Magnetic resonance spectroscopy on hepatocellular carcinoma after transcatheter arterial chemoembolization / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Proton magnetic resonance spectroscopy (MRS) of the liver in vivo is in experimental phase. MRS observation on liver cancer after transcatheter arterial chemoembolization (TACE) has seldom been reported. This study was to investigate the value of MRS in assessing the metabolic changes of hepatocellular carcinoma (HCC) after TACE.</p><p><b>METHODS</b>Twenty-five consecutive patients with pathologically-confirmed HCC received 1H MRS of all hepatic lesions using 1.5T whole body MR scanner before TACE and at 3-10 days after TACE. Choline-to-lipid (Cho/Lip), glucogen/glucose-to-lipid (Glu/Lip), and glytamine/glutamate-to-lipid (Glx/Lip) ratios were measured and analyzed statistically.</p><p><b>RESULTS</b>The Cho/Lip, Glu/Lip, and Glx/Lip ratios were 0.21 +/- 0.08, 0.11 +/- 0.05, 0.28 +/- 0.10 before TACE, respectively, and were 0.10 +/- 0.08, 0.07 +/- 0.07, 0.18 +/- 0.12 after TACE, respectively, with significant differences (P < 0.05).</p><p><b>CONCLUSIONS</b>Using MRS can evaluate the early metabolic responses of HCC to TACE.</p>

Comparison between pathological findings and MR diffusion-weighted imaging in primary hepatocellular carcinoma after transcatheter arterial chemoembolization / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the pathological basis of diffusion-weighted imaging (DWI) findings in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).</p><p><b>METHODS</b>DWI was performed in 15 patients with HCC treated by TACE within 24 - 48 hours before II-phase operation. The DWI findings of the liver lesions were analyzed and correlated with pathological findings including macroscopic observation, HE staining and immunohistochemical staining for bFGF.</p><p><b>RESULTS</b>(1) The viable tumor area showed mostly hypersignal intensity (12/15), whereas coagulative necrotic lesions showed hyposignal (8/15) or isosignal intensity (6/15). The ADC values of zones of viable tumor and necrosis in tumor were (1.42 +/- 0.16) x 10(-3) mm(2)/s and (1.58 +/- 0.18) x 10(-3) mm(2)/s, respectively. There was a significant difference of ADC values between the two zones (t = 2.618, P < 0.05). (2) There was a significant difference in ADC values of viable tumor between well and poorly differentiated tumors (t = -2.646, P < 0.05). The distinction of ADC values of the whole tumor was significant among tumors with different degree of necrosis (chi(2) = 7.236, P < 0.05). (3) A negative correlation was observed between bFGF protein expression index and ADC values of viable parts of the tumors in the study group (r = -0.552, P = 0.033).</p><p><b>CONCLUSION</b>DWI shows certain characteristic features of the HCC after TACE, and can be used to distinguish viable and necrotic tumor tissues in HCC after TACE.</p>

Preliminary clinical application of percutaneous vertebroplasty / 中南大学学报(医学版)

OBJECTIVE@#To investigate the clinical application of percutaneous vertebroplasty (PVP).@*METHODS@#PVP was performed in 21 cases of 37 vertebral lesions,including 14 osteoporotic compression fractures, 6 metastases, 1 hemangioma,and 17 lesions in thoracic vertebra and 20 in lumbar. The procedures of PVP were as follows: The needle was inserted via percutaneous transpedicular approach or percutaneous posterolateral vertebral approach; the needle tip was placed at the junction of the anterior located the one third of the vertebral body; intraosseous venography was performed; and last bone cement was injected at 2-10 mL. The technical success rate, clinical efficacy and complications were observed after the procedure. Results The procedure was successful in 18 cases with 31 lesions,and the success rate according to the number of cases and vertebral lesions was 85.7% (18/21) and 83.8% (31/37), respectively. After the procedure, the numbers of complete remission, partial remission, mild remission and no remission were 10, 5, 2 and 1, respectively; and the total effective rate was 94.4% (17/18). Progressive compression did not occur. Three patients had transient neuropathy and recovered after physiotherapy. Other complications were insignificant; no severe complications occurred. Conclusion PVP is an effective and micro-traumatic treatment for patients with benign and malignant lesions in vertebral bodies.

Transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the effect of transcatheter arterial chemoembolization (TACE) on the result and the prognosis of hepatocellular carcinoma (HCC) at systemic, cellular, genetic and molecular levels.</p><p><b>METHODS</b>Patients with histologically proven HCC were divided into two groups: 81 patients in Group A undergoing TACE before operation and 58 patients in Group B treated with surgical resection alone. The degree of apoptosis was analyzed by transferase -mediated dUTP nick end labeling (TUNEL) stain. The expressions of bcl-2, bax, p53, Ki-67 and PCNA proteins were detected by immunohistochemical method. The changes of these markers, tumor necrosis, encapsulation, volume, metastasis, recurrence and cumulative survival in each group were retrospectively analyzed.</p><p><b>RESULTS</b>The more tumor necrosis, apoptosis, encapsulation and tumor shrinkage observed, and the less recurrence resulted from TACE in group A than in group B. The cumulative 1-, 2-, and 3-year survival rates and median survival time were 84.0%, 67.9%, 40.7%, and 803.3 days in group A patients; they were 72.4%, 55.2%, 24.1%, and 742.5 days in group B patients (P < 0.05).</p><p><b>CONCLUSION</b>Preoperative transcatheter arterial chemoembolization is safe and effective as an auxiliary preparatory means before surgical treatment of hepatocellular carcinoma as it may improve the survival of HCC patients.</p>

Relation between vascular endothelial growth factor and reoccurence-metastasis after transcatheter arterial chemoembolization in hepatocellar carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the relation between changes in serum vascular endothelial growth factor (VEGF) level after transcatheter arterial chemoembolization (TACE) and hepatocellular carcinoma (HCC) progression, especially in relation to metastasis.</p><p><b>METHODS</b>Serum VEGF expression level, measured by quatitative sandwich enzyme-linked immunosorbent assay (ELISA, R&D system), was measured before, 3 days and 4 weeks after TACE in 30 patients with HCC. The development of metastasis was evaluated at the end of the third month after TACE.</p><p><b>RESULTS</b>1. The serum VEGF level in 30 patients was 154.47 +/- 90.17 pg/ml, 2. Post-TACE total serum VEGF level increased as compared with their basal level in 30 patients (P < 0.05) and serum VEGF level had a tendency to increase in patients with heterogeneous uptake of iodized oil and portal vein thrombosis. During the follow-up of 1 - 2 years, metastatic foci were found in 74% (20) patients with SVEGF increase, while none of the patients showing SVEGF decrease developed metastasis.</p><p><b>CONCLUSION</b>Serum VEGF expression increase is associated with the development of metastasis in hepatocellular carcinoma after TACE.</p>

A dynamic study of correlation between the MR diffusion weighted imaging findings and the expression of proliferation-related and metastasis-related genes in rabbit models of liver VX,tumor before and after chemoembolization / 中华放射学杂志

0.05).Conclusions The potential of VX_2 tumor infiltration and metastasis will decrease after chemoembolization in the long-run,while the proliferation ability will increase within a short period of time. The ADC may reflect the proliferation of VX_2 tumor cells.

Dynamic image-pathological investigation on MR diffusion weighted imaging in rabbit liver VX_2 tumor model / 中华放射学杂志

Objective To investigate the value and dynamic characteristics of diffusion-weighted imaging(DWI)in rabbit liver VX_2 tumor model,with correlation of pathology.Methods Forty New Zealand rabbits were included in the study and VX_2 tumor piece was implanted directly into the liver after laporotomy.Fiffteen had two intrahepatic implants while twenty-five had one implant.DWI was performed on the seventh,fourteenth and twenty-first day after implantation,while routine T_1WI and T_2WI sequences were done on the seventh and fourteenth day.Ten VX_2 tumor samples were studied by pathology.Results The lump detection rates on the seventh day after implantation of DWI,T_1WI and T_2WI were 78.7%(37/47), 10.7%(3/28)and 53.6%(15/28)respectively with statistical significance(x~2=32.61,P

Application of rotational DSA in the diagnosis and interventional treatment of liver disease / 介入放射学杂志

The notational DSA was first proposed for the application as a managing tool of neuronradiology in the early 70's of 20th centery.Later on,three dimensional image reconstruction(3D DSA) was aquired along with the progressing development of technique and equipment devices.As a rather practical instrument,it has been utilized successfully in the diagnosis and management of head and neck vascular disorders,and abdominal parenchymal diseases during recent years.We comprehensively intoduce the application of rotational DSA for the diagnosis and management in hepatic diseases.