Two patients with mixed hepatocellular and cholangiocellular carcinoma underwent partial hepatectomy after magnetic resonance (MR) imaging. Correlation is made with the histopathologic manifestations. In both cases the tumors showed relative low signal intensities on T1-weighted spin-echo (SE) images and high signal intensities on T2-weighted SE images. Dynamic MR imaging showed the enhancement from the periphery of the tumor to the inner area gradually and the enhancement continued into the delayed phase. With both cases fibrosis was marked in the inner area of the tumor compared to the peripheral area. The extent and degree of fibrotic tissue is considered to reflect the enhancement on dynamic MR imaging.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Fatal septic complication of transcatheter chemoembolization for hepatocellular carcinoma.

A patient with hepatocellular carcinoma, associated segmental portal vein thrombosis, and accompanying pneumobilia, developed a liver abscess and sepsis following transcatheter chemoembolization (TCE). It was believed that the combination of bile duct necrosis after arterial occlusion and pneumobilia led to ascending enteric infection and seeding of the necrotic tumor, which ultimately led to fatal outcome. We conclude that TCE is contraindicated in such cases.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Retroperitoneal schwannomas simulating adrenal tumors.

Tumors in the area of the adrenal were detected by chance in two patients who underwent a regular physical check-up. On arteriography the tumors were found to be fed by the adrenal artery. The diagnosis was retroperitoneal schwannoma, but in both patients it was difficult to differentiate the schwannoma from an adrenal tumor preoperatively.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

Acalculous cholecystitis (panniculitis) associated with Weber-Christian disease.

Acalculous cholecystitis occurred in a patient with Weber-Christian disease. It reflected a panniculitis similar to that which developed in the orbit, abdominal cavity, and the retroperitoneal space.

Adolescent↗

PubMedDate not supplied

A simple single-tube procedure of PCR assay for the detection of hepatitis C virus RNA.

We developed a simple single tube procedure using the PCR (polymerase chain reaction) for the detection of hepatitis C virus RNA. The entire reaction from RNA extraction to PCR occurred in one tube; this was made possible by the use of more than 1,000 micrograms/ml of proteinase K for RNA extraction, instead of the acid-guanidinium thiocyanate-phenol-chloroform method. All necessary reagents were added to the tube, and PCR products were not removed from the tube until the end of PCR, although opening of the tube during the procedure could not be avoided. Therefore, cross-contamination which might theoretically take place during transfer of products between tubes never occurred. This method detected about 1 chimpanzee infectious dose of HCV in H strain plasma.

Base Sequence↗

PubMedDate not supplied

Differentiation between hepatoma and hemangioma with inversion-recovery snapshot FLASH MRI and Gd-DTPA.

Thirty-eight patients with focal liver tumors (20 hepatomas, 18 hemangiomas) were studied by dynamic sequential inversion recovery (IR) snapshot fast low angle shot (FLASH) MR imaging with Gd-DTPA. Immediately after 0.05 mmol/kg Gd-DTPA was administered intravenously for 2-3 s followed by flushing with normal saline for 4-5 s, 10 images were obtained in the first 20 s (time zero is the end of flush, early phase). Then, one image every 30 s from 1 to 3 min (late phase) and images at 5 min and 7 min (delayed phase) were obtained serially. Hepatomas showed total enhancement in 18 of 20 patients in the early phase, and isointense or low intensity enhancement with respect to the surrounding liver parenchyma in 18 patients in the late to delayed phases. Hemangiomas showed peripheral enhancement in 14 patients in the early phase, but did not show total enhancement (except for two hemangiomas less than 3 cm in size) in the early phase, and showed high intensity enhancement in 15 patients in the late phase. Ninety percent of hepatomas and 82% of hemangiomas showed their characteristic enhancement patterns in the early to delayed phases. We conclude that dynamic sequential IR snapshot FLASH MR images enhanced with Gd-DTPA can facilitate differentiation between hepatomas and hemangiomas.

Aged↗

PubMedDate not supplied

CT and MRI of siderotic regenerating nodules in hepatic cirrhosis.

The demonstration by CT of siderotic regenerating liver nodules in cirrhosis was evaluated and compared with that of MR imaging retrospectively in 27 patients with histologically diagnosed hepatic cirrhosis. Only in one of the two patients with marked iron deposits in regenerating nodules did CT demonstrate multiple high density nodules. In the other patient with marked iron deposits and in seven of the nine patients with moderate iron deposits, the liver parenchyma on CT was demonstrated as heterogeneous and of slightly high density without focal nodules. In 8 patients with mild to moderate iron deposits and in the 10 with no iron deposits, the liver parenchyma was homogeneous on CT. Multiple low intensity nodules in the liver were seen on fast low-angle shot (FLASH) MR images in all 17 patients with iron deposits in regenerating nodules. No low intensity nodules were seen on FLASH MR images in the 10 patients with no iron deposits. If there are iron deposits above a certain level, siderotic regenerating nodules may appear as nodules of high density on CT or as heterogeneous regions of high density liver parenchyma. Magnetic resonance is more sensitive than CT in demonstrating siderotic regenerating nodules.

Adult↗

PubMedDate not supplied

3DFT-FISP MRI with gadopentetate dimeglumine in differential diagnosis of small liver tumors.

OBJECTIVE: We assessed the value of dynamic sequential three-dimensional Fourier transformation (3DFT) MRI in differentiating various types of small liver tumors. MATERIALS AND METHODS: Forty-seven patients with 65 liver masses < 3 cm in size (42 hepatocellular carcinomas, 11 hemangiomas, 12 metastatic tumors) were studied by 3DFT fast imaging with steady-state precession (FISP) MRI [TR(ms)/TE(ms)/flip angle (degree): 20/8/30]. The slab thickness was 21-35 mm, and there were seven partitions. The 3DFT-FISP MR images were obtained immediately after 0.1 mmol/kg of gadopentetate dimeglumine was administered intravenously over 2-3 s (early phase), 60 s after (late phase I), and 120 s after (late phase II). RESULTS: Eighty-six percent of small hepatocellular carcinomas showed hyperintense enhancement relative to the surrounding liver parenchyma and iso- or hypointense enhancement with or without capsular enhancement in the late phase. Eighty-two percent of small hemangiomas showed peripheral globular enhancement in the early phase and total hyperintense or peripheral enhancement in the late phases. Ninety-two percent of the small metastatic liver tumors showed doughnut-like ring enhancement in the early phase. CONCLUSION: By dynamic 3DFT-FISP MRI, we were able to accurately evaluate the hemodynamics and morphological findings of each type of small liver tumor.

Aged↗

PubMedDate not supplied

Loss of heterozygosity and analysis of mutation of p53 in hepatocellular carcinoma.

Thirty-six hepatocellular carcinoma (HCC) tissues obtained from 34 patients were classified according to histological diagnosis into six well-differentiated HCC, 20 moderately differentiated HCC and 10 poorly differentiated HCC. High molecular weight DNA was prepared from each tumour and the corresponding non-tumour tissue. Loss of heterozygosity (LOH) on chromosomes 4q, 5q, 10q, 11p, 16q, 17p, mutation of the p53 gene and polymorphism of intron 25 of the retinoblastoma (RB) gene were simultaneously analysed. The patients were composed of three cases of small HCC (the diameter of which was < 3 cm) and 31 cases of advanced HCC. Twenty-nine of 34 (85.3%) patients analysed had been exposed to hepatitis B virus and/or hepatitis C virus. The frequencies of LOH on seven chromosomes were 57.9% in 17p13.3, 45.1% in 17p, 45.1% in 11p, 41.9% in 5q, 41.9% in 16q24, 29.0% in 4q, 25.8% in 10q in advanced HCC (four of well differentiated, 18 of moderately differentiated and nine of poorly differentiated carcinoma). In contrast, LOH was observed on 4q, 5q, 16q and 17p in 33% (1/3) of the small HCC (two of well differentiated and one of moderately differentiated carcinoma). The mutation of the p53 genes and polymorphism of the RB gene were present in 25.8% (8/31) and 12.9% (4/31) of the advanced tumours, respectively, but the mutation was not found in small HCC. LOH on every chromosome and the p53 mutation were observed more frequently in more advanced tumours, and the genetic changes accumulated with the increase of the histopathological grade.(ABSTRACT TRUNCATED AT 250 WORDS)

Blotting, Southern↗

PubMedDate not supplied

Dynamic MR studies of hepatocellular carcinoma with portal vein tumor thrombosis.

Gd-DTPA enhanced dynamic MR studies were evaluated in six patients with hepatocellular carcinoma associated with portal vein tumor thrombus. The portal vein tumor thrombus was clearly visualized as a low intensity lesion. The hepatic segment supplied by the portal vein showed high intensity, probably due to decreased portal blood flow and compensatory arterial blood flow. Tumors located in this segment were shown as areas of relatively low intensity compared with segmental high intensity areas. Thus dynamic MR study was found to be a useful method for differentiating the tumor from the surrounding nontumorous tissue with decreased portal blood flow.

Adult↗

PubMedDate not supplied

Pancreatic angiography using balloon catheter occlusion and a vasoconstrictor.

When a vasoconstrictor (noradrenaline) was injected during occlusion of the common hepatic artery with a balloon catheter, the vasoconstrictor flowed only into the proper hepatic artery and constricted it. The balloon was immediately deflated and contrast medium injected into the common hepatic artery. The flow of the contrast medium into the gastroduodenal artery was then increased, clearly visualizing the entire pancreatic-duodenal arcade.

Angiography↗