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Biomedical subjects

H Fukatsu

Publications and source records attributed to H Fukatsu.

At least 37 records · Page 2Linked to original sources

MR imaging of the enlarged endolymphatic duct and sac syndrome by use of a 3D fast asymmetric spin-echo sequence: volume and signal-intensity measurement of the endolymphatic duct and sac and area measurement of the cochlear modiolus.

BACKGROUND AND PURPOSE: In enlarged endolymphatic duct (EED) and sac (EES) syndrome, deformity of the EED and EES is congenital; however, hearing loss is acquired. To investigate the pathophysiology of progressive sensorineural hearing loss in EED and EES syndrome, we measured the volume of the EED and EES, the diameter of the EED and EES, the area of the cochlear modiolus, and the signal intensity of the EES and compared our findings against degree of hearing loss. METHODS: Thin-section MR images of 33 ears in 17 patients with EED and EES syndrome were studied. All studies were obtained on a 1.5-T MR unit using a quadrature surface phased-array coil. Heavily T2-weighted 3D fast asymmetric spin-echo images were obtained with a voxel size of 0.3 x 0.3 x 0.8 mm without zero-fill interpolation. Two radiologists traced the areas of the EED and EES manually, and the volume was calculated. The area of the cochlear modiolus, diameter of the EED and EES, and signal intensity of the EES were also measured by drawing regions of interest manually. The signal intensity ratio of EES/CSF was calculated. These measured values were compared against audiographic data, and the degree of linear correlation was determined. RESULTS: The volume of the EED and EES, the area of the modiolus, the diameter of the EED and EES, and the signal intensity of the EES did not show significant correlation with degree of hearing loss. CONCLUSION: These findings suggest that there is a microscopic area of damage or fragility in the inner ear not visible even with thin-section heavily T2-weighted MR imaging.

Adolescent↗

Magnitude subtraction vs. complex subtraction in dynamic contrast-enhanced 3D-MR angiography: basic experiments and clinical evaluation.

Magnitude subtraction and complex subtraction in dynamic contrast-enhanced three-dimensional magnetic resonance (3D-MR) angiography were compared using a phantom and 23 human subjects. In phantom studies, complex subtraction showed far better performance than magnitude subtraction, especially for longer echo times, with thicker slices, and without fat suppression. With complex subtraction, non-fat-suppressed studies showed contrast-to-noise ratios comparable to those in fat-suppressed studies. In human subjects, complex subtraction was superior to magnitude subtraction in 9 subjects, but comparable to magnitude subtraction in 14 subjects. There were no cases in which magnitude subtraction was superior to complex subtraction. Although the differences observed in human studies when complex subtraction was applied with thinner slices, shorter echo times, and the fat-suppression technique were not as pronounced as those seen in phantom studies, complex subtraction should be performed in dynamic contrast-enhanced 3D-MR angiography because there are no drawbacks in complex subtraction. Further research is necessary to assess the feasibility of dynamic contrast-enhanced 3D-MR angiography without fat suppression in human subjects using complex subtraction, as suggested by the results of phantom studies. If it is found to be feasible, dynamic contrast-enhanced 3D-MR angiography without fat suppression using complex subtraction may prove to be a robust technique that eliminates the need for shimming and can reduce the acquisition time. J. Magn. Reson. Imaging 1999;10:813-820.

Adult↗

Evaluation of sleep apnea syndrome with low-field magnetic resonance fluoroscopy.

The aim of this study was to assess the upper airway status of sleep apnea syndrome (SAS) patients with low-field MR fluoroscopy. Twenty patients with clinically diagnosed SAS underwent upper airway monitoring using MR fluoroscopy for 5 min while awake and for 30 min while asleep. A 0.064-T permanent-magnet MR imaging system was used for the study. No patients required any sedative drugs because of the very small gradient noise, except in one case. No occlusion was observed while patients were awake. Nine patients showed repeated occlusion at retropalatal (Rp) pharynx, whereas 11 demonstrated both simple Rp occlusion and combined retropalato-retroglossal (Rp + Rg) occlusions (complex occlusion). The mean frequency of occlusion in complex cases was significantly higher than that in simple Rp cases (p < 0.05). Low-field MR fluoroscopy was useful in determining the occlusion level while asleep in patients with SAS because of its quiet gantry and long-term monitoring capability. The MR fluoroscopy technique should prove to be a valuable clinical tool for the diagnosis and for determining the appropriate therapy in patients with SAS.

Adult↗

MR imaging of the cochlear modiolus: area measurement in healthy subjects and in patients with a large endolymphatic duct and sac.

PURPOSE: To evaluate the cochlear modiolus with thin-section magnetic resonance (MR) imaging in healthy subjects and patients with a large endolymphatic duct and sac, and to assess whether the cochlea is normal or abnormal in patients with a large endolymphatic duct and sac. MATERIALS AND METHODS: MR images were obtained in 10 ears in five volunteers (group 1), 40 ears in 20 patients with bilateral sensory hearing loss (group 2), three ears in two patients with Mondini malformation (group 3), and 12 ears in seven patients with a large endolymphatic duct and sac (group 4). RESULTS: In groups 1 and 2, all modiolar areas were larger than 4.0 mm2. In group 3, each modiolus was smaller than 2.0 mm2. In group 4, modiolar areas were smaller than 2.0 mm2 in eight ears and were larger than 4.0 mm2 in four ears. CONCLUSION: Findings in this study confirm that a large endolymphatic duct and sac is frequently associated with modiolar deficiency, but the modiolar area is normal in some cases. This result does not support the recently proposed hypothesis that hearing loss with a large endolymphatic duct and sac is caused by the transmission of subarachnoid pressure forces into the labyrinth through a deficient modiolus.

Adolescent↗

High-resolution MR cisternography of the cerebellopontine angle: 2D versus 3D fast spin-echo sequences.

BACKGROUND AND PURPOSE: The clinical usefulness of MR cisternography of the cerebellopontine angle, applying 2D or 3D fast spin-echo sequences, has been reported recently. Our purpose was to investigate the cause of signal loss in CSF in the prepontine or cerebellopontine angle cistern on 2D FSE MR images and to compare the cisternographic effects of 2D and 3D FSE sequences. METHODS: Preliminary experiments were performed in four volunteers to assess the causes of signal loss. Initially, using a 2D cardiac-gated cine phase-contrast method with a velocity encoding value of 6 cm/s, we measured the velocity and flow pattern of CSF. Comparisons were made to assess the effects of intravoxel dephasing, amplitude of the section-selecting gradient, echo time (TE), and section thickness. Four healthy subjects and 13 patients with ear symptoms were examined, and multisection 3-mm-thick 2D images and 30-mm-slab, 1-mm-section 3D images were compared qualitatively and quantitatively. Then, 3D MR cisternography was performed in 400 patients with ear symptoms, and qualitative evaluation was performed. RESULTS: In volunteers, the average peak velocity of CSF was 1.2 cm/s. With TE = 250, CSF may move an average of 3 mm, and can be washed out of a 3-mm-thick 2D section volume. The CSF signal relative to that of a water phantom decreased gradually as TE increased on single-section 3-mm-thick 2D images. The CSF signal relative to that of the water phantom increased gradually as section thickness increased. No significant differences were noted in intravoxel dephasing and amplitude of the section-selecting gradient. The contrast-to-noise ratio (CNR) between CSF and the cerebellar peduncle, and the visibility of the cranial nerves and vertebrobasilar artery were significantly improved on 3D images in 17 subjects. In images from 400 patients, no significant signal loss in the cistern was observed using 3D FSE. CONCLUSION: CSF signal loss in thin-section 2D MR cisternography is mainly attributable to the wash-out phenomenon. 3D acquisition can reduce this phenomenon and provide thinner sections. The scan time for 3D acquisition is not excessive when a long echo train length and half-Fourier imaging are used. MR cisternography should be performed using a 3D acquisition.

Cerebellopontine Angle↗

Clinical study on recurrence in bladder cancer patients undergoing total cystectomy--statistical analysis of factors related to recurrence.

A clinico-pathological study was performed retrospectively for 77 patients undergoing total cystectomy for primary transitional cell carcinoma of the urinary bladder between 1981 and 1995 to clarify the mode of recurrence, the risk factors which may affect recurrence following cystectomy and prognostic factors. Postoperative recurrence was recognized in 27 (35.1%) out of 77 patients and the one-, two- and three-year non-recurrent rates by the Kaplan-Meier method were 75.3, 64.9% and 63.3%, respectively. The duration from cystectomy to recurrence was 1 to 102 months with a mean of 12.1 months, and approximately 92.6% of recurrence occurred within two years. Among 27 patients with recurrence, pelvic recurrence, distant metastasis, both of them and urethral recurrence were recognized in 6 (22.2%), 18 (66.7%), 1 (3.7%) and 2 (7.4%), respectively as the first site of recurrence. The overall one-, three- and five-year cause-specific survival rates of the 77 patients were 84.7, 71.1% and 65.6%, respectively. Of the 27 patients with recurrence, 25 (92.6%) died of bladder cancer. Of the factors related to recurrence or prognosis, pathological stage, lymphatic invasion, venous invasion, type of infiltration and lymph node metastasis but not pathological grade or adjunctive chemotherapy were significant risk factors for recurrence and prognostic factors in univariate analysis. However, lymphatic invasion was the only significant risk factor for recurrence and prognosis in multivariate analysis using Cox's proportional hazard model.

Adult↗

Intramammary Extension of Breast Cancer: Diagnosis with MR Mammography.

Purpose: Intramammary extension of breast cancer was investigated using contrast-enhanced magnetic resonance (MR) imaging by comparing MR findings with the histopathology of specimens used for pretreatment planning. Materials and Methods: Thirty-nine breast cancers were examined. The dynamic protocol was performed with a 2- or 3-dimensional fast spin echo sequence (1.5 T), once before and 2-5 times immediately after Gd-DTPA administration with an original fat suppression technique. The findings were correlated with the histopathology. Results: All main tumors showed early enhancement. All with direct invasion histopathologically showed spicular enhancement. The four patients who had separate nodular enhancement showed satellite lesions histopathologically. Three-typed MR findings were found to be indicative of an intraductal component. Conclusion: Various forms of breast cancer were reliably demonstrated using MR imaging. MR imaging could be useful for the pretreatment planning for patients with breast cancer.

Journal Article↗

MR imaging of the inner ear: comparison of a three-dimensional fast spin-echo sequence with use of a dedicated quadrature-surface coil with a gadolinium-enhanced spoiled gradient-recalled sequence.

PURPOSE: To prospectively evaluate the sensitivity and specificity of magnetic resonance (MR) imaging in the inner ear with a long echo train, three-dimensional (3D), asymmetric Fourier-transform, fast spin-echo (SE) sequence with use of a dedicated quadrature-surface phased-array coil to detect vestibular schwannoma in the cerebellopontine angle and the internal auditory canal. MATERIALS AND METHODS: In 205 patients (410 ears) with ear symptoms, 1.5-T MR imaging was performed with unenhanced 3D asymmetric fast SE and gadolinium-enhanced 3D gradient-recalled (SPGR) sequences with use of a quadrature surface phased-array coil. The 3D asymmetric fast SE images were reviewed by two radiologists, with the gadolinium-enhanced 3D SPGR images used as the standard of reference. RESULTS: Nineteen lesions were detected in the 410 ears (diameter range, 2-30 mm; mean, 10.5 mm +/- 6.4 [standard deviation]; five lesions were smaller than 5 mm). With 3D asymmetric fast SE, sensitivity, specificity, and accuracy, respectively, were 100%, 99.5%, and 99.5% for observer 1 and 100%, 99.7%, and 99.8% for observer 2. CONCLUSION: The unenhanced 3D asymmetric fast SE sequence with a quadrature-surface phased-array coli allows the reliable detection of vestibular schwannoma in the cerebellopontine angle and internal auditory canal.

Adolescent↗

Three-dimensional fast spin-echo MR of the inner ear: ultra-long echo train length and half-Fourier technique.

We compared the image quality of the newly developed ultra-long echo train length (ETL) 3-D fast spin-echo (FSE) and half-Fourier technique, which is performed in less than 3 minutes, with the conventional 3D-FSE imaging technique, which takes 15 minutes, in assessing MR examinations of the inner ear. The new method's images were almost comparable to the conventional 3D-FSE images in depicting anatomic details and pathologic findings. Implementation of the ultra-long ETL and half-Fourier 3D-FSE imaging technique enables acquisition of inner ear MR studies in a vastly reduced time and with high spatial resolution without significant penalty, opening the possibility for low-cost screening of acoustic tumors without contrast enhancement in less than 3 minutes.

Ear Neoplasms↗

[A case of asynchronous renal cell carcinoma, hepatocellular carcinoma and residual ureteral cancer].

A case of asynchronous triple cancer in an 88-year-old male is reported. Six years ago, he had received left radical nephrectomy for renal cell carcinoma, and 2 years ago partial hepatectomy for hepatocellular carcinoma detected by follow-up computed tomography (CT). During the post-operative follow-up, no metastasis of either the renal or hepatic carcinoma was detected. On February 12, 1997 he presented with macroscopic hematuria. Cystoscopy revealed a tumor emerging from the left ureteral orifice, while CT and magnetic resonance imaging (MRI) revealed a tumor mass in the left exterior of bladder. Diagnosis of residual ureter tumor, we performed both left ureterectomy and partial cystectomy. Histological diagnosis revealed transitional cell carcinoma of the residual ureter (G2 > G3, pT1, pV0, pL0, pR0). Convalescence was uneventful and 10 months after the operation, he is alive with no recurrence or metastasis. We stress the importance of careful follow-up not only to perceive the recurrence or metastasis of renal cancer but also to detect cancer in other parts of the body.

Aged↗

[MR-cholangiopancreatography using three-dimensional Fourier transfer fast asymmetric spin-echo method (3DFT-FASE)--clinical evaluation].

MR-cholangiopancreatography (MRCP) is a new and non-invasive method. With the three-dimensional Fourier transform fast asymmetric spin-echo (3DFT-FASE) method that allows data collection as volume and three-dimensional expression, a higher spatial resolution can be obtained in the direction of both slab thickness and in-plane. In this method, analysis by multi planar reconstruction (MPR) and observation from various angle by maximum intensity projection (MIP) are available. Although further studies are required to shorten the imaging time to stop breathing only once, to use the respiratory gating or navigator echo, clinically useful diagnosis are possible utilizing by the advantages of the 3DFT method.

Biliary Tract↗

Prostaglandin levels of primary bone tumor tissues correlate with peritumoral edema demonstrated by magnetic resonance imaging.

BACKGROUND: Several reports have shown peritumoral edema accompanying primary bone tumors demonstrated by magnetic resonance imaging (MRI). However, the mechanism of this inflammatory reaction is still unclear. The authors postulated that the reaction was caused by some chemical mediators including prostanoids, because several investigators have observed that some types of bone tumors synthesize prostanoids. Therefore, the authors compared MRI findings and tumor prostaglandin (PG) levels. METHODS: The subjects were 29 patients with primary bone tumor or tumor-like conditions: chondroblastoma (n = 5); chondrosarcoma, including rare variants (n = 8); giant cell tumor (n = 6); osteochondroma (n = 5); osteoblastoma (n = 2); Ewing's sarcoma (n = 2); and eosinophilic granuloma (n = 1). T1- and T2-weighted spin echo images were obtained in all but one patient before surgery. The tumor concentration of prostaglandin E2, 6-keto-PGF1 alpha, and thromboxane B2 were measured by radioimmunoassay. RESULTS: MRI distinctly showed bone marrow edema in 9 and soft tissue edema in 12 of the 28 patients examined. These findings were significantly correlated with the PG levels. Moreover, the PG levels were correlated with the histologic classifications (P < 0.001). In particular, the chondroblastomas showed prominent concentrations of PGs compared with other cartilaginous tumors or giant cell tumors. CONCLUSIONS: Although peritumoral edema accompanying benign and malignant bone tumors is not necessarily related to one single pathophysiologic mechanism, these results suggest that PG production was an important cause of the inflammatory reaction that was revealed by MRI. Recognition of this phenomenon is advantageous not only for strict diagnostic purposes but also for understanding the characteristic features of individual primary bone tumors.

6-Ketoprostaglandin F1 alpha↗

Effects of electrochemotherapy on CaSki cells derived from a cervical squamous cell carcinoma.

Electrochemotherapy is a new approach to the treatment of tumors that takes advantage of the permeabilization of the cell membranes by electric pulses to facilitate the intracellular delivery of chemotherapeutic drugs into cells. Using the female genital squamous cell carcinoma cell line, CaSki, the antitumor effectiveness of electrochemotherapy was tested. In vitro studies showed that the cytotoxicity of some anticancer drugs, especially bleomycin, can be greatly enhanced by exposing cells to noncytotoxic electric pulses. This enhancement was significantly greater when the electric treatment was given after exposure to the drug than when applied preexposure. Treatment of nude mice bearing subcutaneous transplanted tumors with noneffective intraperitoneal doses of bleomycin followed by local delivery of electric pulses similar to those performed in vitro resulted in tumor reduction and complete disappearance after 12 days this electrochemotherapy. Histological changes in tumor tissue such as necrosis and degeneration were extensive even 6 hr after the electrochemotherapy. Thus the antitumor effects of bleomycin in mice can be considerably potentiated by local electric pulses, suggesting that electrochemotherapy with bleomycin may have promise for treatment of vulvar or ectocervical squamous cell carcinomas with early invasion.

Animals↗

1 beta-Methyl-2-(5-substituted pyrrolidin-3-ylthio)carbapenems. 2. Synthesis and antibacterial activity of 5-aminopropyl and 5-aminopropenyl pyrrolidine derivatives.

The synthesis and biological activity of (1 R, 5S, 6S)-2-[(3S, 5S)-5-substituted pyrrolidin-3-ylthio]-6-[(R)-1-hydroxyethyl]-1-methyl-1- carbapen-2-em-3-carboxylic acid, in which aminopropyl, aminopropenyl, and aminopropynyl groups were introduced as substituents, are described. Aminopropyl and aminopropenyl derivatives showed potent in vitro and in vivo antibacterial activity against Gram-positive and Gram-negative bacteria including P. aeruginosa.

Animals↗

1 beta-Methyl-2-(5-substituted pyrrolidin-3-ylthio)carbapenems. 3. Synthesis and antibacterial activity of BO-2727 and its related compounds.

The synthesis and biological activity of (1R,5S,6S)-2-[(3S,5S)- 5-substituted pyrrolidin-3-ylthio]- 6-[(R)-1-hydroxyethyl]-1-methyl-1-carbapen-2-em-3-carboxylic acid in which hydroxy-substituted aminoethyl, aminopropyl, and aminobutyl groups were introduced as substituents, are described. These derivatives showed potent antibacterial activity against Gram-positive and Gram-negative bacteria including P. aeruginosa. Among them, lenapenem (BO-2727, 7b), carrying an (R)-1-hydroxy-3-(N-methylamino)propyl group, was selected as a development candidate.

Anti-Bacterial Agents↗

High-resolution T2-weighted MR imaging of the inner ear using a long echo-train-length 3D fast spin-echo sequence.

The purpose of this study was to assess the value of a long echo-train-length 3D fast spin-echo (3D-FSE) sequence in visualizing the inner ear structures. Ten normal ears and 50 patient ears were imaged on a 1.5T MR unit using a head coil. Axial high-resolution T2-weighted images of the inner ear and the internal auditory canal (IAC) were obtained in 15 min. In normal ears the reliability of the visualization for the inner ear structures was evaluated on original images and the targeted maximum intensity projection (MIP) images of the labyrinth. In ten normal ears, 3D surface display (3D) images were also created and compared with MIP images. On the original images the cochlear aqueduct, the vessels in the vicinity of the IAC, and more than three branches of the cranial nerves were visualized in the IAC in all the ears. The visibility of the endolympathic duct was 80%. On the MIP images the visibility of the three semicircular canals, anterior and posterior ampulla, and of more than two turns of the cochlea was 100%. The MIP images and 3D images were almost comparable. The visibility of the endolymphatic duct was 80% in normal ears and 0% in the affected ears of the patients with Meniere's disease (p < 0.01). In one patient ear a small intracanalicular tumor was depicted clearly. In conclusion, the long echo train length T2-weighted 3D-FSE sequence enables the detailed visualization of the tiny structures of the inner ear and the IAC within a clinically acceptable scan time. Furthermore, obtaining a high contrast between the soft/bony tissue and the cerebrospinal/endolymph/ perilymph fluid would be of significant value in the diagnosis of the pathologic conditions around the labyrinth and the IAC.

Adult↗

Magnetic resonance imaging in osteoarthrosis of the dysplastic hip.

We performed magnetic resonance imaging (MRI) in osteoarthrosis (OA) of 35 dysplastic hips in 28 patients using a 1.5-Tesla superconductive magnet. MR images were compared with conventional radiographs and arthrograms. MRI demonstrated cartilage irregularity and joint space narrowing in 17 hips earlier than did radiographs. Acetabular labrum tears were observed in 24 hips by MRI and in 23 hips by arthrography, suggesting that the former may be as useful as the latter. Osteophytes, joint effusion and synovial proliferation can be identified better by MRI than by conventional radiography. An MR grading system was established according to the thickness of the cartilage and sclerosis of the acetabulum or femoral head. This system can be a powerful tool to recognize the early stage of OA. MRI can demonstrate directly the severity of OA, including early degeneration of articular cartilage and acetabular labrum tear.

Hip Dislocation, Congenital↗

Ultra-low-field magnetic resonance imaging in upper airways obstruction in sleep apnea syndrome.

The hypothesis that the sites of upper airways obstruction (UAO) are varied in a patient with obstructive sleep apnea syndrome (OSAS) among different sleep stages is studied. Four patients with OSAS underwent ultra-low-field magnetic resonance imaging (MRI) with a field strength of 0.064 Tesla provided real-time images and generated less noise and necessitated less strict magnetic isolation compared with conventional high-field MRI. After the fixed end-apneic sleep stage was determined, the polysomnogram was switched off and ultra-low-field MRI was commenced. The effects of continuous positive airway pressure (CPAP) on the upper airway patency in the deepest sleep stage obtained for each patient was assessed. Upper airway obstruction was found at the level of the palatopharynx (PP) at sleep onset extended to the glossopharynx (GP) during rapid eye movement (REM) sleep in two cases and during NREM sleep in one case. This combined PP and GP obstruction was observed from sleep onset and remained unchanged in one case. The patent upper airways were observed during treatment with CPAP during REM sleep in two patients and during stage two of NREM sleep in the other two patients. It can be concluded that the sites of UAO vary in a patient with OSAS in different sleep stages. The results also suggest the use of the ultra-low-field MRI in order to visualize the dynamic and real-time behaviors of the upper airways during sleep in patients with OSAS.

Adult↗