Functioning islet cell tumor of the pancreas. Localization with dynamic spiral CT

PURPOSE

The purpose of this study was to evaluate the usefulness of dynamic spiral CT, including multidimensional reformation, in the detection and localization of islet cell tumors of the pancreas.

MATERIAL AND METHODS

Seven patients with histopathologically proven functioning islet cell tumors of the pancreas were studied with 2-phase contrast-enhanced spiral CT. Scanning of the arterial phase and late phase was started 30 s and 180 s, respectively, after injection of 100 ml of contrast medium at a rate of 3 ml/s.

RESULTS

Axial images in the arterial phase depicted the lesions in 5 patients, but in the late phase in only one patient. Multiplanar reformatted images of the arterial phase depicted the lesions in all 7 patients. Maximal intensity projection images demonstrated all lesions with information of their relationship to the vascular structure.

CONCLUSION

Dynamic spiral CT with scanning during the arterial phase and retrospective multidimensional reformation is useful for preoperative detection and localization of small islet cell tumors of the pancreas.

Detection of hypervascular nodular hepatocellular carcinomas: value of triphasic helical CT compared with iodized-oil CT

OBJECTIVE

The objective of this study was to compare the capability of arterial, portal venous, and delayed phases of helical CT with that of iodized-oil CT for revealing nodular hepatocellular carcinomas.

MATERIALS AND METHODS

Forty-eight patients with nodular hepatocellular carcinomas underwent triphasic helical CT examination with 10-mm collimation at 10-mm/sec table speed. We injected 120 ml of contrast material (36 g of iodine) at the rate of 3 ml/sec. Arterial-phase, portal venous-phase, and delayed-phase images were obtained with 30-sec, 65-sec, and 360-sec delays, respectively. All 48 patients also underwent angiography and intraarterial infusion of iodized oil after helical CT; iodized-oil CT was performed about 2 weeks after infusion of iodized oil. Helical CT images were compared with iodized-oil CT images for revealing hepatic nodules.

RESULTS

In 48 patients, 79 hepatocellular carcinomas were seen with iodized-oil CT. Using helical CT, the arterial phase revealed 68 lesions (86%), the portal venous phase revealed 53 lesions (67%), and the delayed phase revealed 57 lesions (72%). The arterial phase proved superior to the portal venous and delayed phases for revealing lesions (p = .0025). The portal venous phase showed no significant difference for revealing lesions compared with the delayed phase. When combined, helical CT of the arterial and portal venous phases revealed 73 lesions (92%); a combination of the arterial and delayed phases revealed 72 lesions (91%); and a combination of the portal venous and delayed phases revealed 63 lesions (80%). Any combination of two phases that included the arterial phase proved superior to the combination of the portal venous and delayed phases (p = .0033). Overall, the combination of the arterial and portal venous phases (92%) or the combination of all three phases (92%) proved best at revealing lesions.

CONCLUSION

The arterial phase of helical CT is better for revealing nodular hypervascular hepatocellular carcinoma than are the portal venous and delayed phases. The combination of the arterial and portal venous phases is superior to the arterial phase alone. Also, the combination of the arterial and portal venous phases is equal to the combination of the three phases for revealing hypervascular hepatocellular carcinomas.

Insulin-induced maturation of Xenopus oocytes is inhibited by microinjection of a Brassica napus cDNA clone with high similarity to a mammalian receptor for activated protein kinase C

A cDNA clone encoding a WD-40 repeat protein (BGB1) was characterized in Brassica napus L. The clone contained an open reading frame of 327 amino acid residues almost entirely composed of seven segments of WD-40 repeats. Among the WD-40 repeat proteins, BGB1 showed high similarity (63% identity) to a rat intracellular receptor for protein kinase C (RACK1) that functions in the translocation of activated protein kinase C (PKC) from the cytosolic fraction to the membrane fraction. BGB1 also had two sequence motifs involved in binding of RACK1 to PKC. The cDNA clone, when carried in a Xenopus oocyte expression vector and injected into Xenopus laevis oocytes, inhibited insulin-induced maturation of the oocytes, a PKC-mediated pathway, and this inhibition was accompanied by reduction of PKC in the membrane fraction, as in the case of mammalian RACKs. The data show that BGB1 shares some common functional characteristics with the mammalian RACK1 along with the structural similarity, suggesting that a mammalian RACK1-related cellular process might be operating in plants. Southern blot analyses of the genome of B. napus and Arabidopsis thaliana (L.) Heynh. revealed that BGB1-related genes constitute a small multigene family in both species. An approximately 1.4-kb transcript was constitutively expressed in all organs examined.

Preoperative evaluation of the curative resectability of gastric cancer by abdominal computed tomography and ultrasonography: a prospective comparison study

OBJECTIVES

We compared the ability of preoperative abdominal computed tomography (CT) with that of preoperative abdominal ultrasonography (US) in predicting the extent of tumor growth and the curative resectability of gastric cancer.

METHODS

Abdominal CT and US were done in 95 patients with gastric adeno-carcinoma. The radiologic findings were prospectively compared with surgical and pathologic findings.

RESULTS

The sensitivities of abdominal CT and US in detecting the perigastric lymph node involvement were 26.6% and 20%, respectively. The sensitivity of abdominal CT in predicting the pancreatic invasion (60%) was better than that of abdominal US (20%). However, there were 6 false positive diagnosis of pancreatic invasion by abdominal CT; in contrast, there was no false positive diagnosis of pancreatic invasion by abdominal US. Of 95 patients who underwent surgical exploration, 14 were found to have unresectable tumors because of extragastric organ involvement and distant metastases. Abdominal CT falsely predicted 8 of 14 cases in which curative gastric resection was impossible as resectable. Moreover, abdominal CT falsely predicted 5 of 81 cases in which curative gastric resection was possible as unresectable. Abdominal US falsely predicted 12 of 14 cases in which curative surgery was impossible as resectable.

CONCLUSION

Preoperative abdominal Ct and US did not accurately predict the tumor extent and the curative resectability of the gastric cancer. Especially, abdominal CT finding of pancreatic invasion by gastric cancer should not be a contraindication for surgical exploration.

Helical CT anatomy of pancreatic arteries

BACKGROUND

To assess the frequency of visualization of pancreatic arteries in the arterial phase of helical computed tomography (CT).

METHODS

The visibility of pancreatic and peripancreatic arteries in helical CT images was evaluated in 20 consecutive patients who had no evidence of pancreatic disease. CT examinations were performed by using a continuously rotating CT scanner and intravenous injection of contrast media. The scans were taken 35 s after the start of injection and with a table speed of 3 mm/s. Images were reconstructed in 3-mm section increments.

RESULTS

Frequently visualized arteries were the gastroduodenal, anterior and posterior superior pancreaticoduodenal, and right gastroepiploic arteries. Infrequently visualized arteries were the dorsal pancreatic, pancreatica magna, caudal pancreatic, transverse pancreatic, and common, anterior, and posterior inferior pancreaticoduodenal arteries.

CONCLUSION

Helical CT enabled us to recognize small pancreatic arteries, and the evaluation of these arteries should be considered in the staging of pancreatic carcinoma.

Tuberculous colitis. Findings at double-contrast barium enema examination

PURPOSE

This study was undertaken to elucidate characteristic findings of tuberculous (TB) colitis at double-contrast barium enema examination (DCBE).

MATERIALS AND METHODS

Twenty-five patients with TB colitis diagnosed by biopsy (n = 13) or therapeutic trial (n = 12) were included. DCBE findings were retrospectively analyzed, with special emphasis on distribution of lesions and mucosal changes.

RESULTS

Involvement was asymmetric in 12. The lesion was noted more commonly in the ascending colon (n = 23), cecum (n = 21), and terminal ileum (n = 19) compared with the transverse colon (n = 15) and descending and sigmoid colon (n = 9). Skipped lesions were seen in 13 patients. Sixteen patients had multiple ulcers that were mostly transverse or circumferential in alignment (n = 11). Depth of ulcers was superficial (< 2 mm) in 9 patients and deep in 13. Two patients had fistulas. Twelve patients had inflammatory polyposis. Three patients presented with mass, and misdiagnosis of malignant tumor was made in two. Thickening, deformity, and incompetence of the ileocecal valve were frequently noted (5, 6, and 8, respectively).

CONCLUSION

DCBE revealed detailed mucosal changes of TB colitis. Ulcers aligned in transverse or circumferential pattern, involvement of the right side colon, and deformity of the ileocecal valve suggest diagnosis of TB colitis.

Iodized-oil retention within hepatic hemangioma: characteristics on iodized-oil CT

OBJECTIVE

The purpose of this study was to describe the characteristic computed tomographic (CT) appearance of iodized-oil retention in hepatic hemangioma and to evaluate the duration of the retention of iodized oil on follow-up CT.

METHODS

Seventeen hepatic hemangiomas of 14 patients were studied with CT performed 1-3 weeks after injection of 2-9 ml of iodized oil (iodized-oil CT) for the characterization of focal hepatic lesions, which needed differential diagnosis with hepatocellular carcinoma in 10 patients, for therapy in two patients, and for chemoembolization therapy of accompanying hepatocellular carcinomas in two. Twelve patients had 1-7 follow-up CT scans within an interval of 1-38 months.

RESULTS

In all cases, iodized-oil CT showed iodized-oil retention within the tumor, regardless of tumor size, shape, location, and amount of injected iodized oil. The distribution was incomplete and predominantly peripheral in all cases. Central retention was also seen in seven cases, in which a relatively large amount of iodized oil was injected, but retention of iodized oil in the tumor was incomplete even in two cases in which a large amount of iodized oil was injected to relieve symptoms and in three cases in which prominent uptake of surrounding liver parenchyma was seen. Patterns of retention were predominantly spotty in five, predominantly nodular in four, and mixed in eight patients. Retention materials slowly washed out but persisted for at least 3 months and up to 38 months (mean = 18.1 months), and complete washout was not seen in any cases at follow-up CT.

CONCLUSION

In all cases of hepatic hemangiomas, iodized oil was retained, and retention persisted over several months. Distribution and patterns of retention were characteristically peripheral, spotty, and nodular at iodized-oil CT. Knowledge of the iodized-oil CT appearance of hepatic hemangioma would be helpful to interpret follow-up CT studies of patients who have undergone iodized-oil chemoembolization procedures.

Spiral CT for the detection of hepatocellular carcinomas:relative value of arterial- and late-phase scanning

BACKGROUND

Spiral computed tomography (CT) can image the liver during arterial and late phases of contrast and optimize the evaluation of hypervascular tumor. The objective of this study was to evaluate the relative value of arterial- and late-phase spiral CT in the detection of hepatocellular carcinomas.

METHODS

Fifty-eight patients with hepatocellular carcinomas underwent two-phase spiral CT examination with 10-mm collimation at 10 mm/s table speed (Siemens Somatom Plus S), and 120 mL of contrast material (36 g iodine) was injected at the rate of 3 mL/s. CT images of hepatic arterial and late phases were obtained with a 35-s and 180-s delay, respectively.

RESULTS

In 58 patients, 111 hepatocellular carcinoma lesions were seen. The arterial phase detected 93 (84%) and the late phase 75 (68%) lesions (p < 0.01). The arterial phase detected more lesions in 11 patients, and the late phase detected more in two patients and an equal number in 45 patients. If lesions larger than 2 cm are excluded, the arterial phase detected 40 (74%) and the late phase 21 (39%) of 54 lesions (p < 0.001).

CONCLUSION

The arterial phase of spiral CT greatly improves the detection of hepatocellular carcinoma when compared with the late phase.

Hemodynamic characteristics of extracellular UTP in the perfused rat liver

Uridine 5'-triphosphate (UTP) is stored in the granules of cells such as platelets and is released into the extracellular space upon cell stimulation. Extracellular UTP is known to influence many biological processes. We investigated the hemodynamic effects of UTP on the perfused rat liver and characterized its receptors. Liver perfusions were performed in a recirculation system under constant pressure (28 cmH2O). The perfusion flow and oxygen consumption rate were measured at 30 second intervals. UTP decreased the perfusion flow and the oxygen consumption rate, dose-dependently. UTP-induced changes were transient and disappeared in about 10 minutes. Suramin (P2-purinergic antagonist, 100 uM) and indomethacin (cyclooxygenase inhibitor, 20 uM) blocked UTP-induced hemodynamic changes significantly. The effects of UTP were also inhibited when Kupffer cells were damaged with treatment of gadolinium chloride (10 mg/kg iv). L-NAME (1 mM), a potent inhibitor of nitric oxide synthase, markedly enhanced and prolonged the contractile response of UTP in the hepatic vessel. These results suggest that UTP acts mainly on suramin-sensitive UTP receptors on the Kupffer cell through prostanoid synthesis. The nitric oxide systems in the endothelium seem to counteract the vasoconstrictile action of UTP in the hepatic circulation.

Intraperitoneal drop metastases from hepatocellular carcinoma: CT and angiographic findings

Our goal was to describe the radiological manifestations of intraperitoneal drop metastases (IPDMs) from hepatocellular carcinoma (HCC).

METHODS

Seven patients with clinically (n = 4) or pathologically (n = 3) proven IPDMs from HCC were retrospectively analyzed. Medical records, CT scans (n = 7), and angiographic findings (n = 5) were reviewed.

RESULTS

On CT scans, all seven patients had single or multiple nodular masses in the liver. In six patients, the hepatic masses showed an exophytic growth. Single (n = 4) or multiple (n = 3) discrete omental masses, 3-10 cm in diameter, were also demonstrated in all patients. Intratumoral necrosis in the omental mass and engorgement of adjacent omental vessels were demonstrated in five and three patients, respectively. On angiography, the omental masses showed hypervascularity supplied by omental branches (n = 4) and superior mesenteric (n = 2) and inferior mesenteric (n = 1) artery and also showed prominent draining veins.

CONCLUSION

The radiological manifestations of IPDM from HCC are single or multiple discrete hypervascular masses in the omentum. These are quite different from those of usually carcinomatosis peritonei.

Power versus conventional color Doppler sonography: comparison in the depiction of vasculature in liver tumors

PURPOSE

To compare power and conventional color Doppler sonography in the depiction of the intratumoral vasculature of hemangiomas, hepatocellular carcinomas (HCCs), and metastases of the liver.

MATERIALS AND METHODS

Thirty-two patients with liver tumors (12 hemangiomas, 11 HCCs, and nine metastases) were prospectively evaluated with power and conventional color Doppler sonography by using a 2-4-MHz convex probe with 2-MHz Doppler frequency. Power Doppler sonography was performed with a 75%-88% gain. Conventional color Doppler sonography was performed with a 55%-75% gain and a pulse repetition frequency of 700 Hz. Power Doppler signals and color Doppler signals interrogated in one plane were analyzed by two radiologists, who subjectively rated power Doppler sonography as superior, equal, or inferior to color Doppler sonography.

RESULTS

Overall, power Doppler sonography was superior to color Doppler sonography in 18 patients and equal in 14 (P < .01). In hemangiomas, power Doppler sonography was superior to color Doppler sonography in 10 patients and equal in two (P < .01). In HCCs, power Doppler sonography was superior to color Doppler sonography in four patients and equal in seven (P > .05). In metastases, power Doppler sonography was superior to color Doppler sonography in four patients and equal in five (P < .05).

CONCLUSION

Power Doppler sonography is more sensitive than color Doppler sonography in the depiction of the vasculature of liver tumors, particularly in hemangiomas.

MR findings in human fascioliasis

Fasciola hepatica is a trematode of herbivorous mammals, and man is infected by accidental ingestion of contaminated raw aquatic vegetables or water. There have been many reports on computed tomographic and cholangiographic features of human fascioliasis. However, findings of magnetic resonance (MR) imaging have not been reported. Hepatic fascioliasis produces three types of lesions in MR images arranged in tract-like fashion. The outermost area presents as an iso-signal area in T1WI, with slightly higher signal intensity in T2WI and diffuse enhancement after i.v. contrast. The second type presents as a well defined low signal area in T1WI, not enhanced, and also shows low signal intensity in T2WI. The third type has low signal intensity in T1WI, is not enhanced, and has high signal intensity in T2WI which is similar to fluid-containing inflammatory lesions such as pyogenic abscess. These findings suggest various changes associated with traumatic hepatitis caused by the migration of the worm in the liver. This diverse signal intensity can be a suggestive finding of fascioliasis.

Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization

PURPOSE

To elucidate major complications and their predisposing factors in transcatheter oily chemoembolization (TOCE) for hepatic tumors.

MATERIALS AND METHODS

In a retrospective study of 351 patients (aged 26-82 years) with hepatic tumors, TOCE was performed 942 times with an emulsion of iodized oil (3-40 mL) and doxorubicin hydrochloride (20-60 mg). In 126 patients, TOCE was followed by absorbable gelatin sponge embolization.

RESULTS

Complications were severe postembolization syndrome (n = 53); hepatic insufficiency (n = 20), infarction (n = 1), or abscess (n = 1); intrahepatic biloma formation (n = 3); tumor rupture (n = 3); septicemia (n = 9); coagulopathy (n = 1); gastrointestinal bleeding (n = 10); gallbladder (n = 5) or splenic infarction (n = 4); pulmonary oil embolism (n = 6); and spinal cord injury (n = 1). Important predisposing factors were major portal vein obstruction, compromised hepatic functional reserve, biliary obstruction, previous biliary surgery, excessive amount (> 20 mL) of iodized oil, hepatic arterial occlusion after repeated TOCE, and nonselective embolization.

CONCLUSION

Most patients with major complications after TOCE had preexisting risk factors.

Focal hepatic nodules after transcatheter oily chemoembolization; detection with spiral CT versus conventional CT

BACKGROUND

The objective of this study was to determine if spiral computed tomography (CT) results in increased rate of detection of focal hepatic nodules containing iodized oil after transcatheter oily chemoembolization when compared with conventional CT.

METHODS

Spiral CT with single 24-s breath-hold technique was compared with conventional sequential CT in 42 patients with suspected hepatocellular carcinomas. Two sets of CT scans obtained after transcatheter oily chemoembolization were independently reviewed by two radiologists. The slice thickness was 10 mm for both data sets. The number and sizes of focal hepatic nodules containing iodized oil were documented. All 42 patients had at least hepatic nodule. The lesion size varied from 2 mm to 12 cm.

RESULTS

In six of the 42 patients, more hepatic nodules could be identified on spiral CT compared with conventional CT. When scans with spiral CT were used, 107 nodules were detected, whereas 98 nodules were detected with conventional CT. Overall, nine (9%) more nodules were detected with spiral CT (p = .002). If lesions larger than 2 cm are excluded, nine (15%) more lesions were detected with spiral CT (p = .002).

CONCLUSION

Spiral CT results in increased rate of detection of focal hepatic nodules after transcatheter oily chemoembolization, particularly in lesions smaller than 2 cm.

Reducing PIP2 hydrolysis, Ins(1,4,5)P3 receptor availability, or calcium gradients inhibits progesterone-stimulated Xenopus oocyte maturation

In this report, we investigated the possibility that a product of phosphatidylinositol 4,5-bisphosphate (PIP2) breakdown, inositol 1,4,5-trisphosphate (Ins(1,4,5)P3), and its downstream effector, Ca2+, is involved in oocyte maturation. Microinjection of monoclonal antibody specifically directed to PIP2 into oocytes prior to progesterone addition inhibited meiotic maturation. In addition, preventing or suppressing the progesterone-induced increase in [Ca2+]i and maintaining cytosolic free Ca2+ of oocyte at 0.1 or 0.3 microM by Br2-BAPTA buffered Ca2+ solutions, completely blocked maturation. However, raising cytosolic Ca2+ concentration of oocyte to 1.0 or 3.0 microM, the inhibitory Br2-BAPTA effects on oocyte maturation was greatly diminished. Finally, microinjection of heparin, a potent antagonist of Ins(1,4,5)P3 receptor, inhibited progesterone-induced oocyte maturation in a manner that is linearly proportional to its cytoplasmic concentration. These results strongly support the hypothesis that PIP2 turnover as well as Ins(1,4,5)P3-induced Ca2+ release play crucial roles in regulating normal meiotic cell division in Xenopus oocyte.

Characterization of focal hepatic tumors. Value of two-phase scanning with spiral computed tomography

BACKGROUND

Spiral computed tomography (CT) allows imaging of the liver during the peak contrast material levels due to the capability of fast data acquisition. The objective of this study was to evaluate the usefulness of two-phase spiral CT in the differential diagnosis of focal hepatic tumors.

METHODS

One hundred two patients who had hepatic tumors (211 nodules; 149 hepatocellular carcinomas [HCCs], 36 metastases, and 26 hemangiomas) underwent two-phase spiral CT with 10-mm collimation at 10 mm/second table speed and 120 mL of contrast material injected at the rate of 3 mL/second. Computed tomography images of the hepatic arterial phase and late (equilibrium) phase were obtained at 35-second and 180-second delays, respectively. The enhancement patterns of tumors were divided into six types and were compared with the attenuation of surrounding liver parenchyma: totally high, peripherally high, centrally high, mixed, iso, and low.

RESULTS

The common enhancement patterns of HCC in two-phase spiral CT were totally high in the arterial phase and low (n = 63, 42%) or iso (n = 28, 19%) in the late phase. Metastasis showed peripherally nonnodular high attenuation (n = 9, 25%) or low attenuation (n = 9, 25%) in the arterial phase and low attenuation in the late phase, followed by totally high attenuation in the arterial phase and iso in the late phase (n = 6, 17%). Hemangiomas showed totally or peripherally nodular enhancement in the arterial and late phases (n = 23, 89%). In distinguishing hemangiomas from malignant tumors, totally high or peripherally nodular high attenuation in the late phase was the most useful contrast enhancement pattern (96% of hemangioma vs. 0% of malignant tumors). In distinguishing HCCs from metastases, a combination of contrast enhancement pattern of totally high attenuation in the arterial phase and low in the late phase was the most useful contrast enhancement pattern (42% of HCCs vs. 0% of metastases). The predictability of differentiation between hemangiomas and malignant tumors and between HCCs and metastases was 99% and 90% with spiral CT, respectively.

CONCLUSIONS

Two-phase spiral CT is useful in the differential diagnosis of focal hepatic tumors with evaluation of contrast enhancement patterns.

Hepatocellular carcinoma and portal vein invasion: results of treatment with transcatheter oily chemoembolization

OBJECTIVE

Our objective was to evaluate the efficacy and safety of transcatheter oily chemoembolization therapy in a series of patients with hepatocellular carcinoma and portal vein invasion.

MATERIALS AND METHODS

We retrospectively analyzed the results of transcatheter oily chemoembolization for 110 patients with hepatocellular carcinoma invading major portal branches. The Child's classes were A for 94 patients and B for 16. The main portal vein was partially (n = 33) or completely (n = 15) invaded in 48 patients, the right portal vein was invaded in 36, and the left portal vein was invaded in 26. Oily chemoembolization was performed with an emulsion of iodized oil and doxorubicin hydrochloride. Gelatin sponge particle embolization was added for 78 patients. Seventy-one patients underwent multiple treatment sessions.

RESULTS

Our initial findings showed that 31 patients had complete or partial remission, with an overall median survival time of 6 months. The cumulative survival rates were 48% (6 months), 30% (1 year), 18% (2 years), and 9% (3 years). The parenchymal tumor extent was the most significant predicting factor for complications and efficacy of therapy. Of 33 patients with a parenchymal tumor limited to one or two segments of a hepatic lobe, 22 had complete or partial remission, with a median survival time of 22 months; this survival time was significantly longer than that (5 months) for 77 patients with a more extensive tumor (p < .0001). Hepatic insufficiency developed in 10 patients, and three of them died within 1 month after chemoembolization. All 10 patients had an extensive parenchymal tumor involving more than two hepatic segments, and four had impaired hepatic functional reserve of Child's class B.

CONCLUSION

When a tumor is limited in extent and hepatic function is preserved, transcatheter oily chemoembolization is effective and safe for the palliation of hepatocellular carcinoma and major portal vein invasion. However, when a parenchymal tumor is extensive, chemoembolization is associated with a poor response and a risk of hepatic failure.

Peripheral cholangiocarcinoma: comparison of MRI with CT

To evaluate the clinical utility of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of peripheral cholangiocarcinoma of the liver, 11 patients with pathologically proven peripheral cholangiocarcinoma were examined with both CT and MRI. On CT scans in 10 cases, the tumors appeared as irregular, low-attenuation masses with a wide variation in heterogeneity. Contrast enhancement of the tumors was mild in nine cases and moderate in one case, at the periphery. Tumor was not identified in one case. On T1-weighted MRIs, the tumors showed low intensity in eight cases and isointensity in three cases. On T2-weighted images, the tumors showed high intensity in all 11 cases. Focal dilatation of the intrahepatic bile ducts around the tumor was seen in one case on MRIs and in four cases on CT scans. Portal vein invasion of the tumors was seen in one case, and lymphadenopathy was seen in four cases on both MRIs and CT scans. MRI was slightly superior to CT in detecting the tumors, was inferior to CT in delineating focal ductal dilatation around the tumors, and was equal to CT in assessing extent of the tumors.

Cystic peripheral cholangiocarcinoma: sonography and CT

A case of cystic peripheral cholangiocarcinoma is presented. Both sonography and computed tomography (CT) demonstrated a large intrahepatic cystic neoplasm containing an enhancing solid portion. Despite the very rare incidence of this tumor, we believe that cystic degeneration of peripheral cholangiocarcinoma should be considered with these radiologic findings.

Oscillation of inositol polyphosphates in the embryonic cleavage cycle of the Xenopus laevis

Evidence suggests that a transient increase in intracellular calcium ([Ca2+]i) is an important modulator during the cell division cycle in early embryos. We have recently shown that inhibition of Ins(1,4,5)P3-induced Ca2+ release in the cleaving Xenopus embryos greatly lengthens the cell cycle duration. In this report, we have directly measured the changes of Ins(1,4,5)P3 content during the first two cleavage cycles in the Xenopus embryos. HPLC profiles of cell extracts from dividing embryos show oscillations of inositol polyphosphates throughout the cleavage cycle with a transient production of Ins(1,4,5)P3 by the time of cleavage furrow completion. In addition, cyclic changes in inositol phospholipids, phosphatidylinositol 4,5-bisphosphate (PIP2) and phosphatidylinositol 4-phosphate (PIP) were detected during the cleavage cycle. These data strongly suggest the involvement of PIP2 turnover and periodic increase in Ins(1,4,5)P3 triggers [Ca2+]i transients during the early embryonic cell cycle in the Xenopus.

Iatrogenic dissection of the celiac artery and its branches during transcatheter arterial embolization for hepatocellular carcinoma: outcome in 40 patients

PURPOSE

To study the sequelae of iatrogenic dissection of the celiac axis and its branches in a large patient population.

METHODS

We analyzed 40 patients with hepatocellular carcinoma (HCC) whose celiac artery or its branches were dissected during transcatheter arterial embolization (TAE) and underwent follow-up angiography within 2 months.

RESULTS

The two most common sites of dissection were the celiac artery in 13 patients (32.5%) and the proper hepatic artery in 11 patients (27.5%). Follow-up angiography revealed complete recanalization in 32.5% (13/40), irregularity and narrowing of the lumen in 40% (16/40), and complete obstruction in 27.5% (11/40). Therefore, 72.5% (29/40) of the dissected arteries recanalized. Pseudoaneurysm formation of the dissected artery was observed in 32.5% (13/40). Subsequent TAE was possible via the dissected arteries in 79% (27/34) of patients in this series.

CONCLUSION

Iatrogenic dissection of the celiac and proximal hepatic arteries heals spontaneously in the majority of patients, and in most instances allows subsequent TAE.