ABSTRACT
Objective To explore the clinical application value of ultrasound-guided intrahepatic biliary puncture combined with internal double biliary stenting under DSA in elderly patients with malignant hilar biliary obstruction (MHBO).Methods Totally 108 elderly MHBO patients received interventional treatment were analyzed retrospectively.Half of patients were treated with ultrasound-guided intrahepatic biliary puncture (ultrasound group),and another 54 patients were treated with DSA intrahepatic biliary puncture (DSA group).After successful puncture,the patients received percutaneous transhepatic cholangial drainage (PTCD) with 4 methods under DSA guidance,namely internal double biliary stenting,contralateral external PTCD with single biliary stenting,complete external PTCD and external PTCD on the dominant side.The recent complications of intrahepatic biliary puncture at two groups and the curative effect with four methods were observed.Results The frequency of intrahepatic biliary puncture,the dosage of contrast agent,the incidence of pain at the puncture point and hemobilia in ultrasound group were all lower than those in DSA group (all P＜0.05),the successful rate of intrahepatic biliary puncture in first time was significantly higher compared with DSA group (P＜0.05).The liver function indicators at 14 days postoperation and total bilirubin at 21 days postoperation had statistical differences between any two biliary drainage methods (all P＜ 0.05).Conclusion Ultrasound-guide intrahepatic biliary puncture combined with internal double biliary stenting under DSA can significantly benefit elderly patients with MHBO.
ABSTRACT
Objective To probe the blood supply of liver metastasis by celiac artery,proper hepatic artery DSA.portal vein perfusion CT during superior mesenteric arterial poaography(PCTAP).Methods One hundred patients with liver metastases were examined prospectively by plain CT scan,multiphase enhanced CT scan,celiac arteriography and proper hepatic artefiography.Of them,56 patients were examined by PCTAP.All primary lesions wero confirmed by operation and(or)pathology examination.In order to investigate the blood supply of metastasis lesions.the software of Photoshop Was used to obtain the time-attenuation cugves(TDC)of tumor center,tumor edge,portal vein and normal liver parenchyma adjacent to the tumor to talculate liver perfusion for DSA image analysis,while a deconvolution model from CT perfusion software Was designed for the dual blood supply.Results DSA findings:TDC of proper hepatic arteriography showed:the mean peak concentration(K value)in tumor centers was(67±12)%,and it was(76±15)%for peritumor tissue,(51±10)%in normal liver parenchyma.TDC of celiac arteriogaphy showed that the contrast concentration of tumor centers and tumor edge increased fast in early stage.then maintained a slight upward plateau,in the meanwhile,the contrast concentration of normal liver parenchyma kept increasing slowly.PCTAP findings:tumors exhibited no enhancement during 30 s continued scans.Conciusion The blood supply of liver metastasis mainly comes from hepatic artery,but barely from portal vein.
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Objective To explore the value of CR in the diagnosis of breast cancer in young women.Methods The relationshipbetween X-ray features of 50 cases of breast cancer in young women and pathology were analysed retrospectively.Results Infiltratinglobular carcinoma was in 26 cases,and infiltrating ductal carcinoma was in 24 cases.Mass shadows was in 13 cases,pure calcification 7cases,structure disorder 5 cases,patches shadows 16 cases,patches shadows with calcification 4 cases and mass with calcification 5 cases.Conclusion Mammography is still the best method for breast cancer in young women.