Biomedical subjects

Yasuhiro Kawamori

Publications and source records attributed to Yasuhiro Kawamori.

4 recordsLinked to original sources

PubMed2002

Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material.

PURPOSE: To analyze the correlation between intranodular blood supply of borderline lesions (ie, dysplastic nodules or hypovascular well-differentiated hepatocellular carcinoma [HCC] nodules) and their progression to hypervascular classic HCC in cirrhotic livers. MATERIALS AND METHODS: One hundred seventy-six borderline lesions seen at computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) were evaluated in 49 patients with cirrhosis who underwent repeated CTAP and/or CTHA but no therapy. On the basis of CTAP findings, nodules were categorized as group A (showing almost the same portal venous supply as the surrounding liver), group B (showing decreased portal venous supply) or group C (showing partially absent portal venous supply); on the basis of CTHA findings, nodules were categorized as group I (showing almost the same arterial supply as the liver), group II (showing decreased arterial supply), or group III (showing partially increased arterial supply). RESULTS: Progression to classic HCC was observed in 29.4% of group A nodules, 53.9% of group B nodules, and 87.9% of group C nodules within 1,000 days; in 58.6% of group I nodules, 12.9% of group II nodules, and 92.2% of group III nodules within 730 days; and in 0% of nodules in group A and I, 28% of nodules in group B and/or II, and 88.7% of nodules in group C and/or III within 730 days. CONCLUSION: Evaluation of intranodular blood supply was valuable in predicting the prognosis in borderline lesions, except when only arterial blood supply was evaluated.

Adult↗

PubMedDate not supplied

Bronchial artery aneurysm embolization with NBCA.

We present a case of asymptomatic bronchial artery aneurysm that formed a fistula with part of the pulmonary artery (there was no definite fistula with the pulmonary vein). We were able to catheterize the feeding vessel but could not reach the aneurysm. We therefore injected a mixture of N-butyl-2-cyanoacrylate (NBCA; Histoacryl, B. Braun, Melsungen, Germany) and iodized oil (Lipiodol; Guerbet, Aulnay-sous-Bois, France) from the feeding vessel. The fistula, aneurysm, and feeding vessel were almost totally occluded. After embolization, the patient coughed a little; there were no other definite side effects or complications. One and 3 months later, on chest CT, the aneurysm was almost completely occupied with hyperattenuating NBCA-Lipiodol embolization. NBCA is a liquid embolization material whose time to coagulation after injection can be controlled by diluting it with Lipiodol. It is therefore possible to embolize an aneurysm, feeding vessels, and efferent vessels (in our case, it was a fistula) by using an NBCA-Lipiodol mixture of an appropriate concentration, regardless of whether the catheter can reach the aneurysm or not.

Adult↗

PubMedDate not supplied

Peritumoral rim enhancement of liver metastasis: hemodynamics observed on single-level dynamic CT during hepatic arteriography and histopathologic correlation.

PURPOSE: The purpose of this work was to clarify the mechanism of peritumoral rim enhancement of metastatic liver cancer. METHOD: Twenty-nine liver metastases of colon cancer were examined by single-level dynamic CT during hepatic arteriography, which was performed without table feed. We analyzed these findings and correlated them with the histopathologic findings. RESULTS: Eleven metastases were hypervascular and 18 were hypovascular. Early appearance of rim enhancement was seen in 3 of 10 hypervascular metastases and 17 of 18 hypovascular metastases (p < 0.01). The time of appearance and thickness of peritumoral rim enhancement showed no apparent correlation with the desmoplastic reaction or inflammation in the surrounding hepatic parenchyma. CONCLUSION: Two types of intra- and peritumoral enhancement were observed. Peritumoral rim enhancement was considered to be due mainly to the drainage of blood flow from the tumor to the surrounding hepatic parenchyma in hypervascular metastasis or increased arterioportal shunts surrounding the tumor in hypovascular metastasis.

Angiography↗

PubMedDate not supplied

Prevention of hepatic infarction as acute-phase complication of TIPS by temporary balloon occlusion in a patient with primary myelofibrosis.

Severe acute liver dysfunction occurred following transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with massive ascites due to portal hypertension associated with primary myelofibrosis. On US and TIPS venography, we considered that the acute liver ischemia was induced by TIPS. To avoid diffuse hepatic infarction and irreversible liver damage, a balloon catheter was inserted transjugularly into the TIPS tract and occluded it to increase portal venous flow toward the peripheral liver parenchyma. The laboratory data indicating hepatic dysfunction were improved after the procedure. We should pay attention to the possible occurrence of acute hepatic ischemia and infarction after TIPS creation even in a case of noncirrhotic portal hypertension. In such cases, temporary balloon occlusion of TIPS is an effective therapeutic method, probably as a result of inducing the development of arterial compensation through the peribiliary plexus.

Acute-Phase Reaction↗