• 제목/요약/키워드: Interventional Radiology

검색결과 215건 처리시간 0.025초

악성 기관지호흡기루와 기관지흉강루에 대한 인터벤션 치료 (Interventional Management of Malignant Esophagorespiratory Fistula and Bronchopleural Fistula)

  • 신지훈;김경래;김진형;송호영
    • 대한기관식도과학회지
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    • 제14권1호
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    • pp.8-13
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    • 2008
  • Malignant esophagorespiratory fistula is a devastating and life-threatening complication of esophageal and bronchogenic carcinomas. As a non-surgical treatment, peroral stent placement into the esophagus or airway can close-off the fistula and prevent progression of the pneumonia. Although reopening of the fistula is not uncommon despite stent placement, interventional treatment is effective for sealing off reopened ERFs. Bronchopleural fistula is a well-recognized complication of pneumonectomy. There have been several reports to occlude the fistula with use of stents and much more experience is required.

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Spontaneous hepatic arterioportal fistula in extrahepatic portal vein obstruction: Combined endovascular and surgical management

  • Ananya Panda;Durgadevi Narayanan;Arjunlokesh Netaji;Vaibhav Kumar Varshney;Lokesh Agarwal;Pawan Kumar Garg
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.307-312
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    • 2023
  • Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.

Improved Diagnostic Accuracy in Characterization of Adnexal Masses by Detection of Choline Peak Using 1H MR Spectroscopy in Comparison to Internal Reference at 3 Tesla

  • Malek, Mahrooz;Pourashraf, Maryam;Gilani, Mitra Modares;Gity, Masoumeh
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5085-5088
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    • 2015
  • Background: The aim of this study was to assess the role of the presence of a choline peak in 3 Tesla 1H magnetic resonance spectroscopy (MRS) for differentiating benign from malignant adnexal masses. Materials and Methods: A total of 46 adnexal masses (23 malignant and 23 benign) underwent 1H MRS study prior to surgery to assess the presence of choline peak. Results: A choline peak was detected in 16 malignant masses (69.5%) and was absent in the other 7 (30.5%). A choline peak was only detected in 6 (26%) of the benign adnexal masses. The presence of an MRS choline peak had a sensitivity of 69.5%, a specificity of 74%, a positive predictive value (PPV) of 72.7%, and a negative predictive value (NPV) of 71% for diagnosing malignant adnexal masses. A significant difference between the frequency of mean choline peaks in benign and malignant adnexal masses was observed (P value < 0.01). Conclusions: A 1H MRS choline peak is seen in malignant adnexal masses more frequently than the benign masses, and may be helpful for diagnosing malignant adnexal masses.

Factors Associated with Psychological Characteristics in Patients with Hepatic Malignancy before Interventional Procedures

  • Wang, Zi-Xuan;Yuan, Chang-Qing;Guan, Jun;Liu, Si-Liang;Sun, Chun-Hui;Kim, Seong-Hwan
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권1호
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    • pp.309-314
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    • 2012
  • Objective: To investigate the psychological characteristics of hepatic malignancy patients before interventional procedures and assess associations with related factors. Methods: Two hundred and thirteen patients requiring interventional procedure for hepatic malignancy were asked to complete a survey of health knowledge and psychological symptom on health knowledge questionnaire and SCL-90 before interventional procedure. Logistic regression analysis was employed to determine the association of various demographic, clinical and health knowledge factors with the presence of psychological symptoms in patients. Results: Eight psychological symptom scores, i.e. somatization, obsessive-compulsive tendencies, depression, anxiety, hostility, phobia, paranoid ideations and psychotic states, were significantly higher than the normal range (P< 0.001). Of 213 cases in the study, 49 families (23.00%) concealed the diagnoses of hepatic carcinoma from patients; 135 patients (63.38%) described the prognosis of the disease correctly. It was demonstrated that the correlations between psychological symptoms and related factors, i.e. age, gender, education, interventional procedure times and health knowledge, were statistically significant (P<0.05). Conclusion: Psychological distress is severe in hepatic malignancy patients before interventional procedures. Age, gender, education, interventional procedure times and health knowledge are associated with psychological symptoms which are significant different from the normal range in Chinese.

Giant Serpentine Intracranial Aneurysm: A Case Report

  • Jae Seong Park;Myeong Sub Lee;Myung Soon Kim;Dong Jin Kim;Joong Wha Park;Kum Whang
    • Korean Journal of Radiology
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    • 제2권3호
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    • pp.179-182
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    • 2001
  • The authors present a case of giant serpentine aneurysm (a partially thrombosed aneurysm containing tortuous vascular channels with a separate entrance and outflow pathway). Giant serpentine aneurysms form a subgroup of giant intracranial aneurysms, distinct from saccular and fusiform varieties, and in this case, too, the clinical presentation and radiographic features of CT, MR imaging and angiography were distinct.

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Current Topics on Quality Assurance of X-ray Diagnosis in Japan

  • Katoh, Tuguhisa;Imamura, Keiko;Matumoto, Toru
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.13-16
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    • 2002
  • Recent topics on quality assurance (QA) of X-ray diagnosis in Japan were reported in this presentation. These were related to mass screening mammography (MMG), lung screening CT (LSCT), skin injury caused by interventional radiology (IVR) and traceable system of dosimeters for x-ray diagnosis. In these successful stories, the author would like to stress the cooperation of all the medical am: clinical staff including medical doctors, radiological technologists, medical physicists, manufacturers of medical devices and others.

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Interventional radiography in management of high-flow arteriovenous malformation of maxilla: report of a case

  • Khambete, Neha;Risbud, Mukund;Mehta, Nikit
    • Imaging Science in Dentistry
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    • 제41권3호
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    • pp.123-128
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    • 2011
  • Arteriovenous malformations are extremely rare conditions in that can result from abnormalities in the structure of blood vessels, which may be potentially fatal. A 30-year-old female patient visited our hospital with a complaint of swelling on the right maxillary posterior gingiva along with the large port-wine stain on right side of face. On clinical examination, the swelling was compressible and pulsatile. Radiographic examination revealed a lytic lesion of maxilla. Diagnostic angiography revealed a high-flow arteriovenous malformation of maxilla which was treated by selective transarterial embolization of maxillary artery using polyvinyl alcohol particles.

Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications

  • Akinori Hata;Yoshitake Yamada;Rie Tanaka;Mizuki Nishino;Tomoyuki Hida;Takuya Hino;Masako Ueyama;Masahiro Yanagawa;Takeshi Kamitani;Atsuko Kurosaki;Shigeru Sanada;Masahiro Jinzaki;Kousei Ishigami;Noriyuki Tomiyama;Hiroshi Honda;Shoji Kudoh;Hiroto Hatabu
    • Korean Journal of Radiology
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    • 제22권4호
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    • pp.634-651
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    • 2021
  • Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD). This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

심장내과의 중재적 시술시 시술조건에 따른 방사선사의 방사선 노출 특성 (The Characteristic of Radiation Exposure for Radiologist with Applying Condition in Interventional Radiology in Cardiology)

  • 박정규;조의현
    • 디지털콘텐츠학회 논문지
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    • 제13권3호
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    • pp.421-429
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    • 2012
  • 최근 방사선 의료에서 중재적 시술의 확대로 인하여 시술 건수가 증가하고 있으며, 시술자에 따라 방사선 노출이 다르게 나타 날 수 있으며 시술자와 환자가 받는 방사선 피폭의 증가를 가져온다. 본 연구는 2011년 11월 01일부터 2012년 01월 31일 까지 경북지역 S대학 병원에 내원한 303명의 심장내과 환자를 대상으로 중재적 방사선시술을 시행한 시술자 5명에 따른 방사선 노출특성을 비교분석하였다. 투시시간의 경우 5명의 시술의의 평균 투시시간은 697.95초, cumulative DAP(exp)의 경우 평균 환자 면적선량은 $52,730mGycm^2$, total DAP의 경우 평균 환자면적선량은 $104,875.14mGycm^2$, acquired image의 경우 평균 영상은 855.52frame, exposure image의 평균 영상은 802.2frame로 나타나 통계적으로 유의한 차이를 보였다(p<0.05). 장비의 X선 노출 특성 즉, 투시시간, cumulative DAP(fluro), cumulative DAP(exp), total DAP, acquired image, exposure image는 서로 높은 상관관계를 보이나 cumulative DAP(exp)와 acquired runs는 상관관계를 보이지 않았다. 시술자와 가장 큰 비중을 차지하는 것은 투시시간으로 나타나 투시시간이 길어질수록 방사선 피폭이 증가함을 의미한다. 시술시 피폭선량은 시술자에 따라 시술능력과 경험, 시술의 난이도 및 정밀 시술여부와 관련 있으며, 혈관 조영의 횟수와 투시시간이 정해진 것이 아니어서 인위적인 조절이 어려운 부분이라 할 수 있다. 따라서, 중재방사선 절차를 수행하는 의료진의 실질 피폭을 합리적으로 평가하는 시스템이 필요하며, 불필요한 피폭을 줄이기 위해 시술자를 비롯한 방사선 작업종사자에 대한 자체교육과 훈련이 필요할 것으로 사료된다.