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Biomedical subjects

J Hachiya

Publications and source records attributed to J Hachiya.

115 records · Page 7Linked to original sources

Pre- and postcontrast FLAIR MR imaging in the diagnosis of intracranial meningeal pathology.

PURPOSE: Few reports address the use of fluid-attenuated inversion-recovery (FLAIR) images of the brain in the diagnosis of extraaxial lesions. Our purpose was to assess the value of FLAIR images, including postcontrast ones, in the diagnosis of intracranial meningeal diseases. METHODS: We reviewed precontrast (n=24) and postcontrast (n=20) FLAIR images obtained from 25 patients with infectious meningitis (n=13), carcinomatous meningitis or dissemination of primary brain tumor (n=7), dural metastasis (n=3), and others (n=2) in comparison with fast spin-echo T2-weighted and postcontrast T1-weighted images. RESULTS: In lesion detectability, precontrast FLAIR images were significantly superior to fast spin-echo T2-weighted images but inferior to postcontrast T1-weighted images. There was no significant difference between postcontrast T1-weighted and FLAIR images. CONCLUSION: Precontrast FLAIR images can substitute for conventional fast spin-echo T2-weighted images. Postcontrast FLAIR images have diagnostic potential equivalent to conventional postcontrast T1-weighted images.

Adolescent↗

Magnetic resonance cholangiopancreatography for diagnosing hepatolithiasis.

BACKGROUND/AIMS: Direct cholangiography with endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography sometimes fails to adequately opacify the entire biliary tract, because of severe biliary obstruction caused by ductal stricture or lodged stones. We assessed the diagnostic accuracy of magnetic resonance cholangiopancreatography for hepatolithiasis. METHODOLOGY: Five patients with hepatolithiasis underwent ultrasonography, computed tomography, direct cholangiography, and magnetic resonance cholangiopancreatography, using a half-Fourier acquisition single-shot turbo spin-echo sequence. Surgical exploration or pathologic examination revealed stricture and dilatation of the intrahepatic ducts in all patients. Diagnostic accuracies for stones and ductal abnormalities were compared among the imaging studies. RESULTS: No complications occurred during magnetic resonance cholangiopancreatography studies. Magnetic resonance cholangiopancreatography fully depicted the biliary tract. Magnetic resonance cholangiopancreatography accurately detected and localized intrahepatic stones, as well as bile duct stricture and dilatation, in all patients. Intrahepatic stones were detected by endoscopic retrograde cholangiopancreatography in one of four patients and by percutaneous transhepatic cholangiography in all three who underwent this procedure. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography demonstrated ductal stricture in all patients but failed to completely demonstrate the biliary tree in three of four patients, and one of three, respectively. On ultrasonography and computed tomography, precise localization of stones was difficult. Ultrasonography and computed tomography failed to demonstrate ductal stricture in one and two of the five patients, respectively. CONCLUSIONS: Magnetic resonance cholangiopancreatography diagnoses intrahepatic stones and bile duct abnormalities less invasively and more accurately than endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography.

Adult↗

Non-contrast enhanced MR venography using 3D fresh blood imaging (FBI): initial experience.

OBJECTIVE: This study examined the efficacy of 3D-fresh blood imaging (FBI) in patients with venous disease in the iliac region to lower extremity. MATERIALS AND METHODS: Fourteen patients with venous disease were examined [8 deep venous thrombosis (DVT) and 6 varix] by 3D-FBI and 2D-TOF MRA. All FBI images and 2D-TOF images were evaluated in terms of visualization of the disease and compared with conventional X-ray venography (CV). RESULTS: The total scan time of 3D-FBI ranged from 3 min 24 sec to 4 min 52 sec. 3D-FBI was positive in all 23 anatomical levels in which DVT was diagnosed by CV (100% sensitivity) as well as 2D-TOF. The delineation of collateral veins was superior or equal to that of 2D-TOF. 3D-FBI allowed depiction of varices in five of six cases; however, in one case, the evaluation was limited because the separation of arteries from veins was difficult. CONCLUSION: The 3D-FBI technique, which allows iliac to peripheral MR venography without contrast medium within a short acquisition time, is considered clinically useful.

Adult↗

MR imaging of the breast with Gd-DTPA enhancement: comparison with mammography and ultrasonography.

The accuracy of MR imaging with Gd-DTPA enhancement was compared with mammography and ultrasonography in 52 patients with clinically palpable benign and malignant breast masses (36 carcinomas, 2 malignant phyllodes tumors, 7 fibroadenomas, 7 cysts). On dynamic MR imaging, carcinomas and fibroadenomas were discriminated by their different dynamic enhancement profiles. In carcinomas, signal intensity increased rapidly, reaching a peak or plateau within 2 min after the injection of contrast medium. In fibroadenomas, signal intensity showed a much slower continuous increase without ceasing until about 8 min after injection. Malignant phyllodes tumors showed a dynamic enhancement profile identical to that of benign fibroadenomas. MR imaging correctly identified 84% of malignant tumors, 86% of fibroadenomas, and 100% of cysts, and was substantially more accurate in tissue characterization than mammography. The results of ultrasonography were highly similar to those of MR imaging. However, no single modality was infallible, and the three modalities were complementary rather than competitive. Considering the high cost and long examination time of MR imaging, mammography supplemented by ultrasonography seems to be the method of choice in the diagnosis of breast lesions. Nevertheless, MR imaging can add important information when the results of mammography and ultrasonography are insufficient or contradictory.

Adenofibroma↗

Atelectasis as a complication of tracheobronchial stent therapy.

Although insertion of expandable metallic stents in cases of tracheobronchial stenosis is effective as palliation for respiratory distress, the potential risk of creating obstructive atelectasis and aggravating symptoms of patients should be noted. The authors' experience in two cases is presented, and prevention of this potential complication is discussed.

Adult↗

Preliminary evaluation of fluid-attenuated inversion-recovery MR in the diagnosis of intracranial tumors.

PURPOSE: To report our preliminary results in the application of a turbo fluid-attenuated inversion-recovery (FLAIR) MR technique to the diagnosis of intracranial tumors and to assess the clinical usefulness of this technique. METHODS: Thirty-four patients with various intracranial tumors were studies with MR imaging, including a turbo FLAIR sequence. FLAIR images were compared with images obtained with conventional spin-echo sequences. RESULTS: Except for 2 lesions in 1 patients, tumor signal intensities on FLAIR images were consistent with those shown on T2-weighted spin-echo images. FLAIR images showed peritumoral edema more clearly than T2-Weighted and proton density-weighted images when the tumor itself was not hyperintense. In 8 of 23 patients in whom edema was associated with tumor, FLAIR images provided better definition between edema and tumor than did T2-weighted and proton density-weighted images. In 5 patients, FLAIR images depicted different signal intensity between cerebrospinal fluid and a cystic or necrotic component. In 20 of 22 patients, postcontrast FLAIR images showed contrast enhancement comparable to that seen on postcontrast T1-weighted images. CONCLUSION: Turbo FLAIR images can supplement conventional spin-echo images in the diagnosis of intracranial tumors.

Adolescent↗

Fast MR imaging of abdomen: application of the QD body coil and low refocusing flip angle.

The fast spin-echo (FSE) method as applied to abdominal imaging has undergone considerable technical and clinical study over the past several years. However, except in a limited number of institutions, this time-saving sequence has not replaced the conventional spin-echo (CSE) method. In particular, FSE is less frequently employed for examination of the liver because FSE and CSE images of hepatic tumors and normal hepatic tissues differ significantly in terms of contrast. The signal reduction effect of magnetization transfer contrast (MTC) is affected by the number of slice sections and by the specific absorption rate (SAR). We have employed a newly developed quadrature detection (QD) body coil to enhance the signal-to-noise ratio (S/N) and a low refocusing flip angle to suppress SAR and MTC effects. We have also evaluated the effectiveness of this new method by carrying out visual assessment of clinical images and quantitative measurements of signal intensity in these images. Several problems must be overcome before the FSE method is able to replace the CSE method in the clinical examination of the abdomen. The selection of sequences with a low refocusing flip angle combined with the use of the QD body coil promises to be one possible solution to these problems.

Abdomen↗