Reactive lymphoid hyperplasia of the liver: Perinodular enhancement on contrast-enhanced computed tomography and magnetic resonance imaging.

We report the case of a 69-year-old woman with reactive lymphoid hyperplasia (RLH) of the liver. She underwent partial hepatectomy under a preoperative diagnosis of hepatocellular carcinoma; however, histopathological analysis revealed RLH. The liver nodule showed the imaging feature of perinodular enhancement in the arterial dominant phase on contrast-enhanced computed tomography and magnetic resonance imaging, which could be a useful clue for identifying RLH in the liver.

Emergency balloon-occluded retrograde transvenous obliteration of ruptured gastric varices.

Aim: To evaluate the effectiveness and safety of emergency balloon-occluded retrograde transvenous obliteration (BRTO) for ruptured gastric varices.

Methods: Emergency BRTO was performed in 17 patients with gastric varices and gastrorenal or gastrocaval shunts within 24 h of hematemesis and/or tarry stool. The gastric varices were confirmed by endoscopy, and the gastrorenal or gastrocaval shunts were identified by contrast-enhanced computed tomography (CE-CT).

Three benefits of microcatheters for retrograde transvenous obliteration of gastric varices.

Aim: To evaluate the usefulness of the microcatheter techniques in balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices.

Methods: Fifty-six patients with gastric varices underwent BRTOs using microcatheters. A balloon catheter was inserted into gastrorenal or gastrocaval shunts.

Balloon-occluded retrograde transvenous obliteration for gastric varices via the intercostal vein.

Gastric varices are usually associated with a gastro-renal (G-R) shunt. However, the gastric varices described in this case report were not associated with a G-R shunt. The inflow vessel was the posterior gastric vein and the outflow vessels were the narrow inferior phrenic vein and the dilated cardio-phrenic vein.

Differentiation of pancreatic serous cystadenoma from endocrine tumor and intraductal papillary mucinous neoplasm based on washout pattern on multiphase CT.

Objective: To evaluate the washout (WO) pattern of serous cystadenomas (SCAs) compared with endocrine tumors (ETs) and intraductal papillary mucinous neoplasm (IPMN).

Methods: Patients with serous cystadenoma (n = 12), ET (n = 29), and IPMN (n = 35) underwent 4-phase computed tomography CT. Tumors were categorized as hyperdense or hypodense.

Prospective evaluation of transcatheter arterial chemoembolization (TACE) with multiple anti-cancer drugs (epirubicin, cisplatin, mitomycin c, 5-fluorouracil) compared with TACE with epirubicin for treatment of hepatocellular carcinoma.

Purpose: To compare the efficacy of transcatheter arterial chemoembolization (TACE) using multiple anticancer drugs (epirubicin, cisplatin, mitomycin C, and 5-furuorouracil: Multi group) with TACE using epirubicin (EP group) for hepatocellular carcinoma (HCC).

Materials And Methods: The study design was a single-center, prospective, randomized controlled trial. Patients with unrespectable HCC confined to the liver, unsuitable for radiofrequency ablation, were assigned to the Multi group or the EP group.

Usefulness of microcatheters inserted overnight for additional injection of sclerosant after initial balloon-occluded retrograde transvenous obliteration of gastric varices.

In patients with large gastric varices, dose limitation of the sclerosant can cause difficulties in achieving complete thrombosis of varices during a single balloon-occluded retrograde transvenous obliteration (BRTO) procedure. For patients with incomplete variceal thrombosis after the first BRTO, additional sclerosant must be injected in a second BRTO. We report a successful case of BRTO for large gastric varices in whom additional sclerosant was injected through a microcatheter that remained inserted overnight.

Effect of interval between transcatheter hepatic arterial embolization and radiofrequency ablation on ablated lesion size in a swine model.

Purpose: The aim of the study was to clarify the effect of the interval between transcatheter hepatic arterial embolization (TAE) with Lipiodol plus gelatin sponge particles and radiofrequency (RF) ablation on the extent of ablation.

Materials And Methods: Eight healthy swine were divided into four groups: RF ablation (ablation only), RF ablation immediately after TAE (immediate ablation), RF ablation 3 days after TAE (3-day ablation), and RF ablation 6 days after TAE (6-day ablation). Five ablated lesions were created in each swine (10 per group).

Pathologic evaluation of damage to bronchial artery, bronchial wall, and pulmonary parenchyma after bronchial artery embolization with N-butyl cyanoacrylate for massive hemoptysis.

Histologic evidence of safety after bronchial arterial embolization (BAE) with N-butyl cyanoacrylate (NBCA) should be assured. The present report describes a 78-year-old man with massive hemoptysis from lung cancer who underwent surgical lobectomy 23 days after hemostasis had been achieved via BAE with NBCA. Pathologic examination revealed that NBCA filled the lumen of bronchial branch arteries 143-1,094 μm in diameter from the lobar bronchus to subsegmental bronchus but was not seen in the lumen of the pulmonary artery or pulmonary vein.

Balloon occlusion retrograde transvenous obliteration for inferior mesenteric vein-systemic shunt.

Two cases of portosystemic encephalopathy caused by an inferior mesenteric vein (IMV)-internal iliac vein shunt and an IMV-renal vein shunt are presented. IMV and systemic varicosity consisted of a first functional segment, a stagnant segment, and a second functional segment. Both patients underwent balloon occlusion retrograde transvenous obliteration (BRTO), using a microcatheter, to occlude the stagnant segment selectively.

Interlocking detachable coil embolization by technique of dumbbell-shaped framing and filling and bridge formation under balloon dilatation for huge conglomerate pulmonary arteriovenous malformation.

A 60-year-old woman presented with a conglomerate pulmonary arteriovenous malformation (PAVM) size 8.2 × 7.2 cm on chest X-ray.

Distribution of functional liver volume in hepatocellular carcinoma patients with portal vein tumor thrombus in the 1st branch and main trunk using single photon emission computed tomography-application to radiation therapy.

Purpose: To analyze the distribution of functional liver volume (FLV) in the margin volume (MV) surrounding hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) before radiation therapy (RT) and to verify the safety of single photon emission computed tomography-based three-dimensional conformal radiotherapy (SPECT-B3DCRT) by exploring the relation of FLV in MV to radiation-induced liver disease (RILD).

Methods And Materials: Clinical target volume (CTV) included main tumor and PVTT, and planning target volume (PTV) included CTV with a 10 mm margin. MV was defined as PTV-CTV.

Bone marrow nails created by percutaneous osteoplasty for long bone fracture: comparisons among acrylic cement alone, acrylic-cement-filled bare metallic stent, and acrylic-cement-filled covered metallic stent.

Purpose: This study was designed to compare the strength among bone marrow nails created to treat long bone fractures using interventional procedures.

Methods: Twelve resected intact tibiae of healthy swine were used. A circumferential bone fracture was made in nine tibiae and restored with the following created bone marrow nails: acrylic cement alone (ACA) (n=3), acrylic-cement-filled bare metallic stent (AC-FBMS) (n=3), and acrylic-cement-filled covered metallic (AC-FCMS) stent (n=3).

Percutaneous osteoplasty with a bone marrow nail for fractures of long bones: experimental study.

Purpose: To develop percutaneous osteoplasty with the use of a bone marrow nail for fixation of long-bone fractures, and to evaluate its feasibility and safety in vivo and in vitro.

Materials And Methods: Six long bones in three healthy swine were used in the in vivo study. Acrylic cement was injected through an 11-gauge bone biopsy needle and a catheter into a covered metallic stent placed within the long bone, creating a bone marrow nail.

Prospective comparison of transcatheter arterial chemoembolization with Lipiodol-epirubicin and Lipiodol-cisplatin for treatment of recurrent hepatocellular carcinoma.

Purpose: The aim of this study was to compare the safety and short-term efficacy of transcatheter arterial chemoembolization (TACE) using cisplatin-Lipiodol suspension (CP/Lp) with that using epirubicin-Lipiodol emulsion (EP/Lp) in patients with recurrent hepatocellular carcinoma (HCC).

Materials And Methods: A total of 28 HCC patients were enrolled prospectively and assigned to the CP/Lp group or EP/Lp group. Adverse effects related to TACE were graded; and the treatment effect (TE) on HCC nodules at 3 months and overall tumor response at 6 months were assessed as the endpoint.

Comparison of hemostatic durability between N-butyl cyanoacrylate and gelatin sponge particles in transcatheter arterial embolization for acute arterial hemorrhage in a coagulopathic condition in a swine model.

This study was designed to compare the efficacy of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) or gelatin sponge particles (GSP) for acute arterial bleeding in a coagulopathic condition using a swine model. Four healthy swine were divided into two coagulopathic conditions: mild and severe. Five hemorrhages were created in each swine (10 hemorrhages per coagulopathy).

A new soluble gelatin sponge for transcatheter hepatic arterial embolization.

To prepare a soluble gelatin sponge (GS) and to explore the GS particles (GSPs) that inhibit development of collateral pathways when transcatheter hepatic arterial embolization is performed. The approval of the Institutional Committee on Research Animal Care of our institution was obtained. By means of 50 and 100 kDa of regenerative medicine-gelatin (RM-G), RM-G sponges were prepared by freeze-drying and heating to temperatures of 110-150°C for cross-linkage.

Ischemic effects of transcatheter arterial embolization with N-butyl cyanoacrylate-lipiodol on the colon in a Swine model.

This study was designed to assess the safety of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate-lipiodol (NBCA-Lp) for the large bowel and to investigate the vital response to NBCA-Lp in a swine model. In nine swine, nine arteries nourishing the colon were embolized with NBCA-Lp (1 ml of NBCA mixed with 4 ml of lipiodol): sigmoid-rectal branch artery in six swine, right colic branch artery in two, and middle colic branch artery in one. The amount of NBCA-Lp was 0.

Triple-phase computed tomography during arterial portography with bolus tracking for hepatic tumors.

Purpose: The purpose of this study was to assess the usefulness of triple-phase computed tomography during arterial portography (CTAP) using a bolus-tracking technique.

Material And Methods: The subjects were 60 patients with hepatic tumors: 20 patients with metastatic liver tumors with a normal liver and 40 with hypervascular hepatocellular carcinoma (HCC) with liver cirrhosis. The region of interest was set in the portal vein, and CTAP was automatically started after the triggering threshold (180 HU) was reached.

Effects of hepatic artery chemoembolization using cisplatin-lipiodol suspension with gelatin sponge particles on swine liver.

Purpose: To define the effects of hepatic artery chemoembolization with cisplatin-lipiodol suspension and gelatin sponge particles on swine liver tissue and estimate the concentration of cisplatin that would have a minimal negative effect on normal liver parenchyma.

Materials And Methods: Twelve pigs were divided into four groups: group A was the control group in which hepatic arteries were embolized with lipiodol and gelatin sponge particle (n = 3); group B animals were embolized with 10 mg/mL cisplatin-lipiodol suspension plus gelatin sponge particle (n = 3), group C with 20 mg/mL cisplatin-lipiodol suspension plus gelatin sponge particle (n = 3), and group D with 30 mg/mL cisplatin-lipiodol suspension plus gelatin sponge particle (n = 3). Pigs were euthanized 1 week after embolization, and the resected livers were cut into 10-mm-thick sections.

Changes in portal systemic pressure gradient after balloon-occluded retrograde transvenous obliteration of gastric varices and aggravation of esophageal varices.

The purpose of this study was to evaluate change in the portal systemic pressure gradient (PSPG) following balloon-occluded retrograde transvenous obliteration (BRTO) and the aggravation of esophageal varices. The PSPG was monitored before and after BRTO in 19 patients. PSPG changes were obtained by subtracting the PSPG before BRTO from that after BRTO.

Evaluation of transcatheter arterial embolization with gelatin sponge particles, microcoils, and n-butyl cyanoacrylate for acute arterial bleeding in a coagulopathic condition.

Purpose: To evaluate the outcome of transcatheter arterial embolization with gelatin sponge particles, microcoils, and N-butyl cyanoacrylate (NBCA) for acute arterial hemorrhage in the setting of coagulopathy.

Materials And Methods: Coagulopathy is defined by a platelet count less than 5 x 10(4)/microL and/or International Normalized Ratio (INR) greater than 1.5.

Repair of traumatic abdominal aortic pseudoaneurysm using N-butyl-2-cyano-acrylate embolization.

Embolization using N-butyl-2-cyano-acrylate (NBCA) has been highly regarded for treating pseudoaneurysm, arteriovenous malformation, and hemorrhage of the visceral arteries. We report the case of a patient who fell from a cliff and sustained hemorrhagic shock with blunt abdominal aortic rupture and who underwent embolization using NBCA. This treatment achieved immediate hemostasis and stabilization of vital signs.

Radiofrequency ablation assisted by real-time virtual sonography and CT for hepatocellular carcinoma undetectable by conventional sonography.

Real-time virtual sonography (RVS) is a diagnostic imaging support system, which provides the same cross-sectional multiplanar reconstruction images as ultrasound images on the same monitor screen in real time. The purpose of this study was to evaluate radiofrequency ablation (RFA) assisted by RVS and CT for hepatocellular carcinoma (HCC) undetectable with conventional sonography. Subjects were 20 patients with 20 HCC nodules not detected by conventional sonography but detectable by CT or MRI.

Effectiveness of hepatic arterial embolization on radiofrequency ablation volume in a swine model: relationship to portal venous flow and liver parenchymal pressure.

Purpose: To evaluate the effectiveness of transcatheter arterial embolization (TAE) on radiofrequency (RF) ablation volume and compare portal vein (PV) flow and liver parenchymal pressure before and after treatment.

Materials And Methods: Eight healthy female swine were divided into four groups to be treated with RF ablation alone (RF-only group), RF ablation after TAE with gelatin sponge particles (GSPs; RF/TAE group), RF ablation after TAE with Lipiodol plus GSPs (RF/TAE/Lipiodol group), and PV embolization (PVE) with GSPs after TAE with Lipiodol plus GSPs (RF/TAE/Lipiodol/PVE group). Five ablations were created in each swine, with 10 ablations per group.