, Min Jeong Kim, Seung Yon Baek To evaluate MRI findings of non-recurrent hepatocellular carcinomas with lipiodol uptake (LHCCs) treated with transarterial chemoembolization.
28 LHCCs were divided into two groups according to amount of lipiodol uptake and tumor size, retrospectively. According to amount of lipiodol uptake, HCCs were classified into group A with dense lipiodol uptake (more than 90%) and group B with partial lipiodol uptake (between 50% and 90%). For HCC size analysis, group I was defined by a longest diameter of less than 2 cm, and group II was defined by a longest diameter of greater than or equal to 2 cm.
In group A (n=16), eight LHCCs showed high signal intensity (SI) on T2-weighted images (T2WI), ten LHCCs showed low SI on T1-weighted imaged (T1WI), six LHCCs showed decreased SI at higher b value of diffusion-weighted images (DWI). In group B (n=12), six LHCCs revealed high SI on T2WI, six LHCCs revealed low SI on T1WI, ten LHCCs decreased SI at higher b value of DWI. As compared with tumor size and SI, six of 12 LHCCs in group I and eight of 16 LHCCs in group II showed high SI on T2WI. Six LHCCs in group I and ten LHCCs in group II showed low SI on T1WI. All LHCCs were not enhanced.
Signal intensities of LHCCs were variable, but more than half of LHCCs showed high SI on T2WI, low SI on T1WI, decreased SI at higher
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To compare fast spin echo(FSE) T2WI of the body coil(BC) with FSE T2WI of the endorectal surface coil(ERC) in the evaluation of parametrial and vaginal invasion and to evaluate tue dynamic enhanced images on the aspect of parametrial invasion.
Twenty consecutive patients of uterine cervical carcinomas confirmed by biopsy were included in this study and staging was determined by the surgery (2 cases) and the radiologic and clinical studies(18 cases). 1.5T Signa(GE,USA) was used and FSE T2-weighted axial and sagittal images were obtained by the body coil and endorectal surface coil respectively. Then dynamic enhanced axial images with FMPSPGR were performed at 2-3 slices of cervical cancer level. Parametrial and vaginal invasion on the body coil images were compared with those on the endorectal coil images retrospectively. Parametrial enhancement was evaluated on the dynamic enhanced images.
The accuracy of parametrial invasion was 100% of BC and 60% of ERC in 5 cases below stage Ib, 64% of BC and 73% of ERG in 11 cases of stage IIb and IIIa, 100% of BC and ERC in 4 cases above stage IVa. Overall accuracy of parametrial invasion was 80% of Bc and 75% of ERC without significant difference between two images. The accuracy of vagianl invasion was 80% of BC and 100% of ERC below stage Ib, 100% of BC and ERC above stage IIb. Overall accuracy of vaginal invasion was 95% of BC and 100% of ERC without difference between two images. On the dynamic enhanced images, parametrial enhancement was seen in all 20 cases and vascular enhancement in the parametrium was noted in 9 pf 20(45%) cases regardless of parametrial invasion.
There was no difference between BC and ERC images to evaluate the accuracy of parametrial and vaginal invasion. Therefore, ERC should be used in the cases which revealed suspicious invasion on BC images. Dynamic-enhanced images were not useful in the evaluation of parametrial invasion.
, Kyung Ja Lee, Chung Sik Rhee Cis-DDP has been used as a radiosensitizer in combination treatment modality far malignanttumors, of which mechanism is uncertain. The efects of combined Cis-DDP and irradiationon number of tumors have been studied in vitro and in vivo. The effects of combined Cis-DDP and irradiation on the liver are important because the liver is a radiosensitive organand frequently exposed to irradiation during treatment for intra-abdominal malignancies. Butthe studies of combined Cis-DDP and irradiation on the liver have not been reported.
So, this study was peformed to see the effect of Cis-DDP in combination with radiationon the liver. Total 66 Sprague-Dawley rats were divided into 5 groups; control, Cis-DDP(2.5mg/kg) administration, radiation(6, 8, lOGy, respectively), and combined Cis-DDP and radia-tion. which consisted of pre- and post-administration of Cis-DDP. Light and electron microscopic examination was performed 30 days after each experiments.
Cis-DDP administration induced mild congestion and focal hemorrhage in hepatic lobuleswith focal necrosis and degeneration of hepatocytes. Electron microscopic examination showedirregular cytoplasmic organelles and chromatin clumping in hepatocytes. In radiation treatmentgroup. hemorrhage of hepatic lobules, necrosis and degeneration of hepatocytes, edema andinflammation in portal tracts were aggravated with increased dosage of radiation. Hepatic lobulardisarray and inflammatory cell infiltration in portal tracts were noted from 8 Gy radiation.Vacuoles and electron dense bodies as well as swollen mitochondria in hepatocytes were frequently noted on electron microscopic examination. With combined treatment all He light andelectron microscopic changes were more severe than radiation alone regardless of sequenceof Cis-DDP administration and lobular disarray and inflammation in portal tracts were startedto note with 6 Gy radiation. When the hepatic lobular disarray and inflammation in portaltracts were used as end-points. the enhancement ratio of Cis-DDP was 1.3 in normal rat livers.
To evaluate the efficacy of dual phase MDCT findings to differentiate gallbladder cancer from chronic cholecystitis.
Dual phase MDCT findings in 45 patients(GB cancer, n=18, chronic cholecystitis, n=27) were retrospectively reviewed. The thickness, contour, involved extent, single or double layered pattern of wall thickening, enhancement degree of wall, degree of intrahepatic(IHD) and extrahepatic duct(EHD) dilatation, and other associated findings were evaluated.
Mean wall thickness was 14.7mm in cancer, and 5.5mm in cholecystitis(p=0.00). Irregular wall thickening(p=0.00), high enhancement of single layer of wall on arterial phase (p=0.00), associated mass(p=0.00), dilatation of IHD(p=0.00) and EHD(p=0.00), invasion to liver(p=0.01), larger diameter of GB(p=0.03), and pericholecystic fat infiltration(p=0.05) were significant to cancer. Associated stone(p=0.00), diffuse wall thickening(p=0.03), iso or low enhancement of outer layer of wall on venous phase(p=0.05) were significant to cholecystitis.
High enhancement of single layer of wall on arterial phase was significant to differentiate GB cancer from chronic cholecystitis with ancillary findings on dual phase MDCT.
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