著者

Takayuki KIKUCHI Yasushi TAKAGI Jyoji NAKAGAWARA Tsukasa UENO Shiho UBUKATA Kiyohiro HOUKIN Yoshio ARAKI Jun C TAKAHASHI Hiroyuki NAKASE Toshiya MURAI Susumu MIYAMOTO COSMO-Japan Study Group

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.2023-0041, (Released:2023-05-11)

参考文献数

24

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Cognitive impairment in adult patients with moyamoya disease (MMD) is sometimes overlooked and can occur in patients with no ischemic or hemorrhagic lesions. Better profiling and reliable diagnostic methods that characterize the group and associate the impairments and pathology of MMD are required in order to deliver appropriate treatments and support. The potential of 123I-iomazenil single-photon emission computed tomography (SPECT) for this issue has been reported in some studies, but the universality of this method remains unclear. A multicenter study of adult patients (aged 18-60 years) with MMD who experienced difficulties in social lives despite normal activities of daily living was implemented to delineate the common characteristics of this group of patients. In this study, iomazenil SPECT, besides patient characteristics, cognitive functions, and conventional imaging, was acquired to examine whether this method is suitable as a universal diagnostic tool. A total of 36 patients from 12 institutes in Japan were included in this study. Domain scores of world health organization quality of life 26 indicated low self-rating in physical health and psychological domains. The percentages of patients who had <85 in each index were 27.8%-33.3% in the WAIS-III and 16.7%-47.2% in the Wechsler Memory Scale-Revised. The group analysis of iomazenil SPECT demonstrated a decreased accumulation in the bilateral medial frontal areas in comparison with the normal control, whereas there were no specific characteristics on conventional imaging in the cohort. Iomazenil SPECT is a possible universal diagnostic method for the extraction of patients with cognitive impairment in MMD.

著者

Toshihiro MUNEMITSU Akira ISHII Eiji OKADA Hideo CHIHARA Kazumichi YOSHIDA Jun C TAKAHASHI Yasushi TAKAGI Susumu MIYAMOTO

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.oa.2018-0203, (Released:2019-02-28)

参考文献数

30

被引用文献数

4

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We previously reported that near-infrared hyperspectral imaging enabled the localization of atherosclerotic plaques from outside the vessels, but not the optical characteristics of each histological component. Therefore, the near-infrared spectrum of each component was collected from the sliced section of the human carotid plaque obtained with endarterectomy and the optical characteristics were confirmed in several wavelengths. Based on this information, we assessed the diagnostic accuracy for ex vivo chemogram in each plaque component created with near-infrared spectroscopy (NIRS), using multiple wavelengths. The chemogram projected on the actual image of plaque was created based on light intensity and transmittance change at three wavelengths. The wavelengths that were mainly were 1440, 1620, 1730, and 1930 nm. We evaluated the accuracy of histological diagnosis in chemogram compared with pathological findings, analyzing interobserver agreement with κ-statistics. The chemograms that we created depicted the components of fibrous tissue, smooth muscle, lipid tissue, intraplaque hemorrhage, and calcification. Diagnostic odds ratio in each component was as follows: 259.6 in fibrous tissue, 144 in smooth muscle, 1123.5 in lipid tissue, 29.3 in intraplaque hemorrhage, and 136.3 in calcification. The κ-statistics revealed that four components, excluding intraplaque hemorrhage, had substantial or almost perfect agreement. Thus, this study demonstrated the feasibility of using chemogram focused on specific component during the histological assessment of atherosclerotic plaques, highlighting its potential diagnostic ability. Chemograms of various target components can be created by combining multiple wavelengths. This technology may prove to be useful in improving the histological assessment of plaque using NIRS.