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Dynamic magnetic resonance defecography in 10 asymptomatic volunteers

World Journal of Gastroenterology 2012年第46期18卷 6836-6842页

作者： Andreas G Schreyer christian Paetzel Alois Fürst Lena M Dendl Elisabeth Hutzel René Müller-Wille Philipp Wiggermann Stephan Schleder christian stroszczynski Patrick Hoffstetter Department of Radiology University Medical Center Regensburg Department of Radiology Weiden Hospital Department of Surgery St. Josef Hospital

AIM: Evaluation of the wide range of normal findings in asymptomatic women undergoing dynamic magnetic resonance (MR) defecography. METHODS: MR defecography of 10 healthy female volunteers (median age: 31 years) without previous pregnancies or history of surgery were evaluated. The rectum was filled with 180 mL gadolinium ultrasound gel mixture. MR defecography was performed in the supine position. The pelvic floor was visualized with a dynamic T2-weighted sagittal plane where all relevant pelvic floor organs were acquired during defecation. The volunteers were instructed to relax and then to perform straining maneuvers to empty the rectum. The pubococcygeal line (PCGL) was used as the line of reference. The movement of pelvic floor organs was measured as the vertical distance to this reference line. Data were recorded in the resting position as well as during the defecation process with maximal straining. Examinations were performed and evaluated by two experienced abdominal radiologists without knowledge of patient history. RESULTS: Average position of the anorectal junction was located at -5.3 mm at rest and -29.9 mm during straining. The anorectal angle widened significantly from 93° at rest to 109° during defecation. A rectocele was diagnosed in eight out of 10 volunteers showing an average diameter of 25.9 mm. The bladder base was located at a position of +23 mm at rest and descended to -8.1 mm during defecation in relation to the PCGL. The bladder base moved below the PCGL in six out of 10 volunteers, which was formally defined as a cystocele. The uterocervical junction was located at an average level of +43.1 mm at rest and at +7.9 mm during straining. The uterocervical junction of three volunteers fell below the PCGL; described formally as uterocervical prolapse. CONCLUSION: Based on the range of standard values in asymptomatic volunteers, MR defecography values for pathological changes have to be re-evaluated.

关键词： Magnetic resonance imaging Defecography Standard values

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Impact of Different Embolic Agents for Transarterial Chemoembolization (TACE) Procedures on Systemic Vascular Endothelial Growth Factor (VEGF) Levels

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Journal of Clinical and Translational Hepatology 2016年第4期4卷 288-292页

作者： Andreas Schicho Claus Hellerbrand Kristina Krüger Lukas P.Beyer Walter Wohlgemuth Christoph Niessen Ernst Hohenstein christian stroszczynski Philippe L.Pereira Philipp Wiggermann Department of Radiology University Hospital Regensburg Regensburg Germany Friedrich-Alexander University Erlangen-Nürnberg Institute of Biochemistry(Emil-Fischer Zentrum) Erlangen Germany Clinic for Radiology Minimally-invasive Therapies and Nuclear Medicine SLK Kliniken Heilbronn GmbH Heilbronn Germany

Background and Aims:Intermediate stage hepatocellular carcinoma (HCC) can be treated by transarterial chemoem-bolization (TACE).However,there appear to be side effects,such as induction of proangiogenic factors,*** endothelial growth factor (VEGF),which have been shown to be associated with a poor *** prospective study was designed to compare serum VEGF level response after TACE with different embolic agents in patients with ***:Patients were assigned to one of three different TACE regimens:degradable starch microspheres (DSM) TACE,drugeluting bead (DEBDOX) TACE or Lipiodol TACE (cTACE).All patients received 50 mg doxorubicin/m2 body surface area (BSA) during *** VEGF levels were assessed before TACE treatment,24 h post-treatment and 4 weeks ***:Twenty-two patients with 30 TACE treatments were *** to baseline VEGF levels,a marked increase was observed for 24 h post-TACE (164% of baseline level) and during the 4-week follow-up (170% of baseline level) only for the cTACE arm (p < 0.05).In contrast,the increase of serum VEGF levels were only 114% and 123% for DEBDOX and 121% and 124% for DSM,***:Conventional TACE using Lipiodol shows marked increase in blood levels of the proangiogenic factor VEGF,while DEBDOX and DSM TACE induce only a moderate VEGF response.

关键词： Transarterial chemoembolization Vascular endothelial growth factor Embolic agents Hepatocellular carcinoma Angiogenesis

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