Akira Fujikawa

University Hospital Medical Information Network, Tokyo, Tokyo-to, Japan

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Publications (23)50.23 Total impact

  • Article: Pseudomesotheliomatous lung cancer mimicking mesothelioma on (18)F-FDG PET/CT images: report of 2 cases.
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    ABSTRACT: The authors report two cases of pseudomesotheliomatous lung cancer (PLC) detected by (18)F-FDG PET/CT scan. (18)F-FDG PET/CT clearly revealed the extent of the disease in both cases, a case of adenocarcinoma of the lung and a case of squamous cell carcinoma of the lung. Intense (18)F-FDG uptake by the diffusely thickened pleurae and primary lesion was observed in both cases, and increased (18)F-FDG uptake by a pelvic bone metastasis was observed in the case of squamous cell carcinoma. Although PLC is indistinguishable from malignant pleural mesothelioma on (18)F-FDG PET/CT scans, (18)F-FDG PET/CT was helpful in identifying the primary focus of the PLCs and in staging the disease. Diagnostic image interpreters should be familiar with the (18)F-FDG PET/CT findings in PLC.
    Japanese journal of radiology 04/2013; · 0.65 Impact Factor
  • Article: A case of incidentally detected IgG4-related sclerosing disease involving inflammatory abdominal aortic aneurysm and autoimmune pancreatitis.
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    ABSTRACT: A 59-year-old asymptomatic man was incidentally found to have a periaortic mass and an elevated serum amylase level during his medical check-up. Additional findings, such as infiltration of immunoglobulin G4 (IgG4)-producing plasma cells in the mass lesion, elevation of serum IgG4 (1000 mg/dl), and pancreatic duct narrowing as evidenced on a magnetic resonance cholangiopancreatography scan, confirmed the diagnosis as retroperitoneal fibrosis complicated with autoimmune pancreatitis. The patient responded favorably to steroid treatment before the appearance of symptoms.
    Modern Rheumatology 02/2010; 20(3):306-10. · 1.58 Impact Factor
  • Article: CT angiography covering both cervical and cerebral arteries using high iodine concentration contrast material with dose reduction on a 16 multidetector-row system.
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    ABSTRACT: Our aim was to examine the feasibility of a computed tomographic angiography (CTA) protocol using a reduced dose of high-concentration contrast material on a 16 multidetector-row system to visualize both cervical and cerebral arteries in one session. In 31 consecutive patients, we performed CTA covering the cervical and cerebral arteries. The patients were assigned to one of three groups: group A, 100 mL of 300 mgI/mL; group B, 80 mL of 370 mgI/mL; and group C, 60 mL of 370 mgI/mL followed by a 30-mL saline flush. Arterial enhancements were quantified by measuring attenuation values of the common carotid artery, internal jugular vein, proximal middle cerebral artery (MCA), basilar artery, and straight sinus on source images. Visualizations of the carotid bifurcation and arteries continuing to the circle of Willis were rated on a three-point grading scale on CTA images for qualitative assessment. There were no statistically significant differences in attenuation of all the target vessels among the three groups, with the one exception being a lower attenuation of the MCA in group C than in groups A and B (P < 0.01). Neither were there any significant differences noted among the three groups on the visual assessment. Use of a reduced dose of high iodine concentration contrast material may provide an equal degree of image quality for CTA covering the craniocervical region on a 16 multidetector-row system.
    Neuroradiology 10/2009; 52(4):291-5. · 2.82 Impact Factor
  • Article: Immediate Improvement of a Persistent Cough After Tumor Embolization for Renal Cell Carcinoma
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    ABSTRACT: We report an interesting case of a patient with renal cell carcinoma who developed a refractory cough, which immediately resolved after tumor embolization. Patient's symptoms including low-grade fever, weight loss, and abnormal laboratory results also improved shortly after subsequent nephrectomy. The clinical manifestations of the patient are most likely representing paraneoplastic syndrome secondary to renal cell carcinoma.
    07/2009; 36(5):393-395.
  • Article: Diffusion tensor tractography of the lower spinal cord.
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    ABSTRACT: We employed a diffusion-tensor (DT) imaging technique involving a single-shot echo-planar sequence in combination with parallel imaging for tractography of the lower spinal cord and assessed the feasibility of this technique. Images were obtained at 1.5 T using a five-channel receiver coil. We used a single-shot echo-planar sequence with parallel imaging to acquire diffusion-weighted (DW) images in the axial plane with phase encoding in the right-left direction. A motion-probing gradient was applied in six directions with a b-value of 1,000 s/mm(2). The scan time was 5 min 15 s. On a reconstructed DW image in the sagittal plane, the spinal cord was included in a single region-of-interest to generate a tractogram of the entire cord in seven volunteers and nine patients with spinal canal stenosis or vertebral metastasis. In each subject, although the conus medullaris and cauda equina were continuously visualized, the cord was demonstrated as a bundle of tracts color-coded in the z-axis. Nerve roots were depicted showing color-coding in the x- and y-axes. In the patient group, displacement of the cord was depicted showing changes in the color of the cord. Displacement of the proximal nerve roots was also depicted in the two patients with vertebral metastasis. DT imaging using parallel imaging shows potential as a method for routine tractography of the lower spinal cord.
    Neuroradiology 04/2008; 50(3):221-5. · 2.82 Impact Factor
  • Article: Achilles tendon after percutaneous surgical repair: serial MRI observation of uncomplicated healing.
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    ABSTRACT: The purpose of this study was to prospectively explore the MRI features of normal healing of the expected residual tendon gap in the Achilles tendon after percutaneous surgical repair. MR images of the Achilles tendon were obtained approximately 4, 8, and 12 weeks after surgery. Assessment of MR images was focused on the presence of residual tendon gap and gap length, Achilles tendon contour, and contrast enhancement in the ruptured area. Cases of open surgical repair were used for comparison. We attempted to statistically compare the timing of tendon gap disappearance within the percutaneous surgical repair group and between the percutaneous and open surgical repair groups. A total of 30 tendons repaired with percutaneous surgical technique and 10 repaired with open surgical technique were evaluated. At the first, second, and third MRI sessions of the percutaneous surgical repair group, a residual gap was found in 100%, 80%, and none of the tendons on T1-weighted images and in 87%, 63%, and none of the tendons on T2-weighted images. Achilles tendon contour was visualized in 30%, 90%, and 100% of the tendons on T1-weighted images and 90%, 100%, and 100% of the tendons on T2-weighted images. Intratendinous enhancement was present in 100%, 73%, and 7% of the tendons in the percutaneous surgical repair group. Ring-shaped peritendinous enhancement was recognized at the third session in all subjects. A significantly longer time was required for tendon gap disappearance after percutaneous than after open surgical repair. The time course of the MR findings in the ruptured Achilles tendon after percutaneous surgical repair appears to reflect regular healing.
    American Journal of Roentgenology 12/2007; 189(5):1169-74. · 2.78 Impact Factor
  • Article: Neurography of the spinal nerve roots by diffusion tensor scanning applying motion-probing gradients in six directions.
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    ABSTRACT: Diffusion-weighted (DW) magnetic resonance (MR) imaging of the nerve roots and peripheral nerves has been reported. We applied a sequence similar to brain diffusion tensor (DT) tractography to such a technique and assessed its feasibility. On a 1.5-T MR system, we acquired DW images in the axial plane using a single-shot echo-planar short tau inversion-recovery (STIR)-based sequence. Motion-probing gradients (MPGs) were applied in 6 directions with a b-value of 500 s/mm(2). For postprocessing, we performed maximum-intensity projection to reconstruct the images. We obtained cervical spine images from 3 volunteers and 8 patients and thoracolumbar spine images from 3 volunteers and 6 patients. On the source images of the cervical spine obtained from the volunteers, we compared the signal-to-noise ratios (SNRs) of the neural structures between images obtained applying MPG in 6 directions and in 3 directions. We visually assessed the nerve roots and proximal portions of the contiguous peripheral nerves in the images from volunteers and patients. The SNRs were significantly superior in the images obtained with the application of MPGs in 6 directions to those obtained with the application of MPGs in 3 directions (P<0.01). Visual assessment demonstrated the nerve roots as well as the nerve ganglia and the contiguous peripheral nerves up to 3 cm or more from the respective neural foramina in each subject. Image distortion was minimal. Our technique provides neurographic images of the nerve roots and proximal portions of the contiguous peripheral nerves, and images obtained using our sequence applying MPGs in 6 directions are superior to those obtained in 3 directions.
    Magnetic Resonance in Medical Sciences 02/2007; 6(1):1-5. · 0.97 Impact Factor
  • Article: Value of diffusion-weighted MR imaging in acute cervical cord injury as a predictor of outcome.
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    ABSTRACT: We analyzed the findings of diffusion-weighted (DW) imaging using the single-shot fast spin-echo sequence in acute cervical cord injury and evaluated the usefulness of this method for predicting the prognosis. Our patient group comprised 14 patients examined 2 h to 3 days after injury. First, we visually evaluated the DW imaging findings in all patients. Apparent diffusion coefficient (ADC) maps were also assessed in 13 patients. Second, we assessed follow-up magnetic resonance (MR) examinations obtained in six patients whose DW images showed hyperintensity. Third, we reviewed the functional outcome at discharge. The lesions showed hyperintensity in ten patients, and no abnormal signal was noted in the remaining four patients. The ADC maps showed restricted diffusion in all patients with hyperintensity on DW imaging except in one patient for whom the ADC map was unavailable. Repeated MR examinations obtained in six of the ten patients showed either myelomalacia or exacerbation. Seven of the ten patients (70%) required assistance and the other three were independent. Among the four patients without hyperintensity on DW imaging, three (75%) were independent and only one required assistance. DW imaging in acute cervical cord injury often reveals restricted diffusion. This finding may predict an unfavorable functional prognosis.
    Neuroradiology 12/2006; 48(11):803-8. · 2.82 Impact Factor
  • Article: Comparison of MRI sequences to detect ventriculitis.
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    ABSTRACT: OBJECTIVE: The ability of different MRI sequences to depict characteristic findings suggestive of ventriculitis was compared. CONCLUSION: The study comprised 20 brain MRI studies in 13 patients who had a final diagnosis of ventriculitis. Both diffusion-weighted imaging and FLAIR imaging were equally and highly sensitive for detecting intraventricular debris and pus--the most common MRI finding suggestive of ventriculitis. FLAIR imaging was superior to contrast-enhanced T1-weighted imaging for depicting ventricular wall abnormalities--a less common finding that also is suggestive of ventriculitis.
    American Journal of Roentgenology 11/2006; 187(4):1048-53. · 2.78 Impact Factor
  • Article: Postoperative assessment of extracranial-intracranial bypass by time-resolved 3D contrast-enhanced MR angiography using parallel imaging.
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    ABSTRACT: Our goals were to assess image quality of time-resolved contrast-enhanced MR angiography (CE MRA), by using 3D data acquisition along with a parallel imaging technique that can improve temporal resolution and to compare this technique with 3D-time-of-flight (TOF) MRA in the postoperative assessment of extracranial (EC)-intracranial (IC) bypass surgery. On a 1.5T imaging system, we performed CE MRA by using a 3D fast field-echo sequence in combination with a parallel imaging technique, to obtain images in the coronal plane centered at the postoperative site. Our patient group comprised 17 patients, including 13 after superficial temporal artery-middle cerebral artery (MCA) anastomosis, 3 after external carotid artery-MCA anastomosis, and one after extracranial vertebral artery-posterior cerebral artery anastomosis. Visualization of the anastomosis and the distal flow on the CE-MRA images was assessed comparatively with that on 3D-TOF MR angiograms obtained at the same time. In 6 patients, we also compared the efficiency of visualization on CE-MRA images with that on conventional angiograms. A temporal resolution of 0.8 s/frame could be achieved with the technique employed. The bypass was better demonstrated postoperatively on CE-MRA images than on 3D-TOF MR angiograms in 13 patients (76%), whereas the 2 methods were equivalent in 4 patients (24%). Good correspondence of results was observed in the 6 patients for whom CE MRA and conventional digital subtraction angiography (DSA) images were compared. CE MRA by using the parallel imaging technique can increase image acquisition speed with sufficient image quality. This technique is at least equivalent to 3D-TOF MRA to evaluate the postoperative status of EC-IC bypass.
    American Journal of Neuroradiology 11/2005; 26(9):2243-7. · 2.93 Impact Factor
  • Article: Diffusion tractography of the cervical spinal cord by using parallel imaging.
    Kazuhiro Tsuchiya, Akira Fujikawa, Yuriko Suzuki
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    ABSTRACT: We applied a single-shot echo-planar axial diffusion tensor sequence with parallel imaging for tractography of the cervical cord. Placing a large region of interest on a reconstructed sagittal image, the cervical cord was depicted as a tract bundle showing color-encoded cephalocaudally. By setting one region of interest in the cerebral peduncle and another in the entire cord on source images, tracts on each side were visualized. This method is promising for tractography of the cervical cord.
    American Journal of Neuroradiology 03/2005; 26(2):398-400. · 2.93 Impact Factor
  • Article: Diffusion-weighted MR imaging in acute spinal cord ischemia.
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    ABSTRACT: We report diffusion-weighted (DW) MR findings for acute spinal cord ischemia in a 56-year-old patient. MR imaging obtained approximately 3 h after symptom onset demonstrated an area of hyperintensity on DW images, but no conspicuous signal abnormality on T2-weighted images in the conus medullaris. DW imaging of the spinal cord can contribute to the early detection of spinal cord vascular compromise.
    European Radiology 12/2004; 14(11):2076-8. · 3.22 Impact Factor
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    Article: Chronic scapulothoracic bursitis associated with thoracoplasty.
    American Journal of Roentgenology 12/2004; 183(5):1487-8. · 2.78 Impact Factor
  • Article: Three-dimensional MR digital subtraction angiography using parallel imaging and keyhole data sampling in cerebrovascular diseases: initial experience.
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    ABSTRACT: We assessed the feasibility of MR digital subtraction angiography (DSA) using parallel imaging and keyhole data sampling in the diagnosis of cerebrovascular diseases (CVDs) in 11 patients. Their diseases included arterial trunk stenosis/occlusion ( n=4), aneurysm ( n=3), arteriovenous malformation ( n=2), venous angioma ( n=1), and sinus thrombosis ( n=1). The technique depicted not only anatomical features, comparably to MR angiography ( n=10/11), but also hemodynamics such as collateral flow at a temporal resolution of 1.68 s/frame. When compared with conventional angiograms ( n=7), details were missed in four patients (incomplete demonstration of aneurysmal neck in two and poor separation of AVM components in two). Although inferior to conventional angiography, this technique can provide both anatomical and hemodynamic information of CVDs.
    European Radiology 09/2004; 14(8):1494-7. · 3.22 Impact Factor
  • Article: Serial Ga-67 scintigraphic findings of adult onset Still's disease.
    Clinical Nuclear Medicine 07/2004; 29(6):372-4. · 3.67 Impact Factor
  • Article: Ga-67 citrate scintigraphy in the diagnosis of primary hepatic lymphoma.
    Clinical Nuclear Medicine 02/2004; 29(1):53-4. · 3.67 Impact Factor
  • Article: Schwannoma of the trachea; a new resection technique.
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    ABSTRACT: Tumors of the trachea are rare, especially schwannoma. We diagnosed a 27-year-old man with schwannoma of the trachea after he was admitted to our hospital with complaints of progressive dyspnea and wheezing. He was treated as having bronchial asthma initially, but his signs and symptoms did not improve with conventional therapy. Flexible fiberscopy revealed the presence of a submucosal tumor in the subglottic area. Tracheal tomography, computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of a mass in the trachea that extended from the cricoid cartilage level to the second tracheal ring. After tracheostomy, we removed the tumor from a tracheostoma upwards to the larynx without a laryngofissure, using forceps and scissors usually used for laryngomicrosurgery and endoscopes usually used for sinus surgery. No complications developed during or after the procedure. To our knowledge, this is the first report of the removal of a tracheal schwannoma by this technique.
    Auris Nasus Larynx 01/2004; 30(4):425-7. · 0.76 Impact Factor
  • Article: MR imaging of meniscal malformations of the knee mimicking displaced bucket-handle tear.
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    ABSTRACT: We report two cases of patients with lateral meniscal malformations of the knee that were found incidentally. Magnetic resonance imaging (MRI) of both cases showed a fragment-like meniscus structure located in the intercondylar notch, very similar to the "fragment in the intercondylar notch sign" observed in displaced bucket-handle tear. Arthroscopic examinations revealed a ring-shaped lateral meniscus in one case, and "flipped-over" lateral meniscus in the other. In the latter, a similar lateral meniscal malformation was observed contralaterally at MR arthrography.
    Skeletal Radiology 06/2002; 31(5):292-5. · 1.54 Impact Factor
  • Article: Immediate improvement of a persistent cough after tumor embolization for renal cell carcinoma--a rare manifestation of paraneoplastic syndrome.
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    ABSTRACT: We report an interesting case of a patient with renal cell carcinoma who developed a refractory cough, which immediately resolved after tumor embolization. Patient's symptoms including low-grade fever, weight loss, and abnormal laboratory results also improved shortly after subsequent nephrectomy. The clinical manifestations of the patient are most likely representing paraneoplastic syndrome secondary to renal cell carcinoma.
    Scandinavian Journal of Urology and Nephrology 02/2002; 36(5):393-5. · 0.99 Impact Factor
  • Article: [Without Title]
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    ABSTRACT: Carmofur (1-hexylcarbamyl-5-fluorouracil), a derivative of 5-fluorouracil (5-FU), has been widely used in Japan as a postoperative adjuvant chemotherapy agent for colorectal and breast cancer. Periventricular hyperintensity on T2-weighted MR images in carmofur-induced leukoencephalopathy confront the physician with a broad range of differential diagnoses. We describe two cases of carmofur-induced leukoencephalopathy in which diffusion-weighted MR imaging revealed periventricular hyperintensity. We compared their findings with those of age-related periventricular hyperintensity in five patients and found discrepancies in signal intensity of periventricular areas. Our results suggest that diffusion-weighted MR imaging may be useful to differentiate carmofur-induced leukoencephalopathy from age-related periventricular hyperintensity.
    European Radiology 11/2001; 11(12):2602-2606. · 3.22 Impact Factor