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Shuji Sugihara

Publications and source records attributed to Shuji Sugihara.

15 recordsLinked to original sources

Serial diffusion-weighted MRI in hemorrhagic shock and encephalopathy syndrome.

This report presents a case of hemorrhagic shock and encephalopathy syndrome. In the acute stage, brain magnetic resonance imaging demonstrated symmetrical hyperintensity on diffusion-weighted images and hypointensity on the apparent diffusion coefficient maps in the subcortical white matter. Whereas the abnormal diffusion-weighted imaging signals of the white matter resolved in the subacute stage, the adjacent gray matter became hyperintense on diffusion-weighted images and hypointense on apparent diffusion coefficient maps. The evolution of diffusion-weighted imaging signals is thus considered to be one of the early findings in hemorrhagic shock and encephalopathy syndrome.

Brain↗

White matter changes in elderly people: MR-pathologic correlations.

Magnetic resonance (MR) imaging features of white matter lesions, often seen in the elderly, are correlated with histologic findings. Dilatation of perivascular spaces is seen, especially in the frontal and/or parietal subcortical white matter; the spaces are less than 3 mm in diameter and have sharp margins with no perifocal abnormality. Old lacunar infarcts are larger than 3 mm in diameter and are irregularly shaped and accompanied by perifocal myelin pallor and gliosis. Periventricular hyperintensity, including cap and rim, histologically shows myelin pallor, dilatation of perivascular spaces, discontinuity of the ependymal lining, and subependymal gliosis. Deep and subcortical white matter hyperintensity reflects myelin pallor and dilatation of perivascular spaces. Diffuse white matter lesion, seen in Binswanger's disease, shows myelin pallor and tissue rarefaction associated with loss of myelin and axons. U-fibers are usually well preserved. Severe arteriosclerosis and arteriolosclerosis are usually seen in the white matter. Knowledge of the pathologic features of incidental changes in white matter helps in understanding MR imaging findings.

Aged↗

Clinically silent choroid plexus cyst: evaluation by diffusion-weighted MRI.

We retrospectively reviewed diffusion-weighted magnetic resonance images of 57 patients with a choroid plexus cyst diagnosed by contrast-enhanced T1-weighted imaging. All the cysts appeared to represent incidental findings. Thirty-eight of 57 patients had bilateral cysts and 19 had unilateral ones. On diffusion-weighted images, 78 of 95 cysts showed homogeneously high signal intensity, 12 showed focal high signal areas, and 5 had no portion with a high signal. The apparent diffusion coefficient of the high signal areas in the cysts was (1.46+/-0.14) x10(-3) mm(2)/s, intermediate between the apparent diffusion coefficients of cerebrospinal fluid and cerebral white matter, (3.15+/-0.67) x10(-3) and (0.79+/-0.22) x10(-3) mm(2)/s, respectively. Pathological correlation was available in one case, showing high signal intensity areas in the glomera of the choroid plexuses in the lateral ventricles on diffusion-weighted images corresponding to gelatinous cysts with highly proteinaceous content.

Adult↗

Sequential MR imaging and SPECT studies in herpes simplex encephalitis with crossed cerebellar hyperperfusion.

We report a case of herpes simplex encephalitis in which sequential MR imaging and SPECT studies showed interesting findings. SPECT in the acute stage showed wide increased uptake in the left cerebral hemisphere, as well as increased uptake in the contralateral right cerebellar hemisphere. T1-weighted images in the subacute stage showed hyperintense signals along the cerebral cortices, but T2*-weighted gradient-echo images did not show any signal decrease caused by the magnetic susceptibility effect of hemoglobin degradation. Sequential SPECT studies in addition to MR imaging facilitate precise understanding of the pathophysiology of herpes simplex encephalitis.

Aged↗

Pallidoreticular damage in acute carbon monoxide poisoning: diffusion-weighted MR imaging findings.

We describe a case of carbon monoxide poisoning that led to pallidoreticular damage and delayed leukoencephalopathy. Serial diffusion-weighted MR imaging was performed. A restricted water diffusion pattern was demonstrated in the globus pallidus and substantia nigra in the early stage. Diffusion-weighted imaging is useful for early identification of the effects of acute carbon monoxide poisoning.

Adult↗

[Cerebral atrophy and crossed cerebellar atrophy following acute subdural hematoma in infant].

Crossed cerebellar atrophy (CCA) on imaging study reflects secondary degeneration of the cerebellar hemisphere caused by neuronal disconnection with the contralateral cerebral hemisphere. We report an 11-month-old child with traumatic left acute subdural hematoma, who showed crossed cerebellar atrophy on MR images. Eighteen months after the trauma, MR images showed brain atrophy not only in the left cerebral hemisphere but also in the right cerebellar hemisphere. The cerebellar atrophy was prominent in the lateral part. This finding is consistent with CCA and may support neuronal interactions between the cerebral hemisphere and the lateral part of the contralateral cerebellar hemisphere.

Atrophy↗

[MR imaging for evaluation of severe facial nerve damage in patients with facial nerve palsy].

PURPOSE: To evaluate the usefulness of MR imaging for the detection of severe facial nerve damage in patients with facial nerve palsy. MATERIALS AND METHODS: We retrospectively reviewed 26 consecutive patients with facial nerve palsy (13 non-responders and 13 responders). T1-weighted, T2-weighted, and postcontrast T1-weighted images were obtained in all patients. FLAIR images were also obtained in 3 non-responders. RESULTS: The geniculate ganglion, labyrinthine segment, and tympanic segment or mastoid segment showed high signal intensity on T2-weighted images in 9 of 13 non-responders, whereas high signal intensity of the nerve was only seen in 1 of 13 responders. FLAIR imaging revealed high signal intensity lesions of the distal intrameatal segment in 2 non-responders. Contrast enhancement of the facial nerve showed a similar pattern in non-responders and responders. High signal intensity lesions on T2-weighted or FLAIR images showed enhancement on postcontrast T1-weighted images. CONCLUSION: These results suggest that a high signal intensity area on T2-weighted images is a marker of severe facial nerve damage. FLAIR imaging is useful for identification of T2-prolongation in the distal intrameatal segment.

Adolescent↗

Multicystic acoustic schwannoma with intratumoral hemorrhage: a report of two cases.

We encountered two multicystic acoustic schwannomas with intratumoral hemorrhage. The radiological appearance in each case was similar to that obtained with CT and MRI. From a histological perspective, in each case we observed hypervascularity with thin-walled, dilated vessels in clusters and hemosiderin depositions around the dilated vessels.

Adult↗

HTLV-I carrier with unusual brain MR imaging findings.

We describe unusual brain MR imaging findings in a patient who is an HTLV-I carrier without myelopathy. T2-weighted MR images showed hyperintense signal abnormalities in the pyramidal tract, superior and middle cerebellar peduncles, and decussation of the superior cerebellar peduncles, in addition to subcortical white matter involvement. Diffusion-weighted images also showed hyperintense signal abnormalities in the same regions by T2 shine-through effect.

Brain↗

123I-Metaiodobenzylguanidine myocardial scintigraphy in panic disorder.

UNLABELLED: Although autonomic function has been investigated in panic disorder, previous studies have not yet revealed a consistent autonomic change in this disease. The purpose of this study was to evaluate the cardiac sympathetic function in panic disorder using (123)I-metaiodobenzylguanidine ((123)I-MIBG). METHODS: Myocardial imaging using (123)I-MIBG was performed on 9 patients with panic disorder (7 men, 2 women; mean age, 37.4 +/- 13.2 y) and 11 control subjects (11 men; mean age, 37.6 +/- 9.3 y). Early (30 min) and delayed (4 h) planar images were taken after the injection of 111 MBq (123)I-MIBG. The mean counts in the whole heart and the mediastinum were obtained from the early and delayed images to calculate the heart-to-mediastinum count ratios (H/M ratios) and the myocardial washout rate. RESULTS: The (123)I-MIBG H/M ratios of the patients with panic disorder were 1.80 +/- 0.16 for the early images and 1.86 +/- 0.30 for the delayed images, which were significantly lower than those of the control subjects (2.15 +/- 0.15 [P = 0.001] and 2.26 +/- 0.21 [P = 0.009], respectively). The (123)I-MIBG washout rate from the heart in the patients with panic disorder (33.8% +/- 6.9%) was significantly higher than that in the control subjects (27.8% +/- 3.5%) (P = 0.02). CONCLUSION: (123)I-MIBG myocardial scintigraphy demonstrated impairment of cardiac sympathetic function in panic disorder. The results suggest that (123)I-MIBG imaging could become a useful tool for analyzing the pathophysiology of panic disorder.

Adolescent↗

Transneuronal degeneration in patients with temporal lobe epilepsy: evaluation by MR imaging.

The aim of this study was to assess the MR imaging findings of transneuronal degeneration of limbic system in the patients with temporal lobe epilepsy, and to detect the influence of surgery on the anatomy of the limbic system. Axial and coronal T1- and T2-weighted MR images were retrospectively analyzed in 34 patients with temporal lobe epilepsy, focusing on transneuronal degeneration. In 17 of the 34 patients, MR images were also analyzed after selective amygdalo-hippocampectomy. Atrophy of the fornix, mamillary body, mamillothalamic tract (MTT), and thalamus ipsilateral to the epileptic focus was demonstrated on MR images in 14.7, 17.6, 8.8, and 11.8% of the 34 patients, respectively. Focal hyperintensity of the thalamus was found on T2-weighted images in 8.8% of the 34 patients. In 17 patients who were evaluated before and after surgery, transneuronal degeneration was seen more frequently after surgery: fornix (11.8 vs 29.4%), mamillary body (11.8 vs 52.9%), MTT (5.9 vs 11.8%), and thalamus (11.8 vs 11.8%). Transneuronal degeneration of the limbic system is clearly demonstrated by MR imaging in patients with temporal lobe epilepsy, and surgical intervention induces transneuronal degeneration more frequently.

Adolescent↗

[Evaluation of the anisotropy in the patients with Alzheimer's disease].

Diffusion-weighted MR imaging was performed in 5 control subjects and 8 patients with Alzheimer's disease(AD). The mean values of fractional anisotropy(FA) were calculated in the genu and splenium of the corpus callosum, and anterior and posterior cerebral white matter. The FA value of the posterior white matter in patients with AD was significantly lower than that of controls. Fractional anisotropy may be useful in the diagnosis of AD.

Aged↗

Congenital mirror movement: a study of functional MRI and transcranial magnetic stimulation.

Two male patients (a child and an adult) with congenital mirror movement were studied using functional MRI (fMRI) and transcranial magnetic stimulation (TMS). Bilateral primary sensorimotor cortices were activated during unilateral hand gripping on fMRI when the child patient was 8 years old andthe adult was 37 years old. Bilateral motor evoked potentials were induced from the hand and forearm muscles after TMS of each hemisphere. Bilateral motor responses were also induced from the arm muscles in the adult patient. Bilateral motor responses had short and similar latencies. Contralateral motor responses to TMS were smaller than ipsilateral ones in the hand muscles, while contralateral responses were larger than ipsilateral ones in the arm muscles. Contralateral hand motor responses reduced in amplitude or disappeared with increasing age while in the child patient, mirror movements decreased gradually. Our results suggest that bilateral activation of the primary sensorimotor cortices during intended unilateral hand movement and bilateral motor responses to TMS account, at least in part, for the pathophysiology of congenital mirror movement. Reduction of contralateral hand motor responses may be related to the decrease in mirror movements during development.

Adult↗

White matter lesions in panencephalopathic type of Creutzfeldt-Jakob disease: MR imaging and pathologic correlations.

BACKGROUND AND PURPOSE: A panencephalopathic type of Creutzfeldt-Jakob disease (pCJD) is characterized by the extensive involvement of the cerebral white matter as well as the cerebral gray matter. It has been a point of controversy, however, whether the white matter changes represent primary or secondary degeneration. The aim of this study was to elucidate, by using MR images and histologic examinations, whether the white matter lesions in pCJD are primary or secondary degeneration. METHODS: Serial changes of T2 hyperintensities and histologic findings of six autopsy-proved cases of pCJD were retrospectively analyzed. RESULTS: Serial MR images of brains affected by pCJD revealed that T2 hyperintensities appeared in the cerebral gray matter 2-5 months after onset and in the cerebral white matter around the lateral ventricles approximately 5 months after onset. They rapidly extended to deep and subcortical white matter during the next several months and then to the entire cerebral white matter 10 months after onset. Histologic examination of the white matter lesions revealed spongy changes or tissue rarefaction associated with gemistocytic astrocytosis, which indicates primary involvement of the white matter. At the terminal stages of cases with a longer clinical course, MR images showed T2 hyperintensities in the corticospinal tracts in the internal capsule and brain stem, which histologically disclosed loss of myelin and axons accompanied by fibrillary gliosis that indicates secondary degeneration. CONCLUSION: Cerebral white matter lesions in pCJD were considered to be primary changes of the disease, but the lesions of the corticospinal tracts were secondary to cortical or cerebral or both white matter lesions.

Aged↗