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  • 1
    ISSN: 1432-086X
    Keywords: Key words: Alcohol〈+〉—〈+〉Liver neoplasms〈+〉—〈+〉US interventional procedures〈+〉—〈+〉Hepatocellular carcinoma〈+〉—〈+〉Liver cirrhosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To verify the efficacy of ultrasound (US)-guided injection of large amounts of ethanol into large or multiple liver lesions, in a single session under general anesthesia (one-shot PEI) for percutaneous ablation of hepatic tumors. Methods: Twenty-nine patients (27 with 51 hepatocellular carcinoma (HCC) nodules on cirrhosis, diameter range 1.0〈+〉–〈+〉9.0 cm; two patients with a single metastasis from the gastroenteric tract, 5.0 and 9.0 cm, respectively, in diameter) were treated with one-shot PEI. Results: The total volume of alcohol delivered per patient ranged from 16 to 210 ml. Mean ethanol volume in all patients was 49 ml. Dynamic computed tomography (CT) examination showed complete necrosis in 41 of 50 lesions. Two patients died of hypovolemic shock due to massive upper gastrointestinal bleeding, 3 and 7 days, respectively, after the interventional procedure. All the remaining patients are alive (follow-up 5〈+〉–〈+〉14 months) except one who died of liver failure 5 months after. New HCC nodules occurred in six patients within 6 months and one intralesional relapse was recorded. Conclusion: In this preliminary experience, one-shot PEI is as effective in inducing liver tumor necrosis as traditional PEI; its advantages are shorter treatment time and the capability of treating larger and multiple liver lesions.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1438-1435
    Keywords: Blunt abdominal trauma, adults ; Blunt abdominal trauma, CT ; Shock, CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical charts and contrast mediumenhanced computed tomographic (CT) examinations of 15 adults with a history of serious shock and resuscitation were reviewed. Several hypovolemia-related abnormalities were recognizable and were variably associated with each other. Diminished caliber of the abdominal vessels with intense vascular contrast medium enhancement and renal abnormalities were the most common findings; decreased and/or increased enhancement of the abdominal organs and other hypovolemic changes were also present. Most of the series in the radiologic literature describe findings in pediatric subjects, but the various vascular and extravascular CT findings with regard to shock in adults may be different from those reported in children. Although the diagnosis of shock is based on clinical signs, hypovolemia-related CT abnormalities must be distinguished from organic lesions. CT may also identify a previously unsuspected shock state.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1438-1435
    Keywords: Key words Hepatic lymphedema ; CT ; Hemopericardium ; CT ; Aneurysm ; rupture ; Aorta ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To correlate computed tomography (CT) findings with clinical-pathologic results and discuss the possible significance of periportal hypodensity in patients with clinical cardiac tamponade secondary to acute proximal thoracic aortic dissection, aneurysm, or heart rupture. Materials and methods: In a retrospective review of thoracoabdominal CT scans and records of 17 consecutive patients with hemopericardium, 10 patients with clinical signs of cardiac tamponade associated with hypodensity around the portal vein were selected; at surgery or autopsy all 10 patients had a thoracic aortic aneurysm, dissecting aneurysm, and heart rupture. The ratio of transverse inferior vena cava diameter to the diameter of the aorta at the level of the right adrenal gland was determined. Results: Abdominal CT scans showed focal (n = 1) or diffuse (n = 9) areas of hypodensity around the portal vein associated with pericaval hypodensity in four cases. Other abdominal abnormalities included persistent enhancement of renal parenchyma (n = 5), and gallbladder wall edema (n = 2); in nine cases the inferior vena cava diameter was significantly increased compared with that of patients with normal findings on CT scans (P 〈 0.01). Pathologic correlation, available in nine cases by autopsy, showed evidence of periportal lymphatic vessel dilatation and lymphedema. Conclusions: Periportal hypodensity on CT scans corresponds to the histopathologic picture of dilated lymphatic vessels or hepatic lymphedema; a diagnosis of hepatic lymphedema may be considered on the basis of CT scans in patients with pericardial effusion.
    Type of Medium: Electronic Resource
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