Radiofrequency ablation appears to be a promising therapeutic modality capable of extending the possibilities of partial hepatectomy and of efficiently treating small metastases percutaneously.
Craniocervical artery dissection is a potentially disabling yet probably underrecognized condition that often occurs in young and middle-aged adults. Accurate and prompt diagnosis of this condition is crucial because timely and appropriate therapy can significantly reduce the risk of stroke and long-term sequelae. Because of the great diversity in the clinical features of craniocervical artery dissection, imaging plays a primary role in its diagnosis. The increased diagnosis of this disorder in the past two decades can be attributed to an increased awareness of the clinical manifestations of internal carotid artery and vertebral artery dissection and to use of noninvasive diagnostic imaging techniques. To achieve an accurate diagnosis of craniocervical artery dissection, it is important to be familiar with its pathologic features (intimal tear, intramural hematoma, and dissecting aneurysm); the spectrum of imaging findings at color duplex ultrasonography, computed tomographic angiography, magnetic resonance (MR) imaging with MR angiography, and conventional angiography; and potential pitfalls in image interpretation.
Because of the great diversity of clinical features, its unforeseeable evolution, and a small proportion of cases that will worsen in the acute phase, cerebral venous thrombosis must be diagnosed as early as possible so that specific treatment can be started, typically transcatheter thrombolysis or systemic anticoagulation. Unenhanced computed tomography (CT) is usually the first imaging study performed on an emergency basis. Unenhanced CT allows detection of ischemic changes related to venous insufficiency and sometimes demonstrates a hyperattenuating thrombosed dural sinus or vein. Helical multidetector CT venography with bolus power injection of contrast material and combined use of two-dimensional and three-dimensional reformations (maximum intensity projection, integral display, and volume rendering) provides exquisite anatomic detail of the deep and superficial intracranial venous system and can demonstrate filling defects. However, common variants of the sinovenous system should not be mistaken for sinus thrombosis. A comprehensive diagnostic approach facilitates imaging of cerebral venous thrombosis with multidetector CT.
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