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Concurrent and subsequent radiofrequency ablation combined with hepatectomy for hepatocellular carcinomas 被引量:6
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作者 Dongil Choi Hyo K Lim Hyunchul Rhim 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2010年第4期137-142,共6页
Partial hepatectomy has long been the standard treatment modality for patients with hepatocellular carcinoma(HCC),although the majority of patients with HCCs are not candidates for curative resection.Radiofrequency ab... Partial hepatectomy has long been the standard treatment modality for patients with hepatocellular carcinoma(HCC),although the majority of patients with HCCs are not candidates for curative resection.Radiofrequency ablation(RFA) has been widely used as the preferred locoregional therapy.RFA and hepatectomy can be complementary to each other for the treatment of multifocal HCCs.Combining hepatectomy with RFA permits the removal of larger tumors while simultaneously ablating any smaller residual tumors.By using this combination treatment,more patients might become candidates for curative resection.For treating recurrent tumors involving the liver after hepatectomy,RFA has been performed recently instead of transcatheter arterial chemoembolization or ethanol ablation.Many retrospective studies on the combination of RFA and hepatectomy demonstrate favorable results of effectiveness and safety.However,further investigation of prospective design will be needed to confirm these encouraging results. 展开更多
关键词 RADIOFREQUENCY ablation HEPATOCELLULAR CARCINOMA HEPATECTOMY Combination treatment
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Sarcomatoid carcinoma of the pancreas—multimodality imaging findings with serial imaging follow-up:A case report and review of literature
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作者 Hyun Jae Lim Hye Seon Kang +4 位作者 Jeong Eun Lee Ji Hye Min Kyung Sook Shin Sun Kyoung You Kyung-Hee Kim 《World Journal of Clinical Cases》 SCIE 2021年第13期3102-3113,共12页
BACKGROUND Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis.Although a few cases of sarcomatoid carcinoma of pancreas have been reported,most are focused on a histopathologic... BACKGROUND Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis.Although a few cases of sarcomatoid carcinoma of pancreas have been reported,most are focused on a histopathological review.To the best of our knowledge,there are no reports documenting multimodality imaging characteristics and chronological changes with emphasis on radiologic features.CASE SUMMARY A 64-year-old woman was admitted to Chungnam National University Hospital with acute appendicitis.Contrast-enhanced computed tomography of the abdomen revealed a 2.6 cm×2.8 cm multilobular cystic mass in the pancreatic tail.The pancreatic lesion showed suspected mural nodules and thin septa.Hence,mucinous cystic neoplasm of pancreas was considered.After 7 mo,the patient was readmitted for repeated epigastric abdominal pain and nausea.Follow-up contrast-enhanced computed tomography of the abdomen and magnetic resonance imaging revealed a marked enlargement(5.4 cm×4 cm),with a predominant internal solid component.The mass showed low signal intensity on a T1-weighted image and heterogeneously intermediate high signal intensity on a T2-weighted image. It showed diffusion restriction and peripheral rimenhancement on an arterial phase image, and progressive enhancement on portalvenous and delayed phase images. Distal pancreatectomy was performed. Basedon the morphology and immunohistochemical staining of the specimen,pancreatic sarcomatoid carcinoma was diagnosed.CONCLUSIONWe present the computed tomography, magnetic resonance imaging, and positronemission tomography computed tomography findings, pathologic features, andchronological changes for preoperative diagnosis. 展开更多
关键词 CARCINOSARCOMA PANCREAS Computed tomography Magnetic resonance imaging PANCREATECTOMY Case report
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Percutaneous ablation for perivascular hepatocellular carcinoma: Refining the current status based on emerging evidence and future perspectives 被引量:13
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作者 Tae Wook Kang Hyo Keun Lim Dong Ik Cha 《World Journal of Gastroenterology》 SCIE CAS 2018年第47期5331-5337,共7页
Various therapeutic modalities including radiofrequency ablation, cryoablation, microwave ablation, and irreversible electroporation have attracted attention as energy sources for effective locoregional treatment of h... Various therapeutic modalities including radiofrequency ablation, cryoablation, microwave ablation, and irreversible electroporation have attracted attention as energy sources for effective locoregional treatment of hepatocellular carcinoma(HCC); these are accepted non-surgical treatments that provide excellent local tumor control and favorable survival. However, in contrast to surgery, tumor location is a crucial factor in the outcomes of locoregional treatment because such treatment is mainly performed using a percutaneous approach for minimal invasiveness; accordingly, it has a limited range of ablation volume. When the index tumor is near large blood vessels, the blood flow drags thermal energy away from the targeted tissue, resulting in reduced ablation volume through a socalled "heat-sink effect". This modifies the size and shape of the ablation zone considerably. In addition, serious complications including infarction or aggressive tumor recurrence can be observed during follow-up after ablation for perivascular tumors by mechanical or thermal damage. Therefore, perivascular locations of HCC adjacent to large intrahepatic vessels can affect post-treatment outcomes. In this review, we primarily focus on physical properties of perivascular tumor location, characteristics of perivascular HCC,potential complications, and clinical outcomes after various locoregional treatments; moreover, we discuss the current status and future perspectives regarding percutaneous ablation for perivascular HCC. 展开更多
关键词 Hepatocellular carcinoma PERIVASCULAR RADIOFREQUENCY ablation Liver CRYOABLATION Microwave ablation IRREVERSIBLE ELECTROPORATION
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Invasive and non-invasive diagnosis of cirrhosis and portal hypertension 被引量:14
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作者 Moon Young Kim Woo Kyoung Jeong Soon Koo Baik 《World Journal of Gastroenterology》 SCIE CAS 2014年第15期4300-4315,共16页
With advances in the management and treatment of advanced liver disease,including the use of antiviral therapy,a simple,one stage description for advanced fibrotic liver disease has become inadequate.Although refining... With advances in the management and treatment of advanced liver disease,including the use of antiviral therapy,a simple,one stage description for advanced fibrotic liver disease has become inadequate.Although refining the diagnosis of cirrhosis to reflect disease heterogeneity is essential,current diagnostic tests have not kept pace with the progression of this new paradigm.Liver biopsy and hepatic venous pressure gradient measurement are the gold standards for the estimation of hepatic fibrosis and portal hypertension(PHT),respectively,and they have diagnostic and prognostic value.However,they are invasive and,as such,cannot be used repeatedly in clinical practice.The ideal noninvasive test should be safe,easy to perform,inexpensive,reproducible as well as to give numerical and accurate results in real time.It should be predictive of long term outcomes related with fibrosis and PHT to allow prognostic stratification.Recently,many types of noninvasive alternative tests have been developed and are under investigation.In particular,imaging and ultrasound based tests,such as transient elastography,have shown promising results.Although most of these noninvasive tests effectively identify severe fibrosis and PHT,the methods available for diagnosing moderate disease status are still insufficient,and further investigation is essential to predict outcomes and individualize therapy in this field. 展开更多
关键词 Hepatic fibrosis Portal hypertension Liver biopsy Hepatic venous pressure gradient Non-invasive test Transient elastography
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Computed tomographic differentiation between alcoholic and gallstone pancreatitis:Significance of distribution of infiltration or fluid collection 被引量:11
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作者 Young-Sun Kim Yongsoo Kim +1 位作者 Sung-Kyu Kim Hyunchul Rhim 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第28期4524-4528,共5页
AIM: To evaluate the usefulness of various computed tomography (CT) findings including distribution of infiltration or fluid collection in differentiating the major etiologies of acute pancreatitis. METHODS: We re... AIM: To evaluate the usefulness of various computed tomography (CT) findings including distribution of infiltration or fluid collection in differentiating the major etiologies of acute pancreatitis. METHODS: We reviewed 75 relatively severe cases of acute pancreatitis of alcoholic (n = 43) or biliary stone (n = 32) etiology having infiltration or fluid collection on CT. We compared the pancreatic size, CT grading, presence or absence of biliary calculi, and dilatation of pancreatic or bile duct. We also evaluated degree and the distribution of infiltration and fluid collection in each group. RESULTS: The sizes of pancreas were not different between alcohol group and stone group. Alcohol group showed higher CT grading than stone group (P 〈 0.05). Presence of biliary stone and duct dilatation was statistically significant in differentiating etiology (P 〈 0.05). Alcohol group showed significantly prominent peripancreatic pathology than stone group only in left peritoneal compartment (P = 0.020). CONCLUSION: Alcoholic pancreatitis tends to form more prominent peripancreatic changes than gallstone pancreatitis in relatively severe cases. This is evident on the anterior aspect of left abdomen. Although clinical history and some CT findings usually are a major determinant of the etiology, this pattern of peripancreatic pathology may have an ancillary role in determining the etiologies of acute pancreatitis in the equivocal cases. 展开更多
关键词 PANCREATITIS PANCREAS Computed tomography PERITONEUM FLUID Retroperitoneal space
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Current status of radiofrequency ablation of hepatocellular carcinoma 被引量:7
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作者 Hyunchul Rhim Hyo K Lim Dongil Choi 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2010年第4期128-136,共9页
Loco-regional treatments for hepatocellular carcinoma(HCC) are important alternatives to curative transplantation or resection.Among them,radiofrequency ablation(RFA) is accepted as the most popular technique showing ... Loco-regional treatments for hepatocellular carcinoma(HCC) are important alternatives to curative transplantation or resection.Among them,radiofrequency ablation(RFA) is accepted as the most popular technique showing excellent local tumor control and acceptable morbidity.The current role of RFA is well documented in the evidence-based practice guidelines of European Association of Study of Liver,American Association of Study of the Liver Disease and Japanese academic societies.Several randomized controlled trials have confirmed that RFA is superior to percutaneous ethanol injections in terms of local tumor control and survival.The overall survival after RFA is comparable to after surgical resection in a selected group of patients with smaller(< 3 cm) tumors.Currently,the clinical benefits of combined RFA with transarterial chemoembolization for intermediate stage HCC are increasingly being explored.Here we review the ongoing technical advancements of RFA and future potential. 展开更多
关键词 IMAGE-GUIDED tumor ablation RADIOFREQUENCY ablation HEPATOCELLULAR CARCINOMA Thermal ablation Loco-regional therapy
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Single hepatocellular carcinoma ≤ 3 cm in left lateral segment:Liver resection or radiofrequency ablation? 被引量:4
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作者 Jong Man Kim Tae Wook Kang +7 位作者 Choon Hyuck David Kwon Jae-Won Joh Justin Sangwook Ko Jae Berm Park Hyunchul Rhim Joon Hyeok Lee Sung Joo Kim Seung Woon Paik 《World Journal of Gastroenterology》 SCIE CAS 2014年第14期4059-4065,共7页
AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular car... AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular carcinoma (HCC) in the left lateral segments. 展开更多
关键词 Small hepatocellular carcinoma Left lateral segment Radiofrequency ablation Liver resection Tumor recurrence SURVIVAL
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High-risk esophageal varices in patients treated with locoregional therapy for hepatocellular carcinoma:Assessment with liver computed tomography 被引量:4
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作者 Hyojin Kim Dongil Choi +6 位作者 Joon Hyeok Lee Soon Jin Lee Hangi Jo Geum-Youn Gwak Kwang Cheol Koh Moon Seok Choi Seonwoo Kim 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第35期4905-4911,共7页
AIM: To assess the diagnostic performance of follow- up liver computed tomography (CT) for the detection of high-risk esophageal varices in patients treated with Io- coregional therapy for hepatocellular carcinoma ... AIM: To assess the diagnostic performance of follow- up liver computed tomography (CT) for the detection of high-risk esophageal varices in patients treated with Io- coregional therapy for hepatocellular carcinoma (HCC). METHODS: We prospectively enrolled 100 patients with cirrhosis who underwent transcatheter arterial chemoembolization, radiofrequency ablation or both procedures for HCCs. All patients underwent upper endoscopy and subsequently liver CT. Three radiolo- gists independently evaluated the presence of high-riskesophageal varices with transverse images alone and with three orthogonal multiplanar reformation (MPR) images, respectively. With endoscopic grading as the reference standard, diagnostic performance was as- sessed by using receiver operating characteristic (ROC) curve analysis. RESULTS: The diagnostic performances (areas under the ROC curve) of three observers with transverse im- ages alone were 0.947 ± 0.031, 0.969 ± 0.024, and 0.916 + 0.038, respectively. The mean sensitivity, spec- ificity, positive predicative value (PPV), and negative predicative value (NPV) with transverse images alone were 90.1%, 86.39%, 70.9%, and 95.9%, respectively. The diagnostic performances, mean sensitivity, specific- ity, PPV, and NPV with three orthogonal MPR images (0.965 ± 0.025, 0.959 ± 0.027, 0.938 ± 0.033, 91.4%, 89.5%, 76.3%, and 96.6%, respectively) were not su- perior to corresponding values with transverse images alone (P 〉 0.05), except for the mean specificity (P = 0.039). CONCLUSION: Our results showed excellent diagnos- tic performance, sensitivity and NPV to detect high-risk esophageal varices on follow-up liver CT after Iocore- gional therapy for HCC, 展开更多
关键词 Liver computed tomography High-riskesophageal varices Locoregional therapy Hepatocel-lular carcinoma Multiplanar reformation images
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Cryptogenic multifocal ulcerous stenosing enteritis: Radiologic features and clinical behavior 被引量:5
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作者 Jiyoung Hwang Jin Sil Kim +6 位作者 Ah Young Kim Joon Seok Lim Se Hyung Kim Min Ju Kim Mi Sung Kim Kyoung Doo Song Ji Young Woo 《World Journal of Gastroenterology》 SCIE CAS 2017年第25期4615-4623,共9页
To investigate the characteristic radiologic findings of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) which can be differentiated from other similar bowel disease and to assess their clinical behavior. ... To investigate the characteristic radiologic findings of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) which can be differentiated from other similar bowel disease and to assess their clinical behavior. METHODSTwenty pathologically and clinically confirmed CMUSE patients (males:females = 8:12; mean age: 40.4 years) between March 2002 and August 2015 from seven academic centers in South Korea were retrospectively reviewed. We evaluated small bowel series (SBS; n = 25), computed tomography (CT) enterography (n = 21), magnetic resonance (MR) enterography (n = 2), and abdominopelvic CT (n = 18) images, focusing on enteric and perienteric manifestations. Any change in radiologic features during follow-up period was recorded. We evaluated clinical data including presenting symptoms, laboratory finding and presence of relapse from electronic medical records. Histopathologic findings were also evaluated. RESULTSThe main symptoms were abdominal pain (n = 12) and anemia (n = 10). All patients showed small bowel strictures (n = 52, mean: 2.6 per patient) on initial CT/MR, located in the ileum (n = 47) or jejunum (n = 5). Strictures showed short-length (mean: 10.44 mm) and circumferential bowel wall thickening (mean: 5.56 mm) with layered enhancement (n = 48) that were also noted on initial SBS (n = 36) with shallow ulcers (n = 10). Some ulcerative lesions or wall thickening progressed into strictures on follow-up SBS/CT, and some strictures revealed recurrent ulceration on follow-up SBS. There were no penetrating disease features like fistula or abscess and no gastrointestinal tract involvement except the small bowel. Nine patients experienced disease recurrence (median relapse-free period: 32 mo) even post-operatively. Histopathologic features of surgically resected specimens were characterized as multiple superficial ulcerations confined to mucosa or submucosa and multiple strictures. CONCLUSIONUnder characteristic radiologic findings with multiple short-segmental strictures and/or shallow ulcers of the small intestine, CMUSE should be considered when assessing patients with recurrent abdominal pain and anemia. 展开更多
关键词 Cryptogenic multifocal ulcerous stenosing enteritis Small intestine Computed tomography Small bowel series Diagnosis
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与耐多药肺结核相关的放射学征象的文献分析 被引量:9
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作者 王毅翔 Myung Jin Chung +5 位作者 Aliaksandr Skrahin Alex Rosenthal Andrei Gabrielian Michael Tartakovsky 于英杰 陆普选 《新发传染病电子杂志》 2018年第4期244-253,共10页
背景尽管肺药物敏感结核(DS-TB)和耐多药结核(MDR-TB)的诊断需要微生物检查证实,但胸部影像学早期识别可疑MDR-TB可以对诊断过程提供指引。本文对文献资料中与MDR-TB相关的放射学征象进行分析。方法于2018年1月29日搜索PubMed数据库,搜... 背景尽管肺药物敏感结核(DS-TB)和耐多药结核(MDR-TB)的诊断需要微生物检查证实,但胸部影像学早期识别可疑MDR-TB可以对诊断过程提供指引。本文对文献资料中与MDR-TB相关的放射学征象进行分析。方法于2018年1月29日搜索PubMed数据库,搜索关键字组合为"((extensive drug resistant tuberculosis)OR(multidrug-resistant tuberculosis))AND(CT or radiograph or imaging or X-ray or computed tomography)",并分析了报道DS-TB和MDR-TB放射学征象的英文文献。结果我们发现和分析了与分析目的有充分相关性的17篇文章。我们将报告的肺MDR-TB病例分为四个类别:(1)之前治疗过(继发或获得性)的HIV阴性成人MDRTB;(2)新发(或原发)HIV阴性成人MDR-TB;(3)HIV阳性成人MDR-TB;(4)儿童MDR-TB。肺MDR-TB的常见放射学表现包括:小叶中央小结节、分枝状线征和结节影(树芽征)、斑块或叶实变、空洞和支气管扩张。虽然总体上MDR-TB病例倾向病变更广泛、更容易双侧发病、胸膜受累、支气管扩张,及肺体积缩小;但仅依据这些征象难以作出MDR-TB的鉴别诊断。迄今的文献提示,肺MDR-TB特异性较高的放射学征象是厚壁多发空洞病变(特别是空洞≥3个时),虽然可能其敏感性不高。对于成人HIV阴性患者,与继发MDR-TB一致,新发MDR-TB也往往有较高的空洞病变发生率,估计在70%左右。结论厚壁多发空洞病变是提示MDR-TB诊断最有意义的放射学征象。未来的研究应该细致地量化空洞病变形态特征。 展开更多
关键词 鉴别诊断 结核病 耐多药 断层扫描 X线
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一体化PET/CT与3.0 T全身MRI对非小细胞肺癌分期的对照研究 被引量:29
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作者 C.A.Yi K.M. Shin +5 位作者 K.S. Lee B.T. Kim H. Kim O.J. Kwon 高莉(译) 唐光健(校) 《国际医学放射学杂志》 2008年第5期407-407,共1页
目的前瞻性对照一体化PET/CT和3.0T全身MRI确定非小细胞肺癌(NSCLC)TMN分期的诊断效用。方法本研究经伦理委员会批准.所有受试者均签署知情同意书。本研究包括了病理证实的165例NSCLC病人(男125例,女40例,平均年龄61岁),均进... 目的前瞻性对照一体化PET/CT和3.0T全身MRI确定非小细胞肺癌(NSCLC)TMN分期的诊断效用。方法本研究经伦理委员会批准.所有受试者均签署知情同意书。本研究包括了病理证实的165例NSCLC病人(男125例,女40例,平均年龄61岁),均进行了PET/CT平扫和全身MRI检查。病理结果作为T(n=123)和N(n=150)的分期参考标准,病理结果或随访的影像结果作为M(n=54)的分期参考标准。采用McNemas检验对PET/CT和全身MR成像对NSCLC的分期诊断作用进行对照检验。结果123例原发肺癌中,PET/CT正确分期101例(82%), 展开更多
关键词 一体化PET/CT 3.0T全身MRI 非小细胞肺癌 临床研究
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特发性纤维性间质性肺炎预后的决定因素:临床、薄层CT、组织病理学研究(第三期研究) 被引量:4
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作者 K.M.Shin K.S.Lee +3 位作者 M.P.Chung Y.A.Bae T.S.Kim 郑丽丽 《国际医学放射学杂志》 2008年第A06期506-506,共1页
目的探讨临床、薄层CT、组织病理学三者对普通型间质性肺炎(UIP)与纤维性非特异性间质性肺炎(NSIP)预后的应用价值。
关键词 间质性肺炎 纤维性 伦理委员会 病理学研究 支气管肺泡灌洗 组织病理学 特异性 病人生存率 功能测试
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Bosniak Ⅲ级或Ⅳ级囊性肾肿瘤在影像引导下射频消融治疗的初步临床经验 被引量:3
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作者 B.K.Park C.K.Kim +1 位作者 H.M.Lee 唐光健 《国际医学放射学杂志》 2008年第5期416-416,共1页
本研究的目的是评价肾囊性肿瘤在影像引导下射频(RF)消融治疗的效果。2005年11月-2007年8月对9例病人的14个BosniakⅢ级(n=5)和Ⅳ级(n=9)囊性肾肿瘤在CT或超声引导下采用内冷却RF消融系统进行了RF消融治疗。对能量应用次数、周期... 本研究的目的是评价肾囊性肿瘤在影像引导下射频(RF)消融治疗的效果。2005年11月-2007年8月对9例病人的14个BosniakⅢ级(n=5)和Ⅳ级(n=9)囊性肾肿瘤在CT或超声引导下采用内冷却RF消融系统进行了RF消融治疗。对能量应用次数、周期、持续时间,治疗结果,病变大小的改变及并发症进行了评价。囊性肾肿瘤总的能量可应用15次,共23个周期。每个肿瘤消融的能量应用需持续1~12min(平均6min)。最终的CT随访提示全部14个病变完全性凝固(100%)。1~19个月(平均8个月)这些肿瘤均无复发。 展开更多
关键词 肾细胞癌 射频消融 CT 超声检查
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肝细胞癌的经皮射频消融:80例病人连续2期治疗分析 被引量:2
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作者 H.Rhim Y.S.Kim +3 位作者 D.Ghoi H.K.Lim K.Park 唐光健 《国际医学放射学杂志》 2008年第5期414-414,共1页
本研究探讨了一些病人需要连续2期经皮射频(RF)消融治疗肝细胞癌(HCC)的原因。回顾6a内1179例(1624次治疗)超声(US)引导下经皮RF消融治疗HCC的资料,对第1期治疗后需要第2期治疗的80例病人进行分析,研究其病案与CT随访的资料... 本研究探讨了一些病人需要连续2期经皮射频(RF)消融治疗肝细胞癌(HCC)的原因。回顾6a内1179例(1624次治疗)超声(US)引导下经皮RF消融治疗HCC的资料,对第1期治疗后需要第2期治疗的80例病人进行分析,研究其病案与CT随访的资料。评估了第2期治疗的理由及其结果。1642次经皮RF消融治疗HCC中需要第2期治疗的共80例(4.8%)。需第2期治疗的原因包括:由于病人或操作原因的技术性失败(n=26),因肿瘤残余造成的技术性失败(n=40), 展开更多
关键词 射频 影像引导下消融 肝肿瘤 热疗
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Managing portal hypertension in patients with liver cirrhosis and hepatocellular carcinoma:non-invasive diagnosis and systemic treatment considerations 被引量:1
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作者 Woo Kyoung Jeong 《Hepatobiliary Surgery and Nutrition》 SCIE 2023年第6期960-962,共3页
Portal hypertension(PH)represents a crucial complication of liver cirrhosis that significantly impacts a patient’s prognosis.Controlling portal venous pressure requires a combination of medical and interventional tre... Portal hypertension(PH)represents a crucial complication of liver cirrhosis that significantly impacts a patient’s prognosis.Controlling portal venous pressure requires a combination of medical and interventional treatments.However,it’s important to note that the presence of other conditions in patients,such as hepatocellular carcinoma(HCC),can influence the treatment approaches for PH and subsequently affect the overall outcomes.Clinicians should consider that condition when developing treatment strategies to enhance patient outcomes(1). 展开更多
关键词 Portal hypertension(PH) hepatocellular carcinoma(HCC) ELASTOGRAPHY BEVACIZUMAB variceal bleeding
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