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ObjectiveTo investigate the diagnostic value of early undiscovered nodosity metastasis by hepatic artery Doppler flow imaging perfusion index(DPI) and contrast-enhanced ultrasound (CEUS).MethodsSix hundred and fifty-five patients were collected who suffered with malignant tumor which is not from liver and without liver metastasis.DPI were detected in all patients first,and then patients of higher DPI were taken CEUS and contrast-enhanced CT(CECT).All the diagnosis were confirmed by operation,biopsy under ultrasound or follow-up.ResultsAfter 6 months' follow-up,there were 19 patients found liver metastasis in 562 patients without increase of DPI,and 75 patients found liver metastasis in 93 patients with increase of DPI(DPI＞30％).The negative and the positive predictive value were respectively 96.6％and 80.6％.Seventy-five patients were found 132 liver metastasis who were given CEUS,and 60 patients were found 94 liver metastasis who were given CECT,there was significance difference between them( P ＜0.01).ConclusionsThe combination of DPI and CEUS can get higher detection rate of liver metastasis.
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Objective To investigate the ischemic injury of hepatic cell caused by hepatic artery occlusion.Methods The hepatic artery was occluded in 20 dogs via operation,while the portal vein remained patent.Specimens were gained from the right liver at four time points:before occlusion of the hepatic artery,20(minutes),40 minutes and 60 minutes after artery occlusion.Each specimen was examined by HE and BCL-2 by immunohistochemistry.The gray scale of BCL-2 in HE sections was detected.Results Hepatic cellular injury was obvious 20 minutes after occlusion of the hepatic artery.Irreversible hepatic cellular injury was(observed) 60 minutes after hepatic artery occlusion.The results showed that the gray scale of BCL-2 at every time point after hepatic artery occlusion were significantly different from that before hepatic artery occlusion(P
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ObjectiveTo investigate the methods of hepatic arterial reconstruction in orthotopic liver (transplantation)(OLT), and the prevention and management of associated complications, so as to improve the therapeatic results and donor survival rate of OLT.MethodsThe clinical data of 85 cases of orthotopic liver transplantation performed in our institute from May 1995 to May 2004 were retrospectively analysed. Hepatic artery reconstruction was made by use of Carrels patch of donor celiac artery or bifurcation of donor common hepatic artery and splenic artery anastoniosed to left and right hepatic artery of recipient in 16 cases((18.82)%), to bifurcation of gastroduodenal and proper hepatic arteries of recipient in 61 cases((71.76)%), or use of donor iliac artery interposition graft to abdominal aorta in 8 cases(9.42%). Regular heparin or low-molecular-weight heparin as a prophylactic anticoagulation therapy was maintained during and after (operation) as indicated by prothrombin time. Intra-and postoperative Doppler ultrasonography was used to (monitor) hepatic arterial blood supply.ResultsHepatic artery thrombosis(HAT) was observed in 1 case (intraoperatively)(overall incidence 1.2%).Thrombectomy and reconstruction of the arterial anastomosis were performed immediately.This patient currently has a survival time of 13 months without HAT. HAT was not observed in any of the other 84 cases during the follow up of 2 to 52 months.Conclusions Hepatic artery thrombosis may be minimized by proper selection of anastomotic site of hepatic artery reconstruction and (effective) use of postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt diagnosis of HAT, salvage grafts and avoid re-transplantation.
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Objective To evaluate radio frequency hyperthemia combined with intrahepatic arterial chemotherapy in the treatment of advanced liver cancer. Methods 50 cases of primary or secondary advanced liver concers were selected and treated with chemotherapeutic perfusion or chemoembolization via hepatic artery by the method of Seldinger, combining synergetically radio frequency heat therapy for achieving better efficacy. Results Clinical conditions in 18 of 509 cases were improved with ? fetoprotein returned to negative in 6 cases and decreased in 13 Ultrasound or CT demonstrated tumor shrinkage in 18 cases. Conclusions Radio frequency hyperthermia combined with interventional chemotherapy via hepatic artery is effective in the treatment of advanced liver cancer together with no obvious side effects.
