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Masafumi Harada

Publications and source records attributed to Masafumi Harada.

29 records · Page 2Linked to original sources

Difference of signal change by a language task on autistic patients using functional MRI.

OBJECTIVE: Cerebral function with a language task was evaluated by functional magnetic resonance imaging (MRI), and the differences of activated pattern and signal changes were compared between autistic patients and normal controls. METHODS: Ten autistic and ten normal subjects were tested by fMRI with a language task requiring the attribution of complex mental states. Activation maps analyzed between two groups were generated and the asymmetry indexes calculated by the quotient of activated pixels of the right frontal lobe divided by those of the left frontal lobe were statistically compared by unpaired t-test. RESULTS: Both the autistic and the normal subjects showed activation at the bilateral prefrontal cortical areas and the ventral occipito-temporal regions. However, the autistic patients demonstrated more activation at the right frontal lobe than the normal controls. Thus it was considered that in the autistic patients the right-hemisphere was more dominant for the language task than that of the normal controls. The result is consist to the theory that autism is related to early left-hemisphere dysfunction. CONCLUSIONS: We considered that fMRI may be a useful non-invasive method to evaluate the cerebral functional abnormality in autistic patients.

Adolescent↗

Magnetic resonance imaging and proton MR spectroscopy of the brain in a patient with carbohydrate-deficient glycoprotein syndrome type I.

This is a report on a case of carbohydrate-deficient glycoprotein syndrome (CDGS) with neurological deficits. Magnetic resonance (MR) images showed remarkable atrophy of the cerebellum and brainstem, and hypointensity was seen in the pallidum on diffusion-weighted images (DWI), suggesting deposits of metal substances. In the cerebellum, proton MR spectroscopy (MRS) showed decreased concentrations of N-acetylaspartate and a complex of glutamine and glutamate (Glx) while the concentration of myo-inositol was increased, indicating neuronal impairment and gliosis. In the parietal lobe, there was an increased concentration of Glx, possibly reflecting dysfunction caused by liver injury.

Adolescent↗

Comparison of FAIR technique with different inversion times and post contrast dynamic perfusion MRI in chronic occlusive cerebrovascular disease.

The purpose of this study was to examine the signal change occurring with different inversion times (TIs) of the flow-sensitive alternating inversion recovery (FAIR) technique and to compare with the perfusion image obtained with Gd-DTPA injection. The subjects were 11 patients with unilateral occlusive cerebrovascular disease. Two FAIR images with different TIs (800 ms and 1600 ms) were measured for each patient and dynamic perfusion MRI was performed to produce four kinds of parameter maps: mean transit time (MTT), time to peak (TTP), relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) maps. Asymmetry ratios (ARs) between the affected and contra-lateral vascular sides were measured in both FAIR images and the four dynamic parameter maps. The AR of the MTT map of the four parameters showed the highest correlation with that of the FAIR images, especially with that of TI = 1600 ms (r = 0.829), and the AR of the rCBV map revealed the worst correlation with the FAIR images. The AR of the FAIR image with TI = 800 ms was less correlated with that of MTT than that with TI = 1600 ms. These results suggested that the signal intensity of the FAIR image was influenced by flow transition time and the change in TI could be used to select the flow with a different transition time. Our study suggested that a longer TI in the FAIR technique might be more useful than a shorter TI for evaluating chronic occlusive cerebrovascular disease in the clinical setting.

Brain↗

Myocardial perfusion magnetic resonance imaging for diagnosing coronary arterial stenosis.

It has been reported that myocardial perfusion MRI is a useful method for evaluating the severity of myocardial ischemia. We evaluated whether the severity of coronary arterial stenosis could be assessed by the signal-intensity time curve (SITC) obtained by myocardial perfusion MRI. The subjects consisted of 10 patients who showed no abnormalities on coronary angiographies (CAG) (A group), 12 with single-vessel disease of 75-90% stenosis on CAG (B group), and 15 with single-vessel disease of 90% or more stenosis (C group). After infusion of dipyridamole for 4 minutes, gadolinium-diethylenetriamine pentaacetic acid was administered intravenously, followed by serial acquisition of T1-weighted left ventricular short-axis MR images. These images were evaluated after dividing them into the following 3 myocardial segments: anterior wall, lateral wall, and inferior wall. Mean values of the slope of SITC ( 1.4 +/- 0.2 vs 1.1 +/- 0.2. P < 0.01), and increases to the peak corrected SI (deltaSI) (47.5 +/- 1.9 % vs 33.7 +/- 2.4%, P < 0.01) in normal myocardial segments were significantly greater than in ischemic segments in the C group, while there was no significant distinction between normal and ischemic segments in the B group. The mean values of time to the peak SI were not significantly different between normal and ischemic regions in the B and C groups. The results suggest that myocardial segments exhibiting 30% decreases in both the slope and deltaSI of SITC can be diagnosed as having 90% or more severe coronary stenosis. The present study shows that visual and SITC evaluations of myocardial perfusion MR images may be useful for clinically evaluating the severity of coronary stenosis.

Aged↗

Diffusion-weighted in vivo localized proton MR spectroscopy of human cerebral ischemia and tumor.

The apparent diffusion coefficients (ADCs) of water and brain metabolites were determined by proton MR spectroscopy on a clinical MR scanner for healthy volunteers and for pathological changes in cases of acute cerebral infarction and brain tumor. The ADCs of N-acetyl aspartate (NAA) and creatines in tissue involved in acute infarction were decreased compared to normal control values, while in tumors they showed increased values. Since NAA is a neuronal marker, these findings suggest that neuronal cell viscosity changes according to the pathological status of the tissue. The lactate ADC was significantly larger than the values for other major metabolites in cases of ischemia and tumor, suggesting that lactate is present in a different compartment. These results indicate that metabolite diffusion data can be used to reveal changes in the intracellular environment depending on the pathological status.

Adult↗

Twisted atrioventricular valves in double inlet left ventricle.

Twisted atrioventricular connections usually occur in hearts with biventricular artioventricular connections. Here, we describe a case of twisted atrioventricular valves associated with double inlet left ventricle and discordant ventriculo-arterial connections. Color Doppler echocardiography, and cine magnetic resonance imaging, clearly demonstrated that the right atrioventricular valve was located anterior and superior to the left atrioventricular valve, and that the axes of the two atrioventricular valves crossed each other within the dominant left ventricle.

Crisscross Heart↗

Can diffusion- and perfusion-weighted magnetic resonance imaging evaluate the efficacy of acute thrombolysis in patients with internal carotid artery or middle cerebral artery occlusion?

OBJECTIVE: The value of combined diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) for detecting ischemic lesions of patients with acute ischemic injury was analyzed. Combined pre- and posttreatment DWI and PWI studies were used to assess the efficacy of intra-arterial thrombolysis. METHODS: Intra-arterial thrombolysis was performed within 6 hours of onset in 10 patients who presented with acute middle cerebral artery or internal carotid artery occlusion. DWI and PWI obtained before and after treatment were studied. The final T2-weighted magnetic resonance scans were obtained 1 month after onset. Thrombolysis resulted in recanalization in seven patients. The mismatch ratio percentage ([initial PWI-initial DWI/initial PWI] x 100) and the rescued ratio percentage ([initial PWI-final T2/initial PWI] x 100) were calculated. The National Institutes of Health Stroke Scale (NIHSS) was used for neurological assessment of stroke severity at admission and at 1 month after onset. RESULTS: In all patients, the mismatch ratio was greater than 60% (mean +/- standard deviation, 81.7 +/- 16.7%) and was significantly correlated with initial NIHSS score (-0.74; P = 0.03), and the rescued ratio was significantly correlated with the NIHSS score 1 month after the insult (r = -0.83; P = 0.01). In patients who exhibited recanalization of the occluded artery (n = 7), the mean rescued ratio was 89.6 +/- 12.8% (range, 63-100%). In addition, the lesion volume on posttreatment DWI scans and final T2-weighted magnetic resonance images was not enlarged; on posttreatment PWI scans, it was significantly decreased. The NHISS score at 1 month after the insult (2.3 +/- 2.1) was markedly improved as compared with the initial NHISS score (10.7 +/- 3.9). CONCLUSION: In a small number of patients who presented with internal carotid artery or middle cerebral artery occlusion, the DWI/PWI mismatch ratio correlated with the initial neurological severity. The rescued ratio may be an objective indicator of the efficacy of treatment.

Aged↗

Brain abscess and glioblastoma identified by combined proton magnetic resonance spectroscopy and diffusion-weighted magnetic resonance imaging--two case reports.

The differential diagnosis between brain abscesses and necrotic tumors such as glioblastomas is sometimes difficult to establish by conventional computed tomography and magnetic resonance imaging. Combined proton magnetic resonance spectroscopy (1H-MRS) and diffusion-weighted magnetic resonance imaging (DWI) were used to establish the preoperative diagnosis of brain abscess and glioblastoma. DWI visualized the brain abscess as a homogeneous hyperintense lesion and 1H-MRS revealed the presence of acetate, lactate, and amino acids and the absence of the normal brain components. DWI sometimes shows glioblastoma as a hyperintense lesion, but 1H-MRS reveals markedly increased lactate and decreased N-acetyl-aspartate. Combined DWI and 1H-MRS findings can distinguish brain abscess and glioblastoma.

Acetates↗

Evaluation of cerebral blood flow reserve in patients with cerebrovascular disease by SPECT using technetium-99m-L, L-ethyl cysteinate dimer.

A technique for measuring the resting and acetazolamide (Acz)-activated cerebral blood flow without blood sampling by consecutive single-photon emission computed tomography (SPECT) using technetium-99m-L, L-ethyl cysteinate dimer (99mTc-ECD), called the 99mTc-ECD-RVR method, was recently developed by Matsuda et al. and Takeuchi et al. We evaluated the cerebral blood flow reserve in 77 patients with cerebrovascular diseases and 24 controls using this method. Baseline mean CBF (mCBF) was calculated from the application of Patlak plot graphical analysis with radionuclide angiography, and quantitative regional CBF (rCBF) images were obtained from qualitative axial SPECT images by the mCBF and Lassen's linearization correction. The activated SPECT images were obtained by subtraction of the first image from the second image. The mean increment ratio (IR) by calculating the mean CBF for the pre- and post-Acz in the controls was 1.26+/-0.12 (mean+/-SD). In patients with cerebrovascular disease, the reduction of the mean IR and regional IR was parallel with the degree of stenosis. This noninvasive method was also considered to be useful in evaluating the change in the hemodynamic reserve in cerebrovascular disease.

Acetazolamide↗

Reproducibility of metabolite concentration evaluated by intraclass correlation coefficient using clinical MR apparatus.

OBJECTIVE: The purpose of this study was to evaluate the reproducibility of in vivo quantitative proton MR spectroscopy (MRS) by repeated-measure analysis of variance and intraclass correlation coefficient (ICC) including assessment of both inter- and intrasubject variation. METHODS: The concentration of metabolites was quantified using long-TR and short-TE stimulated-echo acquisition mode sequences with a quadrature head coil. All preparation procedures for MRS measurement except volume of interest determination were done by an automatic preparation scanning system equivalent to a clinical setting. Analyses were conducted by an LCModel running based on our original basis set by two different reference methods. RESULTS: The ICC showed a good correlation (r = 0.61-0.99) in any metabolite and almost the same value between the two different reference methods, but the concentration of myoinositol had a large intersubject variation. CONCLUSION: Our results suggest that the reproducibility of quantified metabolite concentration is acceptable in the clinical setting regardless of the reference method, although quantified values may have different intersubject variations.

Adult↗

Magnetic resonance imaging and spectroscopy in a patient with treated methylmalonic acidemia.

Magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (proton MRS) findings before and after carnitine therapy in a patient with methylmalonic acidemia (MMA) are evaluated. The hyperintensity on T2-weighted image and diffusion-weighted image and the decreased apparent diffusion coefficient of bilateral basal ganglia were normalized in parallel with normalization of the elevated lactate levels and the decreased N-acetyl-aspartate levels, corresponding to improvement of clinical symptoms. MRI and proton MRS may serve as a suitable, noninvasive modality for monitoring treated MMA.

Basal Ganglia↗