Guio Uchiyama

A new liver functional study using Tc-99m DTPA-galactosyl human serum albumin : evaluation of the validity of several functional parameters

Several parameters calculated with a new functional imaging agent for the liver, Tc-99m DTPA-galactosyl human serum albumin, were evaluated in 9 patients with liver cirrhosis, one with hepatocellular carcinoma, and five with both liver cirrhosis and hepatocellular carcinoma. LU3, which represents the cumulative uptake of the tracer from 3 to 4 minutes after injection, showed a strong correlation (r=0.858, p=0.0001) with LHL15, which represents the count ratio for the liver to sum for the liver and heart 15 minutes-after injection of the tracer. It also showed a strong correlation (r= −0.896, p=0.0001) with the indocyanine green retention rate (ICGR15). Regional ICGR15 is therefore calculable from the regional LU3. GSAR15, which represents the radioactivity of the tracer retained in the blood 15 minutes after injection, showed a strong correlation (r=0.878, p=0.0001) with HH15, which represents the count ratio for the heart 15 minutes after injection of the tracer divided by the count for the heart 3 minutes after injection. In conclusion, LU3 and GSAR15 are interesting and promising parameters for assessing liver function.

Giant calcifying epithelioma of Malherbe (pilomatrixoma): imaging features.

Abstract We present a case of giant calcifying epithelioma of Malherbe (pilomatrixoma) in the right upper arm of a 62-year-old man. It measured 18×12×8 cm in size, making it the largest of all the cases reported previously. CT clearly demonstrated a well-defined, subcutaneous mass with amorphous calcifications. The mass showed intermediate signal intensity on T2*-weighted MR images and slight contrast uptake on contrast-enhanced MR images. Histopathologically, this tumor showed no aggressive or malignant nature. The patient is without evidence of recurrence or metastasis 3 years following the resection.

Cystic cavernous hemangioma of the liver

We report an unusual case of multilocular cystic cavernous hemangioma of the liver. The patient was a 61-year-old woman without liver disfunction but who had multicystic mass lesions in the liver. Although cavernous hemangiomas are usually accurately diagnosed by the various imaging modalities, our case showed atypical features.

Newly developed transarterial chemoembolization material: CDDP—lipiodol suspension

Cis-Diamminedichloroplatinum (CDDP) — lipiodol suspension (CLS) was developed as a transarterial chemoembolization (TACE) material. The CLS was injected into the proper hepatic artery or distal branches of patients with hepatocellular carcinoma. Strong anticancer effects were observed. Plasma concentrations of total and filtrable CDDP following TACE were much lower than those following intravenous administration of CDDP solution. No major adverse complications were noted, presumably due to low CDDP concentrations in circulating plasma. The CLS appears to be an excellent TACE material.

Abdominal wall desmoid mimicking intra-abdominal mass: MR features

A case of abdominal wall desmoid which enlarged toward the liver and mimicked an intra-abdominal tumor is presented. T*2-weighted MR images clearly demonstrated the tumors continuity with the rectus abdominis muscle. The case presented suggests MRI may provide more valuable information concerning the origin of a right-upper-quadrant mass than CT does. However, the nature of the signals and attachment which this case showed were so unusual for desmoids that this case has not been diagnosed accurately.

Magnetic Resonance Imaging of Macroscopic Intrahepatic Portal-Hepatic Venous Shunts

Direct communication between portal branches and the hepatic vein [macroscopic intrahepatic portal-hepatic venous shunt (IPHVS)] is a rare entity. We have recently studied five patients with this condition. Magnetic resonance imaging (MRI) clearly demonstrated in each case the portal-hepatic venous shunt due to “flow void. “ Multiple diffuse shunts were present in one case and a solitary shunt was demonstrated in the others. The solitary shunt was either tubular, focally dilated or racemose in configuration. The MRI findings and clinical significance of this rare entity are discussed.

Exophytic regenerating nodule of the liver: misleading appearance on iodized-oil CT.

Iodized-oil CT in a patient with chronic liver disease revealed focal accumulation of iodized oil in an exophytic mass. Single photon emission CT (SPECT) with [99mTc]phytate showed the existence of functioning Kupffer cells, excluding hepatocellular carcinoma. Biopsy revealed a regenerating nodule. Positive iodized-oil CT does not always indicate hepatoma. In such cases, SPECT with [99mTc]phytate will help to make a correct diagnosis.

Visualization of the bone/bone marrow of lower extremities in Ga-67 whole-body images

Patients whose Ga-67 whole-body images showed increased uptake by the bone/bone marrow of the lower extremities were selected and classified into three types according to the extent and the grade of the visualization. These types were then compared with their serum iron levels, iron-binding capacities, and the results of several other serum biochemical tests. Of 374 consecutive whole body 72-hr images reviewed, 59 (15.8%) showed increased uptake of the tracer by the bone/bone marrow of the lower extremities. The three classified types were as follows: type T—visualization of both tibiae and femurs; type S—strong visualization of the femurs; and type W—weak visualization of the femurs. The serum iron concentration was significantly high in type T and low in type S. In conclusion, the pattern of Ga-67 uptake by the bone/bone marrow of the lower extremities fairly closely reflects the status of iron metabolism.

Diffuse arteriovenous malformation involving jejunum and total colon with mesenteric varices: Case report

Diffuse intestinal arteriovenous malformation (AVM) is very rare. We describe a case of diffuse AVM involving the jejunum and the total colon in an adult. In addition, mesenteric varices without portal hypertension is demonstrated on angiography of the superior mesenteric artery. The high flow through the AVMs may be a major component in the etiology of the mesenteric varices in our case.

Scintigraphic changes in bone metastasis from prostate cancer after hormonal therapy—Comparison with tumor markers and bone X-ray

Bone scintigraphy is often performed to assess the response to systemic therapy of bone metastasis from prostate cancer. We examined the changes in bone scintigraphic findings and the agreement with AIP, AcP, or other tumor markers measured in the follow-up of patients with known bone metastasis after hormonal therapy. Out of 32 patients, 22 (69%) showed improved scintigraphic findings on the first follow-up bone scintigraphy after hormonal therapy. However, 7 out of 22 patients who showed improvement on the first follow-up scintigraphy, deteriorated thereafter. Changes in the scintigraphic findings were closely correlated with those in the measured tumor markers except for patients with small bone metastasis. Though there were no significant differences in the agreement ratios of the 6 tumor markers evaluated, AIP might be a practical and acceptable indicator. Bone X-ray findings did not change at all in almost half of the cases though the scintigraphic findings showed improvement or deterioration.