Abnormal pulmonary accumulation of indium-111 chloride in pneumocystis carinii pneumonia as detected by bone marrow scintigraphy.

PURPOSE: Unusual pulmonary uptake of In-111 chloride in a patient with Pneumocystis carinii pneumonia and autoimmune hepatitis is described. METHOD: In-111 chloride bone marrow scintigraphy was performed to evaluate the bone marrow activity associated with pancytopenia in a 56-year-old woman with autoimmune hepatitis. RESULTS: An In-111 chloride bone marrow scan showed increased pulmonary uptake predominantly in both upper lung fields. P. carinii pneumonia was seen to be developing as an immunocompromised complication after treatment for autoimmune hepatitis. CONCLUSION: When In-111 chloride bone marrow scintigraphy shows increased uptake in the lungs of immunocompromised patients, a combined opportunistic inflammatory disease such as P. carinii pneumonia should be considered in the diagnosis.

[Serial hepatic and splenic volumetry in acute severe hepatitis].

In this study, we elucidate a relationship between final outcome and changes in hepatic and splenic volume in patients with acute severe hepatitis. The subjects were 40 patients: 10 with sever acute hepatitis (prothrombin time < 40%) and 30 with fulminant hepatic failure (acute type in 12 and subacute type in 18). Liver and spleen volume were measured by CT initially on hospitalization and subsequently 1 to 40 days after hospitalization, and the scans were analyzed retrospectively. Liver volume decreased in 15 of 26 survivors, and all 14 non-survivors. Among 15 survivors and 14 non-survivors whose liver volume decreased, spleen volume increased in none of the survivors, whereas it increased in 11 of the 14 non-survivors. In survivors there was a close parallelism between changing rates of the liver volume and that of the spleen volume (r = 0.82, p < 0.0001). These observations suggest that the decrease of liver volume accompanied by that of spleen volume implies a good prognosis, while the decrease without such accompaniment implies a bad prognosis.

[MR cholangiopancreatography of pancreas divism and anomalous arrangement of the pancreaticobiliary ducts].

The purpose of this study was to evaluate the usefulness of MR cholangiopancreatography (MRCP) for pancreas divism and anomalous arrangement of pancreaticobiliary ducts (APBD). In 214 patients, MRCP was performed. In 204 patients (94%), pancreaticobiliary ductal junction could be recognized. Pancreas divism was observed in 13 of 204 patients (6%), and APBD was observed in 10 of 204 patients (5%). Dynamic MRCP after secretin stimulation was useful for diagnosing pancreas divism and APBD.

[MR cholangiopancreatography of Mirizzi syndrome and Lemmel syndrome].

The purpose of this study is to evaluate the usefulness of MR cholangiopancreatography (MRCP) in diagnosing Mirizzi syndrome and Lemmel syndrome. MRCP could show compressed common hepatic duct by enlarged gallbladder in Mirizzi syndrome. Periampulary duodenal diverticulum and compressed lower bile duct can be recognized clearly by MRCP after secretin stimulation. So MRCP should apply for diagnosing of Mirizzi syndrome or Lemmel syndrome.

[Breath-hold 3D MR urography with 2 ml Gd-DTPA injection].

Breath-hold gadolinium-enhanced 3D MR urography was performed in five healthy volunteers. Enhanced 3D fast gradient-echo with a spectral IR pulse sequence was used for depicting MR urography, which was obtained 5-10 minutes after the injection of 2 ml of gadopentate dimeglumine (0.013-0.02 mmol/kg). The urinary tract was depicted as a high-signal intensity area, and detectability of the non-dilated urinary tracts was superior to that of heavy T2-weighted images. At the same time, comparison between the urinary tract and vascular structure could be made using breath-hold contrast-enhanced 3D MR angiography with an additional Gd-DTPA injection.

[Arterial infusion chemotherapy with SMANCS-Lipiodol for multiple hepatocellular carcinoma].

Fifty-five patients with hepatocellular carcinoma were treated with oily anticancer agent SMANCS dissolved in Lipiodol (SMANCS-LPD). The local response rate after the first arterial infusion in all patients was 39%, against 63% in 27 patients with Lipiodol accumulation occupying more than two thirds of tumor areas. The infusion therapy with SMANCS-LPD is adapted for a vascular-rich hepatocellular carcinoma. An infusion of 4 mg of SMANCS was ineffective for patients with tumors distributing in bilateral lobes of liver. Thus, an increase of infusion dosage or repeated infusions were recommended for such cases.

[Arterial infusion chemotherapy with SMAN CS-Lipiodol for hepatocellular carcinoma evaluation of infusion method].

Forty-four patients with hepatocellular carcinoma were treated with oily anticancer agent SMANCS dissolved in Lipiodol (SMANCS-LPD). The local response rate after the first arterial infusion in all patients was 39%, against 63% in 27 patients with Lipiodol accumulation occupying more than two third of tumor areas. Repeated arterial infusion of SMANCS-LPD did not enhance the therapeutic effect. An infusion of 4mg of SMANCS was ineffective for patients with tumors distributing in bilateral lobes of liver, and 6 mg was recommended for such cases.