Harumi Itoh

Apparent Diffusion Coefficient in Pancreatic Cancer: Characterization and Histopathological Correlations

To clarify the components primarily responsible for diffusion abnormalities in pancreatic cancerous tissue.

Multislice continuous arterial spin-labeled perfusion MRI in patients with chronic occlusive cerebrovascular disease: a correlative study with CO2 PET validation.

To compare the use of multislice continuous arterial spin labeling (CASL) and CO2 positron emission tomography (PET) to assess CBF in patients with chronic occlusive cerebrovascular disease for the validation of quantitative CASL perfusion in an altered hemodynamic state.

Reliability of the proposed international classification of high-resolution computed tomography for occupational and environmental respiratory diseases.

Reliability of the Proposed International Classification of High‐Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases: Narufumi Suganuma, et al. Department of Environmental Medicine, Kochi Medical School

The spectrum of pulmonary sarcoidosis: Variations of high-resolution CT findings and clues for specific diagnosis

Sarcoidosis is a systemic disease of unknown cause, characterized by widespread non-caseating granulomas. There is a wide spectrum of radiologic manifestations in pulmonary sarcoidosis, providing challenges to radiologists. However, recognition of the key features of sarcoidosis with knowledge of its pathologic background can often allow for specific diagnosis. In this review, we describe the variety of high-resolution CT findings in pulmonary sarcoidosis along with its pathologic features as the basis for radiographic manifestations, and discuss the key features on high-resolution CT for the specific diagnosis of pulmonary sarcoidosis.

Tissue characterization of glioma by proton magnetic resonance spectroscopy and perfusion-weighted magnetic resonance imaging : glioma grading and histological correlation

BACKGROUND AND PURPOSE Our intent was to clarify the usefulness of proton magnetic resonance spectroscopy (MRS) and perfusion-weighted magnetic resonance imaging (PW-MRI) in the grading of glioma. METHODS Twenty-three consecutive patients with gliomas were investigated by both proton MRS and PW-MRI. For quantitative analysis, the metabolite data of the gliomas were estimated using the LCModel software. Receiver operating characteristic (ROC) curve analyses were also performed to assess which metabolite parameter was optimal for discrimination of glioma grade. From the PW-MRI data, the value of blood volume was measured on the parametric map corresponding to the location of MRS analysis. We then compared tumor blood volume with the amount of choline (Cho). RESULTS The mean Cho/creatine (Cre) ratio was useful to discriminate between Grades II and III, and the mean lactate (Lac)/Cre ratio was found to be significantly different between Grades III and IV. ROC curve analysis showed that measurements involving Cho were superior indices for grading glioma compared with blood volume information. Furthermore, the correlation between tumor blood volume and the amount of choline was statistically significant. CONCLUSION MRS may provide valuable information for glioma grading.

Utility of high-resolution computed tomography for predicting risk of sputum smear-negative pulmonary tuberculosis

BACKGROUND To diagnose sputum smear-negative pulmonary tuberculosis (PTB) is difficult and the ability of high-resolution computed tomography (HRCT) for diagnosing PTB has remained unclear in the sputum smear-negative setting. We retrospectively investigated whether or not this imaging modality can predict risk for sputum smear-negative PTB. METHODS We used HRCT to examine the findings of 116 patients with suspected PTB despite negative sputum smears for acid-fast bacilli (AFB). We investigated their clinical features and HRCT-findings to predict the risk for PTB by multivariate analysis and a combination of HRCT findings by stepwise regression analysis. We then designed provisional HRCT diagnostic criteria based on these results to rank the risk of PTB and blinded observers assessed the validity and reliability of these criteria. RESULTS A positive tuberculin skin test alone among clinical laboratory findings was significantly associated with an increase of risk of PTB. Multivariate regression analysis showed that large nodules, tree-in-bud appearance, lobular consolidation and the main lesion being located in S1, S2, and S6 were significantly associated with an increased risk of PTB. Stepwise regression analysis showed that coexistence of the above 4 factors was most significantly associated with an increase in the risk for PTB. Ranking of the results using our HRCT diagnostic criteria by blinded observers revealed good utility and agreement for predicting PTB risk. CONCLUSIONS Even in the sputum smear-negative setting, HRCT can predict the risk of PTB with good reproducibility and can select patients having a high probability of PTB.

Sacral insufficiency fracture detected by FDG-PET/CT: report of 2 cases.

We report 2 cases of sacral insufficient fracture detected by FDG-PET/CT. In case 1, a 79-year-old female patient with malignant lymphoma, who had recent lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint was observed on FDG-PET and a fracture line corresponding to FDG uptake was observed in bone window of CT images. In case 2, an 81-year-old male patient with colon cancer, who also complained of lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint and horizontal uptake which connects vertical line (H-shaped) was demonstrated and CT also demonstrated a fracture line corresponding to FDG uptake. H-shaped high intensity area corresponding to FDG uptake was observed on T2-weighted image of MRI. On bone scintigraphy, H-shaped uptake was also observed. Like bone scintigraphy, typical H-shaped FDG uptake may be diagnostic in sacral insufficiency fracture. Adding CT information to FDG-PET, that is, assessing SIF with FDG-PET/CT may be useful when atypical findings are observed.

Imaging by multiple modalities of patients with a carotidynia syndrome

The purpose of this article is to familiarize readers with the clinical syndrome of carotidynia. In the past, the International Headache Society (IHS) described idiopathic carotidynia as a diagnostic entity consisting of a self-limiting neck pain syndrome and tenderness over the carotid bifurcation without structural abnormality and then recently removed it from its classification. Although the clinical criteria of carotidynia in the former classification of the IHS included the absence of structural abnormality, several publications have demonstrated associated radiological findings and have described the usefulness of radiological investigations in diagnosing this syndrome. In this paper, we report four additional cases with a carotidynia clinical syndrome (according to the former classification) and the presence of abnormal soft tissue infiltration surrounding the symptomatic carotid artery as demonstrated by multiple imaging modalities, without any other underlying cause for the carotid pain syndrome. Our findings support the hypothesis that carotidynia could be a distinct disease entity, possibly caused by inflammation.

Utility of multi-detector CT for pre-operative diagnosis of internal hernia through a defect in the broad ligament (2007: 1b)

Internal hernia through a defect in the broad ligament is a rare cause of intestinal obstruction, and pre-operative diagnosis is generally difficult. Here, we report our experience in which multi-detector computed tomography (MDCT), which allows direct recognition of incarcerated small bowel, was useful in the pre-operative diagnosis of this hernia.

Endovascular Treatment for an Iliac Artery–Ureteral Fistula with a Covered Stent

Iliac artery-ureteral fistula (IAUF) is a rare entity that has a potential risk of life-threatening hemorrhage. It is difficult to diagnose and treat appropriately. Conventional treatment for the disease consists of surgical ligation and vascular reconstruction or coil embolization. Surgical treatment is usually difficult for patients with several risk factors. In recent years, endovascular stent-graft treatment for iliac artery pseudoaneurysm has been reported. The present report describes two cases in which endovascular covered stent-graft treatment was successfully applied to treat IAUF, with good clinical outcomes.