[Specifics of blood flow in the main portal vein in correlation with patterns of hepatic neoplasia].

We examined 121 patients with solid hepatic masses and 62 healthy volunteers with Doppler ultrasonography. Blood flow in the main portal vein was identified as ante-or retrograde. Hepatofugal blood flow was detected in 3 patients with primary tumors and in 2 with hemangiomas. Arterio-portal fistula was diagnosed in all angiographic findings. In most cases of malignant tumors. Blood flow volume in the main portal vein was either normal or excessive. Our evidence may be instrumental in working out therapeutic strategies for hepatic tumors.

[Use of 18F-FDG PET scan in the diagnosis of large liver neoplasms and in the evaluation of therapeutic effectiveness].

The study involved 207 patients with large-size tumors. Results of 18FDG PET pointed to the basic factor of malignant transformation--foci of enhanced accumulation of radiological medicinal substances. Absence of ultrasound and CT-based evidence of such pathological accumulations contributed to interpretation of changes as benign ones. The effectiveness of chemotherapy was assessed by tumor metabolic response to treatment given at the time of 18FDG PET examination.

[Current possibilities of radiodiagnosis in liver tumors].

The report deals with potential of present-day techniques for radiological imaging, differential diagnosis and working out of modalities of treatment for primary and metastatic hepatic tumors. Results of complex examination (ultrasound, CT, MRI, PET using fluorine -18 FDG) of patients with benign and malignant tumors are discussed. Sensitivity and specificity of each procedure have been identified to be used in diagnosis of large-size tumors.

[Combined arterial and intraportal therapy of hepatocellular carcinoma: preliminary results]. / Kombinirovannaia arterial'naia i vnutriportal'naia terapiia gepatotselliuliarnogo raka: predvaritel'nye rezul'taty.

Tentative results of consecutive arterial and portal chemoembolizations in 4 patients with advanced hepatoma are presented. Hepatic artery occlusion was achieved by administration of 20-60 mg adriablastin in 6-12 ml iodized oil and minced gelatin sponge. Said adriablastin-in-oil alone was used for transhepatic catheterisation and chemoembolization of portal vein 2-4 weeks later. The patients received a total of 10 courses of combined therapy, without any complication development. All the patients have been alive for 18 months and two of them have been in remission. The preliminary results of application of the new modification of transcatheter management of primary hepatoma are encouraging and make the case for undertaking prospective randomized clinical trials.

[Combined radio-endovascular and percutaneous procedures in the treatment of liver hemangioma]. / Sochetannye rentgenoéndovaskuliarnye i chreskozhnye punktsionnye sposoby lecheniia gemangiom pecheni.

A spectrum of roentgenoendovascular and percutaneous procedures of hepatic hemangioma treatment is considered for situations in which resection of the liver is not justified. Stage I of therapy involved embolisation of hepatic artery and its branches. At stage II, ultrasonography and roentgenoscopy-controlled aiming percutaneous puncture and sclerosation of hemangioma were conducted. Said procedure was used in treatment of 12 patients. The results were evaluated using scintigraphy, ultrasonography, computed tomography and aiming puncture biopsies.

[Imaging of collaterals and their impact on portal venous flow in patients with liver cirrhosis].

When the portal hypertension syndrome occurs, patients with liver cirrhosis develop three major collateral blood flow pathways. These are gastroesophageal, splenorenal, and paraumbilical ones along the recanalized umbilical veins. Only both the splenorenal pathway of blood return from the portal venous system, which considerably reduces portal blood flow volume and the paraumbilical one that increases portal blood flow are of hemodynamic significance.

[Table for determining minimal toxic dosage]. / Tablichnyi metod opredeleniia minimal'noi toksicheskoi dozy.

The authors suggest a rapid, simple and economical method for the measurement of the minimal toxic dose for the drugs with marked dose-effect dependence. The method is based on the use of the precalculated tables, with minimal consumption of laboratory animals. The data obtained, while providing for statistical significance, make it possible to measure, as the minimal toxic dose, the TD10 rather than the TD16, which raises the method sensitivity.

[Complex radiation diagnosis of post-operative recurrent hepatic tumors]. / Kompleksnaia luchevaia diagnostika posleoperatsionnykh retsidivov opukholei.

The postoperative course of the disease was studied in 63 patients operated on for malignant hepatic lesion in 1990-1998. The pattern of surgical intervention-caused hepatic changes, which is observed at ultrasonography, CT, MRI, angiography, and oil-injected CT is described. Recurrences took place at the site of resection (9.5%) and outside (34.9%). Their largest number (71%) occurred in the first postresectional year. Diagnostic difficulties arose in the differential diagnosis of postoperative inflammatory changes and tumor recurrences at the site of resection (17% false positive results). Contrast MRI and intraarterial iodized oil CT proved to be the most effective radiation diagnostic techniques.

[The state of the veins of the esophagus and the stomach in chronic diffuse liver diseases (based on data from a combined roentgeno-endoscopic and echographic study)]. / Sostoianie ven pishchevoda i zheludka pri khronicheskikh diffuznykh zabolevaniiakh pecheni (po dannym kompleksnogo rentgenoéndoskopicheskogo i ékhograficheskogo issledovaniia).

Combined roentgenological and endoscopic investigation was used to study the state of the esophageal submucous veins. Echography was used for investigation of the gastric subserous veins and esophageal abdominal veins. The results obtained indicate that in the presence of portal hypertension there are two types of shunting: via the esophageal submucous (82%) and subserous (18%) veins. In patients with the predominant affection of the esophageal subserous veins x-ray investigation and endoscopy do not allow correct estimation of the presence and a degree of the gastroesophageal shunt. Echography results enable one to arrive at a correct conclusion in all patients.

[Changes in gastric and duodenal mucosa in patients with chronic diffuse liver diseases]. / Izmeneniia slizistoi zheludka i dvenadtsatiperstnoi kishki u bolnykh khronicheskimi diffuznymi zabolevaniiami pecheni.

Comprehensive x-ray endoscopic and morphologic examinations of 182 patients with chronic diffuse diseases of the liver were carried out to detect changes in gastroduodenal mucosa and the incidence of these changes in this patient population. Pathologic shifts were revealed in 132 patients (72.6%); various morphologic forms of chronic gastritis were found in 67 (39%), erosions in 41 (23%), gastroduodenal ulcers in 24 (13%) of these. The incidence of the detected changes was in direct correlation with the stage of the underlying disease.

[Choice of the approach in catheterization and embolization of the hepatic artery in malignant tumors of the liver]. / Vybor dostupa dlia kateterizatsii i émbolizatsii pechenochnoi arterii pri zlokachestvennykh opukholiakh pecheni.

The results of catheterization (transfemoral and transaxial) and embolization of the hepatic artery in 67 patients with malignant hepatic tumors are analysed. In patients with hepatomegaly, the unfavourable topographic-anatomical interrelations of the intraorganic hepatic vessels were established. Distribution of the vessels more accurately is defined by means of ultrasonography. In detection of the unfavourable anatomical factors, the more wide use of primary transaxial catheterization of the hepatic arteries without an attempt of transfemoral catheterization is recommended.

Extraorganic hepatic artery aneurysm: failure of transcatheter embolization.

Hepatic artery aneurysm (HAA) was diagnosed in a 62-year-old man who was a poor candidate for surgery because of severe liver cirrhosis and diabetes mellitus. Two attempts to occlude the HAA by transcatheter embolization failed because of recanalization of the aneurysm. Moreover, aneurysmal dilatation of the superior mesenteric artery and the left renal artery developed and progressed. Both the literature and the present case show that an individual approach to treatment of extraorganic HAA should be chosen in dependantan location and anatomy of the lesion.