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1.
Article in Chinese | WPRIM | ID: wpr-1029766

ABSTRACT

Objective:To evaluate the efficacy and safety of comprehensive treatment for retinoblastoma (RB).Methods:A retrospective clinical study. From January to December in 2019, 157 cases (203 eyes) of RB who were diagnosed by the Department of Ophthalmology of Xinhua Hospital and received comprehensive treatment were included in this study. Of cases, 76 were male, and 81 were female; 111 were unilateral, and 46 were bilateral. The medium of age at diagnosis was 20.1 months. All patients received treatment for the first time. Patients with intraocular tumors were divided into A-E stages, extraocular stage and distant metastasis according to international intraocular RB classification standard. The median follow-up time was 37.4 months. Clinical features, treatment, prognosis and ocular complications of all cases were recorded.Results:Among 157 cases (203 eyes), 137 cases (180 eyes) were in intraocular stage; 6, 14, 10, 98, and 52 of eyes were in A-E stages, respectively. Twelve cases (12 eyes) were in extraocular stage; 8 cases (11 eyes) were in distant metastasis stag; 8 cases died due to distant metastasis; 149 cases (94.9%, 149/157) survived; 48 eyes were enucleated, 34 of which underwent initial enucleation, and 14 eyes underwent enucleation after eye-preserving treatment. The overall global salvage rate was 155 eyes (76.4%,155/203), and that after eye-preserving treatment was 91.7% (155/169). Severer eye for bilateral cases was taken into account for statistic; 120 cases (120 eyes) received initial eye-preserving treatment. Among them, 36 and 84 eyes underwent initial intravenous chemotherapy (IVC) and initial intra-arterial chemotherapy (IAC), respectively. The enucleation of the two groups was 7(19.4%, 7/36), 7(8.3%, 7/84); 33 (91.7%, 33/36) and 33 (39.3%, 33/84) eyes received the second treatment, respectively. There was no significant difference in the rate of enucleation between the two treatments ( χ2=2.037, P=0.154). There was significant difference in the percentage of secondary treatment ( χ2=27.937, P<0.001). Fifty-four eyes (45.0%, 54/120) stabilized after initial treatment, and 66 eyes (55.0%, 66/120) underwent secondary treatments due to poor response or tumor recurrence. For 66 eyes receiving secondary treatments, enucleation, IAC, intravitreous chemotherapy (IVitC), IAC combined with IVitC, and laser and/or cryotherapy was performed in 6, 18, 12, 13, and 17 eyes, respectively. The number of eyes of enucleation among the IAC, IVitC, and IAC combined with IVitC group was 5 (27.8%, 5/18), 1 (9.3%, 1/12), and 2 (15.4%, 2/13) eyes, which was no significantly different ( χ2=2.001, P=0.368). Until the last follow-up, visual acuity outcomes were acquired in 148 eyes (72.9%, 148/203). Among them, 41, 53, 16 and 38 eyes had no light perception, light perception to finger counting, 20/400, and ≥20/200, respectively. In total, among 203 eyes, 121 eyes received IAC, of which 2, 4, and 1 eyes had optic disc atrophy, vitreous hemorrhage, and severe retinal-choroidal atrophy, respectively; 60 eyes received IVitC, of which one and one eye had vitreous hemorrhage and macular hemorrhagic necrosis, respectively. Conclusions:In this study, the overall survival rate was 94.9% after comprehensive treatment and the rate of global salvage after eye-preserving treatment was 91.7%. The comprehensive treatment of retinoblastoma had a relatively high efficacy and safety.

2.
Article in Chinese | WPRIM | ID: wpr-934309

ABSTRACT

Objective:To evaluate the functional and anatomical outcomes of autologous single retinal pigment epithelium (RPE) transplantation for severe obsolete submacular hemorrhage (SMH) in late age-related macular degeneration (AMD).Methods:A retrospective clinical study. From January 2012 to December 2015, 11 patients with AMD (11 eyes) with obsolete SMH who were diagnosed and treated by pars plana vitrectomy (PPV) combined with autologous RPE transplantation at the Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were included. Among them, there were 9 eyes in 9 males and 2 eyes in 2 females. All the eyes underwent the examinations of best corrected visual acuity (BCVA) and optical coherence tomography; 4 eyes underwent macular fixation function (MAIA) at the same time. The BCVA examination was carried out using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. All eyes were treated with PPV combined with autologous single-layer RPE transplantation or autologous RPE-choroidal full-thickness transplantation, and were divided into S group and C group, with 5 and 6 eyes respectively. The differences of age ( t=-0.363), gender composition ratio ( χ2=0.549), course and thickness of SMH ( t=0.118, 0.231), average times of anti-vascular endothelial growth factor drug treatments ( t=0.129), times of PPV ( t=-0.452) between the two groups were not statistically significant ( P>0.05). The follow-up period was 6-40 months after the operation, and the BCVA, MAIA, graft status and complications of the eyes after the operation were observed. The comparison of continuous variables between groups was performed by independent-sample t test; the comparison of categorical variables was performed by χ2 test. Results:At the last follow-up, the average logMAR BCVA of the eyes in group S and C were 1.62±0.34 and 1.03±0.20, respectively; group C was better than group S, however, the difference was not statistically significant ( t=1.532, P=0.160). There were 4 eyes (80%, 4/5) and 6 eyes (100%, 6/6) in S group and C group with BCVA better than preoperative, the difference was no statistical significance ( χ2=0.677, P=0.895). There were 2 (40%, 2/5) and 3 (50%, 3/6) eyes with logMAR BCVA better than 1.0 in S group and C group, and the difference was not statistically significant ( χ2=0.572, P=0.423). After the operation, 6 eyes of grafts were in good condition and 5 eyes were in poor condition; the BCVA of grafts in good condition was significantly higher than that of poor condition, the difference was statistically significant ( t=4.894, P=0.001). Among the 4 eyes that underwent MAIA examination, 2 eyes were unstable and diffusely fixed on the graft; the fixation point was located at the normal retina adjacent to the graft area in 2 eyes. Secondary subretinal hemorrhage occurred in 3 eyes after the operation; the intraocular pressure was high in 1 eye after the operation. During the follow-up period, no intraocular infection, secondary retinal detachment, recurrent choroidal neovascularization or low intraocular pressure occurred in all eyes. Conclusions:Both autologous single-layer RPE transplantation and autologous RPE-choroidal full-thickness transplantation can help stabilize or even improve the visual function of eyes with severe SMH secondary to advanced AMD. The visual acuity after surgery is closely related to the state of the graft.

3.
Article in Chinese | WPRIM | ID: wpr-862063

ABSTRACT

125I radioactive seeds interstitial implantation in brachytherapy of malignant solid tumors develop quickly, which had been used in treatment of various solid malignant tumors and obtained good effects, such as prostate carcinoma, malignant tumors of head and neck, intracranial malignant tumor, lung cancer and hepatoma, etc. However, there exist some problems, including the unclear disciplinary location, practitioner chaos, arbitrary clinical practice, non-uniform operating techniques and so on. The application progresses of 125I radioactive seeds interstitial implantation in brachytherapy of malignant solid tumors were reviewed in this article.

4.
Article in Chinese | WPRIM | ID: wpr-792110

ABSTRACT

Objective To observe the clinical characteristics of rhegmatogenous retinal detachment (RRD) secondary to conservative therapy in retinoblastoma (RB) patients.Methods A retrospective study. From July 2013 to May 2017, 20 RRD patients (20 eyes) of 456 RB patients (573 eyes) treated in Xinhua Hospital of Shanghai Jiao Tong University School of Medicine were included in the study. Eleven patients (11 eyes) were boy and 9 patients (9 eyes) were girls. Thirteen patients demonstrated bilateral RB and 7 patients had unilateral RB. Average age when diagnosed with RB was 25 months. International Classification of Retinoblastoma groups were C in 1 eye, D in 17 eyes, and E in 2 eyes. These patients received intra-arterial chemotherapy (17 eyes), intravenous chemotherapy (11 eyes), intravitreal chemotherapy (8 eyes), laser (14 eyes) and/or cryotherapy (5 eyes). Twelve patients (12 eyes) received vitreoretinal surgery including vitrectomy (6 eyes) and scleral buckling (7 eyes). The mean follow-up was 39 months. Fundus examination was performed under general anesthesia during comprehensive treatment and follow-up. The time interval of fundus examination varied from 1 to 6 months depending on the stability of the tumor.Results RRD was noted in 20 eyes (3.5%) with RB. Retinal hole was found in 15 eyes (75%). The cause of RRD was atrophic hole in calcified tumor (6 eyes, 30%), cryotherapy-related hole (5 eyes, 25%) and laser-related hole (9 eyes, 45%). Multiple atrophic hole in calcified tumor was noted in 3 eyes. Size of hole smaller than 2 DD was noted in 8 eyes (53%), and larger than 2 DD was noted in 7 eyes (47%). Holes were in posterior (3 eyes), equator (2 eyes) and periphery (10 eyes). Severe proliferated was noted in 1 eye. No tear was found. No bulbar retinal detachment and choroidal detachment was noted. Among 12 eyes who underwent vitreoretinal surgery, reattachment was achieved in 9 eyes (75%). No metastasis was noted.Conclusions Calcified regression of tumor, cryotherapy and laser were main reasons of RRD. Most of the holes are small in diameter and located in the periphery.

5.
Zhonghua zhong liu za zhi ; (12): 600-606, 2017.
Article in Chinese | WPRIM | ID: wpr-809171

ABSTRACT

Objective@#To study imaging features of primary hepatic neuroendocrine neoplasm (PHNEN) with CT and MRI.@*Methods@#CT/MRI findings of ten patients with pathologically confirmed PHNEN were retrospectively analyzed. The result was compared with pathologic features classified by the 2010 WHO classification of gastro-entero-pancreatic neuroendocrine tumor which was also compared with the conventional method.@*Results@#Six cases of neuroendocrine tumor (NET), all of which were classified as grade 2 (G2), consisted of 5 cases of carcinoid and 1 case of atypical carcinoid. Four cases of neuroendocrine carcinoma (NEC) classified as grade 3 (G3) were composed of 1 case of atypical carcinoid and 3 cases of small cell carcinoma. On the basis of conventional classification method, CT/MRI features were as follows: (1) Carcinoid: For 5 carcinoid cases, two with solitary mass, two with dominant masses and satellite nodules, and one with diffused nodules. Four cases were cystic-solid and one was solid. Four showed low density on plain CT and moderate to obvious enhancement in arterial phase. Three showed consistent enhancement in portal and delayed phase while one showed rapid washout in portal phase. Four showed low density in delayed phase. One case with cystic degeneration showed hypo-intensity on T1W, hyper-intensity on T2W and halo like hyper-intensity on DWI. In dynamic MRI, the solid part of tumor showed obvious enhancement in arterial phase, consistent enhancement in portal phase with slight washout and homogeneous or slight hypo-geneous signal density in delayed phase. (2) Atypical carcinoid: Two cases presented with cystic-solid mass. They were all dominant masses with satellite nodules. They showed low density on plain CT and mild to moderate enhancement in arterial phase. One case showed rapid washout in portal and delayed phase with embolus in portal vein. The other case showed consistent enhancement in portal phase and hypo-density in delayed phase without enhancement of satellite nodules. (3) Small cell neuroendocrine carcinoma: Three cases of small cell carcinoma were composed of one cystic-solid tumor, one solid tumor and one dominant mass with satellite nodules. Two cases showed low density in CT plain scan while one with cystic degeneration presented hypo-intensity on T1W, hype-rintensity on T2W and halo like hyper-intensity on DWI. Dynamic CT and MRI showed mild to moderate enhancement in arterial phase, consistent enhancement in portal phase and low density or hypo-intensity in delayed phase.@*Conclusion@#PHNEN has specific features on CT and MRI which are valuable in diagnosis and differential diagnosis.

6.
Article in Chinese | WPRIM | ID: wpr-497721

ABSTRACT

Objective To review computed tomographic angiography (CTA) signs and its potential use in the diagnose of blunt thoracic aortic injury Methods We reviewed 37 cases with blunt thoracic aortic injury (TAI) confirmed by surgery or aortography in Chinese PLA General Hospital emergency department from June 2004 to June 2014.CTA were performed on these patients,and CTA images were analyzed retrospectively to obtain characteristic CTA signs of blunt thoracic aortic injury.Results Of the 37 cases,the blunt injury in aortic isthmus were 83.8% (31/37),aortic arch 5.4% (2/37),descending aorta 8.1% (3/37),and ascending aorta 2.7% (1/37),respectively.CTA signs of thoracic aortic injury manifested as intimal flap in 34 patients (91.8%),abnormal aortic contour or cavity in 37 cases (100%),arterial contraction in 17 cases (45.9%),aortic dissection in 10 cases (27.0%),pseudoaneurysm in 21 cases (56.7%),thrombosis in 1 case (2.7%).Conclusions CTA signs could be used to facilitate the diagnosis of blunt thoracic aortic injury with a qualitative diagnostic value.

7.
Article in Chinese | WPRIM | ID: wpr-428423

ABSTRACT

Objective To observe the clinical effects of vitrectomy for advanced retinopathy of prematurity (ROP) and evaluate influence factors of anatomical recovery for stage 5 ROP.Methods Fiftyeight eyes of 40 infants with advanced ROP who underwent vitrectomy were retrospectively analyzed.There were 16 eyes of stage 4a,7 eyes of stage 4b,and 35 eyes of stage 5 ROP.Eighteen eyes received laser photocoagulation,2 eyes received cryotherapy,and 11 eyes received intravitreous injection of Bevacizumab (IVB) before surgery.The average follow-up time was 17.01 months.Anatomical outcome of retina after surgery was recorded by indirect ophthalmoscope and RetCam Ⅱ digital camera system.Visual outcome was measured by grating acuity test(lea gratingTM),and was converted to Snellen acuity values for analysis.For those who cannot cooperate to accomplish the test,we use hand move,light perception and non-light perception to record visual outcome. Results All 16 eyes of stage 4a were anatomically recovered (100.00%).5/7 eyes of stage 4b were anatomically recovered (71.43%) and 2/7 eyes were anatomically failed(28.57%).12/35 eyes of stage 5 were anatomically recovered (34.29%); 10/35 eyes were partial anatomically recovered (28.57%); 13 eyes were anatomically failed (37.14%). Anatomical outcome of stage 4a or 4b was better than stage 5 statistically(x2 =22.55,P<0.05).Of 16 eyes of stage 4a,3 eyes were absent for visual function test.In the rest 13 eyes of stage 4a,VA of 6 eyes (46.15%) was between 0.03 and 0.07; 5 eyes (38.46%) were hand move; 2 eyes (15.39%) were light perception.Of 7 eyes of stage 4b,2 eyes (28.57%) accomplished grating acuity test with VA of 0.008 and 0.017 respectively; 1 eye (14.29%) was hand move; 2 eyes (28.57%) were light perception; 2 eyes (28.57%) were non-light perception.Of 35 eyes of stage 5,5 eyes were absent for visual function test.In the rest 30 eyes of stage 5,VAof2 eyes (6.67%) was 0.004; 4 eyes (13.33%) were hand move; 12 eyes (40.00%) were light perception; 12 eyes (40.00%) were non-light perception.Visual outcome of stage 5 was worse than stage 4a or 4b statistically(x2=15.734,P<0.05).There was no statistically significant relationship between anatomical outcome and birth weight,gestational weeks,age at surgery,IVB therapy,laser or cryotherapy before surgery.Conclusions Vitrectomy can effectively control the lesions progress of stage 4a ROP,and achieve partially anatomically recovery of some stage 4b/5 patients.There was no statistically significant relationship between anatomical outcome and birth weight,gestational weeks,age at surgery,IVB,laser or cryotherapy before surgery.

8.
Article in Chinese | WPRIM | ID: wpr-473155

ABSTRACT

Objective To analyze the influence factors of complications in CT-guided percutaneous pulmonary biopsy,and to explore the optimal methods of operation.Methods Totally 410 patients who underwent CT-guided percutaneous pulmonary biopsy were retrospectively analyzed,and the complications of biopsy were observed.Results Pulmo-related complications occurred in 54 patients (54/410,13.17%) ,including pneumothorax in 18 patients (18/410,4.39%) ,1 of them had pneumothorax and pulmonary bleeding around the needles in 35 patients (35/410,8.54%) ,15 of which with haemoptysis (15/410,3.66%) ,and 1 patient had acute pleura reaction.No severe complications such as infection.excessive bleeding,hemothorax,aeroembolism,needle track implantation metastasis occurred.Conclusion Accurate and skillful CT-guiding techniques and appropriate operation methods are important to improve the success rate and to reduce complications of CT-guided percutaneous pulmonary biopsy.

9.
Article in Chinese | WPRIM | ID: wpr-591140

ABSTRACT

Objective To evaluate the CT findings of the parotid basal cell adenoma and it's diagnostic value.Methods The CT appearances of 10 patients with parotid basal cell adenoma confirmed by histopathology were reviewed retrospectively.The plain and the contrast-enhanced CT scan were performed in all cases.Results The well-defined mass in varied size with marked enhancement in contrast-enhanced CT imagines,in which the CT value increased to 200Hu maximally(average,84Hu),were the pathognomonic CT characteristics of the parotid basal cell adenoma.Conclusion The qualitative diagnosis of the parotid basal cell adenoma could be made based on the CT findings combined with some valuable clinical information before operation.

10.
Article in Chinese | WPRIM | ID: wpr-472090

ABSTRACT

Objective To explore the causes of hepatic perfusion disorders (HPD), and to analysis the CT features of this phenomenon. Methods Nine experimental pigs were randomly divided into three groups. In Group A, B and C, intrahepatic portal, arterial branches and hepatic vein were selectively embolized, respectively. Then all animals underwent contrast enhanced CT scans immediately and after one week. Results On CT images immediately after intervention, HPD were found in all animals. Multiple transient wedge-shaped hyperattenuation represented during the hepatic arterial phase and isoattenuating areas during the portal venous phase. In group A, the site of HPD was in correspondence with the area of embolization,whereas in group B, the embolized area displayed hypoattenuation and non-embolized area displayed hyerattenuation during arterial phase. In group C, the site of HPD was correspondence with the area of embolization in two pigs, but in one pig, the region of HPD was larger than the region of embolization. After one week, HPD disappeared due to sponges absorption and the vessels reopening in group A and B. In group C which hepatic vein was coagulated by laser, HPD remained partially. Conclusion Intrahepatic vascular occlusions of portal, hepatic arterial and hepatic venous branches are the main factors that cause HPD.

11.
Article in Chinese | WPRIM | ID: wpr-405540

ABSTRACT

Objective To compare the clinical effectiveness of ozone (O_3) nucleus pulposus ablation only with that of 03 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome in treating lumbar disk herniation accompanied with intervertebral facet arthritis. Methods Eighty patients with lumbar disk herniation and intervertebral facet arthritis were equally and randomly divided into two groups. Under CT guidance, O_3 nucleus pulposus ablation was performed in patients of group A(n = 40), while O_3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome (0.5 ~ 1 ml) was carried out in patients of group B (n = 40). Using double blind method the therapeutic effectiveness was evaluated before and 1 week, 3, 6-months after the procedure by an Oswestry Low Back Pain Disability Questionnaire. Results One week after the procedure the effective rate of group A and group B was 65% and 82.5% respectively. Three and six months after the treatment, the effective rate was 75% and 70% respectively for group A, while it was 90% and 92.5% respectively for group B. The difference between two groups was significant (P < 0.05). Conclusion lntradiscal injection of O_3 combined with intervertebral facet joint injection of compound Betamethasome is an effective and safe treatment for lumbar disk herniation accompanied with intervertebral facet arthritis. It is worth popularizing this technique in clinical practice.

12.
Article in Chinese | WPRIM | ID: wpr-575916

ABSTRACT

Objective To evaluate the clinical value of CT-guided percutaneous biopsy for bone lesions.Methods Forty-Eight patients with different sited bone lesions had received the procedure of CT-guided percutaneous biopsy from July 2003 to January 2005,including 34 cases only with complete clinical records.The procedure was carried out with patient lied on CT table and followed by localization scanning to demonstrate the best sites for puncture and biopsy route.11-14 G bone puncture needle or 18 G trigger type biopsy needle was undertaken to penetrate into the lesion for obtaining specimens under local anesthesia and CT monitoring and in turn for fixation with 10% formalin to have pathologic examination.Results The whole procedure finished within 20-40 minutes with adequate samples obtained for pathologic examination of all cases.Confirmed diagnosis was made in 30 cases with an accuracy of 91.2% and no correlative complications were found.Conclusions The CT-guided percutaneous biopsy is safe and efficient for diagnosis of bone lesions,deserving to be extensively used.(J Intervent Radiol,2006,15: 603-606)

13.
Article in Chinese | WPRIM | ID: wpr-579051

ABSTRACT

Objective To evaluate the efficacy of the renal arterial embolization with lipidol and absolute alcohol emulsion in the treatment of renal tumors. Methods The superselective renal arterial embolization by using coaxial-cathaterization with infusion of lipiodol and absolute alcohol (in proportion of 2 ∶ 1) emulsion was performed in twenty patients with malignant and benign kidney tumors. 4 weeks later, the renal arteriography was taken routinely and repeated embolization was performed in case of necessary; and follow up was carried out periodically. Results The imaging findings showed thorough tumor necrosis and feeding vessel abruption in 18 cases after one session of treatment. The volume of tumors decreased more than a half in 13 patients (82.25%, 13 / 18) associated with a well-distributed lipidol inside the tumors. The second session of treatment was performed in other 2 patients and the clinical symptoms relieved obviously. Conclusions The superselective renal artery embolization with lipidol and absolute alcohol emulsion can permanently embolize all tumor feeding arteries in capillary vessel level with maximum reservation of renal function, providing definitively efficacy and worthwhile to be recommended widely.

14.
Article in Chinese | WPRIM | ID: wpr-537029

ABSTRACT

Objective To study the anatomic characteristics of hepatogastric artery(HGA) and its significance in preventing gastrointestinal complications in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization(TACE).Methods 1000 cases of hepatic arteriograms were retrospectively reviewed,the aberrant gastrointestinal arteries that originate from proper hepatic artery(PHA)and distal intrahepatic arteries to PHA were named HGA.The frequency,origine,course and distribution of all of HGAs were carefully analyzed.The trial group consists of 34 cases(42 times of TACE)who had HGA and controlled group consists 32 cases(56 times of TACE)who had no HGA.The incidence of gastrointestinal complications after TACE between two groups were compared.Within trial group,superselective catheterization was made and had the tip of catheter away from orifice of the HGA before infusion of embolic agents(Lipiodol)during TACE in 18 times,which was called relative safety group;whereas,the tip of catheter was not laid distal to orifice of HGA when infused Lipiodol through catheter in 24 times,which was called dangerous group.The incidence of complications between this two groups was also compared.Results Of 1000 cases of hepatic arteriography,HGA was found in 740 cases (74%).The incidence of gastrointestinal complication and its grave degree in trial group were more excessive than that in controlled group((?=0.004),similarly,the frequency of gastrointestinal complication and its graveness in dangerous group exceeded significantly that in relative safety group((?=0.000).Conclusion HGA is common vascular variation.That embolic agents (Lipiodol)was perfused carelessly into HGA may induced occurrence of gastrointestinal complications in patients after TACE,and having the tip of catheter away from the orifice of HGA by superselective catheterization during TACE could efficiently prevent happening of this kind of complications after operation.

15.
Article in Chinese | WPRIM | ID: wpr-579677

ABSTRACT

Objective To discuss the therapeutic efficacy of transcatheter arterial chemoembolization(TACE) via a coaxial microcatheter combined with radiofrequency ablation(RFA) for primary hepatocellular carcinoma(HCC).Methods The preoperative DSA and multi-slice CT findings in 1 000 patients with HCC,encountered from May1998 to May 2007,were retrospectively analyzed.In 179 cases,the lesion was limited in one hepatic segment,and super-selective catheterization TACE with a coaxial microcatheter was performed in these patients.Four weeks after TACE,dynamic enhanced CT and / or MR scanning was made to observe the results.In 40 cases,there was poor lipiodol deposit in the lesion,and CT-guided RFA was employed for these patients.Follow-up check was done one month after the treatment.Results DSA examination totally revealed 670 lesions with diameter larger than 3 cm,202 lesions with diameter smaller than 3 cm,400 satellite nodules,482 arteriovenous fistulae or arterio-portal shunts,430 abnormal blood-supplying vessels and 362 cancerous thrombosis in portal vein.Four weeks after microcatheter embolization,the local control rate of the tumor was 77.6%.RFA was carried out for patients with poorly-controlled tumors,and one month after RFA the local control rate of the tumor reached 97.5%.Conclusions DSA is the most powerful examination means in detecting lesions less than 3 cm,satellite nodules,tumor’s blood-supply,arteriov-enous fistulae and arterio-portal shunts.Therefore,DSA plays an important role in making the preoperative evaluation of HCC,undoubtedly,this role can not be substituted by any other equipment.RFA is an effective treatment for HCC as well as an ideal alternative for patients who show poor response to TACE.

16.
Article in Chinese | WPRIM | ID: wpr-579679

ABSTRACT

Objective To evaluate the effectiveness of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) and TACE combined with 125I interstitial brachytherapy in the treatment of primary hepatocellular carcinoma(HCC) and to compare the results of the two therapies.Methods Fifty patients with HCC underwent TACE and RFA during laparotomy and 34 patients received TACE and radioactive 125I particle seeding.Four weeks after the procedure,dynamic enhanced CT or MR scanning was performed for a check.If the lipiodol deposit was poor,TACE was repeated.Follow-up check was made at regular intervals to observe the results.Results One month after the treatment,the local control rate of the tumor for TACE +RFA and TACE + 125I particle seeding combination therapy was 98.0% and 97.1%,respectively.No statistically significant difference existed between the two therapies.Conclusions Both TACE combined with RFA or with 125I particle seeding are effective therapies for HCC,which can be regarded as an ideal alternative therapy for patients who have failed to respond to TACE alone.

17.
Article in Chinese | WPRIM | ID: wpr-552363

ABSTRACT

Objective To study the characteristics of hepatogastric artery (HGA) with DSA and its clinical significance in transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma. Methods One thousand cases of hepatic DSA arteriograms had been retrospectively reviewed. The aberrant gastrointestinal arteries that originated from proper hepatic artery (PHA) or distal intrahepatic arteries to PHA were named HGA. Furthermore, according to their different courses and distributions, HGAs were subdivided into right gastric artery (RGA), aberrant left gastric artery (AbLGA), aberrant gastroduodenal artery (AbGDA), aberrant right gastroepiploic artery (AbRGEA), superior duodenal artery (SDA) and other difficult-to-named HGA. The incidence of each of them had been summed up and their anatomic characteristics such as origin, course, branches, and distribution had been described. Results Of the 1000 cases, at least one branch of HGA was found in 740 cases (74%), and altogether there were 839 branches of HGA in them. The composition of 839 branches of HGA was as follows: 682 branches of RGA (81.29%, 682/839), 84 branches of AbLGA (10.01%, 84/839), 45 branches of SDA (5.36%, 45/839), 21 branches of AbGDA (2.50%, 21/839), 1 branch of AbRGEA (0.12%, 1/839) and 6 branches of difficult-to-named HGA (0.72%, 6/839). Of the 839 branches of HGA, 412 branches originated from PHA (49.11%, 412/839), 314 branches from left hepatic artery (LHA)(37.43%, 314/839), 98 branches from right hepatic artery (RHA)(11.68%, 98/839), and 15 branches from middle hepatic artery (MHA)(1.79%, 15/839). Conclusion HGA is a common gastrointestinal arterial variation and it is very important to be familiar with it so as to prevent the gastrointestinal complications after TACE in patients with hepatocellular carcinoma.

18.
Article in Chinese | WPRIM | ID: wpr-560497

ABSTRACT

Objective To assess the therapeutic value of CT guided percutaneous radiofrequency thermal ablation(RFA)for peripheral lung carcinoma(PLC).Methods Forty-three patients with PLC were treated with RFA under the CT guidance.The patients included 26 males and 17 females,and the age ranged from 52 to 76 years.The CT guided percutaneous biopsies were performed to obtain the pathology before the procedures.Results The operations in all cases were successful,little amount of pneumothorax was found in 3 cases,liquid-pneumothorax in 1 case,and large amount of pneumothorax was drainaged in 1 case.The volume of the lesion in 40 cases from 43 patients was diminished gradually at 3 and 6 months follow-up after the procedures.No change in the volume of lesion with peripheral enhancement was seen in 3 cases.Conclusion CT guided percutaneous RFA for PLC is a safe,effective,and minimal invasive procedure.

19.
Article in Chinese | WPRIM | ID: wpr-570332

ABSTRACT

Objective To investigate the anatomic characteristics of hepatopancreatic artery(HPA) by DSA and its significance in preventing pancreatic complications after transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma.Methods 1 000 cases of hepatic arteriograms have been retrospectively reviewed. The aberrant pancreatic arteries that originate from proper hepatic artery(PHA) and all distal intrahepatic branches to PHA were called hepatopancreatic arteries. The incidence of HPA has been summed up and its anatomic characteristics such as origine, course, branches and distribution have been described. Results Of 1000 cases, HPA were found in 16 cases(1.6%). There were 2 branches of HPA in one case and there was only one branch of HPA in other 15 cases. Altogether 17 branches of HPA were found; of which, 7 branches originated from PHA(41.2%,7/17), 6 branches arose from right hepatic artery(RHA)(35.3%,6/17) and 4 branches came from left hepatic artery(LHA)(23.5%,4/17). Conclusions HPA is a kind of rare variations of pancreatic artery. The importance to avoid embolizing HPA during TACE is preventing pancreatic complications.

20.
Article in Chinese | WPRIM | ID: wpr-591100

ABSTRACT

Objective To investigate the value of optimizing the thoracic CT scanning dose on reducing radiation dose.Methods 50 patients were undergone CT scanning using CARE Dose 4D technique,the mAs of each slices,CT dose index of volume(CTDIvol) and images qualities were evaluated respectively.And the results were compared with traditional thoracic CT scanning(200mAs,15.31mGy).Results Compared with routine sequence,the exposure dose of singe-slice was decreased by 48.2% when the CARE Dose 4D technique was used(maximal decreasing 84%),CTDIvol was reduced about 32.98%(maximal reduction of 56.5%),there was statistically significant difference(P

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