Noriko Oyama-Manabe

Purpose To evaluate the feasibility of magnetic resonance cholangiopancreatography (MRCP) using a multi-planar voxel (MPV) sequence combined with a pre-contrast pulse (MPV-MRCP) and to compare its image quality with conventional three-dimensional MRCP (C-MRCP) and breath-hold MRCP (BH-MRCP). Materials and Methods In this retrospective study, MRCP images from 50 patients who underwent evaluation for pancreaticobiliary disease were analyzed. All examinations were performed using a 1.5-T MRI scanner. Quantitative assessments included signal-to-noise ratio (SNR) and contrast ratio (CR). Qualitative image quality and duct visualization were independently evaluated by two radiologists using standardized scoring systems. Statistical analysis was performed using the Kruskal–Wallis test with post hoc comparisons and weighted κ statistics for interobserver agreement. Results MPV-MRCP was successfully acquired in all patients. It demonstrated significantly higher SNR compared with both C-MRCP and BH-MRCP (p < 0.01), while no significant differences in CR were observed. MPV-MRCP achieved significantly higher overall image quality scores and improved visualization of the proximal pancreatic duct (p < 0.01). Additionally, MPV-MRCP demonstrated less apparent respiratory motion–related image degradation on qualitative assessment. Conclusion MPV-MRCP improves image quality and duct visualization compared with conventional MRCP techniques and may serve as a clinically valuable alternative, particularly in patients with limited breath-holding ability or irregular respiration.

We report a case of Wallenberg syndrome associated with vertebral artery occlusion and suspected atherosclerotic changes. The patient was evaluated using accelerated 3D fluid-attenuated inversion recovery MRI incorporating T2 preparation and magnetization transfer contrast pulses. This technique enabled a shortened acquisition time while preserving high image contrast, allowing clear visualization of the lateral medullary infarction. This approach provides a non-contrast, high-resolution method for assessing brainstem infarcts and may contribute to improved diagnostic accuracy in the acute setting.

Coronary artery disease is a major cause of mortality in patients with chronic kidney disease (CKD); however, the actual burden of asymptomatic coronary artery stenosis in patients with advanced-stage CKD remains unclear. We investigated the prevalence and associated factors of significant coronary artery stenosis (≥ 50%) in asymptomatic patients with moderate-to-severe (stage G3–5) CKD. Furthermore, we evaluated the usefulness of carotid maximum intima-media thickness (IMT) in predicting significant coronary artery stenosis in these patients. We enrolled 128 patients (men: 68.0%; mean age: 70.3±11.2 years; mean estimated glomerular filtration rate: 37.6±12.9 mL/min/1.73 m²) in a prospective, cross-sectional study. The presence and severity of coronary artery stenosis was evaluated by coronary magnetic resonance angiography. Carotid maximum-IMT was also evaluated by carotid ultrasonography. Factors which were associated with the presence of significant coronary artery stenosis were explored by multivariable logistic regression analysis. The diagnostic accuracy of carotid maximum-IMT for detecting significant coronary artery stenosis was explored by receiver operating characteristic (ROC) curve analysis. Seventy-six patients (60%) had significant coronary artery stenosis. Univariable analyses showed that age, body mass index, high-density lipoprotein cholesterol, glycated hemoglobin, C-reactive protein, and carotid maximum-IMT were associated with the presence of significant coronary artery stenosis. However, multivariable logistic regression analysis revealed that only carotid maximum-IMT (odds ratio: 4.86; P < 0.001) was associated with the presence of significant coronary artery stenosis. The ROC curve of carotid maximum-IMT was significant (P < 0.001), with an area under the curve of 0.788 (cut-off value, 1.5 mm; sensitivity, 0.84; specificity, 0.58). The prevalence of significant coronary artery stenosis was high (60%) in patients with moderate-to-severe CKD. Carotid maximum-IMT was the primary factor associated with the presence of significant coronary artery stenosis and might be a surrogate marker for significant coronary artery stenosis in these patients.

Oyama-Manabe N, et al. Korean J Radiol. 2025 Jul;26:e62. https://doi.org/10.3348/kjr.2025.0148

OBJECTIVES: Sarcopenia and malnutrition often occur simultaneously in adults with cardiovascular diseases. Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery METHODS: We retrospectively analysed 154 consecutive patients who underwent elective cardiac surgery between January 2015 and June 2018 at two institutions in Japan. Sarcopenia and nutritional status were preoperatively assessed by bilateral psoas muscle volume index (PMVI) using CT scans and the prognostic nutritional index (PNI), respectively. RESULTS: The median age in the total cohort was 69 years, and 43% were women. Within 30 days after surgery, 20 patients developed in-hospital MACCE and seven patients died of any cause. Low PMVI (<72.25 cm3/m2) and low PNI (<48.15) were each independent predictors of postoperative MACCE occurrence with odds ratios (95% confidence interval) of 3.58 (1.22–10.53) and 3.73 (1.25–11.09) when adjusted for age and sex, and 3.25 (1.07–9.87) and 3.27 (1.08–9.89) when adjusted for preoperative left ventricular ejection fraction, angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, and anticoagulant. In addition, the combination of low PMVI and low PNI conferred the highest risk of in-hospital MACCE among the four groups (i.e. the low PMVI, low PNI, low PMVI + low PNI and neither low PMVI nor low PNI groups). CONCLUSIONS: Preoperative low PMVI and low PNI were respectively associated with 30-day in-hospital MACCE occurrence after cardiac surgery. Notably, coexistence of these reductions further enhanced the risk of postoperative MACCE.

サルコイドーシスは全身性肉芽腫性疾患で，いまだ原因不明の疾患である．サルコイドーシス病変は多臓器に分布して様々な臨床症状を来すが，なかでも心臓病変は大きな予後規定因子となるために早期発見が望まれる．FDG PETは2012年4月から心臓サルコイドーシスの炎症部位診断として保険適用となった．FDGはグルコースの類似体であり，炎症を伴う非乾酪性類上皮細胞肉芽腫に強い集積を認めるために活動性を評価でき，現在では心臓サルコイドーシスの診療に欠かせない検査となっている．今回は我々の経験を踏まえて，心臓サルコイドーシス診療におけるFDG PETの原理，評価方法，役割についてまとめる．

Osamu Manabe, MD, PhD, Hiroyuki Jinnouchi, MD, PhD, Tadao Aikawa, MD, PhD, Katsuyuki Shirai, Noriko Oyama-Manabe, MD, PhD; Ischemia in the RV and LV, and rheuma