ABSTRACT
General rules for recording endoscopic findings of esophageal varices were initially proposed in 1980 and revised in 1991. These rules have widely been used in Japan and other countries. Recently, portal hypertensive gastropathy has been recognized as a distinct histological and functional entity. Endoscopic ultrasonography can clearly depict vascular structures around the esophageal wall in patients with portal hypertension. Owing to progress in medicine, we have updated and slightly modified the former rules. The revised rules are simpler and more straightforward than the former rules and include newly recognized findings of portal hypertensive gastropathy and a new classification for endoscopic ultrasonographic findings.
Subject(s)
Documentation/standards , Endosonography , Esophageal and Gastric Varices/pathology , Esophagoscopy , Esophageal and Gastric Varices/classification , Esophageal and Gastric Varices/diagnostic imaging , Humans , Medical RecordsABSTRACT
The purpose of this study was to retrospectively clarify the current status in Japan of TACE using Lipiodol together with anticancer agents to treat hepatocellular carcinoma (HCC). We retrospectively surveyed 4,659 (average annual total) procedures for HCC over the years 2002-2004 at 17 institutions included in the TACE Study Group of Japan. The survey included six questions that were related mainly to TACE and Lipiodol for HCC treatment. The most frequently applied among the 4,659 procedures at the 17 institutions were TACE (2,310; 50%) and local ablation (1,395; 30%). Five of the institutions applied 201-300 procedures and 4 applied 101-200. Lipiodol was used in "all procedures" and in "90% or more" at seven and nine institutions, respectively. Almost all institutions applied 4-6 (mean, 5) ml of Lipiodol during TACE to treat tumors 5 cm in diameter. In conclusion, this survey clarified that TACE using Lipiodol and anticancer agents is a popular option for HCC treatment in Japan.
Subject(s)
Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/statistics & numerical data , Drug Utilization Review/statistics & numerical data , Iodized Oil , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/therapy , Biopsy, Needle , Carcinoma, Hepatocellular/mortality , Catheterization/methods , Contrast Media/administration & dosage , Cross-Sectional Studies , Female , Humans , Immunohistochemistry , Japan , Liver Neoplasms/mortality , Male , Neoplasm Staging , Prognosis , Risk Assessment , Sensitivity and Specificity , Surveys and Questionnaires , Survival Rate , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
OBJECTIVE: The purpose of this study was to assess the capability of MR perfusion imaging and angiography (MRA) for management of pulmonary arteriovenous malformation (PAVM). METHODS AND PATIENTS: Eight patients, having 15 PAVMs underwent pulmonary angiography (PAG), CT, MR perfusion imaging and MRA. For the pretherapeutic management, MRA was compared with PAG and CT regarding detectability and diameter of vasculature. For post-therapeutic management, the change in size of aneurysmal sac, any residual contrast-enhancement and the blood supply within the sac were evaluated. RESULTS: All PAVMs with aneurysmal sac, feeding artery and draining vein diameters of equal to or more than 3 mm, were identified and measured with similar results by all modalities. On follow-up studies, 7 (58.4%) out of 12 treated PAVMs showed a decrease in size and residual contrast-enhancement. The residual contrast-enhancement was considered as bronchial artery-to-pulmonary artery collateral flow by MR perfusion imaging. CONCLUSION: MR perfusion imaging and MRangiography are useful for management of PAVMs over 3 mm in diameter.
