Drug-eluting beads in the treatment of hepatocellular carcinoma with hepatic arterio-portal shunt / 中国医师杂志

Objective To investigate the safety and efficiency of drug-eluting beads (DEB) in the treatment of hepatocellular carcinoma (HCC) with hepatic arterio-portal shunt (HAPS).Methods 26 HCC patients with HAPS who underwent DEB-TACE (transcatheter arterial chemoembolization) were included in this retrospective study.Liver function level included preoperative serum albumin level,ascites,Child-Pugh classification,imaging manifestations of HAPS,follow-up and record survival time and response to cancer treatment.According to the degree of HAPS,all the patients were divided into 4 groups.After performing Kaplan-Meier,survival rate was calculated.Tumor response was measured by mRECIST criteria.Results The median survivals were 310 days,261 days,333 days,and 250 days in the entire study population,group 1,group 2,and group 3,respectively.There was no statistical significance in the survival curve among three groups (P =0.456).In the entire study population,the survival rates were 76.9％,37.3％,and 12.4％ at 6 months,12 months,and 24 months,respectively.After performing proportional hazards model,the preoperative serum albumin level,presence or absence of ascites,and preoperative Child-Pugh classification were independent predict factors for prognosis.Conclusions DEB-TACE is a safe and effective treatment for HCC with HAPS.The preoperative liver function is essential for patients'prognosis.

Effect of Image Quality of Gd-EOB-DTPA Enhanced MRI by Increasing Flip Angle / 中国医学影像学杂志

Purpose It has been demonstrated that hepatocytes uptake of Gd-EOB-DTPA obviously decreased,which would result in decreased liver-to-lesion contrast.Therefore,this study was to evaluate the potential of increasing flip angle to improve the image quality of Gd-EOB-DTPA enhanced MR.Materials and Methods A total of 114 patients with focal liver lesions (FLLs),who underwent Gd-EOB-DTPA-enhanced MR of the liver,were enrolled in this retrospective study.39 patients were noncirrhotic group,36 patients were Child-Pugh A group,23 patients were Child-Pugh B group,and 16 patients were ChildPugh C group.Tl-weighted with fat suppression volume interpolated breath hold examination (VIBE) sequence was acquired before and 5 min,10 min,15 min,20 min after the administration of Gd-EOB-DTPA with both conventional low FA (9 °) and high FA (27 °) protocols separately.Signal to noise ratio (SNR),liver to lesion contrast (LLC),the liver to lesion SI ratio (LLSIR) were calculated and analyzed between low and high FA protocol images in each group and each scan time.Results The LLC and LLSIR on GdEOB-DTPA-enhanced MR images using a high FA (27 °) protocol were significantly higher in comparison with the conventional low FA (9°).In Child B group and Child C group,the LLC and the LLSIR with low FA significantly reduced during 15～20 min after contrast agent injection,however with high FA,the value of LLC and LLSIR tended to be horizontal.Conclusion A high FA protocol in comparison with the conventional 9° FA can obviously improve the image quality,which is reliable for liver lesion depiction on GdEOB-DTPA-enhanced MR images,especially to those with severe liver cirrhosis.

A comparative study of the atypical CT findings and pathological features of bladder leiomyoma / 中华泌尿外科杂志

Objective To investigate the relationship between the atypical CT findings and pathological features of bladder leiomyoma.Methods A retrospective analysis of the CT findings and pathological features was conducted in 9 cases of atypical bladder leiomyoma.All the 9 cases were females aged 27 to 53 years (average 38 years).All patients had plain and enhanced spiral CT scans and were treated surgically.Results The atypical CT findings of bladder leiomyomas showed as similar malignant tumor signs (n =3),solid mass with obvious inhomogeneous enhancement (n =5) and solid mass with no enhancement (n =1).All cases had lesions appearing as solid lobulated cystic mass in different degrees,whose solid part showed intermediate density on CT,with heterogeneous enhancement after contrast agent injection.Tumor cell and interstitial cell swelling to varying degrees,vascular hyalinosis,myxoedema,hyalinosis and cystic degeneration were found in these lesions.CT findings showed the consistency with similar malignant tumor signs and pathological showed bigger tumor volume,obvious interstitial edema,red degeneration,cystic degeneration and significantly increasing enlargement circuitous blood vessels.While the CT findings of the obvious inhomogeneous enhancement solid mass and pathological showed moderate tumor size,relatively obvious interstitial edema and cystic degeneration,significantly increasing enlargement circuitous blood vessels were consistent.The consistency was found among mild enhancement solid tumors and pathological showed mild interstitial edema,mild degeneration and no enlargement circuitous blood vessels.Conclusion Through the contrast analysis,atypical CT performance and pathological features might have some certain correlation.