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Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation

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World Journal of Transplantation 2024年第2期14卷 126-134页

作者： Gabriel Lazzarotto-da-Silva Leandro A Scaffaro Mauricio Farenzena Lucas Prediger Rafaela K Silva Flávia Heinz Feier Tomaz J M Grezzana-Filho Pablo D Rodrigues Alexandre de Araujo Mario Reis Alvares-da-Silva Roberta C Marchiori Cleber Rosito Pinto Kruel Marcio Fernandes Chedid department of Liver Transplant and Hepatobiliary Surgery Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil department of interventional radiology Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil department of Gastroenterology and Hepatology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil

BACKGROUND Hepatocellular carcinoma(HCC)is an aggressive malignant neoplasm that requires liver transplantation(LT).Despite patients with HCC being prioritized by most organ allocation systems worldwide,they still have to wait for long *** therapies(LRTs)are employed as bridging therapies in patients with HCC awaiting *** largely used in the past,transarterial embolization(TAE)has been replaced by transarterial chemoembolization(TACE).However,the superiority of TACE over TAE has not been consistently shown in the *** To compare the outcomes of TACE and TAE in patients with HCC awaiting *** All consecutive patients with HCC awaiting LT between 2011 and 2020 at a single center were *** patients underwent LRT with either TACE or *** patients also underwent percutaneous ethanol injection(PEI),concom-itantly or in different treatment *** choice of LRT for each HCC nodule was determined by a multidisciplinary *** primary outcome was waitlist dropout due to tumor progression,and the secondary outcome was the occurrence of adverse *** the subset of patients who underwent LT,complete pathological response and post-transplant recurrence-free survival were also *** Twelve(18.5%)patients in the TACE group(only TACE and TACE+PEI;n=65)and 3(7.9%)patients in the TAE group(only TAE and TAE+PEI;n=38)dropped out of the waitlist due to tumor progression(P log-rank test=0.29).Adverse events occurred in 8(12.3%)and 2(5.3%)patients in the TACE and TAE groups,respectively(P=0.316).Forty-eight(73.8%)of the 65 patients in the TACE group and 29(76.3%)of the 38 patients in the TAE group underwent LT(P=0.818).Among these patients,complete pathological response was detected in 7(14.6%)and 9(31%)patients in the TACE and TAE groups,respectively(P=0.145).Post-LT,HCC recurred in 9(18.8%)and 4(13.8%)patients in the TACE and TAE groups,respectively(P=0.756).Posttransplant recurrence-free survival was simila

关键词： Hepatocellular carcinoma Transarterial embolization Transarterial chemoembolization Liver transplantation Locoregional therapy Bridging

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Treatment and Clinical Management of Chronic Thromboembolic Pulmonary Hypertension:An Update of Literature Review

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Congenital Heart Disease 2024年第2期19卷 157-176页

作者： Yuan Ren Yingxian Sun Zhiguang Yang Yanli Chen The department of Cardiology The First Affiliated Hospital of China Medical UniversityShenyang110000China The radiology department Shengjing Hospital of China Medical UniversityShenyang110020China

Chronic thromboembolic pulmonary hypertension(CTEPH)is a chronic,progressive,debilitating,and life-threa-tening complication of pulmonary embolism(PE).Recent technological advances have permitted various treat-ment options for the treatment of CTEPH,including surgery,angioplasty,and medical treatment,depending on the location and characteristics of *** endarterectomy(PEA)is the treatment of choice for CTEPH,as it offers excellent long-term outcomes and a high probability of ***,various medical and interventional therapies are currently being developed for patients with inoperable *** review mainly summarizes the current treatment approaches of CTEPH,offering more options for specialist physicians to,thus,better manage chronic thromboembolic syndromes.

关键词： Chronic thromboembolic pulmonary hypertension(CTEPH) chronic thromboembolic pulmonary disease(CTEPD) pulmonary endarterectomy(PEA) balloon pulmonary angioplasty(BPA) COVID-19

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Application of subharmonic-aided pressure estimation in a patient with giant hepatic cyst:A case report

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Portal Hypertension & Cirrhosis 2024年第2期3卷 124-127页

作者： Xiuyun Lu Jiaying Cao Yaozu Liu Jingqin Ma Jianjun Luo Yi Dong Wenping Wang Shanghai Institute of Medical Imaging ShanghaiChina department of Ultrasound Zhongshan HospitalFudan UniversityShanghaiChina department of Ultrasound Xinhua Hospital Affiliated to Shanghai Jiaotong University School of MedicineShanghaiChina department of interventional radiology Zhongshan HospitalFudan UniversityShanghaiChina National Clinical Research Center for interventional Medicine Zhongshan HospitalFudan UniversityShanghaiChina

Giant hepatic cysts may lead to impaired liver function by compressing surrounding tissue,resulting in symptoms such as nausea or portal ***-aided pressure estimation(SHAPE)offers a noninvasive method for quantitatively estimating pressure and monitoring interstitial fluid pressure.A 55-year-old female patient with giant hepatic cysts was admitted to our hospital with elevated protein electrophoretic gamma levels,likely caused by compression of important liver vessels by the *** surgery,B-mode ultrasound(BMUS)revealed multiple anechoic cystic lesions with thin,smooth walls in the right *** SHAPE,the curve of the portal vein was lower than that of the hepatic vein,which is absolutely different from a healthy volunteer in our previous SHAPE *** suggested that the patient may have had portal *** days after laparoscopic fenestration and drainage of hepatic cysts,the size of the largest cyst had decreased on BMUS and protein electrophoretic gamma levels had *** the curve of the portal vein remained lower than that of the hepatic vein,the difference between them had decreased compared to presurgery *** shows promise as a tool for noninvasively estimating portal hypertension and improving prognosis assessment in patients.

关键词： hepatic admitted impaired

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Transjugular intrahepatic portosystemic shunt for esophagogastric variceal bleeding in patients with hepatocellular carcinoma and portal vein tumor thrombus

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2778-2786页

作者： Zhi-Qiang Wu Fan Wang Feng-Pin Wang Hong-Jie Cai Song Chen Jian-Yong Yang Wen-Bo Guo department of interventional radiology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080Guangdong ProvinceChina department of Medical Oncology Affiliated Cancer Hospital&Institute of Guangzhou Medical UniversityGuangzhou 510080Guangdong ProvinceChina

BACKGROUND Whether hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT)and acute esophagogastric variceal bleeding(EGVB)can improve the success rate of endoscopic hemostasis and overall survival(OS)from transjugular intrahepatic portosystemic shunt(TIPS)remains *** To compare the clinical outcomes between TIPS and standard treatment for such HCC *** This monocenter,retrospective cohort study included patients diagnosed as HCC with PVTT and upper gastrointestinal *** were grouped by the treatment(TIPS or standard conservative treatment).The success rate of en-doscopic hemostasis,OS,rebleeding rates,and main causes of death were *** Between July 2015 and September 2021,a total of 77 patients(29 with TIPS and 48 with standard treatment)were *** success rate of endoscopic hemostasis was 96.6%in the TIPS group and 95.8%in the standard treatment *** the 29 patients in TIPS group successful underwent TIPS procedure and had a better OS compared with standard treatment within the first 160 days after treatment(68 days vs 43 days,P=0.022),but shorter OS after 160 days(298 days vs 472 days, P = 0.022). Cheng’s Classification of PVTT, total bilirubin and Child-Pugh class wereindependently negative associated with OS (all P < 0.05). The main causes of death were liver failure or hepaticencephalopathy (75.9%) in the TIPS group and rebleeding (68.8%) in the standard *** could reduce the risk of early death due to rebleeding and prolong short-term survival in HCC patients withPVTT and acute EGVB, which deserves further investigation.

关键词： Hepatocellular carcinoma Portal vein tumor thrombus Transjugular intrahepatic portosystemic shunts Acute esophagogastric variceal bleeding Standard treatment Endoscopic treatment

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PET/MRI改善癌症患儿管理

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中华核医学与分子影像杂志 2024年第2期44卷 124-128页

作者： Lucia Baratto K.Elizabeth Hawk Lisa States Jing Qi Sergios Gatidis Louise Kiru Heike E.Daldrup-Link 陈素芸(译) 王辉(审校) department of radiology Stanford UniversityStanfordCalifornia department of radiology Children′s Hospital of PhiladelphiaPhiladelphiaPennsylvania department of radiology Children′s WisconsinMilwaukeeWisconsin department of Diagnostic and interventional radiology University Hospital TübingenTübingenGermany department of Pediatrics Stanford UniversityStanfordCalifornia 上海交通大学医学院附属新华医院核医学科上海200092

一体化PET/MRI通过一站式成像提供肿瘤解剖学及功能评估,且与^(18)F-FDG PET/CT相比其辐射暴露量减少80%,因此对癌症患儿的分期与再分期具有显著临床价值。该文回顾了^(18)F-FDG PET/MRI在小儿肿瘤中的临床应用,尤其关注PET/MRI在患儿... 详细信息

一体化PET/MRI通过一站式成像提供肿瘤解剖学及功能评估,且与^(18)F-FDG PET/CT相比其辐射暴露量减少80%,因此对癌症患儿的分期与再分期具有显著临床价值。该文回顾了^(18)F-FDG PET/MRI在小儿肿瘤中的临床应用,尤其关注PET/MRI在患儿管理中的价值。来自4个不同机构的PET/MRI应用先行者分享了他们对PET/MRI技术在癌症患儿评估中特殊优势的见解。文章作者讨论了全身PET/MRI在评估某些解剖区域(如软组织和骨髓)中的价值以及儿童特殊的PET/MRI影像学特征,并强调了全身PET/MRI如何通过在不失去诊断准确性的同时减少所需放射学检查次数(因此减少辐射暴露),改善淋巴瘤、肉瘤和神经纤维瘤病患儿的临床管理。文章论述了PET/MRI如何帮助区分恶性肿瘤与感染性或炎性疾病;另外,简要探讨了PET/MRI用于接受免疫治疗的患儿疗效评估以及对不同诊疗一体化药物评估的未来研究方向。从儿童应用中所获得的经验也可拓展至成人患者的评估中。

关键词：肿瘤学儿科学 PET/MRI 癌症儿科肿瘤学

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Enhancing transjugular intrahepatic portosystemic shunt procedure efficiency with digital subtraction angiography image overlay technology in esophagogastric variceal bleeding

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2870-2877页

作者： Xiao-Yan Li Yao Li Wen-Qiang Li Shuai Ju Zhi-Hui Dong Jian-Jun Luo Vascular and Wound Center Jinshan HospitalFudan UniversityShanghai 201508China department of Vascular Surgery Institute of Vascular SurgeryZhongshan Hospital Fudan UniversityShanghai 200032China department of interventional radiology Zhongshan Hospital Fudan UniversityShanghai 20032China

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a pivotal intervention for managing esophagogastric variceal bleeding in patients with chronic hepatic *** To evaluate the efficacy of digital subtraction angiography image overlay tech-nology(DIT)in guiding the TIPS *** We conducted a retrospective analysis of patients who underwent TIPS at our hospital,comparing outcomes between an ultrasound-guided group and a DIT-guided *** analysis focused on the duration of the portosystemic shunt puncture,the number of punctures needed,the total surgical time,and various clinical indicators related to the *** The study included 52 patients with esophagogastric varices due to chronic hepatic *** demonstrated that the DIT-guided group expe-rienced significantly shorter puncture times(P<0.001)and surgical durations(P=0.022)compared to the ultrasound-guided ***,postoperative assessments showed significant reductions in aspartate aminotransferase,B-type natriuretic peptide,and portal vein pressure in both ***,the DIT-guided group also showed significant reductions in total bilirubin(P=0.001)and alanine aminotransferase(P=0.023).CONCLUSION The use of DIT for guiding TIPS procedures highlights its potential to enhance procedural efficiency and reduce surgical times in the treatment of esophagogastric variceal bleeding in patients with chronic hepatic schistoso-miasis.

关键词： Portal hypertension Digital subtraction angiography Image overlay technology Hepatic artery labeling Transjugular intrahepatic portosystemic shunt

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Renal resistive index measurements by ultrasound in patients with liver cirrhosis:Magnitude and associations with renal dysfunction

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World Journal of radiology 2024年第6期16卷 221-231页

作者： Himanshu Surya Ramesh Kumar Rajeev Nayan Priyadarshi Sabbu Surya Prakash Sudhir Kumar department of Gastroenterology All India Institute of Medical SciencesPatna 801507India department of radiodiagnosis All India Institute of Medical SciencesPatna 801507India

BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular *** To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high *** This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with *** association of RRI with AKI was *** receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI *** analysis was conducted to determine the predictors of high *** The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of ***,AKI was present in 129(64.5%)*** mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-*** mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)*** demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.

关键词： Renal resistive index Cirrhosis Acute kidney injury Hepatorenal syndrome Renal Doppler

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Advances in the imaging of gastroenteropancreatic neuroendocrine neoplasms

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World Journal of Gastroenterology 2022年第26期28卷 3008-3026页

作者： Anupama Ramachandran Kumble Seetharama Madhusudhan department of radiodiagnosis and interventional radiology All India Institute of Medical SciencesNew Delhi 110029India

Gastroenteropancreatic neuroendocrine neoplasms comprise a heterogeneous group of tumors that differ in their pathogenesis,hormonal syndromes produced,biological behavior and consequently,in their requirement for and/or response to specific chemotherapeutic agents and molecular targeted *** imaging techniques are available for functional and morphological evaluation of these neoplasms and the selection of investigations performed in each patient should be customized to the clinical ***,with the increased availability of cross sectional imaging,these neoplasms are increasingly being detected incidentally in routine radiology *** article is a review of the various imaging modalities currently used in the evaluation of neuroendocrine neoplasms,along with a discussion of the role of advanced imaging techniques and a glimpse into the newer imaging horizons,mostly in the research stage.

关键词： Neuroendocrine tumor Gastroenteropancreatic Intravoxel incoherent motion Diffusion weighted imaging Perfusion imaging Dual energy computed tomography

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Conformity Assessment of Lead Aprons Used in Conventional radiology: A Multi-Centre Survey in Togo

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Open Journal of radiology 2024年第2期14卷 55-63页

作者： Massaga Dagbé Bidamin N’timon Ousmane Aminata Bah Pihou Gbandé Komi Awobanou Koku Adambounou Masamaesso Tchaou Abdoulatif Amadou Lantam Sonhaye Lama Kegdigoma Agoda-koussema Komlanvi Victor Adjénou radiology department Kara University Hospital Kara Togo Armed Forces Reference Imaging Center (CIRA) Conakry Guinea radiology department Sokod Regional Hospital Sokod Togo radiology department Lom University Hospital Lom Togo Radiation Protection/Telemedicine department Lom University Hospital Lom Togo radiology department Kara Regional Hospital Kara Togo

Aim: Lead aprons are used to protect against scattered radiation from the patient during interventional procedures and certain special conventional radiological examinations. Given the importance of the role lead aprons are supposed to play in radiation protection, we propose to assess their conformity in medical imaging departments in public and religious hospitals in Togo. Materials and method: A multi-centre survey conducted from 26 November to 06 December 2021 in the radiology departments of public and religious health facilities in Togo. All aprons in use were included. The evaluation criteria were physical (visual), quantitative (radiographic) and qualitative (dosimetric). Results: We had registred 43 aprons among wich 27 (62.79%) leaded aprons were labelled non-compliant and 16 (37.21%) were labelled compliant. Of the aprons judged to be non-compliant, 70.37% were more than 10 years old and 96.30% showed defects on the radiographic images. The most common defects were vampire marks (18.64%), multiple folds (16.96%), cracks (16.96%), multiple cracks (15.25%), tears (8.47%), absence of lead (5.08%), holes (3.39%) and lead corrosion (1.69%). Defective aprons (62.96%) had at least two defects. The defects were of thoraco-abdomino-pelvic (74.07%), thoracic (14.82%) and abdomino-pelvic (11.11%) topography. For indirect exposure at 50 and 70 kilovolts, all the aprons had an attenuation factor greater than 90%. After dosimetric measurement, 13.95% of aprons had attenuation factors below 90% for indirect exposure at 100 kilovolts. Conclusion: The compliance of the leaded decks is trifactorial (physical, radiographic and dosimetric). However, there is no significant difference in X-ray attenuation capacity between defective and normal decks.

关键词： Lead Apron Compliance Radiation Protection radiology Togo

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Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

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International Journal of Ophthalmology(English edition) 2024年第8期17卷 1483-1488页

作者： Shaikha Al Eid Hamad M AlSulaiman Sahar M Elkhamary Osama Al Sheikh Alicia Ferrero-Galindo Rajiv Kandekhar Silvana A Schellini Oculoplastic Division King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia radiology Division King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia department of Diagnostic radiology Mansoura Faculty of MedicineMansoura 35511Egypt University Hospital Rio Hortega Valladolid 47012Spain Research department King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia Ophthalmology department Medical SchoolState University of Sao PauloBotucatu 18618-687Brazil

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic ***:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric ***-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were *** data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal *** relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

关键词： anophthalmic socket spheric implant levator palpebrae superioris superior rectus lagophthalmos fornix depth

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