Radiological Aspect of Klippel-Trénaunay Syndrome:A Case Series With Review of Literature

Klippel-Trénaunay syndrome (KTS)is arare angio-osteo-hypertrophic syndrome characterized by vascular malformations,soft tissue and/or bone hypertrophy, and varicose veins.For the purpose of describing the imaging findings and elucidating the role of medical imaging in the diagnosis and assessment of patient with KTS,we have reviewed the imaging data of 14 KTS patients.The imaging features on different imaging modalities were analyzed.Unilateral lower limb involvement was evident in 71% of cases (n=10)and bilateral but asymmetric lower limb involvement in the remaining 29% of cases (n=4).The most commonly depicted imaging features were varicosities in 93% (n=13),muscle hypertrophy in 79%(n=11)and venous anomalies in 64%(n=9).Other less common imaging findings included lymphedema in 29%(n=4),arterial malformations 29%(n=4),soft tissue hemangiomas 21%(n=3),pelvic and thigh phleboliths 21%(n=3), venous aneurysrns 21%(n=3),bone abnormalities 14%(n=2)and lymphadenopathy 14%(n=2).A severe unilateral lower limb deformity resulting in contractures and muscle atrophy of the whole limb was depicted in 1 case.The pathognomonic marginal vein of Servelle was identified in 2 cases.AV shunt was highly suspected in 4 cases and was confirmed by DSA in 1 case,making Klippel-Trénaunay-Weber syndrome a more apt diagnosis.Associated ipsilateral duplicated renal artery:was found in 1 case.We have concluded that medical imaging is the cornerstone in the.diagnosis and assessment of severity and complications,follow-up and differentiation of KTS from other similar conditions.Different imaging modalities play complementary roles in the evaluation of KTS patients.

Transarterial Chemoembolization Combined with Apatinib for Treatment of Advanced Hepatocellular Carcinoma:Analysis of Survival and Prognostic Factors

Objective Apatinib is a novel inhibitor of vascular endothelial growth factor receptor-2.The goal of this study was to evaluate overall survival(OS)after a combination of transarterial chemoembolization(TACE)and apatinib in patients with advanced hepatocellular carcinoma(HCC)and to identify the factors affecting patient survival.Methods Fifty-one patients with advanced HCC who received TACE in combination with apatinib in our hospital from June 2015 to May 2017 were enrolled.The OS and progression-free survival(PFS)were calculated using the Kaplan-Meier method.The log-rank test and Cox regression model were used to determine the factors affecting OS.Results The median OS and PFS of the patients were 15 months and 10 months,respectively.The 1-,2-,and 3-year survival rates were 64.7%,23.5%,and 1.8%,respectively.Univariate survival analysis showed that patients with Child-Pugh A(P=0.006),reduction rate of proper hepatic artery(P=0.016),hand-foot syndrome(P=0.005),secondary hypertension(P=0.050),and without ascites(P=0.010)had a better OS.Multivariate analysis showed that hand-foot syndrome(P=0.014),secondary hypertension(P=0.017),and reduction rate of proper hepatic artery(P=0.025)were independent predictors of better OS.Conclusion TACE combined with apatinib is a promising treatment for advanced HCC.Hand-foot syndrome,secondary hypertension,and the reduction rate of proper hepatic artery were associated with a better OS.