[Diagnosis of hepatocellular carcinomas using CT arterial portography].
Explore the source record for details and available documents.
Carcinoma, Hepatocellular↗
Biomedical subjects
J Yoshikawa
Publications and source records attributed to J Yoshikawa.
[Angiography in the early diagnosis of cholangiocarcinoma].
Explore the source record for details and available documents.
Adenoma, Bile Duct↗
Valvular regurgitation in heart-lung transplant recipients: a Doppler color flow study.
To assess the frequency and degree of valvular regurgitation in combined heart and lung transplant recipients, 50 patients were investigated using Doppler color flow echocardiography 20 to 909 days (mean 369) after heart-lung transplantation. The mean age (+/- SD) of the patients was 25 +/- 9 years. No patient had evidence of rejection at the time of the study. Fifty normal volunteers acted as control subjects. Tricuspid, mitral and pulmonary regurgitation were commonly observed in the patients undergoing heart-lung transplantation (78%, 52% and 68%, respectively), but were not significantly more frequent than in the normal subjects (68%, 42% and 70%, respectively). Aortic regurgitation was uncommon in both groups (4% and 2%, respectively). However, tricuspid and mitral regurgitant jet areas were significantly greater (p less than 0.01) in heart-lung transplant recipients than in normal subjects (156 +/- 120 and 84 +/- 52 mm2 compared with 40 +/- 38 and 28 +/- 26 mm2, respectively); pulmonary regurgitant jet area was not significantly different in the two groups (32 +/- 26 and 28 +/- 26 mm2, respectively). Regurgitant jet area was not significantly correlated with patient or donor age, donor organ total ischemic time, time after operation, use of steroids for immunosuppression or total number of rejection episodes. These results show that valvular regurgitation is not significantly more frequent after heart-lung transplantation than in normal subjects, but atrioventricular (AV) valve regurgitation, when present, is significantly greater in degree. This suggests that the degree but not the frequency of AV valve regurgitation is related to transplantation.
Adolescent↗
Direct visualization of ruptured chordae tendineae by transesophageal two-dimensional echocardiography.
To determine the value of transesophageal echocardiography in the detection of ruptured chordae tendineae, 28 patients who had surgical therapy for pure mitral regurgitation were evaluated prospectively by conventional transthoracic and transesophageal two-dimensional echocardiography. Seventeen patients (Group I) had ruptured chordae tendineae and 11 (Group II) had intact chordae tendineae. Transthoracic echocardiography detected ruptured chordae tendineae in 6 patients from Group I (sensitivity 35%) and flail leaflets in 11 patients from Group I (sensitivity 65%). Transesophageal echocardiography disclosed ruptured chordae tendineae in all 17 Group I patients (sensitivity 100%); the sensitivity was significantly higher than that of transthoracic echocardiography. No abnormal chordal echoes were visualized in any patient from Group II by either transthoracic or transesophageal echocardiography (specificity 100%). Transesophageal echocardiography is a highly sensitive method for detecting ruptured chordae tendineae and is superior to transthoracic echocardiography in establishing its diagnosis.
Chordae Tendineae↗
Surgical treatment for paraplegia resulting from vertebral fractures in senile osteoporosis.
Seven extremely rare cases of paraplegia secondary to senile osteoporotic vertebral compression fractures were treated by posterior decompression followed by Harrington rod stabilization. This approach not only ensures more satisfactory decompression, but also facilitates early mobilization and rehabilitation. The follow-up period ranged from 1 year to 3 years, 3 months (average, 24.7 months); in all seven cases a substantial overall improvement was achieved. This report demonstrates that an osteoporotic vertebral body fracture can cause a cord compression, and emphasizes the effectiveness and importance of early surgical treatment.
Aged↗
Ciliated hepatic foregut cyst: radiologic features.
Ciliated hepatic foregut cysts (CHFCs) are solitary unilocular cysts in the liver that are histologically similar to bronchogenic cysts. Three cases of CHFC are reported that demonstrated radiologic features similar to those of solid masses. All the lesions were smaller than 3 cm in diameter and were subcapsular. At ultrasonography, one lesion appeared anechoic but the other two were hypoechoic. Unenhanced computed tomography demonstrated the lesions to be hyperattenuating or isoattenuating relative to surrounding liver parenchyma, and no lesions enhanced with administration of contrast material. Magnetic resonance imaging was performed in one case and demonstrated the lesion to be markedly hyperintense with a spin-echo (SE) 2,500/80 (repetition time msec/echo time msec) sequence. All the lesions were resected and found to be filled with viscous mucinous fluid. The CHFCs are not neoplasms and must be differentiated from cystic neoplasms and hypovascular solid tumors. When a subcapsular lesion demonstrated the varied appearance described, a diagnosis of CHFC should be considered.
Aged↗
Value of acceleration flows and regurgitant jet direction by color Doppler flow mapping in the evaluation of mitral valve prolapse.
To clarify the role of color Doppler echocardiography in the evaluation of mitral valve prolapse, we studied 49 consecutive patients in whom the sites of mitral valve prolapse were confirmed at the time of operation. The study group consisted of 22 patients with anterior leaflet prolapse, 24 patients with posterior leaflet prolapse, and three patients with multiple scallop prolapse (one patient with both anterior leaflet and middle scallop prolapse, and two patients with both medial and lateral scallop prolapse). Two-dimensional echocardiographic diagnosis of anterior leaflet prolapse was correct in all patients. The diagnosis of posterior leaflet prolapse by two-dimensional echocardiography, however, was mistaken as anterior leaflet prolapse in 16 (13 patients with medial scallop prolapse and three patients with lateral scallop prolapse) of the 24 patients according to current diagnostic criteria for mitral valve prolapse. Eight patients with middle scallop prolapse were diagnosed correctly by two-dimensional echocardiography. Acceleration flows in the left ventricle were observed by color Doppler echocardiography in all 49 patients. The sites of acceleration flows detected by color Doppler echocardiography coincided with those of prolapse confirmed in all at the time of operation. There was a significant correlation between the maximum area of acceleration flow signals and severity of mitral regurgitation estimated by angiography. In the 13 patients with medial scallop prolapse and the three patients with lateral scallop prolapse, a regurgitant jet originated from a bulged portion of the posterior leaflet and was directed toward the opposite left atrial cavity to the bulged portion by short-axis images of color Doppler echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)
Blood Flow Velocity↗
Detection of left main coronary artery stenosis by transesophageal color Doppler and two-dimensional echocardiography.
Although transthoracic two-dimensional echocardiography can detect dilation of the coronary arteries, the reliability of this technique in the detection of coronary artery stenosis is still doubtful. The purpose of this study was to test the ability of newly developed biplane transesophageal color Doppler and two-dimensional echocardiography in the detection of left main coronary artery stenosis. Blood flow in the left main coronary artery was detected in 57 of 67 (85%) patients by transesophageal color Doppler flow imaging. Using transesophageal two-dimensional echocardiography, adequate images of the full length of the left main coronary artery and identification of the bifurcation were obtained in 60 of 67 (90%) patients. Transesophageal echocardiography clearly showed significant (greater than or equal to 50%) narrowing of the coronary lumen in 10 of 11 patients (sensitivity, 91%) and insignificant narrowing or no abnormalities of the coronary lumen in the other 49 patients (specificity, 100%). The positive predictive accuracy for left main coronary artery disease was 100%, and the negative predictive accuracy was 98%. This preliminary study suggests that biplane transesophageal color Doppler and two-dimensional echocardiography appears to be a feasible noninvasive technique for imaging the left main coronary artery and detecting hemodynamically significant luminal obstruction.
Adult↗
Assessment of mitral regurgitation by biplane transesophageal color Doppler flow mapping.
To test the role of recently developed biplane transesophageal color Doppler echocardiography in the assessment of severity of mitral regurgitation, we examined 51 patients undergoing cardiac catheterization and left ventriculography. Transesophageal color Doppler flow imaging detected mitral regurgitation in all 32 patients proved to have this lesion. In 10 of 16 patients without mitral regurgitation by angiography, mitral regurgitation signals were detected by transesophageal color Doppler flow imaging. Thus, the sensitivity and specificity of transesophageal color Doppler echocardiography for the detection of mitral regurgitation were 100% and 38%, respectively. There was some correlation between the regurgitant jet area from the longitudinal plane and angiographic grading. An improved angiographic correlation was achieved with the regurgitant jet area from the transverse plane. The best correlation with angiography was obtained when the maximum regurgitant jet area from two planes (the greater of the two measurements, each from a different plane) was considered. There was a significant difference in the maximum regurgitant jet area between none and mild (p less than 0.01), mild and moderate (p less than 0.001), and moderate and severe (p less than 0.01) mitral regurgitation. The maximum regurgitant jet area of less than 1.5 cm2 predicted the angiographic grading as none with a sensitivity and specificity of 88% and 94%, respectively. The maximum regurgitant jet of between 1.5 and 4 cm2 predicted the angiographic grading as mild with a sensitivity and specificity of 82% and 95%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Value of transesophageal color Doppler echocardiography in the evaluation of coronary artery anatomy and blood flow.
The purpose of this study was to test the efficacy of newly developed biplane transesophageal color Doppler and two-dimensional echocardiography in the evaluation of coronary artery anatomy and blood flow. Using these two techniques, high quality images of the entire main left coronary artery (from the left coronary ostium to the bifurcation of the left anterior descending and circumflex coronary arteries), adequate for assessment of luminal diameter and percent stenosis, were obtained in 34 (89%) out of 38 patients. Transesophageal color Doppler echocardiography visualized coronary blood flow in 32 (84%) of the 38 patients. Transesophageal two-dimensional echocardiography clearly showed significant (50% of greater) narrowing of the coronary lumen in 10 out of 12 patients (sensitivity; 83%) and insignificant narrowing or no abnormalities of the coronary lumen in 23 of 26 normal individuals (specificity; 88%). This preliminary study suggests that biplane transesophageal color Doppler and two-dimensional echocardiography are feasible, noninvasive techniques for imaging the main left coronary artery and blood flow.
Adult↗
CT demonstration of calcification in an adenoid cystic carcinoma of the lung.
Explore the source record for details and available documents.
Adult↗
[Valve reconstruction for mitral regurgitation secondary to mitral valve prolapse].
This study was performed to evaluate the late results of mitral valve replacement for isolated mitral regurgitation and the early results of mitral valve reconstruction for mitral regurgitation secondary to mitral valve prolapse. Between January 1974 and March 1989, 106 patients underwent isolated mitral valve replacement for mitral regurgitation. There were 54 male and 52 female patients ranging in age at operation from 22 to 76 years (average: 50.2 years). Mitral valve replacement with the Carpentier-Edwards bioprosthesis was performed in 55 patients and with the Björk-Shiley disc valve in 51 patients. The follow-up period ranged from four to 182 months with a mean of 64 months. There were three hospital deaths (2.8%). The actuarial survival including hospital deaths were 94.0% at five years and 89.3% at 10 years. The event-free rate was 75.5% at five years and 51.8% at 10 years. There was no significant differences in these results between two prosthetic valve groups. Because of high incidence of prosthetic valve-related events, mitral valve reconstruction for mitral regurgitation was performed in recent two years. Twenty patients had mitral reconstructive surgery. There were 11 male and nine female patients ranging in age at operation from 22 to 70 years (average: 54.4 years). Two had elongated chordae and 18 had torn chordae (anterior leaflet; four cases, posterior leaflet; 14 cases). There was no hospital and late death. One had reoperation because of severe hemolysis.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Continuous aortic regurgitation in severely dysfunctional native hearts after heterotopic cardiac transplantation.
Doppler techniques were used to investigate the frequency and characteristics of aortic regurgitation (AR) in the severely deteriorated native heart after heterotopic cardiac transplantation. Ten patients were studied in whom the native left ventricular fractional shortening was less than 6%. AR was detected by Doppler in 6 patients. The AR was continuous throughout the cardiac cycle in 3 patients, continuous when present (but not occurring with every beat) in 2 patients and present throughout diastole and continued into midsystole in the remaining patient. AR was associated with abnormalities of aortic valve opening (either its complete or intermittent absence) and with poor forward flow and even reversed flow through the native heart. It is postulated that AR in this group mainly occurs as a result of abnormal locking of the aortic valve due to severely impaired left ventricular ejection. Abnormal left ventricular diastolic function and enlargement may also be contributory.
Adult↗
Temporal resolution of mitral regurgitation in patients with mitral valve prolapse: a phonocardiographic and Doppler echocardiographic study.
To assess the timing and duration of mitral regurgitation in mitral valve prolapse, 20 patients with a mid-systolic click or late systolic murmur, or both (Group 1) and 16 patients with a pansystolic murmur with late systolic accentuation (Group 2) were studied with phonocardiography and echocardiography including various Doppler techniques. The subjects' ages ranged from 15 to 73 years. Mitral valve prolapse with mitral regurgitation was observed in 15 of 20 patients in Group 1 and in all 16 patients in Group 2. M-mode Doppler color echocardiography demonstrated a mitral regurgitant signal throughout systole and isovolumic relaxation in all but 1 of these 31 patients regardless of the pattern of the systolic murmur. The regurgitant signal was recorded after the click in only one patient with mitral valve prolapse in Group 1. Two of the five patients in Group 1 without two-dimensional echocardiographic findings of mitral valve prolapse had the early systolic signal of mitral regurgitation. The timing and duration of the mitral regurgitant signal detected in patients in Group 1 with pulsed or continuous wave Doppler ultrasound varied with the site of the sample volume or beam direction. In the patients in Group 2, however, the signal was demonstrated throughout systole and isovolumic relaxation by both Doppler methods. Compared with M-mode Doppler color echocardiography, therefore, pulsed and continuous wave Doppler methods were less sensitive and thus inadequate to investigate the timing and duration of mitral regurgitation in mitral valve prolapse, especially in patients with a mid-systolic click or a late systolic murmur, or both, who had mild or eccentric mitral regurgitant jets.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Noninvasive diagnosis of coronary artery fistula by Doppler color flow mapping.
Sixteen patients with coronary artery fistula proved by coronary angiography or surgery were studied using two-dimensional echocardiography and Doppler color flow mapping. The coronary artery fistula drained into the right atrium in 4 patients, the right ventricle in 2 and the pulmonary artery in 10. The dilated coronary artery was visualized in 7 of the 16 patients with a fistula, as compared with none of the 40 control subjects. These 7 patients included 5 of 6 patients with a fistula draining into the right atrium or right ventricle and only 2 of 10 patients with a fistula draining into the pulmonary artery. Abnormal flow signals in the dilated coronary artery were visualized with Doppler color flow mapping in five of these seven patients. Color flow imaging visualized abnormal flow signals with mosaic appearance in the pulmonary artery in eight patients, the right atrium in four and the right ventricle in two. The chamber in which abnormal signals were detected corresponded with the entry site of the fistula by angiography. Intraoperative imaging during surgical repair was needed in two cases to confirm ligation of all arteries feeding into the fistula network. In conclusion, Doppler color flow imaging is diagnostically useful to visualize shunt flows originating from the opening or exit of a coronary artery fistula. Furthermore, intraoperative use of this technique may provide confirmation of successful surgical ligation of the fistula.
Adult↗
Intrahepatic periportal abnormal intensity on MR images: an indication of various hepatobiliary diseases.
The frequency and degree of intrahepatic periportal abnormal intensity (PAI) on magnetic resonance images in patients with or without various hepatobiliary and pancreatic diseases were analyzed. In 63 patients without hepatobiliary disease, except for a small metastatic liver tumor or cavernous hemangioma, no definite PAI was seen. Definite PAI was seen in all patients with obstructive jaundice, cholangitis, and cholangiocellular carcinoma. It was also clearly seen in all four cases of malignant lymphadenopathy in the hepatoduodenal ligament, in one of two cases of acute hepatitis, and in four of 47 cases of liver cirrhosis. However, in patients with bile duct dilatation or with gallstone or pancreatic disease without obstructive jaundice or cholangitis, no definite PAI was seen. Histologic studies of the liver performed in 23 patients with definite PAI showed edema, ductular proliferation, dilatation of lymph vessels, and inflammatory cell infiltration in portal tracts. It is concluded that definite intrahepatic PAI is a useful sign that indicates the presence of biliary or diffuse hepatic disease.
Adult↗
Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging.
Differentiation of hepatocellular carcinomas from adenomatous hyperplastic nodules (AHNs) is important for the early and precise detection of hepatocellular carcinoma in the cirrhotic liver. For this purpose, the authors compared findings on magnetic resonance (MR) images of surgically resected AHNs (n = 7) with those of hepatocellular carcinoma (n = 47). AHNs were divided into two histologic groups: those without atypia (n = 5) and those with atypical hepatocytes or malignant foci (n = 2). All AHNs without atypia were hyperintense on T1-weighted spin-echo images and hypointense on T2-weighted spin-echo images relative to the surrounding liver. However, almost all hepatocellular carcinomas, except for two lesions with massive coagulation necrosis, were demonstrated as hyperintense on T2-weighted images. MR imaging may be useful in the differentiation of AHN without atypia from hepatocellular carcinoma in the cirrhotic liver.
Carcinoma, Hepatocellular↗
Assessment of left-to-right atrial shunting after percutaneous mitral valvuloplasty by transesophageal color Doppler flow-mapping.
To evaluate left-to-right shunts after percutaneous balloon mitral valvuloplasty, we studied 15 consecutive patients by using transesophageal color Doppler flow-imaging system. Transesophageal color Doppler examinations were performed five times in each patient (before valvuloplasty and 1 day, 1 week, 1 month, and 6 months after valvuloplasty). No shunt flow was observed before valvuloplasty. On 1 day after mitral valvuloplasty, transesophageal color Doppler echocardiography demonstrated left-to-right shunts in 13 (87%) of 15 patients. However, a significant oxygen step-up was present in the right heart in only one patient. The mean diameter of the interatrial septal defect detected by transesophageal two-dimensional echocardiography was 1.8 +/- 1.0 mm. The mean velocity of left-to-right shunting flow measured by high-pulse repetition frequency Doppler technique was 0.83 +/- 0.38 m/sec. One week after the procedure, left-to-right shunt flow was detected in 11 (73%) patients. One month after valvuloplasty, left-to-right shunting flow was detected in seven (47%) of 15 patients. There was a significant decrease in the diameter of an interatrial septal defect between 1 day and 1 week (p less than 0.01), between 1 week and 1 month (p less than 0.01), and between 1 month and 6 months (p less than 0.05). Six months after valvuloplasty, left-to-right shunting flow remained in three (20%) patients. By using transthoracic color Doppler echocardiography, we detected left-to-right shunting flow in two patients on 1 day after the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗