研究者詳細 - 陣崎　雅弘

論文 - 陣崎　雅弘

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特集これだけおさえる胸腹部解剖-血管と管腔のvariation & anomalyを中心に- 1. 胸部　胸郭出口症候群

荒井学, 陣崎雅弘

画像診断（学研メディカル秀潤社） 41 （ 6 ） 555 - 558 2021年04月

ISSN 0285-0524

特集これだけおさえる胸腹部解剖-血管と管腔のvariation & anomalyを中心に- 2. 腹部(2)膵臓・脾臓　膵・十二指腸の破格と血管解剖

田村謙太郎, 井上政則, 岸本理和, 尾松徳彦, 山﨑香奈, 西井龍一, 陣崎雅弘

画像診断（学研メディカル秀潤社） 41 （ 6 ） 588 - 595 2021年04月

ISSN 0285-0524

Diagnostic value of computed high b-value whole-body diffusion-weighted imaging for primary prostate cancer

Arita Y., Yoshida S., Waseda Y., Takahara T., Ishii C., Ueda R., Kwee T.C., Miyahira K., Ishii R., Okuda S., Jinzaki M., Fujii Y.

European Journal of Radiology （European Journal of Radiology） 137 2021年04月

ISSN 0720048X

Purpose: To investigate the utility of post-acquisition computed diffusion-weighted imaging (cDWI) for primary prostate cancer (PCa) evaluation in biparametric whole-body MRI (bpWB-MRI). Methods: Patients who underwent pelvic MRI for PCa screening and subsequent bpWB-MRI for staging were included. Two radiologists assessed the diagnostic performance of the following datasets for clinically significant PCa diagnosis (grade group ≥2 according to the Prostate Imaging-Reporting and Data System, version 2.1): bpMRI (axial DWI scans with a b-value of 2,000 s/mm + axial T2WI scans from pre-biopsy pelvic MRI), computed bpWB-MRI (computed WB-DWI scans with a b-value of 2,000 s/mm + axial WB-T2WI scans), and native bpWB-MRI (native axial WB-DWI scans with a b-value of 1,000 s/mm + axial WB-T2WI scans). Systemic biopsy was used as reference standard. Results: Fifty-one patients with PCa were included. The areas under the curve (AUCs) of bpMRI (0.89 for reader 1 and 0.86 for reader 2) and computed bpWB-MRI (0.86 for reader 1 and 0.83 for reader 2) were significantly higher (p < 0.001) than those of native bpWB-MRI (0.67 for both readers). No significant difference was observed between the AUCs of bpMRI and computed bpWB-MRI (p = 0.10 for reader 1 and p = 0.25 for reader 2). Conclusions: The diagnostic performance of computed bpWB-MRI was similar to that of dedicated pelvic bpMRI for primary PCa evaluation. cDWI can be recommended for implementation in standard WB-MRI protocols to facilitate a one-step evaluation for concurrent detection of primary and metastatic PCa. 2000 2000 1000 2000 2000 1000 2000 2000 2000 2000 2 2 2

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Radiologic features of mixed epithelial and stromal tumors of the kidney: Hyperattenuating on unenhanced computed tomography and T2-hypointensity on magnetic resonance imaging

Tatsuya S., Hirotaka A., Yuki A., Akiko T., Masahiro H., Shigeo O., Shuji M., Ryuichi M., Mototsugu O., Masahiro J.

Radiology Case Reports （Radiology Case Reports） 16 （ 4 ） 858 - 862 2021年04月

In the 2016 World Health Organization renal tumor classification, the mixed epithelial and stromal tumor family was introduced as a new entity. This family encompasses a spectrum of tumors, ranging from predominantly cystic tumors (adult cystic nephromas) to tumors that are variably solid (mixed epithelial and stromal tumors). The majority of previous studies incorporating “mixed epithelial and stromal tumor” in the titles were actually reports of imaging findings of adult cystic nephroma. Thus, the solid component of mixed epithelial and stromal tumors has not been well evaluated. In this study, we present 2 cases of mixed epithelial and stromal tumors, as defined by the 2016 World Health Organization classification, showing a predominantly solid component. The characteristic findings of the solid component of these tumors were T2-hypointensity on magnetic resonance imaging and hyperattenuation on unenhanced computed tomography. Angiomyolipoma with epithelial cysts and epithelioid angiomyolipoma should be considered in the differential diagnosis of mixed epithelial and stromal tumors.

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Dynamic chest X-ray using a flat-panel detector system: Technique and applications

Hata A., Yamada Y., Tanaka R., Nishino M., Hida T., Hino T., Ueyama M., Yanagawa M., Kamitani T., Kurosaki A., Sanada S., Jinzaki M., Ishigami K., Tomiyama N., Honda H., Kudoh S., Hatabu H.

Korean Journal of Radiology （Korean Journal of Radiology） 22 （ 4 ） 634 - 651 2021年04月

ISSN 12296929

Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD). This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

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JCS 2018 Guideline on Diagnosis of Chronic Coronary Heart Diseases

Yamagishi M., Tamaki N., Akasaka T., Ikeda T., Ueshima K., Uemura S., Otsuji Y., Kihara Y., Kimura K., Kimura T., Kusama Y., Kumita S., Sakuma H., Jinzaki M., Daida H., Takeishi Y., Tada H., Chikamori T., Tsujita K., Teraoka K., Nakajima K., Nakata T., Nakatani S., Nogami A., Node K., Nohara A., Hirayama A., Funabashi N., Miura M., Mochizuki T., Yokoi H., Yoshioka K., Watanabe M., Asanuma T., Ishikawa Y., Ohara T., Kaikita K., Kasai T., Kato E., Kamiyama H., Kawashiri M., Kiso K., Kitagawa K., Kido T., Kinoshita T., Kiriyama T., Kume T., Kurata A., Kurisu S., Kosuge M., Kodani E., Sato A., Shiono Y., Shiomi H., Taki J., Takeuchi M., Tanaka A., Tanaka N., Tanaka R., Nakahashi T., Nakahara T., Nomura A., Hashimoto A., Hayashi K., Higashi M., Hiro T., Fukamachi D., Matsuo H., Matsumoto N., Miyauchi K., Miyagawa M., Yamada Y., Yoshinaga K., Wada H., Watanabe T., Ozaki Y., Kohsaka S., Shimizu W., Yasuda S., Yoshino H.

Circulation journal : official journal of the Japanese Circulation Society （Circulation journal : official journal of the Japanese Circulation Society） 85 （ 4 ） 402 - 572 2021年03月

ISSN 13469843

特集押さえておくべき注目の疾患2021 7章泌尿生殖器　1 腎のmixed epithelial and stromal tumor(MEST)

鈴木達也, 有田祐起, 秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 41 （ 5 ） 464 - 465 2021年03月

ISSN 0285-0524

特集押さえておくべき注目の疾患2021 7章泌尿生殖器　4 前立腺神経内分泌腫瘍

有田祐起, 陣崎雅弘

画像診断（学研メディカル秀潤社） 41 （ 5 ） 470 - 471 2021年03月

ISSN 0285-0524

特集押さえておくべき注目の疾患2021 7章泌尿生殖器　3 内反性尿路上皮乳頭腫

秋田大宇, 陣崎雅弘

画像診断（学研メディカル秀潤社） 41 （ 5 ） 468 - 469 2021年03月

ISSN 0285-0524

特集押さえておくべき注目の疾患2021 7章泌尿生殖器　2 腎のBCG肉芽腫

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） 41 （ 5 ） 466 - 467 2021年03月

ISSN 0285-0524

Assessment of the image quality of virtual monochromatic spectral computed tomography images: a phantom study considering object contrast, radiation dose, and frequency characteristics

Masuda S., Sugisawa K., Minamishima K., Yamazaki A., Jinzaki M.

Radiological Physics and Technology （Radiological Physics and Technology） 14 （ 1 ） 41 - 49 2021年03月

ISSN 18650333

Fast kilovoltage (kVp)-switching technology cannot obtain conventional 120 kVp images; thus, 70 keV virtual monochromatic spectral computed tomography (CT) images (VMSI) are generally used. The contrast-to-noise ratio (CNR) is used to evaluate the image quality of VMSI; however, CNR does not include frequency characteristics. The present study aimed to investigate the evaluation methods of VMSI considering frequency characteristics by comparing the image quality of 70 keV VMSI with that of conventional 120 kVp images. The evaluated object contrasts were 70 and 300 Hounsfield units (HU). Scans used two radiation dose levels: low (LD) and standard (SD). The volume CT dose index of LD and SD was 4.8- and 12 mGy, respectively. Images were reconstructed by filtered back projection, evaluating CNR, noise power spectrum (NPS), task transfer function (TTF), and system performance (SP) function calculated as TTF / NPS. The total NPS values (spatial frequency range: 0.2 ~ 0.4 mm ) of 70 keV VMSI were higher than those of 120 kVp images. The spatial frequency TTF values that reached 10% (f ) of the 70 keV VMSI changed based on object contrast. For the low-contrast condition, a lower f was observed with 70 keV VMSI. The CNR of 70 keV VMSI was comparable to that of 120 kVp images in low- and high-contrast conditions. However, for 70 keV VMSI, SP of low-contrast was low, and SP of high-contrast was high, compared with those of 120 kVp images. This study suggested that only CNR was not sufficient to evaluate the image quality of VMSI; thus, evaluation methods considering frequency characteristics should be used. 2 −1 10% 10%

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特集 CTとMRIのサインから読み解く病態・病理Ⅱ 胸部(肺)領域-心血管は除く

八木文子, 栗原泰之, 山田祥岳, 杉浦弘明, 陣崎雅弘

臨床放射線（金原出版） 66 （ 2 ） 137 - 146 2021年02月

ISSN 0009-9252

Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions

Arita Y., Shigeta K., Akita H., Suzuki T., Kufukihara R., Kwee T.C., Ishii R., Mikami S., Okuda S., Kikuchi E., Oya M., Jinzaki M.

European Radiology （European Radiology） 31 （ 2 ） 875 - 883 2021年02月

ISSN 09387994

Objectives: To investigate the clinical utility of the Vesical Imaging-Reporting and Data System (VI-RADS) by comparing its diagnostic performance for muscle-invasive bladder cancer (MIBC) between radiologists and urologists based on multiparametric MRI, including three-dimensional (3D) fast spin-echo (FSE) T2-weighted acquisitions. Methods: This study included 66 treatment-naïve patients (60 men, 6 women; mean age 74.0 years) with pathologically proven bladder cancer who underwent multiparametric MRI, including 3D FSE T2-weighted imaging, before transurethral bladder tumour resection between January 2010 and November 2018. The MRI scans were categorised according to the five-point VI-RADS score by four independent readers (two board-certified radiologists and board-certified urologists each), blinded to the histopathological findings. The VI-RADS scores were compared with the postoperative histopathological diagnosis. Interobserver agreement was assessed using weighted kappa coefficients. ROC analysis and generalised estimating equations were used to evaluate the diagnostic performance. Results: Forty-nine (74.2%) and 17 (25.8%) tumours were confirmed to be non-MIBC and MIBC, respectively, based on pathological examination. The interobserver agreement was good-to-excellent between all pairs of readers (range, 0.73–0.91). The urologists’ sensitivity/specificity values for DCE-MRI VI-RADS scores were significantly lower than those of radiologists. No significant differences were observed for the overall VI-RADS score. The AUC for the overall VI-RADS score was 0.94, 0.92, 0.89, and 0.87 for radiologists 1 and 2 and urologists 1 and 2, respectively. Conclusions: The VI-RADS score, based on multiparametric MRI including 3D FSE T2-weighted acquisitions, can be useful for radiologists and urologists to determine the bladder cancer muscle invasion status preoperatively. Key Points: • VI-RADS (using multiparametric MRI including 3D FSE T2-weighted acquisitions) achieves good to excellent interobserver agreement and has similar diagnostic performance for detecting muscle invasion by both radiologists and urologists. • The diagnostic performance of the overall VI-RADS score is high for both radiologists and urologists, particularly due to the dominant effect of diffusion-weighted imaging on the overall VI-RADS score. • The sensitivity and specificity values of the T2WI VI-RADS scores for four readers in our study (using 3D FSE T2-weighted acquisitions) were similar (with slightly higher specificity values) to previously published results (using 2D FSE T2-weighted acquisitions).

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Embolization of congenital hemangioma with severe hemorrhage

Kamata M., Aramaki-Hattori N., Okabe K., Sakai S., Nakatsuka S., Jinzaki M., Kishi K., Inoue M.

Journal of Pediatric Surgery Case Reports （Journal of Pediatric Surgery Case Reports） 65 2021年02月

Congenital hemangioma is a rare vascular lesion in children. Although most cases are asymptomatic, severe complications can arise, including severe bleeding. We describe the case of a female infant who was born with a congenital hemangioma on her right thigh. Ulceration appeared at the center of the tumor and gradually progressed over the following weeks. One month after birth, the lesion started hemorrhaging severely. Transfusions were required. The bleeding recurred repeatedly despite compression therapy. Embolization was performed urgently and succeeded in arresting the hemorrhage. Bleeding did not recur and the lesion involuted completely over the next few months. A literature review revealed that this is the eighth case where embolization was used to arrest severe hemorrhage of a congenital hemangioma. In the previous cases, embolization permanently (five cases) or temporarily (two cases) arrested the bleeding. In one of the latter cases, selective hemostatic surgery successfully arrested bleeding recurrence after embolization. In the other, the patient had Von Willebrand's Disease; while embolization arrested the hemorrhaging for several years, it restarted at the age of 18 years and the lesion had to be resected to manage the bleeding. Thus, embolization can be a first choice to arrest massive bleeding of congenital hemangioma.

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CT screening for COVID-19 in asymptomatic patients before hospital admission

Uchida S., Uno S., Uwamino Y., Hashimoto M., Matsumoto S., Obara H., Jinzaki M., Kitagawa Y., Hasegawa N.

Journal of Infection and Chemotherapy （Journal of Infection and Chemotherapy） 27 （ 2 ） 232 - 236 2021年02月

ISSN 1341321X

Introduction: In the novel coronavirus disease (COVID-19) pandemic era, it is essential to rule out COVID-19 effectively to prevent transmission in both communities and medical facilities. According to previous reports in high prevalence areas, CT screening may be useful in the diagnosis of COVID-19. However, the value of CT screening in low prevalence areas has scarcely been reported. Methods: This report examines the diagnostic efficacy of CT screening before admission to a hospital in Tokyo. We conducted a retrospective analysis at Keio University Hospital from April 6, 2020, through May 29, 2020. We set up an outpatient screening clinic on April 6 for COVID-19, administering both PCR with nasopharyngeal swabs and chest CT for all patients scheduled for surgery under general anesthesia. Results: A total of 292 asymptomatic patients were included in this study. There were three PCR-positive patients, and they all had negative CT findings, which revealed that both the sensitivity and positive predictive value of CT (PPV) were 0%. There were nine CT-positive patients; the specificity and the negative predictive value (NPV) were 96.9% and 98.9%, respectively. Conclusion: CT screening was not useful in low prevalence areas at this time in Tokyo, even with the inclusion of the most prevalent phase. Given that the utility of CT screening depends on disease prevalence, the criteria for performing CT screening based on the prevalence of COVID-19 should be established.

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多発性肝嚢胞に起因した門脈圧亢進症・肝性脳症の制御に経皮的嚢胞ドレナージ・硬化療法が有用であった1例

小川遼, 中塚誠之, 鳥飼秀幸, 田村全, 伊東伸剛, 井上政則, 陣崎雅弘

日本インターベンショナルラジオロジー学会雑誌（(一社)日本インターベンショナルラジオロジー学会） 35 （ 3 ） 241 - 244 2021年02月

ISSN 1340-4520

症例は50歳代女性。意識障害を主訴に、肝性脳症の診断で入院となった。造影CTにて残肝に存在する多発嚢胞により、門脈右枝は高度な狭小化を認め、門脈本幹に血栓を疑う造影欠損を認めた。胃静脈瘤は認めなかった。嚢胞による門脈右枝圧排が主因と考え、経皮的ドレナージを行った。CTガイド下に18G Chiba針にて門脈右枝腹側・背側の嚢胞を穿刺し、次に0.335"J型ワイヤ誘導下に、7Fr.J型ドレナージカテーテルを2本留置し、腹側病変と背側病変から嚢胞を吸引した。術後、門脈血栓症に対し、抗凝固療法を継続し、15日目には食道静脈瘤に対して内視鏡的静脈瘤結紮術が施行された。翌日、背側病変は70%の縮小が得られたが、腹側病変は48%に留まったため、硬化療法が行われた。その後は経過良好で、34日目に退院となった。1年9ヵ月後の現在も外来観察にて肝性脳症の再燃や肝機能の増悪は認められていない。

新連載　AI画像診断は,いま第1回連載序説−AI時代を迎えて−

陣崎雅弘

画像診断（学研メディカル秀潤社） 41 （ 2 ） 238 - 239 2021年01月

ISSN 0285-0524

特集胸部の最新画像情報2021 症例関節リウマチを背景にした多発nodular lymphoid hyperplasiaの1例

池田織人, 松迫正樹, 栗原泰之, 小島史嗣, 板東徹, 鈴木髙祐, 陣崎雅弘

臨床放射線（金原出版） 66 （ 1 ） 105 - 111 2021年01月

ISSN 0009-9252

Orthostatic Enlargement of a Supracerebellar Arachnoid Cyst With Cerebellar Descent Visualized by Upright Computed Tomography

Yoshida K., Toda M., Yamada Y., Yamada M., Yokoyama Y., Fujiwara H., Kosugi K., Sasaki H., Jinzaki M.

World Neurosurgery （World Neurosurgery） 145 256 - 259 2021年01月

ISSN 18788750

Background: Posterior fossa arachnoid cysts are often asymptomatic, but can rarely cause postural headache, the mechanism of which remains unknown. Case Description: We present a 40-year-old woman with an asymptomatic supracerebellar arachnoid cyst. Upright computed tomography (CT) showed enlargement of the arachnoid cyst and caudal descent of the cerebellum compared with supine CT with narrowing of the craniocervical junction cerebrospinal fluid space. Conclusions: This finding aids in understanding the association of posterior fossa arachnoid cysts with orthostatic headache. Clinicians should be aware of possible posture-related changes in intracranial structures.

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Progression of traction bronchiectasis/bronchiolectasis in interstitial lung abnormalities is associated with increased all-cause mortality: Age Gene/Environment Susceptibility-Reykjavik Study

Hino T., Hida T., Nishino M., Lu J., Putman R.K., Gudmundsson E.F., Hata A., Araki T., Valtchinov V.I., Honda O., Yanagawa M., Yamada Y., Kamitani T., Jinzaki M., Tomiyama N., Ishigami K., Honda H., San Jose Estepar R., Washko G.R., Johkoh T., Christiani D.C., Lynch D.A., Gudnason V., Gudmundsson G., Hunninghake G.M., Hatabu H.

European Journal of Radiology Open （European Journal of Radiology Open） 8 2021年01月

Purpose: The aim of this study is to assess the role of traction bronchiectasis/bronchiolectasis and its progression as a predictor for early fibrosis in interstitial lung abnormalities (ILA). Methods: Three hundred twenty-seven ILA participants out of 5764 in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study who had undergone chest CT twice with an interval of approximately five-years were enrolled in this study. Traction bronchiectasis/bronchiolectasis index (TBI) was classified on a four-point scale: 0, ILA without traction bronchiectasis/bronchiolectasis; 1, ILA with bronchiolectasis but without bronchiectasis or architectural distortion; 2, ILA with mild to moderate traction bronchiectasis; 3, ILA and severe traction bronchiectasis and/or honeycombing. Traction bronchiectasis (TB) progression was classified on a five-point scale: 1, Improved; 2, Probably improved; 3, No change; 4, Probably progressed; 5, Progressed. Overall survival (OS) among participants with different TB Progression Score and between the TB progression group and No TB progression group was also investigated. Hazard radio (HR) was estimated with Cox proportional hazards model. Results: The higher the TBI at baseline, the higher TB Progression Score (P < 0.001). All five participants with TBI = 3 at baseline progressed; 46 (90 %) of 51 participants with TBI = 2 progressed. TB progression was also associated with shorter OS with statistically significant difference (adjusted HR = 1.68, P < 0.001). Conclusion: TB progression was visualized on chest CT frequently and clearly. It has the potential to be the predictor for poorer prognosis of ILA.

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