Journal De Radiologie最新文献

Purpose

To determine the presence of Gamna-Gandy bodies (GGB) on MRI in patients with liver cirrhosis.

Patients and methods

A total of 117 consecutive patients with cirrhosis followed-up by MRI were retrospectively reviewed. Two groups were defined: the first group included patients with GGB on MRI (n = 15), the other group included patients without GGB (n = 102). Both characteristics of groups were reviewed using standard cirrhosis criteria evaluation: sex, age, etiology of cirrhosis, Child-Pugh score, presence of esophageal varices, splenomegaly, ascitis, recanalization of the periumbilical veins, and presence of hepatic encephalopathy. Fisher's exact test and student t-test were used to compare both groups.

Results

GGB were more frequently observed in patients with splenomegaly (P = 0.035). Hemochromatosis was the only etiology for cirrhosis statistically correlated to the presence of GGB (P = 0.006) in our series. No other statistically significant association was noted between GGB and other characteristics of our cirrhotic patients.

Conclusion

Easily identified on all MRI pulse sequences, GGB do not correlate with the severity of cirrhosis. However, they are strongly correlated with the presence of splenomegaly and may be the result of segmental splenic hypertension. They are frequent in patients with hemochromatosis.

The purpose was to determine the efficacy and technical particularities related to the use of Amplatzer^® Vascular Plugs (AVP) for preoperative portal vein embolization. Between 2005 and 2009, a total of 48 type I AVP were embolized into the portal venous system of 17 patients (51–83 years) prior to extended hepatic resection where the residual liver volume (RLV) was deemed sufficient (RLV < 35–40% in patients with underlying hepatocellular disease, < 25–30% in patients with normal liver). AVP were used alone in seven patients and combined to other embolization agents in 10 patients (coils: n = 5, microparticles: n = 1, resorbable gel foam: n = 4). The procedure was technically successful in 100% of cases with immediate success rate of 94.1% (imcomplete embolization of a segmental branch of segment VIII). The procedure was well tolerated clinically in 94.1% of cases, and in 100% of cases based on laboratory values. The rate of recanalization on follow-up CT at 5 weeks (2–22) was 11.7%. The rate of complications, major (left portal vein thrombosis following right portal vein embolization) and minor (one case of portovenous fistula), was 11.7%. The rate of RLV growth was from +13 to +285 cm³ (mean at +122 cm³), or +4.98 to +78.51% (mean at +33.3%) (hepatocellular carcinoma: mean of +30.7%, metastases: mean of +19.7%). The rate of surgical candicacy was 94.1% (two patients were excluded: insufficient growth of RLV, development of peritoneal carcinomatosis). AVP appear to be reliable and effective for the preoperative embolization of the portal vein, with low morbidity and sufficient growth of RLV.

Purpose

We have studied the post-treatment follow-up of patients with history of limb soft tissue sarcoma including MR imaging to determine its added value compared to simple clinical follow-up and the impact of MR imaging findings on patient management. We have also studied the value of chest CT to detect metastases.

Patients and methods

Retrospective study of 85 patients treated for limb soft tissue sarcoma with post-treatment MR imaging of the affected region. We have studied the percentage of local recurrences and the modality of detection of these recurrences. We have evaluated the impact on management of patients with abnormalities detected on MRI. For distant metastases, we have recorded their percentage and date of occurrence.

Results

There were five cases of local recurrence, for a percentage of 6%, with 50% detected clinically. The percentage of metastases was 26%. Six biopsies were performed and complementary examinations were performed in 18 cases based on abnormalities detected on MR.

Conclusion

These results are in keeping with recommendations from the Fédération nationale des centres de lutte contre le cancer. Imaging is necessary to detect lung metastases.