Search PubMed⌕ Search

Biomedical subjects

Hirohiko Kimura

Publications and source records attributed to Hirohiko Kimura.

15 recordsLinked to original sources

Imaging by multiple modalities of patients with a carotidynia syndrome.

The purpose of this article is to familiarize readers with the clinical syndrome of carotidynia. In the past, the International Headache Society (IHS) described idiopathic carotidynia as a diagnostic entity consisting of a self-limiting neck pain syndrome and tenderness over the carotid bifurcation without structural abnormality and then recently removed it from its classification. Although the clinical criteria of carotidynia in the former classification of the IHS included the absence of structural abnormality, several publications have demonstrated associated radiological findings and have described the usefulness of radiological investigations in diagnosing this syndrome. In this paper, we report four additional cases with a carotidynia clinical syndrome (according to the former classification) and the presence of abnormal soft tissue infiltration surrounding the symptomatic carotid artery as demonstrated by multiple imaging modalities, without any other underlying cause for the carotid pain syndrome. Our findings support the hypothesis that carotidynia could be a distinct disease entity, possibly caused by inflammation.

Carotid Artery Diseases↗

[Optimization of three-dimensional triple IR fast spoiled gradient recalled acquisition in the steady state (FSPGR) to decrease vascular artifact at 3.0 Tesla].

The purpose of this study was to decrease vascular artifacts caused by the in-flow effect in three-dimensional inversion recovery prepared fast spoiled gradient recalled acquisition in the steady state (3D IR FSPGR) at 3.0 Tesla. We developed 3D triple IR (3IR) FSPGR and examined the signal characteristics of the new sequence. We have optimized scan parameters based on simulation, phantom, and in-vivo studies. As a result, optimized parameters (1st TI=600 ms, 3rd TI=500 ms) successfully have produced the vessel signal at more than 40% reduction, while gray-white matter contrast was preserved. Moreover, the reduced artifact was also confirmed by visual inspection of the in-vivo images for which this condition was used. Thus, 3D 3IR FSPGR was a useful sequence for the acquisition of T1-weighted images at 3.0 Tesla.

Adult↗

Multifractal analysis of deep white matter microstructural changes on MRI in relation to early-stage atherosclerosis.

Multifractal analysis based on generalized concepts of fractals has been applied to evaluate biological tissues composed of complex structures. This type of analysis can provide a precise quantitative description of a broad range of heterogeneous phenomena. Previously, we applied multifractal analysis to describe heterogeneity in white matter signal fluctuation on T2-weighted MR images as a new method of texture analysis and established Deltaalpha as the most suitable index for evaluating white matter structural complexity (Takahashi et al. J. Neurol. Sci., 2004; 225: 33-37). Considerable evidence suggests that pathophysiological processes occurring in deep white matter regions may be partly responsible for cognitive deterioration and dementia in elderly subjects. We carried out a multifractal analysis in a group of 36 healthy elderly subjects who showed no evidence of atherosclerotic risk factors to examine the microstructural changes of the deep white matter on T2-weighted MR images. We also performed conventional texture analysis, i.e., determined the standard deviation of signal intensity divided by mean signal intensity (SD/MSI) for comparison with multifractal analysis. Next, we examined the association between the findings of these two types of texture analysis and the ultrasonographically measured intima-media thickness (IMT) of the carotid arteries, a reliable indicator of early carotid atherosclerosis. The severity of carotid IMT was positively associated with Deltaalpha in the deep white matter region. In addition, this association remained significant after excluding 12 subjects with visually detectable deep white matter hyperintensities on MR images. However, there was no significant association between the severity of carotid IMT and SD/MSI. These results indicate the potential usefulness of applying multifractal analysis to conventional MR images as a new approach to detect the microstructural changes of apparently normal white matter during the early stages of atherosclerosis.

Aged↗

Endovascular treatment for an iliac artery-ureteral fistula with a covered stent.

Iliac artery-ureteral fistula (IAUF) is a rare entity that has a potential risk of life-threatening hemorrhage. It is difficult to diagnose and treat appropriately. Conventional treatment for the disease consists of surgical ligation and vascular reconstruction or coil embolization. Surgical treatment is usually difficult for patients with several risk factors. In recent years, endovascular stent-graft treatment for iliac artery pseudoaneurysm has been reported. The present report describes two cases in which endovascular covered stent-graft treatment was successfully applied to treat IAUF, with good clinical outcomes.

Aged↗

Depressive psychosis: clinical usefulness of MR spectroscopy data in predicting prognosis.

PURPOSE: To prospectively assess the usefulness of magnetic resonance (MR) spectroscopy data acquired before the initiation of medical therapy in predicting prognosis in patients with depressive psychosis. MATERIALS AND METHODS: All subjects gave written informed consent to an institutional committee for clinical research-approved study protocol. The clinical course after medication in 52 patients with depressive psychosis (age range, 52-78 years; 21 men, 31 women) was investigated. In all patients, MR spectroscopy was performed with a 1.5-T MR imaging unit before the initiation of medical therapy. Cerebrovascular lesions (CVLs), which appear as high-signal-intensity areas on T2-weighted MR images, were evaluated by using the Fazekas rating scale. Patients were classified into two groups on the basis of the ratio of N-acetylaspartate (NAA) to creatine and phosphocreatine (Cr): Patients in group A had an NAA/Cr ratio greater than 1.91, and patients in group B had an NAA/Cr ratio of 1.91 or less. To assess the response of the patients to medication, standard psychiatric tests--the Verbal Associative Fluency Test (VAFT), the Digit Symbol Test (DST), the Mini-Mental State Examination (MMSE), and the Hamilton Depression Rating Scale (HAM-D)--were administered before and after medical therapy was initiated. Mean test scores before and after medication were compared with paired t testing. P < .05 was considered to indicate a significant difference. RESULTS: There were 25 patients in group A and 27 in group B. In group A, the mean VAFT and DST scores increased and the mean HAM-D score decreased after medication. There was no significant difference in mean MMSE scores before and after medication (P = .945 for group A and P = .934 for group B). In group B, there were no significant differences in any of the psychiatric test scores before and after medication. The high-signal-intensity area score in group B was significantly higher than that in group A (P = .004). CONCLUSION: MR spectroscopy data obtained before the initiation of medical therapy were useful in predicting prognosis in patients with depressive psychosis; this suggests that the combined burden of all CVLs may affect the response to antidepressant medication.

Aged↗

Multislice continuous arterial spin-labeled perfusion MRI in patients with chronic occlusive cerebrovascular disease: a correlative study with CO2 PET validation.

PURPOSE: To compare the use of multislice continuous arterial spin labeling (CASL) and CO(2) positron emission tomography (PET) to assess CBF in patients with chronic occlusive cerebrovascular disease for the validation of quantitative CASL perfusion in an altered hemodynamic state. MATERIALS AND METHODS: Eleven patients with occlusive carotid artery disease were studied with CASL and conventional MRI. Cerebral blood flow (CBF) was also measured with O(15)-labeled CO(2) gas using a whole-body PET scanner. The average values within region of interests (ROIs) drawn on coregistered CASL and PET images were used for the linear regression analysis and to assess the effect of transit time on the quantification using CASL. RESULT: In all patients there was a significant correlation between the CBF values from CASL and PET (r = 0.71 +/- 0.07, P < 0.001). The slope of regression lines varied widely among patients (0.54-1.77). Longer transit times were estimated in four of 11 patients in the hypoperfusion region. CONCLUSION: Quantification of CBF using CASL is feasible and reasonable, even when employed in a routine clinical setting. However, the long transit time may lead to underestimation of the affected side in occlusive cerebrovascular disease.

Aged↗

Dynamic T1 estimation of brain tumors using double-echo dynamic MR imaging.

PURPOSE: To assess the clinical utility of a new method for real-time estimation of T1 during the first pass of contrast agent by using this method to examine brain tumors. MATERIALS AND METHODS: The multi-phase spoiled gradient-echo pulse sequence using the double-echo magnetic resonance (MR) technique was modified. In the first half of the pulse sequence, the flip angle was varied systematically. Then, static T1 values were calculated using differences in MR signal intensities between different flip angles. In the latter half of this sequence, changes in absolute T1 were calculated using differences in signal intensities before and after injection of contrast agent. The double-echo MR data were used to minimize the T2* effect. Five cases of neurinoma and seven cases of meningioma were examined. Changes in T1 during the first pass of contrast agent were compared between neurinoma and meningioma. RESULTS: Changes in absolute T1 were clearly demonstrated on the parametric map. Although the changes in absolute T1 during the first pass of contrast agent did not allow differentiation between the two types of tumors, the mean gradient after the first pass was statistically higher for neurinoma than for meningioma (P < 0.05; meningioma, 0.011 +/- 0.012 second(-1)/second; neurinoma, 0.034 +/- 0.020 second(-1)/second). CONCLUSION: The present method appears to be useful for estimation of dynamic T1 changes in brain tumors in clinical settings.

Adult↗

[Dynamic contrast-enhanced T(1) measuring MRI using variable flip angle SPGR].

We modified the multi-phase spoiled gradient recalled echo (SPGR) pulse sequence using the double-echo MR technique for estimation of T(1) during the first pass of contrast agent, and examined its precision. In the first half of the pulse sequence, the flip angle was varied systematically to calculate static T(1) values. It was necessary to choose optimal flip angles to minimize the calculation error of static T(1) values. In the latter half of this sequence, changes in absolute T(1) were calculated using differences in signal intensities before and after the injection of contrast agent. The optimal flip angle was 20 degrees for precise conversion to T(1) values under the short TR (33.3 ms) condition. Double echo MR data were used to minimize the T(2)* effect. The present method appears to be useful for quantitative estimation of dynamic contrast-enhanced MRI.

Brain Neoplasms↗

Differentiation of prostate cancer from benign prostate hypertrophy using dual-echo dynamic contrast MR imaging.

OBJECTIVE: To investigate the usefulness of dynamic contrast magnetic resonance (MR) imaging in the differentiation of prostate cancer (PC) from benign prostate hypertrophy (BPH). MATERIALS AND METHODS: Eleven PC patients and 13 BPH patients were entered into the analysis. The mean gradient (MG) was calculated from the T2* term-eliminated time-signal intensity curve obtained from dynamic contrast MR data, and the MG of PC and that of BPH were compared. RESULTS: The MG of PC was significantly higher than that of BPH. When the threshold value was set to 1.88% per s for discriminating PC from BPH, the sensitivity, specificity, and accuracy were 100, 85, and 92%, respectively. CONCLUSION: The MG, which is derived from the T2* term-eliminated time-signal intensity curve, may be a useful index for differentiating PC from BPH.

Adult↗

Measurement of the vascularity and vascular leakage of gliomas by double-echo dynamic magnetic resonance imaging: a preliminary study.

RATIONALE AND OBJECTIVE: To evaluate the vascularity and vascular leakage of well-enhanced gliomas by double-echo dynamic magnetic resonance (MR) imaging. MATERIALS AND METHODS: Eight patients with glioblastoma multiforme (GBM) and two patients with juvenile pilocytic astrocytoma (JPA) were studied. Double-echo dynamic MR imaging was utilized to separate the T2* shortening effect and the T1 shortening effect. The former was represented by the vascularity index, and the latter was represented by the leakage index. These indexes were compared with histopathologic data. RESULTS: The mean vascularity index of the GBM was higher than that of the JPA (mean +/- SD, 3.48 +/- 1.57 [GBM] versus 0.51 +/- 0.29 [JPA]), and the mean leakage index of the JPA was higher than that of the GBM (1.35 +/- 0.87 [JPA] versus 0.27 +/- 0.15 [GBM]). Abundant vascularity was noted in the tight interstitial space in the pathologic specimen of GBM. Conversely, sparse vasculature was observed in the wide interstitial space in the pathologic specimen of JPA. CONCLUSION: This method may enable better characterization of grade in well-enhanced glioma by providing the information on the vascularity and leakage indexes.

Adult↗

Age-dependent change in metabolic response to photic stimulation of the primary visual cortex in infants: functional magnetic resonance imaging study.

The blood oxygen level-dependent (BOLD) response to photic stimulation in the primary visual cortex (V1) reverses from positive to negative around 8 weeks of age. This phenomenon may be caused by increased oxygen consumption during stimulation as the result of a rapid increase of synaptic density at this age. To test this hypothesis, we applied existing mathematic models of BOLD signals to the experimental data from infants. When the stimulus-related increments of cerebral blood flow and cerebral blood volume were fixed at 60% and 20%, respectively, the mean estimated increment of the cerebral metabolic rate of oxygen of the V1 in the elder infant group (57.1% +/- 8.8%) was twice as large as that in the younger infant group (32.2% +/- 4.7%), which corresponds to the reported difference in synaptic density. The present data confirmed that a change in oxygen consumption could explain a transition from a positive to a negative BOLD response.

Age Factors↗

Specific high-resolution computed tomography findings associated with sputum smear-positive pulmonary tuberculosis.

OBJECTIVES: This study aimed to evaluate whether high-resolution computed tomography (HRCT) could predict the results of a sputum smear in patients with active pulmonary tuberculosis. METHODS: Forty-eight patients with active pulmonary tuberculosis were divided into 2 groups: sputum smear-positive (n = 25) and -negative (n = 23). The HRCT findings were retrospectively reviewed, focusing on the presence or absence of features previously reported to indicate active pulmonary tuberculosis, including ground-glass opacity, cavitation, centrilobular opacity, and air space consolidation. RESULTS: Although air space consolidation was the least common feature overall, it occurred significantly more frequently in the smear-positive group than in the smear-negative group. This feature also had the highest specificity and positive predictive value. Cavitation and ground-glass opacity also occurred significantly more frequently in the smear-positive group. The frequency of centrilobular opacity did not differ between the 2 groups. CONCLUSIONS: The present study suggested that the HRCT findings of air space consolidation, cavitation, and ground-glass opacity are significantly associated with smear-positive pulmonary tuberculosis.

Adult↗

Carbon monoxide poisoning: two cases of assessment by magnetization transfer ratios and 1H-MRS for brain damage.

We describe two patients with carbon monoxide (CO) poisoning. One developed diseased hypoxic encephalopathy, and the other recovered completely. In the patient with progressive hypoxic encephalopathy, the magnetization transfer ratios (MTRs) had already decreased during the lucid period, while the patient with complete recovery showed no reduction of MTRs during this period. 1H-MRS in the two patients revealed no definite abnormality during this lucid period. The MTR maps suggested that irreversible change had already occurred during the lucid period, and 1H-MRS was useful to determine the duration of treatment. The combination of MTRs and 1H-MRS may help to manage patients with CO poisoning.

Adult↗