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<論文紹介:AJNR 2019;40(10):1681-1688.他>

神経放射線診断学において、American Journal of Neuroradiology (AJNR)がとても役立ちますよ、ということを以前お話ししましたが、
最新号(2019;Oct Volume 40,Issue 10)から、下記4論文を紹介します。

Paracoccidioidomycosis of the Central Nervous System: CT and MR Imaging Findings. (AJNR 2019;40(10):1681-1688.)」
中南米に好発する真菌症のパラコクシジオイデス症に関する脳病変の検討です。

Paracoccidioidomycosis (PCM) is a fungal infection, which is endemic in Latin America and is mainly caused by the thermodimorphic fungus Paracoccidioides spp, which primarily attacks the lungs and has a potential to disseminate to other organs. Recently described are 4 other species of the genus Para-coccidioides apart from P brasiliensis: P lutzii, P restrepiensis, P venezuelensis, and P Americana.
Paracoccidioides spp inhabits primarily the soil and causes autochthonous infection from southern Mexico to northern Argentina. Most reported cases (approximately 80%) are from Brazil, and the rest are mainly from Venezuela, Colombia, and Argentina.

Headache was the most common neurologic symptom, while the pseudotumoral form was the most common pattern. The number of lesions ranged from 1 to 11, with most localized on the frontal lobe with >2-cm lesions. CT showed mainly hypoattenuating lesions, whereas MR imaging demonstrated mainly hyposignal lesions on T1WI and T2WI. Furthermore, ring enhancement was present in most patients. The “dual rim sign” on SWI occurred in 100% of our patients with lesions of >2 cm.

Multinodular and Vacuolating Posterior Fossa Lesions of Unknown Significance. (AJNR 2019;40(10):1689-1694.)」

Multinodular and vacuolating neuronal tumor of the cerebrum (MVNT)の小脳版みたいな感じですが、病理が無いのが残念です。

Multinodular and vacuolating neuronal tumor of the cerebrum is a rare supratentorial brain tumor described for the first time in 2013. Here, we report 11 cases of infratentorial lesions showing similar striking imaging features consisting of a cluster of low T1-weighted imaging and high T2-FLAIR signal intensity nodules, which we referred to as multinodular and vacuolating posterior fossa lesions of unknown significance.
Only 1 nodule of 1 multinodular and vacuolating posterior fossa lesion of unknown significance showed enhancement on postcontrast T1WI.

Carotid Artery Tortuosity Is Associated with Connective Tissue Diseases. (AJNR 2019;40(10):1738-1743.)」
connective tissues diseaseにおける頭蓋外頸動脈蛇行の検討です。

Among the various connective tissue diseases, the rates of any carotid tortuosity were 88% for Marfan syndrome, 63% for Loeys-Dietz syndrome, 42% for neurofibromatosis type 1, and 19% for both vascular- and nonvascular-type Ehlers-Danlos syndrome.

Chimeric Antigen Receptor T-Cell Neurotoxicity Neuroimaging: More Than Meets the Eye. (AJNR 2019;40(10):E50-E51.)」

白血病などに対する最新の免疫療法のCAR-T療法は、遺伝子改変によって特定のがん抗原を標的とさせたT細胞を体内に戻す治療法です。
しかし、このCAR-T療法による神経障害がかなり報告されつつあり、要注意です。

他のAJNR関連は、こちら。
https://ocu-radiology.jp/news/news-2272/)
https://ocu-radiology.jp/news/news-1571/)
https://ocu-radiology.jp/news/news-942/)