PURPOSE:To lower the rate of cutaneous complications after transcatheter arterial treatment for hepatocellular carcinoma (HCC) via the internal mammary artery (IMA) we retrospectively assessed the complications.MATERIALS AND METHODS:We reviewed cutaneous complications in 14 patients with 18 HCCs who had undergone 17 treatment procedures via the IMA, including selective transcatheter arterial infusion chemotherapy with Lipiodol (Lip-TAI) (n = 3), selective Lip-TAI + transcatheter arterial embolization (TAE) (n = 3), nonselective Lip-TAI (n = 1), nonselective Lip-TAI + TAE (n = 5), and nonselective TAE (n = 5). The filling and nonfilling of subcutaneous vessels with Lipiodol was examined on postoperative computed tomography (CT) scans.RESULTS:Skin rash (n = 3) and ulceration (n = 1) occurred after 4 of 17 (24%) procedures: two of three selective Lip-TAI procedures and two of five nonselective Lip-TAI + TAE procedures. The doses of chemotherapeutic agents for tumor sizes in selective Lip-TAI procedures were higher than those in selective Lip-TAI + TAE procedures. Cutaneous complications were encountered after two of three procedures with filling but not after any of eight procedures without filling.CONCLUSION:A lower dose of chemotherapeutic agents may be less risky when undertaking a selective procedure via the IMA for HCC. If nonselective, TAE alone may be less risky. Postoperative CT may be helpful for predicting cutaneous complications.

We have developed an automated computerized schema for the detection of lung nodules in 3D CT images obtained by helical CT. In our previous schema, linear discriminant analysis (LDA) and a rule-based method with 53 image features were employed in order to reduce false positives. However, several false positives have remained. Therefore, in this study, we improved the false-positive reduction technique by using the edge image and radial image analysis. Overall performance for the detection of lung nodules was greatly improved. Sensitivity was higher than that of our previous study. Moreover, we evaluated the overall performance of the new scheme by using 69 cases acquired from four hospitals. The average number of false positives was 5.2 per case at a percent sensitivity of 95.8%. Our new scheme would assist in the detection of early lung cancer.

We have developed an automated computerized method for the detection of lung nodules in three-dimensional (3D) computed tomography (CT) images obtained by helical CT. In this scheme, a lung segmentation technique for the determination of the nodule search area is performed based on a gray-level thresholding technique. To enhance lung nodules, we employed the 3D cross-correlation method by using a 3D Gaussian template with zero-surrounding as a model of lung nodule. False positives are then eliminated by using a rule-base with 53 features. For further reduction of false positives, we performed linear discriminant analysis using these 53 features. The average number of false positives was 6.7 per case at a percent sensitivity of 85.0%. This computerized scheme will be useful to radiologists by providing a "second opinion" in case of possible early lung cancer.

年以上CTによる経過観察が行われた肺野型肺腺癌について, retrospectiveに発育形態の検討を行った.対象は, 1年以上経過観察が行われた肺腺癌5症例で, 組織型は高分化乳頭腺癌3症例, 高ないし中分化乳頭腺癌1症例, 低分化腺癌1症例である.腫瘤影のdoubling timeは, 高～ 中分化乳頭腺癌の4例では14.8～36.8月で, 低分化腺癌の1例では10.0月であった.高ないし中分化乳頭腺癌の3症例で, 腫瘤影の大きさがほとんど変化していないのにもかかわらず胸膜または血管の巻き込みが増強する時相が存在した.また全症例で種瘤内部にair bronchogramが認めら礼内3例では経過中にair bronchogramは狭小化あるいは消失した.確定診断のついていない孤立性肺結節をCTなどにより経過観察を行う際は, 以上に述べたような腺癌の発育様式を念頭に置く必要がある.

A case of pancreatic arteriovenous malformation (AVM) with hepatocellular carcinoma is reported. The patient, a 56-year-old Japanese man, was asymptomatic. The pancreatic lesion was found incidentally during an evaluation for hepatocellular carcinoma. Celiac arteriogram demonstrated tortuous feeding arteries, a racemose intrapancreatic stain, which disappeared before the venous phase, and early portal filling.

The colon is the least common site for leiomyosarcoma (LMS) throughout the entire gastrointestinal tract. Fifty-eight cases of colonic LMS have been so far reported in the Japanese literature. We report a case of large LMS which arised in the transverse colon.The case was a 53-year-old man complaining of upper abdominal pain with a palpable hand-grip sized mass in the right upper quadrant. Although computed tomograpy scan revealed a low density area in the tumor which acounted for central necrosis, preoperative diagnosis was colonic carcinoma. Right hemicolectomy with lymph nodes dissection (R3) was performed. The tumor, 170×105×70 mm in size, and of intraluminal type, was located at the transverse colon adjacent to the hapatic flexure. Neither lymph node involvement nor liver metastasis was present.Receiving no chemotherapy, the patient has spent 4 years and 2 months without any sign of recurence or metastasis.

During the past ten years, 180 patients with liver cirrhosis and hematologic disorders underwent splenectomy and distal splenorenal shunts, 56 of whom were evaluated by CT, ultrasonography (US) and/or angiography, postoperatively at Hiroshima University Hospital and Hiroshima Red Cross Hospital. Five patients were asymptomatic; thrombosis was observed in 10; and two died of liver failure. Three patients each complained of postprandial epigastralgia with diarrhea, fever, and general malaise. Angiography was performed to evaluate the patency of the shuts; CT and US, to follow up the liver cirrhosis not the portal vein thrombosis. Since thrombosis of the portal venous system occurs frequently during surgery, and since it causes marked changes in portal vein hemodynamics, the portal and superior mesenteric veins must be observed by US and CT for the early postoperative detection and treatment, to avoid major surgery.

びまん性肝疾患におけるdynamic CTの診断的有用性を検討する目的で,32例の肝硬変,23例の慢性活動性肝炎(CAH), 15例の正常例に対し本法を実施した.各症例の肝右葉から得られたtime-density curveを数量的に評価するためgamma variatefit techniqueを用い,fitting equationの2つの係数(α,β)から導びかれた3つのparameterすなわちrise time (RT), decay time (DT), corrected first moment (MC)を比較することによりcurveの変化を分析した.3つのparameterは疾患の重症度に伴い増加し,これは障害された肝のcurveでpeakが遅れ,下降部分の傾きが緩徐化し,curveが遅延することを反映したものであった.MCは疾患の程度と最良の相関を示し,MC>95の33例中30例が肝硬変,95≧MC>70の21例中19例がCAH,70≧MCの16例中15例が正常であった.以上よりgamma variate fitによるdynamic CT time-density studyはびまん性肝疾患の鑑別診断に有用であることが結論された.