Spectrum of Imaging Findings and Complications After Hepatic Transarterial Chemoembolization for Liver Tumors.

ABSTRACT: This study reviews the spectrum of imaging findings and complications after transarterial chemoembolization (TACE) for the treatment of primary liver tumors (hepatocellular carcinoma, cholangiocarcinoma) and liver metastases. The review encompasses a spectrum of imaging criteria for assessing treatment response, including the modified Response Evaluation Criteria in Solid Tumors guidelines, tumor enhancement, and apparent diffusion coefficient alterations.We discuss the expected posttreatment changes and imaging responses to TACE, describing favorable and poor responses. Moreover, we present cases that demonstrate potential complications post-TACE, including biloma formation, acute cholecystitis, abscesses, duodenal perforation, arterial injury, and nontarget embolization. Each complication is described in detail, considering its causes, risk factors, clinical presentation, and imaging characteristics.To illustrate these findings, a series of clinical cases is presented, featuring diverse imaging modalities including computed tomography, magnetic resonance imaging, and digital subtraction angiography.

Accuracy of diffusion-weighted imaging in discriminating atypical vertebral haemangiomas from malignant masses in patients with vertebral lesions: a cross-sectional study.

PURPOSE: Vertebral haemangiomas are incidental findings in imaging modalities. Atypical haemangiomas are haeman-giomas rich in vascular tissue, and they are found to be hypointense in T1 sequences and hyperintense in T2 sequences, mimicking the findings of metastatic lesions. In the present study we aim to evaluate the ability of diffusion- weighted imaging to differentiate these two groups of vertebral lesions. MATERIAL AND METHODS: In the present cross-sectional study, a total of 23 lesions were included, including 10 haemangiomas and 13 malignant lesions. Diffusion-weighted imaging was used to compare atypical haemangiomas and metastatic lesions. The apparent diffusion co-efficient was determined for each lesion, and then the mean of each group was calculated. The means were then compared. Receiver operating characteristic analysis was used to determine a cut-off ADC value to differentiate these lesions. RESULTS: The difference between the mean age of the two groups was not significant. The mean ADC value for atypical haemangiomas was 1884 ± 74 × 10-6 mm2/s and 1008 ± 81 × 10-6 mm2/s for the malignant lesions. The difference between the two groups was statistically significant (p < 10-3). ROC curve analysis determined an ADC value of 958 × 10-6 mm2/s to be able to differentiate between atypical haemangiomas and malignant lesions. CONCLUSIONS: Diffusion-weighted MRI could be used to differentiate between atypical haemangiomas and malignant metastatic lesions.

QT dispersion in the electrocardiogram in hemodialysis and peritoneal dialysis patients.

To evaluate QT dispersion (QTd) in dialysis patients in an analytic cross-sectional study, three groups were enrolled: Hemodialysis (HD), peritoneal dialysis (PD) and control (30 patients in each group) to study QT parameters in 12-lead electrocardiograms (ECGs). QTd was calculated (maximum QT interval minus minimum QT interval in different leads in each ECG). In dialysis patients, left ventricle mass index (LVMI) was also evaluated using the ECG of the patients. QT, corrected QT (QTc), QTd and QTc dispersion were significantly higher in the HD and PD groups than in controls, but there was no difference between the dialysis groups. There was no difference between the HD and the PD groups in LVMI and ejection fraction. In the PD group, there was a positive correlation of LVMI and QTd (r = 0.5, P = 0.004) and QTc dispersion (r = 0.54, P = 0.004). We conclude that the QT changes were more prominent in HD and PD patients than in controls, which could be due to electrolyte changes. Further studies to evaluate the causes of the QT changes in a larger population are needed.