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Objective:To investigate the incidence and risk factors of hepatic artery injury during percutaneous transhepatic biliary drainage (PTBD).Methods:From Apr 2002 to Dec 2020, the clinical data of 1 446 patients undergoing PTBD were retrospectively analyzed.Results:Hepatic artery injury occurred in 7 cases, with an incidence of 0.48%. Fluoroscopy guided puncture was used in all cases. In those 7 cases (0.48%) a drainage catheter was failed to put in place after multiple attempts, hepatic artery injury occurred in 1 case; One drainage catheter was inserted in 1 314 cases (90.87%), hepatic artery injury occurred in 5 cases; One hundred and twenty-five cases (8.65%) were implanted with two drainage catheter, and 1 case had hepatic artery injury. Failure to successfully insert the drainage catheter increase the incidence of hepatic artery injury ( OR=0.06,95% CI 0.01-0.71, P=0.026) .There were 1 430 cases (98.89%) with oblique needle tip and 5 cases had hepatic artery injury; There were 16 cases (1.11%) with triangular needle tip and 2 cases had hepatic artery injury. Triangular needle tip increased the incidence of hepatic artery injury( OR=55.57, 95% CI 6.84-451.38, P<0.001). Conclusion:Hepatic artery injury is a rare complication of PTBD.The use of triangular needle and the failure of drainage were the risk factors of hepatic artery injury.
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Objective To compare computed tomography angiography (CTA) and digital subtraction angiography (DSA) in identifying anatomical variation of hepatic artery.Methods A retrospective analysis was made on 220 patients who underwent both CTA and DSA in our hospital.The volume rendering (VR) reconstruction of CTA images was performed.The image quality and the recognition of hepatic artery anatomic variation between CTA and DSA were compared.Results There was a significant difference in the image quality of hepatic artery between the two imaging methods (x2 =88.016,P =0.000),DSA was superior to CTA.There was no significant difference in the accuracy of hepatic artery anatomical identification between CTA and DSA (x2 =0.252,P =0.615).This study has found five other types of hepatic artery anatomical variation besides Micheles types.Conclusion The anatomical variation of hepatic artery is complex,and there are many other variations besides Micheles types.CTA,as a noninvasive method,can provide sufficient information for hepatic artery anatomy.
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Objective To study the value of parameters of Transit-Time Flow Measurement(TTFM) as predictor and judge for one-year after coronary artery bypass transplantation in patency rate of vessel grafts .Methods Parameters of quantity of blood flow and the value of PI( pulsation index) were measured and recorded by intraoperative TTFM in CABG .One-year of follow-ing up, coronary artery CT or coronary angiography examination were accomplished.Results Our study include artery grafts 46(including LIMA grafts 44, RIMA graft 1 and radial artery graft 1) with the patency rate of grafts 91.3％ for one-year after CABG, and vein grafts 48 with the patency rate of grafts 66.7％ .There exists statistically significant difference between above two groups(P<0.001).High PI is independent risk factor(P =0.037) in patency rate of vessel grafts for one-year after CABG by binary logistics regression analysis but no other parameters have the statistical significance (P>0.05) .The results from logistic regression were summarized using the area under the ROC curve(AUC) .The pulsation index has been found hav-ing moderate judgment ability(P=0.016) for the dysfunction of grafts after CABG for one-year with optimal cut-off value of 2. 45.Conclusion Intraoperative high value of PI is the independent risk factor in patency rate of vessel grafts for one-year after CABG.
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Objective To explore the value of virtual monochromatic spectral (VMS) images acquired from dual-energy spectral CT (DESCT) with metal artifact reduction (MAR) algorithm in CT-guided microcoil localization for lung nodules.Methods Totally 80 patients with lung nodules underwent DESCT after CT-guided microcoil placement.At optimal keV level,VMS images and VMS with MAR algorithm (VMS+MAR) images were reconstructed,and image quality scores were compared.Results 74 keV was selected as the optimal level.The image quality of VMS+ MAR images at 74,90,110 and 140 keV were better than that at 50 keV (all P＜0.05).There was no statistical difference of image quality among 74,90,110 and 140 keV VMS+MAR images (all P＞0.05).At 74 keV,the image quality of VMS+MAR images was better than that of VMS images (P＜0.05).The consistency was good between the 2 observers (Kappa=0.78).Conclusion VMS images at 74 keV with MAR algorithm could reduce artifacts from microcoil,and clearly display lung nodules.