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ABSTRACT: There are many studies on changes in Doppler waveforms of hepatic veins in cirrhotic liver. It is postulated that dampening of phasic oscillations appears with worsening of liver function. Our aim was to reevaluate the significance of Doppler waveforms of hepatic vein in cirrhotic patients and to correlate with hepatic blood flow.
One hundred and thirty-five consecutive patients of liver cirrhosis and 60 age and sex matched non-cirrhotic controls were enrolled in this study. Doppler waveforms were obtained from right hepatic vein during normal respiration. Other parameters measured were flow volume of portal trunk, right portal vein and proper hepatic artery.
Waveforms of the hepatic vein were classified into triphasic, biphasic and flat patterns. Flat waveform was rare and appeared in only 3% cases. There was no correlation between liver dysfunction and patterns of waveforms. Inflow, particularly to the right lobe, was significantly elevated in cases associated with the non-triphasic waveforms.
This study shows that the flat waveforms have no diagnostic value. Role of hepatic blood flow seems to be important suggesting hemodynamic changes rather than liver dysfunction as a plausible cause of change in waveforms.
Hepatology International 01/2010; 5(1):581-5. · 2.64 Impact Factor
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ABSTRACT: To study the morphology of residual abscess in successfully treated pyogenic liver abscess by ultrasound.
116 consecutive patients of liver abscess diagnosed from April 2004 to March 2007 were included in this study. Patients with amebic liver abscess were excluded. Patients were treated with antibiotics for 6 weeks and when indicated drained percutaneously. Ultrasound scan was repeated after 2 weeks, 1 month, 3 months, 6 months and 12 months of treatment. Thereafter it was repeated every 6 months.
After exclusion, 102 patients with >150 lesions were studied. Diagnosis was made on the basis of clinical presentation, ultrasound examination and diagnostic aspiration. It was single in 83, double in 12 and more than 2 in seven patients. Size varied from 4.2cm to 15cm. Organisms were isolated in 29 patients (E. coli 10, Kliebsiella sp. 6, S. aureus 5, Pseudomonas aeruginosa 2, Acenetobacter 1 and multiple growth 5) in blood and eight patients (E. coli 5 and S. aureus 3 and multiple growth 2) in pus. Majority of abscess resolved sonologically after 2-18 weeks of treatment. Healing was delayed in alcoholic and diabetic patients. In eight patients there was residual abscess even after 104 weeks of follow-up. In four patients it healed with calcification.
Majority of pyogenic liver abscess resolve to normal parenchyma within 18 weeks time. However, some lesions may take longer time to heal even after successful treatment. It should be considered in differential diagnosis of space occupying lesion of the liver in ultrasound and need no therapeutic intervention.
European journal of radiology 02/2009; 74(1):195-8. · 2.65 Impact Factor
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Jinglin Xia,
Zhenggang Ren,
Shenglong Ye, Dilip Sharma,
Zhiying Lin,
Yuhong Gan,
Yi Chen,
Ninglin Ge,
Zengchen Ma,
Zhiquan Wu,
Jia Fan,
Lunxiu Qin,
Xinda Zhou,
Zhaoyou Tang,
Binghui Yang
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ABSTRACT: To study severe and rare complications of transarterial chemoembolization (TACE) for liver cancer.
Clinical records of severe and rare complications following TACE in 1348 cases of liver cancer from January 1997 to February 2004 were studied retrospectively.
A total of 2012 TACE procedures were performed for 1348 patients. There were 3 cases of spontaneous rupture of liver cancer, 1 case of perforation of duodenum, 3 cases of liver abscess (1 of them was associated with sepsis), 1 case of pulmonary embolism, 1 case of spasm of the hepatic artery, 40 cases of hepatic artery occlusion, 3 cases of femoral nerve injury, 1 case of bilioma and 1 case of acute renal failure.
Although the severe complications of TACE are rare, the procedure should be done cautiously including super selection of hepatic artery, slow infusion of lipiodol, careful postoperative observations and early detection and management of complications.
European Journal of Radiology 10/2006; 59(3):407-12. · 2.61 Impact Factor
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ABSTRACT: Acute tumor lysis syndrome is a very serious and sometimes life-threatening complication of cancer therapy [Oztop I, Demirkan B, Yaren A, et al. Rapid tumor lysis syndrome in a patient with metastatic colon cancer as a complication of treatment with 5-fluorouracil/leucoverin and irinotecan. Tumori 2004;90(5):514–6]. It can be defined as a pattern of metabolic abnormalities resulting from treatment-related tumor necrosis or fulminant apoptosis. The pathogenesis of tumor lysis syndrome is related to rapid tumor cell destruction, which may result in the release of intracellular ions and metabolic byproducts into the systemic circulation. Acute renal failure may frequently complicate tumor lysis syndrome and is mainly due to renal tubule precipitation of uric acid, calcium phosphate, or hypoxanthine [Locatelli F, Rossi, F. Incidence and pathogenesis of tumor lysis syndrome. Contrib Nephrol 2005;147:61–8]. The metabolic abnormalities observed in patients with tumor lysis syndrome include hyperkalemia, hyperuricemia, and hyperphosphatemia with secondary hypocalcemia. There are few reports of acute tumor lysis syndrome following transcatheter arterial chemoembolisation (TACE) in patients with HCC. Recently a case of acute tumor lysis syndrome after transcatheter arterial chemoembolisation (TACE) was managed on our ward.
European Journal of Radiology Extra.
