慶應義塾研究者情報データベース

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• Classification, angioarchitecture and treatment outcomes of medullary bridging vein-draining dural arteriovenous fistulas in the foramen magnum region: a multicenter study

  T Ozaki, M Hiramatsu, H Nakamura, Y Niimi, S Tanoue, K Mizutani, ...

  Neuroradiology 67 (1), 213-225 67 （ 1 ） 213 - 225 2025年

  ISSN  00283940

  　概要を見る

  Purpose: This study aimed to classify medullary bridging vein-draining dural arteriovenous fistulas (MBV-DAVFs) located around the foramen magnum (FM) according to their location and characterize their angioarchitecture and treatment outcomes. Methods: Patients with MBV-DAVFs diagnosed between January 2013 and October 2022 were included. MBV-DAVFs were classified into four groups. Jugular vein-bridging vein (JV-BV) DAVF: located in proximity to jugular fossa, Anterior condylar vein (ACV)-BV DAVF: proximity to anterior condylar canal, Marginal sinus (MS)-BV DAVF: lateral surface of FM and Suboccipital cavernous sinus (SCS)-BV DAVF: proximity to dural penetration of vertebral artery. Results: Twenty patients were included, three JV-BV, four ACV-BV, three MS-BV and ten SCS-BV DAVFs, respectively. All groups showed male predominance. There were significant differences in main feeders between JV (jugular branch of ascending pharyngeal artery) and SCS group (C1 dural branch). Pial feeders from anterior spinal artery (ASA) or lateral spinal artery (LSA) were visualized in four SCS and one MS group. Drainage pattern did not differ between groups. Transarterial embolization (TAE) was performed in three, two, one and two cases and complete obliteration was obtained in 100%, 50%, 100% and 0% in JV, ACS, MS and SCS group, respectively. Successful interventions without major complications were finally obtained in 100%, 75%, 100%, and 40% in JV, ACS, MS and SCS group, respectively. Conclusion: JV-BV DAVFs were successfully treated using TAE alone. SCS-BV DAVFs were mainly fed by small C1 dural branches of vertebral artery often with pial feeders from ASA or LSA, and difficultly treated by TAE alone.

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• Upright multidetector CT with 320-row gantry: a technical innovation providing insights into human anatomy under gravity and potential clinical implications

  M Jinzaki, M Yamada, Y Yokoyama, T Nakahara, T Nagura, Y Inamoto, ...

  British Journal of Radiology 98 (1175), 1754-1765 98 （ 1175 ） 1754 - 1765 2025年

  ISSN  00071285

  　概要を見る

  CT performed in the supine position has been highly effective in diagnosing organic diseases such as cancer, arteriosclerosis, and infections, significantly contributing to increased life expectancy. In an ageing society, extending healthy life expectancy becomes more critical, requiring early diagnosis of functional disorders. We have led the industry-academia collaboration in developing an upright MDCT system. Although this system maintains the same physical specifications as conventional MDCT, it differs significantly in imaging configuration—allowing supine, upright, and sitting positions—and offers improved workflow while requiring only two-thirds of the installation space. Unlike conventional MDCT, it allows for the assessment of anatomical changes under gravity. It also enables the objective diagnosis and grading of functional diseases, in which findings were not apparent on conventional CT, and enable the study of the pathogenesis of functional diseases which worsen symptoms in the upright position. Furthermore, it allows for noninvasive evaluation of dynamic functions such as swallowing and voiding, which can only be assessed in standing or sitting positions.

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• Variations in venous anatomy associated with the suboccipital transhorizontal fissure approach: Imaging and cadaveric studies with clinical application

  J Sogano, R Tamura, K Mizutani, Y Kitamura, R Ueda, M Toda

  Acta Neurochirurgica 167 (1), 204 167 （ 1 ）  2025年

  ISSN  00016268

  　概要を見る

  Purpose: This study aimed to examine the venous anatomy of the horizontal fissure (HF) of the cerebellum by using contrast-enhanced magnetic resonance imaging (MRI) and computed tomography venography (CTV). We also studied the venous anatomy and cerebellar structures surrounding the HF relevant to the suboccipital trans-HF (SOTHF) approach in cadaver studies. Methods: We conducted an imaging analysis of 200 cerebellar hemispheres from 100 patients who underwent surgical treatment for intracranial supratentorial lesions between March 2021 and March 2023 at our institution. All patients underwent preoperative contrast-enhanced MRI and CTV. A cadaver study was conducted to assess the feasibility of the medial, intermediate, and lateral surgical corridors of the SOTHF approach while preserving the veins. We also present a clinical case. Results: Veins traversing the HF longitudinally, which act as a potential barrier when splitting the HF, were observed in 82% of the hemispheres, with an average of 1.28 per hemisphere. Distinctive veins running horizontally along the HF, observed in 24% of hemispheres, also act as potential barriers during wide HF opening. Cadaver studies demonstrated essential anatomical structures around the HF and that the medial, intermediate, and lateral corridors of the SOTHF approach could be achieved while preserving surrounding venous structures. Conclusion: The SOTHF approach is feasible for accessing deep cerebellar lesions, the medial aspect of cerebellopontine angle, and the upper fourth ventricle. Preoperative analysis and prediction of the venous architecture around the HF can enhance the safety and efficiency of the surgery.

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• Angiographical Investigation of Vagal and Carotid Body Paragangliomas

  K Yamamoto, T Akiyama, K Mizutani, H Ozawa, M Toda

  Journal of Neuroendovascular Therapy 19 (1), oa. 2024-0096 2025年

• A Case of Aneurysmal SAH and Stanford Type A Acute Aortic Dissection: A Case Report

  T Enomoto, K Mizutani, K Karatsu, T Iwama, R Tamura, T Akiyama, T Ito, ...

  NMC Case Report Journal 12, 459-464 2025年

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• Intraosseous venous structures adjacent to the jugular tubercle associated with an anterior condylar dural arteriovenous fistula (要約)

  水谷, 克洋

  （慶應義塾大学大学院医学研究科）  2018年

• Intraosseous venous structures adjacent to the jugular tubercle associated with an anterior condylar dural arteriovenous fistula (要旨)

  水谷, 克洋

  （慶應義塾大学大学院医学研究科）  2018年

• Intraosseous venous structures adjacent to the jugular tubercle associated with an anterior condylar dural arteriovenous fistula (審査報告)

  水谷, 克洋

  （慶應義塾大学大学院医学研究科）  2018年

• くも膜下出血後遅発性脳虚血のマーカー及び治療標的としてのmiRNAスクリーニング

  水谷, 克洋

  科学研究費補助金研究成果報告書 2017年

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• Bridging veins at the craniocervical junction: from anatomy to clinical significance in dural arteriovenous shunts

  T Miyauchi, K Mizutani, T Akiyama, M Toda

  Neuroradiology （Neuroradiology）  66 （ 1 ） 55 - 62 2023年10月

  ISSN  00283940

  　概要を見る

  Purpose: Bridging veins (BVs) serve as a route of pial venous reflux, and its anatomy is essential to understand the pathophysiology of dural arteriovenous shunts (dAVSs) around the craniocervical junction (CCJ) (from the jugular foramen level to the atlantal level). However, the anatomical variations of the BVs and their proximal connections remained poorly elucidated. This study aimed to radiologically investigate the anatomy of the bridging veins around CCJ and discuss the clinical significance of these BVs in the dAVS. Methods: We investigated normal venous anatomy of the BVs from the jugular foramen level to the atlantal level using preoperative computed tomography digital subtraction venography in patients undergoing elective neurosurgery. BVs affected by the dAVSs in the same region were also evaluated. The three types of dAVS, craniocervical junction, anterior condylar, and proximal sigmoid sinus, were investigated. Results: We identified six BV groups: superolateral, anterolateral, lateral, posterior, inferolateral, and inferoposterior. The superolateral and inferolateral groups, connected with the proximal sigmoid sinus and suboccipital cavernous sinus, respectively, were the largest groups. Each group has a specific downstream venous connection. The association with dVASs was observed only in the inferolateral group, which was typically the sole venous drainage in most dAVSs at the CCJ. Conclusion: We reported detailed anatomy of BVs from the jugular level to the atlantal level, which enhanced our understanding of the pathophysiology of dAVSs in the corresponding region.

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• Detailed Anatomy of Bridging Veins Around the Foramen Magnum: a Multicenter Study Using Three-dimensional Angiography

  M Hiramatsu, T Ozaki, S Tanoue, K Mizutani, H Nakamura, K Tokuyama, ...

  Clinical Neuroradiology （Clinical Neuroradiology）  34 （ 1 ） 67 - 74 2023年08月

  ISSN  18691439

  　概要を見る

  Background and Purpose: There has been limited literature regarding the bridging veins (BVs) of the medulla oblongata around the foramen magnum (FM). The present study aims to analyze the normal angioarchitecture of the BVs around the FM using slab MIP images of three-dimensional (3D) angiography. Methods: We collected 3D angiography data of posterior fossa veins and analyzed the BVs around the FM using slab MIP images. We analyzed the course, outlet, and number of BVs around the FM. We also examined the detection rate and mean diameter of each BV. Results: Of 57 patients, 55 patients (96%) had any BV. The median number of BVs was two (range: 0–5). The BVs originate from the perimedullary veins and run anterolaterally to join the anterior condylar vein (ACV), inferior petrosal sinus, sigmoid sinus, or jugular bulb, inferolaterally to join the suboccipital cavernous sinus (SCS), laterally or posterolaterally to join the marginal sinus (MS), and posteriorly to join the MS or occipital sinus. We classified BVs into five subtypes according to the draining location: ACV, jugular foramen (JF), MS, SCS, and cerebellomedullary cistern (CMC). ACV, JF, MS, SCS, and CMC BVs were detected in 11 (19%), 18 (32%), 32 (56%), 20 (35%), and 16 (28%) patients, respectively. The mean diameter of the BVs other than CMC was 0.6 mm, and that of CMC BV was 0.8 mm. Conclusion: Using venous data from 3D angiography, we detected FM BVs in most cases, and the BVs were connected in various directions.

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• Role of endovascular treatment for ruptured aneurysms involving the anterior spinal artery at the craniocervical junction

  Mizutani K, Akiyama T, Tomita H, Toda M

  Journal of Neuroradiology （Journal of Neuroradiology）  50 （ 1 ） 44 - 49 2023年02月

  ISSN  0150-9861

  　概要を見る

  Ruptured aneurysms at the craniocervical junction (CCJ) involving the anterior spinal artery (ASA) are rare and consist of heterogenous lesions with variable clinical entities. However, the standard therapeutic strategy for the lesions has not been well-established. Moreover, despite advances in modern neurointervention, reports describing endovascular treatment for this specific lesion have been few. Here, we report three cases of ruptured aneurysms on the pial tributary of the ASA at the CCJ, which were subsequently treated by transarterial glue injection or coil embolization. Endovascular treatment can be a therapeutic option, particularly for these ruptured aneurysms. Either transarterial glue injection or coil embolization can be effective depending on the type of etiology and the surrounding vasculature anatomy.

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• Extracranial prevertebral venous network of the craniocervical junction: CT-digital subtraction venography analysis

  Yamada H, Mizutani K, Akiyama T, Toda M

  Neuroradiology （Neuroradiology）  64 （ 12 ） 2227 - 2233 2022年12月

  ISSN  0028-3940

  　概要を見る

  Purpose: Although the craniocervical junction has a complex anatomical structure associated with clinical diseases, its ventral venous network has not been well studied. This study aimed to clarify the extracranial ventral venous structure at the craniocervical junction. Methods: Head computed tomography digital subtraction venography (CT-DSV) images of 273 patients (age 6 months to 93 years) taken at our department were retrospectively analyzed. We analyzed the frequency and anatomical features of the venous channels, as well as their upstream and downstream connections with the surrounding channels at the ventral craniocervical junction, from the level of the hypoglossal canal to the second cervical vertebra. Results: In 54% of the cases, the vein descended from the anterior condylar confluence, running medially along the basioccipital and fusing with its counterpart in the midline at the level of the atlanto-occipital membrane. Furthermore, 24% of this vein was connected caudally to the anterior external vertebral venous plexus. We also identified venous channels, either as a sole vein or venous plexus, on the tip of the odontoid process (10%), which has not been well described previously. The vein around the odontoid process was connected to several veins, including the aforementioned vein anterior to the condyle and the anterior internal vertebral venous plexus. Conclusions: CT-DSV analysis revealed a detailed venous architecture ventral to the craniocervical junction. Venous structures identified in this study may be involved in diseases in this area.

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• 一般的な脊髄動静脈シャントの分類に含まれない非典型的な脊髄動静脈瘻

  秋山 武紀, 水谷 克洋, 名越 慈人, 辻 収彦, 中村 雅也, 松本 守男, 戸田 正博

  脳血管内治療 （(NPO)日本脳神経血管内治療学会）  7 （ Suppl. ） S30 - S30 2022年11月

  ISSN  2423-9119

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競争的研究費の研究課題 【 表示 ／ 非表示 】

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• 脳動脈瘤壁の炎症をターゲットとしたコイル塞栓術後の再発抑制

  2023年04月

  -

  2026年03月

  日本学術振興会, 科学研究費助成事業, 水谷 克洋, 若手研究, 補助金,  研究代表者

  　研究概要を見る

  実験開始から一年をかけて動脈瘤モデルの構築および動脈瘤モデルの評価を行なった。動脈瘤モデルは当初ウサギを用いることを考えていたが、管理のしやすさと、頭蓋内での動脈瘤モデルの方が生理的なモデルであると考えラットを用いた頭蓋内動脈瘤モデルに変更した。過去に報告のあったモデル(Surg Neurol 11: 243-246, 1979)を用いて片側腎動脈結紮及び総頸動脈結紮による血行力学的負荷及びbeta-aminopropionitrile (BAPN)及び高塩分食を負荷を行なうことで動脈瘤を形成するモデルを使用した。上記、処置後２週間程度で弾性板の破綻などの動脈瘤形成の初期段階が確認された。
  また最終的な動脈瘤の治療を考える上で、動脈瘤形成や成長の病態や過程を明らかにすることは必須と思われた。形態的な評価や血行力学的な負荷についても検討が必要と考え、Computed flow dynamics（CFD）を用いた解析を追加することを検討した。そのためCFDの解析に耐えうるラットにおける微細な造影CT撮影プロトコルの確立を試みた。
  ラットに腹腔麻酔を行い、尾静脈から造影剤を注入し、頭蓋内の撮影を行なった。造影剤の注入量や注入速度、撮影タイミングを工夫することでCFDの解析に耐えうる画像を取得できる撮影プロトコルを確立した。造影CT撮影によりラットの頭蓋内動脈・静脈の解剖構造が詳細に観察できるようになった。従来報告されていたラットの海綿静脈洞の解剖において、今回観察された造影CTでの観察結果の間に齟齬があることが副次的に明らかになったため、この内容をJ Vet Anat 2024;17:19-29にて報告を行なった。また今後ある程度以上の瘤形成がされれば造影CTによりラットの解剖を行わなず動脈や瘤の形態変化を確認できるようになった。

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• 教育展示賞金賞

  水谷克洋, 2024年11月, 第40回日本脳神経血管内治療学会学術集会, 舌下神経管周囲の静脈解剖とanterior condylar arteriovenous shunts

• 日本頭蓋底外科学会優秀論文賞

  2016年, 日本頭蓋底外科学会

  受賞区分： 国内学会・会議・シンポジウム等の賞

• 日本頭蓋底外科学会優秀論文賞

  2016年, 日本頭蓋底外科学会, The Analysis of the Petrosal Vein to Prevent Venous Complications During the Anterior Transpetrosal Approach in the Resection of Petroclival Meningioma

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• メディカル・プロフェッショナリズムⅥ

  2025年度

• 脳神経外科学講義

  2025年度

• メディカル・プロフェッショナリズムⅥ

  2024年度

• 脳神経外科学講義

  2024年度

• メディカル・プロフェッショナリズムⅥ

  2023年度

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