Fifty-three patients who had hepatic tumors (24 hepatomas, ten metastases, and 19 cavernous hemangiomas) underwent MR imaging using a 0.35-T superconducting imager. The transverse relaxation time (T2) was calculated from a pair of spin echo images (repetition time [TR] of 1600 msec) with echo delay times (TE) of 35 and 70 msec. The computed T2 value was obtained in a fashion similar to that used to obtain CT numbers with region-of-interest cursors. The mean T2 was 59 +/- 9 msec in hepatomas, 64 +/- 15 msec in metastases, and 100 +/- 30 msec in hemangiomas. The difference between the T2 of hemangioma and that of liver malignancies was statistically significant (P less than .001); however, differentiation between hepatoma and metastases was not possible. The T2 was shorter than 80 msec in all 24 hepatomas and in nine of ten metastases, and was longer than 80 msec in 16 of 19 hemangiomas. Forty-nine of 53 cases (92%) were correctly classified when the borderline of T2 between hemangioma and hepatic malignancies was set at 80 msec. MR with T2 calculation was valuable in differentiating between hemangioma and hepatic malignancies.

Carcinoma, Hepatocellular↗

PubMed1985

Embolism detection and prevention using scintigraphy during therapeutic arterial blockade.

We describe an application of simple scintigraphic localization of therapeutic gelatin emboli during and after transcatheter arterial embolization using gelatin particles labeled with technetium 99m. This scintigraphy required an additional 15-30 minutes and can be useful for prevention of serious complications and for early detection of adverse embolisms.

Arteries↗

PubMed1985

Solitary renal hamartoma not associated with tuberous sclerosis: roles of CT and angiography.

CT and angiography of five solitary renal hamartomas not associated with tuberous sclerosis are reviewed. CT revealed fat in four hamartomas and was the more reliable in the differentiation from renal cancer. Bleeding from the tumour was detected in two cases and the extent of each haematoma was precisely determined by CT. Angiography showed specific findings in only one tumour. In a pararenal hamartoma, angiography was of value in clarifying the renal origin of the tumour. Though angiography may be of help when CT is inconclusive, we think it should not be relied upon as a major diagnostic tool and we utilise it mainly for preoperative mapping and embolisation. In one case CT did not detect fat and preoperative diagnosis was impossible. In one case with haematoma, detection of fat was difficult. We believe potential hamartomas with no detectable fat should be treated as malignancy until proved otherwise. There seems to be discrepancy between the vascularity of the hamartoma and the degree of contrast enhancement (CE) with a bolus injection method; hamartomas seem to show weaker CE than that expected for renal cancer of equal vascularity, a fact which may differentiate solitary hamartoma from cancer.

Adult↗

PubMed1985

Noninvasive diagnosis of small cavernous hemangioma of the liver: advantage of MRI.

Thirty-three lesions of small cavernous hemangioma of the liver under 3 cm in diameter detected by sonography, computed tomography (CT), or magnetic resonance imaging (MRI) were reviewed. Sonography detected 23 lesions, plain CT 15 out of 26, and MR 31, including one equivocal. On sonography, 18 of 23 revealed a strong, almost homogeneous hyperechoic mass without a rim. On CT, eight of 33 showed characteristic findings of hemangioma by contrast enhancement. On MRI, 26 of 31 appeared as a markedly high-intensity area, which was rarely the appearance of other hepatic tumors of similar size. Spin-spin relaxation time (T2) of hemangioma was prolonged over 80 msec in 15 of 18 while one of 20 lesions in patients with primary or secondary liver cancers under 3 cm showed T2 of 80 msec or more. MRI in addition to sonography and/or CT allowed detection of almost all cavernous hemangiomas over 1 cm in diameter and diagnosis with considerably high accuracy and specificity. MRI will play an important role in determination of necessity of further invasive diagnostic methods for patients with small liver tumors detected by sonography and/or CT.

Angiography↗

PubMed1985

Clinical diversity in adult T-cell leukemia-lymphoma.

Adult T-cell leukemia-lymphoma (ATL) is a unique T-cell cancer first described in Japan. We estimate that more than 200 patients a year have been detected in Kyushu. The surface phenotype of ATL cells characterized by monoclonal antibodies is T3+, T4+, T8-, T11+, and Tac+. In all cases the serum is positive for anti-human T-cell leukemia (lymphotropic) virus (HTLV-I) antibodies and the ATL cells contain the proviral DNA of HTLV-I. Variations in the clinical features of atypical cases suggest a division of the spectrum of ATL into five types: acute (prototypic), chronic, smoldering, crisis, and lymphoma. Screening of the sera from healthy adults for presence of the anti-HTLV-I antibodies revealed that 3.6% of healthy individuals in Kumamoto Prefecture, which is located in the middle of Kyushu, were HTLV-I carriers. The percentage of positivity increased with age and was higher in females than in males. It varied from town to town, ranging from 0 to 17.6%. Family studies showed that the routes of natural infection of HTLV-I are from mother to child and also from husband to wife. The third route is blood transfusion. The borderline between the healthy carrier state and smoldering ATL remains unclear. In the endemic areas smoldering ATL is frequently diagnosed in patients with fungus infection of the skin, chronic lymphadenopathy, interstitial pneumonitis, chronic renal failure, and strongyloidiasis. In addition our experiences with a concurrence of lymphoma-type ATL in three sisters and spontaneous remissions in a patient with chronic ATL are cited.

Adult↗

PubMed1985