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論文 【 表示 ／ 非表示 】
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Tamura M, Yamashita S, Kawano T, Komaki S, Tsukino T, Kojima K, Maeda K, Kimoto Y, Kadota Y, Azuma M, Okita Y
NMC case report journal 13 ( 0 ) 69 - 75 2026年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本脳神経外科学会
Abusive head trauma in infants and young children can have a significant impact on neurological outcomes and, in severe cases, may be life-threatening. We report 3 cases of abusive head trauma that presented with acute subdural hematomas on computed tomography scans, accompanied by extensive low-density areas and parenchymal brain swelling. All patients exhibited impaired consciousness due to brain injury and underwent craniotomy for hematoma evacuation as well as extensive decompressive craniectomy. Despite the severity of the initial presentation, hemiparesis was mild and gradually improved over several months. Postoperative magnetic resonance imaging revealed widespread parenchymal injury but preservation of the corticospinal tract, including the precentral gyrus. In the acute phase, diffusion-weighted imaging showed no irreversible infarction in the motor cortex, and arterial spin labeling demonstrated increased perfusion in peri-motor regions of the affected hemisphere. These findings suggest that preserved corticospinal pathways and compensatory hyperperfusion may correlate with favorable motor recovery even in the presence of extensive parenchymal damage. These cases highlight the radiological features and short-term neurological outcomes of abusive head trauma, demonstrating preserved motor function despite extensive parenchymal damage.
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Cerebral radiation necrosis successfully treated with high-dose bevacizumab 査読あり
Kugimiya K., Tsubouchi H., Saito K., Kadota Y., Azuma M., Sakai K., Oda Y., Sumiyoshi M., Yanagi S., Miyazaki T.
Respiratory Medicine Case Reports 58 102282 2025年1月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Respiratory Medicine Case Reports
Cerebral radiation necrosis (CRN) is a late complication that can occur after the treatment of a brain tumor with focal radiation therapy, particularly stereotactic radiosurgery (SRS). Since an excessive production of vascular endothelial growth factor (VEGF) from necrotic lesions is a possible etiology of radiation necrosis, the anti-VEGF antibody bevacizumab has been reported as an effective treatment option. We report a case of a 71-year-old Japanese male with CRN following SRS, successfully treated with bevacizumab. He had presented with aphasia and right lower-limb muscle weakness 6 years after a left upper lobectomy for lung adenocarcinoma. Head magnetic resonance imaging (MRI) showed a metastatic brain tumor in the left temporal lobe. A craniotomy and pre- and post-operative SRS treatments were performed to relieve his neurological symptoms. Although initial symptom improvement was observed, the patient developed lower-limb muscle weakness and aphasia symptoms 7 months after the last SRS treatment.<sup>11</sup>C-methionine positron emission tomography (PET) and<sup>18</sup>F-fluorodeoxyglucose PET scans showed no abnormal uptake, leading to a diagnosis of CRN. The patient was treated with bevacizumab 15 mg/kg every 3 weeks for six cycles. The bevacizumab treatment resulted in an improvement of neurological symptoms and lesions showing gadolinium-enhancing effects and high-signal areas on T2-weighted fluid attenuated inversion recovery on MRI. The improvement was maintained 44 months after the completion of the last bevacizumab treatment. Although no definitive number of cycles and dosage of bevacizumab for CRN have been established, this case suggests that administering six cycles of bevacizumab may prevent long-term recurrence of CRN.
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Kawano T, Matsumoto F, Yamashita S, Oguri N, Akizuki K, Tomonaga T, Akiyama Y, Kadota Y, Oda Y, Azuma M, Yamashita A, Okita Y
NMC case report journal 12 ( 0 ) 525 - 530 2025年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本脳神経外科学会
A 72-year-old woman with a history of breast cancer presented with left oculomotor nerve palsy. Magnetic resonance imaging revealed a progressive mass lesion in the cavernous sinus. Initially, Tolosa-Hunt syndrome and metastatic brain tumor from breast cancer were suspected; however, radiological differentiation proved challenging. Pathological examination confirmed the diagnosis of primary intracranial Ewing sarcoma. The tumor exhibited progressive growth, and Gamma Knife radiosurgery was performed. After treatment, tumor shrinkage and symptomatic improvement were observed. Ewing sarcoma typically occurs in children and young adults; however, the safety and efficacy of chemotherapy in older populations remain largely unstudied. In this older patient, the rare location of the tumor within the cavernous sinus posed challenges to surgical resection. Chemotherapy was administered at a reduced dose of 50%, with limited side effects. After 7 cycles of chemotherapy, tumor showed further shrinkage, and no recurrence was observed. This case demonstrates that, even in rare tumors with unestablished chemotherapy protocols for older patients, satisfactory outcomes can be achieved with accurate pathological diagnosis and a multidisciplinary treatment approach.
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Uetani H, Azuma M, Khant ZA, Watanabe Y, Kudo K, Kadota Y, Yokogami K, Takeshima H, Kuroda JI, Shinojima N, Hamasaki T, Mukasa A, Hirai T
Journal of computer assisted tomography 47 ( 4 ) 659 - 665 2023年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Computer Assisted Tomography
Purpose This study aimed to investigate the most useful clinical and magnetic resonance imaging (MRI) parameters for differentiating isocitrate dehydrogenase (IDH)-mutant and-wildtype glioblastomas in the 2016 World Health Organization Classification of Tumors of the Central Nervous System. Methods This multicenter study included 327 patients with IDH-mutant or IDH-wildtype glioblastoma in the 2016 World Health Organization classification who preoperatively underwent MRI. Isocitrate dehydrogenase mutation status was determined by immunohistochemistry, high-resolution melting analysis, and/or IDH1/2 sequencing. Three radiologists independently reviewed the tumor location, tumor contrast enhancement, noncontrast-enhancing tumor (nCET), and peritumoral edema. Two radiologists independently measured the maximum tumor size and mean and minimum apparent diffusion coefficients of the tumor. Univariate and multivariate logistic regression analyses with an odds ratio (OR) were performed. Results The tumors were IDH-wildtype glioblastoma in 306 cases and IDH-mutant glioblastoma in 21. Interobserver agreement for both qualitative and quantitative evaluations was moderate to excellent. The univariate analyses revealed a significant difference in age, seizure, tumor contrast enhancement, and nCET (P < 0.05). The multivariate analysis revealed significant difference in age for all 3 readers (reader 1, odds ratio [OR] = 0.960, P = 0.012; reader 2, OR = 0.966, P = 0.048; reader 3, OR = 0.964, P = 0.026) and nCET for 2 readers (reader 1, OR = 3.082, P = 0.080; reader 2, OR = 4.500, P = 0.003; reader 3, OR = 3.078, P = 0.022). Conclusions Age and nCET are the most useful parameters among the clinical and MRI parameters for differentiating IDH-mutant and IDH-wildtype glioblastomas.
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Yamashita S., Takeshima H., Kadota Y., Azuma M., Fukushima T., Ogasawara N., Kawano T., Tamura M., Muta J., Saito K., Takeishi G., Mizuguchi A., Watanabe T., Ohta H., Yokogami K.
Brain Tumor Pathology 39 ( 2 ) 88 - 98 2022年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Brain Tumor Pathology
After the new molecular-based classification was reported to be useful for predicting prognosis, the T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign has gained interest as one of the promising methods for detecting lower grade gliomas (LGGs) with isocitrate dehydrogenase (IDH) mutations and chromosome 1p/19q non-codeletion (IDH mut-Noncodel) with high specificity. Although all institutions could use T2-FLAIR mismatch sign without any obstacles, this sign was not completely helpful because of its low sensitivity. In this study, we attempted to uncover the mechanism of T2-FLAIR mismatch sign for clarifying the cause of this sign’s low sensitivity. Among 99 patients with LGGs, 22 were T2-FLAIR mismatch sign-positive (22%), and this sign as a marker of IDH mut-Noncodel showed a sensitivity of 55.6% and specificity of 96.8%. Via pathological analyses, we could provide evidence that not only microcystic changes but the enlarged intercellular space was associated with T2-FLAIR mismatch sign (p = 0.017). As per the molecular analyses, overexpression of mTOR-related genes (m-TOR, RICTOR) were detected as the molecular events correlated with T2-FLAIR mismatch sign (p = 0.020, 0.030. respectively). Taken together, we suggested that T2-FLAIR mismatch sign could pick up the IDH mut-Noncodel LGGs with enlarged intercellular space or that with overexpression of mTOR-related genes.
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特集：時系列から学ぶ中枢神経疾患の画像診断 −MR Retroscopy−
東 美菜子、門田善仁、平井俊範（ 担当： 共著）
株式会社学研メディカル秀潤社 2020年8月
総ページ数：1154 担当ページ：1048-1051 記述言語：日本語 著書種別：学術書
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知っておきたい顎・歯・口腔の画像診断
門田善仁、平井俊範（ 担当： 共著）
学研メディカル秀潤社 2017年7月
総ページ数：368 担当ページ：250-251,254-255,256-257 記述言語：日本語 著書種別：学術書
MISC 【 表示 ／ 非表示 】
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特集 時系列から学ぶ中枢神経疾患の画像診断-MR Retroscopy- Ⅱ.天幕上(大脳)A. 脳実質内? 脳実質外? 2 前頭部正中の嗅索と連続する腫瘤
東 美菜子, 門田 善仁, 平井 俊範
画像診断 40 ( 10 ) 1048 - 1051 2020年8月
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特集：脳梗塞超急性期診療 ２．脳梗塞超急性期の画像診断 CT － Advanced Neuro Imaging －
門田善仁、平井俊範
日獨医報 62 ( 2 ) 20 - 28 2018年1月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌） 出版者・発行元：バイエル薬品
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特集 MRIのT2・FLAIR画像での白質高信号の意味を読み解く
平井俊範、東美菜子、門田善仁
精神医学 59 ( 7 ) 619 - 625 2017年7月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア） 出版者・発行元：医学書院
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CASE OF THE MONTH,CASE OF January 招待あり
門田善仁、平井俊範
画像診断 37 ( 1 ) 91 - 91 2016年12月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア） 出版者・発行元：株式会社学研メディカル秀潤社
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特集 脳腫瘍WHO2016 －読影のための実践講座－ 松果体部腫瘍 招待あり
門田善仁、平井俊範
画像診断 36 ( 13 ) 1284 - 1292 2016年10月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア） 出版者・発行元：株式会社学研メディカル秀潤社
講演・口頭発表等 【 表示 ／ 非表示 】
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末梢神経に生じたメトトレキサート関連リンパ増殖性疾患（MTX-LPD）の1例
松村 研吾、門田 善仁、東 美菜子、金丸 和樹、塩見 一剛、岩尾 浩昭
第195回日本医学放射線学会九州地方会
開催年月日： 2022年6月18日 - 2022年6月19日
記述言語：日本語 会議種別：口頭発表（一般）
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頭部IVR 後に出現した高吸収域の原因判別における2層検出器スペクトラルCTの有用性の初期経験
服部洋平、東 美菜子、門田 善仁、平井俊範、竹島秀雄
第49回日本神経放射線学会
開催年月日： 2020年6月10日 - 2020年6月30日
記述言語：日本語 会議種別：口頭発表（一般）
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静脈洞血栓症における単純MRI 撮像法の診断能の比較検討：全国多施設共同研究
東 美菜子、渡邉嘉之、門田善仁、横上聖貴、竹島秀雄、平井俊範
第49回日本神経放射線学会
開催年月日： 2020年6月10日 - 2020年6月30日
記述言語：日本語 会議種別：口頭発表（一般）
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ASLにて両側基底核に高灌流を認めた尿毒症性脳症の一例
東 美菜子、門田善仁、Zaw Aung Khant、服部洋平、平井俊範
第49回日本神経放射線学会
開催年月日： 2020年6月10日 - 2020年6月30日
記述言語：日本語 会議種別：口頭発表（一般）
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頭頚部膿瘍の診断における２層検出器スペクトラルCTの有用性の検討
井手貴一、東 美奈子、門田善仁、平井俊範
第190回日本医学放射線学会九州地方会 (佐賀県佐賀市)
開催年月日： 2020年2月8日 - 2020年2月9日
記述言語：日本語 会議種別：口頭発表（一般）
開催地：佐賀県佐賀市