep 2021; 16:2697-2700. [PMID: 34345332 PMCID: PMC8319001 DOI: 10.1016/j.radcr.2021.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022] Open
Abstract
Retropharyngeal cellulitis/abscesses are deep neck infections that may become life-threatening if airway compromise occurs. This condition is more common in children than in adults, and associated intracranial vessel narrowing has been reported. We report an adult patient with extensive retropharyngeal cellulitis and intracranial vasospasm. The patient was a 62-year-old woman who presented with fever, sore throat, and neck pain. She also had uncontrolled type 2 diabetes mellitus. Leukocytosis, prolonged erythrocyte sedimentation rate, elevated C-reactive protein, and hyperglycemia were present on admission. Computed tomography and contrast-enhanced magnetic resonance imaging revealed severe swelling in the nasopharyngeal, retropharyngeal, prevertebral, and bilateral carotid spaces. Gadolinium enhancement extended to the middle cranial fossa and visceral space. Multiple stenoses in several intracranial vessels was also identified. Intravenous antibiotic therapy was initiated, the patient's symptoms resolved, and repeat imaging confirmed improvement. Intracranial vasospasm should be considered in patients with retropharyngeal cellulitis.
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Affiliation(s)
- Hirofumi Koike
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Minoru Morikawa
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chisei Sato
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masayuki Tsuda
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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23
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Koike H, Sueyoshi E, Nishimura T, Iwano Y, Oka T, Uetani M, Maemura K. Effect of Balloon Pulmonary Angioplasty on Homogenization of Lung Perfusion Blood Volume by Dual-Energy Computed Tomography in Patients with Chronic Thromboembolic Pulmonary Hypertension. Lung 2021; 199:475-483. [PMID: 34459967 DOI: 10.1007/s00408-021-00471-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/21/2021] [Indexed: 01/20/2024]
Abstract
OBJECTIVE Balloon pulmonary angioplasty (BPA) is used to treat patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH); the goal is to improve pulmonary perfusion. We aimed to evaluate lung perfusion blood volume (PBV) with haemodynamic and exercise-capacity parameters to assess the efficacy of BPA in the treatment of CTEPH. METHODS We retrospectively studied 33 patients over a 6-year period. DECT pulmonary angiography was performed before and after BPA. DECT provided iodine distribution maps; whole-lung and regional PBV images and quantification were generated using post-processing software. A mosaic pattern suggesting perfusion inhomogeneity is typical in CTEPH. Hypothetically, BPA treatment would promote homogenization that would be reflected in the calculated standard deviation. RESULTS Lung perfusion images showed decreased heterogeneity after BPA. There was a significant difference before and after BPA in the whole-lung PBV and in the regional standard deviation for pulmonary arterial pressure (R = 0.37, p = 0.032 and R = 0.57, p = 0.006), pulmonary vascular resistance (R = 0.51, p = 0.023 and R = 0.60, p = 0.002), transtricuspid pressure gradient (R = 0.50, p = 0.0028 and R = 0.61, p = 0.0001), brain natriuretic peptide (R = 0.54, p = 0.0012 and R = 0.46, p = 0.0078), and 6-min walking distance (R = 0.59, p = 0.003 and R = 0.26, p = 0.14). The effects were especially pronounced after the first BPA procedure. CONCLUSION Decreased lung heterogeneity may suggest BPA efficacy in treating CTEPH. After BPA treatment, improved lung PBV and improved regional standard deviation showed a strong positive correlation with haemodynamic parameters and exercise capacity, which also suggests that BPA is effective in treating CTEPH.
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Affiliation(s)
- Hirofumi Koike
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Eijun Sueyoshi
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takamasa Nishimura
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yusuke Iwano
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Taiga Oka
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kouji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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24
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Oki N, Ikebe Y, Koike H, Ideguchi R, Niino D, Uetani M. FDG-PET vs. chemical shift MR imaging in differentiating intertrabecular metastasis from hematopoietic bone marrow hyperplasia. Jpn J Radiol 2021; 39:1077-1085. [PMID: 34101119 PMCID: PMC8568862 DOI: 10.1007/s11604-021-01149-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022]
Abstract
Purpose To evaluate the utility of SUVmax on FDG-PET and chemical shift imaging (CSI) on MRI in the differentiation of intertrabecular metastasis (ITM) from hematopoietic bone marrow hyperplasia (HBMH). Patients and methods We retrospectively evaluated 54 indeterminate focal bone marrow lesions in 44 patients detected on FDG-PET. The lesions were assigned to the metastasis group (M group, 29 lesions of 24 patients) and the non-metastasis group (non-M group, 25 lesions of 20 patients) based on the follow-up or the histopathological studies. The lesions were assessed with the maximum standardized uptake value (SUVmax) on FDG-PET CT images and signal change ratio (SCR) on CSI. Results The median SUVmax were 5.62 and 2.91; the median SCR were − 0.08 and − 34.8 in M and non-M groups respectively, with significant difference (p < 0.001). With ROC curve analysis, the optimal cutoff value of SUVmax was 4.48 with a sensitivity of 72.4%, a specificity of 100%, and AUC of 0.905. The cutoff value of SCR was − 6.15 with a sensitivity of 82.8%, a specificity of 80%, and AUC of 0.818. Conclusion FDG-PET and CSI on MRI are useful in distinguishing ITM from HBMH. Though their sensitivities are similar, the specificity of FDG-PET was higher than that of MRI.
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Affiliation(s)
- Nozomi Oki
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Yohei Ikebe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648 Japan
| | - Hirofumi Koike
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Reiko Ideguchi
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Daisuke Niino
- Pathology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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25
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Koike H, Suzuka M, Morikawa M, Sueyoshi E, Uetani M. Intravascular lipoma of the inferior vena cava and left renal vein. Radiol Case Rep 2021; 16:1233-1236. [PMID: 33868526 PMCID: PMC8041654 DOI: 10.1016/j.radcr.2021.02.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/27/2021] [Indexed: 01/03/2023] Open
Abstract
Intravenous lipoma of the inferior vena cava is an incidental finding on contrast-enhanced computed tomography in 0.5% of individuals. We report a case of multiple intravenous lipomas discovered during diagnosis of cholangitis in a 39-year-old woman. Imaging revealed three fatty masses that appeared connected by cordlike structures: one in the left renal vein with wide mural attachment and two in the inferior vena cava, the higher of which was mobile. We hypothesize that these originated as a single lipoma that subsequently divided into three distinct masses. Because mobile masses may cause pulmonary thromboembolism, surgery is recommended in these cases.
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Affiliation(s)
- Hirofumi Koike
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Miyakawa Suzuka
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Minoru Morikawa
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Eijyun Sueyoshi
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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26
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Sueyoshi E, Sakamoto I, Uetani M. Embolization for massive bleeding due to spontaneous left external iliac vein rupture: report of a successful case. CVIR Endovasc 2021; 4:33. [PMID: 33792801 PMCID: PMC8017067 DOI: 10.1186/s42155-021-00219-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spontaneous rupture of the iliac vein has rarely been reported. Its associated hypovolemic shock-related symptoms and signs, including syncope and hypotension, have been observed in most of these cases. Successful transcatheter venous embolization for massive bleeding due to spontaneous rupture of the external iliac vein was herein reported. CASE PRESENTATION An 82-year-old female patient developed sudden left lower abdominal and back pain. Immediately, she lost consciousness and went into shock. CT images of her abdomen revealed a huge retroperitoneal hematoma, with leakage of contrast medium in the hematoma in the left flank. These findings suggested left external iliac vein rupture. Open surgery was considered; however, since the patient's condition may have deteriorated further due to the time needed to prepare for surgery, including general anesthesia, transcatheter venous embolization of the left iliac vein was selected. A 5.2-Fr compliant balloon catheter (nominal diameter of 10 mm) was inflated at the distal site of the external iliac vein to reduce extravasation. N-butyl-2-cyanoacrylate (NBCA) was mixed with Lipiodol at a ratio of 1:2. The left Iliac vein was filled and completely embolized with the NBCA/Lipiodol mixture (total injected volume, 5 mL) using a 1.8-Fr microcatheter. After embolization, the patient quickly. An inferior vena cava filter was placed 1 day after embolization. CONCLUSION Spontaneous rupture of the iliac vein is a very rare and lethal condition. Transcatheter venous embolization may control potentially life-threatening bleeding. Rapid bleeding control in a critical condition is facilitated by this minimally invasive approach.
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Affiliation(s)
- Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Ichiro Sakamoto
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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27
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Sueyoshi E, Koike H, Nagayama H, He X, Sakamoto I, Uetani M. Endovascular Repair of Diffuse Pulmonary Arteriovenous Malformations with Systemic Arterial Shunts. Vasc Endovascular Surg 2021; 55:642-644. [PMID: 33622206 DOI: 10.1177/1538574421996948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diffuse pulmonary arteriovenous malformations (PAVMs) are defined as arteriovenous malformations (AVMs) involving subsegmental, segmental, or both types of arteries in at least 1 lung lobe and are more extensive than multiple PAVMs. Diffuse PAVMs involving systemic arterial shunts are very rare. We describe a rare case, in which diffuse PAVMs involving systemic arterial shunts were successfully treated with coil embolization.
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Affiliation(s)
- Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hirofumi Koike
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroki Nagayama
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Xi He
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Ichiro Sakamoto
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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28
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Sasaki M, Hotokezaka Y, Ideguchi R, Uetani M, Fujita S. Traumatic myositis ossificans: multifocal lesions suggesting malignancy on FDG-PET/CT-a case report. Skeletal Radiol 2021; 50:249-254. [PMID: 32588098 PMCID: PMC7677150 DOI: 10.1007/s00256-020-03521-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 02/06/2023]
Abstract
Myositis ossificans (MO) is a benign soft-tissue lesion characterized by the heterotopic formation of the bone in skeletal muscles, usually due to trauma. MO is occasionally difficult to diagnose because of its clinical and radiological similarities with malignancy. We report a case of traumatic MO (TMO) in the masseter and brachial muscles of a 37-year-old man who presented with painless swelling in the left cheek and severe trismus. Due to the absence of a traumatic history at the first consultation and identification of a tumorous lesion in the left masseter muscle by magnetic resonance imaging (MRI), the lesion was suspected to be a malignant tumor. Subsequently, 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) showed multiple regions of high FDG uptake across the whole body, suggestive of multiple metastases or other systemic diseases. However, intramuscular calcifications were also observed in the left masseter and brachial muscles, overlapping the areas with high FDG uptake. Moreover, multiple fractures were seen in the rib and lumbar spine, also overlapping the areas with high FDG uptake. Based on these imaging findings, along with a history of jet-ski trauma, TMO was suspected. The left cheek mass was surgically excised and histologically diagnosed as TMO. In this case report, FDG-PET/CT could detect multiple TMOs across the whole body. To the best of our knowledge, cases of multiple TMOs located far apart in different muscles are rare, and this may be the first report.
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Affiliation(s)
- Miho Sasaki
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Yuka Hotokezaka
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
| | - Reiko Ideguchi
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Shuichi Fujita
- Department of Oral Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
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29
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Nishimura T, Sueyoshi E, Tasaki Y, Uetani M. Asymptomatic floating thrombus in the ascending aorta depicted on four-dimensional computed tomography. SAGE Open Med Case Rep 2020; 8:2050313X20971894. [PMID: 33224502 PMCID: PMC7649852 DOI: 10.1177/2050313x20971894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022] Open
Abstract
Aortic mural thrombi of the ascending aorta are rare. If an aortic mural thrombus is dislodged, it can cause various embolic complications, which can sometimes be fatal. Although contrast-enhanced computed tomography (CT) and transesophageal echography are useful for diagnosing aortic mural thrombi, four-dimensional CT (4D-CT) is one of the most useful modalities for both diagnosis and treatment selection in such cases. 4D-CT can be used to evaluate the morphology and mobility of thrombi. Furthermore, it is minimally invasive. To the best of our knowledge, there have not been any reports about 4D-CT being used to depict an asymptomatic ascending aortic thrombus. We report a very unusual case, involving an aortic mural thrombus of the ascending aorta.
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Affiliation(s)
- Takamasa Nishimura
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yuichi Tasaki
- Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Iriki J, Yamamoto K, Senju H, Nagaoka A, Yoshida M, Iwasaki K, Ashizawa N, Hirayama T, Tashiro M, Takazono T, Imamura Y, Miyazaki T, Izumikawa K, Yanagihara K, Tsujino A, Fukuoka J, Uetani M, Satoh M, Mukae H. Influenza A (H3N2) infection followed by anti-signal recognition particle antibody-positive necrotizing myopathy: A case report. Int J Infect Dis 2020; 103:33-36. [PMID: 33217572 DOI: 10.1016/j.ijid.2020.11.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 01/13/2023] Open
Abstract
A 60-year-old Japanese woman presented with subacute progressive muscle pain and weakness in her proximal extremities. She was diagnosed with influenza A (H3N2) infection a week before the onset of muscle pain. At the time of admission, she exhibited weakness in the proximal muscles of the upper and lower limbs, elevated serum liver enzymes and creatinine kinase, and myoglobinuria. She did not manifest renal failure and cardiac abnormalities, indicating myocarditis. Electromyography revealed myogenic changes, and magnetic resonance imaging of the upper limb showed abnormal signal intensities in the muscles, suggestive of myopathy. Muscle biopsy of the biceps revealed numerous necrotic regeneration fibers and mild inflammatory cell infiltration, suggesting immune-mediated necrotizing myopathy (IMNM). Necrotized muscle cells were positive for human influenza A (H3N2). Autoantibody analysis showed the presence of antibodies against the signal recognition particle (SRP), and the patient was diagnosed with anti-SRP-associated IMNM. She was resistant to intravenous methylprednisolone pulse therapy but recovered after administration of oral systemic corticosteroids and immunoglobulins. We speculate that the influenza A (H3N2) infection might have triggered her IMNM. Thus, IMNM should be considered as a differential diagnosis in patients with proximal muscle weakness that persists after viral infections.
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Affiliation(s)
- Jun Iriki
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan; Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan.
| | - Hiroaki Senju
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Atsushi Nagaoka
- Department of Neurology and Strokology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Masataka Yoshida
- Department of Respiratory Medicine, Sasebo City General Hospital, 9-3 Hirasemachi, Sasebo City, Japan
| | - Keisuke Iwasaki
- Department of Pathology, Sasebo City General Hospital, 9-3 Hirasemachi, Sasebo City, Japan
| | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Yoshifumi Imamura
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Taiga Miyazaki
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Akira Tsujino
- Department of Neurology and Strokology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City, Japan
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31
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Sueyoshi E, Sakamoto I, Koide Y, Uetani M. Endovascular repair of an internal mammary artery aneurysm in a patient with Takayasu arteritis. Interact Cardiovasc Thorac Surg 2020; 31:740-742. [PMID: 32910191 DOI: 10.1093/icvts/ivaa174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/02/2020] [Accepted: 07/26/2020] [Indexed: 11/14/2022] Open
Abstract
Internal mammary artery aneurysms are rare, but serious, clinical entities. We describe a rare case in which an internal mammary artery aneurysm in a patient with Takayasu arteritis was successfully treated with coil embolization. To the best of our knowledge, this is the first report of an internal mammary artery aneurysm associated with Takayasu arteritis.
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Affiliation(s)
- Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Ichiro Sakamoto
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yuji Koide
- Nagasaki Medical Education Center, Medical Education and Development Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Tasaki Y, Sueyoshi E, Takamatsu H, Matsushima Y, Miyamura S, Sakamoto I, Mochizuki Y, Uetani M. The outcomes of carbon dioxide digital subtraction angiography for percutaneous transluminal balloon angioplasty of access circuits and venous routes in hemodialysis patients. Medicine (Baltimore) 2020; 99:e21890. [PMID: 32899019 PMCID: PMC7478692 DOI: 10.1097/md.0000000000021890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The outcomes of carbon dioxide digital subtraction angiography (CO2-DSA) for performing percutaneous transluminal balloon angioplasty (balloon PTA) in hemodialysis patients has not been fully clarified. The purpose was to compare the outcomes of balloon PTA of hemodialysis shunts in terms of vessel patency between patients treated using CO2-DSA and conventional digital subtraction angiography using iodine contrast medium (C-DSA).We retrospectively evaluated 76 patients (38 males and 38 females, mean age: 65.0 ± 14.0 years). They were under hemodialysis and treated with balloon PTA using CO2-DSA or C-DSA at our institution between 2009 and 2016. Mean duration of the follow-up period was 25.59 ± 21.45 months. We compared the patency rates obtained after CO2-DSA-based balloon PTA with those after C-DSA-based balloon PTA. Secondary patency, which was defined as the duration of patency after all further endovascular interventions until surgical repair, was considered as the endpoint in this study.Overall, 19 and 57 patients underwent CO2-DSA- and C-DSA-based balloon PTA, respectively. CO2-DSA- and C-DSA-based balloon PTA produced clinical success rates of 100% and 96.5%, respectively. Blood vessel injury occurred in one patient who underwent C-DSA-based balloon PTA. No major complications occurred in CO2 group. At 24 months, the post-PTA secondary patency rates of CO2-DSA- and C-DSA-based balloon PTA were 94.1% and 93.9%, respectively (P = .9594).CO2-DSA is safe for hemodialysis patients. Compared with C-DSA, CO2-DSA-based balloon PTA produces have a similar secondary patency rate.
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Affiliation(s)
- Yutaro Tasaki
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
| | - Eijun Sueyoshi
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
| | - Hiroko Takamatsu
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
| | - Yoshifumi Matsushima
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
| | - Shuto Miyamura
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
| | - Ichiro Sakamoto
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
| | - Yasushi Mochizuki
- Division of Blood Purification, Nagasaki University Hospital, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences
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33
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Sueyoshi E, Iwano Y, Oka T, Nishimura T, Honda T, Kawaguchi Y, Koike H, Nagayama H, Sakamoto I, Uetani M. The Successful Treatment of an Ilio-Iliac Fistula and Aneurysms Affecting the Abdominal Aortic and Iliac Arteries via Endovascular Stent Graft Repair. Vasc Endovascular Surg 2020; 55:91-94. [PMID: 32875955 DOI: 10.1177/1538574420953933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spontaneous ilio-iliac arteriovenous fistula (AVF) associated with aneurysms affecting the abdominal aortic and iliac arteries is a rare condition. The classical clinical symptoms of ilio-iliac AVF include high-output heart failure, abdominal pain, abdominal bruits and thrills, a pulsatile abdominal mass, and venous congestion symptoms (leg edema and hematuria). The prompt repair of AVF is necessary to restore the patient's hemodynamics. We report a case in which a patient with aneurysms affecting the abdominal aortic and iliac arteries and an ilio-iliac AVF presented with high-output heart failure and leg ischemia and was successfully treated via endovascular stent graft repair.
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Affiliation(s)
- Eijun Sueyoshi
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan.,Department of Radiological Science, 200674Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yusuke Iwano
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Taiga Oka
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Takamasa Nishimura
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Takahide Honda
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Yutaro Kawaguchi
- Department of Cardiovascular Surgery, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Hirofumi Koike
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Hiroki Nagayama
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan
| | - Ichiro Sakamoto
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan.,Department of Radiological Science, 200674Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, 12961Nagasaki University School of Medicine, Nagasaki, Japan.,Department of Radiological Science, 200674Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Otsuka T, Sueyoshi E, Tasaki Y, Uetani M. Computed tomography findings and in-hospital mortality in patients with rupture of type B aortic dissection. Acta Radiol 2020; 61:136-144. [PMID: 31154812 DOI: 10.1177/0284185119852730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The relationships between the computed tomography (CT) findings and outcomes of patients with ruptured type B aortic dissection have not been clarified. Purpose To evaluate the initial CT findings of patients with ruptured type B aortic dissection and investigate the relationships between the initial CT findings and in-hospital mortality. Material and Methods This study was approved by the institutional review board. Thirty-three patients were diagnosed with ruptured Stanford type B aortic dissection at our hospital between 2007 and 2016 (21 men, 12 women; mean age = 76.1±10.7 years). We retrospectively evaluated the initial CT findings of ruptured type B aortic dissection and the relationships between clinical factors and in-hospital mortality using logistic regression analysis. Results Type B aortic dissections ruptured in the acute and chronic phases in 23 and 10 patients, respectively. The initial CT images showed various findings, including an open false lumen (58%), arch involvement (88%), hematomas in the pleural space (55%), hematomas in the pericardial space (18%), and the extravasation of vascular contrast material (12%). The mean maximum diameter of the affected aorta was 49.5 ± 16.1 mm. Among the 33 patients, 14 died at hospital. Female gender (hazard ratio = 10.284; 95% confidence interval [CI] = 1.61–65.54; P = 0.0136) and the presence of a hematoma in the pleural space (hazard ratio = 6.803; 95% CI = 1.07–43.24; P = 0.0421) were found to be predictors of in-hospital mortality. Conclusion Female gender and the presence of a hematoma in the pleural space are significant predictors of in-hospital mortality in patients with ruptured type B aortic dissection.
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Affiliation(s)
- Tetsuhiro Otsuka
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Eijun Sueyoshi
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yutaro Tasaki
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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35
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Fujikawa K, Kawashiri SY, Endo Y, Mizokami A, Tsukada T, Mine M, Uetani M, Kawakami A. Diagnostic efficacy of ultrasound detection of enthesitis in peripheral spondyloarthritis. Mod Rheumatol 2019; 30:1060-1066. [PMID: 31663417 DOI: 10.1080/14397595.2019.1687113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: We investigated the diagnostic efficacy of power Doppler ultrasound (PDUS) to detect enthesitis in Japanese patients with peripheral spondyloarthritis (SpA).Methods: This was a single-center cohort study of patients with peripheral symptoms suggestive of SpA. Articular synovia, tendons, and entheses were assessed by PDUS at baseline. Clinical, laboratory, and radiologic findings and classification criteria for SpA were also evaluated.Results: 136 patients were consecutively evaluated. A definite diagnosis was obtained in 111 patients, including 72 with SpA and 39 non-SpA. Among the patients with SpA, PDUS demonstrated articular synovitis in 40 of the 72 patients (56%), tenosynovitis or peritendinitis in 48 (67%), and enthesitis in 63 (88%). Considering PDUS alone, enthesitis in at least one site was the most useful means of differentiating SpA from non-SpA (sensitivity 87.5%; specificity 82.1%; accuracy 85.6%; positive likelihood ratio 4.88). Combining that finding along with fulfillment of Amor, European Spondyloarthropathy Study Group, or Assessment of SpondyloArthritis international Society criteria for peripheral SpA increased the specificity of the diagnosis (92.5%, 92.3%, and 97.4%, respectively).Conclusion: PDUS enthesitis is useful for the diagnosis of SpA with peripheral symptoms. Combining PDUS enthesitis with established SpA classification criteria is beneficial in diagnosing peripheral SpA.
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Affiliation(s)
- Keita Fujikawa
- Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Isahaya, Japan
| | - Shin-Ya Kawashiri
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yushiro Endo
- Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Isahaya, Japan.,Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Akinari Mizokami
- Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Isahaya, Japan
| | - Toshiaki Tsukada
- Department of Rheumatology, Aino Memorial Hospital, Unzen, Japan
| | - Masanobu Mine
- Department of Rheumatology, Suga Orthopedic Hospital, Isahaya, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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36
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Hotokezaka Y, Hotokezaka H, Katayama I, Fujita S, Sasaki M, Eida S, Uetani M. A case of tophaceous pseudogout of the temporomandibular joint extending into the cranium. Oral Radiol 2019; 36:203-208. [PMID: 31559516 DOI: 10.1007/s11282-019-00410-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/11/2019] [Indexed: 02/07/2023]
Abstract
A case of tophaceous pseudogout (i.e., calcium pyrophosphate dihydrate crystal deposition disease) in the temporomandibular joint (TMJ) extending into the cranium is reported. A 59-year-old woman was referred to hospital with swelling and pain in the left cheek, and with trismus. Computed tomography imaging revealed a large, granular, calcified mass surrounding the left condylar head, partly destroying the cortex of the condylar head, and extending into the cranium by destroying the glenoid fossa. Magnetic resonance imaging revealed that the soft-tissue mass was of low-signal intensity on T1- and T2-weighted images, and was enhanced after intravenous injection of gadolinium. The mass was clinically and radiographically suspected to be a neoplastic lesion or a synovial osteochodromatosis. However, histological analysis demonstrated that the mass contained granulomatous lesion due to multiple nodular deposits of numerous rod-shaped and rhomboid crystals, which verified the diagnosis of tophaceous pseudogout. The lesion was excised surgically using a preauricular approach. Neither radiographic nor clinical examination demonstrated any signs of mass recurrence in the long-term 8- and 14-year postoperative recall examinations. Tophaceous pseudogout is a rare benign arthropathy that presents with clinical and radiographic features mimicking neoplastic conditions of the TMJ. Therefore, it is recommended that tophaceous pseudogout is considered in the differential diagnosis when a calcified mass lesion of the TMJ is encountered.
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Affiliation(s)
- Yuka Hotokezaka
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Hitoshi Hotokezaka
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Ikuo Katayama
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
| | - Shuichi Fujita
- Department of Oral Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Miho Sasaki
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Sato Eida
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
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Chiba A, Kudo T, Ideguchi R, Altay M, Koga S, Yonekura T, Tsuneto A, Morikawa M, Ikeda S, Kawano H, Koide Y, Uetani M, Maemura K. P386Comparison of whether a beginner can be close to an expert with an artificial neural network in myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez149.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Chiba
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
| | - T Kudo
- Nagasaki University, Radioisotope Medicine, Nagasaki, Japan
| | - R Ideguchi
- Nagasaki University, Radioisotope Medicine, Nagasaki, Japan
| | - M Altay
- Nagasaki University, Radioisotope Medicine, Nagasaki, Japan
| | - S Koga
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
| | - T Yonekura
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
| | - A Tsuneto
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
| | - M Morikawa
- Nagasaki University Hospital, Radiological Sciences, Nagasaki, Japan
| | - S Ikeda
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
| | - H Kawano
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
| | - Y Koide
- Nagasaki Memorial Hospital, Nagasaki Medical Education Center, Nagasaki, Japan
| | - M Uetani
- Nagasaki University Hospital, Radiological Sciences, Nagasaki, Japan
| | - K Maemura
- Nagasaki University Hospital, Cardiovascular Medicine, Nagasaki, Japan
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Ikebe Y, Ishimaru H, Imai H, Abe K, Izumo T, Morofuji Y, Ideguchi R, Morikawa M, Uetani M. Quantitative Susceptibility Mapping for Carotid Atherosclerotic Plaques: A Pilot Study. Magn Reson Med Sci 2019; 19:135-140. [PMID: 31155568 PMCID: PMC7232036 DOI: 10.2463/mrms.mp.2018-0077] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose: Identifying plaque components such as intraplaque hemorrhage, lipid rich necrosis, and calcification is important to evaluate vulnerability of carotid atherosclerotic plaque; however, conventional vessel wall MR imaging may fail to discriminate plaque components. We aimed to evaluate the components of plaques using quantitative susceptibility mapping (QSM), a newly developed post-processing technique to provide voxel-based quantitative susceptibilities. Methods: Seven patients scheduled for carotid endarterectomy were enrolled. Magnitude and phase images of five-echo 3D fast low angle shot (FLASH) were obtained using a 3T MRI, and QSM was calculated from the phase images. Conventional carotid vessel wall images (black-blood T1-weighted images [T1WI], T2-weighted images [T2WI], proton-density weighted images [PDWI], and time-of-flight images [TOF]) were also obtained. Pathological findings including intraplaque hemorrhage, calcification, and lipid rich necrosis at the thickest plaque section were correlated with relative susceptibility values with respect to the sternocleidomastoid muscle on QSM. On conventional vessel wall images, the contrast–noise ratio (CNR) between the three components and sternocleidomastoid muscle was measured respectively. Wilcoxon signed-rank test analyses were performed to assess the relative susceptibility values and CNR. Results: Pathologically, lipid rich necrosis was proved in all of seven cases, and intraplaque hemorrhage in five of seven cases. Mean relative susceptibility value of hemorrhage was higher than lipid rich necrosis unexceptionally (P = 0.0313). There were no significant differences between CNR of hemorrhage and lipid rich necrosis on all sequences. In all six cases with plaque calcification, susceptibility value of calcification was significantly lower than lipid rich necrosis unexceptionally (P = 0.0156). There were significant differences between CNRs of lipid rich necrosis and calcification on T1WI, PDWI, TOF (P < 0.05). Conclusion: QSM of carotid plaque would provide a novel quantitative MRI contrast that enables reliable differentiation among intraplaque hemorrhage, lipid rich necrosis, and calcification, and be useful to identify vulnerable plaques.
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Affiliation(s)
- Yohei Ikebe
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Hideki Ishimaru
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | | | - Kuniko Abe
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences
| | - Tsuyoshi Izumo
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Yoichi Morofuji
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Reiko Ideguchi
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Minoru Morikawa
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences
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39
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Mori M, Hayashi H, Fukuda M, Honda S, Kitazaki T, Shigematsu K, Matsuyama N, Otsubo M, Nagayasu T, Hashisako M, Tabata K, Uetani M, Ashizawa K. Clinical and computed tomography characteristics of non-small cell lung cancer with ALK gene rearrangement: Comparison with EGFR mutation and ALK/EGFR-negative lung cancer. Thorac Cancer 2019; 10:872-879. [PMID: 30811109 PMCID: PMC6449252 DOI: 10.1111/1759-7714.13017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 01/12/2023] Open
Abstract
Background The study was conducted to evaluate the clinical and computed tomography (CT) findings of non‐small cell lung cancer (NSCLC) patients to distinguish between ALK gene rearrangement, EGFR mutation, and non‐ALK/EGFR (no genetic abnormalities). Methods We enrolled 201 patients with primary NSCLC who had undergone molecular testing for both ALK gene rearrangement and EGFR mutation. The clinical features and CT findings of the main lesion and associated pulmonary abnormalities were investigated. Results Female gender (P = 0.0043 vs. non‐ALK/EGFR), young age (P = 0.0156 vs. EGFR), and a light or never smoking history (P = 0.0039 vs. non‐ALK/EGFR) were significant clinical characteristics of NSCLC with ALK gene rearrangement. The significant CT characteristics compared to NSCLC with EGFR mutation were a large mass (P = 0.0155), solid mass (P = 0.0048), and no air bronchogram (P = 0.0148). A central location (P = 0.0322) and lymphadenopathy (P = 0.0353) were also more frequently observed. Coexisting emphysema was significantly less frequent in NSCLC patients with ALK gene rearrangement (P = 0.0135) than non‐ALK/EGFR. Conclusions NSCLC with ALK gene rearrangement was more likely to develop in younger women with a light or never smoking history. The characteristic CT findings of NSCLC with ALK gene rearrangement were a large solid mass, less air bronchogram, a central location, and lymphadenopathy.
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Affiliation(s)
- Mio Mori
- Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideyuki Hayashi
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Minoru Fukuda
- Clinical Oncology Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Publish Health and Nursing, Public Health and Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Kitazaki
- Division of Respiratory Diseases, Department of Internal Medicine, Japanese Red Cross, Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kazuto Shigematsu
- Department of Pathology, Japanese Red Cross, Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Naohiro Matsuyama
- Department of Radiology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Mayumi Otsubo
- Department of Radiology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mikiko Hashisako
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Tabata
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuto Ashizawa
- Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Clinical Oncology Center, Nagasaki University Hospital, Nagasaki, Japan
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Abstract
Spondyloarthritis may be increasingly present in older patients as life expectancy increases. We investigated clinical differences between early-onset and late-onset spondyloarthritis in Japan.We retrospectively reviewed 114 patients consecutively diagnosed with spondyloarthritis. The clinical course of each patient was observed for ≥1 year. We defined early-onset and late-onset spondyloarthritis as <57 or ≥57 years at a median age of this study group, respectively. We compared clinical characteristics between these 2 groups.Disease duration was significantly shorter before diagnosis in the late-onset group (P < .01). Inflammatory back pain (IBP) was significantly more common in the early-onset group (P < .01), whereas dactylitis frequency was significantly higher in the late-onset group. Significantly more patients with early-onset spondyloarthritis were human leukocyte antigen (HLA) B27-positive (P < .01). Articular synovitis, particularly of the wrist, was significantly more common on power Doppler ultrasound (PDUS) in the late-onset group (P < .01). Tenosynovitis or peritendinitis, particularly in the finger and wrist flexors were also more frequent in the late-onset group (P < .001 and P < .05, respectively). Enthesitis of the finger collateral ligament and lateral collateral ligament were significantly more common in the late-onset group (both P < .05). Multiple logistic regression analysis revealed that, comparatively, IBP was significantly and independently much more likely to occur in the early-onset group.The patients with late-onset spondyloarthritis had a lower frequency of IBP and HLA B27 and a higher frequency of dactylitis and PDUS findings in peripheral involvement.
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Affiliation(s)
- Yushiro Endo
- Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Keita Fujikawa
- Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Akinari Mizokami
- Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital
| | - Masanobu Mine
- Department of Rheumatology, Suga Orthopedic Hospital
| | | | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences
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41
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Sueyoshi E, Koike H, Sakamoto I, Uetani M. Successful treatment of hemoptysis caused by a type 2 endoleak after thoracic endovascular aortic repair. CVIR Endovasc 2019; 1:10. [PMID: 30652143 PMCID: PMC6319520 DOI: 10.1186/s42155-018-0019-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background Massive hemoptysis is a life-threatening condition and can arise as a complication of conditions. Conversely, hemoptysis rarely occurs as a complication of a ruptured thoracic aortic aneurysm (TAA). Case presentation A 76-year-old male had a history of surgical replacement of the whole aortic arch due to a TAA. Three years after the surgery, severe hemoptysis occurred, which resulted in the patient’s emergency hospitalization at our hospital. The patient was diagnosed with ruptured pseudoaneurysms of the aortic arch. Emergency thoracic endovascular aortic repair (TEVAR) was performed. . After that, the hemoptysis stopped, and the patient was discharged. Two months later, the hemoptysis reccurred so the patient was re-admitted to our hospital. CT showed a type 2 endoleak from the bronchial artery. The anastomotic pseudoaneurysms remained. As re-rupturing of the anastomotic aneurysms due to a type 2 endoleak was suspected, transcatheter arterial embolization was performed to treat the type 2 endoleak. The patient’s hemoptysis stopped, and he was discharged. One year later, CT showed that the anastomotic pseudoaneurysms had disappeared, and the diameter of the aorta had also reduced. Conclusion We present a case of hemoptysis caused by a type 2 endoleak that occurred after TEVAR for a ruptured TAA. The hemoptysis was secondary to aortobronchial fistulas caused by anastomotic aortic pseudoaneurysms. Transcatheter arterial embolization of the type 2 endoleak was very effective against the hemoptysis, and the pseudoaneurysms also disappeared. No such cases have been reported previously.
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Affiliation(s)
- Eijun Sueyoshi
- 1Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan.,2Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirofumi Koike
- 1Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan.,2Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ichiro Sakamoto
- 1Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan.,2Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- 1Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan.,2Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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42
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Myssayev A, Myssayev A, Ideguchi R, Eguchi S, Adachi T, Sumida Y, Tobinaga S, Uetani M, Kudo T. Usefulness of FDG PET/CT derived parameters in prediction of histopathological finding during the surgery in patients with pancreatic adenocarcinoma. PLoS One 2019; 14:e0210178. [PMID: 30629646 PMCID: PMC6328180 DOI: 10.1371/journal.pone.0210178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 12/18/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose Pancreatic cancer is the 4th most common cause of cancer death in Japan and exhibits a 5-year overall survival rate of approximately 7%. The accurate diagnosis of pancreatic cancer is important for determining the optimal management strategy. Fludeoxyglucose-positron emission tomography (FDG PET) integrated with computed tomography (18F-FDG PET/CT) has emerged as a powerful imaging tool for detecting and evaluating various cancers, and it is used for staging, detecting local recurrence and distant metastasis, measuring therapeutic effects, and predicting prognosis in pancreatic cancer patients. Lately, FDG PET/CT-derived parameters, such as standardized uptake values (SUV), the metabolic tumor volume (MTV), and total lesion glycolysis (TLG), have been suggested as prognostic factors for various types of cancer, including pancreatic cancer. However, there is no consensus regarding the best parameters for evaluating patient prognosis, operability, etc. The purpose of this study was to examine the differences between operable and non-operable pancreatic cancer using FDG PET/CT-derived parameters, and to investigate whether volumetric parameters (TLG and the MTV) are superior to SUV-based parameters for predicting infiltration status/determining operability. Materials and methods We conducted a retrospective study of the cases of 48 patients with clinically proven pancreatic adenocarcinoma, who underwent FDG PET/CT imaging before treatment. In the operable group, the surgical specimens were subjected to histopathological examinations, and the cases were separated into those exhibiting less and greater infiltration. SUVmax, SUVpeak, the tumor background ratio (TBR), TLG, and the MTV were compared between these groups as well as between the operable and non-operable groups. Results Venous infiltration showed significant associations with several metabolic parameters (SUVmax, SUVpeak, and the TBR). However, it did not display any significant associations with volumetric parameters, such as TLG or the MTV. None of the FDG PET/CT-derived parameters exhibited significant associations with lymphatic or neural infiltration. Significant differences in volumetric parameters, such as the MTV and TLG, were detected between the operable and non-operable subgroups. Conclusions Metabolic 18F-FDG PET/CT-derived parameters, such as SUVmax, SUVpeak, and the TBR, are useful for predicting venous infiltration status in patients with operable pancreatic adenocarcinoma.
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Affiliation(s)
- Altay Myssayev
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ayan Myssayev
- Public Health Department, Semey State Medical University, Semey City, Republic of Kazakhstan
| | - Reiko Ideguchi
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yorihisa Sumida
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Surgery, Sasebo City General Hospital, Nagasaki, Japan
| | - Shuichi Tobinaga
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Kudo
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
- * E-mail:
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43
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Ishimaru H, Morikawa M, Sakugawa T, Sakamoto I, Motoyoshi Y, Ikebe Y, Uetani M. Cerebral lipiodol embolism related to a vascular lake during chemoembolization in hepatocellular carcinoma: A case report and review of the literature. World J Gastroenterol 2018; 24:4291-4296. [PMID: 30310262 PMCID: PMC6175758 DOI: 10.3748/wjg.v24.i37.4291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 08/04/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
A male patient underwent conventional transcatheter chemoembolization for advanced recurrent hepatocellular carcinoma (HCC). Even after the injection of 7 mL of lipiodol followed by gelatin sponge particles, the flow of feeding arteries did not slow down. A repeat angiography revealed a newly developed vascular lake draining into systemic veins; however, embolization was continued without taking noticing of the vascular lake. The patient’s level of consciousness deteriorated immediately after the procedure, and non-contrast computed tomography revealed pulmonary and cerebral lipiodol embolisms. The patient’s level of consciousness gradually improved after 8 wk in intensive care. In this case, a vascular lake emerged during chemoembolization and drained into systemic veins, offering a pathway carrying lipiodol to pulmonary vessels, the most likely cause of this serious complication. We should be aware that vascular lakes in HCC may drain into systemic veins and can cause intratumoral arteriovenous shunts.
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Affiliation(s)
- Hideki Ishimaru
- Department of Radiology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Minoru Morikawa
- Department of Radiology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Takayuki Sakugawa
- Department of Radiology, University of the Ryukyus, Okinawa 903-0213, Japan
| | - Ichiro Sakamoto
- Department of Radiology, Nagasaki Harbor Medical Cancer, Nagasaki 850-8555, Japan
| | - Yasuhide Motoyoshi
- Department of Gastroenterology, Nagasaki Harbor Medical Cancer, Nagasaki 850-8555, Japan
| | - Yohei Ikebe
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
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44
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Koike H, Ashizawa K, Hayashi H, Sakamoto I, Nakamura S, Nishino A, Hayashi T, Uetani M. Takayasu Arteritis Presenting as Unexplained Pulmonary Consolidation: A Case Report. Vasc Endovascular Surg 2018; 52:579-582. [PMID: 29742991 DOI: 10.1177/1538574418775186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Although Takayasu arteritis (TA) is rare as a form of chronic inflammatory arteritis, it is important that it is diagnosed early because the 10-year survival rate is only 84% to 87%. Many reported patients have been young women in East Asia. We report a case of a young woman who originally presented with unexplained pulmonary consolidation. Five years later, contrast-enhanced computed tomography (CT) imaging showed thickening of the walls of the aorta and its branches and of the main and right pulmonary artery (PA), and occlusion of the left subclavian and left PAs. A diagnosis of TA was made based on these CT findings. Patients with TA often have PA involvement, and this can be the initial site of arteritis. Therefore, TA should be included in the differential diagnosis of young women with unexplained pulmonary consolidation.
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Affiliation(s)
- Hirofumi Koike
- 1 Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,2 Department of Radiology, Nagasaki Rosai Hospital, Sasebo, Japan
| | - Kazuto Ashizawa
- 3 Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideyuki Hayashi
- 4 Department of Radiology, Isahaya Health Insurance General Hospital, Nagasaki, Japan
| | - Ichiro Sakamoto
- 1 Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeki Nakamura
- 5 Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ayako Nishino
- 6 Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki, Japan
| | - Tomayoshi Hayashi
- 7 Department of Pathology, Nagasaki Prefecture Shimabara Hospital, Nagasaki, Japan
| | - Masataka Uetani
- 1 Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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45
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Koike H, Sueyoshi E, Sakamoto I, Uetani M, Nakata T, Maemura K. Correlation between lung perfusion blood volume and SPECT images in patients with chronic thromboembolic pulmonary hypertension by balloon pulmonary angioplasty. Clin Imaging 2018; 49:80-86. [DOI: 10.1016/j.clinimag.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/11/2017] [Accepted: 11/02/2017] [Indexed: 12/31/2022]
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46
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Ideguchi R, Yoshida K, Ohtsuru A, Takamura N, Tsuchida T, Kimura H, Uetani M, Kudo T. The present state of radiation exposure from pediatric CT examinations in Japan-what do we have to do? J Radiat Res 2018; 59:ii130-ii136. [PMID: 29420748 PMCID: PMC5941147 DOI: 10.1093/jrr/rrx095] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/23/2017] [Indexed: 06/08/2023]
Abstract
The use of computed tomography (CT) has increased dramatically over the past several decades and has resulted in a concurrent increase in medical exposure to ionizing radiation. Several recent studies have examined the link between medical radiation and the risk of cancer, especially in children. The cancer risk associated medical exposure has not been definitively confirmed. However, we have to reduce unwarranted medical radiation exposure in pediatric patients. Justification and optimization are of great importance in order to minimize these risks, and the standardization of CT usage is essential. However, in Japan no clinical guidelines for the use of CT have been commonly agreed upon, especially in children. Furthermore, the CT-associated radiation exposure in Japan varies widely among the different facilities. Further studies based on a nationwide survey in Japan will be required in order to establish simple and useful clinical guidelines.
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Affiliation(s)
- Reiko Ideguchi
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Koji Yoshida
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences
| | - Akira Ohtsuru
- Department of Radiation Health Management, Fukushima Medical University
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | | | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui
| | - Masataka Uetani
- Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University
| | - Takashi Kudo
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
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47
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Ogihara Y, Ashizawa K, Hayashi H, Nagayasu T, Hayashi T, Honda S, Uetani M. Progressive massive fibrosis in patients with pneumoconiosis: utility of MRI in differentiating from lung cancer. Acta Radiol 2018; 59:72-80. [PMID: 28361545 DOI: 10.1177/0284185117700929] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background It is occasionally difficult to distinguish progressive massive fibrosis (PMF) from lung cancer on computed tomography (CT) in patients with pneumoconiosis. Purpose To evaluate the magnetic resonance imaging (MRI) features of PMF and to assess its ability to differentiate PMF from lung cancer. Material and Methods Between 2000 and 2014, 40 pulmonary lesions suspected to be lung cancer on the basis of CT in 28 patients with known pneumoconiosis were evaluated. Twenty-four of the 40 lesions were pathologically or clinically diagnosed as PMF. The signal pattern on T2-weighted (T2W) images, post-contrast enhancement pattern on T1-weighted (T1W) images, and the pattern of the time intensity curve (TIC) on contrast-enhanced dynamic studies were evaluated. All images were analyzed independently by two chest radiologists. Results All 24 PMF lesions showed low signal intensity (SI) on T2W images (sensitivity, 100%), while 15 of 16 lung cancer lesions showed intermediate or high SI on T2W images (specificity, 94%) when PMF was regarded as a positive result. Six of 17 PMF lesions showed a homogeneous enhancement pattern (sensitivity, 35%), and 4/9 lung cancer lesions showed an inhomogeneous or a ring-like enhancement pattern (specificity, 44%). Six of 16 PMF lesions showed a gradually increasing enhancement pattern (sensitivity, 38%), and 7/9 lung cancer lesions showed rapid enhancement pattern (specificity, 78%). Conclusion When differentiation between PMF and lung cancer in patients with pneumoconiosis is difficult on CT, an additional MRI study, particularly the T2W imaging sequence, may help differentiate between the two.
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Affiliation(s)
- Yukihiro Ogihara
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Radiology, Nagasaki Prefecture Shimabara Hospital, Nagasaki, Japan
| | - Kazuto Ashizawa
- Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideyuki Hayashi
- Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomayoshi Hayashi
- Department of Pathology, Nagasaki Prefecture Shimabara Hospital, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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48
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Onizuka H, Sueyoshi E, Ishimaru H, Sakamoto I, Uetani M. Arterial injury during transcatheter arterial chemoembolization for hepatocellular carcinoma: predictors of risk and outcome. Abdom Radiol (NY) 2017; 42:2544-2550. [PMID: 28493072 DOI: 10.1007/s00261-017-1168-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate clinical features and results of follow-up in patients with arterial injury during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma. METHODS From 2005 to 2015, 2219 TACE procedures were performed in 906 patients in our hospital. Iatrogenic arterial injury occurred during 38 TACE procedures (sessions) in 35 patients (24 men, 11 women; mean age 71.8 years). The incidence of arterial injury was 1.7%. We evaluated the characteristics of arterial injury, and evaluated the risk factors for incomplete recanalization of the injured artery at follow-up angiography conducted after 1-11 months (mean 102.5 days). RESULTS Iatrogenic arterial injury was caused by the microcatheter in 34 of 38 cases (86.8%). There were 15 cases (39.5%) in which the replaced hepatic artery or the extrahepatic artery was the parasitic supply. Extravasation occurred in five cases. In 36 of 38 cases, follow-up angiography was performed. We divided 36 cases into two groups: complete reopening (n = 24) and non-complete reopening (n = 12). The two groups were compared regarding the factors associated with incomplete recanalization of the injured artery at follow-up. Injury length >3 cm (p = 0.0002) and proximal arterial injury (proximal to the segmental artery; p = 0.03) were significant risk factors for non-complete reopening of the injured artery. CONCLUSION Iatrogenic arterial injury frequently occurred in the extrahepatic artery or replaced hepatic artery. Recanalization rate of arterial injury was high; however, injury length >3 cm and proximal arterial injury were risk factors for non-complete reopening of the injured artery.
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Affiliation(s)
- Hironori Onizuka
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Eijun Sueyoshi
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Hideki Ishimaru
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Ichiro Sakamoto
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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49
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Taguchi K, Chiba K, Okazaki N, Kido Y, Miyamoto T, Yonekura A, Tomita M, Uetani M, Osaki M. Characterization of cartilage defects detected by MRI in Kellgren-Lawrence grade 0 or 1 knees. J Orthop Sci 2017; 22:868-873. [PMID: 28734667 DOI: 10.1016/j.jos.2017.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 05/08/2017] [Accepted: 06/13/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Osteoarthritis of the knee is generally evaluated by plain X-rays, which are incapable of detecting small cartilage damage. There are some patients who have small cartilage defects on MRI with no abnormal findings on plain X-rays. In this study, the prevalence and regional characteristics of cartilage defects detected by MRI were studied in cases with normal X-ray findings (Kellgren-Lawrence grade 0 and 1). Relationships between the cartilage defects and OA risk factors such as obesity and leg alignment were also investigated. METHODS A total of 51 knees of Kellgren-Lawrence grade 0 or 1 without knee joint pain were included. Fat-suppressed spoiled-gradient recalled (SPGR) sagittal images were scanned by 3 T MRI, and the presence of cartilage damage was confirmed. Cartilage damage was visualized three-dimensionally, and its location and morphology were analyzed. On a full length standing radiograph of the lower extremities, leg alignment and other parameters were measured, and their associations with cartilage damage were analyzed. RESULTS Cartilage defects were detected in 26% of women aged >50 years. Cartilage damage was located on the medial femoral condyle near the intercondylar notch, and was mostly elliptically shaped in the anteroposterior direction. Subjects with damaged cartilage were not obese and did not have abnormal leg alignment. CONCLUSION It should be borne in mind that some elderly women may have damaged cartilage on the intercondylar notch side of the medial joint, even though plain X-rays appear normal, and this cannot be predicted by obesity or leg alignment.
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Affiliation(s)
- Kenji Taguchi
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan
| | - Ko Chiba
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan.
| | - Narihiro Okazaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan
| | - Yasuo Kido
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Miyamoto
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan
| | - Akihiko Yonekura
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan
| | - Masato Tomita
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan
| | - Masataka Uetani
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Makoto Osaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences; Nagasaki, Japan
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50
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Tamai M, Arima K, Nakashima Y, Kita J, Umeda M, Fukui S, Nishino A, Suzuki T, Horai Y, Okada A, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Yamasaki S, Nakamura H, Origuchi T, Aoyagi K, Uetani M, Eguchi K, Kawakami A. Baseline MRI bone erosion predicts the subsequent radiographic progression in early rheumatoid arthritis patients who achieved sustained good clinical response. Mod Rheumatol 2017; 27:961-966. [PMID: 28269999 DOI: 10.1080/14397595.2017.1294280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To examine whether magnetic resonance imaging (MRI) findings at baseline predict radiographic progression in early-stage rheumatoid arthritis (RA) patients who have achieved sustained good clinical response. METHODS This is a sub-analysis from the one-year observational study of Nagasaki University Early Arthritis Cohort. Definition of 'good clinical response' was a decrement of disease activity score (DAS) 28 ≧ 1.2 at three months with achievement of DAS28 remission through 6-12 months. Gd-enhanced MRI of both wrists and finger joints were examined at baseline and scored using rheumatoid arthritis magnetic resonance imaging score (RAMRIS). Annual increment of Genant-modified Sharp score (GSS) > 0 was defined as 'radiographic progression'. Predictors of radiographic progression were determined by logistic regression analysis. RESULTS Twenty-four subjects were selected in the present study. Each median RAMRIS synovitis, bone edema, bone erosion, and GSS at baseline were 6.5, 0.5, 0, and 0, respectively. Five patients developed radiographic progression at one year. Multivariate logistic regression analysis has shown that RAMRIS bone erosion at baseline is the only independent predictor of radiographic progression at one year (p = .032). CONCLUSIONS Our data suggest that MRI bone erosion predicts poor radiographic outcome of early-stage RA even if it has been successfully treated.
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Affiliation(s)
- Mami Tamai
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Kazuhiko Arima
- b Department of Public Health , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Yoshikazu Nakashima
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Junko Kita
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Masataka Umeda
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Shoichi Fukui
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Ayako Nishino
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Takahisa Suzuki
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,b Department of Public Health , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Yoshiro Horai
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Akitomo Okada
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,c Department of Rheumatology , Japanese Red Cross Nagasaki Genbaku Hospital , Nagasaki , Japan
| | - Tomohiro Koga
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Shin-Ya Kawashiri
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,d Department of Community Medicine , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Naoki Iwamoto
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Kunihiro Ichinose
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Satoshi Yamasaki
- e Division of Rheumatology , Kurume University Medical Center , Kurume , Japan
| | - Hideki Nakamura
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Tomoki Origuchi
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,f Department of Locomotive and Rehabilitation Sciences , Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University , Nagasaki , Japan
| | - Kiyoshi Aoyagi
- b Department of Public Health , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Masataka Uetani
- g Department of Radiological Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Katsumi Eguchi
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,h Department of Rheumatology , Sasebo Chuo Hospital , Sasebo , Japan
| | - Atsushi Kawakami
- a Department of Immunology and Rheumatology , Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
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