研究者詳細 - 陣崎　雅弘

論文 - 陣崎　雅弘

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Relationship between body mass index and pancreas volume in japanese adults

Kou K., Saisho Y., Jinzaki M., Itoh H.

Journal of the Pancreas （Journal of the Pancreas） 15 （ 6 ） 626 - 627 2014年

研究論文（学術雑誌）, 共著, ISSN 1590-8577

Renal cell carcinoma in patients with acquired cystic disease of the kidney: Assessment using a combination of T2-weighted, diffusion-weighted, and chemical-shift MRI without the use of contrast material

Akita H., Jinzaki M., Akita A., Mikami S., Oya M., Kuribayashi S.

Journal of Magnetic Resonance Imaging （Journal of Magnetic Resonance Imaging） 39 （ 4 ） 924 - 930 2014年

研究論文（学術雑誌）, 共著, ISSN 1053-1807

Purpose To evaluate the MRI findings of renal cell carcinoma (RCC), including findings on diffusion-weighted images (DWIs) and chemical shift images (CSIs), in patients with acquired cystic disease of the kidney (ACDK) in relation to the histopathologic findings. Materials and Methods Two radiologists retrospectively reviewed the MRI findings of 10 RCCs in seven consecutive patients with ACDK. They evaluated the signal intensities (SIs) and signal homogeneity of the lesions on T2-weighted images, DWIs, and T1-weighted images. Thereafter, they evaluated the cytoplasmic fat in the lesions by CSIs. After image analyses, the MRI findings were correlated with the histopathologic findings. Results The RCCs tended to show heterogeneous high SIs on T2-weighted images and DWIs. The high SIs on DWIs were mainly attributable to the viable parts, and the heterogeneity was due to the various SIs arising from the intratumoral degenerative components. Unlike the reported findings for hemorrhagic cysts, the RCCs did not show homogeneous high SIs or fluid-iron levels on T1-weighted images. The four lesions, in which the presence of cytoplasmic fat was suggested on CSIs, were clear cell RCCs. Conclusion The MRI findings, including findings on DWIs and CSIs, well reflected the histopathologic findings of RCC in patients with ACDK. © 2013 Wiley Periodicals, Inc.

Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: The CORE320 study

Rochitte C.E., George R.T., Chen M.Y., Arbab-Zadeh A., Dewey M., Miller J.M., Niinuma H., Yoshioka K., Kitagawa K., Nakamori S., Laham R., Vavere A.L., Cerci R.J., Mehra V.C., Nomura C., Kofoed K.F., Jinzaki M., Kuribayashi S., De Roos A., Laule M., Tan S.Y., Hoe J., Paul N., Rybicki F.J., Brinker J.A., Arai A.E., Cox C., Clouse M.E., Di Carli M.F., Lima J.A.C.

European Heart Journal （European Heart Journal） 35 （ 17 ） 1120 - 1130 2014年

研究論文（学術雑誌）, 共著, ISSN 0195-668X

Aims To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed tomography (SPECT). Methods and results We conducted a multicentre study to evaluate the accuracy of integrated CTA-CTP for the identification of patients with flow-limiting CAD defined by ≥50% stenosis by invasive coronary angiography (ICA) with a corresponding perfusion deficit on stress single photon emission computed tomography (SPECT/MPI). Sixteen centres enroled 381 patients who underwent combined CTA-CTP and SPECT/MPI prior to conventional coronary angiography. All four image modalities were analysed in blinded independent core laboratories. The prevalence of obstructive CAD defined by combined ICA-SPECT/MPI and ICA alone was 38 and 59%, respectively. The patient-based diagnostic accuracy defined by the area under the receiver operating characteristic curve (AUC) of integrated CTA-CTP for detecting or excluding flow-limiting CAD was 0.87 [95% confidence interval (CI): 0.84-0.91]. In patients without prior myocardial infarction, the AUC was 0.90 (95% CI: 0.87-0.94) and in patients without prior CAD the AUC for combined CTA-CTP was 0.93 (95% CI: 0.89-0.97). For the combination of a CTA stenosis ≥50% stenosis and a CTP perfusion deficit, the sensitivity, specificity, positive predictive, and negative predicative values (95% CI) were 80% (72-86), 74% (68-80), 65% (58-72), and 86% (80-90), respectively. For flow-limiting disease defined by ICA-SPECT/MPI, the accuracy of CTA was significantly increased by the addition of CTP at both the patient and vessel levels. Conclusions The combination of CTA and perfusion correctly identifies patients with flow limiting CAD defined as ≥50 stenosis by ICA causing a perfusion defect by SPECT/MPI. © The Author 2013.

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A randomized, double-blind, placebo-controlled, phase III study of the short-acting β<inf>1</inf>-adrenergic receptor blocker Landiolol hydrochloride for coronary computed tomography angiography in Japanese patients with suspected ischemic cardiac disease

Hirano M., Yamashina A., Hara K., Ikari Y., Jinzaki M., Iino M., Yamaguchi T., Tanimoto M., Kuribayashi S.

Clinical Drug Investigation （Clinical Drug Investigation） 34 （ 1 ） 53 - 62 2014年

研究論文（学術雑誌）, 共著, ISSN 1173-2563

Objectives and Background: The objective of this study was to investigate the image quality-improving and heart rate-lowering effects of landiolol hydrochloride (a short-acting β1-adrenergic receptor blocker) on coronary computed tomography angiography (CCTA). During CCTA, β-adrenergic receptor blockers have been commonly used to lower heart rate and improve image quality. Methods: A total of 258 subjects suspected of having ischemic cardiac disease and requiring CCTA were randomized to either a landiolol hydrochloride 0.125 mg/kg group or placebo group to study the efficacy and safety of landiolol hydrochloride in a multicenter, double-blind, randomized parallel study. The primary endpoint was the diagnosable proportion (proportion of subjects whose coronary stenosis was diagnosable). Results: The diagnosable proportions about the reconstruction images at mid-diastole were 68.2 and 38.2 % in the landiolol hydrochloride and placebo group, respectively, indicating significant superiority of landiolol hydrochloride over placebo (p < 0.0001). The diagnosable proportions about the optimal reconstruction images were 81.4 and 54.2 % in the landiolol hydrochloride and placebo group, respectively, indicating significant superiority of landiolol hydrochloride over placebo (p < 0.0001). The mean heart rate-lowering effect was first observed soon after administration of landiolol hydrochloride, was most marked at 3-5 min, and disappeared 30 min after completion of administration. The mean heart rate-lowering proportion at that time was -19.1 ± 8.1 % and -5.9 ± 9.7 % in the landiolol hydrochloride and placebo groups, respectively, showing a significantly higher proportion in the landiolol hydrochloride group. Conclusions: Landiolol hydrochloride was confirmed to significantly and rapidly lower heart rate after intravenous injection, suggesting that it is a safe and useful agent for improving the image quality of CCTA. © 2013 The Author(s).

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Independent predictors for bladder outcomes after treatment of intravesical recurrence following radical nephroureterectomy in patients with primary upper tract urothelial carcinoma

Tanaka N., Kikuchi E., Kanao K., Matsumoto K., Shirotake S., Kobayashi H., Miyazaki Y., Ide H., Obata J., Hoshino K., Hayakawa N., Hagiwara M., Kosaka T., Oyama M., Miyajima A., Momma T., Nakagawa K., Jinzaki M., Hasegawa S., Nakajima Y., Oya M.

Annals of Surgical Oncology （Annals of Surgical Oncology） 21 （ 9 ） 3151 - 3158 2014年

研究論文（学術雑誌）, 共著, ISSN 1068-9265

Background. Few studies have described the clinical courses and outcomes in the bladder after treatment of intravesical recurrence after radical nephroureterectomy (RNU) in patients with primary upper tract urothelial carcinoma (UTUC). We investigated the indicators for predicting subsequent bladder outcomes after treatment of intravesical recurrence after RNU. Methods. A total of 241 patients with primary UTUC (pTa-4N0M0) who experienced intravesical recurrence after RNU were included. Of these patients, 101 (41.9 %) underwent Bacillus Calmette-Guérin treatments, whereas 49 (20.3 %) underwent intravesical chemotherapy. The median follow-up period after initial transurethral resection of the bladder tumor was 33 months. Relationships with bladder outcomes were analyzed by using multivariable analysis. Results. Ninety-six patients experienced intravesical recurrence, and bladder progression was observed in 13. Cumulative incidence rates of intravesical recurrence at 1 and 5 years after treatment of the first intravesical recurrence were 31.0 and 48.4 %, whereas those of bladder progression at 1 and 5 years thereafter were 2.4 and 8.0 %. Multivariate analysis showed that the number of recurrent tumors and pT1 tumors at the time of the first intravesical relapse were independent risk factors for subsequent intravesical recurrence. With respect to bladder progression, multivariate analysis showed that pT1 tumors, the appearance of concomitant carcinoma-in situ at the time of the first intravesical relapse, and the absence of the Bacillus Calmette-Guérin treatment were independent risk factors. Conclusions. This retrospective study presents a detailed picture of further bladder outcomes after intravesical recurrence after RNU in primary UTUC patients. The results may assist physicians to develop a more rational protocol in bladder surveillance. © 2014 Society of Surgical Oncology.

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Cryoablation of early-stage primary lung cancer

Inoue M., Nakatsuka S., Jinzaki M.

BioMed Research International （BioMed Research International） 2014 1 - 8 2014年

研究論文（学術雑誌）, 共著, ISSN 2314-6133

Worldwide, lung cancer is the most commonly diagnosed cancer, and lobectomy is the gold-standard treatment for early-stage non-small cell lung cancer (NSCLC). However, many patients are poor surgical candidates for various reasons. Recently, image-guided ablation is being used for lung tumors. Cryoablation has been applied for the treatment of cancer in various nonaerated organs; recently it has been adapted to the treatment of lung tumors. Since an ice ball can be detected by computed tomography (CT), cryoablation of lung tumors is performed under CT guidance. Its first clinical application was reported in 2005, and it has been reported to be feasible in a few studies. Minor complications occurred at a high frequency (up to 70.5%), but major complications were rare (up to 1%). The most common complication is pneumothorax, and most cases need no further intervention. Local efficacy depends on tumor size and presence of a thick vessel close to the tumor. Midterm survival after cryoablation is 77%-88% at 3 years in patients with early-stage NSCLC. Although surgery is the gold-standard treatment for such patients, the initial results of cryoablation are promising. In this paper, the current status of cryoablation for primary lung tumors is reviewed. © 2014 Masanori Inoue et al.

1P2-U04 ヒト足部機能解明のための屍体足人工筋骨格歩行シミュレータの開発(移動知と身体性システム科学)

久米真之介, 伊藤幸太, 細田耕, 荻原直道, 清水正宏, 池本周平, 陣崎雅弘, 名倉武雄, 中村俊康, 今西宣晶, 相磯貞和

ロボティクス・メカトロニクス講演会講演概要集（一般社団法人日本機械学会） 2014 （ 0 ） _1P2-U04_1 - _1P2-U04_4 2014年

A human foot has a complex structure which consists of a flexible flesh and many muscles, tendons, ligaments, and bones. The complex structure is supposed to contribute to efficient and stable bipedal locomotion. Detailed behavior of the foot complex during walking, however, is not well unerstood. We built a musculoskeletal gait simulator driven by pneumatic artificial muscles in order to solve a mechanism of a human gait. We measured ground reaction force of the musculoskeletal gait simulator during the stance phase by using a force plate. This gait simulator's vertical ground reaction force has two high peaks like a human's.

いま、注目の疾患2014 泌尿器・男性生殖器(症例1)　類上皮血管筋脂肪腫

塚田実郎, 陣崎雅弘, 栗林幸夫

画像診断（学研メディカル秀潤社） 34 （ 1 ） 68 - 69 2013年12月

ISSN 0285-0524

いま、注目の疾患2014 泌尿器・男性生殖器(症例2)　透析関連腎腫瘍　後天性嚢胞随伴腎細胞癌

秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 34 （ 1 ） 70 - 71 2013年12月

ISSN 0285-0524

Visceral fat is correlated with prolonged operative time in laparoendoscopic single-site adrenalectomy and laparoscopic adrenalectomy

Hasegawa M., Miyajima A., Jinzaki M., Maeda T., Takeda T., Kikuchi E., Shibata H., Oya M.

Urology （Urology） 82 （ 6 ） 1312 - 1318 2013年12月

研究論文（学術雑誌）, 共著, ISSN 0090-4295

Objective To investigate the effect of visceral fat on operative time and discuss whether the measurement of adipose accumulation could be used as a sensitive predictor of technical difficulty in performing laparoendoscopic single-site adrenalectomy (LESS-A) and laparoscopic adrenalectomy (LA). Methods We reviewed the medical records of 106 patients undergoing LA or LESS-A at our institution. Total fat area (TFA) and visceral fat area (VFA) were measured at the level of the L4 vertebra by computed tomography. To categorize the type of obesity, the VFA/TFA ratio was calculated. Multiple logistic regression analyses were performed to identify independent predictors of prolonged operative time. Results The VFA/TFA ratio does not always coincide with body mass index (BMI, r = 0.415), and a higher correlation coefficient was observed between operative time and the VFA/TFA ratio (r = 0.359) than with that of BMI (r = 0.189). Multivariate analysis revealed that pheochromocytoma, tumor size ≥5 cm, and the VFA/TFA ratio ≥0.35, defined as the visceral type of adipose accumulation, were independent predictive factors for prolonged operative time in LA and LESS-A. We were able to stratify patients into short, intermediate, and long operative times using these preoperative variables. Conclusion This study revealed that the visceral type of adipose accumulation increases operative complexity in LA and LESS-A as measured by operative time. The VFA/TFA ratio might be a more sensitive indicator of technical difficulty than that of BMI. © 2013 Elsevier Inc. All Rights Reserved.

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Periprostatic fat area is an independent factor that prolonged operative time in laparoscopic radical prostatectomy

Kaneko G., Miyajima A., Yuge K., Hasegawa M., Takeda T., Jinzaki M., Kikuchi E., Nakagawa K., Oya M.

Urology （Urology） 82 （ 6 ） 1304 - 1309 2013年12月

研究論文（学術雑誌）, 共著, ISSN 0090-4295

Objective To evaluate the effect of visceral obesity on surgical outcomes in laparoscopic radical prostatectomy (LRP). Methods Visceral fat area (VFA) and periprostatic fat area (PPFA) were used as index of visceral obesity. In addition to VFA and PPFA, age, body mass index (BMI), prostate weight, cross-section area of Retzius space, history of previous abdominal surgery, repeated transrectal needle biopsy, and neoadjuvant hormone therapy were recorded. LRP was separated into 7 steps (1: port insertion and lymph node dissection, 2: endopelvic fascia incision, 3: dorsal vein complex ligation, 4: prostate dissection from bladder neck, 5: dissection of seminal vesicle and vas deferens, 6: prostate dissection from rectum, and 7: vesicourethral anastomosis). Potential factors that prolonged total operative time (OT), pneumoperitoneum time, and duration of each step were assessed by multivariate logistic regression analysis. The association between visceral obesity and other surgical outcomes was also evaluated. Results One hundred sixteen LRPs were performed by a single experienced surgeon. High PPFA and prostate weight were independent factors that prolonged total OT and pneumoperitoneum time. High BMI was not a factor. PPFA affected steps 1, 4, 5, and 6, and prostate weight affected prolonged steps 5 and 6. Estimated blood loss, duration of urethral catheterization, postoperative hospital stay, perioperative complications, and margin status were not affected by visceral obesity. Conclusion PPFA was more useful to accurately predict prolonged OT than VFA or BMI. Safety and margin status were not compromised even in high PPFA group when operations were performed by an experienced surgeon. © 2013 Elsevier Inc. All Rights Reserved.

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Epithelioid angiomyolipoma of the kidney: Radiological imaging

Tsukada J., Jinzaki M., Yao M., Nagashima Y., Mikami S., Yashiro H., Nozaki M., Mizuno R., Oya M., Kuribayashi S.

International Journal of Urology （International Journal of Urology） 20 （ 11 ） 1105 - 1111 2013年11月

研究論文（学術雑誌）, 共著, ISSN 0919-8172

Objectives: To review the imaging findings of renal epithelioid angiomyolipomas. Methods: Eight patients treated at two institutions were pathologically diagnosed as having epithelioid angiomyolipoma. All of them underwent computed tomography, and four underwent magnetic resonance imaging. The tumor size, existence of fat, heterogeneity, computed tomography attenuation, degree of enhancement, enhancement pattern and magnetic resonance imaging signal intensity were evaluated. Results: Intratumoral fat was not detected in any of the cases. On unenhanced computed tomography, the intratumoral attenuation was hyperattenuating in six of the seven patients who were examined using this modality. On T2-weighted images, the signal intensity of the solid component, cyst wall or septum was low in three of the four cases. Four of the eight cases were heterogeneous solid-type accompanied by hemorrhage, necrosis or hyalinization. One homogeneous solid-type lesion was large in size and was pathologically accompanied by neither hemorrhage nor necrosis. All three multilocular cystic types were pathologically accompanied by massive hemorrhage in the cystic component. One was accompanied by spontaneous perirenal hematoma. Conclusions: The radiological appearance of most epithelioid angiomyolipomas has a tendency to be hyperattenuating on unenhanced computed tomography images, with low intensities on T2-weighted images. They can be heterogeneously solid, homogeneously solid or a multilocular cystic lesion with massive hemorrhage. © 2013 The Japanese Urological Association.

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Differential diagnosis of upper urinary tract disorders

Yazawa S., Kikuchi E., Oya M., Jinzaki M.

Japanese Journal of Clinical Urology （Japanese Journal of Clinical Urology） 67 （ 11 ） 863 - 870 2013年10月

研究論文（学術雑誌）, 共著, ISSN 0385-2393

癌の術後画像診断-合併症と局所再発のチェックポイント- (第9章)腎癌・腎盂尿管癌上部尿路癌　腎尿管全摘除術

秋田大宇, 陣崎雅弘, 大家基嗣

画像診断（学研メディカル秀潤社） 33 （ 11 ） s163 - s166 2013年09月

ISSN 0285-0524

癌の術後画像診断-合併症と局所再発のチェックポイント- (第9章)腎癌・腎盂尿管癌腎細胞癌　腎部分切除術

秋田大宇, 陣崎雅弘, 大家基嗣

画像診断（学研メディカル秀潤社） 33 （ 11 ） s158 - s162 2013年09月

ISSN 0285-0524

癌の術後画像診断-合併症と局所再発のチェックポイント- (第9章)腎癌・腎盂尿管癌腎細胞癌　根治的腎摘除術

秋田大宇, 陣崎雅弘, 大家基嗣

画像診断（学研メディカル秀潤社） 33 （ 11 ） s152 - s157 2013年09月

ISSN 0285-0524

Dose-Finding study of landiolol hydrochloride: A short-acting Β<inf>1</inf>-Blocker for controlling heart rate during coronary computed-Tomography angiography in japan

Hirano M., Hara K., Ikari Y., Jinzaki M., Iino M., Hamada C., Kuribayashi S.

Advances in Therapy （Advances in Therapy） 30 （ 9 ） 803 - 818 2013年09月

研究論文（学術雑誌）, 共著, ISSN 0741-238X

Introduction: Coronary computedtomography angiography (CCTA) has high diagnostic performance, but it sometimes does not allow evaluation because of artifacts. Currently, the use of a β -blocker is recommended to prevent motion artifacts, but the b-blocker (metoprolol, propranolol, etc.) commonly used has a slow onset and long duration of action. andiolol hydrochloride is an intravenous β 1-blocker with a very short half-life. We investigated the efficacy and optimal dose of this drug for reduction of heart rate in patients undergoing CCTA. Methods: Eighty-seven subjects with ischemic heart disease were divided into three groups to receive landiolol hydrochloride at a dose of 0.125 (Group L), 0.25 (Group M), or 0.5 mg/kg (Group H). CCTA was performed at 3-7 min after administration, and heart rate, blood pressure, and image quality were assessed. Results: Heart rate decreased rapidly after completion of landiolol hydrochloride administration in all groups, with a heart rate reduction of 15.55 ± 6.56% in Group L, 16.48 ± 7.80% in Group M, and 21.49 ± 6.13%in Group H (Group L vs Group H, P = 0.0008; Group M vs Group H, P = 0.0109). Since there was no significant difference in heart rate during imaging among the three groups, although there was a significant difference between groups L and H and groups M and H in terms of percent change in heart rate, coronary stenosis was diagnosable in all groups with no significant difference. Conclusion: Landiolol hydrochloride showed a rapid onset and short b-blocking effect, and was most effective at a dose of 0.5 mg/kg. However, the diagnosable proportion had no significant differences among the three groups in CCTA. Therefore, the clinically recommended dose was 0.125 mg/kg or less, considering the heart rate of patients with suspected coronary stenosis during CCTA. © The Author(s) 2013.

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Tomosynthesis for the early detection of pulmonary emphysema: Diagnostic performance compared with chest radiography, using multidetector computed tomography as reference

Yamada Y., Jinzaki M., Hashimoto M., Shiomi E., Abe T., Kuribayashi S., Ogawa K.

European Radiology （European Radiology） 23 （ 8 ） 2118 - 2126 2013年08月

研究論文（学術雑誌）, 共著, ISSN 0938-7994

Objectives: To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. Methods: Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. Results: ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. Conclusions: The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. Key Points: • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT. © 2013 European Society of Radiology.

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Clinical utility of preoperative evaluation of bronchial arteries by three-dimensional computed tomographic angiography for esophageal cancer surgery

Wada T., Takeuchi H., Kawakubo H., Nakamura R., Oyama T., Takahashi T., Wada N., Saikawa Y., Omori T., Jinzaki M., Kuribayashi S., Kitagawa Y.

Diseases of the Esophagus （Diseases of the Esophagus） 26 （ 6 ） 616 - 622 2013年08月

研究論文（学術雑誌）, 共著, ISSN 1120-8694

An identification of bronchial arteries (BAs) is critical in esophageal cancer surgery to avoid tracheobronchial ischemia and unexpected massive bleeding during surgical procedure particularly in thoracoscopic video-assisted esophagectomy. We describe the efficacy of three-dimensional computed tomographic angiography (3D-CTA) of BAs for preoperative evaluation in esophageal cancer surgery. Sixty-four patients with esophageal cancer who preoperatively underwent multidetector computed tomography examination were included in this study. We evaluated the number, origin, and intraoperative preservation rate of BAs, and we compared the number of thoracic paratracheal lymph nodes harvested between two groups comprising patients who either underwent preoperative 3D-CTA of BAs (3D-CTA group) or did not (non-3D-CTA group). The right and left BAs were preoperatively identified in 62 patients (97%) and 55 patients (86%), respectively, using 3D-CTA. In 34 patients (53%), the right BA originated as a common trunk with the right intercostal artery. In 48 patients (75%), the left BA originated from the descending aorta as a single or double branch. Some anomalies such as the right BA originated from the left subclavian artery were observed. In all patients, either the right or the left BA was preserved. The number of harvested lymph nodes in left side of paratrachea was significantly increased in 3D-CTA group, than those in non-3D-CTA group. 3D-CTA clearly revealed BA anatomy, contributing to BA preservation and safe and precise lymphadenectomy in esophageal cancer surgery. 3D-CTA of BAs is useful for preoperative evaluation in esophageal cancer surgery. © 2012 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Three-dimensional imaging and mapping of the right and left phrenic nerves: Relevance to interventional cardiovascular therapy

Fukumoto K., Takatsuki S., Jinzaki M., Yamada M., Tanimoto K., Nishiyama N., Aizawa Y., Hagiwara Y., Fukuda Y., Kimura T., Miyoshi S., Kuribayashi S., Fukuda K.

Europace （Europace） 15 （ 7 ） 937 - 943 2013年07月

研究論文（学術雑誌）, 共著, ISSN 1099-5129

AimsPhrenic nerves (PNs) can be damaged during interventional cardiovascular therapy because of the nerves' proximity to the heart. This study aimed to analyse the anatomy of the PN by performing three-dimensional (3-D) imaging and pace mapping.Methods and resultsForty consecutive patients with atrial fibrillation referred for catheter ablation were enrolled in this study and underwent preoperative cardiovascular computed tomography (CT). In 10 patients with sinus rhythm during tomography, 3-D images of the right and left pericardiophrenic bundles (PBs), consisting of the ipsilateral PN and accompanying vessels, were reconstructed from the CT data. During the electrophysiological study, PN pace mapping was performed from both atria. The course of the PBs generated by CT imaging and the PN pace map generated by the 3-D mapping system were compared. By electrical pacing, the PNs were captured in 40 individuals (100%) from the superior vena cava and the right atrium, and in 17 patients (43%) from the left atrial appendage. Clear 3-D images of PBs were reconstructed in all cases in which CT-reconstruction was performed. The distance between the locations of the right PB generated by CT imaging and those of the right PN-capture sites in the right-sided heart on the mapping system was 8.7 ± 5.8 mm.ConclusionsThe 3-D routes of the bilateral PNs passing near the heart were verified by pace mapping. The preoperatively reconstructed 3-D course of the PB succeeded in locating the PN, which may facilitate the comprehension of PN anatomy to avoid its injury during interventional cardiovascular therapy. © 2013 The Author.

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