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ObjectiveTo summarize our experience on the diagnosis and surgical treatment of hepatocellular adenoma (HCA).MethodsClinical data of 47 HCA cases managed from 1989 to 2009 were analyzed retrospectively. ResultsAll were single lesions.Preoperative correct diagnosis was established in only 7 cases ( 14.9％ ).Tentative malignant space-occupying lesions was diagnosed in other 40 cases (85.1％),including hepatocellular carcinoma in 11 cases,liver hemangioma in 10 cases,liver focal nodular hyperplasia in 14 cases and miscellaneous in the remaining 5 cases.Local resection,segmental hepatectomy,hepatic lobectomy and hemiheptectomy were performed according to the size and location of the lesions.To prevent recurrence or malignant transformation,not less than 1.0 cm safe margin was allowed in all cases.Final diagnosis was made by fast frozen pathology or postoperative pathology.Postoperatively 45 cases were followed up to 6 years without recurrence.ConclusionsPreoperative misdiagnosis of HCA is common.Surgical resection is the only effective treatment,and the prognosis of HCA is favorable.
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Objective To summarize the diagnosis and surgical treatment of hepatic focal nodular hyperplasia (FNH). Methods The clinical data of 63 patients with FNH proved by pathology were analyzed retrospectively. Results The disease mainly affected young to middle aged, 50 cases (79. 4% )were of 31-50 years old. Male and female ratio was 2.94: 1. Fifty-six patients (89%) were asymptomatic, 3 cases were HBsAg positive (4.8%). Liver function was basically normal (92. 1%),5 cases (7.9%) were with elevated level of total bilirubin and rGT. AFP, CEA and CA19-9 was all negative. FNH occured as a single node in 95.2% cases, ranging from 1.5 cm to 17 cm in diameter ( average 4. 5 cm). Of these patients, 25 lesions were present in the left lobe, 29 in the right lobe, 6 in the mid lobe, and 3 in the caudate lobe. A big central artery was found in 2 cases (3. 2% ) as found by color Doppler ultrasound. CT scan showed transient immediate enhancement in 96. 8% (61/63) of patients, with central scar in 6 cases. MRI demonstrated early vigorous enhancement in 93. 7% (59/63) of patients, with central scar in 5 cases. All patients underwent surgical resection; including local resection in 34 cases;segmentectomy or hepatectomy in 13 cases; hemihepatectomy in 13 cases. There was no postoperative mortality and major complications. Conclusions FNH is a kind of hepatic benign disease and characteristic of high preoperative misdiagnosis rate (25. 4% ).
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This paper describes the development of mobile MRI system. The system technical solution, some calculation and test results are introduced, the technical characteristics are analysed, the same performance has been realized with an MRI system equipped in a vehicle, the market of original fixed MRI system has been extended.
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Equipment Design , Magnetic Resonance Imaging , Methods , Mobile Health Units , Software DesignABSTRACT
Objective To summarize our experience in the diagnosis and treatment of thyroid Hurthle cell neoplasms. Methods Clinical data of thyroid Hurthle cell neoplasm patients admitted from 1972 to 2003 were analyzed retrospectively. Results The main symptoms were thyroid solitary node or mass (37 cases) and multiple nodule (9 cases). 4 cases had cervical lymph node metastasis. With BUS、CT、ECT and FNAC,only 10 cases were diagnosed as HCNs preoperatively, 36 cases were misdiagnosed as nodular benign single or multiple node. Twenty-eight cases were diagnosed by FNAC and quick freezing pathology. Benign HCNs was treated by isolateral thyroidectomy and malignant HCNs by additional contralateral subtotal thyroidectomy. Eighteen cases were diagnosed by postoperative paraffin pathology, and retrival second operation was performed according to the benignity or malignancy of the thyroid lesion. All cases were followed-up for 2 to 10 years and doing well without recurrence. Conclusions We should realize thyroid Hurthle cell neoplasms fully, if HCNs is suspected intraoperatively, quick freezing pathology is helpful. With appropriate therapy, the prognosis is satisfactory.
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Objective To evaluate the effect of choledochoduodenostomy for the treatment of bile duct calculi. MethodsClinical data of 420 patients with choledochoduodenostomy from 1962 to 2002 were respectively analyzed. ResultsBefore 1982,this procedure was performed in 230 cases with postoperative cholangitis or sink syndrome found in 46 cases, and mortality in 6 cases. Since 1983,190 cases underwent large-sized choledochoduodenostomy with 7 cases suffering from postoperative cholangitis or sink syndrome and no mortality. The anastomotic stoma was less than 2.0 cm in 110 cases, between 2.0 to 2.5 cm in 184 cases, from 2.5 to 3.0 cm in 107 cases, no record in 19 cases. A total of 358 cases (85.2%) were followed up from 2 to 20 years. Result was excellent and good in 183 out of 190 cases(96.3%) after the year of 1983. ConclusionsCholedochoduodenostomy when the stoma was larger than 2.5 cm in diameter and was put low in position was effective for the prevention of recurrent cholangitis and sink syndrome for the treatment of bile duct calculi.
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Objective To investigate the diagnosi s and management of inflammatory abdominal mass after appendectomy. Methods Clinical data of 42 patients wit h inflammatory abdominal mass developing after appendectomy from 1972 to 2004 we re retrospectively analyzed. Results There were two kinds of mass: on abdominal wall (26 cases) and that within the abdominal cavity (16 cases). Diagnosis was established on clinical fi ndings and the barium enema examination. Correct preoperative diagnosis was achi eved in 30 cases, with 12 cases (28.6%) misdiagnosed. Laparotomy was performed in 29 cases. Postoperative pathology revealed inflammatory mass. All the 42 case s recovered from the illness. Conclusions Post-appendectomy abdominal mass is infrequent complication. T he clinical course is most often self-limited. However, laparotomy is indicated in patients when conservative therapy fails or there is a fear of malignancy or tuberculosis.
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Objective To elevate diagnosis level and improve treatment for retroperitoneal chemodectoma. Methods Clinical data of 21 cases with retroperitoneal chemodectoma in four hospitals of Songhua river drainage area were analyzed retrospectively. Results CT, Ultrasonography and arteriography delineated retroperitoneal tumor in all 21 cases including 2 cases diagnosed as having retroperitoneal chemodectoma by MRI and arteriography, 19 cases were misdiagnosed (90.5%). All cases underwent surgical resection, with tumors removed completely in 16 cases (76. 2% ) , and 5 were irresetable. Four cases who were not resected died within 11 months postoperatively and 1 died intraoperatively in an resection attempt. In tumor resected cases, 11 have survived more than 12 years, 3 died 8 years later, 2 were still alive at the follow-up of 2 years. Conclusion Surgical treatment is the only effective method to treat the retroperitoneal chemodectoma.