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Biomedical subjects

K Ichijo

Publications and source records attributed to K Ichijo.

At least 19 recordsLinked to original sources

Abnormal uterine cavity: differential diagnosis with MR imaging.

The objective of the study was to assess the usefulness of magnetic resonance (MR) imaging in distinguishing malignant from benign conditions in patients with an abnormal uterine cavity. Fifty-four patients that were suspected of having abnormal uterine cavities were retrospectively evaluated by using MR imaging. The diagnosis of an abnormal uterine cavity included a thickened endometrium, and/or a endometrial mass, and/or a submucosal mass. Threshold values to classify the uterine cavity as abnormal on sagittal T2-weighted images were >10 mm for premenopausal women and >5 mm for postmenopausal women. Malignancy was diagnosed when lesions invaded the myometrial/junctional zone, and/or lesion enhancement was lower than that of the adjacent myometrium. The results found that histology confirmed 18 malignant and 37 benign lesions. Twelve of 15 endometrial carcinomas and 3 malignant mixed mesodermal tumors (MMMT) were correctly characterized as malignant on enhanced T1-weighted images; whereas 6 of 15 endometrial carcinomas and 3 MMMT were correctly characterized on T2-weighted images. Thirty-four of 37 benign cases were correctly characterized as not malignant on enhanced T1-weighted images. One of 14 submucosal leiomyomas, one endometrial stromal metaplasia, and one of ten pathologically normal endometria were misdiagnosed on enhanced T1-weighted images but were correctly diagnosed on T2-weighted images. The overall sensitivity, specificity, and accuracy for distinguishing malignant from benign central uterine masses were 83%, 92%, and 89% for enhanced T1-weighted image, and 50%, 97%, and 82% for T2-weighted image, respectively. We came to the conclusion that in diagnosing patients with abnormal uterine cavity, MR imaging may help differentiate malignant from benign disorders.

Adult

Evaluation of the pancreas: a comparison of single thick-slice MR cholangiopancreatography with multiple thin-slice volume reconstruction MR cholangiopancreatography.

OBJECTIVE: The purpose of this study was to assess abilities of single thick-slice MR cholangiopancreatography and multiple thin-slice multiprojection volume reconstruction (MPVR) MR cholangiopancreatography to evaluate diseases in and around the pancreas. SUBJECTS AND METHODS: Eighty-nine patients underwent both single and MPVR MR cholangiopancreatography using a single-shot fast spin-echo technique. Image quality (five-point scale), visualization of the common bile and pancreatic ducts (three-point scale), stenotic, dilatational, or cystic changes of the pancreatic ducts, and other pathologic findings were evaluated. RESULTS: Image quality was high for single and MPVR MR cholangiopancreatography (4.1+/-0.7 and 4.5+/-0.6, respectively). Misregistration was noted in 19 patients with MPVR MR cholangiopancreatography. Ducts on and around the greater duodenal papilla and the common bile duct were revealed better using MPVR than single MR cholangiopancreatography (p < .05). Overall sensitivity, specificity, and accuracy for detection of stenosis of the main pancreatic ducts were 83.3%, 93.6%, and 88.8%, respectively, using single MR cholangiopancreatography and 76.2%, 97.9%, 87.6%, respectively, using MPVR MR cholangiopancreatography. Dilatation of the pancreatic ducts (100%) and cystic changes (n = 17 and n = 19, respectively) were well seen using either single or MPVR MR cholangiopancreatography. Although stenotic changes of the nondilated main pancreatic ducts and their branches were difficult to evaluate using single (62.5% and 14.3%, respectively) or MPVR (43.8% and 21.4%, respectively) MR cholangiopancreatography, single MR cholangiopancreatography better depicted ductal continuity. CONCLUSION: For evaluation of the pancreas, single and MPVR MR cholangiopancreatography provide complementary data; thus, we recommend using a combination of these two MR cholangiopancreatography techniques.

Adult

MR and CT cholangiography in evaluation of the biliary tract.

OBJECTIVE: To compare MR and CT cholangiography (MRC and CTC) in evaluating the anatomy of the extrahepatic biliary tract and the pathology related to the gallbladder. MATERIAL AND METHODS: Twenty-three patients underwent MRC and CTC with a biliary contrast medium for investigation of biliary disease. 3D displays of both were also obtained. Endoscopic retrograde cholangiography was performed in 17 patients, and the pathology of all 23 was evaluated. RESULTS: Overall, the image quality was higher with CTC than with MRC (4.7 vs 3.9, p < 0.05). The cystic duct was demonstrated better by CTC than MRC (p < 0.05). Multiplanar reformation (MPR) and source images provided additional information to that obtained from 3D MRC and CTC images. Gallstones were revealed in 6 patients by CTC and in 5 of these 6 by MRC. In 2 patients with cholecystitis, CTC demonstrated gallbladder wall thickening but MRC did not. In 3 patients with adenomyomatosis. MRC demonstrated Rokitansky-Aschoff sinuses (RAS) while CTC demonstrated focal gallbladder wall thickening in all 3 and RAS in 1 of them. CONCLUSION: Both MRC and CTC provided anatomical and pathological information about the biliary system. With both techniques, however, either MPR or source images proved necessary in addition for evaluating the biliary system anatomy and pathology. The gallbladder wall was depicted clearly in source CTC, but MRC is recommended for the evaluation of adenomyomatosis because it depicts RAS clearly.

Adult

[Clinical efficacy of MRCP for diagnosis of patients with pancreatic neoplasm].

We examined the usefulness of MRCP in pancreatic cancer compared with ERCP. Moreover, it examined in the same way in focal pancreatitis, too. We compare three findings of 1) main pancreatic duct, 2) branches of the stricture part, 3) side of tail main pancreatic duct about ERCP and MRCP. As for the branches of the stricture part, MRCP was poor compared with ERCP but as for the property of the side of the tail main pancreatic duct, MRCP excelled. The study of mass forming chronic pancreatitis was a similar result and was not the one, which excels ERCP in case of qualitative diagnosis. However, we thought that it was not invasively, suitable behind the digestive operation and digestive passage fault, in case of elapse observation and moreover that MRCP is suitable for pick up the pancreatic cancer in our clinic.

Adenocarcinoma

MR angiography of the renal artery: comparison of breath-hold two-dimensional phase-contrast cine technique with the phased-array coil and breath-hold two-dimensional time-of-flight technique with the body coil.

Breath-hold 2D phase-contrast (PC) cine MR angiography with a phased-array coil and 2D time-of-flight (TOF) MR angiography were performed in the renal arteries and their findings were compared. Breath-hold 2D thin slice PC and TOF MR angiography were performed in 10 normal volunteers for renal arteries. A PC technique with k-space segmentation was utilized with the phased-array coil. A PC technique provided visualization of the renal artery more distally than a TOF technique (4.8 +/- 0.5 cm vs. 3.7 +/- 0.8 cm). With cardiac triggering, distal renal arteries were well demonstrated in PC MR angiography. On PC images, up- or downward movements of the mid to distal renal arteries with aortic pulsatility were recognized. The quality of the images was better with the PC than with the TOF technique (3.4 vs. 2.7). The mid to distal portions of the renal arteries translationally move with aortic pulsatility. To consistently visualize and evaluate them on MR angiography, cardiac triggering might be required to reduce the effects of pulsatile motions of the renal artery in the use of a phased-array coil.

Adult

[Enhanced delineation of the pancreatic duct in MR cholangiopancreatography (MRCP) with a combined use of secretin].

Magnetic resonance cholangiopancreatography (MRCP) is a method that can depict the main pancreatic duct non-invasively; however, its tendency to overestimate ductal stenosis is being noted. The authors used secretin to stimulate the output of pancreatic juice, which increased the signal of the main pancreatic duct and consequently minimized the occurrence of pseudostenosis artifacts in MRCP. MRCP images of 54 patients suspected of having pancreatic disease were visually evaluated by two observers before and after administration of secretin (1 clinical unit/kg). Improved delineation of the main pancreatic duct (68.5-59.3%, p < 0.05) and its side branches (40.7-29.6%, p < 0.05) was obtained with good interobserver agreement (kappa = 0.71-0.68).

Aged

Breath-hold MR cholangiopancreatography with a long-echo-train fast spin-echo sequence and a surface coil in chronic pancreatitis.

PURPOSE: To assess heavily T2-weighted breath-hold magnetic resonance cholangiopancreatography (MRCP) for imaging the pancreatic duct in patients with chronic pancreatitis. MATERIALS AND METHODS: Thirty-nine patients with chronic pancreatitis were examined with a breath-hold fast spin-echo (FSE) sequence employing an echo train length of 32 and with a surface coil. Results were compared with those of endoscopic retrograde cholangiopancreatography (ERCP). RESULTS: MRCP showed the head, body, and tail of the pancreatic duct well in 79%, 64%, and 53% of cases, respectively. Agreement between MRCP and ERCP was 83%-92% in cases of ductal dilatation, 70%-92% in cases of ductal narrowing, and 92%-100% in cases of filling defects. Interobserver variation was low (kappa > 0.5) for most findings. CONCLUSION: Breath-hold MRCP with an FSE technique depicts the pancreatic duct well in patients with chronic pancreatitis and demonstrates narrowing, dilatation, and filling defects with moderate to high accuracy.

Aged

Occlusion of the posterior humeral circumflex artery: detection with MR angiography in healthy volunteers and in a patient with quadrilateral space syndrome.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of MR angiography in detecting occlusion of the posterior humeral circumflex artery and to determine if the finding is specific for the diagnosis of quadrilateral space syndrome. SUBJECTS AND METHODS: Two-dimensional fast low-angle shot MR angiography was used to image both shoulders of one symptomatic patient and six asymptomatic volunteers (10 posterior humeral circumflex arteries). RESULTS: With the arm in a neutral position, the posterior humeral circumflex arteries appeared normal on MR angiograms of all subjects. However, when the arm was in abduction, occlusion of the posterior humeral circumflex artery was seen both in the symptomatic patient and in 80% of the asymptomatic volunteers. CONCLUSION: Our data show that occlusion of the posterior humeral circumflex artery is common in asymptomatic volunteers. Thus, MR angiography has no value in the diagnosis of quadrilateral space syndrome.

Adult

[MR cisternography using "long echo train length fast spin echo sequence" for demonstrating the inner ear].

Excellent quality of MR cisternography was acquired using "long echo train length fast spin echo sequence" (TR/TE = 2666/200, ETL = 24, 6 or 8 NEX, 3 mm thickness, 0 mm interslice gap, 19 cm FOV, 512 * 384, 2 DFT method). The inner ear anatomy such as canaliculus cochleae or lamina spiralis ossea were well visualized. The VII, VIII th nerve bundles within the internal auditory canal were detectable as 1 to 4 bundles. The vessels in the cerebellopontine angle or the internal auditory canal were also demarcated from the VII, VIII th nerve bundles because of their flow void. Signal to noise ratio seemed to be better than 3 DFT method, however limited spatial resolution in the cranio-caudal direction might require additional sagittal or coronal scan.

Adult

[Breath hold MR cholangio-pancreatography (MRCP) using long echo train length fast spin echo sequence in combination with surface coil].

To test the feasibility of MR cholangio-pancreatography (MRCP) using long echo train length (32) fast spin echo sequence in combination with shoulder surface coil, 20 patients who had had ERCP were examined. Good correlations were acquired between the findings obtained by two modalities in terms of ductal strictures, dilatations and intraductal lesions. MRCP was considered to be an examination of choice in various kinds of pathologies affecting biliary duct as well as pancreatic duct for its non-invasiveness and reasonable image quality.

Adult

Case report: MR appearance of a retained surgical sponge.

A case of a retained surgical sponge found in the retroperitoneum is presented with findings on magnetic resonance (MR) imaging, computed tomography (CT), ultrasonography (US) and angiography. Among all the performed modalities, a characteristic internal structure of the gauze granuloma was best visualized on MR imaging. If no radio-opaque marker is seen on plain radiography or CT, the folded fabric inner structure visualized on T2-weighted images can be a most important clue to the correct diagnosis of this iatrogenic mass.

Female

Gallium-67-citrate scanning in patients with sarcoid uveitis.

Gallium-67-citrate is useful for characterizing activity in patients with sarcoidosis. Gallium-67 uptake in bilateral symmetrical hilar lymphadenopathy and/or symmetrical salivary glands is typical of this clinical entity. Sarcoidosis is a systemic disease, and uveitis is considered the hallmark of ophthalmic sarcoidosis. We present two cases of ophthalmic sarcoidosis that shows uveal accumulation of 67Ga-citrate associated with clinical symptoms.

Citrates