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Anatomic and technical skill factor of gastroduodenal complication in post-transarterial embolization for hepatocellular carcinoma: A retrospective study of 280 cases

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World Journal of Gastroenterology 2005年第10期11卷 1554-1557页

作者： Ting-Kai Leung Chi-Ming Lee Hsin-Chi Chen department of diagnostic radiology

AIM: To reduce the possibility of gastroduodenal complications. The purpose of this retrospective study was to survey the literature and compare and discuss the incidence of post-transarterial embolization (TAE)gastroduodenal ***: We found reports describing 280 cases of hepatocellular carcinoma with TAE procedures done during the past 4 years and selected all of them for our *** these cases, 86 were suspected of suffering gastroduodenal complications within one month of postTAE treatment. Fifteen of these cases were proved by pan-endoscopy to have gastroduodenal erosions or ulcerations. We reviewed the angiographic pictures in patient records to evaluate the possibility that anatomic and technical skill factors could explain the ***: Amongst the 15 cases, 9 were primary lesions of the antrum and prepylorus; 4 had duodenal ulcer or erosions; 2 had mid-body lesions; none showed a lesion at the fundus or cardia region. Three cases had not received TAEs using our ideal method, and may be associated with possible regurgitation of gel-foam pieces into the right or left gastric arteries. Two cases involved sub-selective embolization at a distal point on the hepatic artery; one case was found by angiography to have complete occlusion of the celiac ***: Comparing our results with past cases of post-TAE gastroduodenal complications, we surmise that our relatively low incidence (5.3%) of gastric complications might be explained by our concerted efforts to improve our technical skills in multi-sequential, selective and superselective approaches to the embolization of tumor vessels.

关键词： Post-TAE complication Transarterial embolization Gastroduodenal complication

Fatal thrombotic complications of hepatic cystic compression of the inferior vena: A case report

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World Journal of Gastroenterology 2005年第11期11卷 1728-1729页

作者： Ting-Kai Leung Chi-Ming Lee Hsin-Chi Chen department of diagnostic radiology

Of 5% of patients who develop liver cysts, only 10-15%of them come for medical attention, typically because of dull right upper quadrant pain, abdominal bloating or early satiety. We treated a 77-year-old female with a rare complication of inferior vena cava thrombosis. The patient expired due to septic shock and multiple organ failure.

关键词： Liver cyst Inferior vena cava thrombosis Non-parasitic cyst Cellulitis IVC compression Sepsis

CT diagnosis of recurrence after pancreatic cancer:Is there a pattern?

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World Journal of Gastroenterology 2011年第9期17卷 1126-1134页

作者： Tobias Heye Nicola Zausig Miriam Klauss Reinhard Singer Jens Werner Gtz Martin Richter Hans-Ulrich Kauczor Lars Grenacher department of diagnostic and Interventional radiology University Hospital department of Surgery University Hospital department of diagnostic and Interventional radiology Katharinen Hospital

AIM:To investigate predilection sites of recurrence of pancreatic cancer by computed tomography(CT)in follow-up after surgery. METHODS:Seventy seven patients with recurrence after pancreatic cancer surgery were retrospectively *** operative technique,R-status,T-stage and development of tumor markers were evaluated. Two radiologists analyzed CT scans with consensus *** of local recurrence,lymph node recurrence and organ metastases were *** and progression of findings on follow-up CT were con-sidered as reference standard. RESULTS:The mean follow-up interval was 3.9± 1.8 mo,with a mean relapse-free interval of 12.9± 10.4 *** predominant site of recurrence was local (65%),followed by lymph node(17%),liver metastasis (11%)and peritoneal carcinosis(7%).Local recurrence emerged at the superior mesenteric artery(n=28),the hepatic artery(n=8),in an area defined by the surrounding vessels:celiac trunk,portal vein,inferior vena cava(n=22),and in a space limited by the mesenteric artery,portal vein and inferior vena cava(n=17). Lymph node recurrence occurred in the mesenteric root and left lateral to the *** was confirmed by surgery(n=22)and follow-up CT(n=55).Tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)]increased in accordance with signs of recurrence in most cases(86%CA19-9;79.2% CEA). CONCLUSION:Specific changes of local and lymph node recurrence can be found in the course of the cardinal peripancreatic *** superior mesenteric artery is the leading structure for recurrence.

关键词： Pancreatic cancer Recurrence Computed tomography Follow-up Tumor marker

Effect of gamification applications on success of dentistry students

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World Journal of Methodology 2025年第1期15卷 80-87页

作者： Hatice Ahsen Deniz Elif Polat Balkan Burak İncebeyaz Kıvanç Kamburoğlu department of Dentomaxillofacial radiology Ankara University Faculty of DentistryAnkara 06500Türkiye

BACKGROUND Gamification,the use of game materials in education,has been used in several scientific fields,and studies have demonstrated its effectiveness in student *** To evaluate whether the success of 4th-and 5th-grade dentistry students increases when using the gamification applications Kahoot!and *** An experimental design was used to measure the effect of gamification applications on students who were taught using the traditional *** this purpose,Mentimeter and Kahoot!applications were used in this experimental *** groups of 4th-and 5th-grade students were formed:Mentimeter,Kahoot!,and control *** effect of gamification applications on achievement was evaluated by administering a post-test to these groups after the instructional ***-way analysis of variance and t-tests were used for statistical *** A total of 35.5%of the students were in the Mentimeter group,29.8%in the Kahoot!group,and 34.6%in the control *** the total number of students,54.8%were female and 45.2%were male,while 52.2%were 5th-grade students and 47.8%were 4th-grade *** overall grade point average was found to be 66.65(range,24-100).There was a statistically significant difference in average success scores between students of different groups(P=0.003radiology *** outperformed both the Kahoot!and the traditional method in terms of average student success rates.

关键词： Gamification Mentimeter Kahoot! Education Dentistry

Liver fat content determined by magnetic resonance imaging and spectroscopy

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World Journal of Gastroenterology 2010年第13期16卷 1560-1566页

作者： Fabian Springer Jürgen Machann Claus D Claussen Fritz Schick Nina F Schwenzer Section on Experimental radiology Department of Diagnostic and Interventional Radiology University Hospital Tübingen department of diagnostic and Intervent ional radiology University Hospital Tübingen

Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fatcontaining vacuoles within their cytoplasm, which is the key histological feature. In contrast to ALD, NAFLD is commonly associated with metabolic syndrome, obesity and insulin resistance. To determine increased liver fat content, liver biopsy is currently considered the gold standard. Besides the invasive technique, various other non-invasive techniques have been developed, such as ultrasound, computed tomography (CT), magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) based methods. Among these techniques, ultrasound and CT provide only qualitative information about hepatic steatosis, whereas MRS-or MRI-based methods are able to determine even small amounts of fat accurately. These non-invasive magnetic resonance techniques have already proven their great potential, especially in longitudinal and cross-sectional studies regarding various metabolic conditions and medical treatment regimens. In this review, the most common, non-invasive MRS/MRI techniques for assessment of intrahepatic lipid content are described with their inherent advantages and limitations.

关键词： Hepatic steatosis Magnetic resonance imaging Proton magnetic resonance spectroscopy Lipids

Initial experience from a combination of systemic and regional chemotherapy in the treatment of patients with nonresectable cholangiocellular carcinoma in the liver

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World Journal of Gastroenterology 2005年第8期11卷 1091-1095页

作者： Timm Kirchhoff Lars Zender Sonja Merkesdal Bernd Frericks Nisar Malek Joerg Bleck Stefan Kubicka Stefan Baus Ajay Chavan Michael P.Manns Michael Galanski department of diagnostic radiology department of Gastroenterology Division of Rheumatology department of radiology and Nuclear Medicine

AIM: In nonresectable cholangiocellular carcinoma (CCC)therapeutic options are limited. Recently, systemic chemotherapy has shown response rates of up to 30%.Additional regional therapy of the arterially hyper vascularized hepatic tumors might represent a rational approach in an attempt to further improve response and palliation. Hence, a protocol combining transarterial chemoembolization and systemic chemotherapy was applied in patients with CCC limited to the ***: Eight patients (6 women, 2 men, mean age 62 years) with nonresectable CCC received systemic chemotherapy (gemcitabine 1 000 mg/m2) and additional transarterial chemoembolization procedures (50 mg/m2cisplatin, 50 mg/m2 doxorubicin, up to 600 mg degradable starch microspheres). Clinical follow-up of patients, tumor markers, CT and ultrasound were performed to evaluate maximum response and ***: Both systemic and regional therapies were tolerated well; no severe toxicity (WHO Ⅲ/Ⅳ) was encountered. Nausea and fever were the most commonly observed side effects. A progressive rarefication of the intrahepatic arteries limited the maximum number of chemoembolization procedures in 4 patients. A median of 2 chemoembolization cycles (range, 1-3) and a median of 6.5 gemcitabine cycles (range, 4-11) were *** responses were not achieved. As maximum response, partial responses were achieved in 3 cases,stable diseases in 5 cases. Two patients died from progressive disease after 9 and 10 mo. Six patients are still alive. The current median survival is 12 mo (range, 9-18); the median time to tumor progression is 7 mo (range, 3-18). Seven patients suffered from tumor-related symptoms prior to therapy, 3 of these experienced a treatment-related clinical relief. In one patient the tumor became resectable under therapy and was successfully removed after 10 ***: The present results indicate that a combination of systemic gemcitabine therapy and repeated regional chemoembolizati

关键词： Cholangiocellular carcinoma Gemcitabine Intraarterial chemoembolization

Portal vein thrombosis and arterioportal shunts:Effects on tumor response after chemoembolization of hepatocellular carcinoma

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World Journal of Gastroenterology 2011年第10期17卷 1267-1275页

作者： Thomas J Vogl Nour-Eldin Nour-Eldin Sally Emad-Eldin Nagy NN Naguib Joerg Trojan Hans Ackermann Omar Abdelaziz Institute for diagnostic and Interventional radiology Johan Wolfgang Goethe University Hospital diagnostic and Interventional radiology department Cairo University Hospital

AIM: To evaluate the effect of portal vein thrombosis and arterioportal shunts on local tumor response in advanced cases of unresectable hepatocellular carcinoma treated by transarterial chemoembolization. METHODS: A retrospective study included 39 patients (mean age: 66.4 years, range: 45-79 years, SD: 7) with unresectable hepatocellular carcinoma (HCC) who were treated with repetitive transarterial chemoembolization (TACE) in the period between March 2006 and October 2009. The effect of portal vein thrombosis (PVT) (in 19 out of 39 patients), the presence of arterioportal shunt (APS) (in 7 out of 39), the underlying liver pathology,Child-Pugh score, initial tumor volume, number of tumors and tumor margin definition on imaging were correlated with the local tumor response after TACE. The initial and end therapy local tumor responses were evaluated according to the response evaluation criteria in solid tumors (RECIST) and magnetic resonance imaging volumetric measurements. RESULTS: The treatment protocols were well tolerated by all patients with no major complications. Local tumor response for all patients according to RECIST criteria were partial response in one patient (2.6%), stable disease in 34 patients (87.1%), and progressive disease in 4 patients (10.2%). The MR volumetric measurements showed that the PVT, APS, underlying liver pathology and tumor margin definition were statistically significant prognostic factors for the local tumor response (P = 0.018, P = 0.008, P = 0.034 and P = 0.001, respectively). The overall 6-, 12- and 18-mo survival rates from the initial TACE were 79.5%, 37.5% and 21%, respectively. CONCLUSION: TACE may be exploited safely for palliative tumor control in patients with advanced unresectable HCC; however, tumor response is significantly affected by the presence or absence of PVT and APS.

关键词： Hepatocellular carcinoma Transarterialchemoembolization Portal Shunt Thrombosis

Doppler ultrasonography in living donor liver transplantation recipients: Intra- and post-operative vascular complications

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World Journal of Gastroenterology 2016年第27期22卷 6145-6172页

作者： Omar Abdelaziz Hussein Attia department of diagnostic and Interventional radiology Cairo University Hospitals department of diagnostic and Interventional radiology National Cancer Institute Cairo University

Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. Vascular complications remain the most serious complications and a common cause for graft failure after hepatic transplantation. Doppler ultrasound remains the primary radiological imaging modality for the diagnosis of such complications. This article presents a brief review of intra- and post-operative living donor liver transplantation anatomy and a synopsis of the role of ultrasonography and color Doppler in evaluating the graft vascular haemodynamics both during surgery and post-operatively in accurately defining the early vascular complications. Intra-operative ultrasonography of the liver graft provides the surgeon with useful real-time diagnostic and staging information that may result in an alteration in the planned surgical approach and corrections of surgical complications during the procedure of vascular anastomoses. The relevant intraoperative anatomy and the spectrum of normal and abnormal findings are described. Ultrasonography and color Doppler also provides the clinicians and surgeons early post-operative potential developmental complications that may occur during hospital stay. Early detection and thus early problem solving can make the difference between graft survival and failure.

关键词： Doppler Ultrasound Living donor Liver transplantation Intraoperative Postoperative Vascular Complications

Low-dose computed tomography with 4th-generation iterative reconstruction algorithm in assessment of oncologic patients

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World Journal of Gastrointestinal Oncology 2017年第10期9卷 423-430页

作者： Davide Ippolito Alessandra Silvia Casiraghi Cammillo Talei Franzesi Davide Fior Franca Meloni Sandro Sironi department of diagnostic radiology 'San Gerardo' Hospital School of Medicine University of Milano-Bicocca department of diagnostic radiology 'Papa Giovanni XXIII' Hospital

AIM To compare radiation dose and image quality of lowdose computed tomography(CT) protocol combined with hybrid-iterative reconstruction algorithm with standarddose CT examinations for follow-up of oncologic patients. METHODS Fifty-one patients with known malignant diseases which underwent, during clinical follow-up, both standarddose and low-dose whole-body CT scans were enrolled. Low-dose CT was performed on 256-row scanner, with 120 kV and automated m A modulation, and iterative reconstruction algorithm. Standard-dose CT was performed on 16-rows scanner, with 120 kV, 200-400 m As(depending on patient weight). We evaluated density values and signal-to-noise ratio, along with image noise(SD), sharpness and diagnostic quality with 4-point *** Density values in liver, spleen and aorta were higher in lowdose images(liver 112.55 HU vs 103.90 HU, P diagnostic *** Automatic tube-current modulation combined with hybriditerative algorithm allows radiation dose reduction of 28.9% without loss of diagnostic quality, being useful in reducing dose exposure in oncologic patients.

关键词： Computed tomography Low-dose computed tomography Tube current modulation Oncologic imaging Radiation dose