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Objective To report the clinical features,imaging findings and endoscopic dacryocystosinostomy(En-DCR)of acquired lacrimal sac mucocele(ALSM).Methods 63 patients(63 eyes)with ALSM treated with En-DCR combined with bicanalicular silicone tube intubation from January 2016 to March 2021 were reviewed.The clinical features,imaging findings,and surgical treatment of the included patients were analyzed by preoperative examination and 12 month postoperative follow-up.Fifty-seven patients(21 males and 36 females)were enrolled in this study at last,including 30 right eyes and 27 left eyes,25～71 years old,with an average age of(52.89±11.66)years old.All eyes with history of epiphora and purulent secretion.Results CT examination revealed enlargement of the lacrimal sac,but no destruction of the adjacent bone.MRI imaging showed enlargement of the lacrimal sac,fluid collection separated from adjacent tissues by a thin rim,corresponding to mucocele in the sac and increase in the sac diameters in all analyzed cases.The mass was found to shrink significantly when the lacrimal sac was opened during the surgery,and the swelling was completely relieved within 7 days post-operation.After 12 months of follow-up,the anatomical success rate of En-DCR was 92.98%(53/57),the functional success rate was 89.47%(51/57),no complications such as mucocele recurrence,diminution of vision and infection were found.Conclusion All the patients with ALSM had a history of previous lacrimal duct obstruction.Imaging examinations are valuable for the diagnosis of ALSM.En-DCR for ALSM is safe and effective,and worthy of clinical promotion.
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Objective To compare the value of biphasicmulti-detector row helical computed tomogrpahy(MDCT),digital subtraction angiography(DSA)and lipiodol computed tomography(CT)in hypervascular hepatocellular carcinoma(HCC).Methods 80 cases with liver cancer were underwent MDCT、DSA、iodized oil CT scan,then compared detection rates of three methods.Results In detecting hepatic nodules(＞2cm),these three imaging techniques had the same sensitivity;for 1～2cm hepatic nodules,the detecting rate had no significant difference;The MDCT scan＜1cm detected 47 nodules(94.0%),iodized oil CT detected 27 nodules(54.0%),both statistically significant difference in detection rate(χ~2=3.11,P＜0.01),DSA is only detected 16 nodules(32.0%)compared with enhanced dual-phase MDCT scan and iodized oil CT detection rate the differences were statistically significant(χ~2=9.09,9.03,all P＜0.01).Conclusion MDCT is able to better show feeding arteries of hepatocellular carcinoma,The imaging examination of liver cancer before treatment can be used as a comprehensive evaluation.
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Objective To investigate the value of multislice spiral CT(MSCT,)in interventional therapy of the hepatocellular carcinoma(HCC)emphasising on transcatheter hepanc arterial chemoembolization(TACE).Methods MSCT were performed in 60 cases of HCC before interventional procedure,CT findings of hepatic artery phase,portal venous phase and hepatic venous phase were observed respectively,among which CTA were done in 15 cases,and the anatomy of celiacartery and its branches were observed in 45 cases.The schemes of interventional therapy were worked out according to the findings of MSCT.Results MSCT showed 250 lesions,10 cases of tumor thrombosis in portal vein and 19 cases of hepatic arterioportal shunt.There was no significant difference between MSCT and digital subtraction angiography(DSA)in positive rate of in showing number of tumor or tumor thrombosis in portal vein(P＞0.05),but the 3D construction of celiac artery branches in CTA was better than that in DSA,while angles between celiac artery and abdominal aorta in MSCT were more convenient than that in DSA.MSCT showed 5 eases of hepatic artery original abnormality,according to that in DSA.Conclusion MSCT is of importance for guidance of interventional therapy of hepatocellular carcinoma.