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1.
Choledochal cyst due to anomalous pancreatobiliary junction in the adult: sonographic findings 总被引:1,自引:0,他引:1
M. Sato H. Ishida K. Konno H. Naganuma J. Ishida M. Hirata N. Yamada S. Watanabe 《Abdominal imaging》2001,26(4):395-400
Background: Adult cases of choledochal cyst due to anomalous pancreaticobiliary duct junction have been rarely reported. At present,
sonography (US) is the first tool for diagnosing biliary disorders. The aim of this study was to reevaluate the US findings
of choledochal cysts due to anomalous pancreaticobiliary duct junction in adults.
Methods: We reviewed the clinical manifestations and US findings of 12 such adult cases confirmed by endoscopic retrograde cholangiopancreatic
ductography (ERCP). Patients were assigned to three groups: (a) associated with biliary carcinoma (two cases), (b) associated
with choledocholithiasis (one case), and (c) not associated with other abdominal diseases (nine cases).
Results: Patients in group c were asymptomatic, and the lesions were detected incidentally detected by US. In contrast, patients in
group a sought medical care because of symptoms such as jaundice and those in group b sought medical attention because of
abdominal pain. The diameter of a dilated bile duct on US was considerably less than that of ERCP (ERCP: 26–58 mm, mean =
37.6 mm; US: 13–32 mm, mean = 21.8 mm). Its diameter changed significantly under probe compression when the dilated bile duct
took a purely cystic form but changed very little when it took a tubular form.
Conclusion: Unlike cases in children, adult cases of choledochal cyst are generally asymptomatic. Careful US observation of the bile
duct is thus expected to detect asymptomatic adult choledochal cysts cases. Cyst diameter can change significantly under probe
compression, so it is important not to compress the bile duct during routine US examination.
Received: 13 September 2000/Accepted: 18 October 2000 相似文献
2.
Tamada K Tomiyama T Wada S Ohashi A Satoh Y Higashizawa T Miyata T Ido K Sugano K 《Abdominal imaging》2000,25(6):587-591
Background: To identify the appropriate puncture points in the bile duct to avoid catheter dislodgement.
Methods: Percutaneous transhepatic biliary drainage catheters (n = 300) were placed in 242 patients. The frequency of dislodgement (complete dislodgement or bending of the catheter) was prospectively
investigated. The puncture site of the bile duct was classified on the ultrasonographic findings as follows: Main-B3, main
branch of the lateral inferior segment; peripheral-B3, peripheral branch of the lateral inferior segment; B2, lateral superior
segment; left hepatic duct, proximal portion of the left hepatic duct; B8, anterior superior segment; B5, anterior inferior
segment; B5 + 8, main bile duct of the anterior segment; B6, bile duct of posterior inferior segment; and right hepatic duct,
proximal portion of the right hepatic duct.
Results: When a catheter without an outer sheath was used, catheter dislodgement in peripheral-B3 (2/11, 18%) was more common than
in main-B3 (0/32, 0%; p < 0.05). In B5, catheter dislodgement (6/12, 50%) was more frequent than in B8 (3/20, 15%; p < 0.05) and in B6 (0/14, 0%; p < 0.005). When a catheter with an outer sheath was used, catheter dislodgement (2/207, 1%) was rare.
Conclusion: Drainage from B5 and peripheral-B3 is associated with a high risk of dislodgement of the catheter. A catheter with an outer
sheath was useful to prevent catheter dislodgement. RID=" ID=" <E5>Correspondence to:</E5> K. Tamada
Received: 8 February 2000/Accepted: 8 March 2000 相似文献
3.
Background: To define the signs useful for differentiating between gallbladder–enteric fistula (GB-EF) and common bile duct–enteric fistula
(CBD-EF) on computed tomography (CT) because the prognosis and management of the two are different.
Methods: CT scans in 13 patients with pneumobilia, who had not had surgical biliary–enteric anastomosis and endoscopic sphincterotomy,
were reviewed. The presence of fistula itself, the location of air in the biliary system, and the appearance of the gallbladder
were assessed.
Results: The causes of pneumobilia were GB-EF in seven patients, CBD-EF in three patients, emphysematous cholecystitis (EC) in one
patient, gallbladder cancer (GBC) in one patient, and incompetent sphincter of Oddi in one patient. In three of seven GB-EF
patients (43%) and in none of the three CBD-EF patients (0%), the fistula itself was detected. Air was detected in the common
bile duct in four of seven GB-EF (57%) and in all three CBD-EF (100%) patients, and GBC. In six of seven GB-EF (86%) and in
one of three CBD-EF (33%) patients, the gallbladder was contracted. Thus, the location of air and the contraction of gallbladder
were useful signs to differentiate GB-EF from CBD-EF.
Conclusion: CT can distinguish between GB-EF and CBD-EF.
Received: 17 December 1996/Accepted: 5 February 1997 相似文献
4.
Fascioliasis: US, CT, and MRI findings with new observations 总被引:2,自引:0,他引:2
Kabaalioğlu A Cubuk M Senol U Cevikol C Karaali K Apaydin A Sindel T Lüleci E 《Abdominal imaging》2000,25(4):400-404
Background: The purpose of this study is to describe the ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging
(MRI) findings in fascioliasis and to emphasize the impact of radiology in diagnosis.
Methods: Radiologic findings in 23 consecutive patients with fascioliasis were prospectively recorded. All patients had at least one
US and CT examination, and 10 of them were studied by MRI. All diagnoses were confirmed by serologic methods. In the first
three cases, initial diagnosis was reached by microscopic demonstration of the parasites' eggs in bile obtained by US-guided
gallbladder aspiration.
Results: In the hepatic phase of fascioliasis, multiple, confluent, linear, tractlike, hypodense, nonenhancing hepatic lesions were
detected by CT. On US, the parasites could be clearly identified in the gallbladder or common bile duct as floating and nonshadowing
echogenic particles. MRI showed the lesions as hypo- or isointense on T1-weighted images and as hyperintense on T2-weighted
images.
Conclusions: CT findings in the hepatic phase and US findings in the biliary phase are characteristic of fascioliasis. Because clinical
and laboratory findings of fascioliasis may easily be confused with several diseases, radiologists should be familiar with
the specific radiologic findings of the disease to shorten the usual long-lasting diagnostic process.
Received: 15 December 1999/Accepted: 26 January 2000 相似文献
5.
Preoperative evaluation of Klatskin tumor: accuracy of spiral CT in determining vascular invasion as a sign of unresectability 总被引:6,自引:0,他引:6
Cha JH Han JK Kim TK Kim AY Park SJ Choi BI Suh KS Kim SW Han MC 《Abdominal imaging》2000,25(5):500-507
Background: To assess the accuracy of spiral computed tomography (CT) in predicting the resectability of Klatskin tumor as determined
by vascular invasion.
Methods: Twenty-one consecutive patients with Klatskin tumor who had undergone laparotomy were included in this study. The preoperative
thin-section (5-mm-thick) spiral CT scans of these patients were assessed for the surgical resectability of tumor by evaluating
the vascular invasion. The criterion for vascular invasion indicating unresectability was the tumoral invasion of the proper
hepatic artery or main portal vein or simultaneous invasion of one side of the hepatic artery and the other side of the portal
vein.
Results: All nine patients with tumors thought to be unresectable on the basis of CT findings had tumors that were unresectable at
surgery (positive predictive value, 100%). Of 12 patients with tumors thought to be resectable, six had resectable tumors
(negative predictive value, 50%). Spiral CT failed to detect small hepatic metastasis (n= 1), lymph node metastasis (n= 1), extensive tumor (n= 2) and variation of bile duct (n= 2), which precluded surgical resection.
Conclusion: Spiral CT is a reliable method for detecting vascular invasion and unresectable tumors. However, it has limitations in detecting
variations of the bile duct or the intraductal extent of tumor.
Received: 24 November 1999/Accepted: 26 January 2000 相似文献
6.
M. Kawakatsu V. Vilgrain M. Zins M.-P. Vullierme J. Belghiti Y. Menu 《Abdominal imaging》1997,22(1):87-90
Background: The purpose of this study was to describe the imaging findings of papillary adenoma of the bile ducts.
Methods: Imaging modalities including sonography, computed tomography, cholangiography, and endoscopic sonography obtained in five
patients with papillary adenoma of the bile duct were retrospectively reviewed and correlated with pathologic findings.
Results: In four cases, imaging findings were a dilatation of the bile ducts due to a protruding mass within the lumen of the common
bile duct. In one case, the biliary tract obstruction was not due to the mass but to mucus secretion that was detected at
sonography, endoscopic sonography, and cholangiography. Multiple lesions were observed in two cases at pathology and not detected
preoperatively. All the lesions contained foci of in situ carcinoma or mild dysplasia.
Conclusion: Imaging is useful in detecting bile duct tumors. Hypersecretion of mucus is rare but highly characteristic of bile duct adenoma.
Received: 6 July 1995/Accepted: 18 August 1995 相似文献
7.
A case of acute common bile duct obstruction caused by a roundworm in a 6-year-old girl is reported. Computed tomography (CT)
and magnetic resonance imaging (MRI) showed “bull's-eye” and “eye-glass” appearances of the ascaris in the common bile duct.
On reformation of the transverse CT and coronal MR images, the tubular Ascaris was better depicted. MRI and navigator endoscopic demonstrations of the common bile duct ascaris have not been described
previously in the literature. These CT and MRI findings may be helpful in the diagnosis of Ascaris.
Received 6 November 1998/Accepted 14 December 1998 相似文献
8.
Icteric-type hepatoma: magnetic resonance imaging and magnetic resonance cholangiographic features 总被引:4,自引:0,他引:4
Background: We evaluated the imaging features of magnetic resonance imaging (MRI) and magnetic resonance cholangiography (MRC) of icteric-type
hepatoma and correlated these with the findings of endoscopic retrograde cholangiography (ERC), percutaneous cholangiography,
and surgery.
Methods: Thirteen patients with viral hepatitis complicated by cirrhosis of the liver and obstructive jaundice underwent MRC and dynamic
MRI. Five patients received percutaneous transhepatic cholangiography and drainage; one of these patients also underwent resection
of the left hepatic lobe. Another patient received MRC followed by thrombectomy and T-tube insertion. ERC and endoscopic nasobiliary
drainage were performed in another patient for bile diversion.
Results: Primary liver tumors and dilatation of biliary system were demonstrated in all patients. No capsule formation could be found
in any primary liver tumors. MRI showed the simultaneous presence of an intraluminal tumor in the portal trunk and common
hepatic duct in eight patients. Three different MRC features were found: (a) an oval defect in the hilar bile duct(s) with
dilated intrahepatic ducts (n= 9), (b) dilated intrahepatic ducts with missing major bile ducts (n= 2), and (c) localized stricture of the hilar bile duct(s) (n= 2).
Conclusion: The presence of one or more of the following features in multiplanar MRI and MRC help to identify this rare, specific type
of hepatocellular carcinoma: (a) the presence of an intraluminal tumor in both the portal trunk and the common hepatic duct,
(b) enhancement of the intraluminal tumor in the common hepatic duct on the arterial phase, (c) type I MRC feature, and (d)
hemobilia, blood clot within the gallbladder, and/or type II MRC feature.
Received: 12 January 2000/Revision accepted: 12 July 2000 相似文献
9.
Gadopentetate dimeglumine as an oral negative gastrointestinal contrast agent for MRCP 总被引:16,自引:0,他引:16
Background: We investigated the feasibility of using intravenous magnetic resonance (MR) contrast agent as a gastrointestinal oral negative
contrast agent to null the bowel signal during MR cholangiopancreatography (MRCP).
Methods: In the first part of the study, a phantom study was performed to select the optimal concentration of MR contrast agent to
be used as an oral negative contrast agent in MRCP. In the second part of the study, 23 consecutive patients suffering from
different pancreaticobiliary diseases were imaged with a single-shot fast spin-echo pulse sequence. The data acquisition was
started without oral contrast agent and then repeated with oral contrast agent. From the MR images taken with and without
oral contrast agent, the gallbladder, cystic duct, common bile duct, and pancreatic duct were assessed and graded by two radiologists.
Results: The oral contrast agent was tolerated well by all patients. In all patients the high signal intensity from the intestinal
fluid was completely suppressed. The depictions of the gallbladder and cystic duct were slightly and moderately improved,
respectively, whereas the depictions of the common bile duct and pancreatic duct were markedly improved by the oral contrast
agent administration.
Conclusion: Diluted intravenous MR contrast agent can be an effective and safe oral negative contrast agent in eliminating signal intensity
of the gastrointestinal tract, thus improving the depiction of the biliary system in MRCP.
Received: 14 September 1999/Revision accepted: 12 January 2000 相似文献
10.
Tamada K Tomiyama T Ohashi A Wada S Satoh Y Higashizawa T Gotoh Y Ido K Sugano K 《Abdominal imaging》2001,26(2):210-214
Background: This is the first study to correlate intraductal ultrasonography (IDUS) with cholangioscopy in evaluating the patency of
biliary metallic stents.
Methods: The findings of IDUS (probe 2.0 mm in diameter and 20-MHz frequency) through a percutaneous transhepatic (n = 24) or transpapillary (n = 2) approach were retrospectively reviewed without other information. Criteria for IDUS are as follows: type 1, the inside of
the stent is free; type 2, the inner edge is smooth; type 3, the inner edge is irregular; type 4, the inside of the stent
is totally occupied; type 5, the solid echo is connected to the outside mass; type 2+D, a hypoechoic line is seen between
the bile duct wall and the inside solid component and the inner edge of the bile duct wall is smooth; type 3+D, an irregular
hypoechoic line is seen between the bile duct wall and the inside solid component.
Results: In the control group (n = 11), IDUS showed type 1 (n = 9) or type 2 (n = 2). In the occluded group (n = 15), when IDUS showed type 3 or 5, the patients (n= 5) required additional stents (n = 3), microwave coagulation of the tumor (n= 1), or transient external drainage (n= 1). When IDUS showed type 4 (n = 5), after washing, the findings changed to type 2+D (n = 4). When IDUS after washing showed a smooth inner edge (type 2+D), the patients were treated without additional stents more frequently
than the other groups (eight of nine vs. two of six), a significant distinction (p < 0.05).
Conclusion: IDUS is useful in assessing the patency of metallic stents. When the inside of the stent is totally occupied, however, examination
after washing is necessary.
Received: 19 May 2000/Accepted: 28 June 2000 相似文献
11.
Konno K Ishida H Sato M Naganuma H Komatsuda T Kimura H Ishida J Watanabe S 《Abdominal imaging》2003,28(1):0075-0078
Background: It is well known that obstructive jaundice causes biliary dilatation, but sonographic (US) findings of the cystic duct in
patients with obstructive jaundice are rarely reported.
Methods: We reviewed US findings in 25 such patients.
Results: US findings of dilated cystic duct could be divided roughly into two patterns: tortuous and tubular. The former pattern was
a tortuously dilated cystic duct arising from the gallbladder neck, running predominantly deeply, turning anteromedially,
and then joining the posterior face of the common hepatic duct. The latter pattern was a straight dilated cystic duct running
parallel with the common hepatic duct, giving the appearance of a septated bile duct.
Conclusion: A better understanding of the US findings of dilated cystic duct translates into improved biliary US diagnosis. 相似文献
12.
A. Schulman 《Abdominal imaging》1998,23(1):60-66
Background: To determine the range of ultrasonographic (US) appearances of Ascaris lumbricoides roundworms in the biliary system, their distribution in the intra- and extrahepatic parts of the system, and associated features.
Methods: All cases of biliary ascariasis during a 10-year period were reviewed. There were 42 cases in which diagnosis was based on
established US criteria, and 2 cases diagnosed surgically in which US had been negative. These 44 cases occurred in 36 patients.
Results: In the US-diagnosed cases, worms were present in intrahepatic ducts in 32 cases, in the main duct in 37, and in the gallbladder
in eight. In six cases, the liver was lifted off the main portal vein by a bundle of worms obliterating the lumen of the main
bile duct. Worms packing and dilating intrahepatic ducts produced pseudotumorous appearances in the liver in four cases and
bundlelike appearances in three. Worms were also seen in the pancreatic duct in two cases. Stones in intrahepatic ducts were
present in 12 patients.
Conclusion: Biliary ascariasis should be searched for inside and outside the liver. The appearances of bundles and boluses are different
from those of single worms. Intra- and extrahepatic biliary stones may be present.
Received: 7/30/96/Accepted: 9/4/96 相似文献
13.
Background: Treatment of malignant pancreatic and/or biliary strictures requires tissue diagnosis. Since cytologic brushings at endoscopic
retrograde cholangiopancreatography (ERCP) of these strictures has a poor sensitivity for malignancy (30–83%) (see ME Ryan.
Gastrointestinal Endoscopy 1991;37(2):139–143; and MB Cohen, Wittchow RJ, Johlin FC, et al. Mod Pathol 1995;8:498–502), tissue diagnosis must be obtained by another route. We report our experience of percutaneous biopsy of malignant
pancreatic and/or biliary strictures even when no radiographic mass is present.
Methods: At ERCP, five patients demonstrated pancreatic and/or biliary duct strictures, had atypical cytological brushings, and had
their strictures stented. No mass to account for the strictures could be identified on CT. These five patients underwent percutaneous
biopsy of the peri-stent material by CT within 10 days of the ERCP.
Results: Two patients had adenocarcinoma of the pancreas. One patient had malignant lymphoma and another had cholangiocarcinoma. One
patient had inflammatory cells and was followed.
Conclusions: If the diagnosis of malignancy cannot be made at the time of the ERCP sampling, then our experience suggests that a percutaneous
biopsy should be performed even if a mass is not present using the stent as a target.
Received: 30 January 1996/Accepted: 28 March 1996 相似文献
14.
Safe percutaneous canalization of the biliary tree using a sheath in patients with malignant biliary stenosis 总被引:1,自引:0,他引:1
Background: Percutaneous canalization of the bile duct is essential for radiologic interventions of the biliary tract. This study discusses
technical considerations for safe approaches for canalization of the bile duct when using a sheath.
Methods: During early and late periods, percutaneous canalization was performed in 104 patients and 79 patients with malignant biliary
stenosis, respectively. The late period differed from the early period in that the bile duct was canalized with a previously
placed sheath to prevent catheter dislodgement during the procedure.
Results: During the early and late periods, catheter dislodgement during canalization occurred in three of 104 patients (3%) and none
of 79 patients (0%), respectively. The success rate of canalization without cholangioscopy in the late period (99%) was better
than that in the early period (89%; p < 0.05).
Conclusion: Placement of a sheath into the biliary tree increases the safety and success of canalization in patients with malignant stenosis.
Received: 13 March 13, 2001/Revision accepted: 17 May 2001 相似文献
15.
V. H. S. Low 《Abdominal imaging》1997,22(5):509-512
Purpose: To evaluate normal retrograde cholangiograms to determine a normal range of ductal calibers and identify its variation with
age.
Materials and methods: The retrograde cholangiograms of 136 patients (age range: 17–84 years; mean age 49.8 years ± 17.3 [standard deviation]) with
clinical follow-up and subsequent studies suggesting normal biliary trees were evaluated. Patients with previous cholecystectomy,
choledocholithiasis, or pancreatitis were excluded. Common bile duct (CBD) and common hepatic duct (CHD) sizes were measured.
Results: Measurements uncorrected for radiographic magnification of CBD revealed a mean of 8.5 mm ± 2.7 mm [standard deviation] and
CHD had a mean of 8.1 mm ± 2.6 mm. There was an increase in CBD caliber by 0.5 mm per decade of increasing age (p < 0.001) and an increase in CHD caliber by 0.35 mm per decade of age (p < 0.01).
Conclusion: The range of normal cholangiographic bile duct caliber is wide and a CBD caliber of 13.9 mm occurs at the top of this range
(mean plus two standard deviations). There is a small but statistically significant trend of ductal dilatation with advancing
age.
Received: 13 December 1995/Accepted after revision: 24 April 1996 相似文献
16.
Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels 总被引:14,自引:0,他引:14
Background: We investigated the constituting collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor
thrombosis of hepatocellular carcinoma (HCC) by using contrast-enhanced spiral computed tomographic (CT) examination.
Methods: Fifty-four histopathologically proven HCC patients with tumor thrombosis-induced CTPV were retrospectively included and assigned
to cirrhosis negative (n= 31) and positive (n= 23) groups. Another 15 cirrhotic patients with portal hypertension but no HCC and CTPV were used for comparison. Standardized
dual-phase contrast-enhanced spiral CT was performed for all patients. CT appearances of the collateral vessels of CTPV were
observed, and their visualization rates were analyzed.
Results: Biliary (cystic and paracholedochal veins) and gastric (left and right gastric veins) branches of the portal vein were the
most frequently visualized collateral vessels of CTPV. There was a marked difference in CT visualization rates for biliary
branches between patients with and without CTPV (83–94% vs. 0). No difference existed in visualization rates for gastric branches
across the three groups (77–87% for left gastric, 58–61% for right gastric vein).
Conclusions: Biliary and gastric branches of the portal vein are the major collateral vessels of CTPV. The intergroup differences in CT
visualization rates may provide clues to the roles that they might play in the hemodynamic adaptation process of CTPV.
Received: 13 October 1999/Accepted: 12 January 2000 相似文献
17.
Iliopsoas abscess: a report of 24 patients diagnosed by CT 总被引:1,自引:0,他引:1
Background: We wanted to define the role of computed tomography (CT) in the diagnosis, etiology, and treatment of iliopsoas abscess.
Methods: Twenty-four patients (18 men, six women; age range = 17–86 years) with iliopsoas abscesses diagnosed over 8 years were retrospectively
reviewed. All presented with fever and elevated white blood cell counts. Twenty-one had abdominal, flank or pelvic pain and
nine had specific psoas signs suggesting the diagnosis.
Results: Seventeen of the abscesses were right-sided. Twenty were regarded as secondary to various underlying causes that were clearly
demonstrated on CT and related to gastrointestinal (n= 12), skeletal (n= 5), or urinary tract (n= 3) diseases. All patients received appropriate antibiotic treatment. Thirteen also had their abscesses drained and eight
had definitive surgical procedures.
Conclusion: CT is an effective imaging technique for diagnosing iliopsoas abscess, even when classic clinical signs are absent. Treatment
by percutaneous drainage under CT guidance is another advantage. When a psoas abscess is a complication of Crohn's disease,
resection of the affected bowel segment is recommended in addition to drainage because drainage alone even in conjunction
with appropriate medical therapy is usually not effective.
Received: 30 August 2000/Accepted: 1 November 2000 相似文献
18.
V. H. S. Low 《Abdominal imaging》1997,22(4):421-425
Abstract
Purpose: To evaluate retrograde cholangiograms, ex~
plore the morphology of malignant biliary strictures,
and determine if there are any features that may indicate
a specific diagnosis.
Materials and methods: The retrograde cholangiograms
of 514 patients were reviewed. Cases with clinical fol~
low-up and subsequent studies indicating malignant in~
volvement of the biliary tree were identified. Fifty pa~
tients were found.
Results: Carcinoma of the pancreatic head was the most
common disease with 21 patients in this group. The
morphology of the bile duct at the point of involvement
was nonspecific comprising shouldered intrinsic ap~
pearing lesions as well as tapered in other cases. Pan~
creatic duct dilatation was a relatively specific finding
occurring in 80% of this group. Other malignancies to
involve the bile ducts included cholangiocarcinoma,
metastases, ampullary carcinoma and gallbladder car~
cinoma. As with pancreatic carcinoma, the morphology
of the lesion (e.g., shouldered versus tapered, length of
stricture, severity of proximal dilatation) did not aid in
the specific diagnosis of the pathology. Illustrative cases
are presented where the morphology was unexpected for
the eventual diagnosis (e.g., simulating intraluminal fill~
ing defects).
Conclusion: The cholangiographic appearance of a bil~
iary stricture is usually not helpful in the specific diag~
nosis of the underlying etiology. Carcinoma of the pan~
creatic head may be suspected if pancreatic duct
dilatation is also found. This article presents some un~
usual cholangiographic pitfalls that were identified,
which initially distracted from the ultimate diagnosis.
Received: 16 September 1996/Accepted: 30 October 1996 相似文献
19.
Background: We investigated the incidence and imaging features of hepatic neoplasms containing normal hepatic vessels.
Methods: Among 3183 patients with various hepatic neoplasms, we found nine patients with normal hepatic vessels traversing hepatic
neoplasms. The presence of mass effect on the vessel traversing hepatic neoplasms was evaluated. Other suggestive findings
of neoplasms such as altered hepatic contour, portal vein thrombosis, mass effect on extratumoral vessel, and bile duct dilatation
were analyzed.
Results: Thirteen hepatic vessels (nine hepatic veins and four portal veins) extended through hepatic neoplasms in nine patients.
Undisturbed hepatic vessels within the neoplasms were found in five patients with either primary or metastatic hepatic neoplasm.
In one patient with undisturbed hepatic vessels within the neoplasm, there were no associated abnormal findings such as biliary
dilatation, change of hepatic contour, or any changes involving the vessels external to neoplasms.
Conclusion: Although rare, various primary and secondary hepatic neoplasms can have normal hepatic vessels passing through them without
mass effect. However, correct diagnosis in most neoplasms would be possible with careful examination of associated findings.
RID=" ID=" <E5>Correspondence to:</E5> J. K. Han
Received: 2 February 2000/Accepted: 5 April 2000 相似文献
20.
Background: Multisection helical computed tomography (CT) has the potential for providing data sets with better section profiles, more
anatomic coverage, and shorter breath-holding periods. Our purpose was to quantitate these advantages in a clinical setting
when imaging the abdomen and pelvis.
Methods: CT parameters including collimation, timing, z-axis coverage, and milliamperes were gathered retrospectively for the image set of both single-section (GE CT/i with 0.8-s
rotation) and four-section (GE QX/i Lightspeed with 0.8-s rotation) helical CT scanners. Data were recorded for the abdomen
and pelvis CT (n= 30 each), dual-phase liver CT including the pelvis (n= 15 each), and dual-phase pancreas CT (n= 15 each).
Results: The abdominal and pelvic CT averaged 128.4 ± 5.4 s for single-section scanners (70-s delay, two breath-holds of 21.1 and
17.7 s with a 19.5-s interscan delay) and 92.2 ± 2.2 s for the four-section scanner (70-s delay and a 22.2-s breath-hold;
p < 0.0001). For the dual liver and pelvis CT, single-section scanners averaged 119.9 ± 7.5 s (30-s delay, 15.8-s arterial
phase, 20.0-s interscan delay, 21.2-s venous phase, 19.5-s interscan delay, and 14.2 s for the remaining abdomen and pelvis),
whereas the four-section scanner averaged 86.8 ± 2.5 s (30-s delay, 6.7-s arterial phase, 27.9-s interscan delay, and 21.8-s
venous phase including the pelvis; p < 0.0001). For the dual pancreas CT, single-section scanners averaged 86.7 ± 2.5 s (20-s delay, 28.3-s arterial phase, 17.8-s
interscan delay, 21.7-s venous phase), whereas the four-section scanner averaged 78.0 ± 2.9 s (20-s delay, 9.7-s arterial
phase, 30.7-s interscan delay, 13.0-s venous phase; p < 0.0001).
Conclusion: CT scanners having four-section technology can reduce overall data acquisition times by 10–30% and total milliamperes by
50–60% depending on the protocol with thinner slice profiles. RID=" ID=" <E5>Correspondence to:</E5> R. C. Nelson
Received: 8 December 1999/Revision accepted: 22 March 2000 相似文献