Papers - Yamada, Yoshitake

Use of computed tomography in an upright position for preoperative planning in orbital wall fracture treatment: A pilot study.

Sakamoto Y, Yamada Y, Yamada M, Yokoyama Y, Kishi K, Jinzaki M

Journal of plastic, reconstructive & aesthetic surgery : JPRAS  2019.10

ISSN  1748-6815

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Glenohumeral translation during active external rotation with the shoulder abducted in cases with glenohumeral instability: a 4-dimensional computed tomography analysis.

Matsumura N, Oki S, Fukasawa N, Matsumoto M, Nakamura M, Nagura T, Yamada Y, Jinzaki M

Journal of shoulder and elbow surgery (Journal of Shoulder and Elbow Surgery)  28 ( 10 ) 1903 - 1910 2019.10

ISSN  1058-2746

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© 2019 Journal of Shoulder and Elbow Surgery Board of Trustees Background: Although glenohumeral instability is common, the mechanism of instability remains unclear. The purpose of this study was to quantitatively evaluate humeral head translation during active external rotation with abduction in patients with glenohumeral instability by use of 4-dimensional computed tomography scans. Methods: Ten patients with unilateral glenohumeral instability with a positive fulcrum test were prospectively included in this study. Sequential computed tomography of bilateral shoulders during active external rotation at 90° of shoulder abduction was performed for 6 seconds at 5 frames per second. The 3-dimensional positions of the humeral head center in the anteroposterior, superoinferior, and mediolateral directions were calculated at 0°, 20°, 40°, 60°, and maximum shoulder abduction–external rotation from the starting position. Translation of the humeral head center from the starting position was evaluated using Dunnett multiple-comparison tests, and the differences between the affected and intact shoulders were assessed using Wilcoxon signed rank tests. Results: The humeral head center translated posteriorly, inferiorly, and medially during glenohumeral external rotation with the shoulder in the abducted position on the intact side. However, the affected humeral head showed significantly less posterior translation (P = .028), greater inferior translation (P = .047), and less medial translation (P = .037) than the contralateral side. Conclusions: This study indicated that dysfunction of the anterior band of the inferior glenohumeral ligament causes decreased posterior, increased inferior, and decreased medial translation of the humeral head during active shoulder abduction–external rotation.

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Periosteal Reaction Possibly Induced by Pazopanib: A Case Report and Literature Review.

Hosokawa T, Hara T, Arakawa Y, Oguma E, Yamada Y

Journal of pediatric hematology/oncology  2019.09

ISSN  1077-4114

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Development of Upright Computed Tomography With Area Detector for Whole-Body Scans: Phantom Study, Efficacy on Workflow, Effect of Gravity on Human Body, and Potential Clinical Impact.

Jinzaki M, Yamada Y, Nagura T, Nakahara T, Yokoyama Y, Narita K, Ogihara N, Yamada M

Investigative radiology  2019.09

ISSN  0020-9996

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Impact of the cerebrospinal fluid-mask algorithm on the diagnostic performance of ¹²³I-Ioflupane SPECT: an investigation of parkinsonian syndromes.

Iwabuchi Y, Nakahara T, Kameyama M, Matsusaka Y, Minami Y, Ito D, Tabuchi H, Yamada Y, Jinzaki M

EJNMMI research (EJNMMI Research)  9 ( 1 ) 85 2019.09

ISSN  2191-219X

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© 2019, The Author(s). Background: A cerebrospinal fluid (CSF)-mask algorithm has been developed to reduce the adverse influence of CSF-low-counts on the diagnostic utility of the specific binding ratio (SBR) index calculated with Southampton method. We assessed the effect of the CSF-mask algorithm on the diagnostic performance of the SBR index for parkinsonian syndromes (PS), including Parkinson’s disease, and the influence of cerebral ventricle dilatation on the CSF-mask algorithm. Methods: We enrolled 163 and 158 patients with and without PS, respectively. Both the conventional SBR (non-CSF-mask) and SBR corrected with the CSF-mask algorithm (CSF-mask) were calculated from 123I-Ioflupane single-photon emission computed tomography (SPECT) images of these patients. We compared the diagnostic performance of the corresponding indices and evaluated whether the effect of the CSF-mask algorithm varied according to the extent of ventricle dilatation, as assessed with the Evans index (EI). A receiver-operating characteristics (ROC) analysis was used for statistical analyses. Results: ROC analyses demonstrated that the CSF-mask algorithm performed better than the non-CSF-mask (no correction, area under the curve [AUC] = 0.917 [95% confidence interval (CI) 0.887–0.947] vs. 0.895 [95% CI 0.861–0.929], p < 0.001; attenuation correction, AUC = 0.930 [95% CI 0.902–0.957] vs. 0.903 [95% CI 0.870–0.936], p < 0.001). When not corrected for attenuation, no significant difference in the AUC was observed in the low EI group between the non-CSF-mask and CSF-mask algorithms (0.927 [95% CI 0.877–0.978] vs. 0.942 [95% CI 0.898–0.986], p = 0.11); in the middle and high EI groups, the CSF-mask algorithm performed better than the non-CSF-mask algorithm (middle EI group, AUC = 0.894 [95% CI 0.825–0.963] vs. 0.872 [95% CI 0.798–0.947], p < 0.05; high EI group, AUC = 0.931 [95% CI 0.883–0.978] vs. 0.900 [95% CI 0.840–0.961], p < 0.01). When corrected for attenuation, significant differences in the AUC were observed in all three EI groups (low EI group, AUC = 0.961 [95% CI 0.924–0.998] vs. 0.942 [95% CI 0.895–0.988], p < 0.05; middle EI group, AUC = 0.905 [95% CI 0.843–0.968] vs. 0.872 [95% CI 0.800–0.944], p < 0.005; high EI group, AUC = 0.954 [95% CI 0.917–0.991] vs. 0.917 [95% CI 0.862–0.973], p < 0.005). Conclusion: The CSF-mask algorithm improved the performance of the SBR index in informing the diagnosis of PS, especially in cases with ventricle dilatation.

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Poor outcomes in carriers of the RNF213 variant (p.Arg4810Lys) with pulmonary arterial hypertension.

Hiraide T, Kataoka M, Suzuki H, Aimi Y, Chiba T, Isobe S, Katsumata Y, Goto S, Kanekura K, Yamada Y, Moriyama H, Kitakata H, Endo J, Yuasa S, Arai Y, Hirose N, Satoh T, Hakamata Y, Sano M, Gamou S, Kosaki K, Fukuda K

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (Journal of Heart and Lung Transplantation)   2019.09

ISSN  1053-2498

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© 2019 International Society for Heart and Lung Transplantation BACKGROUND: A variant of c.14429G>A (p.Arg4810Lys, rs112735431) in the ring finger protein 213 gene (RNF213; NM_001256071.2) has been recently identified as a risk allele for pulmonary arterial hypertension (PAH). PAH can be added as a new member of RNF213-associated vascular diseases, which include Moyamoya disease and peripheral pulmonary stenosis. Our aim was to identify the clinical features and outcomes of PAH patients with this variant. METHODS: Whole-exome sequencing was performed in 139 idiopathic (or possibly heritable) PAH patients. RESULTS: The RNF213 p.Arg4810Lys variant was identified in a heterozygous state in 11 patients (7.9%). Time-course changes in hemodynamics after combination therapy in the patients with the RNF213 p.Arg4810Lys variant were significantly poorer compared with those carrying the bone morphogenic protein receptor type 2 (BMPR2) mutation (n = 36) (comparison of changes in mean pulmonary arterial pressure, p = 0.007). The event-free rate of death or lung transplantation was significantly poorer in RNF213 p.Arg4810Lys variant carriers than in BMPR2 mutation carriers (5-year event-free rate since the introduction of prostaglandin I2 infusion, 0% vs 93%, respectively; p < 0.001). CONCLUSIONS: Idiopathic PAH patients with the RNF213 p.Arg4810Lys variant are associated with poor clinical outcomes even in recent times. Earlier consideration of lung transplantation might be required for RNF213 p.Arg4810Lys variant carriers who are developing PAH. Documentation of the RNF213 p.Arg4810Lys variant, as well as already known pathogenic genes, such as BMPR2, can provide clinically relevant information for therapeutic strategies, leading to a personalized approach for the treatment of PAH.

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Postnatal Ultrasound to Determine the Surgical Strategy for Congenital Diaphragmatic Hernia.

Hosokawa T, Yamada Y, Takahashi H, Tanami Y, Sato Y, Ishimaru T, Tanaka Y, Kawashima H, Hosokawa M, Oguma E

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine)  38 ( 9 ) 2347 - 2358 2019.09

ISSN  0278-4297

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© 2019 by the American Institute of Ultrasound in Medicine. OBJECTIVES: To compare defect sizes in congenital diaphragmatic hernia (CDH) measured by postnatal ultrasound (US) between neonates who underwent thoracoscopic surgery and neonates who underwent open surgery and between neonates who underwent primary repair and those who underwent patch repair; additionally, to compare the accuracy of US diagnosis with that of surgical diagnosis for the location of the diaphragmatic hernia and the hernial contents. METHODS: We included 8 neonates who underwent preoperative US evaluations of CDH. We compared anterior-to-posterior diaphragm defect sizes between thoracoscopic and open surgery approaches and between primary and patch repair by using the Mann-Whitney U test. The diaphragm was divided into 3 segments: anterior, lateral, and posterior. We evaluated the location of the diaphragmatic hernia and the hernial contents. RESULTS: Four neonates who underwent open surgery had larger diaphragmatic hernias than those who underwent thoracoscopic surgery (mean ± SD, 30.5 ± 5.6 versus 16.3 ± 3.3 mm; P = .030). They were also larger in neonates who underwent patch repair than in those who underwent primary repair (33.0 ± 3.0 versus 17.6 ± 4.2 mm; P = .037). Detection of anterior and lateral diaphragm segments was consistent between US and surgical findings. Three of 4 neonates who underwent open surgery and all 3 neonates who underwent patch repair did not show the lateral segment. The hernial contents were also consistent between US and surgical findings. CONCLUSIONS: Postnatal US examinations of neonates with CDH could provide surgeons with useful information to determine the surgical approach and repair method. However, since our study cohort was small, further studies are needed with a larger number of neonates with CDH.

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Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography.

Fujita N, Yagi M, Michikawa T, Yamada Y, Suzuki S, Tsuji O, Nagoshi N, Okada E, Tsuji T, Nakamura M, Matsumoto M, Watanabe K

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (European Spine Journal)  28 ( 9 ) 2034 - 2041 2019.09

ISSN  0940-6719

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© 2019, The Author(s). Purpose: Although lung volume (LV) can be measured directly by computed tomography (CT), the literature regarding CT-assessed LV in adolescent idiopathic scoliosis (AIS) patients is limited, and the influence of posterior spinal fusion with instrumentation (PSF) on LV has not been established. This study aimed to identify factors associated with decreased LV after PSF in AIS patients. Methods: We retrospectively reviewed 111 consecutive AIS patients who were between 10 and 20 years of age and were treated by PSF at our facility. We assessed age at surgery, sex, height, body weight, Risser stage, Lenke classification, radiographic parameters, pulmonary function tests, and LV. Factors associated with a postoperative decrease in LV were identified by multivariable analysis. Results: The mean total LV had increased at the 2-year follow-up, although marginally significant (p =.06), and there was a significant increase in the left LV (p =.01) but not the right LV (p =.25). We observed a postoperative reduction in total LV, defined as a total LV postoperative/preoperative ratio < 0.9, in 20 of the 111 patients (18.0%). Univariable analysis showed a significant correlation between ≥ 11 fusion levels and postoperative LV reduction (OR 3.11, 95% CI 1.13–8.57). This factor remained significant in the multivariable analysis, which yielded an adjusted OR of 2.82 (95% CI 1.01–7.93) for postoperative LV reduction in patients with ≥ 11 fusion levels. Conclusion: Our data suggest that a longer fusion area is associated with postoperative LV reduction. Therefore, avoidance of a longer fusion area of ≥ 11 will be preferable for preserving LV. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

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Diagnostic performance of ultrasound without any colon preparation for detecting colorectal polyps in pediatric patients.

Hosokawa T, Hosokawa M, Tanami Y, Sato Y, Nambu R, Iwama I, Oguma E, Yamada Y

Pediatric radiology (Pediatric Radiology)  49 ( 10 ) 1306 - 1312 2019.09

ISSN  0301-0449

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© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Background: There are limited data on the sensitivity, specificity and accuracy of ultrasound for detecting colorectal polyps in children and young adults. Objective: To evaluate the diagnostic accuracy of ultrasound, without any colon preparation, for detecting colorectal polyps in pediatric patients and to determine the causes of false-negative results. Materials and methods: We included 74 children with clinical signs like rectal bleeding, abdominal pain or diarrhea who underwent both ultrasound and colonoscopy. We evaluated the diagnostic performance of ultrasound for detecting colorectal polyps before colonoscopy, which served as the reference standard. We used Fisher exact and Student’s t-tests for statistical analyses. Results: Fifteen pediatric patients were diagnosed with colorectal polyps in the transverse (n=3), descending (n=1) and sigmoid (n=6) colon, and rectum (n=5) by colonoscopy. The sensitivity, specificity and accuracy of ultrasound to detect colorectal polyps were 47% (7/15, 95% confidence interval [CI] 21–73%), 100% (59/59, 95% CI 94–100%) and 89% (66/74, 95% CI 80–95%), respectively. The volume (mean ± standard deviation) of polyps not detected by ultrasound was significantly smaller than that detected (270±380 mm3 vs. 4,600±3,900 mm3, P=0.0124). We observed a significant difference in the location between the polyps detected and not detected by ultrasound (rectal/non-rectal=0/7 vs. 5/3, P=0.0256). No significant age or gender difference was observed. Conclusion: The accuracy for detecting colorectal polyps by ultrasound was 89% (95% CI, 80–95%) in our cohort. Polyps found in the rectum and relatively smaller polyps accounted for several false-negative cases.

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【救急疾患の鑑別診断のポイント】(第11章)肺野異常陰影　肺間質影の鑑別

杉浦 弘明, 南 康大, 山田 祥岳, 陣崎 雅弘

画像診断 ((株)Gakken)  39 ( 11 ) A210 - A215 2019.09

ISSN  0285-0524

【救急疾患の鑑別診断のポイント】(第11章)肺野異常陰影　肺野空洞性病変の鑑別

南 康大, 山田 祥岳, 杉浦 弘明, 陣崎 雅弘

画像診断 ((株)Gakken)  39 ( 11 ) A204 - A209 2019.09

ISSN  0285-0524

Diagnostic Accuracy of Ultrasound for the Directionality of Testicular Rotation and the Degree of Spermatic Cord Twist in Pediatric Patients With Testicular Torsion.

Hosokawa T, Takahashi H, Tanami Y, Sato Y, Ishimaru T, Tanaka Y, Kawashima H, Oguma E, Yamada Y

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine  2019.07

ISSN  0278-4297

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Effect of natural full weight-bearing during standing on the rotation of the first metatarsal bone.

Ota T, Nagura T, Yamada Y, Yamada M, Yokoyama Y, Ogihara N, Matsumoto M, Nakamura M, Jinzaki M

Clinical anatomy (New York, N.Y.) (Clinical Anatomy)  32 ( 5 ) 715 - 721 2019.07

ISSN  0897-3806

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© 2019 Wiley Periodicals, Inc. To evaluate the rotational change in the first metatarsal bone (1MT) of the foot during natural standing using an upright computed tomography (CT) scanner with 320-detector rows. A total of 52 feet of 28 asymptomatic subjects (aged 23–39 years) were evaluated in the natural standing position with or without weight-bearing. A foot pressure plate was used to determine the non-weight-bearing (NWB) or single leg full-weight-bearing (s-FWB) conditions. CT examinations were performed using a noise index of 15 for a slice thickness of 5 mm, rotation speed of 0.5 sec, and slice thickness of 0.5 mm. The rotation of the 1MT was measured on the coronal CT image, which cut the sesamoids' bellies in the frontal slide of the first metatarsal and sesamoids perpendicular to the longitudinal bisection of the third metatarsal, and compared between the weight-bearing conditions. Intra- and inter-observer reliabilities of the rotation angle were also evaluated. The intra- and inter-observer correlation coefficients were 0.961 and 0.934, respectively. The 1MT pronation angle was significantly greater in the s-FWB condition than in the NWB condition (15.2° ± 5.4° vs. 12.5° ± 5.3°, P < 0.01). No sex difference was found in the magnitude of the 1MT pronation angle as a result of weight-bearing. This study first demonstrated that pronation of 1MT occurs due to natural full-weight-bearing in asymptomatic feet. The 1MT's rotational movement under weight-bearing conditions may relate to the onset and pathogenesis of the hallux valgus. Clin. Anat. 32:715–721, 2019. © 2019 Wiley Periodicals, Inc.

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Ultrasound of portal venous gas in a child with short bowel syndrome.

Hosokawa T, Yamada Y, Tanami Y, Sato Y, Oguma E

Pediatrics international : official journal of the Japan Pediatric Society (Pediatrics International)  61 ( 7 ) 733 - 735 2019.07

Research paper (scientific journal), Joint Work, Accepted,  ISSN  1328-8067

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全身撮影可能な立位CTの開発　ファントムスタディ、人体に対する重力の影響

横山 陽一, 山田 祥岳, 名倉 武雄, 中原 健裕, 成田 啓一, 山田 稔, 南島 一也, 荻原 直道, 陣崎 雅弘

日本医用画像工学会大会予稿集 ((一社)日本医用画像工学会)  38回   471 - 475 2019.07

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【目的】(1)立位CTの物理特性の評価,(2)大血管と骨盤底への重力の影響を評価すること.【方法】ファントムを用いて立位CTと臥位CT,それぞれの物理特性の評価を行った.健常人ボランティアを対象に立位CTと臥位CTを同日に施行,大静脈と大動脈の面積と骨盤底の変化を評価した.【結果】立位CTと臥位CT両者の物理特性に有意差は見られなかった.仰臥位と比較して直立位では,上大静脈の面積は有意に小さく,横隔膜の高さでの下大静脈の面積に有意差は見られず,下大静脈下端部での面積は有意に大きくなった.一方,大動脈の面積に関しては姿勢による有意差は見られなかった.骨盤底は直立位で下降した.【結論】立位CTと臥位CTの性能はほぼ同等であり,立位CTは,人体に対する重力の影響を評価するのに有用であった.(著者抄録)

【循環器疾患の画像診断-現状と進歩】肺循環疾患　MRIを用いた右室機能評価を知る

奥田 茂男, 山田 祥岳, 陣崎 雅弘

循環器ジャーナル ((株)医学書院)  67 ( 3 ) 420 - 426 2019.07

ISSN  2432-3284

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＜文献概要＞Point　・右室容積計測や肺動脈弁逆流の評価は経胸壁エコーでは難しく,MRIにより行われる.・右室容積計測に際しては輪郭描画,血流速度・血流量の計測に当たっては撮像断面とVENC設定の最適化が重要である.・肺動脈弁閉鎖不全がある場合には,渦流やらせん流により血流量の計測値が影響を受けることがあり,大動脈と肺動脈血流の整合性を確認する必要がある.

【循環器疾患の画像診断-現状と進歩】弁膜疾患　CTでTAVIの術前評価を行う

山田 祥岳, 松本 俊亮, 山田 稔, 中原 健裕, 陣崎 雅弘

循環器ジャーナル ((株)医学書院)  67 ( 3 ) 388 - 401 2019.07

ISSN  2432-3284

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＜文献概要＞Point　・重症大動脈弁狭窄症に対する外科的な大動脈弁置換術のリスクが高い症例に対し,TAVIが施行されるようになった.・CTは,TAVI術前精査において重要な役割を担い,大動脈基部,大動脈弁輪,アクセス経路などに関する有用な情報をもたらす.・CT画像から,大動脈弁の断面に対して直交する適切な透視角度(perpendicular view)を予測することが可能である.

【循環器疾患の画像診断-現状と進歩】肺循環疾患　CT angiographyおよびCT perfusionを活用する

田村 全, 杉浦 弘明, 山田 祥岳, 川上 崇史, 陣崎 雅弘

循環器ジャーナル ((株)医学書院)  67 ( 3 ) 410 - 419 2019.07

ISSN  2432-3284

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＜文献概要＞Point　・肺循環疾患の画像診断は従来肺血管造影,シンチグラフィによって行われてきたが,多列化・高速化によるCT angiographyの画質向上やDual Energy CTやsubtraction技術によるCT perfusionの日常臨床導入により,CTの役割は大きくなってきている.・CTは肺高血圧症診療においてスクリーニングから分類,CT perfusionを利用した重症度評価・治療効果判定にまで広く用いることができるが,特に慢性血栓塞栓性肺高血圧症(CTEPH)を確実に拾い上げることが非常に重要である.・CT perfusionでは従来の肺血流シンチグラフィに比べて短時間で空間分解能の高い血流画像を取得することが可能であり,最近ではCTEPHにおける肺血流評価においても肺血流シンチグラフィとほぼ同等の成績が報告されている.

Postnatal ultrasonography for evaluation of hernia sac of neonate with congenital diaphragmatic hernia.

Hosokawa T, Tanami Y, Sato Y, Oguma E, Omata K, Kawashima H, Yamada Y

Radiology case reports (Radiology Case Reports)  14 ( 6 ) 683 - 686 2019.06

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© 2019 The Authors Congenital diaphragmatic hernia (CDH) is one of the most common major congenital anomalies. The presence of a hernia sac is associated with additional benefits in terms of improved neonatal survival. Here, we report a case of CDH with a hernia sac detected via postnatal ultrasonography. Our literature search did not find other cases where CDH with hernia sac was found by postnatal ultrasound in neonates. In prenatal imaging, the diagnosis of CDH with a hernia sac is challenging. In our case, the meniscus of the thymus was clearly noted, and smooth convexity between the hernia contents and thymus was detected. Although evaluation of the presence of a hernia sac with postnatal ultrasonography might be difficult, our findings suggest that a hernia sac could be evaluated with postnatal ultrasonography.

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Difference in Detection Rate of Portal Venous Gas via Computed Tomography and Ultrasonography in Pediatric Patients.

Hosokawa T, Yamada Y, Tanami Y, Sato Y, Hosokawa M, Oguma E

Ultrasound quarterly (Ultrasound Quarterly)  35 ( 2 ) 181 - 185 2019.06

ISSN  0894-8771

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© Wolters Kluwer Health, Inc. All rights reserved. This study was performed to compare computed tomography (CT)- and ultrasonography (US)-derived detection rates of portal venous gas (PVG) in pediatric patients and investigate whether discrepancies between these modalities were influenced by patient age and interval between examinations. We included 25 children who underwent both CT and US within 2 days for evaluation of intestinal ischemia. McNemar test was used to compare the detection of PVG between the 2 modalities. The cohort was retrospectively divided into 2 groups based on whether comparable results were obtained via both modalities; the Mann-Whitney U test was used to compare patient age and interval between CT and US between these 2 groups. Among 25 children, CT and US yielded similar results in 17 patients regarding the presence or absence of PVG (median age/interval, 2 years [range, 0-17 years]/51 minutes [range, 2-1196 minutes]; 3/14 detected via both/not both modalities) and different results in 8 (median age/interval, 0 years [range, 0-15 years]/171.5 minutes [range, 64-1486 minutes]; 7/1 detected via US only/via CT only). There was a significant difference in PVG detection rate between US and CT (P = 0.034). Patient age did not differ significantly between the 2 groups (P = 0.206), but the interval between CT and US did (P = 0.025). In conclusion, the detection rate of PVG was higher with US, compared with CT, although the timings of the examinations could have influenced this finding. Ultrasonography could be useful for PVG detection in pediatric patients because it can be performed repeatedly at the bedside without radiation exposure.

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