BACKGROUND: To examine the incidence and predisposing factors of gallbladder opacification in delayed computed tomography (CT) after angiography. METHODS: CT examination 12-24 h after angiography was performed in 389 patients. Univariate and multivariate analyses were made. RESULTS: Two hundred thirty-three of 389 patients (60%) revealed gallbladder opacification. Type of contrast medium (P < 0. 01), total bilirubin (P < 0.01), and serum creatinine (P < 0.01) were significant and independent factors relating to gallbladder opacification. Ioxaglate (70%, relative odds = 2.86) and iohexol (63%, relative odds = 2.03) showed higher gallbladder opacification rates than that of iopamidol (45%, relative odds = 1.43) and diatrizoate (30%). Patients with a lower serum bilirubin level (relative odds = 1.67) and a raised serum creatinine level (relative odds = 2.01) showed higher incidence of gallbladder opacification. CONCLUSION: Gallbladder opacification after angiography is not an abnormal finding on delayed CT in patients with not only abnormal renal function but also normal hepatobiliary and normal renal function, especially for modern contrast media.

Angiography↗

PubMedDate not supplied

Dynamic MR imaging for extraserosal invasion of advanced gastric cancer.

Dynamic magnetic resonance (MR) images in 37 patients with gastric cancers were obtained by a two-dimensional fast multiplanar spoiled gradient technique. The degree of tumor invasion was classified into four grades regarding a low-intensity band between the stomach and surrounding fat. Advanced gastric cancer was strongly enhanced, appearing as a thickened wall, by the contrast medium during the early to delayed phases of dynamic studies. The extent of invasion of the adjacent organs was diagnosed by the difference in enhancement between the tumor and the parenchyma. The sensitivity of extraserosal invasion was 93%. Dynamic MR diagnosis is useful for evaluating the extent of gastric carcinoma.

Adult↗

PubMedDate not supplied

MR imaging of cervical carcinoma: comparison among T2-weighted, dynamic, and postcontrast T1-weighted images with histopathological correlation.

BACKGROUND: To identify the reasons for misdiagnosis of the degree of stromal invasion by uterine cervical cancer with various magnetic resonance sequences. METHODS: T2-weighted, dynamic, and postcontrast T1-weighted images were obtained in the sagittal plane in 20 patients with uterine cervical cancer. After evaluating these sequences for the degree of stromal invasion, histologic specimens were directly correlated with these images. RESULTS: The degree of stromal invasion was correctly diagnosed in 15 of the 20 cases on T2-weighted images, in 12 on dynamic images, and in eight on postcontrast T1-weighted images. All misdiagnoses were due to overestimation. Histologically, peritumoral stroma showed inflammation or edema in two patients, whereas no histological abnormality was found in the other patients. A hyperintense rim, i.e. , a peritumoral enhanced ring-shaped structure, was observed on the enhanced images of five patients. The hyperintense rim corresponded to the periphery of the tumor in three patients and to the cervical stroma in two patients. CONCLUSION: T2-weighted images permitted the most accurate evaluation of stromal invasion by uterine tumors. Overdiagnosis may be due to an abnormal intensity of the cervical stroma, which was observed more frequently on dynamic and postcontrast T1-weighted images than on T2-weighted images.

Adult↗

PubMedDate not supplied

Optimal phases of dynamic CT for detecting hepatocellular carcinoma: evaluation of unenhanced and triple-phase images.

BACKGROUND: To determine the optimal phases of dynamic computed tomography (CT) for detecting hepatocellular carcinoma (HCC). METHODS: Fifty-two patients with 85 HCC nodules were examined by means of unenhanced and triple-phase CT images of the whole liver. The time for obtaining the arterial-phase images was 25-55 s after intravenous bolus injection of contrast material, the time for obtaining the portal venous-phase images was 65-100 s, and the time for obtaining late-phase images was 145 s to 4 min. Detectability of the HCC nodules for all phases was statistically compared. RESULTS: The detection rates for the arterial- and late-phase images were significantly higher than for the unenhanced and portal venous-phase images (p < 0.01). The combination of arterial- and late-phase images showed the same number of HCC nodules in the same number of patients as did the combination of unenhanced and triple-phase images. CONCLUSION: The combination of the arterial- and late-phase imagings was best for detecting HCC nodules.

Adult↗

PubMedDate not supplied

Detection of hypervascular hepatocellular carcinoma by dynamic MRI and dynamic spiral CT.

OBJECTIVE: Our goal was to evaluate the detectability of hypervascular hepatocellular carcinomas (HCCs) by multislice dynamic MRI and dynamic spiral CT. MATERIALS AND METHODS: Prior to transcatheter arterial chemoembolization (TACE) with iodized oil, the liver was subjected to T1- and T2-weighted SE-MRI, multislice dynamic MRI after intravenous bolus injection of Gd-DTPA, early phase imaging with spiral CT (dynamic spiral CT) after intravenous bolus injection of contrast medium (at a rate of 2 or 3 ml/s), and delayed phase CT in 64 patients with 208 HCC nodules. The detectability of HCCs by MRI and CT was evaluated retrospectively compared with CT after TACE as a gold standard. RESULTS: The detectability of nodules < 1 cm in diameter was superior with dynamic MRI (67%) and dynamic spiral CT (50%) in comparison with SE-MRI (26%) and delayed phase CT (11%) (p < 0.01). The detectability of these tumors with dynamic MRI was significantly superior to that with dynamic spiral CT using an injection rate of 2 ml/s (p < 0.01), but not significantly different from that of dynamic spiral CT using a rate of 3 ml/s. CONCLUSION: Dynamic MRI and dynamic spiral CT are comparable for detecting hypervascular intrahepatic metastases of HCC.

Adult↗

PubMedDate not supplied

Helical CT angiography of living renal donors: comparison with 3D Fourier transformation phase contrast MRA.

PURPOSE: The purpose of this study was to determine whether helical CT angiography (CTA) or MR angiography (MRA) is the optimal method to use as a preoperative examination for anatomic arterial assessment of living renal donors. METHOD: Eighteen candidates to be renal donors underwent helical CTA, 3D Fourier transformation phase contrast (3D-FT-PC) MRA, and digital subtraction angiography (DSA). The CTA and MRA were interpreted separately by three readers independently, and these results were correlated with the findings of DSA. RESULTS: DSA showed nine accessory renal arteries and 10 prehilar branches. CTA revealed seven or eight accessory renal arteries. MRA showed six or seven accessory arteries. Of 10 prehilar branches, 7-9 branches were detected with CTA and 5-8 branches with MRA. CONCLUSION: Helical CTA is superior to 3D-FT-PC MRA for evaluating the arterial anatomy of living renal donors.

Adult↗

PubMedDate not supplied

Sensitivity of double-phase helical CT during arterial portography for detection of hypervascular hepatocellular carcinoma.

PURPOSE: The purpose of our work was to determine the usefulness of double-phase helical CT during arterial portography (CTAP) for the detection of hypervascular hepatocellular carcinoma (HCC). METHOD: Eighty-four patients with 176 hypervascular HCC nodules underwent double-phase CTAP. Hypervascular HCCs were diagnosed by iodized oil CT after transcatheter arterial chemoembolization (TACE). The first-phase images were obtained 30 s after the initiation of injection of a nonionic iodinated contrast medium into the superior mesenteric artery or splenic artery, and the second-phase images were obtained after 70 s. These images were interpreted separately for detection of HCC. RESULTS: The double-phase CTAP detected two nodules and six nodules that were missed by the first- and second-phase images, respectively. The sensitivity for hypervascular HCC nodules was 89% for the first phase, 91% for the second phase, and 93% for the first phase and second phase combined. The double-phase CTAP showed significantly superior sensitivity to the first-phase CTAP for detecting HCC nodules (p < 0.05). However, there was no statistically significant difference between the sensitivities of the double-phase CTAP and the second-phase CTAP. The positive predictive values of the double-phase images were inferior to those of either the first-phase or the second-phase images alone. CONCLUSION: Double-phase helical CTAP was found to be no better than second-phase CTAP alone for the detection of hypervascular HCC nodules.

Adult↗

PubMedDate not supplied

C-reactive protein as an indicator of effect and of adverse reaction to transcatheter arterial embolization.

Serum C-reactive protein (sCRP) levels were measured before and after angiography and transcatheter arterial embolization (TAE) in 25 patients (four angiography, 21 TAE for hepatocellular carcinoma) to examine the correlation of sCRP to patients' reaction to TAE and the efficacy of TAE. Four patients without TAE showed little elevation of sCRP. Twenty-one patients with TAE showed a significant increase in sCRP. Peak levels of sCRP in the patients who achieved partial response were higher than those of the no-change group after TAE (p = 0.005). Peak sCRP levels of patients who showed an adverse reaction to TAE were higher than those of patients with no adverse reaction (p = 0.02). Increased sCRP after TAE reflects not only the degree of untoward reaction but also the effectiveness of TAE. Therefore, measurement of sCRP may be a useful means to assess the effect of TAE.

Aged↗

PubMedDate not supplied

Renal cortical retention of contrast medium after angiography as assessed by delayed CT: a multivariate analysis.

Renal cortical retention (RCR) of contrast medium discovered by delayed X-ray examination is sometimes reported in patients with problems in the urinary system. However, we frequently found RCR even in patients with normal renal function. Therefore, we examined the incidence and factors involved in RCR by delayed computed tomography (CT) 12-24 hours after angiography in 168 patients. RCR was found in 80 of 168 cases (48%). Ioxaglate (60%) and iohexol (60%) showed higher incidences of RCR than diatrizoate (37%) and iopamidol (37%). Multivariate logistic regression analysis was performed to determine the predisposing factors of RCR. Dose of administered contrast medium by body weight (p = 0.004), age (p = 0.009), sex (p = 0.013), type of contrast medium (p = 0.003), serum albumin (p = 0.011), and serum creatinine (p = 0.002) were identified as significant and independent predisposing factors of RCR. We suggest that RCR is not a rare phenomenon if delayed CT is carried out.

Adolescent↗

PubMedDate not supplied

Delayed vs. immediate adverse reactions to ionic and non-ionic low-osmolality contrast media.

PURPOSE: To evaluate the correlation between immediate and delayed adverse reactions to low-osmolality ionic and non-ionic contrast media. MATERIALS AND METHODS: A comparative survey of 984 consecutive patients was performed using contrast enhanced CT examination; 472 patients were administered ioxaglate, 512 iopamidol. The immediate adverse reactions were recorded during and after completion of the injection, and delayed reactions were surveyed by questionnaire. Delayed reactions were analyzed in 242 patients of the ioxaglate group and 215 of the iopamidol group from whom questionnaires were returned. The incidence of delayed adverse reactions was evaluated in comparison with immediate reactions. RESULTS: The incidence of immediate reactions in the iopamidol group (6.4%) was lower than that in the ioxaglate group (23.9%) (p < 0.01). There was no statistically significant difference in delayed reactions between the two groups: 16.5% for ioxaglate vs. 14.9% for iopamidol. History of allergy was relatively highly correlated with the incidence of delayed reactions in the ioxaglate group, but not in the iopamidol group. Thirty-two of 40 ioxaglate cases and all of the iopamidol group who reported delayed reactions were without immediate reactions. CONCLUSION: It is not possible to predict delayed reaction on the basis of a history of allergy or manifestation of a preexisting immediate reaction.

Contrast Media↗

PubMedDate not supplied

Heparin induces rapid and remarkable elevation of hepatocyte growth factor/scatter factor during trans arterial embolization of renal cell carcinoma.

BACKGROUND: Our aim was to determined the change of serum hepatocyte growth factorl scatter factor (HGF) before and after transarterial embolization (TAE) for renal cell carcinoma (RCC). MATERIALS AND METHODS: We examined serum HGF levels in two patients. RESULTS: Serum HGF levels rapidly increased to six-fold higher levels immediately after heparin-injection even before embolization. Serum HGF then decreased to below 1.0 ng/ml at 6 hours after the procedure. The second peak (a two-fold increase) appeared 1-3 days after TACE. The first increase may have been due to the injection of heparin which releases HGF from the cell-surface and extracellular matrix. HGF is a pleiotropic cytokine which has a potential to enhance cell motility and angiogenesis related to tumor progression and the first larger elevation of serum HGF is enough to make a physiological effects. CONCLUSION: Therefore, we should remind the physiological influence of heparin injection not only to prevent of clotting.

Aged↗