Chemo-embolization in the treatment of hepatocellular carcinoma: should we switch to charged particles in our countries? About 102 procedures of a North African radiology center.

BACKGROUND: Hepatocellular carcinoma (HCC) is a public health problem in african countries. The chemoembolization (CE) could represent the only therapeutic strategy. Two methods can be proposed: charged microparticles and lipiodol chemoembolization. The purpose of this study was to compare results, morbidity and survival between charged microparticles and lipiodol chemoembolization. METHODS: A 5 years retrospective, study was conducted including 62 patients with HCC treated by chemioembolization. The efficacy of the treatment was evaluated for patients by performing a computed tomography four to six weeks after the act. We used « European Association for Study of the Liver ¼ criteria to evaluate the therapeutic outcome. RESULTS: A total of 102 sessions of chemoembolization were performed. This was a with charged microparticles in 70 cases (68.6%) and lipiodol chemoembolization in 32 cases (31.3 %). The difference was not significant between the two CE techniques (lipiodol and charged microparticles) in terms of complete and objective response and complications. The mean survival rate was 30 months ± 4 for all techniques combined, with no statistically significant difference in terms of survival time without recurrence between the two chemoembolization techniques. CONCLUSION: The efficacy, morbidity and survival of the two CE techniques to lipiodol or microfilled particles are comparable. The selectivity of the technique is to be taken into consideration. For economic health purposes, the CE lipiodolée appears to be more adapted to the context of the developing African countries.

[Imaging cardiac hydatid cysts: 8 cases]. / Imagerie du kyste hydatique du coeur. A propos de 8 observations.

BACKGROUND: Early diagnosis of cardiac echinococcosis is required because this uncommon disease may lead to serious complications. We report 8 cases of cardiac hydatidosis, review the modes of diagnosis, and stress the contribution of modern imaging techniques. METHODS: This retrospective study describes 8 patients with cardiac echinococcosis. All had chest radiographs and thoracic computed tomography (CT). Transthoracic sonography was performed in 6 cases and magnetic resonance imaging (MRI) in 5. RESULTS: Our patients ranged in age from 7 to 46 years, and the clinical features of their disease varied. Chest radiography showed the contours of the heart to be deformed in 3 cases and cardiomegaly in 3 others. Echocardiography revealed a homogeneous unilocular hydatid cyst in 5 cases. CT found homogeneous hypodense unilocular lesions in 7 cases, and a septated cyst with cardiac wall calcifications in one case. MRI showed round homogeneous lesions in 3 cases, all dark in T1-weighted sequences and bright in T2. DISCUSSION: Clinical features vary substantially, and clinical latency is not uncommon. Chest radiography generally shows mediastinal masses. Transthoracic echocardiography can locate and count cardiac hydatid cysts and identify their borders. CT can simultaneously assess any visceral extension of the disease, while MRI provides details of mediastinal extensions. CONCLUSION: Transthoracic echocardiography suggests the initial diagnosis. CT and MRI provide details of the location and extension of the cardiac hydatidosis.