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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

Treatment of hepatocellular carcinoma with portal venous tumor thrombosis: A comprehensive review

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World Journal of Gastroenterology 2016年第1期22卷 407-416页

作者： Kichang Han Jin Hyoung Kim Gi-Young Ko Dong Il Gwon Kyu-Bo Sung Department of radiology and Research Institute of radiology Asan Medical CenterUniversity of Ulsan College of Medicine

The natural history of hepatocellular carcinoma(HCC)with portal vein tumor thrombosis(PVTT)is dismal(approximately 2-4 mo),and PVTT is reportedly found in 10%-40%of HCC patients at *** to the Barcelona Clinic Liver Cancer(BCLC)Staging System(which is the most widely adopted HCC management guideline),sorafenib is the standard of care for advanced HCC(i.e.,BCLC stage C)and the presence of PVTT is included in this ***,sorafenib treatment only marginally prolongs patient survival and,notably,its therapeutic efficacy is reduced in patients with *** this context,there have been diverse efforts to develop alternatives to current standard systemic chemotherapies or combination treatment *** date,many studies on transarterial chemoembolization,3-dimensional conformal radiotherapy,hepatic arterial chemotherapy,and transarterial radioembolization report better overall survival than sorafenib therapy alone,but their outcomes need to be verified in future prospective,randomized controlled studies in order to be incorporated into current treatment ***,combination strategies have been applied to treat HCC patients with PVTT,with the hope that the possible synergistic actions among different treatment modalities would provide promising *** narrative review describes the current status of the management options for HCC with PVTT,with a focus on overall survival.

关键词： Hepatocellular carcinoma Portal vein tumorthrombosis Sorafenib Transarterial chemoembolization Transarterial radioembolization Hepatic arterial chemotherapy Radiotherapy

Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes

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World Journal of Hepatology 2017年第12期9卷 603-612页

作者： Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski Department of radiology Division of Interventional RadiologyMount Sinai Hospital Department of radiology Division of Interventional RadiologyHospital of the University of Pennsylvania

AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated *** Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging( 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive *** Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(

关键词： Variceal hemorrhage Portal hypertension Transjugular intrahepatic portosystemic shunts Ascites Sub-maximal dilation Underdilated Passive expansion Hepatic encephalopathy

Cryptogenic multifocal ulcerous stenosing enteritis: Radiologic features and clinical behavior

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World Journal of Gastroenterology 2017年第25期23卷 4615-4623页

作者： Jiyoung Hwang Jin Sil Kim Ah Young Kim Joon Seok Lim Se Hyung Kim Min Ju Kim Mi Sung Kim Kyoung Doo Song Ji Young Woo Department of radiology Soonchunhyang University Seoul Hospital Department of radiology and Research Institute of radiology University of Ulsan College of Medicine Asan Medical Center Department of radiology Research Institute of Radiological Science Yonsei University College of Medicine Department of radiology Seoul National University Hospital Department of radiology Anam Hospital Korea University College of Medicine Department of radiology Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of radiology and Center for Imaging Science Samsung Medical Center Sungkyunkwan University School of Medicine Department of radiology Hallym University College of Medicine Kangnam Sacred Heart Hospital

To investigate the characteristic radiologic findings of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) which can be differentiated from other similar bowel disease and to assess their clinical behavior. METHODSTwenty pathologically and clinically confirmed CMUSE patients (males:females = 8:12; mean age: 40.4 years) between March 2002 and August 2015 from seven academic centers in South Korea were retrospectively reviewed. We evaluated small bowel series (SBS; n = 25), computed tomography (CT) enterography (n = 21), magnetic resonance (MR) enterography (n = 2), and abdominopelvic CT (n = 18) images, focusing on enteric and perienteric manifestations. Any change in radiologic features during follow-up period was recorded. We evaluated clinical data including presenting symptoms, laboratory finding and presence of relapse from electronic medical records. Histopathologic findings were also evaluated. RESULTSThe main symptoms were abdominal pain (n = 12) and anemia (n = 10). All patients showed small bowel strictures (n = 52, mean: 2.6 per patient) on initial CT/MR, located in the ileum (n = 47) or jejunum (n = 5). Strictures showed short-length (mean: 10.44 mm) and circumferential bowel wall thickening (mean: 5.56 mm) with layered enhancement (n = 48) that were also noted on initial SBS (n = 36) with shallow ulcers (n = 10). Some ulcerative lesions or wall thickening progressed into strictures on follow-up SBS/CT, and some strictures revealed recurrent ulceration on follow-up SBS. There were no penetrating disease features like fistula or abscess and no gastrointestinal tract involvement except the small bowel. Nine patients experienced disease recurrence (median relapse-free period: 32 mo) even post-operatively. Histopathologic features of surgically resected specimens were characterized as multiple superficial ulcerations confined to mucosa or submucosa and multiple strictures. CONCLUSIONUnder characteristic radiologic findings with multiple short-segmen

关键词： Cryptogenic multifocal ulcerous stenosing enteritis Small intestine Computed tomography Small bowel series Diagnosis

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

Dynamic magnetic resonance defecography in 10 asymptomatic volunteers

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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

Budd-Chiari syndrome: A case with a combination of hepatic vein and superior vena cava occlusion

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World Journal of Gastroenterology 2005年第24期11卷 3797-3799页

作者： Yoshio Araki Chikara Sakaguchi Izumi Ishizuka Masaya Sasaki Tomoyuki Tsujikawa Shigeki Koyama Akira Furukawa Yoshihide Fujiyama Department of Internal Medicine Department of radiology

We here report a recent, rare case of Budd-Chiari syndrome, associated with a combination of hepatic vein and superior vena cava occlusion. A young female, who had been ingood health, was admitted to our hospital because of massive ascites. The patient had used no oral contraceptives. Tests for coagulation disorders, hematological disorders, and antiphospholipid syndrome were all negative. BuddChiari syndrome was diagnosed by radiographic examination. The patient was suffering from a combination of hepatic vein and superior vena cava occlusion. In particular, the venous flow returned from the liver mainly through a right accessory hepatic vein, and stenosis was recognized at the orifice of this collateral vein into the vena ***, the patient underwent percutaneous balloon dilatation therapy for this stenosis. After this treatment, the massive ascites was gradually reduced, and she was discharged from our hospital. It has now been one year since discharge, and the patient has been doing well. If deteriorating liver function or intractable ascites occur again, a liver transplantation may be anticipated. This is the first case report of Budd-Chiari syndrome associated with a superior vena cava occlusion.

关键词： Budd-Chiari syndrome Hepatic vein occlusion Superior vena cava ocdusion Percutaneous balloon dilatation

Spontaneous rupture of intrahepatic pseudocyst into the inferior vena cava

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Gastroenterology Report 2018年第3期6卷 225-227,I0003页

作者： Yashwant Patidar Binit Sureka Vaibhav Pratap Singh Kalpana Bansal Rakhi Maiwall Department of radiology/Interventional radiology Institute of Liver and Biliary SciencesNew DelhiIndia

We present an extremely rare case of caudate lobe intrahepatic pancreatic pseudocyst with spontaneous rupture into the inferior vena cava(IVC).A 58-year-old male,a chronic alcoholic,presented with features of pancreatitis for which imaging was *** and contrast-enhanced computed tomography were carried out,which revealed intrahepatic pancreatic pseudocyst in the caudate lobe of the *** was suggestion of spontaneous rupture of the pseudocyst into the IVC,which was well delineated on imaging.

关键词： pancreatic pseudocyst spontaneous rupture inferior vena cava

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

Diagnostic detection with cardiac tomography and resonance of extremely rare coronary anomaly:A case report and review of literature

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World Journal of Clinical Cases 2019年第5期7卷 628-635页

作者： Nicolò Schicchi Marco Fogante Gian Marco Giuseppetti Andrea Giovagnoni Department of radiology Azienda Ospedaliero-Universitaria Ospedali Riuniti Department of radiology Università Politecnica delle Marche

BACKGROUND The association of two congenital coronary artery anomalies(CAAs) is extremely rare but represents one of the main cause of sudden cardiac death in young athletes. Although coronary angiography(CX-A) is still widely used in childhood, cardiac magnetic resonance(C-MRI) and cardiac computed tomography(C-CT) have recently taken on an increasing diagnostic role in early detection of CAAs and concomitant congenital cardiac *** SUMMARY A healthy 10-year-old male patient was referred to the Radiological Department of our Institution due to no evidence of left coronary artery in echocardiographic examination. With C-MRI was detected marked myocardial trabeculation and was suspected anomalous origin and course of left circumflex(LCx) artery and of left anterior descending(LAD) artery. With third generation Dual Source C-CT192x2-sections(SOMATOM Force, Siemens, Germany) was confirmed anomalous origin of LCx artery from right pulmonary artery associated with anomalous origin of LAD artery from right coronary artery with course in front of right ventricular outflow tract. The patient underwent surgical treatment with reimplantation of the anomalous LCX and LAD arteries into the wall of ascending aorta, with no postoperative complications. The patient remained asymptomatic and follow-up C-MRI scan four months after operation showed complete success of surgery *** This case highlights the diagnostic potential of C-CT and C-MRI in evaluation of CAAs and of cardiac morphology and functionality, with very low radiation dose and without the risks related to invasive procedure.

关键词： Coronary anomalies Cardiac computed tomography Cardiac magnetic resonance Case report Coronary artery anomalies