CBCTAP had sufficient image quality to detect almost all small HCC lesions compared to conventional CTAP and could depict approximately 89% of HCC nodules, including eight suboptimal lesions.

Iodized oil accumulation and retention in the hypovascular portion of early-stage HCC was frequently observed after ultraselective TACE, mainly in the hypovascular portion with decreased portal blood.

Abstract:Purpose: The present study aimed to distinguish between glioblastomas and primary central nervous system lymphomas (PCNSLs) using 1 H-Magnetic Resonance Spectroscopy (MRS), especially glutamate (Glu) / creatine (Cr) and Glu/Glu + glutamine (Gln) ratios.Materials and methods: A total of 46 patients (31 cases diagnosed with glioblastoma, 15with PCNSL) were examined by in vivo single-voxel proton 1 H-MRS with a 3-T MR imaging system. Differences in absolute concentration of Cr, choline/Cr, lipid (1.3ppm)/Cr, Glu+Gln/Cr, Glu /Cr, and Glu/Glu+Gln ratios among groups were evaluated with Mann-Whitney U test.Results: PCNSLs (3.408 ± 1.194 [standard deviation]) showed significantly higher Glu/Cr ratios as compared to glioblastomas (2.220 ± 0.942; P= 0.003) (Glu/Cr cutoff ratio of 2.509showed a sensitivity of 88% (7/8) and a specificity of 92% (22/24)), while glioblastomas (0.539 ± 0.098) showed significantly lower Glu/Glu+Gln ratios as compared to PCNSLs (0.728 ± 0.147; P<0.001) (Glu/Glu+Gln cutoff ratio of 0.558 showed a sensitivity of 69%(18/26) and a specificity of 100% (13/13)). And PCNSLs (1.101 ± 0.387) showed significantly higher Cho/Cr ratios as compared to glioblastomas (0.850 ± 0.465; P= 0.026). Conclusion:Glu/Cr, Glu/Glu+Gln, and Cho/Cr ratios may be useful in distinguishing (Figure 1d, 1e). The independent quantification of Glu and Gln can be considerably improved by moving from 1.5T to 3T.With regard to Glu+Gln, it has been reported that Glu+Gln/Cr ratios from contrast-enhancing regions do not differ significantly between glioblastomas and PCNSLs [2]. No differences inGlu or Gln alone in in vivo 1 H-MRS between them have been reported, to the extent that we could determine.On the other hand, it has been reported that in high-grade gliomas (World HealthOrganization grades III and IV), microdialysates in the tumor periphery consistently show significantly higher extracellular Glu relative to microdialysates in non-tumoral regions, unlike PCNSL [5]. And, high extracellular Glu has been noted to stimulate Gln synthetase and promote the synthesis of Gln from Glu in cultured astrocytes [6].Based on these reports, we hypothesized that in glioblastomas due to high extracellular Glu the synthesis of Gln from Glu would be promoted [6], and so Glu/Glu+Gln ratios might be lower than those in PCNSLs. The purpose of this study was to analyze the differences in the 1 H-MRS findings among glioblastomas and PCNSLs with special reference to Glu and Gln expression. Materials and Methods:Patients:This retrospective analysis of the data was approved by the institutional review board of our university. All patients gave informed consent prior to inclusion in this study. All patients Clinical parameters in the analyzed groups are summarized in Table 1. All tumors were confirmed histopathologically after preoperative diagnosis with magnetic resonance imaging (MRI) and 1 H-MRS, and were not subjected to biopsy, surgical resection, chemotherapy or radiation therapy before the preoperative diagnosis with MRI and 1 H-MRS. We...

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Transcatheter arterial chemoembolisation for hepatocellular carcinoma is widely carried out not only through the hepatic artery but also through the extrahepatic collateral pathways. Anatomically, there are many anastomoses between the hepatic artery and the extrahepatic collateral as well as among the extrahepatic collaterals. However, these anastomoses may not be shown on angiography because the anastomosing branches are too small. These anastomoses may not only interfere with effective control of hepatocellular carcinoma by transcatheter arterial chemoembolisation but also cause unexpected procedure-related complications. Therefore, radiologists should have sufficient knowledge of these underlying anastomoses. In this report, we present our angiographic images.

We present the case of a common hepatic artery aneurysm successfully treated with an endovascular stent-graft. Although the long-term usefulness of stent-graft placement is not confirmed, the favorable mid-term course in our patient suggests that stent-graft placement may be considered as the treatment of choice in selected cases with hepatic artery aneurysm.

We report the successful management of acute cholecystitis using cystic duct stent placement in 3 patients with inoperable malignant cystic duct obstruction (2 cholangiocarcinoma and 1 pancreatic carcinoma). All patients underwent stent placement in the bile duct, using an uncovered stent in 2 and a covered stent in 1, to relieve jaundice occurring 8-184 days (mean 120 days) before the development of acute cholecystitis. The occluded cystic duct was traversed by a microcatheter and a stent was implanted 4-17 days (mean 12 days) after cholecystostomy. Acute cholecystitis was improved after the procedure in all patients. Two patients died 3 and 10 months later, while 1 has survived without cholecystitis for 22 months after the procedure to date.

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