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Pictorial essay: imaging findings following Y90 radiation segmentectomy for hepatocellular carcinoma

机译：图案论文：肝细胞癌Y90辐射分段切除术后的成像结果

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摘要

Transarterial radioembolization is a novel therapy that has gained rapid clinical acceptance for the treatment of hepatocellular carcinoma (HCC). Segmental radioembolization [also termed radiation segmentectomy (RS)] is a technique that can deliver high doses ( 190 Gy) of radiation selectively to the hepatic segment(s) containing the tumor. The aim of this comprehensive review is to provide an illustrative summary of the most relevant imaging findings encountered after radiation segmentectomy. A 62-patient cohort of Child-Pugh A patients with solitary HCC 5 cm in size was identified. A comprehensive retrospective imaging review was done by interventional radiology staff at our institution. Important imaging findings were reported and illustrated in a descriptive account. For the purposes of completeness, specific patients outside our initial cohort with unique educational imaging features that also underwent segmentectomy were included in this pictorial essay. This review shows that response assessment after RS requires a learning curve with common drawbacks that can lead to false-positive interpretations and secondary unnecessary treatments. It is important to recognize that treatment responses and pathological changes both are time dependent. Findings such as benign geographical enhancement and initial benign pathological enhancement can easily be misinterpreted. Capsular retraction and segmental atrophy are some other examples of unique post-RS response that are not seen in any other treatment.
机译：rantarterial放射性栓塞是一种新的治疗，其患有对肝细胞癌（HCC）的治疗方法进行了快速的临床验收。分段放射性栓塞[也称为辐射分段切除术（RS）]是一种能够选择性地为含有肿瘤的肝脏的肝脏递送高剂量（＆ 190 gy）的技术。这种全面审查的目的是提供辐射分段切除术后遇到的最相关的成像结果的说明性概述。一个62患者的儿童抚育患者孤零零HCC患者患者确定了5厘米的尺寸。全面的回顾性成像评论是由我们机构的介入放射学工作人员完成的。报告和说明了重要的成像结果并在描述性账户中说明。出于完整性的目的，我们初始群组之外的特定患者，具有独特的教育成像特征，也包含在此图案论文中的接近分段切除术。此述评显示RS之后的响应评估需要一个具有共同缺点的学习曲线，这可能导致假正解释和次要不必要的治疗。重要的是要认识到治疗反应和病理变化都是时间依赖。良性地理增强和初始良性病理增强等调查结果很容易被误解。曲囊缩回和节段性萎缩是在任何其他治疗中没有看到的独特RS响应的其他一些例子。

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  • 来源
    《Abdominal radiology.》 |2018年第7期|共16页
  • 作者

    Mora Ronald A.; Ali Rehan; Gabr Ahmed; Abouchaleh Nadine; Al Asadi Ali; Kallini Joseph Ralph; Miller Frank H.; Yaghmai Vahid; Mouli Samdeep; Thornburg Bartley; Desai Kush; Riaz Ahsun; Lewandowski Robert J.; Salem Riad;

  • 作者单位

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Dept Radiol Sect Body Imaging Robert H Lurie Comprehens Canc Ctr Chicago;

    Northwestern Mem Hosp Dept Radiol Sect Body Imaging Robert H Lurie Comprehens Canc Ctr Chicago;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

    Northwestern Mem Hosp Sect Intervent Radiol Dept Radiol Robert H Lurie Comprehens Canc Ctr 676;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 内科学;
  • 关键词

    Radioembolization; Radiation segmentectomy; Hepatocellular carcinoma (HCC); World Health Organization (WHO); European Association for the Study of the Liver (EASL);

    机译：放射骨髓化;辐射分段切除术;肝细胞癌（HCC）;世界卫生组织（世卫组织）;欧洲肝脏研究协会（EASL）;

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