研究室概要

体に負担が無く、高い精度で疾患の診断が可能な新しい画像診断の開発や既存の技術の新たな分野への応用を目指して研究を行っています。当面、被曝のない、MR装置を用いた血行動態の4次元（3次元＋時系列）での可視化技術の臨床応用を試みています。

研究プロジェクト

１．研究の背景・意義
心疾患、肺動脈疾患、動脈瘤、動脈解離、閉塞性動脈硬化症、など全身血管の病変の発生やその後の進行に血流動態が重要な因子であると考えられています。健常人や患者の個々の血流動態を正確に解析できれば、将来の病変の発生、その後の病気の進行状態が推定可能となり、予防や治療計画に役立つと考えられます。今までヒト血管の血流動態をin-vivoで３次元的に解析する方法は存在しなかったのですが、私共は10年ほど前に、スタンフォード大学とで開発された３次元シネ位相コントラスト磁気共鳴画像法（以下4DFLOW）を使用する機会を得て、それまで描出できなかった３次元血流情報を可視化して、今までに無い生理学情報を得て診療への応用を模索しております。最近になって、ウイスコンシン大学や、GEヘルスケア社、Siemens社、philips社などの大手医療機器メーカーも4DFLOWの製品開発に向けて注力しており、臨床現場では本技術の普及前夜といった状態であります。

２．研究の目的
私共の研究の当面の目的は磁気共鳴血管撮影所見（MR angiography; MRA）と３次元シネ位相コントラスト磁気共鳴画像法で求めた血流速度ベクトル、並びにこれから派生する壁剪断応力などのパラメータを病的血管と非病的血管で比較し、更に、患者と健常人で比較し、これにより、血行動態の異常と血管病変との関係を明らかにします。また、上記の磁気共鳴画像を用いた血流解析、血管モデルを使用したインビトロの血流解析、コンピュータを用いたシミュレーションによる血流解析（computational fluid dynamics、CFD、計算力学的流体解析）との比較検討も試みています。

腹部大動脈瘤の流線図（収縮期）　　　　　　　　　　　　剪断応力マップ

図の説明
流線図では非拡張部では血流は層流であるが、瘤内では乱流を生じているのがわかる。乱流により、同部の壁剪断応力は低下し、血管内皮はそれを感知して壁にatherogenic driveをかけ、ますます同部の壁は脆弱化し、瘤径増大、破裂へと向かうと推測される。

教員

構成員名	役職	所属
飯間 麻美	特任教授	新規低侵襲画像診断法基盤開発研究
兵藤 良太	特任講師	新規低侵襲画像診断法基盤開発研究

研究実績

• 2022年

  1. de Boer A, Villa G, Bane O, Bock M, Cox EF, Dekkers IA, Eckerbom P, Fernández-Seara MA, Francis ST, Haddock B, Hall ME, Hall Barrientos P, Hermann I, Hockings PD, Lamb HJ, Laustsen C, Lim RP, Morris DM, Ringgaard S, Serai SD, Sharma K, Sourbron S, Takehara Y, Wentland AL, Wolf M, Zöllner FG, Nery F, Caroli A. Consensus-Based Technical Recommendations for Clinical Translation of Renal Phase Contrast MRI. J Magn Reson Imaging. 255(2):323-335. 2022 Feb
  2. Itatani K, Sekine T, Yamagishi M, Maeda Y, Higashitani N, Miyazaki S, Matsuda J, Takehara Y. Hemodynamic Parameters for Cardiovascular System in 4D Flow MRI: Mathematical Definition and Clinical Applications. Magn Reson Med Sci. 21(2):380-399. 2022 Mar 1
  3. Takehara Y, Sekine T, Obata T. Why 4D Flow MRI? Real Advantages. Magn Reson Med Sci. 21(2):253-256. 2022 Mar 1
  4. Sugiyama M, Takehara Y, Naganawa S. Does the Pulsatile Non-uniform Flow Matter in MR Flowmetry? Magn Reson Med Sci. 21(2):365-371. 2022 Mar 1
  5. Terada M, Takehara Y, Isoda H, Wakayama T, Nozaki A. Technical Background for 4D Flow MR Imaging. Magn Reson Med Sci. 21(2):267-277. 2022 Mar 1
  6. Takehara Y. Clinical Application of 4D Flow MR Imaging for the Abdominal Aorta. Magn Reson Med Sci. 21(2):354-364. 2022 Mar 1

• 2021年

  1. Suzuki K, Takehara Y, Sakata M, Kawate M, Ohishi N, Sugiyama K, Akai T, Suzuki Y, Sugiyama M, Kawamura T, Morita Y, Kikuchi H, Hiramatsu Y, Yamamoto M, Nasu H, Johnson K, Oliver Wieben, Kurachi K, Takeuchi H. Daikenchuto increases blood flow in the superior mesenteric artery in humans: A comparison study between four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction magnetic resonance imaging and Doppler ultrasound. PLoS One. 16(1):e0245878. 2021 Jan 27
  2. Ryota Hyodo, Yasuo Takehara, Takashi Mizuno, Kazushige Ichikawa, Yasuhiro Ogura , Shinji Naganawa. Portal Vein Stenosis Following Liver Transplantation Hemodynamically Assessed with 4D-flow MRI before and after Portal Vein Stenting. Magn Reson Med Sci. 20(3):231-235. 2021 Sep 1
  3. Ryota Horiguchi, Hiroshi Ogawa, Naoya Nagai, Yasuo Takehara, Shinji Naganawa. Yukihiro Yokoyama, Yoshie Shimoyama. A case of intraductal tubulopapillary neoplasm of the pancreas originating from the branch duct: cast in the mold sign. Nagoya J Med Sci. 83(4):869-875. 2021 Nov
  4. Takahashi M, Takehara Y, Fujisaki K, Okuaki T, Fukuma Y, Tooyama N, Ichijo K, Amano T, Goshima S, Naganawa S. Three Dimensional Ultra-short Echo Time MRI Can Depict Cholesterol Components of Gallstones Bright. Magn Reson Med Sci. 20(4):359-370. 2021 Dec 1
  5. Hyodo R, Takehara Y, Nishida A, Matsushima M, Naganawa S. “Speckled Enhancement” on Gd-EOB-DTPA Enhanced MR Imaging of Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma. Magn Reson Med Sci. doi: 10.2463/mrms.mp.2021-0069. 2021 Oct 7
  6. Inoue J, Matsuo K, Iwabuchi T, Takehara Y, Yamasue H. How Memory Switches Brain Responses of Patients with Post-traumatic Stress Disorder. Cereb Cortex Commun. 2(2):tgab021. 2021 Mar 20
  7. Hyodo R, Takehara Y, Mizuno T, Ichikawa K, Yokoyama S, Ishizu Y, Naganawa S. Assessing the Complicated Venous Hemodynamics and Therapeutic Outcomes of Budd-Chiari Syndrome with Respiratory-gated 4D Flow MR Imaging During the Expiratory and Inspiratory Phases. Magn Reson Med Sci. doi: 10.2463/mrms.ici.2021-0110. 2021 Dec 9
  8. Miyajima K, Urushida T, Ito K, Kin F, Okazaki A, Takashima Y, Watanabe T, Kawaguchi Y, Wakabayashi Y, Takehara Y, Maekawa Y. Four-dimensional flow magnetic resonance imaging visualizes reverse vortex pattern and energy loss increase in left bundle branch block. Europace. euab299. doi: 10.1093/europace/euab299. 2021 Dec 17
  9. Hyodo R, Takehara Y, Mizuno T, Ichikawa K, Ishizu Y, Sugiyama M, Naganawa S. Time-resolved 3D cine phase-contrast magnetic resonance imaging (4D-flow MRI) can quantitatively assess portosystemic shunt severity and confirm normalization of portal flow after embolization of large portosystemic shunts. Hepatol Res. 51(3):343-349. 2021 Mar
  10. Ogawa H, Takehara Y, Naganawa S. Imaging diagnosis of autoimmune pancreatitis: computed tomography and magnetic resonance imaging. J Med Ultrason (2001) 48(4):565-571. 2021 Oct

• 2020年

  1. Perera R, Isoda H, Ishiguro K, Mizuno T, Takehara Y, Terada M, Tanoi C, Naito T, Sakahara H, Hiramatsu H, Namba H, Izumi T, Wakabayashi T, Kosugi T, Onishi Y, Alley M, Komori Y, Ikeda M, Naganawa S. Assessing the Risk of Intracranial Aneurysm Rupture Using Morphological and Hemodynamic Biomarkers Evaluated from Magnetic Resonance Fluid Dynamics and Computational Fluid Dynamics. Magn Reson Med Sci. 19(4):333-344. 2020 Dec 1
  2. Sugiyama M, Takehara Y, Kawate M, Ooishi N, Terada M, Isoda H, Sakahara H, Naganawa S, Kevin M. Johnson, Oliver Wieben, Wakayama T, Nozaki A, Kabasawa H. Optimal Plane Selection for Measuring Post-prandial Blood Flow Increase within the Superior Mesenteric Artery: Analysis Using 4D Flow and Computational Fluid Dynamics. Magn Reson Med Sci. 19(4):366-374. 2020 Dec 1
  3. Umakoshi H, Nihashi T, Shimamoto H, Yamada T, Ishiguchi H, Takada A, Hirasawa N, Ishihara S, Takehara Y, Naganawa S, Matthew Davenport, Terasawa T. Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol. BMJ Open. 10(3):e033023. 2020 Mar 9
  4. Takehara Y, Isoda H, Takahashi M, Unno N, Shiiya N, Ushio T, Goshima S, Naganawa S, Marcus Alley, Wakayama T, Nozaki A. Abnormal Flow Dynamics Result in Low Wall Shear Stress and High Oscillatory Shear Index in Abdominal Aortic Dilatation: Initial in vivo Assessment with 4D-flow MRI. Magn Reson Med Sci. 19(3):235-246. 2020 Aug 3
  5. Karayama M, Yoshizawa N, Sugiyama M, Mori K, Yasui H, Hozumi H, Suzuki Y, Furuhashi K, Fujisawa T, Enomoto N, Nakamura Y, Inui N, Goshima S, Suda T, Takehara Y. Intravoxel incoherent motion magnetic resonance imaging for predicting the long-term efficacy of immune checkpoint inhibitors in patients with non-small-cell lung cancer. Lung Cancer. 143:47-54. 2020 May
  6. Takehara Y. 4D Flow when and how? Radiol Med. 125 (9) 838-850. 2020
  7. Motosugi U, Takehara Y. Motion and solution in hepatobiliary agent-enhanced dynamic MRI: solid evidence and unanswered question. Jpn J Radiol. 38(2):99-100. 2020 Feb

• 2019年

  1. Ogawa H, Takehara Y, Naganawa S, Yamaguchi J, Nakaguro M. A case of human pancreatic eurytremiasis. Abdom Radiol (NY). 44(4):1213-1216. 2019 Apr.
  2. Katahashi K, Sano M, Takehara Y, Inuzuka K, Sugiyama M, Alley MT, Takeuchi H, Unno N. Flow dynamics of type II endoleaks can determine sac expansion after endovascular aneurysm repair using four-dimensional flow-sensitive magnetic resonance imaging analysis. J Vasc Surg. 70(1):107-116.e1. 2019 Jul
  3. Watanabe T, Isoda H, Fukuyama A, Takahashi M, Amano T, Takehara Y, Oishi N, Kawate M, Terada M, Kosugi T, Komori Y, Fukuma Y, Alley M. Accuracy of the Flow Velocity and Three-directional Velocity Profile Measured with Three-dimensional Cine Phase-contrast MR Imaging: Verification on Scanners from Different Manufacturers. Magn Reson Med Sci. 18(4):265-271. 2019 Oct 15
  4. Uchida W, Tokuda Y, Takehara Y, Usui A. Mechanical haemolytic anaemia assessed with four-dlmenslonal flow cardiac magnetic resonance. Eur J Cardiothorac Surg. 56(4):813-814. 2019 Oct 1

• 2018年

  1. Watanabe T, Isoda H, Takehara Y, Terada M, Naito T, Kosugi T, Onishi Y, Tanoi C, Izumi T. Hemodynamic vascular biomarkers for initiation of paraclinoid internal carotid artery aneurysms using patient-specific computational fluid dynamic simulation based on magnetic resonance imaging. Neuroradiology. 2018 Mar 8.

• 2017年

  1. Miyazaki S, Itatani K, Furusawa T, Nishino T, Sugiyama M, Takehara Y, Yasukochi S. Validation of numerical simulation methods in aortic arch using 4D Flow MRI. Heart Vessels. 2017 Aug;32(8):1032-1044.
  2. Motoyama D, Ishii Y, Takehara Y, Sugiyama M, Yang W, Nasu H, Ushio T, Hirose Y, Ohishi N, Wakayama T, Kabasawa H, Johnson K, Wieben O, Sakahara H, Ozono S.Four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction (4D PC-VIPR) MR evaluation of the renal arteries in transplant recipients: Preliminary results. J Magn Reson Imaging. 2017 Aug;46(2):595-603.
  3. Natsume K, Shiiya N, Takehara Y, Sugiyama M, Satoh H, Yamashita K, Washiyama N. Characterizing saccular aortic arch aneurysms from the geometry-flow dynamics relationship. J Thorac Cardiovasc Surg. 2017 Jun;153(6):1413-1420.

• 2016年

  1. Suwa K, Saitoh T, Takehara Y, Sano M, Saotome M, Urushida T, Katoh H, Satoh H,Sugiyama M, Wakayama T, Alley M, Sakahara H, Hayashi H. Intra-left ventricular flow dynamics in patients with preserved and impaired left ventricular function: Analysis with 3D cine phase contrast MRI (4D-Flow). J Magn Reson Imaging. 2016 Dec;44(6):1493-1503.
  2. Yoshizawa N, Ueda Y, Nasu H, Ogura H, Ohmae E, Yoshimoto K, Takehara Y,Yamashita Y, Sakahara H. Effect of the chest wall on the measurement of hemoglobin concentrations by near-infrared time-resolved spectroscopy in normal breast and cancer. Breast Cancer. 2016 Nov;23(6):844-850.
  3. Odagiri K, Inui N, Hakamata A, Inoue Y, Suda T, Takehara Y, Sakahara H,Sugiyama M, Alley MT, Wakayama T, Watanabe H. Non-invasive evaluation of pulmonary arterial blood flow and wall shear stress in pulmonary arterial hypertension with 3D phase contrast magnetic resonance imaging. Springerplus.2016 Jul 13;5(1):1071.
  4. Sakata M, Takehara Y, Katahashi K, Sano M, Inuzuka K, Yamamoto N, Sugiyama M, Sakahara H, Wakayama T, Alley MT, Konno H, Unno N. Hemodynamic Analysis of Endoleaks After Endovascular Abdominal Aortic Aneurysm Repair by Using 4-Dimensional Flow-Sensitive Magnetic Resonance Imaging. Circ J. 2016 Jul 25;80(8):1715-25.
  5. Sakai N, Takehara Y, Yamashita S, Ohishi N, Kawaji H, Sameshima T, Baba S,Sakahara H, Namba H. Shear Stiffness of 4 Common Intracranial Tumors Measured Using MR Elastography: Comparison with Intraoperative Consistency Grading. AJNR Am J Neuroradiol. 2016 Jun 23. [Epub ahead of print]
  6. Sato Y, Nakahara K, Shimada M, Hara Y, Takayanagi D, Sawada N, Mukai S,Shimada S, Yamaguchi N, Hidaka E, Takehara Y, Ishida F, Kudo SE. Donor Left-Sided Heptectomy by Use of the Real-Time Moving Windows Method With 8-Centimeter Transverse Skin Incision. Transplant Proc. 2016 May;48(4):1083-6.
  7. Yoshihara S, Matsunaga M, Yaegashi T, Suzuki S, Naito M, Takehara Y. Unusual Serial Electrocardiographic Changes which Progressed to Arrhythmogenic Right Ventricular Cardiomyopathy. Intern Med. 2016;55(9):1103-8.
  8. Tsushima Y, Ishiguchi T, Murakami T, Hayashi H, Hayakawa K, Fukuda K, Korogi Y, Sugimoto H, Takehara Y, Narumi Y, Arai Y, Kuwatsuru R, Yoshimitsu K, Awai K,Kanematsu M, Takagi R. Safe use of iodinated and gadolinium-based contrast media in current practice in Japan: a questionnaire survey. Jpn J Radiol. 2016 Feb;34(2):130-9.
  9. Yamashita Y, Murayama S, Okada M, Watanabe Y, Kataoka M, Kaji Y, Imamura K, Takehara Y, Hayashi H, Ohno K, Awai K, Hirai T, Kojima K, Sakai S, Matsunaga N, Murakami T, Yoshimitsu K, Gabata T, Matsuzaki K, Tohno E, Kawahara Y, Nakayama T,Monzawa S, Takahashi S. The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline. Jpn J Radiol. 2016 Jan;34(1):43-79.
  10. Terada M, Takehara Y, Isoda H, Uto T, Matsunaga M, Alley M. Low WSS and High OSI Measured by 3D Cine PC MRI Reflect High Pulmonary Artery Pressures in Suspected Secondary Pulmonary Arterial Hypertension. Magn Reson Med Sci. 2016;15(2):193-202.