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Toshifumi Gabata

Publications and source records attributed to Toshifumi Gabata.

13 recordsLinked to original sources
PubMed2006

Successful cystic fenestration for a macrocystic serous cystadenoma of the pancreas causing obstructive jaundice: report of a case.

A 72-year-old man was admitted to our hospital for investigation of jaundice. We made a preoperative diagnosis of macrocystic serous cystadenoma (SCA) of the pancreas, but did not perform palliative choledochojejunostomy because aspiration of the pancreatic cystic fluid caused the cysts to shrink and relieved the compressive stenosis of the common bile duct (CBD) during the operation. Frozen sections of the cyst wall taken by incision biopsy showed no signs of malignancy. Therefore, we performed fenestration of the cystic wall after fixing the inner epithelium of the cyst with 100% ethanol and aspirating the cystic fluid. Cholangiography after the cystic fenestration showed resolution of the CBD stenosis and abdominal computed tomography (CT) confirmed the disappearance of the pancreatic cysts. No recurrence of cystic swelling or obstructive jaundice has been detected by abdominal CT or laboratory data for more than 2 years since the cystic fenestration. Thus, cystic fenestration may be a better palliative option for treating benign compressive tumors such as macrocystic SCA of the pancreas causing obstructive jaundice.

Aged↗
PubMed2006

Autoimmune pancreatitis with multifocal mass lesions.

Autoimmune pancreatitis (AIP) is radiologically characterized as diffuse swelling of the pancreatic parenchyma and irregular narrowing of the pancreatic ducts. We present a case of AIP with multiple small nodular lesions in the pancreas. This case suggests that AIP with only small nodular or localized lesions is more difficult to differentiate from pancreatic cancer than typical cases of AIP.

Autoimmune Diseases↗
PubMed2005

Cirrhotic nodules: association between MR imaging signal intensity and intranodular blood supply.

PURPOSE: To retrospectively determine whether there is a relationship between the intranodular blood supply evaluated at computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) and the magnetic resonance (MR) imaging signal intensity of nodules associated with cirrhosis. MATERIALS AND METHODS: Neither institutional review board approval nor informed consent was required for retrospective reviews of medical records and images. One hundred fourteen hepatocellular nodules 10 mm or greater in largest diameter in 58 patients (39 men, 19 women; mean age, 61 years) with cirrhosis were evaluated at CTAP, CTHA, and MR imaging. The CTAP and CTHA nodule findings were divided into three main types: Type A nodules were isoattenuating at CTAP and hypoattenuating at CTHA; type B nodules, slightly hypoattenuating at CTAP and hypoattenuating at CTHA; and type C nodules, strongly hypoattenuating at CTAP and hyperattenuating at CTHA. The relationships between the CTAP and CTHA findings and the MR imaging signal intensity among these nodules were analyzed by using the chi(2) test. RESULTS: On T1-weighted MR images, 27 (63%) of 43 type A nodules were hyperintense, nine (39%) of 23 type B nodules were isointense, and 19 (48%) of 40 type C nodules were hypointense; differences were not significant. On T2-weighted MR images, 31 (72%) of 43 type A nodules were hypointense (P < .05), 12 (52%) of 23 type B nodules were isointense, and 34 (85%) of 40 type C nodules were hyperintense (P < .05). CONCLUSION: There was a significant association between intranodular blood supply and nodule signal intensity on T2-weighted MR images. However, study findings did not show whether the blood itself (ie, blood volume or blood flow amount) directly influenced the signal intensity.

Adult↗
PubMed2005

Phlebosclerotic colitis: imaging-pathologic correlation.

OBJECTIVE: The objective of this study was to analyze the imaging findings of phlebosclerotic colitis in comparison with histologic findings. CONCLUSION: Calcifications and/or obstructions of the veins of the colonic wall and adjacent mesentery and collateral formation, edematous thickening of the colonic wall, and increased density in the fatty tissue of the surrounding mesentery were features of this rare entity. However, in the early stage of the disease, no definite calcification of the affected veins was observed.

Aged↗
PubMed2005

[Effect of saline flush using dual injector on abdominal dynamic contrast enhanced computed tomography].

PURPOSE: To evaluate the efficacy of the saline flush technique for abdominal multidetector-row computed tomography (CT). METHODS: As a clinical study, 147 patients with chronic hepatic disease were divided into two groups: group A, given 100 cc of contrast material flushed with 50 cc of saline; and group B, given 100 cc of contrast material only. The difference in attenuation values between groups A and B, and cirrhotic liver and non-cirrhotic liver were evaluated. As an in-vitro experimental study, time vs. peak pressure curve was obtained changing injection devices. RESULTS: Group B showed a greater contrast enhancement effect in the early arterial equilibrium phase of the aorta and late arterial phase of the liver. In cirrhotic liver, the aorta showed greater contrast enhancement in the early arterial phase in group A. Attenuation values of hypervascular hepatic nodules showed no statistically significant difference between groups A and B. Time to reach peak pressure was prolonged when using saline flush devices in vitro. Flow of contrast material from the contrast material cylinder to the saline cylinder was also discovered. CONCLUSION: Saline flush causes peak arterial contrast to be strong for a short duration. Abdominal organ attenuation values are not necessarily increased in the saline flush method. It is important to know that contrast enhancement is dependent on the injection device.

Aorta, Abdominal↗
PubMed2005

CT and MRI findings of carcinoma showing thymus-like differentiation.

Carcinoma showing thymus-like differentiation (CASTLE) is a rare tumor that occurs in the soft tissue of the neck or in the thyroid gland. We report a case of CASTLE in a 54-year-old man presenting with hoarseness. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a mass enclosing the right carotid artery with the shape of lobulation and invasion to the trachea. The mass was hypointense on T1-weighted imaging and, on T2-weighted imaging, showed a hyperintense periphery with isointense center relative to muscle. In dynamic MRI, the mass revealed gradual but slight heterogeneous enhancement from the periphery. Diagnosis was confirmed by histopathology.

Carcinoma↗
PubMed2003

Vertebral body osteonecrosis without vertebral collapse.

STUDY DESIGN: A case of idiopathic focal vertebral body osteonecrosis without vertebral collapse is reported. OBJECTIVES: To report a rare case of focal vertebral osteonecrosis and to clarify the features of imaging studies. SUMMARY OF BACKGROUND DATA: There are no previous reports describing focal vertebral body necrosis without collapse in the literature. METHODS: A case report and literature review are presented. RESULTS: Imaging studies demonstrated: 1) sclerotic change on computed tomography scan; 2) low intensity on T1, high intensity on T2 with clear margin, and no gadolinium enhancement on magnetic resonance imaging; and 3) no uptake on bone scan. Histologic examination revealed empty lacunas, fatty necrosis with vacuolar degeneration, and cell debris compatible with bone marrow necrosis. CONCLUSION: Vertebral body osteonecrosis must be considered a possible diagnosis of patients presenting with low intensity on T1, high intensity on T2 with clear margin, and no gadolinium enhancement on magnetic resonance imaging.

Adult↗
PubMed2002

Groove pancreatic carcinomas: radiological and pathological findings.

The aim of this study was to clarify the characteristics of pancreatic head carcinomas mainly invading the groove between the duodenum and the pancreatic head. Nine patients with pathologically proven pancreatic head carcinomas underwent thin-slice dynamic CT, MR imaging, duodenal endoscopy, and angiography (seven patients). Plate-like masses within the groove region were seen in all cases, which showed hypointensity on T1-weighted images and slight hyperintensity on T2-weighted MR images. The masses appeared hypovascular in the early phase and delayed enhancement in the late phase of dynamic CT and MR imaging. On MR cholangiopancreatography, stenosis of intrapancreatic common bile duct was seen in all patients, whereas stenosis of the main pancreatic duct was seen in only three cases. Endoscopy revealed luminal narrowing of the duodenum in all patients, and duodenal mucosal biopsy demonstrated adenocarcinoma in seven patients. Abdominal arteriography showed serrated encasement of peripancreatic arteries in seven patients who received angiographic examinations. The CT and MR imaging findings of groove pancreatic carcinomas resemble those of groove pancreatitis. Differential diagnosis may be achieved by the pathological diagnosis of a biopsy specimen of the duodenal mucosa and arterial encasement on arteriography.

Adenocarcinoma↗
PubMed2002

Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material.

PURPOSE: To analyze the correlation between intranodular blood supply of borderline lesions (ie, dysplastic nodules or hypovascular well-differentiated hepatocellular carcinoma [HCC] nodules) and their progression to hypervascular classic HCC in cirrhotic livers. MATERIALS AND METHODS: One hundred seventy-six borderline lesions seen at computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) were evaluated in 49 patients with cirrhosis who underwent repeated CTAP and/or CTHA but no therapy. On the basis of CTAP findings, nodules were categorized as group A (showing almost the same portal venous supply as the surrounding liver), group B (showing decreased portal venous supply) or group C (showing partially absent portal venous supply); on the basis of CTHA findings, nodules were categorized as group I (showing almost the same arterial supply as the liver), group II (showing decreased arterial supply), or group III (showing partially increased arterial supply). RESULTS: Progression to classic HCC was observed in 29.4% of group A nodules, 53.9% of group B nodules, and 87.9% of group C nodules within 1,000 days; in 58.6% of group I nodules, 12.9% of group II nodules, and 92.2% of group III nodules within 730 days; and in 0% of nodules in group A and I, 28% of nodules in group B and/or II, and 88.7% of nodules in group C and/or III within 730 days. CONCLUSION: Evaluation of intranodular blood supply was valuable in predicting the prognosis in borderline lesions, except when only arterial blood supply was evaluated.

Adult↗
PubMedDate not supplied

MR imaging of hepatocellular carcinomas with biliary tumor thrombi.

We retrospectively evaluate the MR imaging findings of hepatocellular carcinomas (HCC) with biliary tumor thrombi. MR imaging was performed on six patients presenting with obstructive jaundice and/or biliary hemorrhage. T1-weighted images, T2-weighted images, MR cholangiopancreatography (MRCP), and dynamic MR images were obtained. Duodenal endoscopy was performed on all cases and hepatic resection on two cases. HCCs were 1.8-10 cm in diameter (mean 5.8 cm). Biliary tumor thrombi were detected in all patients on MR imaging. Tumor thrombi showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and contrast enhancement on the early phase of dynamic MR images. MRCP showed intrahepatic bile duct dilatation in all cases. Biliary hemorrhage was clearly depicted by MR images in five cases and showed hyperintensity on T1-weighted images and hyperintensity or hypointensity on T2-weighted images. Biliary hemorrhage was confirmed by endoscopy in two cases. Portal vein thrombi were also associated in five of six patients. Pathologically, tumor thrombi of HCCs were demonstrated in two patients who underwent hepatic resection. In conclusion, MR imaging is useful for the diagnosis of biliary tumor thrombi from HCC and for evaluating the extension of thrombi and biliary hemorrhage.

Aged↗
PubMedDate not supplied

Peritumoral rim enhancement of liver metastasis: hemodynamics observed on single-level dynamic CT during hepatic arteriography and histopathologic correlation.

PURPOSE: The purpose of this work was to clarify the mechanism of peritumoral rim enhancement of metastatic liver cancer. METHOD: Twenty-nine liver metastases of colon cancer were examined by single-level dynamic CT during hepatic arteriography, which was performed without table feed. We analyzed these findings and correlated them with the histopathologic findings. RESULTS: Eleven metastases were hypervascular and 18 were hypovascular. Early appearance of rim enhancement was seen in 3 of 10 hypervascular metastases and 17 of 18 hypovascular metastases (p < 0.01). The time of appearance and thickness of peritumoral rim enhancement showed no apparent correlation with the desmoplastic reaction or inflammation in the surrounding hepatic parenchyma. CONCLUSION: Two types of intra- and peritumoral enhancement were observed. Peritumoral rim enhancement was considered to be due mainly to the drainage of blood flow from the tumor to the surrounding hepatic parenchyma in hypervascular metastasis or increased arterioportal shunts surrounding the tumor in hypovascular metastasis.

Angiography↗
PubMedDate not supplied

Prevention of hepatic infarction as acute-phase complication of TIPS by temporary balloon occlusion in a patient with primary myelofibrosis.

Severe acute liver dysfunction occurred following transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with massive ascites due to portal hypertension associated with primary myelofibrosis. On US and TIPS venography, we considered that the acute liver ischemia was induced by TIPS. To avoid diffuse hepatic infarction and irreversible liver damage, a balloon catheter was inserted transjugularly into the TIPS tract and occluded it to increase portal venous flow toward the peripheral liver parenchyma. The laboratory data indicating hepatic dysfunction were improved after the procedure. We should pay attention to the possible occurrence of acute hepatic ischemia and infarction after TIPS creation even in a case of noncirrhotic portal hypertension. In such cases, temporary balloon occlusion of TIPS is an effective therapeutic method, probably as a result of inducing the development of arterial compensation through the peribiliary plexus.

Acute-Phase Reaction↗