ABSTRACT
Objective To discuss the method,mid-long term clinical therapeutic effect and safety of coil embolization in treating patients with hepatic arterial pseudoaneurysm(HAPA).Methods Seven patients with repeatedly massive hemorrhage of gastrointestinal tract were undertaken DSA of celiac arteries and hepatic arteries and embolization of the feeding artery by coils or microcoils after correct diagnosis.All cases underwent follow-up from 6 to 60 months(mean 38).Results The blood loss before angiography was ranged from 1200 to 4000(mean 2385)ml.There were 3 cases with normal hepatic function and 4 with hepatic dysfunction including ALT increase in 2 and obstructive jaundice in another.Digital substraction angiography(DSA)clearly showed the location,shape and feeding arteries of HAPA.There were 2 types of HAPA namely intrahepatic (n=3)and extrahepatic(n=4),adding one case with arteriovenous fistula(AVF).Embolization was successful in all cases by coils(n=13)or microeoils(n=12).No recurrence and any definite clinical complication occurred during follow-up.Conclusion Coil embolization in treating HAPA is safe and effective with mid-long term positive clinical therapeutic efficiency without severe complications.(J Intervent Radiol, 2007,16:803-806)
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the imaging features of MR Imaging (MRI) and MR cholangiopancreatography (MRCP) and their clinical value in the diagnosis of extrahepatic cholangiocarcinoma.</p><p><b>METHODS</b>MRI was performed in 54 patients with extrahepatic cholangiocarcinoma proved surgically and pathologically, MRCP in 44 patients, Gadolinium-enhanced in 29 patients. MRI, MRCP and pathological findings were analyzed retrospectively.</p><p><b>RESULTS</b>By MRI, the mass was shown (n = 39) and all bile duct thickened (n = 13) in extrahepatic cholangiocarcinoma. Gadolinium-enhanced ones revealed calcified focus (n = 22). By MRCP, interrupted, abruptly cut-off or cone-like changes of the bile duct (n = 16), beak-like or mouse tail changes (n = 26) or tumbler mouth appearance (n = 2) were shown. The bile duct distal to the obstruction was observed in 29 patients. Of the 54 patients examined by MRI in combination with MRCP, correct tumor localization was made in 52 (96.3%) and correct judgement of tumor nature in 50 (92.6%).</p><p><b>CONCLUSION</b>Conventional MRI is an effective supplement to MRCP in the diagnosis of extrahepatic cholangiocarcinoma. MRCP combined with MRI is able to significantly improve the diagnostic accuracy of MR examination.</p>