AIM: To utilize transcatheter arterial steroid injection therapy (TASIT) via the hepatic artery to reduce hepatic macrophage activity in patients with severe acute hepatic failure.METHODS: Thirty-four patients with se...AIM: To utilize transcatheter arterial steroid injection therapy (TASIT) via the hepatic artery to reduce hepatic macrophage activity in patients with severe acute hepatic failure.METHODS: Thirty-four patients with severe acute hepatic failure were admitted to our hospital between June 2002 to June 2006 providing for the possibility of liver transplantation (LT). Seventeen patients were treated using traditional liver supportive procedures, and the other 17 patients additionally underwent TASIT with 1000 mg methylprednisolone per day for 3 continuous days. RESULTS: Of the 17 patients who received TASIT, 13 were cured without any complications, 2 died, and 2 underwent LT. Of the 17 patients who did not receive TASIT, 4 were self-limiting, 7 died, and 6 underwent LT. Univariate logistic analysis revealed that ascites, serum albumin, prothrombin time, platelet count, and TASIT were significant variables for predicating the prognosis. Multivariate logistic regression analysis using stepwise variable selection showed that prothrombin time, platelet count, and TASIT were independent predictive factors. CONCLUSION: TASIT might effectively prevent the progression of severe acute hepatic failure to a fatal stage of fulminant liver failure.展开更多
AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clin...AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clinically and radiologically diagnosed OO(femoral neck,n = 4;femoral diaphysis,n = 2;tibial diaphysis,n = 1;fibular diaphysis,n = 1).Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius.No cooling system was used.The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus.We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation.RESULTS:All procedures were technically successful.No major or immediate complications were observed.Clinical success was achieved in six of eight patients in the first procedure.A second procedure was performed for two patients who had recurrent or continued pain,and one of these cases was successfully treated.The overall rate of success was 87.5%(7/8).No complication was observed.CONCLUSION:Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.展开更多
Purpose: The purpose was to compare the effectiveness of MDCT reconstruction methods that improve detectability for detecting the renal arteries in patients undergoing laparoscopic nephrectomy irrespective of the abil...Purpose: The purpose was to compare the effectiveness of MDCT reconstruction methods that improve detectability for detecting the renal arteries in patients undergoing laparoscopic nephrectomy irrespective of the ability of the radiologist. Methods: 128 patients with left nephrectomy and either one or multiple renal arteries were enrolled. Radiologists with varying levels of expertise (5 board-certified and 3 non-certified) interpreted all MDCT images, including axial, VR and MIP images, independently and determined the numbers of renal arteries. The interpretation times, sensitivity, specificity and diagnostic accuracy rates were analyzed. A receiver operating characteristic analysis was used to compare the results from the various reconstruction methods. Results: At surgery, there were 156 arteries: 101 donors had one renal artery and 27 had multiple arteries. The interpretation time for board-certified radiologists was shorter than that for non-certified radiologists, and the interpretation time using MIP images was significantly shorter than that of using the other reconstruction methods. The sensitivity, specificity and diagnostic accuracy on axial images were significantly higher than those on other images. The average Az value for detection of the numbers of renal arteries using axial images was higher than that of using other images. Conclusion: MDCT is helpful in reviewing the numbers of donated renal arteries for radiologists with different levels of expertise, and different types of reconstructions.展开更多
Introduction: The purposes were to clarify the magnetic resonance imaging (MRI) findings of malignant ovarian lesions arising from endometriomas, and to compare the lesions’ histopathology and MRI characteristics. Ma...Introduction: The purposes were to clarify the magnetic resonance imaging (MRI) findings of malignant ovarian lesions arising from endometriomas, and to compare the lesions’ histopathology and MRI characteristics. Materials and Methods: Between May 2004 and December 2012, 140 patients, all of whom were diagnosed as having an endometrioma by using MR imaging, underwent surgery. We compared the MR characteristics including size and signal intensity of the tumor and mural nodules, the thickness of the septum, and the thickness of the wall with the pathological diagnoses. The attached angles of the mural nodules to the cyst wall were also evaluated. Results: Among the 179 lesions, preoperative MR imaging diagnosed 153 benign and 26 malignant. Based on the pathological results, 169 were diagnosed as benign and 10 were diagnosed as malignant. Finally, preoperative MR imaging correctly diagnosed 152 benign (group 1) and nine malignant (group 2), misdiagnosed 17 benign as malignant (group 3) and misdiagnosed one malignant as benign (group 4). As for mural nodules, there was a significant difference between groups 1 and 2 in the mean maximum diameter of the mural nodules. An acute attached angle was shown in 1 of 7 in group 1, in 11 of 16 in group 2, and in 14 of 22 in group 3. We also compared benign group with malignant group on the final pathological findings. As for mural nodules, there was a significant difference between groups 1 + 3 and group 2 in the mean maximum diameter of the mural nodules. On dynamic study, there were 22 enhanced mural nodules (75.9%) on group 1 + 3. Conclusion: Most of endometriomas preoperatively diagnosed as benign were pathological benign lesions. Endometriomas that contain many enhanced mural nodules with papillary shape, larger size, showing hypointense on T1WI, hyperintense on T2WI and showing an acute attached angle may have malignant potential.展开更多
Aim:To evaluate the effectiveness of using cone-beam computed tomography(CBCT)in transcatheter arterial chemoembolization(TACE)to detect hapatocellular carcinoma(HCC)nodules and their feeding arteries.Methods:Twenty-f...Aim:To evaluate the effectiveness of using cone-beam computed tomography(CBCT)in transcatheter arterial chemoembolization(TACE)to detect hapatocellular carcinoma(HCC)nodules and their feeding arteries.Methods:Twenty-four patients with HCCs who underwent TACE using CBCT in addition to conventional digital subtraction angiography(DSA)were enrolled.After both conventional DSA and CBCT through the hepatic artery were acquired,TACE were performed.The nodules were defined as an HCC when dense accumulation of iodized oil was found within the nodule on CT obtained 2 weeks after the TACE.The number of detected nodules and identified feeding arteries,and their correlations with anatomical locations were assessed.Results:A total of 39 HCC nodules(tumor diameter,7-40 mm;mean,17.4±7.9 mm)were detected.Thirty-one nodules were detected by DSA alone but 8 nodules were additionally detected by adding CBCT to DSA.There were 53 feeding arteries associated with the 39 HCC nodules.Among these arteries,21 were identified by DSA alone;however,47 were identified by combining CBCT with DSA.Additional feeding arteries,especially for the nodules located at the right and caudate lobes,were identified by CBCT.On the other hand,there was no difference in detection of nodules between the anatomical locations by CBCT.Conclusion:The use of CBCT in addition to DSA offers potential for increasing the number of detected nodules,and the number of their feeding arteries at the right and caudate lobes.CBCT might improve the quality of TACE procedure for HCC than DSA alone.展开更多
文摘AIM: To utilize transcatheter arterial steroid injection therapy (TASIT) via the hepatic artery to reduce hepatic macrophage activity in patients with severe acute hepatic failure.METHODS: Thirty-four patients with severe acute hepatic failure were admitted to our hospital between June 2002 to June 2006 providing for the possibility of liver transplantation (LT). Seventeen patients were treated using traditional liver supportive procedures, and the other 17 patients additionally underwent TASIT with 1000 mg methylprednisolone per day for 3 continuous days. RESULTS: Of the 17 patients who received TASIT, 13 were cured without any complications, 2 died, and 2 underwent LT. Of the 17 patients who did not receive TASIT, 4 were self-limiting, 7 died, and 6 underwent LT. Univariate logistic analysis revealed that ascites, serum albumin, prothrombin time, platelet count, and TASIT were significant variables for predicating the prognosis. Multivariate logistic regression analysis using stepwise variable selection showed that prothrombin time, platelet count, and TASIT were independent predictive factors. CONCLUSION: TASIT might effectively prevent the progression of severe acute hepatic failure to a fatal stage of fulminant liver failure.
文摘AIM:To present our initial experience with computed tomography guided radiofrequency ablation(RFA) of osteoid osteoma(OO) in our institution.METHODS:RFA was performed on eight patients(5 males and 3 females) with clinically and radiologically diagnosed OO(femoral neck,n = 4;femoral diaphysis,n = 2;tibial diaphysis,n = 1;fibular diaphysis,n = 1).Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius.No cooling system was used.The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus.We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation.RESULTS:All procedures were technically successful.No major or immediate complications were observed.Clinical success was achieved in six of eight patients in the first procedure.A second procedure was performed for two patients who had recurrent or continued pain,and one of these cases was successfully treated.The overall rate of success was 87.5%(7/8).No complication was observed.CONCLUSION:Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.
文摘Purpose: The purpose was to compare the effectiveness of MDCT reconstruction methods that improve detectability for detecting the renal arteries in patients undergoing laparoscopic nephrectomy irrespective of the ability of the radiologist. Methods: 128 patients with left nephrectomy and either one or multiple renal arteries were enrolled. Radiologists with varying levels of expertise (5 board-certified and 3 non-certified) interpreted all MDCT images, including axial, VR and MIP images, independently and determined the numbers of renal arteries. The interpretation times, sensitivity, specificity and diagnostic accuracy rates were analyzed. A receiver operating characteristic analysis was used to compare the results from the various reconstruction methods. Results: At surgery, there were 156 arteries: 101 donors had one renal artery and 27 had multiple arteries. The interpretation time for board-certified radiologists was shorter than that for non-certified radiologists, and the interpretation time using MIP images was significantly shorter than that of using the other reconstruction methods. The sensitivity, specificity and diagnostic accuracy on axial images were significantly higher than those on other images. The average Az value for detection of the numbers of renal arteries using axial images was higher than that of using other images. Conclusion: MDCT is helpful in reviewing the numbers of donated renal arteries for radiologists with different levels of expertise, and different types of reconstructions.
文摘Introduction: The purposes were to clarify the magnetic resonance imaging (MRI) findings of malignant ovarian lesions arising from endometriomas, and to compare the lesions’ histopathology and MRI characteristics. Materials and Methods: Between May 2004 and December 2012, 140 patients, all of whom were diagnosed as having an endometrioma by using MR imaging, underwent surgery. We compared the MR characteristics including size and signal intensity of the tumor and mural nodules, the thickness of the septum, and the thickness of the wall with the pathological diagnoses. The attached angles of the mural nodules to the cyst wall were also evaluated. Results: Among the 179 lesions, preoperative MR imaging diagnosed 153 benign and 26 malignant. Based on the pathological results, 169 were diagnosed as benign and 10 were diagnosed as malignant. Finally, preoperative MR imaging correctly diagnosed 152 benign (group 1) and nine malignant (group 2), misdiagnosed 17 benign as malignant (group 3) and misdiagnosed one malignant as benign (group 4). As for mural nodules, there was a significant difference between groups 1 and 2 in the mean maximum diameter of the mural nodules. An acute attached angle was shown in 1 of 7 in group 1, in 11 of 16 in group 2, and in 14 of 22 in group 3. We also compared benign group with malignant group on the final pathological findings. As for mural nodules, there was a significant difference between groups 1 + 3 and group 2 in the mean maximum diameter of the mural nodules. On dynamic study, there were 22 enhanced mural nodules (75.9%) on group 1 + 3. Conclusion: Most of endometriomas preoperatively diagnosed as benign were pathological benign lesions. Endometriomas that contain many enhanced mural nodules with papillary shape, larger size, showing hypointense on T1WI, hyperintense on T2WI and showing an acute attached angle may have malignant potential.
文摘Aim:To evaluate the effectiveness of using cone-beam computed tomography(CBCT)in transcatheter arterial chemoembolization(TACE)to detect hapatocellular carcinoma(HCC)nodules and their feeding arteries.Methods:Twenty-four patients with HCCs who underwent TACE using CBCT in addition to conventional digital subtraction angiography(DSA)were enrolled.After both conventional DSA and CBCT through the hepatic artery were acquired,TACE were performed.The nodules were defined as an HCC when dense accumulation of iodized oil was found within the nodule on CT obtained 2 weeks after the TACE.The number of detected nodules and identified feeding arteries,and their correlations with anatomical locations were assessed.Results:A total of 39 HCC nodules(tumor diameter,7-40 mm;mean,17.4±7.9 mm)were detected.Thirty-one nodules were detected by DSA alone but 8 nodules were additionally detected by adding CBCT to DSA.There were 53 feeding arteries associated with the 39 HCC nodules.Among these arteries,21 were identified by DSA alone;however,47 were identified by combining CBCT with DSA.Additional feeding arteries,especially for the nodules located at the right and caudate lobes,were identified by CBCT.On the other hand,there was no difference in detection of nodules between the anatomical locations by CBCT.Conclusion:The use of CBCT in addition to DSA offers potential for increasing the number of detected nodules,and the number of their feeding arteries at the right and caudate lobes.CBCT might improve the quality of TACE procedure for HCC than DSA alone.
