21 results on '"H, Koito"'
Search Results
2. [The findings of computed tomography (CT) and magnetic resonance imaging (MRI) in pulmonary arterial hypertension].
- Author
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Koito H
- Subjects
- Humans, Hypertension, Pulmonary diagnosis, Magnetic Resonance Imaging, Tomography, X-Ray Computed
- Abstract
Technical advances of multidetector-row computed tomography(MDCT) and magnetic resonance imaging(MRI) made these modalities more important in the evaluation and for differential diagnosis of pulmonary arterial hypertension (PAH). The advantages of CT and MRI are noninvasive examination, wide field of view, excellent reproducibility, high spatial resolution and 3-dimensional (3-D) reconstruction images. Morphological changes of the PAH, which are right ventricular hypertrophy and dilatation of main and central pulmonary artery(PA), right ventricle, right atria, superior and inferior vena cava, and coronary sinus, are depicted well by these modalities. The 3-D CT and MR angiography can depict peripheral and central PA, and pulmonary veins, which are important information of the cause of PAH. Myocardial changes of PAH can be detected by gadolinium delayed enhancement of MRI. CT and MRI are promising method to diagnose and manage the PAH in future.
- Published
- 2008
3. [Deposition of subepicardial fat].
- Author
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Iwasaka T, Koito H, Nishiue T, Miyasaka Y, and Haiden M
- Subjects
- Cardiotonic Agents therapeutic use, Diagnosis, Differential, Diagnostic Imaging, Diuretics therapeutic use, Electrocardiography, Female, Heart Failure, Diastolic diagnosis, Heart Failure, Diastolic physiopathology, Heart Failure, Diastolic therapy, Humans, Middle Aged, Pericardiectomy, Prognosis, Ventricular Dysfunction diagnosis, Ventricular Dysfunction physiopathology, Ventricular Dysfunction therapy, Adipose Tissue metabolism, Heart Failure, Diastolic etiology, Pericardium metabolism, Ventricular Dysfunction etiology
- Published
- 2007
4. [CT and MRI findings of pulmonary hypertension].
- Author
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Koito H and Yutaka H
- Subjects
- Chronic Disease, Humans, Hypertension, Pulmonary etiology, Myocardial Contraction, Pulmonary Circulation, Pulmonary Embolism complications, Pulmonary Embolism diagnostic imaging, Ventricular Function, Right, Hypertension, Pulmonary diagnosis, Magnetic Resonance Imaging, Tomography, X-Ray Computed
- Abstract
Although computed tomography (CT) and magnetic resonance imaging (MRI) can not measure the pulmonary arterial pressure, those can depict the morphological changes due to pulmonary hypertension, which are dilatation of main and central pulmonary artery, right ventricular hypertrophy and dilatation of right ventricle, right atrium, vena cava and coronary sinus. Right ventricular volume, mass and ejection fraction are calculated quantitatively by MRI using Simpson method. Thromboembolism can be detected by enhanced CT. Information about pulmonary blood flow and tricuspid regurgitation are given by MRI. Three dimensional MR angiography depicts the pulmonary artery as a whole. CT and MRI can detect pulmonary and congenital heart disease, the cause of pulmonary hypertension. CT and MRI are useful complementary method for evaluating pulmonary hypertension.
- Published
- 2001
5. [Multicentric Castleman's disease with reversible left ventricular diffuse hypokinesis].
- Author
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Yamamoto S, Nakatani S, Kijima K, Kohno K, Morita S, Koito H, Yutaka H, Miyasaka Y, Nakamura S, Iwasaka T, and Uemura Y
- Subjects
- Castleman Disease pathology, Humans, Male, Middle Aged, Ultrasonography, Cardiomyopathy, Dilated diagnostic imaging, Castleman Disease diagnostic imaging
- Published
- 2001
- Full Text
- View/download PDF
6. [Chemotherapy of endocarditis due to Candida glabrata].
- Author
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Miyazaki H, Yonemura M, Yanagiya S, Matsumoto T, Amo Y, Watanabe T, Inoue K, and Koito H
- Subjects
- Adult, Antifungal Agents therapeutic use, Female, Humans, Immunocompromised Host, Itraconazole therapeutic use, Treatment Outcome, Candidiasis, Endocarditis drug therapy, Endocarditis microbiology
- Published
- 1999
7. [Oval echo-free space at the atrioventricular sulcus].
- Author
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Koito H and Iwasaka T
- Subjects
- Humans, Male, Middle Aged, Echocardiography, Heart Aneurysm diagnostic imaging, Lipoma diagnostic imaging
- Published
- 1999
8. [Usefulness of magnetic resonance imaging for managing patients with prosthetic carbon valve in the mitral position].
- Author
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Koito H, Imai Y, Suzuki J, Ohkubo N, Nakamura C, Takahashi H, Iwasaka T, and Inada M
- Subjects
- Aged, Carbon, Female, Heart Valve Diseases diagnosis, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Heart Valve Prosthesis, Magnetic Resonance Imaging methods, Mitral Valve pathology
- Abstract
The safety, findings and clinical usefulness of magnetic resonance (MR) imaging were assessed in patients with a prosthetic carbon valve in the mitral position. In vitro deflection, heating and image distortion due to the magnetic field of a 1.5 tesla MR machine were examined in three carbon valves (CarboMedics, St. Jude Medical and Björk-Shiley valves). In vivo MR imaging of the left ventricular horizontal long-axis, vertical long-axis and short-axis views was performed by electrocardiographically synchronized spin echo and field (gradient) echo techniques in eight patients with prosthetic mitral carbon valves, consisting of six CarboMedics valves, one St. Jude Medical valve and one Björk-Shiley valve. No deflection and significant heating was seen in all three valves in vitro. Although little image distortion was shown in the CarboMedics and St. Jude Medical valves, a small distortion toward the frequency encoded direction was seen in the Björk-Shiley valve but caused no difficulty in assessing the surrounding images. Four of the eight patients had normal sinus rhythm and the other four had atrial fibrillation. The prosthetic valves were depicted as signal voids in the images taken by both spin echo and field echo techniques in vivo. Clear structural information with little image distortion of the adjacent tissues of the prosthetic valves were obtained in all patients, although the image of the Björk-Shiley valve which contained stainless steel in the frame had a slightly stronger distortion than those of the CarboMedics and St. Jude Medical valves which contained titanium. The stainless wire suture material used to close the sternal incision was depicted as a signal void, and the areas of the signal loss were larger in the images taken by the field echo technique than those by the spin echo technique. The images taken by the spin echo technique in patients with atrial fibrillation had reduced quality due to the irregularity of repetition time. Cine MR imaging by the field echo technique showed physiological mitral regurgitant jets as signal loss within the flowing blood, which appeared as high signal intensity, bidirectionally in the bileaflet mechanical valve and unidirectionally in the monoleaflet mechanical valve. An abnormal cavity was seen behind the basal left ventricular myocardium in one patient with a CarboMedics valve. The wall of the abnormal cavity was disrupted abruptly and the rest of the wall consisted of pericardium and adjacent tissue in the image taken by the spin echo technique. The image taken by the field echo technique showed an abnormal jet flow from the basal part of the left ventricular cavity into the abnormal cavity, which was compatible with left ventricular pseudoaneurysm. Two-dimensional echocardiography and Doppler color flow mapping disclosed the abnormal cavity and the abnormal flow inside, but failed to show the connection between the left ventricle and the cavity due to reverberation of the ultrasound signal by the prosthetic valve. These findings suggest that MR imaging is a safe and promising method to assess the complications and valvular function in patients with a prosthetic carbon valve in the mitral position.
- Published
- 1997
9. [Three-dimensional reconstructed magnetic resonance imaging for diagnosing persistent left superior vena cava: comparison with magnetic resonance angiography and plain chest radiography].
- Author
-
Koito H, Suzuki J, Ohkubo N, Ishiguro Y, Iwasaka T, Inada M, and Nakano Y
- Subjects
- Adolescent, Adult, Aged, Child, Female, Humans, Male, Middle Aged, Sensitivity and Specificity, Image Enhancement methods, Image Processing, Computer-Assisted methods, Magnetic Resonance Angiography, Magnetic Resonance Imaging methods, Radiography, Thoracic, Superior Vena Cava Syndrome diagnosis
- Abstract
The usefulness of low-cost, three-dimensional (3D) images reconstructed from magnetic resonance (MR) imaging for investigating persistent left superior vena cava was assessed and compared to the diagnostic accuracy of chest radiography. MR imaging by the spin-echo technique and MR angiography were performed in 10 patients with this anomaly diagnosed previously by contrast echocardiography and radionuclide angiocardiography. Four patients had complicating cardiac anomalies, one with postoperative atrial septal defect, one with postoperative ventricular septal defect, one with atrial septal defect and partial anomalous pulmonary venous return, and one with aortic coarctation and patent ductus arteriosus. Multisectional and multiphasic MR images were used for the 3D-reconstruction of the cardiovascular and mediastinal structures with a NeXT workstation and a 3D-kit. The 3D-reconstructed MR imaging clearly showed the persistent left superior vena cava and the anatomical relationship with the other cardiovascular and mediastinal structures in all 10 patients. Vascular shadows were observed outside the upper left border of the aortic arch on the chest radiographs in seven patients, and the 3D-reconstructed MR images revealed these shadows to be compatible with superior caval vein. The ratios of the diameter between the left and right superior venae cavae with and without the left innominate vein were 0.63 +/- 0.14 (mean +/- SD) and 0.94 +/- 0.08, respectively. Three-dimensional reconstructed MR imaging is a useful method for recognizing persistent left superior vena cava and precise examination of the chest radiographs often allowed detection of the vascular shadows caused by this anomaly.
- Published
- 1996
10. [Gadolinium-diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging of dilated cardiomyopathy: clinical significance of abnormally high signal intensity of left ventricular myocardium].
- Author
-
Koito H, Suzuki J, Ohkubo N, Ishiguro Y, Iwasaka T, and Inada M
- Subjects
- Adult, Aged, Aged, 80 and over, Angiocardiography, Cardiomyopathy, Dilated pathology, Cardiomyopathy, Dilated physiopathology, Echocardiography, Electrocardiography, Female, Gadolinium DTPA, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Stroke Volume, Tomography, Emission-Computed, Single-Photon, Cardiomyopathy, Dilated diagnosis, Heart diagnostic imaging, Organometallic Compounds, Pentetic Acid analogs & derivatives
- Abstract
This study investigated the clinical significance of abnormally high signal intensity in the left ventricular myocardium on gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced magnetic resonance (MR) imaging in patients with dilated cardiomyopathy. Gd-DTPA enhanced MR imaging, Tl-201 myocardial single photon emission computed tomography (SPECT), Tc-99m radionuclide angiocardiography, M-mode echocardiography, electrocardiography and chest radiography were performed in 18 patients with dilated cardiomyopathy. The left ventricle was divided into five areas, the anteroseptal, anterolateral, inferoseptal, posterolateral and apical areas. Five patients (group A) had 0-2 and 13 patients (group B) had 3-5 high signal intensity areas. High signal intensity areas were demonstrated in 19 of 90 areas (21%) before Gd-DTPA enhancement and 50 of 90 areas (56%) after enhancement. Fifteen of 34 areas (44%) with abnormal Tl-201 uptake showed high signal intensity before Gd-DTPA enhancement and 31 (91%) showed high signal intensity after enhancement. Fifteen areas without abnormal Tl-201 uptake also showed high signal intensity after enhancement. Left ventricular ejection fraction (LVEF) and percent fractional shortening (%FS) in group B were lower than those in group A. LVEF(r = 0.78) and %FS (r = 0.82) were significantly correlated with the number of high signal intensity areas. Systolic left ventricular dimension was larger in group B than that in group A, and a significant correlation (r = 0.62) between systolic left ventricular dimension and the number of high signal intensity areas was found. There was no significant difference in right ventricular ejection fraction, left ventricular peak filling rate, diastolic left ventricular dimension, left ventricular thickness, cardiothoracic ratio or SV1+RV5 or 6 between group A and B. There was no correlation of peak filling rate, diastolic left ventricular dimension, cardiothoracic ratio or SV1+RV5 or 6 with the number of high signal intensity areas. These results suggest that abnormal high signal intensity on Gd-DTPA enhanced MR imaging may reflect myocardial degeneration, necrosis or fibrosis, and the high signal intensity predicts the severity of left ventricular dysfunction in dilated cardiomyopathy.
- Published
- 1996
11. [Deposition of subepicardial fat].
- Author
-
Iwasaka T and Koito H
- Subjects
- Echocardiography, Transesophageal, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Pericardium diagnostic imaging, Radiography, Adipose Tissue metabolism, Pericardium metabolism
- Published
- 1996
12. [Clinical significance of abnormal high signal intensity of left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid enhanced magnetic resonance imaging in hypertrophic cardiomyopathy].
- Author
-
Koito H, Suzuki J, Nakamori H, Ohkubo N, Wakayama Y, Iwasaka T, Inada M, and Katoh T
- Subjects
- Adolescent, Adult, Aged, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic physiopathology, Echocardiography, Electrocardiography, Female, Gadolinium DTPA, Heart diagnostic imaging, Heart Ventricles pathology, Humans, Male, Middle Aged, Thallium Radioisotopes, Tomography, Emission-Computed, Single-Photon, Ventricular Function, Left, Cardiomyopathy, Hypertrophic diagnosis, Gadolinium, Magnetic Resonance Imaging, Myocardium pathology, Organometallic Compounds, Pentetic Acid analogs & derivatives
- Abstract
The significance of abnormal high signal intensity observed in left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) enhanced magnetic resonance (MR) imaging in hypertrophic cardiomyopathy (HCM) patients was assessed by comparison with T1-weighted MR imaging, thallium-201 (201Tl) myocardial scintigraphy, radionuclide angiocardiography, M-mode echocardiography, electrocardiography, and chest radiography. The 16 patients were divided into three groups: 8 patients (group I) with abnormal high signal intensity before and after Gd-DTPA enhancement, 4 (group II) with abnormal high signal intensity only after enhancement and 4 (group III) without abnormal high signal intensity. Thallium-201 myocardial single photon emission computed tomography (SPECT) showed 4 of the 8 patients in group I, 3 of the 4 patients in group II and only 1 of the 4 patients in group III had abnormalities of regional 201Tl uptake in the left ventricular myocardium. No significant difference in left ventricular ejection fraction (LVEF) was seen between groups I, II, and III (64 +/- 13%, 67 +/- 17% and 71 +/- 7%, respectively) although three patients of group I had LVEF of less than 55%. Left ventricular peak filling rates (PFR) of groups I and II were significantly lower than that of group III (1.90 +/- 0.44, 2.41 +/- 0.43 and 3.37 +/- 0.48 EDV/sec, respectively). Group I had larger end-diastolic left ventricular dimension (LVDd), significantly larger end-systolic left ventricular dimension (LVDs), and smaller % fractional shortening (%FS) than group III (49 +/- 4 vs 42 +/- 6 mm, 31 +/- 5 vs 22 +/- 4 mm, and 38 +/- 8 vs 49 +/- 4%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1995
13. [Gadolinium-DTPA magnetic resonance imaging in the diagnosis of left atrial myxoma in the elderly].
- Author
-
Koito H, Ohkubo N, Wakayama Y, Nakamori H, Suzuki J, Iwasaka T, Inada M, and Katoh T
- Subjects
- Aged, Aged, 80 and over, Contrast Media, Female, Gadolinium DTPA, Heart Atria, Humans, Magnetic Resonance Imaging, Heart Neoplasms diagnosis, Myxoma diagnosis, Organometallic Compounds, Pentetic Acid analogs & derivatives
- Abstract
A 85-year-old woman consulted our hospital with general fatigue, palpitation and chest discomfort changing with different postures. Her electrocardiogram showed sinus tachycardia, atrial premature beats and left atrial overload. 53% cardiothoracic ratio, slightly protruding third arch of the cardiac silhouette and dilated pulmonary artery were seen on the chest X-ray. Two dimensional echocardiography revealed a mass in the left atrium although the quality of echocardiography was suboptimal due to her thoracic deformity. There was no uptake of T1-201 or Ga-67 by the mass. The four-chamber view of Tc-99m ECG-gated SPECT radionuclide angiocardiography showed a filling defect in the left atrium. The T1 weighted magnetic resonance imaging revealed a left atrial mass with relatively low signal intensity. After intravenous injection of Gadolinium-DTPA the signal intensity of the mass increased significantly and the contrast of the mass was improved. The size of the mass was 4 x 4 x 3 cm with a stalk connecting to the interatrial septum. These findings were compatible with left atrial myxoma. Gadolinium-DTPA magnetic resonance imaging is useful in diagnosing left atrial myxoma because it provides information on the size, anatomical location, relationship with other cardiovascular structures and even the characteristics of the mass.
- Published
- 1993
- Full Text
- View/download PDF
14. [Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system].
- Author
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Kawamura M, Kataoka M, Nakagawa H, Tanaka H, Koito H, Inatsuki S, Fujii T, Itoh H, Ishine M, and Hamamoto K
- Subjects
- Adenocarcinoma complications, Adenocarcinoma mortality, Aged, Aged, 80 and over, Biliary Tract Neoplasms complications, Biliary Tract Neoplasms mortality, Cholestasis etiology, Cholestasis mortality, Combined Modality Therapy, Drainage, Female, Humans, Male, Middle Aged, Survival Rate, Adenocarcinoma radiotherapy, Biliary Tract Neoplasms radiotherapy, Cholestasis radiotherapy
- Abstract
From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p less than 0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significantly). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system.
- Published
- 1992
15. [Two cases of hepatocellular carcinoma with omental mass].
- Author
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Kubota S, Inatsuki S, Koito H, Tanada M, Takashima N, Mandai K, and Moriwaki S
- Subjects
- Aged, Humans, Male, Middle Aged, Carcinoma, Hepatocellular secondary, Liver Neoplasms pathology, Omentum, Peritoneal Neoplasms secondary
- Abstract
Hepatocellular carcinoma rarely causes disseminated metastasis or distant metastasis. We have recently encountered two cases of hepatocellular carcinoma with omental mass. In the first case, we misdiagnosed the omental metastasis as part of the primary tumor. In the second case, omental mass was hypervascular on angiography and this was very useful for an exact diagnosis.
- Published
- 1990
16. [First-pass radionuclide angiocardiographic assessment of left ventricular diastolic function in patients with old myocardial infarction].
- Author
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Koito H, Iwasaka T, Yoshioka H, and Kimura Y
- Subjects
- Adult, Aged, Cardiac Volume, Female, Fourier Analysis, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Myocardial Infarction physiopathology, Radionuclide Imaging, Scintillation Counting methods, Stroke Volume, Diastole, Heart diagnostic imaging, Myocardial Contraction, Myocardial Infarction diagnostic imaging
- Published
- 1985
17. [Right ventricular function in patients with chronic right ventricular infarction].
- Author
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Koito H, Kurimoto T, Sugiura T, Kimura Y, Iwasaka T, Inada M, Shiraishi T, and Kobayashi A
- Subjects
- Adult, Aged, Aged, 80 and over, Coronary Angiography, Female, Heart Ventricles physiopathology, Hemodynamics, Humans, Male, Middle Aged, Myocardial Infarction diagnosis, Technetium, Myocardial Infarction physiopathology, Stroke Volume
- Abstract
To assess right ventricular function in patients with chronic right ventricular infarction, Tc-99m angiocardiography was performed in 64 patients one to three months after the onset of myocardial infarction. These patients were categorized into four groups according to their hemodynamic data in the acute stage using the Forrester classification: 39 patients in group I, 15 in group II, eight in group III and two in group IV. Mean right atrial pressure was nearly equal to or greater than diastolic pulmonary arterial pressure in all patients in group III. We calculated right ventricular ejection fraction (RVEF) and the right ventricular end-diastolic volume index (RVEDVI) as the parameter of right ventricular function, and assessed right ventricular wall motion using the right ventricular regional ejection fraction images (RVREFI). 1. RVEF in group III (25 +/- 3%) was significantly lower than those in groups I, II and IV (44 +/- 6%, 45 +/- 7% and 37 +/- 4%, respectively), and RVEF of all patients in group III was less than 30%. 2. RVEDVI in group III (150 +/- 25 ml/m2) was significantly greater than those in groups I, II and IV (74 +/- 20 ml/m2, 59 +/- 14 ml/m2 and 91 +/- 36 ml/m2, respectively). 3. RVREFI in group III decreased at the inferior and/or septal regions of the right ventricle, indicating wall motion abnormalities at the corresponding sites. 4. Six patients in group III were examined by coronary angiography and all had definite lesions in the proximal portion of the right coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1987
18. [Assessment of diastolic properties of left ventricle by Fourier analysis of global left ventricular volume curve obtained from RI angiography].
- Author
-
Koito H, Iwasaka T, Yoshioka H, Sakai A, Inada M, Natsuzumi S, Matsumoto K, and Kasahara A
- Subjects
- Adult, Aged, Coronary Disease physiopathology, Female, Fourier Analysis, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Radionuclide Imaging, Coronary Disease diagnostic imaging, Diastole, Myocardial Contraction
- Published
- 1983
19. [Transcatheter arterial embolization of hemangiomas in the perioral region].
- Author
-
Yamada M, Mogami H, Yasuhara Y, Koito H, Kataoka M, Tanada S, Hamamoto K, Inatsuki S, and Hashimoto A
- Subjects
- Adult, Child, Preschool, Female, Humans, Male, Middle Aged, Embolization, Therapeutic, Hemangioma therapy, Mouth Neoplasms therapy
- Abstract
This paper presents four cases with successful transcatheter arterial embolization (TAE) for oral and perioral hemangiomas. Four TAEs were performed without major complications and the tumors disappeared in one case and decreased in size in the other 3 cases.
- Published
- 1989
20. [Assessment of cardiac performance by radionuclide angiocardiography in the patient with myocardial infarction--comparison between infarcted area and non-infarcted area].
- Author
-
Kimura Y, Iwasaka T, Onoyama H, Sugiura T, Ichibangase J, Koito H, Yoshioka H, Inada M, Natsuzumi S, and Matsumoto K
- Subjects
- Female, Heart diagnostic imaging, Humans, Male, Middle Aged, Heart physiopathology, Myocardial Infarction diagnostic imaging, Radionuclide Angiography
- Published
- 1987
21. [Diagnostic value of the reflux sign in cholescintigraphy after administration of a gallbladder contracting agent--a comparison with X-ray cholangiography].
- Author
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Itoh H, Shimono R, Murase K, Koito H, Iio A, and Hamamoto K
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Radionuclide Imaging, Biliary Tract Diseases diagnostic imaging, Ceruletide, Cholangiography, Gallbladder drug effects, Organometallic Compounds, Organotechnetium Compounds, Pyridoxal analogs & derivatives, Technetium, Tryptophan analogs & derivatives
- Abstract
This study reviewed 25 patients with the reflux sign in cholescintigraphy to assess its diagnostic value in evaluating biliary passage. After at least 4-hour fasting 5 mCi of 99mTcPMT or p-butyl IDA was injected intravenously and serial images were recorded before and after intramuscular injection of 10 micrograms of ceruletide diethylamine (caerulein). The reflux sign was determined positive when increased radioactivities in the left hepatic duct (minor reflux; MIR) or more peripheral intrahepatic ducts (major reflux; MAR) were recognized after injection of caerulein. The reflux sign was found in 28 of 237 (12%) studies. Direct and/or indirect X-ray cholangiograms were available in 25 (MIR; 15, MAR; 10). They included common bile duct (CBD) stone in 4, dilated CBD in 4, biliary dyskinesia (BD) in 4, chronic pancreatitis (CP) in 4, gallbladder (GB) stone in 3, duodenal ulcer (DU) in 2, CBD adenoma, pancreatic pseudocyst (PP), duodenal diverticle (DD), and acute cholangitis (AC) in 1 each. Their serum bilirubin levels were within normal limit in all but 2 at the time of cholescintigraphy. Transit time of radionuclides to the duodenum was found prolonged more than 60 min in 17 (68%) patients and persistent pooling in the CBD was found in 8 (28%) patients on scintigrams. The diameter of the CBD on X-ray cholangiogram was ranged 4 to 17 mm. Dilated CBD of more than 10 mm was found in 13 (52%) patients and apparent stenosis of the CBD in 6 (24%) patients. MAR seemed to correspond to increased diameter of the common hepatic more than 2 mm after caerulein injection in DIC. No abnormal findings in X-ray cholangiography was found in 10 (40%) patients including 3 with BD, 2 with GB stone, 2 with DU, 1 each with CP, PP, and AC. All those patients demonstrated MIR. We concluded that major reflux (MAR) sign was helpful in detecting an incomplete obstruction of the CBD, especially in patients with slightly to mildly dilated CBD.
- Published
- 1989
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