-
[show abstract]
[hide abstract]
ABSTRACT: A 74-year-old man presented with hepatocellular carcinoma extending into the main portal vein. Two bare Wallstents were placed to maintain portal vein patency. The main portal vein remained patent for 6 months after treatment. No serious complications were observed during or after treatment.
CardioVascular and Interventional Radiology 04/2012; 23(2):159-61. · 2.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Purpose: The objective of this study was to identify the factors affecting the visualization of regenerating nodules in cirrhotic liver by MR imaging. Material and Methods: MR images from patients with liver cirrhosis and normal subjects were studied, and signal intensity within the liver was measured and correlated with histologic findings. A reference phantom was also used as a standard. Results: The signal intensity of the liver on T2-weighted (T2WI) spin-echo (SE) images was significantly increased in patients with liver cirrhosis. Multiple ring-like or reticular high-intensity areas (RHAs) were demonstrated on T2WI SE images in 44 of 125 cirrhotic livers. Histologic examination in 44 cases revealed various degrees of inflammatory changes in fibrous septa surrounding regenerative nodules in all specimens, vascular dilation in fibrous septa in 4 specimens, and no hemosiderin deposition in some specimens. The results of linear discriminant analysis showed that inflammatory changes in fibrous septa were significantly more pronounced in cases with RHAs on MR. Conclusion: RHAs seen on T2WI SE images may correspond to fibrous septa with inflammation. The signal intensity of fibrous septa surrounding regenerative nodules on T2WI SE images may be increased in liver cirrhosis due to inflammation or vascular dilation, contributing to the visualization of regenerating nodules as relatively low-intensity regions on MR.
01/2010; 37(2):198-203.
-
[show abstract]
[hide abstract]
ABSTRACT: We evaluated the clinical usefulness of virtual CT gastroendoscopy (VCTGE).
The subjects were 124 patients with endoscopically identified gastric lesions. VCTGE images were obtained using a GE-Navigator. We evaluated VCTGE in the visualization of gastric lesions for their presence and morphology.
The detection rate of all gastric lesions by VCTGE was 76% (94 of 124 patients). The smallest detectable early gastric cancer was II c measuring 10 x 8 mm. The detection rates of each gastric lesion by VCTGE were 73% in early gastric cancer, and 90% in advanced gastric cancer. VCTGE imaging in the advanced gastric cancer was good in 12 (30%), fair in 25 (60%) and poor in 4 (10%). VCTGE imaging in early gastric cancer was good in 20 (46%), fair in 12 (27%) and poor in 12 (27%). The significance P level was 0.005 between the evaluation of the imaging of advanced and early gastric cancer.
VCTGE visualized the characteristics of diverse gastric lesions and was considered useful for the detection and the diagnosis of these lesions.
Osaka city medical journal 01/2002; 47(2):115-26.
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to assess the usefulness of three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiography for evaluation of the intracranial venous system.
Thirty-three patients underwent 3D dynamic gadolinium-enhanced MR angiography as well as two-dimensional (2D) time-of-flight (TOF) MR venography in transverse and coronal planes and conventional catheter cerebral angiography with digital subtraction. MR venography was displayed using a maximum-intensity-projection (MIP) algorithm. The acquisition time of 3D gadolinium-enhanced MR angiography was 102 seconds, and that of 2D TOF MR venography was about 7 minutes in the transverse plane and about 9 minutes in the coronal plane. Degree of visualization of the intracranial venous system on each MR sequence was compared with that on conventional catheter cerebral angiography as a standard.
Superficial cortical veins and the dural sinus were better visualized on 3D gadolinium-enhanced MR angiography than on 2D TOF MR venography.
Three-dimensional gadolinium-enhanced MR angiography is noninvasive and very useful for imaging of the intracranial venous system. It can replace 2D TOF MR venography not only because of its short examination time but because it better demonstrates intracranial venous structures. For evaluation of the SSS, lateral sinus, sigmoid sinus and straight sinus in particular, conventional catheter angiography seems to be unnecessary.
Osaka city medical journal 01/2002; 47(2):165-75.
-
Nippon rinsho. Japanese journal of clinical medicine 11/2001; 59 Suppl 6:721-5.
-
M Toyoshima,
T Matsuoka,
S Tanaka,
T Ohara,
Y Hamazawa,
M Tokunaga,
T Ninoi,
K Satou,
M Isota,
T Kaminou,
K Nakamura, R Yamada,
K Inoue,
S Nishida
Gan to kagaku ryoho. Cancer & chemotherapy 11/2001; 28(11):1604-6.
-
[show abstract]
[hide abstract]
ABSTRACT: Unusual MR and CT findings of an inflammatory pseudotumor in the parapharyngeal space of a 73-year-old woman are reported. The mass was hypointense on T1- and T2-weighted images and demonstrated ring enhancement after contrast medium injection. Punctated calcifications were scattered at the periphery. Inflammatory pseudotumors in the parapharyngeal space are rare, and only three cases have been reported. The possible pathogenesis and varieties of inflammatory pseudotumors are discussed.
American Journal of Neuroradiology 09/2001; 22(7):1394-7. · 2.93 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although endoscopic injection sclerotherapy has been a main treatment option for gastroesophageal varices, intraportal inflow of the sclerosant, ethanolamine oleate, induce liver damage. The aim of this study was to clarify the liver damage due to intraportal inflow of ethanolamine oleate. Ethanolamine oleate suspension was injected into livers of male Wistar rats via the portal (ileocolic) vein. Degrees of liver damage were evaluated by serum levels of transaminases and by histological examination. Intraportal injection of ethanolamine oleate led to extensive liver necrosis, which was marked 1 day after the injection and recovered by 7 days after injection. Liver necrosis became severe as the dose of the injected sclerosant increased. Histologically, neither portal thrombosis nor embolism was evident. Carbon powder particles of India ink, which were injected together with ethanolamine oleate, reached and deposited in sinusoids of the necrotic portions of the liver. These findings suggested that the liver damage had not developed simply as a result of impairment of portal blood flow. Ethanolamine oleate may itself have direct hepatotoxic effects.
Osaka city medical journal 07/2001; 47(1):53-62.
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to examine stenosis in the aorta, portal vein (PV), and inferior vena cava (IVC) after bare and covered Z-stent placement. Eight beagles underwent bare (n=4) or polytetrafluoroethylene (PTFE) covered (n=4) Z-stent placement in the aorta, PV, and IVC. Angiography was performed 1 and 3 weeks later to evaluate stenosis. The animals were sacrificed after 3 weeks for histopathologic examination. Angiographic findings revealed that stenosis in the bare stent group tended to be smaller than in the covered stent group in 3 vessels and stenosis tended to be smaller in the order of the aorta, PV and IVC in either group. In both groups, stenosis in the PV and IVC was mainly caused by organized thrombus. In addition, in the covered stent group, the space between the cover and native vessel wall (subgraft space) was formed and filled with neointima in every vessel. Preventing thrombus formation in the PV and IVC after bare and covered stent placement and reducing the subgraft space in the aorta after covered stent placement are important for minimizing stenosis.
Osaka city medical journal 07/2001; 47(1):43-52.
-
[show abstract]
[hide abstract]
ABSTRACT: In clinical F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) studies of the head and neck region, remarkable symmetric tonsillar FDG uptake is sometimes observed. We determined the incidence and degree of tonsillar FDG uptake and investigated the significance of tonsillar FDG uptake. Between June 1998 and August 1998, we obtained informed consent from 17 patients who were scheduled to undergo a FDG-PET study for their own disease (11 men and 6 women; aged 22 to 77 yr) and who did not have head and neck disease to perform FDG-PET scanning of the head and neck region in addition to their target organs. The incidence and degree of tonsillar FDG uptake were determined. Remarkable tonsillar FDG uptake was found in 9 patients. The SUVs of these FDG uptakes ranged from 2.48 to 6.75, with a mean of 4.29 +/- 1.20 (SD). Tonsillar FDG uptakes in the remaining 8 patients were not remarkable, and their SUVs ranged from 1.93 to 3.31, with a mean of 2.46 +/- 0.45. Head and neck disease does not appear to have been responsible for the increase in tonsillar FDG uptake. Differences among tonsillar FDG uptake in these 17 patients without head and neck disease appear to reflect differences in activity of "physiological" inflammation of the palatine tonsils.
Annals of Nuclear Medicine 07/2001; 15(3):297-300. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Rupture of a hepatocellular carcinoma (HCC) is a well-known cause of death in patients with HCC. This report describes a rare case of HCC presenting as cardiac tamponade caused by a spontaneous rupture of mediastinal lymph node metastasis into the pericardial space. A transcatheter arterial embolization (TAE) of internal thoracic artery successfully controlled the bleeding, and the patient was rescued from cardiac tamponade. Although there was no rebleeding, the patient died from liver failure 2 months later. An autopsy revealed a poorly differentiated HCC in the liver, lung and mediastinal lymph nodes.
Journal of Gastroenterology and Hepatology 07/2001; 16(6):702-4. · 2.87 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We have already reported satisfactory therapeutic results of cisplatin-based cyclic balloon-occluded arterial infusion chemotherapy (BOAI) because it enabled advanced cervical cancer of the uterus (cervical cancer) to be treated by simple total hysterectomy (STH). In the present study, we investigated the expression of apoptosis regulatory proteins in advanced cervical cancer treated by cyclic BOAI. The results showed that the proportion of Bax-positive cells was 75.2 +/- 5.6% after the first BOAI in the cases in which STH became possible (group C), and significantly lower, 11.6 +/- 11.7% (p=0.0001), in the cases in which STH remained impossible (group I). The proportion of Bax-positive cells was significantly higher in group C than in group I throughout the treatment period, but there was no significant difference in Bcl-2 expression between the two groups. The survival rate by the Kaplan-Meier method was significantly higher in group C than in group I. These results suggest that the antitumor effect of cyclic BOAI is closely associated with apoptotic cell death, which may in part be influenced by the expression of Bax.
International Journal of Oncology 07/2001; 18(6):1151-5. · 2.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We reviewed the MRI of seven patients with syringomyelia associated with surgically proven adhesive spinal arachnoiditis to describe clinical and MRI findings in this condition. Using 0.5, 1.0 or 1.5 tesla units, we obtained sagittal T1- and T2-weighted spin-echo and axial T1-weighted images. Additional sagittal T2-weighted images were obtained without using motion-artefact suppression. Contrast medium was given intravenously to five patients. The syrinx cavities were thoracic in five cases, cervicothoracic in one, and extended from C4 to L1 in one. No Chiari malformation or craniovertebral junction anomaly was demonstrated. Meningeal thickening was seen on T2-weighted sagittal images only in one case. Cord deformity due to adhesion or displacement due to an associated arachnoid cyst was seen in all cases best demonstrated on axial images. Focal blurring of the syrinx wall on axial images was seen in six patients. Flow voids were seen in the syrinx fluid in all cases on T2-weighted images obtained without motion-artefact suppression. No abnormal contrast enhancement was demonstrated.
Neuroradiology 05/2001; 43(4):325-30. · 2.82 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We investigated nine patients with rhabdomyosarcoma in the head and neck (6-53 years of age), using CT and MRI. The tumours originated in the paranasal sinuses (3), cheek (2), soft palate (1), orbit (1), sternocostoclavicular muscle (1) and parapharyngeal space (1). The histological subtype was embryonal in five, alveolar in three and pleomorphic in one case. The tumours enhanced markedly and heterogeneous on CT and MRI. The masses were isointense or gave slightly higher signal than surrounding muscles on T1- and heterogeneously high signal on T2-weighted images. In four tumours, multiple ring enhancement resembling bunches of grapes. This appears to be characteristic of rhabdomyosarcoma and probably reflects a component of botryoid-type rhabdomyosarcoma in which mucoid-rich stroma is covered with a thin layer of tumour cells. We have named this imaging feature the "botryoid sign".
Neuroradiology 05/2001; 43(4):331-5. · 2.82 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim was to evaluate a subtraction technique for breath-hold gadolinium enhanced three-dimensional magnetic resonance portography (3D-MRP). 26 patients with gastric and/or duodenal varices related to portal hypertension were investigated by 3D-MRP with two phase acquisitions. A partial volume maximum intensity projection (MIP) image after subtracting selective arterial phase images from subsequent portal venous phase images (subtraction 3D-MRP) was compared with the partial volume MIP without subtraction (non-subtraction 3D-MRP) to assess visualization of the portal vein and its collaterals. Subtraction 3D-MRP depicted excellent visualization of the portal vein, although this was not significantly better than non-subtraction 3D-MRP. However, subtraction 3D-MRP gave superior visualization of portal collaterals, with effective suppression of arterial and renal signal intensities, compared with non-subtraction 3D-MRP (p<0.001).
British Journal of Radiology 02/2001; 74(878):147-52. · 1.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The purpose of this study was to investigate the feasibility of [18F]2-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) in patients with a pancreatic mass by comparing the results with those of X-ray computed tomography (CT) and magnetic resonance (MR) imaging.
METHODS: Eighty-six patients with pancreatic lesions, included 65 malignant tumors and 21 benign masses (55 masses were proven histologically and the others were diagnosed clinically), were studied. The diagnostic factors of CT and MR imaging were evaluated, and those of FDG PET were also evaluated for malignant and benign masses by visual interpretation and quantitative interpretation with the standardized uptake value (SUV) and SUVgluc which was designed to reduce the effects of a high blood sugar level. Visual interpretations were evaluated only in FDG PET images, and quantitative interpretations were evaluated by referring to CT and/or MR imaging. The correlation between SUV and the degree of histological differentiation in pancreatic ductal adenocarcinoma was investigated.
RESULTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for CT imaging were 91, 62, 88, 68 and 84%, and for MR imaging 78, 70, 88, 54 and 76%, respectively. In visual interpretation of FDG PET images, the sensitivity, specificity, PPV, NPV and accuracy were 82, 81, 93, 59 and 81%, respectively. Significant differences between malignant and benign lesions existed in SUV and SUVgluc (p < 0.0001, each). With the cutoff value of SUV as 2.1 and SUVgluc as 2.2, the accuracy of diagnosis was maximal. With that cutoff value, the sensitivity, specificity, PPV, NPV and accuracy for SUV were 89, 76, 92, 70 and 86%, and for SUVgluc 91, 76, 92, 73 and 87%, respectively. The sensitivity and NPV of SUVgluc were higher than those of SUV, which suggests that SUVgluc may be more useful in reducing the number of overlooked malignant tumors. The specificity and PPV of FDG PET were superior to those of CT and MR imaging. There were no significant differences between the SUVs of moderately differentiated adenocarcinomas and those of well differentiated adenocarcinomas.
CONCLUSION: To improve the diagnostic procedure for classifying masses, FDG PET with not only SUV but also SUV corrected by the blood sugar level is required in addition to morphological diagnosis by CT and/or MR imaging.
Annals of Nuclear Medicine. 01/2001;
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the utility of proton MR spectroscopy (MRS) for the early detection of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunting (TIPS).
Six patients, who underwent TIPS for treatment of portal hypertension, were examined by MRS I week before and 1 week after TIPS. They were simultaneously clinically examined for number connection test, blood NH3 level, liver function test and the Fischer ratio.
Three of 6 patients showed overt HE 1 to 5 weeks after TIPS and the other 3 patients did not show overt HE. The overt HE group showed the larger ratio of the amounts of glutamine and glutamate/myo-inositol (Glx/MI) than that of non-overt HE group (p<0.05).
The Glx/MI ratio estimated by MRS was useful for early detection of HE after TIPS.
Acta Radiologica 12/2000; 41(6):567-71. · 1.37 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the usefulness of embolotherapy with ethanol for the treatment of venous impotence.
Twenty-three patients with venous impotence underwent embolotherapy. The diagnosis of venous impotence was made by means of pharmacocavernosometry and cavernosography. After exposure of the deep dorsal penile vein, a intravenous catheter was inserted directly into the deep dorsal penile vein and advanced into just front of the preprostatic plexus. Fifty percent ethanol was injected through the catheter and the endpoint of the procedure was determined based on results of venography immediately after injection. The procedure was finished when lack of venous leakage was confirmed.
In all patients, the deep dorsal penile vein was successfully exposed surgically, the sclerosing agent successfully injected, and the endpoint successfully achieved. Immediate clinical therapeutic effect (restoration of erection) was obtained in 20 cases (87%). No severe complications were observed during or after the procedure. The follow-up period was 6-50 months. Long-term therapeutic effect was confirmed for 18 of 23 patients (78%).
The authors' findings suggest that this treatment had satisfactory short-term and long-term clinical results and that longer follow-up is necessary to confirm its safety.
Journal of Vascular and Interventional Radiology 10/2000; 11(8):1053-7. · 2.08 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We studied the relationship between the findings of computed tomography during arteriography (CTA) and computed tomography during arterial portography (CTAP), and pathologic findings of 81 small nodular lesions (3 cm or less in diameter) in resected liver specimens. The 81 lesions consisted of 8 dysplastic nodule (DN) lesions, 23 well-differentiated hepatocellular carcinomas (early HCCs) and 50 moderately or poorly differentiated HCCs (advanced HCCs). We also performed standard computed tomography (CT), digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and ultrasonography, and compared sensitivities with CTA, CTAP, or combination of CTA and CTAP with other imaging methods. Forty-four of the 50 advanced HCCs, 12 of the 23 early HCCs, and none of 8 DNs hyperattenuated with CTA and hypoattenuated with CTAP. The sensitivity for the early HCCs was significantly higher for CTA and CTAP in combination as compared with DSA or standard CT. The sensitivity for the advanced HCCs was significantly higher for CTA and CTAP in combination than with DSA. The sequential changes of the blood supply from the portal vein to the hepatic artery during the development of the HCCs were observed. Although CTA and CTAP in combination were useful for the distinction of advanced HCC from early HCC or DN, CTA and CTAP used in combination were not superior to CTA alone in the detection of such lesions.
Japanese journal of cancer research: Gann 09/2000; 91(8):859-63.
-
[show abstract]
[hide abstract]
ABSTRACT: We applied the Maximum Intensity Projection method (MIP method), volume rendering method (VR method) and Shading process in reconstruction of arteries, portal veins and hepatic veins using Contrast-enhanced MR Angiography (MRA) in the epigastric region and examined its usefulness. In addition, the visibility of tumor vessels in the liver was evaluated using original images.
The subjects were 85 patients. Abdominal dynamic imaging was performed using the efgre3d sequence. We reconstructed MRA for stereoscopic images using the MIP, VR, or VR + Shading process method and evaluated the visibility rates and score of each artery, portal vein and hepatic vein. The visibility of tumor vessels in the liver was also evaluated from original images obtained using MRA.
In the arterial phase, the VR method and shading process yielded greater visibility than the MIP method. The average score was highest in the shading process followed by the VR method, and then the MIP method. In the portal phase, there was little difference in visibility among the reconstruction methods. The average score with the MIP method was slightly, but not significantly, higher than with the VR method and Shading process. For the hepatic veins, visibility rates of each three-dimensional reconstruction image were markedly lower than in original images. Tumor vessels were visualized over 85% using MRA.
The VR method and Shading process were useful for evaluation of arteries. The MIP method was useful for evaluation of the portal vein. Original images were useful for evaluation of the hepatic veins. Contrast-enhanced MRA of the epigastric and hepatic regions was clinically quite useful in that it permitted evaluation of all vessels including arteries, portal vein and other veins throughout the liver as well as evaluation of tumor vessels.
Osaka city medical journal 07/2000; 46(1):1-15.
