Yasunari Fujinaga

Shinshu University, Shonai, Nagano, Japan

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Publications (34)56.94 Total impact

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    ABSTRACT: We aimed to clarify the usefulness of free-breathing readout-segmented echo-planar imaging (RESOLVE), which is multi-shot echo-planar imaging based on a 2D-navigator-based reacquisition technique, for detecting malignant liver tumor.
    European journal of radiology. 06/2014;
  • Journal of Gastroenterology 03/2014; · 3.79 Impact Factor
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    ABSTRACT: To compare radial volumetric imaging breath-hold examination with k-space weighted image contrast reconstruction (r-VIBE-KWIC) to Cartesian VIBE (c-VIBE) in arterial phase dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (DCE-MRI) of the liver. We reviewed 53 consecutive DCE-MRI studies performed on a 3-T unit using c-VIBE and 53 consecutive cases performed using r-VIBE-KWIC with full-frame image subset (r-VIBEfull) and sub-frame image subsets (r-VIBEsub; temporal resolution, 2.5-3 s). All arterial phase images were scored by two readers on: (1) contrast-enhancement ratio (CER) in the abdominal aorta; (2) scan timing; (3) artefacts; (4) visualisation of the common, right, and left hepatic arteries. Mean abdominal aortic CERs for c-VIBE, r-VIBEfull, and r-VIBEsub were 3.2, 4.3 and 6.5, respectively. There were significant differences between each group (P < 0.0001). The mean score for c-VIBE was significantly lower than that for r-VIBEfull and r-VIBEsub in all factors except for visualisation of the common hepatic artery (P < 0.05). The mean score of all factors except for scan timing for r-VIBEsub was not significantly different from that for r-VIBEfull. Radial VIBE-KWIC provides higher image quality than c-VIBE, and r-VIBEsub features high temporal resolution without image degradation in arterial phase DCE-MRI. • Radial VIBE-KWIC minimised artefact and produced high-quality and high-temporal-resolution images. • Maximum abdominal aortic enhancement was observed on sub-frame images of r-VIBE-KWIC. • Using r-VIBE-KWIC, optimal arterial phase images were obtained in over 90 %. • Using r-VIBE-KWIC, visualisation of the hepatic arteries was improved. • A two-reader study revealed r-VIBE-KWIC's advantages over Cartesian VIBE.
    European Radiology 03/2014; · 4.34 Impact Factor
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    ABSTRACT: This multicentre prospective clinical trial aimed to determine whether early administration of alendronate (ALN) delays fracture healing after surgical treatment of fractures of the distal radius. The study population comprised 80 patients (four men and 76 women) with a mean age of 70 years (52 to 86) with acute fragility fractures of the distal radius requiring open reduction and internal fixation with a volar locking plate and screws. Two groups of 40 patients each were randomly allocated either to receive once weekly oral ALN administration (35 mg) within a few days after surgery and continued for six months, or oral ALN administration delayed until four months after surgery. Postero-anterior and lateral radiographs of the affected wrist were taken monthly for six months after surgery. No differences between groups was observed with regard to gender (p = 1.0), age (p = 0.916), fracture classification (p = 0.274) or bone mineral density measured at the spine (p = 0.714). The radiographs were assessed by three independent assessors. There were no significant differences in the mean time to complete cortical bridging observed between the ALN group (3.5 months (se 0.16)) and the no-ALN group (3.1 months (se 0.15)) (p = 0.068). All the fractures healed in the both groups by the last follow-up. Improvement of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, grip strength, wrist range of movement, and tenderness over the fracture site did not differ between the groups over the six-month period. Based on our results, early administration of ALN after surgery for distal radius fracture did not appear to delay fracture healing times either radiologically or clinically. Cite this article: Bone Joint J 2013;95-B:1544-50.
    The bone & joint journal. 11/2013; 95-B(11):1544-50.
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    ABSTRACT: OBJECTIVE: To describe the imaging findings of primary and secondary pancreatic malignant lymphoma on magnetic resonance imaging (MRI), to help differentiate lymphoma of the pancreas from primary adenocarcinoma and autoimmune pancreatitis among others, and to discuss a few atypical presentations of pancreatitis mimicking lymphoma. CONCLUSION: Knowledge of these imaging manifestations of lymphoma may be helpful to arrive at an accurate diagnosis and avoid unnecessary morbidity and mortality from inadvertent surgery. MAIN MESSAGES: • Pancreatic malignant lymphoma is shown as a nodular low-density area with mild enhancement on CT. • It sometimes shows variable manifestations mimicking other tumours and inflammatory conditions. • MRI provides useful information for differentiating malignant lymphoma from other mimickers.
    Insights into imaging. 03/2013;
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    ABSTRACT: Objectives: Immunoglobulin (Ig)G4-related disease is a recently proposed systemic disorder that includes autoimmune pancreatitis (AIP), Mikulicz's disease, and various other organ lesions. In the present retrospective study, we examined whether thyroid lesions should also be included in IgG4-related disease (Ig4-RD) under the new term IgG4-related thyroiditis. Method: We enrolled 114 patients with Ig4-RD, including 92 patients with AIP, 15 patients with Mikulicz's disease, and seven patients with IgG4-related cholangitis, and analysed clinical findings, function, serum values of activity markers, computed tomography (CT) images, and histology of the thyroid gland. Results: Among the 22 patients (19%) in our cohort who were found to have hypothyroidism [thyroid stimulating hormone (TSH) > 4 mIU/L], 11 patients had clinical hypothyroidism [free thyroxine (FT4) < 1 ng/dL] and 11 patients had subclinical hypothyroidism (FT4 ≥ 1 ng/dL). Serum concentrations of IgG, IgG4, circulating immune complex (CIC), and β2-microglobulin (β2-MG) were significantly higher in the hypothyroidism group compared with the remaining 92 euthyroid patients, and serum C3 concentration was significantly lower. After prednisolone treatment, TSH values had decreased significantly (p = 0.005) in this group and FT4 values had increased significantly (p = 0.047). CT images showed that the thyroid glands of patients with clinical hypothyroidism had a significantly greater volume than those of the euthyroid and other groups. Pathological analysis of one resected thyroid gland disclosed a focused lesion with infiltration of lymphocytes and IgG4-bearing plasma cells and loss of thyroid follicles. Conclusions: Thyroid lesions associated with hypothyroidism can be considered as a new disease termed IgG4-related thyroiditis. Awareness of this condition should lead to appropriate corticosteroid treatment that may prevent progression to a fibrous state.
    Scandinavian journal of rheumatology 03/2013; · 2.51 Impact Factor
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    ABSTRACT: We summarize here the consensus reached at the Symposium of the 48th Annual Meeting of the Liver Cancer Study Group of Japan held in Kanazawa on July 20th and 21st, 2012, on the role of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) in the management of hepatocellular carcinoma (HCC). Currently, dynamic CT is the first choice of imaging modality when HCC is suspected. EOB-MRI is useful for differentiation and definitive diagnosis of HCC when dynamic CT/MRI does not show conclusive findings for HCC. In addition, contrast- enhanced ultrasound with Sonazoid is useful for making a decision on whether or not to treat a hypovascular lesion <1 cm when the nodules are shown with low intensity in the hepatocyte phase of EOB-MRI. Furthermore, EOB-MRI should be performed in selected cases of HCC ultrahigh-risk groups every 3-4 months, or EOB-MRI should be performed at least once at the first visit in all HCC ultrahigh-risk groups.
    Oncology 01/2013; 84 Suppl 1:21-7. · 2.17 Impact Factor
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    ABSTRACT: PURPOSE: To evaluate the difference in the time-intensity curves (TICs) of the abdominal aorta on dynamic contrast-enhanced MRI (DCE-MRI) between Gd-DTPA and Gd-EOB-DTPA. MATERIALS AND METHODS: Ten healthy volunteers underwent DCE-MRI three times with the following protocol: group A, Gd-DTPA at an injection rate of 3 ml/s; group B, Gd-EOB-DTPA, 3 ml/s; group C, Gd-EOB-DTPA, 1.5 ml/s. Signal intensities (SIs) of the abdominal aorta were measured, and the contrast enhancement ratio (CER) was calculated. Time-to-CER curves were compared among the three groups. The differences in maximum CER (CER(max)) and time-to-peak of CER were analyzed. RESULTS: The time-to-CER curve showed a double peak pattern in group A and single-peak pattern in groups B and C. The mean time between the first and the second peak was 6.2 s. The mean CER(max) of each group was 4.50, 4.52 and 4.27, respectively. In group A, B and C, the mean time-to-peak was 14.6, 10.6 and 12.6 s, respectively. There was a significant difference between group A and B (P < 0.01). CONCLUSION: To set up the optimal protocol for abdominal DCE-MRI, it should be noted that TIC in the Gd-DTPA and Gd-EOB-DTPA group showed different patterns, and a slower injection rate showed a less abrupt SI change in the Gd-EOB-DTPA group than in the Gd-DTPA group.
    Japanese journal of radiology 11/2012; · 0.73 Impact Factor
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    ABSTRACT: AIM: We aimed to correlate the macroscopic and magnetic resonance imaging (MRI) findings of hepatocellular carcinomas (HCC). METHODS: This was a multicenter study, whose study protocol was approved by each institutional review board. One hundred and forty-six resected nodules in 124 patients who had received a preoperative hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) were analyzed. In both findings, we compared the diameter of HCC and macroscopic types divided into five types: (i) small nodular type with indistinct margin (SN-IM); (ii) simple nodular type (with distinct margin) (SN-DM); (iii) simple nodular type with extranodular growth (SN-EG); (iv) confluent multinodular type (CMN); and (v) infiltrative type (IF). RESULTS: The diameters in each finding (D(surg) and D(MRI) ) were significantly correlated (R = 0.961), although D(surg) was larger than D(MRI) (P = 0.0216). There were significant differences between D(surg) in SN-IM and the other groups (P < 0.0001). Sensitivity, specificity and accuracy were 5.3, 99.2 and 87; 84.8, 62.7 and 81.4; 58.1, 91.3 and 84.2; 70.6, 91.5 and 89, in SN-IM, SN-DM, SN-EG and CMN, respectively. The kappa value of every size was as follows: all sizes, 0.45; 20 mm or less, 0.23; more than 20 mm, 0.56. CONCLUSION: EOB-MRI could predict the macroscopic pathological findings except for SN-IM. Small tumor size might be helpful to diagnose SN-IM.
    Hepatology Research 09/2012; · 2.07 Impact Factor
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    ABSTRACT: To identify characteristic magnetic resonance (MR) features of focal autoimmune pancreatitis (f-AIP) useful for differentiation from pancreatic cancer (PC). We retrospectively analyzed MR imaging findings of 20 f-AIP lesions and 40 PC lesions smaller than 40 mm in diameter. On fat-suppressed T2-weighted images and dynamic contrast-enhanced fat-suppressed T1-weighted images (DCE-T1WI), we classified MR features of internal signal intensity for each lesion into homogeneous, speckled, or target type. We assessed the sensitivity, specificity, and accuracy of these findings in the diagnosis of f-AIP. We also investigated the incidence of previously reported findings for differentiation between f-AIP and PC. Speckled enhancement within a hypointense or isointense lesion on pancreatic phase DCE-T1WI (speckled type) was observed more frequently in f-AIP than in PC, with high sensitivity, high specificity, and high accuracy. Hypointensity to hyperintensity surrounding a less enhanced focal area on DCE-T1WIs (target type) and upper stream main pancreatic duct dilatation were observed more frequently in PC than in f-AIP. Speckled enhancement inside an f-AIP lesion on pancreatic phase DCE-T1WI was useful for differentiation from PC.
    Japanese journal of radiology 01/2012; 30(4):296-309. · 0.73 Impact Factor
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    ABSTRACT: We aimed to reveal the difference in contrast enhancement of the abdominal organs and major vessels on dynamic contrast-enhanced magnetic resonance imaging (DCM-MRI) using gadoxetic sodium (Gd-EOB-DTPA) and gadopentetate dimeglumine (Gd-DTPA) in the same patients. DCM-MRI using Gd-EOBDTPA and Gd-DTPA were performed in the same 17 patients. Precontrast and DCM-MRI images [arterial phase (AP), portal venous phase (PP), hepatic venous phase (HP)] were acquired before and after bolus injection of each contrast agent. The organ-to-muscle ratio [liver (L/M), spleen (S/M), aorta (A/M), portal vein (P/M), hepatic vein (V/M)] were calculated at each phase and analyzed statistically. There was no significant difference between Gd-EOB-DTPA and Gd-DTPA images regarding the L/M or V/M mean on precontrast images or the mean of L/M at AP and L/M at the PP. At the AP, PP, and HP, the means of S/M, A/M, P/M, and V/M with Gd-EOBDTPA were lower than those with Gd-DTPA. On HP, The mean L/M with Gd-EOB-DTPA was higher than that with Gd-DTPA. On 3-T DCM-MRI using Gd-EOB-DTPA, contrast enhancement of the organs, except for the liver, was lower than that on DCM-MRI using Gd-DTPA. The HP was already affected by hepatobiliary uptake in Gd-EOB-DTPA.
    Japanese journal of radiology 12/2011; 29(10):695-700. · 0.73 Impact Factor
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    ABSTRACT: To determine whether liver function correlating with indocyanine green (ICG) clearance could be estimated quantitatively from gadoxetate disodium-enhanced magnetic resonance (MR) images. This retrospective study was approved by the institutional review board, and the requirement for informed consent was waived. Twenty-three consecutive patients who underwent an ICG clearance test and gadoxetate disodium-enhanced MR imaging with the same parameters as were used for a preoperative examination were chosen. The hepatocellular uptake index (HUI) from liver volume (V(L))and mean signal intensity of the liver on contrast-enhanced T1-weighted images with fat suppression (L(20)) and mean signal intensity of the spleen on contrast-enhanced T1-weighted images with fat suppression (S(20)) on 3D gradient-echo T1-weighted images with fat suppression obtained at 20 minutes after gadoxetate disodium (0.025 mmol per kilogram of body weight) administration was determined with the following equation: V(L)[(L(20)/S(20)) - 1]. The correlation of the plasma disappearance rate of ICG (ICG-PDR) and various factors derived from MR imaging, including HUI, iron and fat deposition in the liver and spleen, and spleen volume (V(S)), were evaluated with stepwise multiple regression analysis. The difference between the ratio of the remnant HUI to the HUI of the total liver (rHUI/HUI) and ratio of the liver remnant V(L) to the total V(L) (rV(L)/V(L)) was evaluated in four patients who had segmental heterogeneity of liver function. HUI and V(S) were the factors significantly correlated with ICG-PDR (R = 0.87). The mean value and its 95% confidence interval were 0.18 and 0.01 to 0.34, respectively, for the following calculation: (rHUI/HUI) - (rV(L)/V(L)). The liver function correlating with ICG-PDR can be estimated quantitatively from the signal intensities and the volumes of the liver and spleen on gadoxetate disodium-enhanced MR images, which may improve the estimation of segmental liver function.
    Radiology 06/2011; 260(3):727-33. · 6.34 Impact Factor
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    ABSTRACT: To clarify the preoperative differential diagnosis and management of minimal deviation adenocarcinoma (MDA) and lobular endocervical glandular hyperplasia (LEGH), a multicenter study was performed. A total of 112 patients who underwent conization or a hysterectomy for suspected MDA were collected from 24 hospitals. The pathological diagnosis in each case was determined by a central pathological review board. The diagnostic significance of clinicopathologic findings including results of magnetic resonance imaging (MRI), Papanicolaou (Pap) smears, and testing for gastric mucin was analyzed. The central pathological review identified 37 cases of Nabothian cyst or tunnel cluster, 54 cases of LEGH, 6 cases of MDA, 11 cases of adenocarcinoma, and 4 cases of benign disease. Lobular endocervical glandular hyperplasia was often associated with adenocarcinoma in situ, MDA, and mucinous adenocarcinoma. Three MDA patients had a recurrence, whereas none of LEGH patients had a recurrence irrespective of the type of surgery. On MRI, LEGH appeared as a characteristic multicystic lesion with an inner solid component, whereas MDA showed a predominantly solid pattern. A Pap smear or gastric mucin alone had limited diagnostic power. However, a combination of these findings is useful; that is, a cystic structure with inner solid components on MRI associated with mild glandular atypia and gastric mucin strongly suggested LEGH (24/26, 92%). A solid structure with atypical glandular cells was indicative of MDA or adenocarcinoma (5/5, 100%). The combination of MRI, Pap smears, and gastric mucin will improve the accuracy of the preoperative diagnosis of MDA and LEGH. Patients suspected of having LEGH may need to be treated with less aggressive methods.
    International Journal of Gynecological Cancer 06/2011; 21(7):1287-96. · 1.94 Impact Factor
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    ABSTRACT: Autoimmune pancreatitis (AIP), characterized by an autoimmune phenomenon of prominent lymphocytes, IgG4-bearing plasma cell infiltration and storiform fibrosis, has been widely reported as a specific type of chronic pancreatitis. Typical image findings of this disease are reported as diffuse pancreatic swelling and a capsule-like rim on CT or MRI. However, AIP presents with a variable morphology, such as focal, segmental and multifocal swellings. Because imaging findings for AIP can look like those of pancreatic cancer, AIP has often been treated with unnecessary surgical resection. In addition, AIP is complicated by the involvement of various other organs besides the pancreas that show lymphoplasmacytic infiltration and fibrosis. These are frequently misdiagnosed as inherent lesions of corresponding organs. Furthermore, these extra-pancreatic lesions show systemic distribution and share common features of IgG4- bearing plasma cell infiltration as well as favorable responses to corticosteroid, indicating the presence of systemic condition, IgG4-related diseases. AIP is now recognized as an IgG4-related disease. Detailed evaluations of imaging findings of CT, MRI and Gallium-67 (Ga-67) scintigraphy for the involvement of these various organs are useful for a correct diagnosis of this systemic disease.
    Current Immunology Reviews 04/2011; 7(2):186-203.
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    ABSTRACT: Autoimmune pancreatitis is a unique form of chronic pancreatitis with autoimmune phenomena, including hypergammaglobulinemia, lymphoplasmacytic infiltration, and responsiveness to corticosteroid therapy. Autoimmune pancreatitis tends to affect elderly males and it presents with pancreatic swelling and irregular narrowing of the pancreatic duct. The symptoms of autoimmune pancreatitis mimic the clinical features of pancreatic cancer; thus, it is important to differentiate between the two conditions. Autoimmune pancreatitis is also characterized by high serum IgG4 concentrations and infiltration of IgG4-bearing plasma cells into the pancreatic tissue. Although these are considered serological and histological hallmarks of autoimmune pancreatitis, the role of IgG4 in the pathogenesis of the disease remains unclear. Furthermore, many cases are complicated by extra-pancreatic manifestations with pathological findings similar to those observed in the pancreatic lesions; these extra-pancreatic manifestations tend to respond favorably to corticosteroid therapy. Autoimmune pancreatitis is now regarded as a member of a new class of IgG4-related disease. Due to inconsistencies in the diagnostic criteria for autoimmune pancreatitis, there is a need for an international consensus on this disease.
    Current Immunology Reviews 04/2011; 7(2):144-161.
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    ABSTRACT: The aim of our study was to examine the relation between autoimmune pancreatitis (AIP) and infraorbital nerve swelling. A total of 11 AIP patients underwent magnetic resonance imaging (MRI) examination of the head and neck region. The infraorbital nerve thicknesses were measured on coronal images and compared with those of a control group. We also examined whether the infraorbital nerve thicknesses were altered from before to after steroid therapy in nine patients who underwent MRI examination after such therapy. The mean thicknesses were 3.8 ± 2.0 mm in the AIP group and 2.6 ± 0.5 mm in the control group (P < 0.05). The nerve thicknesses were >5 mm in 5 of 11 patients (45%) in the AIP group, and <5 mm in all of the control group. Among the nine patients who underwent MRI examination after steroid therapy, three had shown nerve swelling before steroid therapy; the therapy diminished the swelling in all three patients. Infraorbital nerve swelling was observed more frequently in AIP patients than in patients without a history of AIP. Therefore, such swelling seems to be an extrapancreatic lesion of AIP.
    Japanese journal of radiology 04/2011; 29(3):194-201. · 0.73 Impact Factor
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    ABSTRACT: To assess the degree of hepatic fat content, simple and noninvasive methods with high objectivity and reproducibility are required. Magnetic resonance imaging (MRI) is one such candidate, although its accuracy remains unclear. We aimed to validate an MRI method for quantifying hepatic fat content by calibrating MRI reading with a phantom and comparing MRI measurements in human subjects with estimates of liver fat content in liver biopsy specimens. The MRI method was performed by a combination of MRI calibration using a phantom and double-echo chemical shift gradient-echo sequence (double-echo fast low-angle shot sequence) that has been widely used on a 1.5-T scanner. Liver fat content in patients with nonalcoholic fatty liver disease (NAFLD, n = 26) was derived from a calibration curve generated by scanning the phantom. Liver fat was also estimated by optical image analysis. The correlation between the MRI measurements and liver histology findings was examined prospectively. Magnetic resonance imaging measurements showed a strong correlation with liver fat content estimated from the results of light microscopic examination (correlation coefficient 0.91, P < 0.001) regardless of the degree of hepatic steatosis. Moreover, the severity of lobular inflammation or fibrosis did not influence the MRI measurements. This MRI method is simple and noninvasive, has excellent ability to quantify hepatic fat content even in NAFLD patients with mild steatosis or advanced fibrosis, and can be performed easily without special devices.
    Journal of Gastroenterology 12/2010; 45(12):1263-71. · 3.79 Impact Factor
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    ABSTRACT: We ascertained the difference in the level of pulmonary hilar (PH) gallium-67 (Ga-67) uptake in autoimmune pancreatitis (AIP) patients between the active (before corticosteroid therapy) and remittent (after 4 weeks of corticosteroid therapy) phases using a semiquantitative measurement method based on single photon emission computed tomography (SPECT) with integrated low-dose computed tomography (CT). Ga-67 planar scans and SPECT were performed in 11 AIP patients before and after 4 weeks of corticosteroid therapy. A region of interest (ROI) was drawn over the bilateral pulmonary hilum and the liver, and average counts of the pulmonary hilum and liver were calculated. The average counts of the pulmonary hilum divided by those of the liver gave the pulmonary hilum/liver ratio (H/L). A significant difference was observed in the H/L between active and remittent phases. H/L in the active phase was 1.03±0.32 and that in the remittent phase was 0.58±0.25 (t-test, P=0.0016). PH Ga-67 uptake in patients with active AIP was semiquantitatively higher than that in those with remittent AIP. Hence, this may be a useful finding for an early diagnosis, estimating the effectiveness of corticosteroid therapy, and following up patients with this disease.
    Japanese journal of radiology 12/2010; 28(10):733-9. · 0.73 Impact Factor
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    ABSTRACT: As the patients with autoimmune pancreatitis (AIP) are increasing in Japan, the practical guideline for managing AIP is required to be established. Three committees (the professional committee for making clinical questions [CQs] and statements by Japanese specialists, the expert panelist committee for rating statements by the modified Delphi method, and the evaluating committee by moderators) were organized. Fifteen specialists for AIP extracted the specific clinical statements from a total of 871 literatures by PubMed search (approximately 1963-2008) and from a secondary database and made the CQs and statements. The expert panelists individually rated these clinical statements using a modified Delphi approach, in which a clinical statement receiving a median score greater than 7 on a 9-point scale from the panel was regarded as valid. The professional committee made 13, 6, 6, and 11 CQs and statements for the concept and diagnosis, extrapancreatic lesions, differential diagnosis, and treatment, respectively. The expert panelists regarded them as valid after a 2-round modified Delphi approach. After evaluation by the moderators, the Japanese clinical guideline for AIP has been established. Further studies for the international guideline are needed after international consensus for diagnosis and treatment.
    Pancreas 10/2009; 38(8):849-66. · 2.95 Impact Factor
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    ABSTRACT: Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by a variety of extra-pancreatic involvements which are frequently misdiagnosed as lesions of corresponding organs. The purpose of this study was to clarify the diagnostic imaging features of extra-pancreatic lesions associated with autoimmune pancreatitis. We retrospectively analyzed diagnostic images of 90 patients with autoimmune pancreatitis who underwent computer-assisted tomography, magnetic resonance imaging, and/or gallium-67 scintigraphy before steroid therapy was initiated. AIP was frequently (92.2%) accompanied by a variety of extra-pancreatic lesions, including swelling of lachrymal and salivary gland lesions (47.5%), lung hilar lymphadenopathy (78.3%), a variety of lung lesions (51.2%), wall thickening of bile ducts (77.8%), peri-pancreatic or para-aortic lymphadenopathy (56.0%), retroperitoneal fibrosis (19.8%), a variety of renal lesions (14.4%), and mass lesions of the ligamentum teres (2.2%). Characteristic findings in CT and MRI included lymphadenopathies of the hilar, peri-pancreatic, and para-aortic regions; wall thickening of the bile duct; and soft tissue masses in the kidney, ureters, aorta, paravertebral region, ligamentum teres, and orbit. Recognition of the diagnostic features in the images of various involved organs will assist in the diagnosis of autoimmune pancreatitis and in differential diagnoses between autoimmune pancreatitis-associated extra-pancreatic lesions and lesions due to other pathologies.
    European journal of radiology 08/2009; 76(2):228-38. · 2.65 Impact Factor