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Virtual endoscopy of the urinary tract

Asian Journal of Andrology 2006年第1期8卷 31-38页

作者： George C.Kagadis dimitrios siablis Evangelos N.Liatsikos Theodore Petsas George C. Nikiforidis Department of Medical Physics Department of Radiology Department of Urology School of MedicineUniversity of PatrasGR 26500 RionGreece Department of Radiology Department of Medical Physics

Technological breakthroughs have advanced the temporal and spatial resolutions of diagnostic imaging, and 3 dimensional （3-D） reconstruction techniques have been introduced into everyday clinical practice. Virtual endoscopy （VE） is a non-invasive technique that amplifies the perception of cross-sectional images in the 3-D space, providing precise spatial relationships of pathological regions and their surrounding structures. A variety of computer algorithms can be used to generate 3-D images, taking advantage of the information inherent in either spiral computed tomography or magnetic resonance imaging （MRI）. VE images enable endoluminal navigation through hollow organs, thus simulating conventional endoscopy. Several clinical studies have validated the diagnostic utility of virtual cystoscopy, which has high sensitivity and specificity rates in the detection of bladder tumor. Published experience in the virtual exploration of the renal pelvis, ureter and urethra is encouraging but still scarce. VE is a safe, non-invasive method that could be applied in the long-term follow-up of patients with ureteropelvic junction obstruction, urinary bladder tumors and ureteral and/or urethral strictures. Its principal limitations are the inability to provide biopsy tissue specimens for histopathologic examination and the associated ionizing radiation hazards （unless MR/is used）. However, in the case of endoluminal stenosis or obstruction, VE permits virtual endoluminal navigation both cephalad and caudal to the stenotic segment. To conclude, VE provides a less invasive method of evaluating the urinary tract, especially for clinicians who are less familiar with cross-sectional imaging than radiologists. （Asian J Androl 2006 Jan; 8： 31-38）

关键词： computed tomography three-dimensional imaging virtual endoscopy urethral stricture

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Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature

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World Journal of Gastroenterology 2006年第26期12卷 4264-4266页

作者： dimitrios siablis Zafiria G Papathanassiou dimitrios Karnabatidis Nikolaos Christeas Konstantinos Katsanos Constantine Vagianos Departments of Interventional Radiology and Surgery University Hospital of Patras RioGreece

为不平常却记录得好的享受的脾的动静脉瘘(SAVF ) 报道门静脉高血压的有能力的原因([1-4 ]) 。突然由于 SAVF 形成开发了门静脉高血压的 50 岁的经产的女性的一个盒子被介绍。受不了的病人在过去的 12 天期间重复了 haematemesis 和 mel... 详细信息

为不平常却记录得好的享受的脾的动静脉瘘(SAVF ) 报道门静脉高血压的有能力的原因([1-4 ]) 。突然由于 SAVF 形成开发了门静脉高血压的 50 岁的经产的女性的一个盒子被介绍。受不了的病人在过去的 12 天期间重复了 haematemesis 和 melaena 的事件，因此， emer 轻轻地为管理进入医院。临床并且实验室调查当肝实质的不在时建立了门静脉高血压的诊断疾病。内视镜检查法揭示了多重食道的流血静脉曲张。腹的计算断层摄影术(CT ) 和 transfemoral 腹的动脉 X 线摄影法记录了一根曲折、动脉瘤的脾的动脉并且一根扩大脾的静脉的早熟的充满的存在， SAVF 高度暗示的调查结果。上述的脉管的反常成功地与经皮的 transcatheter embolization 被对待。既不复发也不其它复杂并发症被观察。

关键词：脾脏疾病动静脉瘘高血压并发症

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Hemobilia secondary to hepatic artery pseudoaneurysm: An unusual complication of bile leakage in a patient with a history of a resected Ⅲb Klatskin tumor

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World Journal of Gastroenterology 2005年第33期11卷 5229-5231页

作者： dimitrios siablis Zafiria G.Papathanassiou dimitrios Karnabatidis Nikolaos Christeas Constantine Vagianos Department of Interventional Radiology Medical School University of PatrasRioGreece Department of Surgery Medical School University of PatrasRioGreece

我们由于 resected 门 cholangiocarcinoma (类型 IIIb Klatskin 肿瘤) 与双 bilo 伤寒吻合的 16 年的历史报导一个 74 岁的女人的一个案例。与对导致了大肝内 biloma 的良性的吻合狭窄第二等的胆管炎介绍的病人。以便恢复吻合的明显并... 详细信息

我们由于 resected 门 cholangiocarcinoma (类型 IIIb Klatskin 肿瘤) 与双 bilo 伤寒吻合的 16 年的历史报导一个 74 岁的女人的一个案例。与对导致了大肝内 biloma 的良性的吻合狭窄第二等的胆管炎介绍的病人。以便恢复吻合的明显并且克服胆管炎，几次尝试发生了，包括 endobiliary 小型机关枪的一种叮当响，帮助汽球的 biloplasty 和 transhepatic billiary 排水。吻合明显被完成，复杂，然而由坚持上面的胃肠的流血，作为胆道出血介绍了。左肝的动脉的一个导致 biloma 的假动脉瘤被诊断。这破裂了进胆道，并且介绍了胆道出血的实际原因。假动脉瘤的选择栓塞控制出血结果，并且成功地与吻合的 transhepatic 膨胀和 biloma 的经皮的排水被相结合。病人最终被治好并且似乎处于优秀状况， 5 瞬间术后疗法。

关键词：肝动脉疾病胆汁渗漏并发症胆管炎手术治疗

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Percutaneous trans-hepatic bilateral biliary stenting in Bismuth Ⅳ malignant obstruction

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World Journal of Hepatology 2013年第3期5卷 114-119页

作者： dimitrios Karnabatidis Stavros Spiliopoulos Paraskevi Katsakiori Odissefs Romanos Konstantinos Katsanos dimitrios siablis Department of Interventional Radiology Patras University Hospital

AIM: To investigate the clinical efficiency of percutaneous trans-hepatic bilateral biliary metallic stenting for the management of Bismuth Ⅳ malignant obstructive disease. METHODS: Our hospital's database was searched for all patients suffering from the inoperable malignant biliary obstruction Bismuth Ⅳ, and treated with percutaneous bilateral trans-hepatic placement of selfexpandable nitinol stents. The indication for percutaneous stenting was an inoperable, malignant, symptomatic, biliary obstruction. An un-correctable coagulation disorder was the only absolute contra-indication for treatment. Bismuth grading was performed using magnetic resonance cholangiopancreatography. Computed tomography evaluation of the lesion and the dilatation status of the biliary tree was always performed prior to the procedure. All procedures were performed under conscious sedation. A single trans-hepatic track technique was preferred (T-configuration stenting) and a second, contra-lateral trans-hepatic track (Y-configuration stenting) was used only in cases of inability to access the contra-lateral lobe using a single track technique. The study's primary endpoints were clinical success, defined as a decrease in bilirubin levels within 10 d and patient survival rates. Secondary endpoints included peri-procedural complications, primary and secondary patency rates. RESULTS: A total of 35 patients (18 female, 51.4%) with a mean age 69 ± 13 years (range 33-88) were included in the study. The procedures were performed between March 2000 and June 2008 and mean time follow-up was 13.5 ± 22.0 mo (range 0-96). The underlying malignant disease was cholangiocarcinoma (n = 10), hepatocellular carcinoma (n = 9), pancreatic carcinoma (n = 5), gastric cancer (n = 2), bile duct tumor (n = 2), colorectal cancer (n = 2), gallbladder carcinoma (n = 2), lung cancer (n = 1), breast cancer (n = 1) or non-Hodgkin lymphoma (n = 1). In all cases, various self-expandable bare metal stents with diameters rangin

关键词： Bismuth Ⅳ Malignant biliary obstruction Percutaneous bilateral stenting Nitinol stents Palliative treatment Fluoroscopically-guided

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