文献詳細
特集 神経画像のピットフォール―見落としと読み過ぎ
文献概要
はじめに
頭部MRI検査は臨床の現場で広く用いられているが,その解釈は必ずしも容易ではなく,無症候性脳病変,急性期脳梗塞,くも膜下出血などの病変の“見落とし”や“読み過ぎ”につながる場合も少なくない。本稿では,これらのcommon diseaseにおけるMRI形態画像の読影上のピットフォールについて概説する。
頭部MRI検査は臨床の現場で広く用いられているが,その解釈は必ずしも容易ではなく,無症候性脳病変,急性期脳梗塞,くも膜下出血などの病変の“見落とし”や“読み過ぎ”につながる場合も少なくない。本稿では,これらのcommon diseaseにおけるMRI形態画像の読影上のピットフォールについて概説する。
参考文献
1) Vermeer SE, Hollander M, van Dijk EJ, Hofman A, Koudstaal PJ, et al: Silent brain infarcts and white matter lesions increase stroke risk in the general population: The Rotterdam Scan Study. Stroke 34: 1126-1129, 2003
2) Sasaki M, Hirai T, Taoka T, Higano S, Wakabayashi C, et al: Discriminating between silent cerebral infarction and deep white matter hyperintensity using combinations of three types of magnetic resonance images: a multicenter observer performance study. Neuroradiology 50: 753-758, 2008
3) 日本脳ドック学会: 脳ドックのガイドライン2008改訂第3版. 響文社, 札幌, 2008, pp32-39
4) 佐々木真理: 神経系のMR撮像法. 日磁医誌19: 503-509, 1999.
5) Heier LA, Bauer CJ, Schwartz L, Zimmerman RD: Large Virchow-Robin spaces: MR-clinical correlation. AJNR Am J Neuroradiol 10: 929-936, 1989
6) Sasaki M, Sone M, Ehara S, Tamakawa Y: Hippocampal sulcus remnant: potential cause of change in signal intensity in the hippocampus. Radiology 188: 743-746, 1993
7) Elster AD, Richardson DN: Focal high signal on MR scans of the midbrain caused by enlarged perivascular spaces: MR-pathologic correlation. AJR Am J Roentgenol 156: 157-160, 1991
-weighted MR images: Virchow-Robin spaces of the extreme capsule and insular cortex. Radiology 214: 671-677, 2000
9) Fiebach JB, Fiebach JB, Schellinger PD, Jansen O, Meyer M, et al: CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 33: 2206-2210, 2002
10) Sasaki M, Ida M, Yamada K, Watanabe Y, Matsui M: Standardizing display conditions of diffusion-weighted images by using concurrent b0 images: a multivendor multi-institutional study. Magn Reson Med Sci 6: 133-137, 2007
11) Hirai T, Sasaki M, Maeda M, Ida M, Katsuragawa S, et al: Diffusion-weighted imaging of ischemic stroke: effect of display method on observers' diagnostic performance. Acad Radiol 16: 305-312, 2009
12) 日本脳卒中学会: rt-PA(アルテプラーゼ)静注療法適正治療指針. 脳卒中27: 327-354, 2005
13) Barber PA, Hill MD, Eliasziw M, Demchuk AM, Pexman JH, et al: Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging. J Neurol Neurosurg Psychiatr 76: 1528-1533, 2005
14) Schaefer PW, Hassankhani A, Putman C, Sorensen AG, Schwamm L, et al: Characterization and evolution of diffusion MR imaging abnormalities in stroke patients undergoing intra-arterial thrombolysis. AJNR Am J Neuroradiol 25: 951-957, 2004
15) Oppenheim C, Stanescu R, Dormont D, Crozier S, Marro B, et al: False-negative diffusion-weighted MR findings in acute ischemic stroke. AJNR Am J Neuroradiol 21: 1434-1440, 2000
16) Nakamura H, Yamada K, Kizu O, Ito H, Yuen S, et al: Effect of thin-section diffusion-weighted MR imaging on stroke diagnosis. AJNR Am J Neuroradiol 26: 560-565, 2005
17) Kim HJ, Choi CG, Lee DH, Lee JH, Kim SJ, et al: High-b-value diffusion-weighted MR imaging of hyperacute ischemic stroke at 1.5T. AJNR Am J Neuroradiol 26: 208-215, 2005
18) Kidwell CS, Chalela JA, Saver JL, Starkman S, Hill MD, et al: Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA 292: 1823-1830, 2004
19) Ogawa T, Inugami A, Shimosegawa E, Fujita H, Ito H, et al: Subarachnoid hemorrhage: evaluation with MR imaging. Radiology 186: 345-351, 1993
20) Chagla GH, Busse RF, Sydnor R, Rowley HA, Turski PA: Three-dimensional fluid attenuated inversion recovery imaging with isotropic resolution and nonselective adiabatic inversion provides improved three-dimensional visualization and cerebrospinal fluid suppression compared to two-dimensional flair at 3 tesla. Invest Radiol 43: 547-551, 2008
21) Stuckey SL, Goh TD, Heffernan T, Rowan D: Hyperintensity in the subarachnoid space on FLAIR MRI. AJR Am J Roentgenol 189: 913-921, 2007
-weighted sequences. AJNR Am J Neuroradiol 26: 662-665, 2005
掲載誌情報