High-signal-intensity abnormalities evaluated by 3D fluid-attenuated inversion recovery imaging within the drainage territory of developmental venous anomalies identified by susceptibility-weighted imaging at 3 T

application/pdfPurpose To evaluate brain parenchymal high-signalintensity abnormalities within the drainage territory of developmental venous anomalies (DVAs) identified by susceptibility-weighted imaging (SWI) at 3 T. Methods One hundred and thirty patients with 137 DVAs identified by SWI were retrospectively studied. 3D fluidattenuated inversion recovery (FLAIR) images were reviewed for parenchymal high-signal-intensity abnormalities and SWI images were reviewed for hypointense foci (microhemorrhages or cavernous malformations) adjacent to DVAs. Patient age, the degree of underlying white matter disease, DVA location (supratentorial or infratentorial), and the presence or absence of hypointense foci were compared across DVAs with and without high-signalintensity abnormalities. The correlation between patient age and the size of any high-signal-intensity abnormality was analyzed using linear regression. Results Forty-two of 137 DVAs (30.7 %) had high-signal- intensity abnormalities. An adjusted prevalence of 18/71 (25.4 %) was obtained after excluding patients with considerable underlying white matter disease. Only DVA location (supratentorial) was associated with the presence of high-signal-intensity abnormalities (p\0.05). There was a significant correlation between patient age and the size of high-signal-intensity abnormalities (p\0.01). Conclusions 3D FLAIR imaging permits detection of small high-signal-intensity abnormalities within the drainage territory of DVAs. The size of high-signal-intensity abnormalities increased with patient age.本文 / Department of Radiology, Mie University School of Medicine8

High-signal-intensity abnormalities evaluated by 3D fluid-attenuated inversion recovery imaging within the drainage territory of developmental venous anomalies identified by susceptibility-weighted imaging at 3 T

application/pdf内容の要旨・審査結果の要旨 / 三重大学大学院医学系研究科 生命医科学専攻 病態制御医学講座 放射線医学分

Vertebral artery dissection associated with familial Mediterranean fever and Behçet's disease

Abstract Vertebral artery dissection and recurrent meningitis are rare complications in Behçet's disease. Behçet's disease may be associated with familial Mediterranean fever. Here, we describe a 52‐year‐old woman with severe headache who exhibited recurrent meningitis and vertebral artery dissection. Cerebrospinal fluid showed high levels of interleukin‐6. Magnetic resonance imaging revealed right vertebral artery dissection. The patient had three heterozygous mutations in the familial Mediterranean fever gene (MEFV) gene. She fulfilled criteria for diagnosis of Behçet's disease and familial Mediterranean fever. In conclusion, mutations of the MEFV gene may cause neuro‐inflammatory disorders and cerebrovascular disorders by reducing anti‐inflammatory activity of pyrin

A Combination of Amide Proton Transfer, Tumor Blood Flow, and Apparent Diffusion Coefficient Histogram Analysis Is Useful for Differentiating Malignant from Benign Intracranial Tumors in Young Patients: A Preliminary Study

Purpose: To evaluate the amide proton transfer (APT), tumor blood flow (TBF), and apparent diffusion coefficient (ADC) combined diagnostic value for differentiating intracranial malignant tumors (MTs) from benign tumors (BTs) in young patients, as defined by the 2021 World Health Organization classification of central nervous system tumors. Methods: Fifteen patients with intracranial MTs and 10 patients with BTs aged 0–30 years underwent MRI with APT, pseudocontinuous arterial spin labeling (pCASL), and diffusion-weighted imaging. All tumors were evaluated through the use of histogram analysis and the Mann–Whitney U test to compare 10 parameters for each sequence between the groups. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The APT maximum, mean, 10th, 25th, 50th, 75th, and 90th percentiles were significantly higher in MTs than in BTs; the TBF minimum (min) was significantly lower in MTs than in BTs; TBF kurtosis was significantly higher in MTs than in BTs; the ADC min, 10th, and 25th percentiles were significantly lower in MTs than in BTs (all p < 0.05). The APT 50th percentile (0.900), TBF min (0.813), and ADC min (0.900) had the highest area under the curve (AUC) values of the parameters in each sequence. The AUC for the combination of these three parameters was 0.933. Conclusions: The combination of APT, TBF, and ADC evaluated through histogram analysis may be useful for differentiating intracranial MTs from BTs in young patients

Ipilimumab-induced hypophysitis involving the optic tracts and tuber cinereum evaluated using 3D fluid-attenuated inversion recovery

Ipilimumab, a human monoclonal antibody against cytotoxic T-lymphocyte antigen 4, was approved by the U.S. FDA (Food and Drug Administration) in 2011 for the treatment of unresectable or metastatic malignant melanoma. Occurrence of hypophysitis, an immune-related adverse event due to ipilimumab use, has been frequently reported. We report a case of ipilimumab-induced hypophysitis involving the optic tracts and tuber cinereum, identified using 3D fluid-attenuated inversion recovery

機能的MR撮影法による頭頸部腫瘍の診断と早期治療効果判定の検討

application/pdfMRI を用いた血流と拡散の研究は、脳腫瘍で活発に行われ臨床的にも有用性が確立しているが、頭頸部腫瘍においては十分に検討がされていない。本研究の目的は、3 テスラMRI を使い、頭頸部腫瘍における血流と拡散の情報を非侵襲的に取得する新たな撮影法とそれらのデータを定量評価するための解析ソフトウェアを開発することである。ターボスピンエコー法を用いたarterial spin labelingという血流撮像法と拡散強調画像で頭頚部腫瘍の定量的評価法の確立を試みた。血流量と拡散の情報を解析するソフトウェアを使うことで頭頚部腫瘍の診断で良悪性の鑑別が可能となり、腫瘍の質的診断に有用であることを証明した。Pseudocont inuous arterial spin labeling (pCASL) imaging enables noninvasive quantification of tumor blood flow in the head and neck. The purpose of this study was to compare echo-planar (EP) and turbo spin-echo (TSE) sequences of pCASL, to demonstrate the clinical applications and usefulness of this method in the diagnosis of particular diseases via both tumor blood flow (TBF) quantification and the apparent diffusion coefficient (ADC) obtained by diffusion-weighted imaging (DWI), and to demonstrate changes in TBF after chemoradiation treatments. TSE pCASL showed less image torsion and higher lesion conspicuity than EP pCASL. Combination of TSE pCASL and ADC enabled to differentiate benign parotid tumors from malignant parotid tumors. TBF changes were observed in head and neck squamous cell carcinomas in response to chemoradiation at an early stage. This study showed that the combination of pCASL and ADC is a promising tool for head and neck tumors.2016年度～2021年度科学研究費補助金(基盤研究(C))研究成果報告書16K1031

Advanced multiparametric MRI and FDG-PET/CT in multinodular and vacuolating neuronal tumor: A pathologically confirmed case

Multinodular and vacuolating neuronal tumor (MVNT) is a relatively new disease concept proposed in 2013 and was classified as a separate tumor type in 2021 by the World Health Organization (WHO) classification. MVNT can cause seizures but is a benign disease, with no cases of enlargement or postoperative recurrence reported. Recent reports described advanced MRI features in MVNT cases, but the diagnosis of MVNT is usually based on characteristic MRI findings of clusters of nodules. Here, we report advanced multiparametric MRI and FDG-PET/CT findings in a case of MVNT with epileptiform symptoms that was pathologically confirmed by surgery