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| 1 | Preoperative evaluation of colorectal cancer using CT colonography, MRI, and PET/CT显示文摘Imaging studies are a major component in the evaluation of patients for the screening,staging and surveillance of colorectal cancer.This review presents commonly encountered findings in the diagnosis and staging of patients with colorectal cancer using computed tomography(CT)colonography,magnetic resonance imaging(MRI),and positron emission tomography(PET)/CT colonography.CT colonography provides important information for the preoperative assessment of T staging.Wall deformities are associated with muscular or subserosal invasion.Lymph node metastases from colorectal cancer often present with calcifications.CT is superior to detect calcified metastases.Three-dimensional CT to image the vascular anatomy facilitates laparoscopic surgery.T staging of rectal cancer by MRI is an established modality because MRI can diagnose rectal wall laminar structure.N staging in patients with colorectal cancer is still challenging using any imaging modality.MRI is more accurate than CT for the evaluation of liver metastases.PET/CT colonography isvaluable in the evaluation of extra-colonic and hepatic disease.PET/CT colonography is useful for obstructing colorectal cancers that cannot be traversed colonoscopically.PET/CT colonography is able to localize synchronous colon cancers proximal to the obstruction precisely.However,there is no definite evidence to support the routine clinical use of PET/CT colonography. | Shigeyoshi Kijima Takahiro Sasaki Koichi Nagata Kenichi Utano Alan T Lefor Hideharu Sugimoto | 2014 | World Journal of Gastroenterology2014，20，45： | 46 |
| 2 | Laterally spreading tumors:Limitations of computed tomography colonography显示文摘AIM:To prospectively investigate the detection rate of laterally spreading tumors(LSTs)of the colorectum by computed tomography(CT)colonography(CTC).METHODS:Patients with LSTs measuring≥20 mm detected during colonoscopy were prospectively enrolled in the study.All patients underwent colonoscopy and subsequent CTC on the same day.CTC was performed using multi-detector CT without contrast in the prone and supine positions.Two radiologists blinded to the existence of LSTs read the virtual endoscopic images as well as 2-D images.LSTs were classified into granular and non-granular types based on colonoscopic appearance.RESULTS:Forty-seven pathologically proven LSTs were evaluated prospectively.Histology included adenomas in 19,mucosal cancers in 19 and T1 cancers in 9.The mean diameter of the LSTs was 35.1 mm.Twenty-eight(60%)LSTs were correctly identified by CTC,and the configuration was similar to the colonoscopic appearance in most cases.Detection rate for the granular type was significantly higher than that for the nongranular type(71%vs 31%,P=0.013).Detection rate of adenomas was significantly lower than mucosal cancers(32%vs 79%,P=0.008)and T1 cancers(32%vs 78%,P=0.042).CONCLUSION:The detection rate of LSTs by CTC,particularly the non-granular type was not acceptable.Practitioners should be aware of the relatively low detection rate when using CTC. | Kazutomo Togashi Kenichi Utano Shigeyoshi Kijima Yosuke Sato Hisanaga Horie Keijirou Sunada Alan T Lefor Hideharu Sugimoto Yoshikazu Yasuda | 2014 | World Journal of Gastroenterology2014，20，46： | 4 |
| 3 | Right anterior segmental hepatic duct emptying directly into the cystic duct in a living donor显示文摘A 35-year-old mother was scheduled to be the living donor for liver transplantation to her second son,who suffered from biliary atresia complicated with biliary cirrhosis at the age of 2 years.The operative plan was to recover the left lateral segment of the mother's liver for living donor transplantation.With the use of cholangiography at the time of surgery,we found the right anterior segmental duct(RASD) emptying directly into the cystic duct,and the catheter passed into the RASD.After repairing the incision in the cystic duct,transplantation was successfully performed.Her postoperative course was uneventful.Biliary anatomical variations were frequently encountered,however,this variation has very rarely been reported.If the RASD was divided,the repair would be very difficult because the duct will not dilate sufficiently in an otherwise healthy donor.Meticulous preoperative evaluation of the living donor's biliary anatomy,especially using magnetic resonance cholangiography and careful intraoperative techniques,is important to prevent bile duct injury and avoid the risk to the healthy donor. | Yasunao Ishiguro Masanobu Hyodo Takehito Fujiwara Yasunaru Sakuma Nobuyuki Hojo Koichi Mizuta Hideo Kawarasaki Alan T Lefor Yoshikazu Yasuda | 2010 | World Journal of Gastroenterology2010，16，29： | 2 |
| 4 | Hepatic portal venous gas after endoscopy in a patient with anastomotic obstruction显示文摘A 72-year-old male underwent a laparoscopic low anterior resection for advanced rectal cancer.A diverting loop ileostomy was constructed due to an anastomotic leak five days postoperatively.Nine months later,colonoscopy performed through the stoma showed complete anastomotic obstruction.The mucosa of the proximal sigmoid colon was atrophic and whitish.Ten days after the colonoscopy,the patient presented in shock with abdominal pain.Abdominal computed tomography scan showed hepatic portal venous gas(HPVG) and a dilated left colon.HPVG induced by obstructive colitis was diagnosed and a transverse colostomy performed emergently.His subsequent hospital course was unremarkable.Rectal anastomosis with diverting ileostomy is often performed in patients with low rectal cancers.In patients with anastomotic obstruction or severe stenosis,colonoscopy through diverting stoma should be avoided.Emergent operation to decompress the obstructed proximal colon is necessary in patients with a blind intestinal loop accompanied by HPVG. | Ai Sadatomo Koji Koinuma Rihito Kanamaru Yasuyuki Miyakura Hisanaga Horie Alan T Lefor Yoshikazu Yasuda | 2015 | World Journal of Gastrointestinal Surgery2015，7，2： | 2 |
| 5 | Primary hepatic choriocarcinoma in a 49-year-old man:Report of a case显示文摘We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course.The patient was a 49-year-old man who presented with acute right-sided abdominal pain.There were no masses palpable on physical examination.Radiographic findings showed large multi-nodular tumors mainly in the right lobe of the liver.Fludeoxyglucosepositron emission tomography scan showed uptake only in the liver,and no uptake in the testes.We initially planned to perform a liver resection for the presumed diagnosis of intra-hepatic cholangiocarcinoma.However,the tumors grew rapidly and ruptured.Multiple lung metastases rapidly developed resulting in respiratory failure,preventing liver resection or even biopsy.He died 60 d after initial presentation with no pathological diagnosis.Postmortem studies included histopathological and immunohistological examinations which diagnosed a primary choriocarcinoma of the liver.Primary hepatic choriocarcinoma is very rare but should be considered in the differential diagnosis of a liver tumor in a middle aged man.Establishing this diagnosis may enable treatment of the choriocarcinoma.Liver biopsy and evaluation of serum human chorionic gonadotropin are recommended in these patients. | Ryosuke Sekine Masanobu Hyodo Masayuki Kojima Yoshiyuki Meguro Akifumi Suzuki Taku Yokoyama Alan T Lefor Norio Hirota | 2013 | World Journal of Gastroenterology2013，19，48： | 1 |
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