RESUMEN
Eight patients with inoperable hepatocellular carcinoma were treated by means of percutaneous alcoholization of the malignancy (11 nodular lesions less than 5 cm O). Upon treatment completion they were all given intraarterial injection of lipiodol, which was followed, a week later, by a CT scan. At angiography, during the parenchymal phase, 7 of 11 nodules appeared as avascular areas, whereas in the remaining 4 cases an intense parenchymal effect was seen within the previously treated areas. Lipiodol CT scans revealed intense uptake of oily material in the 4 hypervascular lesions as well as in 1 of those with avascular appearance. In 4 lesions, pathology of bioptic specimens obtained from the areas with contrast pooling was consistent with the persistence of viable neoplastic tissue. In these patients alcoholization had therefore to be continued. Lipiodol accumulation within previously treated nodules has proved to be related to the presence of residual neoplasm. Moreover, in 2 cases, focal retention of lipiodol was very helpful for biopsy under CT guidance. According to our experience, we believe lipiodol administration followed by CT to be very useful in evaluating and staging HCCs. We nevertheless believe that the procedure should be performed only after alcoholization has been completed: this would inform us of treatment effectiveness and subsequently enable us to decide whether treatment can be discontinued.
Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Etanol/uso terapéutico , Aceite Yodado , Neoplasias Hepáticas/diagnóstico por imagen , Angiografía de Substracción Digital , Biopsia , Carcinoma Hepatocelular/tratamiento farmacológico , Arteria Celíaca/diagnóstico por imagen , Arteria Hepática , Humanos , Inyecciones Intraarteriales , Aceite Yodado/administración & dosificación , Hígado/diagnóstico por imagen , Hígado/patología , Neoplasias Hepáticas/tratamiento farmacológico , Factores de Tiempo , Tomografía Computarizada por Rayos X , UltrasonografíaAsunto(s)
Sulfato de Bario , Enema/efectos adversos , Recto/lesiones , Fibrosis Retroperitoneal/inducido químicamente , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Fibrosis Retroperitoneal/diagnóstico por imagen , Espacio Retroperitoneal/diagnóstico por imagen , Rotura Espontánea , Tomografía Computarizada por Rayos XRESUMEN
The Authors studied the effects induced by long administration of hypothalamic phospholipids on the rat liver. They showed that the most important histologic changes can be observed in the liver of animals who received the longest treatment. Such changes consist of significant infiltration of lymphocytes and red blood cells that have overflowed into the pericentrolobular space. This picture of a not-too-serious blood stasis could justify the alterations of the epatocytes contemporarily observed.