Publications by authors named "Hideki Ota"

Preoperative identification of the Adamkiewicz artery (AKA) with adequate reconstruction or preservation during surgery is useful for protecting the spinal cord from ischemia during thoracoabdominal aortic repair. However, the identification of the AKA remains challenging in some cases, especially with chronic aortic dissection. In a 45-year-old man with chronic aortic dissection requiring thoracoabdominal aortic repair, conventional contrast-enhanced CT or MR angiography failed to detect AKA due to the large entry tear and an enlarged false lumen.

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Background: Identifying patients on dialysis among those with an estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m remains challenging. To facilitate clinical research in advanced chronic kidney disease (CKD) using electronic health records, we aimed to develop algorithms to identify dialysis patients using laboratory data obtained in routine practice.

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Patients with borderline pulmonary hypertension (PH) often experience shortness of breath or exacerbation of PH during exercise, known as exercise-induced PH. However, the pathogenesis of exercise-induced post-capillary PH (post-EIPH) and its treatment strategies remain unclear. Recent guidelines and consensus documents have highlighted the benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors in heart failure and chronic kidney disease (CKD).

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A 70-year-old woman had been taking steroids for granulomatosis with polyangiitis since the age of 60 years and warfarin for deep vein thrombosis since the age of 63 years. She was admitted to the emergency unit of our hospital in a shock vital with complaints of sudden onset of epigastralgia, nausea, and melena. Laboratory data revealed anemia, hypoalbuminemia, and coagulation disorders.

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Article Synopsis
  • Patients with cardiac sarcoidosis (CS) are at a heightened risk of fatal ventricular arrhythmic events (FVAE), but the role of FDG-PET in predicting these risks was unclear.
  • Data from 121 CS patients were analyzed, focusing on differences in F-FDG uptake in specific heart regions, particularly the basal inferoseptal segment, during FDG-PET imaging.
  • Results indicated that lower F-FDG uptake in the basal inferoseptal segment correlated with a higher incidence of FVAE, suggesting it could serve as a valuable predictor for assessing future FVAE risk in patients with CS.
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Background: Balloon pulmonary angioplasty (BPA) has exhibited substantial progress in the management of chronic thromboembolic pulmonary hypertension (CTEPH). However, nearly one-half of the patients with CTEPH experience persistent pulmonary hypertension after undergoing BPA, emphasizing the need for enhanced therapies.

Objectives: The authors sought to investigate the clinical significance of functional assessment-guided dilation of the pulmonary artery (PA) in patients with CTEPH undergoing BPA treatment.

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Objectives: This study aimed to investigate the relationship between microvascular status in the non-ischemic myocardium and the diagnostic performance of stress dynamic CT perfusion imaging (CTP) in detecting hemodynamically significant stenosis.

Materials And Methods: This study included 157 patients who underwent coronary computed tomography angiography (CTA), CTP, and invasive coronary angiography (ICA), including fractional flow reserve (FFR). Hemodynamically significant stenosis was defined by FFR and ICA.

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  • This study highlights the critical role of radiologists in diagnosing and managing adrenal lesions, particularly focusing on primary aldosteronism (PA) and secondary hypertension prevalent in Japan.
  • It emphasizes the importance of advanced imaging techniques like CT and MRI for differentiating between various benign and malignant adrenal conditions, and details the significance of adrenal venous sampling (AVS) for accurate diagnosis when imaging is inconclusive.
  • The paper also discusses the advanced method of segmental adrenal venous sampling (SAVS) for better diagnosis and the role of radiologists in treating conditions like unilateral PA, advocating for a collaborative approach in patient care involving multiple medical departments.
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The increased utilization of computed tomography (CT) has raised concerns about patient radiation exposure. Effective dose (ED), which requires precise estimation, is crucial for assessing and managing these risks. Traditional ED estimation methods, which are based on the dose-length product (DLP), often lack accuracy due to variations in patient size and anatomy.

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Purpose: The purpose of this study was to evaluate the cost-effectiveness of comprehensive treatment strategy, including segmental adrenal venous sampling (sAVS) and radiofrequency ablation (RFA), versus medication-only strategy for primary aldosteronism.

Materials And Methods: A Markov decision model was developed to compare the cost-effectiveness of a comprehensive treatment strategy and a medication-only strategy for 50-year-old men and women with stage I-III hypertension. The comprehensive treatment strategy included aldosterone/renin ratio measurement, two loading tests, computed tomography, sAVS, drugs, surgery, and RFA.

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Intrinsic cerebrospinal fluid (CSF) dynamics in the brain have been extensively studied, particularly the egress sites of tagged intrinsic CSF in the meninges. Although spinal CSF recirculates within the central nervous system (CNS), we hypothesized that CSF outflows from the lumbar spinal canal. We aimed to visualize and semi-quantify the outflow using non-contrast MRI techniques.

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The purpose of this study was to determine if dual-energy CT (DECT) vital iodine tumor burden (ViTB), a direct assessment of tumor vascularity, allows reliable response assessment in patients with GIST compared to established CT criteria such as RECIST1.1 and modified Choi (mChoi). From 03/2014 to 12/2019, 138 patients (64 years [32-94 years]) with biopsy proven GIST were entered in this prospective, multi-center trial.

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Article Synopsis
  • A new MR coronary angiography (MRCA) technique was created using a zigzag fan-shaped centric k-k k-space trajectory and high-resolution deep learning reconstruction (HR-DLR) to improve imaging efficiency and quality.
  • The study involved 12 healthy subjects and 2 patients, comparing different imaging techniques (standard 3D fast gradient echo vs. centric ky-kz k-space trajectory), highlighting that the new technique significantly reduced scan time from 15 minutes to under 5 minutes.
  • Results showed that the new method with HR-DLR produced better image quality than the standard approach without HR-DLR, with a clinical application that yielded good-quality images in patients, including one with a
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We present a case of prophylactic endovascular embolization in a 51-year-old man with necrotizing pancreatitis (NP) before undergoing endoscopic necrosectomy (EN). Contrast-enhanced CT imaging revealed the presence of a walled-off necrosis (WON) surrounding the pancreas, with the splenic artery coursing through the cavity. The splenic artery was embolized using n-butyl-2-cyanoacrylate (NBCA) and coils to mitigate the risk of massive bleeding in EN.

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We describe the endovascular embolization of a 65-year-old man with chronic hepatic encephalopathy. A contrast-enhanced computed tomography demonstrated a splenorenal shunt and a recanalized paraumbilical vein as a continuous portal shunt connecting the left branch of the portal vein and the right common femoral vein. A 2-session embolization was performed for the splenorenal shunt.

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Background: Systemic-to-pulmonary artery shunt (SPAS) is a rare condition that can occur as a result of congenital heart disease or chronic pulmonary inflammation, occasionally leading to life-threatening hemoptysis. Computed tomography (CT) imaging is crucial in the diagnosis of SPAS, and the optimal management approach for SPAS remains uncertain. This case report presents a novel approach to the treatment of SPAS, consisting of transcatheter arterial embolization of the systemic artery followed by lung segmentectomy.

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Purpose: To describe a novel technique of transvenous radiofrequency catheter ablation of an aldosterone-producing adenoma (APA) of the left adrenal gland using the GOS System (Japan Lifeline, Tokyo, Japan). Using the GOS system, a flexible radiofrequency tip catheter can be inserted into the adrenal central and tributary veins, the drainers for functional tumors.

Materials And Methods: An APA at the left adrenal gland, which was diagnosed by segmental adrenal venous sampling following administration of 0.

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Postoperative portal vein obstruction could occur as a complication of portal vein reconstruction during hepatic lobectomy or pancreaticoduodenectomy. We report a case of patient with postoperative portal vein obstruction treated with percutaneous transhepatic portal vein stenting without using iodinated contrast media owing to a history of severe allergic reactions. Under ultrasound guidance, carbon dioxide angiography, and appropriate device selection, successful stenting was achieved without serious adverse events.

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We herein report a 37-year-old man who experienced recurrence of metastatic cardiac rhabdomyosarcoma along with intractable ventricular tachycardia (VT) 7 years after resection of rhabdomyosarcoma in his right elbow. At 36 years old, he developed VT unresponsive to radiofrequency catheter ablation (RFCA). Initially, the cardiac tumor was not detected, but it gradually grew in size at the RFCA site.

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Objectives: Fractal analysis of dynamic myocardial stress computed tomography perfusion imaging (4D-CTP) has shown potential to noninvasively differentiate obstructive coronary artery disease (CAD) and coronary microvascular disease (CMD). This study validates fractal analysis of 4D-CTP in a multicenter setting and assesses its diagnostic accuracy in subgroups with ischemia and nonobstructed coronary arteries (INOCA) and with mild to moderate stenosis.

Materials And Methods: From the AMPLIFiED multicenter trial, patients with suspected or known chronic myocardial ischemia and an indication for invasive coronary angiography were included.

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Article Synopsis
  • Closed spinal dysraphism (CSD) includes various spinal cord deformities that can show mild skin features like sacral dimples and gluteal clefts, but the connection to CSD isn't always clear.
  • A study analyzed MRI data from 1,255 asymptomatic children with skin stigmata from 2003 to 2015 to reevaluate the need for MRI and surgery in these cases.
  • Findings indicated that dimples and gluteal clefts had low rates of CSD needing surgical treatment, suggesting that asymptomatic children with minor skin features might not need urgent MRI scans.
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Purpose: To assess the diagnostic performance of carbon dioxide (CO) and intraprocedural unenhanced computed tomography (CT) for adrenal venous sampling (AVS) (CO-intraprocedural unenhanced CT-AVS) in patients with primary aldosteronism (PA) and a history of iodine contrast medium allergy.

Materials And Methods: CO-intraprocedural unenhanced CT-AVS was performed in 18 patients with iodine contrast media allergies at the authors' hospital between December 2015 and January 2021. CT and noncontrast magnetic resonance angiography were used to evaluate the preoperative adrenal vein anatomy.

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