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1.
J Anus Rectum Colon ; 4(1): 34-40, 2020.
Article in English | MEDLINE | ID: mdl-32002474

ABSTRACT

OBJECTIVES: The pre-operative diagnostic value of detecting lateral pelvic lymph node (LPLN) metastasis with magnetic resonance imaging, multidirectory computed tomography, and positron emission tomography/computed tomography was investigated in lower rectal cancer patients. METHODS: We retrospectively evaluated, using the three different modalities, the metastatic status of LPLNs in four regions, including both the internal iliac and the obturator, in 46 patients affected by lower rectal cancer patients who underwent LPLN dissection. The size inclusion criterion for LPLN metastasis was set at 6 mm in the short axis diameter. Histological examination was performed for determining the false positive and negative rate of LPLNs metastasis detection. RESULTS: Among 184 LPLNs regions, 17 (9%) were positive for metastasis. The region-based sensitivity, specificity, and accuracy rate did not differ among the three tested diagnostic modalities. Moreover, a significant increase in these rates could not be observed when the modalities were combined. Of 184 regions, 8 (4.4%) were false negative, whereas 2 (1.1%) were false positive. The histological pattern of metastatic regions did not differ in 8 false negative LPLNs. CONCLUSIONS: Each modality had a similar detection power for LPLNs metastasis, with a cut-off value at 6 mm in the short axis diameter. However, the sensitivity of all the modalities was slightly low, along with the number of false negative LPLNs. Further reduction of the false negative rate with these modalities may be difficult because of an inherent limitation of current imaging technologies to accurately detect lymph node metastases.

2.
J Cardiothorac Surg ; 13(1): 43, 2018 May 18.
Article in English | MEDLINE | ID: mdl-29776385

ABSTRACT

BACKGROUND: While many studies have evaluated the change in lung volume before and after lung resection and correlated this with pulmonary function test results, there is very little evidence on the changes in ventilation perfusion ratio (V/Q) before versus after lung resection. In the present pilot study, we evaluated if V/Q mapping can be constructed using dual energy CT images. METHODS: Thirty-one lung cancer patients planned for pulmonary resection were included in this study. To evaluate ventilation, Xenon-enhanced CT was performed. This was immediately followed by perfusion CT. The two images were registered manually as well as using dedicated softwares, and division between ventilation pixels and perfusion pixels were done to produce the V/Q map. Also, in order to characterize the distribution of the V/Q, the following numerical indices were calculated; mean, median, mode, standard deviation (SD), coefficient of variation (CV), skewness, kurtosis, and fractal dimension (FD). Pulmonary function tests and blood gas parameters were measured using standard institutional procedures. RESULTS: In the whole group, VC, %VC, and FEV1 decreased significantly after resection. FEV1.0% was increased significantly after resection. No significant changes were seen in PaO2, PaCO2, and DLCO/VA before and after resection. The mean, median, mode, SD, skewness, kurtosis and FD of the V/Q did not change significantly before and after resection. A marginal but significant decrease in CV was seen before versus after resection. CONCLUSIONS: Overall, it was considered that the V/Q maps could be adequately generated in this study. With further accumulation of data, V/Q map generated by dual energy CT may become one of the potentially useful tools for functional lung imaging. TRIAL REGISTRATION: This trial was registered in University Medical Information Network in Japan ( UMIN000010023 ) on 13Feb2013.


Subject(s)
Lung Neoplasms/surgery , Lung/diagnostic imaging , Pneumonectomy , Tomography, X-Ray Computed/methods , Ventilation-Perfusion Ratio , Administration, Inhalation , Administration, Intravenous , Adult , Aged , Aged, 80 and over , Contrast Media , Female , Forced Expiratory Volume , Humans , Lung/physiopathology , Lung/surgery , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/physiopathology , Male , Middle Aged , Pilot Projects , Pulmonary Diffusing Capacity , Respiratory Function Tests , Vital Capacity , Xenon
3.
J Obstet Gynaecol Res ; 44(3): 456-462, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29297951

ABSTRACT

AIMS: We investigated whether common iliac artery balloon occlusion (CIABO) was effective for decreasing blood loss during cesarean hysterectomy (CH) in patients with placenta previa with accreta and was safe for mothers and fetuses. METHODS: Of the 67 patients who underwent CH for placenta previa with accreta at our facility from 1985 to 2014, 57 patients were eligible for the study. The amount of intraoperative bleeding during CH was compared between three groups: surgery without blood flow occlusion (13 patients), internal iliac artery ligation (15 patients) and CIABO (29 patients). Additionally, multivariate analysis was performed to assess risk factors for massive bleeding during CH. RESULTS: The mean blood loss in the CIABO group (2027 ± 1638 mL) was significantly lower than in the other two groups (3787 ± 2936 mL in the no occlusion, 4175 ± 1921 mL in the internal iliac artery ligation group; P < 0.05). Multivariate analysis showed that spontaneous placental detachment during surgery (odds ratio [OR] 49.174, 95% confidence interval [CI] 4.98-1763.67), a history of ≥ 2 cesarean sections (OR 9.226, 95% CI 1.07-231.15) and no use of CIABO (OR 26.403, 95% CI 3.20-645.17) were significantly related to massive bleeding during surgery. There was no case of necrosis resulting from ischemia. The mean radiation dose during balloon placement never exceeded the threshold value for fetal exposure. CONCLUSION: Bleeding during CH for placenta previa with accreta can be decreased by CIABO. This study also confirmed the safety of CIABO in regard to maternal lower limb ischemia and fetal radiation exposure during balloon placement.


Subject(s)
Balloon Occlusion , Blood Loss, Surgical/prevention & control , Cesarean Section , Hysterectomy , Iliac Artery , Placenta Accreta/surgery , Placenta Previa/surgery , Adult , Balloon Occlusion/adverse effects , Balloon Occlusion/methods , Balloon Occlusion/standards , Cesarean Section/adverse effects , Cesarean Section/methods , Cesarean Section/standards , Female , Humans , Hysterectomy/adverse effects , Hysterectomy/methods , Hysterectomy/standards , Pregnancy
4.
Nihon Hinyokika Gakkai Zasshi ; 108(2): 96-100, 2017.
Article in Japanese | MEDLINE | ID: mdl-29669983

ABSTRACT

A 47-year-old woman was transferred to our hospital in June 2014 in hemorrhagic shock due to rupture of a huge right renal angiomyolipoma (AML). Selective right renal arterial embolization performed that same day reversed the shock immediately. Despite the huge abdominal tumor, the patient was discharged 2 weeks later after refusing any further treatment.Two weeks later she noticed the abdominal tumor growing. One month after discharge, she was readmitted due to dyspnea caused by restriction of her breathing by the growing tumor mass. A CT revealed a massive increase in tumor size with internal liquefaction, a thrombus in the left common iliac vein, and a 12 mm aneurysm in the right renal artery. The patient requested removal of the abdominal tumor since her ADL had deteriorated. We decided to perform a right nephrectomy with consideration of the left common iliac vein thrombus and right renal arterial aneurysm.As a precaution against pulmonary embolism in case the left common iliac vein thrombus dislodged, a retrievable inferior vena cava (IVC) filter was inserted before surgery. We were also concerned about possible rupture of the right renal aneurysm, so the right renal artery was embolized before surgery. After these procedures, a right nephrectomy was performed via a transperitoneal approach.The surgery was uneventful. The tumor weighed about 11 kg including 7,000 mL of bloody fluid. The IVC filter was removed the day after surgery, but the thrombus in the left common iliac vein remained, and an anticoagulant was started. Three months later, the thrombus had disappeared, and the anticoagulant was discontinued six months after surgery.According to the treatment guidelines for deep vein thrombosis, anticoagulants are the drugs of choice. IVC filters are seldom used to prevent pulmonary embolism. We initially administered an anticoagulant for the thrombus in the left iliac vein. However, an increase in abdominal tumor size suggested the drug had caused internal rebleeding and it had to be discontinued. Ultimately, we used a temporary retrievable IVC filter during the right nephrectomy with success.There is currently no consensus on when to use an IVC filter. Moreover, very little data exists on the use of an IVC filter during the perioperative period. Therefore, given the risk of potential thromboembolism, although we were able to use it successfully in our surgery, it should not be employed without a thorough benefit-risk assessment.

6.
Jpn J Radiol ; 31(6): 377-85, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23547011

ABSTRACT

PURPOSE: To assess the use of xenon ventilation maps (Xe-images) for predicting postoperative pulmonary function. MATERIALS AND METHODS: After study approval by the institutional review board, written informed consent was obtained from 30 patients with lung tumors who underwent pre- and postoperative spirometry, pulmonary perfusion SPECT and dual-energy CT (80 kV and 140 kV/Sn) after single-breath inspiration of 35 % xenon. Xe-images were calculated by three-material decomposition. Sum of pixel values of the part to be resected (A) and of the whole lung (B) on Xe-images or lung perfusion SPECT, and volumes or the number of segments of the part to be resected (A) and of the whole lung (B) on Xe-images were enumerated, respectively. We multiplied (1 - A/B) by each preoperative value from spirometry for prediction. Predictions by each of the four methods were compared with postoperative values. RESULTS: Predicted values for vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) by the four methods regressed significantly with measured values (R (2) = 0.56-0.77, p < 0.001 for all). CONCLUSION: Analysis of Xe-images can predict postoperative VC, FVC and FEV1 with accuracy comparable to that of CT volumetry.


Subject(s)
Contrast Media , Forced Expiratory Volume , Pneumonectomy , Postoperative Period , Radiography, Dual-Energy Scanned Projection/methods , Tomography, X-Ray Computed/methods , Vital Capacity , Xenon , Aged , Aged, 80 and over , Female , Humans , Lung Neoplasms/physiopathology , Lung Neoplasms/surgery , Male , Middle Aged , Predictive Value of Tests , Pulmonary Ventilation , Sensitivity and Specificity , Spirometry , Tomography, Emission-Computed, Single-Photon/methods
7.
Jpn J Radiol ; 30(9): 706-12, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22911101

ABSTRACT

Adhesive small bowel obstruction (SBO) is a common cause of abdominal pain after surgery or peritonitis. The role of computed tomography (CT) in the evaluation of SBO has expanded. Diagnosis of adhesive SBO, however, remains challenging. Adhesions causing SBO are classified as either matted adhesions or single adhesive bands, and both types have different mechanisms that lead to SBO. In patients with matted adhesions, SBO results from angulation and kinking or from torsion of the intestines. In patients with adhesive bands, SBO results from compression of the intestine caused by the band itself. Recent advances in spatial resolution using multidetector CT (MDCT) have enabled detailed assessment of the configuration of the SBO site. Presented in this pictorial essay are characteristic MDCT findings regarding the mechanism of the obstruction process of adhesive SBO.


Subject(s)
Intestinal Obstruction/diagnostic imaging , Multidetector Computed Tomography , Aged , Female , Humans , Intestine, Small , Male , Middle Aged
8.
Jpn J Radiol ; 30(3): 242-8, 2012 Apr.
Article in English | MEDLINE | ID: mdl-22190074

ABSTRACT

PURPOSE: Appendiceal diverticulitis has been difficult to distinguish from acute appendicitis clinically and radiologically. The purpose of this study was to describe multidetector computed tomography (MDCT) features of cases of pathologically proved appendiceal diverticulitis at our institution over a 36-month period. MATERIALS AND METHODS: Seven of 156 patients who underwent appendectomy with the preoperative diagnosis of acute appendicitis were pathologically diagnosed with appendiceal diverticulitis. Two radiologists reviewed the MDCT images for these 7 patients. RESULTS: On MDCT, a total of 8 inflamed diverticula were visualized as small fluid-filled luminal structures with thick enhanced walls or as solid enhanced masses protruding from the appendix for 6 of 7 patients. For 2 of these 6 patients, MDCT revealed a total of 5 normal diverticula visualized as small air-filled luminal structures with thin walls. For 1 of the 7 patients, neither inflamed or normal diverticula could be identified on MDCT. MDCT revealed appendiceal wall thickening with a tiny or no luminal fluid collection for 5 patients and with a moderate fluid collection for 1 patient, and a normal appendiceal wall for 1 patient. CONCLUSION: Our results suggest that MDCT can reveal appendiceal diverticula and has potential in the preoperative diagnosis of appendiceal diverticulitis.


Subject(s)
Appendicitis/diagnostic imaging , Diverticulitis/diagnostic imaging , Multidetector Computed Tomography , Adult , Appendectomy , Appendicitis/pathology , Appendicitis/surgery , Contrast Media , Diagnosis, Differential , Diverticulitis/pathology , Female , Humans , Iohexol , Iopamidol , Male , Middle Aged
9.
Radiology ; 262(1): 262-8, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22025733

ABSTRACT

PURPOSE: To assess single-breath-hold technique for ventilation mapping by using dual-energy computed tomography (CT) in phantom experiments and volunteers. MATERIALS AND METHODS: Institutional review board approved this study, and written informed consent was obtained from all volunteers. A rubber bag filled with a mixture of xenon (0%-35.4%) and oxygen was scanned with dual-source dual-energy CT (80 kV and 140 kV with tin [Sn] filter [Sn/140 kV] and 100 kV and Sn/140 kV). A cylinder containing six tubes of identical sizes with different apertures was ventilated once with a mixture of 35% xenon and 65% oxygen and was scanned in dual-energy mode (80 kV and Sn/140 kV). Xenon-enhanced images were derived by using three-material decomposition technique. Four volunteers were scanned twice in dual-energy mode (80 kV and Sn/140 kV) during breath hold after a single vital-capacity inspiration of air (nonenhanced) and of 35% xenon. Xenon-enhanced images were obtained by using two methods: three-material decomposition and subtraction of nonenhanced from xenon-enhanced images. Regression analysis with t and F tests was applied to the data of the rubber bag scans, with the significance level set at .05. RESULTS: Mean pixel values of gas in the bag were linearly related to xenon concentration for all x-ray tube voltages (r(2) = 1.00, P < .00001). Pixel values of the xenon-enhanced images of the tubes were related to their aperture size. Nearly homogeneous (coefficient of variation: 0.22, 0.23, and 0.34) pixel values were found in the lungs of healthy volunteers, with higher pixel values in the trachea and lower pixel values in the bullae. Xenon-enhanced images calculated by using three-material decomposition had better image quality on visual comparison than those calculated by using subtraction. CONCLUSION: Xenon-enhanced dual-energy CT with the single-breath-hold technique could depict ventilation in phantoms and in four volunteers.


Subject(s)
Lung/diagnostic imaging , Radiography, Dual-Energy Scanned Projection/methods , Tomography, X-Ray Computed/methods , Xenon , Algorithms , Humans , Imaging, Three-Dimensional , Phantoms, Imaging , Regression Analysis , Respiration
10.
Pediatr Radiol ; 41(1): 113-6, 2011 Jan.
Article in English | MEDLINE | ID: mdl-20593170

ABSTRACT

Gallbladder volvulus in children is rare. Pre-operative diagnosis is considered difficult because of the nonspecific symptoms and inflammatory blood analysis findings. Sometimes diagnosis is confirmed at laparotomy. Many reports mention that the chief complaints of this disease are sudden and severe abdominal pain. We report a case of gallbladder volvulus in a boy with mild clinical symptoms and laboratory data of nonspecific inflammation. A reconstructed coronal CT abdominal view showed clearly the gallbladder torsion. Laparoscopic cholecystectomy was performed and postoperative course was uneventful. Recent reports have suggested the effectiveness of MRI. This case highlights the utility of a reconstructed coronal view of abdominal CT in successful pre-operative diagnosis for gallbladder volvulus in children.


Subject(s)
Gallbladder Diseases/diagnosis , Child , Gallbladder Diseases/diagnostic imaging , Gallbladder Diseases/surgery , Humans , Male , Radiography , Treatment Outcome , Ultrasonography
11.
Int Surg ; 96(4): 300-4, 2011.
Article in English | MEDLINE | ID: mdl-22808610

ABSTRACT

We analyzed data on the three-dimensional vascular anatomy of the right colon from the operative documents of 215 patients undergoing oncologic resection for right colon cancer. The right colic artery (RCA) was absent in 146 patients (67.9%), with the ileocolic artery (ICA) crossing the superior mesenteric vein (SMV) ventrally in 78 patients (36.3%). When the RCA was present, both the ICA and the RCA crossed the SMV ventrally in 44 patients (20.5%), dorsally in 10 patients (4.7%), the RCA crossed the SMV ventrally and the ICA dorsally in 10 patients (4.7%), and the RCA crossed the SMV dorsally and the ICA ventrally in 5 patients (2.2%). The arterial branches toward the hepatic flexure crossed the SMV ventrally in 151 eligible cases: the branch originated from the common trunk of the middle colic artery in 97 patients (64.2%) and 1 and 2 arteries directly originated from the SMA in 49 patients (32.5%) and in 5 patients (3.3%), respectively. These data would be useful to safely perform lymph node dissection around the SMV.


Subject(s)
Colonic Neoplasms/surgery , Mesenteric Artery, Superior/anatomy & histology , Mesenteric Veins/anatomy & histology , Female , Humans , Imaging, Three-Dimensional , Male
13.
Jpn J Radiol ; 28(2): 162-5, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20182852

ABSTRACT

Blunt gallbladder injury is rare, and bleeding from the cystic artery due to blunt trauma is even rarer. We report herein a case of extraluminal bleeding of the gallbladder in a patient following blunt abdominal trauma. Contrast-enhanced computed tomography revealed pericholecystic fluid and extravasation of contrast material in the subcapsular liver space adjacent to the gallbladder. Abdominal digital subtraction angiography revealed pseudoaneurysm originating from a branch of the cystic artery. Successful treatment was achieved using selective transcatheter embolization, and cholecystectomy was not required.


Subject(s)
Cholecystography/methods , Embolization, Therapeutic/methods , Gallbladder/blood supply , Gallbladder/injuries , Tomography, X-Ray Computed/methods , Wounds, Nonpenetrating/diagnostic imaging , Wounds, Nonpenetrating/therapy , Angiography, Digital Subtraction/methods , Contrast Media , Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging , Follow-Up Studies , Gallbladder/diagnostic imaging , Hematoma/complications , Humans , Iodipamide/analogs & derivatives , Liver/diagnostic imaging , Male , Middle Aged , Radiographic Image Enhancement/methods , Treatment Outcome , Ultrasonography , Wounds, Nonpenetrating/complications
14.
Jpn J Radiol ; 28(1): 34-42, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20112091

ABSTRACT

PURPOSE: The aim of this study was to determine whether pulmonary embolus volume (PEV) obtained with multi-detector row computed tomography is related to clinical status and outcomes. MATERIALS AND METHODS: Subjects comprised 48 patients with acute pulmonary embolism (PTE). PEV was measured by tracing the contours manually and compared between sets of two groups divided by clinical status. Correlations of PEV to blood gases and D-dimer levels were investigated. PEV was tested as a predictor of clinical probability of acute PTE using Wells' criteria and as a predictor of survival after PTE by logistic regression analysis. RESULTS: The PEV was greater in groups with respiratory symptoms (P < 0.001), PTE as pretest clinical diagnosis (P = 0.027), and heart rate >100 beats/min (P < 0.001). It was smaller in subjects with concurrent malignancy (P = 0.02). It was correlated with PaCO(2) (P = 0.04, rho = -0.37) and the D-dimer level (P = 0.002, rho = 0.46); it was not a predictor of clinical probability of acute PTE or survival after PTE. The survival rate did not differ between groups with PEV > 10 ml (8/9) or

Subject(s)
Health Status , Outcome and Process Assessment, Health Care/methods , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed/methods , Acute Disease , Aged , Blood Gas Analysis/methods , Contrast Media , Female , Heart Rate , Humans , Image Processing, Computer-Assisted/methods , Iohexol , Iopamidol , Male , Observer Variation , Pulmonary Artery/diagnostic imaging , Radiographic Image Enhancement/methods , Reproducibility of Results , Respiratory System/physiopathology , Survival Analysis
15.
J Gastroenterol Hepatol ; 25(4): 731-7, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20074166

ABSTRACT

BACKGROUND AND AIM: The aim of this study was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for the evaluation of tumor spread in hilar cholangiocarcinoma. METHODS: Images obtained from a 16-detector row scanner of 22 patients were interpreted. The diagnostic accuracy of longitudinal ductal spread, vertical invasion (including hepatic parenchyma), and lymph node metastasis was assessed with reference to histopathological findings. RESULTS: The location of the tumor was correctly diagnosed in 95% of cases (21/22), but in five of these cases, the cut end of the intrahepatic bile duct was positive, resulting in 77% diagnostic accuracy for longitudinal spread. Among the patients with a negative bile duct surgical margin, there was a significant difference in the measurement of tumor spread between MDCT and microscopic investigation (P < 0.001). For vertical invasion, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT were 69%, 100%, 100%, and 69% for the liver parenchyma, respectively. The sensitivity, specificity, PPV, and NPV of MDCT for lymph node metastasis were 50%, 75%, 43%, and 80%, respectively. CONCLUSIONS: The diagnostic accuracy of MDCT for tumor location and vertical invasion was satisfactory, but ductal spread was underestimated in comparison with microscopic measurements.


Subject(s)
Bile Duct Neoplasms/diagnostic imaging , Bile Ducts, Intrahepatic/diagnostic imaging , Cholangiocarcinoma/diagnostic imaging , Tomography, X-Ray Computed , Aged , Aged, 80 and over , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/surgery , Bile Ducts, Intrahepatic/pathology , Bile Ducts, Intrahepatic/surgery , Cholangiocarcinoma/secondary , Cholangiocarcinoma/surgery , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Predictive Value of Tests , Radiographic Image Interpretation, Computer-Assisted , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity
16.
J Hepatobiliary Pancreat Surg ; 16(2): 216-22, 2009.
Article in English | MEDLINE | ID: mdl-19214370

ABSTRACT

BACKGROUND/PURPOSE: The aim of this study was to compare the diagnostic accuracy of multidetector computed tomography (MDCT) and direct cholangiography in evaluating the longitudinal spread of extrahepatic bile duct cancer. METHODS: Images obtained from a 16-detector row scanner (MDCT) and from direct cholangiography (via either endoscopic naso-biliary drainage or percutaneous transhepatic biliary drainage) of 47 patients with histopathologically proven extrahepatic bile duct cancer were retrospectively interpreted. Differences between measures of longitudinal tumor spread determined by each modality and measures of macroscopic spread in resected specimens were assessed and compared. RESULTS: Assessments carried out using MDCT differed significantly less from the macroscopic measurements than those made using direct cholangiography (P < 0.0001). Provided the diagnosis was defined as being accurate, based on a diagnostic difference of within +/-5 mm, the diagnostic accuracy of MDCT (96%) was significantly higher than that of direct cholangiography (70%) (P = 0.028). Preoperative evaluation with direct cholangiography resulted in a 30% underestimation of the incidence. CONCLUSION: MDCT is superior to direct cholangiography for evaluating the preoperative longitudinal extent of bile duct cancer. Consequently, the utility of MDCT for preoperative evaluation of extrahepatic bile duct cancer warrants further examination.


Subject(s)
Bile Duct Neoplasms/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/surgery , Cholangiography , Female , Hepatectomy/methods , Humans , Male , Middle Aged , Pancreaticoduodenectomy/methods , Preoperative Care , Radiographic Image Interpretation, Computer-Assisted , Retrospective Studies , Treatment Outcome
17.
Radiat Med ; 26(7): 396-401, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18769996

ABSTRACT

PURPOSE: The importance of the quality of life (QOL) and mental condition of patients being treated for cancer is now recognized. In this study, we evaluated QOL and mental condition in patients with cancer before and after radiotherapy. MATERIALS AND METHODS: The subjects were 170 patients who had undergone radiotherapy. The examination of QOL was performed using the quality of life questionnaire for cancer patients treated with anticancer drugs (QOL-ACD), and mental condition (anxiety and depression) was examined using the hospital anxiety and depression scale (HADS). These examinations were performed at the start of radiotherapy and immediately after radiotherapy. RESULTS: The QOL score was slightly higher in all patients after the completion of radiotherapy than before the start of radiotherapy. In the palliative radiotherapy group, QOL score was significantly improved by treatment. Anxiety and depression were improved after radiotherapy. There was a correlation between the degrees of improvement of the HADS and QOL score. CONCLUSION: We could treat cancer patients by radiotherapy without reducing their QOL, and improvement in QOL was significant in the palliative radiotherapy group. Mental condition was also improved after radiotherapy.


Subject(s)
Breast Neoplasms/psychology , Esophageal Neoplasms/psychology , Lung Neoplasms/psychology , Mental Disorders/etiology , Quality of Life , Urogenital Neoplasms/psychology , Adult , Aged , Aged, 80 and over , Anxiety Disorders/diagnosis , Anxiety Disorders/etiology , Anxiety Disorders/psychology , Attitude to Health , Breast Neoplasms/radiotherapy , Depressive Disorder/diagnosis , Depressive Disorder/etiology , Depressive Disorder/psychology , Esophageal Neoplasms/complications , Esophageal Neoplasms/radiotherapy , Female , Humans , Lung Neoplasms/complications , Lung Neoplasms/radiotherapy , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Middle Aged , Palliative Care/psychology , Palliative Care/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Surveys and Questionnaires , Urogenital Neoplasms/complications , Urogenital Neoplasms/radiotherapy , Young Adult
18.
Radiat Med ; 26(10): 582-6, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19132488

ABSTRACT

PURPOSE: The aim of this study was to evaluate the epiploic appendages in patients with acute abdomen using multidetector computed tomography (MDCT) and to determine the incidence of primary and secondary epiploic appendagitis (EA). MATERIALS AND METHODS: A radiologist reviewed MDCT images from 1338 patients with acute abdomen for visible epiploic appendages. Two radiologists then reviewed the MDCT images showing inflamed epiploic appendages and diagnosed primary EA, secondary EA, or other conditions by consensus. The CT criteria for primary EA are a round or oval pericolonic fatty lesion with a hyperattenuated rim and adjacent fat stranding, without other causes of inflammation. Secondary EA is diagnosed if an epiploic appendage is found to be due to inflammation from other inflammatory entities. RESULTS: Epiploic appendages were identified in 19 patients. Four patients (0.3%) had a retrospective CT diagnosis of primary EA. Twelve patients (0.9%) had a retrospective CT diagnosis of secondary EA (primary condition was diverticulitis in 10 patients and inflammatory bowel disease in 2 patients). The remaining three patients had calcification of an epiploic appendage suggestive of old EA. CONCLUSION: Primary EA should be included in the differential diagnosis of acute abdomen. Occasionally, inflammation of the epiploic appendages is secondary to other inflammatory conditions.


Subject(s)
Colitis/diagnostic imaging , Tomography, X-Ray Computed/methods , Abdomen, Acute/etiology , Adult , Colitis/complications , Colon/diagnostic imaging , Contrast Media , Diagnosis, Differential , Diverticulitis/complications , Female , Humans , Inflammatory Bowel Diseases/complications , Iohexol , Male , Middle Aged , Observer Variation , Radiographic Image Enhancement/methods , Retrospective Studies
19.
Ann Nucl Med ; 21(5): 245-9, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17634841

ABSTRACT

OBJECTIVES: In order to predict the prognosis or complications of portal hypertension in patients with chronic liver disease, it is important to evaluate both hepatic functional reserve and portal circulation. On (99m)Tc-galactosyl human serum albumin ((99m)Tc-GSA) scintigraphy, the index of blood clearance (HH15) and receptor index (LHL15) have been widely used to evaluate the hepatic functional reserve. However, the relationship between these indices and portal circulation is unknown. The purpose of this study was to examine the relationship between HH15 and LHL15 and portosystemic shunts evaluated with arteriographic portography or esophagogastroduodenoscopy. METHODS: A total of 82 patients with chronic liver disease (mean age, 66.7 years) who underwent (99m)Tc-GSA scintigraphy, arteriographic portography, and esophagogastroduodenoscopy were enrolled. HH15 and LHL15 were obtained from dynamic (99m)Tc-GSA scintigraphy. The patients were divided into three groups according to the arteriographic portography findings: group 1, no portal collateral circulation; group 2, mild collateral development; and group 3, moderate to severe collateral development. They were also divided into three groups based on the esophagogastroduodenoscopic findings: group A, no varices; group B, small-caliber varices; and group C, enlarged varices. The Kruskal-Wallis test was used to compare each index among these groups. Receiver operating characteristic (ROC) analysis was used to determine whether each index was an indicator for the presence of portosystemic shunts. RESULTS: Both HH15 and LHL15 differed significantly between groups 1 and 2 and between groups 1 and 3. However, only HH15 differed significantly between groups A and B and between groups A and C. On the basis of the ROC analysis, the HH15 threshold value of 0.62 yielded both excellent sensitivity (83.9%) and specificity (84.6%) for the presence of portosystemic shunts, as evaluated with arteriographic portography. The HH15 threshold value of 0.64 yielded both good sensitivity (66.1%) and specificity (69.2%) for the presence of portosystemic shunts, as evaluated with esophagogastroduodenoscopy, whereas no adequate threshold value of LHL15 was found for the presence of portosystemic shunts. CONCLUSIONS: HH15 is a potent indicator of the presence of portosystemic shunts in chronic liver disease.


Subject(s)
Liver Diseases/diagnostic imaging , Liver Diseases/diagnosis , Liver Function Tests/methods , Radiopharmaceuticals/pharmacology , Technetium Tc 99m Aggregated Albumin/chemistry , Technetium Tc 99m Pentetate/chemistry , Aged , Angiography/methods , Endoscopy , False Positive Reactions , Humans , Middle Aged , Portasystemic Shunt, Surgical , ROC Curve , Radionuclide Imaging/instrumentation , Radionuclide Imaging/methods
20.
Int J Urol ; 14(7): 665-7, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17645618

ABSTRACT

The incidence of stonestreet formation after extracorporeal shock wave lithotripsy (ESWL) rises with increasing stone burden. However, stonestreet after ESWL is often experienced even in stones smaller than 20 mm. To examine whether the non-contrast helical computed tomography (CT) data could predict stonestreet formation in these stones, 53 radiopaque stones of 5-20 mm treated with ESWL were evaluated. Maximal dimension was measured on plain radiograph. From an attenuation value histogram graphed from the CT data, total stone volume and mean attenuation value were calculated. Seven stonestreets longer than 25 mm developed. There was no significant difference in maximal dimension and total stone volume between stones that did and stones that did not develop stonestreet. Mean attenuation value was the sole significant predictive factor. Application of mean attenuation value with cut-off level of 650 HU would anticipate stonestreet formation with a sensitivity of 85.7% and a specificity of 71.7%. The estimated risk of stonestreet formation is high in the treatment of stones with higher mean attenuation value.


Subject(s)
Imaging, Three-Dimensional , Kidney Calculi/therapy , Lithotripsy/adverse effects , Tomography, Spiral Computed , Ureteral Calculi/diagnostic imaging , Ureteral Calculi/therapy , Humans , Predictive Value of Tests , Ureteral Calculi/etiology
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