Faculty Profiles - MATSUMOTO Kazuyuki

Papers - MATSUMOTO Kazuyuki

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Contrast-enhanced harmonic endoscopic ultrasonography with time-intensity curve analysis for intraductal papillary mucinous neoplasms of the pancreas. International journal

Naoki Yamamoto, Hironari Kato, Takeshi Tomoda, Kazuyuki Matsumoto, Ichiro Sakakihara, Yasuhiro Noma, Shigeru Horiguchi, Ryo Harada, Koichiro Tsutsumi, Keisuke Hori, Takehiro Tanaka, Hiroyuki Okada, Kazuh de Yamamoto

Endoscopy 48 ( 1 ) 26 - 34 2016.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND AND STUDY AIMS: Preoperative diagnosis of the pathological grade of intraductal papillary mucinous neoplasms (IPMNs) is difficult. This study aimed to evaluate the accuracy of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) with time - intensity curve analysis in differentiating between low or intermediate grade dysplasia (LGD/IGD) and high grade dysplasia or invasive carcinoma (HGD/invasive carcinoma) in IPMNs and to assess correlation between the time - intensity curve parameters and tumor microvessel density. PATIENTS AND METHODS: Data from 30 patients with resected IPMNs (14 LGD/IGD, 16 HGD/invasive carcinoma) who underwent CH-EUS with time - intensity curve analysis were evaluated retrospectively. Time - intensity curve parameters and the microvessel density of the mural nodule were compared between the HGD/invasive carcinoma and LGD/IGD groups; the diagnostic accuracy of the time - intensity curve parameters was evaluated. RESULTS: The echo intensity change and echo intensity reduction rate of the mural nodule, and the nodule/pancreatic parenchyma contrast ratio were significantly higher in the HGD/invasive carcinoma group than in the LGD/IGD group (P < 0.05); the accuracies of these parameters were 80 %, 86.7 %, and 93.3 %, respectively. The microvessel density of the mural nodule was significantly higher in the HGD/invasive carcinoma group (P = 0.002). There was a strong positive, linear correlation between the echo intensity change of the mural nodule and the microvessel density (r = 0.803, P < 0.001). CONCLUSIONS: CH-EUS with time - intensity curve analysis is potentially useful for quantitatively evaluating the blood flow of IPMN microvasculature, and for differentiating between HGD/invasive carcinoma and LGD/IGD.

DOI： 10.1055/s-0034-1393563

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Performance of novel tissue harmonic echo imaging using endoscopic ultrasound for pancreatic diseases. International journal

Kazuyuki Matsumoto, Akio Katanuma, Hiroyuki Maguchi, Kuniyuki Takahashi, Manabu Osanai, Kei Yane, Toshifumi Kin, Ryo Takaki, Tomoaki Matsumori, Katsushige Gon, Akiko Tomonari, Masanori Nojima

Endoscopy international open 4 ( 1 ) E42-50 2016.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND AND STUDY AIMS: Recently, tissue harmonic echo (THE) imaging has advanced with the development of a new endoscopic ultrasound (EUS) monitor/processing unit. With this new technology, penetration (THE-P) and resolution (THE-R) images can be obtained. The aim of this study was to investigate the performance of this novel THE imaging using a new processing unit for pancreatic diseases. PATIENTS AND METHODS: Fifty patients with pancreatic lesions (38 cystic, 12 solid) were retrospectively analyzed. At each examination, 3 EUS images of the same pancreatic lesion were obtained using B-mode, THE-P mode, and THE-R mode imaging. Each set of EUS images was randomly arranged and evaluated independently by 4 physicians blinded to the imaging technique. Images were compared using a Likert scale 5-point grading system for each parameter. RESULTS: For cystic lesions, THE-P mode images were significantly superior to conventional B-mode images for visualizing the boundary, septum, nodules, and total image quality (P < 0.05). THE-R mode images were significantly superior to conventional B-mode images for visualizing the boundary, septum, and total image quality (P < 0.05). However, for solid lesions, there was no significant difference in all the evaluation points between THE-P and conventional B-mode images. THE-R mode images were inferior to conventional B-mode images for visualizing the boundary, internal structure, and total image quality (P < 0.05). CONCLUSIONS: For pancreatic cystic lesions, THE mode images provided better lesion characterization than conventional B-mode images. Further research is required to determine if this improvement will result in improved EUS diagnostics.

DOI： 10.1055/s-0034-1393367

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Alteration of serum N-glycan profile in patients with autoimmune pancreatitis Reviewed

Takeshi Tomoda, Kazuhiro Nouso, Hironari Kato, Koji Miyahara, Chihiro Dohi, Yuki Morimoto, Hideaki Kinugasa, Yutaka Akimoto, Kazuyuki Matsumoto, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Koichiro Tsutsumi, Maho Amano, Shin-Ichiro Nishimura, Kazuhide Yamamoto

PANCREATOLOGY 16 ( 1 ) 44 - 51 2016.1

A Case of Capillary Malformation of the Retroperitoneum.

Kazuyuki Matsumoto, Hironari Kato, Ryo Harada, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 55 ( 2 ) 203 - 5 2016

Time-dependent image changes after ethanol injection into the pancreas: an experimental study using a porcine model. International journal

Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Soichiro Fushimi, Masaya Iwamuro, Shinsuke Oda, Sho Mizukawa, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada

Ecancermedicalscience 10 663 - 663 2016

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Ethanol, a commonly available agent, has been used to successfully ablate cystic and solid lesions in the pancreas. The aim of this study is to investigate the effects of an ethanol injection into the porcine pancreas and observe the time-dependent image changes in the pancreatic parenchyma. METHODS: Pure ethanol was injected into the pancreatic tail using a 25-gauge EUS needle with direct ultrasound guidance under celiotomy: 1 mL and 2 mL were injected, respectively. The abdomen was closed after the injection. MRI was performed before the procedure, immediately after, and on postoperative day (POD) seven. Blood samples were taken before the procedure and on PODs one, three, five, and seven. The pigs were euthanised on POD seven. RESULTS: Immediately after the injection, linear high signal areas in the pancreatic tail on T2 and rounded speckled high signal areas on DWI images were detected in both animals, measuring 35 × 32 mm in the 1 mL injected pig and 42 × 38mm in the 2 mL injected pig. After POD seven, rounded high signal areas were noted on T2 images, measuring 22 × 18 mm and 36 × 28 mm respectively. On POD one, the 1 mL injected animal had a 53% elevation in serum amylase while the 2 mL injected animal had a 66% elevation. Histologically, cystic and necrotic changes in the parenchyma were observed, measuring 23 × 22 mm and 40 × 35 mm respectively. CONCLUSIONS: Our results, which are limited to normal pancreas, suggested that a 1 mL injection caused localised changes within the pancreas while a 2 mL injection induced more widespread changes beyond the pancreas. The effective area of ethanol was widespread immediately after injection, and then the area was reduced with cystic and necrosis changes.

DOI： 10.3332/ecancer.2016.663

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Pancreatic Hepatoid Carcinoma Mimicking a Solid Pseudopapillary Neoplasm: A Challenging Case on Endoscopic Ultrasound-guided Fine-needle Aspiration.

Yutaka Akimoto, Hironari Kato, Kazuyuki Matsumoto, Ryo Harada, Shinsuke Oda, Soichiro Fushimi, Shou Mizukawa, Shuntaro Yabe, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Takahito Yagi, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 55 ( 17 ) 2405 - 11 2016

Language：English Publishing type：Research paper (scientific journal)

A 59-year-old man was admitted to our hospital for treatment of a 45 mm pancreatic mass found during a medical examination. Endoscopic ultrasound-guided fine-needle aspiration cytology showed polygonal cells with pseudopapillary structures. The tumor cells were positive for nuclear/cytoplasmic β-catenin and CD10, and negative for chromogranin A. After a tentative diagnosis of a solid pseudopapillary neoplasm, middle pancreatectomy was performed. Histologically, polygonal cells with abundant eosinophilic cytoplasm formed in the trabeculae and were immunohistochemically positive for HepPar1 and protein induced by vitamin K absence or antagonist-II. The tumor was finally diagnosed to be pancreatic hepatoid carcinoma. No recurrence occurred for 12 months, even without adjuvant chemotherapy.

DOI： 10.2169/internalmedicine.55.6741

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Utility of serum N-glycan analysis in diagnosis of invasive IPMNs

AKIMOTO Yutaka, NOUSO Kazuhiro, KATO Hironari, MIYAHARA Koji, MIZUKAWA Shou, YABE Shuntaro, UCHIDA Daisuke, SEKI Hiroyuki, TOMODA Takeshi, MATSUMOTO Kazuyuki, YAMAMOTO Naoki, HORIGUCHI Shigeru, TSUTSUMI Koichiro, OKADA Hiroyuki

Suizo 31 ( 1 ) 25 - 31 2016

Language：Japanese Publisher：Japan Pancreas Society

Glycosylation, -a common post-translational modification of proteins,- is involved in several processes associated with cancer progression, including signaling, cell-cell adhesion, invasion and metastasis. We previously found that levels of multi-branch antennary and fucosylated glycans were elevated in pancreatic cancer and hepatocellular carcinoma. Another potentially malignant disorder of the pancreas, invasive pancreatic intraductal papillary mucinous neoplasm (IPMN), is hard to diagnose pre-operatively. A new serum biomarker for invasive IPMNs would help to diagnosis and identify cases needing high-risk pancreatic resection. In our recent study, we evaluated the potential use of glycans as clinical markers for invasive IPMNs. N-glycan profiles of whole-serum samples were evaluated from patients with a confirmed diagnosis of IPMNs. The serum profiles showed high expression levels of fucosylated glycans with multi-branch antennary structures, suggesting that these complex glycans may serve as biomarkers for the prediction of invasive IPMNs.

DOI： 10.2958/suizo.31.25

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Other Link： http://search.jamas.or.jp/link/ui/2016190234

[Radical surgery after successful chemotherapy in a case of primary small cell carcinoma of the liver].

Yutaka Akimoto, Koichiro Tsutsumi, Hironari Kato, Hidenori Hata, Hiroyuki Sakae, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Ryo Harada, Hiroyuki Okada, Hiroyuki Yanai, Takahito Yagi, Kazuhide Yamamoto

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 112 ( 11 ) 2024 - 34 2015.11

Language：Japanese Publishing type：Research paper (scientific journal)

A 52-year-old woman was admitted to our hospital with right upper quadrant pain with gallbladder wall thickening and multiple liver tumors. Endoscopic ultrasound-guided biopsy revealed small cell carcinomas of both the gallbladder and liver. After 10 cycles of chemotherapy with etoposide and cisplatin, marked shrinkage of the tumors was evident on computed tomography. The patient subsequently underwent hepatectomy and resection of the extrahepatic bile duct and gallbladder with curative intent. Although no viable tumor cells were found in the resected specimens, we confirmed phagocytosis of tumor cells killed by chemotherapy in the resected liver specimen. Therefore, we suspected that the patient had primary small cell carcinoma of the liver that had been successfully treated. This is a rare case of primary small cell carcinoma of the liver that showed pathological complete response to chemotherapy with etoposide and cisplatin.

DOI： 10.11405/nisshoshi.112.2024

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Endoscopic ultrasonography-guided transjejunal drainage for postoperative pancreatic fistula using forward-viewing echoendoscope.

Takeshi Tomoda, Hironari Kato, Yutaka Akimoto, Kazuyuki Matsumoto, Naoki Yamamoto, Yasuhiro Noma, Ryo Harada, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

Clinical journal of gastroenterology 8 ( 4 ) 228 - 31 2015.8

Language：English Publishing type：Research paper (scientific journal)

There are few reports on endoscopic ultrasonography (EUS)-guided transjejunal drainage. Here, we report a case with postoperative pancreatic fistula treated by endoscopic transjejunal drainage using a forward-viewing (FV) echoendoscope. A 69-year-old woman who had undergone pancreaticoduodenectomy was admitted because of pancreatic fistula. Placement of plastic stents into the pancreatic duct using a double-balloon enteroscope and EUS-guided transgastric drainage failed. We attempted EUS-guided transjejunal drainage using an FV echoendoscope that can advance through the acute-angled intestinal tract safely, and drainage was performed. There were no complications, and follow-up computed tomography showed complete resolution.

DOI： 10.1007/s12328-015-0580-0

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Diagnostic ability of EUS-FNA for pancreatic solid lesions with conventional 22-gauge needle using the slow pull technique: a prospective study. International journal

Toshifumi Kin, Akio Katanuma, Kei Yane, Kuniyuki Takahashi, Manabu Osanai, Ryo Takaki, Kazuyuki Matsumoto, Katsushige Gon, Tomoaki Matsumori, Akiko Tomonari, Hiroyuki Maguchi, Toshiya Shinohara, Masanori Nojima

Scandinavian journal of gastroenterology 50 ( 7 ) 900 - 7 2015.7

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) using the slow pull technique (SP-FNA) has recently attracted attention as an effective tissue acquisition technique. However, efficacy of SP-FNA with a 22-gauge conventional needle remains unclear. The aim of this study is to evaluate the diagnostic ability of SP-FNA with a 22-gauge needle. MATERIAL AND METHODS: Patients with a pancreatic solid lesion were prospectively enrolled in this study. SP-FNA was performed at two needle passes with a 22-gauge needle. One dedicated pathologist evaluated the obtained samples in terms of quantity (Grade 0: scant; Grade 1: inadequate; Grade 2: adequate), quality (Grade 0: poor; Grade 1: moderate; Grade 2: good), and blood contamination (Grade 0: significant; Grade 1: moderate; Grade 2: low), and provided a pathological diagnosis. Additional EUS-FNA was performed by applying suction (SA-FNA). The evaluation points were as follows: diagnostic accuracy of SP-FNA compared with that of SA-FNA, and the quantity, quality, and blood contamination level of SP-FNA-obtained samples. RESULTS: We enrolled 40 cases. The diagnostic accuracy of SP-FNA was 90% (36/40). There was no significant difference in the accuracy between SP-FNA and SA-FNA (90% vs. 90%, p = 1.000). The samples obtained using SP-FNA were assessed as Grade 2 for quantity in 29 cases (73%), quality in 31 (78%), and blood contamination in 25 (63%). CONCLUSIONS: Adequate, high-quality, and unsubstantially blood-contaminated samples could be obtained using SP-FNA. The diagnostic ability of SP-FNA was 90%, which appeared to be similar to that of SA-FNA.

DOI： 10.3109/00365521.2014.983155

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Successful biliary drainage using a metal stent through the gastric stoma. International journal

Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto

World journal of gastroenterology 21 ( 24 ) 7594 - 7 2015.6

Language：English Publishing type：Research paper (scientific journal)

We report a case of biliary drainage for malignant stricture using a metal stent with an ultrathin endoscope through the gastric stoma. A 78-year-old female was referred to our hospital for jaundice and fever. She had undergone percutaneous endoscopic gastrostomy (PEG) for esophageal obstruction after radiation therapy for cancer of the pharynx. Abdominal contrast-enhanced computed tomography showed a 3-cm enhanced mass in the middle bile duct and dilatation of the intra-hepatic bile duct. We initially performed endoscopic retrograde cholangiopancreatography (ERCP) with a trans-oral approach. However, neither the side-viewing endoscope nor the ultrathin endoscope passed through the esophageal orifice. Thus, we eventually performed ERCP via the PEG stoma using an ultrathin endoscope. We performed biliary drainage with a 6F introducer self-expanding metal stent. The cytology findings obtained by brush cytology showed malignancy. Her laboratory results were restored to normal levels after drainage and no complication occurred.

DOI： 10.3748/wjg.v21.i24.7594

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Feasibility, efficacy, and predictive factors for the technical success of endoscopic nasogallbladder drainage: a prospective study. International journal

Kei Yane, Hiroyuki Maguchi, Akio Katanuma, Kuniyuki Takahashi, Manabu Osanai, Toshifumi Kin, Ryo Takaki, Kazuyuki Matsumoto, Katsushige Gon, Tomoaki Matsumori, Akiko Tomonari, Masanori Nojima

Gut and liver 9 ( 2 ) 239 - 46 2015.3

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/AIMS: Several studies have shown the useful-ness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to eval-uate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis. METHODS: All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were ex-cluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined. RESULTS: Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure. CONCLUSIONS: ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited suc-cess rate. Because of technical difficulties, ENGBD should be reserved for limited indications. (Gut Liver, 2015;9239-246).

DOI： 10.5009/gnl14070

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Successful biliary drainage with peroral direct cholangioscopy in a patient with Roux-en-Y hepaticojejunostomy for congenital biliary dilatation. International journal

Kazuyuki Matsumoto, Koichiro Tsutsumi, Yuki Baba, Koji Takemoto, Hirofumi Tsugeno, Shigeatsu Fujiki, Hiroyuki Okada

Endoscopy 47 Suppl 1 UCTN E497-8 2015

Effectiveness of a balloon catheter with a side hole for introducing a guidewire into an infected pancreatic pseudocyst. International journal

Toshifumi Kin, Hiroyuki Maguchi, Akio Katanuma, Kuniyuki Takahashi, Manabu Osanai, Ryo Takaki, Kazuyuki Matsumoto, Katsushige Gon, Tomoaki Matsumori, Akiko Tomonari

Gastrointestinal endoscopy 80 ( 4 ) 725 - 725 2014.10

胆嚢腺筋腫症合併胆嚢癌の特徴

金俊文, 真口宏介, 高橋邦幸, 潟沼朗生, 小山内学, 矢根圭, 高木亮, 松本和幸, 松森友昭, 権勉成, 安保義恭, 篠原敏也

胆道 28 ( 4 ) 633 - 640 2014.10

The efficacy and safety of single-session endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for evaluation of pancreatic masses. International journal

Yasuhiro Noma, Hirofumi Kawamoto, Hironari Kato, Masaya Iwamuro, Ken Hirao, Masakuni Fujii, Koichiro Tsutsumi, Shigeru Horiguchi, Naoki Yamamoto, Ichiro Sakakihara, Takeshi Tomoda, Kazuyuki Matsumoto, Hiroyuki Okada, Kazuhide Yamamoto

Hepato-gastroenterology 61 ( 134 ) 1775 - 9 2014.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/AIMS: There have been limited studies evaluating single-session EUS-FNA and ERCP for evaluation of pancreatic masses. The aim of this study was to determine the safety of single-session EUS-FNA and ERCP, and to compare the diagnostic accuracies of cytodiagnosis by EUS-FNA, ERCP, and their combination. METHODOLOGY: A total of 100 patients with pancreatic masses were prospectively enrolled. All patients underwent single-session EUS-FNA and ERCP. The main outcome measurement was frequency of post-procedural complications. Another measurement was diagnostic accuracy of cytodiagnosis by EUS-FNA, ERCP, and their combination. RESULTS: Procedure-related pancreatitis occurred in 10 patients, but all patients were conservatively managed. Cytodiagnosis by EUS-FNA was significantly superior to ERCP in accuracy. In patients with a pancreatic head mass, 3 cases of false negative EUS-FNA were positive on ERCP. The combination procedures improved accuracy compared with EUS-FNA alone. By contrast, in the subgroup of the pancreatic body or tail mass, the combination of EUS-FNA and ERCP did not improve cytodiagnosis compared to that with EUS-FNA alone. CONCLUSIONS: Single-session EUS-FNA and ERCP appears to be as safe as performing each procedure separately. EUS-FNA should be considered the principal procedure for cytodiagnosis. ERCP has only a complementary role in patients with pancreatic head mass.

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Endoscopic management of benign biliary stricture: should we treat more aggressively? International journal

Akio Katanuma, Hiroyuki Maguchi, Kuniyuki Takahashi, Manabu Osanai, Kei Yane, Toshifumi Kin, Kazuyuki Matsumoto, Tomoaki Matsumori, Ryo Takaki, Katsushige Gon, Akiko Tomonari

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 26 ( 4 ) 536 - 7 2014.7

Endoscopic removal technique of migrated pancreatic plastic stents.

Kazuyuki Matsumoto, Akio Katanuma, Hiroyuki Maguchi

Journal of hepato-biliary-pancreatic sciences 21 ( 6 ) E34-40 2014.6

Language：English Publishing type：Research paper (scientific journal)

Endoscopic pancreatic stenting (EPS) is used for various pancreatic conditions. With the increasing use of pancreatic stents, many complications have been observed. Especially, proximal stent migration presents a more serious condition because of the possibility of pancreatic duct (PD) damage. However, the removal of proximally migrated stents is technically challenging because of the small PD diameter, the bended PD course, the presence of PD strictures, and the lack of suitable devices for stent removal. Thus, few cases of surgical intervention have been encountered. In this study, we review the endoscopic treatment of proximally migrated pancreatic plastic stents. We classify migrated stent conditions into four types according to stent and PD conditions. In Type A, the main pancreatic duct (MPD) has no stricture. In Type B, the stent is positioned across the stricture on the MPD. In Type C, the stent is positioned further away from the stricture on the MPD. The tip of the proximal stent is located in the MPD in types A thru C. In Type D, the tip of the proximal stent is located in a branch duct. We introduced the strategy of endoscopic removal technique of each type of migrated plastic stents.

DOI： 10.1002/jhbp.94

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Novel tissue harmonic imaging clearly visualizes a case of intraductal papillary mucinous neoplasm with mural nodules. International journal

Kazuyuki Matsumoto, Akio Katanuma

JOP : Journal of the pancreas 15 ( 3 ) 274 - 5 2014.5

Language：English Publishing type：Research paper (scientific journal)

Tissue Harmonic Echo (THE) imaging is a sonographic technique that potentially provides images of higher quality than can conventional B-mode images. Potential advantages of THE imaging include improved resolution, improved signal-to-noise ratio, and reduced artifacts [1, 2]. Recently, a novel THE imaging performed using an EUS system with a monitor/processing unit (EU-ME2 PREMIER PLUS; Olympus Medical Systems, Tokyo, Japan) has been developed. Using this technology, we can obtain two THE mode images, namely, THE-P (penetration) and THE-R (resolution). The THE-P mode is suitable for middle range distance observation because it receives a harmonic signal whose frequency is mainly 7.5 MHz. The THE-R mode is suitable for close distance observation from the probe because it receives a harmonic signal whose frequency mainly ranges from 10 to 12 MHz. Here, we report a case of intraductal papillary mucinous neoplasm (IPMN) with mural nodules which could be clearly detected using this novel THE imaging.

DOI： 10.6092/1590-8577/2385

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Biliary tumor fragment of hepatocellular carcinoma containing lipiodol mimicking a bile duct stone. International journal

Kazuyuki Matsumoto, Manabu Osanai, Hiroyuki Maguchi

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 26 ( 2 ) 295 - 6 2014.3

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Papers - MATSUMOTO Kazuyuki