Biomedical subjects

Fuminari Tatsugami

Publications and source records attributed to Fuminari Tatsugami.

8 recordsLinked to original sources

PubMed2006

Diffusion-weighted MR imaging for urinary bladder carcinoma: initial results.

The aim of this study was to demonstrate the feasibility of using diffusion-weighted (DW) magnetic resonance (MR) imaging under free breathing for the detection of a urinary bladder carcinoma. In 15 patients with 17 urinary bladder carcinomas, DW images were obtained in the axial plane under free breathing scanning with a multisection spin-echo type single-shot echo planar sequence with a body coil. DW images were evaluated based on cystoscopic findings. Moreover, the apparent diffusion coefficient (ADC) value was measured in a circular region of interest (ROI) within the carcinoma, urine, normal bladder wall, prostate and seminal vesicle. In the results, on the DW images, all 17 carcinomas were clearly shown as high signal intensity relative to the surrounding structure. The ADC value (x10(-3) mm(2)/s) in the carcinoma was 1.18+/-0.19, which was significantly lower compared with that of urine (3.28+/-0.20), the normal bladder wall (2.27+/-0.24), prostate (transition zone: 1.57+/-0.09, peripheral zone:1.85+/-0.22) and seminal vesicle (2.01+/-0.22). In conclusion, DW images under free breathing enabled the clear detection of the urinary bladder carcinoma, whose ADC values were lower compared with those of the surrounding structure. The DW images may be useful in evaluating tumors invading to the surrounding structures.

Aged↗

PubMed2006

CT and MR features of sclerosing mesenteritis mimicking a mesenteric metastasis from the carcinoid tumor.

Sclerosing mesenteritis is a rare and benign inflammatory entity characterized by fibrofatty thickening of the mesentery. To our knowledge, there are only a few reports on the features of sclerosing mesenteritis on magnetic resonance (MR) imaging and computed tomography (CT). In this present case, MR imaging demonstrated tissue characterization of fibrosis, and partial maximum intensity projection (MIP) and three-dimensional angiography images obtained using multislice CT clearly revealed the extent of the tumor and the vascular appearance affected by the mass. However, a mesenteric metastasis from the carcinoid tumor may show such imaging features. Therefore, when encountering such a case, we suggest that a tentative diagnosis of sclerosing mesenteritis be made, followed by a biopsy for intraoperative histopathologic analysis to avoid aggressive surgery.

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PubMed2006

Dual-phase 3D CT angiography during a single breath-hold using 16-MDCT: assessment of vascular anatomy before laparoscopic gastrectomy.

OBJECTIVE: In this study, we evaluated the efficacy of dual-phase 3D CT angiography (CTA) during a single breath-hold using 16-MDCT in the assessment of vascular anatomy before laparoscopic gastrectomy. MATERIALS AND METHODS: The study involved 20 consecutive patients (10 men, 10 women; mean age, 59 years) scheduled for laparoscopic gastrectomy for the treatment of early gastric cancer. A dual-phase contrast-enhanced CT scan using 16-MDCT was obtained before laparoscopic gastrectomy. After rapid infusion of a nonionic contrast agent, arterial and venous phase scans were obtained serially with an interval of 15 sec during a single breath-hold of 31 sec. Three-dimensional CTA images in the arterial phase (3D CT arteriography) and venous phase (3D CT venography) were individually reconstructed using the volume-rendering technique, and then the images were fused together. We evaluated the detectability of the celiac trunk, left gastric artery (LGA), right gastric artery (RGA), left gastric coronary vein (LCV), Henle's gastrocolic trunk, right gastroepiploic vein (RGEV), and accessory right colic vein on 3D CTA to compare with surgical findings. RESULTS: In all 20 patients, 3D CT arteriography and venography clearly showed the celiac trunk, LGA, RGA, Henle's gastrocolic trunk, RGEV, and accessory right colic vein, which were correctly identified during surgery. The branching pattern of the celiac trunk was classified as Michels type I in 19 patients and Michels type II in one patient. Imaging showed the RGA originating from the proper hepatic artery (PHA) in nine patients; from the gastroduodenal artery (GDA) in seven patients; and from the left hepatic artery (LHA) in four patients. In 12 patients, the LCV joined the portal vein (PV) and in eight, the splenic vein (SV). In all patients, the accessory right colic vein joined the RGEV, and Henle's gastrocolic trunk proximal to the joining point flowed to the superior mesenteric vein (SMV). In all 20 patients, the fused image simultaneously showed arteries and veins around the stomach, with no mismatch between the arterial and venous phase images. In 10 patients, the LCV joined the PV after running along the dorsal side of the PHA, common hepatic artery (CHA), or splenic artery (SA). In eight patients, the LCV joined the SV after running along the ventral side of the PHA, CHA, or SA. In two patients, the LCV joined the PV after running along the ventral side of the CHA, which correlated with the surgical findings. Both the sensitivity and positive predictive values of 3D CTA revealed 100% correct identification of the celiac trunk, LGA, RGA, LCV, Henle's gastrocolic trunk, RGEV, and accessory right colic vein. CONCLUSION: Dual-phase 3D CTA using 16-MDCT clearly revealed individual arteries and veins around the stomach before laparoscopic gastrectomy. The fused image of 3D CT arteriography and venography during a single breath-hold enabled the simultaneous assessment of arteries and veins before laparoscopic gastrectomy.

Aged↗

PubMed2004

Preoperative assessment of vascular anatomy around the stomach by 3D imaging using MDCT before laparoscopy-assisted gastrectomy.

OBJECTIVE: Our aim was to evaluate the efficacy of 3D imaging using MDCT in the preoperative assessment of the vascular anatomy around the stomach before laparoscopy-assisted gastrectomy. SUBJECTS AND METHODS. Thirty-six consecutive patients scheduled for laparoscopy-assisted distal gastrectomy were evaluated on MDCT. CT was performed at the arterial phase after a bolus IV injection of contrast material. Three-dimensional CT angiography (3D CTA) of the arterial and venous systems was reconstructed separately using a volume-rendering algorithm, and the images were fused. Three-dimensional CTA for the left gastric, right gastric, and replaced left hepatic arteries and the left gastric coronary vein was evaluated prospectively by three reviewers, and then a surgical correlation was made. RESULTS: In all 36 cases, the left gastric artery was correctly identified on 3D CTA. In 35 of 36 cases, the right gastric artery was correctly identified, whereas in one case, the right gastric artery could not be visualized on 3D CTA because of its small size. In 35 of 36 cases (i.e., one case with agenesis of the left gastric coronary vein was excluded), the left gastric coronary vein was correctly identified. In six cases, the replaced left hepatic artery was correctly identified on 3D CTA. All 36 cases underwent successful laparoscopy-assisted distal gastrectomy on the basis of the 3D CTA. Both the sensitivity and positive predictive values of 3D CTA revealed 100% correct determination of the left gastric artery, replaced left hepatic artery, and left gastric coronary vein. The sensitivity and positive predictive values for the right gastric artery were 97% and 100%, respectively. CONCLUSION: Three-dimensional CTA using MDCT clearly revealed individual vascular anatomies around the stomach and could play an important role in safely facilitating the laparoscopy-assisted gastrectomy procedure.

Algorithms↗

PubMed2004

[Fusion imaging of three-dimensional angiographies of arteries and veins around the stomach by multiphase fusion technique under single breath-hold using 16-detector multislice CT].

Postcontrast CT scan using multislice CT was performed in 10 patients prior to laparoscopic gastric cancer surgery. Using 16-detector multislice CT, images were obtained at both arterial and venous phases under a single breath-hold. Three-dimensional CT angiography at arterial and venous phases was respectively reconstructed using the volume-rendering technique and then fused. Multiphase fusion imaging was able to demonstrate clearly, simultaneously, and three-dimensionally the gastric arteries and veins without a respiratory gap. In conclusion, multiphase fusion images were considered to be very useful for the intraoperative navigation of laparoscopic gastric cancer surgery.

Aged↗

PubMed2003

[Clinical application of three-dimensional imaging with multislice CT for laparoscopic colorectal surgery].

PURPOSE: Laparoscopic colorectal surgery, while minimally invasive, is a complicated technique. Therefore, prior to this surgery, it is important to determine the anatomical information of colorectal cancer. MATERIALS AND METHODS: Fifty-eight cases of patients with a confirmed diagnosis of colon cancer [caecal (n = 4), ascending colon (n = 6), transverse colon (n = 7), descending colon (n = 2), sigmoid colon (n = 22), and rectal (n = 17) cancer] were evaluated using multislice CT before laparoscopic surgery. CT examination was performed in an air-filled colorectum by colon fiberscopy. Contrast-enhanced images on multislice CT were obtained at arterial and venous phases. All images were reviewed on a workstation, and three-dimensional (3D) images of vessels, colorectum, cancer, and swollen lymph nodes were reconstructed by volume rendering and fused (integrated 3D imaging). We evaluated the usefulness of integrated 3D imaging with multislice CT for laparoscopic colorectal surgery. RESULTS: Integrated 3D imaging demonstrated clearly the distribution of arteries feeding the colorectal cancer and the anatomical location of colorectal cancer and arterial and venous systems. Moreover, measurement of the distance between the aortic bifurcation and the origin of the inferior mesenteric artery and that between the base of the inferior mesenteric artery and the origin of the left colic artery on integrated 3D imaging contributed to safe, prompt ligation of the vessels and excision of lymph nodes. CONCLUSION: Integrated 3D imaging with multislice CT was useful for simulation of laparoscopic colorectal surgery.

Colorectal Neoplasms↗

PubMed2003

[Effect of contrast material pushed with saline solution using dual injection on enhancement of aorta, portal vein, and liver parenchyma in multislice CT of the liver].

We evaluated the effect of the enhancement value of the abdominal aorta, portal vein, and liver parenchyma by the saline flush technique. One hundred eight patients who underwent multislice CT of the liver were randomly divided into four groups: 100 ml of contrast material (Iomeprol 300 mgI/ml or 350 mgI/ml) only and 100 ml of contrast material (300 mgI/ml or 350 mgI/ml) flushed with 50 ml of saline solution at a rate of 5 ml/sec. The saline flush technique demonstrated statistically significantly greater portal enhancement. Therefore, we consider that this technique contributes to the visualization of three-dimensional CT portography.

Adult↗

PubMed2003

[Three-dimensional angiography of arteries and veins around the stomach using multislice CT for preoperative simulation of laparoscopic gastric cancer surgery: trial of multiphase fusion method].

Postcontrast CT scanning using multislice CT was performed for 20 patients with gastric cancer. Three-dimensional (3D) CT angiography of the arterial and venous phases was reconstructed using the volume-rendering technique and then fused. 3D-CT angiography showed the arteries and veins around the stomach, and multiphase fusion imaging was able to demonstrate clearly and three-dimensionally the gastric vascular anatomy. In conclusion, the multiphase fusion image was considered to be useful in the preoperative simulation of laparoscopic gastric cancer surgery.

Aged↗