-
[show abstract]
[hide abstract]
ABSTRACT: Purpose. Interventional treatment strategies for patients with encephalopathy due to splenorenal shunt remain controversial. Portosplenic blood flow separation by occluding the splenic vein could avoid the complication of severe portal hypertension, but it would require repeated reintervention due to recurrence of symptoms. This paper describes occlusion of the splenic vein using coil anchors and prophylactic embolization of a collateral hepatofugal vessel with no recurrence of hyperammonemia. Materials and Methods. A 51-year-old woman with severe cirrhosis had hepatic encephalopathy due to a large splenorenal shunt. The serum ammonia level was 132 μ g/dL. Via a transileocolic approach, the splenic vein was completely embolized with 0.035-inch metallic coils using coil anchors while preserving the splenorenal shunt. In addition, one of the collateral vessels of the portal vein, the retrogastric vein, was also embolized prophylactically. Results. After this procedure, the serum ammonia level decreased immediately to 24 μ g/dL. The portal venous pressure increased by only 1.5 mmHg. Hepatic encephalopathy had not been observed for 25 months after the procedure, and neither retention of ascites nor worsening of esophageal varices and liver function was observed. Conclusion. This procedure appears to be safe and effective for hepatic encephalopathy caused by a splenorenal shunt.
Case reports in radiology. 01/2013; 2013:160653.
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND:: Retrograde leptomeningeal venous drainage (RLVD) in dural arteriovenous fistulas (DAVFs) is associated with intracerebral hemorrhage and nonhemorrhagic neurological deficits or death. Angiographic evidence of RLVD is a definite indication for treatment, but less-invasive methods of identifying RLVD are required. OBJECTIVE:: To evaluate the efficacy of susceptibility-weighted magnetic resonance imaging (SWI) in detecting RLVD in DAVFs. METHODS:: We retrospectively identified 17 DAVF patients who had angiographic evidence of RLVD and received treatment. Conventional angiography and SWI were assessed at pre- and post-treatment time points. The presence of RLVD on SWI was defined as cortical venous hyperintensity, and the presence of venous congestion on SWI venograms was defined as increased caliber of cortical or medullary veins. RESULTS:: Cortical venous hyperintensity was identified in pre-treatment SWI of 15 patients. Cortical venous hyperintensity was absent in early post-treatment SWI, consistent with the absence of RLVD in post-treatment angiography, in all but one of these patients. In two patients, cortical venous hyperintensity was identified during follow-up, indicating recurrence of RLVD. Cortical venous hyperintensity was not identified in pre-treatment SWI of two patients, despite angiographic evidence of RLVD. Venous congestion was identified in pre-treatment SWI venograms of 11 patients, and was of similar appearance to that identified from angiography. Venous congestive signs improved over the follow-up period. CONCLUSION:: The presence of SWI hyperintensity within the venous structure could be a useful indicator of RLVD in DAVF patients. SWI offers a noninvasive alternative to angiography for identification of RLVD in pre- and post-treated DAVF patients.
Neurosurgery 10/2012; · 2.79 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: INTRODUCTION: The current study evaluated the signal characteristics of susceptibility weighted imaging (SWI) of arteriovenous malformation (AVM), especially for draining veins. For this purpose, we identified the draining veins of the AVM on angiography and evaluated the signal on magnitude image for SWI (SWI-mag) and minimum intensity projection image (SWI-minIP). METHODS: Subjects were 14 cases with angiographically proven AVM. SWI-mag, SWI-minIP, and time-of-flight (TOF) magnetic resonance angiography were acquired. For the draining veins of the AVM identified on angiography, we analyzed signal intensity on the images listed above, and classified it into hyperintensity (hyper), mixed intensity (mixed), hypointensity (hypo), and no visualization. RESULTS: On the analysis of 27 angiographically proven draining veins, 19 draining veins were classified as hyper, 3 as mixed, 0 as hypo, and 6 as no visualization on SWI-mag. On TOF images, 21 draining veins were classified as hyper, 2 as mixed, 0 as hypo, and 4 as no visualization, while 6 draining veins did not show hyperintensity on TOF, and SWI-mag visualized 3 of these 6 veins as hyper. CONCLUSION: SWI-mag depicted most draining veins of AVM as hyperintensity. We speculate that this is mainly due to the higher concentration of oxygenated hemoglobin (oxy-Hb) and inflow effect of the draining vein. SWI-mag seems to be useful in the analysis and follow-up for AVM as the signal on the image may reflect physiological status.
Neuroradiology 05/2012; · 2.82 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Intravascular treatment of cavernous dural arteriovenous fistula (dAVF) is usually safe and effective. However, we describe a patient with a rare brainstem hemorrhage during transvenous embolization (TVE). A 79-year-old woman suffered from left chemosis and diplopia. Cerebral angiography revealed a left cavernous dAVF with cortical venous drainage. The patient underwent TVE of the cavernous sinus (CS) via the left inferior petrosal sinus. Superior petrosal sinus (SPS) outflow occlusion was performed to avoid venous congestion, followed by superficial middle cerebral vein outflow occlusion, selective shunt occlusion of the middle meningeal artery, and superior orbital vein outflow occlusion. The patient's condition suddenly deteriorated during CS packing. A CT scan revealed a massive brainstem hemorrhage. Cerebral angiography did not show SPS reopening or redistributed drainage to the posterior fossa. Thus, TVE for cavernous dAVF can result in life-threatening vascular complications. Well-planned treatment strategies could avert this rare complication.
Journal of Clinical Neuroscience 04/2012; 19(4):589-92. · 1.25 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Purpose: We evaluated the diagnostic effectiveness of magnetic resonance (MR) imaging at 3 tesla to visualize ovarian tumors and problems associated with its use. Materials and Methods: From the records of 423 consecutive women who underwent pelvic MR imaging using a 3T system from April 2009 to June 2010, we analyzed 50 continuous cases of ovarian tumors proved by histopathology. We evaluated visualization of these tumors for image quality and artifacts using 5-point scales. For qualitative assessment, we scored overall image quality (1, poor, to 5, excellent), degree of conviction regarding the diagnosis (1, undiagnosable, to 5, diagnosable with high certainty), and 4 representative artifacts (penetrating, chemical shift, motion, and susceptibility artifact) (1, severe, to 5, little degradation). We also retrospectively reviewed the diagnostic features of the ovarian tumors and preoperative diagnostic accuracy. For quantitative assessment, we determined tumor size and ADC value. Results: Overall quality score was scored 4.9±0.5, and conviction regarding diagnosis was 4.9±0.3. Artifacts caused little degradation in most cases: penetrating, 4.8±0.5; chemical shift, 4.3±0.5; motion, 4.6±0.6; and susceptibility, 3.8±0.9. Preoperative diagnostic accuracy was 92% (sensitivity 94.7%, specificity 90.3%). Mean tumor diameter was 88.3±61 mm. The mean ADC value was 1.04±0.3 in malignant tumors and 1.15±0.5 (×10(-6) mm(2)/s) in benign tumors. Conclusion: The quality of ovarian tumor images obtained with a 3T MR imaging system is adequate for diagnosis, with only slight degradation from penetrating or susceptibility artifacts.
Magnetic Resonance in Medical Sciences 01/2012; 11(3):171-8. · 0.97 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Hemifacial spasm is usually caused by compression of the facial nerve at the root exit zone (REZ), whereas fusiform aneurysmal compression is extremely rare. The authors describe symptomatic hemifacial spasm caused by a contralateral fusiform aneurysm of the vertebral artery (VA) that was treated by endovascular coil embolization.
A 55-year-old woman developed left hemifacial spasm that had gradually worsened over a period of 2 years before admission to our hospital. Cerebral angiography showed an elongated right VA fusiform aneurysm near the VA union that inclined toward the left side. The cause of the facial spasm was considered to be compression of the left facial nerve REZ by the aneurysm. Endovascular parent artery embolization including the aneurysm was performed. The hemifacial spasm disappeared within 3 months.
Hemifacial spasm caused by contralateral VA fusiform aneurysm can be treated by intravascular parent artery occlusion with coil embolization.
Neurosurgery 09/2011; 69(3):E768-71; discussion E771-2. · 2.79 Impact Factor
-
Katsutoshi Takayama,
Toshiaki Taoka, Hiroyuki Nakagawa,
Kaoru Myouchin,
Takeshi Wada,
Toshiteru Miyasaka,
Masahiko Sakamoto,
Akio Fukusumi,
Satoru Iwasaki,
Ryota Kimura,
Shinichiro Kurokawa,
Kimihiko Kichikawa
[show abstract]
[hide abstract]
ABSTRACT: The Carotid WALLSTENT (CWS) and Filter-Wire EZ (FWEZ) embolic protection devices for use in carotid arterial stenting (CAS) were newly approved for national health insurance coverage in Japan in April 2010. This article describes our initial experience of CAS using the CWS and FWEZ.
A group of 14 patients (12 men, 2 women; mean age 70.1 years, range 59-83 years) with 15 carotid artery stenoses at high risk for carotid endarterectomy were treated by CAS using the CWS and FWEZ. Of these stenoses, 5 were symptomatic with ≥50% stenosis of the common or internal carotid artery (ICA), and 10 were asymptomatic with ≥80% stenosis. The rates of technical success, ICA flow impairment during filter protection, periprocedural ischemic stroke, 30-day major adverse events (MAEs) (stroke, death, myocardial infarction), and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed.
CAS was successful in all cases. There was no ICA flow impairment, periprocedural ischemic stroke, or MAEs. DWI showed new ipsilateral ischemic lesions in only one patient (6.7%).
Our initial clinical experience using the CWS and FEWZ for CAS was generally excellent, and the incidence of postprocedural ischemic lesions was low.
Japanese journal of radiology 01/2011; 29(1):51-8. · 0.65 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We assessed the signal of the globus pallidus (GP) in cases of hepatic insufficiency, especially to evaluate the degree of discrepancy in paramagnetic effects on shortening of T(1) and T(2)* using susceptibility-weighted images (SWI).
Seven patients with hepatic insufficiency underwent magnetic resonance (MR) examinations that included T(1)-weighted images (T(1)WI), T(2)-weighted images (T(2)WI), and SWI on a 1.5-tesla MR imager, and we compared their results to those of controls. On T(1)WI and T(2)WI, we measured signal intensity in the GP and posterior segment of the putamen (Put) to obtain a signal ratio (GP/Put ratio), and on SWI, we classified signal intensity into 4 grades: A, higher than the cortex; B, lower than the cortex and higher than the cerebrospinal fluid (CSF); C, lower than the CSF and higher than the red nucleus; and D, lower than the red nucleus.
In the 7 patients with hepatic insufficiency, the mean GP/Put ratio was significantly higher on T(1)WI and T(2)WI than those values in controls. On SWI, we classified 2 cases each as Grade A, Grade B, and Grade C, and one as Grade D. Although the signal of the GP was elevated on T(1)WI, there was no decrease in signal on T(2)WI. On SWI, we obtained no low signal intensity.
In patients with hepatic insufficiency, the globus pallidus did not show low signal intensity on either T(2)WI or SWI. Hyperintensity of the GP on T(1)WI without hypointensity on T(2)WI, or even SWI, suggests a discrepancy between paramagnetic effect on T(1) and T(2) shortening that reflects the accumulation of manganese and the presence of hepatic insufficiency.
Magnetic Resonance in Medical Sciences 01/2011; 10(2):79-83. · 0.97 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The torcular herophili, or "confluence of the sinuses," shows various configurations with other venous sinuses, as revealed by angiography. The aims of this study were to evaluate anatomic variations of this confluence and to assess their clinical relevance using three-dimensional (3D) computed tomographic (CT) venography.
The torcular herophili and its relevant venous sinuses were analyzed using 3D CT venography in 120 adults, consisting of 76 patients who were proven to have aneurysms and 44 patients who were proven to have no vascular malformations or aneurysms after the examinations. Three-dimensional CT venography was performed following the arterial phase of 3D CT angiography without any additional injection of contrast material. Three-dimensional volume-rendered venous images were reconstructed on a workstation and reviewed.
The superior sagittal sinus (SSS) drained into the transverse sinus (TS) in four patterns: the SSS reached the centrally located confluence, where it divided into the bilateral TS (20.0%); the SSS was prematurely duplicated into the right and left limbs and drained into the same side TS (26.7%); the SSS drained exclusively into the right TS (44.2%); or the SSS drained exclusively into the left TS (9.2%). The draining pattern of the straight sinus was also classified into four types. The right TS was larger than the left TS. The right TS were higher compared to the left TS. Persistent occipital sinuses were recognized in 57.5% of the subjects. Finally, persistent falcial sinuses were seen in 2.5% of the subjects. A septum in the SSS and complicated venous channels in the confluence were each seen in only one case.
Three-dimensional CT venography is useful as a noninvasive method to evaluate the confluence and its relevant dural sinuses and can provide useful information for surgical intervention.
Academic radiology 09/2010; 17(9):1103-11. · 2.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Bow hunter's stroke (BHS) is a cerebrovascular disease caused by occlusion of the vertebral artery (VA) on head rotation. BHS is generally associated with hemodynamic changes, often leading to vertebrobasilar insufficiency symptoms, such as vertigo and faintness. Although artery-to-artery embolism has also been proposed as an underlying mechanism, it remains controversial. This report documents a case of BHS without hemodynamic changes. We describe a 26-year-old male patient who had VA occlusion on head rotation and repetitive infarction of thalami. He had an anomalous bypass of the VA and therefore no symptomatic hemodynamic changes. Thus, non-hemodynamic BHS should be considered in juvenile patients with vertebrobasilar stroke.
Clinical medicine insights. Case reports. 01/2010; 3:1-4.
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to evaluate the feasibility of magnetic resonance angiography (MRA) with midsagittal saturation for depiction of superficial temporal artery-to-middle cerebral artery bypass flow.
Eleven patients undergoing bypass surgery in 13 regions were examined by external carotid artery angiography (ECAG) and 3-dimensional time-of-flight MRA with saturation pulse applied to the midsagittal plane covering the internal carotid arteries. We classified the extent of visualization of bypass flow into 4 types and examined the agreement of findings between them.
The MRA revealed types of bypass flow in agreement with those observed on ECAG in 10 of the 13 regions. The MRA underestimated bypass flow in 2 regions and overestimated it in 1 region.
The MRA with midsagittal saturation demonstrated bypass flow in agreement with ECAG in most cases. Application of MRA with midsagittal saturation permits noninvasive assessment of physiological flow from superficial temporal artery-to-middle cerebral artery bypass for a postoperative follow-up.
Journal of computer assisted tomography 01/2010; 34(1):89-92. · 1.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 77-year-old man presented with transient motor weakness of the left hand. Cerebral angiography showed 90% stenosis at the origin of the right internal carotid artery. Carotid artery stenting (CAS) was performed 3 weeks later, and a large intraluminal thrombus was found during the procedure. The blood around the thrombus was aspirated using an aspiration catheter under distal protection with a filter wire protection device, and CAS was successfully performed without complications. Although this patient was treated by CAS without complications, carotid stenosis associated with intraluminal thrombus-because it has a high risk of distal embolism-should be carefully diagnosed immediately before CAS.
Japanese journal of radiology 11/2009; 27(9):367-70. · 0.65 Impact Factor
-
Masahiko Sakamoto,
Toshiaki Taoka, Hiroyuki Nakagawa,
Katsutoshi Takayama,
Takeshi Wada,
Kaoru Myouchin,
Toshiaki Akashi,
Toshiteru Miyasaka,
Akio Fukusumi,
Satoru Iwasaki,
Kimihiko Kichikawa
[show abstract]
[hide abstract]
ABSTRACT: The purpose is to investigate the feasibility of magnetic resonance (MR) plaque imaging in predicting the arterial flow impairment (slow-flow phenomenon) during carotid artery stenting (CAS) using a filter-type protection device.
Thirty-one carotid artery stenotic lesions in 30 patients (28 men and two women; mean age, 71.8 years) were evaluated by MR plaque imaging with black blood T1- and T2-weighted and time-of-flight sequences before CAS. Main plaque components were classified as vulnerable (intraplaque hemorrhage and lipid-rich/necrotic core) or stable (fibrous tissue and dense calcification) from the signal pattern. The plaque classification was statistically compared with the occurrence of slow-flow phenomenon.
The slow-flow phenomenon was observed in ten CAS procedures (five flow arrests and five flow reductions). Flow arrests consisted of four vulnerable and one stable plaque, and flow reductions consisted of four vulnerable and one stable plaque. The slow-flow phenomenon occurred significantly (P<0.01) more frequently in patients with vulnerable plaque.
Vulnerable carotid plaques have a significantly higher risk of slow-flow phenomenon than stable plaques. The occurrence of the slow-flow phenomenon can be predicted by MR plaque imaging before CAS.
Neuroradiology 11/2009; 52(4):275-83. · 2.82 Impact Factor
-
Kozue Saito,
Makito Hirano,
Toshiaki Taoka, Hiroyuki Nakagawa,
Takanori Kitauchi,
Emi Tanizawa,
Koichi Yoshida,
Yoshihiko Sakurai,
Kentaro Tamura,
Hiroyuki Nakase,
Akira Yoshioka,
Toshisuke Sakaki,
Kimihiko Kichikawa,
Satoshi Ueno
[show abstract]
[hide abstract]
ABSTRACT: Rotational vertebral artery (VA) occlusion can cause ischemic strokes due to hemodynamic insufficiency and possibly artery-to-artery (A-to-A) embolism. The former is known as bow hunter's stroke. The latter has been proposed only from indirect evidence. We have described a 7-year-old boy with cerebral infarction associated with A-to-A embolism due to repetitive rotational VA occlusion. He had a mobile mural thrombus at the VA occlusion site on head rotation. Surgical treatment may effectively prevent recurrences.
Journal of neuroimaging: official journal of the American Society of Neuroimaging 11/2008; 20(3):284-6. · 1.72 Impact Factor
-
Toshiaki Taoka,
Hidehiro Hirabayashi, Hiroyuki Nakagawa,
Masahiko Sakamoto,
Satoru Kitano,
Junko Takahama,
Nagaaki Marugami,
Katsutoshi Takayama,
Toshiaki Akashi,
Toshiteru Miyasaka,
Satoru Iwasaki,
Naoko Kurita,
Toshisuke Sakaki,
Kimihiko Kichikawa
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to assess the usefulness of signs ("Sukeroku sign" and "dent internal-capsule sign") for the recognition of subthalamic nucleus (STN).
Five Parkinson's disease cases in which there was a successful placement of deep brain stimulation (DBS) electrodes at the STN were retrospectively reviewed. Five radiologists who were not engaged in localization of STNs in clinical practice were asked to locate the STNs before and after instructions on the signs. We evaluated the deviation between the reader-located points and the location of the DBS electrode for which there had been a successful installation.
After instruction, there was a significant reduction in the deviation between the reader-located points and the DBS electrode. The time required for localization was also reduced after the instructions.
Sukeroku sign and dent internal-capsule sign are feasible indicators of STN and seem to be useful in helping to identify the STN.
Neuroradiology 10/2008; 51(1):11-6. · 2.82 Impact Factor
-
Katsutoshi Takayama, Hiroyuki Nakagawa,
Satoru Iwasaki,
Toshiaki Taoka,
Toshiteru Miyasaka,
Kaoru Myouchin,
Takeshi Wada,
Masahiko Sakamoto,
Akio Fukusumi,
Ichiro Nakagawa,
Shinichiro Kurokawa,
Kimihiko Kichikawa
[show abstract]
[hide abstract]
ABSTRACT: No filter protection devices for carotid artery stenting (CAS) have been formally approved for use in Japan; however, as of April 2008, the Angioguard XP (AGXP) was approved. This article describes our initial results using the AGXP during CAS for the treatment of carotid artery stenosis.
A group of 15 patients (14 men) with a mean age of 72.3 years (range 53-81 years) were treated by CAS using the AGXP. Among them, 10 were symptomatic with >50% stenosis of the common or internal carotid artery (ICA), and 5 were asymptomatic with >70% stenosis. The rates of technical success, periprocedural stroke, ICA flow impairment, filter movement, and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed.
CAS using the AGXP was successful in all cases. There was one minor stroke, and flow impairment occurred in six patients. Filter movement averaged 1.9 vertebral bodies. DWI showed new ipsilateral ischemic lesions in eight of the patients.
Initial clinical experience using the AGXP for CAS has been generally sufficient. However, attention must be paid to three problems when using the AGXP: the filter may move after placement; the filter may disturb blood flow in the ICA; and debris may pass around the filter.
Radiation Medicine 07/2008; 26(6):348-54.
-
Chatchada Wuttikul,
Toshiaki Taoka,
Toshiaki Akashi, Hiroyuki Nakagawa,
Toshiteru Miyasaka,
Masahiko Sakamoto,
Katsutoshi Takayama,
Takeshi Wada,
Satoru Kitano,
Junko Takahama,
Nagaaki Marugami,
Kimihiko Kichikawa
[show abstract]
[hide abstract]
ABSTRACT: This study discusses prominent signal intensity of T(1)/T(2) prolongation of subcortical white matter within the anterior temporal region in premature infant brains that radiologists may encounter when interpreting conventional screening MRIs.
T(1)- and T(2)-weighted images of 69 preterm and term infants with no neurological abnormalities or developmental delays were evaluated retrospectively for areas of prominent signal intensity of T(1)/T(2) prolongation in white matter. We measured signal intensities of anterior temporal white matter, deep temporal white matter, frontopolar white matter and subcortical white matter of the precentral gyrus. We accessed chronological changes in signal intensity in the anterior and deep temporal white matter. We also analyzed variance tests among the signal intensity ratios to the ipsilateral thalamus of white matter areas by gestational age.
There was high frequency of prominent signal intensity of T(1)/T(2) prolongation in the temporal tip, particularly at a gestational age of 36-38 weeks. Signal intensity ratio of the anterior temporal white matter was lower on T(1)-weighted images and higher on T(2)-weighted images, and the finding became less prominent with increasing gestational age. The signal intensity ratios of anterior temporal white matter at a gestational age of 36-37 weeks and 38-39 weeks were significantly different from other regions.
Prominent signal intensity of T(1)/T(2) prolongation of subcortical white matter of the anterior temporal region is seen in normal premature infants, especially those at 36-39 gestational weeks. Although it is a prominent finding, radiologists should understand that these findings do not represent a pathological condition.
Magnetic Resonance Imaging 07/2008; 26(10):1374-80. · 1.99 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The cerebrovascular complications of Takayasu arteritis are primarily related to the presence of occlusive lesions. Cerebral aneurysms rarely occur as complications; only 18 cases have been reported thus far. The use of coil embolization to treat cerebral aneurysms occurring as a complication of Takayasu arteritis has not been previously reported. We report a case of Takayasu arteritis with a basilar tip aneurysm and a P1 segment aneurysm of the left posterior cerebral artery that were successfully treated with coil embolization. Because coil embolization for cerebral aneurysms associated with Takayasu arteritis requires the use of limited access routes that have extremely curved and tortuous courses, catheter navigation was difficult. The guide catheter, microcatheter, and guidewire must be selected and navigated with greater care than is usually required for common aneurysm embolization.
Radiation Medicine 02/2008; 26(1):33-8.
-
[show abstract]
[hide abstract]
ABSTRACT: Recognizing cerebral hyperperfusion syndrome with intracerebral hemorrhage following carotid artery stenting is critical because the mortality rate is high. This type of hemorrhage usually arises from within several hours to a few days after the procedure. Here we describe a putaminal hemorrhage with extravasation during angiography that developed immediately after carotid artery stenting. A search of the literature revealed only one other similar case report. The etiology of the intracerebral hemorrhage immediately after carotid stenting might be analogous to that of hypertensive hemorrhage.
Radiation Medicine 09/2007; 25(7):359-63.
-
Toshiaki Taoka,
Tesseki Kin, Hiroyuki Nakagawa,
Makito Hirano,
Masahiko Sakamoto,
Takeshi Wada,
Katsutoshi Takayama,
Chatchada Wuttikul,
Satoru Iwasaki,
Satoshi Ueno,
Kimihiko Kichikawa
[show abstract]
[hide abstract]
ABSTRACT: This study accessed the feasibility of using tractography-based analysis to evaluate the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of three cerebellar peduncles in subtypes of spinocerebellar degenerative disease.
We examined 7 cases of dentatorubro-pallidoluysian atrophy (DRPLA), 4 cases of multiple system atrophy, cerebellar type (MSA-C), 4 cases of late cerebellar cortical atrophy (LCCA) and 8 controls. Diffusion tensor images were obtained, and tractographies of cerebellar peduncles were generated. ADC and FA along the cerebellar peduncles and volume of cerebellar peduncle were measured, and analyses of variance were made among the control and each spinocerebellar degenerative disease groups.
There were statistically significant decrease in FA and volume and increase in ADC values between DRPLA cases and controls in all three cerebellar peduncles. On the other hand, MSA-C cases mainly showed statistically significant decreased FA and volume and increased ADC values in the middle cerebellar peduncle. LCCA cases did not show prominent difference in the three cerebellar peduncles.
The values of diffusivity and diffusion anisotropy of cerebellar peduncles evaluated by tractography based measurements seem to reflect characteristics of the different types of spinocerebellar degenerative diseases. Tractography-based measurements may be a feasible tool for differential diagnosis of spinocerebellar degenerative disease.
NeuroImage 09/2007; 37(2):387-93. · 5.89 Impact Factor
