The prevalence, risk factors, and clinical outcome of balloon rupture in balloon-occluded retrograde transvenous obliteration of gastric varices.

Purpose: To evaluate the prevalence, risk factors, and clinical outcome after balloon rupture during balloon-occluded retrograde transvenous obliteration (BRTO).

Materials And Methods: Sixty-nine patients who underwent the BRTO procedure from August 1999 to January 2009 were analyzed retrospectively. The occurrence of balloon rupture was recorded by a review of medical records and imaging studies.

Optimal scan timing and intravenous route for contrast-enhanced computed tomography in patients after Fontan operation.

Purpose: To determine the optimal scan timing and adequate intravenous route for patients having undergone the Fontan operation.

Materials And Methods: A total of 88 computed tomographic images in 49 consecutive patients who underwent the Fontan operation were retrospectively evaluated and divided into 7 groups: group 1, bolus-tracking method with either intravenous route (n = 20); group 2, 1-minute-delay scan with single antecubital route (n = 36); group 3, 1-minute-delay scan with both antecubital routes (n = 2); group 4, 1-minute-delay scan with foot vein route (n = 3); group 5, 1-minute-delay scan with simultaneous infusion via both antecubital and foot vein routes (n = 2); group 6, 3-minute-delay scan with single antecubital route (n = 22); and group 7, 3-minute-delay scan with foot vein route (n = 3). The presence of beam-hardening artifact, uniform enhancement, and optimal enhancement was evaluated at the right pulmonary artery (RPA), left pulmonary artery (LPA), and Fontan tract.

Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma: a Markov model analysis.

Unlabelled: No adequate randomized trials have been reported for a comparison between hepatic resection (HR) versus radiofrequency ablation (RFA) for the treatment of patients with very early stage hepatocellular carcinoma (HCC), defined as an asymptomatic solitary HCC <2 cm. For compensated cirrhotic patients with very early stage HCC, a Markov model was created to simulate a randomized trial between HR (group I) versus primary percutaneous RFA followed by HR for cases of initial local failure (group II) versus percutaneous RFA monotherapy (group III); each arm was allocated with a hypothetical cohort of 10,000 patients. The primary endpoint was overall survival.

Identification of the anterior sectoral trunk with particular reference to the hepatic hilar plate and its clinical importance.

Background: At the hilum of the liver, there is a structure called the hilar plate, which is of great surgical importance because all variations in the bile ducts and blood vessels occur within this region. The Rex-Cantlie line does not always pass the point of portal bifurcation. Classifying portal vein (PV) variations based on the shape and origin of anterior sectoral trunk (AST) within the hepatic plate system will be of higher anatomical and surgical value than the conventional method based on PV ramification.

CT findings of completely regressed hepatocellular carcinoma with main portal vein tumor thrombosis after transcatheter arterial chemoembolization.

Objective: The objective of this study was to determine the sequential CT findings of controlled hepatocellular carcinoma (HCC) with main portal vein (MPV) thrombosis with the use of transcatheter arterial chemoembolization and additional intra-arterial cisplatin infusion.

Materials And Methods: From January 2004 to September 2006, 138 patients with HCC invading MPV were referred to the angiography unit of our institution for chemoembolization and additional intra-arterial cisplatin infusion. Until August 2008, seven (5%) of 138 patients were followed-up and found not to have tumor recurrence.

Retrospective versus prospective ECG-gated dual-source CT in pediatric patients with congenital heart diseases: comparison of image quality and radiation dose.

We wanted to compare the image quality and radiation dose of retrospective versus prospective ECG-gated dual-source CT imaging in pediatric patients with congenital heart diseases. We retrospectively evaluated 44 thorax CT images that were obtained using two different protocols (retrospective helical ECG-gated [n = 22] versus prospective non-helical ECG-triggering [n = 22]) in patients younger than 5 years. Two radiologists evaluated the image quality, using a 3- or 4-point scale, in terms of the degree of homogeneity of vascular enhancement, the stair-step artifacts, the subjective image noise and the overall subjective image quality.

Losartan/Hydrochlorothiazide fixed combination versus amlodipine monotherapy in korean patients with mild to moderate hypertension.

Background And Objectives: The antihypertensive efficacy and tolerability of losartan (LST) in fixed combination with hydrochlorothiazide (HCTZ) has not been compared to those of amlodipine monotherapy in Asians. This is an important comparison to draw, because Asians have been suggested to respond more favorably to calcium channel blockers and less favorably to angiotensin-converting enzyme inhibitors in comparison to Westerners. We sought to compare these two regimens in Korean patients with mild to moderate hypertension.

The antitumor effect and hepatotoxicity of a hexokinase II inhibitor 3-bromopyruvate: in vivo investigation of intraarterial administration in a rabbit VX2 hepatoma model.

Objective: The purpose of this study was to compare the antitumor effect and hepatotoxicity of an intraarterial delivery of low-dose and high-dose 3-bromopyruvate (3-BrPA) and those of a conventional Lipiodol-doxorubicin emulsion in a rabbit VX2 hepatoma model.

Materials And Methods: This experiment was approved by the animal care committee at our institution. VX2 carcinoma was implanted in the livers of 36 rabbits.

Venous reflux from the pelvis and vulvoperineal region as a possible cause of lower extremity varicose veins: diagnosis with computed tomographic and ultrasonographic findings.

Objective: The aim of this study was to demonstrate with the use of computed tomography and ultrasonography that isolated venous reflux from the pelvis and vulvoperineal region is a possible cause of lower extremity varicose veins.

Methods: From a consecutive series of patients who were referred to the vascular imaging laboratory, we retrospectively selected patients who had unusual lower extremity varicose veins that arose from the pelvis and vulvoperineal region. Computed tomographic venography and ultrasonograhy were used to exclude other causes of varicose veins.

Left inferior phrenic artery feeding hepatocellular carcinoma: angiographic anatomy using C-arm CT.

Objective: The left inferior phrenic artery (LIPA) is one of the common extrahepatic collateral arteries that supply hepatocellular carcinomas (HCCs). The purpose of this study is to describe the anatomy of the LIPA that supplies HCCs using C-arm CT in 23 patients.

Conclusion: The anteromedial limb of the ascending branch was present in 14 patients and accessory gastric branches were noted in 11 patients.

Risk factors for rebleeding after angiographically negative acute gastrointestinal bleeding.

Aim: To identify possible predictive factors for rebleeding after angiographically negative findings in patients with acute non-variceal gastrointestinal bleeding.

Methods: From January 2000 to July 2007, 128 patients with acute non-variceal gastrointestinal bleeding had negative findings after initial angiography. Clinical and laboratory parameters were analyzed retrospectively.

The right inferior phrenic artery: origin and proximal anatomy on digital subtraction angiography and thin-section helical computed tomography.

Purpose: To investigate the origin sites of the right inferior phrenic artery (RIPA) and its proximal anatomy with use of digital subtraction angiography (DSA) and thin-section computed tomography (CT).

Materials And Methods: Among 2,593 patients, selective RIPA arteriography was attempted in 591 (507 men; mean age, 54 years) who underwent chemoembolization and thin-section liver CT. CT and DSA images were reviewed.

Transcatheter arterial embolization of arterial esophageal bleeding with the use of N-butyl cyanoacrylate.

Objective: To evaluate the clinical efficacy and safety of a transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding.

Materials And Methods: Between August 2000 and April 2008, five patients diagnosed with arterial esophageal bleeding by conventional angiography, CT-angiography or endoscopy, underwent a TAE with NBCA. We mixed NBCA with iodized oil at ratios of 1:1 to 1:4 to supply radiopacity and achieve a proper polymerization time.

Importance of angiographic visualization of round ligament arteries in women evaluated for intractable vaginal bleeding after uterine artery embolization.

Purpose: To determine the incidence of angiographic visualization and the clinical significance of round ligament arteries in patients who present with intractable vaginal bleeding.

Materials And Methods: A review of 113 patients (age range, 20-67 years) who underwent pelvic angiography for intractable vaginal bleeding between June 1992 and May 2008 was retrospectively performed. It was recorded whether round ligament artery was visualized on pelvic aortography after uterine artery embolization (UAE).

Transcatheter arterial chemoembolization for hepatocellular carcinoma: prospective assessment of the right inferior phrenic artery with C-arm CT.

Purpose: To assess the usefulness of C-arm computed tomography (CT) of the right inferior phrenic artery (RIPA) in transcatheter arterial chemoembolization of patients with hepatocellular carcinoma (HCC).

Materials And Methods: From December 2007 to April 2008, C-arm CT of the RIPA was prospectively performed in 32 patients with HCC. Two interventional radiologists who performed C-arm CT assessed the additional information provided with C-arm CT as grade 1 (no additional information), grade 2 (added information without an effect on the treatment plan), or grade 3 (added information with an effect on the treatment plan).

Optimization of the scan protocol for the reduction of diaphragmatic motion artifacts depicted on CT angiography: a phantom study simulating pediatric patients with free breathing.

Objective: This study was designed to optimize the scan protocol of CT angiography to reduce diaphragmatic motion artifacts in pediatric patients with free-breathing.

Materials And Methods: A phantom with twelve tubes with different diameters was constructed. To simulate free-breathing, the phantom was connected to a motor, and the phantom moved along the axis of scan.

The image quality and radiation dose of 100-kVp versus 120-kVp ECG-gated 16-slice CT coronary angiography.

Objective: This study was conducted to assess the feasibility of performing 100-kVp electrocardiogram (ECG)-gated coronary CT angiography, as compared to 120-kVp ECG-gated coronary CT angiography.

Materials And Methods: We retrospectively evaluated one hundred eighty five gender- and body mass index-matched 16-slice coronary CT sets of data, which were obtained using either 100 kVp and 620 effective mAs or 120 kVp and 500 effective mAs. The density measurements (image noise, vessel density, signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) and the estimated radiation dose were calculated.

Rare location of Castleman disease in the temporal region.

Castleman disease is a lymphocytic hyperplastic disease that is also known as angiofollicular lymphoid hyperplasia or giant lymph node hyperplasia. It occurs mainly in the mediastinum but rarely in the face. Our experience is a case of a 65-year-old man who had a slow-growing, nontender temporal mass for 1 year.

Unusual causes of varicose veins in the lower extremities: CT venographic and Doppler US findings.

There are various causes of varicose veins in the lower extremities. Among the causes are venous insufficiency of the saphenofemoral junction, saphenopopliteal junction, or usual perforating veins. Traditionally, Doppler ultrasonography (US) has been used for evaluation of varicose veins.

Transcatheter arterial embolization therapy for a massive polycystic liver in autosomal dominant polycystic kidney disease patients.

Polycystic liver is the most common extra-renal manifestation associated with autosomal dominant polycystic kidney disease (ADPKD), comprising up to 80% of all features. Patients with polycystic liver often suffer from abdominal discomfort, dyspepsia, or dyspnea; however, there have been few ways to relieve their symptoms effectively and safely. Therefore, we tried transcatheter arterial embolization (TAE), which has been used in treating hepatocellular carcinoma.

Development of diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery: frequency and determinant factors.

Purpose: To assess the frequency of diaphragmatic weakness and its determinant factors after transcatheter arterial chemoembolization of the right inferior phrenic artery (IPA) in patients with hepatocellular carcinoma (HCC).

Materials And Methods: From June 2006 to October 2006, 60 patients (48 men, 12 women; mean age, 59 years) who had undergone chemoembolization of the right IPA underwent follow-up angiography of the right IPA and fluoroscopic diaphragmatic movement assessment. Diaphragmatic weakness was determined by the presence of paradoxical or decreased movement at fluoroscopy.

One-stage skin grafting of the exposed skull with acellular human dermis (AlloDerm).

In cases of soft tissue defects in which the calvaria is exposed, the use of flap is generally considered. However, in cases in which patients' general status is poor or vascular insufficiency is present, the use of flap becomes difficult. A 90-year-old male patient visited our outpatient clinic with a chief complaint of scalp defect accompanied by calvarial exposure after falling from an escalator.

Selective or targeted gene/drug delivery for liver tumors: advantages and current status of local delivery.

There are various disorders involving the liver. They include metabolic diseases, hepatitis, liver cirrhosis and cancer, the latter of which may be the most serious. Delivery of therapeutic genes or drugs should be targeted to either one of the following cells in the liver: hepatocytes, Kupffer cells and tumor endothelial cells, or to the tumor cells themselves.

Extrahepatic collateral artery supply to the tumor thrombi of hepatocellular carcinoma invading inferior vena cava: the prevalence and determinant factors.

Purpose: To retrospectively evaluate the prevalence of extrahepatic collateral artery supply to tumor thrombi of hepatocellular carcinomas (HCCs) invading the inferior vena cava (IVC) and to assess the determining factors.

Materials And Methods: From February 1998 to June 2007, 82 patients with IVC tumor thrombi on computed tomography (CT) underwent angiographic evaluation of their extrahepatic collateral artery supply. Potential determining factors for extrahepatic collateral artery supply to the IVC tumor thrombi included sex, age, Child-Pugh class, history of chemoembolization, tumor factors (ie, size, number, and growth pattern), distance from primary tumor to IVC thrombi, portal vein invasion, and extent of IVC thrombi (ie, occupying more than half the IVC lumen on transverse CT image, completely filling and distending IVC lumen, or extending into the right atrium).

Cardiovascular Behcet disease: the variable findings of rare complications with CT angiography and conventional angiography and its interventional management.

Unusual radiological manifestations of rare complications of cardiovascular Behcet disease (BD) are the following: (a) aneurysm and (b) occlusion in the aorta and its major branches, (c) pseudoaneurysms on the aortic root and coronary artery, and recurrent valvular dehiscence in the heart, (d) venous thrombosis in the deep and superficial venous system and vena cava. The initial exact diagnosis of cardiovascular BD has been extremely difficult for these rare complicated findings, especially in the absence of the florid clinical manifestations of BD. Radiologist should be aware of possibility of cardiovascular BD via familiarity with its rare imaging features, including computed tomographic angiography (and its 3-dimensional reconstructed images), conventional angiography, and with the clinical characteristics of BD because of high mortality of cardiovascular BD.