ABSTRACT
Objective To evaluate the early diagnosis value of MRI combined with DSA in cirrhotic nodules (regenerative nodules, dysplastic nodules) becoming small hepatocellular carcinoma. Methods 40 patients diagnosed as cirrhosis and whose liver nodules detected by ultrasound were followed up as MR dynamic study. All patients were followed up by three dynamic contrast-enhanced MR scanning once every 3 months,and the changes of cirrhotic nodules were observed and analyzed in the signal. If MRI suggested cancerous nodules cirrhosis, hepatic artery DSA would be carried out. Results 40 patients were followed up for 1.5 to 3 years,all patients MR nodules were found in liver regeneration. Follow-up process, the dysplastic nodules were founded in 28 cases and the small hepatocellular carcinoma were founded in 18 patients. 16 cases of 18 patients with small hepatocellular carcinoma carried out routine DSA all had typical of hepatic arterial blood supply and angiogenesis, and were given to Integrated Traditional and Western intervention simultaneously. Conclusion Combined use of MRI-DSA in the evaluation of cirrhotic nodules had a definite value, and could find smaller hepatocellular carcinoma,provide the basis for smaller hepatocellular carcinoma therapy.
ABSTRACT
Objective To evaluate the selective angiography and interventional management in nonvariceal gastrointestinal hemorrhage.Methods 94 cases with nonvariceal gastrointestinal hemorrhage were accepted for selective angiography.According the location and cause of hemorrhage finding by angiography,these patients were checked by arterial embolization and/or perfusion of vasoconstrictor substance.Results DSA revealed positive result in 58 cases(61.7%) of 94 cases.Meanwhile,13 cases accepted 99m Tc-labeled erythrocytes nuclear scan,11 cases(84.6%) showed hemorrage.Arterial embolization was carried out in 34 cases,the hemostasis and relapse rate was 91.2% and 8.8% respectively.Besides arterial embolization,8 cases were selected vasopressin infusion,the hemostasis and relapse rate of vasopressin infusion was 75.0% and 25.0% respectively.No severe complication such as intestinal necrosis occurred among the 42 cases with interventional therapy.Conclusion Selective angiography is a valuable method for the diagnosis of the nonvariceal gastrointestinal hemorrhage of unknown reasons.The()~(99m)Tc-labeled erythrocytes nuclear scan is more sensitive than selective angiography in detecting bleeding,however,as to find bleeding location accurately,it was inferior to selective angiography.