Language：English   Publishing type：Research paper (scientific journal)  

A Japanese man in his 30s died suddenly. Postmortem computed tomography and autopsy revealed a pulmonary embolism from an organizing thrombus in the inferior vena cava as the cause of death. Genomic analysis of congenital thrombophilia-related genes (i.e., SERPINC1, PROC, PROS1, F2, F5, PLG, and MTHFR) revealed a heterozygous variant of PROS1 (p.A139V), which has been reported in patients with congenital protein S deficiency. After a genetic conference that included forensic pathologists, molecular scientists, genetic researchers, genetic clinicians, and clinical physicians, the results of the genetic analysis were explained to the family. Biochemical analyses of protein S (PS) activity and total PS antigen levels were performed with samples from the deceased's family and genetic analysis was not performed until clinical symptoms appear. Herein we demonstrate the importance of genetic background in cases of a sudden death due to pulmonary embolism.

DOI： 10.1016/j.legalmed.2022.102029

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BACKGROUND: Head computed tomography (CT) is a commonly used imaging modality in radiology facilities. Since multiplanar reconstruction (MPR) processing can produce different results depending on the medical staff in charge, there is a possibility that the antemortem and postmortem images of the same person could be assessed and identified differently. OBJECTIVE: To propose and test a new automatic MPR method in order to address and overcome this limitation. METHODS: Head CT images of 108 cases are used. We employ the standardized transformation of statistical parametric mapping 8. The affine transformation parameters are obtained by standardizing the captured CT images. Automatic MPR processing is performed by using this parameter. The sphenoidal sinus of the orbitomeatal cross section of the automatic MPR processing of this study and the conventional manual MPR processing are cropped with a matrix size of 128×128, and the value of zero mean normalized correlation coefficient is calculated. RESULTS: The computed zero mean normalized cross-correlation coefficient (Rzncc) of≥0.9, 0.8≤Rzncc < 0.9 and 0.7≤Rzncc < 0.8 are achieved in 105 cases (97.2%), 2 cases (1.9%), and 1 case (0.9%), respectively. The average Rzncc was 0.96±0.03. CONCLUSION: Using the proposed new method in this study, MPR processing with guaranteed accuracy is efficiently achieved.

DOI： 10.3233/XST-221142

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Acute subdural hematoma (SDH) occurs following severe head trauma with brain contusion or rupture of bridging veins. Conversely, SDH caused by rupture of a cortical artery without trauma or with minor trauma is also possible. Although over 150 cases of the latter SDH have been reported, they were predominantly diagnosed only during surgery, and therefore, no adequate histological evaluation has been performed. Therefore, essential etiology of this SDH type has remained unclear. In addition, the scarcity of autopsy cases may be attributed to arterial rupture being missed if the macroscopic findings are too minimal to detect during autopsy. Here, we describe two autopsy cases of SDH of cortical artery origin. Extravasation on postmortem computed tomography angiography and arterial leakage on macroscopic observation during autopsy facilitated detection of the ruptured artery and allowed detailed histological evaluation of the ruptured artery and adjacent dura mater. The etiology of arterial rupture is briefly described on the basis of histopathological findings in this study and the available literature.

DOI： 10.1016/j.legalmed.2021.101941

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PURPOSE: To clarify an early postmortem change, we investigated the volume changes of the spleen and kidney on postmortem CT compared with antemortem CT in the same patients. MATERIALS AND METHODS: We retrospectively evaluated the volumes of 56 spleens (56 cases) and 50 kidneys (25 cases) using antemortem and postmortem CT, which were performed within 168 min after death. We divided the cases of spleen analysis into a hemorrhagic group (n = 12) and a non-hemorrhagic group (n = 44). RESULTS: The volumes of the organs before and after death were 101.0 ± 70.9 (cm3, mean ± standard deviation) and 81.1 ± 57.8 in spleens, 120.3 ± 49.2 and 109.2 ± 39.2 in kidneys, respectively. Both spleens and kidneys shrank after death (p < 0.05). The volumes of spleens before and after death were 111 ± 66.5 and 67.5 ± 27.7 in the hemorrhagic group, and 98.2 ± 72.5 and 84.9 ± 63.3 in the non-hemorrhagic group, respectively. The median value of the ratio of postmortem splenic volume to antemortem volume in the hemorrhagic group (65.0%) was smaller than the one in the non-hemorrhagic group (90.5%) (p < 0.05). CONCLUSION: We demonstrated that spleens and kidneys significantly reduced in size after death. The rate of shrinkage of spleens in the hemorrhagic group significantly became larger than the one in the non-hemorrhagic group.

DOI： 10.1007/s11604-019-00841-3

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This report describes the autopsy case of a 4-year-old boy who died from hepatic hemorrhage and rupture caused by peliosis hepatis with X-linked myotubular myopathy. Peliosis hepatis is characterized by multiple blood-filled cavities of various sizes in the liver, which occurs in chronic wasting disease or with the use of specific drugs. X-linked myotubular myopathy is one of the most serious types of congenital myopathies, in which an affected male infant typically presents with severe hypotonia and respiratory distress immediately after birth. Although each disorder is rare, 12 cases of pediatric peliosis hepatis associated with X-linked myotubular myopathy have been reported, including our case. Peliosis hepatis should be considered as a cause of hepatic hemorrhage despite its low incidence, and it requires adequate gross and histological investigation for correct diagnosis.

DOI： 10.1016/j.legalmed.2019.04.005

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BACKGROUND: Measurement of heart weight is important when investigating cause of death, but there is presently no satisfactory method of heart weight estimation by postmortem computed tomography (PMCT). METHOD: We investigated 33 consecutive cases that underwent both PMCT and autopsy between February 2008 and June 2014. Heart and left ventricular (LV) weights were calculated by PMCT morphometry. We used a simple method to estimate LV weight: We assumed that LV was an ellipsoid and multiplied its volume on PMCT with myocardial specific gravity. We then compared the various heart and LV weights using linear regression. The calculated and estimated LV weights on PMCT were also compared. RESULTS: It was not possible to predict heart weight at autopsy from PMCT (R2 = 0.53). However, heart weight at autopsy could be accurately predicted from LV weight calculated by PMCT (R2 = 0.77). In addition, there was a strong correlation between the estimated and calculated LV weights by PMCT (R2 = 0.92). Heart weight at autopsy could also be accurately predicted using the PMCT-estimated LV weight (R2 = 0.72). CONCLUSION: Heart weight at autopsy could be accurately predicted using a simple method in which LV volume was assumed to be an ellipsoid on PMCT.

DOI： 10.1016/j.forsciint.2018.12.019

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DOI： 10.2214/AJR.18.19552

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Tokyo  

Purpose: The purpose of this study was to characterize and determine the prevalence of the sternalis muscle using 64-row multidetector computed tomography (MDCT). Materials and methods: We retrospectively reviewed MDCT chest scans that were performed in a hospital during the course of a month. The study population consisted of 948 consecutive patients (511 males and 467 females). On the MDCT scans the sternalis muscle was defined as the longitudinal muscle lying on and superficial to the pectoralis major muscle. Results: The prevalence of the sternalis muscle was 10.5 %. The muscle was present more frequently in females (13.0 %) compared to males (8.4 %) (P = 0.02). In the majority of patients, the muscle was located longitudinally in the parasternal position
however, in two patients it was positioned across the sternum. One hundred twenty were flat types, while the remaining five had oblique shapes. The muscle mean height, width and depth were 77.9 ± 25.1, 19.4 ± 12.2 and 2.8 ± 1.3 mm, respectively. The muscle was wider in males compared to females (P &lt
0.001). Conclusion: Using MDCT, its prevalence was shown to be 10.5 %. This variant muscle can be differentiated from other pathological structures using its specific characteristic appearance. © 2012 Japan Radiological Society.

DOI： 10.1007/s11604-012-0114-3

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In the original publication of the article, the seventh author name was incorrectly published as Hidehumi Aoyama. The correct author name should read as Hidefumi Aoyama.

DOI： 10.1007/s11604-017-0708-x

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Language：Japanese   Publisher：新潟大学医学部保健学科  

滑車神経は脳神経の中で最も細く長いため画像による評価は難しいとされてきた。近年、MRIの高磁場化や傾斜磁場性能の向上によりスライス厚を薄くすることが可能となり、滑車神経同定の報告もされるようになってきている。本検討では、3D-constructive interference in steady state(3D-CISS)法を用い、高磁場化や高分解能撮像を行うことと、滑車神経を描出するために特化した再構成画像の連続したスライスデータを用いることによる滑車神経同定への影響を検討した。滑車神経の同定は、multi planar reconstruction(MPR)を用いて、脳槽内のpoint of exit(PE)からテント切痕まで描出できる連続したスライスデータの画像再構成を、滑車神経同定のための指導を受けた診療放射線技師2名が試みた。滑車神経の同定率は、1.5Tに比べ3Tの方が有意に高い結果であった。また同定された滑車神経の距離計測では、3Tでスライス厚0.25mmの方が0.5mm厚よりも有意に長くなり、またスライス厚0.5mmでは、1.5Tよりも3Tの方が有意に長くなった。3D-CISS法を用いて3Tで高分解能撮像を行い、MPRによる適切な画像再構成を行うことで、より確実に滑車神経を同定し、その描出距離も長くなる。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J06421&link_issn=&doc_id=20180420580006&doc_link_id=http%3A%2F%2Fhdl.handle.net%2F10191%2F49821&url=http%3A%2F%2Fhdl.handle.net%2F10191%2F49821&type=%90V%8A%83%91%E5%8Aw%81F%90V%8A%83%91%E5%8Aw%8Aw%8Fp%83%8A%83%7C%83W%83g%83%8A_Nuar&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80230_3.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

PURPOSE: To evaluate the changes in splenic volume during hypovolemic shock and after recovery by use of multidetector computed tomography (MDCT). MATERIALS AND METHODS: We investigated 22 cases who underwent MDCT during hypovolemic shock up to 3 h after presentation, compared the splenic volume with that after recovery, and evaluated the volume difference. We compared the volume ratio (recovery/shock) for two age groups: under 60 years (n = 10) and 60 years and over (n = 12). For cases (n = 10) undergoing CT examination twice after treatment, we compared the volume ratios by using the initial recovery CT and the second CT images. RESULTS: The average spleen volume in shock was 63 cm(3); under normal conditions it was 132 cm(3) (P < 0.001). The average volume ratio for groups under 60 years old was 2.34; for groups 60 years and over it was 2.05 (P = 0.051). The average volume ratio obtained by use of the initial post-recovery CT was 2.11; the ratio obtained by use of the second post-recovery CT was 2.16 (P = 0.386). CONCLUSIONS: Our results revealed that splenic volume was reduced during hypovolemic shock and rapidly increased after recovery. Splenic contraction is an important CT finding in shock.

DOI： 10.1007/s11604-015-0470-x

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Language：English   Publisher：JAPANESE SOCIETY ALLERGOLOGY  

DOI： 10.2332/allergolint.13-LE-0655

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

PURPOSE: To investigate the characteristics and imaging features of localized air foci in the lower thorax in patients with pneumothorax using thin-section multidetector computed tomography. MATERIALS AND METHODS: Of 10,547 consecutive CT examinations comprising the chest, the CT scans of 146 patients with ordinary pneumothoraces were identified and retrospectively evaluated. The study group included 110 male and 36 female patients (mean age, 50 years; range, 1-93 years). All examinations were performed at our institution between January 2009 and December 2009. Cause of pneumothorax was classified as traumatic or non-traumatic. Localized air foci in the lower thorax were defined as being localized air collections in the lower thorax that did not appear to be adjacent to the lung. If these criteria were met, the shape, size, location laterality, and number of foci were evaluated. Associations with trauma, sex, severity of the pneumothorax, and laterality were evaluated using the χ(2) test. All P values <0.05 were considered significant. RESULTS: Localized air foci in the lower thorax presented as slit-like or small ovoid air collections in the lowest part of the pleural space. These foci were observed in 79/146 (54.1%) patients. The traumatic pneumothoraces group showed a higher prevalence of these features than the non-traumatic group. Some foci that were situated in the anterior part mimicked the appearance of free intraperitoneal air. CONCLUSION: Patients with pneumothorax commonly had localized air foci in the lower thorax. Because such foci can mimic pneumoperitoneum, accurate recognition of them is required to avoid confusion with free intraperitoneal air, especially in traumatic cases.

DOI： 10.1016/j.ejrad.2013.02.008

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DOI： 10.1007/s00414-012-0782-7

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

PURPOSE: The purpose of this study is to evaluate the postmortem deformation of the aorta on postmortem computed tomography (CT) by comparison with the antemortem CT in the same patient. MATERIALS AND METHODS: A total of 58 non-traumatic patients without hemorrhagic events who underwent torso CT before and shortly after death were enrolled. Antemortem chest and abdominal CT were obtained in 44 cases and in 57 cases, respectively. The lengths of the major and minor axes of the ascending and descending thoracic aorta and the abdominal aorta were measured on both antemortem and postmortem CT in the same patient. To evaluate the shape of the aorta, the major axis-minor axis ratio (Ma-MiR) was calculated. Mean values of the diameters of the aorta and Ma-MiRs on postmortem CT were compared with those on antemortem CT using the Wilcoxon signed-rank test. We also evaluated the major and minor axes and Ma-MiRs on both antemortem and postmortem CT in two age groups: 65 years and under (n=13) and over 65 years (n=45). RESULTS: At each level tested, the aorta significantly shrank after death (p<0.001) (ascending thoracic aorta, descending thoracic aorta, and abdominal aorta: 38.5 mm × 33.5 mm, 28.0 mm × 25.9 mm, and 24.4 mm × 21.8 mm on antemortem CT, 30.0 mm × 26.2 mm, 24.4 mm × 20.7 mm, and 21.5 mm × 14.5 mm on postmortem CT, respectively). The postmortem Ma-MiRs significantly increased at the descending thoracic aorta and the abdominal aorta (p<0.001). The diameters of the aorta are longer in older cases at all levels on both antemortem and postmortem CT. The reduction rates were larger in younger cases than older cases at all levels. CONCLUSIONS: After death, the aorta shrunk at all levels, and became oval in shape in descending thoracic and abdominal aorta. The contraction was greater in younger cases than older cases. Investigators who interpret postmortem imaging should be aware of the postmortem deformation of the aorta.

DOI： 10.1016/j.forsciint.2012.04.037

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PURPOSE: The purpose of this study was to characterize and determine the prevalence of the sternalis muscle using 64-row multidetector computed tomography (MDCT). MATERIALS AND METHODS: We retrospectively reviewed MDCT chest scans that were performed in a hospital during the course of a month. The study population consisted of 948 consecutive patients (511 males and 467 females). On the MDCT scans the sternalis muscle was defined as the longitudinal muscle lying on and superficial to the pectoralis major muscle. RESULTS: The prevalence of the sternalis muscle was 10.5 %. The muscle was present more frequently in females (13.0 %) compared to males (8.4 %) (P = 0.02). In the majority of patients, the muscle was located longitudinally in the parasternal position; however, in two patients it was positioned across the sternum. One hundred twenty were flat types, while the remaining five had oblique shapes. The muscle mean height, width and depth were 77.9 ± 25.1, 19.4 ± 12.2 and 2.8 ± 1.3 mm, respectively. The muscle was wider in males compared to females (P < 0.001). CONCLUSION: Using MDCT, its prevalence was shown to be 10.5 %. This variant muscle can be differentiated from other pathological structures using its specific characteristic appearance.

DOI： 10.1007/s11604-012-0114-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Tokyo  

In the original publication of the article, the seventh author name was incorrectly published as Hidehumi Aoyama. The correct author name should read as Hidefumi Aoyama.

DOI： 10.1007/s11604-017-0708-x

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BACKGROUND: To date, bronchial diverticula have generally been treated as a pathological condition associated with chronic obstructive pulmonary disease (COPD), although only a limited amount of published information is available on the relationship between bronchial diverticula as depicted by multidetector computed tomography (MDCT) and airflow limitations. PURPOSE: To evaluate the relationship between airflow limitations and main bronchial diverticula in the subcarinal region using spirometry and thin-section MDCT. MATERIAL AND METHODS: A total of 189 consecutive adult patients were retrospectively evaluated based on spirometry and thin-section MDCT of the chest. All examinations were performed at our institution between June and October 2008. The study group included 70 women and 119 men with a mean age of 65 years (range 19-86 years). The relationship between the FEV(1)% and bronchial diverticula in the subcarinal region was analyzed (Student's t-test). RESULTS: The indications for conducting the examinations were pulmonary diseases (82 patients), cardiovascular diseases (22), extrapulmonary malignancies (74), and other conditions (11). A total of 84/189 (44.4%) patients showed bronchial diverticula, and the FEV(1)% of 70/84 (83.3%) patients was above 70. The FEV(1)% of patients with lesions ranged from 26.0 to 97.8 (mean 76.8), whereas the range was 28.1-94.4 (mean 73.7) in those without lesions. There was no significant association between the FEV(1)% and the presence of subcarinal bronchial diverticula (P > 0.05). CONCLUSION: Our data demonstrate that thin-section chest CT commonly demonstrates main bronchial diverticula in the subcarinal region in patients without airflow limitations. We propose that the presence of a small number of tiny bronchial diverticula under the carina may not be a criterion for the diagnosis of COPD.

DOI： 10.1258/ar.2011.110222

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

OBJECTIVES: To investigate the diagnostic performance of postmortem multidetector computed tomography (PMMDCT) for the detection of fatal findings related to causes of non-traumatic death in the emergency department (ED). METHODS: 494 consecutive cases of clinically diagnosed non-traumatic death in ED involving PMMDCT were enrolled. The fatal findings were detected on PMMDCT and classified as definite or possible findings. These findings were confirmed by autopsy in 20 cases. RESULTS: The fatal findings were detected in 188 subjects (38.1%) including 122 with definite (24.7%) and 66 with possible finding (13.4%). Definite findings included 21 cases of intracranial vascular lesions, 84 with intra-thoracic haemorrhage, 13 with retroperitoneal haemorrhage and one with oesophagogastric haemorrhage. In three patients who had initially been diagnosed with non-traumatic death, PMMDCT revealed fatal traumatic findings. Two definite findings (two haemopericardiums) and seven possible findings (two intestinal obstructions, one each of multiple liver tumours central pulmonary artery dilatation, pulmonary congestion, peritoneal haematoma, and brain oedema) were confirmed by autopsy. The causes of death were not determined in cases with possible findings without autopsy. CONCLUSIONS: PMMDCT is a feasible tool for detecting morphological fatal findings in non-traumatic death in ED. It is important to know the ability and limitation of PMMDCT.

DOI： 10.1007/s00330-011-2248-6

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PURPOSE: The aim of this study was to evaluate the effectiveness of a worksheet for diagnosing postmortem computed tomography (PMCT) in emergency departments (EDs). MATERIALS AND METHODS: A total of 49 cases of clinically diagnosed nontraumatic deaths in the ED who underwent total body PMCT were enrolled. PMCT images were prospectively evaluated by four radiologists: two radiologists with 1.5 and 3.5 years of residency and two board-certified radiologists with >20 years of experience. Readers were independently instructed to detect and interpret findings with reference to fatal findings, postmortem features, changes caused by cardiopulmonary resuscitation, and other pathological findings according to a worksheet that was composed of the possible findings previously reported. Agreement on detection and interpretation of findings between each reader was measured using Cohen's kappa coefficients. RESULTS: For the detection of findings, there was substantial agreement among the four readers (kappa > 0.60, P < 0.0001). There was substantial (kappa > 0.60, P < 0.0001) and near-substantial (kappa = 0.60, P < 0.0001) agreement in the interpretation of the finding. CONCLUSION: Results of our study suggest equivalency on diagnosing PMCT regardless of the reader's level of experience. We conclude that the worksheet is useful for diagnosing PMCT in emergency departments.

DOI： 10.1007/s11604-011-0618-2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ROENTGEN RAY SOC  

OBJECTIVE: The purpose of this study was to quantitatively analyze postmortem hypostasis in the intracranial venous sinus on head CT scans compared with the antemortem CT findings in the same patients with the aim of evaluating sedimentation in the heart and great vessels. MATERIALS AND METHODS: A total of 50 patients on whom head CT was performed before and after death were enrolled. Attenuation in the dorsal part of the superior sagittal sinus was measured at the level of the basal ganglia on both antemortem and postmortem CT scans. Increased attenuation in the transverse sinus and cerebellar tentorium and sedimentation in the heart and great vessels were evaluated visually. RESULTS: Attenuation in the dorsal part of the superior sagittal sinus increased significantly (p < 0.0001) between antemortem (42.77 ± 6.23 HU) and postmortem (49.72 ± 10.58 HU) CT in 80% of cases. Increased attenuation of the transverse sinus or cerebellar tentorium was observed in 48% of cases and sedimentation in the heart or great vessels in 62% of cases. Increased attenuation in the superior sagittal sinus was clearly evident in patients with sedimentation in the heart or great vessels (antemortem, 43.81 ± 6.17 HU; postmortem, 54.65 ± 8.51 HU) compared with the patients without evidence of sedimentation (antemortem, 41.06 ± 6.10 HU; postmortem, 41.66 ± 8.57 HU) (p < 0.0001). CONCLUSION: Intracranial hypostasis is a common postmortem CT finding. Radiologists and physicians who interpret postmortem neurologic images should be aware of intracranial hypostasis and differentiate this phenomenon from intracranial hemorrhage.

DOI： 10.2214/AJR.10.4442

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PURPOSE: The aim of this study was quantitatively to analyze brain edema and swelling due to early postmortem changes using computed tomography (CT) scans of the head. MATERIALS AND METHODS: Review board approval was obtained, and informed consent was waived. A total of 41 patients who underwent head CT before and shortly after death were enrolled. Hounsfield units (HUs) of gray matter (GM) and white matter (WM) were measured at the levels of the basal ganglia, centrum semiovale, and high convexity area on both antemortem and postmortem CT. The length of the minor axis of the third ventricle at the level of the basal ganglia and the width of the central sulcus at the level of high convexity were measured. RESULTS: At each level tested, the HUs of GM and the GM/WM ratios on postmortem CT were significantly lower than those on antemortem CT (P < 0.001). HUs of WM on postmortem CT were slightly higher than those on antemortem CT but without significant difference (P > 0.1). Postmortem CT showed subtle loss of distinction between GM and WM. The size of the third ventricle and the width of the central sulcus did not vary before and after death (P > 0.1). CONCLUSION: Early postmortem CT shows mild brain edema but does not show brain swelling.

DOI： 10.1007/s11604-010-0430-4

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The aim of this study was to evaluate the characteristics and CT features of subcarinal air collections on thin-section multidetector-row computed tomography (MDCT). Two hundred asymptomatic adult subjects without a history of pulmonary disease underwent MDCT. The CT appearances and characteristics of foci of extraluminal air contiguous to the main bronchus in the subcarinal region were retrospectively analysed. Subcarinal air collections were found in 81 of 200 subjects (41%) and were spotty or microtubular in 67 of 81 subjects and rounded or oval in the other 14. Each subcarinal air focus communicated, or seemed to communicate, with the adjacent bronchus in 76 of 81 cases. Our data demonstrate that extraluminal air foci in the subcarinal region are common CT findings and routinely depicted on thin-section MDCT, and that most of these lesions seem to be main bronchial diverticula. Cystic air foci in the subcarinal region should be called subcarinal air cysts. The precise recognition of these cysts improves the ability to avoid misidentification, such as pneumomediastinum.

DOI： 10.1007/s00330-009-1526-z

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A 77-year-old woman who had been in the hospital suffering from a subarachnoid hemorrhage suddenly died after undergoing a cerebral aneurysmal operation. Postmortem whole-body computed tomography (CT) demonstrated multiple lung tumors with abnormal masses in the bronchus with no evidence of complications in the cranium. The patient was estimated to have died from asphyxia caused by metastatic lung and endobronchial tumors. Although a traditional autopsy was not performed, postmortem CT provided strong evidence for detecting the cause of death. In this case, postmortem CT played an important role in hospital risk management.

DOI： 10.1007/s11604-009-0340-5

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PURPOSE: The purpose of this study was to investigate the cause and significance of intrahepatic gas (IHG). MATERIALS AND METHODS: There were 208 nontraumatically deceased individuals retrospectively investigated concerning the occurrence and location of IHG by postmortem multislice computed tomography (MSCT) imaging. The location of IHG was graded on a scale from 0 to 3: 0, no gas; 1, gas only in the left lobe; 2, gas in the left lobe and anterior segment of the right lobe; 3, gas in the left lobe and the anterior and posterior segments of the right lobe). We also assessed and noted the occurrence of intestinal distention, airway management, the interval between cardiopulmonary arrest (CPA) and subsequent examination, and the postmortem interval. RESULTS: IHG was found in 66 cases (31.7%): grade 1, 15 (7.2%); grade 2, 21 (10.1%); grade 3, 30 (14.4%). The presence of IHG was strongly related to intestinal distention and the period between the time of CPA and the examination. CONCLUSION: IHG is a frequent finding on postmortem CT in cases of nontraumatic death. The presence of IHG is related to intestinal distention and the interval between the time of CPA and examination.

DOI： 10.1007/s11604-009-0337-0

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Arterial aneurysms represent a severe complication of Behcet's disease. A 42-year-old woman with Behcet's disease had a recurrence of an aneurysm after two surgical repair attempts using grafts. A covered stent-graft was implanted in her iliac external artery to occlude the neck of the aneurysm at the anastomosis of the bypass graft to her external iliac artery. The procedure reduced the size of the aneurysm by allowing the formation of a thrombus within its cavity. The implantation of an endovascular stent-graft may be a sound alternative to surgical repair for aneurysms associated with Behcet's disease.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：W B SAUNDERS CO LTD  

AIM: To investigate the usefulness of high-resolution MR imaging in the evaluation of the extracranial. facial nerve, compared with surgical findings.
MATERIALS AND METHODS: Thirteen patients with benign parotid tumours were studied on a 1.5-T MR system with a 3 in circular surface coil. High-resolution T1-weighted spin-echo, T2-weighted fast spin-echo, and three-dimensional gradient-recalled acquisition in the steady state (GRASS) images were obtained in the axial planes. Oblique reformatted images were generated. Tumours, parotid ducts and facial nerves were identified on these images. The relationship of the tumours to the facial nerves was confirmed at surgery.
RESULTS: Facial nerves appeared as linear structures of low intensity on all pulse sequences. The main trunks and cervicofacial and temporofacial divisions of the facial nerves were identified in 100%, 84.1% and 53.8% of GRASS images, respectively. Parotid ducts appeared as structures of low intensity on T1-weighted (66.6%) and GRASS images (81.8%), and as structures of very high intensity on T2-weighted images (91.7%). The relationships of the tumours to the facial nerves were correctly diagnosed in 11 (91.7%) of 12 cases.
CONCLUSION: High-resolution MR imaging depicts the extracranial facial nerve and the parotid duct, and is useful for preoperative evaluation of parotid gland tumours. (C) 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.crad.2004.06.018

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The clinical management and prognosis of patients with diffusely infiltrating astrocytomas are dependent on neuropathological grading of the tumors. The characteristics of MR images of high-grade astrocytic tumors are well known, but the early MRI appearance and the MRI evolution of high-grade astrocytic tumors have rarely been examined. We retrospectively reviewed MR images obtained from 4 months to 3 years and 3 months before admission, as well as MR images on admission, for five patients with pathologically proven high-grade astrocytic tumors (two glioblastomas and three anaplastic astrocytomas). In two patients, neoplastic lesions were not detectable on initial MRI, even retrospectively. In the remaining three patients, however., hyperintense areas with little or no mass effect were demonstrated on T2-weighted imaging. These lesions were misinterpreted as non-neoplastic processes, such as ischemic lesion or infarction, or demyelinating processes. All tumors showed gadolinium enhancement on admission, that emerged from the previously existing hyperintense areas on T2-weighted images without gadolinium enhancement, except for one de novo glioblastoma. Development of a small central cyst without gadolinium enhancement was demonstrated in one case before the emergence of an enhancing area.

DOI： 10.1007/s00234-001-0725-3

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Germ-cell tumors of the central nervous system generally develop in the midline, but the tumors can also occur in the basal ganglia and/or thalamus. However, M R images have rarely been documented in the early stage of the tumor in these regions. We retrospectively reviewed MR images obtained on admission and approximately 3 years earlier in two patients with germinoma in the basal ganglia, and compared them with CT. In addition to hyperdensity on CT, both hyperintensity on T1-weighted images and a small hyperintense lesion on T2-weighted images were commonly seen in the basal ganglia. These findings may be early MRI signs of germinoma in this region, and the earliest and most characteristic diagnostic feature on MRI was atrophy of the basal ganglia, which was recognizable before development of hemiparesis.

DOI： 10.1007/s00234-001-0735-1

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We reported the findings on MRI in a patient with proven Riedel's thyroiditis. The lesion was seen as slightly heterogeneous hypointensity on both T1- and T2-weighted images and had a mild enhancement after administration of gadpentate dimeglumine (GdDTPA). Dynamic MR study showed gradual increase in signal intensity of the lesion. These Findings were different from those of thyroid neoplasms and were considered to reflect the mixture of inflammatory cells infiltration and fibrosis of Riedel's thyroiditis. (C) 2002 Elsevier Science Inc. All rights reserved.

DOI： 10.1016/S0899-7071(01)00373-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: The purpose of this work was to evaluate signal intensity change of the middle cerebellar peduncles on diffusion-weighted imaging in patients with large supratentorial lesions.
Methods: Signal intensity of the middle cerebellar peduncles: was measured using a region of interest in 40 normal control subjects and in 28 patients with moyamoya disease on axial diffusion-weighted imaging with the motion-probing gradient perpendicular to the image. An additional six patients without moyamoya but with large supratentorial sequelae of hemorrhage or infarction were also included.
Results: There was no difference in signal intensity between both middle cerebellar peduncles in normal subjects. but lower signal intensity was consistently observed in the contralateral middle cerebellar peduncle in 12 moyamoya patients with large supratentorial lesions in the middle cerebral artery distribution. This finding was observed in the six non-moyamoya patients, too.
Conclusion: Decreased signal intensity of the contralateral middle cerebellar peduncle might be a remote effect caused by a large supratentorial lesion in a crossed cerebellar fashion.

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To evaluate the redistribution phenomenon on delayed I-123 IMP SPECT images of children and adolescents with partial seizures, 25 patients were selected and investigated in the interictal state. Early and delayed SPECT were performed 15-20 minutes and 5 hours, respectively, after I-123 IMP injection. Redistribution patterns were classified into three groups: 1) redistribution (RD) (-) group (n = 5), in which a low-uptake area on the early image persisted or was enlarged on the delayed image, 2) RD (+) group (n = 14), in which a low-uptake area on the early image changed to normal distribution on the delayed image, and 3) marked redistribution (MRD) (+) group (n = 6), In which a low-uptake area on the early image changed to a high uptake area on the delayed image. Among the patients who were followed for at least 12 months after the SPECT scans, the short-term clinical outcome tended to be good in the RD (+) group, intermediate in the MRD (+) group, and poor in the RD (-) group. These results of our preliminary comparative study indicate that the redistribution pattern of I-123 IMP may be related to the clinical aspects in patients with partial seizures and that it may play an important role in predicting their short-term clinical outcome.

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To evaluate the accuracy of conventional microsphere method for the measurement of regional cerebral blood flow (rCBF) based on the microsphere model with N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) and SPECT, we performed simulation analysis and clinical studies. Although the microsphere method requires early SPECT scan at a few minutes after injection of the tracer for the accurate measurement of rCBF, the conventional microsphere method, which is generally used, requires more delayed SPECT scan with long scan-duration. In the conventional microsphere method, the delayed SPECT image is corrected to the image at a few minutes after injection of the tracer by using the monitored entire brain activity. By the simulation analysis based on the 2-compartment model (influx; K1 and outflux; k2) using the input function and the entire brain activity obtained from eight subjects respectively, it was found that the conventional microsphere method overestimated the rCBF in the practical range of rCBF and Vd (= K1/k2) given in the 2-compartment model. When the values of rCBF and Vd in the 2-compartment model were given at 0.5 (ml/g/min) and 30 (ml/g) respectively, the rate of overestimation of rCBF by the conventional microsphere method was determined to be 17.3 +/- 0.7% (mean +/- S.D.). Also in clinical studies for eight subjects, the conventional microsphere method overestimated the rCBF compared with those evaluated by non-linear least squares fitting (NLLSF) analysis based on the 2-compartment model. Those results agreed well with the simulation analysis, suggesting the validity of the simulation. The rCBF values clinically estimated by the conventional method were, however, significantly correlated with those calculated by NLLSF analysis, and there were not so much difference between the two quantitative rCBF images obtained by the conventional microsphere method and the microsphere method. Therefore, we conclude that the conventional microsphere method is clinically useful in spite of the overestimation of rCBF.

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The microsphere model and the continuous withdrawal of arterial blood have commonly been used in clinical studies when measuring regional cerebral blood flow (rCBF) by N-isopropyl-p-[123I]iodoamphetamine (IMP) single photon emission tomography. The method is considered to underestimate rCBF because of the washout of tracer from brain tissue; however, the extent of this underestimation is not known. To assess whether this underestimation can be determined quantitatively, we performed simulation analysis based on the microsphere model and the two-compartment model [influx, K1(rCBF); and outflux, k2(washout)] using the time-activity curves of 123I-IMP in arterial blood [Ca(t)] of 10 subjects. With the microsphere method, rCBF values fell as time post-injection increased. The extent of underestimation of rCBF was 4.7 +/- 0.28% (mean +/- S.D.) at 5 min, 10.2 +/- 0.42% at 10 min and 15.2 +/- 0.55% at 15 min. There was little variation in the extent of underestimation and it was not dependent on the Ca(t) of the subjects. We therefore considered the results to be generally applicable to various studies of the microsphere model. As 4.7% is considered to be negligible in clinical studies, we conclude that the microsphere model can be applied to obtain accurate measurement of rCBF up to 5 min regardless of washout.

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Language：Japanese   Publisher：(一社)日本核医学会  

N-isopropyl-p-[123I]iodoamphetamine(IMP)を用いたmicrosphere modelに基づく局所脳血流量(rCBF)の測定(microsphere法)を行う場合,123I-IMP静注数十分後にSPECT撮像した画像を,同時に測定した全脳カウントの変化率によって補正して利用する簡便法(conventional microsphere法)が用いられる場合が多い.この方法を2コンパートメントモデルに基づくシミュレーション解析により検討したところ,rCBFは10%以上の過大評価となることが分かった.臨床データを用いた検討でも,conventional microsphere法がrCBFを過大評価する傾向がみられ,シミュレーション解析結果とよく適合した.しかし2コンパートメントモデルにおける値との線形相関はよく,またrCBF定量画像を作成したところmicrosphere法による画像と大きな違いはみられなかったことから,rCBFを過大評価することに留意すればconventional microsphere法は有用な方法であると考えた

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In the treatment and therapy of patients suffering a stroke, it is very important to predict whether viable neurones, even those of poor function, remain intact in the lesions of the brain. To determine whether viable neurones of low functional activity are represented in in vivo neuroreceptor imaging, we undertook experiments in gerbils with cerebral infarction, in which we examined histological changes and the results of dual-tracer in vivo autoradiography of glucose utilization with 14C-labelled deoxyglucose and benzodiazepine receptor binding with 123I-labelled Ro 16-0154. The unrelated findings of cerebral glucose metabolism and benzodiazepine receptor binding were observed in the primary infarct lesion and in remote areas, including the ipsilateral striatum and thalamus. Our experiments showed that when viable neurones with low functional activity remain intact, normal in vivo binding to benzodiazepine receptors is demonstrated as hypometabolism of glucose utilization. This functional, contrast-enhanced technique with 123I-labelled Ro 16-0154 may have an important role to play in the prediction of neuronal cell viability after recent brain infarction in experimental animals and humans using single photon emission tomography (SPET).

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Double injection method using brain perfusion 99mTc-HMPAO SPECT is popular one for evaluating stress scintigraphy. For appropriate evaluation of this method 555 MBq (15 mCi) of 99mTc-HMPAO was injected twice in sequence at the resting state. The first and second SPECT images were obtained 5 min after each injection. Twenty-five ROIs of 8 x 8 pixels were placed on in various regions of the first images, and calculate each counts (C1). Then the counts of the same region of the second scan were calculated (C2). One hundred and fifty ROIs/6 patients were examined. We derived the linear relationship as C2 = 1.66 x C1 + 106 (r = 0.97), where C1 and C2 represents counts of the first scan, and second scan, respectively. This results suggests that the counts of the second scan is derived from the counts of the first scan without second scanning if they are obtained in the same condition. When we applied this method to stress scintigraphy, it may be useful for evaluating the regional brain perfusion changes before and after loading instead of using subtraction technique.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Lippincott Williams and Wilkins  

To determine whether regional cerebral blood flow (rCBF) would change on standing in patients with idiopathic orthostatic hypotension (IOH), Tc-99m HMPAO SPECT studies were performed during postural testing in five patients with IOH. After 10 minutes of quiet rest on a bed, the patients arose quickly and, at the same time, the radiotracer was injected intravenously. SPECT data were obtained with a ring-type SPECT scanner. Another dose of Tc-99m HMPAO was injected with the subjects in the supine position, and SPECT was performed again. Image subtraction was used to evaluate the change in rCBF caused by postural testing. In all patients, the authors observed a decrease of rCBF in the frontal cortex and basal ganglia. This preliminary study suggests that changes in rCBF occur in patients with IOH on standing, and Tc- 99m HMPAO SPECT performed during postural testing may have an important role in evaluating these changes.

DOI： 10.1097/00003072-199509000-00010

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A more accurate quantitative method for the measurement of regional cerebral blood flow (rCBF) with the microsphere model and N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) and ring-type single-photon emission computed tomography (SPECT) was developed. Continuous withdrawal of arterial blood was carried out for 5 minutes after the injection. Static SPECT data were acquired from 25 min to 55 min. To estimate reconstructed images at 5 min, total brain count collections and one minute SPECT studies were performed at 5, 20, and 60 min. Quantitative values for rCBF were calculated from short time SPECT images at 5 min (rCBF), static SPECT images corrected by total brain counts (rCBFCt) and those corrected by reconstructed counts on short time SPECT images (rCBFCb). Practically, rCBFCb is calculated by using reconstructed counts of regions of interest placed in the same position as static SPECT and short time SPECT at 5, 20, 60 min. Although there was good correlation between rCBF and rCBFCt (r = 0.69), rCBFCt tended to be underestimated in high flow areas and overestimated in low flow areas. A better correlation was observed between rCBF and rCBFCb (r = 0.92). The overestimation and underestimation observed in rCBFCt was considered to be due to the correction method with a total cerebral time activity curve, because the kinetic behavior of 123I-IMP was different in each region.

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We developed a new non-invasive technique; one-point sampling method, for quantitative measurement of regional cerebral blood flow (rCBF) with N-isopropyl-p-[123I]iodoamphetamine and SPECT. Although the continuous withdrawal of arterial blood and octanol treatment of the blood are required in the conventional microsphere method, the new technique does not require these two procedures. The total activity of 123I-IMP obtained by the continuous withdrawal of arterial blood is inferred by the activity of 123I-IMP obtained by the one point arterial sample using a regression line. To determine when one point sampling time was optimum for inferring integral input function of the continuous withdrawal and whether the treatment of sampled blood for octanol fraction was required, we examined a correlation between the total activity of arterial blood withdrawn from 0 to 5 min after the injection and the activity of one point sample obtained at time t, and calculated a regression line. As the results, the minimum % error for the inference using the regression line was obtained at 6 min after the 123I-IMP injection, moreover, the octanol treatment was not required. Then examining an effect on the values of rCBF when the sampling time was deviated from 6 min, we could correct the values in approximately 3% error when the sample was obtained at 6 +/- 1 min after the injection. The one-point sampling method provides accurate and relatively non-invasive measurement of rCBF without octanol extraction of arterial blood.

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Regional cerebral blood flow (rCBF) was measured in five Japanese patients who were clinically diagnosed as having Joseph disease, also called Machado-Joseph disease or Azorean disease, using N-isopropyl-p-[123I]iodoamphetamine (IMP) and single-photon emission tomography (SPECT). Cerebellar atrophy was evaluated by a five-step rating scale as defined on X-ray computed tomography (X-CT). Compared with ten age-matched normal controls (mean cerebellar CBF +/- SD: 66.9 +/- 6.6 ml/100 g/min), rCBF in patients with Joseph disease was significantly decreased in the cerebellum (mean +/- SD: 50.2 +/- 7.3 ml/100 g/min). No significant relationship, however, was found between the decrease in rCBF in the cerebellum and the degree of cerebellar atrophy on X-CT. rCBF in the cerebellum was minimally decreased in one patient who had severe cerebellar atrophy and in two patients with moderate atrophy. These data may support the findings that Purkinje cells in the cerebellum are almost normal in Joseph disease, and that the granular and molecular layers remain intact in spite of cortical atrophy of the cerebellum. It is concluded that [123I]-IMP SPET is able to identify pathological and metabolic changes in the cerebellum that do not appear on X-CT or magnetic resonance imaging, and thus is useful for the diagnosis of Joseph disease.

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We developed a new method for quantitative measurement of regional cerebral blood flow (rCBF) using one-point arterial sampling with N-isopropyl-p-[123I]-iodoamphetamine (123I-IMP) and single photon emission computed tomography (SPECT) based on the microsphere model. Although the conventional microsphere method requires both the continuous withdrawal of arterial blood (integral of Ca(t)) and treatment of the blood with octanol to obtain the fraction of true tracer activity in the integral of Ca(t) (N), the new method does not require these two procedures. We examined 14 patients to analyse the correlation between the integral of Ca(t)N and a small arterial sample obtained at one time point [one-point Ca(t)] after the injection of 123I-IMP without octanol treatment. The integral of Ca(t)N was calculated from one point Ca(t) using the regression line of the correlation. An error of 8.1% in the calculated value compared to the actual value of the integral of Ca(t)N, could be inferred from one-point Ca(t) obtained at 6 min after the injection. Then regional cerebral blood flow was measured by the method and a significant correlation was obtained with rCBF measured using the 133Xe inhalation method (r = 0.773). The one-point Ca(t) method provides fast, easy, accurate and non-invasive measurement of rCBF without inserting catheters and without treatment of arterial blood with octanol.

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publisher：(一社)日本核医学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Regional cerebral blood flow (rCBF) was measured in 13 patients with various cerebral disease by N-isopropyl-p-[123I]iodoamphetamine (IMP) SPECT with the microsphere model (rCBF (CbST)), which was compared with 133Xe inhalation SPECT (rCBFXe). Continuous withdrawal of arterial blood was performed for 5 minutes and SPECT image was obtained from 25 min to 55 min after the tracer injection. The reconstructed counts at 5 min was corrected using entire cerebral counts collected at 5 min, 20 min, and 60 min after the tracer injection. As compared with rCBFXe, rCBF (CbST) was underestimated in high flow areas and overestimated in low flow areas. Regional CBF was also measured using one minute short time SPECT images at 5 min (rCBF (Cb5)), 20 min (rCBF (Cb20)), and 60 min (rCBF (Cb60)) after the injection. Regional CBF tended to be underestimated with time from the tracer injection due to the wash-out from brain tissue to blood. In comparison with rCBF (Cb5), rCBF (CbST) was underestimated in high flow areas and overestimated in low flow areas. This error was considered to be due to the correction of reconstruct counts using entire cerebral counts, because of the kinetic behavior of 123I-IMP was different in each region of the brain.

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中枢神経疾患に対し123I-IMPとmicrosphere modelを用いて局所脳血流量(rCBF)を求め,133Xe吸入SPECTによって求めたrCBFと比較した。得られたrCBFは133Xeから求めたrCBFと比べ,高血流域で過小,低血流域で過大に評価された。123I-IMPの静注5分,20分,60分後の1分間の短時間SPECTからそれぞれ算出したrCBFは,20分で15-30%,60分で30-60%少ない値を示し,洗い出しの存在が確認された。平衡時のSPECTのrCBFを早期のSPECTのrCBFと比べると,高血流域で過小に低血流域で過大に評価された。これは平衡時のSPECTを補正することにより生じた誤差であると考えられた

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Language：Japanese   Publishing type：Research paper (scientific journal)  

To evaluate the regional cerebral blood flow measurement with N-isopropyl-p-[123I]iodoamphetamine (IMP), we performed 123I-IMP SPECT and 133Xe inhalation method on 9 patients with mild cerebrovascular diseases and so on. A tracer dose of 123I-IMP (111 MBq) was injected i.v. and the data were obtained 15 min later. Regional CBF was measured by the microsphere model and arterial blood sampling method. However, mean cerebral blood flow values was not in agreement with both methods. We supposed the reason of the disagreement was due to the difference of PaCO2 when the studies were performed. Hence, CBF measurement with 123I-IMP was performed on the other patient's population with loading of hyperventilation before the IMP injection. Comparing with the control state with normal breathing, we calculated the rate of change of mean CBF between the state with normal breathing and the state with hyperventilation that was 1.02 ml/100 g/min/mmHg PaCO2. After the correction with the rate, we observed a much significant relation between the mean CBF measured with 123I-IMP SPECT and 133Xe inhalation method. When compared CBF values with loading studies or certain therapies, the correction of CBF with the rate of change of PaCO2 is one of the very important factors to be considered. Moreover, 133Xe inhalation method without the correction of PaCO2 can not be a golden standard method for rCBF measurement.

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脳血管障害など9例を対象に両検査を同日に施行したが,両者の平均脳血流の間には相関が見られなかった。その原因は検査時の動脈血炭酸ガス分圧(PaCO2)の違いにあると推測し,過呼吸試験を負荷しながら123I-IMP SPECTにて脳血流を測定し,安静呼吸時の脳血流と比較して,炭酸ガス分圧1mmHgあたりの脳血流の変化率(1.02ml/100g/min/mmHg PaCO2)を求めて補正した。その結果,両検査法による平均脳血流はよく相関した。治療効果判定や負荷試験など,同一症例において脳血流の変化を比較検討する場合には炭酸ガス分圧で脳血流を補正する必要がある。また133Xe吸入法SPECTは,このような補正をしない限り脳血流測定の基準検査にはならない

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Epilepsy Society  

We investigated the distribution changes between the early and delayed images of single photon emission computed tomography using N-isopropyl-p-[123I] iodoamphetamine (IMP) in 15 children with symptomatic or cryptogenic localization-related epilepsies in the interictal phase. We found three types of distribution changes as follows: Type 1
a low uptake area on the early image persisted unchanged on the delayed image in 2 cases, Type 2
a low uptake area on the early image changed to normal distribution on the delayed image in 9 cases, Type 3
a low uptake area on the early image changed to a high uptake area on the delayed image in 4 cases. We speculate that these phenomena may provide a considerable new information for interpreting 123I-IMP SPECT scans in children with epilepsy.

DOI： 10.3805/jjes.12.205

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Language：Japanese   Publisher：Japanese Society of Radiological Technology  

DOI： 10.6009/jjrt.KJ00003326310

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We developed a new graphic method using N-isopropyl-p-[123I]iodoamphetamine (IMP) and SPECT of the brain, the graph on which all three parameters, cerebral blood flow, distribution volume (Vd) and delayed count to early count ratio (Delayed/Early ratio), were able to be evaluated simultaneously. The kinetics of 123I-IMP in the brain was analyzed by a 2-compartment model, and a standard input function was prepared by averaging the time activity curves of 123I-IMP in arterial blood on 6 patients with small cerebral infarction etc. including 2 normal controls. Being applied this method to the differential diagnosis between Parkinson's disease and progressive supranuclear palsy, we were able to differentiate both with a glance, because the distribution volume of the frontal lobe significantly decreased in Parkinson's disease (Mean +/- SD; 26 +/- 6 ml/g). This method was clinically useful. We think that the distribution volume of 123I-IMP may reflect its retention mechanism in the brain, and the values are related to amine, especially to dopamine receptors and its metabolism.

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IMP脳血流SPECTを用いて,脳血流量K1,初期像と後期像のカウント比(Delayed/Early ratio)および脳血液分配定数distribution volume (Vd)を同一のグラフ上で評価できる新しい診断法-Magic square法を開発した。正常人を含む6例を対象に動脈血中の123I-IMPの時間放射能曲線を分析して標準入力関数とし,123I-IMPの脳内挙動を2-コンパートメントモデルで解析してグラフ(Magic square)を作成した。この方法をParkinson病と進行性核上麻痺の鑑別診断に応用したところ,Parkinson病では前頭葉におけるVdが有意に低下しており,両者を明瞭に鑑別できた。両疾患においてVdを測定する意義があることが示唆された。distribution volumeは123I-IMPの脳内保持機能の程度を反映し,その値はアミン類でも特にドーパミン系の受容体や代謝に大きく関与していると考えられた

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The biodistribution of 125I-Iomazenil (Ro 16-0154), a benzodiazepine receptor antagonist, was examined using in vivo autoradiography of gerbil brain. 125I-Iomazenil was administrated i.v. into male gerbils, and autoradiography was prepared from coronary sections of the animals decapitated at 5, 60, 120 and 180 min after injection. Initial uptake images (5 min) of 125I-Iomazenil were thought to show blood flow distribution. On the images obtained 120-180 min after administration, high activity of 125I-Iomazenil was observed in the cerebral cortex, amygdala, hippocampus, globus pallidus, thalamus, hypothalamus, superior colliculus, substantia nigra and cerebellar cortex in the areas of which benzodiazepine receptor concentration was reported to be high. However, low activity was observed in the caudate-putamen. Accumulation of 125I-Iomazenil was blocked by pre-administration of flumazenil. 123I-Ro 16-0154 has a high potentiality for benzodiazepine receptor mapping by SPECT.

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Language：Japanese   Publisher：日本メジフィジックス(株)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Crossed cerebellar diaschisis (CCD) is interpreted as a functional deactivation, presumably caused by a loss of excitatory or inhibitory afferent inputs on the corticopontocerebellar pathway and others. A redistribution phenomenon (RD) is usually observed in the contralateral cerebellum with CCD on delayed images of 123I-IMP SPECT. This phenomenon was analyzed in a view point of rCBF measurement in 24 patients with brain tumor, infarction and so forth. Regional CBF was measured by the microsphere method with 123I-IMP and a delayed-to-early counts ratio (D/E ratio) was used. As a result, there was no relation between rCBF and the D/E ratio in the cerebellum, which means that RD is occurred by other factors except for rCBF in the cerebellum. Regional CBF and the D/E ratio in the contralateral and ipsilateral cerebellum was 46.3 ml/100 g/min, 1.01 and 57.0 ml/100 g/min, 0.86, respectively. These results mean that the high activity of IMP gradually decreased in the ipsilateral cerebellum, while, the low activity in the contralateral cerebellum was almost stable, and the difference of both activity reduced after 5 hours and RD was observed on the delayed image. The data indicate that retention mechanism of IMP and vascular permeability are not affected in the cerebellum with CCD.

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Language：English   Publishing type：Research paper (scientific journal)  

N-isopropyl-p-[I-123] iodoamphetamine (I-123 IMP) SPECT studies were performed on a 75-year-old patient who could be clinically classified as subcortical arteriosclerotic encephalopathy (Binswanger's disease). Regional cerebral blood flow (rCBF) was quantitatively measured by a microsphere model, and was diffusely decreased in the whole brain (mean rCBF: 36 ml/100 g/minute). After a ventriculoperitoneal shunt operation, his clinical symptoms were markedly improved, and the improvement was validated by a 32% increase of mean rCBF. However, MRI and CT images showed no significant interval changes before and after the shunt operation. Regional rCBF measurement by I-123 IMP SPECT should be performed and plays an important role in the evaluation of Binswanger's disease.

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Language：Japanese   Publisher：医学書院  

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Other Link： http://search.jamas.or.jp/link/ui/2015175737

Language：Japanese   Publisher：産業開発機構(株)  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：新潟医学会  

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Language：Japanese   Publisher：(株)インナービジョン  

近年、世界的に死亡時画像診断(オートプシー・イメージング:Ai)の研究が盛んになり、Aiの有用性に関する論文が相次いで発表されている。"Aiがどこまでわかるか。どう役立つか"といった診断基準が確立されつつある。本稿では、最近発表された論文を中心に、Aiに関して明らかにされた知見を紹介する。(著者抄録)

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Language：Japanese   Publisher：(株)メジカルビュー社  

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Other Link： http://search.jamas.or.jp/link/ui/2013186654

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Language：Japanese   Publisher：新潟医学会  

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Language：Japanese   Publisher：金原出版(株)  

救急病院で通常行われる非外傷突然死の早期死後CT(PMCT)において、注意すべき所見を見落としなく拾い上げ、判断するためのチェックシートを作成した。その内容は、これまでに報告されているPMCT所見を部位別に列記し、それぞれ[所見の有無][所見の判断][死亡原因][死後変化][心肺蘇生術後の変化][その他の異常所見]についてチェックまたは記入するものとした。当院で26例に使用した結果を報告した。

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Language：Japanese   Publisher：新潟医学会  

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Language：Japanese   Publisher：金原出版(株)  

死後CT(オートプシー・イメージング)360例における死後所見・心肺蘇生術後所見について検討した。全例でCT検査、12例で剖検を行った。心肺停止状態で来院し24時間以内に死亡した例が354例、入院中に死亡した例が6例であった。死亡原因は、自然死268例、外因死92例であった。355例で、心臓マッサージや人工呼吸を含めた心肺蘇生術が施行された。死亡確認時刻からCT検査までの時間は、30分以内が285例、30分から60分が42例、60分以上が33例であった。大動脈壁高濃度像は96%以上、肺の異常陰影は80%以上、心大血管内の血液就下は70%程度で認めた。血管内の気体像は、血管が解放された症例を含めた外傷死において頭蓋内に29.4%、肝内に68%で認めたが、非外傷死においても、それぞれ10.5%、30.9%で認めた。

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Language：Japanese   Publisher：新潟大学  

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Other Link： http://search.jamas.or.jp/link/ui/2008317041

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：RADIOLOGICAL SOC NORTH AMERICA  

Web of Science

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Language：Japanese   Publisher：金原出版(株)  

上咽頭腫瘤性病変のMR像を検討した.特に,腫瘍と鑑別が必要なアデノイドにおいて,隔壁様線状造影効果に加えて,T2強調像における点状高信号が高率に認められ,鑑別診断上有用であった

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Language：Japanese   Publisher：新潟医学会  

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Other Link： http://search.jamas.or.jp/link/ui/1998015307

Language：English   Publisher：Niigata University  

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Other Link： http://search.jamas.or.jp/link/ui/1996037168

Language：Japanese   Publisher：金原出版(株)  

1)131I内照射を行ったのべ55回の症例における検査量の123I全身スキャンと治療量の131I全身スキャンを比較検討した。2)治療量の131Iスキャンで描出された病変は42病変であり,そのうち123Iスキャンで30部位(71.4%)が描出された。3)検査量の123Iで描出された病巣は,頸部リンパ節17/17,肺7/13,骨4/6,縦隔リンパ節2/4,腎0/1であった。4)検査量の123Iによる甲状腺癌の転移巣の検出能は,従来報告されている検査量の131Iによる検出能と同程度であり,臨床上有用な検査となりうる

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Other Link： http://hdl.handle.net/10191/42002

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Language：Japanese   Publisher：Niigata University  

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Other Link： http://hdl.handle.net/10191/38069

Language：Japanese   Publisher：Niigata University  

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Language：Japanese   Publisher：金原出版(株)  

1)99mTc-MDP骨シンチグラフィにて骨外集積を認めた10症例の,画像所見,病理組織所見を検討した。2)同一症例中では,腫瘍径の大きいものに優位に集積がみられた。これは血液供給量の不足による組織障害と関係するものと推測された。3)骨外集積を示す疾患とその集積機序に関する知識を深めることは,RIの集積部位とそのパターンから,集積を認めた組織の状態を知る助けとなり,画像診断上追加すべき適切な検査項目の指示を容易にし,骨シンチのみで一歩進んだ診断を可能にすることもある

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Language：Japanese   Publisher：新潟医学会  

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