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Elucidation of the Mechanism of Cognitive Dysfunction caused by Cerebral Hyperperfusion after Carotid Endarterectomy using 7T Quantitative Susceptibility Mapping.

Research Project

Project/Area Number 20K16735
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 52040:Radiological sciences-related
Research InstitutionIwate Medical University

Principal Investigator

Yoshida Jun  岩手医科大学, 医学部, 助教 (50869047)

Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
Fiscal Year 2020: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Keywords頚部頚動脈狭窄症 / 鉄沈着 / 7 Tesla MRI / 認知機能 / 過灌流 / 定量的磁化率マッピング / 頚動脈内膜剥離術 / 頚部内頚動脈狭窄症 / 超高磁場ヒト用7 Tesla MRI / QSM / 認知機能低下 / 脳血流SPECT / 神経心理検査
Outline of Research at the Start

脳主幹動脈狭窄・閉塞症に対する血行再建術における合併症の一つに過灌流がある。この過灌流は、認知機能障害を来すことが知られているが、過灌流が認知機能へ与える詳細なメカニズムはいまだ解明されていない。認知機能へ影響を与える脳内の存在因子として、鉄の存在が知られている。したがって、脳内鉄沈着の定量化は認知機能障害の進行度推定に重要な役割を果たす可能性がある。近年ではquantitative susceptibility mappingによる高精度な鉄定量化が試みられている。そこで、頚動脈内膜剥離術後過灌流を呈した症例の鉄沈着の増加を検出し、その結果が認知機能低下と関連するかを明らかにする事とした。

Outline of Final Research Achievements

This study aimed to detect and quantify iron deposition before and after carotid endarterectomy (CEA) in a case exhibiting postoperative hyperperfusion using quantitative susceptibility mapping (QSM) with ultra-high-field human 7 Tesla MRI (7TMRI), and to investigate its association with cognitive impairment.

Although our facility's 7TMRI QSM can assess iron deposition in the cortical surface of the entire brain, the disadvantage of strong image distortion became evident with the multi-echo method on 7TMRI images. Therefore, we opted to first perform imaging with less distortion using 3 Tesla MRI (3TMRI) compared to 7TMRI. 3TMRI QSM yielded images with minimal distortion and appropriate quality. The research findings revealed that preoperative cortical magnetization and postoperative changes in cerebral blood flow were associated with cognitive improvement after CEA. We compiled the paper at our department, and it was published in Cerebrovascular Disease in February 2024.

Academic Significance and Societal Importance of the Research Achievements

本研究により、術前の鉄沈着の程度によりCEA後に認知機能が改善する事が予測でき、手術治療を行う事での利益を術前からの把握する事が可能となる。この事実は患者が手術の結果をより正確に理解した上で同意の判断を可能とすると考える。また、3TMRIにて適切なQSM画像を安定して作成する事が出来た。今後は7TMRIQSMの歪みの問題を解消して、7TMRIでのより高精細なQSM画像を作成する事を目標とする。その結果が認知機能改善に対する予測精度のさらなる上昇に寄与するものと考える。

Report

(5 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (5 results)

All 2024 2023 2022 2021

All Journal Article (3 results) (of which Peer Reviewed: 3 results,  Open Access: 2 results) Presentation (2 results) (of which Int'l Joint Research: 2 results)

  • [Journal Article] Correlation Between Low-Density Hematoma at 1-Week Post-Middle Meningeal Artery Embolization and Rapid Resolution of Chronic Subdural Hematoma2024

    • Author(s)
      Akamatsu Yosuke、Kashimura Hiroshi、Kojima Daigo、Yoshida Jun、Chika Kohei、Komoribayashi Nobukazu、Fujiwara Shunrou、Ogasawara Kuniaki
    • Journal Title

      World Neurosurgery

      Volume: 181 Pages: e1088-e1092

    • DOI

      10.1016/j.wneu.2023.11.045

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] A case of intracerebral hemorrhage due to cerebral hyperperfusion after stenting for acute cervical carotid artery dissection2023

    • Author(s)
      Fujimoto Kentaro、Chida Kohei、Yoshida Jun、Kojima Daigo、Yoshida Koji、Misaki Toshinari、Konno Hiromu、Ogasawara Kuniaki
    • Journal Title

      Radiology Case Reports

      Volume: 18 Issue: 11 Pages: 3856-3860

    • DOI

      10.1016/j.radcr.2023.08.004

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Development of cerebral microbleeds in patients with cerebral hyperperfusion following carotid endarterectomy and its relation to postoperative cognitive decline2021

    • Author(s)
      Igarashi S, Ando T, Takahashi T, Yoshida J, Kobayashi M, Yoshida K, Terasaki K, Fujiwara S, Kubo Y, Ogasawara K
    • Journal Title

      J Neurosurg

      Volume: in press Issue: 4 Pages: 0-0

    • DOI

      10.3171/2020.7.jns202353

    • Related Report
      2021 Research-status Report 2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] Cerebral white matter abnormalities can affect cognitive improvement after carotid endarterectomy in carotid artery steno-occlusive patients2022

    • Author(s)
      Yoshida J, Yamashita F, Sasaki M, Yoshioka K, Fujiwara S, Kobayashi M, Yoshida K, Kubo Y, Ogasawara K.
    • Organizer
      ISMRM JPC 2022
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] Cerebral white matter abnormalities can affect cognitive improvement after carotid endarterectomy in carotid artery steno-occlusive patients2022

    • Author(s)
      Yoshida J, Yamashita F, Sasaki M, Yoshioka K, Fujiwara S, Kobayashi M, Yoshida K, Kubo Y, Ogasawara K.
    • Organizer
      10th European Japanese Cerebrovascular Congress
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research

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Published: 2020-04-28   Modified: 2025-01-30  

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