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- 저자 : ( Shu-cheng Chou ) (검색결과 2 건)
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Polypoid Lesions of the Gallbladder: A Long-Term Follow-Up of 1204 Patients
( Shu-cheng Chou ),( Shin-e Wang ),( Shih-chin Chen ),( Yi-ming Shyr ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Polypoid lesions of the gallbladder (PLG) are common, and most of them are benign. Few lesions are found malignant, but cannot be distinguished preoperatively by using common image modalities. Therefore, we compared characteristics of benign and malignant PLGs. Methods: We enrolled 1204 consecutive patients diagnosed with PLG at Taipei Veterans General Hospital during January 2004 to December 2013. Patients underwent either surgery or regular follow-up with various imaging modalities for at least 24 months. The mean follow-up duration was 72 ± 32 months. Results: Amoung our 1204 patients, 194 underwent surgical treatment and 1010 underwent regular follow-up. In addition, 73% patients were asymptomatic. The mean PLG size was 6.9 ± 7.7 (range, 0.8-129) mm; the PLGs of 337 patients (28%) grew during their follow-up periods. The majority of PLGs (90.4%) were single lesions, and 10.5% of patients had associated gallstones. The PLGs of 20.1% of surgical patients were malignant. Malignant PLGs were found in 32.4% of patients ≥50 years old and in 4.7% of those <50 years old (p < 0.001). Right quadrant abdominal pain, epigastric pain, and body weight loss were the three most common symptoms associated with malignancy. Malignant PLGs were significantly larger than benign lesions (means: 27.5 ± 18.4 mm vs. 12.3 ± 12.3 mm respectively, p < 0.001). Notably, the size of 5% of malignant PLGs was 3-5 mm, and that of 8% was 5-10 mm. The negative predictive value for gallbladder malignancy was 92.8% based on a size ≥10 mm and 100% based on a size ≥3 mm. Conclusions: Our study reassesses the PLG size that warrants more aggressive intervention. Cholecystectomy remains mandatory for PLGs >10 mm, but should also be considered a definitive diagnostic and treatment modality for PLGs with diameters of 3-10 mm.
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Tan Cher Heng,Chou Shu-cheng,Inmutto Nakarin,Ma Ke,Sheng RuoFan,Shi YingHong,Zhou Zhongguo,Yamada Akira,Tateishi Ryosuke 대한영상의학회 2022 Korean Journal of Radiology Vol.23 No.7
Gadoxetate magnetic resonance imaging (MRI) is widely used in clinical practice for liver imaging. For optimal use, we must understand both its advantages and limitations. This article is the outcome of an online advisory board meeting and subsequent discussions by a multidisciplinary group of experts on liver diseases across the Asia-Pacific region, first held on September 28, 2020. Here, we review the technical considerations for the use of gadoxetate, its current role in the management of patients with hepatocellular carcinoma (HCC), and its relevance in consensus guidelines for HCC imaging diagnosis. In the latter part of this review, we examine recent evidence evaluating the impact of gadoxetate on clinical outcomes on a continuum from diagnosis to treatment decision-making and follow-up. In conclusion, we outline the potential future roles of gadoxetate MRI based on an evolving understanding of the clinical utility of this contrast agent in the management of patients at risk of, or with, HCC.
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