• Radiation Oncology Journal
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• 제32권3호
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• pp.170-178
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• 2014

Purpose: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. Materials and Methods: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. Results: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). Conclusion: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.

• Parasites, Hosts and Diseases
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• 제51권4호
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• pp.475-477
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• 2013

Although alveolar echinococcosis (AE) can cause a serious disease with high mortality and morbidity similar to malign neoplasms. A 62-year-old woman admitted to a hospital located in Sivas, Turkey, with the complaints of fatigue and right upper abdominal pain. On contrast abdominal CT, a $54{\times}70{\times}45$ mm sized cystic lesion was detected in the left lobe of the liver that was seen to extend to the posterior mediastinum and invade the diaphragm, esophagus, and pericardium. The cystic lesion was seen to be occluding the inferior vena cava and left hepatic vein at the level where the hepatic veins poured into the inferior vena cava. Bilateral pleural effusion was also detected. We discussed this secondary Budd-Chiari Syndrome (BCS) case, resulting from the AE occlusion of the left hepatic vein and inferior vena cava, in light of the information in literature.

• Journal of Chest Surgery
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• 제27권8호
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• pp.710-713
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• 1994

The Budd-Chiari syndrome is a rare type of portal hypertension caused by complete or incomplete obstruction of the hepatic vein or the corresponding portion of the inferior vena cava or both. In this case, the obstruction was located just beneath the diaphragm, above the right hepatic vein opening, which was confirmed by vena cavography preoperatively. Budd-Chiari syndrome with stenosis or thrombosis of the inferior vena cava may be cured by prosthetic bypass to the right atrium. This case is caused by thrombus of unknowed primary origin. Combined mesoatrial and cavoatrial shunt should be encouraged in this specific situation. Postoperatively, there were marked fall of venous pressure and symptoms and signs improved remarkably.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2009년도 추계학술발표대회
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• pp.345-346
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• 2009

The segmentation of vessel including portal vein, hepatic vein and artery, from Computed Tomography (CT) images plays an important role in the therapeutic strategies for hepatic diseases. Representing segmented vessels in three dimensional spaces is extremely useful for doctors to plan liver surgery. In this paper, proposed method is focused on smoothing technique of segmented 3D liver vessels, which derived from 3D region growing approach. A pixel expand algorithm has been developed first to avoid vessel lose and disconnection cased by the next smoothing technique. And then a binary volume filtering technique has been implemented and applied to make the segmented binary vessel volume qualitatively smoother. This strategy uses an iterative relaxation process to extract isosurfaces from binary volumes while retaining anatomical structure and important features in the volume. Hard and irregular place in volume image has been eliminated as shown in the result part, which also demonstrated that proposed method is a suitable smoothing solution for post processing of fine vessel segmentation.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1110-1123
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• 2021

Owing to improvements in surgical techniques and medical care, living-donor liver transplantation has become an established treatment modality in patients with end-stage liver disease. However, various vascular or non-vascular complications may occur during or after transplantation. Herein, we review how interventional radiologic techniques can be used to treat these complications.

• 한국임상수의학회지
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• 제20권4호
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• pp.508-515
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• 2003

A 4-month-old 5.7 kg male Golden retriever with history of seizure, depression, lethargy and anorexia was referred to Veterinary Medical Teaching Hospital, Chungbuk National University. Hematologic examination revealed microcytosis and nonregenerative anemia. Serum chemical values showed increased serum ammonia (423 $\mu$mol/L), ALP (1101 U/L), r-GTP (13.9 U/L) and CPK (1454 U/L), and decreased total protein (4.9 g/dl) and BUN (1.6 mg/dl). Microhepatia was shown in survey abdominal radiographs. Color doppler ultrasonographic examination revealed dilated tortuous vein with turbulent flow within liver parenchyma. Intraoperative jejunoportography and intraoperative ultrasonography confirmed the location and size of single intrahepatic shunt vessel in the left medial liver lobe. Also, the anomalous vessel entering the caudal vena cava was identified beneath the diaphragm. The shunting vessel was ligated with using an Ameroid constrictor. General conditions, hematologic and serum chemical values resolved gradually after surgery. One month after surgery abdominal radiograph showed normal gastric axis and it was consistent whit the normal size liver. Normal echogenecity of liver and enlargement of portal vein were shown in ultrasonography. It is assumed that survey radiography and ultrasonography are useful for diagnosis of single intrahepatic shunt in a dog and especially jejunoportography vein portography and intraoperative ultrasonography are suitable for confirmation of the anatomic location and size of the shunting vessels.

• 대한방사선협회지
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• 제30권1호
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• pp.131-142
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• 2004

In this study, when intravenous contrast medium was injected in spiral CT study, the effects of injection volume, injection rate, injection mode, location and lumen of IV catheter on enhancement of contrast medium in aorta, portal vein and liver parenchym

• 대한핵의학회지
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• 제22권1호
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• pp.47-53
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• 1988

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows : 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

• 한국임상수의학회지
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• 제24권2호
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• pp.269-275
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• 2007

Two dogs referred to Veterinary Medical Center, Chungbuk National University diagnosed as multiple extrahepatic portosystemic shunt were reported. The first dog was a 20-month-old, 8 kg, male Cocker spaniel with history of peritoneal effusion, diarrhea, anorexia and stunted growth. The second dog was a 3-year-old, 13.4 kg, male Jindo with a history of severe depression. Hematologic examination of first dog revealed mild microcytosis and nonregenerative anemia. All of 2 cases, serum chemical values showed increase of serum ammonia, ALP, r-GTP and glucose. In survey radiography, microhepatia was apparent. In the color Doppler ultrasonographic examination, the first dog revealed a dilated tortuous vein communicating with caudal vena cava was observed near the left kidney and the second dog revealed numerous shunting vessels ventral to L5 and L6. Transcolonic portal scintigraphy of the first dog confirmed the presence of portosystemic shunt. In intraoperative jejunoportography, the first dog showed single congenital extrahepatic portosystemic shunt and multiple acquired extrahepatic portosystemic shunts. The second dog showed multiple acquired extrahepatic portosystemic shunts. In these dogs, the presence of congenital and acquried portosystemic shunts and histopathologic findings were considered to represent a combination of multiple extrahepatic portosystemic shunts and noncirrhotic portal hypertension or portal vein hypoplasia.

• 대한전자공학회논문지SP
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• 제47권1호
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• pp.17-24
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• 2010

본 논문은 생체간이식 전에 복부 MDCT(Multi-Detector Computed Tomography) 영상에서 이식편의 체적(the volume of right and left liver lobe)을 정확하게 계산하기 위하여 좌간과 우간을 나누는 방법을 제안하였다. 간이 추출된 영상에 해부학적인 좌간과 우간을 나누는 4점(하대정맥(Inferior Vena Cava)를 반으로 나눌 수 있는 중심점, 담낭와와 가까운 중간정맥(Middle Hepatic Vein)의 끝부분 한 점, 좌우문맥(Portal Vein) 분지부에서 한 점, 담낭와(gallbladder fossa)를 좌우로 나눌 수 있는 중심점)을 선택한다. 선택된 4점을 기준으로 좌간과 우간을 나누고 체적과 간 전체에 대한 좌우간의 비율을 계산한다. 계산된 체적의 정확성을 입증하기 위해 방사선과 의사가 수동으로 처리하여 계산한 체적과 함께 수술 중 획득한 실측무게와 비교하였다. 그리고 4점을 선택한 후 좌우간을 분할하여 체적을 계산하는 시간을 측정하여 수술실에서 실시간으로 처리 가능한 지의 여부를 확인하였다. 본 연구는 간이식에 참여하는 기증자와 수혜자의 안전을 보장하기 위하여 진행되었다.