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

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: 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

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: To compare the findings of MR cholangiography with those of ultrasound and biochemistry in patients with suspected choledocholithiasis, and to evaluate the clinical utility and role of MR cholangiography prior to laparoscopic cholecystectomy. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings and clinical records of 103 consecutive patients in whom choledocholithiasis was suspected and who underwent both ultrasound and MR cholangiography. For MR imaging, a 1.5T unit was used, and axial T1-FLASH, True FISP, and oblique coronal HASTE and RARE images were obtained. Initial biochemical values (AST, ALT, total bilirubin) were correlated with the findings of MR cholangiography. RESULTS: Choledocholithiasis was present in 36 of 103 patients: overall, there were 34 true-positive, 63 truenegative, four false-positive, and two false-negative results. In the detection of choledocholithiasis, MR cholangiography showed the following characteristics: sensitivity, 94%; specificity, 94%; positive predictive value, 89%; negative predictive value, 96%; accuracy, 95%. Calculi in the common bile duct were detected in 3 of 33 patients (9%) in whom ultrasound showed that the caliber of the common bile duct was normal and whose laboratory findings were normal, and in 12 of 43 (28%) of those whose common bile duct was dilatated or whose laboratory values were abnormal. Calculi were present in the common bile duct of 21 of 27 patients (78%) with abnormal laboratory values and abnormal ultrasound findings. CONCLUSION: Choledocholithiasis was detected in 25% of patients without clinical suspicion and was not present in 25% of patients with strong clinical suspicion. In patients with this condition, MR cholangiography is noninvasive and accurate, and we suggest that in patients with suspected choledocholithiasis, it should be a routine diagnostic procedure prior to laparoscopic cholecystectomy.
Biochemistry ; Calculi ; Cholangiography* ; Cholecystectomy, Laparoscopic* ; Choledocholithiasis* ; Common Bile Duct ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

Spindle-cell carcinoma of the esophagus is a rare malignant tumor composed of both carcinomatous and sarcomatous elements, and has generated many terminology problems. It is characterized by a bulky polypoid intraluminal mass with a lobulated surface located in the middle third of the esophagus. Local expansion of this organ is observed. The lesion may be pedunculated but despite its bulk, causes little obstruction. We report the imaging findings of a case of spindle-cell carcinoma arising in the upper esophagus.
Carcinoma* ; Esophagus*

Warthin's tumor is a benign lesion of the salivary and principally-parotid gland. An extraparotid location is rare. We report a case of Warthin 's tumor which was located in the neck, far from the parotid gland.
Head and Neck Neoplasms ; Neck* ; Parotid Gland

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*