研究者詳細 - 陣崎　雅弘

論文 - 陣崎　雅弘

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押さえておきたい臨床・画像分類第5章腹部・骨盤　16. 気腫性腎盂腎炎

成田啓一, 秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A232 - A234 2018年09月

ISSN 0285-0524

押さえておきたい臨床・画像分類第5章腹部・骨盤　15. 血管筋脂肪腫

成田啓一, 秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A228 - A231 2018年09月

ISSN 0285-0524

押さえておきたい臨床・画像分類第5章腹部・骨盤　14. 嚢胞性腎病変

成田啓一, 秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A224 - A227 2018年09月

ISSN 0285-0524

押さえておきたい臨床・画像分類第5章腹部・骨盤　1. 肝動脈,胆道の解剖学的変異

田村全, 中塚誠之, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A166 - A169 2018年09月

ISSN 0285-0524

押さえておきたい臨床・画像分類第4章心臓・血管　7. 下大静脈の破格

横山陽一, 山田祥岳, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A152 - A156 2018年09月

ISSN 0285-0524

押さえておきたい臨床・画像分類第4章心臓・血管　6. 閉塞性動脈硬化症

田村全, 井上政則, 中塚誠之, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A148 - A151 2018年09月

ISSN 0285-0524

押さえておきたい臨床・画像分類第4章心臓・血管　2. 冠動脈と心筋のセグメント

中原健裕, 山田稔, 中原理紀, 山田祥岳, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 11 ） A130 - A135 2018年09月

ISSN 0285-0524

下部消化管出血の治療戦略―放射線科の立場から―

御須学, 井上政則, 伊東伸剛, 塚田実郎, 中塚誠之, 陣崎雅弘

日本腹部救急医学会雑誌（日本腹部救急医学会） 38 （ 5 ） 831 - 834 2018年07月

ISSN 1340-2242

<p>下部消化管出血は年齢とともに増加し，背景疾患として大腸憩室，angiodysplasia，大腸炎や大腸癌があげられる。中でも大腸憩室出血は頻度がもっとも高く，本邦で増加している。NSAIDsやステロイド，抗血小板薬の使用が憩室出血の増加に拍車をかけている。出血の程度は軽微なものから生命を脅かすほど重篤なものまであるが，多くは保存的治療によって自然に止血し，特別な処置を要さない。重篤な出血に対しては内視鏡的止血術，IVRによる止血術いずれの有用性も報告されているが，どちらの治療法にも長所，短所がある。本稿では当院での大腸からの出血に対するIVRの治療成績を検討し，若干の文献的考察を加えて報告する。</p>

Fatal Intracranial Hemorrhage Due to Thrombocytopenia in a Patient with Castration-Resistant Prostate Cancer Showing Extensive Bone Uptake of Injected 223Ra Dichloride

Nakahara T., Owaki Y., Kosaka T., Fukada J., Ichimura A., Jinzaki M.

Clinical Nuclear Medicine （Clinical Nuclear Medicine） 43 （ 7 ） 546 - 547 2018年07月

ISSN 03639762

© 2018 Wolters Kluwer Health, Inc. All rights reserved. A 64-year-old man with castration-resistant prostate cancer received 223Ra injection to treat bone metastases. The patient underwent a 223Ra SPECT scan after the first 223Ra injection in which there was increased uptake all over the spine. Spine-to-background activity ratio in the patient was approximately three times greater than normal spine-to-background activity ratios in 223Ra SPECT obtained from the other patients. Eight days after the fifth injection, the patient exhibited a very poor neurologic examination and died of intracranial hemorrhage due to severe thrombocytopenia (platelet counts, 23,000/mm3). The extensive radiation to the spine may have enhanced myelophthisic process in this case.

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【大腸憩室出血に対する診断と治療-各科からの提言-】下部消化管出血の治療戦略　放射線科の立場から

御須学, 井上政則, 伊東伸剛, 塚田実郎, 中塚誠之, 陣崎雅弘

日本腹部救急医学会雑誌（(一社)日本腹部救急医学会） 38 （ 5 ） 831 - 834 2018年07月

ISSN 1340-2242

下部消化管出血は年齢とともに増加し、背景疾患として大腸憩室、angiodysplasia、大腸炎や大腸癌があげられる。中でも大腸憩室出血は頻度がもっとも高く、本邦で増加している。NSAIDsやステロイド、抗血小板薬の使用が憩室出血の増加に拍車をかけている。出血の程度は軽微なものから生命を脅かすほど重篤なものまであるが、多くは保存的治療によって自然に止血し、特別な処置を要さない。重篤な出血に対しては内視鏡的止血術、IVRによる止血術いずれの有用性も報告されているが、どちらの治療法にも長所、短所がある。本稿では当院での大腸からの出血に対するIVRの治療成績を検討し、若干の文献的考察を加えて報告する。(著者抄録)

特集エキスパートが本音で語る! 膀胱癌診療の最前線〈膀胱癌診断の最前線〉膀胱癌の画像診断

秋田大宇, 岩渕雄, 陣崎雅弘

臨床泌尿器科（株式会社医学書院） 72 （ 7 ） 514 - 525 2018年06月

ISSN 0385-2393

Bilateral Adrenal Hyperplasia Due to Adrenocorticotropic Hormone-Secreting Esthesioneuroblastoma on FDG PET and 111In-Pentetreotide Scintigraphy

Matsusaka Y., Nakahara T., Kurihara I., Iwabuchi Y., Jinzaki M.

Clinical Nuclear Medicine （Clinical Nuclear Medicine） 43 （ 6 ） 452 - 453 2018年06月

ISSN 03639762

© 2018 Wolters Kluwer Health, Inc. All rights reserved. A 53-year-old woman with metastatic esthesioneuroblastoma was referred for FDG PET/CT imaging. FDG PET/CT showed symmetrical uptake in bilaterally enlarged adrenal glands, in addition to abnormal uptake in bone and lymph node metastases. 111In-pentetreotide scintigraphy was further performed and revealed the lack of adrenal uptake. The patient's serum adrenocorticotropic hormone (ACTH) level was extremely high, suggesting that hyperplastic condition in the adrenal glands due to ACTH stimulation from the metastatic esthesioneuroblastoma was responsible for increased FDG uptake. The combination of FDG PET and 111In-pentetreotide scintigraphy was useful for the pathophysiological evaluation of ACTH-secreting esthesioneuroblastoma.

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Quantitative evaluation of the tracer distribution in dopamine transporter SPECT for objective interpretation

Iwabuchi Y., Nakahara T., Kameyama M., Yamada Y., Hashimoto M., Ogata Y., Matsusaka Y., Katagiri M., Itoh K., Osada T., Ito D., Tabuchi H., Jinzaki M.

Annals of Nuclear Medicine （Annals of Nuclear Medicine） 32 （ 5 ） 363 - 371 2018年06月

ISSN 09147187

© 2018, The Japanese Society of Nuclear Medicine. Purpose: Quantification of the tracer distribution would add objectivity to the visual assessments of dopamine transporter (DAT) single photon emission computed tomography (SPECT) data. Our study aimed to evaluate the diagnostic utility of fractal dimension (FD) as a quantitative indicator of tracer distribution and compared with the conventional quantitative value: specific binding ratio (SBR). We also evaluated the utility of the combined index SBR/FD (SBR divided by FD). Materials and methods: We conducted both clinical and phantom studies. In the clinical study, 150 patients including 110 patients with Parkinsonian syndrome (PS) and 40 without PS were enrolled. In the phantom study, we used a striatal phantom with the striatum chamber divided into two spaces, representing the caudate nucleus and putamen. The SBR, FD, and SBR/FD were calculated and compared between datasets for evaluating the diagnostic utility. Mann–Whitney test and receiver-operating characteristics (ROC) analysis were used for analysis. Results: ROC analysis revealed that the FD value had high diagnostic performance [the areas under the curve (AUC) = 0.943] and the combined use of SBR and FD (SBR/FD) delivered better results than the SBR alone (AUC, 0.964 vs 0.899; p < 0.001). The sensitivity, specificity, and accuracy, respectively, were 79.1, 85.0, and 80.7% with SBR, 84.5, 97.5, and 88.0% with FD, and 92.7, 87.5, and 91.3% with SBR/FD. Conclusion: Our results confirmed that the FD value is a useful diagnostic index, which reflects the tracer distribution in DAT SPECT images. The combined use of SBR and FD was more useful than either used alone.

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特集症例から迫る!関節疾患のMRI診断新入門膝関節

許斐佑介, 大堀訓明, 陣崎雅弘, 新津守

臨床画像（(株)メジカルビュー社） 34 （ 5 ） 558 - 568 2018年05月

ISSN 0911-1069

FDG PET/CT Findings in a Localized Reactive Lymphoid Hyperplasia of the Spleen

Ito Y., Nakahara T., Nishihara Y., Shiraishi J., Jinzaki M.

Clinical Nuclear Medicine （Clinical Nuclear Medicine） 43 （ 5 ） 354 - 355 2018年05月

ISSN 03639762

© 2018 Wolters Kluwer Health, Inc. All rights reserved. A 38-year-old man with sigmoid colon cancer underwent a preoperative contrast-enhanced CT which incidentally revealed a modestly enhancing splenic mass. FDG PET/CT showed mildly increased uptake in the splenic lesion in contrast to prominently increased uptake in the colonic tumor. In addition, the splenic mass demonstrated only slightly increased signal intensity in diffusion-weighted MRI, suggesting low probability of metastasis. Splenectomy nonetheless was performed at surgery of the colon cancer. The histopathologic examination showed aggregated lymphoid follicles with germinal centers in the splenic lesion and made the diagnosis of localized reactive lymphoid hyperplasia a rare benign lymphoid tumor.

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

Mizutani K., Akiyama T., Minami Y., Toda M., Fujiwara H., Jinzaki M., Yoshida K.

Neuroradiology （Neuroradiology） 60 （ 5 ） 487 - 496 2018年05月

ISSN 00283940

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Although involvement of the osseous component with an anterior condylar dural arteriovenous fistula (AC-DAVF) has been frequently described, osseous venous structures in which AC-DAVFs develop have not been fully elucidated. We investigated osseous venous structures adjacent to the hypoglossal canal in normal controls and patients with AC-DAVFs. Methods: The study included 50 individuals with unruptured aneurysms as normal controls and seven patients with AC-DAVFs. Osseous venous structures adjacent to the hypoglossal canal in normal controls were analyzed using computed tomography (CT) digital subtraction venography. In patients with AC-DAVFs, the fistulous pouches, draining veins, and surrounding venous structures were examined using cone beam CT. Results: In 46.0% of laterals in normal controls, osseous venous structures were visualized within the jugular tubercle superomedially to the hypoglossal canal. We named these structures the jugular tubercle venous complex (JTVC). The JTVC was always continuous with the anterior condylar vein and was sometimes connected to surrounding venous channels. We detected nine fistulous pouches in the seven patients with AC-DAVFs. The fistulous pouches were in the JTVC (33.3%), anterior condylar vein (33.3%), and other venous channels within the exoccipital region (33.3%). Conclusion: Although the JTVC is a venous structure frequently found in normal people, it had not been investigated until now. The venous channel between the anterior condylar vein and JTVC is a common origin site for AC-DAVFs, and it was associated with 66.6% of the AC-DAVF cases in the current study.

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The psychological impact of disclosing amyloid status to Japanese elderly: A preliminary study on asymptomatic patients with subjective cognitive decline

Wake T., Tabuchi H., Funaki K., Ito D., Yamagata B., Yoshizaki T., Kameyama M., Nakahara T., Murakami K., Jinzaki M., Mimura M.

International Psychogeriatrics （International Psychogeriatrics） 30 （ 5 ） 635 - 639 2018年05月

ISSN 10416102

© 2018 International Psychogeriatric Association. In Japan, 4.6 million people are living with dementia and the number is expected to rise to 7 million by 2025. Amyloid-β (Aβ) positron emission tomography (PET) is used for cognitively normal Japanese people with or without subjective cognitive decline (SCD) for the purpose of clinical trials or diagnosis. Nevertheless, no empirical studies have been conducted on the safety of disclosing amyloid status to such populations. We conducted amyloid PET imaging on 42 participants (Aβ positive (n = 10) and negative (n = 32)). State anxiety and depression were measured at pre- and post-disclosure, and test-related distress at post-disclosure. Mean state anxiety and depression scores were below the cut-off through pre- and post-disclosure in the Aβ positive and negative groups. State anxiety and depression did not change over time and were not different between groups. Mean test-related distress scores were within normal limits at post-disclosure in both groups. No significant difference was found between groups. Disclosing Aβ positive results did not cause greater mood disturbance than negative results in a short period of time. The short-term psychological safety of disclosing Aβ PET results to asymptomatic Japanese adults with SCD was indicated.

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Quantitative and qualitative evaluation of hybrid iterative reconstruction, with and without noise power spectrum models: A phantom study

Minamishima K., Sugisawa K., Yamada Y., Jinzaki M.

Journal of Applied Clinical Medical Physics （Journal of Applied Clinical Medical Physics） 19 （ 3 ） 318 - 325 2018年05月

© 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine. The purpose of this phantom study was to investigate the feasibility of dose reduction with hybrid iterative reconstruction, with and without a noise power spectrum (NPS) model, using both quantitative and qualitative evaluations. Standard dose (SD), three-quarter dose (TQD), and half-dose (HD) of radiation were used. Images were reconstructed with filtered back projection (FBP), adaptive iterative dose reduction 3D (AIDR 3D) (MILD, STR), and AIDR 3D enhanced (eAIDR 3D) (eMILD, eSTR). An NPS analysis, task-based modulation transfer function (MTFtask) analysis, and comparisons of low-contrast detectability and image texture were performed. Although the eAIDR 3D had a higher NPS value in the high-frequency range and improved image texture and resolution as compared with AIDR 3D at the same radiation dose and iteration levels, it yielded higher noise than AIDR 3D. Additionally, although there was no statistically significant difference between SD-FBP and the TQD series in the comparison of the mean area under the curve (AUC), the mean AUC was statistically significantly different between SD-FBP and the HD series. NPS values in the high-frequency range, 10% MTFtask values, low-contrast detectability, and image textures of TQD-eMILD were comparable to those of SD-FBP. Our findings suggested that using eMILD can reduce the radiation dose by 25%, while potentially maintaining diagnostic performance, spatial resolution, and image texture; this could support selecting the appropriate protocol in a clinical setting.

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ここが知りたい! 画像診断2017年12月号特集「知っておきたい泌尿器画像診断─新たな動向も含めて─」

片平和博, 陣崎雅弘

画像診断（学研メディカル秀潤社） 38 （ 6 ） 590 - 591 2018年04月

ISSN 0285-0524

Silent navigator–triggered silent MRI of the abdomen

Iwadate Y., Nozaki A., Nunokawa Y., Okuda S., Jinzaki M., Kabasawa H.

Magnetic Resonance in Medicine （Magnetic Resonance in Medicine） 79 （ 4 ） 2170 - 2175 2018年04月

ISSN 07403194

© 2017 International Society for Magnetic Resonance in Medicine Purpose: To develop and demonstrate the feasibility of a silent respiratory navigator technique for prospective triggering, which was incorporated into a three-dimensional radial zero-echo-time sequence for respiratory navigated silent abdominal imaging. Methods: A nonselective hard excitation radiofrequency pulse was used for the navigator sequence with a derated readout gradient, to avoid generation of high levels of acoustic noise. The acquired navigator signals were processed in real time and used for prospective triggering of the zero-echo-time sequence. Ten healthy volunteers were scanned using the proposed and conventional techniques at 1.5 T. An acoustic noise measurement with A-weighted continuous equivalent sound pressure level was also performed. Results: The sound pressure–level values of the background noise, zero-echo-time imaging, conventional, and silent navigators were 68.3, 68.4, 102.5, and 69.4 dBA, respectively. Excellent correlation with correlation coefficients greater than 0.9 was observed between the bellows signals and displacement values calculated from the navigators. Sharpness of the portal vein of both conventional and silent navigator–triggered images was significantly higher than those of nontriggered images. Conclusions: The silent navigator–triggered zero-echo-time technique is feasible and might improve image quality and workflow of abdominal MRI of patients who are prone to acoustic noise. Magn Reson Med 79:2170–2175, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

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陣崎 雅弘

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陣崎　雅弘

論文 - 陣崎　雅弘