To assess the indication, intraoperative monitoring with selective shunting and surgical outcomes of carotid endarterectomy for patients with contralateral carotid occlusion, the clinical manifestations, imaging data, surgical methods and results of 16 patients were analysed retrospectively. It was verified that the surgical risk of these patients was not as high as prediction,satisfactory results coold be achieved with intraoperative monitoring, selective shunting and skilled surgical techniques. It is reasonable to offer the following typical treatment examples: Carotid endarterectomy should be performed for patients with symptomatic carotid stenosis irrespective of the contralateral carotid occlusion, while medical therapy should be maintained for patients with asymptomatic carotid stenosis and contralateral carotid occlusion. maintained. If the asymptomatic stenosis is found to be progressing in noninvasive testing, then a prophylactic endarterectomy should be considered.

Exposure of the distal internal carotid artery is very important and difficult in carotid endarterectomy for patients with high bifurcations or extension of the atherosclerotic plaque into the distal internal carotid artery. Exposure techniques are introduced based on the surgical experiences of 28 cases.

Objective To probe the value of both liver volume(LV)measurement and Gd-EOB-DTPA enhanced MRI to evaluate hepatic reserve function in order to obtain a better assessment method.Methods Clinical and imaging data of 42 patients with hepatic focal lesions were analyzed retrospectively.Gd-EOB-DTPA enhanced MRI scan,Child-Pugh scoring and ICG clearance tests were performed in all patients,and the liver relative enhancement (RE)and LV were used to assess the hepatic reserve function.The differences of LV, LV/standard liver volume (SLV)and RE between the Child-Pugh class A and B were compared using independent student's t-test. Spearman correlation analysis was applied to analyze the relationship of indocyanine green retention rate at 1 5 minutes (ICG-R1 5) with the LV,LV/SLV,RE,RE×LV and RE×LV/SLV.Results There was no significant difference in LV between two groups(P>0.05), whereas the RE had significant difference(P=0.039).There were no significant correlations between ICG-R15 and LV,LV/SLV(P>0.05). ICG-R1 5 was negatively correlated with RE,RE×LV and RE×LV/SLV,and RE×LV/SLV showed significant correlation with ICG-R15 (r=-0.524,P=0.000).Conclusion Gd-EOB-DTPA enhanced MRI can assess the status of hepatic reserve function, while the combination of RE with LV is a more effective method.