PURPOSE: Intrahepatic portal vein injuries secondary to blunt abdominal trauma are difficult to diagnose and can result in insidious bleeding. We aimed to compare computed tomography arterial portography (CTAP), reperfusion CTAP (rCTAP), and conventional computed tomography (CT) for diagnosing portal vein injuries after blunt hepatic trauma.
Lymphangiography and percutaneous embolization of injured lymphatics are minimally invasive and effective techniques for the diagnosis and treatment of thoracic and retroperitoneal lymphatic leaks. We present a 58-year-old man who had abdominal chylous collection developed after multiple abdominal surgeries. Retroperitoneal lymphatic duct leakage was detected by ultrasound-guided intranodal lymphangiography and treated successfully using computed tomography (CT)-guided transabdominal embolization with percutaneous N-butyl cyanoacrylate (NBCA) glue and percutaneous NBCA glue and coil embolization by directly catheterizing the leaking lymphatic channel through the chylous collection. To the best of our knowledge, this is the first report of a lymphatic leakage case treated by percutaneous direct catheterization and embolization of leaking lymphatic channels through the chylous fluid collection.
OBJECTIVE: The purpose of this article is to briefly describe the various techniques used for percutaneous ablation of breast cancer, their preliminary results, and their limitations. The techniques include thermotherapy (radiofrequency ablation, laser irradiation, microwave irradiation, and insonation with high-intensity focused ultrasound waves), cryotherapy, and irreversible electroporation.
OBJECTIVE: The objective of our study was to evaluate our experience with the use of endovascular treatments for superior mesenteric artery (SMA) pseudoaneurysms using covered stents.
OBJECTIVE: We performed balloon-occluded retrograde transvenous obliteration in three consecutive patients with small gastric varices without indwelling balloon catheter occlusion. Foam of 3% sodium tetradecyl sulfate mixed with iodized oil and room air was injected retrograde through the gastrorenal shunt, followed by a thick absorbable gelatin sponge (Gelfoam, Pfizer) plug under only 10-minute balloon occlusion.
OBJECTIVE: The objective of our study was to describe our technique and preliminary results of ultrasound-guided fine-needle aspiration (FNA) of indeterminate internal mammary (IM) lymph nodes in patients with a history of breast cancer.
OBJECTIVE: The purpose of this study was to determine which MRI features observed 24 hours after technically successful percutaneous cryoablation of liver tumors predict subsequent local tumor progression and to describe the evolution of imaging findings after cryoablation.
OBJECTIVE: The purpose of this study was to retrospectively compare the size of hepatocellular carcinoma (HCC) on images obtained using different MRI pulse sequences with the tumor size determined at pathologic evaluation of liver explant specimens.
Lower extremity deep venous disease is highly prevalent, economically burdensome, morbid, and debilitating. In selected situations, when associated with acute pulmonary embolus or limb-threatening venous ischemia, it can be fatal. This article reviews the interventional management of acute and chronic lower extremity deep venous disease. While many questions remain to be answered, substantial progress has been made in our understanding of the disease and how and when to intervene. Techniques have evolved to reduce bleeding and more efficiently remove acute thrombus. Endovascular recanalization in the setting of chronic venous disease has compared well against open surgery with much lower morbidity. Thus, this article seeks to comprehensively review the state of the art in the endovascular management of lower extremity deep venous disease.
Liver cirrhosis is defined pathologically as fibrosis and inflammation of the liver, which is mainly caused by chronic hepatitis B virus infection, chronic hepatitis C virus infection, nonalcoholic steatohepatitis, nonalcoholic fatty liver disease, and chronic alcohol abuse. It is known to lead to metabolic hepatic failure, as well as portal hypertension. The population of patients with cirrhosis has been observed to be growing, along with increased incidence of hepatitis C virus infections and increased detection of nonalcoholic steatohepatitis or nonalcoholic fatty liver disease.
Bolus-chase contrast material–enhanced magnetic resonance (MR) angiography is commonly used to image peripheral arterial disease throughout the lower extremities. Since its introduction 15 years ago, bolus-chase MR angiography has continued to evolve, with technical advancements that have improved imaging efficiency, spatiotemporal resolution, and acquisition timing. Current techniques use station-specific imaging parameters, parallel imaging with an acceleration factor as high as R of 4, patient-specific and physiologically based imaging parameters, and often, hybrid techniques to acquire time-resolved images at the most distal station before the bolus-chase runoff. These and other technical developments have made bolus-chase MR angiography a competitive alternative to other modalities such as computed tomographic (CT) angiography and digital subtraction angiography.
Endovascular aortic aneurism repair (EVAR) has become a widely used treatment for abdominal aortic aneurysm. Short-to-midterm results after EVAR have shown lower 30-day perioperative mortality and almost the same short-to-midterm (1–3-year) morbidity and mortality as those of open surgical repair. Although the results of randomized clinical trials have shown no significant differences in long-term outcomes over 5 years when compared with surgical repair, frequent graft-related complications have been reported to be associated with repeat intervention 5 years after EVAR.
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third most prevalent cause of tumor-related death. Portal vein tumor thrombus (PVTT) occurs in up to 44% of patients with HCC at the time of death and approximately 10%–40% of patients at the time of diagnosis. PVTT has a profound adverse effect on prognosis, with a very short median survival time (2–4 months). The presence of PVTT also limits treatment options, such as liver transplantation and curative resection. The optimal treatment for patients with HCC and PVTT remains largely controversial.
Ectopic varices are unusual with portal hypertension and can involve any site along the digestive tract outside the gastroesophageal region. Hemorrhage from ectopic varices generally are massive and life threatening. Diagnosis of ectopic varices is difficult and subsequent treatment is also difficult; the optimal treatment has not been established. Recently, interventional radiology and endoscopic treatments have been carried out successfully for hemorrhage from ectopic varices.
Hepatocellular carcinoma (HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosis is determined by several factors; tumour extension, alpha-fetoprotein (AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient’s performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound (US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography (CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.
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