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医学部 附属病院 脳神経外科 |
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講師 |
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Miyazaki Brain Tumor Research Group. Epidemiologic Study of Primary Brain Tumors in Miyazaki Prefecture: A Regional 10-year Survey in Southern Japan 査読あり
Matsumoto F, Takeshima H, Yamashita S, Yokogami K, Watanabe T, Ohta H
Neurol Med Chir (Tokyo) Jun ( 21 ) 2021年6月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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Suematsu Y., Watanabe T., Takeshima H.
World Neurosurgery 150 110 - 113 2021年6月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：World Neurosurgery
Persistent trigeminal artery (PTA) is the most common persistent carotid-basilar fetal anastomosis and terminates extremely rarely directly in the dominant hemispheric branch of the anterior inferior cerebellar artery (AICA). We present a case of a branch of this PTA variant (Saltzman type 3b) demonstrated as the feeding artery of a large posterior petrous meningioma, which was confirmed under direct vision during surgery through the extended retrosigmoid approach. Meticulous dissection from the tumor surface provided early identification of the feeding branch from the PTA and its bifurcation at the attachment of the posterior petrous surface adjacent to the jugular foramen enabled preservation of the terminal cortical branch of the cerebellar hemisphere. Meningioma in the posterior cranial fossa may recruit substantial supply from branches of the PTA terminating in the AICA. This PTA variant should be recognized during surgical resection of posterior fossa neoplasms to prevent ischemic complication of the AICA territory.
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Azuma M, Khant ZA, Kadota Y, Takeishi G, Watanabe T, Yokogami K, Takeshima H, Hirai T
Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine 2021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：日本磁気共鳴医学会
Purpose: Half of the surgically proven Rathke's cleft cysts (RCCs) can be preoperatively misdiagnosed as cystic pituitary adenoma (CPA). We aimed to evaluate the usefulness of contrast-enhanced (CE) 3D T2 fluid-attenuated inversion-recovery (3D T2-FLAIR) imaging for differentiating between CPA and RCC.Methods: This retrospective study included six patients with RCC (all pathologically confirmed) and six patients with CPA (five pathologically confirmed, one clinically diagnosed). The 12 patients underwent pre- and post-contrast T1-weighted (T1W)- and 3D T2-FLAIR imaging at 3T. Based on the degree of enhancement of the lesion wall, two radiologists independently scored the images using a 3-point grading system. Interobserver agreement was calculated by using the κ coefficient. The statistical significance of grading differences was analyzed with the Mann–Whitney U-test. Another neuroradiologist first interpreted conventional MR images (1st session), and then the reader read images to which the 3D T2-FLAIR images had been added (2nd session). Sensitivity, specificity, and accuracy of the reader's interpretation were calculated.Results: Interobserver agreement for post-contrast T1W- and 3D T2-FLAIR images was excellent (κ = 1.000 and 0.885, respectively). Although the mean enhancement grade on post-contrast T1W images of RCCs and CPAs was not significantly different, on post-contrast 3D T2-FLAIR images it was significantly higher for RCCs and CPAs (P < 0.05). Three CPAs (50%) showed remarkable, donut-like enhancement along the inner margin of the cyst on CE-3D T2-FLAIR images; this was not the case on CE-T1W images. The sensitivity, specificity, and accuracy of the 2nd session were 1.00, 0.83, and 0.92, respectively, which were improved compared to the 1st session (1.00, 0.50, and 0.75, respectively).Conclusion: CE-3D FLAIR imaging is useful for discriminating CPAs and RCCs.
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Selection of surgical approach for cerebellar hemangioblastomas based on venous drainage patterns
Watanabe T., Suematsu Y., Saito K., Takeishi G., Yamashita S., Ohta H., Yokogami K., Takeshima H.
Neurosurgical Review 2021年
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Neurosurgical Review
Cerebellar hemangioblastomas remain surgically challenging because of the narrow, deep surgical corridors and tumor hypervascularity. Various surgical approaches are used according to the location, but optimal approaches have not been established. We propose a system of surgical approaches based on the venous drainage systems to facilitate surgical planning and achieve acceptable neurological outcomes. Cerebellar hemangioblastomas were divided into five types based on the main drainage systems: suboccipital hemangioblastomas draining to the transverse sinus (TS) or torcula, tentorial hemangioblastomas draining to the tentorial sinus or straight sinus, petrosal hemangioblastomas draining to the superior petrosal sinus (SPS), quadrigeminal hemangioblastomas draining to the galenic system, and tonsillar hemangioblastomas draining to the TS or torcula in conjunction with jugular bulb or SPS. Microsurgical approaches and patient outcome were retrospectively reviewed according to this classification. This study included 17 patients who underwent 21 operations for resection of 19 cerebellar hemangioblastomas, classified into 9 suboccipital, 4 tentorial, 2 petrosal, 2 quadrigeminal, and 2 tonsillar. Standard suboccipital craniotomies were utilized for suboccipital hemangioblastomas, the occipital transtentorial approach (OTA), and supracerebellar infratentorial approach for tentorial hemangioblastomas, the retrosigmoid approach for petrosal hemangioblastomas, OTA for quadrigeminal hemangioblastomas, and midline suboccipital approach for tonsillar hemangioblastomas. Gross total resection was achieved in all patients except one. Two patients with large hemangioblastomas (tonsillar and quadrigeminal) required second-stage operation which finally achieved gross total removal. No single approach had a significantly higher incidence of postoperative neurological deficits. Selection of the optimum surgical approach for cerebellar hemangioblastomas was successful based on the main drainage systems. Understanding of tumor growth and extension with respect to the venous drainage system is critical to select the appropriate surgical approach.
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M.Azuma, Z.A.Khant, M.Kitajima, H.Uetani, T.Watanabe, K.Yokogami, H.Takeshima, T. Hirai
American Journal of Neuroradiology 41 ( 1 ) 106 - 110 2020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：American Journal of Neuroradiology
BACKGROUND AND PURPOSE: Because it can be difficult to discriminate between a Rathke cleft cyst and cystic craniopharyngioma by conventional MR imaging alone, we investigated whether contrast-enhanced 3D T2-FLAIR MR imaging at 3T helps to distinguish a Rathke cleft cyst from a cystic craniopharyngioma. MATERIALS AND METHODS: We evaluated pre- and postcontrast T1-weighted and 3D T2-FLAIR images of 17 patients with pathologically confirmed Rathke cleft cyst (n = 10) or cystic craniopharyngioma (n = 7). All underwent 3T MR imaging studies before surgery. Two neuroradiologists independently recorded the enhancement grade of the lesion wall as grade 2 (most of the wall enhanced), grade 1 (some of the wall enhanced), and grade 0 (none of the wall enhanced). One neuroradiologist performed a blinded reading study of conventional MR images with/without 3D T2-FLAIR images. Interobserver agreement was determined by calculating the k coefficient. Statistical analyses, including receiver operating characteristic curve analysis were performed. RESULTS: Interobserver agreement for postcontrast T1WI and 3D T2-FLAIR images was excellent (k = 0.824 and k = 0.867, respectively). Although the difference in the mean enhancement grade of Rathke cleft cysts and cystic craniopharyngiomas was not significant on postcontrast T1WIs, it was significant on postcontrast 3D T2-FLAIR images (P = .0011). The area under the receiver operating characteristic curve of the conventional MR alone and conventional MR with 3D T2-FLAIR readings was 0.879 and 1.0, respectively, though there was no significant difference in the area under the curve between the 2 readings. CONCLUSIONS: Contrast-enhanced 3D T2-FLAIR imaging at 3T helps to distinguish a Rathke cleft cyst from cystic craniopharyngioma.
DOI： 10.3174/ajnr.A6359
講演・口頭発表等 【 表示 ／ 非表示 】
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Optic recess の偏位からみた頭蓋咽頭腫に対する手術到達法の選択
渡邉孝
第30回日本間脳下垂体腫瘍学会
開催年月日： 2020年2月21日 - 2020年2月22日
記述言語：日本語 会議種別：口頭発表（一般）
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高齢者髄膜腫の臨床的特徴と治療戦略
渡邉孝
日本脳神経外科学会第78回学術総会
開催年月日： 2019年10月9日 - 2019年10月12日
記述言語：日本語 会議種別：口頭発表（一般）
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高齢者髄膜腫の臨床的特徴と治療戦略
渡邉孝
第24回日本脳腫瘍の外科学会
開催年月日： 2019年9月13日 - 2019年9月14日
記述言語：日本語 会議種別：口頭発表（一般）
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高齢者の非機能性下垂体腺腫に対する内視鏡下経鼻的経蝶形骨洞手術における視機能改善効果
渡邉孝
第32回日本老年脳神経外科学会
開催年月日： 2019年3月29日
記述言語：日本語 会議種別：口頭発表（一般）
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高齢者下垂体腺腫に対する内視鏡下経鼻的経蝶形骨洞手術における視機能改善効果
渡邉孝
第29回日本間脳下垂体腫瘍学会
開催年月日： 2019年2月22日 - 2019年2月23日
記述言語：日本語 会議種別：口頭発表（一般）
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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EVI1によるPDGFRβ転写制御とグリオブラストーマ血管新生機構について
研究課題/領域番号：22K09237 2022年04月 - 2027年03月
独立行政法人日本学術振興会 科学研究費補助金 基盤研究(C)
水口 麻子、
担当区分：研究分担者
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代謝経路再編成が概日リズム経路を介し、幹細胞性維持、細胞死回避に及ぼす影響の解明
研究課題/領域番号：22K09262 2022年04月 - 2025年03月
科学研究費補助金 基盤研究(C)
担当区分：研究分担者