No abstract available.
Oxides/*diagnostic use ; *Magnetic Resonance Imaging ; Liver/*pathology ; Iron/*diagnostic use ; Humans ; Focal Nodular Hyperplasia/*diagnosis ; Female ; *Contrast Media ; Adult

OBJECTIVE: To determine if a combination of ferucarbotran-enhanced T2*weighted-gradient echo (T2*W-GRE) and T2-weighted turbo spin echo (T2W-TSE) images in gadolinium- and ferucarbotran-enhanced MRI has additive efficacy compared to each image alone for detecting small (< or = 2.0 cm) hepatocellular carcinoma (HCC) lesions in a group of cirrhotic patients and metastases in a group of non-cirrhotic patients. MATERIALS AND METHODS: Two readers retrospectively analyzed gadolinium- and ferucarbotran-enhanced T2*W-GRE, T2W-TSE, and combined T2*W-GRE/T2W-TSE images of 119 patients with 157 HCCs and 32 patients with 98 metastases. The diagnostic accuracy and sensitivity for each image set and the combined set were evaluated using the alternative-free response receiver operating characteristic method. RESULTS: The mean area under the curve value of the combined set (0.966) tended to be better than that for each individual image set (T2W-TSE [0.910], T2*W-GRE [0.892]). Sensitivities in the combined set were higher than those in each individual image set for detecting HCC (mean, 93.0% versus 81.6% and 86.7%, respectively, p < 0.01). Sensitivities in the combined set and the T2W-TSE set were the same for detecting metastases, and both were higher than the sensitivity seen in the T2*W-GRE set (mean, 97.5% versus 85.2 %, p < 0.01). CONCLUSION: Combining ferucarbotran-enhanced T2*W-GRE and T2W-TSE has additive efficacy for detecting HCC in cirrhotic patients, but T2W-TSE is preferred for detecting metastases in non-cirrhotic patients.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; Contrast Media/*administration & dosage ; Female ; Gadolinium DTPA/*diagnostic use ; Humans ; Iron/*diagnostic use ; Liver Neoplasms/*diagnosis/secondary ; *Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Observer Variation ; Oxides/*diagnostic use ; Predictive Value of Tests ; Sensitivity and Specificity

OBJECTIVE: To access the feasibility of clinically available 3T MRI to detect the migration of labeled neural stem cells (NSCs) in intracerebral hemorrhage (ICH) in a rat model. MATERIALS AND METHODS: The ethics committee of our institution approved this study. ICH was induced by the injection of collagenase type IV into the right striatum of ten Sprague-Dawley rats. Human NSCs conjugated with Feridex (super-paramagnetic iron oxide: SPIO) were transplanted into the left striatum one week after ICH induction. MRI was performed on a 3T scanner during the first, second, third, fourth, and sixth weeks post-transplantation. MRI was obtained using coronal T2- and T2*-weighted sequences. Two rats were sacrificed every week after in vivo MRI in order to analyze the histological findings. RESULTS: ICH in the right striatum was detected by MRI one and two weeks after transplantation without migration of the NSCs. There was no migration of the NSCs as seen on the histological findings one week after transplantation. The histological findings two weeks after transplantation showed a small number of NSCs along the corpus callosum. On MRI three weeks after transplantation, there was a hypointense line along the corpus callosum and decreased signal intensity in the right periventricular region. Histological findings three weeks after transplantation confirmed the presence of the hypointense line representing SPIO-labeled NSCs. MRI four and six weeks after transplantation showed a hypointense spot in the right periventricular region. The histological findings four and six weeks after transplantation showed the presence of prominent NSCs in the right periventricular region. CONCLUSION: 3T MRI can detect the migration of NSCs in rats with ICH along the corpus callosum. Therefore, 3T MRI could be feasible for detecting the migration of NSCs in the clinical setting of stem cell therapy.
Animals ; Cell Movement/*physiology ; Cerebral Hemorrhage/*pathology ; Corpus Callosum/pathology ; Humans ; Iron/diagnostic use ; Magnetic Resonance Imaging/*methods ; Neurons/*physiology ; Oxides/diagnostic use ; Rats ; Rats, Sprague-Dawley ; Stem Cell Transplantation ; Stem Cells/*physiology ; Time Factors

BACKGROUND/AIMS: It is still unclear whether Super Paramagnetic Iron Oxide-Magnetic Resonance Imaging (SPIO-MRI) is a clinically useful imaging modality for patients with hepatocellular carcinoma (HCC). This study searched for the clinical usefulness and limitations of SPIO-MRI with respect to tumor detection capacity, false positive and negative rate, and early recurrence rate. METHODS: From December 1999 to February 2001, 218 patients who were surgical candidates by 3-phase dynamic helical CT (3dHCT) were enrolled. We reviewed the medical records and radiologic findings, retrospectively, and postulated the post-operative pathologic findings and the early recurrences within 3 months as the standards for the true positive lesion. RESULTS: The mean number of nodules detected by SPIO-MRI was significantly more numerous than that of 3dHCT (p<0.01). Modifications of treatment strategy due to the discordant findings between SPIO-MRI and 3dHCT for tumor resectability were observed in 22 (10.1%) out of 218 patients. Early recurrences were observed in 10 patients (7.8%). The false positive and negative rates of SPIO-MRI were 6.3% and 13.3%, respectively. CONCLUSIONS: We demonstrated that the tumor detection rate of SPIO-MRI was better than that of 3dHCT. Given the relatively acceptable false positive and negative rates, SPIO-MRI could be an appropriate preoperative imaging modality for patients with HCCs.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; *Contrast Media ; False Negative Reactions ; False Positive Reactions ; Female ; Ferrosoferric Oxide ; Humans ; Iron/*diagnostic use ; Liver Neoplasms/*diagnosis ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Oxides/*diagnostic use ; Tomography, Spiral Computed

OBJECTIVE: To identify the optimal pulse sequence for ferumoxides-enhanced magnetic resonance (MR) imaging in the detection of hepatocelluar carcinomas (HCCs). MATERIALS AND METHODS: Sixteen patients with 25 HCCs underwent MR imaging following intravenous infusion of ferumoxides. All MR studies were performed on a 1.5-T MR system, using a phased-array coil. Ferumoxides (Feridex IV) at a dose of 15 micro mol/Kg was slowly infused intravenously, and axial images of seven sequences were obtained 30 minutes after the end of infusion. The MR protocol included fast spin-echo (FSE) with two echo times (TR3333-8571/TE18 and 90-117), singleshot FSE (SSFSE) with two echo times (TR infinity/TE39 and 98), T2*-weighted gradient-recalled acquisition in the steady state (GRASS) (TR216/TE20), T2*-weighted fast multiplanar GRASS (FMPGR) (TR130/TE8.4-9.5), and T2*-weighted fast multiplanar spoiled GRASS (FMPSPGR) (TR130/TE8.4-9.5). Contrast-to-noise ratios (CNRs) of HCCs determined during the imaging sequences formed the basis of quantitative analysis, and images were qualitatively assessed in terms of lesion conspicuity and image artifacts. The diagnostic accuracy of all sequences was assessed using receiver operating characteristic (ROC) analysis. RESULTS: Quantitative analysis revealed that the CNRs of T2*-weighted FMPGR and T2*-weighted FMPSPGR were significantly higher than those of the other sequences, while qualitative analysis showed that image artifacts were prominent at T2*-weighted GRASS imaging. Lesion conspicuity was statistically significantly less clear at SSFSE imaging. In term of lesion detection, T2*-weighted FMPGR, T2*- weighted FMPSPGR, and proton density FSE imaging were statistically superior to the others. CONCLUSION: T2*-weighted FMPGR, T2*- weighted FMPSPGR, and proton density FSE appear to be the optimal pulse sequences for ferumoxidesenhanced MR imaging in the detection of HCCs.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; Contrast Media ; Echo-Planar Imaging ; Female ; Human ; Image Enhancement ; Iron/*diagnostic use ; Liver Neoplasms/*diagnosis ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Oxides/*diagnostic use

BACKGROUND/AIMS: To determine the value of fusion imaging with contrast-enhanced ultrasonography (CEUS) and computed tomography (CT)/magnetic resonance (MR) images for percutaneous radiofrequency ablation (RFA) of very-early-stage hepatocellular carcinomas (HCCs) that are inconspicuous on fusion imaging with B-mode ultrasound (US) and CT/MR images. METHODS: This retrospective study was approved by our institutional review board and the requirement for informed consent was waived. Fusion imaging with CEUS using Sonazoid contrast agent and CT/MR imaging was performed on HCCs (<2 cm) that were inconspicuous on fusion imaging with B-mode US. We evaluated the number of cases that became conspicuous on fusion imaging with CEUS. Percutaneous RFA was performed under the guidance of fusion imaging with CEUS. Technical success and major complication rates were assessed. RESULTS: In total, 30 patients with 30 HCCs (mean, 1.2 cm; range, 0.6-1.7 cm) were included, among which 25 (83.3%) became conspicuous on fusion imaging with CEUS at the time of the planning US and/or RFA procedure. Of those 25 HCCs, RFA was considered feasible for 23 (92.0%), which were thus treated. The technical success and major complication rates were 91.3% (21/23) and 4.3% (1/23), respectively. CONCLUSIONS: Fusion imaging with CEUS and CT/MR imaging is highly effective for percutaneous RFA of very-early-stage HCCs inconspicuous on fusion imaging with B-mode US and CT/MR imaging.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis/radiography/ultrasonography ; Catheter Ablation ; Contrast Media/diagnostic use ; Female ; Ferric Compounds/diagnostic use ; Humans ; Iron/diagnostic use ; Liver Neoplasms/*diagnosis/radiography/ultrasonography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Oxides/diagnostic use ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo observe the clinical effect of iatrogenic perforation repaired by mineral trioxide aggregate (MTA).

METHODSTwenty-one iatrogenic perforation cases were included. The root canals were shaped and cleaned and then obturated after MTA was used to repair the perforation with microscopes. Preoperative, immediate postoperative, and follow-up radiographs were evaluated to determine the pathologic changes adjacent to the perforation site.

RESULTSNineteen cases healed and two cases were healing. No cases failed.

CONCLUSIONSMTA is effective in the treatment of iatrogenic perforation.

Aluminum Compounds ; therapeutic use ; Calcium Compounds ; therapeutic use ; Dental Pulp Cavity ; diagnostic imaging ; injuries ; Drug Combinations ; Follow-Up Studies ; Humans ; Iatrogenic Disease ; Incisor ; diagnostic imaging ; injuries ; Molar ; diagnostic imaging ; injuries ; Oxides ; therapeutic use ; Radiography ; Root Canal Filling Materials ; therapeutic use ; Silicates ; therapeutic use

OBJECTIVE: Arsenic trioxide (As2O3) can be used as a possible pharmaceutical alternative that augments radiofrequency (RF) ablation by reducing tumor blood flow. The aim of this study was to assess the effect of intraarterial and intravenous administration of As2O3 on RF-induced ablation in an experimentally induced liver tumor. MATERIALS AND METHODS: VX2 carcinoma was grown in the livers of 30 rabbits. As2O3 (1 mg/kg) was administered through the hepatic artery (n = 10, group A) or ear vein (n = 10, group B), 30 minutes before RF ablation (125 mA +/- 35; 90 +/- 5degrees C). As a control group, 10 rabbits were treated with RF ablation alone (group C). RF was intentionally applied to the peripheral margin of the tumor so that ablation can cover the tumor and adjacent hepatic parenchyma. Ablation areas of the tumor and adjacent parenchymal changes among three groups were compared by the Kruskal-Wallis and Mann-Whitney U test. RESULTS: The overall ablation areas were 156 +/- 28.9 mm2 (group A), 119 +/- 31.7 (group B), and 92 +/- 17.4 (group C, p < 0.04). The ablation area of the tumor was significantly larger in group A (73 +/- 19.7 mm2) than both group B (50 +/- 19.4, p = 0.02) and group C (28 +/- 2.2, p < 0.01). The ratios of the tumoral ablation area to the overall ablation area were larger in group A (47 +/- 10.5%) than that of the other groups (42 +/- 7.3% in group B and 32 +/- 5.6% in group C) (p < 0.03). CONCLUSION: Radiofrequency-induced ablation area can be increased with intraarterial or intravenous administration of As2O3. The intraarterial administration of As2O3 seems to be helpful for the selective ablation of the tumor.
Animals ; Arsenicals/*pharmacology ; Catheter Ablation/*methods ; Combined Modality Therapy ; Contrast Media/diagnostic use ; Disease Models, Animal ; Liver/radiography ; Liver Neoplasms, Experimental/*drug therapy/radiography/*surgery ; Oxides/*pharmacology ; Rabbits ; Statistics, Nonparametric ; Tomography, X-Ray Computed

OBJECTIVE: This study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings. MATERIALS AND METHODS: Seventy-two patients with 84 pathologically proven well-differentiated HCCs underwent triple-phase MDCT and SPIO-enhanced MRI at a magnetic field strength of 1.5 Tesla (n = 49) and 3.0 Tesla (n = 23). Two radiologists in consensus retrospectively reviewed the CT and MR images for attenuation value and the signal intensity of each tumor. The proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images were compared in terms of tumor size (< 1 cm and > 1 cm), five CT attenuation patterns based on arterial and equilibrium phases and magnetic field strength, by the use of univariate and multivariate analyses. RESULTS: Seventy-eight (93%) and 71 (85%) HCCs were identified by CT and on SPIO-enhanced T2- and T2*-weighted images, respectively. For the CT attenuation pattern, one (14%) of seven isodense-isodense, four (67%) of six hypodense-hypodense, four (80%) of five isodense-hypodense, 14 (88%) of 16 hyperdense-isodense and 48 (96%) of 50 hyperdense-hypodense HCCs were hyperintense (Cochran-Armitage test for trend, p < 0.001). Based on the use of multivariate analysis, the CT attenuation pattern was the only factor that affected the proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images (p < 0.001). Tumor size or magnetic field strength was not a factor that affected the proportion of hyperintense HCCs based on the use of univariate and multivariate analysis (p > 0.05). CONCLUSION: Most well-differentiated HCCs show hyperintensity on SPIO-enhanced MRI, although the lesions show various CT attenuation patterns. The CT attenuation pattern is the main factor that affects the proportion of hyperintense well-differentiated HCCs as depicted on SPIO-enhanced MRI.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/*pathology ; Contrast Media ; Female ; Humans ; Image Enhancement/methods ; Image Processing, Computer-Assisted ; Iron/*diagnostic use ; Liver Neoplasms/*pathology ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Oxides/*diagnostic use ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

BACKGROUNDDespite great reduction of in-stent restenosis, first-generation drug-eluting stents (DESs) have increased the risk of late stent thrombosis due to delayed endothelialization. Arsenic trioxide, a natural substance that could inhibit cell proliferation and induce cell apoptosis, seems to be a promising surrogate of sirolimus to improve DES performance. This randomized controlled trial was to evaluate the efficacy and safety of a novel arsenic trioxide-eluting stent (AES), compared with traditional sirolimus-eluting stent (SES).

METHODSPatients with symptoms of angina pectoris were enrolled and randomized to AES or SES group. The primary endpoint was target vessel failure (TVF), and the second endpoint includes rates of all-cause death, cardiac death or myocardial infarction, target lesion revascularization (TLR) by telephone visit and late luminal loss (LLL) at 9-month by angiographic follow-up.

RESULTSFrom July 2007 to 2009, 212 patients were enrolled and randomized 1:1 to receive either AES or SES. At 2 years of follow-up, TVF rate was similar between AES and SES group (6.67% vs. 5.83%, P = 0.980). Frequency of all-cause death was significantly lower in AES group (0 vs. 4.85%, P = 0.028). There was no significant difference between AES and SES in frequency of TLR and in-stent restenosis, but greater in-stent LLL was observed for AES group (0.29 ± 0.52 mm vs. 0.10 ± 0.25 mm, P = 0.008).

CONCLUSIONSAfter 2 years of follow-up, AES demonstrated comparable efficacy and safety to SES for the treatment of de novo coronary artery lesions.

Aged ; Arsenicals ; administration & dosage ; therapeutic use ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; surgery ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Oxides ; administration & dosage ; therapeutic use ; Percutaneous Coronary Intervention ; methods ; Polymers ; chemistry ; Sirolimus ; administration & dosage ; therapeutic use