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Biomedical subjects

Y Itai

Publications and source records attributed to Y Itai.

At least 145 records · Page 8Linked to original sources

Phase-contrast imaging with synchrotron X-rays for detecting cancer lesions.

RATIONALE AND OBJECTIVES: We obtained image contrast in pathologic specimens without the use of contrast material by using phase-contrast imaging with synchrotron X-rays. METHODS: An experiment was performed at the three-pole superconducting vertical wiggler beam line BL-14B at the Photon Factory in Tsukuba, Japan. The X-ray phase-contrast imaging system consisted of a double crystal monochromator, an asymmetrically cut crystal monochromator, a triple Laue-case X-ray interferometer, and film. The pathologic specimen was a sample from human liver that had metastatic carcinoma. RESULTS: The X-ray phase-contrast images of the pathologic specimen clearly depicted the cancerous lesion without the use of contrast enhancement, and the image showed good correlation with the photograph of the specimen. The X-ray absorption image did not differentiate between the normal liver tissue and the tumor. CONCLUSION: The results of this preliminary experiment reveal that for materials such as biologic specimens with a low atomic number, X-ray phase-contrast imaging better differentiates tissues than does the absorption contrast imaging commonly used in radiology.

Humans↗

Straight border sign of the liver: spectrum of CT appearances and causes.

Attenuation differences bordered by straight lines within the liver (the straight border sign) are sometimes seen at computed tomography (CT). This phenomenon, which was demonstrated with unenhanced CT over a dozen years ago, does not represent a hepatic mass and is often associated with vascular compromise. Major causes of the straight border sign include fatty liver, confluent fibrosis, radiation hepatitis, and vascular abnormalities such as tumor thrombus, thromboembolus, compression, and arterioportal shunt. The frequency of this finding increases when intense contrast enhancement is used, especially when contrast material is administered via the superior mesenteric artery (CT during arterial portography) or hepatic artery (CT arteriography). The use of spiral CT is apparently increasing the chances of encountering this sign in daily practice. To correctly interpret the straight border sign, one should consider the distribution (anatomic vs nonanatomic), the attenuation (low vs high), and the use and technique of contrast enhancement.

Contrast Media↗

Fat tissue: relationship between chemical shift and magnetization transfer.

The middle calves of the legs of 25 volunteers (12 men and 13 women, aged 18-25 years), as well as phantoms, were examined with 1.5-T magnetic resonance imaging. Gradient-recalled technique was combined with magnetization transfer contrast (MTC) and chemical shift imaging. Periodic oscillation of the MTC effect in fat tissue with variation of echo time was identified at the frequency corresponding to the water-fat chemical shift difference.

Adipose Tissue↗

Congenital ossification of the stapedius tendon: diagnosis with CT.

PURPOSE: To describe the features of congenital ossification of the stapedius tendon at thin-section computed tomography (CT). MATERIALS AND METHODS: Thin-section CT scans, clinical records, and surgical findings were retrospectively evaluated in nine ears of five patients with surgically proved congenital ossification of the stapedius tendon. Thin-section CT scans of 50 control ears were also reviewed. RESULTS: On thin-section CT scans, a linear area of soft-tissue attenuation was demonstrated between the monopod stapes and the pyramidal eminence (nine ears), as well as thickening of the stapes footplate (two ears). In the 50 control ears, the normal stapes tendon was not clearly seen on thin-section CT scans. CONCLUSION: At CT, a linear area of soft-tissue attenuation that extends from the pyramidal eminence to the monopod stapes is suggestive of congenital ossification of the stapedius tendon or a bony bar adjacent to it.

Adolescent↗

Effect of temporary occlusion of the hepatic vein on dual blood in the liver: evaluation with spiral CT.

PURPOSE: To evaluate the contribution of hepatic veins to the dual blood supply in the liver under temporary hepatic venous occlusion. MATERIALS AND METHODS: Selected hepatic veins in 23 patients with liver tumors were temporarily occluded with a balloon catheter. Computed tomography (CT) arteriography, CT during arterial portography (CTAP), or both were performed with a spiral technique with and without temporary occlusion of a hepatic vein. RESULTS: After hepatic vein occlusion, a well-demarcated, wedge-shaped area of hypoattenuation was seen at CTAP and/or hyperattenuation was seen at CT arteriography in the following regions: left lobe (left hepatic vein), ventral part of the anterior segment and the medial segment except for the ventromedial part (middle hepatic vein), dorsal part of the anterior segment and the ventral part of the posterior segment (right hepatic vein), and dorsocaudal part of the right lobe (inferior right hepatic veins). CONCLUSION: After hepatic venous occlusion, the portal veins become draining veins and the occluded area is supplied with arterial blood alone.

Adult↗

Usefulness of hyperventilation thallium-201 single photon emission computed tomography for the diagnosis of vasospastic angina.

To establish a safe and sensitive diagnostic procedure for detecting coronary vasospasm, we utilized 201-thallium myocardial SPECT combined with hyperventilation (HV-SPECT) in 29 patients with vasospastic angina (VAP) and 11 controls. Twenty-five of 29 patients with VAP and 5 of 11 controls developed transient perfusion defects on HV-SPECT, resulting in a sensitivity and specificity calculated at 86% and 55%, respectively. Overall accuracy in identifying corresponding vessels with coronary vasospasm, respectively. Coronary vasospasm tended to be identified more accurately in the left anterior descending branch and the right coronary artery than in the circumflex branch (75%, 71% and 50%, respectively). The hyperventilation test induced ischemic ECG changes in 11 of 29 patients with VAP, yielding a sensitivity of 38%. Analyzing the washout rate of HV-SPECT in patients with VAP, both the extent and severity scores of patients with ischemic ECG changes were larger than those of patients without. No serious complications occurred during HV-SPECT. In conclusion, HV-SPECT was a safe and sensitive procedure as a primary diagnostic approach for VAP. From the results of washout analysis, HV-SPECT could detect more mild myocardial ischemia than could the ECG, and seemed quite useful especially for detecting coronary vasospasm accompanied by minimal ischemic ECG changes.

Adult↗

Hepatobiliary cysts in patients with autosomal dominant polycystic kidney disease: prevalence and CT findings.

OBJECTIVE: Hepatobiliary (intrahepatic and peribiliary) cysts have been described for patients with autosomal dominant polycystic disease. The purpose of this study was to determine the prevalence of these cysts and to describe the wide variation in their appearance on CT scans. MATERIALS AND METHODS: We studied CT scans for 64 patients (31 men and 33 women) who either had known autosomal dominant polycystic kidney disease or had renal cysts and a family member with polycystic kidney disease. Contrast enhancement was used for 31 patients. CT scans were retrospectively evaluated by consensus by two experienced radiologists. The presence, number, and size of hepatobiliary cysts and the presence and appearance of the two variations, peribiliary and intrahepatic cysts, were analyzed. Peribiliary cysts were determined to be present when many small (< or = 10-mm) cysts were seen adjacent to the larger (up to the third order) portal triad. Cysts present in the hepatic parenchyma but not in contact with the larger portal triad were regarded as intrahepatic cysts. RESULTS: CT showed hepatobiliary cysts in 56 of the 64 patients (24 men and 32 women; 88%). Intrahepatic cysts were noted in all 56 patients; peribiliary cysts were definitely seen on CT scans for 22 patients and were probably seen (fewer than five cysts and/or cysts located only on one side of the portal vein) on CT scans for 19 patients (73% of all patients with hepatobiliary cysts). Peribiliary cysts appeared as discrete cysts in 31 patients, as a string of cysts in six patients, and as a tubular structure in four patients. Intrahepatic cysts generally were round but occasionally were polygonal. They were variable in number, size, and location. CONCLUSION: Hepatobiliary cysts were noted in 56 of 64 patients (intrahepatic cysts in all cases and peribiliary cysts in 73% of positive cases). Intrahepatic cysts varied widely in number, size, and location, whereas peribiliary cysts were small and appeared as discrete cysts, a string of cysts, or a tubular structure adjacent to the larger portal triad. It is important to be aware of the wide variety of findings for hepatobiliary cysts so that they are not confused with other abnormalities.

Bile Duct Diseases↗

[Secondary signs of anterior cruciate ligament tear at MR imaging].

The value of secondary signs of anterior cruciate ligament (ACL) tear was evaluated MR images of 47 knees, 15 with normal, 6 with acutely torn and 26 with chronically torn ACLs confirmed at arthroscopy, were reviewed. Lateral and medial anterior tibial translocations (ATT), posterior cruciate ligament (PCL) bowing ratio and depth of lateral femoral notch (LFN) were measured. The degrees of lateral and medial ATTs and the PCL bowing ratio of the chronically torn ACLs were significantly higher than those of normal ACLs. With cutoff values of 5-mm lateral ATT, 2.5-mm medial ATT and 0.35-PCL bowing ratio, torn ligaments were distinguished from intact ligaments with accuracies of over 80%. Depth of LFN was less sensitive and less accurate. All knees with lateral ATT of 6.4 mm, medial ATT of 3.5 mm, PCL bowing ratio of 0.43 and LFN depth of 1.5 mm or more had torn ACLs. Higher correlations were revealed between lateral ATT and medial ATT, and also between lateral ATT and PCL bowing ratio. Combined criteria of lateral ATT and PCL bowing ratio indicated the highest diagnostic value as a reliable secondary sign of torn ACLs.

Adolescent↗

[MR imaging features of chronically torn anterior cruciate ligament].

Magnetic resonance (MR) images of 40 knee joints with arthroscopically proved chronic anterior cruciate ligament (ACL) tears were retrospectively evaluated. MRI demonstrated various features of chronic ACL tears: 19 knees revealed with no identifiable ligamentous structure, and 21 had residual ligamentous structures. These pseudoligaments, 14 discontinuous bands and seven continuous bands with elongation, were residual torn ligamentous fibers and/or synovial tissues. All the discontinuous bands were disrupted from the femoral attachment and were likely to traverse the lower intercondylar space. Six disrupted ligaments were attached to the lateral aspect of the posterior cruciate ligament (PCL). Coronal T2-weighted gradient echo images showed better delineation of the disrupted femoral attachment and adhesion to the PCL. A chronic ACL tear with minimal elongation or with PCL attachment at a higher position may occasionally be difficult to distinguish from an intact ligament.

Adolescent↗

[The efficacy of early 123I-MIBG scintigraphy for pheochromocytoma diagnosis].

Early scintigraphy, that obtained 6 hours after intravenous administration of a low dose of 123I-metaiodobenzylguanidine (111 MBq) was evaluated for diagnostic efficacy. The accumulation of 123I-MIBG in the tumor masses of nine patients with pheochromocytoma and one patient with cortical adenoma were noted. The smallest pheochromocytoma visualized was 3 cm in diameter. The hepatic uptake of this radiolabeled compound was helpful to understand the anatomical position of the abnormal uptake. Three of five postoperative cases of pheochromocytoma showed uptake in the metastasis in the skeleton or recurrences in the neck or contralateral adrenal gland. No ectopic pheochromocytoma was found in the pelvic cavity. Faint accumulation in the normal medulla was noted in 45% of the cases. The present results demonstrate that superior images can be obtained in scintigrams takes 6 hours after administration of a lower dose of 123I-MIBG.

3-Iodobenzylguanidine↗

Focal fatty masses of the pancreas.

Five patients with solitary fatty mass of the pancreas examined with CT and ultrasound (US) were evaluated. The areas of fat replacement were located in the pancreatic neck, body or tail. The size ranged from 4 to 30 mm in the longest diameter. The shape varied from roundish, to ovoid to semicircular, and the contour was universally well defined. The internal structure was homogeneous in 3 patients, but in one case there were thin septa and, in another, a slightly hyperdense part in the peripheral portion. All the masses except the smallest one were in part contact with pancreatic fat. CT showed fat with the same density as the peripancreatic fat and low HU units. The mass was hypoechoic in 2 cases and hyperechoic in one. The masses in the tail of the pancreas were not detected by US.

Adipose Tissue↗

[Spatial and temporal alteration of the dual supply of the hepatic circulation with transient occlusion of the hepatic veins: spiral volumetric CT during arterial portography and arteriography].

To elucidate the contribution of hepatic veins to the blood flow of liver, CT arterial portography and/or arteriography was performed in eight patients having hepatocellular carcinoma with transient occlusion of the hepatic vein and eight without occlusion. In each patient with occlusion of the hepatic vein, CT showed a well-demarcated fan-shaped area of low density during arterial portography and increased density during arteriography in the corresponding area. Hepatic vein occlusion could result in the pooling of arterial blood in the liver parenchyma. Transient segmental hepatic venous occlusion might improve the results of transcatheter arterial infusion and transcatheter arterial embolization for liver tumors.

Adult↗

Magnetization transfer contrast on gradient echo MR imaging of the temporomandibular joint.

Thirty-nine temporomandibular joints (TMJ) from 20 patients with suspected internal derangements were imaged by a 1.5 T MR imager. The on-resonance binomial magnetization transfer contrast (MTC) pulse was applied to gradient echo images with a dual receiver coil (9 s/section). With the use of an opening device, a series of sequential images were obtained at increments of mouth opening and closing. The tissue signal intensities with (Ms) and without (Mo) MTC were measured and subjective image analysis was performed. Compared with the standard images, MTC technique provided selective signal suppression of disks. The average of Ms/Mo ratio of the disks (0.56) was lower than that of the retrodiskal pad (0.79) and of the effusion (0.89). With MTC technique, fluid conspicuity was superior to standard image. However, no significant superiority was found in disk definition subjectivity.

Adolescent↗

Resting asynchronous left ventricular contraction abnormality analyzed by a phase method in spastic angina pectoris.

UNLABELLED: Quantitative phase analysis of equilibrium ventriculography was performed to study the character of left ventricular (LV) wall motion abnormalities in patients with spastic angina pectoris, who may have clinically and electrocardiographically silent ischemia combined with myocardial stunning, during rest and hyperventilation stress testing. METHODS: Phase analysis of the left ventricle at rest was performed by equilibrium radionuclide ventriculography in 13 control subjects and 36 patients with spastic angina pectoris. First-pass methodology along with hyperventilation stress testing was performed to assess spasm occurrences. Phase analysis of equilibrium multigated blood-pool scintigrams was performed to evaluate LV asynchrony at rest. RESULTS: The mean s.d. of LV phase distribution in the patients with variant and vasospastic angina was greater than that in the healthy control subjects (11.28 +/- 1.79 and 10.02 +/- 1.57 degrees versus 6.16 +/- 1.07 degrees). In addition, the mean s.d. of LV phase distribution in the variant angina group was greater than that in the vasospastic angina group. Furthermore, a linear correlation was found between the s.d. of LV phase distribution at rest and the percent decrease in ejection fraction during hyperventilation stress. CONCLUSION: Asynchronous LV contraction without significant hypokinesis was detected at rest in spastic angina pectoris. The severity of this asynchronous contraction corresponded well with decreases in ejection fraction during hyperventilation stress testing. Thus, analysis of the s.d. of LV phase distribution at rest is expected to provide useful information regarding LV asynchrony in spastic angina pectoris.

Adult↗