Biomedical subjects
Publications and source records attributed to K Hasuo.
A case of accessory nerve neurinoma presenting with a so-called "intraaxial mass sign" on the angiograms is reported. The tumor originated from the intracranial portion of the accessory nerve and displaced the lateral medullary segment of the posterior inferior cerebellar artery posterolaterally. The displacement of the artery can be understood by the microanatomical relations.
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Lipiodol Ultra-Fluid (Lipiodol) remains selectively in the tumor for an extended time when applied through arteries feeding the tumor. Although lipophilic antitumor drugs are selective when combined with Lipiodol, wide application of common hydrophilic agents is limited, as these compounds are insoluble in oil. We propose "Lipiodolization" of water-soluble agents using as an intermediate Urografin, a water-soluble contrast medium. Thirteen patients with primary hepatocellular carcinoma were treated with this Lipiodol-Urografin system containing antitumor agents. Marked decrease in serum alpha-fetoprotein (AFP) levels, decrease in tumor size in the hepatic imaging, and histologic studies of the resected specimen revealed this mode of therapy to be effective in 10 of 13 patients (77%) with hepatocellular carcinoma. Lipiodolization of antitumor agents is a new approach to selective cancer chemotherapy.
The postcontrast CT scans and angiography of 26 lesions in 23 patients with hepatomas who underwent transcatheter arterial embolization therapy were reviewed. Newly developed low density and high density areas and gas were noted on CT scans of the tumors after embolization in 100, 8 and 58% of the lesions, respectively. The CT findings of residual tumors correlated well with those of follow-up angiography. When discrete smooth round low density zones were observed on CT, there was no residual neovascularity on follow-up arteriography. When there were nodular or thick septum-like structures in low density lesions, arteriography revealed residual tumor vascularity in the lesions. CT proved useful not only in evaluating the effects of embolization, but also in providing important information about residual tumors.
Computed tomography was performed in two cases of blood-brain barrier (BBB) disruption due to cerebral arteriography. The first case showed diffuse contrast enhancement in the right frontotemporal region in the distribution of the middle cerebral artery; in the second case patchy contrast enhancement in both gray and white matter of both hemispheres was demonstrated. The possible mechanism for BBB disruption in these patients is discussed.
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A cavernous hemangioma in the pineal region of a 22-year-old man is reported. Because the patient had diabetes insipidus and a contrast-medium-enhanced mass in his pineal region on computed tomography, a germinoma was suspected. A ventricular shunt was made and the tumor was irradiated, but without a response. After irradiation the tumor was entirely removed, and postoperatively the diabetes insipidus improved.
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Publications in the scientific literature are controversial in regard to the clinical significance of intracerebral venous angiomas. The present study of 11 patients with venous angiomas underscores the clinical importance of these lesions as potential causes of cerebral hemorrhage and obstructive hydrocephalus. The clinical and radiographic manifestations in 9 of these 11 patients correlated well. In cases of venous angiomas, the venous phase of angiography must be carefully scrutinized, particularly in patients with subarachnoid or intracerebral hemorrhage. Some diagnostic problems related to the angiography of venous angiomas are discussed.
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The radiological manifestations of 16 pituitary adenomas, six meningiomas and 14 craniopharyngiomas were reviewed. The differential diagnosis of these tumors is possible with a few exceptions when skull radiography, CT, angiography and metrizamide cisternography are carefully evaluated. Prolonged injection angiography (PIA) is particularly important for demonstrating the contours of pituitary adenomas and meningiomas. Metrizamide cisternography is indicated when the tumor contours are obscure using PIA, or when the differential diagnosis is uncertain.
Anomalous single pulmonary veins (AUSPV) is a rare anomaly of the pulmonary venous system. Six cases have been documented in the literature, and two additional are reported here. Since AUSPV mimics pulmonary varices on pulmonary angiography, careful interpretation of the pulmonary venous anatomy by bidirectional and stereoscopic angiography is mandatory for diagnosing this anomaly.
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