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RISS 인기검색어
- 검색키워드
- 저자 : Motoyuki Iwasaki (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
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Highly Accurate Analysis of the Cervical Neural Tract of the Elderly Using ZOOM DTI
Sho Furuya,Motoyuki Iwasaki,Takumi Yokohama,Daisuke Ohura,Tomoyuki Okuaki 대한척추신경외과학회 2018 Neurospine Vol.15 No.2
Objective: To investigate the fractional anisotropy (FA) values of the cervical spinal cord in elderly individuals using zonally magnified oblique multislice (ZOOM) diffusion tensor imaging (DTI). Methods: Fourteen healthy elderly volunteers (group E) and 10 young volunteers (group Y) were enrolled. We assessed the FA, apparent diffusion coefficient (ADC), and λ1–λ3 values using 3-T magnetic resonance imaging. The region of interest was contoured entirely inside the spinal cord, with no gray/white matter distinction, in order to avoid including the cerebrospinal fluid. Results: As lower cervical levels were approached, the FA values gradually decreased, while the ADC values increased. The mean FA values at each cervical level were as follows in groups E and Y: 0.71 and 0.70 at the C2/3 level, 0.66 and 0.66 at the C3/4 level, 0.63 and 0.62 at the C4/5 level, 0.57 and 0.57 at the C5/6 level, and 0.58 and 0.57 at the C6/7 level, respectively. The mean ADC values in groups E and Y were 1.06 and 0.99 at the C2/3 level, 1.05 and 1.06 at the C3/4 level, 1.14 and 1.06 at the C4/5 level, 1.18 and 1.21 at the C5/6 level, and 1.39 and 1.46 at the C6/7 level, respectively. There were no significant differences between the elderly and young participants. Conclusion: In both asymptomatic elderly and young individuals, the FA values gradually decreased and the ADC values increased moving towards lower cervical levels. Age did not affect the FA values, even though mild cord compression was evident due to spondylotic changes. ZOOM DTI has the potential to provide more information than conventional DTI.
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Soichiro Takamiya,Motoyuki Iwasaki,Takumi Yokohama,Daisuke Oura,Yoshimasa Niiya,Miki Fujimura 대한척추신경외과학회 2023 Neurospine Vol.20 No.1
Objective: Although cervical spondylotic myelopathy (CSM) can be easily diagnosed using magnetic resonance imaging (MRI), prediction of surgical effect using preoperative radiological examinations remains difficult. In previous studies, it was reported that diffusion tensor imaging (DTI) may be used for the prediction of surgical effect; however, these studies did not consider the influences of spinal cord compression even though the values of DTI indexes can be distorted by compressive lesions in patients with CSM. Therefore, it is uncertain whether preoperative DTI indexes can actually predict the surgical effect. The aim of this study was to investigate DTI metrics that are hardly affected by spinal cord compression and can accurately predict neurological status after decompressive surgery. Methods: Twenty-one patients with CSM who underwent surgery and 10 healthy volunteers were enrolled in this study. The subjects underwent cervical MRI, and values of DTI indexes including axial diffusivity (AD), radial diffusivity (RD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were recorded at each intervertebral level. Further, the Japanese Orthopaedic Association (JOA) score of each patient with CSM was recorded before and after surgery for neurological status evaluation. Preoperative and postoperative values of DTI indexes were compared, and correlations between preoperative DTI parameters and postoperative neurological recovery were assessed. Results: After surgery, the lesion-adjacent (LA) ratios of RD and ADC increased (p = 0.04 and p = 0.062, respectively), while the LA ratio of FA decreased (p = 0.075). In contrast, the LA ratio of AD hardly changed. A negative correlation was observed between preoperative LA ratio of AD and JOA recovery rate 6 months after surgery (r = -0.379, p = 0.091). Based on preoperative LA ratio of AD, the patients were divided into a low AD group and a high AD group, and JOA recovery rate 6 months after surgery was found to be higher in the low AD group than in the high AD group (p = 0.024). Conclusion: In patients with CSM, preoperative LA ratio of AD is seldom affected by spinal cord compression, and it negatively correlates with JOA recovery rate 6 months after surgery.
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Takashi Yagi,Masaki Mizuno,Hiroto Kageyama,Kotaro Tatebayashi,Toshiki Endo,Yasuhiro Takeshima,Motoyuki Iwasaki,Ryu Kurokawa,Keisuke Takai,Misao Nishikawa,Kazutoshi Hida 대한척추신경외과학회 2023 Neurospine Vol.20 No.3
Objective: This study aimed to analyze the clinical characteristics, treatment strategies, and surgical outcomes of subependymoma patients from the 2022 Neurospinal Society of Japan multicenter intramedullary spinal cord tumor study. Methods: Twenty-six patients with spinal cord subependymoma who were included in the index study of 1,033 patients were retrospectively analyzed. Results: Mean patient age was 49.4 years. Seventeen patients were men and 9 were women. Sensory disturbance was reported in 22 patients and motor weakness in 18. Median duration of symptoms was 24 months. The tumor was eccentrically located in 19 patients (73.1%) and unilateral in 17 (65.4%). Gross total resection was achieved in 6 patients (23.1%). The same rate for ependymoma patients in the index study was significantly higher (74.8%). Median follow-up was 40.5 months (interquartile range, 18–68 months). In 2 patients who underwent only partial resection, reoperation was required owing to progression 68 and 90 months after surgery, respectively. No recurrence occurred in patients who underwent gross total resection. Five patients experienced neurological worsening after surgery. Conclusion: Although spinal cord subependymoma can be difficult to distinguish from other intramedullary spinal cord lesions before surgery, it is characterized by an indolent clinical course and eccentric location. Surgical treatment should prioritize functional preservation because the prognosis is good even after subtotal resection.
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