Abdominal Pain ; etiology ; Female ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Teratoma ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVEThe predictive value of postoperative hepatic function evaluated by liver functional imaging combined with single photon emission computed tomography (SPECT) technique was appraised in the present study.

METHODSTwenty New Zealand white rabbits were divided randomly into two groups, including the Hepatic Fibrosis with Carcinoma Group (FC-Group, n = 10) and the Control Group (C-Group, n = 10). All the rabbits underwent the resection of outer-right lobe of the liver. The whole hepatic function indexes, such as HCI(5), HLI(5) and Ex(15), and the hepatic function remnant indexes, including HCI(5P), HLI(5P) and Ex(15P), were calculated by 99mTc-EHIDA liver imaging.

RESULTSEx(15) of FC-Group was lower than that of C-Group (P < 0.05). HCI(5) and HLI(5) of FC-Group had the trends to increase compared with the C-Group. Ex(15) was positively correlated with ALB, and negatively correlated with TBil and GGT (P < 0.05). HCI(5) had a positive correlation with CHE (P < 0.05), while HLI(5) had a negative correlation with A/G (P < 0.05). HLI(5P) had the negative correlation with postoperative A/G (P < 0.05), and Ex(15P) had the negative correlation with postoperative TBil and GGT (P < 0.05).

CONCLUSIONSThis study has established a method of 3-D liver function evaluation system on an animal model. Among the indexes, Ex(15) can exactly represent the whole liver function while Ex(15P) and HLI(5P) can predict the liver function after the liver resection. The results may help the future clinical use of this technique to evaluate the risk of operation.

Animals ; Hepatectomy ; Liver ; diagnostic imaging ; physiopathology ; surgery ; Liver Cirrhosis, Experimental ; diagnostic imaging ; physiopathology ; surgery ; Liver Function Tests ; Liver Neoplasms, Experimental ; diagnostic imaging ; physiopathology ; surgery ; Postoperative Period ; Rabbits ; Tomography, Emission-Computed, Single-Photon

Adult ; Female ; Humans ; Laparoscopy ; methods ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Magnetic Resonance Imaging ; Neoplasms, Multiple Primary ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

BACKGROUNDTriple-phase enhancement of multi-slice computed tomography (MSCT) has markedly improved the diagnostic accuracy of hepatocellular carcinoma (HCC), and MSCT angiography (MSCTA) has been proved useful in detecting vascular anatomy noninvasively. This study aimed to explore the value of MSCTA by triple-phase enhancement in preoperative evaluation of HCC.

METHODSFifty-six consecutive cases of primary HCC scheduled for resection were studied with MSCTA by triple-phase enhancement. The raw data images were processed on a workstation for multiplanar reconstruction (MPR) and three-dimensional (3D) reconstruction. The findings after processing of the data were compared with those after surgery or intraoperative sonography.

RESULTSThe false positive rate of MSCTA by triple-phase enhancement was 10.1% and its false negative rate was 4.3% in detecting HCC. No significant difference was observed in MSCTA and surgery or intraoperative sonography in detecting vascular anatomy anomalies and pathologic variations, whereas significant difference was found in detecting bile duct invasion with MSCT compared to intraoperative sonography.

CONCLUSIONSMSCTA by triple-phase enhancement not only improves the detection of HCC, but also provides valuable preoperative information about hepatic vascular architecture and parenchyma. MSCTA by triple-phase enhancement is worthy of application as a non-invasive method in preoperative evaluation of HCC.

Adult ; Angiography ; Carcinoma, Hepatocellular ; diagnostic imaging ; pathology ; surgery ; Female ; Hepatic Artery ; diagnostic imaging ; Hepatic Veins ; diagnostic imaging ; Humans ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Portal Vein ; diagnostic imaging ; Radiographic Image Enhancement ; Tomography, X-Ray Computed

Gastrinoma has a low incidence, and the pancreas-originated gastrinoma is rare. Pancreatic gastrinoma patients with liver metastases have poor prognosis and short survival. Local treatment to reduce the tumor burden helps to improve symptoms and slows down tumor progression for patients with unresectable tumors. We report a case of pancreatic tail gastrinoma with unresectable liver metastases. The patient received a comprehensive minimally invasive interventional treatment, that is, chemoembolization and radiofrequency ablation for liver metastases, and percutaneous transplenic radiofrequency ablation combined with radioactive 125I seed implantation for pancreatic tail gastrinoma. The patient was followed up for more than 20 months, and showed no clear evidence of tumor recurrence. We explored the safety and feasibility of percutaneous transplenic radiofrequency ablation for unresectable pancreatic tail gastrinoma. This transplenic approach allow more indications for minimally invasive therapy and provides a new treatment option not only for patients with unresectable pancreatic tail tumor but also for patients refusing surgery.
Catheter Ablation ; Gastrinoma ; diagnostic imaging ; secondary ; surgery ; Humans ; Liver Neoplasms ; diagnostic imaging ; secondary ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multimodal Imaging ; Pancreatic Neoplasms ; diagnostic imaging ; pathology ; surgery ; Positron-Emission Tomography ; Tomography, X-Ray Computed

Adenosquamous carcinoma of the liver is a rare variant of cholangiocarcinoma. It is known to be a highly aggressive tumor with a poor prognosis, but its pathogenesis remains unclear owing to limited data in the literature. We report a case of 56-year-old woman who presented with a 1-week history of epigastric pain. Magnetic resonance imaging revealed a 6.5-cm ill-defined mass with low signal intensity in the left lobe of the liver, which was suspicious of cholangiocarcinoma. The patient underwent left hemihepatectomy. Microscopically, the tumor consisted of malignant glandular and squamous components and staged as pT2aN1. Despite postoperative chemoradiation, the patient had recurrence 8 months after surgery.
Abdomen/diagnostic imaging ; Carcinoma, Adenosquamous/diagnostic imaging/*pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Gallstones/surgery ; Humans ; Liver Neoplasms/diagnostic imaging/*pathology ; Middle Aged ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed

Local ablation therapy is considered as a conventional treatment option for patients with early stage hepatocellular carcinoma (HCC). Although radiofrequency (RF) ablation is widely used for HCC, the use of cryoablation has been increasing as newer and safer cryoablation systems have developed. The thermodynamic mechanism of freezing and thawing used in cryoablation is the Joule-Thomson effect. Cryoablation destroys tissue via direct tissue destruction and vascular-related injury. A few recent comparative studies have shown that percutaneous cryoablation for HCCs is comparable to percutaneous RF ablation in terms of long term therapeutic outcomes and complications. Cryoablation has several advantages over RF ablation such as well visualization of iceball, no causation of severe pain, and lack of severe damage to great vessels and gallbladder. It is important to know the advantages and disadvantages of cryoablation compared with RF ablation for improvement of therapeutic efficacy and safety.
Carcinoma, Hepatocellular/diagnostic imaging/*surgery ; Catheter Ablation ; *Cryosurgery ; Humans ; Liver Neoplasms/diagnostic imaging/*surgery ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography

Catheter Ablation ; methods ; Ethanol ; administration & dosage ; Humans ; Liver Neoplasms ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

In recent years, the emerging optical imaging technologies have shown their unique value in diagnosis of disease and surgical navigation. This article focus on describing the optical imaging technology mediated by the only one near-infrared light imaging molecule--indocyanine green which has already been approved by FDA to use in clinical and inmates a characteristics of passive targeting liver cancer tissue. This article reviews the application of the technology in liver cancer surgery and demonstrates the value, deficiency and possible improvements of this technology.
Diagnostic Imaging ; Fluorescent Dyes ; Humans ; Indocyanine Green ; Infrared Rays ; Liver Neoplasms ; surgery

The solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors, which are commonly found in adolescent women. Radical surgical resection of the primary tumor or metastases is the standard treatment for SPTP and could achieve long-term survival. We reported a case of a 20-year-old female with multiple liver metastases of SPTP, and performed surgical resection for primary tumor 14 cm in diameter and 2 major liver metastases (both 5 cm in diameter), radiofrequency ablation (RFA) for small lesions and one major liver metastase 6 cm in diameter successfully. No evidence of recurrence in situ or in the liver was found by computed tomography (CT) scan 3 months after the operation. RFA is a safe and effective treatment for unresectable multiple liver metastases of SPTP.
Adult ; Catheter Ablation ; methods ; Female ; Humans ; Liver Neoplasms ; diagnostic imaging ; secondary ; surgery ; Pancreatic Neoplasms ; complications ; diagnostic imaging ; surgery ; Radiography ; Young Adult