• 제목/요약/키워드: Interventional study

검색결과 354건 처리시간 0.022초

혈관 조영 검사 및 중재적 방사선 시술시 방사선량에 대한 참고 기준치 : 대뇌 중심으로 (Reference Levels for Radiation Dose in Angiography and Interventional Radiology : In the Cerebrum)

  • 한재복
    • 한국콘텐츠학회논문지
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    • 제11권3호
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    • pp.302-308
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    • 2011
  • 혈관 조영 검사 및 중재적 방사선 시술을 통한 환자에게 주어지는 피폭선량에 대해 대뇌를 중심으로 환자 체형을 표준화하여 검사 및 시술 차이에 따른 투시시간, 면적 선량률(kerma area product rate)을 관측하고 참고 기준치를 비교하고자 하였다. 그 결과 질병 분류에 따른 면적 선량률은 지주막하출혈(subarachnoid hemorrhage)이 가장 높았고, 뇌동맥류가 가장 낮았다. 또한 검사 및 시술에 따른 면적 선량률은 양쪽 내경동맥, 양쪽 총경동맥 및 추골동맥으로 하는 방법이 가장 높았으며, guglielmi detachable coil(GDC)이 가장 낮게 나타났다. 따라서 이를 혈관 조영 검사 및 중재적 방사선 시술시 환자 피폭 선량에 대한 참고 기준치로 이용할 수 있을 것이며 향후 환자 피폭 선량 교육과 관리에 유용할 것이라 사료된다.

Safety and Efficacy of Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization prior to Major Hepatectomy for Patients with HCC

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An;Wang, Li-Fu
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.703-706
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    • 2014
  • Objective: To evaluate the safety and efficacy of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) before major hepatectomy for patients with hepatocellur carcinoma (HCC). Methods: In this retrospective case-control study, data were collected from patients who underwent sequential TACE and PVE prior to major hemihepactectomy. Liver volumes were measured by computed tomography volumetry before TACE, and preoperation to assess degree of future remnant liver (FRL) hypertrophy and to check whether intro- or extrohepatic metastasis existed. Liver function was monitored by biochemistry after TACE, prior to and after major hepatectomy. Results: Mean average FRL volume increased 32.3-71.4% (mean 55.4%) compared with preoperative FRL volume. After TACE, liver enzymes were elevated, but returned to normal in four weeks. During PVE and resection, no patient had intro- or extrohepatic metastasis. Conclusion: Sequential TACE and PVE is an effective method to improve resection opportunity, expand the scope of surgical resection, and greatly reduce postoperative intra- and extrahepatic metastasis.

방사선 중재적 시술 중 시술자의 피폭선량에 대한 연구 (A Study on Radiation Exposure Dose of Operator During Interventional Radiology Procedure)

  • 전미은;임청환;정홍량;유인규;홍동희;강병삼
    • 대한방사선기술학회지:방사선기술과학
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    • 제35권3호
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    • pp.219-226
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    • 2012
  • 방사선 중재적 시술자들이 중재적 시술 중 잠재적인 위험을 인식하지 못하고 있다. 본 연구의 목적은 방사선 중재적 시술 중 시술자들의 피폭선량을 평가하여 이를 바탕으로 중재적 시술 중 피폭선량을 줄일 수 있는 방법의 기준안을 제안하는 것이다. 본 연구는 3개월 동안 전신선량계를 사용하여 20명의 중재적 시술자로부터 시행하는 모든 중재적 시술에서 방사선 피폭선량을 측정하였다. 방사선 중재적 시술을 시행하는 동안 납당량이 0.5 mmPb 방사선장해방어용 기구를 착용하는 것으로 평균 89.5 %의 피폭선량이 감쇄되었고, 납당량이 두꺼울수록 선량감쇄율은 증가하였다. TACE 시술을 시행하는 동안 연속투시보다 펄스투시를 선택하여 사용하는 것은 피폭선량이 평균 47.7 % 감쇄되었다. 중재적 시술자는 중재적 시술이 진행되는 동안 방사선장해방어용 기구를 착용하고, 적극적인 방사선방호 활동을 실시하여야 하며, 자신의 피폭선량에 대해 알고 있어야 한다. 그리고 피폭선량을 최소화하기 위한 자신의 위치나 장비 사용에 대해서도 알아야 한다.

Endovascular Closure Resolves Trimethylaminuria Caused by Congenital Portosystemic Shunts

  • Ponce-Dorrego, Mar?a Dolores;Garzon-Moll, Gonzalo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권6호
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    • pp.588-593
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    • 2019
  • This study aimed to report three new cases of an association between two rare conditions, congenital portosystemic shunts (CPSS) and trimethylaminuria (TMAU), and the efficacy of endovascular closure of the CPSS for resolving TMAU. Between November 2014 and April 2017, 15 patients with CPSS were enrolled in this prospective study to assess the efficacy of percutaneous endovascular shunt closure. Three patients presented with clinical symptoms of TMAU that were confirmed by urine analysis of trimethylamine (TMA) and TMA n-oxide. One year after endovascular closure of the congenital portosystemic shunt, the same parameters were evaluated were obtained and the values were compared to the pretreatment values. The results indicated the disappearance of clinical symptoms of TMAU and normalization of the urine test parameters in two patients and no changes in one patient, who developed new portosystemic communications.

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

  • Ying Wei;Lili Peng;Yan Li;Zhen-long Zhao;Ming-an Yu
    • Korean Journal of Radiology
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    • 제21권5호
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    • pp.572-581
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    • 2020
  • Objective: To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). Materials and Methods: This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18-83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months after. Results: Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 of whom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The median follow-up time was 13.6 months (range, 10.0-31.1 months). The clinical success rate was 89.4%. The volume reduction rate was 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantly improved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L; phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness was a major complication in 4 patients (6.0%), but it improved spontaneously within 2-3 months. Conclusion: MWA is safe, feasible, and effective for the treatment of PHPT.

Role of interventional endoscopic ultrasound in a developing country

  • Hasan Maulahela;Nagita Gianty Annisa;Achmad Fauzi;Kaka Renaldi;Murdani Abdullah;Marcellus Simadibrata;Dadang Makmun;Ari Fahrial Syam
    • Clinical Endoscopy
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    • 제56권1호
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    • pp.100-106
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    • 2023
  • Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

Lobaplatin-TACE Combined with Radioactive 125I Seed Implantation for Treatment of Primary Hepatocellular Carcinoma

  • Peng, Sheng;Yang, Qiu-Xia;Zhang, Tao;Lu, Ming-Jian;Yang, Guang;Liu, Zhen-Yin;Zhang, Rong;Zhang, Fu-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5155-5160
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    • 2014
  • Aim: To investigate the efficacy and safety of lobaplatin-transcatheter arterial chemoembolization (TACE) combined with radioactive $^{125}I$ seed implantation in treatment of primary hepatocellular carcinoma (HCC). Methods: 75 patients with primary HCC were enrolled in the study, among them 43 receiving lobaplatin-TACE (TACE group) and 32 lobaplatin-TACE combined with $^{125}I$ seed implantation (TACE+$^{125}I$ group). After treatment, the local remission rates and postoperative complications of two groups were compared using the Pearson Chi-square test. Overall survival in the two groups was calculated using Kaplan-Meier survival curves and the differences were tested using Log-rank test. Results: There were 7 cases of complete response (CR), 13 of partial response (PR), 6 of stable disease (SD) and 17 of progressive disease (PD) in the TACE group, with 13 cases of CR, 9 of PR, 5 of SD and 5 of PD in the TACE+$^{125}I$ group. The disease control rates of TACE and TACE+$^{125}I$ group were 60.5% (26/43) and 84.4% (27/32), respectively, with a significant difference between them (P < 0.05). The survival rates at 6, 12 and 18 months in the TACE group were 100.0%, 81.8% and 50.0%, respectively, and those in TACE+$^{125}I$ group were 100.0%, 93.8% and 65.6%. The mean survival times in the TACE and TACE+$^{125}I$ groups were 19.5 and 22.9 months, respectively. There was a significant difference in the overall survival rate between two groups (P < 0.05). No serious complications were encountered in either group. Conclusion: Lobaplatin-TACE combined with $^{125}I$ seed implantation is favorable and safe for treatment of primary HCC.

The Blood Neutrophil-to-lymphocyte Ratio Predicts Survival in Patients with Advanced Hepatocellular Carcinoma Receiving Sorafenib

  • Zheng, You-Bing;Zhao, Wei;Liu, Bing;Lu, Li-Gong;He, Xu;Huang, Jian-Wen;Li, Yong;Hu, Bao-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5527-5531
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    • 2013
  • Background and Aim: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the prognostic significance of the blood neutrophil-to-lymphocyte ratio (NLR) in patients with advanced HCC who received sorafenib monotherapy. Methods: A total of sixty-five patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib were enrolled. Potential prognostic factors such as age, gender, tumoral characteristics, performance status and NLR were analyzed. Results: Median OS and TTP for the entire cohort were 10.0 months (95%CI, 7.6-12.3 months) and 4.5 months (95% CI, 4.0-4.9 months). The mean NLR at baseline was 2.89. The median OS of patients with a high NLR (>4) was 6.5 months (95%CI, 5.2-7.7 months) compared with 12.5 months (95%CI, 9.9-15.0) for patients with a normal NLR (${\leq}4$) (P=0.01). Age ${\leq}65$, NLR>4, extrahepatic metastases and vascular invasion were all predictors of poorer overall survival. Multivariate analysis showed that NLR > 4, vascular invasion and extrahepatic metastases were independent predictors of poorer overall survival. The median TTP of patients with a high NLR was 2.5 months (95%CI, 1.4-3.6 months) compared with 4.5 months (95%CI, 3.9-5.1 months) for patients with a normal NLR (P=0.012). Conclusions: High baseline NLR was associated with worse OS and TTP for patients with advanced HCC treated with sorafenib.

Efficacy and Safety of the Safe Triangular Working Zone Approach in Percutaneous Vertebroplasty for Spinal Metastasis

  • Bi Cong Yan;Yan Feng Fan;Qing Hua Tian;Tao Wang;Zhi Long Huang;Hong Mei Song;Ying Li;Lei Jiao;Chun Gen Wu
    • Korean Journal of Radiology
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    • 제23권9호
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    • pp.901-910
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    • 2022
  • Objective: This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. Materials and Methods: We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31-76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29-81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan-Meier curves. Results: The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (p < 0.001). Cement leakage was not significantly different between groups A and B (p = 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan-Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). Conclusion: The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.