[en] Objective: To explore DSA findings curative measures and effects of bronchial arterial embolization (BAE)of bronchiectasis with massive hemoptysis. Methods: 35 patients with massive hemoptysis due to bronchiectasis were performed selective bronchial arterial DSA and BAE referring to image data of chest plain film and CT. Embolic materials were polyvinyl alcohol (PVA)and/or gelatinum sponge particles. Curative effects were followed-up for 3 months to 3 years. Results: (1)DSA revealed bronchial artery as being the only abnormal vessel accounted for 74.3%, bronchial artry combined with nonbronchial systemic artery as 22.9% and only non-bronchial artery involved 2.9%. Abnormal vessel number was 1-5 (mean 1.8) per case; Direct and indirect bleeding sign was displayed as 25.7% and 100% respectively. (2)Curative and embolization effects were shown as 61 target vessels of 34 patients being embolized and total effective rate reaching 85.3%; of which 16 cases were adopted super-selective technique, 1 case was failure of stopping bleeding for two times within 3 days, 4 cases recurred within 3 months and 2 cases recurred over 3 months; with recurrent rate of 20.6%, but no serious complications such as spinal cord injury. Conclusions: DSA examination and selective BAE of bronchiectasis with massive hemoptysis could provide high positive angiographic features and reliable curative effect. (authors)

[en] Objective: To study the application of the assistant digital subtraction angiography (DSA) with selective intra-arterial embolization in comprehensive treatment of juvenile nasopharyngeal angiofibroma. Methods: Among 17 patients with juvenile nasopharyngeal angiofibroma confirmed by surgery and biopsy from February 2000 to June 2005, 13 cases underwent DSA examination and selective intra-arterial embolization on 1-4 days before surgical operation, and 4 cases with uncontrollable epistaxis through conventional therapy were carried out urgent DSA and embolization as well as surgical operation on a scheduled day. Angiographic manifestations and hemostatic effects and impacts in surgical operation were observed. Results: The extent and blood supply of lesions and the features of feeding artery were clearly demonstrated by DSA. Supplying vessel was mainly maxillary artery originating from external caroted artery in 16 cases, and double supplying vessels from ramus of internal and external carotid arteries in 1 case. In general, the higher the nasopharyngeal angiofibroma grade was the more supplying branches would exist. As for epistaxis patients, the number of the presence of irregular distal vessels and the punctiform extravasation of contrast media were displayed in positive proportion. No severe complications occurred and active bleeding was stopped after embolization and furthermore with less blood loss during surgical operation statistically about 280-1600 ml (460±255.5). Conclusions: DSA examination and selective arterial embolization can not only present more accurate important clinical imaging features but also in favour of stop bleeding and enhance surgical outcomes for patients with nasopharyngeal angiogibroma. (authors)

[en] Objective: To evaluate the value on temporary balloon occlusion of the abdominal aorta to decrease blood loss during the removal of sacral tumors. Methods: Six patients with sacral tumors including giant cell tumor 4 and chordoma 2, were implanted balloon catheter in the abdominal aorta below the orifice of renal artery via femoral artery approach before surgical operation. The balloon was inflated every 45 minutes with 10 minutes of free interval during surgical operation. Blood loss was recorded and operation effect was observed. Results: In interventional department every case needed about 30-60 minutes for successful placement of' the balloon catheter before the surgical operation. The balloon was inflated for blood flow occlusion from 40 minutes to 130 minutes accumulatively and blood loss ranged from 800 ml to 2000 ml (mean 1350 ml)during the surgical operation. All the tumors of 6 cases were removed successfully and without complications, including acute renal failure. Conclusions: The temporary balloon occlusion technique is safe and simple, which can make the removal of sacral tumors more safer with less blood loss. (authors)

[en] Objective: To compare the clinical value of three-dimensional DSA (3D DSA) and conventional DSA (2D DSA) in the diagnosis and treatment of carotid stenosis. Methods: Fifty stenosed carotid arteries in 42 patients confirmed by 2D DSA were performed with rotational angiography and three-dimensional reconstruction, of which 19 patients received both 2D DSA and 3D DSA before and after carotid stenting. The images of 3D and 2D DSA were studied double-blindly by two experienced radiologists. Diameters and cross-sectional areas of the most stenotic and distal nonstenotic vessels were calculated. Linear stenosis rate and area stenosis rate were computed with the method of North American Symptomatic Carotid Endarterectomy Trial (NASCET). Atherosclerotic plaques were observed mainly by means of virtual angioscopy (VA). Results: There was no statistically significant difference in linear stenosis rate between 3D DSA and 2D DSA(P>0.05). About 68% area stenosis rate of 3D DSA of total cases was significantly greater than the linear stenosis rate of other methods (P<0.01). The grade on area stenosis was higher than that on other methods in most vessels. Only 6 of 34 plaques displayed on 3D DSA were demonstrated on 2D DSA(P<0.005). There was statistical difference between 3D DSA and 2D DSA in assessing the therapeutic efficacy of carotid stenting (P<0.05). Conclusion: 3D DSA is more accurate than 2D DSA in evaluating carotid stenosis. 3D DSA can offer more valuable information for the diagnosis and treatment of carotid stenosis and assessment for the therapeutic efficacy of carotid stenting. (authors)

[en] Objective: To explore the short-term efficacy of transcatheter arterial chemoembolization (TACE) in treating early intrahepatic recurrence or metastasis of primary liver carcinoma(PLC) that occurs within 6 months after surgical resection. Methods: Thirty-six patients with early intrahepatic recurrence or metastasis of PLC after surgical resection were treated with TACE. According to the recurrence site observed on the initial DSA, the patients were divided into group A (n = 15) and group B (n = 21). Patients of group A had incisal margin recurrence or single lesion, while patients of group B showed multiple lesions in the liver. Transarterial infusion of proper chemotherapeutic agent was performed in all patients, which followed by embolization of tumor-feeding vessels with epirubicin-iodized oil emulsion. The repetition of the above treatment was decided by the check-up CT scanning and AFP level. All the patients were followed up for 12 months. The results were statistically analyzed by using t-test or fisher test. A difference with P < 0.05 was considered to be statistically significant. Results: Preoperative satellite foci, portal thrombosis within the second or distal branches and massive tumor with no capsule were more commonly seen in group B than in group A (P < 0.05 ). No serious intervention-related complications occurred in all patients. The overall mean number of TACE procedure was (3.0 ± 0.7) times. The total 6-month effective rate after the initial TACE was 58.3%, and the 12-month survival rate was 66.7%. The mean numbers of TACE procedure of group A and group B were (3.3 ± 0.8) and (2.9 ± 0.7) times respectively (t = 1.688, P = 0.101). The 6-month effective rates of group A and group B were 80.0% and 42.9% respectively (P = 0.024), while the 12-month survival rates of group A and group B were 86.7% and 52.4% respectively (P = 0.03). Conclusion: TACE has some certain clinical efficacy in treating early intrahepatic recurrence or metastasis of primary liver carcinoma that occurs within 6 months after surgical resection, although its control ability of the tumor and its 12-month survival rate for patients with multiple lesions are limited. (authors)

[en] Objective: To compare the consistency of the results of prothrombin induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) chemiluminescence and enzyme-linked immunosorbent assay, and to further verify the diagnostic performances of PIVKA-Ⅱ and AFP chemiluminescence on primary hepatocellular carcinoma. Methods: Spearman correlation coefficient analysis, Deviation analysis and the coincidence rate of negative or positive were used to evaluate the consistency of the results of chemiluminescence and enzyme-linked immunosorbent assay. We examined the levels of PIVKA-Ⅱ and AFP in healthy people, hepatitis and cirrhosis patients, as well as the hepatocellular carcinoma group. The critical value movement method was used to evaluate the specificity and sensitivity of PIVKA-Ⅱ and AFP in the diagnosis of hepatocellular carcinoma, and the results were compared with the diagnostic performance obtained through a meta-analysis. Results: The levels of PIVKA-Ⅱ of serum detected by the two methods were well correlated (R² = 0.925). PIVKA-Ⅱ was diagnosed with 40 mAU/mL as the cut-off value, and for patients with hepatocellular carcinoma, the coincidence rate of negative or positive was 100%. When PIVKA-Ⅱ < 200 mAU/mL, the absolute deviation detected by the two methods was less than 10 mAU/mL, and the relative deviation was mostly within 20%. PIVKA-Ⅱ and AFP had no correlation. When the critical values of PIVKA-Ⅱ and AFP were 26.5 mAU/mL and 15.5 ng/mL respectively, the sensitivity and specificity of PIVKA-Ⅱ and AFP in the diagnosis of hepatocellular carcinoma were 79.7% and 56.3%, respectively, and the specificity were 80.6% and 78.3%, respectively. The positive rate of the joint inspection of the two indicators could reach 86%. The results of this experiment were similar to those of the meta-analysis. Conclusion: The detection of PIVKA-Ⅱ by enzyme-linked immunoassay and electrochemiluminescence has a good comparability but there are still some differences. AFP combined with PIVKA-Ⅱ can improve the diagnosis efficiency of primary hepatocellular carcinoma. (authors)