Biomedical subjects

Y Narumi

Publications and source records attributed to Y Narumi.

At least 19 recordsLinked to original sources

PubMed1995

Prophylactic irradiation of para-aortic lymph nodes in carcinoma of the uterine cervix. A prospective randomized study.

PURPOSE: For assessment of the advantages and side effects of para-aortic lymph nodes irradiation under the evaluation by computer tomography, a prospective randomized study was started in 1986. The results for survival, local control and late complications are presented in the following. PATIENTS AND METHODS: From November 1986 to October 1990, 93 patients with cervical carcinoma were randomly allocated for treatment with either pelvic irradiation (pelvic group) or pelvic plus para-aortic lymph nodes irradiation (para-aortic group). Thirty-six patients underwent external irradiation and intracavitary therapy (RT arm) and 57 patients, extended radical hysterectomy and external irradiation (OP-RT arm). Para-aortic lymph nodes irradiation delivered 45 Gy in 1.8 Gy per day for 5 days per week through anterior-posterior fields. RESULTS: The 3-year cause specific survival rates were para-aortic group: 57% and pelvic group: 89% in RT arm group, and para-aortic group: 70% and pelvic group: 86% in OP-RT arm group. Differences for the 2 groups in each treatment arm were not significant. In pelvic failure, para-aortic lymph nodes metastases and distant metastases showed no statistically significant differences for the 2 groups in each treatment arm. In the para-aortic group, complications were more frequent than in the pelvic group (13/45 vs. 2/48, p < 0.025). As an enteric complication ileus was found in 7% (3/45) of the para-aortic group while 2% (1/48) in the pelvic group. Compression fractures of the lumber vertebral body were apparent in 9% (4/45) and 0%, respectively. CONCLUSION: Routine para-aortic lymph nodes irradiation delivered through anterior-posterior fields for high risk patients with cervical carcinoma is of limited value occurring to the high incidence of late complications and this treatment fails to improve no survival rates.

Adenocarcinoma↗

PubMed1994

[Evaluation of multislice dynamic MR imaging of the whole liver].

In 47 patients with liver cirrhosis, we performed dynamic MRI with a multisection FLASH technique that enabled us to obtain 13 T 1-weighted images of the entire liver within a single breath hold. Computed tomographic arterial portography (CTAP), US, CT, angiography (AOG) and MRI (spin echo [SE] and dynamic MRI) were performed in all 47 patients. Except for cyst, hemangioma and metastatic tumor, 104 focal nodules less than 3 cm in diameter were detected. These 104 focal lesions were divided into three groups according to the pattern of CTAP: 69 portal supply negative, 11 portal supply decreased, and 24 portal supply normal. In the portal supply negative group, 63 lesions (91%) were detected by dynamic MRI, which was superior to other modalities (US 77%, CT 41%, AOG 70%, MRI-SE 61%). The superiority of dynamic MRI resulted from its excellent ability to detect liver lesions less than 1 cm in diameter. We confirmed histologically that dynamic MRI had almost the same ability to detect hepatocellular carcinoma (HCC) as CTAP. Dynamic MRI should be clinically useful as a noninvasive examination for the detection of HCC.

Carcinoma, Hepatocellular↗

PubMed1994

Small PACS for digital medical images--reliability and security in a clinical setting.

Recently we introduced a small Picture Archiving Communication System (PACS) for handling CT and MRI data. Our experience with this system has been useful in identifying potential problems in a clinical setting. Since the use of PACS raises both medical and social concerns, it cannot be instituted without addressing concerns related to the reliability and security issues. Although PACS is useful in the management of medical images, there are concerns about their reliability and security in a clinical setting. Reliability encompassed image quality, timeliness of the reports, and the PACS to the Radiological Information System (RIS) interface including the retrieval of the previously obtained images. The security of the patient's medical data is also essential.

Computer Security↗

PubMed1994

Pleural invasion by peripheral bronchogenic carcinoma: assessment with three-dimensional helical CT.

PURPOSE: To evaluate the potential role of three-dimensional (3D) computed tomography (CT) in assessment of pleural invasion by peripheral bronchogenic carcinoma. MATERIALS AND METHODS: Twenty-four-second helical CT scans were obtained during a single breath hold in 42 consecutive patients with peripheral bronchogenic carcinoma. Conventional two-dimensional (2D) images and 3D reconstruction images were reviewed independently by three blinded observers, who reached a decision by consensus. All patients underwent surgical resection of the tumor, and CT findings were correlated with the findings in pathologic specimens. RESULTS: Twelve patients had visceral pleural invasion, five had parietal pleural invasion, and 25 had no evidence of pleural invasion. Visceral pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in 11. Parietal pleural invasion was identified on 2D CT images in two patients and on 3D reconstructions in three. CONCLUSION: 3D reconstruction imaging is superior to conventional 2D CT in assessment of pleural invasion by peripheral bronchogenic carcinoma.

Carcinoma, Bronchogenic↗

PubMed1993

[Differentiation of bronchogenic carcinoma from benign nodule by MR imaging: quantitative evaluation].

To distinguish benign from malignant nodules with MR imaging, 39 pulmonary nodules (23 bronchogenic carcinomas, nine tuberculomas and seven other benign lesions) were studied. MR equipment of 1.5 Tesla was used, and relative signal intensities of pulmonary nodules on T 2- and T 1-weighted images before and after administration of gadopentate dimeglumine were evaluated. On T 2-weighted images, the relative signal intensity of bronchogenic carcinomas to subcutaneous fat was 5.48 +/- 1.69, that of tuberculomas was -2.56 +/- 2.22 and that of other benign lesions was -0.88 +/- 3.37; the difference between tuberculomas and bronchogenic carcinomas was statistically significant (p < 0.05). On T 1-weighted images before and after administration of gadopentate dimeglumine, the relative signal enhancement of bronchogenic carcinomas was 17.6 +/- 2.0, that of other benign lesions was 20.0 +/- 5.2 and that of tuberculomas was -0.0074 +/- 0.763; the difference between tuberculomas and bronchogenic carcinomas as well as benign nodules was statistically significant (p < 0.001). The relative signal intensity on T 2-weighted images and the ratio of signal enhancement to noise could differentiate tuberculomas from bronchogenic carcinomas and other benign lesions. However, bronchogenic carcinomas and other benign lesions could not be differentiated by MR imaging.

Aged↗

PubMed1993

Magnetic resonance imaging-histologic correlation of small hepatocellular carcinomas adenomatous hyperplasias.

RATIONALE AND OBJECTIVES: Hepatocellular carcinomas (HCCs) usually consist of components of different histologic grade. Using surgically resected specimens, the authors obtained high-resolution magnetic resonance (MR) images and studied the relationship between histologic grade of HCCs and MR signal intensity. METHOD: In vitro MRI was performed on 15 small (less than 20-mm diameter) HCCs and 2 patients with adenomatous hyperplasia (AH) within 1 hour of surgical resection. In these 17 lesions, 24 macroscopic nodular components corresponding to MR images were recognized pathologically. The difference in MR signal intensity was examined by using tumor/phantom (T/P) signal-intensity ratio. In addition, the correlations between signal intensity on MRI and histologic criteria for grading HCC were studied. RESULTS: On T2-weighted images, grade II HCCs had significantly greater T/P values than grade I HCCs (P < .01). There is the correlation (r = .88, P < .001) between nucleocytoplasmic (N/C) ratio and signal intensity of small HCCs and AHs on T2-weighted images. CONCLUSION: The N/C ratio is an important factor relating the signal intensity to the histologic grade of these lesions on T2-weighted images.

Aged↗

PubMed1993

MR imaging of traumatic posterior urethral injury.

To assess the role of magnetic resonance (MR) imaging in defining the surgical approach and in predicting permanent erectile dysfunction in patients with traumatic posterior urethral injury, 27 patients underwent MR imaging before open urethral reconstruction. MR findings were correlated with surgical findings, surgical approach, and sexual potency at 12-month follow-up. MR imaging correctly revealed the length of the urethral injury (allowing for 0.5-cm discrepancy) in 23 of 27 (85%) patients and displacement of the prostatic apex in 19 of 21 (90%) patients. MR findings prompted a change in the clinically planned surgical approach from perineal to combined perineal and transpubic in seven (26%) cases. Significant variables affecting permanent impotence were avulsion of the corpus cavernosum, (P < .001), separation of the corporeal body (P < .05), and superior and/or lateral prostatic displacement (P < .05). When MR imaging findings of both cavernous avulsion and superior and/or lateral prostatic displacement were present, the probability of permanent impotence was 95%. In the absence of these findings, the probability of normal potency was 83%. MR imaging can be performed to help select the most effective surgical approach and to assess permanent erectile dysfunction.

Adolescent↗

PubMed1991

Hepatic arterial embolization in cases of extensive celiac arterial stenosis.

Transarterial hepatic embolization was attempted in 10 and succeeded in nine patients with hepatocellular carcinoma accompanied by extensive celiac arterial stenosis. All catheterization was done through the femoral artery. In six cases, the tip of the catheter (2.5-F ball-tip microcatheter in three cases, 4-F ball-tip supple catheter in three cases) was placed in the proper hepatic artery through the pancreaticoduodenal collaterals. In three cases, a ball-tip microcatheter was injected from the guiding catheter, which was placed in a pinhole of the celiac trunk. These techniques involving flow-guided ball-tip catheters are of great value for hepatic arterial catheterization in cases of extensive celiac arterial stenosis.

Arterial Occlusive Diseases↗

PubMed1991

Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images.

Sixteen patients with cirrhosis of the liver underwent cranial magnetic resonance (MR) imaging and transarterial portography to evaluate the relationship between basal ganglia lesions and portal-systemic collateral vessels. No neuropsychiatric disturbance was observed in any of the patients at the time of the MR examination, but four patients with portal-systemic encephalopathy were included in the study. Basal ganglia lesions, characterized by increased signal intensity on T1-weighted MR images, were observed in nine of the 16 patients, including the four with portal-systemic encephalopathy. These nine patients had large portal-systemic collateral vessels that were more than 10 mm in diameter. These collateral vessels were receiving blood from the superior mesenteric vein (SMV) in all nine patients. The lesions involved the globus pallidus and portions of internal capsules in a bilateral and symmetric fashion and did not exhibit mass effect. The authors conclude that there may be a significant relationship between high-intensity basal ganglia lesions and large portal-systemic collateral vessels receiving blood from the SMV.

Aged↗

PubMed1991

Prevalence of air bronchograms in small peripheral carcinomas of the lung on thin-section CT: comparison with benign tumors.

Despite improved techniques--such as bronchoscopy and percutaneous needle biopsy--to evaluate pulmonary nodules, there are still many cases in which surgical resection is necessary before carcinoma can be differentiated from benign lesions. The present study was undertaken to determine if the presence of an air bronchogram or air bronchiologram (patent visible bronchus or bronchiole) is useful in distinguishing small lung cancers from benign nodules. Thin-section chest CT scans were obtained in patients with 20 peripheral lung cancers less than 2 cm in diameter (18 adenocarcinomas, one squamous cell carcinoma, and one large cell carcinoma) and 20 small benign nodules (eight hamartomas, seven tuberculomas, two foci of aspergillosis, one focus of cryptococcosis, one chronic focal interstitial pneumonitis, and one plasma cell granuloma). The images were compared with regard to the patency of any bronchus or bronchiole within the lesions. After surgical resection, the specimens were inflated with agar and sectioned transversely to correlate gross morphology and low-power histologic sections with the CT appearance. An air bronchogram or air bronchiologram was seen in the tumors on 65% of CT scans and 70% of histologic sections. Benign nodules had a patent bronchus or bronchiole on CT scans and histologic sections in only one case (5%). These findings suggest that the presence of an air bronchogram in a lung nodule is a useful finding to help differentiate adenocarcinomas from benign lesions.

Adenocarcinoma↗

PubMed1990

[Experimental studies of segmental hepatic artery embolization with a super absorbent embolic agent].

Super absorbent (Sumikagel) is a unique polymer mainly composed of polysodium acrylate (PSA). When PSA contacts water, it absorbs water and swells in a few seconds. This new embolic material suspended in Lipiodol (Lp-PSA), was used for hepatic artery embolization in five dogs. The purpose of this study is to examine the necrotizing effect of the new embolic material on segmental hepatic artery embolization. Gross liver examination demonstrated congestion and segmental infarction within the embolized area, and microscopically focal necrosis of liver parenchyma was observed. Segmental hepatic artery embolization with Lp-PSA should be an effective method of hepatic tumor embolization.

Absorption↗

PubMed1990

[Roentgenographic manifestations of peripheral bronchogenic carcinomas].

Peripheral bronchogenic carcinomas in early clinical stage are discovered by plain chest roentgenogram, and good prognosis will be expected by surgical resection. 20 bronchogenic carcinomas (18 adenocarcinomas, one squamous cell carcinoma, and one large cell carcinoma) in 19 patients were examined. 9 cases presented noduler lesion on the plain chest roentgenogram, and the other presented 7 focal patchy shadow and 4 band-like shadow. Thin-section CT could demonstrated indented pleura (95%), notch (95%), convergence of peripheral vessels (70%), irregular border (75%). In adenocarcinomas, thin-section CT demonstrated airbronchogram or airbronchiologram (61%), multiple small cavitation (61%), and heterogeneous density (56%). CT-pathologic correlation proved thin-section CT could demonstrate tumor's internal texture and fine detail of tumor-lung interface. Small peripheral lung cancer in early stage could be discovered by plain chest roentgenogram, and thin-section CT was useful for the diagnosis of small peripheral bronchogenic carcinomas, especially adenocarcinomas.

Adenocarcinoma↗

PubMed1990

[Airbronchogram sign in small peripheral bronchogenic carcinomas].

18 bronchogenic carcinomas (16 adenocarcinomas, one squamous cell carcinoma, and one large cell carcinoma) in 17 patients and the control group (benign nodules) were examined with high resolution and thin section CT. Thin-section CT images showed airbronchogram or airbronchiologram in 63%, multiple small cavitations in 63%, and heterogeneous densities 50% of the adenocarcinomas with excellent spatial and contrast resolution. Airbronchogram or airbronchiologram was not seen in other types of bronchogenic carcinomas and benign nodules. Therefore, demonstration of airbronchogram or airbronchiologram in nodular lesions can make the CT diagnosis of small peripheral bronchogenic carcinomas, especially adenocarcinomas.

Adenocarcinoma↗

PubMed1989

[Contrast material for CT of the liver and spleen--an experimental study on the safety of lipiodol-iopamidol emulsion].

Iodinated oil (Lipiodol Ultra-Fluid) emulsified by non-ionic contrast material (Iopamidol) featuring much iodine and surface activity, was developed for computed tomography (CT) of the liver and spleen. The stability study revealed that Lipiodol-Iopamidol Emulsion (LIE, 1-6 microns in diameter) stored 2 weeks under refrigeration showed no visible change in globule size distribution. The biodistribution study in six rabbits revealed that LIE injected into the vein was accumulated in the liver, spleen, and lung, which have reticuloendothelial cells, however not accumulated in the brain, kidney, and serum, which have no reticuloendothelial cells. The disruption to the blood brain barrier (BBB) was assessed using Evans' Blue dye as a visual marker. After the coarse emulsion (larger than 8 microns in diameter) was injected into the internal carotid artery of three rats, the permeability of BBB increased. However, after the injection of LIE, no increased permeability of BBB was noted. Our results suggest that LIE will have a clinical application in the detection of focal hepatic and splenic lesions.

Animals↗

PubMed1989

[Superselective arterial catheterization using a ball tip supple catheter].

We have devised a non torque, supple and flexible catheter with a Ball-tip and have applied this catheter (combined) with the plastic coated guide wire in a superselective angiography to a total of 43 patients, namely, 41 hepatic and 2 renal tumor patients. Since the pulling forces of the arterial blood flow carries the Ball-tip supple catheter to the distal part of the desired artery, the new system seldom causes spastic change and subintimal injury. We have achieved successful catheterization and embolization in all but one cases, even when there are extensive curves in the arteries leading to the affected site. Our conclusion is that cases which cannot be embolized by the conventional method due to the extensive curves of the artery can be safely treated by using this catheter system.

Aged↗

PubMed1989

[Thin-section computed tomography of intrapulmonary metastases after surgical resection of lung cancer].

To evaluate the morphology of small peripheral intrapulmonary metastases of lung cancers, we studied thin-section computed tomography (CT) images of 12 lesions in 5 cases (1 squamous cell carcinoma, and 4 papillary adenocarcinomas). All lesions were resected, and histopathological diagnosis of them was performed in comparison with primary lesions to differentiate multiple primary lung cancers from intrapulmonary metastases. Thin-section CT images showed mildly lobulated nodules in connection with supplying pulmonary vessels, however, indented pleura and vascular convergence were less frequently seen in intrapulmonary metastases in contrast with primary lung cancers. Thin-section CT is helpful for distinguishing multiple primary lung cancers from intrapulmonary metastases in patients with a history of surgical resection for lung cancers.

Adenocarcinoma, Papillary↗

PubMed1989

Hepatic arterial catheterization with use of a supple catheter with a ball tip.

A new catheter was developed for hepatic angiography and embolization: a non-torque control supple catheter with a ball tip combined with a small guide wire. The catheter was used successfully in 47 of 49 patients with hepatocellular carcinoma or hepatic metastases. It seldom causes spasm or intimal damage of distal arterial branches and is useful even when there are extensive curves in the arteries leading to the affected site.

Carcinoma, Hepatocellular↗

PubMed1989

Squamous cell carcinoma of the uroepithelium: CT evaluation.

Fourteen cases of primary squamous cell carcinoma (SCC) originating in the uroepithelium were studied with computed tomography (CT). Nine cases were of vesical origin, three were of renal pelvic origin, and two were of ureteral origin. CT scans of eight of the 14 cases, including four cases of vesical origin and four cases of renal pelvic or ureteral origin, demonstrated predominantly extraluminal extension with invasion into adjacent organs or the renal parenchyma. CT scans of the remaining six cases showed almost equal extra- and intraluminal tumor growth and no predominantly intraluminal extension. An associated urinary stone was demonstrated in four of the five cases of SCC of renal pelvic or ureteral origin. Two of these cases were diagnosed as urinary stones before CT was performed. Eight of the nine cases of SCC of vesical origin and four of the five cases of SCC of renal pelvic or ureteral origin were correctly staged with the aid of CT.

Aged↗