Yttrium-90 Radioembolization: Current Clinical Practice and Review of the Recent Literature

Curative options for the treatment of primary or secondary hepatic malignancies are transplant and surgical resection. Transplant and surgical resection offers the best clinical outcome; however, it is only available to a limited number of patients who present with early-stage disease. For patients beyond curative resection or outside transplant criteria, locoregional therapies remain an excellent treatment option. Yttrium-90 (⁹⁰Y) radioembolization is a transarterial catheter–based technique that is increasingly being used in the management of primary and secondary liver malignancies. The focus of this article is to discuss the use of ⁹⁰Y radioembolization for the treatment of unresectable hepatic malignancies along with a review of the relevant literature.     

A Case Study: Percutaneous Lung Biopsy and Symptomatic Arterial Air Embolus

Air emboli are rare complications of computed tomography–guided lung biopsies. This case study discusses current recommendations on patient positioning and supportive treatment until an air embolus is reabsorbed or extracted. A plan of action aimed at mitigating the harmful or even fatal effects of air emboli should be developed and reviewed with all staff participating in these types of procedures.     

Midterm results of periprosthetic coiling embolization in high-risk patients

BackgroundWith increasing interest in the prevention of type II endoleaks (EII), the aim of this study was to report midterm results on the intraoperative coiling embolization of the periprosthetic aneurysmal sac in patients at high-risk of EII.MethodsA retrospective review study was conducted with 124 patients with infrarenal abdominal aortic aneurysm who accorded with the inclusion criteria, including 66 patients who underwent standard endovascular aortic aneurysm repair (Group A) and 58 patients who underwent aneurysmal sac coiling embolization (Group B). Baseline data and follow-up results were analyzed.ResultsA mean of 2.84 ± 1.45 coils (range 1–9) were used in Group B. The general incidence of an EII was 15.32% (19/124) at a mean follow-up time of 46.60 ± 15.14 months, with 22.7% (15/66) in Group A and 6.9% (4/58) in Group B (χ² = 5.62; P = 0.018). Logistic multivariate analysis revealed that the independent risk factors of an EII were no sac embolization and a sac volume ≥128 cm³. The Kaplan-Meier subgroup analysis showed no difference in regard to the rate of freedom from EII between the two groups either with a larger or smaller sac.ConclusionsThese results suggest that periprosthetic coiling embolization in patients at high-risk of EII is safe and effective in the prevention of EII. The preventive effect seemed to be weakened when the sac volumes were taken into consideration at midterm follow-up.     

放射信息系统目标管理研究

目的对放射信息系统进行目标管理研究,准确管理病人信息、科室信息。方法通过系统论和目标管理方法,对放射信息系统进行层级目标制定、分解、反馈与测定,构建放射信息系统目标管理框架及测评机制。结果依据科室工作流程,合理制定一级分解目标及相关的二级分解目标。结论目标管理能够对科室进行更加直观的管理。能够加强员工学习和工作积极性,实现“以病人为中心”。     

机械性血栓清除术治疗下腔静脉滤器相关血栓的疗效评价

目的:评价机械性血栓清除术(PMT)治疗下腔静脉滤器相关血栓的临床有效性及安全性。方法:回顾性分析2017年1月一2019年3月14例下腔静脉滤器置入术后12~14d出现下腔静脉滤器相关血栓的患者,比较PMT前后红细胞及肾功能变化,有无症状性肺栓塞以及PMT的血栓清除效果,是否成功回收滤器及有无下腔静脉损伤。结果:PMT前后红细胞及肾功能水平改变无统计学意义,均无症状性肺栓塞发生,PMT后血栓清除Ⅲ级12例(85.71%),Ⅱ级2例(14.29%)联合应用CDT治疗后血栓清除达Ⅲ级,所有患者均成功回收滤器,无下腔静脉损伤发生。结论:PMT可安全、有效的清除下腔静脉滤器相关血栓,从而提高滤器回收的成功率。     

双源CT双能量成像在肝癌经皮肝动脉化疗栓塞术后复查中的应用价值

目的 评价双源CT(DSCT)双能量成像对肝癌经皮肝动脉化疗栓塞(TACE)术后病灶复查的应用价值.方法 对27例接受TACE治疗的原发性肝癌患者资料进行回顾性分析,27例均行常规肝脏平扫及动态三期增强扫描,其中动脉期图像由双能量扫描方式获得.采用2种方法观察,A法观察常规平扫、动脉期、门静脉期及延迟期图像,B法观察虚拟平扫、动脉期、门静脉期及延迟期图像,评价2种方法对栓塞病灶内部及其周围肝组织内强化信息的判断.以DSA结果为参照标准,计算A、B2法的敏感性、特异性等指标,采用x2检验比较两种方法的诊断能力.结果 27例TACE术后复查患者中共检出63个病变,DSA明确其中39个病变有强化,24个病变无强化.B法的敏感性为94.9％( 37/39),高于A法的74.4％( 29/39;x2=6.303,P＜0.05);B法的特异性为95.8％( 23/24),与A法的83.3％ (20/24)差异无统计学意义(x2 =2.009,P＞0.05).结论 以动脉期双能量扫描代替常规CT平扫与动脉期增强扫描,与常规CT动态增强相比,对TACE术后肝癌病灶的评估更加准确.     

经皮肺穿刺活检注射生理盐水与凝血酶预防常见并发症的对比

目的：对比使用生理盐水与凝血酶在经皮肺穿刺活检术中预防常见并发症的效果。方法：回顾性分析注射生理盐水和凝血酶在CT引导下经皮肺穿刺活检且年龄≥55岁的连续病例资料各50例,A组注射生理盐水,B组注射凝血酶。对比两组患者注射液体的分布情况和常见并发症的发生率。结果：100例均穿刺成功。A组患者液体沿穿刺针道分布较广、甚至呈斑片状;B组患者液体基本沿穿刺针道呈线状分布。A组发生气胸4例,肺出血8例;B组气胸3例,肺出血2例。结论：注射凝血酶在预防经皮肺穿刺活检常见并发症方面较注射生理盐水更有效。     

关节盂唇损伤的影像学评估

人体内关节盂唇主要存在于肩关节和髋关节,这两个部位的盂唇在各方面均有极大的相似性,它们均由纤维软骨构成,呈吸盘样包绕骨性关节盂边缘,起到增大球窝关节包绕面积、缓解关节面应力以及稳定关节的作用.盂唇损伤主要包括磨损、撕裂以及移位,是引起关节疼痛、不稳及退变的重要因素.盂唇损伤的正确诊断对指导其临床治疗有着重要的意义.本文着重阐述目前诊断盂唇损伤的各种影像学方法及相关进展,为临床实践提供可靠的参考.