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Objective: To evaluate the efficacy and safety of portal vein stenting combined with 125I particle strand implantation followed by drug-eluting beads transarterial chemoembolization (DEB-TACE) and molecular-targeted therapy for the treatment of stageⅢa liv-er cancer lacking a blood supply. Methods: A retrospective analysis of 11 patients who had stageⅢa liver cancer lacking a blood sup-ply combined with portal vein tumor thrombosis (PVTT) was conducted from October 2016 to October 2018. All the patients under-went portal vein stenting combined with 125I particle strand implantation, DEB-TACE, and comprehensive treatment containing molecu-lar-targeted drugs. During the follow-up period, all patients were evaluated for stent patency after the implantation and tumor re-sponse after DEB-TACE treatment. The liver function and blood routine changes before and 1 month after the surgery were completed, and the complications were summarized. Results: All 11 patients were judged as stageⅢa liver cancer based on the Chinese staging criteria (2017), Child-Pugh classification grade A and B. The imaging findings indicated that these tumors were hypovascular. The maxi-mum diameter of these lesions was (8.4±4.1) (2.8-14.1) cm, and all patients had PVTT. Among them, there were 4 cases of Cheng's typeⅡand 7 cases of typeⅢ: 6 cases of main PVTT≥50% and 1 case of PVTT<50%. All patients underwent portal vein stenting com-bined with 125I particle strand implantation, DEB-TACE, and comprehensive treatment containing molecular-targeted drugs. Three and 6 months after stent implantation, the patency rate was 100%; 3 months after DEB-TACE treatment, complete response was achieved in 4 (36.4%) patients, partial response was achieved in 5 (45.5%) patients, and stable disease was achieved in 2 (18.2%) patients. No patients exhibited progressive disease. Therefore, the objective response rate was 81.8% and disease control rate was 100%. As for the liver and kidney function and blood routine tests, there were no significant differences between baseline and 1 month after the sur- gery. In addition, no patient had any serious complication during the perioperative period. Conclusions: For patients with stageⅢa liv-er cancer lacking a blood supply and PVTT, a comprehensive treatment strategy including portal vein stenting combined with 125I parti-cle strand implantation, DEB-TACE, and molecular-targeted therapy can restore portal vein blood flow and maintain mid-and long-term stent patency, while effectively killing tumors and controlling tumor growth, which is a safe and effective treatment strategy.
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Objective To evaluate the clinical application of prophylactic uterine artery chemoembolization (UACE) together with sequential ultrasound-guided curettage of uterine cavity for the treatment of cesarean scar pregnancy (CSP). Methods The clinical data and follow-up results of 231 CSP patients who were treated with UACE together with sequential ultrasound-guided curettage of uterine cavity were retrospectively analyzed. Results After UACE together with sequential ultrasound-guided curettage of uterine cavity, successful termination of pregnancy was achieved in all 231 patients, neither hemorrhagic shock nor death occurred. The median amount of blood loss during curettage of uterine cavity was 10 ml. After curettage of uterine cavity, the median values of RBC, HGB and HCT were 3.53×1012/L, 105 g/L and 32％ respectively, the preoperative median values of which were 4.04×1012/L, 121 g/L and 36％ respectively, indicating there were a slight reduction in RBC, HGB and HCT after UACE, the differences were statistically significant (P＜0.001). The median values of β-HCG measured before UACE and after curettage of uterine cavity were29 069.0 U/ml and 1723.5 U/ml respectively, the difference was statistically significant (P＜0.001). According to the gestational age, the patients were divided into group A (gestational age ≤56 days) and group B (gestational age 57-81 days). Further stratified analysis showed that no statistically significant differences in blood loss during curettage of uterine cavity and in reduction degree of RBC, HGB and HCT after UACE existed between group A and group B. Conclusion Prophylactic UACE before CSP can effectively reduce the occurrence of massive bleeding during uterine curettage. For the treatment of CSP, UACE together with sequential ultrasound-guided curettage of uterine cavity is safe and reliable. Therefore, this therapy can be used as a routine treatment strategy for CSP.
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Objective To evaluate the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) in treating Standford type B thoracic aortic dissection complicated by type A intramural hematoma.Methods From October 2015 to January 2017,a total of 3 patients with Standford type B thoracic aortic dissection complicated by type A intramural hematoma were admitted to authors' hospital to receive treatment.After admission,conservative treatment such as stabilizing blood pressure and heart rate,symptomatic medication,etc.were carried out for 14 days,then,TEVAR was performed.Results Successful TEVAR was accomplished in all 3 patients,no serious complications,such as reverse tear,occurred.One month after TEVAR,reexamination of total aortic CT angiography revealed that the rupture of dissection was completely closed with no internal leakage,the blood flow in the true lumen was obviously improved,the intramural hematoma was remarkably absorbed and faded away,and the wall thickness of ascending aorta returned to normal range.The clinical symptoms were greatly improved,no serious complications such as paraplegia or death occurred.Conclusion For the treatment of Standford type B thoracic aortic dissection complicated by type A intramural hematoma,TEVAR performed at 14 days after the onset of disease is safe and effective if the ascending aorta intima is intact and the clinical symptoms are relived after medication of lowering blood pressure and heart rate.
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Objective To evaluate the safety and efficacy of interventional procedure for treating the renal artery aneurysm (RAA).Methods From Jan 2009 to Apr 2014,17 patients,who were diagnosed as RAA and accepted the interventional therapy,were reviewed in our hospital.The mean age in those patients,including 7 males and 10 females,was (46.4±10.3) years old (range from 20 to 67 years old).The related symptoms included backache in 4 cases,abdominal pain in 4 cases,intermittent hematuria in 2 cases,chyluria in one case,oligouria in one case.9 cases were diagnosed as multiple RAA and 8 cases were confirmed as signle cases.In 17 cases,31 aneurysms were found,including 26 true aneurysms,5 pseudoaneurysums,17 sacculated aneurysms,4 spindle-like aneurysms,4 irregular shape aneurysms,4 parenchyma aneurysm and 2 dissecting aneurysm.8 aneurysms located in the main renal artery,19 aneurysms located in the branch of renal artery,4 aneurysums located in the renal parenchyma.Intracavitary coil embolization was used in 4 patients.We carried out parent artery embolization in 3 patients.A combination of the former techniques was performed in 6 cases.Covered stent placement was operated in one case.Combination of the intracavitary coil embolization and nude stent placement were performed in 2 patients.We used two techniques in one patient with multiple artery aneurysms in both sides.Results The interventional treatment of RAAs succeed at the first operation in 16 of 17 patients.17 cases were followed-up from 3 to 53 months (mean 23 months).No severe complications or death cases occurred in this study.Urine occult blood in 3 patients turned to negative after one week.Primary symptoms such as gross hematuria,abdominal pain,lumbodorsalgia,fever vanished or obviously eased after a month.Laboratory tests showed that normal level in SCr,BUN,routine urinalysis 3 months,6 months and 1 year later.No tendency of stent and coil stent shifting was found in 16 patients and the parent arteries were patent in 8 cases,with reexamination bv ultrasonic or computed tomography angiography (CTA).Conclusions Interventional techniques are minimally-invasive,safe and effective methods for treating the RAAs.
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Objective To compare the volume of the basal ganglia in patients with Tourette syndrome(T S) and the normal volunteers and to explore the underlying anatomical basis of TS.Methods Thirty-one cases of TS (TS subjects),31 gender and age-matched subjects (the control subjects) were examined on a 3.0 T MRI system.The volume of the caudate nucleus,globus pallidus,putamen of the two sides and the brain volume were measured with volume analysis software,and the data were normalized according to the individual brain volume.Statistical analysis was performed using t test to compare between the TS subjects and the controls.Results The volume of the both sides of the caudate nucleus,putamen and globus pallidus of TS subjects were (4.11 ±0.12) and (3.76 ±0.11),(2.28 ±0.12)and(2.35 ±0.28),(4.98 ±0.20) and (4.89 ±0.31)cm3,while they were (4.88 ±0.19) and (4.30 ±0.12),(2.28 ±0.12)and (2.35 ± 0.28),(4.98 ± 0.20) and (4.89 ± 0.31) cm3 in the controls,respectively.There were significant differences in the bilateral caudate nucleus and globus pallidus between the TS subjects and control subjects (t =2.97,1.74,3.72,3.93,P ＜ 0.05),but there were no significant differences of the volume in the bilateral putamen between the TS and control subjects(t =0.47,1.31,P ＞0.05).The volume was not significantly different between the left and right caudate nucleus in the TS subjects (t =1.81,P ＞0.05),but the left volume of the caudate nucleus was bigger in the control subjects compared with the right volume,however,there was significant difference between the bilateral caudate nucleus in the control subjects (t =2.34,P ＜ 0.05).There were no differences of volume between the bilateral globus pallidus and putamen in both the TS and control subjects (t =1.12,1.44,1.68,0.38,P ＞ 0.05).Conclusion The abnormal volume of caudate nucleus,putamen,and the globus pallidus may be involved in the pathogenesis of TS.
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Objective To evaluate the differentiated effectiveness of two-dimensional proton MR spectroscopy (2D~1H-MRS) to post-operative recurrent glioma and radiation injury. Methods Conventional MR and 2D~1H-MRS examinations were performed with Siemens 3.0T MR system for patients with recurrent contrast-enhancing lesions at the site of the treated glioma. The metabolite peaks were measured at the regions of enhanced nodule and edema, including N-acetylaspartate (NAA), choline-containing compounds (Cho) and creatine (Cr), while the Cho/Cr, Cho/NAA, NAA/Cr ratios were calculated. The new lesions were proved with histo-pathologic examination in 23 patients and clinical-imaging following-up in 12 patients. Recurrent gliomas were found in 20 patients, and radiation injury in 15 patients. Each mean metabolite ratio above was compared between two lesion types. Results At contrast-enhancing regions and edema regions, the mean Cho/Cr and Cho/NAA ratios were all significantly higher in patients with tumor recurrence compared with those with radiation injury. Tthe mean NAA/Cr ratio was significantly lower in patients with tumor recurrence compared with that with radiation injury at contrast-enhancing regions, but no significant difference was found at edema regions. Taking Cho/Cr and (or) Cho/NAA ratios >1.77 based on ROC curves of metabolite ratios as standards, the diagnostic sensitivity, specificity and accuracy was 90.00% (18/20), 93.33% (14/15) and 91.43% (32/35), respectively. Conclusion 2D~1H-MRS is a valuable method to distinguish postoperative recurrent glioma and radiation injury.
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In order to investigate the inhibitory effects of all trans-retinoitc acid (ATRA) on differentiation and apoptosis of Walker-256 hepatocellular carcinoma cells and the therapeutic effects of ATRA combined with transarterial chemoembolization (TACE) on rat Walker-256 transplanted hepatocarcinoma, Walker-256 hepatocarcinoma cell lines were treated with ATRA at different concentrations. After culture for 48 h, the inhibitory rate of cell proliferation was determined by MTT assay; the changes of Fas and Bcl-2 mRNA expression were determined by RT-PCR, and the expression levels of Caspase3 and Caspase8 proteins were detected by Western blot. Twenty-seven Wistar rat models of hepatocarcinoma were set up successfully by implanting Walker-256 cell lines. The tumor volume at the 11th day after implantation (V(preoperation)) was measured by magnetic resonance imaging (MRI). The 27 rats were randomly and equally divided into three groups, and the therapy scheme was performed as follows: group A (ATRA 0.1 mg+mitomycin 0.05 mL+lipiodol 0.05 mL+gelfoam powder 0.025 mg); group B (mitomycin 0.05 mg+lipiodol 0.05 ml+gelfoam 0.025 mg; group C (0.9% NaCl 0.2 mL). After another 11 days, MRI was performed once again to measure the tumor volume (V(postoperation)). The expression of factor and Ki VIII -67 in the tumor tissues was detected by immunohistochemistry. The results showed that ATRA could suppress proliferation of Walker-256 cell lines. After treatment of Walker-256 cell lines with ATRA, the expression of Fas mRNA was significantly up-regulated and the Bcl-2 mRNA was significantly down-regulated by ATRA at the concentration of 10 mumol/L as compared with the control group (P<0.05). After treatment with 10 mumol/L ATRA for 48 h, the Caspase3 and Caspase8 were significantly activated as compared with the control group (P<0.05). Significant difference existed in growth rate among the three groups (P<0.01) and between either two groups (P<0.05). The expression rate of factor VIII and Ki-67 was gradually increased from group A, group B to group C. The study suggests that ATRA could inhibit the proliferation of Walker-256 cells and the effectiveness of the combined therapy (ATRA+TACE) for treating transplanted hepatoma of rats is superior to that of TACE alone.
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Objective To explore the brain changes of electroacupuncturing (EA) different acupoints of peripheral facial paralysis (PFP) with functional magnetic resonance imaging (fMRI). Methods Eighteen patients with left PFP were randomly divided into three groups. Six of them received electroacupuncturing left Dicang, 6 received electroacupuncturing left Hegu, and 6 received electroacupuncturing left Houxi. fMRI data were obtained from scanning of the whole brain. Functional data were processed by SPM99 software and functional responses were established with t-test analysis (P<0.05). Results Electroacupuncturing Dicang and Hegu on the left induced decreasing of signal in bilateral middle frontal gyrus, left cingulate gyrus, signal increased of right precentral gyrus, bilateral postcentral gyrus, left superior temporal gyrus and right insular, while electroacupuncturing Houxi on the left induced decrease of signal in bilateral inferior frontal gyrus, left lentiform nucleus, right middle temporal gyrus, right cerebellar tonsil, signal increased of right caudate head, right cingulate gyrus, brainstem, cerebellar vermis and right parahippocampal gyrus. Conclusion Electroacupunctuing Hegu and Dicang can cause corresponding functional activation in cerebrum, while electroacupuncturing Houxi can not, suggesting that there is association between cerebral and acupoint of owned meridian.
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To examine the effect of transcatheter arterial embolization (TAE) of liver tumors on hypoxia-inducible factor-1alpha (HIF-1alpha) expression in the residual viable tumor, a total of 30 New Zealand White rabbits implanted with VX2 liver tumor were divided into 2 groups. TAE-treated group animals (n=15) were subjected to TAE with 150-250 mum polyvinyl alcohol particles. Control group animals (n=15) underwent sham embolization with distilled water. Six hours, 3 days or 7 days after TAE, the animals were sacrificed, and samples of tumor and adjacent normal liver tissue were harvested. Expression of HIF-1alpha protein was examined immunohistochemically. Real-time PCR was performed to examine the HIF-1alpha mRNA levels. Our results showed that HIF-1alpha protein was expressed in the VX2 tumors but not in the adjacent normal liver tissue. The HIF-1alpha-positive tumor cells were located predominantly at the periphery of necrotic tumor regions. The mean levels of HIF-1alpha protein were significantly higher in TAE-treated tumors than those in control tumors (P=0.002). Among the three sacrificing time points, the difference in increase in HIF-1alpha protein was significant between the two groups at the sacrificing time point of 6 h and 3 days after TAE (P=0.020, P=0.031, respectively), whereas no significant increase was noted 7 days after TAE (P=0.502). In contrast, although HIF-1alpha mRNA was expressed in TAE-treated and control VX2 tumors, there existed no significant difference in the HIF-1alpha mRNA level between the two groups (P=0.372). It is concluded that TAE of liver tumors increases the expression of HIF-1alpha at protein level in the residual viable tumor, which could be attributed to hypoxia generated by the procedure.
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ood long-term efficacy for cirrhosis patients with portal hypertension was a useful treatment for these patients.
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marked hi-atrial dilation, near-normal ventricular chambers and near-normal ventricular thickness were presented. Conclusion MRI is an excellent imaging modality for the diagnosis of restrictive cardiomyopathy.
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Objective To investigate the characteristics of imaging appearances and diagnostic value of ciliochoroidal detachment.Methods Ultrasound,MRI and CT appearances of 19 cases of ciliochoroidal detachment were reviewed,which included 9 cases of serous ciliochoroidal detachment,7 cases of choroid hematoma,and 3 cases of ciliary body detachment.All cases were examined by both B ultrasound and MRI at the same time,11 of them were examined by CT.Results UItrasound showed membrane bulge of the eyeball wall with different extent in 9 cases of serous ciliochoroidal detachment.Its postzone connected the equator or close to optic disc and its prozone could not been detected by ultrasound.There was echofree fluid darkspace under detached membrane.MRI showed membrane detachment at both nasal side and temporal side of ocular annulation in 9 cases of ciliochoroidal detachment.The detached membrane was approximately symmetry,its anterior margin did not exceed ciliary body adhesion of ocular annnlation and its posterior margin stopped at posterior part of ocular annulafion.There was long T1 and long T2 signal under detached membrane.CT showed slight thickening of ocular annulafion and slightly increased density of eyeball in 5 cases of serous cilioehoroidal detachment.Ultrasound showed hemispheroid or curve bulge of eyeball wall,projected toward the vitreous cavity in 7 cases of choroid hematoma,and there was an amount of low echo light spot under the detached membrane.Both MRI (7 cases)and CT (5 cases) showed hemispheroid,fusfform or curve bulge on the nasal side,temporal side and posterior part of ocular annulation.They appeared as isodensity or slight high density on CT,iso- or high signal on T1 WI and T2WI.Stratification was seen on T2WI in I case of choroid hematoma.Ciliary body detachment could not been detected by either MBI (3 cases) or CT (1 case) except ultrasound.Conclusion Imaging examination may provide reliable diagnostic evidence for ciliochoroidal detachment.
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This study examined the effect of different b values on diffusion-weighted MR imaging (DWI) of human prostate by using single-shot spin echo echo planar imaging (SE-EPI) sequences, observed the normal appearances and measured apparent diffusion coefficient (ADC) values in anatomical regions of normal prostate. Twenty-four healthy volunteers (mean age: 32 y) were studied by using a 1.5T system with a phased array surface multicoil. Two kinds of single-shot SE-EPI sequence were used to perform DWI in the prostate in volunteers, with five b values being 0, 30, 300, 500 to 1000 s/mm(2). The image quality with different imaging parameters was analyzed and the ADC values in anatomical regions of normal prostate were measured. DWI of prostate was successfully obtained in all volunteers. The images were of good quality, without artifacts containing pixels within the prostate. The contrast was good between the different anatomical regions of the prostatic gland, i.e., the peripheral zone (PZ), which exhibited higher signal intensity, and the central gland (CG). Signal intensity contrast was related to the magnitude of b values. The ADC values in PZ and CG were (1.27+/-0.22)x10(-3) mm(2)/s and (1.01+/-0.17)x10(-3) mm(2)/s, respectively. The ADC values were found to be significantly higher in PZ than in CG (P<0.05, paired t-test). Significant differences were found between the slice-selecting component and both the read-out and phase-encoding components of the ADC values. It is concluded that SE-EPI is a suitable DWI sequence for human prostate. The contrast between PZ and CG is good when b values are low, while the diffusion and ADC values are accurate when b values are high. ADC values are higher in PZ than in CG in normal prostate. Diffusional anisotropy is present in normal prostatic tissue.
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Magnetic Resonance Imaging/methods , Prostate/anatomy & histologyABSTRACT
This study investigated the changes of CD4(+) CD25(+) regulatory T cells (Tregs) in peripheral blood of patients with hepatocellular carcinoma before and after transcatheter arterial chemoembolization (TACE). The proportion of CD4(+) CD25(+) Tregs among CD4(+) T lymphocytes in peripheral blood of 33 patients with hepatocellular carcinoma was determined by flow cytometry before, 1 week and 1 month after TACE. And 25 healthy volunteers served as control. One month after TACE, the patients were divided into two groups: 22 in group A, who were in stable condition or getting better; and 10 in group B, who were deteriorating. One patient died and was excluded. The results showed that the percentage of CD4(+)CD25(+) Tregs among CD4(+) T lymphocytes did not significantly change in the 33 patients 1 week after TACE as compared with that before TACE, however, the difference was significant (P<0.01) between the patients with hepatocellular carcinoma and the healthy subjects. The percentage of CD4(+) CD25(+) Tregs among CD4(+) T lymphocytes in group A 1 month after TACE was decreased significantly in comparison with that before and 1 week after TACE (P<0.01), whereas, that in group B was increased significantly 1 month after TACE (P<0.01). It was concluded that patients with hepatocellular carcinoma had a higher proportion of CD4(+)CD25(+) Tregs in peripheral blood. TACE did not significantly affect the level of CD4(+) CD25(+) Tregs within short time (such as 1 week). The proportion of CD4(+)CD25(+) Tregs in peripheral blood 1 month after TACE was related to the prognosis of hepatocellular carcinoma.
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Antineoplastic Agents/administration & dosage , Carcinoma, Hepatocellular/immunology , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Liver Neoplasms/immunology , Liver Neoplasms/therapy , T-Lymphocytes, Regulatory/immunologyABSTRACT
In order to observe the feature of age-related marrow conversion and maturation of epiphyseal cartilage and analyze the distribution of red and yellow marrow in the proximal femur at STIR MR imaging, STIR and T(1) weighted MR imaging of the proximal femur in 52 subjects, aged 4 months to 25 years old, were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The subjects with no known bone marrow abnormalities were divided into 6 age groups. The signal intensity of the marrow in the proximal epiphysis, proximal metaphysis, proximal diaphysis, distal diaphysis and greater trochanter was compared with the signal intensity and homogeneity of surrounding muscle and fat and graded by two observers. The results showed that the conversion of hematopoietic marrow in the proximal femur followed a well-defined sequence, occurring first in the proximal epiphysis, followed by the distal diaphysis, and then greater trochanter and metaphysis. STIR in combination with T(1)-weighted imaging could display clearly the origin of ossification center and the course of conversion from red to yellow marrow in proximal epiphysis and greater trochanter. STIR imaging showed that the marrow conversion in proximal metaphysic began below epiphyseal plate and intertrochanter. The site of red yellow was distributed in weight-bearing axis by 20 years of age. The marrow conversion of diaphysis was from distal end to proximal end, and the consequence of conversion was that distal diaphysis contained yellow marrow but proximal diaphysis partly red marrow connected with the red marrow of metaphysic. The epiphyseal cartilage had different characters of signal-intensity with age in STIR sequence. The distribution of red marrow in STIR imaging was more close to that of anatomy than T(1)-weighted imaging. It was concluded that STIR could dynamically display the feature of marrow conversion and the development of epiphyseal cartilage and accurately reveal the age-related distribution of red and yellow marrow on STIR imaging in the proximal femur.
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Young Adult , Age Factors , Bone Marrow/anatomy & histology , Bone Marrow/physiology , Epiphyses/anatomy & histology , Femur/anatomy & histology , Image Enhancement/methods , Magnetic Resonance Imaging/methods , Retrospective StudiesABSTRACT
In order to observe the feature of age-related marrow conversion and maturation of epi-physeal cartilage and analyze the distribution of red and yellow marrow in the proximal femur at STIR MR imaging, STIR and T1 weighted MR imaging of the proximal femur in 52 subjects, aged 4 months to 25 years old, were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The subjects with no known bone marrow abnormalities were divided into 6 age groups. The signal intensity of the marrow in the proximal epiphysis, proximal metaphysis, proximal diaphysis, distal diaphysis and greater trochanter was compared with the signal intensity and homo- geneity of surrounding muscle and fat and graded by two observers. The results showed that the con- version of hematopoietic marrow in the proximal femur followed a well-defined sequence, occurring first in the proximal epiphysis, followed by the distal diaphysis, and then greater trochanter and metaphysis. STIR in combination with T1-weighted imaging could display clearly the origin of ossi-fication center and the course of conversion from red to yellow marrow in proximal epiphysis and greater trochanter. STIR imaging showed that the marrow conversion in proximal metaphysic began below epiphyseal plate and intertrochanter. The site of red yellow was distributed in weight-bearing axis by 20 years of age. The marrow conversion of diaphysis was from distal end to proximal end, and the consequence of conversion was that distal diaphysis contained yellow marrow but proximal diaphysis partly red marrow connected with the red marrow of metaphysic. The epiphyseal cartilage had different characters of signal-intensity with age in STIR sequence. The distribution of red marrow in STIR imaging was more close to that of anatomy than T1-weighted imaging. It was concluded that STIR could dynamically display the feature of morrow conversion and the development of epiphyseal cartilage and accurately reveal the age-related distribution of red and yellow marrow on STIR imag-ing in the proximal femur.
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Along with the rapid development of interventional radiology, a simultaneous increase of the treatment was carried out for diseases of urinary system, including nephrostomy, balloon dilatation and stenting for uninary tract obstruction, calculus removing techniques, stenting for prostatic hypertrophy; TAE/TACE and ablation therapy for benign/ malignant tumors; angioplasty with balloon or stent for stenosis of renal artery or vein; embolotherapy for hemorrhagic diseases; interventional treatment for complications after renal transplatation, and so on. All the above mentioned techniques for urinary diseases have already provided with good results and futher research will bring a promising future.
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The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given beta-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter > or = 1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94% main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of beta-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.
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The role of 16-slice spiral CT was evaluated in the diagnosis of coronary stenosis, with selective X-ray coronary angiography (SCA) serving as the reference standard. Sixty-five patients who were suspected of having coronary heart disease, without percutaneous transluminal coronary angioplasty or coronary bypass-grafting, were investigated using 16-slice CT. Eight patients with pre-scan heart rate of more than 80 beats/min were given β-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume redering (VR), multi-planar reconstruction (MPR), curved MPR and maximum intensity projection (MIP) were used to reconstruct. Every segment of coronary artery with a diameter ≥1.5 mm was assessed, and the presence on CT with a stenosis exceeding 50% diameter reduction was compared with that on SCA. The reasons which lead to some segments unevaluable were analysed. Compared with SCA, 93% coronary segments and 94 % main branches were evaluable. Residual cardiac motion artifacts, severe calcification and poor opacification made 58%, 28% and 14% of the remaining 60 segments unevaluable respectively. Without routine administration of β-blockers, good coronary imaging quality can be acquired using 16-slice spiral CT. It is a reliable noninvasive method for detection of obstructive coronary artery disease.
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<p><b>OBJECTIVE</b>To assess a new intervention for reestablishing the second hepatic hilum by means of puncturing and stenting the liver tissue between the intrahepatic vena cava and a hepatic vein for the treatment of Budd-Chiari syndrome (BCS).</p><p><b>METHODS</b>Two patients with BCS, in which no second hepatic hilum structure was found in transhepatic venography, underwent an interventional procedure of canalizing and stenting the parenchyma tract between the intrahepatic vena cava and a hepatic vein. The procedures were performed in the percutaneous transhepatic and right jugular vein, respectively. A metallic stent with a 10 mm diameter was implanted to maintain tract patency.</p><p><b>RESULTS</b>The free hepatic vein pressure (FHVP) of both patients decreased from 37 mm Hg to 5 mm Hg and from 28 mm Hg to 4 mm Hg, respectively, after the procedure. The complication of hemorrhage due to puncture was observed in one patient. Both patients maintained hepatic improvements in 3-year follow-up. Both clinical conditions and laboratory values were significantly improved after the procedure. Furthermore, the stented canals (the reestablished second hepatic hilum) maintained patent with normal FHVP, which was confirmed by control venography.</p><p><b>CONCLUSION</b>The new technique provides a simple, safe, effective, and relatively inexpensive treatment of Budd-Chiari syndrome. Long-lasting effectiveness is expected.</p>