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Objective: The objective of our study was to evaluate the technical and clinical outcomes of uterine artery embolization (UAE) along with the administration of methotrexate (MTX) for cervical ectopic pregnancy with vaginal bleeding as an alternative nonsurgical treatment to control bleeding and preserve fertility., Materials and Methods: Eight patients (age range, 24-37 years; mean age, 30.1 years) with cervical ectopic pregnancy were treated with UAE using gelatin sponge particles to control vaginal bleeding. In seven patients, the administration of MTX was performed before, after, or before and after UAE. The follow-up periods after UAE ranged from 4 to 46 months (median, 8 months). We evaluated the UAE technique, clinical outcomes, complications, and fertility., Results: In all patients, UAE could control active vaginal bleeding on gynecologic examination. In six patients, the cervical ectopic pregnancy was dramatically resolved. In the other two patients presenting with both fetal heartbeat before UAE and persistent high HCG levels, active vaginal rebleeding was observed. The rebleeding was successfully controlled by a second UAE procedure. No major complication related to UAE was detected. The uterus could be preserved in all patients. In seven patients, normal menses resumed within 2 months after UAE. In only one patient, amenorrhea continued 8 months after UAE. In all three patients who could be followed for 2 years or more, three had subsequent successful natural pregnancies, and two patients had live births., Conclusion: UAE along with the administration of MTX is effective in treating cervical ectopic pregnancy with vaginal bleeding while allowing the preservation of fertility.

Objective: The purpose of this study was to evaluate the imaging features of intraductal tubular tumors of the pancreas., Conclusion: Intraductal tubular tumors of the pancreas presented as solid tumors extending along and obstructing the pancreatic duct without downstream dilatation. Dynamic CT or MRI showed them to be hypovascular without delayed enhancement.

Objective: The objective of this study was to evaluate whether minute portal venous invasion in hepatocellular carcinoma (HCC) can be diagnosed radiologically., Materials and Methods: CT hepatic arteriography and CT with arterioportography (CTAP) of 15 patients with minute portal venous invasion (group 1) and 30 patients without it (group 0) were evaluated. An area showing low attenuation on CTAP and high attenuation on CT hepatic arteriography around the tumor was defined as an area of peritumoral hemodynamic change. The shape and size of the area were compared between the two groups. The ratio of the area of peritumoral hemodynamic change volume to tumor volume (area volume-tumor volume ratio) was used as an indicator of the size of the area of peritumoral hemodynamic change and was categorized as one of three grades: grade I, 10% or less; grade II, between 10% and 30%; and grade III, 30% or more. The detectability of minute portal invasion was assessed when grade III was considered as an indicator. Each comparison was also made independently when the tumor diameter either was limited to less than 3 cm or was 3 cm or more., Results: Three types of area of peritumoral hemodynamic change were identified: wedge-shaped, belt-shaped or irregular, and linear. No significant difference in the frequency of each type of area of peritumoral hemodynamic change was observed between the two groups. The area volume-tumor volume ratio in group 1 was larger than that in group 0, with statistical significance when the tumor diameter was less than 3 cm (p = 0.046). Positive and negative predictive values were 71.4% and 75.0%, respectively, when the tumor diameter was less than 3 cm., Conclusion: The area of peritumoral hemodynamic change in HCC patients with minute portal invasion (group 1) may be larger than in those without it (group 0), especially when tumors are small.

Objective: The purpose of our study was to evaluate the detectability of the gonadal vein of transposed ovaries in patients with uterine cervical cancer on MDCT., Conclusion: Gonadal veins and surgical clips of transposed ovaries can be shown with high consistency on MDCT. Tracking the gonadal veins and detecting the surgical clips may prevent the transposed ovaries from being misinterpreted as peritoneal implants.

Objective: The purpose of this study was to retrospectively compare contrast-enhanced fat-suppressed T1-weighted images with histopathologic findings in ureteral carcinoma to develop accurate preoperative MR criteria for T staging., Conclusion: Contrast-enhanced fat-suppressed T1-weighted images can be used to distinguish thickened noncarcinomatous ureteral walls, which occur due to the proliferation of fibrous tissue, from ureteral carcinoma because fibrous tissue enhances more intensely on MRI than ureteral carcinoma. We also observed that when ureteral carcinomas had invaded periureteral fat tissue, a disruption or fragmentation of the intensely enhancing ureteral wall was seen. Using the MR criteria for T staging that we developed on the basis of these findings, we were able to accurately determine whether a carcinoma had invaded periureteral fat tissue in all of our patients.

Objective: The objective of our study was to evaluate the diagnostic accuracy of MDCT and conventional angiography in the detection of an accessory left gastric artery using CT hepatic arteriography as the standard of reference., Materials and Methods: The study group consisted of 118 patients who underwent MDCT with a triple-phase liver protocol with a slice thickness of 5 mm, conventional angiography, and CT hepatic arteriography. The early-phase images of MDCT and conventional angiography were retrospectively reviewed. The presence or absence of an accessory left gastric artery was evaluated using CT hepatic arteriography as the standard of reference. The sensitivity, specificity, and accuracy of MDCT and conventional angiography were calculated., Results: CT hepatic arteriography revealed an accessory left gastric artery in 25 (21.2%) of 118 cases, including 15 proximal- and 10 distal-type accessory left gastric arteries. On MDCT, there were seven false-negative cases and one false-positive case. Six of the seven false-negative cases were a proximal-type accessory left gastric artery, and nine of 10 distal-type accessory left gastric arteries were correctly diagnosed using MDCT. The sensitivity, specificity, and accuracy of MDCT were 72.0%, 98.9%, and 93.2%, respectively. On conventional angiography, there were three false-negative and two false-positive cases, none of whom underwent selective left hepatic arteriography. Two of the three false-negative cases were the distal-type accessory left gastric artery, but eight of the 10 distal-type accessory left gastric arteries were correctly diagnosed. The sensitivity, specificity, and accuracy of conventional angiography were 88.0%, 97.8%, and 95.8%, respectively., Conclusion: Approximately 70% of accessory left gastric arteries can be diagnosed at the early phase of MDCT even with a slice thickness of 5 mm.

Objective: Our aim was to determine whether variant hepatic artery anatomy in a liver transplant recipient increases the risk of hepatic artery complications after liver transplantation., Materials and Methods: The study group consisted of 84 patients who underwent gadolinium-enhanced 3D MR angiography before orthotopic liver transplantation in which a branch patch arterial anastomosis at the gastroduodenal takeoff was used. MR angiography studies were retrospectively reviewed and assessed for the presence and type of variant hepatic artery anatomy. The diameter of the distal common hepatic artery was measured. The incidence of posttransplantation hepatic artery stenosis or thrombosis was assessed., Results: Seven (8.3%) of the 84 patients developed hepatic artery complications after transplantation. Of the 24 patients with variant hepatic artery anatomy, five (20.8%) had posttransplantation/ hepatic artery complications. In contrast, only two (3.3%) of the 60 patients with classic hepatic artery anatomy had complications. The higher complication rate in patients with variant hepatic artery anatomy was statistically significant (p < 0.05). The odds ratio was 7.6 (95% confidence interval, 1.4-42.6). The diameter of the distal common hepatic artery was smaller in patients with variant hepatic artery anatomy compared with those with classic hepatic artery anatomy (range, 4.3-7.1 mm [mean, 5.8 mm] vs 4.0-8.9 mm [mean 6.3 mm], p < 0.05), and it was also smaller in patients who had posttransplantation hepatic artery complications compared with those who had no complications (range, 4.2-6.3 mm [mean, 5.2 mm] vs 4.0-8.9 mm, [mean, 6.2 mm], p < 0.01)., Conclusion: Variant hepatic artery anatomy in a liver transplant recipient increased the risk of hepatic artery complications after transplantation. The smaller caliber of the native common hepatic artery may contribute to the higher risk.