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Yasokawa K, Kanki A, Nakamura H, Sotozono H, Ueda Y, Maeba K, Kido A, Higaki A, Hayashida M, Yamamoto A, Tamada T. Changes in pancreatic exocrine function, fat and fibrosis in diabetes mellitus: analysis using MR imaging. Br J Radiol 2023; 96:20210515. [PMID: 36961451 PMCID: PMC10161908 DOI: 10.1259/bjr.20210515] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/03/2023] [Accepted: 02/08/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE To evaluate the relationships between hemoglobin A1c (HbA1c) levels with exocrine pancreatic function using cine-dynamic magnetic resonance cholangiopancreatography (MRCP) and the pancreatic parenchyma using fat-suppressed T1 mapping and the proton density fat fraction (PDFF). METHODS Patients who underwent 3T-MRI and HbA1c measurement were retrospectively recruited. MRI included cine-dynamic MRCP with a spatially selective inversion-recovery (SS-IR) pulse, fat-suppressed Look-Locker T1 mapping and multiecho 3D Dixon-based PDFF mapping. The pancreatic exocrine secretion grade on cine-dynamic MRCP, T1 values, and PDFF were analyzed in non-diabetic (n = 32), pre-diabetic (n = 44) and diabetic (n = 23) groups defined using HbA1c. RESULTS PDFF was weakly correlation with HbA1c (ρ = 0.30, p = 0.002). No correlations were detected between HbA1c and secretion grade (ρ = - 0.16, p = 0.118) or pancreatic parenchymal T1 (ρ = 0.13, p = 0.19). The secretion grade was comparable between the three groups. The T1 value was higher in diabetic (T1 = 1006.2+/- 224.8 ms) than in non-diabetic (T1 = 896.2+/- 86.3 ms, p = 0.010) and pre-diabetic (T1 = 870.1+/- 91.7 ms, p < 0.010) patients. The PDFF was higher in diabetic (FF = 11.8+/- 8.7 %) than in non-diabetic (FF = 6.8+/- 4.2 %, p = 0.014) patients. CONCLUSION Pancreatic exocrine function, T1, and FF showed no correlation with HbA1c. Pancreatic T1 and fat fraction is increased in patients with Type 2 diabetes mellitus. ADVANCES IN KNOWLEDGE This study demonstrates unaffected exocrine function in pre-diabetes and diabetes and confirms that pancreatic parenchymal T1 and FF are increased in patients with diabetes.
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Affiliation(s)
- Kazuya Yasokawa
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akihiko Kanki
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hiroki Nakamura
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hidemitsu Sotozono
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yu Ueda
- MR Clinical Science, Philips Japan, Tokyo, Japan
| | - Kiyoka Maeba
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Ayumu Kido
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Atsushi Higaki
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Minoru Hayashida
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Akira Yamamoto
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tsutomu Tamada
- Department of Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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Maeba K, Kanki A, Watanabe H, Yamamoto A, Fujimoto Y, Yoshiyuki M, Tamada T. Mixed epithelial and stromal tumor of the kidney composed mainly of solid components: A case report. Acta Radiol Open 2022; 11:20584601221103019. [PMID: 35794967 PMCID: PMC9251983 DOI: 10.1177/20584601221103019] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Mixed epithelial and stromal tumor (MEST) is a relatively rare lesion of mixed epithelial and mesenchymal origin, consisting of epithelial components that form cysts and stromal cells that are positive for estrogen and progesterone receptors. The present case was a 54-year-old female who presented with hematuria. Abdominal ultrasonography revealed a 41 x 30 mm tumor in the right kidney, with the tumor protruding outward in the direction of the renal pelvis. Dynamic contrast-enhanced computed tomography and magnetic resonance imaging confirmed a solid tumor in the right kidney that showed gradual contrast enhancement and contained a central non-enhancing area with the appearance of a cystic component. Based on the imaging findings, the provisional diagnosis was papillary renal cell carcinoma or angiomyolipoma with epithelial cysts. Right nephrectomy was performed and the tumor was confirmed histopathologically as MEST. We report a very rare case of MEST that was composed mainly of solid components.
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Affiliation(s)
- Kiyoka Maeba
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Akihiko Kanki
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | | | - Akira Yamamoto
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Yasuto Fujimoto
- Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
| | - Miyaji Yoshiyuki
- Department of Urology, Kawasaki Medical School, Kurashiki, Japan
| | - Tsutomu Tamada
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
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Kanki A, Maeba K, Sotozono H, Yasokawa K, Higaki A, Yamamoto A, Tamada T. Evaluation of liver fibrosis using hepatic extracellular volume fraction by contrast-enhanced computed tomography before and after direct-acting antiviral therapy in patients with chronic hepatitis C infection: comparison with serological liver fibrosis markers. Br J Radiol 2021; 94:20210045. [PMID: 34586878 DOI: 10.1259/bjr.20210045] [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] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate time-dependent changes in hepatic extracellular volume (ECV) fraction using contrast-enhanced CT (CECT) and serological liver fibrosis markers, the fibrosis-4 (FIB-4) index and aspartate aminotransferase to platelet ratio index (APRI), before and after direct-acting antiviral therapy (DAA) for hepatitis C virus (HCV) infection. METHODS 41 HCV-infected patients who achieved sustained virological response (SVR) after DAA (SVR group) and 10 control patients (untreated or unresponsive to treatment) who underwent CECT and serum biochemical tests before or after the first examination/DAA (T1) and at intervals thereafter (T2:<6 months after T1, T3: at 6-12 months, T4: at 12-24 months, and T5:>24 months) were evaluated. RESULTS In the control group, ECV fractions remained relatively unchanged through the study, and significant differences in FIB-4 index comparisons and APRI comparisons were only seen between the T2 and T4 values (p = 0.046 and p = 0.028, respectively). In the SVR group, ECV fractions were significantly different between T1 and T4 and T1 and T5 (p = 0.046 and 0.022, respectively), and both FIB-4 index and APRI were significantly different between T1 and all other time points (p = 0.017 to p < 0.001 and p = 0.001 to p < 0.001, respectively). CONCLUSION After DAA, ECV fraction decreased slowly, suggesting an improvement in hepatic fibrosis, while serological liver fibrosis markers decreased immediately, probably due to improvement in hepatic inflammation. ADVANCES IN KNOWLEDGE ECV fraction has the potential to be a non-invasive biomarker for the assessment of liver fibrosis after direct-acting antiviral therapy.
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Affiliation(s)
- Akihiko Kanki
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
| | - Kiyoka Maeba
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
| | - Hidemitsu Sotozono
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
| | - Kazuya Yasokawa
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
| | - Atsushi Higaki
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
| | - Akira Yamamoto
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
| | - Tsutomu Tamada
- Departments of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan
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Shinya T, Shibamoto K, Maeba K, Kato K, Monobe Y, Fujiwara M, Hongo A. Magnetic resonance imaging findings of a myxoid leiomyosarcoma of the uterus: A case report and literature review. Eur J Radiol Open 2021; 8:100328. [PMID: 33604419 PMCID: PMC7873632 DOI: 10.1016/j.ejro.2021.100328] [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: 12/13/2020] [Revised: 01/16/2021] [Accepted: 01/28/2021] [Indexed: 11/16/2022] Open
Abstract
Uterine myxoid leiomyosarcomas (MLMSs) are extremely rare. Here, we report a rare case of uterine MLMS with unique and bizarre magnetic resonance imaging (MRI) findings on diffusion-weighted images (DWIs) and dynamic contrast-enhanced (DCE) MRI scans. A 67-year-old woman presented with a uterine MLMS that had a multilocular cystic mass with a septum and solid components. The tumour demonstrated marked hyperintensity on T2-weighted images in a myxoid stroma with gradual partial contrast enhancement and diffusion restriction, which could be a characteristic feature suggestive of a myxoid malignant smooth muscle tumour of the uterus rather than a uterine leiomyoma with myxoid degeneration.
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Affiliation(s)
- Takayoshi Shinya
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Kentaro Shibamoto
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Kiyoka Maeba
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Katsuya Kato
- Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Yasumasa Monobe
- Department of Pathology, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Michihisa Fujiwara
- Department of Obstetrics and Gynecology 2, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
| | - Atsushi Hongo
- Department of Obstetrics and Gynecology 2, Kawasaki Medical School General Medical Centre, 2-6-2 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan
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