- 著者
- Yuri Sasaki Eikan Mishima Koichi Kikuchi Takafumi Toyohara Takehiro Suzuki Hideki Ota Kazumasa Seiji Mariko Miyazaki Hideo Harigae Sadayoshi Ito Kei Takase Takaaki Abe
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.5290-20, (Released:2020-08-22)
- 参考文献数
- 27
- 被引用文献数
- 3
Angioplasty for cases of chronic total occlusion of renal artery with/without atrophic kidney is generally not recommended. We here report a 57-year-old man who presented with renin-mediated refractory hypertension caused by occlusion of a unilateral renal artery leading to kidney atrophy (length: 69 mm). Angioplasty favorably achieved blood pressure control with normalized renin secretion and enlargement of the atrophic kidney to 85 mm. Timely angioplasty can be beneficial in select patients, even with an atrophic kidney and total occlusion, especially in cases with deterioration of hypertension within six months and the presence of collateral perfusion to the affected kidney.
- 著者
- Eikan Mishima Hideki Ota Takehiro Suzuki Takafumi Toyohara Kazumasa Seiji Sadayoshi Ito Yoshikatsu Saiki Kei Takase Takaaki Abe
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.3855-19, (Released:2020-01-17)
- 参考文献数
- 21
We report a case in which diffusion-weighted magnetic resonance imaging (DWI) demonstrated renal artery stenosis-related renal ischemia and the therapeutic efficacy of revascularization. The patient was a 73-year-old man, who underwent descending thoracic aortic replacement due to DeBakey IIIb chronic aortic dissection, and who showed progressive renal dysfunction due to right renal artery stenosis caused by false lumen thrombosis. DWI demonstrated a decreased apparent diffusion coefficient (ADC) in the right kidney, indicating renal ischemia. Angioplasty with stenting restored renal perfusion and improved the renal function, resulting in the normalization of the decreased ADC in the treated kidney. Thus, DWI can be used to monitor renal ischemia in cases involving advanced renal artery stenosis.
- 著者
- Hidekazu AOKI Shunji MUGIKURA Reizo SHIRANE Toshiaki HAYASHI Tomomi KIMIWADA Kiyohide SAKAI Keiko AINOYA Hideki OTA Kei TAKASE Yoshihisa SHIMANUKI
- 出版者
- The Japan Neurosurgical Society
- 雑誌
- Neurologia medico-chirurgica (ISSN:04708105)
- 巻号頁・発行日
- pp.2023-0002, (Released:2023-08-30)
- 参考文献数
- 22
Closed spinal dysraphism (CSD) encompasses a heterogeneous group of spinal cord deformities, which can be accompanied by several types of skin stigmata. These skin stigmata may include inconspicuous features, such as sacral dimples and deformed gluteal clefts, but the association between such mild skin stigmata and CSD is uncertain. This study aimed to reevaluate the indication for magnetic resonance imaging (MRI) in patients with skin stigmata while considering the indication for surgery. A retrospective analysis was conducted on magnetic resonance images of 1255 asymptomatic children with skin stigmata between 2003 and 2015. Skin stigmata classification was based on medical chart data. All subtypes of CSDs except for filum terminale lipomas (FTL), FTL thicker than 2 mm or with low conus medullaris, were considered to meet the surgical indication. CSD prevalence was estimated while considering the surgical indications and assessed after excluding all FTL cases. Skin stigmata were classified into seven types, dimple, deformed gluteal cleft, hair, subcutaneous mass, appendage, discoloration, and protruding bone, and included 1056 isolated and 199 complex ones. The prevalence of CSD was 19.5%, 6.8%, and 0.5% among patients with isolated dimples (n = 881) and 13.9%, 5.8%, and 0.7% among those with isolated deformed gluteal clefts (n = 136) for all cases, surgical indications, and patients without FTL, respectively. Dimples and deformed gluteal clefts had a low prevalence of CSD requiring surgical intervention, and cases without FTL were rare. Asymptomatic patients with mild skin stigmata may not require immediate MRI.
- 著者
- Hideki Ota Hiroki Kamada Satoshi Higuchi Kei Takase
- 出版者
- Japanese Society for Magnetic Resonance in Medicine
- 雑誌
- Magnetic Resonance in Medical Sciences (ISSN:13473182)
- 巻号頁・発行日
- pp.rev.2021-0111, (Released:2022-02-19)
- 参考文献数
- 67
- 被引用文献数
- 6
Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure (PAP). Although right-heart catheterization is the gold standard method for the diagnosis of PH by definition, various less-invasive imaging tests have been used for screening, detection of underlying diseases-causing PH, and monitoring of diseases. Among them, 4D flow MRI is an emerging and unique imaging test that allows for comprehensive visualization of blood flow in the right heart and proximal pulmonary arteries. The characteristic blood flow pattern observed in patients with PH is vortical flow formation in the main pulmonary artery. Recent studies have proposed the use of these findings to determine not only the presence of PH but also estimate the mean PAP. Other applications of 4D flow MRI for PH include measurement of wall shear stress, helicity, and 3D flow balance in the pulmonary arteries. It is worth noting that 4D flow has also the potential for longitudinal follow-ups. In this review, the clinical definition of PH, summary of conventional imaging tests, characteristics of pulmonary arterial flow as shown by 4D flow MRI, and clinical application of 4D flow MRI in the management of patients with PH will be discussed.
- 著者
- Mitsuaki Isobe Koichi Amano Yoshihiro Arimura Akihiro Ishizu Shuichi Ito Shinya Kaname Shigeto Kobayashi Yoshinori Komagata Issei Komuro Kimihiro Komori Kei Takahashi Kazuo Tanemoto Hitoshi Hasegawa Masayoshi Harigai Shouichi Fujimoto Tatsuhiko Miyazaki Tetsuro Miyata Hidehiro Yamada Akitoshi Yoshida Takashi Wada Yoshinori Inoue Haruhito A. Uchida Hideki Ota Takahiro Okazaki Mitsuho Onimaru Tamihiro Kawakami Reiko Kinouchi Atsushi Kurata Hisanori Kosuge Ken-ei Sada Kunihiro Shigematsu Eiichi Suematsu Eijun Sueyoshi Takahiko Sugihara Hitoshi Sugiyama Mitsuhiro Takeno Naoto Tamura Michi Tsutsumino Hiroaki Dobashi Yoshikazu Nakaoka Kenji Nagasaka Yasuhiro Maejima Hajime Yoshifuji Yoshiko Watanabe Shoichi Ozaki Takeshi Kimura Hiroshi Shigematsu Keiko Yamauchi-Takihara Toyoaki Murohara Shin-ichi Momomura on behalf of the JCS Joint Working Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.84, no.2, pp.299-359, 2020-01-24 (Released:2020-01-24)
- 参考文献数
- 368
- 被引用文献数
- 3 54