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Akira Kunimatsu

Publications and source records attributed to Akira Kunimatsu.

8 recordsLinked to original sources

The optimal trackability threshold of fractional anisotropy for diffusion tensor tractography of the corticospinal tract.

PURPOSE: In order to ensure that three-dimensional diffusion tensor tractography (3D-DTT) of the corticospinal tract (CST), is performed accurately and efficiently, we set out to find the optimal lower threshold of fractional anisotropy (FA) below which tract elongation is terminated (trackability threshold). METHODS: Thirteen patients with acute or early subacute ischemic stroke causing motor deficits were enrolled in this study. We performed 3D-DTT of the CST with diffusion tensor MR (magnetic resonance) imaging. We segmented the CST and established a cross-section of the CST in a transaxial plane as a region of interest. Thus, we selectively measured the FA values of the right and left corticospinal tracts at the level of the cerebral peduncle, the posterior limb of the internal capsule, and the centrum semiovale. The FA values of the CST were also measured on the affected side at the level where the clinically relevant infarction was present in isotropic diffusion-weighted imaging. RESULTS: 3D-DTT allowed us to selectively measure the FA values of the CST. Among the 267 regions of interest we measured, the minimum FA value was 0.22. The FA values of the CST were smaller and more variable in the centrum semiovale than in the other regions. The mean minus twice the standard deviation of the FA values of the CST in the centrum semiovale was calculated at 0.22 on the normal unaffected side and 0.16 on the affected side. CONCLUSION: An FA value of about 0.20 was found to be the optimal trackability threshold.

Aged↗

Amyotrophic lateral sclerosis: diffusion tensor tractography and voxel-based analysis.

The purpose of this study is to investigate whether the diffusional anisotropy of water molecules is disrupted in the pyramidal and extra-pyramidal regions in patients with amyotrophic lateral sclerosis (ALS). We studied seven patients with probable ALS (four women, mean age +/- SD, 57.3 +/- 6.2 years old) according to the criteria of the World Federation of Neurology. A control group consisted of 11 age- and sex-matched volunteers (six women, 57.1 +/- 4.5) without disorders affecting the central nervous system. Voxel-based diffusion tensor analysis was made with statistical parametric mapping (SPM99). We also created the normalized corticospinal tractography from the diffusion tensor data. The significant fractional anisotropy (FA) decrease in the ALS group was found in the right frontal subgyral white matter and left frontal precentral white matter. These clusters with significant FA decrease corresponded well to the average group map of the corticospinal tract in a standard reference frame. These results suggested that the combination of voxel-based diffusion tensor analysis and diffusion tensor tractography might help determine the location of the affected neuronal tissues among ALS patients in a non-invasive manner.

Algorithms↗

Feasibility of a curvature-based enhanced display system for detecting cerebral aneurysms in MR angiography.

PURPOSE: To assess the feasibility of a curvature-based enhanced display system for detecting cerebral aneurysms in MR angiography. METHODS: MR angiography studies of 18 patients (eight male and 10 female, average age 65.7, age range 50 to 75 years old) with 23 known aneurysms were evaluated with a curvature-based display system. The two curvature features-the volumetric shape index and curvedness values-were calculated at each voxel. These were displayed independently on a workstation, overlaid on volume-rendered images. Two neuroradiologists evaluated the images for visibility and diagnosis of the cerebral aneurysms. The diagnostic results were compared with the original reports. RESULTS: The calculation time for each curvature index was 30 to 40 s for 120 to 140 slices of original MR angiography data. Shape index images emphasized smooth and round aneurysms more than aneurysms with irregular surfaces. Curvedness images revealed aneurysms well when the aneurysms had diameters that differed from those of the surrounding vessels. The computer-assisted-detection method detected 24 aneurysms, three of which were not pointed out in the initial report. CONCLUSION: Our results show that the curvature-based display system we have developed is feasible and that it may help to detect small aneurysms that are prone to be overlooked in routine readings.

Aged↗

MR imaging of ischemic penumbra.

Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra.

Brain Ischemia↗

[Simple visualization of the corticospinal pathway using tractography: one-ROI and two-ROI methods].

Diffusion tensor imaging (DTI), a magnetic resonance (MR) technique to analyze diffusion anisotropy of the brain, is able to demonstrate subtle white matter anatomy. Tractography is expected to be a unique, non-invasive tool to provide more pertinent insights into brain structure and orientation not accessible by conventional MRI. In this report, preliminary experiences of visualization of the corticospinal tract using tractography are described. DTI of the brain was performed in 5 normal volunteers using single-shot echo-planar imaging, then tractography was generated by our original software. We determined that the two-region-of-interest (ROI) method is superior to the one-ROI method.

Adult↗

Normal aging in the central nervous system: quantitative MR diffusion-tensor analysis.

The purpose of this study is to elucidate changes in mean diffusivity (ADC) and fractional anisotropy (FA) using MR diffusion tensor imaging (DTI) in the central nervous system during normal aging. We studied 50 normal volunteers (30 men, 20 women; mean age 44.8 +/- 14.0; age range, 21-69 years) without disorders affecting the central nervous system. The frontal, parietal white matter, lentiform nucleus, posterior limb of internal capsule, thalamus, genu and splenium of the corpus callosum were selected for investigation. There was no significant difference in ADC or FA between male and female or between the right and left hemisphere. A significant ADC increase with advancing age was observed in frontal white matter (P = 0.010) and lentiform nucleus (P = 0.022). A significant FA decline was found only in the genu of the corpus callosum (P < 0.001) with advancing age. Quantitative diffusion tensor analysis correlate with normal aging and may help in assessing normal age-related changes and serve as a standard for comparison with neurodegenerative disorders.

Adult↗

Periodically rotated overlapping parallel lines with enhanced reconstruction-based diffusion tensor imaging. Comparison with echo planar imaging-based diffusion tensor imaging.

OBJECTIVE: To evaluate diffusion tensor imaging (DTI) based on periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) compared with DTI based on single-shot echo planar imaging (EPI). METHODS: Diffusion tensor data were acquired with PROPELLER (PROPELLER-DTI, 3 NEX), EPI (EPI-DTI2, 16 NEX) with the same acquisition time (11.4 minutes) and with EPI (EPI-DTI1, number of excitations = 4) with a shorter acquisition time (2.8 minutes). Regions of interest were set in the genu and splenium of the corpus callosum, as determined on T2-weighted fast spin echo images and fractional anisotropy (FA) maps, separately. Two neuroradiologists visually evaluated image distortion and quality in the supra- and infratentorial structures. RESULTS: In the genu, standard deviation determined by respective FA maps was decreased in order of PROPELLER-DTI, EPI-DTI1, and EPI-DTI2. Both EPI-DTI sequences were quantitatively superior in the splenium, but PROPELLER-DTI was less distorted. CONCLUSION: Periodically rotated overlapping parallel lines with enhanced reconstruction-DTI could become a complementary tool when qualitatively evaluating seriously distorted structures.

Adult↗

A case of renal angioleiomyoma with rapid growing: CT findings with histopathological correlation.

We present a rare case of renal angioleiomyoma with rapid growing during one-year and seven-months' follow-up. The CT findings correlated well with the histopathological findings. The patient was a 62-year-old man with right renal mass that was incidentally found on CT. The first CT showed a solitary mass lesion that was 2.0 cm in diameter with a well-defined margin at the right renal medulla. It was gradually enhanced on contrast-enhanced CT. Follow-up CT was performed after one year and seven months, and the mass had grown to 3.8 cm in diameter and showed heterogeneous density on unenhanced CT. The mass had an early enhanced area in the corticomedullary phase, and this enhancement lasted into the nephrographic phase. Another area was gradually enhanced heterogeneously. Right radical nephrectomy was performed, and the histopathological diagnosis was renal angioleiomyoma. The early enhanced area of the mass corresponded to large vessels filled with blood, and the other area was mainly composed of bundles of smooth muscle, fibrous tissue, and minute blood vessels. It is important to know that the CT findings of real angioleiomyoma may show hypervascularity but are atypical for renal cell carcinoma (RCC), and a tendency for growth may be present.

Angiomyoma↗