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Objective To study the intra-and extra-hepatic collateral pathways in various ChildPugh scores by using liver acceleration volume acquisition (LAVA) enhanced magnetic resonance imaging (MRI).Methods The clinical data and imaging findings of 146 patients with Budd-Chiari syndrome (BCS) were collected and analyzed.Intra-and extra-hepatic collateral pathways were evaluated by LAVA enhanced MRI.Intra-and extra-hepatic collateral pathways was analyzed using the Kappa identity test.Correlations of the intra-/extra-hepatic collateral pathways with Child-Pugh scores were analyzed using the Chi-square test.Correlation was calculated by the Cramer correction coefficient of contingency.Results Among 146 BCS patients there were 50 grade A patients,79 grade B patients and 17 grade C patients.Among MRI demonstrated 6 types dilated collateral shunts,only accessory hepatic veins (AHVs) and superficial epigastric veins (SEVs) as collateral pathways were associated with the Child-Pugh scores (x2 =20.324,P ＜ 0.05,x2 =11.855,P ＜ 0.05,respectively).AHVs as collateral pathways were associated with score A and score C (x2 =7.159,P ＜ 0.05,X2 =17.662,P ＜ 0.05,respectively),while SEVs were with score A and score B (x2 =7.244,P ＜ 0.05,x2 =11.855,P ＜ 0.05,respectively).Conclusion AHVs and SEVs as collateral pathways were associated with Child-Pugh scores in cases of Budd-Chiari syndrome.
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Objective To investigate the clinical effects and complications of uterine artery embolization (UAE) therapy using different embolic agents in treating uterine adenomyosis. Methods During 2004—2011, a total of 45 female patients with uterine adenomyosis were admmitted to authors’ hospital to receive uterine artery embolization therapy. The embolic agents used in the procedures included domestic iodized oil, sodium alginate microspheres and Embosphere microspheres. The patients were randomly divided into group A (n=15, using domestic iodized oil as embolic agent), Group B (n=13, using sodium alginate microspheres as embolic agent) and group C (n = 17, using Embosphere microspheres as embolic agent). After the treatment, all the patients were followed up for over 2 years, focusing on the observation of the clinical symptoms such dysmenorrheal, changes of MRI signs and severe complications. The results were analyzed and compared among the three groups. Results After UAE, the clinical symptoms such as the degree of dysmenorrhea, menstrual quantity, etc. were improved in all patients. Six months after UAE, the obvious remission rate of dysmenorrheal in group A, B and C was 33.3% (5/15), 30.8% (4/13) and 41.1%(7/17) respectively. Twelve months after UAE, MRI scanning showed that the uterine sizes in group A, B and C were reduced to 49.19%, 48.25% and 50.05% respectively. Follow-up examination at 24 months after UAE showed that recurrence of dysmenorrheal in group A, B and C was seen in 2, 4 and 2 cases respectively, and amenorrhea was seen in 2 cases of group A and one case in group C. Conclusion The use of domestic iodized oil, sodium alginate microspheres or Embosphere microspheres as embolic agents in performing super-selective uterine artery embolization for adenomyosis can effectively relieve the degree of dysmenorrheal, decrease the uterine size. In addition to ovarian dysfunction, the uterine cavity adhesion may be also a possible cause of amenorrhea occurring after UAE may. In order to ensure a similar clinical efficacy, the use of granular solid embolic agent is preferred as its safety is possibly higher than the liquid embolic agents.
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Objective To observe signal changes induced by USPIO accords with iron swallowed by macrophages in brain tissue sections in rats. Methods Thirty-eight SD rats were divided into two groups randomly. Three of them were involved in sham operation group, other thirty-five rats were divided into five subgroups averagely according to 7.0T MR scanning time (6 h, 12 h, 24 h, 48 h and 72 h). After establishment of MCAO models, USPIO was injected to tail intravenous and monitored with high resolution MRI at different time point, while rats in control group were injected with the same dose of sodium chloride. Brain tissue wax section was acquired after MR scanning. Cell necrosis, iron particle and activated macrophages were observed with HE dying, Prussian Blue dying and CD68 immunochemistry staining respectively. Results The ischemic lesion was detected as hyperintense area on T2WI after occlusion and perfusion of MCA. The accumulation of USPIO appeared as hypointense on T2WI but hyperintense on T1WI. The maximum signal change was observed at 48-72 h in both T1WI and T2WI (P>0.05). The iron particle accumulation was found in the boundary of ischemic lesion and necrotic area with Prussian Blue dying. Activated microglia was manifested with CD68 immunochemistry staining, the number of microglia at 72 h was more than those of the other time points. Conclusion USPIO can be used as a contrast agent to monitor rat ischemic stroke in vivo, and the signal changes induced by USPIO approximately accord with iron swallowed by macrophages in brain tissue sections. The cells which swallow USPIO are mainly activated macrophages.
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Objective To evaluate the selective external carotid arterial embolization of uncontrollable epistaxis. Methods 27 procedures of super-selective external carotid arterial embolization were performed with absorbable gelfoam by using Seldinger's method in 26 cases with uncontrollable epistaxis. Results 27 procedures of super-selective intraaterial embolization of uncontrollable epistaxis were all successful without any serious complication. Conclusions Selective external carotid arterial embolization is safe, effective and successful in the treatment of severe epistaxis.