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左肺上葉切除後の肺静脈断端血栓の原因となる血行動態の特徴 : 4D flow MRIを用いた研究
http://hdl.handle.net/10232/00031993
http://hdl.handle.net/10232/00031993df8f1e72-17c8-4e7e-b891-a42e0f7f4c5d
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Diss_梅原_正_ISK654_2021 (864.5 kB)
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Abstract_梅原_正_4519810070_2021 (76.0 kB)
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Result_Umehara_Tadashi_isk_654 (5.9 MB)
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Comments_Umehara_Tadashi_isk_654 (2.2 MB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2022-05-27 | |||||
| タイトル | ||||||
| タイトル | Hemodynamic features underlying pulmonary vein stump thrombus formation after left upper lobectomy: Four-dimensional flow magnetic resonance imaging study | |||||
| タイトル言語 | en | |||||
| タイトル | ||||||
| タイトル | 左肺上葉切除後の肺静脈断端血栓の原因となる血行動態の特徴 : 4D flow MRIを用いた研究 | |||||
| タイトル言語 | ja | |||||
| 著者 |
梅原, 正
× 梅原, 正 |
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| 言語 | ||||||
| 言語 | eng | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Pulmonary vein stump thrombus | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | four-dimensional flow magnetic resonance imaging (4D MRI) | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | left upper lobectomy (LUL) | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | lung cancer | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||
| 資源タイプ | doctoral thesis | |||||
| アクセス権 | ||||||
| アクセス権 | open access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Background: We previously reported that to-and-fro blood movement near the pulmonary vein stump was particularly prominent after left upper lobectomy compared with other lobectomy, which may be the cause of the high susceptibility of pulmonary vein thrombus after left upper lobectomy. The aim of the present study was to compare the hemodynamics in patients who developed pulmonary vein thrombus after left upper lobectomy with those in patients who did not develop pulmonary vein thrombus using four-dimensional flow magnetic resonance imaging (4D MRI). Methods: This was a retrospective evaluation of a prospectively collected clinical and radiological database of 37 patients who underwent 4D MRI 7 days after left upper lobectomy for lung cancer (n=37). We obtained two parameters by 4D MRI: the grade of to-and-fro blood movement and the flow energy loss around the pulmonary vein stump. The length of the pulmonary vein stump, a known risk factor for pulmonary vein thrombus, was also measured. Results: According to a scatterplot of the grade of to-and-fro blood movement versus the flow energy loss, patients with pulmonary vein thrombus (n=15) were concentrated in an area which appears to be a ‘dangerous’ hemodynamic condition. There were few patients without pulmonary vein thrombus in this ‘dangerous’ area, except for one who unfortunately developed delayed pulmonary vein thrombus and cerebral infarction. We proposed a formula using the 4D MRI-derived parameters based on a stepwise multiple regression analysis that was more closely associated with the development of pulmonary vein thrombus than the length of the pulmonary vein stump (area under the receiver operating characteristics curve: 0.918 vs. 0.705, P=0.0500). Conclusions: We proposed the existence of a ‘dangerous’ hemodynamic condition responsible for pulmonary vein thrombus formation. 4D MRI before the development of pulmonary vein thrombus may help identify patients requiring preventive therapy against pulmonary vein thrombus and subsequent thromboembolic complications. Tadashi Umehara, Koji Takumi, Kazuhiro Ueda, Takuya Tokunaga, Aya Harada-Takeda, Masami Sato Hemodynamic features underlying pulmonary vein stump thrombus formation after left upper lobectomy: four-dimensional flow magnetic resonance imaging study Quantitative Imaging in Medicine and Surgery 2022;12(2):992-1003 https://dx.doi.org/10.21037/qims-21-472 |
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| 内容記述言語 | en | |||||
| 作成日 | ||||||
| 日付 | 2022-03-04 | |||||
| 日付タイプ | Collected | |||||
| 出版タイプ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| NDC | ||||||
| 主題Scheme | NDC | |||||
| 主題 | 490 | |||||
| ファイル（説明） | ||||||
| 内容記述 | 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨 | |||||
| 公開者・出版者 | ||||||
| 出版者 | AME Publishing Company | |||||
| 出版者言語 | en | |||||
| 公開者・出版者 | ||||||
| 出版者 | 鹿児島大学 | |||||
| 出版者言語 | ja | |||||
| 公開者・出版者 | ||||||
| 出版者 | カゴシマ ダイガク | |||||
| 出版者言語 | ja-Kana | |||||
| 備考 | ||||||
| 備考 | 【指導教員:佐藤雅美】 | |||||
| date.appl | ||||||
| appl | 【学位申請日】2021-11-04 | |||||
| 学位名 | ||||||
| 学位名の言語 | ja | |||||
| 学位名 | 博士(医学) | |||||
| 学位名 | ||||||
| 学位名の言語 | en | |||||
| 学位名 | Doctor of Philosophy in Medical Science | |||||
| 学位授与機関名 | ||||||
| 学位授与機関識別子Scheme | kakenhi | |||||
| 学位授与機関識別子 | 17701 | |||||
| 学位授与機関名の言語 | ja | |||||
| 学位授与機関名 | 鹿児島大学 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 2022-03-11 | |||||
| 学位授与番号 | ||||||
| 学位授与番号 | 甲総研第654号 | |||||
