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Objective To studying the MR findings and pathology of peripheral small intrahepatic cholangiocarcinoma and improving the understanding of peripheral small cholangiocarcinoma with no-bile duct dilatation. Methods A retrospective analysis of 12 patients with intrahepatic peripheral cholangiocarcinoma which were confirmed by surgery and pathology, all patients were examined by abdominal MRI without and with contrast. Correlation was made with gross pathology and surgical pathological specimen. Results On T1WI, there were 4 cases of complex low signal intensity and 8 cases of low signal intensity. On T2WI, there were 8 cases of high signal intensity and 4 cases of complex high signal intensity. Enhanced MRI showed: marked nidus enhancement on arterial phase in 1 case, and the pathological diagnosis was poorly differentiated adenocarcinoma. Inhomogeneous enhancement or annular enhancement were seen in 10 cases on arterial phase, 3 of these cases showed thin annular enhancement on arterial phase, low signalintensity on portal venous phase and isointensity on delayed phase. One case showed delayed enhancement. Thick circular enhancement correlated with pathological changes of survival of tumor cells, center areas correlated with fibrous connective tissue, and a small amount of necrotic tissue. Island-like enhancement or inhomogeneous enhancement were seen in 3 cases. Corresponding pathological changes consisted of tumor tissue and a small amount of fibrous connective tissue, as well as somenecrotic tissue. In 1 case, no enhancement was seen on all three phases and pathological changes showed cystic changes, hemorrhage, necrosis, with survival tumor cells seen between cyst and normal liver tissue. Conclusions MRI scanning of peripheral small cholangiocarcinoma lacked characteristic features, but dynamic contrast-enhanced MR had certain specific findings. Due to different pathology, the fibrous tissue, necrotic tissue and survival tumor tissue components were exhibited different imaging findings.
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Objective To investigate the clinical effects of two different partial splenic embolization (PSE) methods in treating portal hypertension due to cirrhosis, and to statistically analyze the difference between the two PSE methods. Methods Sixty-two patients with cirrhotic portal hypertension complicated by hypersplenism were divided into group A (peripheral embolization group) and Group B (lower- pole embolization group). Partial splenic embolization with sponge was carried out in all patients of both groups. Before and after PSE color Doppler ultrasoundgraphy was performed to determine the inner diameter of the portal vein and splenic vein, the velocity and rate of flow, the length and thickness of spleen, etc. The results were compared between the two groups. Results The splenic embolization area within 60% - 80%was obtained in 42 patients, and the embolization area>80%was seen in 20 patients. After PSE, decreased flow velocity as well as flow rate was detected in all patients, and both the length and thickness of the spleen were also significantly reduced when compared with the data determined before PSE. The differences between the two groups were statistically significantly (P < 0.05). Conclusion Partial splenic embolization can effectively relieve the portal hypertension caused by cirrhosis, and selective peripheral arterial embolization is superior to splenic lower-pole embolization in decreasing the portal pressure.
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Objective To compare the efficacy of MRI and multi-slice CT(MSCT) for characterization of liver isolation nodular lesions in cirrhosis patients .Methods A total of 64 patients with 64 lesions ,underwent MSCT and MRI .Chi-square tests were used to compare the performances of MSCT and MRI in characterization of lesions .Results The detection rate ,accuracy ,sensitivity ,spe-cificity ,positive predictive and negative predictie of MSCT and MRI were 76 .56% ,65 .31% ,37 .50% ,78 .79% ,72 .22% ,46 .15%and 87 .50% ,85 .71% ,66 .67% ,97 .14% ,82 .93% ,93 .33% respectively .There were statistical difference in accuracy ,specificity , positie predictie between MSCT and MRI (P< 0 .05) .Conclusion MRI is superior to MSCT in accuracy ,specificity ,and positive predictive for characterization of liver isolation noduler lesions .
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The hypersplenism is a common disease caused by cirrhosis of different reasons. With the development of interventional radiology, partial splenic embolization (PSE) has been widely applied in clinical practice, especially in the treatment of secondary hypersplenism. There is a variety of embolization materials used in PSE, each has its own merits. Because of the anatomical characteristics of the splenic artery, the embolized volume and extent of the spleen will directly affect the therapeutic results. Peripheral blood test, immunological function, hemodynamics and hepatic function can be used to evaluate the effects of PSE. Owing to a variety of reasons, there are still some shortages of PSE in clinical practice, which are badly in need of being improved.
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The application of covered stent in vascular malformation such as aneurysm,pseudoneurysm(PSA) ,arteriovenous fistula(AVF) has outcome to an encouraging result.Recently,it has also been effectively used for PTA,TIPS,traumatic lesions of peripheral vessels,and pseudoneurysm of dialysis grafts,etc.But there still remain some issues on the restenosis and endothelialization after the performance with covered stent.This review will pay attention to them.