Masahiko Fujii

Hyogo Brain and Heart Center, Himezi, Hyōgo, Japan

Are you Masahiko Fujii?

Claim your profile

Publications (66)92.63 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the efficacy of intraarterial infusion of CO2-saturated solution in rabbit VX2 thigh tumors. Fourteen Japanese white rabbits had VX2 tumors implanted in the right femoral muscle 3 weeks before intraarterial infusion. Rabbits were divided into control and CO2 groups (n = 7 each). Fifty milliliters of solution (saline solution and CO2-saturated solution for the control and CO2 groups, respectively) was administered via a 24-gauge catheter in the ipsilateral iliac artery close to the feeding artery of the VX2 tumor. All rabbits were killed for tumor harvest on day 3 after the procedure. Tumor volume was evaluated with in vivo direct caliper measurement and contrast-enhanced computed tomography (CT). Tumor apoptotic changes were examined by DNA fragmentation assay and immunoblot analysis. The tumor growth ratio and apoptotic cell rate were analyzed. Body weight was equally increased in both groups, but the mean tumor growth ratio was significantly decreased in the CO2 group compared with the control group (-9.5% ± 7.9 vs 27.2% ± 6.6 and 4.1% ± 4.4 vs 35.7% ± 4.5 measured by calipers and contrast-enhanced CT, respectively; P < .01). Apoptotic activity in the CO2 group was higher than in the control group (number of apoptotic cells per area, 215.0 ± 58.7 vs 21.8 ± 5.4; adjusted relative density of cleaved caspase-3, 0.23 ± 0.07 vs 0.04 ± 0.01; P < .01). Intraarterial infusion of CO2-saturated solution inhibits rabbit VX2 thigh tumor growth by activation of apoptotic cell death through cleaved caspase-3 upregulation.
    Journal of vascular and interventional radiology: JVIR 01/2014; · 1.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was (1) to assess the diagnostic accuracy of 320-detector row computed tomography (CT) for paraclinoid and intracavernous aneurysms, and (2) to investigate whether this method provides sufficient information for surgery. A total of 14 patients with 16 unruptured proximal ICA aneurysms underwent three-dimensional CT angiography (3D-CTA) fusion imaging, which was created by superimposing 3D-CT venography data and/or 3D-bone data onto 3D-CTA data using 320-detector row CT, magnetic resonance imaging (MRI), and 3D digital subtraction angiography (DSA). The images of each modality were assessed using intraoperative findings as the reference standard. All aneurysms were clearly visualized on 320-detector row CT. Bone subtraction and arterio-venous discrimination were accurate. On 3D-CTA fusion images, 11 aneurysms were diagnosed as "extracavernous" and five as "intracavernous". No discordance in aneurysm location between the 3D-CTA fusion images and the intraoperative findings was found. In contrast, discordance between MRI and intraoperative findings were found in five of the 16 cases (31 %), which was significantly more frequent than with 3D-CTA (p = 0.043). The findings DSA, which was performed in nine patients, were also in excellent agreement with the intraoperative findings. However, 3D-CTA fusion imaging provided more comprehensive information, including venous and osseous structures, than 3D-DSA. The 320-detector row CTA after surgery demonstrated a clear relationship between the clip and aneurysmal neck with notably few artifacts, which suggested the utility of this modality for postoperative assessment. The 320-detector row CT provided high accuracy for the diagnosis of paraclinoid and intracavernous aneurysms. This technique also provided comprehensive depiction of the aneurysms and surrounding structures. Therefore, this modality might be useful for the diagnosis of the paraclinoid and intracavernous aneurysms and for developing a surgical treatment plan.
    Acta Neurochirurgica 01/2014; · 1.55 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Malignant peripheral nerve sheath tumor (MPNST) involving bone is rare. We report a case of MPNST of the fifth toe. The lesion was located in the distal phalanx of the right fifth toe and extended into surrounding subcutaneous tissues. Findings on magnetic resonance imaging and histological features of the case are described and the literature is briefly reviewed.
    Acta radiologica short reports. 01/2014; 3(1):2047981613516033.
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE The purpose of this study was to study early stages of alteration of adjacent discs both above and below the affected segment after posterior vertebral fusion, and to demonstrate the potential benefits of biochemical magnetic resonance imaging (MRI) T2 mapping of intervertebral discs with regards to detection of the early stages of degenerative disc disease. METHOD AND MATERIALS From March 2010 to April 2013, 25 patients (22 female and 3 male) with a mean age of 68.2 years (range, 54-83 years) who underwent posterior lumbar fusion were included in this study. The patients underwent follow-up MRI for over two years. In total, MRIs of over 300 discs were evaluated: one disc in an adjacent segment above an affected lumbar disc, and one disc in an adjacent segment below an affected lumbar disc at each follow-up point. For two upper vertebrae, one disc was selected as a control disc. Selected discs were divided into three parts: anterior annulus fibrosus (AF), posterior AF, and nucleus pulposus (NP). One-Way Repeated-Measures ANOVA and post-hoc tests according to the Tukey test were performed to evaluate the significance of the variation in T2 mapping between 3-months, 1-year, and 2-years of follow-up. A p value of less than 0.05 was considered statistically significant. RESULTS After posterior lumbar fusion, adjacent segment disc T2 values decreased mainly in the anterior AF. The adjacent segment above the affected fused disc had a significantly larger degree of decrease in T2 values compared to below the affected fused disc. There was no significant relationship between T2 values and degree of fusion and the number of fused discs. CONCLUSION Adjacent segment disc degeneration may be caused by altered lumbar biomechanics, which occurs in the anterior AF after lumbar fusion. T2 mapping can be used to detect early stages of alteration in adjacent discs after posterior vertebral fusion. CLINICAL RELEVANCE/APPLICATION Clarification of the factors that effect ASD could be used to select patients who would benefit from operative therapy and to show the benefits of T2 mapping for understanding early disc degeneration.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE. The purpose of this study was to assess the therapeutic effect of lymphangiography for refractory postoperative chylothorax and chylous ascites and analyze the relation between the clinical outcomes and radiologic findings or response to the preceding medical treatment. MATERIALS AND METHODS. Between January 2004 and June 2012, 14 patients underwent lymphangiography. All patients had been unresponsive to at least two medical treatments for 3-62 days (median, 13.5 days) before lymphangiography. Leaks were classified as major, minor, and undetectable on the basis of radiologic findings including CT and conventional radiography after lymphangiography. The clinical outcomes were correlated with the radiologic findings or the changes of the daily chylous output after the preceding medical treatments. RESULTS. The leaks were healed in nine of 14 patients (64.3%) by 3-29 days (median, 8 days) after lymphangiography. Healing was achieved for two of seven major leaks, and all of the minor leaks (n = 4) and undetectable leaks (n = 3) after lymphangiography. The remaining five major leaks were not healed after a median follow-up of 15 days. The daily output decreased more than half after medical treatment in seven of the 14 patients, and the leak was healed in six of these patients (85.7%) by 5-18 days (median, 10 days). CONCLUSION. Lymphangiography might be useful for the treatment of refractory postoperative chylothorax and chylous ascites.
    American Journal of Roentgenology 09/2013; 201(3):659-66. · 2.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to evaluate the sensitivity of ultrashort echo time (uTE) sequence for visualisation of calcified deep layers of articular cartilage. MRI with a uTE sequence was performed on five healthy volunteers. Signals from the calcified deep layers of the articular knee cartilage were evaluated on uTE subtraction images and computed tomography images. The calcified deep layers of the articular cartilage changed from having a low to a high signal when imaged with a uTE sequence. The reported uTE sequence was effective in imaging the deep layers of the knee cartilage.
    Journal of Medical Imaging and Radiation Oncology 06/2012; 56(3):318-23. · 0.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the degree of the effect of aging and weight-bearing on T1rho values in normal cartilage. Thirty-two asymptomatic patients were examined using 3.0-T magnetic resonance imaging (MRI) to determine knee cartilage T1rho values and T2 values. The femoral and tibial cartilage was divided into weight-bearing (WB-Rs) and less-weight-bearing (LWB-Rs) regions. Single regression analysis was used to assess the relationship between cartilage T1rho values and age and between T2 values and age. Analysis of variance and post hoc-testing were used to evaluate differences in WB-Rs and LWB-Rs cartilage T1rho values and T2 values. Multiple linear regression modeling was performed to predict cartilage T1rho values. Cartilage T1rho values correlated positively with age for all cartilage regions tested (p<0.001). There were no significant correlations between cartilage T2 values and age. In both the medial femoral and tibial cartilage, T1rho values were significantly higher in WB-Rs than in LWB-Rs (p<0.05). There were no significant differences in T2 values between WB-Rs and LWB-Rs. Multiple linear regression analysis showed that both age and weight-bearing were significant predictors of increased medial knee cartilage T1rho values (p<0.001). Aging and the degree of weight-bearing correlate with the change in cartilage T1rho values. Based on multiple regression modeling, aging may be a more important factor than weight-bearing for cartilage T1rho values.
    European journal of radiology 04/2012; 81(7):e796-803. · 2.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Xeroderma pigmentosum group A (XPA) is a hereditary dermatological disease in which hypersensitivity to ultraviolet radiation and various neurological symptoms are observed. In this study, to evaluate the degeneration occurring in the brain of XPA patients, neurological examinations by an established neurologist and 3-Tesla magnetic resonance imaging (MRI) were performed in 10 Japanese XPA patients. MRI studies included diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) in addition to conventional sequences. Neurological examinations revealed various deteriorations in the both central and peripheral nervous systems in all subjects. MRI studies demonstrated age-dependent decline in multimodalities. Severe brain atrophy in conventional sequences, decreased fractional anisotropy (FA) value in DTI, and reduced NAA/Cre ratio in MRS were observed in the adult patients. Multimodal MRI studies unmask the neurological deterioration in XPA patients.
    Brain and behavior. 01/2012; 2(1):1-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this study, we reviewed characteristic diagnostic findings of vascular diseases in the central nervous system with 3-dimensional computed tomographic angiography (3D-CTA) using multi-detector row computed tomography (MDCT) and a novel 320-row area detector CT (320-ADCT). With coverage of 160 mm in a single rotation, 320-ADCT enables acquisition of both 4-dimensional CT angiography (dynamic 4D-CTA) and whole-brain CT perfusion imaging. We describe our experience of investigating cerebrovascular diseases with MDCT and 320-ADCT, as well as several postprocessing techniques to acquire images useful for diagnosis, therapy planning, and simulation of neurosurgical and endovascular intervention. 3D-CTA demonstrates has high accuracy in detecting and evaluating cerebral aneurysms and steno-occlusive diseases. Angiographic analysis, including information of surrounding tissues on 3D-CTA, allows assessment of the feasibility of neurosurgical or endovascular approaches and the technique to accomplish the therapy. However, 3D-CTA using MDCT is limited in its detection of aneurysms less than 3 mm in size and aneurysms embedded in the skull base region. In addition, discrimination between intradural paraclinoid aneurysms and extradural intracavernous aneurysms remains an unresolved problem in imaging of cerebral aneurysms. 320-ADCT may solve this problem with its high accuracy in discriminating arteries from the venous system. 3D-CTA could be used as an alternative to DSA for detection of severe carotid artery disease. 3D-CTA enables measurement of the lesions, plaque imaging, prediction of anatomical variants, screening for asymptomatic vascular lesions, and exclusion of patients with risk factors from carotid endoarterectomy (CEA) or carotid artery stenting (CAS). The diagnosis of intracranial dural arteriovenous fistula (DAVF) with CTA is challenging. Recently, several authors proposed diagnostic findings of ADVF by CTA and reported high sensitivity and specificity. 320-ADCT may offer comprehensive information for diagnosis and therapy planning of intracranial DAVF. Although DSA is a standard modality to detect spinal vascular malformations, selective catheterization requires considerable time and a certain amount of contrast medium, and is associated with a risk of neurological complications. Spinal 3D-CTA prior to DSA is useful in selective catheterization to arteries at certain spinal levels as well as when considering treatment options and therapy planning.
    Brain and nerve = Shinkei kenkyū no shinpo 09/2011; 63(9):923-32.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hypothyroidism is a common complication in patients receiving tyrosine kinase inhibitors. We evaluated the relationship between thyroid size evident on CT and thyroid function in patients with advanced renal cell carcinoma (RCC) receiving tyrosine kinase inhibitors. Forty-two patients with metastatic RCC receiving tyrosine kinase inhibitors (sorafenib n=25; sunitinib n=17) and, followed-up for ≥12 months were eligible. Patients who had ever shown an elevated thyroid-stimulating hormone (TSH) level of >10 mU/l were defined as having "hypothyroidism". CT scans were performed before, and 3, 6, 9, and 12 months after the start of treatment. The area of the thyroid in the maximum section at each examination was measured and compared with that before treatment. Using repeated-measures ANOVA, differences in thyroid size were compared over time between patients with and without "hypothyroidism", in relation to the type of drug employed. Twenty-one patients (sorafenib 9, sunitinib 12) developed "hypothyroidism" 95±88 days (range 12-315 days) after the start of treatment. In such patients, the thyroid was reduced in size to 89±16% after 3 months, 81±21% after 6 months, 71±21% after 9 months and 68±21% after 12 months, whereas the patients without "hypothyroidism" maintained a thyroid size of 90±12% even after 12 months (p=0.0030). Among the patients with "hypothyroidism", those treated with sunitinib tended to show greater thyroid size reduction than those with sorafenib (59±23% vs. 79±13%, after 12 months). Tyrosine kinase inhibitors cause an apparent thyroid size reduction in patients with "hypothyroidism".
    European journal of radiology 07/2011; 81(9):2060-5. · 2.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of our study is to investigate whether there is an age-related change in T1 rho values and to evaluate the effects of weight bearing on age-related increase in T1 rho values of normal cartilage. Thirty-two asymptomatic patients were examined using a 3.0T MRI to determine knee cartilage T1 rho values. Femorotibial and patella cartilage was defined as weight-bearing cartilage (WB-C) and non-weight-bearing cartilage (NWB-C), respectively. The femoral cartilage was divided into weight-bearing (WB-P) and less-weight-bearing (LWB-P) portions. Pearson's correlation coefficient and single regression analysis were used to assess the relationship between cartilage T1 rho values and age. The slopes of the regression lines of cartilage T1 rho values and age were compared between WB-C and NWB-C and between WB-P and LWB-P. Cartilage T1 rho values correlated positively with aging for all cartilage regions and all age groups (p<0.001). In the medial femoral cartilage, the age-related increase in T1 rho values was significantly greater for WB-P than for NWB-P (p<0.05). For several cartilage regions, this increase was greater for WB-C than for LWB-C (p<0.05). The T1 rho value is very sensitive to age-related cartilage degeneration and weight bearing-related degeneration, and hence may be a very sensitive and useful measure for the early diagnosis of osteoarthritis.
    The Kobe journal of medical sciences 01/2011; 57(4):E155-70.
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE To directly and prospectively compare capability for distinguishing malignant from benign nodules between profile curve assessment and standard uptake value (SUV) measurement on FDG-PET/CT in patients with solitary pulmonary nodule (SPN) . METHOD AND MATERIALS Sixty-one patients (41males, 20females; mean age, 69years) with 61 SPNs underwent FDG-PET/CT with standard technique, microbacterial and pathological examinations from specimens obtained with transbronchial and CT-guided biopsies and/ or surgical resections, and more than 2-years follow up examinations. Final diagnosis of each patient was based on pathological examinations and/ or follow up examinations. On each SPN, maximum value of SUV (SUVmax) and maxim gradient from profile curve of SUV (SUVmax gradient) within each SPN were assessed by using ROI measurements. To compare two indexes between malignant and benign nodules, Student’s test were performed. Then, diagnostic capabilities of two indexes were evaluated by using ROC analyses, feasible threshold values of both indexes were determined. Finally, sensitivity, specificity and accuracy of each index were compared each other by means of McNemar’s test. RESULTS SUVmax and SUVmax gradient had significant difference between malignant and benign nodules (p<0.05). Area under the curve (Az) of SUVmax (Az=0.71) had no significant difference with that of SUVmax gradient (Az=0.78, p>0.05). Feaslble threshold values of SUVmax and SUV max gradient were determined as 2.9 and 1.9, respectively. Sensitivity (79.2 [42/53] %) and accuracy (77.0 [47/61] %) of SUVmax gradient were significantly higher than those of SUVmax (sensitivity: 64.2 [34/53] %, p<0.05; accuracy: 63.9 [39/61] %, p<0.05). CONCLUSION Profile curve assessment within ROI is more sensitive and accurate method than SUVmax measurement for distinguishing malignant SPNs from benign SPNs on FDG-PET/CT. CLINICAL RELEVANCE/APPLICATION For differentiation of malignant SPNs from benign SPNs, profile curve assessment on FDG-PET/CT is more sensitive and accurate method than SUVmax measurement in routine clinical practice.
    Radiological Society of North America 2010 Scientific Assembly and Annual Meeting; 12/2010
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate two different iodine concentrations of contrast material for detecting hypervascular hepatocellular carcinomas (HCCs) in cirrhotic liver by multi-detector row helical CT (MDCT) when a fixed contrast material volume and injection rate is used. Institutional Review Board approval was obtained, and informed consent was obtained from all patients. In this prospective study, 105 patients were randomly assigned a group A (an iodine concentration of 300 mg I/mL), and a group B (an iodine concentration of 370 mg I/mL). In both groups the volume of contrast material was 100 mL and the injection rate was 4 mL/s. Fifty-two patients had 122 hypervascular HCCs. The diagnosis of HCCs was established histopathologically (n=24) and by imaging findings (n=98). Three readers independently analyzed four image sets: an arterial phase (AP), a portal phase (PP), an equilibrium phase (EP), and combined all three phase images set. Sensitivity, specificity, and diagnostic accuracy were calculated by receiver operating characteristic (ROC) analysis. The mean sensitivity for detecting hypervascular HCCs of the AP set, EP set, and combination set in group B (0.94, 0.81, and 0.93) was significantly higher than in group A (0.84, 0.69, and 0.80). Area under the ROC curve of the AP set and the combination set in group B (0.974 and 0.981) was significantly higher than in group A (0.939 and 0.958). At the same contrast material volume and injection rate, higher iodine concentration of contrast material was effective for detecting hypervascular HCCs by MDCT.
    European journal of radiology 11/2010; 80(3):e237-42. · 2.65 Impact Factor
  • European journal of dermatology: EJD 10/2010; 20(6):847-8. · 1.95 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The rodent static compression loading-induced disc degeneration model still has important gaps among the radiographic, magnetic resonance imaging (MRI), and histological schemes and the acute and chronic expression of catabolic genes such as matrix metalloproteinase (MMP)-3. Our objectives were to assess the validity of a rat tail two-disc static compression model and to elucidate a representative catabolic marker, MMP-3 gene alterations, throughout the degenerative process. Static compression at 1.3 MPa for up to 56 days produced progressive disc height loss in radiographs, lower nucleus intensity on T2-weighted MRIs, and histomorphological degeneration. Real-time RT-PCR mRNA quantification showed significant MMP-3 up-regulation in nucleus pulposus cells from 7 days and a significantly progressive increase as the loading duration lengthened, with high correlations to radiological degenerative scores. Immunohistochemistry demonstrated progressively increased positive staining for MMP-3. These results validate this animal model for disc degeneration research. Progressive mRNA and protein-distributional up-regulations indicate the significant role of MMP-3 and its feasibility as a disc degenerative marker. This model should prove useful for investigating the pathomechanism and for evaluating molecular therapies for degenerative disc disease.
    Journal of Orthopaedic Research 02/2010; 28(8):1026-32. · 2.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Our aim was to clarify the mechanism by which perceptual learning improves motor skills of hands. We included 18 healthy volunteers (age 21.3 ± 0.3 years, mean ± standard deviation) in the study with a crossover design. The subjects were randomly classified into 3 groups, and they performed a 2-ball quick rotation task with a hand. The role of perceptual learning in improving the ability to discern the length of a wooden stick held between the left thumb and index finger was studied between the first and second sessions of the task in group A, and between the second and third sessions in groups B and C with a period of rest interval between the first and second sessions. Functional magnetic resonance imaging (fMRI) was performed for each group during the perceptual learning session. The effect of intervention, in the form of perceptual learning, on the task performance was significantly greater than that of non-intervention in all subjects (p = 0.022). Among all the activated brain areas, the bilateral prefrontal cortices, right premotor area, right supplementary motor area, right primary sensory area, right primary motor area, right inferior parietal lobe, right thalamus, and left cerebellar posterior lobe showed positive correlations between the respective contrasts from the single-subject analysis and the behavioral data before and after the interventions (p < 0.001). This result indicates a pivotal role of the frontoparietal or frontocerebellar circuits in sensorimotor integration; a specific approach that activates these circuits should be developed for clinical rehabilitation of patients.
    The Kobe journal of medical sciences 01/2010; 56(1):E29-37.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Our findings demonstrate that functional MRI (fMRI) combined with a questionnaire is a useful method for studying the neuroanatomy of olfaction. Further studies with various odorants and questionnaires would provide an even better understanding of the mechanism of olfactory perception. To better understand the mechanism of odorant perception in the central nervous system. fMRI was used to identify the activated regions during stimulation by two odorants, beta-phenyl ethyl alcohol and gamma-undecalactone. Participants were asked to describe the quality of the odor and to rate odor intensity and odor hedonic valence. Activation at each region was statistically analyzed according to the answers. The bilateral middle orbitofrontal cortex (OFC), left lateral OFC, right insula, and bilateral anterior/middle cingulate gyri were most frequently activated by odor stimulation. Left middle OFC was significantly more often activated in the participants who could not identify the odor correctly (p = 0.016). The left middle OFC and right lateral OFC were significantly more often activated in the participants who perceived the odor stimulation as unpleasant (p = 0.03), while the right anterior cingulate gyrus was more often activated in those who perceived the odor as pleasant (p = 0.03).
    Acta oto-laryngologica. Supplementum 06/2009;
  • [Show abstract] [Hide abstract]
    ABSTRACT: This prospective study analyzed preoperative and postoperative dynamic changes of the spinal cord in patients with cervical spondylotic myelopathy. (1) To study preoperative kinematic characteristics of the spinal cord in patients with cervical spondylotic myelopathy and compare results with healthy individuals, (2) to understand the dynamic changes of the spinal cord after posterior decompression, and (3) to discover whether the degree of posterior shifting is correlated with surgical outcomes using kinematic magnetic resonance imaging (MRI). Laminoplasty for cervical myelopathy increases the space occupied by the spinal cord leading to a decompressive effect on the cord. However, no consecutive studies have reported the kinematic characteristics of the cervical spine in patients with cervical spondylotic myelopathy both preoperatively and postoperatively. Additionally, there have been no reports investigating the effects of posterior cord shifting in the neutral and maximum flexion and extension positions on surgical outcomes after cervical laminoplasty. Twenty cervical spondylotic myelopathy patients who underwent extensive laminoplasty and 20 healthy individuals were examined. Preoperative and postoperative MRI records were available in all cases. The cervical spines of the subjects were examined in the neutral and maximum flexion and extension positions using an MRI scanner. Sagittal T1-weighted images were obtained at 12 different angles. Images were analyzed for the distance between the dorsal edge of the vertebral column and the center of the cord at each disc level using NIH image software. Average cord distances (L value) in the neutral position and maximum extension position at C4/5 was significantly smaller than those at the other disc levels. The spinal cords of the patients after laminoplasty moved dorsally in the enlarged spinal canal in the neutral position, and in the maximum flexion and extension position. However, the degree of posterior spinal cord shifting was not correlated with surgical outcomes. Cord distances are relatively smaller at C4/5 and C5/6 levels, resulting in a narrowing of the posterior subarachnoid space with posterior cord compression in patients with cervical spondylotic myelopathy. The outcome of surgery was not correlated with the magnitude of postoperative backward shifting of the spinal cord, although the spinal cord of patients after posterior decompression moved significantly dorsally at any of the flexed, neutral, or extended spinal positions. Thus numerous factors might affect the postoperative outcomes.
    Journal of spinal disorders & techniques 03/2009; 22(1):8-13. · 1.21 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of our study was to retrospectively assess the safety and efficacy of endovascular treatment for branch stenosis or obstruction after branched graft replacement in patients with thoracoabdominal aortic aneurysm or aortic arch aneurysm. Seven patients (all men; median age, 62 years; age range, 19-79 years) who had undergone aortic surgery using branched grafts between March 2004 and January 2007 were treated. Diagnosis was established on dynamic contrast-enhanced CT or angiography. A self- or balloon-expandable stent was placed after predilatation with a balloon catheter and, if necessary, thrombolysis was also performed. Stent patency was assessed on thin-slice axial images obtained during the arterial phase on dynamic contrast-enhanced CT. Seven lesions (one celiac artery, two left subclavian arteries, and four renal arteries) were treated. The time between the surgery and treatment was 0-3 days for patients with abdominal lesions and 20-41 days for those with thoracic lesions. Stent placement was successful in five of the seven patients. In one patient, insertion of the stent delivery system was unsuccessful; in the other patient, the stent was not completely expanded. The clinical symptoms and abnormal laboratory data improved in all patients with successful procedures. No restenosis was observed on imaging follow-up, with a median patency of 104 days (range, 5-1,218 days) during clinical follow-up (range, 37-1,218 days; median, 135 days). Endovascular repair can be an alternative treatment for visceral vessel complications of branched grafts, especially in obstructed but peripherally patent branches.
    American Journal of Roentgenology 11/2008; 191(4):1175-81. · 2.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In patients with the cerebellar variant of multiple system atrophy (MSA-C), reduced fractional anisotropy (FA) has been reported in several brain areas. However, since previous studies have employed predetermined regions of interest (ROI), the brain areas showing the earliest alterations in FA are unknown. The sensitivity of detecting early-stage MSA-C and the time course of the FA reduction are also unknown. The purpose was to address these issues to determine the diagnostic value of FA for early diagnosis. Twenty-one patients with MSA-C were investigated. Voxel-based FA analysis and morphometry were used to detect the differences between early-stage MSA-C and normal controls. An ROI-based FA analysis was also used to clarify the temporal profile. From the early-stage, MSA-C patients exhibited reduced FA and white matter atrophy in the middle cerebellar peduncle, the inferior cerebellar peduncle, and the ventral pons. The FA of these areas decreased rapidly during the first few years after onset, after which a rather gradual reduction occurred. The receiver operating characteristics analysis revealed a high sensitivity and specificity for discriminating early MSA-C from normal controls. FA measurement could potentially be used to make an early diagnosis and monitor progression in MSA-C patients.
    Journal of neuroimaging: official journal of the American Society of Neuroimaging 06/2008; 19(2):127-31. · 3.36 Impact Factor

Publication Stats

642 Citations
92.63 Total Impact Points

Institutions

  • 2013
    • Hyogo Brain and Heart Center
      Himezi, Hyōgo, Japan
  • 2002–2011
    • Kobe University
      • • Division of Radiology
      • • Division of Orthopaedic Surgery
      Kōbe, Hyōgo, Japan
  • 2010
    • National Cancer Center, Japan
      • Department of Diagnostic Radiology
      Edo, Tōkyō, Japan
  • 2006
    • Thomas Jefferson University
      • Division of Magnetic Resonance Imaging
      Philadelphia, PA, United States