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Chuang MC, Juan YH, Lee KF, Hsieh MJ. Tracheobronchial calcification in a dialysis patient with metastatic pulmonary calcification. QJM 2021; 114:39-41. [PMID: 32339237 DOI: 10.1093/qjmed/hcaa147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/10/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- M-C Chuang
- Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, No. 6, West Sec., Chiapu Road, Putzu City, Chiayi 61363, Taiwan
- Department of Respiratory Therapy, School of Medicine, Chang-Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan
| | - Y-H Juan
- Department of Medical Imaging and Intervention, Chang-Gung Memorial Hospital, Institute for Radiological Research, Chang-Gung University, Linkou, No.5, Fusing St., Gueishan Dist., Taoyuan City 33305, Taiwan
| | - K-F Lee
- Department of Respiratory Therapy, School of Medicine, Chang-Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan
- Department of Pathology, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, No. 6, West Sec., Chiapu Road, Putzu City, Chiayi 61363, Taiwan
| | - M-J Hsieh
- Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, No. 6, West Sec., Chiapu Road, Putzu City, Chiayi 61363, Taiwan
- Department of Respiratory Therapy, School of Medicine, Chang-Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan
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Ren G, Juan YH, Fei H, Lin Q, Paul S, Wang J, Chen R, Liu H. Congenital absence of the pericardium and tricuspid regurgitation. QJM 2018; 111:895-897. [PMID: 30239954 DOI: 10.1093/qjmed/hcy213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Indexed: 02/05/2023] Open
Affiliation(s)
- G Ren
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong Province, China
| | - Y-H Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan, Taiwan
| | - H Fei
- Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Q Lin
- Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - S Paul
- Case Western University Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - J Wang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong Province, China
| | - R Chen
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong Province, China
| | - H Liu
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Chang CH, Juan YH, Hu HC, Kao KC, Lee CS. Reversal of lung fibrosis: an unexpected finding in survivor of acute respiratory distress syndrome. QJM 2018; 111:47-48. [PMID: 29036729 DOI: 10.1093/qjmed/hcx190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- C-H Chang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkuo Branch, No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, No.259, Wenhua 1st Road, Guishan Dist., Taoyuan City 333, Taiwan
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Saint Paul's Hospital, No.123, Jianxing St., Taoyuan Dist., Taoyuan City 330, Taiwan
| | - Y-H Juan
- School of Medicine, College of Medicine, Chang Gung University, No.259, Wenhua 1st Road, Guishan Dist., Taoyuan City 333, Taiwan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkuo Branch and Chang Gung University, No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan
| | - H-C Hu
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkuo Branch, No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, No.259, Wenhua 1st Road, Guishan Dist., Taoyuan City 333, Taiwan
| | - K-C Kao
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkuo Branch, No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, No.259, Wenhua 1st Road, Guishan Dist., Taoyuan City 333, Taiwan
| | - C-S Lee
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkuo Branch, No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, No.259, Wenhua 1st Road, Guishan Dist., Taoyuan City 333, Taiwan
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Saint Paul's Hospital, No.123, Jianxing St., Taoyuan Dist., Taoyuan City 330, Taiwan
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4
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Lin YC, Huang TS, Wu JS, Cheung YC, Huang YH, Sung CM, Juan YH, Chen FP, Ni Mhuircheartaigh JM. Are bilateral decubitus views necessary in assessing for vertebral compression fractures using DXA vertebral fracture assessment? Osteoporos Int 2017; 28:2377-2382. [PMID: 28488133 DOI: 10.1007/s00198-017-4040-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED The purpose of this study is to assess the differences in VFA diagnostic accuracy when using bilateral decubitus views and whether diagnostic accuracy is affected by scoliosis. Our findings show that the current practice of performing only one side is valid; however, bilateral views can improve specificity in scoliosis. INTRODUCTION The diagnostic accuracy of vertebral fracture assessment (VFA) can be influenced by poor patient position and scoliosis. This study aims to assess the differences in VFA diagnostic accuracy for right and left lateral decubitus views and the effect of scoliosis. METHODS One hundred fourteen postmenopausal women received right and left lateral thoracolumbar spine dual-energy VFA and radiography. Cobb angles were measured from the posteroanterior absorptiometry image, and lumbar spine radiography was the standard reference for vertebral fracture and also provides the levels investigated. McNemar's test was used to compare accuracy between the two decubitus position and Fisher's exact test was used for patients with and without scoliosis. RESULTS Forty-two vertebral fractures (VFs) were identified. There was no significant difference in sensitivity (p = 0.125) or specificity (p = 0.866) between the left lateral decubitus (64.3, 97.2%) and right lateral decubitus (76.2, 91.1%), respectively, views. Scoliotic patients had a significantly worse specificity (92.7 vs 98.1%, p = 0.003) than patients without scoliosis; however, a combination of both decubitus positions significantly improved specificity (p < 0.001). CONCLUSION Right and left side lateral decubitus views have excellent agreement with radiography and similar diagnostic accuracy in the detection of VFs. Thus, the current practice of performing only one side is valid. With scoliosis, bilateral decubitus views can improve the specificity of detecting VF; however, this would increase radiation dose.
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Affiliation(s)
- Y-C Lin
- Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan
- Keelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan
| | - T-S Huang
- Keelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan
- Department of General Surgery, Chang Gung Memorial Hospital, 222 Maijin Road, Keelung, Taiwan
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Kuei-Shan, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - J S Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA, 02215, USA
| | - Y-C Cheung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou/Taoyuan and Chang Gung University, 5 Fu-Shin Street, Kuei-Shan, Taoyuan, 333, Taiwan
| | - Y-H Huang
- Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan
| | - C-M Sung
- Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan
| | - Y-H Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou/Taoyuan and Chang Gung University, 5 Fu-Shin Street, Kuei-Shan, Taoyuan, 333, Taiwan
| | - F-P Chen
- Keelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan.
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, 222 Maijin Road, Keelung, Taiwan.
| | - J M Ni Mhuircheartaigh
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA, 02215, USA
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Liu H, Juan YH, Wang Q, Xie J, Hou Q, Fei H, Zhang X, Zhou H, Liang C, Lin YC, Kwong RY, Saboo SS. Aortic root ring sign: multimodality imaging of aortic root abscess. QJM 2016; 109:53-4. [PMID: 25852152 DOI: 10.1093/qjmed/hcv073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Liu
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China,
| | - Y-H Juan
- Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Q Wang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - J Xie
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - Q Hou
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - H Fei
- Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - X Zhang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - H Zhou
- Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and
| | - C Liang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - Y-C Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - R Y Kwong
- Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S S Saboo
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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6
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Lai CH, Juan YH, Chang SL, Lee WL, How CK, Hsu TF. Subarachnoid haemorrhage mimicking transient ST-segment elevation myocardial infarction. Acta Clin Belg 2015; 70:304-6. [PMID: 26032227 DOI: 10.1179/2295333715y.0000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Patients often present to the emergency department with loss of consciousness. The differential diagnosis of such condition may be difficult because of limited clinical information. The authors present a case of subarachnoid haemorrhage (SAH) with initial electrocardiographic (ECG) finding mimicking ST-segment elevation myocardial infarction (STEMI), which was confirmed to resolve in a follow-up study. Accurate and timely diagnosis of SAH-related ST-segment elevation was important, as the therapeutic strategy for SAH is completely different from that for STEMI. If the clinicians do not have other tools for diagnosis, the follow-up ECG may help us make a most possible diagnosis.
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Abstract
Papillary thyroid cancer is the most common form of thyroid malignancy in children and adult with frequent metastases to the cervical lymph nodes. We present a case of metastatic papillary thyroid cancer with remarkable imaging findings of consecutive metastatic calcified lymph nodes resembling a chain of rings. While accompanying by a coarsely calcified thyroid mass, possible thyroid cancer should be considered and serve as a guide to warrant further thyroid cancer evaluation.
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Affiliation(s)
- Y-H Juan
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080 From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
| | - A H Waller
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
| | - S S Saboo
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
| | - Y-C Lin
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
| | - H Liu
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080 From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
| | - R Y Kwong
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
| | - M L Steigner
- From the Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Cardiovascular Imaging Program, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan 33305, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan 20401 and Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China 510080
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Affiliation(s)
- Y-H Juan
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - P Nagpal
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - S S Saboo
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - Y-C Lin
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - A Khandelwal
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
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10
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Abstract
Intramural haematoma of the esophagus (IHE) is an uncommon clinical condition, which can mimic other cardiothoracic emergencies in both clinical and imaging perspectives. We presented the case of a 54-year-old female who presented to the emergency department with a clinical triad of retrosternal chest pain, odynophagia, and haematemesis for 3 days. Multi-detector computed tomography (MDCT) revealed long-segmental, well-defined, isodense mass in postero-lateral wall of esophagus with smooth arc-shaped indentation into the lumen and no obvious enhancement after IV contrast administration. The preserved fat plane between the thickened esophagus and the aorta allows exclusion of aortic dissection. Subsequent esophagogram and endoscopy confirmed the finding of IHE and thus, patient was successfully treated with conservative treatment and discharged uneventfully. Owing to the presence of clinical and image mimickers of IHE, the recognition of clinical triad of retrosternal pain, odynophagia, and haematemesis, and the typical MDCT and esophagographic presentation of submucosal haematoma are important in avoiding misdiagnosis with inappropriate treatment.
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Liu H, Juan YH, Fei H, Mei P, Zhang X, Xu W, Liang C, Wang Q, Saboo SS. Tumor involvement of the left atrium and mitral valve: imaging features of intra-cardiac malignancy. QJM 2014; 107:747-9. [PMID: 24633259 DOI: 10.1093/qjmed/hcu058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Liu
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y-H Juan
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - H Fei
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - P Mei
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - X Zhang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - W Xu
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - C Liang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Wang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S S Saboo
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan, Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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12
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Affiliation(s)
- Y-H Juan
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan
| | - S S Saboo
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y-C Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan
| | - J R Conner
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - F L Jacobson
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Khandelwal
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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13
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Affiliation(s)
- H Liu
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - Y-H Juan
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - Q Wang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - Y-C Lin
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - C Liang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - X Zhang
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - T Cai
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
| | - S S Saboo
- From the Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, GuangZhou, GuangDong, China
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14
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Lin YC, Mhuircheartaigh JN, Cheung YC, Juan YH, Chiu CH, Yeh WL, Wu JS. Pain following double-bundle anterior cruciate ligament reconstruction: correlation with morphological graft findings and dynamic contrast-enhanced MRI. Clin Radiol 2014; 69:1142-8. [PMID: 25060934 DOI: 10.1016/j.crad.2014.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 06/17/2014] [Accepted: 06/21/2014] [Indexed: 11/29/2022]
Abstract
AIM To determine the relationship between knee pain following anterior cruciate ligament (ACL) graft placement with morphological graft findings and dynamic contrast enhancement as assessed at MRI. MATERIAL AND METHODS Following institutional review board approval, 37 consecutive patients with double-bundle ACL reconstruction were enrolled. Thirteen patients had pain and 24 were asymptomatic. Imaging was performed using a 1.5 T MRI machine an average of 7.6 months after surgery. Graft-related (increase signal intensity, abnormal orientation, discontinuity, cystic degeneration, anterior translation of lateral tibia, arthrofibrosis), and non-graft related causes of knee pain (meniscal tear, cartilage injury, loose bodies, and synovitis) were evaluated. During dynamic contrast enhancement analysis, peak enhancement (ePeak) was calculated by placing a region of interest at the osteoligamentous interface of each bundle. Student's t-test was used for continuous variables analysis and chi-square or Fisher's exact test was used for categorical variables analysis. RESULTS There was no difference between symptomatic and asymptomatic patients regarding morphological graft-related or non-graft-related causes of knee pain. For dynamic contrast enhancement analysis, symptomatic patients had significantly lower ePeak values than asymptomatic patients in the anteromedial (p = 0.008) and posterolateral (p = 0.001) bundles or when using the higher ePeak value in either bundle (p = 0.003). CONCLUSION Morphological ACL graft findings as assessed at MRI could not be used to distinguish between symptomatic and asymptomatic patients. However, lower ePeak values had a significant association with knee pain. This may indicate poor neovascularization of the graft, potentially leading to graft failure.
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Affiliation(s)
- Y-C Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taiwan
| | - J N Mhuircheartaigh
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Y-C Cheung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taiwan
| | - Y-H Juan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taiwan
| | - C-H Chiu
- Department of Orthopedic Surgery, Division of Sports Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taiwan
| | - W-L Yeh
- Department of Orthopedic Surgery, Division of Sports Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taiwan.
| | - J S Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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15
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Kachare MB, Desai NS, Patki VK, Patki VK, Ricci JA, Juan YH, Saboo SS. Gas-forming liver abscess in a patient with multi-organ failure: role of imaging and management. Acta Clin Belg 2014; 69:226-8. [PMID: 24932587 DOI: 10.1179/2295333714y.0000000025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We present an unusual case of air-containing liver abscess demonstrated on plain film and ultrasonography with successful treatment utilizing ultrasound-guided drainage in a patient in septic shock. Although surgical drainage is often indicated, ultrasound-guided catheter drainage along with supportive antibiotic therapy can be a safe treatment alternative in critical patients.
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16
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Tan SJ, Juan YH, Fu PT, Yu MH, Lai HC. Chemotherapy with low-dose bevacizumab and carboplatin in the treatment of a patient with recurrent cervical cancer. EUR J GYNAECOL ONCOL 2010; 31:350-353. [PMID: 21077488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Management of patients with recurrent or advanced cervical cancer is a challenge. Concurrent chemotherapy has become the mainstay of treatment and platinum remains the most effective single agent. Combinations of other agents have not demonstrated significant advantages. The application of angiogenesis inhibitors such as bevacizumab, an antibody inhibiting vascular endothelial growth factor, in metastatic or advanced cervical cancer remains to be evaluated. We present the case of a patient with platinum-resistant recurrent cervical cancer treated with low-dose bevacizumab and carboplatin, with resultant improved disease progression and tolerable toxicity profiles.
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Affiliation(s)
- S J Tan
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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