研究者詳細 - 陣崎　雅弘

論文 - 陣崎　雅弘

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Extracardiac structures are frequently present within close proximity to the left atrium: Relevance to catheter ablation

Takatsuki S., Yamada M., Fukumoto K., Tanimoto K., Jinzaki M., Kuribayashi S., Ogawa S.

Heart Rhythm （Heart Rhythm） 6 （ 11 ） 1559 - 1564 2009年11月

研究論文（学術雑誌）, 共著, ISSN 1547-5271

Background: The coronary sinus (CS) including the great cardiac vein is an important anatomic structure that is considered a landmark for the mitral annulus (MA) and also a target for catheter ablation. Objective: This study evaluated the anatomical relationship between the CS and its surrounding structures visualized by multi-detector computed tomography (MDCT). Methods: We performed MDCT on 42 patients, and the ranges of the coronary arteries (CAs) and esophagus that ran closest (<5 mm) to the CS were examined. In addition, the distances between the CS and the MA and left ventricle and left atrium were compared with the amplitudes of the local atrial and ventricular electrograms in the CS at the most lateral point (3 o'clock) and the inferior point (6 o'clock) in the CS. Results: The distal portion of the right CA ran near the antero-inferior side of the CS ostium in 92% of the patients. The esophagus and the left circumflex CA proximity to the CS ran from 15 to 41 mm and from 53 to 104 mm from the ostium in all patients. At the 3 o'clock and 6 o'clock position of the MA, the distance between the center of the CS and MA was 12 and 13 mm, respectively, and showed negative correlation with the ratio of atrial and ventricular electrograms. Conclusion: The right CA, the left circumflex CA, and the esophagus were frequently located near the CS. The CS was shifted away from the MA, and the CS-MA distance could be predicted with intracardiac electrograms. © 2009 Heart Rhythm Society.

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Increased epicardial fat volume quantified by 64-multidetector computed tomography is associated with coronary atherosclerosis and totally occlusive lesions

Ueno K., Anzai T., Jinzaki M., Yamada M., Jo Y., Maekawa Y., Kawamura A., Yoshikawa T., Tanami Y., Sato K., Kuribayashi S., Ogawa S.

Circulation Journal （Circulation Journal） 73 （ 10 ） 1927 - 1933 2009年10月

研究論文（学術雑誌）, 共著, ISSN 1346-9843

Background: The relationship between the epicardial fat volume measured by 64-slice multidetector computed tomography (MDCT) and the extension and severity of coronary atherosclerosis was investigated. Methods and Results: Both MDCT and conventional coronary angiography (CAG) were performed in 71 consecutive patients who presented with effort angina. The volume of epicardial adipose tissue (EAT) was measured by MDCT. The severity of coronary atherosclerosis was assessed by evaluating the extension of coronary plaques in 790 segments using MDCT data, and the percentage diameter stenosis in 995 segments using CAG data. The estimated volume of EAT indexed by body surface area was defined as VEAT. Increased VEAT was associated with advanced age, male sex, degree of metabolic alterations, a history of acute coronary syndrome (ACS) and the presence of total occlusions, and showed positive correlation with the stenosis score (r=0.28, P=0.02) and the atheromatosis score (r=0.67, P<0.0001) of the coronary arteries. Multiple logistic regression analysis revealed an increased VEAT (≥50 cm3/m2) to be the strongest independent determinant of the presence of total occlusions (odds ratio 4.64, P=0.02). Conclusions: VEAT correlates with the degree of metabolic alterations and coronary atheromatosis. Excessive accumulation of EAT might contribute to the development of ACS and coronary total occlusions.

Percutaneous revascularization of chronic total occlusion of left anterior descending artery using contralateral injection via isolated conus artery

Kawamura Akio, Jinzaki Masahiro, Kuribayashi Sachio

Journal of Invasive Cardiology 21 （ 5 ） 2009年05月

研究論文（学術雑誌）, 共著, ISSN 1042-3931

A 74-year-old male underwent cardiac catheterization that revealed a chronic total occlusion of the proximal left anterior descending coronary artery (LAD). The right coronary artery provided only faint collateral circulation to the LAD. Multislice computed tomography (MDCT) disclosed that a conus artery took off directly from the aorta and provided good collateral circulation to the LAD. Percutaneous coronary intervention of the LAD was successfully performed using contralateral injection via the isolated conus artery. Whenever sufficient collateral filling is not visualized in a chronically occluded LAD, an isolated conus artery should be considered. MDCT is a helpful tool in this setting.

Diagnostic accuracy of angiographic view image for the detection of coronary artery stenoses by 64-detector row CT

Jinzaki Masahiro, Sato Kozo, Tanami Yutaka, Yamada Minoru, Anzai Toshihisa, Kawamura Akio, Ueno Koji, Kuribayashi Sachio

日本循環器學誌（一般社団法人日本循環器学会） 73 （ 4 ） 691 - 698 2009年04月

研究論文（学術雑誌）, 共著, ISSN 1346-9843

Background: The angiographic view (AGV) image is a new post-processing method that is similar to conventional coronary angiography (CAG). The purpose of this study was to evaluate its accuracy for coronary stenosis detection by 64-detector row computed tomography (CT). Methods and Results: CT evaluation results of 17 patients were compared with the results of invasive CAG on a coronary segment basis concerning the presence of stenoses >50% diameter reduction. All images of the 3 viewing methods (combination of conventional methods, AGV image alone, and axial images alone) were evaluated in consensus by 3 cardiovascular radiologists. Among 196 assessable segments, invasive CAG showed significant coronary artery stenoses in 44 segments. 43 of 44 lesions were detected with the AGV image, and absence of significant stenosis was correctly identified in 135 of 152 segments (sensitivity 98%; specificity 89%; accuracy 91%; positive predictive value 72%, negative predictive value 99%). The sensitivity of the AGV image was the same as that of conventional methods (98%). There was no significant difference in accuracy between the AGV image (91%) and conventional methods (94%). The accuracy of the AGV image was significantly higher than the axial images alone (78%). Conclusions: AGV image shows promise as a post-processing method for identifying coronary artery stenosis with high accuracy.

Novel three-dimensional imaging of the anatomical relationship between the pulmonary vein and left atrium

Yamada Minoru, Jinzaki Masahiro, Sato Kozo, Tanami Yutaka, Fukumoto Kotaro, Tanimoto Kojiro, Takatsuki Seiji, Ogawa Satoshi, Kuribayashi Sachio

日本循環器學誌（一般社団法人日本循環器学会） 73 （ 3 ） 573 - 574 2009年03月

研究論文（学術雑誌）, 共著, ISSN 1346-9843

Background: Visualization of the inner anatomical relationship of the pulmonary veins (PVs) and left atrium (LA) is important for achieving a better success rate and avoiding complications in circumferential LA ablation for atrial fbrillation (AF). Methods and Results: Twelve patients with AF underwent computed tomography and novel post-processing images that emphasized the boundaries of the PVs and LA were produced. Conclusions: The "Transparent View" images enabled visualization of the inner anatomical relationship of the PVs and LA in the same geometry as in pulmonary venography in all cases.

Diagnostic capacity of 64-slice multidetector computed tomography for acute coronary syndrome in patients presenting with acute chest pain

Ueno Koji, Anzai Toshihisa, Jinzaki Masahiro, Yamada Minoru, Kohno Takashi, Kawamura Akio, Yoshikawa Tsutomu, Kuribayashi Sachio, Ogawa Satoshi

Cardiology 112 （ 3 ） 211 - 218 2009年01月

研究論文（学術雑誌）, 共著, ISSN 0008-6312

Background/Aims: Early evaluations of patients presenting with acute chest pain remain difficult. We examined the diagnostic capacity of multidetector computed tomography (MDCT) for acute coronary syndrome (ACS) in patients presenting with acute chest pain. Methods/Results: We examined 36 consecutive patients presenting with acute chest pain with neither diagnostic ECG changes nor elevated biomarkers. 64-slice MDCT was performed, and we evaluated the presenceof significant coronaryartery stenosis (>50% reduction in lumen diameter). Significant stenosis was detected in 15 patients by MDCT. Among them, 11 patients were diagnosed as having ACS based on the findings of coronary angiography or myocardial perfusion single photon emission computed tomography (positive predictive value 73%). All 21 patients without significant stenosis by MDCT, except only one, were regarded as not having ACS (negative predictive value 95%). Sensitivity and specificity were 92 and 83%, respectively. In patients without a history of coronary artery disease (CAD), both the specificity and positive predictive value improved to 100% (sensitivity 90%; negative predictive value 95%). In patients with neither a history of CAD nor coronary calcification, the diagnostic accuracy of MDCT was 100%. Conclusions: MDCT has high diagnostic capacity for the early evaluation of ACS, especially in patients without a history of CAD or coronary calcification. Copyright © 2008 S. Karger AG.

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The checkpoints for the diagnosis of renal neoplasms

Jinzaki M., Oya M.

Japanese Journal of Clinical Urology （Japanese Journal of Clinical Urology） 63 （ 9 ） 671 - 678 2009年

研究論文（学術雑誌）, 共著, ISSN 0385-2393

心原性脳梗塞症における左房内血栓および血流動態の評価（第一報）

楠崎浩之, 陣崎雅弘, 栗林幸夫, 新井原泰隆, 大川伸一

日本農村医学会学術総会抄録集（一般社団法人日本農村医学会） 58 （ 0 ） 339 - 339 2009年

ISSN 1880-1749

〈背景〉心原性脳塞栓症の塞栓源検索として経食道心エ 
コー（transesophageal echography, TEE）の有用性は確 
立している。しかし，脳梗塞急性期にTEE を施行するこ 
とは，侵襲的で，しばしば鎮静が必要となり，熟練した術 
者が必要である。従来のCT やelectron beam CT では， 
少数例で左心耳内血栓の検討はされているが，TEE と 
MDCT を比較した報告は少ない。 
〈目的〉TEE とMDCT の相関，TEE をGold standard 
とした場合のMDCT の精度を評価する。 
〈対象〉２００５年１０月から２００７年１０月までに慶應義塾大学病 
院に心原性脳塞栓症の診断で入院した患者，１８例（男性１５ 
例，女性３例，平均年齢７２．９±７．８歳）を対象とした。対 
象患者は入院前または入院後に心房細動（一過性含む）が 
記録されており，発症時に心電図上心房細動が記録された 
のは１７例（９４．４％），検査時に抗凝固療法がなされていた 
のは１１例（７３．３％）であった。TEE とMDCT は１か月以 
内に施行した。脳塞栓症の発症から経食道心エコーと 
MDCT を施行するまでの期間はそれぞれ平均１２．２日（１ 
～４９日）と１２．１日（４～４９日）であった。 
〈方法〉６４列MDCT（GE : LightSpeed VCT）で，心電同 
期下，ヨード造影剤を急速静注後，造影早期相と後期相の 
２相を撮影し左房内血栓の有無および左心耳内の造影効果 
を検討した。 
〈結果〉１８例のうち１２例はMDCT とTEE の所見が一致 
しており，統計学的には有意差は認めなかったがある程度 
の相関を認めた。 
〈結語〉心房内血栓および血流動態に関して，TEE と 
MDCT の間に一定の相関があり，MDCT がTEE に代わ 
る検査となりうる可能性が示唆された。

Extrinsic Compression of the Left Main Coronary Artery by Atrial Septal Defect

Jo Yusuke, Kawamura Akio, Jinzaki Masahiro, Kohno Takashi, Anzai Toshihisa, Iwanaga Shiro, Kokaji Kiyokazu, Yoshikawa Tsutomu, Yozu Ryohei, Kuribayashi Sachio, Ogawa Satoshi

Annals of Thoracic Surgery 86 （ 6 ） 1987 - 1989 2008年12月

研究論文（学術雑誌）, 共著, ISSN 0003-4975

On rare occasions, extrinsic compression of the coronary artery can cause significant stenosis. We report a 42-year-old woman who was referred to our hospital for surgical repair of atrial septal defect. Cardiac 64-slice multi-detector computed tomography before the operation revealed the extrinsic compression of the proximal left main coronary artery by the marked dilatation of pulmonary trunk. The patient eventually underwent atrial septal defect closure and coronary artery bypass simultaneously. Four months after the operation, multi-detector computed tomographic scan revealed reduction of pulmonary trunk diameter and resolution of left main coronary artery narrowing. © 2008 The Society of Thoracic Surgeons.

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Pseudonormal position of an atrial pacemaker lead associated with a contralateral pneumothorax where is the atrial lead?

Yada Hirotaka, Sato Toshiaki, Soejima Kyoko, Jo Yusuke, Jinzaki Masahiro, Togashi Ikuko, Nakamizo Hikaru, Fukumoto Kotaro, Tanimoto Kojiro, Miyoshi Shunichiro, Kuribayashi Sachio, Ogawa Satoshi

Circulation 117 （ 17 ） 2297 - 2298 2008年04月

研究論文（学術雑誌）, 共著, ISSN 0009-7322

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Multislice CT of peripheral arterial diseases

Matsumoto Kazuhiro, Jinzaki Masahiro

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 97 （ 2 ） 325 - 331 2008年02月

研究論文（学術雑誌）, 共著, ISSN 0021-5384

Imaging features of smoking-related interstitial lung disease

Sugiura Hiroaki, Jinzaki Mashiro, Kuribayashi Sachio

Japanese Journal of Chest Diseases 67 （ 9 ） 744 - 753 2008年

研究論文（学術雑誌）, 共著, ISSN 0385-3667

Overview image of the lumen and vessel wall in coronary CT angiography - The plaque-loaded angiographic view

Jinzaki Masahiro, Yamada Minoru, Sato Kozo, Tanami Yutaka, Anzai Toshihisa, Sasaki Kosuke, Kuribayashi Sachio

日本循環器學誌（一般社団法人日本循環器学会） 72 （ 4 ） 671 - 673 2008年

研究論文（学術雑誌）, 共著, ISSN 1346-9843

Background: There is no post-processing technique that can display an overview image of the lumen and vessel wall of a whole heart in one image. A merging coronary lumen view (Angiographic View) with a plaque image can provide a single, comprehensive image of plaque distribution. Methods and Results: A color-coded plaque image is assigned to different computed tomography attenuation ranges in the coronary artery to visualize plaques. This plaque image is re-formatted into a maximum intensity projection image and loaded onto the Angiographic View image. Conclusions: The integrated image of the coronary lumen and vessel wall of a whole heart is feasible. This image (Plaque-loaded Angiographic View) will give effective information in explaining the distribution of coronary lesions in patients as well as providing opportunities to discuss treatment strategies.

Novel post-processing image for the visualization of the coronary sinus by multidetector-row computed tomography before cardiac resynchronization therapy - Edge-enhanced image

Yamada Minoru, Jinzaki Masahiro, Kuribayashi Sachio, Sato Kozo, Tanami Yutaka, Fukumoto Kotaro, Tanimoto Kojiro, Sato Toshiaki, Soejima Kyoko, Ogawa Satoshi

日本循環器學誌（一般社団法人日本循環器学会） 72 （ 3 ） 487 - 488 2008年

研究論文（学術雑誌）, 共著, ISSN 1346-9843

Background: Before performing cardiac resynchronization therapy (CRT), it is useful to visualize the position of the coronary sinus (CS) orifice where the CS lead is inserted. Methods and Results: A raysum image was created in which the outermost 1-voxel layer of the right atrium (RA) and CS was extracted. This image enabled visualization of the positional relationship between the RA and CS ostium using the same geometry as retrograde CS venography. Conclusion: New post-processing imaging of the CS orifice will make the procedure of CRT safer.

6．マルチスライスCT

松本一宏, 陣崎雅弘

日本内科学会雑誌（一般社団法人日本内科学会） 97 （ 2 ） 325 - 331 2008年

ISSN 0021-5384

末梢動脈疾患の診断や治療方針の決定に画像検査が果たす役割は大きく，マルチスライスCTを用いた低侵襲診断が重要な役割を占めるようになっている．マルチスライスCTは簡便で低侵襲であり，3次元画像を用いた詳細な評価が可能で，末梢動脈疾患においても高い診断能が得られている．また精度の高い血管径計測も可能であり，治療のプランニングに有用である．

S3-2 腎非淡明細胞癌の術前診断 : 主に原発巣の画像の特徴、転移巣の特徴について(転移性腎非淡明細胞癌の治療戦略,第96回日本泌尿器科学会総会)

大家基嗣, 小坂威雄, 陣崎雅弘

日本泌尿器科学会雑誌（一般社団法人日本泌尿器科学会） 99 （ 2 ） 85 2008年

ISSN 0021-5287

心臓CTにおける3次元診断の最近の進歩(5.3次元画像診断の進歩,<特集>第71回日本循環器学会学術集会)

陣崎雅弘, 山田稔, 栗林幸夫

循環器専門医（一般社団法人日本循環器学会） 15 （ 2 ） 271 - 275 2007年09月

ISSN 0918-9599

Hyperattenuating renal masses

Silverman Stuart G., Mortele Koenraad J., Tuncali Kemal, Jinzaki Masahiro, Cibas Edmund S.

Radiographics 27 （ 4 ） 1131 - 1143 2007年07月

研究論文（学術雑誌）, 共著, ISSN 0271-5333

Some renal masses have higher attenuation than the surrounding renal parenchyma at computed tomography (CT). Their hyperattenuation is usually the result of proteinaceous fluid or densely packed cells. Most hyperattenuating renal masses are benign hemorrhagic or proteinaceous cysts. However, solid enhancing hyperattenuating renal masses may have malignant as well as benign causes. Possible malignant causes include renal cell carcinoma and lymphoma; benign causes include angiomyolipoma with minimal fat. It is important to identify the cause of a hyperattenuating renal mass so as to avoid unnecessary surgical resection or ablation. CT may be useful for diagnosing benign hyperattenuating renal cysts, hematomas, and vascular anomalies that appear masslike. However, some solid, enhancing, hyperattenuating masses cannot be diagnosed confidently with CT alone: Small (≤3-cm-diameter), homogeneously enhancing, hyperattenuating renal masses depicted on CT images may be either benign angiomyolipomas with minimal fat or renal cell carcinomas. Magnetic resonance (MR) imaging may be helpful for differentiating between angiomyolipomas with minimal fat and clear cell renal cell carcinomas; however, differentiation between angiomyolipomas with minimal fat and papillary renal cell carcinomas often is not possible on the basis of MR imaging. In such cases, a percutaneous biopsy may be useful for diagnosis. If the results of MR imaging and percutaneous biopsy are not definitive, surgery is warranted. ©RSNA, 2007.

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Dynamic contrast-enhanced CT of renal cell carcinoma for evaluation of tumor vascularity

Jinzaki Masahiro, Kuribayashi Sachio

AJR. American journal of roentgenology 188 （ 6 ） 2007年06月

研究論文（学術雑誌）, 共著

特集腎細胞癌診療の新しい展開小腎腫瘍の画像診断-質的診断と術前評価

陣崎雅弘, 大家基嗣, 村井勝

臨床泌尿器科（株式会社医学書院） 61 （ 5 ） 279 - 285 2007年04月

ISSN 0385-2393

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