Utility of Superb micro-vascular imaging ultrasound for the diagnosis of stenotic lesion in carotid artery. An observational study

• Project/Area Number: 19K17048
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52020:Neurology-related
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Hagiwara Yuta 聖マリアンナ医科大学, 医学部, 講師 (90811802)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: カラードプラ法 / 頸動脈狭窄性病変 / 頸動脈超音波 / 経口腔頸動脈超音波 / 頸動脈ステント留置術 / SMI / Carotid Artery Stenting / 頸動脈狭窄症 / ultrasonography / in-stent restenosis / transoral / 頸動脈狭窄 / 頸動脈超音波検査 / 経口腔頸動脈超音波検査

Outline of Research at the Start

本研究は頸動脈ステント留置術（Carotid artery stenting; CAS）において周術期合併症を減少させ、より安全な手術を確立することを目的としている。CAS術前・術後において、新技術を用いた頸動脈超音波検査、経口腔頸動脈超音波検査を施行し、従来行われてきたCT angiography画像や、脳血管撮影画像と比較することで、超音波の有用性を検討する。超音波は低侵襲な検査であり、人体に無害な検査である。本検査の評価が確立されれば、従来の検査で使用されていた腎毒性のある造影剤を使用せずに、より多くの患者が安全に手術に臨むことができる。

Outline of Final Research Achievements

Cerebrovascular disease is the fourth leading cause of death in Japan (2021), and about 10% of all medical expenses are spent on this medical care. Therefore, it is important to suppress the development of stroke. Carotid artery stenosis caused by carotid plaque is one of the causes of cerebral infarction. Carotid artery stenting (CAS) is common treatment for carotid artery stenosis. This study aimed to reduce perioperative complications in CAS and establish safer strategy of the surgery. Recent ultrasounds have a new color Doppler imaging technique for assessing low velocity blood flow such as intra-plaque neovascularization (IPN). IPN might act as nutrient vessels for plaque growth. The present study indicated a significant association between IPN in SMI performed before CAS and development of in-stent restenosis at 6 months after CAS. This study indicated that carotid artery ultrasonography was useful for accurately evaluation for carotid lesions on perioperative CAS procedure.

Academic Significance and Societal Importance of the Research Achievements

頸動脈にプラークが付着し引き起こされる頸動脈狭窄症は、脳梗塞の重大な原因の一つである。頸動脈狭窄を有する患者に対して、ステントで狭窄部を拡張するCASは頸動脈内膜剥離術と並び一般的な治療であるが、しばしば合併症が問題となる。その合併症を減らすために、低侵襲かつ腎毒性がない頸動脈超音波検査による周術期評価が有用と考え、本研究を立案した。本研究によって、術前の超音波所見で新生血管をみとめた症例では、術後のステント内再狭窄を示す可能性が高いことが示された。また術後においても、ステント内の評価に超音波が有用であることが示唆された。本研究の成果は、より安全なCAS手術戦略の立案に寄与するものと考える。

Research Products

• [Journal Article] Carotid Ultrasound Using Superb Microvascular Imaging to Identify Patients Developing In-Stent Restenosis After CAS (2022)
  • Author(s): Hagiwara Yuta、Takao Naoki、Usuki Noriko、Yoshie Tomohide、Takaishi Satoshi、Shimizu Takahiro、Ueda Toshihiro、Hasegawa Yasuhiro、Yamano Yoshihisa
  • Journal Title: Journal of Stroke and Cerebrovascular Diseases Volume: 31 Issue: 8 Pages: 106627-106627
  • DOI: 10.1016/j.jstrokecerebrovasdis.2022.106627
  • Peer Reviewed
• [Journal Article] Usefulness of carotid duplex ultrasonography in predicting residual large-vessel occlusions after intravenous recombinant tissue plasminogen activator therapy in patients with acute ischemic stroke (2022)
  • Author(s): Kaburagi Kei、Shimizu Takahiro、Hagiwara Yuta、Fukano Takayuki、Shibata Soichiro、Hoshino Masashi、Sasaki Naoshi、Akiyama Hisanao、Hasegawa Yasuhiro、Yamano Yoshihisa
  • Journal Title: Journal of Medical Ultrasonics Volume: 50 Issue: 1 Pages: 103-109
  • DOI: 10.1007/s10396-022-01271-x
  • Peer Reviewed
• [Journal Article] Utility of transoral motion‐mode ultrasonography to detect tongue fasciculation in patients with amyotrophic lateral sclerosis (2021)
  • Author(s): Hagiwara Yuta、Shimizu Takahiro、Yanagisawa Toshiyuki、Akasu Yukari、Kaburagi Kei、Kikuchi Takayuki、Shibata Soichiro、Matsumoto Hirofumi、Soga Kaima、Tsuchihashi Yoko、Nagasaka Misako、Sasaki Naoshi、Maki Futaba、Shiraishi Makoto、Akiyama Hisanao、Hasegawa Yasuhiro、Yamano Yoshihisa
  • Journal Title: Muscle & Nerve Volume: Online ahead of print Issue: 6 Pages: 909-913
  • DOI: 10.1002/mus.27218
  • Peer Reviewed
• [Journal Article] 頸動脈超音波所見から頸動脈ステント留置術後のplaque protrusionとプラーク内新生血管の関与が示唆された興味深い症例 (2021)
  • Author(s): 萩原悠太
  • Journal Title: Neurosonology Volume: 34(3) Pages: 148-152
  • NAID: 130008140147
  • Peer Reviewed
• [Journal Article] Soleal vein dilatation in the early phase of hospitalization is associated with subsequent development of deep vein thrombosis in patients with acute stroke (2021)
  • Author(s): Soga Kaima、Shimizu Takahiro、Hagiwara Yuta、Ogura Hana、Akiyama Hisanao、Yamauchi Junji、Sato Tomoo、Hanzawa Kazuhiko、Hasegawa Yasuhiro、Yamano Yoshihisa
  • Journal Title: Journal of Medical Ultrasonics Volume: 48 Issue: 1 Pages: 97-104
  • DOI: 10.1007/s10396-020-01075-x
  • Peer Reviewed
• [Journal Article] 経口腔頸動脈超音波検査 (2020)
  • Author(s): 萩原 悠太
  • Journal Title: Japanese Journal of Medical Ultrasound Technology Volume: 45 Issue: 1 Pages: 39-46
  • DOI: 10.11272/jss.r509
  • NAID: 130007795229
  • ISSN: 1881-4506, 1881-4514
  • Year and Date: 2020-02-01
• [Journal Article] Preprocedural Carotid Plaque Echolucency as a Predictor of In-Stent Intimal Restenosis after Carotid Artery Stenting (2020)
  • Author(s): Takao Naoki、Hagiwara Yuta、Shimizu Takahiro、Soga Kaima、Tsuchihashi Yoko、Otsubo Haruki、Tatsuno Kentaro、Takaishi Satoshi、Usuki Noriko、Yoshie Tomohide、Takada Tatsuro、Ueda Toshihiro、Hasegawa Yasuhiro、Yamano Yoshihisa
  • Journal Title: Journal of Stroke and Cerebrovascular Diseases Volume: 29 Issue: 12 Pages: 105339-105339
  • DOI: 10.1016/j.jstrokecerebrovasdis.2020.105339
  • Peer Reviewed
• [Journal Article] The Risk Factors for Death within 6 Months After Ischemic Stroke in Patients with Cancer. (2020)
  • Author(s): Tsuchihashi Y, Shimizu T, Akiyama H, Hagiwara Y, Soga K, Takao N, Uchino K, Yanagisawa T, Yamauchi J, Sato T, Hasegawa Y, Yamano Y.
  • Journal Title: J Stroke Cerebrovasc Dis Volume: 29(12) Issue: 12 Pages: 105365-105365
  • DOI: 10.1016/j.jstrokecerebrovasdis.2020.105365
  • Peer Reviewed / Open Access
• [Journal Article] The peripheral lymphocyte count as a predictor of severe COVID-19 and the effect of treatment with ciclesonide (2020)
  • Author(s): Yamasaki Yukitaka、Ooka Seido、Tsuchida Tomoya、Nakamura Yuta、Hagiwara Yuta、Naitou Yoshiyuki、Ishibashi Yuki、Ikeda Hiroki、Sakurada Tsutomu、Handa Hiroshi、Nishine Hiroki、Takita Mumon、Morikawa Daiki、Yoshida Hideki、Fujii Shuichi、Morisawa Kenichiro、Takemura Hiromu、Fujitani Shigeki、Kunishima Hiroyuki
  • Journal Title: Virus Research Volume: 290 Pages: 198089-198089
  • DOI: 10.1016/j.virusres.2020.198089
  • Peer Reviewed
• [Journal Article] Ultrasound-Guided Needle Aspiration of Peritonsillar Abscesses: Utility of Transoral Pharyngeal Ultrasonography (2019)
  • Author(s): Hagiwara Yuta、Saito Yoshimitsu、Ogura Hana、Yaguchi Yuichiro、Shimizu Takahiro、Hasegawa Yasuhiro
  • Journal Title: Diagnostics Volume: 9 Issue: 4 Pages: 141-141
  • DOI: 10.3390/diagnostics9040141
  • Peer Reviewed / Open Access
• [Journal Article] Three-dimensional transoral carotid ultrasonography (2019)
  • Author(s): HAGIWARA Yuta、IIJIMA Naoki、OGURA Hana、SHIMIZU Takahiro、HASEGAWA Yasuhiro
  • Journal Title: Neurosonology Volume: 32 Issue: 3 Pages: 134-138
  • DOI: 10.2301/neurosonology.32.134
  • NAID: 130007790309
  • ISSN: 0917-074X, 1884-3336
  • Peer Reviewed
• [Journal Article] Transoral carotid ultrasonography using superb microvascular imaging of carotid artery stenting in cervical internal carotid artery dissection: a case report (2019)
  • Author(s): OGURA Hana、HAGIWARA Yuta、SHIMIZU Takahiro、ITO Hidemichi、HASEGAWA Yasuhiro
  • Journal Title: Neurosonology Volume: 32 Issue: 2 Pages: 57-61
  • DOI: 10.2301/neurosonology.32.57
  • NAID: 130007709118
  • ISSN: 0917-074X, 1884-3336
• [Journal Article] Contrast-enhanced carotid ultrasonography and MRI plaque imaging to identify patients developing in-stent intimal hyperplasia after carotid artery stenting (2019)
  • Author(s): Hagiwara Yuta、Takao Naoki、Takada Tatsuro、Shimizu Takahiro、Yoshie Tomohide、Fukano Takayuki、Tokuyama Yoshiaki、Usuki Noriko、Ueda Toshihiro、Hasegawa Yasuhiro
  • Journal Title: Medical Ultrasonography Volume: 21 Issue: 2 Pages: 170-174
  • DOI: 10.11152/mu-1774
• [Presentation] 特殊な病態に応用した頸動脈超音波検査. (2022)
  • Author(s): 萩原悠太
  • Organizer: 日本超音波医学会第95回学術集会 シンポジウム
  • Invited
• [Presentation] ライブデモンストレーション頸動脈/経口腔超音波 (2022)
  • Author(s): 萩原悠太
  • Organizer: 日本超音波医学会第95回学術集会 シンポジウム
  • Invited
• [Presentation] 経口腔超音波の実際と病変評価 (2022)
  • Author(s): 萩原悠太
  • Organizer: 日本超音波医学会第34回関東甲信越地方会学術集会 特別講演
  • Invited
• [Presentation] 頸動脈超音波検査の最前線 (2021)
  • Author(s): 萩原悠太
  • Organizer: Cardiovascular Disease Joint Meeting
  • Invited
• [Presentation] 筋萎縮性側索硬化症患者におけるM-modeを用いた経口腔超筋萎縮性側索硬化症患者におけるM-modeを用いた経口腔超音波（transoral motion-mode ultrasonography:TOMU)による舌線維束性収縮監察の有用性音波（transoral motion-mode ultrasonography:TOMU)による舌線維束性収縮監察の有用性 (2021)
  • Author(s): 萩原悠太
  • Organizer: 第40回日本脳神経超音波学会総会
  • Invited
• [Presentation] 経口腔超音波検査ライブデモンストレーション (2021)
  • Author(s): 萩原悠太
  • Organizer: 日本超音波医学会第94回学術集会
  • Invited
• [Presentation] 経口腔頸動脈超音波検査 (2021)
  • Author(s): 萩原悠太
  • Organizer: 日本超音波医学会第94回学術集会
  • Invited
• [Presentation] パーキンソン病・ALS・抹消神経疾患における超音波の有用性 (2021)
  • Author(s): 萩原悠太
  • Organizer: 第12回川崎北部PD勉強会
  • Invited
• [Presentation] 経口腔超音波の応用と新たな展望 (2020)
  • Author(s): 萩原悠太
  • Organizer: 第39回日本脳神経超音波学会総会
  • Invited
• [Presentation] 頸動脈病変に対する経口腔超音波の有用性 (2020)
  • Author(s): 萩原悠太
  • Organizer: 第39回日本脳神経超音波学会総会
  • Invited
• [Presentation] 脳神経領域の血管超音波LIVE demonstration (2020)
  • Author(s): 萩原悠太
  • Organizer: 第63回日本脳循環代謝学会学術集会
  • Invited
• [Presentation] Preprocedual Carotid Plaque Characterization by Duplex Ultrasonography as a Predictor of in-Stent Intimal Restenosis 6 months After Carotid Stenting (2020)
  • Author(s): Takao N, Hagiwara Y, Ohtsubo H
  • Organizer: International Stroke Conference 2020
  • Int'l Joint Research
• [Presentation] 動脈原性脳梗塞 (2019)
  • Author(s): 萩原悠太
  • Organizer: 第136回医用超音波講義講習会
  • Invited
• [Presentation] 椎骨脳底動脈系疾患(Bowhunter症候群、椎骨動脈解離など) (2019)
  • Author(s): 萩原悠太
  • Organizer: 第136回医用超音波講義講習会
  • Invited
• [Presentation] アトピー性皮膚炎患者に内頸動脈血栓症を合併した脳塞栓症の一例 (2019)
  • Author(s): 鏑木圭, 荒賀崇, 清水高弘, 萩原悠太, 秋山久尚, 長谷川泰弘
  • Organizer: 第22回日本栓子検出と治療学会
• [Presentation] 救急における頸動脈エコー活用術 (2019)
  • Author(s): 萩原悠太
  • Organizer: 第92回日本超音波医学会学術集会
  • Invited
• [Book] 脳神経超音波マニュアル2020 (2020)
  • Author(s): 萩原悠太（部分執筆）
  • Total Pages: 215
  • Publisher: 双文社
• [Book] 映像情報メディカル (2020)
  • Author(s): 萩原悠太（部分執筆）
  • Total Pages: 80
  • Publisher: 産業開発機構
  • ISBN: 9784860283452