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Shigeki Aoki

Publications and source records attributed to Shigeki Aoki.

At least 19 recordsLinked to original sources

Development of the prefrontal lobe in infants and children: a three-dimensional magnetic resonance volumetric study.

Relatively little is known about normal prefrontal lobe development. We used three-dimensional magnetic resonance imaging (MRI)-based brain volumetry to characterize developmental changes in prefrontal lobe volumes in infants and children. Prefrontal volumes were determined in 30 subjects aged 5 months to 18 years (221 months) and 3 adults aged 28-39 years (324-468 months). Images were acquired on a 1.5-T MRI system using T1-weighted gradient-echo sequences. Volumes of the frontal and prefrontal lobes were determined using a workstation, and the prefrontal-to-frontal volume ratio was calculated. Prefrontal lobe volume increased slowly until 8 years (96 months) of age, contrasting sharply with rapid growth between 8 and 14 years (96 and 168 months). The prefrontal-to-frontal volume ratio increased with age as a sigmoid growth curve. A prefrontal growth spurt occurs in late childhood. Knowledge of prefrontal lobe development is essential for understanding cognitive development and dysfunction.

Adolescent↗

MR diffusion tensor imaging: recent advance and new techniques for diffusion tensor visualization.

Recently, diffusion tensor imaging is attracting the biomedical researchers for its application in depiction of fiber tracts based on diffusion anisotropy. In this paper, we briefly describe the basic theory of diffusion tensor MR imaging, the determination process of diffusion tensor, and the basic concepts of diffusion tensor visualization techniques. Several results of clinical application in our institute are also introduced. Finally, the limitations, advantages and disadvantages of the techniques are discussed for further application of diffusion tensor visualization.

Anisotropy↗

MR imaging of ischemic penumbra.

Cerebral ischemic stroke is one of the most fatal diseases despite current advances in medical science. Recent demonstration of efficacy using intravenous and intra-arterial thrombolysis demands therapeutic intervention tailored to the physiologic state of the individual tissue and stratification of patients according to the potential risks for therapies. In such an era, the role of the neuroimaging becomes increasingly important to evaluate the extent and location of tissues at risk of infarction (ischemic penumbra), to distinguish it from unsalvageable infarcted tissues or doomed hemorrhagic parenchyma. In this review, we present briefly the current role and limitation of computed tomography and conventional magnetic resonance imaging (MRI). We also present the possible applications of advanced MR techniques, such as diffusion and perfusion imaging, concentrating on the delineation or detection of ischemic penumbra.

Brain Ischemia↗

Hemangiomas in the face and extremities: MR-guided sclerotherapy--optimization with monitoring of signal intensity changes in vivo.

The feasibility of a method of magnetic resonance (MR)-guided sclerotherapy for hemangioma was evaluated. The distribution of a test injection and a contiguous sclerosant injection was monitored clearly with MR fluoroscopy. Postsclerotherapy T2-weighted MR images depicted areas with and those without effective sclerosant concentration, which enabled performance of selective supplemental sclerotherapy. This method of MR-guided sclerotherapy seems feasible for clinical application.

Adolescent↗

[Simple visualization of the corticospinal pathway using tractography: one-ROI and two-ROI methods].

Diffusion tensor imaging (DTI), a magnetic resonance (MR) technique to analyze diffusion anisotropy of the brain, is able to demonstrate subtle white matter anatomy. Tractography is expected to be a unique, non-invasive tool to provide more pertinent insights into brain structure and orientation not accessible by conventional MRI. In this report, preliminary experiences of visualization of the corticospinal tract using tractography are described. DTI of the brain was performed in 5 normal volunteers using single-shot echo-planar imaging, then tractography was generated by our original software. We determined that the two-region-of-interest (ROI) method is superior to the one-ROI method.

Adult↗

Transient splenial lesion of the corpus callosum associated with antiepileptic drugs: evaluation by diffusion-weighted MR imaging.

Transient focal lesions in the splenium of the corpus callosum have been reported in epileptic patients receiving antiepileptic drugs. The characteristic imaging features included an oval high signal lesion on T2-weighted images in the central part of the splenium, no enhancement on post-contrast MR images, and complete reversibility without specific treatment. We report identical MR imaging findings in a depressive patient who had received antiepileptic drugs. In addition, diffusion-weighted MR imaging findings are described in our case, which is the first report on this unique lesion associated with antiepileptic drugs. Although this lesion has been assumed to be vasogenic edema in the previous reports, diffusion-weighted MR imaging showed markedly restricted diffusion of the lesion in the present case, suggesting that cytotoxic edema was the main pathophysiological abnormality.

Adult↗

Optimal inversion time for acquiring flow-sensitive alternating inversion recovery images to quantify regional cerebral blood flow.

The purpose of this study was to correlate regional cerebral blood flow (rCBF) measured by I-123-IMP and flow-sensitive alternating inversion recovery (FAIR) studies with different inversion time (TI) values to find out the optimum TI that gives comparable rCBF and images on FAIR study. Nine patients with symptoms and signs of internal carotid or major cerebral arterial stenosis were enrolled in this study. Both I-123-IMP single photon emission computed tomography (SPECT) and FAIR images were acquired in all patients. Single-slice FAIR images (with different TI values) were acquired using a 1.5-T MRI unit. The rCBF was calculated from all I-123-IMP and FAIR images. Receiver operating characteristics (ROC) analysis was performed to detect hypoperfused segments on FAIR images. The rCBF calculated from FAIR and I-123-IMP studies were compared and correlated with each other. The ROC analysis showed no significant differences among the readers or TI values, but a trend of higher sensitivity, specificity, and accuracy was observed with TI of 1400 ms. The rCBF values of FAIR and I-123-IMP studies significantly correlated with each other. The FAIR images with TI value of 1400 ms gave more comparable CBF. A TI value of 1400 ms might be optimum for 1.5-T MR strength to get high quality FAIR images and comparable CBF.

Aged↗

Velocity-coded colour magnetic resonance angiography and perfusion-weighted magnetic resonance imaging for the evaluation of extracranial-to-intracranial arterial bypass surgery.

BACKGROUND AND PURPOSE: Velocity-coded colour magnetic resonance angiography (VCCMRA) and perfusion magnetic resonance imaging (pMRI) were evaluated as methods for investigating the efficacy of extracranial-to-intracranial arterial bypass (EC-IC bypass) by comparing the findings of VCCMRA and those of cerebral angiography and by measuring the improvement ratio after EC-IC bypass by pMRI compared to that by single photon emission computed tomography (SPECT) using the autoradiographic technique. METHODS: Thirteen patients who underwent VCCMRA, angiography, SPECT, and pMRI before and after surgery were analyzed. Findings of VCCMRA were compared to those of angiography. Improvement ratio was calculated compared to the cerebellum for cerebral blood volume, mean transit time (MTT), and regional cerebral blood flow (rCBF) as measured by pMRI and quantitative SPECT. RESULTS: Findings of VCCMRA were in good agreement with those of angiography and clearly showed the direction of bypass flow. No statistically significant correlation was observed between the improvement ratios in CBF in the hemisphere and middle cerebral artery territory on the surgical and non-surgical sides and in rCBF in the same regions of interest (ROIs) (r=-0.574, 0.09). However, a statistically significant correlation was observed between the cerebrovascular reserve capacity (CVRC) in the hemisphere on the surgical side and in MTT in the same ROIs (r=0.955, P<0.001). CONCLUSION: VCCMRA may clearly show the direction of flow in the EC-IC bypass. MIT measured by pMRI may indicate the postoperative state of CVRC. These techniques could replace angiography and positron emission tomography or SPECT in patients undergoing EC-IC bypass.

Adult↗

Accuracy of abnormal paraspinal muscle findings on contrast-enhanced MR images as indirect signs of unilateral cervical root-avulsion injury.

PURPOSE: To evaluate the accuracy of abnormal magnetic resonance (MR) findings in the paraspinal muscles as indirect signs of nerve-root avulsion injury. MATERIALS AND METHODS: Forty-three consecutive patients suspected of having unilateral root-avulsion injury underwent MR imaging and were evaluated. Paraspinal muscles were evaluated for abnormal signal intensity on T1- and T2-weighted images, abnormal enhancement on images obtained after contrast material enhancement, and muscle volume loss. MR images were interpreted independently by two observers for interobserver variability. MR findings were compared with findings of root continuity, determined with a combination of surgery and clinical evaluation. Sensitivities, specificities, and kappa values of the findings were calculated. RESULTS: Sensitivities of MR findings in the paraspinal muscles indicating root-avulsion injury were 88% (36 of 41 patients) for abnormal enhancement, 83% (34 of 41 patients) for high signal intensity on T2-weighted images, 37% (15 of 41 patients) for high signal intensity on T1-weighted images, and 71% (29 of 41 patients) for muscle volume loss. Specificities for all findings were 100% (two of two patients). Of the paraspinal muscles, findings in the multifidus muscle were the most accurate and provided the highest interobserver agreement (kappa = 0.81). CONCLUSION: Contrast material-enhanced abnormal MR findings in the paraspinal muscles are accurate in indicating root-avulsion injuries, and abnormal enhancement in the multifidus muscle is the most accurate among paraspinal muscle findings.

Adolescent↗

Radiation-induced arteritis: thickened wall with prominent enhancement on cranial MR images report of five cases and comparison with 18 cases of Moyamoya disease.

PURPOSE: To evaluate magnetic resonance (MR) imaging findings of radiation-induced cranial arteritis regarding arterial wall thickening and degree of enhancement, as well as to compare the findings with those of idiopathic moyamoya disease. MATERIALS AND METHODS: We reviewed cerebral MR images in five patients with radiation-induced large cerebral arteritis. All patients had undergone irradiation 2-25 years prior to this study. Conventional nonenhanced MR, MR angiographic, and contrast material-enhanced MR images were evaluated. Special attention was paid to wall enhancement of the affected arteries (distal internal carotid artery). Wall enhancement was staged in three levels by two neuroradiologists. We also reviewed MR images in 18 patients with primary moyamoya disease for comparison and analyzed them statistically (Fisher exact test). RESULTS: Wall thickening and prominent ring enhancement of the wall of the affected large cerebral arteries were observed in all (five of five) patients with radiation-induced arteritis. In contrast, wall thickening and prominent ring enhancement of the wall of the occluded arteries either were not seen (13 of 18 patients) or were faint (five of 18 patients) in patients with moyamoya disease. Contrast enhancement of the arterial walls in patients with radiation-induced arteritis was significantly more prominent than in patients with moyamoya disease (P =.003). CONCLUSION: MR images of wall thickening and prominent ring enhancement of the wall of affected large cerebral arteries may be a diagnostic clue in differentiating radiation-induced arteritis from moyamoya disease.

Adolescent↗

Electrophysiological, anatomical and histological remodeling of the heart to AV block enhances susceptibility to arrhythmogenic effects of QT-prolonging drugs.

The present study was designed to investigate what kinds of adaptation occurred in the canine chronic AV block model, which has been used to study torsade de pointes (TdP). Dogs at 7-10 days (acute phase) and 28-56 days (chronic phase) after AV block were assessed. Ventricular effective refractory period and monophasic action potential duration were prolonged in chronic animals compared with acute animals; moreover the electrically vulnerable period was prolonged in chronic animals. Non-specific IKr channel blocker cisapride (1 and 10 mg/kg, p.o.) was administered without anesthesia to estimate the feasibility of QT prolongation. In chronic animals, QT prolongation followed by TdP was induced in one dog by the low dose and in all by the high dose, which was not observed in acute animals. MR images indicated increases of diameter and wall thickness of both ventricles in chronic animals. The degree of hypertrophy was prominent in the right ventricular wall and septal wall. Heart weight of the chronic animals was 1.7 times greater than that of normal control subjects. Photo- and electron-micrograph analyses showed myocardial cell hypertrophy with parallel increases of collagen fiber and extracellular space in chronic animals. These electrophysiological, anatomical and histological adaptations may predispose the chronic AV block heart to drug-induced QT prolongation with enhanced risk of re-entry and early after depolarization, leading to the onset of TdP.

Animals↗

[Selective intraarterial infusion chemotherapy using a combined MRI-angiography system for head and neck cancers].

We performed selective intraarterial infusion chemotherapy using a combined MRI-angiography system for head and neck cancers. In three patients, three or five infusions of CDDP (100 mg/body) were administered to the feeding arteries selectively. For the evaluation of drug distribution, MRI during arteriography through the infusion pump was performed before CDDP administration. When a distribution mismatch was found, arterial selection was attempted again under a mechanically unstable C-arm system, and further evaluation under an MR system was carried out. Thus, more ideal treatment could be provided. We consider MRI during arteriography to be useful in assessing for distribution during intraarterial chemotherapy.

Antineoplastic Agents↗

Quantitative measurement of regional cerebral blood flow with flow-sensitive alternating inversion recovery imaging: comparison with [iodine 123]-iodoamphetamin single photon emission CT.

BACKGROUND AND PURPOSE: Flow-sensitive alternating inversion recovery (FAIR) MR imaging is a technique for depicting cerebral perfusion without contrast enhancement. Our purpose was to determine whether quantification at FAIR imaging can be used to assess regional cerebral blood flow (rCBF) in a manner similar to [iodine 123]-iodoamphetamin ((123)I-IMP) single photon emission CT (SPECT). METHODS: Nine patients with internal carotid or major cerebral arterial stenosis underwent (123)I-IMP SPECT and FAIR imaging (single section, different TIs, 1.5 T) at rest and after acetazolamide (Diamox) stress. FAIR and (123)I-IMP rCBF values were compared and correlated. Receiver operating characteristic analysis was conducted to detect hypoperfused segments on FAIR images. RESULTS: rCBF values of normally perfused segments were 41.53 and 51.91 mL/100 g/min for pre- and post-acetazolamide (123)I-IMP studies, respectively. Corresponding values for pre- and post-acetazolamide FAIR images, respectively, were 46.64 and 59.60 mL/100 g/min with a TI of 1200 milliseconds and 53.23 and 68.17 mL/100 g/min with a TI of 1400 milliseconds. (123)I-IMP and FAIR results were significantly correlated, with both pre- and post-acetazolamide images. Sensitivity (86%) in detecting hypoperfused segments was significantly higher with post-acetazolamide images (TI, 1400 milliseconds), and specificity (82-85%) and accuracy (80-82%) were higher with all pre- and post-acetazolamide images (all TIs). CONCLUSIONS: The significant correlation, high specificity and accuracy in detecting hypoperfused segments, similar increases in flow on both post-acetazolamide images, and absence of the need for contrast enhancement suggest that FAIR imaging, like nuclear medicine study, is complementary to routine MR imaging in the assessment of cerebral perfusion.

Acetazolamide↗

[Line scan diffusion weighted imaging (LSDI) on 0.2 Tesla MRI of the normal cervical cord in vivo: preliminary study].

Diffusion weighted imaging(DWI) has been widely performed in the brain. However, DWI of the spinal cord is rarely performed because of technical and physiologic problems. Line scan diffusion weighted imaging(LSDI) is spin-echo based and relatively insensitive to susceptibility artifacts. We calculated the apparent diffusion coefficient(ADC) values of the normal cervical spinal cord by LSDI on a 0.2 Tesla MR imager and compared the ADC values with those from 1.5 Tesla MRI previously reported in the literature. The ADC values were adequate, and LSDI on 0.2 Tesla MRI is expected to become a useful tool for clinical application.

Adult↗

[Evaluation of PROPELLER MR imaging: preliminary experiences].

Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) MR imaging (MRI) has a unique ability to correct motion artifacts and is expected to be useful in diffusion-weighted MRI. This article describes preliminary experiences with PROPELLER MRI. PROPELLER uses a radial scan variation of the fast spin-echo sequence and it shows much less spatial deterioration than the echo-planar imaging sequence. To determine the optimal parameters of this technique, we calculated the signal intensities of phantoms and brains in various settings. PROPELLER MR examinations were also performed in 66 patients for clinical use. PROPELLER MRI appears to be a promising and useful technique.

Artifacts↗

[MR angiography].

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Angiography, Digital Subtraction↗

Normal aging in the central nervous system: quantitative MR diffusion-tensor analysis.

The purpose of this study is to elucidate changes in mean diffusivity (ADC) and fractional anisotropy (FA) using MR diffusion tensor imaging (DTI) in the central nervous system during normal aging. We studied 50 normal volunteers (30 men, 20 women; mean age 44.8 +/- 14.0; age range, 21-69 years) without disorders affecting the central nervous system. The frontal, parietal white matter, lentiform nucleus, posterior limb of internal capsule, thalamus, genu and splenium of the corpus callosum were selected for investigation. There was no significant difference in ADC or FA between male and female or between the right and left hemisphere. A significant ADC increase with advancing age was observed in frontal white matter (P = 0.010) and lentiform nucleus (P = 0.022). A significant FA decline was found only in the genu of the corpus callosum (P < 0.001) with advancing age. Quantitative diffusion tensor analysis correlate with normal aging and may help in assessing normal age-related changes and serve as a standard for comparison with neurodegenerative disorders.

Adult↗