Biomedical subjects

Tomohiko Masumoto

Publications and source records attributed to Tomohiko Masumoto.

At least 19 recordsLinked to original sources

PubMed2005

Quantitative evaluation of the pyramidal tract segmented by diffusion tensor tractography: feasibility study in patients with amyotrophic lateral sclerosis.

PURPOSE: Diffusion tensor imaging can evaluate the cerebral white matter quantitatively using fractional anisotropy (FA) and also can extract a certain tract by tractography, but these two have been used separately and not combined. The purpose of this study was to assess the clinical feasibility of ROI analysis using diffusion tensor tractography (DTT) in patients with amyotrophic lateral sclerosis (ALS). MATERIALS AND METHODS: Sixteen patients with ALS (9 limb-onset type, 7 bulbar-onset type) and nine age-matched volunteers were studied. DTT of the corticobulbar tract (DTT-CBT) and corticospinal tract (DTT-CST) were visualized by free software (dTV/VOLUME-ONE). Regions-of-interest (ROIs) were semi-automatically placed on the tracts defined by DTT methods, and FA values within the ROIs were measured. RESULTS: Mean FA values of ALS patients in the ROIs along the DTT-CST (bulbar-onset: 0.574, limb-onset: 0.594) were significantly lower than those of controls (DTT-CST: 0.629) (p<0.05). The mean FA of DTT-CBT of the bulbar-onset type (0.509) was significantly lower than that of the limb-onset type (0.558) and that of volunteers (0.561). CONCLUSION: DTT could segmentate certain white matter tracts and evaluate them quantitatively. It could depict the subtle changes between subtypes of ALS as well as the changes between the patients and volunteers.

Amyotrophic Lateral Sclerosis↗

PubMed2005

[In-vitro phantoms for estimating diffusion tensor tractography].

No literature has reported on in-vitro diffusion tensor tractography, although it is a useful method to visualize neuronal fiber projections in the living human brain. We applied this technique to phantoms of asparagus stems and bundled polyester yarn, and obtained tractography with high-quality images. On the asparagus stem phantom, straight tracts along the axis were displayed. On the polyester phantom, these tracts followed the course of the bundle whether it was straight or curved. These phantoms are useful for in-vitro evaluation of diffusion tensor tractography.

Algorithms↗

PubMed2004

The optimal trackability threshold of fractional anisotropy for diffusion tensor tractography of the corticospinal tract.

PURPOSE: In order to ensure that three-dimensional diffusion tensor tractography (3D-DTT) of the corticospinal tract (CST), is performed accurately and efficiently, we set out to find the optimal lower threshold of fractional anisotropy (FA) below which tract elongation is terminated (trackability threshold). METHODS: Thirteen patients with acute or early subacute ischemic stroke causing motor deficits were enrolled in this study. We performed 3D-DTT of the CST with diffusion tensor MR (magnetic resonance) imaging. We segmented the CST and established a cross-section of the CST in a transaxial plane as a region of interest. Thus, we selectively measured the FA values of the right and left corticospinal tracts at the level of the cerebral peduncle, the posterior limb of the internal capsule, and the centrum semiovale. The FA values of the CST were also measured on the affected side at the level where the clinically relevant infarction was present in isotropic diffusion-weighted imaging. RESULTS: 3D-DTT allowed us to selectively measure the FA values of the CST. Among the 267 regions of interest we measured, the minimum FA value was 0.22. The FA values of the CST were smaller and more variable in the centrum semiovale than in the other regions. The mean minus twice the standard deviation of the FA values of the CST in the centrum semiovale was calculated at 0.22 on the normal unaffected side and 0.16 on the affected side. CONCLUSION: An FA value of about 0.20 was found to be the optimal trackability threshold.

Aged↗

PubMed2004

Utilization of low-field MR scanners.

The evident advantage of high-field MR (magnetic resonance) scanners is their higher signal-to-noise ratio, which results in improved imaging. While no reliable efficacy studies exist that compare the diagnostic capabilities of low- versus high-field scanners, the adoption and acceptance of low-field MRI (magnetic resonance imaging) is subject to biases. On the other hand, the cost savings associated with low-field MRI hardware are obvious. The running costs of a non-superconductive low-field scanner show even greater differences in favor of low-field scanners. Patient anxiety and safety issues also reflect the advantages of low-field scanners. Recent technological developments in the realm of low-field MR scanners will lead to higher image quality, shorter scan times, and refined imaging protocols. Interventional and intraoperative use also supports the installation of low-field MR scanners. Utilization of low-field systems has the potential to enhance overall cost reductions with little or no loss of diagnostic performance.

Cost-Benefit Analysis↗

PubMed2004

Amyotrophic lateral sclerosis: diffusion tensor tractography and voxel-based analysis.

The purpose of this study is to investigate whether the diffusional anisotropy of water molecules is disrupted in the pyramidal and extra-pyramidal regions in patients with amyotrophic lateral sclerosis (ALS). We studied seven patients with probable ALS (four women, mean age +/- SD, 57.3 +/- 6.2 years old) according to the criteria of the World Federation of Neurology. A control group consisted of 11 age- and sex-matched volunteers (six women, 57.1 +/- 4.5) without disorders affecting the central nervous system. Voxel-based diffusion tensor analysis was made with statistical parametric mapping (SPM99). We also created the normalized corticospinal tractography from the diffusion tensor data. The significant fractional anisotropy (FA) decrease in the ALS group was found in the right frontal subgyral white matter and left frontal precentral white matter. These clusters with significant FA decrease corresponded well to the average group map of the corticospinal tract in a standard reference frame. These results suggested that the combination of voxel-based diffusion tensor analysis and diffusion tensor tractography might help determine the location of the affected neuronal tissues among ALS patients in a non-invasive manner.

Algorithms↗

PubMed2004

Extradural neurenteric cyst of the cerebellopontine angle. Case report.

Neurenteric cyst is a developmental malformation found mainly in the spinal canal. The authors report on a 47-year-old man with a neurenteric cyst of the cerebellopontine angle (CPA) who presented with progressive hearing disturbance and facial palsy. The tumor was located extradurally with marked destruction of the petrous bone around the internal auditory canal and demonstrated irregular and heterogeneous high-intensity signals on T1- and T2-weighted on MR images, which is atypical for neurenteric cysts. The pathological findings in samples obtained after resection disclosed a single epithelial layer (a feature of neurenteric cyst), which was accompanied by marked xanthogranulomatous changes. Although several neurenteric cysts have been reported in the CPA, extradural lesions with unusual imaging features and marked bone destruction have not been reported previously. This benign developmental lesion should be considered, although it is extremely rare, in patients harboring an extradural temporal bone tumor around the CPA.

Cerebellopontine Angle↗

PubMed2003

Development of intraarterial contrast-enhanced 2D MRDSA with a 0.3 tesla open MRI system.

PURPOSE: The purpose of this study was to develop a new technique for a high temporal resolution two-dimensional MR digital subtraction angiography (2D MRDSA) sequence under intraarterial injection of contrast material to permit the visualization of vascular anatomy and hemodynamics. METHODS: 2D MRDSA was imaged on a 0.3T open MR scanner with a T(1)-weighted fast gradient echo sequence. The phantom study examined vials containing gadolinium (Gd) solutions ranging in concentration from 0.5 mmol/L to 100 mmol/L. Repetition time and echo time were fixed at minimal values in order to achieve high temporal resolution, and only the flip angle was changed in 10-degree increments between 10 and 90 degrees. The in vivo study examined a brachial artery of a human volunteer. MRDSA images were acquired continuously during intraarterial injections of Gd solutions ranging in concentration from 0.5 mmol/L to 100 mmol/L. The subtracted images were displayed on the monitor in real time at a frame rate of one frame per second and evaluated to determine the optimal concentration of contrast material. RESULTS: In the phantom study, a 10-mmol/L Gd concentration with a flip angle of 50 degrees -90 degrees and a 25-mmol/L Gd concentration with a flip angle of 60 degrees -90 degrees showed high signal-to-noise ratios. In the human brachial artery experiment, the forearm arteries were well visualized when solutions of 5-50 mmol/L Gd concentration were used. The 10- and 25-mmol/L Gd concentrations were considered optimal. The palmar digital arteries were also visualized. Higher Gd concentrations showed a paradoxical signal increase when diluted by blood. CONCLUSION: We successfully developed an intraarterial contrast-enhanced 2D MRDSA sequence. With appropriate settings of imaging parameters and Gd concentrations, we obtained acceptable vessel visualization in the human study. The low Gd concentration for optimal visualization permits repeated intraarterial injections. This technique can be a useful tool for investigating the vascular anatomy and hemodynamics required for MR-guided vascular interventions.

Adult↗

PubMed2003

Feasibility of a curvature-based enhanced display system for detecting cerebral aneurysms in MR angiography.

PURPOSE: To assess the feasibility of a curvature-based enhanced display system for detecting cerebral aneurysms in MR angiography. METHODS: MR angiography studies of 18 patients (eight male and 10 female, average age 65.7, age range 50 to 75 years old) with 23 known aneurysms were evaluated with a curvature-based display system. The two curvature features-the volumetric shape index and curvedness values-were calculated at each voxel. These were displayed independently on a workstation, overlaid on volume-rendered images. Two neuroradiologists evaluated the images for visibility and diagnosis of the cerebral aneurysms. The diagnostic results were compared with the original reports. RESULTS: The calculation time for each curvature index was 30 to 40 s for 120 to 140 slices of original MR angiography data. Shape index images emphasized smooth and round aneurysms more than aneurysms with irregular surfaces. Curvedness images revealed aneurysms well when the aneurysms had diameters that differed from those of the surrounding vessels. The computer-assisted-detection method detected 24 aneurysms, three of which were not pointed out in the initial report. CONCLUSION: Our results show that the curvature-based display system we have developed is feasible and that it may help to detect small aneurysms that are prone to be overlooked in routine readings.

Aged↗

PubMed2003

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↗

PubMed2003

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↗

PubMed2003

[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↗

PubMed2002

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↗

PubMed2002

[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↗

PubMed2002

[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↗

PubMed2002

[MR angiography].

Explore the source record for details and available documents.

Angiography, Digital Subtraction↗

PubMedDate not supplied

Visual field damage in normal-tension glaucoma patients with or without ischemic changes in cerebral magnetic resonance imaging.

PURPOSE: To compare the pattern of visual field damage between normal-tension glaucoma (NTG) patients with signs indicative of ischemic changes and those NTG patients without signs of ischemic changes, using brain magnetic resonance imaging (MRI), in a single center, cross-sectional study. METHODS: In 94 consecutive NTG patients who were younger than 61 years old, brain MRI images were obtained using fluid-attenuated inversion recovery pulse sequences. The presence of signs indicative of ischemic changes in brain MRI images was decided separately by two neuroradiologists masked to the diagnosis and stage of glaucoma. Visual field testing was performed using the 30-2 program of the Humphrey Visual Field Analyzer. Between the patients with signs indicative of ischemic changes in brain MRI (ischemic group) and those without MRI signs (nonischemic group), total deviation (TD) at each test point less the average of TDs of the 30-2 program ([TD - TD(mean)])--was compared at each test point. RESULTS: Signs indicative of ischemic changes in brain MRI were found in 32 of the 94 patients (34.0%). Age, blood pressure, refraction, intraocular pressure, the average of TDs, mean deviation, and corrected pattern standard deviation were not significantly different between the ischemic (N = 32) and nonischemic (N = 62) groups (P > 0.2). [TD - TD(mean)] in the ischemic group was significantly smaller than that in the nonischemic group at 6 nonedge contiguous test points in the inferior pericentral to nasal field (P = 0.005-0.047). CONCLUSION: NTG patients with signs indicative of ischemic changes in brain MRI had a relatively deeper depression in the inferior pericentral visual field.

Blood Pressure↗

PubMedDate not supplied

Topography of the human corpus callosum using diffusion tensor tractography.

OBJECTIVE: To evaluate the crossing fiber trajectory through the corpus callosum using distortion-corrected diffusion tensor tractography in the human brain. METHODS: After correcting distortion associated with large-diffusion gradients, T2-weighted echo planar images (EPIs) acquired from 10 right-handed healthy men were coregistered into T2-weighted fast spin echo images using linear through sixth-order nonlinear, 3-dimensional, polynomial warping functions. The optimal transformation parameters were also applied to the distortion-corrected diffusion-weighted EPIs. Diffusion tensor tractography through the corpus callosum was reconstructed, employing the "1 or 2 regions of interest" method. RESULTS: Compared with the lines through the genu, those through the rostrum ran more inferiorly and seemed to enter the orbital gyrus. Those lines entering posterior temporal white matter (tapetum) crossed through the ventral portion of the splenium and were clearly distinguished from lines that reached parieto-occipital white matter (forceps major). CONCLUSION: Diffusion tensor tractography is a feasible noninvasive tool to evaluate commissural fiber trajectory.

Adult↗

PubMedDate not supplied

Corticospinal tracts by diffusion tensor tractography in patients with arteriovenous malformations.

OBJECTIVE: To visualize the corticospinal tract (CST) in patients with arteriovenous malformations (AVMs) by using diffusion tensor tractography (DTT) and to confirm the clinical reliability of DTT in patients with AVMs. METHODS: We performed DTT in 24 patients who had their AVMs near the CST. Tracts and AVMs were shown simultaneously, providing information on their spatial relationships. We also counted numbers of voxels in the DTT-CST at the level of the AVM. RESULTS: DTT was visualized in 23 patients. In all 9 patients with hemiparesis, their DTT-CSTs were involved in the AVM or its surrounding lesion. Their volume of DTT-CST at the affected side was significantly decreased when compared with the contralateral side (P = 0.0469). All 14 patients whose DTT-CSTs were free from lesion had no hemiparesis. CONCLUSIONS: DTT was safe and clinically applicable in patients with AVMs. DTT is recommended when an AVM is located near the corticospinal tract.

Adolescent↗