1.Can Diffusion-Weighted Magnetic Resonance Imaging Predict a High Gleason Score of Prostate Cancer?.
Katsumi SHIGEMURA ; Nozomu YAMANAKA ; Masuo YAMASHITA
Korean Journal of Urology 2013;54(4):234-238
PURPOSE: To determine the relationship between cancer-positive findings on diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) and the Gleason score (GS) of radical prostatectomy specimens in prostate cancer (PC). MATERIALS AND METHODS: We performed a retrospective study of 105 consecutive patients with PC who underwent radical prostatectomy between January 2009 and October 2011 with DWI MRI and full data available for analyses. Prostatectomy specimen pathology included GS, margin status, and capsule invasion, and the clinical factors investigated included age and serum prostate-specific antigen. We investigated the relationship between positive DWI MRI results and these pathological and clinical factors. RESULTS: PC was diagnosed in 62 of 105 patients on DWI MRI. The prostatectomy specimens revealed that the number of cases with GS >4+3 was significantly greater in patients with PC-positive DWI MRI results (34/62, 54.80%) than in those with PC-negative results (2/43, 2.33%; p<0.0001). Positive surgical margins occurred significantly more often in cases with PC-positive DWI MRI results (31/62, 50.0%, compared with 9/43, 21.4%; p=0.0253), and patients with a single tumor lesion in DWI MRI had significantly higher GSs than did those with multiple tumor lesions (p=0.0301). Our statistical results with multiple regression analysis showed that PC-positive DWI MRI results are significantly associated with high GSs. CONCLUSIONS: DWI MRI may help to predict high GSs in prostatectomy specimens. Further studies assessing a greater number of patients will be necessary for a definitive evaluation of DWI MRI as a diagnostic tool for determining PC malignancy.
Diffusion Magnetic Resonance Imaging
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Humans
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Magnetic Resonance Imaging
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Magnetic Resonance Spectroscopy
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Magnetics
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Magnets
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Neoplasm Grading
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Prostate
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Prostate-Specific Antigen
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Prostatectomy
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Prostatic Neoplasms
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Retrospective Studies
2.Discrete Subaortic Stenosis after Repair of Endocardial Cushion Defect.
Kazuo Yamanaka ; Fumitaka Ando ; Fumio Okamoto ; Shigehiro Otani ; Katushi Oda ; Nozomu Sasahashi ; Kou Sogabe ; Tomoki Hanada
Japanese Journal of Cardiovascular Surgery 1996;25(3):181-184
A 6-year-old girl who had undergone repair of an endocardial cushion defect 4.5 years previously, developed discrete subaortic stenosis requiring surgical intervention. On two-dimensional echocardiography a membrane was visualized below the aortic valve. A pressure gradient of 97mmHg was recorded across the left ventricular outflow tract by cardiac catheterization. Operative findings showed a fibrous ring tissue just below the aortic valve, which was peeled away by sharp dissection. Postoperative cardiac catheterization revealed a 25mmHg pressure gradient across the left ventricular outflow tract. Two years later, she continues to do well and the pressure gradient remains unchanged on Doppler echocardiography.
3.Solitary Arteriosclerotic Aneurysm of the Profunda Femoris Artery. A Review of Literature in Japan.
Kazuo Yamanaka ; Fumitaka Ando ; Fumio Okamoto ; Shigehiro Otani ; Nozomu Sasahashi ; Kou Sogabe ; Tomoki Hanada
Japanese Journal of Cardiovascular Surgery 1996;25(3):185-188
We present a case of solitary arteriosclerotic aneurysm of the profunda femoris artery (PFA), which is very rare among peripheral aneurysms and a reviewed the 19 cases reported in the Japanese literature. A 78-year-old man had a chief complaint of a painful pulsatile mass in the left thigh. Enhanced CT showed the ruptured solitary aneurysm of the PFA. The aneurysm was 6.8cm in diameter. It was removed after ligation of the the PFA. In the Japanese literature, the mean age of patients with solitary arteriosclerotic aneurysm of the PFA was 73 (64-84), all patients were males, the rate of rupture of PFA aneurysm was 47%, and the mean diameter was 8.9cm. In our case, we simply ligated the aneurysm because the patient did not have any evidence of peripheral artery occlusive disease and the distal artery of the aneurysm was very small. However, there is a need to reconstruct the PFA whenever possible because the surgical importance of PFA in occlusive arterial disease has been recognized.