Endoscopic submucosal dissection is a promising technique for the treatment of colorectal tumors, giving an excellent outcome in comparison with EMR.

Objective: To determine the eŠect of simultaneous use of respiratory triggering in hepatic diŠusion-weighted imaging (DWI), we compared DWI with respiratory triggering (RT-DWI) and DWI under free breathing (FB-DWI) in terms of relative contrast between hepatic tumor and surrounding liver parenchyma, apparent diŠusion coe‹cient (ADC) measurement, and frequency of respiratory misregistration. Materials and Methods: Thirty patients (21 men, 9 women, aged 25 to 80 years) with liver metastasis or hepatocellular carcinoma in the right hepatic lobe were examined with RT-and FB-DWI. In patients having multiple tumors, up to 3 lesions were selected by mutual agreement of 2 diagnostic radiologists. Finally, 59 nodules were selected for evaluation. Relative contrast ratio (RCR) between the lesions and surrounding parenchyma and ADC were measured in each hepatic lesion in each sequence. The diŠerences in RCR and ADC between RT-and FB-DWI were statistically analyzed using Wilcoxon's signed rank test. The frequency of respiratory misregistration advents in each sequence was visually evaluated by the 2 diagnostic radiologists and assessed using McNemar's test.Results: RCRs were signiˆcantly higher in RT-than in FB-DWI (Pº0.001). The diŠer-ence in ADC between the 2 sequences was not signiˆcant. However, ADCs tended to be more scattered in FB-than in RT-DWI. The frequency of respiratory misregistration advents was signiˆcantly higher in FB-than in RT-DWI.Conclusion: FB-was inferior to RT-DWI in both contrast between tumors and surrounding liver parenchyma and in accuracy of ADC measurement as far as the numbers of excitation in each sequence were the same. For preoperative examination of hepatic resection, RT-is more suitable than FB-DWI.

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ADC measurement of the left hepatic lobe was far more incorrect than that of the right lobe if cardiac gating was not employed. The administration of Buscopan worsened the image quality of the left lobe and made visual evaluation difficult.

We report clinical characteristics and CT and MRI in 16 patients with brain metastases due to hepatocellular carcinoma (HCC). Eight of these 16 patients presented with apoplexy-like symptoms (50%). Pulmonary metastases were found in 13 cases (81.3%). The mean survival from the appearance of cerebral metastases to death was 6.2 weeks, which is one of the shortest survival terms in metastatic brain tumours. Haemorrhagic brain metastases were observed in 14 patients (87.5%) with a tendency for the frequency of bleeding to increase in proportion to the size of the tumour. On both contrast-enhanced CT and MRI, metastatic brain tumours enhanced strongly, suggesting that brain metastases, like HCC, are also hypervascular. MRI is useful in evaluating brain metastases from HCC, especially in order to differentiate tumour from haemorrhage. Our results demonstrated a poor prognosis and bleeding tendency of brain metastases due to HCC and showed the usefulness of CT and MRI in achieving a correct diagnosis.