Efficacy of uterine artery embolization (UAE) for uterine fibroids according to FIGO classification: a single-center experience.

OBJECTIVE: This study aims to retrospectively evaluate the outcomes of uterine artery embolization (UAE) for uterine fibroids (UFs), specifically submucosal UFs, according to the International Federation of Gynecology and Obstetrics (FIGO) classification of UFs. MATERIALS AND METHODS: Forty-two patients with symptomatic UFs underwent UAE with Embosphere® between July 2016 and November 2021. MRI was performed before, at 3 and 6 months after the UAE. At each examination, the volume of UF was measured, and the percentage volume reduction rate (VRR) was calculated. The technical success rate (TSR), symptom improvement rate (SIR), regrowth rate (RR) after 6 months, and adverse events (AEs) were examined; VRR was compared between patients with submucosal UFs (FIGO types 0-2, group A), those with submucosal contacts (FIGO type 3, group B), and those without submucosal UFs (FIGO types 4-7, group C). Statistical analysis was performed on the difference in VRR between groups A, B, and C at 3 and 6 months after UAE. The relationship with hormone levels before UAE and VRR was evaluated. RESULTS: Thirty-seven of the 42 patients were evaluated. Overall, VRR was 37.0% at 3 months and 52.1% at 6 months; TSR, SIR, and RR were 100%, 95.2%, and 5.4%, respectively; VRR at 6 months was 80.7% for group A (n = 7), 57.8% for group B (n = 13), and 37.1% for group C (n = 17). Significant differences were found between A and C (p < 0.001) and B and C (p = 0.023). Hormone levels before UAE had no effect on VRR. There was no significant AEs other than grade 3 pulmonary embolism in one patient. CONCLUSION: UAE was effective for submucosal FIGO types 0-3. UAE was especially useful as an option for FIGO type 3 with a low protrusion rate that is difficult to treat with transcervical resection.

Development and Experimental Study of a Polytetrafluoroethylene-Tipped Microcatheter Poorly Adhesive to n-Butyl-2-Cyanoacrylate.

PURPOSE: We have developed a new microcatheter (designated "NSX") with an outer layer of polytetrafluoroethylene (PTFE) at its tip. We compared the adhesion of the new NSX microcatheter and a conventional microcatheter with n-butyl-2-cyanoacrylate (NBCA) in vitro and in swine blood vessels. MATERIALS AND METHODS: The 3 cm tip of the NSX microcatheter is composed of PTFE, which can be identified by double platinum markers. The tips of the NSX and conventional microcatheters were inserted into a vascular model filled with porcine blood with no flow, and NBCA mixed with lipiodol (1:2) was injected from the microcatheters. Two minutes after the injection of NBCA, the microcatheter was withdrawn and the degree of its adhesion to NBCA was evaluated by measuring the resistance value (N) during catheter removal with a digital force gauge. These measurements were repeated with 20 catheters of each type. Similarly, 5 injections were performed with both the NSX and conventional microcatheters in swine vessels. The degree of adhesion of the catheter and blood vessel was evaluated by 2 radiologists under X-ray fluoroscopy on a 3-point scale: 1, no adhesion; 2, mild adhesion; 3, strong adhesion. RESULTS: The mean resistance values (N) for the NSX and conventional microcatheters were 0.503±0.186 and 1.051±0.367 (N), respectively (p<0.001). The NSX adhered negligibly to the NBCA and was easily removed, whereas the conventional microcatheter adhered strongly to the NBCA in the blood vessels and was difficult to remove from the swine vessels (p=0.008). CONCLUSIONS: The new NSX microcatheter with a PTFE tip exhibits poorer adhesion to NBCA than do conventional microcatheters and allows for safer injection of NBCA than conventional microcatheters, without requiring immediate catheter retrieval. CLINICAL IMPACT: The NSX microcatheter with a PTFE tip adheres less strongly to NBCA than do conventional microcatheters and allows the safe injection of NBCA. The NSX microcatheter has double platinum markers on its tip, which make it easy to distinguish the PTFE-covered region. As the NSX does not adhere firmly to the arterial wall, it is less likely to cause vascular injury during removal of the catheter compared with conventional microcatheters, so there is no need to remove the NSX immediately after injecting NBCA. Even operators unfamiliar with NBCA can use NBCA safely with this new NSX microcatheter without requiring special training or skill.

Application of wireless energy transmission technology into central venous ports with light-emitting diodes.

Implantable central venous (CV) ports are widely used for chemotherapy and parenteral nutrition. Generally, CV ports are used safely; however, some patients suffer from drug leakage around the port septum due to mispuncture. Therefore, we developed a CV port that is visible under the skin. We created a prototype of a CV port using a 3D printer. Three red light-emitting diodes (LEDs) were attached around the septum that made the puncture site visible by applying wireless energy transmission technology using electromagnetic resonance. The CV port was implanted under the skin of pork rose meat. The thickness of the skin of pork loin was measured. Fifteen medical doctors participated in the study to visually confirm the lighted CV port. The visibility of the center of the septum with and without lights was scored 0 as non-diagnostic; 1, slightly visible; 2, well visible; and 3, obviously visible. The visibility with or without lights was assessed. The relationship between the years of experience and the visibility score was assessed. The Wilcoxon test was used for statistical analysis. LEDs were easily transmitted through the skin of pork rose meat. The median visibility scores with or without lights were 2 (range, 1-3) and 3 (range, 1-3), respectively (p = 0.005). No significant relationship was found between experience and visibility score (p = 0.289). CV ports with LEDs can be easily recognized compared with those without LEDs. This technique may contribute to medical safety by improving its visibility to avoid mispuncture.

Usefulness of Percutaneous Drainage in Determining the Causative Microorganism in Patients with Spondylodiscitis: A Retrospective Cross-Sectional Study.

Purpose: To determine the usefulness of CT-guided percutaneous drainage for the causative microorganism detection in patients with spondylodiscitis. Materials and Methods: Data of patients who underwent CT-guided percutaneous drainage for spondylodiscitis from January 2014 to April 2022 were extracted from the radiological database of our hospital and investigated. The administration rate of antibiotics prior to blood culture and CT-guided percutaneous drainage (CTPD) were analyzed. The detection rate of microorganisms via blood culture and CT-guided percutaneous drainage were compared using the Mann-Whitney's U test with the SPSS software. Results: In this study, a total of 30 (20 male and 10 female) patients were analyzed. A total of 13 patients (43%) were administered antibiotics prior to blood culture. Of them, microorganisms were detected via blood culture in only one patient (7%). A total of 25 patients (83%) were administered antibiotics prior to CTPD. Of them, the causative microorganisms in 19 patients (76%) were detected. Overall, the causative microorganism could be detected in 24 out of 26 patients (92%) via CT-guided percutaneous drainage. There was a statistical significance in the detection rate of microorganisms between blood culture and CTPD (P = 0.004) in favor of CTPD. Conclusion: CT-guided percutaneous drainage showed a high positive rate of microorganism detection in patients with spondylodiscitis regardless of antibiotic administration prior to the procedure. CT-guided percutaneous drainage can be a solution for the detection of the causative microorganism in spondylodiscitis patients who received antibiotics before obtaining any culture.

Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports.

BACKGROUND: The ascending pharyngeal artery (APhA) comprises the pharyngeal trunk (PT) and neuromeningeal trunk. The PT feeds the nasopharynx and adjacent tissue, which potentially connects with the sphenopalatine artery (SPA), branched from the internal maxillary artery (IMA). Due to its location deep inside the body, the PT is rarely injured by trauma. Here, we present two cases that underwent transcatheter arterial embolization (TAE) of the PT of the APhA due to trauma and iatrogenic procedure. CASE SUMMARY: Case 1 is a 49-year-old Japanese woman who underwent transoral endoscopy under sedation for a medical check-up. The nasal airway was inserted as glossoptosis occurred during sedation. Bleeding from the nasopharynx was observed during the endoscopic procedure. As the bleeding continued, the patient was referred to our hospital for further treatment. Contrast-enhanced computed tomography (CT) demonstrated extravasation in the nasopharynx originating from the right Rosenmuller fossa. TAE was performed and the extravasation disappeared after embolization. Case 2 is a 28-year-old Japanese woman who fell from the sixth floor of a building and was transported to our hospital. Contrast-enhanced CT demonstrated a complex facial fracture accompanying extravasation in the left pterygopalatine fossa to the nasopharynx. Angiography demonstrated an irregular third portion of the IMA. As angiography after TAE of the IMA demonstrated extravasation from the PT of the APhA, additional TAE to the artery was performed. The bleeding stopped after the procedure. CONCLUSION: Radiologists should be aware that the PT of the APhA can be a bleeding source, which has a potential connection with the SPA.

Successful management of thrombocytopenia by partial splenic embolization in patients with advanced gastric cancer and invasion of the splenic vein: Case reports.

RATIONALE: Hypersplenism causes thrombocytopenia, which may lead to the reduction or discontinuation of chemotherapy. Partial splenic embolization (PSE) is an effective treatment for thrombocytopenia associated with hypersplenism. However, there have been no reports of patients with gastric cancer who have resumed and continued chemotherapy after PSE for splenic hypersplenism associated with tumor infiltration.Here, we report two cases in which we performed PSE for hypersplenism associated with gastric cancer that had invaded the splenic vein. Chemotherapy was continued in both cases. PATIENT CONCERNS: Both patients developed thrombocytopenia with splenomegaly due to advanced gastric cancer that required discontinuation of chemotherapy. DIAGNOSIS: Upper gastrointestinal endoscopy and computed tomography showed advanced gastric cancer with invasion of the splenic vein and splenomegaly. Both patients developed thrombocytopenia. INTERVENTIONS: Patients were treated with PSE. OUTCOMES: PSE produced an increase in thrombocyte count, and chemotherapy could be resumed. LESSONS: PSE seems to be a useful treatment for thrombocytopenia with splenomegaly associated with advanced gastric cancer and may allow continuation of chemotherapy.

Transcirculation microballoon-assisted coil embolization for dorsal pancreatic artery aneurysm due to celiac artery dissection: A case report.

The dorsal pancreatic artery is a part of peripancreatic arcade connecting celiac artery to transpancreatic artery. A dorsal pancreatic artery aneurysm derived from dissection of celiac artery is a rare pathology, and it sometimes requires ingenious strategy in an endovascular surgery. Hereby, we report a case of a patient who underwent coil embolization for dorsal pancreatic artery aneurysm due to celiac artery dissection by applying transcirculation approach of a balloon catheter through the peripancreatic arcade, which was successfully achieved.

Coil embolization of renal artery aneurysms: Simultaneous delivery of three microdevices with a novel 6-Fr guiding sheath.

Here, we report the case of a 59-year-old male patient who underwent transcatheter embolization of bilateral renal artery aneurysms, using 2 microballoons and 1 microcatheter, all carried within a single guiding sheath. During coil embolization in a visceral artery, there are situations that can require multiple microdevices. We developed a new 6-Fr Shephard-hook type guiding sheath (Parent Plus 60) with a lumen large enough to deliver three microdevices simultaneously. This technique can be used broadly in different clinical scenarios, and it may provide novel treatment strategies to clinicians in the future.

A case of a patient who underwent transcatheter arterial embolization for unruptured splenic aneurysm during pregnancy.

Here, we report the case of a 30-year-old female patient who underwent coil embolization for unruptured splenic artery aneurysm without any complication at 26 weeks of pregnancy with reduction in fetal radiation exposure. The patient did not suffer from rupture of splenic artery aneurysm during or after procedure. Pregnancy is a risk factor of splenic artery aneurysm rupture with a high mortality rate. Transcatheter arterial embolization at 26 weeks of pregnancy might be a better treatment alternative for a pregnant patient with splenic artery aneurysm with respect to the endurance of fetal radiation exposure to prevent aneurysm rupture.

Successful Treatment of Bronchial Artery Aneurysms Associated With Racemose Hemangioma by Combined Therapy of Transcatheter Bronchial Artery Embolization and Thoracic Endovascular Aortic Repair.

A 70-year-old man was referred to our hospital for an abnormal chest shadow. Enhanced computed tomography (CT) revealed 2-humped bronchial artery aneurysms (BAAs) associated with racemose hemangioma. The combined therapy of transcatheter bronchial artery embolization and thoracic endovascular aortic repair was performed. Postoperative CT confirmed the complete exclusion of the aneurysms with no evidence of an endoleak. Our result suggests that this combined therapy is a safe and effective treatment for BAA.

Long-term Histopathologic Follow-up of a Spherical Embolic Agent; Observation of the Transvascular Migration of HepaSphereTM.

Very few studies have been published on the long-term histopathologic follow-up of spherical embolic agents after their injection. To our knowledge, there are no reports in the literature regarding pathological analysis of the transvascular migration of HepaSphere particles. We here report a case of a patient with hepatocellular carcinoma (HCC) who underwent liver transplantation 12 months after drug eluting microsphere transcatheter arterial chemoembolization (DEM-TACE), and long-term histopathologic follow-up of the microspheres was performed. Furthermore, to our knowledge, this is the first report in which transvascular migration of a HepaSphere particle was confirmed histologically. A 60-year-old male with chronic hepatitis B was treated with entecavir and seroconversion was obtained. The patient had decompensated cirrhosis, and desired to undergo living donor liver transplantation (LDLT). However, 2 HCC tumors of 3 cm or less were detected in his liver. The transplantation surgeon proposed DEM-TACE as a bridge therapy. The HCCs were located in the right lobe and lateral segment of the liver. A 1.9 F preshaped microcatheter (ProgreatΣ, Terumo, Japan) was selectively inserted into the A3 and anterior segmental branch, 10 mg of epirubicin was injected into each artery, and the arteries were embolized with 7 mg and 13 mg of HepaSphere loaded with epirubicin, respectively. Two months later, contrast-enhanced CT displayed a complete response. At that time, lung metastasis was suspected, but after partial lung resection, the patient was diagnosed as having inflammatory granuloma. One year after DEM-TACE treatment, LDLT was performed. No cancerous cells were detected in the area where the tumor was present, but 22 HepaSphere particles were detected. All particles were present in the interstitium. Furthermore, the transvascular migration of a HepaSphere particle was histologically confirmed. The largest and smallest HepaSphere diameters were 241.6 ± 52.5 µm and 186.5 ± 41.4 µm, respectively, and deformity was 22.6% ± 13.0 %. All the HepaSpheres detected in the examined pathological specimen were noted to be extravascular.

Coil Embolisation for Endovascular Treatment of Proper Hepatic Artery Aneurysm Using the Balloon Occlusion Technique.

INTRODUCTION: Endovascular repair (ER) as a minimally invasive approach can be effective for treating hepatic artery aneurysm (HAA) with gratifying results. Microcoil embolisation is the main technique used in ER. However, the coil embolisation of a large proper HAA (PHAA) with a very wide neck tends to be extremely troublesome owing to the limited length of the inflow and outflow artery. Moreover, it is difficult because of rapid blood flow in the proper hepatic artery (PHA) and the difficulty in preserving its branch flow. Microcoil embolisation of the inflow and outflow of a PHAA with the balloon occlusion technique through an originally developed single guiding sheath system was performed successfully. REPORT: A 73 year old woman was diagnosed with large PHAA (65 mm) by computed tomography examination. The PHAA was successfully treated by endovascular embolisation with microcoils using the balloon occlusion technique through a single guiding sheath system. DISCUSSION: This method is safe and effective for the treatment of a large PHAA.

Evaluation of patients who underwent percutaneous transhepatic portal vein embolisation by Tc-99m GSA scintigraphy.

PURPOSE: To analyse the correlation between the fold change in residual liver volume (RLV) and residual liver uptake at 15 (RLU15) before and after percutaneous transhepatic portal vein embolisation (PTPE). MATERIAL AND METHODS: Between August 2010 and December 2016, 20 patients who underwent PTPE were retrospectively selected. Before and three weeks after PTPE, contrast-enhanced computed tomography (CECT) and Tc-99m GSA scintigraphy were performed to analyse the fold changes in RLV and RLU15, respectively, as well as their correlation. RESULTS: After PTPE, a significant increase was observed in the RLV (before: 464 ±â€…99 ml; after: 573 ±â€…118 ml, p = 0.004) and the RLU15 (before: 11.0 ±â€…2.9%; after: 17.7 ±â€…3.8%, p = 5 × 10-7). The fold increase of RLV and RLU15 in all patients was 1.25 ±â€…0.15 and 1.66 ±â€…0.33, respectively. No significant correlation was observed in the fold increase in both RLV and RLU15 (r = 0.14, p = 0.66). In patients no. 3 and 9, who were outliers, the increase in RLV was minimal and RLU15 increased greatly, and these 2 patients underwent radical hepatectomy after PTPE. CONCLUSIONS: No correlation was observed between the fold increase in RLV and RLU15 before and after PTPE. In order to accurately evaluate the residual liver function, it should be considered necessary to evaluate not only by morphological CECT volumetry, but also by functional outcome of Tc-99m GSA scintigraphy.Residual liver volume may not necessarily reflect RLF. It may be possible to improve the radical resection rate by detecting the potential increase of RLF with RLU15 of Tc-99m GSA scintigraphy.

Successful recanalization of acute extensive portal vein thrombosis by aspiration thrombectomy and thrombolysis via an operatively placed mesenteric catheter: a case report.

Portal vein thrombosis (PVT) after hepatobiliary surgery is rare but can cause lethal and severe complications. If early diagnosis and recanalization can be achieved, the PVT is expected to be eliminated. A 70-year-old male was diagnosed as having hepatocellular carcinoma occupying the right lobe of the liver. As oligometastatic lung tumors were simultaneously detected on contrast-enhanced CT (CECT), hepatectomy was not indicated. However, the primary tumor was very large, and as large tumor size can be associated with an unfavorable prognosis, and owing to the strong desire of the patient, he underwent right lobe hepatectomy. Jaundice appeared on post-operative Day (POD) 2 and CECT displayed slight intraheptatic bile duct dilation. However, a PVT did not exist at this time. Percutaneous transhepatic biliary drainage was performed and Doppler echo displayed intrahepatic and extrahepatic PVT on post-operative Day 5. Emergent thrombectomy was performed using a Vasplyser PlusTM thrombus aspiration catheter (Johnson & Johnson K.K. Medical Company, Tokyo, Japan) via the ileocolic vein under laparotomy. The mesenteric catheter was placed at the distal point of the residual PVT. Thrombolysis and anticoagulant therapy were performed using heparin and urokinase. In the CECT performed 16 days after the additional operation, the PVT had disappeared and the portal vein was completely recanalized. The mesenteric catheter was removed on the same day and oral anticoagulant therapy was continued. At the time of writing, 14 months have passed with no recurrence of PVT. Early diagnosis of PVT enables treatment with emergent thrombectomy, thrombolysis, and anticoagulant therapy. These treatments result in the improvement of portal vein flow and the complete disappearance of PVT.

Salvage Embolization and Histologic Analysis of Gastric Cancer with Hemorrhagic Shock Using Spherical Embolic Material.

BACKGROUND: In a recent study, it was reported that transcatheter arterial embolization with spherical embolic material for life-threatening hemorrhages in various cancer patients was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries, which results in the disappearance of tumor staining. However, there are few reports on the pathological behavior of EmboSpheres in gastric cancer specimens. In this case, we succeeded in salvage embolization for advanced gastric cancer with hemorrhagic shock using spherical embolic material. To our knowledge, this is the first report of a pathological evaluation of spherical embolic microspheres in a gastric cancer specimen. CASE REPORT: A 70-year-old man with scirrhous gastric cancer was admitted to our hospital for staging laparoscopy. Unfortunately, he had a sudden onset of hematemesis and melena leading to hemorrhagic shock due to bleeding from the gastric cancer. While undergoing a rapid blood transfusion, he underwent emergent embolization to achieve hemostasis. The left gastric and right gastroepiploic arteries were embolized with spherical embolic material, and the patient survived. Two days later, the patient was able to undergo gastrectomy. A large number of microspheres were observed in areas of hemorrhage. The range and median diameter of the minor axis were 177-1048 µm and 281 µm, respectively. CONCLUSIONS: Transcatheter arterial embolization using spherical embolic material could become one of safe and effective options, especially when there is no extravasation or pseudoaneurysm but only tumor staining from the clinical and pathological point of view.

Coil embolization for pulmonary artery injury caused by chest tube drainage.

Pulmonary artery injury caused by chest tube drainage is rare, but it requires prompt diagnosis to perform urgent surgical repair. We report that a 53-year-old man who suffered from pulmonary artery injury by chest tube drainage was successfully treated by coil embolization.

Short-Segment Coil Embolization Using a Double-Balloon Technique in an Experimental Vascular Model.

PURPOSE: To evaluate the feasibility of short-segment coil embolization between 2 balloons for tight packing in an experimental vascular model. MATERIALS AND METHODS: Three coil embolization techniques were performed by 5 interventional radiologists as follows: (1) proximal balloon technique (proximal BT) which involved proximal balloon inflation and coil deployment over the balloon, (2) distal balloon technique (distal BT) which involved distal balloon inflation and coil deployment at the proximal side of the inflated balloon, and (3) double-balloon technique (DBT) which involved coil deployment between 2 inflated balloons. We used a 10-mm-diameter and 200-mm-long hydrocoil. The distance between the 2 inflated balloons was set at 5 mm in the perfused tube, and each procedure was performed twice. The longitudinal lengths of the deployed coil mass and volume embolization rates (VERs) at the embolization site obtained using the 3 techniques were compared statistically. RESULTS: The longitudinal lengths of the deployed coil mass were 26 mm (range, 21-34 mm), 10 mm (8-14 mm), and 5 mm (5-5 mm) in proximal BT, distal BT, and DBT, respectively. The median VERs were 15.9% (12.2-19.4%), 41.4% (29.6-51.8%), and 82.9% (82.9-82.9%), respectively. Significant differences in the lengths and VERs were observed among the 3 techniques (p < 0.001). CONCLUSION: DBT achieved the tight packing of a hydrocoil in a short segment of an experimental vascular model compared with proximal BT and distal BT, suggesting DBT as the optimal embolization technique in this model.

Distinguishing liver haemangiomas from metastatic tumours using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced diffusion-weighted imaging at 1.5T MRI.

INTRODUCTION: The aim of this study to evaluate the effectiveness of enhanced diffusion-weighted imaging (DWI) for distinguishing liver haemangiomas from metastatic tumours (mets). METHODS: This study included 23 patients with 27 haemangiomas and 26 patients with 46 mets. Breath-holding diffusion-weighted imaging (DWI) (b-values of 0, 50, 100, 150, 200, 400 and 800 s/mm2 ) were obtained before and 20 min after injection of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA). Lesion contrast-to-noise ratios (CNRs) were calculated. The data were processed using the bi-exponential model of intravoxel incoherent motion (IVIM). Receiver operating characteristic analysis was performed to compare the diagnostic performance when distinguishing haemangioma from mets. RESULTS: The CNRs of haemangioma and mets at post-contrast enhancement increased. All IVIM parameters for liver haemangioma and mets showed no significant differences between pre- and post-contrast enhancement. The highest Az value of CNR and IVIM parameters occurred at a post-contrast b-value of 0 s/mm2 and true diffusion (D). The highest qualitative evaluation occurred at a b-value of 800 s/mm2 . The sensitivity and specificity, with a CNR of 100 or higher at a post-contrast b-value of 0 s/mm2 and considered to be haemangioma, were 89% and 67% (<10 mm, 91%, 77%) respectively. The sensitivity and specificity, when D was higher than 1.4 × 10-3 mm2 /s, were 74% and 83% (<10 mm, 64%, 77%) respectively. The sensitivity and specificity of qualitative evaluation by enhanced DWI were 74% and 76% (<10 mm, 64%, 80%) respectively. CONCLUSIONS: The accuracy of the CNR was highest with b = 0; however, examination at high b-values had advantages in the qualitative evaluation of some small-size lesions.

Is diffusion-weighted imaging a significant indicator of the development of vascularization in hypovascular hepatocellular lesions?

OBJECTIVE: The objective was to evaluate the efficacy of diffusion-weighted imaging (DWI) in predicting the development of vascularization in hypovascular hepatocellular lesions (HHLs). MATERIALS AND METHODS: Forty-two HHLs that were diagnosed by computed tomographic (CT) arteriography were evaluated retrospectively. The lesion on DWI was classified as isointense, hypointense, or hyperintense. Follow-up studies that included intravenous dynamic CT or magnetic resonance imaging were performed. RESULTS: The 730-day cumulative developments of vascularization in hypointense, isointense, and hyperintense lesions were 17%, 30%, and 40%, respectively. The differences among these developments were not statistically significant. CONCLUSION: The signal intensity on DWI showed no significant difference in the development of vascularization.