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Gd-EOB-DTPA-enhanced magnetic resonance imaging for focal liver lesions in Chinese patients:a multicenter,open-label,phase Ⅲ study

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Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 607-616页

作者： Meng-Su Zeng Hui-Yi Ye Liang Guo Wei-Jun Peng Jian-Ping Lu Gao-Jun Teng Josy Breuer Yi Huan Ping Li Jian-Rong Xu Chang-Hong Liang department of radiology Zhongshan HospitalFudan UniversityNo.180 Fenglin Road departmentof radiology General Hospital of PLA department of radiology First Affiliated HospitalSoochowUniversity department of radiology Cancer HospitalFudan University department of radiology Changhai HospitalSecond Military MedicalUniversity department of radiology Zhongda HospitalSoutheast University Bayer HealthCare Bayer Schering Pharma AG department of radiology Xijing HospitalFourth Military MedicalUniversity Bayer HealthCare CompanyLtd department of radiology RenjiHospitalShanghai Jiaotong University department of radiology Guangdong General Hospital

BACKGROUND:Contrast agents help to improve visibility in magnetic resonance(MR)***,owing to the large interstitial spaces of the liver,there is a reduction in the natural contrast gradient between lesions and healthy *** study was undertaken to evaluate the efficacy and safety of the liverspecific MR imaging contrast agent gadoxetate disodium(GdEOB-DTPA)in Chinese ***:This was a single-arm,open-label,multicenter study in patients with known or suspected focal liver lesions referred for contrast-enhanced MR *** imaging was performed in 234 patients before and after a single intravenous bolus of Gd-EOB-DTPA(0.025 mmol/kg body weight).Images were evaluated by clinical study investigators and three independent,blinded *** primary efficacy endpoint was sensitivity in lesion ***:Gd-EOB-DTPA improved sensitivity in lesion detection by 9.46%compared with pre-contrast imaging for the average of the three blinded readers(94.78%vs 85.32%for Gd-EOB-DTPA vs pre-contrast,respectively).Improvements in detection were more pronounced in lesions less than ***-EOB-DTPA improved diagnostic accuracy in lesion ***:This open-label study demonstrated that Gd-EOB-DTPA improves diagnostic sensitivity in liver lesions,particularly in those smaller than 1 ***-EOB-DTPA also significantly improves the diagnostic accuracy in lesion classification,and furthermore,Gd-EOB-DTPA is safe in Chinese patients with liver lesions.

关键词： gadoxetate disodium magnetic resonance imaging liver focal liver lesions

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Virtual endoscopy of the urinary tract

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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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Recent advances in non-invasive magnetic resonance imaging assessment of hepatocellular carcinoma

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World Journal of Gastroenterology 2018年第23期24卷 2413-2426页

作者： Davide Ippolito Riccardo Inchingolo Luigi Grazioli Silvia Girolama Drago Michele Nardella Marco Gatti Riccardo Faletti School of Medicine University of Milano-Bicocca department of Diagnostic radiology HS Gerardo Monza Division of Interventional radiology Department of RadiologyMadonna delle Grazie Hospital department of radiology University of Brescia "Spedali Civili" department of Surgical Sciences Radiology UnitUniversity of Turin

Magnetic resonance(MR) imaging of the liver is an important tool for the detection and characterization of focal liver lesions and for assessment of diffuse liver disease,having several intrinsic characteristics,represented by high soft tissue contrast,avoidance of ionizing radiation or iodinated contrast media,and more recently,by application of several functional imaging techniques(i.e.,diffusion-weighted sequences,hepatobiliary contrast agents,perfusion imaging,magnetic resonance(MR)-elastography,and radiomics analysis). MR functional imaging techniques are extensively used both in routine practice and in the field of clinical and pre-clinical research because,through a qualitative rather than quantitative approach,they can offer valuable information about tumor tissue and tissue architecture,cellular biomarkers related to the hepatocellular functions,or tissue vascularization profiles related to tumor and tissue biology. This kind of approach offers in vivo physiological parameters,capable of evaluating physiological and pathological modifications of tissues,by the analysis of quantitative data that could be used in tumor detection,characterization,treatmentselection,and follow-up,in addition to those obtained from standard morphological imaging. In this review we provide an overview of recent advanced techniques in MR for the diagnosis and staging of hepatocellular carcinoma,and their role in the assessment of response treatment evaluation.

关键词： Liver Cirrhosis Hepatocellular carcinoma Magnetic resonance Transarterial chemoembolization Contrast media

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Modern imaging techniques for preoperative detection of distant metastases in gastric cancer

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World Journal of Gastroenterology 2015年第37期21卷 10502-10509页

作者： Robert M Kwee Thomas C Kwee department of radiology Maastricht University Medical Center department of radiology University Medical Center Utrecht

A substantial portion of patients with newly diagnosed gastric cancer has distant metastases(M1 disease).These patients have a very poor prognosis and it is generally accepted that they should be treated with noncurative intent. Because it dramatically changes prognosis and treatment plans, it is very important to diagnose distant metastases. In this article, the definition, pathways, incidence and sites of distant metastases in gastric cancer are ***, the current performance of imaging in detecting distant metastases in newly diagnosed gastric cancer is outlined and future prospects are discussed.

关键词： Gastric cancer Ultrasonography Distant metastases

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Advanced diffusion-weighted magnetic resonance imaging in the evaluation of white matter axons in patients with idiopathic normal pressure hydrocephalus

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Neural Regeneration Research 2017年第12期12卷 1974-1975页

作者： Masaaki Hori Kouhei Kamiya Ryusuke Irie department of radiology Juntendo University School of MedicineTokyo Japan department of radiology The University of Tokyo Tokyo Japan

With the increasing application of regenerative medicine in vivo,non-invasive and accurate methods for estimating the white matter axons in neuronal tissue have become increasingly *** a non-invasive method for patients,magnetic resonance（MR）imaging has demonstrated potential as a promising tool for evaluating axons in *** particular,diffusion-weighted MR imaging（d MRI）and its applications,

关键词： Advanced diffusion-weighted magnetic white matter pressure hydrocephalus

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Intraoperative ultrasound assistance in resection of intracranial meningiomas

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Chinese Journal of Cancer Research 2013年第3期25卷 339-345页

作者： Hailiang Tang Huaping Sun Liqian Xie Qisheng Tang Ye Gong Ying Mao Qing Xie Mingzhe Zheng Daijun Wang Hongda Zhu Jianhong Zhu Xiaoyuan Feng Zhenwei Yao Xiancheng Chen Liangfu Zhou Neurosurgery department of Huashan Hospital radiology department of Huashan Hospital

Objective： Intracranial meningiomas, especially those located at anterior and middle skull base, are difficult to be completely resected due to their complicated anatomy structures and adjacent vessels. It＇s essential to locate the tumor and its vessels precisely during operation to reduce the risk of neurological deficits. The purpose of this study was to evaluate intraoperative ultrasonography in displaying intracranial meningioma and its surrounding arteries, and evaluate its potential to improve surgical precision and minimize surgical trauma. Methods： Between December 2011 and January 2013, 20 patients with anterior and middle skull base meningioma underwent surgery with the assistance of intraoperative ultrasonography in the Neurosurgery department of Shanghai Huashan Hospital. There were 7 male and 13 female patients, aged from 31 to 66 years old. Their sonographic features were analyzed and the advantages of intraoperative ultrasonography were discussed. Results： The border of the rneningioma and its adjacent vessels could be exhibited on intraoperative ultrasonography. The sonographic visualization allowed the neurosurgeon to choose an appropriate approach before the operation. In addition, intraoperative ultrasonography could inform neurosurgeons about the location of the tumor, its relation to the surrounding arteries during the operation, thus these essential arteries could be protected carefully. Conclusions： Intraoperative ultrasonography is a useful intraoperative technique. When appropriately applied to assist surgical procedures for intracranial meningioma, it could offer very important intraoperative information （such as the tumor supplying vessels） that helps to improve surgical resection and therefore might reduce the postoperative morbidity.

关键词： Intraoperative ultrasonography intracranial meningioma

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Paraesophageal hernia and iron deficiency anemia:Mechanisms,diagnostics and therapy

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World Journal of Gastrointestinal Surgery 2021年第3期13卷 222-230页

作者： Christoph G Dietrich Dolores Hübner Joachim W Heise department of Internal Medicine Bethlehem Center of HealthStolberg D-52222Germany department of radiology Bethlehem Center of HealthStolberg D-52222Germany department of General and abdominal Surgery Bethlehem Health CenterStolberg D-52222Germany

There is ample clinical evidence suggesting that the presence of large axial or paraesophageal hernias may lead to iron deficiency ***-called Cameron lesions,as well as other small mucosa erosions,in the sliding area of these diaphragmatic hernias lead to invisible chronic blood loss and consequently to iron *** the spectrum of symptoms in these patients is large,anemia is often not the only indication and typically not the primary indication for surgical correction of diaphragmatic *** treatment with proton pump inhibitors and iron substitution can alleviate anemia,but this is not always *** exclude other possible bleeding sources in the gastrointestinal tract,a comprehensive diagnostic program is necessary and reviewed in this ***,we discuss controversies in the surgical management of paraesophageal hernias.

关键词： Iron deficiency anemia Paraesophageal hernia Upside-down stomach Cameron lesions

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Clinical characteristics and outcome of a cohort of 101 patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2001年第2期7卷 208-215页

作者： Christian Rabe Tillmann Pilz Christoph Klostermann Marc Berna Hans H.Schild Tilman Sauerbruch Wolfgang H.Caselmann department of Medicine I Department of RadiologyUniversity of BonnGermany

AIM: To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999. METHODS AND RESULTS: Data were retrospectively analyzed by chart review. In 95 cases (72 males and 23 females) sufficient data were available for analysis. Twenty five (29%) of 85 patients were HBsAg or anti HBc positive, 21/85 (25%) were anti HCV positive, and 6/85 (7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV positive patients than in the other two groups. Thirty one (34%) of 90 patients had histories of alcohol abuse. In 79/94 (84%) patients, cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/94 (20%). Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%). According to Okuda 28/94 (30%) were grouped to stage I, 53/94 (56%) were grouped to stage II, and 13/94 (14%) were grouped to stage II. Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8 4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival, though patients with an AFP value greater than 100 microg/L did experience shortened survival. Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of

关键词： Adult Aged Aged, 80 and over Carcinoma, Hepatocellular Cohort Studies Female Germany Hepatitis B Hepatitis C Humans Liver Cirrhosis, Alcoholic Liver Neoplasms Male Middle Aged Research Support, Non-U.S. Gov't Retrospective Studies Risk Factors Survival Analysis

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A prospective cross-over study using a sphincterotome and a guidewire to increase the success rate of common bile duct cannulation

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World Journal of Gastroenterology 2005年第11期11卷 1649-1652页

作者： Georgios Karamanolis Aikaterini Katsikani Nikos Viazis Gerasimos Stefanidis Spilios Manolakopoulos Spiros Sgouros Efthimia Papadopoulou Apostolos Mantides department of Gastroenterology department of radiology Second department of Gastroenterology Gastroenterology department

AIM: During endoscopic retrograde cholangiopancreatography (ERCP), selective cannulation of the common bile duct (CBD) is required in most of the ***: From June 2001 till December 2002, all patients referred to our unit for ERCP were considered for entry into the study. Selective CBD cannulation was first attempted with a standard catheter with or without the use of a guidewire. In cases, where CBD cannulation was considered unsuccessful, patients were crossed over to a double-lumen sphincterotome and a guidewire. All patients were hospitalized for 24 h after the procedure in order to assess the incidence of post-ERCP ***: The study sample consisted of 158 *** CBD cannulation using a standard ERCP catheter with or without the assistance of a guidewire, was accomplished in 129 patients (success rate: 81.65%).From the 29 patients who were crossed over to a sphincterotome and a guidewire, selective CBD cannulation was achieved in 24; the overall success rate rising to 96.8%. Meanwhile, the use of this technique did not increase the incidence of post-ERCP ***: The use of a sphincterotome and a guidewire increases the success rate of selective bile duct cannulation in cases that this has not been accomplished with a standard catheter.

关键词： Common bile duct Cannulation Sphincterotome Guidewire

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Management and outcome of hepatocellular adenoma with massive bleeding at presentation

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World Journal of Gastroenterology 2017年第25期23卷 4579-4586页

作者： Anne J Klompenhouwer Robert A de Man Maarten GJ Thomeer Jan NM Ijzermans department of Surgery department of Gastroenterology and Hepatology department of radiology

To evaluate outcome of acute management and risk of rebleeding in patients with massive hemorrhage due to hepatocellular adenoma (HCA). METHODSThis retrospective cohort study included all consecutive patients who presented to our hospital with massive hemorrhage (grade II or III) due to ruptured HCA and were admitted for observation and/or intervention between 1999-2016. The diagnosis of HCA was based on radiological findings from contrast-enhanced magnetic resonance imaging (MRI) or pathological findings from biopsy or resection of the HCA. Hemorrhage was diagnosed based on findings from computed tomography or MRI. Medical records were reviewed for demographic features, clinical presentation, tumor features, initial and subsequent management, short- and long-term complications and patient and lesion follow-up. RESULTSAll patients were female (n = 23). Treatment in the acute phase consisted of embolization (n = 9, 39.1%), conservative therapy (n = 13, 56.5%), and other intervention (n = 1, 4.3%). Median hemoglobin level decreased significantly more on days 0-3 in the intervention group than in the patients initially treated conservatively (0.9 mmol/L vs 2.4 mmol/L respectively, P = 0.006). In total, 4 patients suffered severe short-term complications, which included hypovolemic shock, acute liver failure and abscess formation. After a median follow-up of 36 mo, tumor regression in non-surgically treated patients occurred with a median reduction of 76 mm down to 25 mm. Four patients underwent secondary (elective) treatment (i.e., tumor resection) to address HCA size of > 5 cm and/or desire for future pregnancy. One case of rebleeding was documented (4.3%). None of the patients experienced long-term complication (mean follow-up time: 36 mo). CONCLUSIONWith a 4.3% risk of rebleeding, secondary (elective) treatment of HCA after massive hemorrhage may only be considered in patients with persistent HCA > 5 cm.

关键词： Hepatocellular adenoma Management Bleeding Outcome Hemorrhage

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