Combination radiofrequency thermal ablation and adjuvant IV liposomal doxorubicin increases tissue coagulation and intratumoural drug accumulation

There has been marked interest in minimally-invasive, image-guided radiofrequency (RF) tumour ablation (i.e. coagulating tumour using short duration heating (<15?min) by directly applying temperatures >50°C via needle electrodes) to treat focal liver, renal, breast, bone and lung tumours. In spite of advances in RF technology and improved understanding of tumour biophysiology that now enable experimental treatment of tumours up to 5?cm, investigators have been unable to achieve complete ablation in many cases, particularly at the tumour margins and adjacent to blood vessels. One strategy for overcoming these limitations has been to take advantage of complementary interactions between RF thermal ablation and chemotherapy, particularly liposomal doxorubicin preparations, to attempt more complete tumour destruction. This paper will review published laboratory investigations demonstrating that this combined treatment paradigm has the unique potential both to potentiate preferential delivery of cytotoxic agents in liposome vehicles and to maximize the completeness of ablation of a treated tumour. New confirmatory data describing increased tumour destruction with RF ablation combined with different liposome preparations, documenting increased lipid peroxidation and expanding on previously published tumour growth studies is presented. Additionally, early clinical data including a randomized, pilot clinical study on 10 patients with primary and metastatic liver tumours, in which a non-optimized combination of RF ablation and IV liposomal doxorubicin (Doxil) increased the volume of tumour destruction 25–30% compared to RF alone, will also be described in detail.     

CT血管成像三维重建技术在布加综合征中的应用价值

目的 评估CT血管成像三维重建在布加综合征中的应用价值。方法 选取2011年2月至2013年12月就诊的布加综合征患者93例为研究对象,采用CT血管成像技术评估其门静脉、下腔静脉及肝静脉病变情况。结果 所有患者中,病变累及下腔静脉者(Ⅰ型和Ⅲ型)69例(74.19%),下腔静脉隔膜形成者34例(49.28%);肝静脉受损者(Ⅱ型和Ⅲ型)59例(63.44%),肝静脉隔膜形成者15例(25.42%);另有2例患者下腔静脉和肝静脉均有隔膜形成。56例(60.22%)患者存在侧支循环,食管胃底静脉曲张阳性39例(41.94%),脾脏肿大73例(78.49%),腹水36例(38.71%),肝脏尾状叶增大8例(8.6%),肾静脉血栓形成6例(6.45%)(双侧受累2例,单侧受累4例),原发性肝细胞癌5例(男性4例,女性1例)。结论 CT血管成像三维重建技术能够较好地反映布加综合征影像学特征,对布加综合征的临床诊疗具有较好的指导意义。     

CT血管造影在脑动静脉畸形诊断中的应用

目的探讨CT血管造影(CTA)在诊断脑动静脉畸形(AVM)中的应用价值。方法选择2010年1月至2013年5月入住连云港市第二人民医院21例AVM患者的影像资料,分析其CT平扫、增强扫描的影像表现,并与手术结果进行比较。结果 21例患者检测出21处AVM,均进行病灶手术切除。三维CTA影像结果和患者手术所见AVM结果进行对比显示:①CTA影像对AVM位置的诊断与手术结果一致,符合率高达100%。②CTA对供血动脉显示率为95.3%(41/43),对引流静脉的显示率为72.7%(24/33)。③21处畸形血管团采用三维CTA检测显示其累及范围与手术结果测量,比较差异无统计学意义(P>0.05)。结论 CTA是一种安全可靠的诊断AVM的影像手段,具有良好的临床诊断及手术指导应用价值。