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Objective: To evaluate the effectiveness and safety of preoperative feeding artery occlusion on vertebral resection of invasive vertebral hemangioma. Methods: The clinical data of 20 patients with invasive vertebral hemangioma who received posterior lumbar vertebral body resection, bone grafting, fusion and internal fixation between March 2010 and March 2017 were retrospectively analyzed. According to whether feeding artery occlusion was performed before operation, the patients were divided into group A (11 cases, tumor feeding artery occlusion before operation) and group B (9 cases, no tumor feeding artery occlusion before operation). There was no significant difference in gender, age, lesion segment, and disease duration between the two groups ( P>0.05). The operation time, intraoperative blood loss, postoperative drainage volume, blood transfusion volume, and ambulant time after surgery, hospitalization time, and deep venous thrombosis of lower extremities were recorded and compared between the two groups. Pain improvement was evaluated by visual analogue scale (VAS) score. Results: The operation time, intraoperative blood loss, blood transfusion volume, and ambulant time after surgery were significantly less in group A than those in group B ( P0.05). Five patients (3 in group A and 2 in group B) suffered from pleural tear due to intraoperative pleural adhesions. Closed thoracic drainage tubes were placed immediately after suture and extubated on 3-5 days. Both groups were followed up 1-1.5 years, with an average of 1.35 years. In group B, 1 patient died of pulmonary embolism at 7 days after operation; and 2 patients developed deep venous thrombosis of lower extremity after operation, who were treated with inferior vena cava filter and thrombolytic therapy, and recovered well after operation. The local pain of the other patients was significantly relieved after operation, and the pain disappeared at 1 month after operation. The VAS scores of the two groups at 3 days after operation were significantly improved when compared with those before operation ( P0.05). Three patients (2 in group A and 1 in group B) who had neurological symptoms were significantly relieved after surgery. Bone healing was achieved in both groups at 1 year after operation. No fracture or loosening of internal fixator occurred during follow-up. Conclusion: Nutritional artery occlusion before vertebrectomy for invasive vertebral hemangioma can effectively reduce intraoperative blood loss, operation time, perioperative blood transfusion, and other perioperative complications.
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Objective: To explore the ability of dual-energy CT angiography for displaying thyroid feeding arteries and its value in quality optimization. Methods: Energy spectrum data of 100 patients who underwent head and neck CTA were analyzed retrospectively. The energy spectrum single energy imaging technique was used to reconstruct 60 keV and 75 keV single energy images. Combining with VR and MIP post-processing images, the anatomical features of the thyroid feeding arteries were observed. The quality of 60 keV and 75 keV single energy images were evaluated objectively and subjectively. Results: A total of 200 superior thyroid arteries (100 left and 100 right), as well as 165 inferior thyroid arteries (76 left and 89 right) and 3 lower thyroid arteries were displayed. The quality of 60 keV single energy images was better than that of 75 keV single-energy images, and the differences of CT value, SNR and subjective scores were all statistically significant (all P<0.05). Conclusion: Dual-energy CT angiography can clearly display thyroid feeding arteries. 60 keV single energy image is recommended.
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BACKGROUND/AIMS: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined. We assessed the possible predictive factors of CEUS for the response to TACE. METHODS: Seventeen patients with 18 hepatocellular carcinoma (HCC) underwent TACE. All of the tumors were studied with CEUS before TACE using a second-generation ultrasound contrast agent (SonoVue(R), Bracco, Milan, Italy). The tumor response to TACE was classified with a score between 1 and 4 according to the remaining enhancing-tumor percentage based on modified response evaluation criteria in solid tumors (mRECIST): 1, enhancing tumor or =75%). A score of 1 was defined as a "good response" to TACE. The predictive factors for the response to TACE were evaluated during CEUS based on the maximum tumor diameter, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, presence of a hypoenhanced pattern, and the feeding artery to the tumor. RESULTS: The median tumor size was 3.1 cm. The distribution of tumor response scores after TACE in all tumors was as follows: 1, n=11; 2, n=4; 3, n=2; and 4, n=1. Fifteen tumors showed feeding arteries. The presence of a feeding artery and the tumor size (< or =5 cm) were the predictive factors for a good response (P=0.043 and P=0.047, respectively). CONCLUSIONS: The presence of a feeding artery and a tumor size of less than 5 cm were the predictive factors for a good response of HCC to TACE on CEUS.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antibiotics, Antineoplastic/administration & dosage , Carcinoma, Hepatocellular/pathology , Chemoembolization, Therapeutic , Contrast Media/chemistry , Doxorubicin/administration & dosage , Liver Neoplasms/pathology , Microspheres , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Objective To study the feeding arteries of sacral tumors with digital substraction angiography (DSA). Methods A total of 27 patients with sacral tumors, who were encountered at authors’ hospital during the period from January 2006 to December 2012 , were enrolled in this study. DSA of abdominal aorta, bilateral internal iliac arteries, median sacral artery and lumbar arteries was performed in all patients. The origins, branches of the feeding arteries were determined, and the results were analyzed. Results Of the 27 cases with sacral tumors, DSA demonstrated median sacral artery in 20 (20 arteries in total), lateral sacral artery in 22 (36 arteries in total), ilio-lumbar artery in 18 (27 arteries in total), lumbar artery in 10 (15 arteries in total), inferior gluteal artery in 3 (3 arteries in total) and superior gluteal artery in 2 (2 arteries in total). Conclusion In our series, the blood supply of the sacral tumors is mainly from the median sacral artery, lateral sacral artery, ilio-lumbar artery and lumbar artery. Occasionally, superior and inferior gluteal arteries also participate in the blood supply of the sacral tumors. For the evaluation of sacral tumors, attention should be paid to the presence of rare feeding arteries.
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Objective To discuss the clinical application of feeding-artery embolization in treating massive hemoptysis.Methods The feeding-artery angiography was performed in 72 patients with massive hemoptysis.Based on the angiographic findings polyvinyl alcohol(PVA)or spring coil were selected as the embolization materials.The therapeutic results were retrospectively analyzed. Results Hemoptysis was completely controned almost immediately after the embolization procedure in 46 cases,while it was obviously alleviated in 13 cases.In 11 cases the hemoptysis disappeared completely after 2-4 times of embolization treatment,and in 2 cases surgery had to be employed.Conclusion Embolization of feeding-artery with PVA particles or spring coils is an effective and safe treatment for massive hemoptysis.The key point for decreasing reoccurrence is to occlude all feeding.arteries as far as possible.
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We report a rare case of scalp AVM concurrent feeding from external carotid artery and internal carotid artery, namely, superficial temporal artery and ophthalmic artery. This 20-year-old woman was seen because of serpiginous pulsatile mass in the frontal scalp, and the mass was enlarged during pregnancy. The case that feeding from the internal carotid artery branch is very rare. Angiography, MRI and MR angiography findings are presented.