• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.66-74
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• 2000

Background: During the follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. Methods: From March 1991 to March 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic methods at Yeungnam University hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months and, divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated for age, sex, child-pugh score, liver cirrhosis, and level of AFP. Results: Pulmonary metastasis was found in 18.0% (26/144), of which 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of the patients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. There was more likelihood for lung metastasis after TAE. but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. Conclusions: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. Child-pugh class was the only related clinical preciptating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-ups may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1216-1221
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• 2020

Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.62-68
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• 1994

This study was aimed to compare the density of the functional microcirculation of hepatocellular carcinoma (HCC) with normal liver and to investigate the effect of hepatic-arterial oily chemoembolization (HAE) by radionuclide examination. Methods : Eight patients with HCC proven by biopsy in five, and clinically and radiologically in three were included. The mixture of 2 cc normal saline with three to four mCi of $^{99m}Tc$-MAA was infused through a hepatic-arterial catheter for a minute. Dynamic images were obtained at a rate of 4 sec per frame for a minute, and static images and SPECT were followed. Results : In three patients who underwent hepatic arterial angiography (HAA) alone, radioactivity was markedly increased in tumors compared to the adjacent liver immediately after infusion of $^{99m}Tc$-MAA. The ratios of tumoral and extratumoral up-take (T/E ratio) were above 6.5 (range; $6.5{\sim}l9$, mean; 12.5). In four of the five patients who under-went superselective HAE, T/E ratio were remark-ably decreased ($0.5{\sim}1.3$). The areas of embolization were better delineated in radionuclide study than in postembolization HAA. In the other one who was considered to be embolized completely on HAA, strong radiouptake in the tumor was disclosed (T/E ratio; 7.0). Conclusions : Therefore hepatic-arterial flow study with radionuclide imaging using $^{99m}Tc$-MAA can be a valuable method to assess the accurate embolization effect in HCC.

• Proceedings of the Korean Society of Radiological Science
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• 2002.06b
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• pp.32.2-32.2
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• 2002

• 대한핵의학회:학술대회논문집
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• 1980.05a
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• pp.6.2-7
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• 1980

간장에 공간점유성병변(암, 농양, 낭종성병변, 혈종 등)이 있을 때는 정적간이미징에서 모두 냉구로 나타난다. 따라서 진단적 특이성이 없다. 그러나 감마카메라를 적절히 잘 이용하면 간암과 간농양을 쉽게 그리고 단시간내에 진단 및 감별할 수 있다. 즉 간암이나 간농양이 의심되는 환자에게 핵제제를 이용한 간동맥기에 열구로 나타나서 정맥기에도 계속 더 강한 열구로 나타내게 되며 간섭취기에는 열구의 음영이 점점 약해져서 종말에는 선명한 냉구로 변해 버린다. 그러나 간농양은 간동맥기, 간정맥기 및 간섭취기 모두에게 계속 냉구로 나타나므로 쉽게 간암과 감별진단이 가능하다. 한편 이 검사는 정적간이미징을 위하여 핵제제를 경정맥투여시에 부담없이 시행하게 되므로 루틴화가 가능하며, 앞으로 간암의 조기진단에 크게 기여하리라 확신한다.

• 간의등불
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• s.21
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• pp.14-17
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• 2001

간경변이 되면 간장에 섬유가 증가되어 간장이 딱딱하게 되고 탄력이 없어진다. 그 때문에 간장 전체 내부의 혈란이 압박을 받는다든지 막힌다든지 하여 혈액의 흐름에 방해를 받게 된다. 간장에 유입되는 혈액의 통로에는 간동맥과 문맥의 두가지가 있지만 간경변이 되면 그 중 특히 문맥의 혈류가 정체되어 문맥압이 상승된다.

• Journal of radiological science and technology
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• v.27 no.1
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• pp.33-36
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• 2004

• Proceedings of the Korean Society of Radiological Science
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• 2001.06a
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• pp.86.2-87
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• 2001

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.613-618
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• 2020

The average dose of Fast Low Dose C-arm CT used during hepatic arterial chemoembolization was compared with the average dose of DSA, and the exposure dose was analyzed by analyzing the average dose for each test technique in the total accumulated dose. 50 patients were randomly selected at our clinic and compared with Fast Low Dose C-arm CT, DAP and Air Kerma of DSA, and the accumulation of four test techniques (DSA, Fast Low Dose C-arm CT, Roadmap, Fluoroscopy) The proportion of dose (DAP, Air Kerma) was analyzed. For statistical comparative analysis, the corresponding sample T test and ANOVA test (post hoc test: Tukey) were performed using the statistical program SPSS 20.0. Fast Low Dose C-arm CT showed statistically significantly lower average dose (DAP, Air Kerma) than DSA. Reducing the number of tests for DSA can reduce the patient's exposure to medical radiation.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1448-1452
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• 2020

Hepatic artery pseudoaneurysm is a rare but potentially life-threatening condition that usually occurs after trauma. Early recognition and prompt management are essential for preventing catastrophic consequences, such as hemoperitoneum. We report a rare case of liver abscess caused by Klebsiella oxytoca resulting in hepatic artery pseudoaneurysm without iatrogenic injury. The unique feature of the present case is that the abscess cavity itself became a pseudoaneurysm as a result of fistula formation with the hepatic artery. Vascular complications should be considered in patients with unfavorable clinical course even in the absence of iatrogenic injury. Endovascular treatment is safe and effective.