Synchronous adrenal metastasis and an inferior vena cava tumor thrombus from an ovarian carcinoma

A 60-year-old woman presented with synchronous adrenal metastasis and an inferior vena cava tumor thrombus in the adrenal vein that developed from an ovarian carcinoma. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and right adrenalectomy with caval tumor thrombectomy for treatment. Microscopic examination revealed a clear cell ovarian carcinoma and a metastatic adrenal tumor. The patient is clinically free of disease after 6 years of follow-up. There have been no reports of synchronous adrenal metastasis with an inferior vena cava thrombus that developed from an ovarian carcinoma. As several reports have described the long-term survival after adrenalectomy for the treatment of isolated adrenal metastasis, clinicians should be aware of this potential occurrence so that patients can be appropriately treated

Incidental discovery of circle contact lens by MRI: you can’t scan my poker face, circle contact lens as a potential MRI hazard

BACKGROUND: Circle contact lenses, also known as color contact lenses and big eye contact lenses, are a type of cosmetic contact lens. It is not generally known that a circle contact lens usually contains iron oxide and other metals, which means their use during magnetic resonance imaging (MRI) is a potential hazard. CASE PRESENTATION: We present a rare case of incidental discovery of circle contact lenses by MRI and MRI images of circle lenses in vitro. CONCLUSIONS: Circle contact lenses usually contain iron oxide, which is a known source of susceptibility artifact on MRI. Not only radiologists and radiographers but also referring physicians should be familiar with the imaging findings and potential risk of scanning circle contact lenses by MRI

Use of a novel coaxial guide needle-wire (GNW) combination system for computed tomography guided radiofrequency tumor ablation

We developed a novel coaxial system using a fine guide needle wire (GNW) to safely and easily place the radiofrequency needle under CT-guidance. The GNW consists of a fine needle (diameter, 21-gauge; length, 150 mm) and a wire (0.018 inch, 250 mm). An exclusive radiofrequency cannula (14-gauge; 160 mm) was also used. This system was used for the treatment of six hepatocellular carcinomas in six patients. All lesions were located deeper than 10 cm from the needle entry site. This system was useful in performing CT-guided RF ablation for deeply or precariously located liver lesions particularly in patients who are unable to hold their breath

Ultrasound-guided thrombin injection for the treatment of an iatrogenic hepatic artery pseudoaneurysm: a case report

<p>Abstract</p> <p>Introduction</p> <p>Percutaneous transhepatic portal embolization is often performed to expand the indications for hepatic resection. Various etiologies of hepatic artery pseudoaneurysm have been reported, but regardless of the etiology, hepatic artery pseudoaneurysm is usually managed with an endovascular approach or open surgery, depending on the location and clinical symptomatology. However, it is difficult to manage hepatic artery pseudoaneurysm after percutaneous transhepatic portal embolization, since embolization of the hepatic artery may cause hepatic infarction</p> <p>Case presentation</p> <p>A 58-year-old Japanese man with hilar bile duct cancer underwent percutaneous transhepatic portal embolization to expand the indication for hepatic resection. Two days after percutaneous transhepatic portal embolization, our patient suddenly complained of abdominal pain. Contrast-enhanced computed tomography confirmed a pseudoaneurysm arising from a segmental branch of his right hepatic artery. Since embolization of the hepatic arterial branches may cause hepatic infarction, ultrasound-guided thrombin injection therapy was successfully performed for the pseudoaneurysm.</p> <p>Conclusion</p> <p>We performed a thrombin injection instead of arterial embolization to avoid hepatic infarction. The rationale of this choice may be insufficient. However, ultrasound-guided percutaneous thrombin injection therapy may be considered as an alternative to percutaneous transarterial embolization or surgical intervention for an iatrogenic hepatic artery pseudoaneurysm.</p

Successful Interventional Management of Life-Threatening Bleeding after Oocyte Retrieval: A Case Report and Review of the Literature

Life-threatening bleeding after oocyte retrieval is unusual. We report a case of massive vaginal bleeding requiring transcatheter arterial embolization (TAE) after transvaginal US-directed follicle aspiration for oocyte retrieval and provide a brief review of cases in which the pseudoaneurysm of the injured artery was managed with a TAE approach. A 40-year-old woman presented massive vaginal bleeding after transvaginal ultrasonography-directed follicle aspiration for oocyte retrieval. Contrast-enhanced computed tomography revealed active bleeding from the uterine ostium. Transcatheter arterial embolization was performed for a pseudoaneurysm of the right pudendal artery to manage the hemorrhage. Potentially life-threatening bleeding should be recognized as a rare complication after oocyte retrieval to promptly establish the diagnosis and preserve the uterus

Multidetector-row computed tomography for evaluating the branching angle of the celiac artery: a descriptive study

Abstract Background We performed this study in order to investigate the shape of the origin of the celiac artery in maximum intensity projection (MIP) using routine 64 multidetector-row computed tomography (MDCT) data in order to plan for the implantation of an intra-arterial hepatic port system. Methods A total of 1,104 patients with hepatocellular carcinoma were assessed with MDCT. In the definition of the branching angle, the anterior side of the abdominal aorta was considered the baseline, and the cranial and caudal sides were designated as 0 and 180 degrees, respectively. The angles between 0 and 90 degrees and between 90 and 180 degrees from the cranial side were considered upward and downward, respectively, and the branching angle of the celiac artery was classified every 30 degrees. The subclavian arterial route was used for the implantation of an intra-arterial hepatic port system in patients with branching angles of 150 degrees or more (sharp downward). Results The median branching angle was (median ± standard deviation) 135 ± 23 (range, 51–174) degrees. The branching was upward in 77 patients (7%) and downward in 1,027 patients (93%). The branching was downward with an angle of 120 to150 degrees in most patients (n = 613). The branching was sharply downward with an angle of 150 degrees or more in 177 patients (16%). A total of 10 patients were referred for interventional placement of an intra-arterial hepatic port system. The subclavian arterial route was used for implantation of an intra-arterial hepatic port system in 2 patients with sharp downward branching. Conclusions The branching angle of the celiac artery can be easily determined by the preparation of MIP images from routine MDCT data. MIP may provide useful information for the selection of the catheter insertion route in order to avoid a sharp branching angle of the celiac artery.</p

Successful Interventional Management of Life-Threatening Bleeding after Oocyte Retrieval: A Case Report and Review of the Literature

Life-threatening bleeding after oocyte retrieval is unusual. We report a case of massive vaginal bleeding requiring transcatheter arterial embolization (TAE) after transvaginal US-directed follicle aspiration for oocyte retrieval and provide a brief review of cases in which the pseudoaneurysm of the injured artery was managed with a TAE approach. A 40-year-old woman presented massive vaginal bleeding after transvaginal ultrasonography-directed follicle aspiration for oocyte retrieval. Contrast-enhanced computed tomography revealed active bleeding from the uterine ostium. Transcatheter arterial embolization was performed for a pseudoaneurysm of the right pudendal artery to manage the hemorrhage. Potentially life-threatening bleeding should be recognized as a rare complication after oocyte retrieval to promptly establish the diagnosis and preserve the uterus

Analysis of the time course of changes in imaging findings of small arteries embolized with the N-Butyl cyanoacrylate-lipiodol mixture

Background: There are no reports analyzing imaging findings of arteries embolized with N-butyl cyanoacrylate (NBCA)-Lipiodol. To evaluate the time course of changes in the imaging findings of small arteries embolized with NBCA-Lipiodol. Materials and Methods: Selective transcatheter arterial embolization procedures via the inferior phrenic artery (right IPA, n = 25; left IPA, n = 5) were performed in 30 patients (25 males, 5 females; mean age 63 years, range: 45–78) at our institution. The NBCA-Lipiodol mixture was used as an embolic agent. The ratio of NBCA to Lipiodol was 1:4 (Group-A, n = 16) or 1:8 (Group-B, n = 14).We retrospectively reviewed the computed tomography (CT) findings and outcomes of small arteries embolized with the NBCA-Lipiodol mixture. The residual lipiodol was compared between Group-A and Group-B. The Student’s t-test and Chi-square test were used for statistical analyses. In addition, the residual lipiodol rate was calculated using the Kaplan–Meier method and compared using the log-rank test. Results: The mean observation period was 264 ± 84 days (range: 104–425). Lipiodol completely disappeared in 20 arteries (66%) during follow-up. Recanalization of arterial flow was not seen in CT images, even when Lipiodol disappeared. Group-B showed a shorter period of progression to disappearance of Lipiodol than Group-A (P < 0.05). On follow up, the rate of residual Lipiodol in Group-A was higher than that in Group-B (P < 0.05). Conclusion: Residual Lipiodol was expected to gradually disappear. Lipiodol disappeared early when the density of NBCA was low in the NBCA-Lipiodol mixture. Further evaluations of various arteries and ratios of NBCA to Lipiodol are needed