Agitation thrombolysis combined with catheter-directed thrombolysis for the treatment of non-cirrhotic acute portal vein thrombosis.

AIM: To evaluate the safety and efficacy of agitation thrombolysis (AT) combined with catheter-directed thrombolysis (CDT) for the treatment of non-cirrhotic acute portal vein thrombosis (PVT). METHODS: Nine patients with non-cirrhotic acute PVT who underwent AT combined with CDT were analyzed retrospectively. Portography was carried out via the transjugular intrahepatic portosystemic (commonly known as TIP) or percutaneous transhepatic (commonly known as PT) route, followed by AT combined with CDT. Complications of the procedure, and the changes in clinical symptoms, hemodynamics of the portal vein and liver function were recorded. Follow-up was scheduled at 1, 3 and 6 mo after treatment, and every 6 mo thereafter, or when the patients developed clinical symptoms related to PVT. Color Doppler ultrasound and contrast-enhanced computed tomography/magnetic resonance imaging were performed during the follow-up period to determine the condition of the portal vein. RESULTS: AT combined with CDT was successfully performed. The portal vein was reached via the TIP route in 6 patients, and via the PT route in 3 patients. All clinical symptoms were relieved or disappeared, with the exception of 1 patient who died of intestinal necrosis 9 d after treatment. Significant differences in the changes in portal vein hemodynamics were observed, including the maximum lumen occupancy of PVT, portal vein pressure and flow velocity between pre- and post-treatment (P < 0.05). During the follow-up period, recurrence was observed in 1 patient at 19 mo after the procedure, and the portal vein was patent in the remaining patients. CONCLUSION: AT combined with CDT is a safe and effective method for the treatment of non-cirrhotic acute PVT.

[Imaging findings of non-contrast CT scan, enhancement and HRCT of pulmonary mucosa-associated lymphoid tissue lymphoma].

OBJECTIVE: To explore the imaging findings of non-contrast CT scan, enhancement and HRCT of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS: All the patients with pathologically proven pulmonary MALT lymphoma underwent non-contrast CT scan, of which 7 underwent CT enhancement and 9 had HRCT. CT features of 16 patients were retrospectively reviewed. RESULTS: Major CT signs of 16 cases were consolidations, nodules and masses, of which 11 had two or more signs and 5 had only one. Together with them, normal or dilated air bronchograms were seen in 13 cases, ground-glass opacity (GGO) in 10, interstitial changes and cysts in respective 5, partial atelectasis and mediastinal and hilar lymphoadenopathy in respective 4, pleural effusion in 2 and MALT lymphoma of tracheobronchial tree in 1. Multiple lesions were found in 12 cases and solitary lesion in 4 cases. Consolidations, greater tubercles and masses mostly had a peribronchovascular distribution. Micronodules occurred in a perilymphatic distribution, of which 8 accompanied other signs.On CT enhancement scans, greater tubercles in the trachea had mild enhancement; most of the consolidations and masses had obvious enhancement, while greater tubercles mostly mild enhancement. CT angiogram sign was found in 3 cases. CONCLUSION: Most cases with pulmonary MALT lymphoma have consolidations, greater tubercles and masses with normal or dilated air bronchograms which have a peribronchovascular distribution, together with GGO and micronodules in a perilymphatic distribution; the distinctive manifestations are obvious enhancement with CT angiogram sign. Minority cases have interstitial changes, cysts, partial atelectasis, mediastinal and hilar lymphoadenopathy, pleural effusion and MALT lymphoma of tracheobronchial tree.