PURPOSE: To determine the effectiveness of percutaneous transarterial embolization for the treatment of arteriovenous malformation (AVM). MATERIALS AND METHODS: Seven patients with AVMs located in the kidney, liver, lung, chest wall, uterus and paraspinal region underwent angiography and percutaneous transarterial embolization. The embolic materials used were steel coil, gelfoam, contour emboli, and absolute alcohol; in some cases, more than one of these were employed. The analysed the angiographic findings and clinical status following embolization were assessed and analysed. RESULTS: The AVMs had tortuous, dilated feeding arteries (n=7) and veins with early venous drainage (n=6). In the hepatic AVM, a grape-like dilated vessel arose from the hepatic artery and was connected to the portal vein. In the uterine AVM, numerous dilated feeding arteries formed a honeycomb. In the feeding arteries of the chest wall AVM and in the nidus of the pulmonary AVM, aneurysms were present. In simple AVMs, the patient's symptoms were relieved by first embolization. Complex AVMs, however, required repeated embolizations for symptomatic relief. Although extensive, complex AVMs of the chest wall and uterus recurred after initial embolization, repeated treatment successfully improved the clinical status of such patients. The complications developing after emboliation were fever (n=3) and pain (n=3), but these were relieved by conservative care. CONCLUSION: Percutaneous transarterial embolization is a safe and effective therapeutic method for the treatment of AVM. In a case of inoperable complex AVM, repeated embolization is the only method for symptomatic relief and the maintenance of life.
Aneurysm ; Angiography ; Arteries ; Arteriovenous Malformations* ; Drainage ; Ethanol ; Fever ; Gelatin Sponge, Absorbable ; Hepatic Artery ; Humans ; Kidney ; Liver ; Lung ; Portal Vein ; Steel ; Thoracic Wall ; Uterus ; Veins

The occurrence of pseudoaneurysm of the femoral artery after catheterization is uncommon. Ultrasonography-guided compression is currently the first choice of treatment, with a success rate of more than 90%. Recently, however, with the increasing use of larger percutaneous instruments and periprocedural anticoagulation, the incidence of pseudoaneurysm unresponsive to ultrasonography-guided compression is increasing. The authors encountered a case of pseudoaneurysm of the common femoral artery which did not respond to the repeated use of this technique, though treatemnt involving was successful. We believe that in ultrasonography-guided percutaneous thrombin injection was successful. We believe that in cases involving occlusion of a a pseudoaneurysm in which ultrasonography-guided mpression has failed, this is a simple, safe, and time-saving procedure.
Aneurysm, False* ; Catheterization ; Catheters ; Femoral Artery* ; Incidence ; Thrombin* ; Ultrasonography*

PURPOSE: The purpose of this study was to evaluate the differences in the ablation effects of percutaneous ethanol injection therapy (PEIT), percutaneous microwave coagulation therapy (PMCT), and radiofrequency (RF) ablation therapy in extracted bovid livers, and to assess the appropriate therapeutic method for treating hepatic tumors according to their shape, size and location. MATERIALS AND METHODS: PEIT, PMCT and RF ablation were performed at 1 cm and 5 cm depth in bovid livers. PEIT was performed with 1, 2, 3 and 4 ml of ethanol, PMCT with 60 watt for a 30 th, 60 th and 120 th of a second, and RF ablation for 6, 8, 10, 12 and 14 minutes. Ultrasonography was used for the detection of the tissue necrosis that followed the different therapeutic modalities. RESULTS: For PEIT, the extent of the necrosis was smaller than that of the other modalities. For PMCT, the necrosis was elliptical and longer in length. For RF, the necrosis was oval and larger in size. At 1 cm depth for PMCT and RF ablation, the liver capsule was injured. CONCLUSION:We concluded that these different findings in tissue necrosis would aid in selecting the appropriate therapeutic method for hepatic tumors according to the tumors' shape, size and location.
Ethanol* ; Liver* ; Microwaves* ; Necrosis ; Ultrasonography

Leiomyomas most frequently occur in the genitourinary and gastrointestinal system. This report describes the clinical and imaging findings of a leiomyoma originating in the prevesical space, a rare location. The mass abutted the fundus of the uterus, but after the correct identification of feeding vessels from the right iliac artery, prevesical leiomyoma was diagnosed radiologically.
Iliac Artery ; Leiomyoma* ; Magnetic Resonance Imaging* ; Uterus

PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

PURPOSE: To evaluate the efficacy of percutaneous microwave coagulation therapy (PMCT) combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty-five nodular HCCs [long diameter of 1.2 -10 (mean, 3.4) cm] in 19 patients (15males and 4 females) were treated by PMCT 4-138 days after TACE. Under ultrasound guidance, the carcinomas were punctured with a 14-G guideneedle through which a microwave electrode(25.0 cm in length, 1.6mm in diameter) was inserted. To coagulate the HCCs and surrounding hepatic parenchyma, microwave irradiation at 60W for 45 -60 seconds was then applied. One to three sessions of PMCT were performed at intervals of 2-6 days, and one week to 29 months later, the therapeutic effect was evaluated by spiral CT, angiography, and serum alpha-fetoprotein. RESULTS: Eighteen of 25 HCCs (72.0%) were necrotized completely, but seven (28.0%) recurred. Ninety percent of HCCs smaller than 4 cm in long diameter showed complete remission, but all those larger than 4 cm recurred. Alpha-fetoprotein levels decreased markedly in five patients (26.3%), while in 12 (63.2%), asparate aminotransferase (AST)/alanine aminotransferase (ALT) showed transient elevation. Minor complications occurred after PMCT (mild abdominal pain in 8 patients, fever in 7, pleural effusion in 3, portal vein thrombosis in 1, and hepatic abscess in 1), but in no case was this serious. CONCLUSION: PMCT combined with TACE provides effective and safe treatement for nodular HCCs with a long diameter of less than 4 cm.
Abdominal Pain ; alpha-Fetoproteins ; Angiography ; Carcinoma, Hepatocellular* ; Fever ; Humans ; Liver Abscess ; Microwaves* ; Pleural Effusion ; Tomography, Spiral Computed ; Ultrasonography ; Venous Thrombosis

PURPOSE: To reduce ethanol reflux from the needle channel by injecting rat blood immediately after theinjection of ethanol into rat liver. MATERIALS AND METHODS: The first experiment involved 33 rat livers whichwere divided into four groups (three livers in group 1 ; ten in groups 2, 3, and 4). Group 1 animals were used ascontrols, and 0.1ml saline was injected into the liver ; in group 2, ethanol-Tc-99m-O4- mixed solution (0.1 ml,0.2 mCi) was injected into the liver ; in groups 3 and 4, the needle channel was blocked with 0.02 ml of freshblood and old blood, respectively, after the injection of ethanol. After removing the needle, a 3cm round filterpaper was laid on each injection site to absorb refluxed ethanol-Tc-99m-O4- mixed solution from the liver, andeach paper was then counted by a gamma camera unit. In the second experiment, 33 rats were divided into fourgroups (three rats in group 1 ; ten in groups 2, 3, and 4). Group 1 animals were used as controls, and afterexposing the left lateral lobe of the liver, 0.05 ml of saline was injected; in group 2, 0.05 ml of ethanol wasinjected into the liver in groups 3 and 4 the needle channel was blocked with 0.02 ml of fresh blood and oldblood, respectively, after the injection of ethanol. After ten days, peritoneal adhesions were scoredmacroscopically and microscopically. RESULTS: In the first experiment using ethanol-Tc-99m-O4- mixed solution,groups blocked with blood after the injection of mixed solution showed lower gamma counts than the group injectedwith mixed solution only (p-value = 0.0002). The group blocked with old blood showed the lowest count.Macroscopical and microscopical examination of peritoneal adhesions indicated that the grade of adhesion was lowerin groups blocked with blood than in the group injected with ethanol only (p-value = 0.0261 and 0.0163,respectively). CONCLUSION: The above results suggest that an injection of blood after an injection of ethanol isa very effective way of preventing reflux from the liver.
Animals ; Ethanol* ; Gamma Cameras ; Liver ; Needles ; Rats*

The antegrade puncture technique represents a new approach to percutaneous transhepatic cholangiography andbiliary drainage. With this technique, ductal puncture begins with the liver capsule toward the hepaticparenchyma. This report briefly describes this new technique, and its safety and feasibility.
Cholangiography* ; Drainage* ; Liver ; Punctures*

We experienced a case of Takayasus arteritis with eclampsia in a 43-year-old woman. The patient had angiographically definite Takayasus arteritis with the involvement of right common and internal carotid arteries. On MR images performed at clinical manifestations of eclampsia, unilateral involvement of T2 high signal intensities were demonstrated in right cerebral hemisphere. We report this case with a literature review.
Adult ; Carotid Artery, Internal ; Cerebrum ; Eclampsia* ; Female ; Humans ; Magnetic Resonance Imaging ; Pregnancy* ; Takayasu Arteritis*

PURPOSE: The purpose of this study was to investigate the pattern of cerebral response to motor tasks in patients with schizophrenia compared with normal subjects using functional MRI. MATERIALS AND METHODS: Nine right handed-schizophrenic patients and six right-handed normal subjects were included. We used right hand movement as task. Series of 120 consecutive echo-planar images per section were acquired during three cycles of task and rest activations. Lateralization index of cortical response was measured and compared between patients and normal subjects. RESULTS: Right hand motor task was associated with greater activation in left sensorimotor cortex than the right in normal subjects. Schizophrenia patients showed relatively decreased activation in left cortex and increased activation in right cortex compared with normal subjects. In one patient, reversed lateralization was noted. CONCLUSION: Normal hemispheric asymmetry of cortical response to motor task was found in different pattern in schizophrenia. Our result is consistent with functional disturbance of motor circuitry in this disorder. Functional MRI will play an important role in diagnosis and research of this disorder.
Brain ; Diagnosis ; Hand ; Humans ; Magnetic Resonance Imaging* ; Schizophrenia*