Tumor chemotherapy is a treatment method that employs chemotherapeutic drugs to eradicate cancer cells. These drugs are cytotoxic, meaning they can affect both tumor cells and normal cells. In recent years, there has been a gradual increase in chemotherapy-induced liver injury. Chemotherapy-induced parenchymal liver injury often manifests as diffuse lesions, although focal lesions can occasionally be observed. There is a diversity in the pathogenesis and pathological changes of chemotherapy-induced focal liver disease. Radiologically, there is often challenging in differentiating chemotherapy-induced focal liver disease from hepatic metastases. Therefore, early and accurate diagnosis of this condition poses a certain challenge in clinical practice. This article presents the radiological findings of a case of chemotherapy-induced focal liver disease induced by chemotherapy for gastric cancer, and summarizes the radiological features and differential diagnostic points of chemotherapy-induced focal liver disease, aiming to enhance the understanding of this type of lesion among radiologists and clinicians and reduce related missed diagnoses and misdiagnoses.
Objective To review the examination techniques and the current research progress of the magnetic resonance diffusion weighted-imaging (DWI) used in liver. Methods The recent and relevant literatures about the principles and the current study situation of liver DWI were scrutinized and analyzed retrospectively. In addition, the existing problems of liver DWI were discussed. Results DWI could demonstrate the normal and abnormal structure and function through measuring the diffusion motions of water molecule in the liver. With the improving technology and better understanding of diffusion dynamics, DWI has been used for the diagnosis and differential diagnosis for hepatic diseases. Conclusion DWI as a non-invasive examine method, may provide valuable functional information for clinical diagnosis and treatment.
Objective To summarize manifestation, imaging characteristics, and treatment of hepatic focal nodular hyperplasia (FNH). Methods From January 2007 to December 2016, the patients pathologically confirmed hepatic FNH were included in this study. The clinical features and imaging characteristics were analyzed retrospectively. Results Twenty-two cases were pathologically diagnosed as hepatic FNH with an age of (36.8±11.2) years (range from 20 to 61 years). Ten were males and 12 were females. Three patients had abdominal pain and 19 patients had no symptoms. The diameter of the lesions was (4.16±1.92) cm (range from 1.0 to 7.8 cm) and approximately 9 (40.9%) lesions were more than 5.0 cm. The diagnosis rates of CT and MRI were 64.70% (11/17) and 84.21% (16/19), respectively. All the patients underwent hepatectomy successfully and recovered without severe complications. No recurrence and metastasis happened during following-up of 1–103 months. Conclusions Hepatic FNH is more common in young patients and has no typical symptoms. MRI is useful in diagnosis of hepatic FNH.
ObjectiveTo explore the clinical features and sum up the laws of the hepatic focal nodular hyperplasia (FNH) in its diagnosis and treatment. MethodsFNH was an uncommon benign hepatic tumor that often posed diagnostic dilemmas. We analyzed retrospectively the clinical, imaging of ultrasound, imaging of computed tomography (CT) and magnetic resonance images (MRI), and pathological materials of 21 patients with FNH proven by the pathological diagnosis during 5 years from April 1996 through April 2001 in two hospitals. ResultsThe diagnosis of FNH remained a challenge for clinicians and surgeons. Rate of correct diagnosis of FNH was low preoperatively (19.0%). The lesions of FNH were seen in males and females (m/f: 14/7). Only three female patients (3/7) had the history of taking oral contraceptive. Patients with FNH were largely young and middle age persons (81.0% under 50 years), discovered by accident (57.1%), without infection of the hepatitis B virus (95.2%) and with normal liver functions (100%) and serum AFP levels (100%). Color Doppler ultrasound showed blood vessels passing through the lesion (80.0%) and there was abundant in blood (66.7%). CT scan showed that the lesion had transient immediate enhancement in 60.0% of patients and had homogeneous signal in 60.0% after bolus injection. MR imaging demonstrated early vigorous enhancement (64.3%), homogenous signal (57.1%) and having central scar (35.7%) in the lesion. The demonstration of a central scar in the lesion was very helpful for the diagnosis of FNH. MRI was more helpful for the diagnosis of FNH using liver specific contrast agents: superparamagnetic iron oxide（SPIO）. All patients underwent focus resection (18 cases) or segmentectomy (2 cases), except one having no treatment. ConclusionFNH shows some typical clinical and imaging features. We could increase the rate of correct diagnosis by comprehensively analyzing the clinical and imaging materials. It is very important and necessary to determine a definite diagnosis of FNH, hepatic adenoma (HA) and primary liver cancer (PLC) preoperatively, because the HA and PLC must be surgically resected, FNH can only be followed up.
ObjectiveTo explore the prognostic factors for seizure control in focal cortical dysplasia(FCD)by analyzing the clinical features of FCD patients. MethodsWe conducted a follow-up study of patients, who were confirmed FCD by pathology after resective surgery,in Epileptic Center, Guangdong Sanjiu Brain Hospital, From January 1, 2014 to December 31, 2014. All patients were followed at least 6 months,they were divided into seizure control group(Engel class I) and seizure group(Engel classⅡ-class Ⅳ) according to surgical outcomes. Clinical features,auxiliary examinations and pathological classification were compared between two groups. Results102 patients were included, male 65 cases (63.7%), female 37 cases (36.3%), onset age 0.01~45 years old, average (10.3±8.26) years old, surgery age (3~47) years old, average (21.21±8.9) years old, all had seizure onset. 83 (81.4%) patients in seizure control group, 19 (18.6%) patients in seizure group. There are 14.5% of the patients' onset ages are younger than 3 years old, 59.8% preoperative electroencephalogram recording a diffusion epileptiform discharge, 32.5% orientation of magnetic resonance imaging (MRI) and electroencephalography (EEG) is inconsistent, 49.4% postoperative electroencephalogram (EEG) reveal an epileptiform discharge, 45.2% of the patients had intellectual disability, 36.1% had an absence of a lesion on MRI, in seizure control group. However,in seizure group they respectively 36.8%, 72.2%, 89.5%, 68.4%,94.1%, 89.5%. Patients in seizure control group got an average scores of (89.4±18.53) in performance intelligence quotient (PIQ)test, while, seizure group 65.80±15.71.There has a statistical significance between two groups. ConclusionPostoperative seizure outcome was favorable in patients with FCD, onset ages younger 3 years old, intellectual disability,getting a lower scores in PIQ test, preoperative electroencephalogram recording a diffusion epileptic discharge, inconsistent orientation of MRI and EEG, and postoperative EEG reveal an epileptiform discharge may be predictive for the postoperative outcome.
Objective To evaluate the sensitivity and accuracy of SPIO-enhanced MR Imaging in the detection of focal hepatic lesions. Methods We searched MEDLINE (1966 to 2004), EMBSAE (1984 to 2004), The Cochrane Library (Issue 1, 2004), CBMdisc (Jan.1978 to Jul. 2004), CMCC (1994 to 2004), “Radiology”, “AJR” and “European Radiology” database. Data from pharmaceutical companies and our research were also added. Related journals published from 1985 to 2003 were handsearched. Participants were clinically suspected of focal hepatic lesions. The quality of studies was assessed, and descriptive systematic review was applied to evaluate the detection sensitivity and accuracy of the imaging modality. Results Ten studies (418 patients with 1 037 focal hepatic lesions) were included. Because the data of sensitivity and specificity could not be extracted from any of the 10 included studies, it was impossible to do the meta-analysis using SROC curve. The sensitivity of SPIO-enhanced MRI ranged from 66% to 100%; accuracy ranged from 76% to 97%. Conclusions At present, there is no evidence to ascertain that SPIO-enhanced MRI has a considerably high accuracy in the detection of focal hepatic lesions. More studies with good methodology are needed.
ObjectiveTo make the model of Wistar suckling rats Focal cortical dysplasia (FCD) by liquid nitrogen freezing brain cortex and verify it. Analysed the electroencephalogram (EEG) and magnetic resonance imaging (MRI) features of the FCD model, in order to provide theoretical and experimental basis for human FCD diagnosis and treatment. MethodsTake the first day of Wistar suckling rats as experimental object, liquid nitrogen freezing Wistar suckling rats brain cortex.Make examination of EEG and MRI for Wistar suckling rats. The Brain tissue slice of Wistar suckling rats model dyed by HE and check with light microscope examination. ResultsIn experiment group, the sample epileptic discharge rate of EEG was about 41.6% on average, and showed visible spike wave, spine slow wave frequency distribution. Experimental Wistar suckling rats MRI showed positive performance for long T1 and long T2 signal, brain tissue slices HE staining showed brain cortex layer structure and columnar structure disorder, exist abnormal neurons and the balloon sample cells. ConclusionThe method of liquid nitrogen freezing Wistar suckling rats cortex can established FCDⅢd animal models successfully, and showed specific EEG and MRI, which has important value for diagnosis and treatment of human FCD.
Approximately 70 million people worldwide suffer from epilepsy, with about 9 million in China. About one-third of patients demonstrating resistance to traditional antiseizure medications (ASMs), Focal Cortical Stimulation (FCS) emerges as a novel neuromodulation therapy based on neural stimulation, showing potential in treating drug-resistant focal epilepsy. FCS reduces seizure frequency by diminishing abnormal excitability in cortical areas. Compared to traditional surgery, it carries lower risks and is particularly suited for patients whose epileptogenic foci are difficult to surgically localize. Its adjustability provides physicians with treatment flexibility, allowing them to tailor therapy based on patient conditions. Recent studies highlight the practical clinical application of FCS, underscoring its advantages in reducing the frequency of drug-resistant epilepsy seizures. The article concludes by exploring the future prospects of FCS, emphasizing the need for research in long-term efficacy assessment and patient adaptability, thus demonstrating its significant potential and direction for development in the field of epilepsy treatment.
Objective To investigate the value of a new double action MR contrast agent——Gd-BOPTA in the diagnosis of focal nodular hyperplasia (FNH) of the liver with correlation of pathology. Methods Dedicated MRI scans were performed for 5 patients suspected to have liver FNH on clinical and imaging basis (six lesions). The MR imaging protocol included axial T1W and T2W plain scan, coronal T2 weighted imaging, 3D MRCP, Gd-BOPTA enhanced LAVA dynamic tri-phasic acquisitions (scanning at 15 s, 55 s and 90 s respectively), enhanced 2D T1W scan, enhanced LAVA in delay phase (at 5 and 10 min) and in the hepatobiliary phase (at 40 and 80 min). The imaging features on each MR sequence were compared with surgical and pathological findings. Results Six lesions in 5 FNH patients were all correctly diagnosed (5 conformed by surgery and 1 by needle biopsy). ①The hemodynamic phase: The parenchyma of 5 lesions were markedly enhanced in the arterial phase, being isointense or slight hypointense in both the portal venous and delay phases, while 1 lesion was isointense in all phases except being slight hyperintense in the arterial phase; The central scar of 5 lesions were not enhanced in the dynamic phase, but showed delayed enhancement. ②The hepatobiliary (excretory) phase: The parenchyma of all 6 lesions were slight hyperintense or isointense, and tree-like bile ducts with hyperintensity were seen within one lesion. The scar showed no enhancement. ③Pathology: The parenchyma was consisted of disarranged normal hepatocytes but with cytoedema, lack of portal tracts and cholestatic change. The central scar showed rich fibrous tissue, a very thick-walled arteriole, proliferative bile ducts, infiltration of inflammatory cells and myxomatous changes. Conclusion As a dual-phase MR contrast agent capable of depicting both the hemodynamic attributes and hepatobiliary excretion, Gd-BOPTA enhanced MRI can reflect the pathological features of FNH and reach a high diagnostic accuracy.