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1.
AJNR Am J Neuroradiol ; 30(5): 923-9, 2009 May.
Article in English | MEDLINE | ID: mdl-19213825

ABSTRACT

BACKGROUND AND PURPOSE: Early accurate diagnosis of brain metastases is crucial for a patient's prognosis. This study aimed to compare the conspicuity and detectability of small brain metastases between contrast-enhanced 3D fast spin-echo (sampling perfection with application-optimized contrasts by using different flip angle evolutions [SPACE]) and 3D gradient-echo (GE) T1-weighted (magnetization-prepared rapid acquisition of GE [MPRAGE]) images at 3T. MATERIALS AND METHODS: Sixty-nine consecutive patients with suspected brain metastases were evaluated prospectively by using SPACE and MPRAGE on a 3T MR imaging system. After careful evaluation by 2 experienced neuroradiologists, 92 lesions from 16 patients were selected as brain metastases. We compared the shorter diameter, contrast rate (CR), and contrast-to-noise ratio (CNR) of each lesion. Diagnostic ability was compared by using receiver operating characteristic (ROC) analysis. Ten radiologists (5 neuroradiologists and 5 residents) participated in the reading. RESULTS: The mean diameter was significantly larger by using SPACE than MPRAGE (mean, 4.5 +/- 3.7 versus 4.3 +/- 3.7 mm, P = .0014). The CR and CNR of SPACE (mean, 57.3 +/- 47.4%, 3.0 +/- 1.9, respectively) were significantly higher than those of MPRAGE (mean, 37.9 +/- 41.2%, 2.6 +/- 2.2; P < .0001, P = .04). The mean area under the ROC curve was significantly larger with SPACE than with MPRAGE (neuroradiologists, 0.99 versus 0.88, P = .013; residents, 0.99 versus 0.78, P = .0001). CONCLUSIONS: Lesion detectability was significantly higher on SPACE than on MPRAGE, irrespective of the experience of the reader in neuroradiology. SPACE should be a promising diagnostic technique for assessing brain metastases.


Subject(s)
Algorithms , Brain Neoplasms/diagnosis , Brain Neoplasms/secondary , Echo-Planar Imaging/methods , Gadolinium DTPA , Image Interpretation, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Adult , Aged , Aged, 80 and over , Contrast Media , Humans , Image Enhancement/methods , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
2.
AJNR Am J Neuroradiol ; 30(5): 930-5, 2009 May.
Article in English | MEDLINE | ID: mdl-19246527

ABSTRACT

BACKGROUND AND PURPOSE: Moyamoya disease is an idiopathic occlusive cerebrovascular disorder with abnormal microvascular proliferation. We investigated the clinical utility of leptomeningeal high signal intensity (ivy sign) sometimes seen on fluid-attenuated inversion recovery images in Moyamoya disease. MATERIALS AND METHODS: We examined the relationship between the degree of the ivy sign and the severity of the ischemic symptoms in 96 hemispheres of 48 patients with Moyamoya disease. We classified each cerebral hemisphere into 4 regions from anterior to posterior. In 192 regions of 24 patients, we examined the relationship between the degree of the ivy sign and findings of single-photon emission CT, including the resting cerebral blood flow (CBF) and cerebral vascular reserve (CVR). RESULTS: The degree of the ivy sign showed a significant positive relationship with the severity of the ischemic symptoms (P < .001). Of the 4 regions, the ivy sign was most frequently and prominently seen in the anterior part of the middle cerebral artery region. The degree of the ivy sign showed a negative relationship with the resting CBF (P < .0034) and a more prominent negative relationship with the CVR (P < .001). CONCLUSIONS: The leptomeningeal ivy sign indicates decreased CVR in Moyamoya disease.


Subject(s)
Brain Ischemia/complications , Brain Ischemia/pathology , Cerebral Arteries/pathology , Magnetic Resonance Angiography/methods , Meningeal Arteries/pathology , Moyamoya Disease/complications , Moyamoya Disease/pathology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , Young Adult
3.
Stereotact Funct Neurosurg ; 86(6): 345-50, 2008.
Article in English | MEDLINE | ID: mdl-18854661

ABSTRACT

PURPOSE: A simple MRI postprocessing technique was developed to display superficial cerebral veins (SCVs) along with brain surface structures. MATERIALS AND METHODS: Thirty-one consecutive patients with brain tumors were studied. All patients underwent brain MR examination, from which three-dimensional (3D) images were reconstructed. Simulation images of craniotomy were created by cutting away the signal from the skull and scalp at the region corresponding to the window planned for surgery. Detectability of the SCVs was evaluated by comparing the simulation images with intraoperative photographs. Reasons for those undetectable SCVs on simulation images of craniotomy were discussed. RESULTS: Detectability of the SCVs >2 mm was 100%; those from 1 to 2 mm was 88.5%, and those from 0.5 to 1 mm 56.9%. Effacement of cortical sulci/subarachnoid space around the supposed craniotomy site, dural/meningeal contrast enhancement and insufficient spatial resolution of the source images were regarded as the main reasons for undetectable SCVs. CONCLUSION: Virtually peeling off the skull and scalp well demonstrates the SCVs along with brain surface structures. This simple technique can provide useful information about the SCVs and their relationships with cortical structures and tumors for preoperative surgical planning.


Subject(s)
Brain Mapping/methods , Brain/blood supply , Cerebral Veins , Scalp/blood supply , Skull/blood supply , Adolescent , Adult , Aged , Aged, 80 and over , Brain/anatomy & histology , Cerebral Veins/anatomy & histology , Child , Craniotomy/methods , Female , Humans , Image Processing, Computer-Assisted/methods , Magnetic Resonance Imaging/methods , Male , Middle Aged , Prospective Studies , Scalp/anatomy & histology , Skull/anatomy & histology , Young Adult
4.
AJNR Am J Neuroradiol ; 29(8): 1544-9, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18556358

ABSTRACT

BACKGROUND AND PURPOSE: High-attenuation areas (HDAs) called pseudo-subarachnoid hemorrhages (SAHs) may develop in some patients resuscitated from cardiopulmonary arrest (CPA), though no hemorrhage has occurred. We investigated the imaging characteristics and clinical significance of this phenomenon. MATERIALS AND METHODS: CT images of consecutive patients resuscitated from nontraumatic CPA were reviewed and classified into cases with pseudo-SAH (pseudo-SAH[+] group, n = 9), those without pseudo-SAH (pseudo-SAH[-] group, n = 28), and those with true SAH (SAH-CPA group, n = 8). Typical patients with SAH (SAH group, n = 13) and 20 healthy individuals were also extracted as control groups. The degree of brain edema was scored visually as none, mild, or severe, and the CT values of the HDAs and brain parenchyma were measured. These parameters were compared among the groups. We also compared the prognosis between the pseudo-SAH(+) and pseudo-SAH(-) groups. RESULTS: On CT, pseudo-SAH was associated with severe brain edema, whereas there was mild or no edema without pseudo-SAH. The CT values of the HDAs in the pseudo-SAH(+) group were significantly lower than those of the CPA-SAH and SAH groups (P < .0001). The brain parenchyma of the pseudo-SAH(+) group had the lowest CT values among all of the groups (P < .0001). The prognosis of the pseudo-SAH(+) group was significantly poorer than that of the pseudo-SAH(-) group in terms of both clinical outcome (P = .02) and survival (P = .046). CONCLUSION: The findings of pseudo-SAH have several imaging characteristics differing from SAH and predict a poor prognosis. This provides important information that can be used for deciding treatment strategies.


Subject(s)
Cardiopulmonary Resuscitation/adverse effects , Heart Arrest/complications , Subarachnoid Hemorrhage/diagnostic imaging , Subarachnoid Hemorrhage/etiology , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Heart Arrest/therapy , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
5.
Scand J Immunol ; 61(4): 376-9, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15853922

ABSTRACT

Recently, an increasing number of adverse reactions in children inoculated with live attenuated virus vaccines containing gelatin have been reported. However, the distribution, magnitude and rate of gelatin sensitization in the Japanese population have not been established. Here, the purpose was to investigate the distribution of children with positive gelatin immunoglobulin G (IgG) and/or IgE in Japan and to ascertain whether the incidence of positive antigelatin antibody cases among the general population, as reflected in the sample employed here, has been increasing during the period in question. The presence of IgE and IgG antibodies were measured against gelatin in 1600 panel sera collected from different age groups of Japanese children in Hokkaido/Sapporo from 1979 through 1996. Among the subjects, 39 had gelatin IgG- and/or IgE-positive sera, and these were correlated with the time of obtaining the sera as well as with the age of the subjects. The older the subject and the later the period, the higher the sero-incidence. Japanese children have become increasingly sensitized to gelatin, especially since the mid-1990s.


Subject(s)
Food Hypersensitivity/epidemiology , Food Hypersensitivity/immunology , Gelatin/adverse effects , Child, Preschool , Drug Hypersensitivity/epidemiology , Drug Hypersensitivity/immunology , Enzyme-Linked Immunosorbent Assay , Gelatin/immunology , Humans , Immunoglobulin E/blood , Immunoglobulin G/blood , Infant , Japan/epidemiology , Logistic Models , Retrospective Studies , Seroepidemiologic Studies , Vaccines, Attenuated/adverse effects , Vaccines, Attenuated/immunology , Viral Vaccines/adverse effects , Viral Vaccines/immunology
6.
Neuroimage ; 17(1): 385-92, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12482091

ABSTRACT

The purpose of our study is to clarify, using functional MRI, brain regions activated during the fist-edge-palm task (FEP) compared to relatively simple hand motor tasks using either the right or the left hand in right-handed normal volunteers. The FEP was introduced to detect a disorder of voluntary movement, and it is believed to be closely related to contralateral frontal lobe damage. However, this assumption still remains controversial. Ten subjects participated in this study. Hand motor tasks were as follows: (1) the FEP, in which the subjects were requested to place their hand in three different positions sequentially: a fist resting horizontally, a palm resting vertically, and a palm resting horizontally; (2) a fist-palm task (FP), in which the subjects were asked to clench and unclench their fist alternately; and (3) a control task requiring the subjects to knock lightly with their clenched fist. The contralateral sensomotor and premotor areas were activated in the FP with the right hand and the contralateral sensorimotor, premotor, and supplementary motor areas (SMA) were activated in the FP with the left hand. In the FEP with either hand, bilateral premotor and left parietal areas and ipsilateral cerebellum were also activated as well as contralateral sensorimotor area and SMA. Our results suggest that successful performance of the FEP requires the participation of more brain areas than FP, which may explain why some patients without frontal lobe damage failed to perform the FEP.


Subject(s)
Brain/physiology , Hand/physiology , Magnetic Resonance Imaging/methods , Movement Disorders/diagnosis , Psychomotor Performance/physiology , Adult , Brain Mapping , Functional Laterality/physiology , Humans , Image Interpretation, Computer-Assisted , Male
7.
Neuroradiology ; 42(9): 634-8, 2000 Sep.
Article in English | MEDLINE | ID: mdl-11071433

ABSTRACT

We report four patients with various types of hydrocephalus in whom constructive interference in steady state (CISS) MRI disclosed the cause of the hydrocephalus. The imaging clearly delineated an abnormal contour of the ventricular system and intraventricular septa, essential information for surgical planning, including endoscopic surgery. Postoperative CISS images were useful for showing not only regression of hydrocephalus but also the patency of small fenestrations.


Subject(s)
Brain/pathology , Hydrocephalus/diagnosis , Magnetic Resonance Imaging , Aged , Child , Child, Preschool , Female , Humans , Hydrocephalus/surgery , Infant , Male , Severity of Illness Index
8.
J Neurophysiol ; 83(2): 1079-87, 2000 Feb.
Article in English | MEDLINE | ID: mdl-10669519

ABSTRACT

The purpose of this study was to determine, by using functional magnetic resonance imaging, the areas of the brain activated during a memory-timed finger movement task and compare these with those activated during a visually cued movement task. Because it is likely that subjects engage in subvocalization associated with chronometric counting to achieve accurate timing during memory-timed movements, the authors sought to determine the areas of the brain activated during a silent articulation task in which the subjects were instructed to reproduce the same timing as for the memory-timed movement task without any lip movements or vocalization. The memory-timed finger movement task induced activation of the anterior lobe of the cerebellum (lobules IV and V) bilaterally, the contralateral primary motor area, the supplementary motor area (SMA), the premotor area (PMA), the prefrontal cortex, and the posterior parietal cortex bilaterally, compared with the resting condition. The same areas in the SMA and left prefrontal cortex were activated during the silent articulation task compared with the resting condition. The anterior lobe of the cerebellum on both sides was also activated during the silent articulation task compared with the resting condition, but these activations did not reach statistical significance (P < 0.05 corrected). In addition, the anterior cerebellum on both sides showed significant activation during the memory-timed movement task when compared with the visually cued finger movement task. The visually cued finger movement task specifically activated the ipsilateral PMA and the intraparietal cortex bilaterally. The results indicate that the anterior lobe of the cerebellum of both sides, the SMA, and the left prefrontal cortex were probably involved in the generation of accurate timing, functioning as a clock within the CNS, and that the dorsal visual pathway may be involved in the generation of visually cued movements.


Subject(s)
Cerebellum/physiology , Fingers/physiology , Magnetic Resonance Imaging , Memory/physiology , Movement/physiology , Adult , Humans , Male , Prefrontal Cortex/physiology , Psychomotor Performance/physiology , Time Perception/physiology
9.
J Allergy Clin Immunol ; 100(1): 130-4, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9257797

ABSTRACT

BACKGROUND: This study was designed to investigate the development of both cellular and humoral immune responses to gelatin in patients with vaccine-related immediate and nonimmediate reactions. Our purpose was to define the nature of the responses in the different clinical states. METHODS: Six patients with immediate reactions and 21 patients with nonimmediate reactions after inoculation of various live vaccines were studied. Measurement of gelatin-specific IgE was performed in all subjects. Gelatin-specific T-cell responses detected by an in vitro lymphocyte proliferation assay and by an assay for IL-2 responsiveness were investigated to compare the immune response in patients with the two types of reaction. RESULTS: All six patients with immediate reactions had IgE responses to gelatin, whereas none of the 21 patients with nonimmediate reactions had any anti-gelatin IgE. All of the six patients with immediate reactions and 17 of the 21 patients with nonimmediate reactions exhibited positive T-lymphocyte responses specific to gelatin. CONCLUSIONS: Immediate and nonimmediate reactions are caused by different types of allergy to gelatin, and cell-mediated immunity to gelatin may play an important role in the pathogenesis of nonimmediate reactions.


Subject(s)
Antibodies, Viral/biosynthesis , Epitopes/immunology , Gelatin/immunology , Hypersensitivity, Delayed/immunology , Hypersensitivity, Immediate/immunology , Viral Vaccines/immunology , Antibody Specificity , Chickenpox Vaccine/adverse effects , Chickenpox Vaccine/immunology , Child, Preschool , Female , Gelatin/adverse effects , Humans , Immunoglobulin E/biosynthesis , Infant , Interleukin-2/biosynthesis , Lymphocyte Activation , Male , Measles Vaccine/adverse effects , Measles Vaccine/immunology , Mumps Vaccine/adverse effects , Mumps Vaccine/immunology , Rubella Vaccine/adverse effects , Rubella Vaccine/immunology , Vaccines, Attenuated/adverse effects , Vaccines, Attenuated/immunology , Viral Vaccines/adverse effects
10.
Histol Histopathol ; 4(2): 153-65, 1989 Apr.
Article in English | MEDLINE | ID: mdl-2485191

ABSTRACT

In this paper, we present a rare disorder which is known as corpora amylacea pulmonum. X-ray CT scanning showed an abnormal focus of the lung as a solitary mass with high density and spicular features around the surface. The resected lung tissue was characterized by the appearance of round, concentrically laminated acellular bodies about 40-80 microns in diameter. The bodies were usually found lying free in the alveolar space and surrounded by the exudate alveolar macrophages or multinuclear giant cells. Some of these macrophages were in a state of progressive degeneration. The bodies showed an affinity for Congo red and exhibited partial birefringence. Moreover, all the bodies had a strong positivity for the PAS reaction and anti lysozyme antibodies. The exudate alveolar macrophages and multinuclear giant cells also displayed reactivity for PAS and lysozyme in a similar manner to that of the bodies. Electron microscopically the bodies were fundamentally composed of fibrillar elements, which bore some resemblance to amyloid fibrils and probably accounted for the partial affinity of the bodies for Congo red. These amyloid-like fibrils were also found in the cytoplasm of the macrophages. This suggested that the concentrically laminated bodies in corpora amylacea pulmonum might be formed by sequential aggregation, fusion, coalescence and compaction of degenerated alveolar macrophages.


Subject(s)
Amyloidosis/pathology , Lung Diseases/pathology , Aged , Amyloidosis/diagnostic imaging , Female , Humans , Immunohistochemistry , Lung/diagnostic imaging , Lung/pathology , Lung Diseases/diagnostic imaging , Macrophages/ultrastructure , Microscopy, Electron , Radiography , Staining and Labeling
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