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Sample records for angiography

  1. Angiography

    International Nuclear Information System (INIS)

    The history of angiography is short, with its centennial approaching. A very brief review of milestones begins with the discovery of x-rays in 1895. Only a few months later contrast agents too toxic for human use were being injected into cadavers, severed limbs, and animals. The next major developments came in the late 1970s when percutaneous translumbar aortography and cerebral angiography were described. Contrast agents were now less toxic, and clinically useful angiography was a reality. In 1953 a technique for percutaneous vascular catheterization which formed the basis of many catheterization techniques to follow was described. In the 1970s the development of less invasive diagnostic methods such as computed tomography and diagnostic ultrasound decreased the indications for angiography, but newer interventional techniques such as embolization therapy and angioplasty have taken up the slack. Angiography remains the most important way to demonstrate vascular diseases graphically. Specific techniques such as angioplasty and digital subtraction angiography will be dealt with in other chapters. The authors hope to provide an overview of major areas of angiographic utilization. The basic techniques of arterial puncture and catheterization have been well described elsewhere

  2. Fluorescein angiography

    Science.gov (United States)

    ... with cataracts. Alternative Names Retinal photography; Eye angiography Images Retinal dye injection References Maguire JI, Federman JL. Intravenous ... Topics Diabetic Eye Problems Eye ... audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  3. Digital angiography

    International Nuclear Information System (INIS)

    The basic principles of digital angiography and the clinical applications of the method are discussed. The authors review the experience at the Hotel-Dieu de Montreal covering more than 1000 digital examinations. The indications, results and contra-indications are exposed: numerous advantages (decreased invasiveness, diminished examination times, reduced radiation and improved cost efficiency) far outweigh the disadvantages (slight loss in resolution and small field of examination). A prospective appraisal of the potential and of future developments in digital radiography is also presented

  4. MR angiography

    International Nuclear Information System (INIS)

    As the result of the application of the recently developed MR techniques, the diagnosis of the morphology and the function has been possible. MR angiography (MRA) is one of these new techniques, and provides vascular anatomy and hemodynamics. At present, there is the limitation in the indication of MRA for pediatric cerebral vascular diseases. However, the frequency of clinical application of MRA is expected to increase by rapidly progressed MR techniques. Of these MRA, time-of flight (TOF) MRA, and phase contrast (PC) MRA are now being examined clinically as main MRA methods for evaluating cerebrovascular diseases, such as Moyamoya disease, arteriovenous malformation, and cerebral aneurysm. During our study, 2D and 3D TOF MRA, and 2D PC and 3D PC MRA were performed for evaluating cerebrovascular diseases. The purpose of this paper is to explain the methods of these MRA, and clinical indications of MRA by showing representative clinical cases of cerebrovascular diseases. We consider that MRA ia a useful method for detecting and following-up pediatric cerebrovascular diseases at present time. It is necessary for radiologists to know the basis and clinical indications of MRA. (author)

  5. Carotid angiography

    Directory of Open Access Journals (Sweden)

    Arne Torkildsen

    1950-03-01

    Full Text Available After a brief review of the history of cerebral angiography, some of the most important points concerning the percutaneous angiographic technique have been described. The value of the angiographic examination in cases of cerebral gliomas has been studied, based upon a consecutive series of 127 verified cases of hemispherical gliomas. Of 31 cases of frontal glioma, 28 could be diagnosed by the angiographic method; of 33 cases of parietal glioma, the angiograms revealed the neoplasm in 27 instances; of 39 cases of temporal glioma, the tumor could be localized in 38 cases; of 13 cases of occipital glioma, the angiographic localization of the tumor was successfull in 9 instances; of 11. cases of glioma infiltrating the corpus callosum and (or the basal ganglia, the angiographic examination was successful in only 3 cases. The angiographic examination in cases of cerebral glioma, in my experience, yields a more satisfactory result as to the localization than does the pneumography. The only exception concerns the gliomas growing in the thalamus or in the basal ganglia. These are more easily localized by means of ventriculography. As to the differential diagnosis of the gliomas, tumor vessels could, be seen both in astrocytomas and in glioblastomas. Most cases of astrocytomas were however devoid of specific tumor vessels. When present they could not be definitely distinguished from those seen in glioblastomas, but the abnormal findings were far less numerous and definitely less pronounced in astrocytomas than in glioblastomas. In most cases the astrocytomas were characterized only by displacement of blood vessels of normal appearance, while the glioblastomas frequently-presented both displacement of normal appearing blood vessels and new formed blood vessels within the neoplasm itself. The pathological blood vessels in the tumor were frequently abnormal both regarding their topographical appearance and their type. Frequent findings were arterio

  6. Magnetic resonance angiography

    Science.gov (United States)

    MRA; Angiography - magnetic resonance ... Kwong RY. Cardiovascular Magnetic Resonance Imaging. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . ...

  7. CT coronary angiography vs. invasive coronary angiography in CHD

    Directory of Open Access Journals (Sweden)

    Anja Hagen

    2012-04-01

    Full Text Available Scientific background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive computed tomography (CT coronary angiography are used in the diagnosis of coronary heart disease (CHD. Research questions: The present report aims to evaluate the clinical efficacy, diagnostic accuracy, prognostic value cost-effectiveness as well as the ethical, social and legal implications of CT coronary angiography versus invasive coronary angiography in the diagnosis of CHD. Methods: A systematic literature search was conducted in electronic data bases (MEDLINE, EMBASE etc. in October 2010 and was completed with a manual search. The literature search was restricted to articles published from 2006 in German or English. Two independent reviewers were involved in the selection of the relevant publications. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography as the reference standard and on diagnostic studies with intracoronary pressure measurement as the reference standard. Study results were combined in a meta-analysis with 95 % confidence intervals (CI. Additionally, data on radiation doses from current non-systematic reviews were taken into account. A health economic evaluation was performed by modelling from the social perspective with clinical assumptions derived from the meta-analysis and economic assumptions derived from contemporary German sources. Data on special indications (bypass or in-stent-restenosis were not included in the evaluation. Only data obtained using CT scanners with at least 64 slices were considered. Results: No studies were found regarding the clinical efficacy or prognostic value of CT coronary angiography versus conventional invasive coronary angiography in the diagnosis of CHD. Overall, 15 systematic reviews with data from 44 diagnostic studies using invasive coronary angiography as the reference standard (identification of obstructive

  8. Coronary CT angiography and MR angiography of Kawasaki disease

    International Nuclear Information System (INIS)

    Although the incidence of coronary artery aneurysms has diminished in patients with Kawasaki disease, coronary artery involvement is still regarded as a major complication of the disease, significantly affecting morbidity and mortality. Recent technical advances in coronary CT angiography (CTA) and MR angiography (MRA) have led to the possibility of using these two imaging methods as minimally invasive alternatives to the more invasive diagnostic catheter angiography in evaluating coronary artery abnormalities, such as aneurysm, stenosis, and occlusion. In this article, we describe imaging techniques and findings of coronary CTA and MRA in Kawasaki disease. (orig.)

  9. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Science.gov (United States)

    ... produced by: Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography (MRA) Transcript Welcome to Radiology Info dot ... I’d like to talk with you about magnetic resonance angiography, or as it’s commonly known, MRA. MRA ...

  10. Pulmonary angiography with lopamidol 370

    International Nuclear Information System (INIS)

    Fifty-one consecutive patients who underwent pulmonary angiography with iopamidol, 370 mg/ml, were studied prospectively. Patients were asked to grade any heat or pain felt on injection, and were observed for coughing. Right atrial and pulmonary artery pressures were obtained before the first and after the final contrast agent injection. Pressure changes were compared with those in a consecutive group of 25 patients who underwent examinations performed with Na-meglumine diatrizoate, 370 mg/ml. Film quality was evaluated for patient motion. Iopamidol generated marked discomfort in only three patients. Pressure changes were largely unremarkable. In no case was there any significant motion artifact secondary to coughing. Iopamidol is a safe, well-tolerated contrast agent for pulmonary angiography. It improves image quality by nearly eliminating coughing

  11. Angiography of the upper extremity

    International Nuclear Information System (INIS)

    This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

  12. Computed Tomographic Angiography (CTA) in Vascular Trauma

    OpenAIRE

    M. Tehrai

    2007-01-01

    In the evaluation of trauma patients, computed tomo-graphy and CT angiography (CTA) are powerful non-invasive tools that provide a large amount of informa-tion in so little time that they have virtually replaced plain film radiography and catheter angiography. In our hospital, CTA has replaced catheter angiogra-phy for diagnosing most vascular injuries, resulting from penetrating and blunt trauma to head, neck, thorax, abdomen and extremities. This lecture will cover current imaging protocols...

  13. Patent ductus venosus: diagnosis by MR angiography

    International Nuclear Information System (INIS)

    We report a 15-year-old boy with patent ductus venosus in whom the diagnosis was made by MR angiography. A patent ductus venosus Arantii is a rare form of portosystemic shunt. Only a few cases have been reported in adults and children. The diagnosis is usually made by US and digital subtraction angiography. In our patient, the diagnosis was first made by MR angiography. This demonstrates the excellent diagnostic potential of the method in paediatric patients. (orig.)

  14. Spinal angiography. Anatomy, technique and indications

    International Nuclear Information System (INIS)

    Spinal angiography is a diagnostic modality requiring detailed knowledge of spinal vascular anatomy. The cervical spinal cord is supplied by the vertebral arteries while segmental arteries which are preserved from fetal anatomy, supply the thoracic and lumbar regions. As spinal angiography carries the risk of paraplegia the indications have to be considered very carefully. Nevertheless, spinal angiography should be performed if there is reason to suspect a spinal vascular malformation from magnetic resonance imaging (MRI). (orig.)

  15. Clinical experience of ioxaglate in femoral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S.; Mine, H.; Iwai, T. (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1982-01-01

    Painless femoral angiography could be performed in patients under slight analgesic premedication by using ioxaglate (320 mg I/ml). Slower flow of ioxaglate resulted in longer segments of the arteries being filled by the contrast column than by using iothalamate, which was confirmed by serial whole-limb angiography. The dynamic characteristics of ioxaglate, in addition to marked reduction of pain, fulfilled the requirements for its use as a contrast medium in femoral or peripheral angiography.

  16. ECG changes during cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, K.; Nishimura, Y.; Yoshida, M.; Itoh, K.; Hayashi, N.; Aoki, J.; Nakamura, K.; Imai, M.; Ono, T.; Morikawa, S.

    1984-09-01

    We have analyzed HR changes greater than 20% among 334 patients and 942 cerebral angiographies. A tachycardial effect was seen in 14.9% of patients, while a bradycardial effect was seen in 7.1% including two patients having cardiac standstill (0.5%). These two patients were examined without atropine premedication after subarachnoid hemorrhage. Patients under 19 years of age, unpremedicated with atropine sulfate and suffering from subarachnoid hemorrhage secondary to ruptured aneurysm or arteriovenous malformation showed a significantly high incidence of bradycardia. On the other hand, patients with the neoplastic disease and having an initial sinus bradycardia showed a significantly high incidence of a tachycardial effect.

  17. Hyperpolarized 13C MR angiography

    DEFF Research Database (Denmark)

    Lipsø, Hans Kasper Wigh; Magnusson, Peter; Ardenkjær-Larsen, Jan Henrik

    2016-01-01

    Magnetic resonance angiography (MRA) is a non-invasive technology that can be used for diagnosis and monitoring of cardiovascular disease; the number one cause of mortality worldwide. Hyperpolarized imaging agents provide signal enhancement of more than 10, 000 times, which implies large reduction......SSFP sequence, where the signal destruction of the GRE sequence is avoided. However, for intra-arterial injections, the bSSFP sequence results in strong artefacts, and the GRE sequence is preferred. Hyperpolarized MRA presents many challenges and cannot currently compete with conventional contrast enhanced MRA...

  18. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Medline Plus

    Full Text Available ... produced by: Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography (MRA) Transcript Welcome to Radiology Info dot ... I’d like to talk with you about magnetic resonance angiography, or as it’s commonly known, MRA. MRA ...

  19. MR angiography in abdominal neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Squillaci, E. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Crecco, M. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Grandinetti, M.L. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Maspes, F. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Lo Presti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Squillaci, S. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Simonetti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy)

    1994-10-01

    The role of magnetic resonance angiography (MRA) in the evaluation of vascular involvement was studied in 55 patients with abdominal neoplasms. A 2-D time-of-flight (TOF) technique was used in all patients. All patients underwent CT and MR examinations before MRA. Also, MR angiograms were compared with digital subtraction angiography in 22 cases, with Doppler US in 13 cases, and with surgical findings in 20 cases. In all patients with liver neoplasms (n=29) MRA demonstrated the absence of flow in the infiltrated segments. Pericapsular neovascularization was observed in 12 patients. Portal vein involvement was correctly detected in 27 patients. In all cases MRA demonstrated in relationship between the tumor and venous structures. Portosystemic shunts were visualized in 20 of 21 patients with portal hypertension. Vena cava thrombosis (3 cases), compression (5 cases), and displacement (2 cases) were correctly demonstrated. In renal (n=6) and adrenal gland (n=3) tumors renal vein compression was correctly detected in 2 cases, displacement in 1 case, and thrombosis in 3 cases, with only 1 false-positive finding. In 7 patients with pancreatic tumors MRA demonstrated splenic vein thrombosis in 2 cases and compression in 2 cases, with one false-positive finding. Our results indicate that MRA provides precise information regarding venous vascular involvement in abdominal neoplasms, but preoperative arterial mapping is still problematic. (orig.)

  20. Digital subtraction angiography for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tsurumi, Kiyohiko; Okuyama, Nobuo

    1987-07-01

    We performed digital subtraction angiography (DSA) on 42 patients with breast diseases to investigate its efficiency. As a result we came to the following conclusions: 1. The sensitivity was well evaluated in intraarterial digital subtraction angiography (IA-DSA) of breast. 2. IA-DSA could diagnose difficult cases like cancer which had undergone augmentation mammoplasty, or like Paget's disease and others. 3. DSA was a safe examination method. 4. The sensitivity of IA-DSA of breast cancer is superior to intravenous digital subtraction angiography (IV-DSA).

  1. Multidetector-row CT angiography of hepatic artery: comparison with conventional angiography

    International Nuclear Information System (INIS)

    To determine the usefulness of three-dimensional CT angiography using multidetector-row CT (MD-CT) for delineating the arterial anatomy of the liver. Hepatic arterial three-dimensional CT angiography was performed using MDCT (lightspeed Qx/I; GE medical systems, milwaukee, Wis., U.S.A.) in 45 patients with HCC undergoing conventional angiography for transcatheter hepatic arterial chemoembolization. The scanning parameters during the early arterial phase were 2.5 mm slice thickness, 7.5 mm rotation of table speed, and a pitch of 3. Images were obtained by one radiologist using maximum intensity projection from axial CT images obtained during the early arterial phase. Two radiologists blinded to the findings of conventional angiography independently evaluated the hepatic arterial anatomy and the quality of the images obtained. Compared with conventional angiography, reader A correctly evaluated the hepatic arterial anatomy depicted at three-dimensional CT angiography. Reader B's evaluation was correct in 40 of 45 patients. Interobserver agreement was good (kappa value, 0.73), and both readers assessed the quality of three-dimensional CT angiography as excellent. Three-dimensional CT angiography using MDCT was accurate for delineating the arterial anatomy of the liver, and interobserver agreement was good. The modality may provide, prior to conventional angiography, valuable information regrading a patient's hepatic arterial anatomy

  2. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Medline Plus

    Full Text Available ... Pediatric Ultrasound Video: Angioplasty & vascular stenting Video: Arthrography Radiology and You About this Site RadiologyInfo.org is ... Explains Magnetic Resonance Angiography (MRA) Transcript Welcome to Radiology Info dot org Hello, I’m Dr. Elliot ...

  3. Your Radiologist Explains Magnetic Resonance Angiography (MRA)

    Medline Plus

    Full Text Available ... this Site RadiologyInfo.org is produced by: Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography (MRA) ... Recently posted: Focused Ultrasound for Uterine Fibroids Dementia Video: General Ultrasound Video: Pediatric Nuclear Medicine Radiology and ...

  4. Giant coronary aneurysm caused by Kawasaki disease: consistency between catheter angiography and electrocardiogram gated dual-source computed tomography angiography

    OpenAIRE

    Hwang, Eun-Ha; Ju, Jung-Ki; Cho, Min-Jung; Lee, Ji-Won; Lee, Hyoung-Doo

    2015-01-01

    We present the case of a 5-year-old child with coronary complications due to Kawasaki disease; this patient unintentionally underwent both dual-source computed tomography (DSCT) coronary angiography and invasive coronary angiographic examination in 2 months. This case highlights the strong consistency of the results between DSCT coronary angiography and invasive coronary angiography. Compared to conventional invasive coronary angiography, DSCT coronary angiography offered additional advantage...

  5. Digital angiography of camel foot

    International Nuclear Information System (INIS)

    In this study, angiography of normal digits of camel has been accomplished, and the vessels of digits and its distribution have been evaluated to be compared with abnormal digits in the future studies. The thoracic and pelvic limb of 16 camels were collected immediately following slaughter. The palmar and plantar arteries were isolated and catheterised by 18-gauge angiocatheter needle; perfused by 40Ð’–50 ml of iodinated compound injected into each vessel. Angiograms were obtained using dorsopalmer, dorsoplanter and latero-medial projections. In the pelvic limb, above the fetlock joint, the deep palmar arch communicates with the median artery via the anastomotic branch, forming the superfcial palmar arch, from which two branches were clear, 1-palmar common digital artery IV that divides into palmar proper digital arteries IV and V, close to the lateral accessory (ffth) digit. 2-Palmar common digital artery III, produces the first branch and continues distally near the middle of the proximal phalanx, it gives off two palmar branches of the proximal phalanx. Vascular distribution of the pelvic limb was similar to thoracic limb, carrying the name of plantar instead of palmar

  6. Three-dimensional coronary angiography

    Science.gov (United States)

    Suurmond, Rolf; Wink, Onno; Chen, James; Carroll, John

    2005-04-01

    Three-Dimensional Coronary Angiography (3D-CA) is a novel tool that allows clinicians to view and analyze coronary arteries in three-dimensional format. This will help to find accurate length estimates and to find the optimal viewing angles of a lesion based on the three-dimensional vessel orientation. Various advanced algorithms are incorporated in this 3D processing utility including 3D-RA calibration, ECG phase selection, 2D vessel extraction, and 3D vessel modeling into a utility with optimized workflow and ease-of-use features, which is fully integrated in the environment of the x-ray catheterization lab. After the 3D processing, the 3D vessels can be viewed and manipulated interactively inside the operating room. The TrueView map provides a quick overview of gantry angles with optimal visualization of a single or bifurcation lesion. Vessel length measurements can be performed without risk of underestimating a vessel segment due to foreshortening. Vessel cross sectional diameters can also be measured. Unlike traditional, projection-based quantitative coronary analysis, the additional process of catheter calibration is not needed for diameter measurements. Validation studies show a high reproducibility of the measurements, with little user dependency.

  7. MR angiography in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Kalita, Jayantee; Prasad, Sreeram; Maurya, Pradeep K.; Misra, Usha K. (Dept. of Neurology, Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India)), Email: drukmisra@rediffmail.com; Kumar, Sunil (Dept. of Radiodiagnosis, Sanjay Gandhi Post Graduate Inst. of Medical Sciences, Lucknow (India))

    2012-04-15

    Background: Infarctions in tuberculous meningitis (TBM) are common but there is a paucity of studies on MR angiography (MRA). Purpose: To evaluate the pattern and predictors of MRA abnormality in patients with TBM. Material and Methods: Sixty-seven patients with TBM were subjected to clinical, laboratory, magnetic resonance imaging (MRI), and MRA evaluation. The severity of meningitis, focal deficit, CSF findings, and stroke co-morbidities were recorded. Presence of exudates, infarction, hydrocephalous, and tuberculoma on MRI were noted. On intracranial MRA, occlusion or more than 50% narrowing of proximal middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA), and basilar artery were considered abnormal. The MRA abnormality was correlated with clinical, laboratory, and MRI findings. Results: Sixty-seven patients, aged 3-75 years (median 34 years) were included. MRI was abnormal in 61 (91%) patients; basal exudates in 24, hydrocephalous in 23, tuberculoma in 33, and infarction in 40. MRA was abnormal in 34 (50.7%); MCA was most commonly involved (n = 21), followed by PCA (n = 14), ICA (n = 8), ACA (n 5), basilar artery (n = 5), and vertebral and superior cerebellar artery (1 each). One-fourth of the patients had abnormality in both anterior and posterior circulations. MRA abnormality was related to hydrocephalous and infarction; corresponding infarct was present in 61.8% patients; 41.7% patients with abnormal MRA developed infarct at 3 months but none with normal MRA. Conclusion: Half the patients with TBM had MRA abnormality involving both anterior and posterior circulations and 61.8% of them had corresponding infarcts

  8. Differential diagnosis of choroidal melanomas and nervi using scanning laser ophthalmoscopical indocyanine green angiography

    DEFF Research Database (Denmark)

    Andersen, Mads V. Nis; Scherfig, Erik; Prause, J.U.

    1995-01-01

    Ophthalmology, choroidal melanoma, choroidal nevus, fluorescein angiography, indocyanine green (ICG), scanning laser ophthalmoscope (SLO), angiography......Ophthalmology, choroidal melanoma, choroidal nevus, fluorescein angiography, indocyanine green (ICG), scanning laser ophthalmoscope (SLO), angiography...

  9. Occupational Exposure in Angiography (Prague Workplaces)

    International Nuclear Information System (INIS)

    The results of measurements, which were performed at angiography departments, are presented. The aim of this work was not only to assess patient exposure but also to perform a survey of the occupational exposures of physicians during common angiography examinations of the skull, chest, abdomen and limbs. Patient data, type of examination, fluoroscopy time, the whole number of film frames, dose-area product (Diameter E) and physician dose (Stephen 6000) were also recorded. There are many factors influencing the level of measured exposures. They include input parameters of X ray performance (kV, mA, projection, diaphragms, ZOOM, type of record etc) and individual approach of the physicians. This paper contributes to the discussion about the increasing exposures of the physicians specialising in diagnostic and interventional angiography. (author)

  10. MR angiography: clinical applications in thoracic surgery

    International Nuclear Information System (INIS)

    MR angiography (MRA) is a promising completion of MR imaging in the preoperative assessment of pulmonary and mediastinal tumours. Scan acquisition was done by sequential FLASH 2D angiograms (TR = 30 ms, TE = 10 ms, FA = 30 ), one section per breathhold, section thickness 5 mm with 1 mm overlap between sequential sections. An automated control procedure allowed individual continuation of the examination. Postprocessing by a maximum-intensity-projection algorithm using angiograms of interest (AOI) resulted in 3D reconstructions illustrating vascular anatomy and avoiding superimposition. This technique was evaluated in a prospective study of 15 patients with malignant intrathoracic tumours. The results were validated by conventional angiographic procedures such as pulmonary angiography, digital subtraction angiography or cavography. Complementing spin-echo (SE) imaging, MRA provided diagnostic information about vessel displacement, stenosis and perfusion defects due to space-occupying lesions. Thus, MRA was helpful in planning thoracic surgery. (orig.)

  11. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  12. Digital subtraction angiography of the thoracic aorta

    International Nuclear Information System (INIS)

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram

  13. Fluorescein and Indocyanine Green Angiography for Uveitis

    Science.gov (United States)

    Herbort, Carl P

    2009-01-01

    In recent years enormous progress has been achieved in investigational procedures for uveitis. Imaging is one such example with the advent of new methods such as indocyanine green angiography, ultrasound biomicroscopy and optical coherence tomography to cite only the most important. This tremendous increase in precision and accuracy in the assessment of the level and degree of inflammation and its monitoring comes in parallel with the development of extremely potent and efficacious therapies. In view of these developments, our whole attitude in the appraisal and investigation of the uveitis patient has to be adapted and correctly reoriented integrating the recent developments and this is no different for ocular angiography. PMID:20404985

  14. Fluorescein and indocyanine green angiography for uveitis

    Directory of Open Access Journals (Sweden)

    Herbort Carl

    2009-01-01

    Full Text Available In recent years enormous progress has been achieved in investigational procedures for uveitis. Imaging is one such example with the advent of new methods such as indocyanine green angiography, ultrasound biomicroscopy and optical coherence tomography to cite only the most important. This tremendous increase in precision and accuracy in the assessment of the level and degree of inflammation and its monitoring comes in parallel with the development of extremely potent and efficacious therapies. In view of these developments, our whole attitude in the appraisal and investigation of the uveitis patient has to be adapted and correctly reoriented integrating the recent developments and this is no different for ocular angiography.

  15. Optical Coherence Tomography Angiography in Fovea Plana.

    Science.gov (United States)

    Dolz-Marco, Rosa; Phasukkijwatana, Nopasak; Sarraf, David; Freund, K Bailey

    2016-07-01

    Fovea plana is characterized by the anatomical absence of the foveal pit in eyes with normal visual function. The authors have analyzed three cases of idiopathic fovea plana with optical coherence tomography angiography (OCTA). As previously reported, the authors found the absence of a foveal avascular zone in all cases with OCTA; however, a preserved fusion of both the superficial and the deep capillary plexuses was found around the foveal center. This novel observation cannot be detected with conventional dye-based angiography, in which the deep capillary plexus is not visualized. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:670-673.].

  16. 3D-MR cholangio-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, Shinichi [Isehara Kyohdoh Hospital, Kanagawa (Japan); Hiramatsu, Kyoichi

    1995-04-01

    This report introduces a new 3D-MR cholangio-angiography technique using 3D Fast SE MR cholangiography and 3D phase contrast MR angiography for obstructive jaundice. In all eight cases, dilated biliary tracts as well as portal veins were clearly visualized in the same image. This new technique helped to determine the operability and surgical strategy for cases with obstructive jaundice. It also provided anatomical guidance for surgical procedures. This study suggests that this technique may replace the currently used modalities for obstructive jaundice. (author).

  17. Value of computed angiography in children with osteosarcomas

    International Nuclear Information System (INIS)

    The authors analyse the results of 50 computed angiographies made for osteosarcoma and Ewing's sarcoma. Better tolerated than conventional angiography, computed angiography is also more sensitive in preoperative evaluation of effectiveness of neoadjuvant chemotherapy. Automatic substraction, direct measuring of tumor size and vascularization density give to angiographic changes after chemotherapy the most predictive value. After conservative surgery or radiotherapy digital angiography provides most reliable local follow up

  18. CT angiography and CT perfusion in acute ischemic stroke

    NARCIS (Netherlands)

    Seeters, T. van

    2016-01-01

    CT angiography and CT perfusion are used in patients with acute ischemic stroke for diagnostic purposes and to select patients for treatment. In this thesis, the reproducibility of CT angiography and CT perfusion is examined, the additional value of CT angiography and CT perfusion for stroke outcome

  19. Magnetic resonance angiography of intracranial aneurysms: comparison with intra-arterial digital subtraction angiography

    International Nuclear Information System (INIS)

    Magnetic resonance angiography (MRA) with flow rephased gradient-echo sequences is a new non-invasive method for vascular imaging. We compared MRA and intra-arterial digital subtraction angiography in 18 patients with intracranial aneurysms to test whether MRA presently provides an alternative to cerebral angiography for the diagnosis of these anomalies. MRA showed 19 of the 22 aneurysms detected (86.4%). However, problems, especially with turbulent or slow flow, resulted in 6 studies (27.3%) with limited and 2 with questionable demonstration of an aneurysm, and 1 false negative study. At present, MRA is definitely inferior to angiography for the demonstration of intracranial aneurysms, due to its lower resolution and other limitations. (orig.)

  20. Renal Artery Stenting Using CO2 Gas Angiography in Combination with Iodinated Contrast Angiography.

    Science.gov (United States)

    Adachi, Yuya; Endo, Akihiro; Nakashima, Ryuma; Sugamori, Takashi; Takahashi, Nobuyuki; Kinoshita, Yoshihisa; Tanabe, Kazuaki

    2016-01-01

    A 76-year-old woman was hospitalized repeatedly due to unexplained heart failure. On admission, she had hypertensive acute heart failure. Her symptoms disappeared promptly after the initial treatment; however, her systolic blood pressure remained at over 160 mmHg despite her taking three antihypertensive drugs. Closer examination revealed hemodynamically significant right renal artery stenosis and a lack of left kidney function. We performed percutaneous transluminal renal angioplasty using CO2 angiography in combination with iodinated contrast agents. The patient's renal function and blood pressure improved, however, CO2 gas-induced mild ischemic colitis occurred. We discuss the possibility of the use of combined iodinated contrast angiography and CO2 angiography to avoid contrast-induced nephropathy and the complications peculiar to CO2 angiography. PMID:27580543

  1. Computed tomographic angiography in tetralogy of Fallot.

    Science.gov (United States)

    Kasar, Pankajkumar Ashok; Ravikumar, Radhakrishnan; Varghese, Roy; Kotecha, Monika; Vimala, Jesudian; Kumar, Raghavan Nair Suresh

    2011-10-01

    Echocardiography is often inadequate for imaging tetralogy of Fallot, prompting cineangiography. This study prospectively evaluated multidetector computed tomographic angiography for preoperative evaluation of tetralogy of Fallot in 112 consecutive patients. Forty-eight had nonconfluent or hypoplastic pulmonary arteries (mean z-score, -2; range, -11.1-0.13) permitting only palliative or no surgery; 64 had adequate pulmonary artery anatomy (mean z-score, 0.59; range, -2.53-3.4) allowing total repair. The surgical data of 50 patients who underwent total correction were compared with transthoracic echocardiography and multidetector computed tomographic angiography findings. Multidetector computed tomographic angiography tended to reveal unsuspected collaterals and coronary abnormalities besides outlining the right ventricular outflow tract and pulmonary artery branches. The branch pulmonary artery diameter z-score was the most important determinant of surgical strategy, with the worst figures being associated with no surgical options or palliative surgery, and the best figures leading to corrective surgery. The mean radiation dose was 3.45 mSv. Multidetector computed tomographic angiography is a powerful supplement to echocardiography in the preoperative evaluation of tetralogy of Fallot.

  2. Digital subtraction angiography: patient preparation and care.

    Science.gov (United States)

    Hunt, A H

    1987-08-01

    The use of digital subtraction angiography (DSA) is increasing. Nurses must be prepared to provide quality care to patients who have this relatively new method for radiographically studying the blood vessels. A description of DSA and its applications is provided. Patient preparation, assessment, teaching, and management are described. Complications of the procedure and their management are presented. PMID:2958568

  3. Angiography and angiotherapy of gastrointestinal tract bleeding

    International Nuclear Information System (INIS)

    In selected patients with upper and lower gastrointestinal hemorrhage there is an indication for angiography. Vasoconstrictive drugs or embolization materials can be submitted through the catheter to stop the hermorrhage (angiotherapy). 81 patients were diagnosed by this method. Treatment through the angiographic catheter followed the diagnostic procedure in 41 cases. The hemorrhage was controlled in 36 patients. (orig.)

  4. Unexpected Angiography Findings and Effects on Management.

    Science.gov (United States)

    Neill, Matthew; Charles, Hearns W; Gross, Jonathan S; Farquharson, Sean; Deipolyi, Amy R

    2016-01-01

    Despite progress in noninvasive imaging with computed tomography and magnetic resonance imaging, conventional angiography still contributes to the diagnostic workup of oncologic and other diseases. Arteriography can reveal tumors not evident on cross-sectional imaging, in addition to defining aberrant or unexpected arterial supply to targeted lesions. This additional and potentially unanticipated information can alter management decisions during interventional procedures. PMID:27688932

  5. Interventional angiography in the diagnosis of acute lower gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Interventional angiography with the use of indwelling arterial catheters, anticoagulants, vasodilators and fibrinolytic agents, complements conventional angiography in the diagnosis of acute lower gastrointestinal bleeding. These interventional techniques prolong, augment or reactive bleeding and, by enabling better timing of examinations, they increase the diagnostic efficacy of angiography. In the reported series of 63 patients with acute lower gastrointestinal hemorrhage, interventions increased the diagnostic yield of angiography for demonstration of extravasation from 32% to 65% and decreased the percentage of negative angiograms from 27% to 16%. Indications, techniques and risks of interventional angiography in the diagnosis of acute lower gastrointestinal bleeding are discussed. (orig.)

  6. Coronary CT angiography in coronary artery disease: Opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Zhonghua Sun

    2016-06-01

    Full Text Available Coronary CT angiography is widely recognised as a reliable imaging modality for the diagnosis of coronary artery disease. Coronary CT angiography not only provides excellent visualisation of anatomical changes in the coronary artery with high diagnostic value in the detection of lumen stenosis or occlusion, but also offers quantitative characterisation of coronary plaque components. Furthermore, coronary CT angiography allows myocardial perfusion imaging with diagnostic value comparable to the reference standard method. Coronary CT angiography-derived haemodynamic analysis has the potential to evaluate functional significance of coronary lesions. This review article aims to provide an overview of clinical applications of coronary CT angiography in coronary artery disease.

  7. Evaluation of vascular pathologies with MR angiography

    International Nuclear Information System (INIS)

    The flow sensitivity of MR imaging methods can be used to visualize vascular structures (MR angiography). In this paper the method of flow-enhanced three-dimensional MR angiography will be presented. This technique makes use of the signal enhancement due to inflow of unsaturated spins into the imaging volume in combination with flow-compensated three-dimensional Fourier transform gradient-echo sequences. Projective images are calculated from the measured data by means of a maximum-intensity algorithm. The procedure was optimized for the visualization of the intra-and extracranial vasculature. The purpose of this study was to demonstrate the potential of this MR angiographic procedure to evaluate vascular disease in a clinical situation. Prospective studies in patients with vascular disease including aneurysms, arteriovenous malformations, arterial occlusion, and stenosis are shown in correlation with conventional procedures

  8. Types of diaphragmatic motion during hepatic angiography.

    Science.gov (United States)

    Katsuda, T; Kuroda, C; Fujita, M

    1997-01-01

    To determine the types and causes of diaphragmatic motion during hepatic angiography, the authors used transarterial cut-film portography (TAP) to study movement of the diaphragm during breath-holding. Thirty-three TAP sequences were studied, and the patients' diaphragmatic motions were classified into four categories according to the distance their diaphragms moved. Results showed that the diaphragm was stationary in 33% of the TAP studies, while perpetual motion occurred in 15% of the studies, early-phase motion occurred in 12% and late-phase motion occurred in 40%. Ten sequences showed diaphragmatic motion of more than 10 mm, with eight sequences showing caudal motion and two showing cranial motion. This article discusses the cause of diaphragmatic motion during breath-holding for hepatic angiography and presents suggestions to reduce motion artifacts during the exam.

  9. Invasive or non invasive angiography? The role of conventional catheder angiography

    International Nuclear Information System (INIS)

    Within the last decade, diagnostic and interventional angiography have been developed to a high degree of performance, due to the widespread use of DSA, the miniaturisation of the puncture trauma and the introduction sets (catheters, sheaths), the development of high-tech materials (e.g., Nitinol guidewires) and the application of non-ionic, low osmolal contrast media. The specific risks of the procedure, thereby, have been significantly reduced, but could not be totally eliminated. To evaluate vascular diseases non-invasively, special attention was attributed to the progress of colour coded duplex, (spiral) CT-angiography and (CE)MR-angiography, based on the estbalished imaging with US, CT and MRT. The matter in question is whether or not they can substitute the role of conventional angiography as the 'gold standard' of vessel imaging. Clinical validity and economic efficiency both determine the indication for the use of invasive or non-invasive methods. In diagnostic procedures, there is a growing tendency for the use of non-invasive techniques, like in imaging of the abdominal and thoracic aorta, the renal, pulmonary and extra- and intra-cranial arteries. Conventional angiography is still reserved for the evaluation of small vessels of the upper and lower extremities, and vessel status in preoperative conditions (carotid, celiac trunk, mesenteric and renal arteries and aneurysms of the cerebral vasculature). Fluoroscopic guiding of catheters and contrast enhancement in interventional procedures, however, cannot be substituted by alternative techniques in the foreseeable future. (orig.)

  10. Cerebral angiography in leptomeningitis and cerebritis

    International Nuclear Information System (INIS)

    This is a report of the cerebral angiographic findings in cases of meningitis and cerebritis. Fifty-nine patients, 38 of whom were under 1 year of age, underwent cerebral angiography by means of femoral catheterization. All the patients had signs of increased intracranial pressure, seizures, focal cerebral signs, positive transillumination of the head, and or abnormal brain scan findings. A few patients who did not respond to systemic antibiotics as was expected were also evaluated by means of cerebral angiography. The following characteristic angiographic findings were observed in 18 cases of active meningitis: (1) A hasy appearance around the arteries (halo formation) between the late arterial and capillary phases. (2) Narrowing of the arteries in the basal cistern. This sometimes extended to the peripheral arteries. (3) Irregular caliber following the narrowing of arteries (in few cases). (4) Circulation time so slow that veins could be seen in the late arterial phase. (5) Halo formation around the anterior chroidal artery and the clear appearance of the choroid plexus in the venous phase (when the infectious process reached the choroid plexus). Cerebritis could be identified on the angiograms by two signs: (1) local swelling of the brain (mainly the temporal lobe) and (2) staining around the veins without any abnormal signs in the arterial phase (laminar staining). In conclusion, angiography is a meaningful test by which to determine the phase of meningitis and cerebritis. These two conditions should be treated based on valid information obtained by means of CSF examinations and neuroradiological tests, especially CT scan and cerebral angiography. (author)

  11. Fluorescein and Indocyanine Green Angiography for Uveitis

    OpenAIRE

    Herbort Carl

    2009-01-01

    In recent years enormous progress has been achieved in investigational procedures for uveitis. Imaging is one such example with the advent of new methods such as indocyanine green angiography, ultrasound biomicroscopy and optical coherence tomography to cite only the most important. This tremendous increase in precision and accuracy in the assessment of the level and degree of inflammation and its monitoring comes in parallel with the development of extremely potent and efficacious therapies....

  12. Optical Coherence Tomography Angiography in Retinal Diseases.

    Science.gov (United States)

    Chalam, K V; Sambhav, Kumar

    2016-01-01

    Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging system that generates volumetric data of retinal and choroidal layers. It has the ability to show both structural and blood flow information. Split-spectrum amplitude-decorrelation angiography (SSADA) algorithm (a vital component of OCTA software) helps to decrease the signal to noise ratio of flow detection thus enhancing visualization of retinal vasculature using motion contrast. Published studies describe potential efficacy for OCTA in the evaluation of common ophthalmologic diseases such as diabetic retinopathy, age related macular degeneration (AMD), retinal vascular occlusions and sickle cell disease. OCTA provides a detailed view of the retinal vasculature, which allows accurate delineation of microvascular abnormalities in diabetic eyes and vascular occlusions. It helps quantify vascular compromise depending upon the severity of diabetic retinopathy. OCTA can also elucidate the presence of choroidal neovascularization (CNV) in wet AMD. In this paper, we review the knowledge, available in English language publications regarding OCTA, and compare it with the conventional angiographic standard, fluorescein angiography (FA). Finally, we summarize its potential applications to retinal vascular diseases. Its current limitations include a relatively small field of view, inability to show leakage, and tendency for image artifacts. Further larger studies will define OCTA's utility in clinical settings and establish if the technology may offer a non-invasive option of visualizing the retinal vasculature, enabling us to decrease morbidity through early detection and intervention in retinal diseases.

  13. Multidetector computed tomography pulmonary angiography in childhood acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Chun Xiang; Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Medical University of South Carolina, Department of Pediatrics, Charleston, SC (United States); Chowdhury, Shahryar M. [Medical University of South Carolina, Department of Pediatrics, Charleston, SC (United States); Fox, Mary A. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2015-09-15

    Pulmonary embolism is a life-threatening condition affecting people of all ages. Multidetector row CT pulmonary angiography has improved the imaging of pulmonary embolism in both adults and children and is now regarded as the routine modality for detection of pulmonary embolism. Advanced CT pulmonary angiography techniques developed in recent years, such as dual-energy CT, have been applied as a one-stop modality for pulmonary embolism diagnosis in children, as they can simultaneously provide anatomical and functional information. We discuss CT pulmonary angiography techniques, common and uncommon findings of pulmonary embolism in both conventional and dual-energy CT pulmonary angiography, and radiation dose considerations. (orig.)

  14. Vertebral angiography of cerebellar astrocytoma. Tumor stain, tumor circulation, CT and angiography in diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, K.; Ito, T.; Tashiro, K.; Abe, H.; Tsuru, M.; Miyasaka, K. (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1982-05-01

    Thirteen cases of cerebellar astrocytoma were examined primarily for tumor stain and pathological tumor circulation by angiography and CT. Tumor stain was observed in only one case by cerebral angiogram. A tumor was demonstrated as an avascular mass in the remaining 12 cases. It is suggested that mural nodules of cystic lesions should have certain weight and sizes so that they could be demonstrated as tumor stain. In the supratentorial region, five of the 12 low-grade astrocytoma exhibited abnormal tumor stain and tumor circulation by cerebral angiogram. It is considered that supratentorial and posterior fossa astrocytoma must usually exhibit different pathological tumor circulation by cerebral angiogram, since each group has distinctive clinical and biological characteristics. CT was performed in 7 of 13 cases. It appeared to be more useful than cerebral angiography in the morphological diagnosis. Especially in cystic tumors, CT produced minute information concerning peritumoral edema, enhancement of margin of cystic astrocytoma after intravenous contrast medium, and marginal enhancement with layering in the dependent part of the cyst. Neuroradiological differential diagnosis of cerebellar astrocytoma and cerebellar hemagioblastoma by CT was difficult in the cases of tumors. However, both tumors were differentiated from each other with ease by tumor stain and tumor circulation in cerebral angiography. Thus, it is concluded that cerebral angiography is superior to CT in differential diagnosis between cerebellar astrocytoma and cerebellar hemangioblastoma.

  15. Usefulness of CT angiography for demonstrating cerebral aneurysm

    International Nuclear Information System (INIS)

    We report the usefulness of computed cerebral angiotomography (CT angiography) for demonstrating cerebral aneurysm and the clinical significance of CT angiography for ruptured cerebral aneurysm. Our modified method of CT angiography was easy and less time-consuming. Fifteen seconds after starting a single bolus injection, 1 ml/kg/25 seconds via cubital vein, of contrast medium (60 % urograffin), 5 serial 5 mm thick-CT slices were scanned in every 6.5 seconds including 2 seconds of interval, beginning from an axial level 20 mm above the orbitomeatal line and ending at a level 40 mm. A total of 103 patients were examined in this report, consisting of 70 unruptured asymptomatic, 8 unruptured symptomatic (oculomotor nerve palsy) and 25 subarachnoid hemorrhage (SAH). Seven unruptured aneurysms in 4 asymptomatic cases, 2 unruptured aneurysms in 2 symptomatic cases 27 aneurysms in 24 SAH cases were suspected by CT angiography. Of these 36 aneurysms suspected by CT angiography 32 aneurysms were confirmed by cerebral angiography. The detection rate of CT angiography in this report was 89 %, higher than those of previous reports. Thirteen aneurysms were located at internal carotidposterior communicating artery (ICPC) junction. 11 at anterior communicating artery (Acom), 7 at middle cerebral artery (MCA). CT angiography showed a false positive findings in 4 cases, which were all located at Acom. Four aneurysms were not detected in CT angiography, which were all located at MCA and were very small (2 - 3 mm) in diameter. There were no deteriorated cases during and after CT angiography. We suggest that CT angiography is a useful and safe method for predicting the location of not only unruptured but ruptured aneurysms. (author)

  16. Assessment of anemia during CT pulmonary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Caroline, E-mail: cjung@uke.de [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Groth, Michael; Bley, Thorsten A.; Henes, Frank O. [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Treszl, András [Department of Medical Biometry and Epidemiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany); Adam, Gerhard; Bannas, Peter [Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Martinistrasse 52, 20246 Hamburg (Germany)

    2012-12-15

    Objectives: Anemia is associated with increased mortality in patients with acute symptomatic pulmonary embolism (PE). The purpose of this study was to evaluate the feasibility of Hounsfield unit (HU) measurements on the single unenhanced trigger slice of pulmonary CT angiography scans for diagnosis of anemia. Material and Methods: 150 consecutive patients (median age 64 ± 16 years) with suspected PE underwent pulmonary CT angiography. Two radiologists, blinded to laboratory results, performed HU measurements in the single unenhanced trigger scan independently by region-based analysis (ROI). HU values from ascending and descending aorta and the calculated mean of both were correlated with serum hemoglobin levels. Inter- and intraobserver variability was determined for HU measurements, and ROC analysis was performed for diagnosis of anemia. Calculated linear models were used to assess formulas for estimation of hemoglobin levels from HU measurements. Results: HU measurements revealed high intra- and interrater reliability (ICC > 0.981 and ICC > 0.965, respectively). Calculated mean HU values showed a strong correlation with serum hemoglobin levels (r = 0.734), which allowed generation of different formulas for calculation of hemoglobin levels from HU measurements. ROC analyses confirmed a high sensitivity (80.4 for men; 91.3 for women) and specificity (84.0 for men; 84.9 for women) for diagnosing anemia. Conclusion: Diagnosis of anemia and quantification of hemoglobin levels upon a single unenhanced trigger scan of pulmonary CT angiography is feasible. We suggest disclosing the anemic state in the radiological report, independent of the presence of PE, since anemia carries increased risks of morbidity and mortality.

  17. Diagnostic angiography of the cerebrospinal vasculature.

    Science.gov (United States)

    Rabinov, James D; Leslie-Mazwi, Thabele M; Hirsch, Joshua A

    2016-01-01

    Diagnostic catheter angiography remains the gold standard for evaluation of vascular lesions of the brain, head and neck, and spine. It is often combined with cross-sectional and functional imaging to provide a complete anatomic and physiologic workup of patients. Such data are combined with clinical information to help make treatment decisions. This chapter describes the specific techniques for arterial access and catheter navigation of the cerebrospinal vasculature. Discussion of patient positioning, injection rates, and basic anatomy of arterial and venous systems is included. Finally, important safety issues related to contrast allergy, renal failure, and complications are considered. PMID:27432664

  18. Multi-section CT angiography compared with digital subtraction angiography in diagnosing major arterial hemorrhage in inflammatory pancreatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Hyare, Harpreet [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom)]. E-mail: hhyare@doctors.org.uk; Desigan, Sharmini [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Nicholl, Helen [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Guiney, Michael J. [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Brookes, Jocelyn A. [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom); Lees, William R. [Department of Imaging, University College London Hospitals NHS Foundation Trust, University College Hospital, 235 Euston Road, London NW1 2BU (United Kingdom)

    2006-08-15

    Purpose: Major arterial hemorrhage is an uncommon but serious complication of pancreatitis with high morbidity and mortality. Digital subtraction angiography (DSA) has long been the gold standard for the detection of a visceral artery pseudoaneurysm or for the site of active bleeding in patients with pancreatitis. Multi-section CT angiography is a minimally invasive technique which can provide high-resolution and high-contrast images of the arterial lumen and wall, with a much lower risk of complication and morbidity compared to DSA. The aim of this study was to determine the accuracy of multi-section CT angiography for the diagnosis of arterial complications of inflammatory pancreatitic disease. Materials and methods: A retrospective analysis of all patients undergoing visceral angiography for major bleeding as a complication of pancreatitis between 1998 and 2004 was performed. Twenty-nine studies in 25 patients (20 males, 5 females) with a mean age of 50.9 years (range 11-67 years) were identified where multi-section CT angiography was performed in the 24 h preceding the digital subtraction angiogram. Results: Digital subtraction angiography detected a pseudoaneurysm or contrast extravasation in 19 studies and no bleeding was demonstrated in 9 studies. CT angiography correctly identified the site and type of bleeding in 18 of the 19 positive studies. CT angiography detected extravasation of contrast in one study that was not demonstrated on digital subtraction angiography. The sensitivity and specificity for multi-section CT angiography for the detection of major arterial bleeding on a background of pancreatitis were 0.947 and 0.900, respectively. Conclusion: Multi-section CT angiography is a sensitive and accurate technique for the detection of major arterial hemorrhage in inflammatory pancreatic disease and should be considered as the first investigation in the management of these patients.

  19. Multi-section CT angiography compared with digital subtraction angiography in diagnosing major arterial hemorrhage in inflammatory pancreatic disease

    International Nuclear Information System (INIS)

    Purpose: Major arterial hemorrhage is an uncommon but serious complication of pancreatitis with high morbidity and mortality. Digital subtraction angiography (DSA) has long been the gold standard for the detection of a visceral artery pseudoaneurysm or for the site of active bleeding in patients with pancreatitis. Multi-section CT angiography is a minimally invasive technique which can provide high-resolution and high-contrast images of the arterial lumen and wall, with a much lower risk of complication and morbidity compared to DSA. The aim of this study was to determine the accuracy of multi-section CT angiography for the diagnosis of arterial complications of inflammatory pancreatitic disease. Materials and methods: A retrospective analysis of all patients undergoing visceral angiography for major bleeding as a complication of pancreatitis between 1998 and 2004 was performed. Twenty-nine studies in 25 patients (20 males, 5 females) with a mean age of 50.9 years (range 11-67 years) were identified where multi-section CT angiography was performed in the 24 h preceding the digital subtraction angiogram. Results: Digital subtraction angiography detected a pseudoaneurysm or contrast extravasation in 19 studies and no bleeding was demonstrated in 9 studies. CT angiography correctly identified the site and type of bleeding in 18 of the 19 positive studies. CT angiography detected extravasation of contrast in one study that was not demonstrated on digital subtraction angiography. The sensitivity and specificity for multi-section CT angiography for the detection of major arterial bleeding on a background of pancreatitis were 0.947 and 0.900, respectively. Conclusion: Multi-section CT angiography is a sensitive and accurate technique for the detection of major arterial hemorrhage in inflammatory pancreatic disease and should be considered as the first investigation in the management of these patients

  20. Coronary computed tomography angiography indicates complexity of percutaneous coronary interventions

    OpenAIRE

    Stähli, B E; Bonassin, F; Goetti, R; Küest, S M; Frank, M.; Altwegg, L A; Gebhard, C; Levis, A; Wischnewsky, M. B.; Lüscher, T F; Alkadhi, H.; Kaufmann, P A; Maier, W.

    2012-01-01

    BACKGROUND: Coronary computed tomography angiography (CCTA) provides information regarding lesion morphology and three-dimensional coronary anatomy incremental to coronary angiography. We addressed the question whether preprocedural CCTA bears potential for guiding percutaneous coronary interventions (PCI). METHODS AND RESULTS: Sixty-six coronary lesions attempted with PCI within 6 months of preprocedural CCTA were retrospectively assessed. Lesion parameters from unenhanced computed tomogr...

  1. On the ultimate x-ray detector for angiography

    NARCIS (Netherlands)

    Slump, C.H.; Kauffman, J.A.; Flynn, M.J.

    2005-01-01

    The purpose of our research is to describe the ultimate X-ray detector for angiography. Angiography is a well established X-ray imaging technique for the examination of blood vessels. Contrast agent is injected followed by X-ray exposures and possible obstructions in the blood vessels can be visuali

  2. Lateral rectus palsy following coronary angiography and percutaneous coronary intervention

    Science.gov (United States)

    Nicholson, Luke; Jones, Ruth; Hughes, David S

    2014-01-01

    We present a rare case of unilateral lateral rectus palsy following an elective coronary angiography and percutaneous coronary intervention in a 78-year-oldwoman. Ophthalmoplegia following coronary angiography is extremely rare and this is the first case of a unilateral lateral rectus palsy following the procedure. PMID:24536054

  3. Computerized tomography and angiography - competing processes in liver diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Wunschik, F.; Luetgemeier, J.; Hoerst, M.

    1981-02-01

    In the diagnostics of liver diseases, computerized tomography is a valuable method. It is particularly superior to angiography in detecting cysts, parasitosis and abscesses. Angiography however is better for known solid tumours regarding differencial diagnosis. Both methods supplement each other in the tumour and bile ducts diagnostics.

  4. Perfusion Angiography in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Fabien Scalzo

    2016-01-01

    Full Text Available Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF and cerebral blood volume (CBV, mean transit time (MTT, time-to-peak (TTP, and Tmax, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely.

  5. Perfusion Angiography in Acute Ischemic Stroke.

    Science.gov (United States)

    Scalzo, Fabien; Liebeskind, David S

    2016-01-01

    Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA) remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF) and cerebral blood volume (CBV), mean transit time (MTT), time-to-peak (TTP), and T max, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA) and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely. PMID:27446232

  6. Computed tomography imaging and angiography - principles.

    Science.gov (United States)

    Kamalian, Shervin; Lev, Michael H; Gupta, Rajiv

    2016-01-01

    The evaluation of patients with diverse neurologic disorders was forever changed in the summer of 1973, when the first commercial computed tomography (CT) scanners were introduced. Until then, the detection and characterization of intracranial or spinal lesions could only be inferred by limited spatial resolution radioisotope scans, or by the patterns of tissue and vascular displacement on invasive pneumoencaphalography and direct carotid puncture catheter arteriography. Even the earliest-generation CT scanners - which required tens of minutes for the acquisition and reconstruction of low-resolution images (128×128 matrix) - could, based on density, noninvasively distinguish infarct, hemorrhage, and other mass lesions with unprecedented accuracy. Iodinated, intravenous contrast added further sensitivity and specificity in regions of blood-brain barrier breakdown. The advent of rapid multidetector row CT scanning in the early 1990s created renewed enthusiasm for CT, with CT angiography largely replacing direct catheter angiography. More recently, iterative reconstruction postprocessing techniques have made possible high spatial resolution, reduced noise, very low radiation dose CT scanning. The speed, spatial resolution, contrast resolution, and low radiation dose capability of present-day scanners have also facilitated dual-energy imaging which, like magnetic resonance imaging, for the first time, has allowed tissue-specific CT imaging characterization of intracranial pathology. PMID:27432657

  7. Bolus characteristics based on Magnetic Resonance Angiography

    Directory of Open Access Journals (Sweden)

    Bi Xiaoming

    2006-10-01

    Full Text Available Abstract Background A detailed contrast bolus propagation model is essential for optimizing bolus-chasing Computed Tomography Angiography (CTA. Bolus characteristics were studied using bolus-timing datasets from Magnetic Resonance Angiography (MRA for adaptive controller design and validation. Methods MRA bolus-timing datasets of the aorta in thirty patients were analyzed by a program developed with MATLAB. Bolus characteristics, such as peak position, dispersion and bolus velocity, were studied. The bolus profile was fit to a convolution function, which would serve as a mathematical model of bolus propagation in future controller design. Results The maximum speed of the bolus in the aorta ranged from 5–13 cm/s and the dwell time ranged from 7–13 seconds. Bolus characteristics were well described by the proposed propagation model, which included the exact functional relationships between the parameters and aortic location. Conclusion The convolution function describes bolus dynamics reasonably well and could be used to implement the adaptive controller design.

  8. Carbon Dioxide Angiography: Scientific Principles and Practice.

    Science.gov (United States)

    Cho, Kyung Jae

    2015-09-01

    Carbon dioxide (CO2) is a colorless, odorless gas which occurs naturally in the atmosphere and human body. With the advent of digital subtraction angiography, the gas has been used as a safe and useful alternative contrast agent in both arteriography and venography. Because of its lack of renal toxicity and allergic potential, CO2 is a preferred contrast agent in patients with renal failure or contrast allergy, and particularly in patients who require large volumes of contrast medium for complex endovascular procedures. Understanding of the unique physical properties of CO2 (high solubility, low viscosity, buoyancy, and compressibility) is essential in obtaining a successful CO2 angiogram and in guiding endovascular intervention. Unlike iodinated contrast material, CO2 displaces the blood and produces a negative contrast for digital subtraction imaging. Indications for use of CO2 as a contrast agent include: aortography and runoff, detection of bleeding, renal transplant arteriography, portal vein visualization with wedged hepatic venous injection, venography, arterial and venous interventions, and endovascular aneurysm repair. CO2 should not be used in the thoracic aorta, the coronary artery, and cerebral circulation. Exploitation of CO2 properties, avoidance of air contamination and facile catheterization technique are important to the safe and effective performance of CO2 angiography and CO2-guided endovascular intervention. PMID:26509137

  9. Angiography with a multifunctional line scanning ophthalmoscope

    Science.gov (United States)

    Hammer, Daniel X.; Ferguson, R. Daniel; Patel, Ankit H.; Vazquez, Vanessa; Husain, Deeba

    2012-02-01

    A multifunctional line scanning ophthalmoscope (mLSO) was designed, constructed, and tested on human subjects. The mLSO could sequentially acquire wide-field, confocal, near-infrared reflectance, fluorescein angiography (FA), and indocyanine green angiography (ICGA) retinal images. The system also included a retinal tracker (RT) and a photodynamic therapy laser treatment port. The mLSO was tested in a pilot clinical study on human subjects with and without retinal disease. The instrument exhibited robust retinal tracking and high-contrast line scanning imaging. The FA and ICGA angiograms showed a similar appearance of hyper- and hypo-pigmented disease features and a nearly equivalent resolution of fine capillaries compared to a commercial flood-illumination fundus imager. An mLSO-based platform will enable researchers and clinicians to image human and animal eyes with a variety of modalities and deliver therapeutic beams from a single automated interface. This approach has the potential to improve patient comfort and reduce imaging session times, allowing clinicians to better diagnose, plan, and conduct patient procedures with improved outcomes.

  10. Coronary CT Angiography versus Conventional Cardiac Angiography for Therapeutic Decision Making in Patients with High Likelihood of Coronary Artery Disease

    NARCIS (Netherlands)

    Moscariello, Antonio; Vliegenthart, Rozemarijn; Schoepf, U. Joseph; Nance, John W.; Zwerner, Peter L.; Meyer, Mathias; Townsend, Jacob C.; Fernandes, Valerian; Steinberg, Daniel H.; Fink, Christian; Oudkerk, Matthijs; Bonomo, Lorenzo; O'Brien, Terrence X.; Henzler, Thomas

    2012-01-01

    Purpose: To assess the efficacy of coronary computed tomographic (CT) angiography for therapeutic decision making in patients with high likelihood of coronary artery disease (CAD)-specifically the ability of coronary CT angiography to help differentiate patients without and patients with a need for

  11. Comparison of digital subtraction angiography, CT angiography, and ultrasonic doppler examination in the evaluation of penile arterial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kawanisi, Yasuo; Kimura, Kazunori; Lee, Kyong Soo; Koizumi, Takahiro; Nakatsuji, Hiroyoshi; Kojima, Keiji; Yamamoto, Akira; Numata, Akira [Takamatsu Red Cross Hospital (Japan)

    2001-11-01

    CT angiography reconstructed by a multidetector-row helical CT scanner is a newly developed form of imaging. We compared CT angiography and ultrasonic Doppler examination with digital subtraction angiography (DSA) in the diagnosis of arterial lesion. Eighteen patients with arteriogenic erectile dysfunction (ED) underwent color Doppler study DSA, and CT angiography after providing informed consent. The CT angiography images were obtained by a multidetector-row helical CT scanner, Asteion TSX021A (TOSHIBA). We injected prostaglandin E{sub 1} into the penile cavernous body, and then rapidly infused nonionic contrast medium into the antecubital vein. DSA and CT angiography images of the bilateral internal pudendal arteries and cavernous arteries were examined for stenotic lesions or occlusion. We also compared the peak systolic blood flow velocity in the cavernous artery measured by color Doppler ultrasound with CT angiography and DSA. The CT anigography and color Doppler studies were performed on an outpatient basis, but DSA required hospitalization. In the 36 internal pudendal arteries, DSA represented 22 normal arteries and 14 stenosis or occlusions. CT angiography showed 15 normal arteries and 21 occlusions. For the diagnosis of stenosis or occlusion in the internal pudendal artery, the CT angiography image had a good agreement, with a sensitivity of 1.00, specificity of 0.68, and accuracy of 0.81. For diagnosis in the cavernous artery, CT angiography image also showed a good agreement with DSA; however, the quality of the images of fine arteries was better in the DSA images. The inferior view and internal view of the pelvis in CT angiography were helpful for visulaizing the internal pudendal artery, especially at the pubic bone. There was insufficient correlation between peak systolic blood flow velocity and DSA findings. There were no serious complications involved in either examination. CT angiography has not yet reached the same level as DSA in the evaluation

  12. Comparison of magnetic resonance angiography and conventional angiography in sickle cell disease: clinical significance and realibility

    Energy Technology Data Exchange (ETDEWEB)

    Kandeel, A.Y. [Dept. of Radiology, Mansoura Univ. Hospital (Egypt); Zimmerman, R.A. [Dept. of Radiology, The Children`s Hospital of Philadelphia, PA (United States); Ohene-Frempong, K. [Div. of Hematology, The Children`s Hospital of Philadelphia, PA (United States)

    1996-07-01

    We retrospectively reviewed the medical records and conventional angiograms of 21 patients with known sickle cell disease, who underwent a total of 50 magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) studies. MRA and conventional angiography were assessed separately for evidence of stenosis or occulusion. Follow up MRI/MRA studies were also assessed for evidence of progression, regression or stability of the disease in these patients. In the carotid circulation, MRA made the correct diagnosis in 85% of the vessels evaluated with a sensitivity of 80.5% and a specificity of 94%. MRA was also found to show evidence of disease progression, more often than did MRI or the clinical condition of the patients. (orig.)

  13. Efficacy and safety of dual-axis rotational coronary angiography versus conventional angiography

    International Nuclear Information System (INIS)

    Background:Conventional coronary angiography (CA) is the gold standard for the diagnosis of coronary artery disease. However, this technique requires several orthogonal projections to determine the severity of the disease. Dual-axis rotational coronary angiography (DARCA) is a new technique which acquires the image of each coronary artery using a single contrast injection, potentially reducing both radiation and contrast exposure. Objective: The aim of this study was to determine the amount of contrast used, radiation exposure and diagnostic accuracy of DARCA compared to conventional CA. Methods: We conducted a prospective, self-controlled study of consecutive patients undergoing elective coronary angiography to compare DARCA versus the conventional technique. All the angiographies were reviewed by two independent interventional cardiologists (observer 1 and observer 2) who evaluated agreement between both types of images. The observers evaluated firstly DARCA and three weeks later conventional CA images to prevent bias in their interpretation. Results: The contrast volume used in the diagnostic procedure was significantly lower with DARCA (33.29 ± 11.2 ml vs. 17±5.4 ml; p < 0.01). Radiation exposure in the patient (235.6 ± 76.8 mGy vs. 82.7 ± 46.6 mGy; p <0.01) and operator was also significantly lower (5.7 ± 3.26 μSv vs. 2.48 ± 1.47 μSv; p <0.04). A slight difference and a strong correlation were seen in the number of lesions, vessel diameter and percentage of stenosis between both observers and both methods. Categorical assessment of percentage of stenosis also showed adequate agreement. Conclusion: DARCA reduces the use of contrast agents and radiation exposure compared to the conventional technique without modifying the diagnostic accuracy of the method. (authors)

  14. The importance of peripheral angiography in elderly patients undergoing coronary angiography

    Institute of Scientific and Technical Information of China (English)

    Gianluca Rigatelli; Giorgio Rigatelli

    2005-01-01

    Objectives Early and accurate diagnosis of peripheral atherosclerosis is of paramount importance for global managerment of patients with known coronary artery disease (CAD), especially in the elderly. We sought to evaluate the prevalence and clinical relevance of significant abdominal vessel stenosis or aneurysm (AVA) in patients undergoing coronary angiography. Methods Medical records of consecutive > 75-year old patients who underwent coronary angiography at two public institutions over a 12-month period were evaluated. Angiographic results of patients who underwent coincident diagnostic abdominal aorta angiography to evaluate abdominal vessels on the basis of clinical and angiographic criteria were analyzed. Results During the study period, AVA was found in 90 (35.7% ) of 252 consecutive patients (185 males, mean age 79±5.8 years), renal artery stenosis in 13.1% of cases (33 patients), aortoiliac artery disease in 13.7 % (35 patients), and aortic aneurismal disease in 8.9% (22 patients). Logistic regression analyses revealed > 3-vessel CAD (odds ratio [OR] :9.917, P = 0.002), and > 3 risk factors (OR: 2.8, P =0. 048) as independent predictors of AVA. Conclusions Aged patients with multivessel CAD frequently have a high risk profile and multiple vascular atherosclerotic distributions, suggesting the usefulness of a mere global and comprehensive cardiovascular approach in aged patients.

  15. Patient radiation dose from computed tomography angiography and digital subtraction angiography of the brain

    Science.gov (United States)

    Netwong, Y.; Krisanachinda, A.

    2016-03-01

    The 64-row multidetector computed tomography angiography (64-MDCTA) provides vascular image quality of the brain similar to digital subtraction angiography (DSA), but the effective dose of CTA is lower than DSA studied in phantom. The purpose of this study is to evaluate the effective dose from 64-MDCTA and DSA. Effective dose (according to ICRP 103) from 64-MDCTA and DSA flat panel detector for cerebral vessels examination of the brain using standard protocols as recommended by the manufacturer was calculated for 30 cases of MDCTA (15 male and 15 female).The mean patient age was 49.5 (23-89) yrs. 30 cases of DSA (14 male and 16 female), the mean patient age was 46.8 (21-81) yrs. For CTA, the mean effective dose was 3.7 (2.82- 5.19) mSv. For DSA, the mean effective dose was 5.78 (3.3-10.06) mSv. The effective dose of CTA depends on the scanning protocol and scan length. Low tube current can reduce patient dose whereas the number of exposures and number of series in 3D rotational angiography (3D RA) resulted in increasing effective dose in DSA patients.

  16. E-learn Computed Tomographic Angiography

    DEFF Research Database (Denmark)

    Havsteen, Inger; Christensen, Anders; Nielsen, Jens K;

    2012-01-01

    BACKGROUND: Computed tomographic angiography (CTA) is widely available in emergency rooms to assess acute stroke patients. To standardize readings and educate new readers, we developed a 3-step e-learning tool based on the test-teach-retest methodology in 2 acute stroke scenarios: vascular...... occlusion and "spot sign" in acute intracerebral hemorrhage. We hypothesized that an e-learning program enhances reading skills in physicians of varying experience. METHODS: We developed an HTML-based program with a teaching segment and 2 matching test segments. Tests were taken before and after...... sign correctly 69% before versus 92% after teaching (P = .009) and reported a median self-perceived diagnostic certainty of 50% versus 75% (P = .030). Self-perceived diagnostic certainty revealed no significant increase for vascular occlusion. CONCLUSIONS: The e-learning program is a useful educational...

  17. Adaptive thresholding of digital subtraction angiography images

    Science.gov (United States)

    Sang, Nong; Li, Heng; Peng, Weixue; Zhang, Tianxu

    2005-10-01

    In clinical practice, digital subtraction angiography (DSA) is a powerful technique for the visualization of blood vessels in the human body. Blood vessel segmentation is a main problem for 3D vascular reconstruction. In this paper, we propose a new adaptive thresholding method for the segmentation of DSA images. Each pixel of the DSA images is declared to be a vessel/background point with regard to a threshold and a few local characteristic limits depending on some information contained in the pixel neighborhood window. The size of the neighborhood window is set according to a priori knowledge of the diameter of vessels to make sure that each window contains the background definitely. Some experiments on cerebral DSA images are given, which show that our proposed method yields better results than global thresholding methods and some other local thresholding methods do.

  18. Radial pseudoaneurysm following diagnostic coronary angiography

    Directory of Open Access Journals (Sweden)

    Shankar Laudari

    2015-06-01

    Full Text Available The radial artery access has gained popularity as a method of diagnostic coronary catheterization compared to femoral artery puncture in terms of vascular complications and early ambulation. However, very rare complication like radial artery pseudoaneurysm may occur following cardiac catheterization which may give rise to serious consequences. Here, we report a patient with radial pseudoaneurysm following diagnostic coronary angiography. Adequate and correct methodology of compression of radial artery following puncture for maintaining hemostasis is the key to prevention.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12776 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 48-50

  19. Digital subtraction angiography of the cerebral vessels by intraarterial injection

    International Nuclear Information System (INIS)

    Three hundred and fifty-seven digital subtraction angiography (DSA) were performed in 184 neurosurgical patients by intraarterial injection. Examinations consisted of 192 carotid angiography, 110 vertebral angiography, 23 aortography, 11 spinal angiography and 21 other angiography. In all examinations, visualization of the vessels was excellent and the complications were never experienced. High contrast sensitivity of DSA resulted in better visualization of tumor stains, phlebogram, and arteries in cerebral arteriovenous malformations with large shunt blood flow than conventional angiography. Selective catheterization into each cerebral arteries was not necessarily demanded for good opacification of the vessels because of high sensitivity. High contrast sensitivity also permitted low concentration of contrast material, small dose of contrast material, and slow injection rate. Low concentration of contrast material reduced pain and heat during injection especially in the external carotid and vertebral angiography. Using slow injection, recoiling of catheter into the aorta was reduced, so that injection from the innominate and subclavian arteries for visualization of origin of the cerebral arteries were always successful. Full study of cerebral arteries by Seldinger's method, if necessary, was easily achieved using DSA even in patient with high age or with severe atherosclerosis. Bolus injection of small dose of contrast material as well as serial imaging was helpful in evaluating hemodynamics in the lesion. Real time display of DSA reduced the time required for angiography and was very convenient for artificial embolization. Besides these advantages, DSA became comparable to conventional angiography in spacial resolution by use of intraarterial injection and could be a preoperative genuine examination as well as a screening method. (author)

  20. Multidetector CT angiography in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Khandelwal, Niranjan; Kalra, Naveen [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Garg, Mandeep Kumar, E-mail: gargmandeep@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Kang, Mandeep; Lal, Anupam [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Jain, Sanjay [Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India); Suri, Sudha [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh 160012 (India)

    2011-02-15

    Objective: To analyse the spectrum of Takayasu's arteritis (TA) on multidetector CT angiography (MDCTA). Materials and methods: A retrospective analysis of the MDCTA findings was performed on 15 patients clinically diagnosed as Takayasu's arteritis. The spectrum and incidence of imaging findings on CTA were compared to studies in literature on catheter angiography in Takayasu's arteritis. Laboratory parameters were available in nine patients. The disease was considered active if erythrocyte sedimentation rate (ESR) levels were elevated and 'C' reactive protein (CRP) was positive. An attempt was made to correlate disease activity with the imaging findings. Results: Ascending aorta, arch of aorta and descending thoracic aorta were involved in 14 out of 15 (93%) patients. The wall thickness varied between 1 and 10 mm with maximal involvement in arch and descending thoracic aorta. Major neck vessels were involved in 11 (73%) patients with most pronounced changes seen in the brachiocephalic trunk, left common carotid artery (CCA) and left subclavian artery (SCA). Abdominal aorta and its branches were involved in all the 11 (100%) patients in whom abdominal CTA was performed. Celiac axis and SMA were involved in 10 (91%) and seven (64%) patients, respectively while renal artery stenosis was present in five (45%) patients. In six patients, ESR was elevated and CRP was positive indicating active disease. All patients in whom the laboratory parameters were available showed mural thickening in the aorta and at least one of the neck vessels except for one patient with inactive disease who had aortic mural thickening only. Conclusion: MDCTA provides information about both the vessel wall and lumen in patients with Takayasu's disease.

  1. Evaluation of the pedal artery: comparison of three-dimensional gadolinium-enhanced MR angiography with digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Kang, Sung Gwon; Byun, Joo Nam; Kim, Young Cheol; Choi, Jeong Yeol; Kim, Dong Hyun [College of Medicine, Chosun Univ., Kwangju (Korea, Republic of)

    2002-07-01

    To compare the three-dimensional gadolinium-enhanced MR angiography with digital subtraction angiography (DSA) for evaluation of the pedal artery. In 12 extremities of 11 patients, both digital subtraction angiography (DSA) and contrast-enhanced MR angiography (CE-MR angiography) were performed during the same week. Among ten of the 11 patients, the following conditions were present: atherosclerosis (n=4), diabetic foot (n=3), Buerger's disease (n=1), calciphylactic arteriopathy (n=1) and arteriovenous malformation of the foot (n=1). The remaining patient underwent angiography prior to flap surgery. For MR angiography, a 1.5T system using an extremity or head coil was used. A three-dimensional FISP (fast imaging with steady state precession) sequence was obtained before enhancement, followed by four sequential acquisitions (scan time, 20 secs, scan interval time, 10 secs) 10 seconds after intravenous bolus injection of normal saline (total 10 cc), following intravenous administration of gadolinium (0.02 mmol/kg, 3 ml/sec). Arterial segments of the ankle and foot were classified as the anterior or posterior tibial artery, the distal peroneal artery, the medial or lateral plantar artery, the pedal arch, and the dorsalis pedis artery. Two radiologists independently analysed visualization of each arteraial segment and the mean of visible arterial segments in one extreminty using CE-MR angiography and DSA. Among 84 arterial segments, 16 were invisible at both CE-MR angiography and DSA, while 39 were demonstrated by both modalities. Twenty-six segments were visible only at CE-MR angiography and three only at DSA. CE-MR angiography displayed a higher number of arterial segments than DSA (mean, 5.42 vs. mean 3.50, respectively), a difference which was statistically significant (p<0.000). The difference between each arterial segment was not statistically significant, except for the dorsalis pedis artery (t test, p<0.000). In that it provides additional information for

  2. Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

    International Nuclear Information System (INIS)

    The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population. (author)

  3. Superselective pseudo-continuous arterial spin labeling angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jensen-Kondering, Ulf [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Lindner, Thomas, E-mail: thomas.lindner@uksh.de [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Osch, Matthias J.P. van [C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden (Netherlands); Rohr, Axel; Jansen, Olav [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Helle, Michael [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Now with Philips GmbH Innovative Technologies, Research Laboratories, Hamburg (Germany)

    2015-09-15

    Highlights: • Superselective arterial spin labeling was capable of acquiring angiograms of individually selected arteries. • Image quality was similar compared with a routinely used time-of-flight angiography. • Superselective arterial spin labeling was utilized in patients with arterio-venous malformations and made it possible to visualize individual feeding vessels in a complete non-invasive way - Abstract: Purpose: To evaluate the utility of a novel non-contrast enhanced, vessel-selective magnetic resonance angiography (MRA) approach based on superselective pseudo-continuous arterial spin labeling (ASL) for the morphologic assessment of intracranial arteries when compared to a clinically used time-of-flight (TOF) MRA. Materials and methods: Three sets of selective ASL angiographies (right and left internal carotid artery, basilar artery) as well as one TOF data set were obtained from each of the five volunteers included in this study on a clinical 1.5T system. The depiction of arterial segments as well as their delineation was evaluated and independently analyzed by two radiologists. Additionally, the ASL angiography approach was performed in two patients suffering from arterio-venous malformations (AVM) in order to illustrate potential applications in a clinical setting. Results: In both angiography techniques, intracranial arteries and their segments (distal branches up to A5 segments of the anterior cerebral arteries, M8 segments of the middle cerebral arteries, and P5 segments of the posterior cerebral arteries) were continuously depicted with excellent inter-reader agreement (κ > 0.81). In AVM patients, reconstructed images of the TOF angiography presented similar information about the size and shape of the AVM as did superselective ASL angiography. In addition, the acquired ASL angiograms of selected vessels allowed assessing the blood supply of individually labeled arteries to the AVM which could also be confirmed by digital subtraction angiography

  4. Fatal Deep Inguinal Infection after Diagnostic Coronary Angiography

    OpenAIRE

    Akkoyun, Dursun Çayan; Alpsoy, Şeref; Akyüz, Aydın; Güneş, Hayati

    2015-01-01

    Herein we would like to share our case complicated with inguinal infection secondary to femoral haematoma after coronary angiography. A-79 years-old female underwent diagnostic coronary angiography suffered from a large haematoma in the right inguinal region where femoral artery puncture was performed at another hospital. She was treated at same hospital 16 days and discharged. She presented to our department with a deep ulcerative and ruptured wound in the femoral artery puncture site. The w...

  5. CT Angiography in the Diagnosis of Brain Death

    International Nuclear Information System (INIS)

    Summary Brain death is defined as the irreversible cessation of functioning of the entire brain, including the brainstem. Brain death is principally established using clinical criteria including coma, absence of brainstem reflexes and loss of central drive to breathe assessed with apnea test. In situations in which clinical testing cannot be performed or when uncertainty exists about the reliability of its parts due to confounding conditions ancillary tests (i.a. imaging studies) may be useful. The objective of ancillary tests in the diagnosis of brain death is to demonstrate the absence of cerebral electrical activity (EEG and evoked potentials) or cerebral circulatory arrest. In clinical practice catheter cerebral angiography, perfusion scintigraphy, transcranial Doppler sonography, CT angiography and MR angiography are used. Other methods, like perfusion CT, xenon CT, MR spectroscopy, diffusion weighted MRI and functional MRI are being studied as potentially useful in the diagnosis of brain death. CT angiography has recently attracted attention as a promising alternative to catheter angiography – a reference test in the diagnosis of brain death. Since 1998 several major studies were published and national guidelines were introduced in several countries (e.g. in France, Austria, Switzerland, the Netherlands and Canada). This paper reviews technique, characteristic findings and criteria for the diagnosis of cerebral circulatory arrest in CT angiography

  6. The feasibility of left radial artery approach for coronary angiography

    Institute of Scientific and Technical Information of China (English)

    Liangbo Chen; Can Chen; Shian Huang

    2008-01-01

    Objective:To study the feasibility of the left radial approach for coronary angiography. Methods:195 patients diagnosed with coronary atherosclerotic heart disease were randomly divided for coronary angiography(CAG) into a left radial artery approach group(98 cases) and a fight radial artery approach group(97 cases) from Jan 2006 to Dec 2006. Selective coronary angiographies were performed with 5F TIG catheters. The time of puncturing, duration under X-ray fluoroscopy and of the operation, successful rates of puncturing and coronary angiography were recorded. Results:There was no difference in the time of puncturing(2.25 -F 1.58 min vs 2.19±1.62 min), duration under X-ray fluoroscopy(3.12±1.53 min vs 3.21±1.49 min) and the duration of the operation(12.87±2.52 rain vs 12.98±2.85 min), nor in the success rates of puncturing(95.91% vs 95.87%) and coronary angiography(94.90% vs 94.85%). Conclusion: Coronary angiography can be accomplished via the left radial artery approach, indicating that this is a worthwhile clinical approach.

  7. Contrast-enhanced MR angiography in patients after kidney transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Huber, A.; Heuck, A.; Scheidler, J.; Holzknecht, N.; Baur, A.; Reiser, M. [Klinikum Grosshadern, Muenchen (Germany). Radiologische Klinik und Poliklinik; Stangl, M.; Theodorakis, J.; Illner, W.-D.; Land, W. [Dept. of Transplant Surgery, Klinikum Grosshadern, Muenchen (Germany)

    2001-12-01

    The aim of this study was to investigate the value of a contrast-enhanced 3D MR angiography in detecting postoperative vascular complications after kidney transplantation in comparison with digital subtraction angiography (DSA). Forty-one patients who underwent a kidney transplantation were examined with MR angiography and DSA. Contrast-enhanced MR angiography was performed as a dynamic measurement with one precontrast and three postcontrast measurements. Maximum intensity projection reconstructions were performed for all postcontrast data sets after DSA. The results were evaluated by two independent observers who were unaware of the DSA results. Twenty-three hemodynamically significant arterial stenoses were identified with DSA in the iliac arteries (n=7), the renal allograft arteries (n=12), and in their first branches (n=4). For a patient-based analysis the sensitivity and specificity, respectively, for observer 1 were 100 and 97%, and for observer 2, 100 and 93%. Respective data were 100 and 100% after a consensus evaluation by two observers. Complications involving the renal veins were detected in 2 cases and perfusion defects of the kidney parenchyma were detected in 4 cases. Contrast-enhanced MR angiography is a reliable method in identifying postoperative arterial stenoses after kidney transplantation. In addition, dynamic MR angiography can be helpful in detecting venous complications and perfusion defects in kidney allografts. (orig.)

  8. Contrast agent choice for intravenous coronary angiography

    Science.gov (United States)

    Zeman, H. D.; Siddons, D. P.

    1990-05-01

    The screening of the general population for coronary artery disease would be practical if a method existed for visualizing the extent of occlusion after an intravenous injection of contrast agent. Measurements performed with monochromatic synchrotron radiation X-rays and an iodine-containing contrast agent at the Stanford Synchrotron Radiation Laboratory have shown that such an intravenous angiography procedure would be possible with an adequately intense monochromatic X-ray source. Because of the size and cost of synchrotron radiation facilities it would be desirable to make the most efficient use of the intensity available, while reducing as much as possible the radiation dose experienced by the patient. By choosing contrast agents containing elements with a higher atomic number than iodine, it is possible to both improve the image quality and reduce the patient radiation dose, while using the same synchrotron radiation source. By using Si monochromator crystals with a small mosaic spread, it is possible to increase the X-ray flux available for imaging by over an order of magnitude, without any changes in the storage ring or wiggler magnet. The most critical imaging task for intravenous coronary angiography utilizing synchrotron radiation X-rays is visualizing a coronary artery through the left ventricle or aorta which also contain contrast agent. Calculations have been made of the signal to noise ratio expected for this imaging task for various contrast agents with atomic numbers between that of iodine and bismuth. The X-ray energy spectrum of the X-17 superconduction wiggler beam line at the National Synchrotron Light Source at Brookhaven National Laboratory has been used for these calculations. Both perfect Si crystals and Si crystals with a small mosaic spread are considered as monochromators. Contrast agents containing Gd or Yb seem to have about the optimal calculated signal to noise ratio. Gd-DTPA is already approved for use as a contrast agent for

  9. The comparative study on diagnostic validity of cerebral aneurysm by computed tomography angiography versus digital subtraction angiography after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-01-01

    Full Text Available Background: In order to declare the preoperative diagnostic value of brain aneurysms, two radiological modalities, computed tomographic angiography and digital subtraction angiography were compared. Methods: In this descriptive analytic study, diagnostic value of computed tomographic angiography (CTA was com-pared with digital subtraction angiography (DSA. Sensitivity, specificity, positive and negative predictive values were calculated and compared between the two modalities. All data were analyzed with SPSS software, version 16. Results: Mean age of patients was 49.5 ± 9.13 years. 57.9 % of subjects were female. CTA showed 89% sensitivity and 100% specificity whereas DSA demonstrated 74% sensitivity and 100% specificity. Positive predictive value of both methods was 100%, but negative predictive value of CTA and DSA was 85% and 69%, respectively. Conclusions: Based on our data, CTA is a valuable diagnostic modality for detection of brain aneurysm and su-barachnoid hemorrhage.

  10. CT angiography versus 3D rotational angiography in patients with subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    CT angiography (CTA) is increasingly used as primary diagnostic tool to replace digital subtraction angiography (DSA) in patients with subarachnoid hemorrhage (SAH). However, 3D rotational angiography (3DRA) has substituted DSA as a reference standard. In this prospective observational study, we compare CTA with 3DRA of all cerebral vessels in a large cohort of patients with SAH. Of 179 consecutive patients with SAH admitted between March 2013 and July 2014, 139 underwent 64- to 256-detector row CTA followed by complete cerebral 3DRA within 24 h. In 86 patients (62 %), 3DRA was performed under general anesthesia. Two observers from outside hospitals reviewed CTA data. In 118 of 139 patients (85 %), 3DRA diagnosed the cause of hemorrhage: 113 ruptured aneurysms, three arterial dissections, one micro-arteriovenous malformation (AVM), and one reversible vasoconstriction syndrome. On CTA, both observers missed all five non-aneurysmal causes of SAH. Sensitivity of CTA in depicting ruptured aneurysms was 0.88-0.91, and accuracy was 0.88-0.92. Of 113 ruptured aneurysms, 28 were ≤3 mm (25 %) and of 95 additional aneurysms, 71 were ≤3 mm (75 %). Sensitivity of depicting aneurysms ≤3 mm was 0.28-0.43. Of 95 additional aneurysms, the two raters missed 65 (68 %) and 58 (61 %). Sensitivity in detection was lower in aneurysms of the internal carotid artery than in other locations. CTA had some limitations as primary diagnostic tool in patients with SAH. All non-aneurysmal causes for SAH and one in ten ruptured aneurysms were missed. Performance of CTA was poor in aneurysms ≤3 mm. The majority of additional aneurysms were not depicted on CTA. (orig.)

  11. CT angiography versus 3D rotational angiography in patients with subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Bechan, R.S.; Peluso, J.P.; Sluzewski, M.; Rooij, W.J. van [Sint Elisabeth Ziekenhuis Tilburg, Department of Radiology, Tilburg (Netherlands); Rooij, S.B. van [Medisch Centrum Alkmaar, Department of Radiology, Alkmaar (Netherlands); Sprengers, M.E.; Majoie, C.B. [Academisch Medisch Centrum, Department of Radiology, Amsterdam (Netherlands)

    2015-12-15

    CT angiography (CTA) is increasingly used as primary diagnostic tool to replace digital subtraction angiography (DSA) in patients with subarachnoid hemorrhage (SAH). However, 3D rotational angiography (3DRA) has substituted DSA as a reference standard. In this prospective observational study, we compare CTA with 3DRA of all cerebral vessels in a large cohort of patients with SAH. Of 179 consecutive patients with SAH admitted between March 2013 and July 2014, 139 underwent 64- to 256-detector row CTA followed by complete cerebral 3DRA within 24 h. In 86 patients (62 %), 3DRA was performed under general anesthesia. Two observers from outside hospitals reviewed CTA data. In 118 of 139 patients (85 %), 3DRA diagnosed the cause of hemorrhage: 113 ruptured aneurysms, three arterial dissections, one micro-arteriovenous malformation (AVM), and one reversible vasoconstriction syndrome. On CTA, both observers missed all five non-aneurysmal causes of SAH. Sensitivity of CTA in depicting ruptured aneurysms was 0.88-0.91, and accuracy was 0.88-0.92. Of 113 ruptured aneurysms, 28 were ≤3 mm (25 %) and of 95 additional aneurysms, 71 were ≤3 mm (75 %). Sensitivity of depicting aneurysms ≤3 mm was 0.28-0.43. Of 95 additional aneurysms, the two raters missed 65 (68 %) and 58 (61 %). Sensitivity in detection was lower in aneurysms of the internal carotid artery than in other locations. CTA had some limitations as primary diagnostic tool in patients with SAH. All non-aneurysmal causes for SAH and one in ten ruptured aneurysms were missed. Performance of CTA was poor in aneurysms ≤3 mm. The majority of additional aneurysms were not depicted on CTA. (orig.)

  12. Comparative evaluation of 64-slice CT angiography and digital subtraction angiography in assessing the cervicocranial vasculature

    Directory of Open Access Journals (Sweden)

    Randolf Klingebiel

    2008-08-01

    Full Text Available Randolf Klingebiel1, Max Kentenich3, Hans-Christian Bauknecht3, Florian Masuhr2, Eberhard Siebert1, Markus Busch2, Georg Bohner11Department of Neuroradiology, 2Department of Neurology, 3Department of Radiology, Charité Universitary Medicine Berlin, GermanyBackground: Noninvasive 64-slice computed tomography angiography (64-MSCTA closely approximates conventional catheter angiography (DSA in terms of detail resolution. Objective: Retrospective evaluation of cervicocranial (cc 64-MSCTA in comparison with DSA in patients with presumptive cc vascular disorders.Material and methods: Twenty-four 64-MSCTA studies (32 mm detector width, slice thickness 0.5 mm, 120 kv, 150 mAs, pitch 0.75 of patients with presumptive cc vascular pathology (13 men, 11 women, mean age 38.3 ± 11.3 yrs, range 19–54 yrs were assessed in comparison with DSA studies without abnormal findings in age-matched patients (11 men, 13 women, mean age 39.7 ± 11.9 yrs, range 18–54 yrs. Study readings were performed in a blinded manner by two neuroradiologists with respect to image quality and assessibility of various cc vascular segments by using a five-point scale. Radiation exposure was calculated for 64-MSCTA.Results: Each reader assessed 384/528 different vessel segments (64-MSCTA/DSA. Superior image quality was attributed to DSA with respect to the C1 ICA–C6 ICA, A3 ACA, and P3 PCA segments as well the AICA and SCA. 64-MSCTA was scored superior for C7 ICA and V4 VA segments. A significantly increased number of nonassessable V2- and V3 VA segments in DSA studies was noted. The effective dose for 64-MSCTA amounted to 2.2 mSv.Conclusions: 64-MSCTA provides near-equivalent diagnostic information of the cc vasculature as compared with DSA. According to our results, DSA should be considered primarily when peripheral vessels (A3/P3 or ICA segments close to the skull base (C2-5 are of interest, such as in primary angiitis or stenoocclusive ICA disease, respectively.Keywords: CT-angiography

  13. Unusual Congenital Aortic Anomaly with Rare Common Celiamesenteric Trunk Variation: MR Angiography and Digital Substraction Angiography Findings

    International Nuclear Information System (INIS)

    Magnetic resonance angiography and digital substraction angiography (DSA) findings in a case with a rare congenital thoracoabdominal aortic hypoplasia and common celiamesenteric trunk variation with occlusion of infrarenal abdominal aorta are described here. To our knowledge, this aortic anomaly has not been previously described in the English literature. DSA is the optimum imaging modality for determination of aortic hypoplasia, associated vascular malformations, collateral vessels, and direction of flow within vessels

  14. Microfocal angiography of the pulmonary vasculature

    Science.gov (United States)

    Clough, Anne V.; Haworth, Steven T.; Roerig, David T.; Linehan, John H.; Dawson, Christopher A.

    1998-07-01

    X-ray microfocal angiography provides a means of assessing regional microvascular perfusion parameters using residue detection of vascular indicators. As an application of this methodology, we studied the effects of alveolar hypoxia, a pulmonary vasoconstrictor, on the pulmonary microcirculation to determine changes in regional blood mean transit time, volume and flow between control and hypoxic conditions. Video x-ray images of a dog lung were acquired as a bolus of radiopaque contrast medium passed through the lobar vasculature. X-ray time-absorbance curves were acquired from arterial and microvascular regions-of-interest during both control and hypoxic alveolar gas conditions. A mathematical model based on indicator-dilution theory applied to image residue curves was applied to the data to determine changes in microvascular perfusion parameters. Sensitivity of the model parameters to the model assumptions was analyzed. Generally, the model parameter describing regional microvascular volume, corresponding to area under the microvascular absorbance curve, was the most robust. The results of the model analysis applied to the experimental data suggest a significant decrease in microvascular volume with hypoxia. However, additional model assumptions concerning the flow kinematics within the capillary bed may be required for assessing changes in regional microvascular flow and mean transit time from image residue data.

  15. Coherent bremsstrahlung used for digital subtraction angiography

    Science.gov (United States)

    Überall, Herbert

    2007-05-01

    Digital subtraction angiography (DSA), also known as Dichromography, using synchrotron radiation beams has been developed at Stanford University (R. Hofstadter) and was subsequently taken over at the Brookhaven Synchrotron and later at Hamburg (HASYLAB) [see, e.g., W.R. Dix, Physik in unserer Zeit. 30 (1999) 160]. The imaging of coronary arteries is carried out with an iodine-based contrast agent which need not be injected into the heart. The radiation must be monochromatized and is applied above and below the K-edge of iodine (33.16 keV), with a subsequent digital subtraction of the two images. Monochromatization of the synchrotron radiation causes a loss of intensity of 10 -3. We propose instead the use of coherent bremsstrahlung [see, e.g., A.W. Saenz and H. Uberall, Phys. Rev. B25 (1982) 448] which is inherently monochromatic, furnishing a flux of 10 12 photon/sec. This requires a 10-20 MeV electron linac which can be obtained by many larger hospitals, eliminating the scheduling problems present at synchrotrons. The large, broad incoherent bremsstrahlung background underlying the monochromatic spike would lead to inadmissible overexposure of the patient. This problem can be solved with the use of Kumakhov's capillary optics [see e.g., S.B.Dabagov, Physics-Uspekhi 46 (2003) 1053]: the low-energy spiked radiation can be deflected towards the patient, while the higher energy incoherent background continues forward, avoiding the patient who is placed several meters from the source.

  16. Posterior Chamber Hemorrhage during Fluorescein Angiography

    Directory of Open Access Journals (Sweden)

    Manuel A. P. Vilela

    2015-01-01

    Full Text Available This paper provides the first reported case of acute posterior chamber hemorrhage during fluorescein angiography (FA. This is a case review with serial color photographs of the anterior segment. A 76-year-old male was referred for angiographic control of age-related macular degeneration. He was pseudophakic OU, BCVA 20/40 OU. He had mild hypertension, but not diabetes. He had had two previous angiograms without adverse effects. Difficulty was experienced in obtaining the images owing to a progressive reduction in the transparency of the media. A dense hemorrhage in the posterior chamber of the right eye was found, involving the visual axis. Thorough biomicroscopy, gonioscopy, and ultrasonic biomicroscopy showed that part of one of the haptics of the right intraocular lens (IOL was touching and tearing the posterior face of the iris, without any visible synechiae, iris, or angle neovascularization. Anterior segment FA and posterior ultrasonography were normal. No similar case has been described in the literature involving dense progressive bleeding located in the capsular bag and posterior chamber, without any detectable triggering ocular event other than mydriasis and fluorescein injection. Contact of the iris or sulcus with part of the intraocular lens, aggravated by the intense use of mydriatics during the FA procedure, probably caused bleeding to happen.

  17. CT Angiography of the Coronary Arteries

    Directory of Open Access Journals (Sweden)

    H.Ghanaati

    2005-08-01

    Full Text Available Introduction & Background: Cardiac imaging is currently one the most rapidly advancing fields in clinical cardiology. Continuing technical innovations are expanding the applicability and usefulness of non-invasive imaging modalities such as ultrasound, nuclear imaging, positron emis-sion tomography Magnetic Resonance Imaging and most recently computed tomography (CT. In 1998, the 4-slice spiral CT scanners were introduced with a rotation time of 500ms a collimated detector width varying from 0.5 to 1.25mm. In 2002, the 16-slice spiral CT scanners were first used for coronary imag-ing. The rotation time and some of these scanners is now less than 400ms, the slice thickness varies be-tween 0.5 and 0.75mm, and a complete cardiac scan can be performed in less than 20s. In 2004, 64-slice spiral CT released into the market. Imaging of the heart requires acquisition or image reconstruction that is synchronized to the motion of the heart. Nie-man et al, irrespectively of the image quality, evalu-ated all branches with a minimal luminal diameter of 2.0mm and sensitivity and specificity of 95% and 86% respectively in comparison to angiography.

  18. When is rotational angiography superior to conventional single‐plane angiography for planning coronary angioplasty?

    Science.gov (United States)

    Taylor, Jane; Boutong, Sara; Brett, Sarah; Louis, Amal; Heppenstall, James; Morton, Allison C.; Gunn, Julian P.

    2015-01-01

    Objectives To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning. Background As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three‐dimensional anatomy. However, its value in PCI remains unknown. Methods We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists. Patients underwent either RoCA or conventional CA pre‐PCI for planning. These were compared with the referral CA (all conventional) in terms of quantitative lesion assessment and operator confidence. An independent panel reanalyzed all parameters. Results Six operators performed 127 procedures (60 RoCA, 60 conventional CA, and 7 crossed‐over) and assessed 212 lesions. RoCA was associated with a reduction in the number of lesions judged to involve a bifurcation (23 vs. 30 lesions, P RoCA improved confidence assessing lesion length (P = 0.01), percentage stenosis (P = 0.02), tortuosity (P RoCA augments quantitative lesion assessment, enhances confidence in the assessment of coronary artery disease and the precise details of the proposed procedure, but does not affect X‐ray dose, contrast agent volume, or procedure duration. © 2015 Wiley Periodicals, Inc. PMID:26012725

  19. Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; You, Jin Jong; Choi, Ho Cheol; Kim, Ji Eun [Dept. of Radiology, Gyeongsang National University Hospital, Jinju (Korea, Republic of); Choi, Dae Seob [Gyeongsang Institue of Health Science, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of); Ryoo, Jae Wook [Dept. of Radiology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2011-10-15

    To evaluate the usefulness of multidetector-row CT angiography (MDCTA) for the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) by comparison of digital subtraction angiography (DSA) and to compare the bone subtraction CT angiography (BS-CTA) and standard CT angiography (S-CTA). Thirty-three patients who were treated with intraarterial nimodipine infusion for the cerebral vasospasm after aneurysmal SAH were evaluated with MDCTA and DSA. BS-CTA images were reconstructed from the S-CTA and unenhanced CT source images. A total of 207 vascular segments were evaluated. A four-step scale for the degree of stenosis was applied for each segment. With DSA as the standard images, BS-CTA and S-CTA images were comparied. On DSA, 56 segments (27%) presented vasospasm. Concordance between the DSA and S-CTA and between DSA and BS-CTA were 94.7% and 82.1%, respectively. Overestimation for the degree of stenosis was shown in 37 segments on BS-CTA and in 8 segments on S-CTA, but underestimated segments were only shown on S-CTA (n = 4). MDCTA with standard technique seems to be a useful imaging tool for the evaluation of the cerebral vasospasm after aneurysmal SAH. However, BS-CTA is not needed because of additional radiation and overestimation of the degree of stenosis.

  20. Gadolinium-enhanced magnetic resonance angiography of the abdominal vessels

    International Nuclear Information System (INIS)

    Contrast enhanced (CE) magnetic resonance angiography (MRA) provides high resolution angiograms within 20-40 sec. The technique is based on the acquisition of heavily T1-weighted threedimensional (3D) gradient-echo data sets (FISP) with ultrashort echo-(<2 ms) and repetition times (<5 ms) during the arterial phase of an intravenously injected bolus of a T1-shortening agent such as Gd-DTPA. For MR-angiography of abdominal vessels CE-MRA is better suited than 'time-of-flight' (TOF) and phase-contrast (PC) MRA because motional artifacts can be obviated with breath-held acquisitions. We have optimised the technique and evaluated its potential for angiography of the abdominal aorta and its branches as well as the portal vein and its tributaries. Whilst CE-MRA provides reliable diagnostic accuracy in the aorta and the proximal sections of its branches, small peripheral arteries cannot be assessed accurately. The portal vein and its tributaries can often be depicted better with CE-MRA than with conventional angiography but, like conventional angiography, CE-MRA is hampered by slow and reversed flow, conditions under which TOF or 'true FISP' MRA may perform bst. We have also investigated FLASH-echo-planar imaging (EPI) hybrid techniques, a further technical development which due to shorter acquisition times of 12-15 sec. allows semi-dynamic imaging of the arterial and venous phase and provide better vessel contrast due to the use of fat-suppression. (orig.)

  1. Patient radiation exposure during coronary angiography and intervention

    Energy Technology Data Exchange (ETDEWEB)

    Fransson, S.G.; Persliden, J. [Univ. Hospital, Linkoeping (Sweden). Dept. of Thoracic Radiology

    2000-03-01

    Purpose: To prospectively register fluoroscopic and cine times in a random fashion, and to measure patient radiation exposure from routine coronary angiography and coronary balloon angioplasty. We also evaluated an optional dose reduction system used during interventions. Material and methods: The incident radiation to the patient was measured as kerma area product (KAP) in Gycm{sup 2}, obtained from an ionisation chamber mounted on the undercouch tube during 65 coronary angiography procedures and another 53 percutaneous transluminal coronary angioplasties, mostly directly following complete coronary angiography. Results and conclusion: The values from coronary angiography were comparable to other reports with a mean fluoroscopic time of 4.4 min and a mean KAP value of 62.6 Gy/cm{sup 2}. The corresponding figures from coronary balloon angioplasty without stenting were lower than otherwise reported, with 8.2 min and 47.9 Gycm{sup 2}, respectively. The use of coronary stents did prolong the mean fluoroscopic time (10.5 min) but did not significantlyenhance the patient mean radiation dose (51.4 Gycm{sup 2}). The dose reduction technique resulted in a significant KAP value reduction of 57%. In conclusion, with regard to radiation exposure, coronary angiography and balloon angioplasty are considered safe procedures.

  2. Transient Global Amnesia following Neural and Cardiac Angiography May Be Related to Ischemia

    Directory of Open Access Journals (Sweden)

    Hongzhou Duan

    2016-01-01

    Full Text Available Introduction. Transient global amnesia (TGA following angiography is rare, and the pathogenesis has not been illustrated clearly till now. The aim of this research is to explore the pathogenesis of TGA following angiography by analyzing our data and reviewing the literature. Methods. We retrospectively studied 20836 cases with angiography in our hospital between 2007 and 2015 and found 9 cases with TGA following angiography. The data of these 9 cases were analyzed. Results. We found all 9 cases with TGA following neural angiography (5 in 4360 or cardiac angiography (4 in 8817 and no case with TGA following peripheral angiography (0 in 7659. Statistical difference was found when comparing the neural and cardiac angiography group with peripheral group (p=0.022. Two cases with TGA were confirmed with small acute infarctions in hippocampus after angiography. This might be related to the microemboli which were rushed into vertebral artery following blood flow during neural angiography or cardiac angiography. There was no statistical difference when comparing the different approaches for angiography (p=0.82 and different contrast agents (p=0.619. Conclusion. Based on the positive findings of imaging study and our analysis, we speculate that ischemia in the medial temporal lobe with the involvement of the hippocampus might be an important reason of TGA following angiography.

  3. CT angiography versus intraarterial DSA in abdominal aortic aneurysms; CT-Angiographie versus intraarterielle DSA bei Bauchaortenaneurysmen

    Energy Technology Data Exchange (ETDEWEB)

    Rieker, O. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Dueber, C. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Schmiedt, W. [Klinik fuer Herz-, Thorax- und Gefaesschirurgie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Neufang, A. [Klinik fuer Herz-, Thorax- und Gefaesschirurgie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Pittow, M. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany); Schweden, F. [Klinik fuer Radiologie, Johannes-Gutenberg-Universitaet, Mainz (Germany)

    1996-07-01

    To evaluate if CT angiography is able to image all features necessary for the preoperative planning of abdominal aortic aneurysms (accessory renal arteries, stenoses or occlusions of renal and iliac arteries, patency of inferior mesentric artery). CT angiography and DSA were performed on 27 patients with abdominal aortic aneurysms. CT angiography was performed using a protocol that covered the abdominal aorta and the pelvic arteries with a single spiral acquisition (contrast dose: 150 ml, collimation: 5 mm, table feed: 7.5 mm/s, increment of reconstruction: 2 mm). Maximum intensity projections (MIP) and axial scans were compared with the results of intraarterial DSA. Using axial scans and subvolume MIP, CTA accurately defined 7/8 accessory renal arteries, 13/13 occlusions and 9/12 high grade stenoses of renal and pelvic arteries. High-grade stenoses of the iliac arteries were underestimated in two cases and overlooked in one case. CT angiography was superior to DSA in imaging the inferior mesenteric artery. CT angiography precisely diagnosed 33 aneurysms of the iliac, renal and coeliac arteries. CT angiography using a single administration of intravenous contrast may replace preoperative DSA in most cases of abdominal aortic aneurysm. (orig.) [Deutsch] Ziel dieser Studie war es zu pruefen, ob mit der CT-Angiographie die fuer die praeoperative Planung von Bauchaortenaneurysmen relevanten Gefaessveraenderungen darstelbar sind (Akzessorische Nierenarterien, Nierenarterienstenosen, A. mesenterica inferior, Beckenarterien). Die CT-Angiographien wurden mit einem Protokoll durchgefuehrt, das die Bauchaorta und die Beckenarterien bis zur Leiste mit einer einzigen Spiralakquisition erfasst (150 ml Kontrastmittel, Kollimation: 5 mm, Tischvorschub: 7,5 mm/s, Rekonstruktionsintervall: 2 mm). Die Befunde aus Maximum-Intensitaets-Projektionen (MIP) und den axialen Schnittbildern wurden mit den Befunden der intraarteriellen DSA bei 27 Patienten verglichen. Bei Hinzuziehung von

  4. MR angiography of the central nervous system in pediatric patients

    International Nuclear Information System (INIS)

    This paper defines the role of both time-of-flight (TOF) and phase-contrast MR angiography in pediatric neuroimaging. MR angiographic techniques included two- and three-dimensional TOF and two- and three-dimensional phase contrast MR angiography in 30 patients. Reprojections were done with a maximum-intensity-pixel algorithm. MR angiograms were reviewed retrospectively with spin-echo images (10 cases) and/or conventional angiograms (20 cases). MR angiography provided additional information compared with spin-echo imaging in cases of sinus thrombosis (n = 5), arterial thrombosis (n = 2), arterial stenosis (n = 5), aneurysm evaluation (n = 3), vascular pathology exclusion (n = 5) and preoperative cortical venous mapping (n = 7). Stationary tissue signal suppression was better achieved with two-dimensional than with three-dimensional TOF images. Signal shine through in two cases of hemorrhage created pitfalls in interpreting the flow on TOF images

  5. Multidetector CT angiography of renal vasculature: normal anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Tuerkvatan, Aysel; Oezdemir, Mustafa; Cumhur, Turhan; Oelcer, Tuelay [Tuerkiye Yueksek ihtisas Hospital, Department of Radiology, Sihhiye, Ankara (Turkey)

    2009-01-15

    Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm. Recently, multidetector computed tomographic (MDCT) angiography has become a principal imaging investigation for assessment of the renal vasculature and has challenged the role of conventional angiography. It is an excellent imaging technique because it is a fast and non-invasive tool that provides highly accurate and detailed evaluation of normal renal vascular anatomy and variants. The number, size and course of the renal arteries and veins are easily identified by MDCT angiography. The purpose of this pictorial essay is to illustrate MDCT angiographic appearance of normal anatomy and common variants of the renal vasculature. (orig.)

  6. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Tonino, Pim A L; De Bruyne, Bernard; Pijls, Nico H J;

    2009-01-01

    BACKGROUND: In patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio...... of maximal blood flow in a stenotic artery to normal maximal flow), in addition to angiography, improves outcomes. METHODS: In 20 medical centers in the United States and Europe, we randomly assigned 1005 patients with multivessel coronary artery disease to undergo PCI with implantation of drug...... in the angiography group were free from angina at 1 year, as compared with 81% of patients in the FFR group (P=0.20). CONCLUSIONS: Routine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point...

  7. Optical Coherence Tomography Angiography in Mice: Comparison with Confocal Scanning Laser Microscopy and Fluorescein Angiography

    Science.gov (United States)

    Giannakaki-Zimmermann, Helena; Kokona, Despina; Wolf, Sebastian; Ebneter, Andreas; Zinkernagel, Martin S.

    2016-01-01

    Purpose Optical coherence tomography angiography (OCT-A) allows noninvasive visualization of retinal vessels in vivo. OCT-A was used to characterize the vascular network of the mouse retina and was compared with fluorescein angiography (FA) and histology. Methods In the present study, OCT-A based on a Heidelberg Engineering Spectralis system was used to investigate the vascular network in mice. Data was compared with FA and confocal microscopy of flat-mount histology stained with isolectin IB4. For quantitative analysis the National Cancer Institute's AngioTool software was used. Vessel density, the number of vessel junctions, and endpoints were measured and compared between the imaging modalities. Results The configuration of the superficial capillary network was comparable with OCT-A and flat-mount histology in BALBc mice. However, vessel density and the number of vessel junctions per region of interest (P = 0.0161 and P = 0.0015, respectively) in the deep vascular network of BALBc mice measured by OCT-A was significantly higher than with flat-mount histology. In C3A.Cg-Pde6b+Prph2Rd2/J mice, where the deep capillary plexus is absent, analysis of the superficial network provided similar results for all three imaging modalities. Conclusion OCT-A is a helpful imaging tool for noninvasive, in vivo imaging of the vascular plexus in mice. It may offer advantages over FA and confocal microscopy especially for imaging the deep vascular plexus. Translational Relevance The present study shows that OCT-A can be employed for small animal imaging to assess the vascular network and offers advantages over flat-mount histology and FA.

  8. CT coronary angiography versus conventional invasive coronary angiography. The view of the referring physician

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Martin H. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Universitaetsspital Bern (Switzerland). Dept. fuer Diagnostische, Interventionelle und Paediatrische Radiologie; Zimmermann, E.; Hamm, B. [Charite - Universitaetsmedizin Berlin (Germany). Dept. of Radiology; Dewey, M.

    2014-12-15

    Assessment of experience gained by local referring physicians with the procedure of coronary computed tomographic angiography (CCTA) in the everyday clinical routine. A 25-item questionnaire was sent to 179 physicians, who together had referred a total of 1986 patients for CCTA. They were asked about their experience to date with CCTA, the indications for coronary imaging, and their practice in referring patients for noninvasive CCTA or invasive catheter angiography. 53 questionnaires (30%) were assessable, corresponding to more than 72% of the patients referred. Of the referring physicians who responded, 94% saw a concrete advantage of CCTA in the treatment of patients, whereby 87% were 'satisfied' or 'very satisfied' with the reporting. For excluding coronary heart disease (CHD) where there was a low pre-test probability of disease, the physicians considered CCTA to be superior to conventional coronary diagnosis (4.2 on a scale of 1-5) and vice versa for acute coronary syndrome (1.6 of 5). The main reasons for unsuitability of CCTA for CT diagnosis were claustrophobia and the absence of a sinus rhythm. The level of exposure to radiation in CCTA was estimated correctly by only 42% of the referring physicians. 90% of the physicians reported that their patients evaluated their coronary CT overall as 'positive' or 'neutral', while 87% of the physicians whose patients had undergone both procedures reported that the patients had experienced CCTA as the less disagreeable of the two. CCTA is accepted by the referring physicians as an alternative imaging procedure for the exclusion of CHD and received a predominantly positive assessment from both the referring physicians and the patients.

  9. CT coronary angiography versus conventional invasive coronary angiography. The view of the referring physician

    International Nuclear Information System (INIS)

    Assessment of experience gained by local referring physicians with the procedure of coronary computed tomographic angiography (CCTA) in the everyday clinical routine. A 25-item questionnaire was sent to 179 physicians, who together had referred a total of 1986 patients for CCTA. They were asked about their experience to date with CCTA, the indications for coronary imaging, and their practice in referring patients for noninvasive CCTA or invasive catheter angiography. 53 questionnaires (30%) were assessable, corresponding to more than 72% of the patients referred. Of the referring physicians who responded, 94% saw a concrete advantage of CCTA in the treatment of patients, whereby 87% were 'satisfied' or 'very satisfied' with the reporting. For excluding coronary heart disease (CHD) where there was a low pre-test probability of disease, the physicians considered CCTA to be superior to conventional coronary diagnosis (4.2 on a scale of 1-5) and vice versa for acute coronary syndrome (1.6 of 5). The main reasons for unsuitability of CCTA for CT diagnosis were claustrophobia and the absence of a sinus rhythm. The level of exposure to radiation in CCTA was estimated correctly by only 42% of the referring physicians. 90% of the physicians reported that their patients evaluated their coronary CT overall as 'positive' or 'neutral', while 87% of the physicians whose patients had undergone both procedures reported that the patients had experienced CCTA as the less disagreeable of the two. CCTA is accepted by the referring physicians as an alternative imaging procedure for the exclusion of CHD and received a predominantly positive assessment from both the referring physicians and the patients.

  10. Pseudoaneurysm after pancreatoduodenectomy: diagnosis and embolization on angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jun Yong [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of); Lee, Sang Hyun; Kim, Sam Soo; Han, Heon; Chung, Hye Won [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Youn, Byung Jae; Han, Joon Koo; Choi, Byung Ihn; Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2002-08-01

    To evaluate the efficacy of angiography in the diagnosis and treatment of pseudoaneurysm manifesting arterial hemorrhage as a significant complication following pancreatoduodenectomy. For 51 months, of a total of 298 patients who had undergone pancreatoduodenectomy, 19 patients (6.4%) developed clinically significant hemorrhage and nine patients proved to have a pseudoaneurysm of angiography. These nine patients (3.0%) were managed by transcatheter arterial embolization. We analyzed clinical feature, angiography findings and hemostatic effect of embolization retrospectively. In nine patients (3.0%), pseudoaneurysm was diagnosed on angiography (common hepatic artery in four, gastroduodenal artery in three, proper hepatic artery in one, and left gastroepoploic artery in on patient). The size ranged from 0.3 cm to 6.5 cm (mean 1.9 cm). And extravasation was noted in five patients (55.6%). The remained ten patients showed no evidence of bleeding on angiography. Those who manifested as early bleeding (within two weeks) or delayed bleeding ( later than two weeks) were five and four patients respectively. Before the onset of major bleeding, among the nine pseudoaneurysm patients, seven patients (77.8%) had experienced percutaneous drainage due to intra-abdominal fluid collection with or without abscess resulting from anastomotic leak, and all nine patients had preliminary minor bleeding. The angiogram demonstrated an exact site of bleeding as a pseucoaneurysm followed by transcatheter arterial embolization (microcoil in eight patients, gelfoam in one) and achieved complete hemostasis yielding a success rate of 100%. Overall, no patients experienced complications related directly to the transcatheter arterial embolization technique. During the follow-up period (72-1, 336days, mean 640), no recurrence of bleeding was note. Although pseudoaneurysm is a rare complication, it is important as a cause of hemorrhage after pancreatoduodenectomy. Angiography followed by

  11. Wounded penetrating to neck: Angiotomography helical vs conventional Angiography

    International Nuclear Information System (INIS)

    Purpose: to determine the diagnostic potential of helical CT angiography (HCTA) in the assessment of arterial injuries resulting from penetrating neck trauma. Materials and methods: forty-seven adult patients with penetrating neck trauma who were referred for angiographic evaluation of suspected arterial injuries were included in the study. All patients underwent both conventional angiography and HCTA within 1 hour, our protocol included a 100 cc nonionic contrast bolus automatically injected at 4.5 cc/sec, with 11 sec scan delay. Scan parameters were: 120 kV, 200 mAs, slice thickness 3 mm and table speed 4 mm/sec. the volumetric data set was reconstructed retrospectively at 1 mm intervals. Three-dimensional and two-dimensional reconstructions were performed at a separate workstation. Two radiologists who were blinded to clinical and angiographic data interpreted the images. HCTA findings were compared with those of conventional angiography and surgery. Results: eight patients (17%) had carotid artery injuries: internal carotid artery occlusion (n=2), arteriovenous fistula with associated carotid pseudoaneurysm (n=1), arteriovenous fistula with vertebral artery pseudoanurysm (n=2) and common carotid pseudoaneurysm (n=2). seven of these arterial injuries were demonstrated by both HCTA and angiography, there was one false negative case. in the remaining 39 patients, HCTA and conventional angiography showed normal carotid arteries; therefore sensitivity was 87.5%, specificity and positive predictive value 100% and negative predictive value 97.5%. Conclusion: our initial experience indicates that helical CT angiography is an adequate non-invasive diagnostic method for the evaluation of patients with suspected arterial injuries resulting from penetrating trauma to the neck

  12. Optimization of Ecg Gating in Quantitative Femoral Angiography

    International Nuclear Information System (INIS)

    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase

  13. Optimization of Ecg Gating in Quantitative Femoral Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, S.; Berglund, I.; Erikson, U. [Univ. Hospital, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology; Johansson, J.; Walldius, G. [Karolinska Hospital, Stockholm (Sweden). King Gustav V Research Inst.

    2003-09-01

    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase.

  14. Evaluation of magnetic resonance angiography in detection of gastric varices

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Suga, Toshihiro [Sapporo Kosei General Hospital (Japan)

    1999-06-01

    We evaluated the detection of gastric varices, inflowing blood vessels to gastric varices, and outflowing blood vessels from gastric varices via magnetic resonance (MR) angiography in 31 patients with gastric varices. Twenty-four patients had F{sub 2} type varices and 7 had F{sub 3} type, classified according to the Japanese Research Society for Portal Hypertension. Seventeen patients had cardiofornical varices, and 14 had fundal varices. All patients were examined with an MR system operating at 1.5 T. MR angiography was performed using the two-dimensional time-of-flight method. With MR angiography, the imaging of gastric varices was clearly delineated in 28 of the 31 patients (90.3%). From the images of MR angiography, flow direction itself cannot be determined. The outflowing blood vessels of gastric varices were reported to be the gastro-renal shunt and the subphrenic vein, and angiographic findings have shown the inflowing blood vessels to be the left gastric vein (LGV), the short gastric vein (SGV), and the posterior gastric vein (PGV). In 25 of the 31 patients (80.7%), the outflowing blood vessels from gastric varices were detected (gastro-renal shunt in 24; subphrenic vein in 1). MR angiography provided clear images of the inflowing blood vessels to gastric varices in 18 of the 31 patients (58.1%). These inflowing vessels were categorized as SGV in 7 patients, LGV in 5, LGV and SGV in 4, and LGV and PGV in 2. We suggest that MR angiography be used as a routine method for detecting and diagnosing collateral veins in patients with gastric varices. (author)

  15. Detection of viable myocardium using coronary angiography and ventriculography.

    Science.gov (United States)

    Conti, C Richard

    2002-08-01

    In 2002, coronary angiography is the only way to assess precisely the combination of proximal stenoses, distal target vessels, collaterals, microcirculation, and TIMI antegrade flow. At the time of coronary angiography, global LV function is best determined using biplane ventriculography in order to correlate wall motion with coronary stenoses, distal target vessels, microcirculation, collaterals, and antegrade TIMI flow. This can be done under resting conditions after nitrates or after postextrasystolic potentiation. The absolute diagnosis of viability can only be made retrospectively. Large areas of ischemic viable myocardium should improve contraction after revascularization, decrease symptoms, and prolong survival.

  16. A comparison of iopamidol and iohexol in cerebral angiography.

    Science.gov (United States)

    Pelz, D M; Fox, A J; Viñuela, F; Lylyk, P

    1988-01-01

    Iopamidol and iohexol, the new nonionic low-osmolality contrast agents, have both been shown to be safe, effective, and better tolerated than conventional ionic agents for cerebral angiography. In this randomized, double-blind study involving 40 patients, these two agents were compared for adverse effects, radiographic quality, and patient tolerance. No significant differences were observed in 220 injections. Because we found iopamidol and iohexol to be equally safe and effective for cerebral angiography, the choice of which contrast agent to use should be based on other considerations.

  17. Digital subtraction angiography in head and neck radiology

    Energy Technology Data Exchange (ETDEWEB)

    Carmody, R.F.; Seeger, J.F.; Smith, R.L.; Horsley, W.W.; Miller, R.W.

    1984-07-01

    Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally.

  18. The Impact of Aromatherapy on the Anxiety of Patients Experiencing Coronary Angiography

    OpenAIRE

    Homeyra Tahmasbi; Ghahraman Mahmoodi; Vahid Mokhberi; Soghra Hassani; Homeyra Akbarzadeh; Niloofar Rahnamai

    2012-01-01

    Background: Anxiety among patients experiencing coronary angiography increases within invasive studies including angiography. Anxiety as an intensifier at cardiovascular reactions can endanger patients in angiography clinics. Studies indicate that lavendula spica L. inhalation can decrease anxiety. The purpose of this study is to determine the impact of aromatherapy on the anxiety level of patients experiencing coronary angiography. Materials and Methods: This research is a clinical trial st...

  19. Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To analyze the accuracy of computed tomography (CT) angiography in the diagnosis of acute gastrointestinal (GI) bleeding. METHODS: The MEDLINE, EMBASE, Cancerlit, Cochrane Library database, Sciencedirect, Springerlink and Scopus, from January 1995 to December 2009, were searched for studies evaluating the accuracy of CT angiography in diagnosing acute GI bleeding. Studies were included if the ycompared CT angiography to a reference standard of upper GI endoscopy, colonoscopy, angiography or surgery in ...

  20. Clinical application of magnetic resonance angiography for coronary arteries. Correlation with conventional angiography and evaluation of imaging time

    Energy Technology Data Exchange (ETDEWEB)

    Nitatori, Toshiaki; Hanaoka, Hideto; Yoshino, Ayako [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine] [and others

    1995-08-01

    Magnetic resonance angiography (MRA) of the coronary arteries is a particularly difficult task because of the small size of the vessels and cardio-respiratory motion. The authors describe a method of performing of ultrafast MRA of the coronary arteries with a standard MR system and body coil. Each image was obtained within a single breath hold by `segmented Turbo FLASH` sequences using an electro-cardiography gate. Clinical application was performed in 20 patients with ischemic heart disease, and a comparison was made with conventional coronary angiography. The imaging time was shortened significantly by our methods. The diagnosis was made by at least two different images to avoid false positives. The results indicated a good correlation between MRA and conventional angiography. (author).

  1. Multimodality evaluation of dural arteriovenous fistula with CT angiography, MR with arterial spin labeling, and digital subtraction angiography: case report.

    Science.gov (United States)

    Alexander, Matthew; McTaggart, Ryan; Santarelli, Justin; Fischbein, Nancy; Marks, Michael; Zaharchuk, Greg; Do, Huy

    2014-01-01

    Dural arteriovenous fistulae (DAVF) are cerebrovascular lesions with pathologic shunting into the venous system from arterial feeders. Digital subtraction angiography (DSA) has long been considered the gold standard for diagnosis, but advances in noninvasive imaging techniques now play a role in the diagnosis of these complex lesions. Herein, we describe the case of a patient with right-side pulsatile tinnitus and DAVF diagnosed using computed tomography angiography, magnetic resonance with arterial spin labeling, and DSA. Implications for imaging analysis of DAVFs and further research are discussed. PMID:23746119

  2. Value of abdominal angiography in Turner's syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Barreto, A.; Castaneda-Zuniga, W.R.; Velasquez, G.; Zollikofer, C.; Amplatz, K.

    1981-01-01

    In patients with Turner's syndrome, there is a relatively high incidence of gastrointestinal bleeding due to telangiectasias of the intestine. Despite the importance of preoperative diagnosis of the lesion in planning surgical treatment. The related angiographic findings have never been reported. We have studied one patient in whom the diagnosis was established by preoperative angiography.

  3. Bilateral persistent trigeminal artery variants diagnosed by MR angiography.

    Science.gov (United States)

    Uchino, Akira

    2011-12-01

    A persistent trigeminal artery (PTA) is the most common anastomosis between the carotid and vertebrobasilar system. A PTA variant (PTAV) is a rare anomaly in which the cerebellar artery arises from the internal carotid artery (ICA) without connection with the basilar artery (BA). I present what I believe is the first report of bilateral PTAVs diagnosed using magnetic resonance (MR) angiography and briefly discuss the embryology of this rare anomaly. An 81-year-old woman with small infarctions underwent cerebral MR imaging and MR angiography with a 1.5-tesla imager for the evaluation of brain lesions. An MR angiography was obtained using the standard noncontrast three-dimensional time-of-flight technique. The MR angiographic demonstration of bilateral anterior inferior cerebellar arteries arising from the precavernous segment of the ICA without anastomosis to the BA indicated bilateral PTAVs. This is the first report of bilateral PTAVs diagnosed by MR angiography. The literature review indicates that an estimated prevalence of bilateral PTAVs is about 0.0012%. PMID:21544587

  4. Evaluation of angiography performed by radiographers and nurses

    International Nuclear Information System (INIS)

    AIM: To evaluate out-patient angiography performed by nurses and radiographers. MATERIALS AND METHODS: A protocol for out-patient angiography performed by nurses and radiographers was drawn up and approved by the Trust's Risk Management Committee. Following training, two experienced radiographers and one nurse undertook elective peripheral or renal angiography according to the protocol on 187 patients. Angiograms were performed using a 3F catheter introduced into the abdominal aorta from a femoral approach. Patients were discharged after 2 hours and contacted by telephone the following morning. RESULTS: No patient refused consent for the procedure. One hundred and seventy-two patients underwent successful catheterization without assistance from a radiologist. Radiologist assistance was required with femoral puncture or catheter/guidewire manipulation in 15 cases (8%). Images were considered diagnostic by the reporting radiologist in all but one case. This patient was recalled for further aortogram and pressure measurements. There was a single puncture site complication due to transient stenosis of the common femoral artery at the puncture site. This is thought to have been the result of subintimal injection of local anaesthetic, and it resolved spontaneously over 30 minutes. There were no delayed complications. CONCLUSION: Experienced nurses and radiographers can rapidly acquire the skills to perform diagnostic angiography safely and efficiently. Chalmers, N. et al. (2002)

  5. Preoperative CT angiography reduces surgery time in perforator flap reconstruction

    NARCIS (Netherlands)

    Smit, Jeroen M.; Dimopoulou, Angeliki; Liss, Anders G.; Zeebregts, Clark J.; Kildal, Morten; Whitaker, Iain S.; Magnusson, Anders; Acosta, Rafael

    2009-01-01

    The use of perforator flaps in breast reconstructions has increased considerably in the past decade. A disadvantage of the perforator flap is difficult dissection, which results in a longer procedure. During spring 2006, we introduced CT angiography (CTA) as part of the diagnostic work-up in perfora

  6. The value of abdominal angiography in Turner's syndrome

    International Nuclear Information System (INIS)

    In patients with Turner's syndrome, there is a relatively high incidence of gastrointestinal bleeding due to telangiectasias of the intestine. Despite the importance of preoperative diagnosis of the lesion in planning surgical treatment. The related angiographic findings have never been reported. We have studied one patient in whom the diagnosis was established by preoperative angiography. (orig.)

  7. Non-enhanced MR angiography of renal arteries - Comparison with contrast-enhanced MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Angeretti, M. G.; Lumia, D.; Cani, A.; Barresi, M.; Cardim, L Nocchi; Piacentino, F.; Genovese, E. A.; Fugazzola, C. [Dept. of Radiology, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy)], e-mail: laranocchi@gmail.com; Maresca, A. M. [Dept. of Internal Medicine, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy); Novario, R. [Dept. of Medical Physics, Insubria Univ., Ospedale di Circolo e Fondazione Macchi, Varese (Italy)

    2013-09-15

    Background: The main causes of renal artery stenosis (RAS) are atherosclerosis and fibromuscular dysplasia. Despite contrast-enhanced magnetic resonance angiography (CE-MRA) being a safe and reliable method for diagnosis of RAS especially in young individuals, recently it has been possible to adopt innovative technologies that do not require paramagnetic contrast agents. Purpose: To assess the accuracy of steady-state free-precession (SSFP) non-contrast-enhanced magnetic resonance angiography (NC-MRA) by using a 1.5 T MR scanner for the detection of renal artery stenosis, in comparison with breath-hold CE-MRA as the reference standard. Material and Methods: Sixty-three patients (33 men, 30 women) with suspected renovascular hypertension (RVHT) were examined by a 1.5T MR scanner; NC-MRA with an electrocardiography (ECG)-gated SSFP sequence was performed in 58.7% (37/63) of patients; in 41.3% (26/63) of patients a respiratory trigger was used in addition to cardiac gating. CE-MRA, with a three-dimensional gradient echo (3D-GRE) T1-weighted sequence, was performed in all patients within the same session. Maximum intensity projection (MIP) image quality, number of renal arteries, and the presence of stenosis were assessed by two observers (independently for NC-MRA and together for CE-MRA). The agreement between NC-MRA and CE-MRA as well as the inter-observer reproducibility were calculated with Bland-Altman plots. Results: MIP image quality was considered better for NC-MRA. NC-MRA identified 143 of 144 (99.3%) arteries detected by CE-MRA (an accessory artery was not identified). Fourteen stenoses were detected by CE-MRA (11 atherosclerotic, 3 dysplastic) with four of 14 (28.5%) significant stenosis. Bland-Altman plot demonstrated an excellent concordance between NC-MRA and CE-MRA; particularly, the reader A evaluated correctly all investigated arteries, while over-estimation of two stenoses occurred for reader B. Regarding NC-MRA, inter-observer agreement was excellent

  8. Case Report of Bullous Pemphigoid following Fundus Fluorescein Angiography

    Directory of Open Access Journals (Sweden)

    Goktug Demirci

    2010-05-01

    Full Text Available Purpose: To report a first case of bullous pemphigoid (BP following intravenous fluorescein for fundus angiography. Clinical Features: A 70-year-old male patient was admitted to the intensive care unit with BP and sepsis. He reported a history of fundus fluorescein angiography with a pre-diagnosis of senile macular degeneration 2 months prior to presentation. At that time, fluorescein extravasated at the antecubital region. Following the procedure, pruritus and erythema began at the wrists bilaterally, and quickly spread to the entire body. The patient also reported a history of allergy to human albumin solution (Plamasteril®; Abbott 15 years before, during bypass surgery. On dermatologic examination, erythematous patches were present on the scalp, chest and anogenital region. Vesicles and bullous lesions were present on upper and lower extremities. On day 2 of hospitalization, tense bullae appeared on the upper and lower extremities. The patient was treated with oral methylprednisolone 48 mg (Prednol®; Mustafa Nevzat, topical clobetasol dipropionate 0.05% cream (Dermovate®; Glaxo SmithKline, and topical 4% urea lotion (Excipial Lipo®; Orva for presumptive bullous pemphigoid. Skin punch biopsy provided tissue for histopathology, direct immunofluorescence examination, and salt extraction, which were all consistent with BP. After 1 month, the patient was transferred to the intensive care unit with sepsis secondary to urinary tract infection; he died 2 weeks later from sepsis and cardiac failure. Conclusions: To our knowledge, this is the first reported case of BP following fundus fluorescein angiography in a patient with known human albumin solution allergy. Consideration should be made to avoid fluorescein angiography, change administration route, or premedicate with antihistamines in patients with known human albumin solution allergy. The association between fundus fluorescein angiography and BP should be further investigated.

  9. Three-Dimensional Respiratory-Gated Coronary Mr Angiography with Reference to X-Ray Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ikonen, A. E. J.; Manninen, H. I.; Vainio, P.; Vanninen, R. L.; Matsi, P. J.; Soimakallio, S. [Kuopio Univ. Hospital (Finland). Dept. of Clinical Radiology; Hirvonen, T.P.J.; Hartikainen, J.E.K. [Kuopio Univ. Hospital (Finland). Dept. of Medicine

    2003-11-01

    Purpose: To assess the clinical value of three-dimensional coronary MR angiography (CMRA) in the detection of significant coronary artery stenosis using conventional X-ray angiography as the standard reference. Material and Methods: Sixty-nine patients underwent X-ray coronary angiography and CMRA because of suspected or previously diagnosed coronary artery disease. MRI was performed with a 1.5-T whole body imaging system using ECG-triggered 3D gradient echo sequence with retrospective navigator echo respiratory gating and fat suppression. Results: A total of 276 coronary artery segments were analyzed. The X-ray coronary angiography was normal in 22 patients. Significant proximal stenoses (exceeding 50%) or occlusions were present in 102 coronary artery segments. In all, 120 stenoses or occlusions were identified in CMRA. Sixteen percent of the coronary artery segments had to be excluded because of poor image quality. The overall sensitivity and specificity for MRA for identification of significant stenosis were 75% and 62%, respectively. CMRA correctly detected 89% of patients with at least one vessel disease, but 6 patients with coronary artery disease would have been missed. Conclusions: Because of the high data exclusion and false-negative case rate, CMRA with retrospective navigator echo triggering is at present not suitable as a clinical screening method in coronary artery disease.

  10. Contrast-enhanced MR angiography of abdominal vessels: Is there still a role for angiography?

    Energy Technology Data Exchange (ETDEWEB)

    Vosshenrich, R.; Fischer, U. [Department of Radiology, Georg-August-Universitaet Goettingen (Germany)

    2002-01-01

    The purpose of this review article is to describe recent advantages in contrast-enhanced (CE) three-dimensional (3D) magnetic resonance angiography (MRA) in comparison with other vascular imaging techniques, and to discuss their current clinical applications for the imaging of abdominal vessels. Principles and technical considerations are presented and clinical applications are reviewed for different vascular diseases. In ruptured aortic aneurysms and acute dissections CT is the method of first choice. Contrast-enhanced 3D MRA can be well used for therapeutic planning and follow-up in patients with stable disease. A comprehensive MR examination including CE 3D MRA, MR urography and MR nephrogram has the potential to replace the conventional studies for the evaluation of renal vascular disease. It is an accurate method for imaging the origins of coeliac and superior mesenteric arteries, although the image resolution is too low for reliable assessment of the inferior mesenteric artery. Contrast-enhanced 3D MRA has emerged as the method of choice for studying the portal venous system in liver transplant recipients, in patients with portal hypertension and in cases with abdominal tumours for preoperative evaluation. Additional non-invasive flow measurements are useful in monitoring portal hypertension. The abdominal veins can be well imaged using unenhanced MR techniques. Imaging may be facilitated with intravascular contrast media. Contrast-enhanced 3D MRA can replace intra-arterial DSA for diagnosis, therapy planning and follow-up in patients with abdominal vascular disease. Catheter-based arteriography will still be used for interventional procedures such as percutaneous transluminal angioplasty, stent placement and embolisation. (orig.)

  11. Current principles in the use of diagnostic coronary angiography

    International Nuclear Information System (INIS)

    Current principles in designing diagnostic coronary angiography by taken into account of fundamental achievements in endovascular medicine in diagnosing and treating various heart diseases are presented. Basic qualitative and quantitative requirements for X-ray contrast study of cardiac vessels to enhance the information value of coronary angiography are given. Necessary diagnostic criteria to be achieved during the study to choose a surgical or endovascular treatment are considered. The present-day accumulated data on X-ray anatomic features of coronary vessels in coronary heart disease are classified. Current classifications of coronary circulation, principles in the development of collateral blood supply, main sources of collaterals, and the specific features of the coronary bed in patients with coronary heart disease are also given

  12. Towards the use of OCT angiography in clinical dermatology

    Science.gov (United States)

    Baran, Utku; Choi, Woo June; Wang, Ruikang K.

    2016-02-01

    Optical coherence tomography (OCT) is a popular imaging technique used in ophthalmology, and on the way to become clinically viable alternative in dermatology due to its capability of acquiring histopathology level images of in vivo tissue, noninvasively. In this study, we demonstrate the capabilities of OCT-based angiography (OMAG) in detecting high-resolution, volumetric structural and microvascular features of in vivo human skin with various conditions using a swept source OCT system that operates on a central wavelength of 1310 nm with an A-line rate of 100 kHz. OMAG images provide detailed in vivo visualization of microvasculature of abnormal human skin conditions from face, chest and belly. Moreover, the progress of wound healing on human skin from arm is monitored during longitudinal wound healing process. The presented results promise the clinical use of OCT angiography in treatment of prevalent cutaneous diseases within human skin, in vivo.

  13. The need for repeat angiography in subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H.; Solymosi, L. [Department of Neuroradiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Zentner, J. [Department of Neurosurgery, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany)

    1998-01-01

    This study was designed to assess the necessity for a second angiogram study in patients in whom initial angiography after primary subarachnoid haemorrhage (SAH) was negative. During a 12-year period, 122 of 694 patients (17.5 %) had negative initial angiograms. CT, available for 98 patients, showed a preponderance of subarachnoid blood in the perimesencephalic cisterns in 50 of 73 patients (68.5 %) in whom blood was visible on CT. Angiography, repeated in 67 patients, revealed an aneurysm in 4 (6 %): 2 had an aneurysm of the anterior communicating artery, 1 of the posterior inferior cerebellar artery, and 1 of the P2 segment of the posterior cerebral artery. CT showed subarachnoid blood in the interpeduncular and ambient cisterns in this last case, and a preponderance of subarachnoid blood outside the perimesencephalic cisterns in the remaining 3 patients. (orig.) With 2 figs., 1 tab., 32 refs.

  14. Ultrahigh-speed non-invasive widefield angiography

    Science.gov (United States)

    Blatter, Cedric; Klein, Thomas; Grajciar, Branislav; Schmoll, Tilman; Wieser, Wolfgang; Andre, Raphael; Huber, Robert; Leitgeb, Rainer A.

    2012-07-01

    Retinal and choroidal vascular imaging is an important diagnostic benefit for ocular diseases such as age-related macular degeneration. The current gold standard for vessel visualization is fluorescence angiography. We present a potential non-invasive alternative to image blood vessels based on functional Fourier domain optical coherence tomography (OCT). For OCT to compete with the field of view and resolution of angiography while maintaining motion artifacts to a minimum, ultrahigh-speed imaging has to be introduced. We employ Fourier domain mode locking swept source technology that offers high quality imaging at an A-scan rate of up to 1.68 MHz. We present retinal angiogram over ˜48 deg acquired in a few seconds in a single recording without the need of image stitching. OCT at 1060 nm allows for high penetration in the choroid and efficient separate characterization of the retinal and choroidal vascularization.

  15. Magnetic resonance tomographic angiography: diagnostic value in trigeminal neuralgia

    International Nuclear Information System (INIS)

    A combination of MRI, MR angiography and MR tomographic angiography (MRTA) was used to study the relationship of the root exit zone of the trigeminal nerve to surrounding vascular structures in seven patients with trigeminal neuralgia (TN) and ten patients with no evidence at a lesion in this region. MRTA is the technique for showing the relationship between vessels, cranial nerves and brain stem. MRTA clearly demonstrated the presence of a vessel at the root exit zone of the trigeminal nerve in all patients with TN. In the ten other patients, examination of 20 trigeminal nerves revealed that only one nerve (5%) was in contact with a vessel at the root exit zone. This study supports vascular compression of trigeminal nerves as a cause of TN, and demonstrates the value of MRTA as noninvasive technique for demonstrating compression. (orig.)

  16. Magnetic resonance tomographic angiography: diagnostic value in trigeminal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Umehara, F. [Third Dept. of Internal Medicine, Faculty of Medicine, Kagoshima Univ. (Japan); Kamishima, K. [Div. of Diagnostic Neuroradiology, Kagoshima Univ. (Japan); Kashio, N. [Third Dept. of Internal Medicine, Faculty of Medicine, Kagoshima Univ. (Japan); Yamaguchi, K. [Div. of Diagnostic Neuroradiology, Kagoshima Univ. (Japan); Sakimoto, T.; Osame, M. [Third Dept. of Internal Medicine, Faculty of Medicine, Kagoshima Univ. (Japan)

    1995-07-01

    A combination of MRI, MR angiography and MR tomographic angiography (MRTA) was used to study the relationship of the root exit zone of the trigeminal nerve to surrounding vascular structures in seven patients with trigeminal neuralgia (TN) and ten patients with no evidence at a lesion in this region. MRTA is the technique for showing the relationship between vessels, cranial nerves and brain stem. MRTA clearly demonstrated the presence of a vessel at the root exit zone of the trigeminal nerve in all patients with TN. In the ten other patients, examination of 20 trigeminal nerves revealed that only one nerve (5%) was in contact with a vessel at the root exit zone. This study supports vascular compression of trigeminal nerves as a cause of TN, and demonstrates the value of MRTA as noninvasive technique for demonstrating compression. (orig.)

  17. Time-resolved CT angiography in aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Meinel, Felix G., E-mail: felix.meinel@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Nikolaou, Konstantin, E-mail: konstantin.nikolaou@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Weidenhagen, Rolf, E-mail: rolf.weidenhagen@med.uni-muenchen.de [Department of Surgery, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Hellbach, Katharina, E-mail: katharina.hellbach@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Helck, Andreas, E-mail: andreas.helck@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Bamberg, Fabian, E-mail: fabian.bamberg@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Reiser, Maximilian F., E-mail: maximilian.reiser@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Sommer, Wieland H., E-mail: wieland.sommer@med.uni-muenchen.de [Department of Clinical Radiology, Ludwig Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany)

    2012-11-15

    Objectives: We performed this study to assess feasibility and additional diagnostic value of time-resolved CT angiography of the entire aorta in patients with aortic dissection. Materials and methods: 14 consecutive patients with known or suspected aortic dissection (aged 60 {+-} 9 years) referred for aortic CT angiography were scanned on a dual-source CT scanner (Somatom Definition Flash; Siemens, Forchheim, Germany) using a shuttle mode for multiphasic image acquisition (range 48 cm, time resolution 6 s, 6 phases, 100 kV, 110 mAs/rot). Effective radiation doses were calculated from recorded dose length products. For all phases, CT densities were measured in the aortic lumen and renal parenchyma. From the multiphasic data, 3 phases corresponding to a triphasic standard CT protocol, served as a reference and were compared against findings from the time-resolved datasets. Results: Mean effective radiation dose was 27.7 {+-} 3.5 mSv. CT density of the true lumen peaked at 355 {+-} 53 HU. Compared to the simulated triphasic protocol, time-resolved CT angiography added diagnostic information regarding a number of important findings: the enhancement delay between true and false lumen (n = 14); the degree of membrane oscillation (n = 14); the perfusion delay in arteries originating from the false lumen (n = 9). Other additional information included true lumen collapse (n = 4), quantitative assessment of renal perfusion asymmetry (n = 2), and dynamic occlusion of aortic branches (n = 2). In 3/14 patients (21%), these additional findings of the multiphasic protocol altered patient management. Conclusions: Multiphasic, time-resolved CT angiography covering the entire aorta is feasible at a reasonable effective radiation dose and adds significant diagnostic information with therapeutic consequences in patients with aortic dissection.

  18. Ischemic enterocolitis examined by colonoscopy and selective angiography

    Institute of Scientific and Technical Information of China (English)

    Lei He; He-Sheng Luo

    2005-01-01

    AIM: To study the value of colonoscopy and selective angiography in diagnosing ischemic enterocolitis.METHODS: Among the 16 cases under study, 10 cases had hypertension and a history of coronary artery disease (one was hospitalized for sub-ventricular-wall infarction). The blood pressure of 10 of the 16 cases ranged from 13.9-23.8 to 13.3-14.6 kPa (170-180/100-110 mmHg). Two cases had chronic auricular fibrillation, and in four cases, a cardiogram showed left-front branch conduction block. Sixteen patients were examined by colonoscopy. Among them, 14 cases had a long course of angiocardiac disease, and were further examined by selective mesenteric inferior angiography.RESULTS: The colonoscopy revealed local mucous hyperemia edema and blood on contact. Lesions were found in the sigmoid colon in four cases, in the descending colon in eight cases and in splenic flexure in four cases, which suggests that the lesion always appeared in the left part of colon. There were different degrees of inflammatory cell infiltration, submucous bleeding, edema, fibro-embolism and hemosiderosis by biopsy in the 16 patients whose membranes affect part of the enteral wall. Of the 14 patients examined by mesenteric inferior angiography, 3 cases showed mesenteric amphraxis inferior and formation of collateral circulation. There were different degrees of stenosis in the other 11 subjects' mesenteric inferior cavities which grew slim and their branches were stenotic, so the radiographic image was not complete and the ends of some branches even cannot be seen. CONCLUSION: The colonoscopy and the selective mesenteric inferior angiography are both helpful in the diagnosis of ischemic enterocolitis.

  19. Waiting for coronary angiography: is there a clinically ordered queue?

    Science.gov (United States)

    Hemingway, H; Crook, A M; Feder, G; Dawson, J R; Timmis, A

    2000-03-18

    Among over 3000 patients undergoing coronary angiography in the absence of a formal queue-management system, we found that a-priori urgency scores were strongly associated with waiting times, prevalence of coronary-artery disease, rate of revascularisation, and mortality. These data challenge the widely held assumption that such waiting lists are not clinically ordered; however, the wide variation in waiting times within urgency categories suggests the need for further improvements in clinical queueing.

  20. Indications for secondary cerebral angiography after primary negative imaging

    OpenAIRE

    Vassilev, Vladislav

    2015-01-01

    The following study evaluates digital subtraction angiography (DSA) as follow-up diabnostic the detection of vascular lesions in patients with perimesencephalic and non perimesencephalic subarachnoid hemorrhage (SAH) after initially negative primary noninvasive and invasive neurovascular imaging. In our Neurovascular Center we analyzed 372 patients with non traumatic SAH over a 14-years period. We used CT or CTA followed by DSA to confirm the diagnosis. Secondary examinations, either secon...

  1. Evaluation of vascular rings with digital subtraction angiography.

    Science.gov (United States)

    Tonkin, I L; Gold, R E; Moser, D; Laster, R E

    1984-06-01

    Seven patients with vascular rings were evaluated over a 2-year period with intravenous digital subtraction angiography (DSA), which was compared with screen-film aortography or cineangiography. The seven patients were also evaluated with barium esophagography. Six of the seven DSA images were totally diagnostic and one study was only partly diagnostic. Six of the seven vascular anomalies were confirmed surgically. DSA is suggested as an alternative to arteriography in evaluating patients with suspected vascular rings. PMID:6372419

  2. Digital subtraction angiography of a persistent trigeminal artery variant.

    Science.gov (United States)

    Temizöz, Osman; Genchellac, Hakan; Unlü, Ercüment; Cağli, Bekir; Ozdemir, Hüseyin; Demir, M Kemal

    2010-09-01

    Persistent trigeminal artery variants are described as cerebellar arteries that directly originate from the precavernous segment of the internal carotid artery. This has been observed in 0.18% of cerebral catheter angiograms. On the other hand, a persistent trigeminal artery variant feeding both the anterior inferior cerebellar artery and the posterior inferior cerebellar artery territory is very rare. We present this uncommon anomalous artery along with digital subtraction angiography findings and discuss its clinical significance in light of the literature. PMID:19821254

  3. Magnetic resonance angiography: current status and future directions

    OpenAIRE

    François Christopher J; Grist Thomas M; Hartung Michael P

    2011-01-01

    Abstract With recent improvement in hardware and software techniques, magnetic resonance angiography (MRA) has undergone significant changes in technique and approach. The advent of 3.0 T magnets has allowed reduction in exogenous contrast dose without compromising overall image quality. The use of novel intravascular contrast agents substantially increases the image windows and decreases contrast dose. Additionally, the lower risk and cost in non-contrast enhanced (NCE) MRA has sparked renew...

  4. Assessment of the kidneys: magnetic resonance angiography, perfusion and diffusion

    OpenAIRE

    Attenberger Ulrike I; Morelli John N; Schoenberg Stefan O; Michaely Henrik J

    2011-01-01

    Abstract Renal magnetic resonance (MR) imaging has undergone major improvements in the past several years. This review focuses on the technical basics and clinical applications of MR angiography (MRA) with the goal of enabling readers to acquire high-resolution, high quality renal artery MRA. The current role of contrast agents and their safe use in patients with renal impairment is discussed. In addition, an overview of promising techniques on the horizon for renal MR is provided. The clinic...

  5. Angiography suite concept for an interdisciplinary centre for cardiovascular interventions

    OpenAIRE

    Teichgräber, Ulf K. M.; Wintzer, Christian; Hamm, Bernd

    2010-01-01

    A permanently mounted angiography suite in an operating room (OR) is considered to be a hybrid OR. However, regular use for angiographic interventions is restricted with this setup. We introduce an alternative use of space for the efficient utilisation of an angiographic suite outside the surgical unit. This concept includes three scenarios that describe a modification of the catheter suite according to the specific clinical demands by adapting the workflow.

  6. Acoustic Angiography: A New Imaging Modality for Assessing Microvasculature Architecture

    Directory of Open Access Journals (Sweden)

    Ryan C. Gessner

    2013-01-01

    Full Text Available The purpose of this paper is to provide the biomedical imaging community with details of a new high resolution contrast imaging approach referred to as “acoustic angiography.” Through the use of dual-frequency ultrasound transducer technology, images acquired with this approach possess both high resolution and a high contrast-to-tissue ratio, which enables the visualization of microvascular architecture without significant contribution from background tissues. Additionally, volumetric vessel-tissue integration can be visualized by using b-mode overlays acquired with the same probe. We present a brief technical overview of how the images are acquired, followed by several examples of images of both healthy and diseased tissue volumes. 3D images from alternate modalities often used in preclinical imaging, contrast-enhanced micro-CT and photoacoustics, are also included to provide a perspective on how acoustic angiography has qualitatively similar capabilities to these other techniques. These preliminary images provide visually compelling evidence to suggest that acoustic angiography may serve as a powerful new tool in preclinical and future clinical imaging.

  7. Intracranial aneurysms: evaluation in 200 patients with spiral CT angiography

    International Nuclear Information System (INIS)

    The goal of this study was to assess the usefulness of spiral CT angiography (CTA) with three- dimensional reconstructions in defining intracranial aneurysms, particularly around the Circle of Willis. Two hundred consecutive patients with angiographic and/or surgical correlation were studied between 1993 and 1998, with CTA performed on a GE HiSpeed unit and Windows workstation. The following clinical situations were evaluated: conventional CT suspicion of an aneurysm; follow-up of treated aneurysm remnants or of untreated aneurysms; subarachnoid haemorrhage (SAH) and negative angiography; family or past aneurysm history; and for improved definition of aneurysm anatomy. Spiral CTA detected 140 of 144 aneurysms, and an overall sensitivity of 97%, including 30 of 32 aneurysms 3 mm or less in size. In 38 patients with SAH and negative angiography, CTA found six of the seven aneurysms finally diagnosed. There was no significant artefact in 17 of 23 patients (74%) with clips. The specificity of CTA was 86% with 8 false-positive cases. Spiral CTA is very useful in demonstrating intracranial aneurysms. (orig.)

  8. Ectopic Origin of Coronary Arteries Diagnozed by Coronary Angiography

    Science.gov (United States)

    Krasniqi, Xhevdet; Gorani, Daut; Sejdiu, Basri; Citaku, Hajdin

    2016-01-01

    Introduction: Anomalous origin of coronary arteries from opposite sinus of Valsalva is rare finding. The incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. The ectopic origin of left coronary artery or right coronary artery from opposite sinus depending on pathways and considering atherosclerotic changes are manifested with different clinical significance. Case report: We report two cases, the first case the coronary angiography showed the left coronary artery arising from the right coronary sinus, presenting with proximally and distally stenosed left anterior descending artery (LAD), associated with medial and distal stenosed right coronary artery (RCA). The second case the coronary angiography revealed the right coronary artery arising from the left coronary sinus, associated with tortuous medial and distal segments of left anterior descending artery (LAD), without atherosclerotic changes. The first case successfully underwent treatment procedures based on guidelines for revascularization. Conclusion: The coronary angiography of patients with coronary ischemia determines atherosclerotic disease with possibility of the presence of coronary artery anomalies that in cases with ectopic origin from opposite sinus continues to exist as a challenge during treatment in interventional cardiology. PMID:27482140

  9. Computed tomography angiography in patients with active gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Reis, Fatima Regina Silva; D' Ippolito, Giuseppe, E-mail: fatima.rsreis@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Cardia, P.P. [Hospital Vera Cruz, Campinas, SP (Brazil)

    2015-11-15

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding. (author)

  10. Carbon dioxide digital subtraction angiography manifestations of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    LU Wei; LI Yan-hao; HE Xiao-feng; CHEN Yong; ZENG Qing-le; XU Xiao-li

    2002-01-01

    Objective: To investigate the imaging features and clinical significance of carbon dioxide digital subtraction angiography (CO2-DSA) in the diagnosis and treatment of hepatocellular carcinoma (HCC).Methods: Both CO2-DSA and conventional DSA were performed in all 47 patients with HCC, and the angiographic manifestations of CO2-DSA were compared with those of conventional DSA in the same patients.Results: Peripheral arterial and capillary imaging by CO2-DSA was inferior to that by conventional DSA, although blood pools were well visualized with CO2. Improved visualization of arterioportal shunting (APS)was obtained with CO2-DSA compared with that by conventional angiography. APS was observed in 33 cases by CO2-DSA and in 12 cases by conventional angiography (P<0. 001). Retrograde visualization of the portal vein (PV) trunk and its large branches was demonstrated in 16 cases by CO2-DSA and in 1 case by conventional DSA (P<0. 001). The manifestation of lipiodol retention in the tumors was consistent with CO2-DSA images after TAE in 38 cases, and with those of conventional DSA in 23 cases (P<0. 01). Conclusion: CO2-DSA was superior to conventional DSA in the detection of APS and retrograde visualization of PV system,and the former can provide usefulness information for the treatment planning (chemoembolization) and patient prognosis. Demonstration of APS by CO2-DSA may suggest the presence of intrahepatic metastases.

  11. Delayed clopidogrel transit during myocardial infarction evident on angiography.

    Science.gov (United States)

    Ghobrial, Joanna; Gibson, C Michael; Pinto, Duane S

    2015-05-01

    We describe the case of a patient with non-ST segment elevation myocardial infarction (NSTEMI) where a limitation of oral clopidogrel loading prior to percutaneous coronary intervention (PCI) was directly visualized on angiography. Clopidogrel is a thienopyridine antiplatelet agent used in acute coronary syndromes. It reduces platelet aggregation via inhibition of the P2Y12 receptor. Clopidogrel is an inactive metabolite that is metabolized into the active metabolite by the cytochrome P450 isoenzymes located mostly in the liver and partly in the gastrointestinal system. As such, it requires at least 2 hours to reach maximal effect. A 63-year-old female went to an outside facility where she was diagnosed with NSTEMI and underwent angiography. She was administered 324 mg of aspirin and 600 mg of clopidogrel, and was transferred to our facility. Upon arrival, approximately 1.5 hours after the oral loading dose, the clopidogrel tablets were visualized intact in the stomach during angiography, implying a very low likelihood of adequate absorption or antiplatelet effect. This observation raises the concern that delayed gastrointestinal transit, apart from other metabolic derangements, may be a factor in achieving optimal platelet inhibition using oral agents. PMID:25929306

  12. Body MR angiography in children: how we do it.

    Science.gov (United States)

    Krishnamurthy, Rajesh; Malone, LaDonna; Lyons, Karen; Ketwaroo, Pamela; Dodd, Nicholas; Ashton, Daniel

    2016-05-01

    Vascular pathology is ubiquitous in children. Common indications for angiographic imaging in the body include congenital anomalies, portal hypertension, assessing resectability of neoplasms, renovascular hypertension, vascular malformations, vasculitis, systemic vein thrombosis, and trauma. MR angiography, with or without the use of intravenous contrast agents, is therefore a mainstay in the repertoire of MR imaging in children. Pediatric contrast-enhanced MR angiography has benefited from several innovations in recent years, including improved hardware options like high-field-strength scanners and integrated high-density coil arrays, new sequences that combine parallel imaging, innovative k-space sampling and Dixon fat suppression with time-resolved imaging, new contrast agents with longer blood-pool residence time, and advanced post-processing solutions like image fusion. This article focuses on the principles of contrast-enhanced MR angiography of the body as it pertains to the physiologies and pathologies encountered in children. It also discusses tools to adapt the MR angiographic technique to the clinical indication, as well as pitfalls of post-processing and interpretation in commonly encountered vascular imaging scenarios in the pediatric body. PMID:27229494

  13. Penile angiography and superselective embolization therapy in arterial priapism

    International Nuclear Information System (INIS)

    Purpose: To report feasibility, benefit and complications of penile angiography and superselective penile embolization in arterial priapism. Materials and Methods: Four consecutive patients (aged 28, 29, 40 and 49 years), who underwent penile angiography for arterial priapism (high-flow priapism) within a four-year period, were identified by a keyword search of our radiology information system. One patient had sustained a direct penile trauma (severe blow to the erected penis) and three patients suffered from recurrent spontaneous priapism. All patients had previously undergone corporeal aspiration and noradrenaline injection to achieve detumescence. Two patients had one or several unsuccessful spongiocavernous shunt procedures. Results: In three of the four patients, superselective pudendal and penile angiography demonstrated pathologic arteriocavernous shunting. In two of the three patients, superselective embolization using a coaxial micro-catheter was attempted. In one of the two patients, the cavernous artery became spastic before embolization material was actually injected, inducing immediate and lasting detumescence. In the other patient, unilateral Gelfoam embolization led to immediate detumescence but the priapism recurred 12 hours after the procedure. A subsequent contralateral Gelfoam embolization was successful. Erectile function was preserved in all cases. No procedure-related complications occurred. Conclusion: Our experience supports the prevailing opinion found in the current literature that superselective coaxial embolization constitutes the treatment of choice in patients with high-flow priapism. Prognosis is good with high probability of preserving the erectile function. (orig.)

  14. Computed tomography angiography in patients with active gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Fatima Regina Silva Reis

    2015-12-01

    Full Text Available Abstract Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding.

  15. CT Pulmonary Angiography and Suspected Acute Pulmonary Embolism

    Energy Technology Data Exchange (ETDEWEB)

    Enden, T.; Kloew, N.E. [Ullevaal Univ. Hospital, Oslo (Norway). Dept. of Cardiovascular Radiology

    2003-05-01

    Purpose: To evaluate the use and quality of CT pulmonary angiography in our department, and to relate the findings to clinical parameters and diagnoses. Material and Methods: A retrospective study of 324 consecutive patients referred to CT pulmonary angiography with clinically suspected pulmonary embolism (PE). From the medical records we registered clinical parameters, blood gases, D-dimer, risk factors and the results of other relevant imaging studies. Results: 55 patients (17%) had PE detected on CT. 39 had bilateral PE, and 8 patients had isolated peripheral PE. 87% of the examinations showing PE had satisfactory filling of contrast material including the segmental pulmonary arteries, and 60% of the subsegmental arteries. D-dimer test was performed in 209 patients, 85% were positive. A negative D-dimer ruled out PE detected at CT. Dyspnea and concurrent symptoms or detection of deep vein thrombosis (DVT), contraceptive pills and former venous thromboembolism (VTE) were associated with PE. The presence of only one clinical parameter indicated a negative PE diagnosis (p < 0.017), whereas two or more suggested a positive PE diagnosis (p < 0.002). CT also detected various ancillary findings such as consolidation, pleural effusion, nodule or tumor in nearly half of the patients; however, there was no association with the PE diagnosis. Conclusion: The quality of CT pulmonary angiography was satisfactory as a first-line imaging of PE. CT also showed additional pathology of importance in the chest. Our study confirmed that a negative D-dimer ruled out clinically suspected VTE.

  16. Data analysis on patient exposures in cardiac angiography

    Energy Technology Data Exchange (ETDEWEB)

    Huyskens, C.J.; Hummel, W.A. [Eindhoven University of Technology (Netherlands). Radiation Protection Dept.

    1995-12-31

    In cardiac interventional radiology the fluoroscopy time and the film length are dominating factors for the resulting exposure of patients. From experiments in laboratory conditions and from measurements in actual practice an empirical formula has been derived to calculate the kerma-exposure product as a function of fluoroscopy time and film length. to simulate actual medical practice as closely as possible during the experiments, reference procedures were composed for fluoroscopy and cine-angiography. Over a period of two years, data on fluoroscopy time and cine film length were collected in the clinical practice of a large cardiology department in a major hospital in the Netherlands. The data refer to nearly 3000 cardiac intervention procedures, 50/50 divided between cardio-angiography (CAG) and percutaneous transluminal coronary angiography (PTCA). The mean value for the kerma-area product over all cardiac procedures is approx. 40 Gy cm{sup 2}. The relative standard deviation is 60%. From the distribution measured, it follows that about 20 % of all cardiac procedures account for approximately half the collective dose for patients. The empirically derived fit-function to calculate the kerma-area product provides a useful method to analyse patient exposures in interventional radiology as an aid in the context of quality assurance of medical practice and ALARA programmes in radiological protection. (Author).

  17. Evaluation of preoperative computed tomography angiography in association with conventional angiography versus computed tomography angiography only, in the endovascular treatment of aortic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, Patrick Bastos; Novero, Eduardo Rafael; Rossi, Fabio Henrique; Moreira, Samuel Martins; Linhares, Frederico Augusto; Almeida, Bruno Lorencao de; Barbato, Heraldo Antonio; Izukawa, Nilo Mitsuru; Kambara, Antonio Massamitsu, E-mail: patrickvascular@gmail.com [Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP (Brazil)

    2013-09-15

    Objective: to evaluate the association of conventional angiography (AG) with computed tomography angiography (CTA) as compared with CTA only, preoperatively, in the treatment of aortic diseases. Materials and methods: retrospective study involving patients submitted to endovascular treatment of aortic diseases, in the period from January 2009 to July 2010, with use of preoperative CTA + conventional AG or CTA only. The patients were divided into two groups, namely: G1 - thoracic aortic diseases; and G2 - abdominal aortic diseases. G1 was subdivided into 1A (preoperative AG + CTA) and 1B (preoperative CTA). G2 was subdivided into 2C (CTA + AG) and 2D (CTA only). Results: the authors evaluated 156 patients. In subgroups 1A and 1B, the rate of technical success was, respectively, 100% and 94.7% (p = 1.0); and the rate of therapeutic success was, respectively, 81% and 58% (p = 0.13). A higher number of complications were observed in subgroup 1B (p = 0.057). The accuracy in the calculation of the prosthesis was higher in subgroup 1A (p = 0.065). In their turn, the rate of technical success in subgroups 2C and 2D was, respectively, 92.3% and 98.6% (p = 0.17). The rate of therapeutic success was 73% and 98.6% (p = 0.79). Conclusion: preoperative conventional AG should be reserved for cases where CTA cannot provide all the information in the planning of a therapeutic intervention. (author)

  18. 3D Multislice CT Angiography in Post-Aortic Stent Grafting: A Pictorial Essay

    International Nuclear Information System (INIS)

    Helical CT angiography has been widely used in both pre- and post-aortic stent grafting and it has been confirmed to be the preferred modality when compared to conventional angiography. The recent development of multislice CT (MSCT) has further enhanced the applications of CT angiography for aortic stent grafting. One of the advantages of MSCT angiography over conventional angiography is that the 3D reconstructions, based on the volumetric CT data, provide additional information during follow-up of aortic stent grafting. While endovascular repair has been increasingly used in clinical practice, the use of 3D MSCT imaging in endovascular repair continues to play an important role. In this pictorial essay, we aimed to discuss the diagnostic performance of 3D MSCT angiography in post aortic stent grafting, including the most commonly used surface shaded display, curvilinear reformation, the maximum intensity projection, volume rendering and virtual endoscopy. The advantages and disadvantages of each 3D reconstruction are also explored

  19. Preoperative evaluation of the artery of adamkiewicz by MR angiography and CT angiography in patients with a thoracic aortic aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Niinuma, Hiroyuki; Ohira, Atsushi; Makita, Shinji; Moriai, Yoshiteru; Hiramori, Katsuhiko [Iwate Medical Univ., Morioka (Japan). School of Medicine; Yoshioka, Kunihiro; Nakajima, Takayuki; Kawazoe, Kohei [Iwate Medical Univ., Morioka (Japan). Memorial Heart Center

    2002-08-01

    Paraplegia is known as an extremely serious and important complication of surgical repair in patients with a thoraco-abdominal aortic aneurysm. It is important to evaluate the artery of Adamkiewicz (AdA) before surgical repair to prevent paraplegia. But the AdA is difficult to visualize by the invasive and hazardous, conventional selective angiography. The aim of this study was to visualize AdA by MR angiography (MRA) and CT angiography (CTA). Twenty-one consecutive patients with a thoracic aortic aneurysm underwent both gadolinium-enhanced, three-dimensional MRA and CTA using multislice helical CT. The AdA was successfully visualized in 15 of the 21 patients (71.4%) by MRA, and in 17 of those 21 patients (80.9%) by CTA. Its continuity was depicted in 12 of 15 patients (80%) by MRA, and in 9 of 17 patients (47%) by CTA. AdA was visualized at 85.7% by MRA or CTA, respectively. This study shows that CTA is a much more sensitive method to detect AdA than MRA. On the other hand, MRA is better to evaluate the continuity of AdA from the descending aorta to the anterior spinal artery, than CTA. Therefore, MRA and CTA are both useful for a preoperative evaluation of AdA and its detailed vascular anatomy from the aorta to the anterior spinal artery. (author)

  20. Persistent Trigeminal Artery Variant Detected by Conventional Angiography and Magnetic Resonance Angiography-Incidence and Clinical Significance-

    Science.gov (United States)

    Rhee, Sun Joo; Lee, Chae Heuck; Lee, Ghi Jai

    2007-01-01

    Objective Persistent trigeminal artery variant (PTAV) is an anastomosis between the internal carotid artery (ICA) and the cerebellar artery without any interposing basilar artery segment. We discuss its probable embryological origin and emphasize clinical implications. Methods Retrospectively 1250 conventional cerebral angiograms and 2947 cranial magnetic resonance angiographies (MRAs) were evaluated for the patients with PTAV. Results Five patients (four men and one woman, 23 to 76 years of age, median age 65 years) had a PTAV. Three patients who underwent MRA had a PTAV (3/2947=0.1%). Four of the patients who underwent cerebral angiography had a PTAV (4/1250=0.32%). Two of 143 patients who underwent both conventional angiography and cranial MRA showed PTAV. The PTAV was an incidental finding in all five patients. The PTAV originated from the cavernous segment of the left ICA in four patients and from the cavernous segment of the right ICA in one patient. The terminal branch of the PTAV was the anterior inferior cerebellar artery (AICA) and superior cerebellar artery (SCA) in two patients and the AICA only in the other three patients. Conclusion Neurosurgeons should be aware of possible presence of PTAV. Manipulation of this vessel during a surgical approach to the parasellar region and percutaneous gasserian ganglion procedure may result in hemorrhage or ischemia. PMID:19096587

  1. Comparison of intra-arterial digital subtraction angiography with conventional angiography after transcatheter arterial embolization for hepatic malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Minakuchi, Kazuo; Takada, Keiji; Manabe, Takao; Kobayashi, Nobuyuki; Nakamura, Kenji; Onoyama, Yasuto (Osaka City Univ. (Japan). Faculty of Medicine)

    Twenty patients with hepatic malignancy were treated with transcatheter arterial embolization (TAE) under examination by intra-arterial digital subtraction angiography (IA-DSA) and conventional angiography (CA). Comparison of these two angiographies revealed that the time required for confirmation of the embolized portion of the artery was about four-and-a-half times shorter with IA-DSA than CA. Moreover, IA-DSA revealed the obstructed portion more readily and accurately than CA. In particular, confirmation could not be made by CA in 35% of cases because of residual Gelform sponge containing contrast medium in the artery. The visualization of residual tumor stain after TAE was 40% better on IA-DSA than CA, because of residual Gelform sponge containing contrast medium and overlapping shadow with calcified costal cartilage, excretory pyelography, and original tumor stain. However, CA was better than IA-DSA in visualizing accidental obstruction of nonobjective arteries such as the cystic artery because of the poor spatial resolution and misregistration artifacts of IA-DSA. CA was better than IA-DSA in visualizing surrounding nonembolized hepatic parenchyma because of the misregistration artifacts of IA-DSA. For effective TAE without severe complication, we concluded that TAE for HCC should be performed under a combination of IA-DSA and CA. (author).

  2. Comparison of effective doses between computed tomography cardiac angiography and conventional angiography at Pantai Hospital, Kuala Lumpur

    Science.gov (United States)

    Mohamed, Faizal; Moin, F. H. A.

    2013-05-01

    This research studies two types of cardiac angiography procedures, namely Computed Tomography Cardiac Angiography (CTCA) and Conventional Angiography (CA). The following research was executed to estimate the difference of mean effective doses that the patients received through both procedures. The mean dose-length-product (DLP) from CTCA and mean dose-area-product (DAP) from CA were utilized in calculating the effective doses. The result shows that the mean effective dose for CTCA and CA are 1.71±0.59 mSv and 53.25±14.22 mSv respectively. This proves that the mean effective dose received by patients undergoing CA is higher than patients undergoing CTCA. According to t-test, both procedures differ significantly, with a difference amounting to p<0.0001. The increases of the effective dose that the patients received through CA procedure were influenced by exposure time, the coronary anatomical condition, the operator's experience, and the operation methods.

  3. Spontaneous occlusion of traumatic carotid-cavernous fistula - the effect of angiography

    Energy Technology Data Exchange (ETDEWEB)

    Stampfel, G.

    1984-08-01

    In two patients with a traumatic carotid-cavernous fistula, permanent occlusion of the lesion was observed following cerebral angiography and confirmed by further angiography. A delay is therefore recommended between performing angiography and carrying out further treatment, which may carry some risk. Possibly the use of ionic contrast media, which irritate the vessels, compression of the carotid artery, which reduces flow through the fistula, and general anaesthesia, which may drop the blood pressure, initiate thrombosis in the cavernous sinus. 3 figs.

  4. Validation of a Novel Clinical Prediction Score for Severe Coronary Artery Diseases before Elective Coronary Angiography

    OpenAIRE

    Zhang-Wei Chen; Ying-Hua Chen; Ju-Ying Qian; Jian-Ying Ma; Jun-Bo Ge

    2014-01-01

    OBJECTIVES: Coronary artery disease (CAD) severity is associated with patient prognosis. However, few efficient scoring systems have been developed to screen severe CAD in patients with stable angina and suspected CAD before coronary angiography. Here, we present a novel scoring system for CAD severity before elective coronary angiography. METHODS: Five hundred fifty-one patients with stable angina who were admitted for coronary angiography were enrolled in this study. Patients were divided i...

  5. MR angiography for follow-up after percutaneous vessel recanalization and surgery

    International Nuclear Information System (INIS)

    This paper compares MR angiography with conventional and digital subtraction angiography (DSA) in arteriosclerosis and to find out whether arteriosclerotic vessel pathology is delineated correctly by MR angiography. MR angiographic findings in 103 cases were correlated with DSA and conventional angiographic findings. The angiograms were obtained in patients with arteriosclerosis before and after percutaneous recanalization or vascular surgery in the femoropopliteal region. For MR angiography, a flow-sensitive, three-dimensional, fast imaging with steady precision sequence with rephased and dephased subtracted images were used on a 1.5-T Magnetom imager. The scan time is 4-5 minutes

  6. Digital subtraction angiography (DSA). Work load and financial implications for a neuroradiology department.

    Science.gov (United States)

    Kingsley, D P; Butler, P; Rowe, G M; Travis, R C; Wylie, I G

    1989-01-01

    A four year study has been undertaken into the effects on the workload and cost implications of the introduction of digital subtraction angiography (DSA) in a large United Kingdom teaching hospital. The increase in workload has been entirely due to the ability to perform intravenous angiography. DSA is cheaper than conventional angiography if more than 210 cases are undertaken each year. This difference is accounted for by the reduced use of X-ray film. However, intravenous angiography is more expensive because of the use of large volumes of nonionic medium. PMID:2674769

  7. Contrast-enhanced MR angiography for differentiation between perigastric and submucosal gastric fundal varices; Kontrastmittelverstaerkte MR-Angiographie zur Differenzierung zwischen perigastrischen und submukoesen Fundusvarizen des Magens

    Energy Technology Data Exchange (ETDEWEB)

    Willmann, J.K.; Boehm, T.; Lutz, A.M.; Goepfert, K.; Marincek, B.; Weishaupt, D. [Inst. fuer Diagnostische Radiologie, Universitaetsspital Zuerich (Switzerland); Bauerfeind, P. [Abt. fuer Gastroenterologie, Universitaetsspital Zuerich (Switzerland)

    2003-04-01

    Purpose: To evaluate contrast-enhanced MR angiography for the distinction between perigastric and submucosal fundal varices. Materials and Methods: Nineteen consecutive patients with clinically suspected fundal varices underwent contrast-enhanced MR angiography and endoscopic ultrasound (EUS) within one week. Diagnostic confidence for the detection of perigastric and submucosal fundal varices was compared between MR angiography (two radiologists) and EUS (one gastroenterologist), and the agreement of size and location was evaluated. Results: Both MR angiography and EUS detected perigastric varices in all 19 patients and submucosal fundal varices in 14 of the 19 patients. The interobserver reliability of MR angiography was good for measuring the variceal diameter ({kappa} = 0.76) and excellent for localizing the varices ({kappa} = 1.0). EUS and MR angiography agreed in 12 of 14 patients (86%) in determining variceal diameter and location. Conclusions: Contrast-enhanced MR angiography is comparable to endoscopic ultrasound in the detection and characterization of gastric fundal varices. (orig.) [German] Fragestellung: Das Ziel dieser Studie war es, die kontrastmittelverstaerkte MR-Angiographie bei der Diagnose von Fundusvarizen des Magens, insbesondere bei der Differenzierung von perigastrischen und submukoesen Fundusvarizen mit dem endoskopischen Ultraschall (EUS) zu vergleichen. Methoden: Neunzehn Patienten mit klinischem Verdacht auf Fundusvarizen wurden prospektiv in die Studie eingeschlossen und innerhalb einer Woche mittels kontrastmittelverstaerkter MR-Angiographie und EUS untersucht. Die Uebereinstimmungen zwischen MR-Angiographie (Radiologe 1 und 2) und EUS (1 Gastroenterologe) bei der diagnostischen Sicherheit bezueglich der Diagnose perigastrischer und submukoeser Fundusvarizen sowie bei der Groessen- und Lokalisationsbestimmung submukoeser Fundusvarizen wurden untersucht. Ergebnisse: Sowohl bezueglich der Diagnose perigastrischer (19/19 Patienten) als

  8. Atorvastatin and prevention of contrast induced nephropathy following coronary angiography

    Directory of Open Access Journals (Sweden)

    Peyman Bidram

    2015-01-01

    Full Text Available Background: Contrast induced nephropathy (CIN is one of the most common complications after radiographic procedures using intravascular radiocontrast media. The aim of the current study was to assess the effect of atorvastatin on prevention of CIN in patients undergoing coronary angiography. Materials and Methods: In a clinical trial study, 200 patients referred for angiography were randomly divided into two groups of using 80 mg atorvastatin and placebo before the procedure. Furthermore, 100 patients who were under chronic treatment of statins were included as the third group. Serum creatinine (Scr levels before and after the procedure were evaluated and incidence of CIN (post-procedural Scr of >0.5 mg/dl or >25% from baseline was assessed. Results: Mean age of the participants was 60.06 ± 0.69 years and 276 (92% were male. There were no significant differences between group with respect to age and gender. In pre-operation atorvastatin, placebo and long term statin groups, the incidence of CIN was 1%, 2% and 1%, and mean changes of Glomerular filtration rate (GFR was 3.68 ± 1.32, −0.77 ± 1.21 and 1.37 ± 0.86; and mean changes of creatinine (Cr was −0.05 ± 0.02, 0.02 ± 0.02 and −0.01 ± 0.01 respectively. (P = 0.776, 0.026 and 0.041 respectively. In pre-operation atorvastatin group, Cr decreased, and GFR increased significantly (P = 0.019 and 0.007 respectively. Conclusion: pre-operation short term high dose atorvastatin use was associated with a significant decrease in serum Cr level and increase in GFR after angiography.

  9. MR-Angiography in young adults with cerebral infarction

    International Nuclear Information System (INIS)

    Out of 111 patient with cerebral infarction of uncertain etiology, who underwent a magnetic resonance angiography (MRA) study, a group of seven patents younger than 40 years is described. In four patients MRA showed patterns typical for cerebral artery with concomitant infarction. Only in one patient MRA was inconspicuous. Especially in young stroke patients, where magnetic resonance tomography (MRT) is indicated, MRT should be completed with a MRA of the circle of Willis. Depending on negative or questionable MRA findings and clinical considerations an additional angio-graphical investigation is required. (authors)

  10. Digital subtraction angiography in the evaluation of chemodectomas

    Energy Technology Data Exchange (ETDEWEB)

    Vlahos, L.; Papathanasiou, M.; Gouliamos, A.; Dimakakos, P.; Papavassiliou, C.

    1988-05-01

    During the last 2 years eleven patients with surgically confirmed chemodectomas have been investigated by means of digital subtraction angiography (DSA). Seven patients underwent i.v. DSA, which revealed eight carotid body tumours, and in the remaining four with jugulotympanic chemodectomas intra-arterial (i.a.) DSA was performed. We found i.v. DSA an easy and satisfactory method for the investigation of carotid body tumours but when glomus intravagale, tympanicum or jugulare is suspected an i.a. selective injection is required.

  11. ECG gated tomographic reconstruction for 3-D rotational coronary angiography

    Science.gov (United States)

    Hu, Yining; Xie, Lizhe; Nunes, Jean Claude; Bellanger, Jean Jacques; Bedossa, Marc; Toumoulin, Christine

    2010-01-01

    A method is proposed for 3-D reconstruction of coronary from a limited number of projections in rotational angiography. A Bayesian maximum a posteriori (MAP) estimation is applied with a Poisson distributed projection to reconstruct the 3D coronary tree at a given instant of the cardiac cycle. Several regularizers are investigated L0-norm, L1 and L2 -norm in order to take into account the sparsity of the data. Evaluations are reported on simulated data obtained from a 3D dynamic sequence acquired on a 64-slice GE LightSpeed CT scan. A performance study is conducted to evaluate the quality of the reconstruction of the structures. PMID:21096844

  12. Radionuclide angiography: Role of the stroke-volume ratio

    International Nuclear Information System (INIS)

    Intracardiac shunts and valvular regurgitation impose an abnormal flow pattern and a ventricular volume overload condition that can be readily assessed by radionuclide angiography. Recent advances in the radionuclide angiographic measurement of ventricular volumes (diastolic, systolic, forward ejected, regurgitant, right, or left) have made it a practical technique for the detection, quantitation, and functional assessment of valvular regurgitation and shunts. The role of these new parameters in determining the prognosis and management of patients with ventricular overload requires further evaluation. In this review, the authors describe the proposed methods for comparison of total to systemic ventricular output and their use in the evaluation of patients with valvular regurgitation and shunts

  13. Stress reduction through music in patients undergoing cerebral angiography

    International Nuclear Information System (INIS)

    We studied the influence of music on stress reaction of patients during cerebral angiography. We randomised 30 patients to a music or a control group. We measured stress hormones, blood pressure, heart rate and psychological parameters. Patients examined without music showed rising levels of cortisol in plasma, indicating high stress levels, while cortisol in patients examined with music remained stable. Systolic blood pressure was significantly lower listening to music. Patients with a high level of fear did appear to benefit particularly from the music. (orig.)

  14. Transient Global Amnesia After Cerebral Angiography With Iomeprol

    Science.gov (United States)

    Tiu, Cristina; Terecoasă, Elena Oana; Grecu, Nicolae; Dorobăţ, Bogdan; Marinescu, Andreea Nicoleta; Băjenaru, Ovidiu Alexandru

    2016-01-01

    Abstract Transient global amnesia is now considered a very rare complication of cerebral angiography. Various etiological mechanisms have been suggested to account for this complication, but no consensus has been reached yet. This case report documents one of the few reported cases of cerebral angiography-related transient global amnesia associated with magnetic resonance imaging (MRI) evidence of unilateral hippocampal ischemia, most probably as a consequence of a transient reduction in regional hippocampal blood flow. However, the possibility of a direct neurotoxic effect of the nonionic contrast media Iomeprol on the Cornu ammonis – field 1 neurons cannot be firmly ruled out. We describe the case of a 54-year-old woman admitted to our department for left upper limb weakness with acute onset 8 days before. The brain computed tomography (CT) scan performed at admission revealed subacute ischemic lesions in the right watershed superficial territories and a right thalamic lacunar infarct. Diagnostic digital subtraction cerebral angiography was performed 4 days after admission with the nonionic contrast media Iomeprol. A few minutes after completion of the procedure, the patient developed symptoms suggestive for transient global amnesia. The brain MRI performed 22 hours after the onset of symptoms demonstrated increased signal within the lateral part of the right hippocampus on the diffusion-weighted imaging (DWI) sequences, associated with a corresponding reduction in the apparent diffusion coefficient (ADC) and increased signal on the fluid-attenuated inversion recovery (FLAIR) sequences, consistent with acute hippocampal ischemia and several T2/FLAIR hyperintensities in the right watershed superficial territories and in the right thalamus, corresponding to the lesions already identified on the CT scan performed at admission. A follow-up MRI, performed 2 months later, demonstrated the disappearance of the increased signal within the right hippocampus on the DWI

  15. Stress reduction through music in patients undergoing cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, N.; Becker, H. [Dept. of Neuroradiology, Hannover Medical School (Germany); Schedlowski, M. [Dept. of Clinical Psychiatry and Psychotherapy, Hannover Medical School (Germany); Schuermeyer, T.H. [Dept. of Endocrinology, Hannover Medical School (Germany)

    2001-06-01

    We studied the influence of music on stress reaction of patients during cerebral angiography. We randomised 30 patients to a music or a control group. We measured stress hormones, blood pressure, heart rate and psychological parameters. Patients examined without music showed rising levels of cortisol in plasma, indicating high stress levels, while cortisol in patients examined with music remained stable. Systolic blood pressure was significantly lower listening to music. Patients with a high level of fear did appear to benefit particularly from the music. (orig.)

  16. Pancreatic pseudoaneurysm in a child with hereditary pancreatitis: diagnosis with multidetector CT angiography

    International Nuclear Information System (INIS)

    Pseudoaneurysm formation is a serious vascular complication of pancreatitis. It most commonly affects splenic and gastroduodenal arteries. We report a rare case of superior mesenteric artery pseudoaneurysm in a child with hereditary pancreatitis. Multidetector CT angiography allowed the comprehensive assessment of the aneurysm and allowed accurate surgical planning obviating the need for catheter angiography. (orig.)

  17. Three-dimensional gadolinium-enhanced MR angiography of the intracranial venous system

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the usefulness of three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiography for evaluation of the intracranial venous system. Thirty-three patients underwent 3D dynamic gadolinium-enhanced MR angiography as well as two-dimensional (2D) time-of-flight (TOF) MR venography in transverse and coronal planes and conventional catheter cerebral angiography with digital subtraction. MR venography was displayed using a maximum-intensity-projection (MIP) algorithm. The acquisition time of 3D gadolinium-enhanced MR angiography was 102 seconds, and that of 2D TOF MR venography was about 7 minutes in the transverse plane and about 9 minutes in the coronal plane. Degree of visualization of the intracranial venous system on each MR sequence was compared with that on conventional catheter cerebral angiography as a standard. Superficial cortical veins and the dural sinus were better visualized on 3D gadolinium-enhanced MR angiography than on 2D TOF MR venography. Three-dimensional gadolinium-enhanced MR angiography is noninvasive and very useful for imaging of the intracranial venous system. It can replace 2D TOF MR venography not only because of its short examination time but because it better demonstrates intracranial venous structures. For evaluation of the SSS, lateral sinus, sigmoid sinus and straight sinus in particular, conventional catheter angiography seems to be unnecessary. (author)

  18. Three-dimensional gadolinium-enhanced MR angiography of the intracranial venous system

    Energy Technology Data Exchange (ETDEWEB)

    Daikokuya, Hideo; Inoue, Yuichi; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2001-12-01

    The purpose of this study was to assess the usefulness of three-dimensional (3D) gadolinium-enhanced magnetic resonance (MR) angiography for evaluation of the intracranial venous system. Thirty-three patients underwent 3D dynamic gadolinium-enhanced MR angiography as well as two-dimensional (2D) time-of-flight (TOF) MR venography in transverse and coronal planes and conventional catheter cerebral angiography with digital subtraction. MR venography was displayed using a maximum-intensity-projection (MIP) algorithm. The acquisition time of 3D gadolinium-enhanced MR angiography was 102 seconds, and that of 2D TOF MR venography was about 7 minutes in the transverse plane and about 9 minutes in the coronal plane. Degree of visualization of the intracranial venous system on each MR sequence was compared with that on conventional catheter cerebral angiography as a standard. Superficial cortical veins and the dural sinus were better visualized on 3D gadolinium-enhanced MR angiography than on 2D TOF MR venography. Three-dimensional gadolinium-enhanced MR angiography is noninvasive and very useful for imaging of the intracranial venous system. It can replace 2D TOF MR venography not only because of its short examination time but because it better demonstrates intracranial venous structures. For evaluation of the SSS, lateral sinus, sigmoid sinus and straight sinus in particular, conventional catheter angiography seems to be unnecessary. (author)

  19. Multislice computed tomography angiography in the diagnosis of coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Zhong-Hua Sun; Yan Cao; Hua-Feng Li

    2011-01-01

    Multislice Cr angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease.Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease.High diagnostic value has been achieved with multisfice CT angiography with use of 64-and more slice CT scanners.In addition,multislice CT angiography shows accurate detection and analysis of coronary calcium,characterization of coronary plaques,as well as prediction of the disease progression and major cardiac events.Thus,patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures.The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease;prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques.Limitations of multislice Cr angiography in coronary artery disease are also briefly discussed,and future directions are highlighted.

  20. Assessment of feasibility of endovascular treatment of ruptured intracranial aneurysms with 16-detector row CT angiography

    NARCIS (Netherlands)

    M. van der Jagt (Mathieu); H.Z. Flach (Zwenneke); H.L.J. Tanghe (Hervé); S.L.M. Bakker (Stef); M.G.M. Hunink (Myriam); P.J. Koudstaal (Peter Jan); A. van der Lugt (Aad)

    2008-01-01

    textabstractBackground: It is unclear whether 16-detector row CT angiography (CTA) can replace digital subtraction angiography (DSA) to assess the feasibility of endovascular treatment (EVT) in the acute phase after aneurysmal subarachnoid hemorrhage. Methods: We studied 80 consecutive patients with

  1. “Real-world” comparison of non-invasive imaging to conventional catheter angiography in the diagnosis of cerebral aneurysms

    OpenAIRE

    Tomycz, Luke; Bansal, Neil K.; Hawley, Catherine R.; Goddard, Tracy L.; Ayad, Michael J; Mericle, Robert A.

    2011-01-01

    Background: Based on numerous reports citing high sensitivity and specificity of non-invasive imaging [e.g. computed tomography angiography (CTA) or magnetic resonance angiography (MRA)] in the detection of intracranial aneurysms, it has become increasingly difficult to justify the role of conventional angiography [digital subtraction angiography (DSA)] for diagnostic purposes. The current literature, however, largely fails to demonstrate the practical application of these technologies within...

  2. Assessment of vessel diameters for MR brain angiography processed images

    Science.gov (United States)

    Moraru, Luminita; Obreja, Cristian-Dragos; Moldovanu, Simona

    2015-12-01

    The motivation was to develop an assessment method to measure (in)visible differences between the original and the processed images in MR brain angiography as a method of evaluation of the status of the vessel segments (i.e. the existence of the occlusion or intracerebral vessels damaged as aneurysms). Generally, the image quality is limited, so we improve the performance of the evaluation through digital image processing. The goal is to determine the best processing method that allows an accurate assessment of patients with cerebrovascular diseases. A total of 10 MR brain angiography images were processed by the following techniques: histogram equalization, Wiener filter, linear contrast adjustment, contrastlimited adaptive histogram equalization, bias correction and Marr-Hildreth filter. Each original image and their processed images were analyzed into the stacking procedure so that the same vessel and its corresponding diameter have been measured. Original and processed images were evaluated by measuring the vessel diameter (in pixels) on an established direction and for the precise anatomic location. The vessel diameter is calculated using the plugin ImageJ. Mean diameter measurements differ significantly across the same segment and for different processing techniques. The best results are provided by the Wiener filter and linear contrast adjustment methods and the worst by Marr-Hildreth filter.

  3. MR-angiography with intravenous administration of Gd-DTPA

    International Nuclear Information System (INIS)

    We carried out phase contrast MR-angiography of the lower extremities with intravenous administration of Gd-DTPA. Five healthy male volunteers, 25 to 40 years of age, were examined with a 0.5T MRI unit. We used fast scan (gradient echo) technique and it took about 8 minutes for whole procedure. Images were obtained before and after intravenous injection of Gd-DTPA. Injection dose was 0.1 mmol/kg. In two cases, we got images with variable flip angles. However angles of 30 or 40 degrees were thought to be best on the scan with Gd-DTPA. In three cases, we repeated short time procedures for about 4 minutes each time and continued to check the signal intensities of vessels for as long as one hour. The signal intensities greatly increased soon after administration of Gd-DTPA, and then they gradually decreased, but for as long as 60 minutes after administration they remained much higher than those before administration of Gd-DTPA. MR-angiography with Gd-DTPA was found very useful to demonstrate the peripheral femoral vessels clearly. No significant side effect was noticed in any case. Therefore, this method was thought to be very useful clinically. (author)

  4. Indocyanine green angiography in chronic central serous chorioretinopathy

    Science.gov (United States)

    Gajdzik-Gajdecka, Urszula; Dorecka, Mariola; Nita, Ewa; Michalska, Anna; Miniewicz-Kurkowska, Joanna; Romaniuk, Wanda

    2012-01-01

    Summary Background Central serous chorioretinopathy (CSC) is a condition that originates from alterations of the choroidal circulation. The aim of this paper was to evaluate the use of indocyanine green angiography (ICGA) in patients with chronic CSC. Material/Methods The analysis included 17 patients (34 eyes) with chronic CSC in at least 1 eye. The eye examination included: distance and near visual acuity, biomicroscopy, applanation tonometry, fundus examination, colored and red-free fundus photography, evaluation of autofluorescence, optical coherence tomography, and fluorescein and indocyanine green angiography. Results In 34 eyes (100%) involved in the ICGA study the results revealed zones of transient increased choroidal vessels permeability. In 18 eyes (52.9%) choroidal changes were accompanied by a focal serous pigment epithelial detachment. In 4 eyes (11.8%) of 3 patients’ the ICGA examination confirmed the presence of occult choroidal neovascularization (CNV). In the patient with bilateral diffuse retinal pigment epitheliopathy, CNV was present in 1 eye, in the patient with unilateral chronic CSC it was also present in 1 eye, and in the third patient with bilateral chronic CSC it was detected in both eyes. Conclusions ICGA is a very useful examination that enables ophthalmologists to visualize choroidal changes due to chronic CSC, as well as to diagnose occult CNV in chronic CSC. PMID:22293877

  5. Study of spatial resolution in three-dimensional rotational angiography

    International Nuclear Information System (INIS)

    In interventional radiology (IVR) of cerebral aneurysms, it is important to understand the form and physical relationships between the cerebral aneurysm and the surrounding vessels. However, because the vessels in the head area are highly complex, it can be difficult to comprehend the structure using conventional angiography. Therefore, three-dimensional rotational angiography (3D-RA) has been used in recent years. This article discusses studies of the spatial resolution of 3D-RA. We reconstructed 3D-RA of an acrylic slit phantom (slit widths: 0.5, 0.75, 1.0, 1.5 mm) and examined spatial resolution by visual evaluation and profile curves. When the slit phantom was arranged to avoid the effect of beam hardening, the spatial resolution of 3D-RA was found to be as high as 0.75 mm. When the slit phantom was placed orthogonal to the rotational axis of the C-arm, the spatial resolution of 3D-RA was decreased because of the cone angle effect of X-rays. However, it was considered within the allowable range for clinical study. Consequently, 3D-RA is valuable in IVR. (author)

  6. Magnetic resonance angiography and CT angiography of persistent primitive olfactory artery: Incidence and association rate with aneurysm in Korea

    International Nuclear Information System (INIS)

    Japanese data indicates an incidence of persistent primitive olfactory artery (PPOA) of 0.14%. We studied the incidence of PPOA and associated cerebral vascular variation or anomalies in Korea. We retrospectively reviewed cranial magnetic resonance angiography (MRA) and computed tomography angiography (CTA) images of a total of 9841 patients of our institution. The diagnostic criterion of PPOA is extreme anterioinferior course of the proximal anterior cerebral artery, with a hairpin turn of the lateral projection. We found 29 cases (0.29%) with PPOA. The PPOA location was on the left in 19 cases, bilateral in 3 cases, and on the right in 7 cases. An aneurysm was found at the hairpin turn in 2 patients. There were aneurysms in other sites in 3 cases. There were hypoplasia of anterior cerebral artery in 3 cases, and fenestration of intracranial artery in 1 case. In Korean populations, the incidence of PPOA found in MRA and CTA was twice as high as that shown in the previous Japanese data. Within Korea, left side laterality is more common than right side or bilalterality. Aneurysmal dilatations at the hairpin turning point and aneurysms at other sites were found, and other vascular variations were observed in several cases

  7. Peripheral Arterial Disease. Contrast-Enhanced 3D MR Angiography of the Lower Leg and Foot Compared with Conventional Angiography

    International Nuclear Information System (INIS)

    Purpose: To determine whether contrast-enhanced 3D MR angiography (CE MRA) could replace digital subtraction angiography (DSA) for the evaluation of atherosclerotic peripheral vascular disease of the lower leg and foot. Material and Methods: Thirty-five patients with symptoms of atherosclerotic disease of the leg were examined prospectively with CE MRA of the foot and the lower legs as well as with DSA from the aorta to the pedal arches. The MRA technique was focused on optimal imaging of the arteries of the foot. Results: The agreement between CE MRA and DSA for grading of stenosis was moderate to good (weighted -values 0.48-0.80). The sensitivity of CE MRA for detection of significant stenosis (50%) was 92% and the specificity was 64% with DSA as gold standard. Conclusion: CE MRA is a fairly accurate method for the demonstration of atherosclerotic disease below the knee including the pedal arches. It can replace DSA for the assessment of distal arteries in patients with impaired renal function. However, image quality and resolution still needs to be improved before CE MRA can become the method of choice in all patients

  8. Comparison of 16-row multislice CT angiography with conventional angiography for detection and evaluation of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Donmez, Halil; Serifov, Elman; Kahriman, Guven [University of Erciyes, School of Medicine, Department of Radiology, Kayseri (Turkey); Mavili, Ertugrul, E-mail: ertmavili@yahoo.com [University of Erciyes, School of Medicine, Department of Radiology, Kayseri (Turkey); Durak, Ahmet Candan [University of Erciyes, School of Medicine, Department of Radiology, Kayseri (Turkey); Menkue, Ahmet [University of Erciyes, School of Medicine, Department of Neurosurgery, Kayseri (Turkey)

    2011-11-15

    Purpose: The aim of this study is to compare the diagnostic performance of 16-row computed tomographic angiography (MDCTA) with digital subtraction angiography (DSA) for the detection and characterization of intracranial aneurysms in patients with nontraumatic subarachnoid hemorrhages (SAH). Materials and methods: One-hundred and twelve consecutive patients with suspected intracranial aneurysm underwent both 16-row MDCTA and DSA. The MDCT angiograms were interpreted in a blinded fashion by using combination with VRI, MIP and MPR techniques. Sensitivity specificity and accuracy were calculated for the CTA and DSA. The results were compared with each other. The DSA reader's interpretation was accepted as the reference standard. Results: A total of 164 aneurysms were detected at DSA in 112 patients, no aneurysms were detected by DSA and MDCTA in 16 patients. Eight aneurysms were missed by MDCTA. The overall sensitivity, specificity, and accuracy of MDCTA on a per-aneurysm basis were 95.1%, 94.1%, and 95%, respectively. According to the size of the aneurysm less than 3 mm; sensitivity, specificity and diagnostic accuracy of MDCTA were 86.1%, 94.1%, 88.6%, respectively. Conclusion: This study suggests that MDCTA is equally as sensitive as DSA in the detection of intracranial aneurysms of greater than 3 mm, and it also reveals 100% detection rate for ruptured aneurysms.

  9. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Feger, S.; Rief, M.; Zimmermann, E.; Richter, F.; Roehle, R. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Dewey, M. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Institut fuer Radiologie, Berlin (Germany); Schoenenberger, E. [Medizinische Hochschule Hannover, Department of Medicine, Hannover (Germany)

    2015-07-15

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

  10. A comparison between magnetic resonance angiography at 3 teslas (time-of-flight and contrast-enhanced and flat-panel digital subtraction angiography in the assessment of embolized brain aneurysms

    Directory of Open Access Journals (Sweden)

    Guilherme S. Nakiri

    2011-01-01

    Full Text Available PURPOSE: To compare the time-of-flight and contrast-enhanced- magnetic resonance angiography techniques in a 3 Tesla magnetic resonance unit with digital subtraction angiography with the latest flat-panel technology and 3D reconstruction in the evaluation of embolized cerebral aneurysms. INTRODUCTION: Many embolized aneurysms are subject to a recurrence of intra-aneurismal filling. Traditionally, imaging surveillance of coiled aneurysms has consisted of repeated digital subtraction angiography. However, this method has a small but significant risk of neurological complications, and many authors have advocated the use of noninvasive imaging methods for the surveillance of embolized aneurysms. METHODS: Forty-three aneurysms in 30 patients were studied consecutively between November 2009 and May 2010. Two interventional neuroradiologists rated the time-of-flight-magnetic resonance angiography, the contrast-enhanced-magnetic resonance angiography, and finally the digital subtraction angiography, first independently and then in consensus. The status of aneurysm occlusion was assessed according to the Raymond scale, which indicates the level of recanalization according to degrees: Class 1: excluded aneurysm; Class 2: persistence of a residual neck; Class 3: persistence of a residual aneurysm. The agreement among the analyses was assessed by applying the Kappa statistic. RESULTS: Inter-observer agreement was excellent for both methods (K = 0.93; 95 % CI: 0.84-1. Inter-technical agreement was almost perfect between time-of-flight-magnetic resonance angiography and digital subtraction angiography (K = 0.98; 95 % CI: 0.93-1 and between time-of-flight-magnetic resonance angiography and contrast-enhanced-magnetic resonance angiography (K = 0.98; 95% CI: 0.93-1. Disagreement occurred in only one case (2.3%, which was classified as Class I by time-of-flight-magnetic resonance angiography and Class II by digital subtraction angiography. The agreement between

  11. Clinical utility and cost-effectiveness of CT-angiography in the diagnosis of nontraumatic subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Jabbarli, Ramazan; Shah, Mukesch; Hippchen, Beate; Velthoven, Vera van [University Hospital of Freiburg, Department of Neurosurgery, Freiburg/Breisgau (Germany); Taschner, Christian [University Hospital of Freiburg, Department of Neuroradiology, Freiburg (Germany); Kaier, Klaus [University Hospital of Freiburg, Institute for Medical Biometry and Medical Informatics, Freiburg (Germany)

    2014-10-15

    CT-angiography gains an increasing role in the initial diagnosis of patients with nontraumatic subarachnoid hemorrhage (SAH). However, the implementation of CT-angiography does not always exclude the necessity of conventional angiography. Our objective was to determine the practical utility and cost-effectiveness of CT-angiography. All patients with nontraumatic subarachnoid hemorrhage admitted to our university hospital after implementation of CT-angiography between June 1, 2011 and June 30, 2012 were retrospectively analyzed in regard to factors of treatment flow, radiation exposure, harms of contrast medium loading, and diagnostic costs. A control group of the same size was assembled from previously admitted SAH patients, who did not undergo pretreatment CT-angiography. Furthermore, cost-effectiveness analysis was performed. The final analysis consisted of 93 patients in each group. Of 93 patients with pretreatment CT-angiography, 74 had to undergo conventional angiography for diagnostic and/or therapeutic purposes. CT-angiography had significant impact on the reduction of collective effective radiation dose by 4.419 mSv per person (p = 0.0002) and was not associated with additional harms. Despite the significantly earlier detection of aneurysms with CT-angiography (p < 0.0001), there were no significant differences in the timing of aneurysm repair and duration of ICU and general hospital stay. There was an increase of diagnostic costs - the cost-effectiveness analysis showed, however, that benefits of CT-angiography in respect to radiation exposure and risk of conventional angiography-related complications justify the additional costs of CT-angiography. Although the implementation of CT-angiography in SAH diagnosis cannot completely replace conventional angiography, it can be approved in regard to radiation hygiene and cost-effectiveness. (orig.)

  12. Patient acceptance of noninvasive and invasive coronary angiography.

    Directory of Open Access Journals (Sweden)

    Eva Schönenberger

    Full Text Available BACKGROUND: Noninvasive angiography using multislice computed tomography (MSCT is superior to magnetic resonance imaging (MRI for detection of coronary stenoses. We compared patient acceptance of these two noninvasive diagnostic tests and invasive conventional coronary angiography (Angio. METHODS AND FINDINGS: A total of 111 consecutive patients with suspected coronary artery disease underwent MSCT, MRI, and Angio. Subsequently, patient acceptance of the three tests was evaluated with questionnaires in all patients. The main acceptance variables were preparation and information prior to the test, degree of concern, comfort, degree of helplessness, pain (on visual analog scales, willingness to undergo the test again, and overall satisfaction. Preparation for each test was not rated significantly differently, whereas patients were significantly more concerned about Angio than the two noninvasive tests (p<0.001. No pain during MSCT, MRI, and Angio as assessed on visual analog scales (0 to 100 was reported by 99, 93, and 31 patients, respectively. Among the 82 patients who felt pain during at least one procedure, both CT (0.9+/-4.5 and MRI (5.2+/-16.6 were significantly less painful than Angio (24.6+/-23.4, both p<0.001. MSCT was considered significantly more comfortable (1.49+/-0.64 than MRI (1.75+/-0.81, p<0.001. In both the no-revascularization (55 patients and the revascularization group (56 patients, the majority of the patients (73 and 71% would prefer MSCT to MRI and Angio for future imaging of the coronary arteries. None of the patients indicated to be unwilling to undergo MSCT again. The major advantages patients attributed to MSCT were its fast, uncomplicated, noninvasive, and painless nature. CONCLUSIONS: Noninvasive coronary angiography with MSCT is considered more comfortable than MRI and both MSCT and MRI are less painful than Angio. Patient preference for MSCT might tip the scales in favor of this test provided that the diagnostic

  13. Sac Angiography and Glue Embolization in Emergency Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Koike, Yuya, E-mail: r06118@hotmail.co.jp; Nishimura, Jun-ichi, E-mail: jun-ichi-n@nifty.com; Hase, Soichiro, E-mail: haseman@hotmail.co.jp; Yamasaki, Motoshige, E-mail: genyamasaki@gmail.com [Kawasaki Saiwai Hospital, Department of Interventional Radiology (Japan)

    2015-04-15

    PurposeThe purpose of this study was to demonstrate a sac angiography technique and evaluate the feasibility of N-butyl cyanoacrylate (NBCA) embolization of the ruptured abdominal aortic aneurysm (AAA) sac in emergency endovascular aneurysm repair (EVAR) in hemodynamically unstable patients.MethodsA retrospective case series of three patients in whom sac angiography was performed during emergency EVAR for ruptured AAA was reviewed. After stent graft deployment, angiography within the sac of aneurysm (sac angiography) was performed by manually injecting 10 ml of contrast material through a catheter to identify the presence and site of active bleeding. In two patients, sac angiography revealed active extravasation of the contrast material, and NBCA embolization with a coaxial catheter system was performed to achieve prompt sealing.ResultsSac angiography was successful in all three patients. In the two patients who underwent NBCA embolization for aneurysm sac bleeding, follow-up computed tomography (CT) images demonstrated the accumulation of NBCA consistent with the bleeding site in preprocedural CT images.ConclusionsEVAR is associated with a potential risk of ongoing bleeding from type II or IV endoleaks into the disrupted aneurysm sac in patients with severe coagulopathy. Therefore, sac angiography and NBCA embolization during emergency EVAR may represent a possible technical improvement in the treatment of ruptured AAA in hemodynamically unstable patients.

  14. New abdominal CT angiography protocol on a 16 detector-row CT scanner - first results

    International Nuclear Information System (INIS)

    Purpose. Purpose of this study was the implementation of a new abdominal CT angiography protocol on a 16 detector-row CT scanner and the comparison to selective catheter angiography.Methods. 76 patients with various vascular disorders underwent abdominal CT angiography on a recently developed 16 detector-row CT scanner using submillimeter slice collimation (16 x 0.75 mm). Results were compared with mesenteric and/or hepatic angiography in 17 patients performed during tumor embolization. Opacification was provided using individually tailored contrast application with a test bolus setting. To evaluate the contrast injection protocol density measurements within the vessel lumen were performed.Results. Diagnostic image quality was achieved in all patients with angiographic comparison (n = 17). Within the hepatic and mesenteric vasculature up to 4th generation vessels could be identified. Compared to selctive angiography CT angiography provided equivalent morphologic information up to the detectable vessel generation. With the applied contrast application regimen there were no significant differences in vessel enhancement along the abdominal aorta and iliac arteries.Conclusion. 16 detector-row CT enables whole abdominal angiographic studies with submillimeter resolution in a single breath-hold. The improved spatial resolution enables for high quality 3D visualization. Compared to invasive angiography, 16 detector-row CT reveals equivalent morphologic information. (orig.)

  15. Role of 3-D Conventional Angiography In Evaluation of Intra Carnial Aneurysms

    Directory of Open Access Journals (Sweden)

    Ahmed M Bassiouny*, Maher M Arafa*, Sameh M Abdelwahab*,

    2013-04-01

    Full Text Available Introduction: intracranial aneurysms are pathological enlargement of the brain arteries that are most commonly located in the circle of Willis. Intracranial aneurysms are relatively common with a prevalence of approximately 4%. The real danger of aneurysms is subarachnoid hemorrhage. 3D digital subtraction angiography has become a critical imaging tool in neuroradiology allowing for the visualization of detailed cerebral vasculature prior to any intervention. Aim of the work: The aim of this work is to evaluate the diagnostic performance of 3D conventional angiography in the evaluation of intracranial aneurysms compared with the conventional cerebral angiography. Methods: The studied group included 20 patients (5 men and 15 women with subarachnoid hemorrhage or known to have cerebral aneurysms. All patients were subjected to conventional cerebral angiography and 3D cerebral angiography, using C-arm (Toshiba rotational technique.Results: 3D digital subtraction angiography is superior to conventional digital subtraction angiography in 100% of the cases 3D imaging revealed the proper aneurysmal shape, size, precise assessment of its neck and relation to the surrounding vessels. Conclusion: Three-dimensional DSA improves the detection and delineation of intracranial aneurysms

  16. Didactics and training in cardiovascular computed tomography angiography.

    Science.gov (United States)

    Bhojraj, Sanjay D; Al-Mallah, Mouaz H

    2009-01-01

    As the role of cardiovascular computed tomography angiography (CCTA) is further expanded through research, the use of this technology will expand as a result of demand both from medical professionals and the public. To ensure a standardized quality of interpretation of these scans in the face of an increased demand for physicians qualified to interpret these studies, the Society of Cardiovascular Computed Tomography, along with several other professional societies, has proposed a didactic curriculum for the study of CCTA. This review highlights the currently proposed didactic curriculum for the study of CCTA, examines current trends in training for both medical trainees and physicians in practice, and proposes future directions for the study of CCTA. PMID:19203747

  17. K-Edge Subtraction Angiography with Synchrotron X-Rays

    CERN Document Server

    Giacomini, J C

    1996-01-01

    The purpose of this project was to utilize dual energy, monochromatic X-rays produced from synchrotrons radiation in order to obtain noninvasive medical imaging. The application of synchrotrons radiation to medical imaging is based on the principle of iodine dichromography, first described by Bertil Jacobson of the Karolinska Institute in 1953. Medical imaging using synchrotrons radiation and K-edge dichromography was pioneered at Stanford University under the leadership of Dr. Ed Rubenstein, and the late Nobel Laureate in Physics, Dr. Robert Hofstadter. With progressive refinements in hardware, clinical-quality images were obtained of human coronary arteries utilizing peripheral injections of iodinated contrast agent. These images even now are far superior to those being presented by investigators using MRI as an imaging tool for coronary arteries. However, new supplies and instruments in the cardiac catheterization laboratory have served to transform coronary angiography into an outpatient procedure, with r...

  18. Evaluation of measurement parameters in clinical cerebral MR angiography

    International Nuclear Information System (INIS)

    A three-dimensional MR angiography technique was developed in patients and volunteers that can produce clinically useful studies of the cerebral vasculature with multiple views possible from a single data set acquisition. A low-flip angle, three-dimensional fast imaging with steady precessing sequence was found to provide the optimal vessel/soft-tissue contrast related to the tissues' relaxation parameters and inflow. The inflowing unsaturated spins and vessel orientation made an axial acquisition most effective. The flow-related phase dispersion could be largelly corrected with the appropriate orientation, strength, order, and combination of refocusing gradients with the shortest possible echo times. Reduced voxel size also affected the phase dispersion due to motion and field inhomogeneities. Postprocessing yielded projection images of vessels throughout the three-dimensional volume

  19. MR-angiography of the carotid and vertebral artery

    International Nuclear Information System (INIS)

    Magnetic Resonance Angiography (MRA) is a new, noninvasive modality for evaluation of carotid and vertebral artery disease. At a field strength of 1.5 T subtraction of flowrephased and dephased images, to eliminate signal from stationary tissue, offers no significant advantage over computerized postprocessing of rephased images. In a protocol of 3D-gradient-echo-sequenzes, using gradient motion refocussing (GMR), 27 patients with evidence of carotid or vertebral artery disease have been examined by MRA in comparison to ultrasound. MRA displays the carotid and vertebral arteries up to the cricle of Willis. Within short examination times, the method is sensitive in the detection of disturbed hemodynamics, secondary to vessel disease. The specific, at that time is limited. MRA has great potential in the diagnoses of cerebrovascular disease. (orig.)

  20. MR angiography of the abdominal aorta: Preliminary results

    International Nuclear Information System (INIS)

    Flowing blood can be demonstrated as bright signal in MR-imaging resulting in MR-angiography (MRA). This study presents the results of MRA using the 'time of flight'-effect in which projection angiograms along the longitudinal axis were established by a row of 2D-gradient echo (GE) images (FLASH) in breathhold technique. The method was proven in 5 normal volunteers and evaluated against DSA in 21 patients with aortic diseases. The preliminary results demonstrate a satisfactory flow signal in the normally perfused aorta; thus occlusions, stenoses, and aneurysms could be defined clearly. In smaller vessels the signal was still insufficient. Diagnostic problems of vascular overlapping can be solved in most cases by rotating the angiograms, and by additional analysis of individual 2D-GE images. In the present form the quality of MRA is still inferior to that of DSA. (orig.)

  1. Optimizing MR angiography of popliteal-tibial arteries

    International Nuclear Information System (INIS)

    Conventional time-of-flight MR angiography techniques have suffered from low signal-to-noise ratio (SNR), cardiac gating requirements, higher-order motion effects at stenoses and branch points, and limited area imaged, yielding poor vascular delineation for lower-extremity studies. The authors of this paper combined a rephase-dephase gradient-refocused-echo (GRE) pulse sequence with bolus injection of Gd-DTPA to improve peripheral MR angiographic image quality. Imaging was performed with a Siemens 1.5-T (Magnetom) imager and a specially constructed, 40-cm-long cylindrical coil. A three-dimensional steady-state free precession pulse sequence was used (flip angle = 25 degrees, 60-mm slab select, TR = 36 msec, TE = 18 msec). Signal from moving spins was alternatively focused and then dephased for each phase-encoding step followed by postprocessing subtraction of stationary components. Maximum-intensity projection algorithms were used to obtain projection MR angiograms

  2. Transvenous coronary angiography in humans with synchrotron radiation

    International Nuclear Information System (INIS)

    The transvenous coronary angiography project at the National Synchrotron Light Source (NSLS) is presently undergoing a significant upgrade to the hardware and software in the synchrotron medical facility. When completed, the project will have reached a level of maturity in the imaging technology which will allow the research team to begin to concentrate on medical research programs. This paper will review the status of the project and imaging technology and will discuss the current upgrades and future advanced technology initiatives. The advantages of using the radiation from a synchrotron, over that from a standard x-ray source, were the motivation for the project. A total of 23 human imaging sessions have been carried out with in the project. The primary goals have been to establish the imaging parameters and protocol necessary to obtain clinically useful images

  3. Statistical analysis of motion contrast in optical coherence tomography angiography

    CERN Document Server

    Cheng, Yuxuan; Pan, Cong; Lu, Tongtong; Hong, Tianyu; Ding, Zhihua; Li, Peng

    2015-01-01

    Optical coherence tomography angiography (Angio-OCT), mainly based on the temporal dynamics of OCT scattering signals, has found a range of potential applications in clinical and scientific researches. In this work, based on the model of random phasor sums, temporal statistics of the complex-valued OCT signals are mathematically described. Statistical distributions of the amplitude differential (AD) and complex differential (CD) Angio-OCT signals are derived. The theories are validated through the flow phantom and live animal experiments. Using the model developed in this work, the origin of the motion contrast in Angio-OCT is mathematically explained, and the implications in the improvement of motion contrast are further discussed, including threshold determination and its residual classification error, averaging method, and scanning protocol. The proposed mathematical model of Angio-OCT signals can aid in the optimal design of the system and associated algorithms.

  4. Statistical analysis of motion contrast in optical coherence tomography angiography

    Science.gov (United States)

    Cheng, Yuxuan; Guo, Li; Pan, Cong; Lu, Tongtong; Hong, Tianyu; Ding, Zhihua; Li, Peng

    2015-11-01

    Optical coherence tomography angiography (Angio-OCT), mainly based on the temporal dynamics of OCT scattering signals, has found a range of potential applications in clinical and scientific research. Based on the model of random phasor sums, temporal statistics of the complex-valued OCT signals are mathematically described. Statistical distributions of the amplitude differential and complex differential Angio-OCT signals are derived. The theories are validated through the flow phantom and live animal experiments. Using the model developed, the origin of the motion contrast in Angio-OCT is mathematically explained, and the implications in the improvement of motion contrast are further discussed, including threshold determination and its residual classification error, averaging method, and scanning protocol. The proposed mathematical model of Angio-OCT signals can aid in the optimal design of the system and associated algorithms.

  5. Cardiac CT angiography in children with congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Siripornpitak, Suvipaporn, E-mail: ssiripornpitak@yahoo.com [Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Pornkul, Ratanaporn [Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Khowsathit, Pongsak [Pediatric Cardiac Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand); Layangool, Thanarat; Promphan, Worakan [Pediatric Cardiology Unit, Queen Sirikit National Institute of Child Health, Bangkok (Thailand); Pongpanich, Boonchob [Pediatric Cardiac Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok (Thailand)

    2013-07-15

    Cardiac imaging plays an important role in both congenital and acquired heart diseases. Cardiac computed tomography (angiography) cCT(A) is a non-invasive, increasingly popular, complementary modality to echocardiography in evaluation of congenital heart diseases (CHD) in children. Despite radiation exposure, cCT(A) is now commonly used for evaluation of the complex CHD, giving information of both intra-cardiac and extra-cardiac anatomy, coronary arteries, and vascular structures. This review article will focus on the fundamentals and essentials for performing cCT(A) in children, including radiation dose awareness, basic techniques, and strengths and weaknesses of cCT(A) compared with cardiac magnetic resonance imaging (cMRI), and applications. The limitations of this modality will also be discussed, including the CHD for which cMRI may be substituted.

  6. 320-detector row CT coronary angiography in patients with arrhythmia

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility of CT coronary angiography (CTCA) in patients with arrhythmia using 320-detector row CT. Methods: Thirty-one patients with persistent atrial fibrillation and 8 patients with premature ventricular contraction were enrolled in this study. All patients underwent 320- detector row CTCA. CT image quality was evaluated with 4-point grading scale by two radiologists. Inter- observer agreement was evaluated by Kappa statistics. The radiation dose was calculated. Results: In total 510 coronary segments, 496 (97.2%) segments met diagnostic standard. The mean effective dose was (12.7±4.8) mSv in this study. There was a good agreement in image quality scoring between the two reviewers (Kappa = 0.72). Conclusion: 320-detector row CTCA is feasible in patients with atrial fibrillation and premature ventricular contraction. Arrhythmia may not be considered as a contraindication to CTCA. (authors)

  7. MR angiography in portal hypertension: state of the art

    International Nuclear Information System (INIS)

    When imaging the portal vascular system colour-coded sonography and CT angiography are used as an alternative to intraarterial DSA. Today fast CE 3D- MRA is the imaging modality of choice in the diagnostic of patients with portal hypertension. It enables a clear picture of the portalvenous vascular system and portalsystemic shunts. Statements regarding velocity and direction of blood flow can be made with additional use of TOF and PC techniques. CE-3D MRA can be used preoperatively before liver transplantation or shunt surgery. In the follow-up of interventional or surgical procedures exact statements concerning haemodynamically significant pathologies e.g. vascular thromboses, stenoses and occlusions can be made. Patient consent is symplify and the numbers of complications can be reduced as well as duration of surgery minimized applying this technique (orig.)

  8. Radiation doses in angiography in the University Hospital of Caracas

    International Nuclear Information System (INIS)

    In the present work is evaluated, in angiography procedures carried out in the Radiology Department of the University Hospital of Caracas, the radiation dose received by the exposed professional when they carry out these explorations invasive and the followed norms of radiological protection during the exploration. The measurement was carried out on the exposed professional conformed by a medical interventionist, a medical assistant (resident), a nurse and a technical radiologist. Dosimeters TL was placed in the inter-orbital line at level of the crystalline lens, on thyroid, on the hands, thorax, breast, and on the gonads. The maximum values of dose (in mGy) that were measured: 1,84 at level of the crystalline lens; 1,24 on thyroid; 9,04 on the right hand; 65,04 on hand left; 0,07 on thorax; 0,07 on Breast; 0,07 for ovaries; and smaller than 0,04 for testicle. (author)

  9. Didactics and training in cardiovascular computed tomography angiography.

    Science.gov (United States)

    Bhojraj, Sanjay D; Al-Mallah, Mouaz H

    2009-01-01

    As the role of cardiovascular computed tomography angiography (CCTA) is further expanded through research, the use of this technology will expand as a result of demand both from medical professionals and the public. To ensure a standardized quality of interpretation of these scans in the face of an increased demand for physicians qualified to interpret these studies, the Society of Cardiovascular Computed Tomography, along with several other professional societies, has proposed a didactic curriculum for the study of CCTA. This review highlights the currently proposed didactic curriculum for the study of CCTA, examines current trends in training for both medical trainees and physicians in practice, and proposes future directions for the study of CCTA.

  10. [Echocardiographic gating in non-cardiac digital angiography].

    Science.gov (United States)

    Gattoni, F; Baldini, U; Cairo, F; Nessi, R; Pozzato, C; Uslenghi, C

    1987-03-01

    This paper reports the results of the ECG-gating in non-cardiac digital subtraction angiography (DSA). One hundred and fifteen patients underwent DSA (126 examinations); ECG-gating was applied in 66/126 examinations: images recorded at 70% of R wave were subtracted. Artifacts produced by vascular movements were evaluated in all patients: only 40 examinations, carried out without ECG-gating, showed vascular artifacts. The major advantage of the ECG-gated DSA is the more efficient subtraction because of the better images superimposition: therefore, ECG-gating can be clinically helpful. On the contrary, it could be a problem in arrhythmic or bradycardic patients. ECG-gating is helpful in DSA imaging of the thoracic and abdominal aorta and of the cervical and renal arteries. In the examinations of peripheral vessels of the limbs it is not so efficient as in the trunk or in the neck.

  11. MRI and MR angiography of persistent trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Piotin, M. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Miralbes, S. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Cattin, F. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Marchal, H. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Amor-Sahli, M. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Moulin, T. [Department of Neurology, University Hospital, Besancon (France); Bonneville, J.F. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France)

    1996-11-01

    We describe the MRA and MR angiography (MRA) features of persistent trigeminal artery (PTA) found incidentally in eight patients, with special attention to its origin, site and course. The different patterns of posterior communicating arteries were also noted. The PTA were shown on sagittal, coronal and axial MRI and on MRA. In four cases, the PTA arose from the lateral aspect of the intracavernous internal carotid artery, ran caudally, passing round the bottom of the dorsum sellae to join the basilar artery. In the other four cases, it arose from the medial aspect, ran caudally through the sella turcica and pierced the dorsum sellae to join the basilar artery. The posterior communicating arteries were present unilaterally in five cases and bilaterally in one, and absent bilaterally in two. Identification of a PTA with a trans-sellar course is crucial if a trans-sphenoidal surgery is planned. (orig.). With 3 figs.

  12. Gadolinium-enhanced magnetic resonance angiography in brain death

    Science.gov (United States)

    Luchtmann, M.; Beuing, O.; Skalej, M.; Kohl, J.; Serowy, S.; Bernarding, J.; Firsching, R.

    2014-01-01

    Confirmatory tests for the diagnosis of brain death in addition to clinical findings may shorten observation time required in some countries and may add certainty to the diagnosis under specific circumstances. The practicability of Gadolinium-enhanced magnetic resonance angiography to confirm cerebral circulatory arrest was assessed after the diagnosis of brain death in 15 patients using a 1.5 Tesla MRI scanner. In all 15 patients extracranial blood flow distal to the external carotid arteries was undisturbed. In 14 patients no contrast medium was noted within intracerebral vessels above the proximal level of the intracerebral arteries. In one patient more distal segments of the anterior and middle cerebral arteries (A3 and M3) were filled with contrast medium. Gadolinium-enhanced MRA may be considered conclusive evidence of cerebral circulatory arrest, when major intracranial vessels fail to fill with contrast medium while extracranial vessels show normal blood flow.

  13. Does Fundus Fluorescein Angiography Procedure Affect Ocular Pulse Amplitude?

    Directory of Open Access Journals (Sweden)

    Gökhan Pekel

    2013-01-01

    Full Text Available Purpose. This study examines the effects of fundus fluorescein angiography (FFA procedure on ocular pulse amplitude (OPA and intraocular pressure (IOP. Materials and Methods. Sixty eyes of 30 nonproliferative diabetic retinopathy patients (15 males, 15 females were included in this cross-sectional case series. IOP and OPA were measured with the Pascal dynamic contour tonometer before and after 5 minutes of intravenous fluorescein dye injection. Results. Pre-FFA mean OPA value was  mmHg and post-FFA mean OPA value was  mmHg (. Pre-FFA mean IOP value was  mmHg and post-FFA mean IOP value was  mmHg (. Conclusion. Although both mean OPA and IOP values were decreased after FFA procedure, the difference was not statistically significant. This clinical trial is registered with Australian New Zealand Clinical Trials Registry number ACTRN12613000433707.

  14. CORONARY ANGIOGRAPHY WITH DUAL SOURCE COMPUTED TOMOGRAPHY: INITIAL EXPERIENCE

    Institute of Scientific and Technical Information of China (English)

    Zhu-hua Zhang; Wen-min Zhao; Wen-bin Mou; Li-ren Zhang; Wen-ling Zhu; Qi Miao; Qi Fang; Zheng-yu Jin; Shu-yang Zhang; Song-bai Lin; Dong-jing Li; Ling-yan Kong; Yi-ning Wang; Lan Song; Yun Wang

    2007-01-01

    To explore the scan technique and image quality of coronary angiography with dual source computed tomography (CT) without oral metoprolol preparation.Methods Plain and enhanced dual source CT coronary angiography without oral metoprolol preparation was prospectively performed in 600 patients. Calcium scoring with plain scan images as well as multi-planar reconstruction( MPR ), maximum intensity projection (MIP), and volume rendering technique (VRT) reconstruction with enhanced scan images were performed in all cases. The scan technique and post-reconstruction experience was summarized. The image quality was classified as 1 to 4 points, and coronary segments classified according to the American Heart Association standards were evaluated.Results The average calcium score of the 600 cases was 213.6 ± 298.7 (0-3 216. 5). The average heart rate of the enhanced scan was 82.1 ± 16.2 (47-139) bpm. The post-reconstruction methods with which coronary segments could be shown as best as possible consisted of single phase reconstruction method, two or more phases supplemented method, and electrocardiogram editing method. Altogether 8 457 coronary segments were evaluated, among which 97.2% were evaluated as point 1, 1.7% point 2, 0.5% point 3, and0.6% point 4. The coronary segments in 261 cases were completely normal, while 360 segments were diagnosed with < 50% stenosis and 625 segments with ≥50%stenosis.Conclusions Excellent coronary artery image can be obtained with dual source CT in patients with any heart rate without oral metoprolol preparation. Heart rate is not a major source of the artifact, coronary segments can be well shown with single or multiple-phase reconstruction method.

  15. Automated myocardial perfusion from coronary x-ray angiography

    Science.gov (United States)

    Storm, Corstiaan J.; Slump, Cornelis H.

    2010-03-01

    The purpose of our study is the evaluation of an algorithm to determine the physiological relevance of a coronary lesion as seen in a coronary angiogram. The aim is to extract as much as possible information from a standard coronary angiogram to decide if an abnormality, percentage of stenosis, as seen in the angiogram, results in physiological impairment of the blood supply of the region nourished by the coronary artery. Coronary angiography, still the golden standard, is used to determine the cause of angina pectoris based on the demonstration of an important stenose in a coronary artery. Dimensions of a lesion such as length and percentage of narrowing can at present easily be calculated by using an automatic computer algorithm such as Quantitative Coronary Angiography (QCA) techniques resulting in just anatomical information ignoring the physiological relevance of the lesion. In our study we analyze myocardial perfusion images in standard coronary angiograms in rest and in artificial hyperemic phases, using a drug e.g. papaverine intracoronary. Setting a Region of Interest (ROI) in the angiogram without overlying major vessels makes it possible to calculate contrast differences as a function of time, so called time-density curves, in the basal and hyperemic phases. In minimizing motion artifacts, end diastolic images are selected ECG based in basal and hyperemic phase in an identical ROI in the same angiographic projection. The development of new algorithms for calculating differences in blood supply in the region as set are presented together with the results of a small clinical case study using the standard angiographic procedure.

  16. Inhalation RI-angiography with 11CO gas, 2

    International Nuclear Information System (INIS)

    15 mCi 11CO was injected with one litre of air into a gas box connected to respiratory circuit. Five volunteers inhaled the gas mixture through the respiratory circuit by single method breathing. After 20-30 seconds breath holding, the alveolar 11CO gas mixture was washed out. During these time, remaining radioactivity of 11CO in the lung was counted with the positron camera and recorded into an on-line computer. This records were fitted to an exponential equation of Y=A.esup(-lambda t) by least square method. Then we calculated the lung clearance values by the equation of Y'=100 (1-esup(-lambda)). The mean value of lambda was 0.0314 (sec-1). The uptake into blood flow from alveoli at t=1 sec. was 3.1% and at t=20 sec. was 45.7%. Simultaneously, 11CO radioactivities at each site of the left thigh and the expiring site of respiratory-circuit were counted using two ratemeters. These dynamic curves gave us a conclusion that the 11CO uptake rate into human blood flow in this method is fast enough for labelling erythrocytes. The erythrocyte labelling rate with 11CO after inhalation was calculated from radioactivities in the plasma and the venous blood. The rates of five volunteers are all over 97.9%. After the inhalation studies, RI-angiography with positron camera were taken. These scintigrams showed good resolution. We could distinguish main sinuses of the head and two arteries of the forearm. We could found a rapid and easy labelling method for RI-angiography using 11CO gas inhalation and we could get RI-angiograms with good resolution using a positron camera. This combination method is safe and comfortable for patients because of the low radiation absorbed dose and an entirely noninvasive method. We concluded this RI-angiogram is a good method for clinical use. (auth.)

  17. The Hunter Pulmonary Angiography Catheter for a Brachiocephalic Vein Approach

    International Nuclear Information System (INIS)

    The purpose of this work was to describe our experience in performing pulmonary angiography using the Hunter pulmonary catheter, manufactured by Cook, Inc., which is a modified 6F pigtail catheter with a 'C-shaped' curve, designed for a brachiocephalic vein approach. One hundred twenty-three patients underwent pulmonary angiograms using the Hunter catheter between August 1997 and January 2002. Operator comments were gathered in 86 (70%) of the cases. The operator was, if possible, the most junior resident on the service. Thirty-nine operators participated in the survey. Efficacy, safety, and ease of use of the catheter were determined by operators' comments and ECG observations during the procedure. Corroborating clinical data were gathered from medical records. In 68 (79%) of the procedures that were commented upon, the operator described insertion into the pulmonary artery (PA) as easy; only 2 (2%) indicated difficulty in accessing the PA. In 41 (63%) of the bilateral angiograms that were commented upon, the operator described accessing the left PA from the right PA as easy; only 6 (9%) rated it as difficult and all were with an older technique in which the catheter was withdrawn to the pulmonary bifurcation without a wire or with only the soft tip of the wire in the pigtail and then rotated to the left main pulmonary artery. Thirty-one of the 41 patients who demonstrated premature ventricular contractions (PVCs) had a previous history of heart disease. Nineteen of the 39 patients who did not have PVCs had a history of heart disease (p = 0.018). The maneuverability and shape of the Hunter catheter make pulmonary angiography an easy procedure, even for operators with minimal experience and limited technical proficiency. PVCs demonstrated a statistically significant correlation with a positive patient history for cardiac disease, rather than being a universal risk

  18. Patient Selection for Diagnostic Coronary Angiography and Hospital-Level PCI Appropriateness: Insights from the NCDR®

    Science.gov (United States)

    Bradley, Steven M.; Spertus, John A.; Kennedy, Kevin F.; Nallamothu, Brahmajee K.; Chan, Paul S.; Patel, Manesh R.; Bryson, Chris L.; Malenka, David J.; Rumsfeld, John S.

    2014-01-01

    Importance Diagnostic coronary angiography in asymptomatic patients may lead to inappropriate percutaneous coronary intervention (PCI) due to a diagnostic to therapeutic cascade. Understanding the relationship between patient selection for coronary angiography and PCI appropriateness may inform strategies to minimize inappropriate procedures. Objective To determine if hospitals that frequently perform coronary angiography in asymptomatic patients, a clinical scenario wherein the benefit of angiography is less clear, are more likely to perform inappropriate PCI. Design, Setting and Participants Multicenter observational study of 544 hospitals participating in the CathPCI Registry® between July 2009 and September 2013. Measures Hospital proportion of asymptomatic patients at diagnostic coronary angiography and a hospital's rate of inappropriate PCI, as defined by 2012 Appropriate Use Criteria for coronary revascularization. Results Of 1,225,562 patients who underwent elective coronary angiography, 308,083 (25.1%) were asymptomatic. The hospital proportion of angiograms in asymptomatic patients ranged from 1.0% to 73.6% (median 24.7%, interquartile range 15.9% to 35.9%). By hospital quartiles of asymptomatic patients at angiography, hospitals with higher rates of asymptomatic patients at angiography had higher median rates of inappropriate PCI (14.8% vs. 20.2% vs. 24.0 vs. 29.4% from lowest to highest quartile, P<.001 for trend). This was attributable to more frequent use of PCI in asymptomatic patients at hospitals with higher rates of angiography in asymptomatic patients (inappropriate and asymptomatic PCI; 5.4% vs. 9.9% vs. 14.7% vs. 21.6% from lowest to highest quartile, P<.001 for trend). Hospitals with higher rates of asymptomatic patients at angiography also had lower rates of appropriate PCI (38.6% vs. 33.0% vs. 32.3% vs. 32.9%% from lowest to highest quartile, P<.001 for trend). Conclusions and Relevance In a national sample of hospitals, performing coronary

  19. Radiation dose in cerebral angiography and flat detector CT applications in neuroradiology; Strahlendosis bei zerebraler Angiographie und Flachdetektor-CT-Applikationen in der Neuroradiologie

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, T.; Lang, S.; Doerfler, A. [Universitaetsklinikum Erlangen, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Abteilung fuer Neuroradiologie, Erlangen (Germany); Scholz, R. [Siemens Healthcare GmbH, Forchheim (Germany); Hauer, M. [Klinikum Nuernberg Sued, Institut fuer Radiologie und Neuroradiologie, Nuernberg (Germany)

    2015-08-15

    Flat detectors (FD) have completely replaced image intensifiers in angiography. Due to this development not only the image quality of 2D digital subtraction angiography series (2-D-DSA) could be improved but also the acquisition of computed tomography (CT)-like cross-sectional images (FD-CT) within the angio suite became feasible. These techniques are now being used in daily clinical routine. Only little information about effective doses of these applications to patients has been published in the literature. We describe the effective patient dose of current applications in the field of angiography and demonstrate strategies to minimize the dose to the patient. In addition, we compare FD-CT applications to standard multislice CT applications. (orig.) [German] Flachdetektoren haben Bildverstaerker in der Angiographie vollstaendig abgeloest. Mit dieser Entwicklung verbesserte sich nicht nur die Bildqualitaet subtrahierter 2-D-Angiographieserien (2-D-DSA), sondern auch die Akquisition CT-aehnlicher Schnittbilder (FD-CT) mit unterschiedlichen Indikationen wurde moeglich. Diese Techniken werden nun in der taeglichen klinischen Routine eingesetzt. Angaben zur effektiven Patientendosis dieser Applikationen sind bis jetzt in der Literatur nur wenige publiziert worden. Wir beschreiben die effektive Patientendosis aktueller Anwendungen im Bereich der Angiographie und zeigen Strategien zur Minimierung der Dosis fuer den Patienten auf. Zudem vergleichen wir FD-CT-Applikationen mit Standard-Multislice-CT-Anwendungen. (orig.)

  20. Contrast enhanced magnetic resonance angiography for determining patency of coronary bypass grafts. A comparison with coronary angiography

    International Nuclear Information System (INIS)

    Aim: Assessment of graft patency with current non-invasive MRA techniques is particularly difficult for evaluating internal mammary artery grafts. Our aim is to determine the accuracy of a contrast enhanced MRA technique in assessing graft patency. Methods: We examined 19 patients with a total of 53 grafts (32 venous/21 arterial), using an ultrafast contrast enhanced 3D gradient-echo technique and compared this with the results of selective angiography. Results: Sensitivity of the contrast enhanced method was 95.2% for venous grafts, 94.4% for IMA grafts and 94.8% overall. Specificity was 85.7% overall, 90.9% for venous and 66.7% for IMA grafts. Positive predictive value was 94.4%. Conclusion: Compared with previous studies, visualisation of IMA grafts was improved by using contrast enhanced MRA. In this preliminary study, contrast enhanced MRA proved promising for the assessment of graft patency. (orig.)

  1. Comparison of MR angiography and conventional angiography in the investigation of intracranial arteriovenous malformations and aneurysms in children

    International Nuclear Information System (INIS)

    Magnetic resonance angiography (MRA) is an attractive alternative to conventional catheter angiography (CCA) in children, especially for the detection of intracranial arteriovenous malformations (AVMs) or aneurysms in the out-of-hours setting, because it has fewer risks and complications. To compare MRA with CCA for the detection of intracranial AVMs, aneurysms and arterial anatomy in children. Retrospective blinded review of MRAs and CCAs by two independent paediatric radiologists, in a group of 19 children already diagnosed with AVMs, aneurysms and subarachnoid haemorrhage (SAH) and who had undergone both imaging techniques. Abnormalities were identified on MRA in 15 of 19 patients and by CCA in 11 of 19 patients. MRA showed one aneurysm, nine AVMs, three haemorrhages and two indeterminate lesions. CCA showed nine AVMs and two indeterminate lesions. The two modalities showed excellent correlation in the detection of AVMs in nine patients. Vascular supply to the AVMs correlated well in four cases. There was complete disagreement in the determination of vessel supply in one case, and in two cases CCA showed additional vessel supply compared to MRA, while in two further cases MRA showed an additional vessel supply compared to CCA. CCA was superior to MRA in demonstrating arterial anatomy, except with regard to the anterior and posterior communicating arteries where MRA was superior. The high sensitivity of MRA in the detection of AVMs when compared to CCA and the low incidence of aneurysms support the use of MRA as the initial imaging modality when intracranial haemorrhage is diagnosed on CT, especially in the out-of-hours setting. (orig.)

  2. Relative safety of intravenous digital subtraction angiography over other methods of carotid angiography and impact on clinical management of cerebrovascular disease.

    Science.gov (United States)

    Stevens, J M; Barter, S; Kerslake, R; Schneidau, A; Barber, C; Thomas, D J

    1989-09-01

    Data from a multicentre survey based on three London teaching hospitals on the relative safety and clinical utility of intravenous carotid digital subtraction angiography (DSA) over intra-arterial DSA and conventional carotid angiography are presented. The incidence of stroke during intra-arterial DSA was 0.7% (n = 538) and during conventional angiography was 0.8% (n = 780). The incidence of stroke during intravenous DSA was zero (n = 3710). When it constituted the initial investigation, intravenous DSA achieved a 93.8% replacement value over intra-arterial studies as a whole (n = 474) and 89% replacement value for patients having carotid endarterectomy (n = 99). It was also noted that the installation of DSA equipment at one unit coincided with a sixfold increase in the number of carotid angiographic examinations and an almost threefold increase in carotid endarterectomies. PMID:2790421

  3. Contrast-enhanced MR Angiography of the Abdomen with Highly Accelerated Acquisition Techniques

    OpenAIRE

    Mostardi, Petrice M.; Glockner, James F; Young, Phillip M.; Riederer, Stephen J.

    2011-01-01

    A three-dimensional time-resolved acquisition can provide accurate timing information for subsequent renal MR angiography, as well as a diagnostic overview of the vasculature; a highly accelerated acquisition can provide high-quality renal angiograms.

  4. Outcome after emergency surgery without angiography in patients with intracerebral haemorrhage after aneurysm rupture

    DEFF Research Database (Denmark)

    Bergdal, Ove; Springborg, Jacob; Hauerberg, John;

    2009-01-01

    and aneurysm occlusion without preoperative angiography. METHODS: We retrospectively identified 13 consecutive patients. We recorded clinical data and evaluated mortality and morbidity with the Glasgow Outcome Score (GOS) and Telephone Interview of Cognitive Status (TICS). FINDINGS: At follow up seven...

  5. Low-dose CT coronary angiography using iterative reconstruction with a 256-slice CT scanner

    OpenAIRE

    Carrascosa, Patricia; Rodriguez-Granillo, Gastón A; Capuñay, Carlos; Deviggiano, Alejandro

    2013-01-01

    AIM: To explore whether computer tomography coronary angiography (CTCA) using iterative reconstruction (IR) leads to significant radiation dose reduction without a significant loss in image interpretability compared to conventional filtered back projection (FBP).

  6. The value of RI scintigraphy and angiography in small intestinal bleeding; Report of eight cases

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Susumu; Kuwata, Hajime; Kushibiki, Kyoko; Akimoto, Kimihiko; Hashimoto, Toshiyuki; Kojima, Toshiya (Showa General Hospital, Kodaira, Tokyo (Japan))

    1991-07-01

    We retrospectively reviewed eight cases of small intestinal bleeding and assessed the value of RI scintigraphy and angiography in diagnosing the bleeding site. The patients' average age was 56.2 years. Chief complaint was melena of variable degree. In most cases neither upper endoscopy nor colonoscopy was diagnostic. RI scientigraphy (Tc-99 labeled human serum albumin) showed 75% of positive rate whereas angiography showed 66.7% (4/6) of positive rate. All four cases of leiomyosarcoma and leiomyoma demonstrated hypervascular stain and/or extra-vasation in angiography whereas RI scintigraphy failed to detect active gastrointestinal bleeding in 2 of the 4 cases. Therefore angiography was considered useful for the detection of bleeding from leiomyoma and leiomyosarcoma which are often hypervascular. Scintigraphy is thought of most value in the demonstration of small amount of bleeding with minimum vascular abnormality. (author).

  7. Coronary Computed Tomography Angiography Derived Fractional Flow Reserve and Plaque Stress

    DEFF Research Database (Denmark)

    Nørgaard, Bjarne Linde; Leipsic, Jonathon; Koo, Bon-Kwon;

    2016-01-01

    Fractional flow reserve (FFR) measured during invasive coronary angiography is an independent prognosticator in patients with coronary artery disease and the gold standard for decision making in coronary revascularization. The integration of computational fluid dynamics and quantitative anatomic...

  8. CLINICAL ASPECTS OF PATIENT SELECTION FOR CORONARY ANGIOGRAPHY IN NON-ST ELEVATION ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    K. A. Kireev

    2015-01-01

    Full Text Available Own clinical experience in the selection of patients with non-ST elevation acute coronary syndrome for coronary angiography based on clinical guidelines of the European Society of Cardiology (2011 is presented.

  9. Generalised brain edema and brain infarct in ergotamine abuse: Visualization by CT, MR and angiography

    International Nuclear Information System (INIS)

    Abuse of ergotamine can release a generalised brain edema and brain infarctions. This can be visualized by CT, MR and angiography. The reason, however, can only be found in the patients history. (orig.)

  10. Co-registration of optical coherence tomography and X-ray angiography in percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hebsgaard, Lasse; Nielsen, Troels Munck; Tu, Shengxian;

    2014-01-01

    Background Intracoronary imaging provides accurate lesion delineation and precise measurements for sizing and positioning of coronary stents. During percutaneous coronary intervention (PCI), it may be challenging to identify corresponding segments between intracoronary imaging and angiography...

  11. Coronary CT Angiography as a Diagnostic and Prognostic Tool: Perspectives from the SCOT-HEART Trial

    OpenAIRE

    Doris, Mhairi; Newby, David, E

    2016-01-01

    Coronary artery disease is the leading cause of death worldwide. Many trials to date have investigated the diagnostic accuracy of coronary computed tomography angiography (CCTA) when compared to the gold standard diagnostic test, invasive coronary angiography. However, whether the use of a non-invasive anatomical test, such as CCTA, can translate into improved patient risk stratification, management and outcome has yet to be established. The Scottish COmputed Tomography of the HEART (SCOT-HEA...

  12. Effect of Benson Relaxation Techniques on Hemodynamic Variables of Patient Undergoing Coronary Angiography

    OpenAIRE

    M khani; R Memarian; Ahmadi, F.; N Hanifi

    2005-01-01

    Introduction: Invasive diagnostic procedures such as coronary angiography, in most cases, are accompanied by stress and anxiety for patients,which may effect on hemodynamic signs. Materials and Methods:This research, as a quasi experimental study, has the objective to determine the influence of applying methods of relaxation on hemodynamic signs in hospitalized 40 patients, experienciny coronary angiography (CA),, has been studied, in regard to existing conditions and methods of sampling and ...

  13. Usefulness of Y-shaped sheaths in CT angiography for examination of liver tumors

    Institute of Scientific and Technical Information of China (English)

    Toru; Ishikawa; Kazuo; Higuchi; Tomoyuki; Kubota; Kei-ichi; Seki; Terasu; Honma; Toshiaki; Yoshida; Takeo; Nemoto; Keiko; Takeda; Tomoteru; Kamimura

    2010-01-01

    AIM: To conduct a single-stage, combined computed tomography (CT) arterial portography (CTAP) and CT arteriography (CTA) imaging operation, we used Y-shaped sheaths with 2 valves, which allowed the insertion of 2 catheters simultaneously. METHODS: Of 1254 patients who underwent abdominal angiography for transarterial embolization and/or intraarterial chemotherapy in our department from May 2002 to November 2009, 664 patients in whom Y-shaped sheaths with 2 valves were used underwent CT angiography using a c...

  14. Ventilation-perfusion imaging and pulmonary angiography: changing pattern of use

    International Nuclear Information System (INIS)

    The hospital and departmental records of the University of Virginia Medical Center from 1976 to 1980 show an increasing frequency of ventilation studies relative to perfusion studies and a decrease in frequency of ventilation-perfusion diagnosis of pulmonary embolus. Pulmonary angiograms have increased from one per 68 nuclear studies to one per 14. A review of 70 patients with correlating angiography or autopsy shows that 89% of nuclear studies were accurate. We have revised our interpretation criteria and indications for pulmonary angiography

  15. Patient’s Radiation Exposure in Coronary Angiography and Angioplasty: The Impact of Different Projections

    OpenAIRE

    Farajollahi Alireza; Rahimi Atena; Khayati Shal Ebrahim; Ghaffari Samad; Ghojazadeh Morteza; Tajlil Arezou; Aslanabadi Nasser

    2014-01-01

    Introduction: We aimed to determine angiography projections with lower Dose Area Product (DAP) rate by measuring the mean DAP and fluoroscopy times in coronary angiography (CAG) and percutaneous coronary intervention (PCI) and calculating DAP rate in different projections. Methods: DAP and fluoroscopy times were measured in all employed projections in real-time in 75 patients who underwent CAG or PCI by a single cardiologist in Madani Cardiovascular University Hospital (45 in CAG group and 30...

  16. Radiation Dose to the Thyroid and Gonads in Patients Undergoing Cardiac CT Angiography

    OpenAIRE

    Behroozi, Hamid; Davoodi, Mohammad; Aghasi, Shahriar

    2015-01-01

    Background: The present data show a global increase in the rate of cardiovascular disease. Cardiac CT angiography has developed as a fast and non-invasive cardiac imaging modality following the introduction of multi-slice computed tomogaraphy. Objectives: The aim of this study was to measure the radiation dose to the thyroid and pelvis regions in patients undergoing cardiac CT angiography using the Care Dose 4D method of 64-slice scanner. Patients and Methods: Eighty-one patients (41 males an...

  17. Coronary Computed Tomography Angiography in the Assessment of Acute Chest Pain in the Emergency Room

    Energy Technology Data Exchange (ETDEWEB)

    Prazeres, Carlos Eduardo Elias dos; Cury, Roberto Caldeira; Carneiro, Adriano Camargo de Castro [Hospital do Coração - HCor, Associação do Sanatório Sírio, São Paulo, SP (Brazil); Rochitte, Carlos Eduardo, E-mail: rochitte@cardiol.br [Hospital do Coração - HCor, Associação do Sanatório Sírio, São Paulo, SP (Brazil); Instituto do Coração - InCor - HCFMUSP, São Paulo, SP (Brazil)

    2013-12-15

    The coronary computed tomography angiography has recently emerged as an accurate diagnostic tool in the evaluation of coronary artery disease, providing diagnostic and prognostic data that correlate directly with the data provided by invasive coronary angiography. The association of recent technological developments has allowed improved temporal resolution and better spatial coverage of the cardiac volume with significant reduction in radiation dose, and with the crucial need for more effective protocols of risk stratification of patients with chest pain in the emergency room, recent evaluation of the computed tomography coronary angiography has been performed in the setting of acute chest pain, as about two thirds of invasive coronary angiographies show no significantly obstructive coronary artery disease. In daily practice, without the use of more efficient technologies, such as coronary angiography by computed tomography, safe and efficient stratification of patients with acute chest pain remains a challenge to the medical team in the emergency room. Recently, several studies, including three randomized trials, showed favorable results with the use of this technology in the emergency department for patients with low to intermediate likelihood of coronary artery disease. In this review, we show data resulting from coronary angiography by computed tomography in risk stratification of patients with chest pain in the emergency room, its diagnostic value, prognosis and cost-effectiveness and a critical analysis of recently published multicenter studies.

  18. Effects of video information on anxiety, stress and depression of patients undergoing coronary angiography

    International Nuclear Information System (INIS)

    Objective: Anxiety and stress are common in patients undergoing invasive procedures. Coronary angiography is a definitive diagnostic evaluation for coronary artery disease and valvular disease. It is necessary to give information to the patients in order to minimize levels of anxiety and stress to this invasive procedure. The aim of this study was to evaluate the effect of patients education by video on levels of anxiety, stress and depression of patients undergoing coronary angiography. Methodology: In a quasi-experimental, pretest-posttest design, 128 patients were randomly assigned to either control or experimental group. Control group received verbal routine education by nurses and experimental group received an informative video about coronary angiography procedure as well as pre and post angiography interventions. Using Depression, Anxiety, Stress Scale (DASS-21) levels of these variables were measured before and after education. Results: Seventy eight (60.9%) males and fifty (39.1%) females participated in the study. There was a statistically significant reduction in the Anxiety, stress and depression levels of experimental group after video information (P = .000). There was a statistically significant correlation between sex with anxiety (P = .000) and stress (P = .04). Conclusions: The use of patients education by informative video is a useful method for decreasing psychological parameters of patients undergoing coronary angiography procedure. Results of the study confirm the usefulness of video information prior to an Invasive angiography procedure. (author)

  19. K-Edge Subtraction Angiography with Synchrotron X-Rays

    International Nuclear Information System (INIS)

    The purpose of this project was to utilize dual energy, monochromatic X-rays produced from synchrotrons radiation in order to obtain noninvasive medical imaging. The application of synchrotrons radiation to medical imaging is based on the principle of iodine dichromography, first described by Bertil Jacobson of the Karolinska Institute in 1953. Medical imaging using synchrotrons radiation and K-edge dichromography was pioneered at Stanford University under the leadership of Dr. Ed Rubenstein, and the late Nobel Laureate in Physics, Dr. Robert Hofstadter. With progressive refinements in hardware, clinical-quality images were obtained of human coronary arteries utilizing peripheral injections of iodinated contrast agent. These images even now are far superior to those being presented by investigators using MRI as an imaging tool for coronary arteries. However, new supplies and instruments in the cardiac catheterization laboratory have served to transform coronary angiography into an outpatient procedure, with relatively little morbidity. We extended the principles learned with coronary angiography to noninvasive imaging of the human bronchial tree. For these images, we utilized xenon as the contrast agent, as it has a K-edge very similar to that of iodine. In this case, there is no true competing diagnostic test, and pulmonary neoplasm is an enormous public health concern. In early experiments, we demonstrated remarkably clear images of the human bronchial tree. These images have been shown internationally; however, funding difficulties primarily with the Department of Energy have not allowed for progression of this promising avenue of research. One potential criticism of the project is that in order to obtain these images, we utilized national laboratories. Some have questioned whether this would lead to a practical imaging modality. However, we have shown that the technology exists to allow for construction of a miniature storage ring, with a superconducting

  20. Kinematics of Compton backscattering x-ray source for angiography

    Energy Technology Data Exchange (ETDEWEB)

    Blumberg, L.N.

    1992-05-01

    Calculations of X-Ray production rates, energy spread, and spectrum of Compton-backscattered photons from a Free Electron Laser on an electron beam in a low energy (136-MeV) compact (8.5-m circumference) storage ring indicate that an X-Ray intensity of 34.6 10{sup 7} X-Ray photons per 0.5-mm {times} 0.5-mm pixel for Coronary Angiography near the 33.169-keV iodine K-absorption edge can be achieved in a 4-msec pulse within a scattering cone of 1-mrad half angle. This intensity, at 10-m from the photon-electron interaction point to the patient is about a factor of 10 larger than presently achieved from a 4.5-T superconducting wiggler source in the NSLS 2.5-GeV storage ring and over an area about 5 times larger. The 2.2-keV energy spread of the Compton-backscattered beam is, however, much larger than the 70-eV spread presently attained form the wiggler source and use of a monochromator. The beam spot at the 10-m interaction point-to-patient distance is 20-mm diameter; larger spots are attainable at larger distances but with a corresponding reduction in X-Ray flux. Such a facility could be an inexpensive clinical alternative to present methods of non-invasive Digital Subtraction Angiography (DSA), small enough to be deployed in an urban medical center, and could have other medical, industrial and aerospace applications. Problems with the Compton backscattering source include laser beam heating of the mirror in the FEL oscillator optical cavity, achieving a large enough X-Ray beam spot at the patient, and obtaining radiation damping of the transverse oscillations and longitudinal emittance dilution of the storage ring electron beam resulting from photon-electron collisions without going to higher electron energy where the X-Ray energy spread becomes excessive for DSA. 38 refs.

  1. Time-resolved MR angiography with limited projections.

    Science.gov (United States)

    Huang, Yuexi; Wright, Graham A

    2007-08-01

    A method for reconstruction of time-resolved MRI called highly-constrained backprojection (HYPR) has been developed. To evaluate the HYPR reconstruction in relation to data sparsity and temporal dynamics, computer simulations were performed, investigating signal modulations under different situations that reflect dynamic contrast-enhanced MR angiography (MRA). In vivo studies were also performed with gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) for abdominal MRA in a canine model to demonstrate the application of HYPR for three-dimensional (3D) time-resolved MRA. When contrast dynamics vary over space, large vessels (e.g., veins) tend to introduce signal interference to small vessels (e.g., arteries) in HYPR, particularly when the vessels are in close proximity. The enhancement of background tissue signals may also alter the arterial and venous temporal profiles in HYPR. However, the artifacts are manifest as intensity modulation rather than structural interference, and therefore have little impact on structural diagnosis. Increasing the number of projections per time point increases temporal blur while reducing corruption of temporal behavior from adjacent tissues. Uniformly interleaved acquisition order, such as the bit-reversed order, is important to reduce artifacts. With high signal-to-noise ratio (SNR) and limited artifacts, HYPR reconstruction has potential to greatly improve time-resolved MRA in clinical practice.

  2. Changes in Medical Management after Coronary CT Angiography

    Directory of Open Access Journals (Sweden)

    Vânia Mairi Naue

    2015-01-01

    Full Text Available Abstract Introduction: Coronary computed tomography angiography (CCTA allows for non-invasive coronary artery disease (CAD phenotyping. There are still some uncertainties regarding the impact this knowledge has on the clinical care of patients. Objective: To determine whether CAD phenotyping by CCTA influences clinical decision making by the prescription of cardiovascular drugs and their impact on non-LDL cholesterol (NLDLC levels. Methods: We analysed consecutive patients from 2008 to 2011 submitted to CCTA without previous diagnosis of CAD that had two serial measures of NLDLC, one up to 3 months before CCTA and the second from 3 to 6 months after. Results: A total of 97 patients were included, of which 69% were men, mean age 64 ± 12 years. CCTA revealed that 18 (18% patients had no CAD, 38 (39% had non-obstructive (< 50% lesions and 41 (42% had at least one obstructive ≥ 50% lesion. NLDLC was similar at baseline between the grups (138 ± 52 mg/dL vs. 135 ± 42 mg/dL vs. 131 ± 44 mg/dL, respectively, p = 0.32. We found significative reduction in NLDLC among patients with obstrctive lesions (-18%, p = 0.001. We also found a positive relationship between clinical treatment intensification with aspirin and cholesterol reducing drugs and the severity of CAD. Conclusion: Our data suggest that CCTA results were used for cardiovascular clinical treatment titration, with especial intensification seen in patients with obstructive ≥50% CAD.

  3. Evaluation of occupational and patient dose in cerebral angiography procedures

    Directory of Open Access Journals (Sweden)

    Neuri Antonio Lunelli

    2013-12-01

    Full Text Available Objective The present study was aimed at estimating the doses received by physicians and patients during cerebral angiography procedures in a public hospital of Recife, PE, Brazil. Materials and Methods The study sample included 158 adult patients, and during the procedures the following parameters were evaluated: exposure parameters (kV, mAs, number of acquired images, reference air kerma value (Ka,r and air kerma-area product (PKA. Additionally, the physicians involved in the procedures were evaluated as for absorbed dose in the eyes, thyroid, chest, hands and feet. Results The results demonstrated that the doses to the patients' eyes region were relatively close to the threshold for cataract occurrence. As regards the physicians, the average effective dose was 2.6 µSv, and the highest effective dose recorded was 16 µSv. Conclusion Depending on the number of procedures, the doses received by the physicians may exceed the annual dose limit for the crystalline lenses (20 mSv established by national and international standards. It is important to note that the high doses received by the physicians are due to the lack of radiation protection equipment and accessories, such as leaded curtains, screens and protective goggles.

  4. Acquisition-related motion compensation for digital subtraction angiography.

    Science.gov (United States)

    Ionasec, Razvan Ioan; Heigl, Benno; Hornegger, Joachim

    2009-06-01

    Subtraction methods in angiography are generally applied in order to enhance the visualization of blood vessels by eliminating bones and surrounding tissues from X-ray images. The main limitation of these methods is the sensitivity to patient movement, which leads to artifacts and reduces the clinical value of the subtraction images. In this paper we present a novel method for rigid motion compensation with primary application to road mapping, frequently used in image-guided interventions. Using the general concept of image-based registration, we optimize the physical position and orientation of the C-arm X-ray device, thought of as the rigid 3D transformation accounting for the patient movement. The registration is carried out using a hierarchical optimization strategy and a similarity measure based on the variance of intensity differences, which has been shown to be most suitable for fluoroscopic images. Performance evaluation demonstrated the capabilities of the proposed approach to compensate for potential intra-operative patient motion, being more resilient to the fundamental problems of pure image-based registration.

  5. Perceptual enhancement of arteriovenous malformation in MRI angiography displays

    Science.gov (United States)

    Abhari, Kamyar; Baxter, John S. H.; Eagleson, Roy; Peters, Terry; de Ribaupierre, Sandrine

    2012-02-01

    The importance of presenting medical images in an intuitive and usable manner during a procedure is essential. However, most medical visualization interfaces, particularly those designed for minimally-invasive surgery, suffer from a number of issues as a consequence of disregarding the human perceptual, cognitive, and motor system's limitations. This matter is even more prominent when human visual system is overlooked during the design cycle. One example is the visualization of the neuro-vascular structures in MR angiography (MRA) images. This study investigates perceptual performance in the usability of a display to visualize blood vessels in MRA volumes using a contour enhancement technique. Our results show that when contours are enhanced, our participants, in general, can perform faster with higher level of accuracy when judging the connectivity of different vessels. One clinical outcome of such perceptual enhancement is improvement of spatial reasoning needed for planning complex neuro-vascular operations such as treating Arteriovenous Malformations (AVMs). The success of an AVM intervention greatly depends on fully understanding the anatomy of vascular structures. However, poor visualization of pre-operative MRA images makes the planning of such a treatment quite challenging.

  6. Cerebral computed tomographic angiography scan delay in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Lukosevicius Saulius

    2005-01-01

    Full Text Available CONTEXT: Computed tomographic angiography (CTA is widely applied in the evaluation of cerebral vessels. Contrast enhancement in cerebral CTA without care or test bolus is not always sufficient for high-quality images. AIMS: Evaluation of the possibilities of calculation of scan delay for cerebral CTA in case of subarachnoid hemorrhage (SAH, based on clinical data of a patient and to find out prognostic error of the model. SETTINGS AND DESIGN: Prospective study in Neurosurgery and Radiology departments. MATERIALS AND METHODS: Scan delay in 53 patients suffering an acute SAH was measured employing test bolus technique. Cerebral CTA was performed afterwards. STATISTICAL ANALYSIS USED: SPSS for Windows v.10.1 software package was applied for dispersion analysis, including one-sample Kolmogorov-Smirnov′s test and Levene′s Test of Equality of Error Variances. RESULTS: A statistical model for the prediction of scan delay in SAH was developed. Cerebral CTA scan delay was dependent upon age, neurological status and impact of the latter factors together (P<0.05. The determined mean square error of prognosis of scan delay of the developed model equals 3.3 sec. CONCLUSION: Using our proposed model it is possible to estimate an optimal delay time for CTA in most patients with SAH with a determined error.

  7. Persistent trigeminal artery variants detected by MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Kato, A.; Takase, Y.; Kudo, S. [Dept. of Radiology, Saga Medical School (Japan)

    2000-11-01

    Persistent trigeminal artery (PTA) variants are cerebellar arteries that originate directly from the precavernous portion of the internal carotid artery (ICA). The goal of our study was to determine the incidence and MR angiographic features of PTA variants. Between April 1996 and September 1999, 523 cranial MR angiographies were performed at our institution. Most of the patients examined had or were suspected of having cerebrovascular disease. We retrospectively reviewed these 523 MR angiograms. A 1.5-T scanner was used in all studies, and maximum intensity projection (MIP) images obtained using the three-dimensional time-of-flight (3D TOF) technique were displayed stereoscopically. Four PTA variants were detected on MR angiograms, at a rate of 0.76 %. At least three of the four PTA variants were anterior inferior cerebellar arteries (AICAs), small tortuous arteries arising from the precavernous portions of the ICAs and taking a posterior course. Although the clinical significance is not great, we found a relatively high incidence of PTA variants on MR angiograms. We stress that knowledge and recognition of these anomalous cerebellar arteries are useful and important in the interpretation of cranial MR angiograms. (orig.)

  8. Magnetic Resonance Angiography in the Pig using Hyperpolarized Water

    DEFF Research Database (Denmark)

    Lipsø, Hans Kasper Wigh; Bowen, Sean; Laustsen, Christoffer;

    , the acquisition time is several minutes, and conventional MRA methods thus fail to image within a single respiration or heartbeat and therefore suffers from motion artefacts. We demonstrate that hyperpolarized (HP) water can be used as an imaging agent to provide subsecond angiographies in pigs. Previous work...... on hyperpolarization for imaging agents in large animals has mainly been focused of 13C 2,3, but small volumes of hyperpolarized water with lower polarization has been demonstrated4,5. Injection of hyperpolarized protons allows for the use of MRI coils and pulse sequences already existing in the clinic. Secondly......, the magnetization achievable with hyperpolarized water is superior to other nuclei. Methods A 1 mL sample of 50% water and 50% glycerol with 30 mM TEMPO is polarized in a Spinlab (GE Healthcare) at 5 T, 0.9 K, 139.9 GHz for an hour. The sample is rapidly dissolved in 16 mL deoxygenized dissolution medium (DM...

  9. Angiography Diagnosis and Treatment of Traumatic Artery Bleeding

    Institute of Scientific and Technical Information of China (English)

    WANG Li; WANG Yan; LIU Jingzhang

    2002-01-01

    Objective After angiography and embolization of three cases suffering from traumatic artery bleeding we summarized the selective embolization of different artery bleeding cases and their treatment analysis. Methods The three cases were all female,among them,one suffering from hepatic artery bleeding by a traffic accident, the other two caused by iatrogenic damage. Of the two, one suffered from bleeding after the gall bladder removal, the other from bleeding after puncture biopsy through the kidney.Seldinger technique was used on the three cases, and puncture intubation was superselected and put through arterial femoralis. Catheters were put separately inside the target blood vessels to have radiography and contrast medium was found to have out flowed out to the bleeding artery. And then the mixed gelatin sponge particles were put into, Ultravist contrast medium to make suspension. Through fluoroscopy the suspension was injected into bleeding artery until no contrast medium out flowed. After that radiography was used to watch the result. Results After the embolization the three cases stopped bleeding at once with remarkable effects. Conclusion Therefore we conclude the embolization is the best method for treating artery bleeding.

  10. Effects of electrocardiogram gating on CT pulmonary angiography image quality

    International Nuclear Information System (INIS)

    Pulmonary embolism (PE) is the third most common cause of death from cardiovascular disease. Computed-tomographic pulmonary angiography (CTPA) is an accurate and safe test for diagnosing PE. The aim of this retrospective analysis was to evaluate the effects on image quality (IQ) of electrocardiogram (ECG) gating during CTPA. Fifty consecutive patients presenting for CTPA were included in the study. A single acquisition was performed, resulting in two reconstructions: one at 75% of the R–R interval and the other without ECG influence. IQ evaluation was undertaken by two radiologists, focusing on respiratory and cardiac motion, image noise, low-contrast resolution, vessel and lung clarity, contrast media opacification and artefacts. Various regions of the lungs and vasculature were evaluated, and IQ scores were statistically compared. For the ECG-tagged reconstructions, IQ was noted to be better overall with regard to vessel clarity (P<0.05) and cardiac motion (P<0.05), while lung clarity was better only in the left lower zone (P<0.05). IQ was better with regard to image noise (P<0.05) and low-contrast resolution (P<0.05) in the non-ECG-tagged reconstructions. No statistical IQ difference between the two types of reconstruction was noted with regard to respiratory motion, contrast media opacification or presence of artefacts. The two types of reconstruction provide complementary information for evaluating CTPA results.

  11. Diagnosis of carotid body tumor by digital subtraction angiography

    Institute of Scientific and Technical Information of China (English)

    戚跃勇; 邹利光; 孙清荣; 徐健; 周政; 谭颖徽

    2004-01-01

    Objective: To make a further understanding of the features of the carotid body tumor (CBT) by digital subtraction angiography (DSA) so as to explore the clinical value of DSA diagnosis and interventional therapy for CBT. Methods: DSA data from 12 cases of CBT were analyzed retrospectively. A consensus interpretation of the DSA appearances in all of the patients was reached after dynamic observation by 2 experienced radiologists in a double-blind manner. Results: Definite diagnosis in all cases could be made by DSA. The DSA features of the CBT included bigger bifurcation angles of the internal and external carotid arteries, displacement of internal and external carotid arteries, CBT supplied by external carotid arteries in most cases and the significant increase of tumor blood vessels in bifurcation. Invasion of internal or external carotid arteries was found in 6 cases. Smaller stained area of the tumor and significantly reduced intraoperative bleeding were found after embolization of the supplying arteria in 2 cases. Conclusion: DSA is the effective method for the diagnosis and preoperative assessment of CBT. Preoperative embolization of CBT may contribute to the reduced intraoperative bleeding.

  12. Comparative Study on 16-slice CT Coronary Angiography vs Conventional Coronary Angiography-A Report of 38 Cases

    Institute of Scientific and Technical Information of China (English)

    Yan CHEN; Ping HAN; Bo LIANG; Huimin LIANG; Ziqiao LEI; Zhiliang TIAN; Gansheng FENG; Jie XIAO

    2008-01-01

    The clinical application of 16-slice CT coronary angiography (CTCA) and the impact of plaques differently characterized on assessing coronary artery stenosis were evaluated. Thirty-eight patients with coronary artery disease diagnosed by conventional coronary angiography (CAG) un- derwent 16-slice CTCA (collimation: 16×0.75 mm; rotation time: 420 msec; kernel: 35f; effective current: 500 mAs; tube voltage: 120 kV). The interval between CTCA and CAG was within one month. CTCA was evaluated by consensus of two independent experienced radiologists unknowing CAG findings. Original images, maximum intensity projections and multiplanar reconstructions were used to assess coronary artery stenosis. For a determined plaque an attenuation value≥130 HU was considered as calcified, and <130 HU noncalcified. The plaques were then classified into significant calcification (extensive calcification), medium calcification (small isolated calcification) and noncal- cification. The diagnostic accuracy of 16-slice CTCA findings as well as to detect ≥50% stenoses caused by plaques was evaluated respectively regarding CAG as the standard of reference. In com- parison with CAG findings, the sensitivity, specificity, positive and negative predictive value derived from CTCA for mild stenosis (<50%) were 72.7%, 38.5%, 50%, 62.5%, respectively; for moderate stenosis (50%-75%) 82.4%, 72.7%, 70%, 84.2%, resepctively; and for severe coronary stenosis (>75%) 85%, 90.5%, 81%, 92.7% respectively. With the increase of stenoses degree, the value of CTCA was greater. For the classification of the plaque calcification with ≥50% stenosis CTCA at- tained the sensitivity, specificity, positive and negative predictive value for severe calcificatoin 73.3%, 22.2%, 61.1% and 33.3%, respectively; for moderate calcification 70%, 55.6%, 63.6% and 62.5%, respectively; for noncalcification 93.8%, 85.7%, 93.8% and 85.7% respectively. CTCA was restricted in assessing coronary artery stenosis in the

  13. Comparison between fast contrast-enhanced MR angiography and DSA in diagnosing spinal cord vascular malformations

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic and clinical value of fast contrast-enhanced MR angiography (CE-MRA) with elliptic centric phase-encoding in spinal cord vascular malformations. Methods Fast three-dimensional contrast-enhanced MR angiography with elliptic centric phase-encoding and superconducting 1.5T system was applied prospectively in twenty-five consecutive patients with clinically suspected of spinal cord vascular malformations. All cases were performed with selective spinal digital subtraction angiography, including 18 cases treated by surgery and 2 of them with embolization before surgery, MR angiography follow up were undertaken in ten patients after surgery. Comparing fast contrast-enhanced MR angiography with DSA in diagnosing spinal cord vascular malformations included the origin of feeding artery, the feeding artery, the fistula or the nidus, the draining vein, and the vessel image quality based on the gold standard of selective spinal digital subtraction angiography. Results: Surgically proven diseases included spinal arteriovenous malformations(3 cases), spinal cord perimedullary arteriovenous fistulas (5 cases), spinal dural arteriovenous fistulas (8 cases), paravertebral arteriovenous fistulas (1 case), and spontaneous spinal epidural hematomas (2 eases). Comparing with DSA, the accuracy of MR angiography in diagnosing spinal cord vascular malformations; and detecting the origin of the feeding artery, the feeding artery, the shunt or the nidus and the draining vein were 93.8%, 92%, 96.2%, 100% and 100%, respectively. Overall the degree vascular enhencement were judged to be similar(P>0.05), but the vessel continuity of MRA was inferior to DSA (P<0.05). However, 9 cases of MRA showed no abnormal vascular malformation coinciding with those of surgery. Posttreatment MR angiography did not depict any abnormal vessels again. Conclusions: Fast three-dimensional contrast-enhanced MR angiography with elliptic centric phase-encoding may provide

  14. MR angiography of the head with Fastcard STAR (gated k-space segmentation signal targeting with alternative radiofrequency)

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Koichiro; Okada, Susumu; Sakurai, Minoru; Saito, Haruyoshi; Takaoka, Shinichi; Kato, Joji [Nippon Medical School (Japan). Chiba Hokusoh Hospital; Kumazaki, Tatsuo; Moriya, Hiroto

    1997-09-01

    Signal targeting with alternative radiofrequency (STAR) is reported to create good vascular depiction in MR angiography. We combined this technique with a Fastcard data acquisition scheme for rapid examination (32 sec acquisition time) and compatibility to pulsative flow. In 60 cases, cerebral MR angiography was performed with the Fastcard STAR sequence and compared with conventional 3D Time-of-Flight MR angiography. In 80% cases, axial Fastcard STAR MR angiography provided good images in quality, but less than a half cases were sufficient in coronal and sagittal images. Concerning arterial depiction, almost similar findings were predicted in both techniques. However, Fastcard STAR MR angiography only revealed very slow flow in a case of traumatic carotid-cavernous sinus fistula. Although Fastcard STAR MR angiography has several drawbacks in lower image SNR and incapability of postprocessings, it provides sufficient arterial depiction in short acquisition time, and is especially advantageous in slow flow. (author)

  15. A Randomized-Controlled Trial Examining the Effects of Reflexology on Anxiety of Patients Undergoing Coronary Angiography

    OpenAIRE

    Molavi Vardanjani, Mehdi; Masoudi Alavi, Negin; Razavi, Narges Sadat; Aghajani, Mohammad; Azizi-Fini, Esmail; Vaghefi, Seied Morteza

    2013-01-01

    Background: The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. Objectives: The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. Patients and Methods: This t...

  16. Induced apnea enhances image quality and visualization of cardiopulmonary anatomic during contrastenhanced cardiac computerized tomographic angiography in children

    OpenAIRE

    Murali Chakravarthy; Gubbihalli Sunilkumar; Sumant Pargaonkar; Rajathadri Hosur; Chidananda Harivelam; Deepak Kavaraganahalli; Pradeep Srinivasan

    2015-01-01

    Objective: The purpose of our study was to determine the effect of induced apnea on quality of cardiopulmonary structures during computerized tomographic (CT) angiography images in children with congenital heart diseases. Methods: Pediatric patients with congenital heart defects undergoing cardiac CT angiography at our facility in the past 3 years participated in this study. The earlier patients underwent cardiac CT angiography without induced apnea and while, later, apnea was induced in pati...

  17. CRosser As First choice for crossing Totally occluded coronary arteries (CRAFT Registry): Focus on conventional angiography and computed tomography angiography predictors of success

    NARCIS (Netherlands)

    H.M. Garcia-Garcia (Hector); S. Brugaletta (Salvatore); C.A.G. van Mieghem (Carlos); N. Gonzalo (Nieves); R. Diletti (Roberto); J. Gomez-Lara (Josep); F. Airoldi (Flavio); M. Carlino (Mauro); D. Tavano (Davide); A. Chieffo (Alaide); M. Montorfano (Matteo); I. Michev (Iassen); A. Colombo (Antonio); M. van der Ent (Martin); P.W.J.C. Serruys (Patrick)

    2011-01-01

    textabstractAims: We investigated the use of the CROSSER catheter, a CTO crossing device based upon high frequency mechanical vibration, as a first resort to treat patients with chronic total occlusions (CTO) while describing angiographic and computed tomography coronary angiography (CTCA) serving a

  18. Radiation Dose and Image Quality at High-Pitch CT Angiography of the Aorta : Intraindividual and Interindividual Comparisons With Conventional CT Angiography

    NARCIS (Netherlands)

    Apfaltrer, Paul; Hanna, E. Lexworth; Schoepf, U. Joseph; Spears, J. Reid; Schoenberg, Stefan O.; Fink, Christian; Vliegenthart, Rozemarijn

    2012-01-01

    OBJECTIVE. The objective of our study was to evaluate radiation dose and quantitative image quality parameters at high-pitch CT angiography (CTA) of the aorta compared with conventional CTA. MATERIALS AND METHODS. We studied the examinations of 110 patients (65 men and 45 women; mean age +/- SD, 64

  19. Radiological findings of dissecting aneurysm -a correlative study of CT with angiography-

    International Nuclear Information System (INIS)

    This study comprised 16 patients with aortic dissecting aneurysm who were admitted to Seoul National University Hospital from May 1984 to January 1987. CT findings in 16 cases of aortic dissecting aneurysm were correlated with angiographic findings retrospectively. The results were analysed. 1. Number of male was 11 and that of female was 5. Male patients in fifties were most common and 4 in number. 13 patients had hypertension or history of hypertension among 14 patients. There were one case of Marfan's syndrome, preeclampsia and Takayasu's arteritis respectively. 2. There were 5 cases of DeBakey type I, 1 case of type II and 9 cases of types III dissecting aneurysm. Type III was most common. 3. CT confirmed as superior vena cava which was not identified whether it was superior vena cava or unopacified false lumen by angiography in one case. Regarding distal extent, authors defined A whose extent was proximal to diaphragm and B beyond it for convenience sake. There was one false negative case in CT among 16 cases which was diagnosed as dissecting aneurysm type IIIB by angiography and confirmed as type III surgically. One case was diagnosed as type IB by CT and as type IIIB by angiography and confirmed as type I surgically. Extent was more accurate in CT than angiography. One case was diagnosed as type II by CT but misdiagnosed as right atrial tumor by angiography. 4. Diagnostic sensitivities of CT and angiography in this study were 94% (15/16) respectively. CT was more advantageous in hemothorax, hemopericardium, hemomediastinum, unopacified false lumen, aortic wall calcification and getting information about mediastinum. In angiography aortic regurgitation and tear site and involvement of abdominal vessels could be observed

  20. Feasibility and utility of transradial cerebral angiography: experience during the learning period

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyung; Park, Yong Sung; Chung, Chul Gu; Park, Kyeong Sug; Chung, Dong Jin; Kim, Hyun Jin [Konyang University Hospital, Daejeon (Korea, Republic of)

    2006-03-15

    We wanted to present our experiences for performing transradial cerebral angiography during the learning period, and we also wanted to demonstrate this procedure's technical feasibility and utility in various clinical situations. Thirty-two patients were enrolled in the study. All of them had unfavorable situations for performing transfemoral angiography, i.e., IV lines in the bilateral femoral vein, a phobia for groin puncture, decreased blood platelet counts, large hematoma or bruise, atherosclerosis in the bilateral femoral artery and the insistence of patients for choosing another procedure. After con firming the patency of the ulnar artery with a modified Allen's test and a pulse oximeter, the procedure was done using a 21-G micorpuncture set and 5-F Simon II catheters. After angiography, hemostasis was achieved with 1-2 minutes of manual compression and the subsequent application of a hospital-made wrist brace for two hours. The technical feasibility and procedure-related immediate and delayed complications were evaluated. The procedure was successful in 30/32 patients (93.8%). Failure occurred in two patients; one patient had hypoplasia of the radial artery and one patient had vasospasm following multiple puncture trials for the radial artery. Transradial cerebral angiography was technically feasible without significant difficulties even though it was tried during the learning period. Pain in the forearm or arm developed in some patients during the procedures, but this was usually mild and transient. Procedure-related immediate complications included severe bruising in one patient and a small hematoma in one patient. Any clinically significant complication or delayed complication such as radial artery occlusion was not demonstrated in our series. Transradial cerebral angiography is a useful alternative for the patients who have unfavorable clinical situations or contraindications for performing transfemoral cerebral angiography. For the experienced

  1. Diagnostic value of 64-slice CT angiography in coronary artery disease: A systematic review

    International Nuclear Information System (INIS)

    Purpose: To perform a systematic review of the diagnostic value of 64-multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography. Materials and methods: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 64-slice MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analysed at segment-, vessel- and patient-based assessment. Results: Fifteen studies met selection criteria and were included for analysis. Pooled sensitivity, specificity, positive predictive value and negative predictive value as well as 95% confidence interval (CI) were 97% (94 and 99%), 88% (79 and 97%), 94% (91 and 97%), and 95% (90 and 99%) for patient-based assessment; 92% (85 and 99%), 92% (85 and 99%), 78% (66 and 91%) and 98% (96 and 99%) for vessel-based assessment; 90% (85 and 94%), 96% (95 and 97%), 75%(68 and 82%) and 98% (98 and 99%) for segment-based assessment, respectively. No significant difference was found in the diagnostic accuracy of 64-slice CT in the detection of CAD when comparison was performed either among four main coronary arteries, or between proximal and middle or distal segments (p > 0.05). Conclusion: Our results showed that 64-slice CT angiography has a high-diagnostic value in the detection of CAD. Severe coronary artery calcification seems to be the major factor affecting the visualisation and assessment

  2. Effect of Benson Relaxation Techniques on Hemodynamic Variables of Patient Undergoing Coronary Angiography

    Directory of Open Access Journals (Sweden)

    M khani

    2005-01-01

    Full Text Available Introduction: Invasive diagnostic procedures such as coronary angiography, in most cases, are accompanied by stress and anxiety for patients,which may effect on hemodynamic signs. Materials and Methods:This research, as a quasi experimental study, has the objective to determine the influence of applying methods of relaxation on hemodynamic signs in hospitalized 40 patients, experienciny coronary angiography (CA,, has been studied, in regard to existing conditions and methods of sampling and random allocation to two groups of control and relaxation at 2003 . Data collection tool included demographic and disease related information sheet, as well as record sheets for hemodynamic parameters at intervals of 8-12 and ½ hrs before, during and after the angiography. For relaxation group, the researcher would speak individually about the influence of relaxation, the day before angiography; Then with the aid of client himself/herself, performed relaxation instances in a single bout, and eventually asked client to perform relaxation technique 2-3 times before going for angiography. In control group was attended in the usual manner preangiographically. Homodynamic parameters were measured in both groups 8-12 and ½ hrs, before during and after CA. Afterward, resulted data were analyzed statistically by T-Test Chi-squre. Results: With T-Test, respiratory rates½ hrs, beforeAngiography, diastolic blood pressure and Respiratory Rate after Angiography showed statisticaly significant difference between two groups (P0.05.but most of parameters showed clinically significant difference between two groups. Conclusion: Therfore it is offered that relaxation method is applied after invasive procedures.

  3. Radiological findings of dissecting aneurysm -a correlative study of CT with angiography-

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Tae Yeong; Park, Jae Hyung; Kim, Seung Hyup; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1987-06-15

    This study comprised 16 patients with aortic dissecting aneurysm who were admitted to Seoul National University Hospital from May 1984 to January 1987. CT findings in 16 cases of aortic dissecting aneurysm were correlated with angiographic findings retrospectively. The results were analysed. 1. Number of male was 11 and that of female was 5. Male patients in fifties were most common and 4 in number. 13 patients had hypertension or history of hypertension among 14 patients. There were one case of Marfan's syndrome, preeclampsia and Takayasu's arteritis respectively. 2. There were 5 cases of DeBakey type I, 1 case of type II and 9 cases of types III dissecting aneurysm. Type III was most common. 3. CT confirmed as superior vena cava which was not identified whether it was superior vena cava or unopacified false lumen by angiography in one case. Regarding distal extent, authors defined A whose extent was proximal to diaphragm and B beyond it for convenience sake. There was one false negative case in CT among 16 cases which was diagnosed as dissecting aneurysm type IIIB by angiography and confirmed as type III surgically. One case was diagnosed as type IB by CT and as type IIIB by angiography and confirmed as type I surgically. Extent was more accurate in CT than angiography. One case was diagnosed as type II by CT but misdiagnosed as right atrial tumor by angiography. 4. Diagnostic sensitivities of CT and angiography in this study were 94% (15/16) respectively. CT was more advantageous in hemothorax, hemopericardium, hemomediastinum, unopacified false lumen, aortic wall calcification and getting information about mediastinum. In angiography aortic regurgitation and tear site and involvement of abdominal vessels could be observed.

  4. CT ANGIOGRAPHY EVALUATION OF PERIPHERAL VASCULAR DISEASE AND COMPARISON WITH COLOR DOPPLER ULTRASOUND

    Directory of Open Access Journals (Sweden)

    Sathyabhuwan Singh

    2015-10-01

    Full Text Available I NTRODUCTION: Peripheral vascular disease is narrowing or occlusion of arteries and comprises of atherosclerosis, burger,s disease, Renoud,s disease and aneurysm. DSA, CT angiography and color Doppler ultrasound are the radiological modalities used for these diseases. Here we compared role of the CT angiography and Color Doppler ultrasonography in detection of peripheral vascular disease. AIMS AND OBJECTIVE: To assess the role of CT angiography in peripheral vascular disease and comparison with color Doppler ultrasound. MATERIAL AND METHOD: we examined 50 patients by CT angiography and color Doppler ultrasound who were suspected for arterial disease. We divided the disease on the ground of severity as follows: No stenosis - grade - 0, 0 - 25% stenosis - grade - 1 , 25 - 50% stenosis - grade - 2, 50 - 75 % stenosis - grade - 3 and 75 - 100% stenosis - grade - 4. We compared the two modalities in terms of diagnosis and grading of peripheral vascular disease . RESULT: We found Color Doppler ultrasound detected more number of normal vessel segment, gra de - 1 and grade - 2 stenosis. In stenosis grade - 3 and grade - 4 CT angiography and Color Doppler ultrasound are equally sensitive. CONCLUSION: Doppler sonography is better than CT angiography in the diagnosis of early onset ( Grade I & II cases, with a better a ssessment of soft plaques, segmental flow and re - canalisation in peripheral arterial disease. CDUS is the initial modality of choice in any case of peripheral arterial disease. CT angiography is more accurate in assessing grade - 3 and grade - 4 stenosis. CT a ngiography exceeds the color Doppler in detecting vascular lesions in cases of gas gangrene and thick patients.

  5. The Impact of Aromatherapy on the Anxiety of Patients Experiencing Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Homeyra Tahmasbi

    2012-03-01

    Full Text Available Background: Anxiety among patients experiencing coronary angiography increases within invasive studies including angiography. Anxiety as an intensifier at cardiovascular reactions can endanger patients in angiography clinics. Studies indicate that lavendula spica L. inhalation can decrease anxiety. The purpose of this study is to determine the impact of aromatherapy on the anxiety level of patients experiencing coronary angiography. Materials and Methods: This research is a clinical trial study performed on a group of 96 patients hospitalized in Sari Fatemeh-Zahra Hospital for coronary angiography who were randomly selected. They were divided in two subject (45 patients and control (46 patients groups. Demographic data sheets, recording sheet of homodynamic variables and Spielberger state-trait anxiety inventory were distributed among the two groups before and after aromatherapy. The data were analyzed using SPSS-16 as well as statistical T-test and chi-square test. Results: The two groups were homogenous in terms of gender, marital status, level of education, sickness background, age and health insurance. The data indicated that anxiety level decreased significantly in the subject group compared with the control group after aromatherapy (P < 0.0001. There was also a significant difference in systolic and diastolic blood pressure and respiratory rate as well as heartbeat parameters in these two groups. (P<0.05 Conclusion: Lavendula aroma inhalation can decrease anxiety level of patients before coronary angiography and accordingly aromatherapy can be used as health care intervention and mental support, without any side effects, for the patients before invasive interventions such as angiography.

  6. Angiography reveals novel features of the retinal vasculature in healthy and diabetic mice.

    Science.gov (United States)

    McLenachan, Samuel; Magno, Aaron Len; Ramos, David; Catita, Joana; McMenamin, Paul G; Chen, Fred Kuanfu; Rakoczy, Elizabeth Piroska; Ruberte, Jesus

    2015-09-01

    The mouse retina is a commonly used animal model for the study of pathogenesis and treatment of blinding retinal vascular diseases such as diabetic retinopathy. In this study, we aimed to characterize normal and pathological variations in vascular anatomy in the mouse retina using fluorescein angiography visualized with scanning laser ophthalmoscopy and optical coherence tomography (SLO-OCT). We examined eyes from C57BL/6J wild type mice as well as the Ins2(Akita) and Akimba mouse models of diabetic retinopathy using the Heidelberg Retinal Angiography (HRA) and OCT system. Angiography was performed on three focal planes to examine distinct vascular layers. For comparison with angiographic data, ex vivo analyses, including Indian ink angiography, histology and 3D confocal scanning laser microscopy were performed in parallel. All layers of the mouse retinal vasculature could be readily visualized during fluorescein angiography by SLO-OCT. Blood vessel density was increased in the deep vascular plexus (DVP) compared with the superficial vascular plexus (SVP). Arteriolar and venular typologies were established and structural differences were observed between venular types. Unexpectedly, the hyaloid artery was found to persist in 15% of C57BL/6 mice, forming anastomoses with peripheral retinal capillaries. Fluorescein leakage was easily detected in Akimba retinae by angiography, but was not observed in Ins2(Akita) mice. Blood vessel density was increased in the DVP of 6 month old Ins2(Akita) mice, while the SVP displayed reduced branching in precapillary arterioles. In summary, we present the first comprehensive characterization of the mouse retinal vasculature by SLO-OCT fluorescein angiography. Using this clinical imaging technique, we report previously unrecognized variations in C57BL/6J vascular anatomy and novel features of vascular retinopathy in the Ins2(Akita) mouse model of diabetes. PMID:26122048

  7. Feasibility and utility of transradial cerebral angiography: experience during the learning period

    International Nuclear Information System (INIS)

    We wanted to present our experiences for performing transradial cerebral angiography during the learning period, and we also wanted to demonstrate this procedure's technical feasibility and utility in various clinical situations. Thirty-two patients were enrolled in the study. All of them had unfavorable situations for performing transfemoral angiography, i.e., IV lines in the bilateral femoral vein, a phobia for groin puncture, decreased blood platelet counts, large hematoma or bruise, atherosclerosis in the bilateral femoral artery and the insistence of patients for choosing another procedure. After con firming the patency of the ulnar artery with a modified Allen's test and a pulse oximeter, the procedure was done using a 21-G micorpuncture set and 5-F Simon II catheters. After angiography, hemostasis was achieved with 1-2 minutes of manual compression and the subsequent application of a hospital-made wrist brace for two hours. The technical feasibility and procedure-related immediate and delayed complications were evaluated. The procedure was successful in 30/32 patients (93.8%). Failure occurred in two patients; one patient had hypoplasia of the radial artery and one patient had vasospasm following multiple puncture trials for the radial artery. Transradial cerebral angiography was technically feasible without significant difficulties even though it was tried during the learning period. Pain in the forearm or arm developed in some patients during the procedures, but this was usually mild and transient. Procedure-related immediate complications included severe bruising in one patient and a small hematoma in one patient. Any clinically significant complication or delayed complication such as radial artery occlusion was not demonstrated in our series. Transradial cerebral angiography is a useful alternative for the patients who have unfavorable clinical situations or contraindications for performing transfemoral cerebral angiography. For the experienced

  8. Development of a theory for generating regional cardiac perfusion images during coronary angiography in the coronary angiography lab.

    Science.gov (United States)

    Sakaguchi, Takuya; Ichihara, Takashi; Trost, Jeffrey C; Yousuf, Omair; Lima, Joao A C; Yao, Jingwu; George, Richard T

    2014-01-01

    The purpose of this study was to develop a novel theory and method for generating regional myocardial perfusion images using fluoroscopy in the coronary angiography lab. We modified the Kety model to introduce the Patlak plot method for two-dimensional fluoroperfusion (FP) imaging. For evaluation, seven porcine models of myocardial ischemia with stenosis in the left coronary artery were prepared. Rest and stress FP imaging were performed using cardiovascular X-ray imaging equipment during the injection of iopamidol via the left main coronary artery. Images were acquired and retrospectively ECG gated at 80 % of the R-R interval. FP myocardial blood flow (MBF) was obtained using the Patlak plot method applied to time-intensity curve data of the proximal artery and myocardium. The results were compared to microsphere MBF measurements. Time-intensity curves were also used to generate color-coded FP maps. There was a moderate linear correlation between the calculated FP MBF and the microsphere MBF (y = 0.9758x + 0.5368, R² = 0.61). The color-coded FP maps were moderately correlated with the regional distribution of flow. This novel method of first-pass contrast-enhanced two-dimensional fluoroscopic imaging can quantify MBF and provide color coded FP maps representing regional myocardial perfusion.

  9. Predictors of positive angiography and evaluation of the outcome of transcatheter control of non variceal upper gastrointestinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Mohammad Abusedera

    2016-03-01

    Conclusion: Transcatheter angiography and embolization is safe and effective. Embolization can be done empirically even when angiographically negative is based on endoscopic localization of bleeding source.

  10. CT coronary angiography in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    Purpose: Reliable visualization of the coronary arteries with multislice spiral CT angiography (MSCTA) in patients with atrial fibrillation (AF) remains a challenge despite retrospective ECG gating. A recently developed new algorithm automatically compensates dynamic changes in the heart rate during the scan, thus reducing misregistration and motion artifacts. The HeartBeat-RT algorithm combines a fixed percent delay determined from the first R wave and the fixed offset delay based on the second R wave in the ECG cycle. The purpose of this study was to find out the optimal reconstruction window in MSCTA in patients with AF for each of the three major coronary arteries during the cardiac cycle. Materials and methods: 20 patients with permanent AF were imaged on a 16-slice scanner (slice collimation: 16 x 0.75 mm; rotation time 0.42 s; 140 kV; 380 mAs; 120 ml Ultravist 370 registered i.v.). The patients had not received any previous drugs for heart frequency regulation. Acquisition was started after bolus tracking of a biphasic bolus of 120 ml Ultravist 370 injected intravenously. Each coronary segment was reconstructed at 0%-90% of the cardiac cycle in increments of 10%. For image analysis we used coronary segments as defined by the American Heart Association. Two blinded independent readers assessed the image quality in terms of visibility and artifacts (five-point rating scale 1=very poor, 2=poor, 3=fair, 4=good and 5=excellent) and the degree of stenosis (five-point rating scale 1=0%, 2=1%-49%, 3=50%-74%, 4=75%-99%, 5=100%) on axial slices, multiplanar reconstructions and three-dimensional volume-rendered images. (orig.)

  11. Medical personnel and patient dosimetry during coronary angiography and intervention

    Science.gov (United States)

    Efstathopoulos, Efstathios P.; Makrygiannis, Stamatis S.; Kottou, Sofia; Karvouni, Evangelia; Giazitzoglou, Eleftherios; Korovesis, Socrates; Tzanalaridou, Efthalia; Raptou, Panagiota D.; Katritsis, Demosthenes G.

    2003-09-01

    Percutaneous coronary interventions are associated with increased radiation exposure compared to most radiological examinations. This prospective study aimed at (1) measuring entrance doses for all in-room personnel, (2) performing an assessment of patient effective dose and intracoronary doses, (3) investigating the contribution of each projection to kerma-area product (KAP) and irradiation time, (4) comparing results with established DRL values in this clinical setting and (5) estimating the risk for fatal cancer to patients and operators. Measurements were performed during 40 consecutive procedures of coronary angiography (CA), half of which were followed by ad hoc coronary angioplasty (PTCA). KAP measurements were used for patients and thermoluminescent dosimetry for the in-room personnel. The mean KAP value per procedure for CA was 29 +/- 9 Gy cm2. Thirty four per cent of KAP was due to fluoroscopy, whereas the remainder (66%) was due to digital cine. Accordingly, the mean KAP value per PTCA procedure was 75 +/- 30 Gy cm2, and contribution of fluoroscopy is 57%. Effective dose per year was estimated to be 0.04-0.05 mSv y-1 for the primary operator, and 0.03-0.04 mSv y-1 for those assisting. Corresponding measurements for radiographer and nurse were below detectable level, implying minimal radiation hazards for them. Regarding radiation exposure, coronary intervention is considered a quite safe procedure for both patients and personnel in laboratories with modern equipment and experienced operators as long as standard safety precautions are considered. Exposure optimization though should be constantly sought through continuous review of procedures.

  12. CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli.

    Directory of Open Access Journals (Sweden)

    Andrew J Schissler

    Full Text Available BACKGROUND: It is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA utilization has resulted in increased detection of pulmonary emboli (PEs with a less severe disease spectrum. METHODS: Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecutive initial CTPAs performed in adult patients in the emergency department of a large urban academic medical center between 1/1/2004 and 10/31/2009. Transthoracic echocardiography (TTE findings and peak serum troponin levels were evaluated to assess for the presence of PE-associated right ventricular (RV abnormalities (dysfunction or dilatation and myocardial injury, respectively. Statistical analyses were performed using multivariate logistic regression. RESULTS: 268 CTPAs (6.6% were positive for acute PE, and 3,780 (93.4% demonstrated either no PE or chronic PE. There was a significant increase in the likelihood of undergoing CTPA per year during the study period (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04-1.07, P<0.01. There was no significant change in the likelihood of having a CTPA diagnostic of an acute PE per year (OR 1.03, 95% CI 0.95-1.11, P = 0.49. The likelihood of diagnosing a less severe PE on CTPA with no associated RV abnormalities or myocardial injury increased per year during the study period (OR 1.39, 95% CI 1.10-1.75, P = 0.01. CONCLUSIONS: CTPA utilization has risen with no corresponding change in diagnostic yield, resulting in an increase in PE detection. There is a concurrent rise in the likelihood of diagnosing a less clinically severe spectrum of PEs.

  13. MRI and MR angiography of vertebral artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, M. [Cattedra di Radiologia, Universita di Pisa (Italy); Bianchi, M.C. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Mangiafico, S. [Servizio di Neuroradiologia, Ospedale di Careggi, Firenze (Italy); Ferrito, G. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Puglioli, M. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Marin, E. [Servizio di Radiologia, Ospedale S. M. Nuova, Firenze (Italy); Mugnai, S. [Clinica Neurologica, Universita di Firenze (Italy); Canapicchi, R. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Quilici, N. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Inzitari, D. [Clinica Neurologica, Universita di Firenze (Italy)

    1997-05-01

    A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3-20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients. (orig.). With 7 figs., 3 tabs.

  14. Manifestations of hepatic cavernous hemangioma in carbon dioxidedigital subtraction angiography

    Institute of Scientific and Technical Information of China (English)

    LU Wei; LI Yan-ha0; HE Xiao-feng; CHEN Yong; ZENG Qing-le

    2002-01-01

    Objective: To describe the characteristic appearance of cavernous hemangioma of the liver (CHL)presented in carbon dioxide digital subtraction angiography (CO2-DSA) and to evaluate the significance of CO2-DSA in the diagnosis of CHL. Methods: Both CO2-DSA and iodinated contrast DSA (IC-DSA) were performed in all 16 patients with CHL, and the angiographic manifestations in the same patients were compared. The image quality was rated by three experienced angiographers, and the complications were also assessed. Results; There was good correlation between angiographers on image quality (R=0. 73). Diagnostic images were obtained with both CO2-DSA and IC-DSA in all CHL patients. No difference was noted between IC-DSA and CO2-DSA in visualizing the proper hepatic arteries and its branches (P>0. 05). CO2-DSA produced better images that clearly described the tumor size, shape and margination than those by IC-DSA (P<0. 05), but both demonstrated characteristic appearances of early opacification and persistent contrast enhancement of the tumors. The portal vein branches near the tumors were constantly demonstrated by CO2-DSA in 15 cases (15/16) but only in 2 cases (2/16) by IC-DSA. Conclusion: CO2-DSA is sensitive in CHL diagnosis, and in patients with contraindications to IC or with unsatisfactory imaging results by IC-DSA,CO2-DSA is a good alternative. As show in most cases by CO2-DSA, the portal veins might act as the main drainage vein of CHLs.

  15. Cerebral angiography, blood flow and vascular reactivity in progressive hypertension

    Science.gov (United States)

    Li, Yunxia; Shen, Qiang; Huang, Shiliang; Li, Wei; Muir, Eric R.; Long, Justin; Duong, Timothy Q.

    2015-01-01

    Chronic hypertension alters cerebral vascular morphology, cerebral blood flow (CBF), cerebrovascular reactivity, increasing susceptibility to neurological disorders. This study evaluated: i) the lumen diameters of major cerebral and downstream arteries using magnetic resonance angiography, and ii) basal CBF, and iii) cerebrovascular reactivity to hypercapnia of multiple brain regions using arterial-spin-labeling technique in spontaneously hypertensive rats (SHR) at different stages. Comparisons were made with age-matched normotensive Wistar Kyoto (WKY) rats. In 10-week SHR, lumen diameter started to reduce, basal CBF, and hypercapnic CBF response were higher from elevated arterial blood pressure, but there was no evidence of stenosis, compared to age-matched WKY. In 20-week SHR, lumen diameter remained reduced, CBF returned toward normal from vasoconstriction, hypercapnic CBF response reversed and became smaller, but without apparent stenosis. In 40-week SHR, lumen diameter remained reduced and basal CBF further decreased, resulting in larger differences compared to WKY. There was significant stenosis in main supplying cerebral vessels. Hypercapnic CBF response further decreased, with some animals showing negative hypercapnic CBF responses in some brain regions, indicative of compromised cerebrovascular reserve. The territory with negative hypercapnia CBF responses corresponded with the severity of stenosis in arteries that supplied those territories. We also found enlargement of downstream vessels and formation of collateral vessels as compensatory responses to vasoconstriction upstream vessels. The middle cerebral and azygos arteries were amongst the most susceptible to hypertension-induced changes. Multimodal MRI provides clinically relevant data that might be useful to characterize disease pathogenesis, stage disease progression, and monitor treatment effects in hypertension. PMID:25731987

  16. Magnetic resonance angiography in the diagnosis of thoracic venous obstruction.

    Science.gov (United States)

    Chang, Y C; Su, C T; Yang, P C; Wang, T C; Chiu, L C; Hsu, J C

    1998-01-01

    The aims of this study were to evaluate the diagnostic value of orthogonal magnetic resonance angiography (MRA) and to compare the results of MRA with those of digital subtraction venography (DSV) in thoracic venous diseases. Ten normal volunteers were evaluated using two-dimensional time-of-flight MRA in three orthogonal planes to determine the image quality of each venous segment. Twelve consecutive patients suspected of having thoracic venous disease were studied with both MRA and DSV. In the normal subjects, the plane perpendicular to the target vein provided the most consistent visualization. Using three orthogonal MRA images, a diagnostic-quality image was obtained in 175 (83%) of 210 venous segments in normal volunteers. In patients with thoracic venous obstructive disease, MRA was more effective than DSV in detecting total (84 vs 54), patent (56 vs 36), stenotic (13 vs 10), and obstructive (15 vs 8) venous segments, poststenotic or postobstructive veins (15 vs 10), thrombosis of the internal jugular vein (7 vs 2), intraluminal thrombus (5 vs 3), and azygos veins (12 vs 2). Using venous segments visible on DVS (n = 54) as the standard, the sensitivity and specificity of MRA were 94% and 100%, respectively, in detecting venous patency, and 100% and 98% in detecting complete venous obstruction. In the shoulder region, the sensitivity and specificity of MRA were 93% and 100%, respectively, in detecting venous patency, and 100% and 97% in detecting venous obstruction. We conclude that MRA with three orthogonal planes can provide relatively complete and reliable venous mapping, without the need for contrast medium. PMID:9481063

  17. Filtered region of interest cone-beam rotational angiography

    International Nuclear Information System (INIS)

    Purpose: Cone-beam rotational angiography (CBRA) is widely used in the modern clinical settings. In a number of procedures, the area of interest is often considerably smaller than the field of view (FOV) of the detector, subjecting the patient to potentially unnecessary x-ray dose. The authors therefore propose a filter-based method to reduce the dose in the regions of low interest, while supplying high image quality in the region of interest (ROI). Methods: For such procedures, the authors propose a method of filtered region of interest (FROI)-CBRA. In the authors' approach, a gadolinium filter with a circular central opening is placed into the x-ray beam during image acquisition. The central region is imaged with high contrast, while peripheral regions are subjected to a substantial lower intensity and dose through beam filtering. The resulting images contain a high contrast/intensity ROI, as well as a low contrast/intensity peripheral region, and a transition region in between. To equalize the two regions' intensities, the first projection of the acquisition is performed with and without the filter in place. The equalization relationship, based on Beer's law, is established through linear regression using corresponding filtered and nonfiltered data. The transition region is equalized based on radial profiles. Results: Evaluations in 2D and 3D show no visible difference between conventional FROI-CBRA projection images and reconstructions in the ROI. CNR evaluations show similar image quality in the ROI, with a reduced CNR in the reconstructed peripheral region. In all filtered projection images, the scatter fraction inside the ROI was reduced. Theoretical and experimental dose evaluations show a considerable dose reduction; using a ROI half the original FOV reduces the dose by 60% for the filter thickness of 1.29 mm. Conclusions: These results indicate the potential of FROI-CBRA to reduce the dose to the patient while supplying the physician with the desired

  18. Medical personnel and patient dosimetry during coronary angiography and intervention

    Energy Technology Data Exchange (ETDEWEB)

    Efstathopoulos, Efstathios P [2nd Department of Radiology, University of Athens, 20 Papadiamantopoulou Str., 11828, Athens (Greece); Makrygiannis, Stamatis S [Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Str., 115 21 Athens (Greece); Kottou, Sofia [Department of Medical Physics, University of Athens, 3 Mikras Asias Str., Athens (Greece); Karvouni, Evangelia [Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Str., 115 21 Athens (Greece); Giazitzoglou, Eleftherios [Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Str., 115 21 Athens (Greece); Korovesis, Socrates [Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Str., 115 21 Athens (Greece); Tzanalaridou, Efthalia [Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Str., 115 21 Athens (Greece); Raptou, Panagiota D [Department of Medical Physics, KAT Hospital, Kifissia, Athens (Greece); Katritsis, Demosthenes G [Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Str., 115 21 Athens (Greece)

    2003-09-21

    Percutaneous coronary interventions are associated with increased radiation exposure compared to most radiological examinations. This prospective study aimed at (1) measuring entrance doses for all in-room personnel, (2) performing an assessment of patient effective dose and intracoronary doses, (3) investigating the contribution of each projection to kerma-area product (KAP) and irradiation time, (4) comparing results with established DRL values in this clinical setting and (5) estimating the risk for fatal cancer to patients and operators. Measurements were performed during 40 consecutive procedures of coronary angiography (CA), half of which were followed by ad hoc coronary angioplasty (PTCA). KAP measurements were used for patients and thermoluminescent dosimetry for the in-room personnel. The mean KAP value per procedure for CA was 29 {+-} 9 Gy cm{sup 2}. Thirty four per cent of KAP was due to fluoroscopy, whereas the remainder (66%) was due to digital cine. Accordingly, the mean KAP value per PTCA procedure was 75 {+-} 30 Gy cm{sup 2}, and contribution of fluoroscopy is 57%. Effective dose per year was estimated to be 0.04-0.05 mSv y{sup -1} for the primary operator, and 0.03-0.04 mSv y{sup -1} for those assisting. Corresponding measurements for radiographer and nurse were below detectable level, implying minimal radiation hazards for them. Regarding radiation exposure, coronary intervention is considered a quite safe procedure for both patients and personnel in laboratories with modern equipment and experienced operators as long as standard safety precautions are considered. Exposure optimization though should be constantly sought through continuous review of procedures.

  19. Choriocapillaris and choroidal microvasculature imaging with ultrahigh speed OCT angiography.

    Directory of Open Access Journals (Sweden)

    WooJhon Choi

    Full Text Available We demonstrate in vivo choriocapillaris and choroidal microvasculature imaging in normal human subjects using optical coherence tomography (OCT. An ultrahigh speed swept source OCT prototype at 1060 nm wavelengths with a 400 kHz A-scan rate is developed for three-dimensional ultrahigh speed imaging of the posterior eye. OCT angiography is used to image three-dimensional vascular structure without the need for exogenous fluorophores by detecting erythrocyte motion contrast between OCT intensity cross-sectional images acquired rapidly and repeatedly from the same location on the retina. En face OCT angiograms of the choriocapillaris and choroidal vasculature are visualized by acquiring cross-sectional OCT angiograms volumetrically via raster scanning and segmenting the three-dimensional angiographic data at multiple depths below the retinal pigment epithelium (RPE. Fine microvasculature of the choriocapillaris, as well as tightly packed networks of feeding arterioles and draining venules, can be visualized at different en face depths. Panoramic ultra-wide field stitched OCT angiograms of the choriocapillaris spanning ∼32 mm on the retina show distinct vascular structures at different fundus locations. Isolated smaller fields at the central fovea and ∼6 mm nasal to the fovea at the depths of the choriocapillaris and Sattler's layer show vasculature structures consistent with established architectural morphology from histological and electron micrograph corrosion casting studies. Choriocapillaris imaging was performed in eight healthy volunteers with OCT angiograms successfully acquired from all subjects. These results demonstrate the feasibility of ultrahigh speed OCT for in vivo dye-free choriocapillaris and choroidal vasculature imaging, in addition to conventional structural imaging.

  20. Hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong-liang; SUN Xing-guo; WANG Yong; LIU Zhi-hong; XIONG Chang-ming; NI Xin-hai; HE Jian-guo; LUO Qin; ZHAO Zhi-hui; ZHAO Qing

    2011-01-01

    Background Pulmonary angiography is widely performed in pulmonary hypertension patients,but its immediate effects on right heart hemodynamics and safety are not well known.The objective of this study was to investigate the right heart hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension.Methods Between January 2008 and June 2009,pulmonary hypertension patients undergoing pulmonary angiography were consecutively enrolled.Pulmonary angiography was performed during breath-holding after deep breathing.The baselineclinical data,hemodynamic measurements before and after pulmonary angiography and complications occurring within 48hours after angiography were recorded.Results Ninety-five patients were included.All received non-ionic contrast medium with a volume of (75.7±29.8) ml.Angiography reduced heart rate in patients with baseline mean pulmonary arterial pressure ≥ 60 mmHg (change of heart rate:(-3.1±7.0) beats/min,P=0.005),increased mean right atrial pressure,diastolic and end-diastolic right ventricular pressure in patients with baseline mean pulmonary arterial pressure <60 mmHg (all P <0.05).Patients with decreased mean pulmonary arterial pressure (change of mean pulmonary arterial pressure ≤ -10 mmHg) had the highest total pulmonary resistance (P=0.009 vs.no change in mean pulmonary arterial pressure (change of mean pulmonary arterial pressure,-10 mmHg to 10 mmHg); P=0.03 vs.increased mean pulmonary arterial pressure (change of mean pulmonary arterial pressure ≥ 10 mmHg)) and the lowest cardiac output (P=0.018 vs.no change in mean pulmonary arterial pressure; P=0.013 vs.increased mean pulmonary arterial pressure).There were 7 complications (7%),with 6 related to catheter and only 1 directly related to angiography.All complications were mild and no death occurred.Conclusion Pulmonary angiography has minimal effect on right heart hemodynamics and is safe in pulmonary hypertension patients.

  1. Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery

    Science.gov (United States)

    Vidal Fortuny, J.; Belfontali, V.; Sadowski, S. M.; Karenovics, W.; Guigard, S.

    2016-01-01

    Background Postoperative hypoparathyroidism remains the most common complication following thyroidectomy. The aim of this pilot study was to evaluate the use of intraoperative parathyroid gland angiography in predicting normal parathyroid gland function after thyroid surgery. Methods Angiography with the fluorescent dye indocyanine green (ICG) was performed in patients undergoing total thyroidectomy, to visualize vascularization of identified parathyroid glands. Results Some 36 patients underwent ICG angiography during thyroidectomy. All patients received standard calcium and vitamin D supplementation. At least one well vascularized parathyroid gland was demonstrated by ICG angiography in 30 patients. All 30 patients had parathyroid hormone (PTH) levels in the normal range on postoperative day (POD) 1 and 10, and only one patient exhibited asymptomatic hypocalcaemia on POD 1. Mean(s.d.) PTH and calcium levels in these patients were 3·3(1·4) pmol/l and 2·27(0·10) mmol/l respectively on POD 1, and 4·0(1.6) pmol/l and 2·32(0·08) mmol/l on POD 10. Two of the six patients in whom no well vascularized parathyroid gland could be demonstrated developed transient hypoparathyroidism. None of the 36 patients presented symptomatic hypocalcaemia, and none received treatment for hypoparathyroidism. Conclusion PTH levels on POD 1 were normal in all patients who had at least one well vascularized parathyroid gland demonstrated during surgery by ICG angiography, and none required treatment for hypoparathyroidism. PMID:26864909

  2. Diagnostic value of color Doppler ultrasonography and MDCT angiography in complications of hemodialysis fistulas and grafts

    International Nuclear Information System (INIS)

    Purpose: The purpose of the study was to compare the diagnostic value of color Doppler ultrasonography (CDUS) and multidetector computed tomography (MDCT) angiography against that of digital subtraction angiography (DSA) or surgery in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs). Materials and methods: CDUS and MDCT angiography were performed with 41 patients (24 men, 17 women; mean age 55.8) with dysfunctional hemodialysis fistulas. The presence of stenosis, thrombosis, aneurysm, pseudoaneurysm and seroma were recorded. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) and accuracy of CDUS and MDCT angiography were calculated both individually and in combination for the detection of vascular segments with significant stenosis, thrombosis, aneurysms, pseudoaneurysms, perivascular complications and stenosis subgroups. Results: Sixty-four segmental lesions were diagnosed by DSA or surgery. Sensitivity, specificity, PPV, NPV and accuracy of CDUS for all vascular tree lesions were 85.9%, 99.2%, 96.4%, 96.7% and 94.5%, respectively. For MDCT angiography the figures were 96.8%, 99.6%, 98.4%, 99.2% and 98.5%, respectively. When both tests were used in combination, sensitivity, specificity, PPV, NPV and accuracy for all vascular tree lesions rose to 100%. Conclusion: Combined use of MDCT and CDUS for diagnosis of AVF dysfunctions is of equivalent value to surgery or DSA, a gold standard technique

  3. Reconstruction of coronary arteries from X-ray angiography: A review.

    Science.gov (United States)

    Çimen, Serkan; Gooya, Ali; Grass, Michael; Frangi, Alejandro F

    2016-08-01

    Despite continuous progress in X-ray angiography systems, X-ray coronary angiography is fundamentally limited by its 2D representation of moving coronary arterial trees, which can negatively impact assessment of coronary artery disease and guidance of percutaneous coronary intervention. To provide clinicians with 3D/3D+time information of coronary arteries, methods computing reconstructions of coronary arteries from X-ray angiography are required. Because of several aspects (e.g. cardiac and respiratory motion, type of X-ray system), reconstruction from X-ray coronary angiography has led to vast amount of research and it still remains as a challenging and dynamic research area. In this paper, we review the state-of-the-art approaches on reconstruction of high-contrast coronary arteries from X-ray angiography. We mainly focus on the theoretical features in model-based (modelling) and tomographic reconstruction of coronary arteries, and discuss the evaluation strategies. We also discuss the potential role of reconstructions in clinical decision making and interventional guidance, and highlight areas for future research. PMID:27054277

  4. Doppler Fourier Domain Optical Coherence Tomography for Label-Free Tissue Angiography

    Science.gov (United States)

    Leitgeb, Rainer A.; Szkulmowski, Maciej; Blatter, Cedric; Wojtkowski, Maciej

    Information about tissue perfusion and the vascular structure is certainly most important for assessment of tissue state or personal health and the diagnosis of any pathological conditions. It is therefore of key medical interest to have tools available for both quantitative blood flow assessment as well as qualitative vascular imaging. The strength of optical techniques is the unprecedented level of detail even for small capillary structures or microaneurysms and the possibility to combine different techniques for additional tissue spectroscopy giving insight into tissue metabolism. There is an immediate diagnostic and pharmacological demand for high-resolution, label-free, tissue angiography and flow assessment that in addition allow for precise depth gating of flow information. The most promising candidate is Doppler optical coherence tomography (DOCT) being noncontact, label free, and without employing hazardous radiation. DOCT provides fully quantitative volumetric information about blood flow together with the vascular and structural anatomy. Besides flow quantification, analysis of OCT signal fluctuations allows to contrast moving scatterers in tissue such as red blood cells from static tissue. This allows for non-invasive optical angiography and yields high resolution even for smallest capillaries. Because of the huge potential of DOCT and lable-free optical angiography for diagnosis, the last years saw a rapid increase of publications in this field with many different approaches. The present chapter gives an overview over existing Doppler OCT approaches and angiography techniques. It furthermore discusses limitations and noise issues, and gives examples for angiography in the eye and the skin.

  5. MR angiography in the diagnosis of tumors in the head and neck

    International Nuclear Information System (INIS)

    40 normal individuals and 153 patients with lesions in the head and neck were examined by conventional imaging methods and by means of MR angiography (1.5 Tesla Magnetome). The problems to be solved concerned the ralationship between tumors and vessels and vascular anomalies and abnormalities at the skull base (56 cases), the facial skeleton (62 cases) and the neck (35 cases). Digital subtraction angiography was performed in 54 patients and the findings corelated with MR angiography. Optimal results were obtained by using a FISP 3D sequence; in this way arterial structures could be rendered reproducibly down to a diameter of 2 mm. The venous system in the head and neck was best shown by a FLASH 2D sequence. Correlation with arterial DSA showed high accuracy of MR angiography (91%) concerning displacement of vessels, the topography and the recognition of vascular occlusions. Our results indicate that MR angiography is a rapid and reliable procedure for evaluating the arterial and venous changes due to tumors in the head and neck region. (orig.)

  6. Diagnostic value of color Doppler ultrasonography and MDCT angiography in complications of hemodialysis fistulas and grafts

    Energy Technology Data Exchange (ETDEWEB)

    Cansu, Aysegul, E-mail: drcansu@gmail.com [Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey); Soyturk, Mehmet; Ozturk, Mehmet Halil; Kul, Sibel [Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey); Pulathan, Zerrin [Department of Cardiovascular Surgery, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey); Dinc, Hasan [Department of Radiology, Karadeniz Technical University, School of Medicine, Farabi Hospital, 61080 Trabzon (Turkey)

    2013-09-15

    Purpose: The purpose of the study was to compare the diagnostic value of color Doppler ultrasonography (CDUS) and multidetector computed tomography (MDCT) angiography against that of digital subtraction angiography (DSA) or surgery in the evaluation of failing hemodialysis arteriovenous fistulas (AVFs). Materials and methods: CDUS and MDCT angiography were performed with 41 patients (24 men, 17 women; mean age 55.8) with dysfunctional hemodialysis fistulas. The presence of stenosis, thrombosis, aneurysm, pseudoaneurysm and seroma were recorded. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) and accuracy of CDUS and MDCT angiography were calculated both individually and in combination for the detection of vascular segments with significant stenosis, thrombosis, aneurysms, pseudoaneurysms, perivascular complications and stenosis subgroups. Results: Sixty-four segmental lesions were diagnosed by DSA or surgery. Sensitivity, specificity, PPV, NPV and accuracy of CDUS for all vascular tree lesions were 85.9%, 99.2%, 96.4%, 96.7% and 94.5%, respectively. For MDCT angiography the figures were 96.8%, 99.6%, 98.4%, 99.2% and 98.5%, respectively. When both tests were used in combination, sensitivity, specificity, PPV, NPV and accuracy for all vascular tree lesions rose to 100%. Conclusion: Combined use of MDCT and CDUS for diagnosis of AVF dysfunctions is of equivalent value to surgery or DSA, a gold standard technique.

  7. Ventilation-perfusion scanning and pulmonary angiography: correlation in clinical high-probability pulmonary embolism

    International Nuclear Information System (INIS)

    During a 3-year period, 173 clinically selected patients underwent pulmonary angiography to confirm or exclude acute pulmonary embolism. All patients had undergone ventilation-perfusion (V/Q) scanning (167 patients) or perfusion scanning alone (six) before angiography. Angiography was done because the results of the V/Q scanning did not satisfy the clinician's needs for certainty. The results of the V/Q and studies were compared to determine the relative accuracy of V/Q scanning in this clinical setting. Pulmonary embolism was found in seven (15%) of 47 patients with low-probability scans, 11 (32%) of 34 patients with intermediate-probability scans, 22 (39%) of 57 patients with indeterminate scans, and 23 (66%) of 35 patients with high-probability scans. In this clinically selected population, low-probability scans were more accurate in excluding pulmonary embolism than were high-probability scans in establishing that diagnosis

  8. Three-dimensional Gd-DTPA MR angiography of cerebral blood vessels

    International Nuclear Information System (INIS)

    Subtraction angiography based on three-dimensional fast MR imaging techniques using rephasing and dephasing gradient pulses is widely used. Similar angiograms can be obtained with three-dimensional gradient techniques before and after the administration of Gd-DTPA followed by imaging subtraction. As Gd-DTPA does not penetrate the blood-brain barrier, it does not alter brain images. Measurements were carried out in 14 patients with a 1.0-T whole-body imager (Siemens, Magnetom). Gd-DTPA angiography was superior to rephased-dephased angiography because of the higher signal intensity, lower noise due to short echo times, and high contrast for moving spins caused by Gd-DTPA

  9. Titanium plate artefact mimicking popliteal artery dissection on digital subtraction CT angiography.

    Science.gov (United States)

    Woodacre, Timothy; Wienand-Barnett, Sophie

    2013-04-05

    Titanium plates used for the internal fixation of long bone fractures cause significant artefact on CT scans but have not been reported to affect digital subtraction CT angiography. We present a patient with clinical suspicion of popliteal artery injury following a high tibial osteotomy. The osteotomy was stabilised with a titanium locking plate. During the digital subtraction process used to produce reconstruction CT angiography, removal of artefact caused by the titanium plate produced CT images mimicking the appearance of a popliteal artery dissection. The imaging inaccuracy was realised prior to the patient undergoing further intervention. We highlight the potential error caused by titanium plates on digital subtraction CT angiography and recommend careful analysis of such images prior to further treatment.

  10. [Intra-arterial thrombolysis of a basilar vascular accident during coronary angiography].

    Science.gov (United States)

    Battikh, K; Rihani, R; Lemahieu, J M; Mokahal, M; Houchaymi, Z; Cornaert, P; Dutoit, A

    2001-09-01

    The authors report the case of a 67 year old man with a previous history of aortobifemoral arterial graft who had unstable angina after carotid endarterectomy. Coronary angiography by the right brachial artery was complicated by a cerebrovascular accident with a reactive coma, convulsions and respiratory problems. Selective angiography of the right vertebral artery showed an image of occlusive thrombosis of the basilar artery. In view of the clinical state and angiographic appearances, the authors decided on immediate intra-arterial thrombolysis with Urokinase which dissolved the clot and reestablished flow in the basilar artery, the cerebellar and posterior cerebral arteries. The outcome was favourable with immediate and good recovery of consciousness and hospital discharge on the sixth day without neurological or radiological sequellae. Cerebrovascular accident is a rare and potentially serious complication of left heart catheterisation which requires immediate cerebral angiography to determine the mechanism and propose an appropriate therapeutic approach. PMID:11603067

  11. Clinical study on RI angiography in vascular diseases of lower extremities

    International Nuclear Information System (INIS)

    In 203 cases of lower extremity vascular diseases, the findings of RI angiography were compared with those of x-ray angiography. After intravenous infusion of sup(99m)Tc-H.S.A., the blood flow distribution was obtained by an equilibrium method. As this method provides an arterio-venous scintigram, some of the first pass method by intravenous infusion of sup(99m)Tc-H.S.A., intraarterial infusion of sup(99m)Tc-M.A.A., distribution of 201Tl-Cl, measurement of skin temperature, and volume pulse wave method were combined for patients with arterial diseases. For patients with venous diseases, the first pass method with sup(99m)Tc-H.S.A. was used together with the intravenous infusion method of sup(99m)Tc-M.A.A. RI angiography was of value in diagnosis, decision of therapy, follow up of postoperative hemodynamics in lower extremity vascular diseases. (Ueda, J.)

  12. Wide-Field OCT Angiography at 400 KHz Utilizing Spectral Splitting

    Directory of Open Access Journals (Sweden)

    Laurin Ginner

    2014-10-01

    Full Text Available Optical angiography systems based on optical coherence tomography (OCT require dense sampling in order to maintain good vascular contrast. We demonstrate a way to gain acquisition speed and spatial sampling by using spectral splitting with a swept source OCT system. This method splits the recorded spectra into two to several subspectra. Using continuous lateral scanning, the lateral sampling is then increased by the same factor. This allows increasing the field of view of OCT angiography, while keeping the same transverse resolution and measurement time. The performance of our method is demonstrated in vivo at different locations of the human retina and verified quantitatively. Spectral splitting can be applied without any changes in the optical setup, thus offering an easy way to increase the field of view of OCT in general and in particular for OCT angiography.

  13. Evaluation of spinal cord vessels using multi-slice CT angiography

    Institute of Scientific and Technical Information of China (English)

    陈爽; 钱建国; 冯晓源

    2004-01-01

    @@ Compared with the large number of head and neck vascular studies, computer tomography (CT) angiography of spinal vascular lesions has received relatively little attention. Several series and a few isolated cases of spinal vascular malformations demonstrated with magnetic resonance (MR) angiography have been reported.1-3 Selective digital subtraction angiography (DSA) is gold standard for diagnosis of spinal vascular lesions.4 However, it is invasive, time consuming, expensive, and dependent on the skills of the operator. Based on the DSA appearance and the surgical findings, spinal vascular malformations are generally, although not universally, classified as intradural (intramedullary and/or extramedullary) arteriovenous malformation (AVM) or arteriovenous fistula (AVF), and dural AVF. Recommended treatments of dural AVF consist of surgical obliteration and/or embolization.5-8

  14. Immediate mobilization after coronary angiography or percutaneous coronary intervention following hemostasis with the AngioSeal vascular closure device (the MOBS study)

    DEFF Research Database (Denmark)

    Larsen, Ellen Nyholm; Hansen, Charlotte Bak; Thayssen, Per;

    2014-01-01

    BACKGROUND: In patients undergoing coronary angiography or percutaneous coronary intervention (PCI), the standard post procedure regime includes immobilization and bed rest despite the use of vascular closure devices. AIM: In the Mobilization after Coronary Angiography or Percutaneous Coronary In...

  15. Nonvariceal Upper Gastrointestinal Bleeding: the Usefulness of Rotational Angiography after Endoscopic Marking with a Metallic Clip

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Soo; Kwak, Hyo Sung; Chung, Gyung Ho [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2011-08-15

    We wanted to assess the usefulness of rotational angiography after endoscopic marking with a metallic clip in upper gastrointestinal bleeding patients with no extravasation of contrast medium on conventional angiography. In 16 patients (mean age, 59.4 years) with acute bleeding ulcers (13 gastric ulcers, 2 duodenal ulcers, 1 malignant ulcer), a metallic clip was placed via gastroscopy and this had been preceded by routine endoscopic treatment. The metallic clip was placed in the fibrous edge of the ulcer adjacent to the bleeding point. All patients had negative results from their angiographic studies. To localize the bleeding focus, rotational angiography and high pressure angiography as close as possible to the clip were used. Of the 16 patients, seven (44%) had positive results after high pressure angiography as close as possible to the clip and they underwent transcatheter arterial embolization (TAE) with microcoils. Nine patients without extravasation of contrast medium underwent TAE with microcoils as close as possible to the clip. The bleeding was stopped initially in all patients after treatment of the feeding artery. Two patients experienced a repeat episode of bleeding two days later. Of the two patients, one had subtle oozing from the ulcer margin and that patient underwent endoscopic treatment. One patient with malignant ulcer died due to disseminated intravascular coagulation one month after embolization. Complete clinical success was achieved in 14 of 16 (88%) patients. Delayed bleeding or major/minor complications were not noted. Rotational angiography after marking with a metallic clip helps to localize accurately the bleeding focus and thus to embolize the vessel correctly.

  16. Diagnostic performance of CT angiography in neck vessel trauma: systematic review and meta-analysis.

    Science.gov (United States)

    Morales-Uribe, Carlos; Ramírez, Ana; Suarez-Poveda, Tatiana; Ortiz, Margarita; Sanabria, Alvaro

    2016-10-01

    This study was conducted in order to define the diagnostic performance of CT angiography for vascular injuries compared with angiography in patients with neck trauma. CT angiography is the cornerstone of diagnosis for hemodynamically stable patients with wounds suspicious of vascular trauma in the limbs, chest, or abdomen. Available evidence for the use of CT angiography in neck vascular trauma comes from small case series and few randomized controlled trials, and high-quality information does not exist regarding its performance. A protocol using the recommendations of the Cochrane Collaboration was designed. A systematic search of diagnostic studies without limits on language or time was carried out to December 2014. Studies including patients with neck trauma with retrospective or prospective data collection that assessed CT angiography compared with other methods were selected. Methodological quality was assessed using the QUADAS-2 tool. A hierarchical model ROC curve and a bivariate random effects model were used for the pooled analysis. Sixteen studies were selected and reviewed, and nine studies with 693 patients were included in this review. The overall sensitivity was 97 % (95 % CI 0.77-1.00; I (2) = 65.7 % (41.4-90.0)), while the overall specificity was 99 % (95 % CI 0.93-1.00; I (2) = 0). The hierarchic ROC curve showed an area under the curve of 0.99. Publication bias was not identified in this study. CT angiography can be stated as the gold standard for diagnosing vascular injuries in hemodynamically stable patients with neck trauma.

  17. Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography.

    Science.gov (United States)

    Weisbord, Steven D; Chen, Huanyu; Stone, Roslyn A; Kip, Kevin E; Fine, Michael J; Saul, Melissa I; Palevsky, Paul M

    2006-10-01

    The absence of a universally accepted definition of radiocontrast nephropathy (RCN) has hampered efforts to characterize effectively the incidence and the clinical significance of this condition. The objective of this study was to identify a clinically relevant definition of RCN by assessment of the relationships between increases in serum creatinine (Scr) of varying magnitude after coronary angiography and clinical outcomes. An electronic medical database was used to identify all patients who underwent coronary angiography at the University of Pittsburgh Medical Center during a 12-yr period and abstract Scr levels before and after angiography, as well as demographic characteristics and comorbid conditions. Changes in Scr after angiography were categorized into mutually exclusive categories on the basis of absolute and relative changes from baseline levels, with a separate category denoting "unknown" change. Discrete proportional odds models were used to examine the association between increases in Scr and 30-d in-hospital mortality and length of stay. A total of 27,608 patients who underwent coronary angiography were evaluated. Small absolute (0.25 to 0.5 mg/dl) and relative (25 to 50%) increases in Scr were associated with risk-adjusted odds ratios for in-hospital mortality of 1.83 and 1.39, respectively. Larger increases in Scr generally were associated with greater risks for these clinical outcomes. Small increases in Scr after the administration of intravascular radiocontrast are associated with adverse patient outcomes. This observation will help guide the post-procedure care of patients who undergo coronary angiography and has important implications for future studies that investigate RCN.

  18. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)

    2014-01-15

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  19. Coronary Artery Spasm during Angiography in a Pediatric Heart Transplant Recipient: Subsequent Prevention by Intracoronary Nitroglycerin Administration

    OpenAIRE

    Ferguson, Matthew E.; Pearce, F. Bennett; Hsu, Hao H; Misra, Vijay K; Kirklin, James K.

    2010-01-01

    Coronary artery spasm can occur during coronary angiography in pediatric heart transplant recipients. The angiographic appearance can suggest allograft vasculopathy. We report coronary artery spasm in a pediatric heart transplant recipient in whom intracoronary nitroglycerin administration prevented a repetition of spasm upon subsequent diagnostic coronary angiography. Additional studies of dose response, particularly in cardiac transplant recipients, may help determine whether lower doses of...

  20. Multislice CT angiography in the selection of patients with ruptured intracranial aneurysms suitable for clipping or coiling

    NARCIS (Netherlands)

    Westerlaan, H. E.; Gravendeel, J.; Fiore, D.; Metzemaekers, J. D. M.; Groen, R. J. M.; Mooij, J. J. A.; Oudkerk, M.

    2007-01-01

    Introduction We sought to establish whether CT angiography (CTA) can be applied to the planning and performance of clipping or coiling in ruptured intracranial aneurysms without recourse to intraarterial digital subtraction angiography (IA-DSA). Methods Over the period April 2003 to January 2006 in

  1. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    International Nuclear Information System (INIS)

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  2. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device.......To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device....

  3. Effect of contrast media on renal function in elderly patients suffering from ischemic cerebral vasular disease and undergoing angiography

    Institute of Scientific and Technical Information of China (English)

    李绍钦

    2014-01-01

    Objective To investigate the effects of the low-osmolar nonionic contrast media on renal function in elderly patients suffering from ischemic cerebral vascular disease and undergoing angiography.To study the incidence and risk factors for contrast-induced nephropathy(CIN).Methods 276 elderly patients who were going to receive selective cranial angiography and bilateral renal angiogra-

  4. Filtered region of interest cone-beam rotational angiography

    Energy Technology Data Exchange (ETDEWEB)

    Schafer, Sebastian; Noeel, Peter B.; Walczak, Alan M.; Hoffmann, Kenneth R. [Department of Mechanical Engineering, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Neurosurgery, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States) and Toshiba Stroke Research Center, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Neurosurgery, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Computer Science, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States) and Toshiba Stroke Research Center, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Neurosurgery, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 and Toshiba Stroke Research Center, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Mechanical Engineering, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Neurosurgery, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States); Department of Computer Science, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States) and Toshiba Stroke Research Center, SUNY at Buffalo, 3435 Main Street, Buffalo, New York 14214 (United States)

    2010-02-15

    Purpose: Cone-beam rotational angiography (CBRA) is widely used in the modern clinical settings. In a number of procedures, the area of interest is often considerably smaller than the field of view (FOV) of the detector, subjecting the patient to potentially unnecessary x-ray dose. The authors therefore propose a filter-based method to reduce the dose in the regions of low interest, while supplying high image quality in the region of interest (ROI). Methods: For such procedures, the authors propose a method of filtered region of interest (FROI)-CBRA. In the authors' approach, a gadolinium filter with a circular central opening is placed into the x-ray beam during image acquisition. The central region is imaged with high contrast, while peripheral regions are subjected to a substantial lower intensity and dose through beam filtering. The resulting images contain a high contrast/intensity ROI, as well as a low contrast/intensity peripheral region, and a transition region in between. To equalize the two regions' intensities, the first projection of the acquisition is performed with and without the filter in place. The equalization relationship, based on Beer's law, is established through linear regression using corresponding filtered and nonfiltered data. The transition region is equalized based on radial profiles. Results: Evaluations in 2D and 3D show no visible difference between conventional FROI-CBRA projection images and reconstructions in the ROI. CNR evaluations show similar image quality in the ROI, with a reduced CNR in the reconstructed peripheral region. In all filtered projection images, the scatter fraction inside the ROI was reduced. Theoretical and experimental dose evaluations show a considerable dose reduction; using a ROI half the original FOV reduces the dose by 60% for the filter thickness of 1.29 mm. Conclusions: These results indicate the potential of FROI-CBRA to reduce the dose to the patient while supplying the physician with

  5. Variations in the usage and composition of a radial cocktail during radial access coronary angiography procedures.

    LENUS (Irish Health Repository)

    Pate, G

    2011-10-01

    A survey was conducted of medication administered during radial artery cannulation for coronary angiography in 2009 in Ireland; responses were obtained for 15 of 20 centres, in 5 of which no radial access procedures were undertaken. All 10 (100%) centres which provided data used heparin and one or more anti-spasmodics; verapamil in 9 (90%), nitrate in 1 (10%), both in 2 (20%). There were significant variations in the doses used. Further work needs to be done to determine the optimum cocktail to prevent radial artery injury following coronary angiography.

  6. Magnetic Resonance Imaging and Angiography for the Prerupture Diagnosis of Rudimentary Uterine Horn Pregnancy

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) imaging and MR angiography were used for the differential diagnosis and preoperative planning of a 17 weeks of age rudimentary horn pregnancy. A 26-year-old primigravida was referred to our hospital with a preliminary diagnosis of abdominal pregnancy. After an inconclusive ultrasound evaluation we were able to identify a rudimentary horn pregnancy, extent of the placental invasion, and the vascular supply via MR imaging and time of flight sequence MR angiography. The obtained data were also used for preoperative planning, which resulted in an uncomplicated, prerupture laparotomy for pregnancy termination and a healthy female

  7. The safe practice of CT coronary angiography in adult patients in UK imaging departments.

    Science.gov (United States)

    Harden, S P; Bull, R K; Bury, R W; Castellano, E A; Clayton, B; Hamilton, M C K; Morgan-Hughes, G J; O'Regan, D; Padley, S P G; Roditi, G H; Roobottom, C A; Stirrup, J; Nicol, E D

    2016-08-01

    Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014. PMID:27207375

  8. Normal diffusion-weighted imaging in cerebral air embolism complicating angiography

    International Nuclear Information System (INIS)

    We report a case of cerebral air embolism resulting from accidental air infection during cerebral angiography. A 60-year-old man was accidentally injected with air via the left subclavian artery. Angiography demonstrated air within the basilar artery. The patient showed signs of posterior circulation ischaemia (confusion, blindness, gaze palsy and hemiparesis). However, MRI, including diffusion-weighted imaging, showed no abnormality 4 h later. The patient was treated with hyperbaric oxygen within 5 h of the embolism. All symptoms and signs resolved completely within a week. (orig.)

  9. Normal diffusion-weighted imaging in cerebral air embolism complicating angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sayama, T.; Inamura, T.; Fukui, M. [Dept. of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan); Mitani, M.; Yagi, H. [Dept. of Neurosurgery, Yagi Hospital, Fukuoka (Japan)

    2000-03-01

    We report a case of cerebral air embolism resulting from accidental air infection during cerebral angiography. A 60-year-old man was accidentally injected with air via the left subclavian artery. Angiography demonstrated air within the basilar artery. The patient showed signs of posterior circulation ischaemia (confusion, blindness, gaze palsy and hemiparesis). However, MRI, including diffusion-weighted imaging, showed no abnormality 4 h later. The patient was treated with hyperbaric oxygen within 5 h of the embolism. All symptoms and signs resolved completely within a week. (orig.)

  10. Evaluation of flow dynamics in the circle of Willis with MR angiography

    International Nuclear Information System (INIS)

    This paper reports two- and three- dimensional MR angiography applied to the study of flow dynamics in the circle of Willis. Presaturation was applied to eliminate signal within the vascular territory supplied by a selected vessel, without affecting other vascular territories. The method was applied to two healthy subjects and 12 patients with cerebrovascular pathology. The results were correlated with those of transcranial Doppler sonography and angiography. MR imaging was able to identify collateral flow over the anterior and posterior communicating and ophthalmic arteries, filling of both pericallosal arteries from one side, and fetal posterior circulation. This technique permits noninvasive functional and morphologic analysis of the cerebrovascular system

  11. Magnetic Resonance Imaging and Angiography for the Prerupture Diagnosis of Rudimentary Uterine Horn Pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Ozeren, S.; Caliskan, E.; Corakci, A.; Ozkan, S.; Demirci, A. [Kocaeli Univ., Faculty of Medicine, Kocaeli (Turkey). Dept. of Obstetrics and Gynecology

    2004-12-01

    Magnetic resonance (MR) imaging and MR angiography were used for the differential diagnosis and preoperative planning of a 17 weeks of age rudimentary horn pregnancy. A 26-year-old primigravida was referred to our hospital with a preliminary diagnosis of abdominal pregnancy. After an inconclusive ultrasound evaluation we were able to identify a rudimentary horn pregnancy, extent of the placental invasion, and the vascular supply via MR imaging and time of flight sequence MR angiography. The obtained data were also used for preoperative planning, which resulted in an uncomplicated, prerupture laparotomy for pregnancy termination and a healthy female.

  12. Detection of malignant right coronary artery anomaly by multi-slice CT coronary angiography

    International Nuclear Information System (INIS)

    Coronary artery anomalies occur in 0.3-0.8% of the population and infer a high risk for sudden cardiac death in young adults. Diagnosis is usually established during coronary angiography, which is hampered by poor spatial visualization. Magnetic resonance imaging is an alternative, but it is not feasible in the presence of metal objects or claustrophobia. In this report, a 15-year-old boy experienced ventricular fibrillation and was successfully resuscitated. Cardiac catheterization was inconclusive, and pacemaker implantation prohibited the use of MR imaging. Multi-slice CT coronary angiography revealed a malignant anomalous right coronary artery. (orig.)

  13. The safe practice of CT coronary angiography in adult patients in UK imaging departments.

    Science.gov (United States)

    Harden, S P; Bull, R K; Bury, R W; Castellano, E A; Clayton, B; Hamilton, M C K; Morgan-Hughes, G J; O'Regan, D; Padley, S P G; Roditi, G H; Roobottom, C A; Stirrup, J; Nicol, E D

    2016-08-01

    Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014.

  14. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Abildstrøm, Steen Zabell; Gøtzsche, Ole;

    2007-01-01

    AIMS: To evaluate the diagnostic accuracy of 64-slice multi-detector computed tomography coronary angiography (64-SCTA) compared with the standard reference conventional coronary angiography (CCA). METHODS AND RESULTS: Based on a systematic search, 27 studies including 1740 patients were eligible...... coronary artery stenosis in per-segment (19 studies) and per-patients (13 studies) populations were 19 and 57.5% respectively. Accuracy tests with 95% confidence intervals comparing 64-SCTA vs. CCA showed that sensitivity, specificity, positive predictive and negative predictive values for native coronary......% by overall per-segment analysis. CONCLUSION: The high diagnostic accuracy of 64-SCTA validates this non-invasive technique as a potential alternative to CCA in carefully selected populations suspected for coronary stenosis....

  15. CT Angiography May Be a More Useful Modality Than Digital Subtractional Angiography in the Diagnosis of Patients with Subarachnoid Hemorrhage Due to Cerebral Aneurysms

    OpenAIRE

    Masih Saboori; Ali Reza Hekmatnia; Navid Omidifar; Amirhossein Ghazavi; Farzaneh Hekmatnia

    2011-01-01

    Background/Objective: The preoperative diagnostic"nvalidity of two radiological modalities (computed"ntomographic angiography and digital subtractional"nangiography) in the diagnosis of brain aneurysms were"ncompared."nPatients and Methods: During 2 years of study,"nreferred patients with signs of SAH to the emergency"nward underwent routine CT scan and after SAH was"nfirmly diagnosed, CTA and DSA methods were done"nand patients with correct indica...

  16. High spatial resolution time-resolved magnetic resonance angiography of lower extremity tumors at 3T: Comparison with computed tomography angiography.

    Science.gov (United States)

    Wu, Gang; Jin, Teng; Li, Ting; Morelli, John; Li, Xiaoming

    2016-09-01

    The aim of this study was to compare diagnostic value of high spatial resolution time-resolved magnetic resonance angiography with interleaved stochastic trajectory (TWIST) using Gadobutrol to Computed tomography angiography (CTA) for preoperative evaluation of lower extremity tumors.This prospective study was approved by the institutional review board. Fifty consecutive patients (31 men, 19 women, age range 18-80 years, average age 42.7 years) with lower extremity tumors underwent TWIST magnetic resonance angiography (MRA) and CTA. Digital subtraction angiography was available for 8 patients. Image quality of MRA was compared with CTA by 2 radiologists according to a 4-point Likert scale. Arterial involvement by tumor was compared using kappa test between MRA and CTA. The ability to identify feeding arteries and arterio-venous fistulae (AVF) was compared using Wilcoxon signed rank test and McNemar test, respectively.Image quality of MRA and CTA was rated without a statistically significant difference (3.88 ± 0.37 vs. 3.97 ± 0.16, P = 0.135). Intramodality agreement was high for the identification of arterial invasion (kappa = 0.806 ± 0.073 for Reader 1, kappa = 0.805 ± 0.073 for Reader 2). Readers found AVF in 27 of 50 MRA cases and 14 of 50 CTA cases (P < 0.001). Mean feeding arteries identified with MRA were significantly more than that with CTA (2.08 ± 1.72 vs. 1.62 ± 1.52, P = .02).TWIST MRA is a reliable imaging modality for the assessment of lower extremity tumors. TWIST MRA is comparable to CTA for the identification of AVF and feeding arteries. PMID:27631262

  17. Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children

    International Nuclear Information System (INIS)

    Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand

  18. Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children

    Energy Technology Data Exchange (ETDEWEB)

    Ayyala, Rama S.; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)

    2015-11-15

    Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand

  19. Bone Subtraction 3-Dimension CT Angiography Using 64-Slice Multidetector CT for the Evaluation of Steno-Occlusive Intra- and Extracranial Vascular Diseases: Comparison with Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Eun; Choi, Dae Seob; Shin, Hwa Seon; You, Jin Jong; Park, Mi Jung; Cho, Jae Min; Choi, Ho Cheol; Son, Seung Nam [Gyeongsang National University School of Medicine, Jinju (Korea, Republic of); Ryu, Jae Wook [Dept. of Radiology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2012-09-15

    To investigate the efficacy of bone subtraction CT angiography (BSCTA) for the evaluation of steno-occlusive intra- and extracranial vascular diseases. Fifty-six patients were examined using 64-slice multidetector CT and digital subtraction angiography (DSA). For BSCTA, both nonenhanced CT and enhanced CT angiography (CTA) data sets were obtained. The stenotic degree of each vascular segment was assessed and classified into 5 grades. With DSA as the standard, CTA images were compared. For the evaluation of the extracranial vessels, 370 arterial segments were analyzed, and the stenotic degree revealed by CTA and DSA agreed in 359 (97.0%). There was a significant correlation between CTA and DSA (Rs = 0.974). For depiction of {>=} 50% stenosis, the sensitivity, specificity, and diagnostic accuracy of BSCTA were 100%, 98.2%, and 98.6%, respectively. For the intracranial arteries, 1029 segments were analyzed, and CTA agreed with DSA in 966 (93.9%). There was a significant correlation between CTA and DSA for stenotic degree (Rs = 0.880). For the depiction of {>=} 50% stenosis, the sensitivity, specificity, and diagnostic accuracy of CTA were 100%, 95.8%, and 96.0%, respectively. In all 74 segments of disagreement, the degree of stenosis was overestimated on CTA. BSCTA is comparable to DSA for the evaluation of steno-occlusive intra- and extracranial vascular diseases. However, the stenotic degree tends to be overestimated on BSCTA, especially in cases of wall calcifications.

  20. Atherosclerotic plaque burden in cocaine users with acute chest pain : Analysis by coronary computed tomography angiography

    NARCIS (Netherlands)

    Ebersberger, Ullrich; Sudarski, Sonja; Schoepf, U. Joseph; Bamberg, Fabian; Tricarico, Francesco; Apfaltrer, Paul; Blanke, Philipp; Schindler, Andreas; Makowski, Marcus R.; Headden, Gary F.; Leber, Alexander W.; Hoffmann, Ellen; Vliegenthart, Rozemarijn

    2013-01-01

    Chest pain associated with cocaine use represents an increasing problem in the emergency department (ED). Cocaine use has been linked to the acute coronary syndrome (ACS) and acute myocardial infarction (AMI). We used coronary computed tomography angiography (cCTA) to evaluate the prevalence, severi

  1. 3D-NMR angiography of atherosclerotic carotid and vertebral artery disease

    International Nuclear Information System (INIS)

    Magnetic Resonance Angiography was performed as part of a routine brain examination, and to assess the potential of MRA as a noninvasive modality to display the peripheral carotid and the vertebral artery in the diagnosis of cerebrovascular disease. (author). 8 refs.; 3 figs

  2. Automatic coronary calcium scoring in cardiac CT angiography using convolutional neural networks

    NARCIS (Netherlands)

    Wolterink, Jelmer M.; Leiner, Tim; Viergever, Max A.; Isgum, I

    2015-01-01

    The amount of coronary artery calcification (CAC) is a strong and independent predictor of cardiovascular events. Non-contrast enhanced cardiac CT is considered a reference for quantification of CAC. Recently, it has been shown that CAC may be quantified in cardiac CT angiography (CCTA). We present

  3. Primary intraventricular hemorrhage: Clinical features, risk factors, etiology, and yield of diagnostic cerebral angiography

    OpenAIRE

    Trilochan Srivastava; Raghavendra Bakki Sannegowda; Vipin Satija; R. S Jain; Shankar Tejwani; Tarun Mathur

    2014-01-01

    Background: Primary intraventricular hemorrhage (PIVH) is a rare neurological disorder, with bleeding confined to the ventricles only, without recognizable parenchymal or subarachnoid component. Aim: The purpose of this retrospective study was to identify clinical features, predisposing risk factors, etiology, radiological features and yield of diagnostic cerebral angiography in identifying the etiological causes. Settings and Design: Records of patients admitted in neurology division were an...

  4. Early Swept-Source Optical Coherence Tomography Angiography Findings in Unilateral Acute Idiopathic Maculopathy.

    Science.gov (United States)

    Nicolo, Massimo; Rosa, Raffaella; Musetti, Donatella; Musolino, Maria; Traverso, Carlo Enrico

    2016-02-01

    Unilateral acute idiopathic maculopathy (UAIM) is a rare disorder presenting in young people with an acute onset of unilateral central visual loss often associated with a prodromal flu-like illness. The authors present the early anatomical findings of a 35-year-old man clinically diagnosed with UAIM using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography.

  5. Coronary angiography in left main stenosis. Now to decrease the risk

    International Nuclear Information System (INIS)

    A close cooperation of researchers and clinicians who shall ensure a control over myocardial ischemia, cardiac insufficiency through medicamental therapy prior to investigation is required to decrease the risk of angiography for the patients suffering from the stenosis of left coronary artery trunk. 37 refs

  6. Mycotic aneurysm of the aorta as an unusual complication of coronary angiography

    NARCIS (Netherlands)

    van der Wal, H.; van Geel, P. P.; de Boer, R. A.

    2008-01-01

    Introduction: Mycotic aneurysm of the aorta is a rare diagnosis with high mortality. Report: Percutaneous coronary intervention was complicated by bacteraemia with Staphylococcus aureus and a mycotic aortic aneurysm, an unusual complication of coronary angiography. Combining CT and PET scan showed a

  7. High-resolution ex vivo magnetic resonance angiography: a feasibility study on biological and medical tissues

    Directory of Open Access Journals (Sweden)

    Boel Lene WT

    2010-03-01

    Full Text Available Abstract Background In biomedical sciences, ex vivo angiography is a practical mean to elucidate vascular structures three-dimensionally with simultaneous estimation of intravascular volume. The objectives of this study were to develop a magnetic resonance (MR method for ex vivo angiography and to compare the findings with computed tomography (CT. To demonstrate the usefulness of this method, examples are provided from four different tissues and species: the human placenta, a rice field eel, a porcine heart and a turtle. Results The optimal solution for ex vivo MR angiography (MRA was a compound containing gelatine (0.05 g/mL, the CT contrast agent barium sulphate (0.43 mol/L and the MR contrast agent gadoteric acid (2.5 mmol/L. It was possible to perform angiography on all specimens. We found that ex vivo MRA could only be performed on fresh tissue because formalin fixation makes the blood vessels permeable to the MR contrast agent. Conclusions Ex vivo MRA provides high-resolution images of fresh tissue and delineates fine structures that we were unable to visualise by CT. We found that MRA provided detailed information similar to or better than conventional CTA in its ability to visualize vessel configuration while avoiding interfering signals from adjacent bones. Interestingly, we found that vascular tissue becomes leaky when formalin-fixed, leading to increased permeability and extravascular leakage of MR contrast agent.

  8. Influence of coronary calcification on the diagnostic accuracy of 64-slice computed tomography coronary angiography

    DEFF Research Database (Denmark)

    Abdulla, Jawdat; Pedersen, Kasper; Budoff, Matthew;

    2012-01-01

    To determine via meta-analysis the diagnostic accuracy of 64-slice computed tomography coronary angiography (CTA) for assessment of significant obstructive coronary artery stenosis at different coronary artery calcium score (CACS) levels. Data of 12,053 versus 5,890 segments, 906 versus 758 arter...

  9. Comparative evaluations of endoscopic retrograde cholangiopancreaticography, angiography and scintiscanning in the diagnosis of pancreatic diseases

    International Nuclear Information System (INIS)

    Endoscopic retrograde cholangiopancreaticography (ERCP) proved to be the appropriate diagnostic method in chronic pancreatitis which can be diagnosed angiographically in advanced stages only. In suspecting pancreatic carcinoma both ERCP and angiography should be performed. Scintiscanning takes the lowest place value in the diagnosis of pancreatic diseases

  10. Diagnostic Accuracy and Radiation Dose of CT Coronary Angiography in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vorre, Mette Medom; Abdulla, Jawdat

    2013-01-01

    Purpose:To determine by means of a systematic review and meta-analysis the diagnostic accuracy, associated radiation dose, and technical challenges of computed tomographic (CT) coronary angiography in patients with atrial fibrillation.Materials and Methods:A systematic literature search was perfo...

  11. Imaging features of double aortic arch shown by multidetector computed tomography angiography

    International Nuclear Information System (INIS)

    We present a three-dimensional reconstructed image of vascular ring in a 2.5-month-old patient, which was obtained using multidetector computed tomography (MDCT). MDCT angiography made an accurate diagnosis of this life-threatening, but correctable, anomaly in an infant with a stridor, repeated respiratory infections and episodes of apnea

  12. Technical note: A simple and effective CO2 delivery system for angiography using a blood bag

    International Nuclear Information System (INIS)

    Several angiographic techniques have been developed to image the arterial system, the commonest using iodinated contrast media. Useful as they may be, they are not without disadvantages. One other modality is angiography using CO2. Although CO2 can be used as an alternative contrast medium, delivery systems are expensive to procure. We describe an indigenous and effective delivery system developed at our institute

  13. Assessment of percutaneous transluminal coronary angioplasty by quantitative coronary angiography: diameter versus densitometric area measurements

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); J.H.C. Reiber (Johan); W. Wijns (William); M.J.B.M. van den Brand (Marcel); C.J. Kooijman; H.J. ten Katen (Harald); P.G. Hugenholtz (Paul)

    1984-01-01

    textabstractCineangiograms of 138 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were analyzed with a computer-based coronary angiography analysis system. The results before and after dilatation are presented. In a first study group (120 patients), the severity of the o

  14. Diagnosis and treatment of renal hemorrhage via angiography and transcatheter embolization

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of diagnosis and treatment of renal hemorrhage via angiography and transcatheter embolization. Methods: Sixty two patients with renal hemorrhage, including 28 cases of renal carcinoma, 13 of renal angiomyolipoma, 12 of renal trauma, 7 of renal vascular malformation and 2 patients of renal aneurysm. All patients had the symptoms of gross hematuria and diagnosed by selective angiography for localization and blood supply, and followed by infusing medicine or/ and embolization with various embolic materials through seldinger method. Results: All patients had obtained correct diagnosis for localization, extent, degree, causes and blood supply of the renal hemorrhage through angiography and contrast medium extravasation was observed in 19 eases. Gross hematuria ceased in 43 patients after 12 hours, 17 patients after 24 hours of interventional therapy respectively. Gross hematuria relieved obviously and ceased after 1 week in 2 renal carcinoma patients. No recurrent renal hemorrhage except 4 renal carcinoma patients occurred after 1 month of therapy. During 1-48 months follow up, the satisfactory embolization effect was observed through CT. Conclusions: Transcatheter angiography and embolization is reliable and effective in diagnosis and treatment of renal hemorrhage with less invasion and complications and furthermore with preservation of renal function to the utmost. (authors)

  15. Early Computed Tomographic Angiography after Endovascular Aneurysm Repair : Worthwhile or Worthless?

    NARCIS (Netherlands)

    Waasdorp, Evert J.; van Herwaarden, Joost A.; van de Mortel, Rob H. W.; Moll, Frans L.; de Vries, Jean-Paul P. M.

    2008-01-01

    This study evaluated the value of computed tomographic angiography (CTA) early after an endovascular aneurysm repair (EVAR) in relation to CTA 3 months after EVAR. We retrospectively reviewed all elective EVAR patients with available postprocedural and 3-month follow-up CTAs who were treated between

  16. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel S.); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment str

  17. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

    NARCIS (Netherlands)

    M.P. Opolski (Maksymilian P.); B.T. Hartaigh (Bríain ó); D.S. Berman (Daniel); M.J. Budoff (Matthew J.); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D. Andreini (Daniele); F. Cademartiri (Filippo); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); M. Hadamitzky (Martin); J. Hausleiter (Jörg); G.M. Feuchtner (Gudrun); Y.-J. Kim (Yong-Jin); P.A. Kaufmann (Philipp A.); J. Leipsic (Jonathon); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee J.); T.C. Villines (Todd); J.K. Min (James)

    2015-01-01

    textabstractObjective Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment stra

  18. Percutaneous trans-ulnar artery approach for coronary angiography and angioplasty; A case series study

    Science.gov (United States)

    Roghani-Dehkordi, Farshad; Hadizadeh, Mahmood; Hadizadeh, Fatemeh

    2015-01-01

    BACKGROUND Coronary angiography is the gold standard method for diagnosis of coronary heart disease and usually performed by femoral approach that has several complications. To reduce these complications, upper extremity approach is increasingly used and is becoming preferred access site by many interventionists. Although radial approach is relatively well studied, safety, feasibility and risk of applying ulnar approach in not clearly known yet. METHODS We followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18) who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 months and recorded their outcomes. RESULTS In 97 patients out of 105 ones (92.38%), procedure through ulnar access were successfully done. Unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet (2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. In 94 patients (89.52%), the angiography and angioplasty was done without any complications. Five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolved with painkiller. No infection, amputation or need for surgery was reported. CONCLUSION This study demonstrated that ulnar access in our patients was a safe and practical approach for coronary angiography or angioplasty, without any major complication. Bearing in mind its high success rate, it can be utilized when a radial artery is not useful for the catheterization and in cases such as prior harvesting of the radial artery (in prior coronary artery bypass grafting). PMID:26715936

  19. Coronary computed tomography angiography: emerging technique for coronary artery imaging - pictorial essay

    International Nuclear Information System (INIS)

    Assessment of potential coronary artery disease is the single most common indication for cardiovascular imaging. Currently, definite anatomic diagnosis requires invasive cardiac catheterization. Recent developments in computed tomography (CT) technology have resulted in substantially improved noninvasive coronary artery imaging. We review an imaging protocol for coronary CT angiography (CTA), study interpretation, and current and future potential applications of this technology. (author)

  20. Effects of contrast media on renal graft function and survival after cerebral angiography of cadaveric donors

    International Nuclear Information System (INIS)

    The effects of intravascularly administered ionic contrast media on renal graft function and survival were retrospectively evaluated in 211 recipients of cadaveric renal transplants. The renal grafts were explanted from the donors within 24 hours (mean 16 hours) after cerebral angiography. There were no differences in renal function of graft survival between those exposed and those not exposed to contrast media before nephrectomy. (orig.)

  1. Bilateral internal carotid agenesis: value of CT angiography and correlation to embryogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Pilleul, F.; Rouviere, O. [Dept. of Radiology, Hopital Edouard Herriot, Lyon (France); Guibaud, L.; Pracros, J.P. [Dept. of Pediatric Imaging, Hopital Debrousse, Lyon (France); Badinand, N. [Dept. of Pediatric Neurology, Hopital Debrousse, Lyon (France)

    2001-05-01

    Bilateral internal carotid artery agenesis is an uncommon disease, difficult to differentiate from bilateral carotid artery thrombosis. A few case reports have described the contribution of conventional angiogram to make the diagnosis and recognize the anatomic details of this rare malformation. Advantages of CT angiography as a non-invasive radiologic tool are discussed in this case report. (orig.)

  2. Ergotism of the lower limb complicating DHE-heparin thrombosis prophylaxis. Observation by serial angiography

    Energy Technology Data Exchange (ETDEWEB)

    Warmuth-Metz, M.

    1988-10-01

    Today ergotism is becoming more and more important as a complication in the treatment of migraine headache or thrombosis prophylaxis with DHE heparin. Although complete recovery is seldom reported in the current literature, in our case it was possible to resolve a spasm of the left lower limb completely by early diagnosis and adaequate pharmacological treatment. The case was well documented by serial angiography.

  3. Observation on 108 Normal Ophthalmic Arteries in 80 Patients by Digital Subtraction Angiography

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    By digital subtraction angiography(DSA), the authors made observations on 108 normal ophthalmic arteries in 80 patients with regard to the origins, courses, branching, morphology and anastomoses of the vessels. The merits and demerits of DSA in observing the ophthalmic artery were discussed. Eye Science 1994; 10: 157- 162.

  4. Pre-treatment with a sinus node blockade, ivabradine, before coronary CT angiography

    DEFF Research Database (Denmark)

    Lambrechtsen, J; Egstrup, K

    2013-01-01

    To evaluate whether a simple pre-treatment regimen of sinus node inhibition by ivabradine taken at home for only 1 day resulted in a lower pre-scanning heart rate (HR) and reduced the need for intravenous beta-blockers (BB) prior to coronary computed tomography angiography (CTA)....

  5. Magnetic Resonance Angiography in the Diagnosis of Cerebral Arteriovenous Malformation and Dural Arteriovenous Fistulas: Comparison of Time-Resolved Magnetic Resonance Angiography and Three Dimensional Time-of-Flight Magnetic Resonance Angiography

    Science.gov (United States)

    Cheng, Yu-Ching; Chen, Hung-Chieh; Wu, Chen-Hao; Wu, Yi-Ying; Sun, Ming-His; Chen, Wen-Hsien; Chai, Jyh-Wen; Chi-Chang Chen, Clayton

    2016-01-01

    Background Traditional digital subtraction angiography (DSA) is currently the gold standard diagnostic method for the diagnosis and evaluation of cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (dAVF). Objectives The aim of this study was to analyze different less invasive magnetic resonance angiography (MRA) images, time-resolved MRA (TR-MRA) and three-dimensional time-of-flight MRA (3D TOF MRA) to identify their diagnostic accuracy and to determine which approach is most similar to DSA. Patients and Methods A total of 41 patients with AVM and dAVF at their initial evaluation or follow-up after treatment were recruited in this study. We applied time-resolved angiography using keyhole (4D-TRAK) MRA to perform TR-MRA and 3D TOF MRA examinations simultaneously followed by DSA, which was considered as a standard reference. Two experienced neuroradiologists reviewed the images to compare the diagnostic accuracy, arterial feeder and venous drainage between these two MRA images. Inter-observer agreement for different MRA images was assessed by Kappa coefficient and the differences of diagnostic accuracy between MRA images were evaluated by the Wilcoxon rank sum test. Results Almost all vascular lesions (92.68%) were correctly diagnosed using 4D-TRAK MRA. However, 3D TOF MRA only diagnosed 26 patients (63.41%) accurately. There were statistically significant differences regarding lesion diagnostic accuracy (P = 0.008) and venous drainage identification (P < 0.0001) between 4D-TRAK MRA and 3D TOF MRA. The results indicate that 4D-TRAK MRA is superior to 3D TOF MRA in the assessment of lesions. Conclusion Compared with 3D TOF MRA, 4D-TRAK MRA proved to be a more reliable screening modality and follow-up method for the diagnosis of cerebral AVM and dAVF.

  6. Three-dimensional volume rendering digital subtraction angiography in comparison with two-dimensional digital subtraction angiography and rotational angiography for detecting aneurysms and their morphological properties in patients with subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Objective: Subarachnoid hemorrhage (SAH), which can cause mortality and severe morbidity, is a serious condition whose underlying cause must be determined. We aimed to compare 2D digital subtraction angiography (2DDSA), rotational angiography (RA) and 3D volume rendering digital subtraction angiography (3DVRDSA) for detecting aneurysms and their morphological properties in patients with subarachnoid hemorrhage. Materials and methods: After an initial diagnosis of SAH with computed tomography, 122 patients (52 males and 70 females with a mean age of 47.77 ± 12.81 ranging between 20 and 83 years) underwent 2DDSA imaging, RA and 3DVRDSA imaging for detection of aneurysms. The location of the aneurysm, the best working angles, the dome/neck ratios, the largest diameter of the aneurysm, the shape of the aneurysm, the presence of spasms or pseudostenoses, and the relationship to the neighboring arteries were recorded. Results: 2DDSA missed 15.6% of the aneurysms that had a mean size of 2.79 ± 0.74 mm. RA was superior to 2DDSA for detecting aneurysm neck, and 3DVRDSA was superior to RA for detecting aneurysm neck. 3DVRDSA conclusively depicted the shape of the aneurysms in all patients. 3DVRDSA imaging was superior to 2DDSA and RA in the detection of the aneurysm relationship to neighboring arteries. The sensitivity and specificity of 3DVRDSA imaging for the detection of vasospasms were 100 and 84%, respectively. Conclusions: 3DVRDSA imaging is superior to 2DDSA and RA for detecting intracranial aneurysms and their morphological properties, especially those of small, ruptured aneurysms. However, 2DDSA should not be neglected in cases of vasospasm

  7. Liver hydatid cyst ruptured into the thorax: CT angiography findings of a case

    International Nuclear Information System (INIS)

    Full text: Introduction: Intrathoracic rupture of hepatic hydatid cyst is a rare but severe condition causing a spectrum of lesions to the pleura, lung parenchyma, and bronchi. Pulmonary complications result from the proximity of hydatid cysts in the liver and the diaphragm. Objectives and tasks: In this report we aimed to present computed tomography (CT) angiography findings of a case with liver hydatid cyst ruptured into the thorax. The patient underwent CT angiography examination with suspicion of pulmonary embolism. Materials and methods: A 71-year-old female patient admitted to our emergency department with complaints of severe and persistent cough. Basal region of the right hemithorax could not get breath sounds on physical examination. Chest radiography revealed the presence of consolidation-effusion. The patient was treated with antibiotherapy for pneumonia and parapneumonic effusion. Because of the clinical symptoms and chest radiograph findings persisted the patient underwent CT angiography examination with suspicion of pulmonary embolism. Results: On CT angiography images pulmonary artery and its branches were normal. There were subtotal collapse in the right middle and lower lung lobes and complicated cystic lesion that has air densities in the basal interlobar space. Another thick walled complicated cystic lesion with multiple septations and air densities was detected in the right posterior liver lobe. The right hemidiaphragm was interrupted and the right liver lobe partially herniated into the thorax cavity. Serologic tests were positive for Echinococcus granulosus and there were prior therapy history for liver cyst hydatid. The diagnostic aspiration findings were consistent with hydatid cyst lesion. Conclusion: In patients with hepatic hydatid cyst associated with persistent and severe cough, thoracic rupture of the cyst should be considered in differential diagnosis. CT angiography is fast, non-invasive and effective method in the detection of

  8. Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Francisco Flávio Costa Filho

    2015-11-01

    Full Text Available AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD, a clinical (non-invasive evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77, age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26, diabetes (OR, 2.01; CI 95%, 1.40 - 2.90, dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07, typical angina (OR, 2.92; CI 95%, 1.77 - 4.83 and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27.Conclusions:In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.

  9. Primary intraventricular hemorrhage: Clinical features, risk factors, etiology, and yield of diagnostic cerebral angiography

    Directory of Open Access Journals (Sweden)

    Trilochan Srivastava

    2014-01-01

    Full Text Available Background: Primary intraventricular hemorrhage (PIVH is a rare neurological disorder, with bleeding confined to the ventricles only, without recognizable parenchymal or subarachnoid component. Aim: The purpose of this retrospective study was to identify clinical features, predisposing risk factors, etiology, radiological features and yield of diagnostic cerebral angiography in identifying the etiological causes. Settings and Design: Records of patients admitted in neurology division were analyzed in a tertiary care teaching hospital. Materials and Methods: We analyzed the records of 27 patients with PIVH evaluated and treated at our institute from August 2010 to April 2013. PIVH was diagnosed as hemorrhage in the ventricles only, detected by computed tomography scan without evidence of intraparenchymal, subarachnoid hemorrhage or intraventricular hemorrhage associated with trauma. CT angiography (CTA alone was done in 10 patients (37.03%, digital subtraction angiography (DSA in 2 patients (7.4% and both CTA as well as DSA was done in 15 patients (55.5%. Statistical Analysis Used: Categorical and continuous data were analyzed using SPSS version 17. Results: 17 (62.96% patients were females and 10 (37.03% were males with ratio of F:M= 1.7:1. Headache was the commonest mode of presentation (85.18%. Hypertension was most common predisposing factor (29.62% followed by arterio-venous malformations (AVMs (25.92%, moyamoya disease (MMD (11.11%, lenticuostriate artery aneurysm (LSA (11.11%, arterial dissections (7.4% and dural arteriovenous fistula (dAVF (3.7%. Conclusions: PIVH is rare and hypertension is important predisposing factor. Yield of cerebral angiography is high in diagnosing the etiology. AVMs and other rare etiological causes like MMD, LSA aneurysm, arterial dissection, and dAVF should be kept in mind with a high index of suspicion and warrants cerebral angiography in them, as some of the causes are potentially treatable.

  10. Diagnostic value of contrast-enhanced intraoperative Doppler sonography for cerebral arteriovenous malformations compared with angiography

    Institute of Scientific and Technical Information of China (English)

    XU Hong-zhi; QIN Zhi-yong; GU Yu-xiang; ZHOU Ping; CHEN Xian-cheng

    2010-01-01

    Background Intraoperative Doppler sonography has been used in the neurosurgical operating room for the localization and description of cerebral arteriovenous malformations (AVMs). This study aimed to investigate the clinical value of contrast-enhanced intraoperative Doppler sonography, including its ability to assess the location and identify of feeding arteries in patients with AVMs and to compare this method with angiography.Methods Twenty-three patients with cerebral AVMs who were diagnosed using angiography, were examined with contrast-enhanced intraoperative Doppler sonography. As an echo-enhancing agent, Sulphur Hexafluoride Microbubbles for Injection ("SonoVue") was administered intravenously in all patients. Sonogram results were reviewed and correlated with angiographic findings. For statistical analysis, the Wilcoxon signed-rank test was applied.Results Angiography identified 20 AVM lesions in the anterior or middle fossa and 3 in the posterior fossa.Contrast-enhanced intraoperative Doppler was somewhat less sensitive for only detecting 21/23 (91.3%) of the AVM lesions. Additionally, contrast-enhanced intraoperative Doppler slightly underestimated AVM size compared with angiographic findings but showed feeding arteries with sufficient acoustic properties. In 15 patients, angiography revealed a coincidental blood supply from another intracranial vessel, which was missed by contrast-enhanced intraoperative Doppler sonography.Conclusions In a limited group of patients with AVMs, contrast-enhanced intraoperative Doppler sonography was a less sensitive but useful and simple method for the detection of AVMs in contrast to angiography. No specific untoward effects were attributed to the use of "SonoVue" as a contrast-enhancing substance.

  11. Clinical superiority of a new nonionic contrast agent (iopamidol) for cardiac angiography.

    Science.gov (United States)

    Gertz, E W; Wisneski, J A; Chiu, D; Akin, J R; Hu, C

    1985-02-01

    The hemodynamic and electrophysiologic alterations induced by ionic contrast agents during cardiac angiography are well described. Recently nonionic contrast agents have become available for cardiac angiography. To evaluate the safety of these new agents, a double-blind randomized study was performed comparing a new nonionic agent (iopamidol) with a commonly used ionic contrast agent (Renografin-76). Eighty-one patients undergoing left ventriculography and coronary angiography were included; 41 received iopamidol and 40 received sodium meglumine diatrizoate (Renografin-76). After left ventriculography, there was a decrease in the arterial pressure with both contrast agents. However, the severity and the duration of hypotension were both significantly greater with Renografin-76 compared with the new nonionic agent (p less than 0.001). After selective injections of the coronary arteries, electrocardiographic analysis demonstrated that the increase in the QT interval (p less than 0.0002) and the changes in both the ST segment and T wave amplitude (p less than 0.001) were significantly greater in the Renografin-76 group compared with the iopamidol group. During coronary angiography, 8 of the 40 patients receiving Renografin-76 required temporary pacing for sinus pauses of 2.5 seconds or more, and 2 of the 40 also developed ventricular fibrillation. None of the 41 patients receiving iopamidol had these complications. This report demonstrates that the electrocardiographic changes, the severity and duration of hypotension and the incidence of serious arrhythmias are significantly greater with Renografin-76 than with iopamidol. Thus, this new nonionic agent appears to enhance the safety of cardiac angiography.

  12. Multi-detector CT angiography for lower gastrointestinal bleeding: can it select patients for endovascular intervention?

    International Nuclear Information System (INIS)

    Full text: This is a retrospective review of the results at our institution of using multi-detector CT angiography (CTA) to localise lower gastrointestinal (GI) bleeding. We hypothesised that in our patient population: (i) CTA was unlikely to demonstrate bleeding in patients who were haemodynamically stable; (ii) in haemodynamically unstable patients in whom CTA was undertaken, the results could be used to select patients who would benefit from catheter angiography; and (iii) in haemodynamically unstable patients in whom CTA was undertaken, a subgroup of patients could be identified who would benefit from primary surgical treatment, avoiding invasive angiography completely. A retrospective review was conducted of the clinical records of all patients undergoing CTA for lower GI haemorrhage at our institution between 1 January 2005 and 30 June 2007. Out of the 20 patients examined, 10 had positive CTAs demonstrating the bleeding site. Nine were haemodynamically unstable at the time of the study. Four patients with positive CT angiograms were able to be treated directly with surgery and avoided invasive angiography. Ten patients had negative CTAs. Four of these were haemodynamically unstable, six haemodynamically stable. Only one required intervention to secure haemostasis, the rest stopped spontaneously. No haemodynamically stable patient who had a negative CTA required intervention. CTA is a useful non-invasive technique for localising the site of lower GI bleeding. In our patient population, in the absence of haemodynamic instability, the diagnostic yield of CTA was low and bleeding was likely to stop spontaneously. In haemodynamically unstable patients, a positive CTA allowed patients to be triaged to surgery or angiography, whereas there was a strong association between a negative CTA and spontaneous cessation of bleeding.

  13. Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

    Science.gov (United States)

    Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

    2007-03-01

    Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

  14. Validation of a novel clinical prediction score for severe coronary artery diseases before elective coronary angiography.

    Directory of Open Access Journals (Sweden)

    Zhang-Wei Chen

    Full Text Available OBJECTIVES: Coronary artery disease (CAD severity is associated with patient prognosis. However, few efficient scoring systems have been developed to screen severe CAD in patients with stable angina and suspected CAD before coronary angiography. Here, we present a novel scoring system for CAD severity before elective coronary angiography. METHODS: Five hundred fifty-one patients with stable angina who were admitted for coronary angiography were enrolled in this study. Patients were divided into training (n = 347 and validation (n = 204 cohorts. Severe CAD was defined as having a Gensini score of 20 or more. All patients underwent echocardiography (ECG to detect ejection fraction and aortic valve calcification (AVC. Multivariable analysis was applied to determine independent risk factors and develop the scoring system. RESULTS: In the training cohort, age, male sex, AVC, abnormal ECG, diabetes, hyperlipidemia, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were identified as independent factors for severe CAD by multivariable analysis, and the Severe Prediction Scoring (SPS system was developed. C-indices of receiver operating characteristic (ROC curves for severe CAD were 0.744 and 0.710 in the training and validation groups, respectively. The SPS system also performed well during calibration, as demonstrated by Hosmer-Lemeshow analysis in the validation group. Compared with the Diamond-Forrester score, the SPS system performed better for severe CAD prediction before elective coronary angiography. CONCLUSIONS: Severe CAD prediction was achieved by analyzing age, sex, AVC, ECG, diabetes status, and lipid levels. Angina patients who achieve high scores using this predicting system should undergo early coronary angiography.

  15. [Intraoperative verification of a perforator flap vascularization by indocyanine green angiography].

    Science.gov (United States)

    Royer, E; Rausky, J; Binder, J-P; May, P; Virzi, D; Revol, M

    2014-02-01

    After Koshima and Soeda first described perforator flaps in 1988, Wei has improved the technique by describing the "free style perforator flap". These flaps have the advantage of being performed on all skin perforators and in reducing donor site morbidity. The disadvantage, however is that the size of their angiosome is not defined and the evaluation of their relay on the experience of the surgeon. An evaluation of the size of an angiosome by conducting intraoperative angiography is proposed. Intraoperative angiography is performed after injection of indocyanine green. Stimulation of the indocyanine green by infrared causes the emission of fluorescent radiation. This fluorescence is then detected by a specific camera that displays real-time visualization of the skin's perfusion. We present the case of a 39-year-old patient who had an open tibial pilon fracture, for which we performed a pedicled propeller flap based on a posterior tibial perforator. Angiography was used to determine accurately the optimal skin perfusion of the propeller flap, which was based on a perforator from the posterior tibial artery. Angiography identified several levels of skin perfusion with a high fluorescence, intermediate and absent. The non-vascularized part of the skin paddle was resected. Given the unreliability of this technique, hypoperfused area was retained. Debridment of this area, however was necessary at day 5 postoperative with repositionning of the flap. Indocyanine green angiography may be a useful decision-making tool for intraoperative surgeon. It allows to adjust the size of the propeller flap's skin paddle to it angiosome. However, this evaluation method needs to be improved with the introduction of a quantitative threshold.

  16. Using synchrotron radiation angiography with a highly sensitive detector to identify impaired peripheral perfusion in rat pulmonary emphysema

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Hiromichi [University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan); Matsushita, Shonosuke, E-mail: shomatsu@md.tsukuba.ac.jp [University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan); Tsukuba University of Technology, Tsukuba, Ibaraki 305-8521 (Japan); Hyodo, Kazuyuki [High Energy Accelerator Research Organization, KEK, Tsukuba, Ibaraki 305-0801 (Japan); Sato, Yukio; Sakakibara, Yuzuru [University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan)

    2013-03-01

    Synchrotron radiation angiography with a HARP detector made it possible to evaluate impaired pulmonary microcirculation in pulmonary emphysema by means of high sensitivity. Owing to limitations in spatial resolution and sensitivity, it is difficult for conventional angiography to detect minute changes of perfusion in diffuse lung diseases, including pulmonary emphysema (PE). However, a high-gain avalanche rushing amorphous photoconductor (HARP) detector can give high sensitivity to synchrotron radiation (SR) angiography. SR angiography with a HARP detector provides high spatial resolution and sensitivity in addition to time resolution owing to its angiographic nature. The purpose of this study was to investigate whether this SR angiography with a HARP detector could evaluate altered microcirculation in PE. Two groups of rats were used: group PE and group C (control). Transvenous SR angiography with a HARP detector was performed and histopathological findings were compared. Peak density of contrast material in peripheral lung was lower in group PE than group C (p < 0.01). The slope of the linear regression line in scattering diagrams was also lower in group PE than C (p < 0.05). The correlation between the slope and extent of PE in histopathology showed significant negative correlation (p < 0.05, r = 0.61). SR angiography with a HARP detector made it possible to identify impaired microcirculation in PE by means of its high spatial resolution and sensitivity.

  17. Computed tomography angiography of lower extremities in the emergency room for evaluation of patients with gunshot wounds

    Energy Technology Data Exchange (ETDEWEB)

    Adibi, Ali; Plotnik, Adam N.; Mohajer, Kiyarash; Arellano, Cesar; Ruehm, Stefan G. [University of California, Diagnostic Cardiovascular Imaging, Department of Radiological Sciences, Los Angeles, CA (United States); Krishnam, Mayil S.; Dissanayake, Sumudu [University of California, Cardiovascular and Thoracic Imaging, Department of Radiology, Irvine, CA (United States)

    2014-07-15

    To assess the role of CT angiography in the evaluation of patients with lower extremity gunshot wounds in the emergency room. Eighty patients (73 male, 7 female, mean age 26 years) underwent CT angiography for the evaluation of lower extremity gunshot injuries. Imaging was conducted on the basis of standardized protocols utilizing 16-slice and 64-slice multidetector systems and images were qualitatively graded and assessed for various forms of arterial injury. CT angiography findings indicative of arterial injury were observed in 24 patients (30 %) and a total of 43 arterial injuries were noted; the most common form was focal narrowing/spasm (n = 16, 37.2 %); the most common artery involved was the superficial femoral artery (n = 12, 50 %). In qualitative assessment of images based on a 4-point grading system, both readers considered CT angiography diagnostically excellent (grade 4) in most cases. Surgical findings were consistent with CT angiography and follow-up of patients' medical records showed no arterial injuries in patients with normal findings on initial imaging. Our findings demonstrate that CT angiography is an effective imaging modality for evaluation of lower extremity gunshot wounds and could help limit more invasive procedures such as catheter angiography to a select group of patients. (orig.)

  18. Using synchrotron radiation angiography with a highly sensitive detector to identify impaired peripheral perfusion in rat pulmonary emphysema

    International Nuclear Information System (INIS)

    Synchrotron radiation angiography with a HARP detector made it possible to evaluate impaired pulmonary microcirculation in pulmonary emphysema by means of high sensitivity. Owing to limitations in spatial resolution and sensitivity, it is difficult for conventional angiography to detect minute changes of perfusion in diffuse lung diseases, including pulmonary emphysema (PE). However, a high-gain avalanche rushing amorphous photoconductor (HARP) detector can give high sensitivity to synchrotron radiation (SR) angiography. SR angiography with a HARP detector provides high spatial resolution and sensitivity in addition to time resolution owing to its angiographic nature. The purpose of this study was to investigate whether this SR angiography with a HARP detector could evaluate altered microcirculation in PE. Two groups of rats were used: group PE and group C (control). Transvenous SR angiography with a HARP detector was performed and histopathological findings were compared. Peak density of contrast material in peripheral lung was lower in group PE than group C (p < 0.01). The slope of the linear regression line in scattering diagrams was also lower in group PE than C (p < 0.05). The correlation between the slope and extent of PE in histopathology showed significant negative correlation (p < 0.05, r = 0.61). SR angiography with a HARP detector made it possible to identify impaired microcirculation in PE by means of its high spatial resolution and sensitivity

  19. Changes of Indocyanine Green and Fluorescein Angiography in Multiple Evanescent White-dot Syndrome: A Case Report

    Institute of Scientific and Technical Information of China (English)

    Changxian Yi; Guilin Zhao; Jiexiong Ou; Hong Yan

    2003-01-01

    Purpose: To study the clinicopathological change on "Multiple Evanescent White-dot Syndrome (MEWDS)"through fundus angiogrphy analyses.Methods:Examing the case with fluorescein angiography (FFA) and indocyanine green angiography(ICGA), visual field and following up for 15 months.Results :There exist multiple white dots in the fundus photo and angiography. The changes on ICGA maintain longer than fundus photo and FFA. Papille may be edematous and macula could present with special hypofluorescent flecks.Conclusions:MEWDS has specific angiographic features. Its pathological changes involve deep retinal pigment epithelium(RPE) as well as choroidal capillaries. The prognosis of the visual acuity for MEWDS is very good.

  20. Descriptive retrospective analysis of the diagnostic yield and morbidity of four vessel catheter-directed cerebral angiography and multidetector computed tomographic angiography (MDCTA) performed at Inkosi Albert Luthuli Central Hospital (IALCH)

    Energy Technology Data Exchange (ETDEWEB)

    Sabri, A., E-mail: sabri.ali@gmail.com [University of Kwazulu Natal, College of Health Sciences, Nelson R Mandela School of Medicine, School of Surgical Disciplines, Department of Radiology, Private Bag 7, Congella 4013, Durban (South Africa); Robbs, J.V., E-mail: jvrobbs@mweb.co.za [University of Kwazulu Natal, College of Health Sciences, Nelson R Mandela School of Medicine, School of Surgical Disciplines, Department of Surgery, Durban (South Africa); Maharajh, J., E-mail: Jaynund.Maharajh@kznhealth.gov.za [University of Kwazulu Natal, College of Health Sciences, Nelson R Mandela School of Medicine, School of Surgical Disciplines, Department of Radiology, Private Bag 7, Congella 4013, Durban (South Africa); Sikwila, T.C., E-mail: tcsikwila@yahoo.co.uk [University of Kwazulu Natal, College of Health Sciences, Nelson R Mandela School of Medicine, School of Surgical Disciplines, Department of Radiology, Private Bag 7, Congella 4013, Durban (South Africa)

    2011-11-15

    Imaging studies are indispensable in order to determine the source, location and pattern of intra and extra-axial brain haemorrhages. In our study of 277 patients carried out over an 18 month period, the most common reason of referral was subarachnoid haemorrhage followed by trauma. Aneurysms were the most common diagnosis (36%) with anterior and posterior communicating arteries being the most common locations. Fifty percent (50%) of patients investigated had a normal study. Our findings show that the yield from MDCTA and conventional angiography was relatively comparable, however, conventional angiography was superior in detection of aneurysms; hence, in cases were the MDCTA result was found to be normal despite a high index of suspicion for a subarachnoid haemorrhage, a follow-up MDCTA study or conventional angiography is useful. Moreover, conventional angiography was superior in detection of multiple aneurysms.

  1. Descriptive retrospective analysis of the diagnostic yield and morbidity of four vessel catheter-directed cerebral angiography and multidetector computed tomographic angiography (MDCTA) performed at Inkosi Albert Luthuli Central Hospital (IALCH)

    International Nuclear Information System (INIS)

    Imaging studies are indispensable in order to determine the source, location and pattern of intra and extra-axial brain haemorrhages. In our study of 277 patients carried out over an 18 month period, the most common reason of referral was subarachnoid haemorrhage followed by trauma. Aneurysms were the most common diagnosis (36%) with anterior and posterior communicating arteries being the most common locations. Fifty percent (50%) of patients investigated had a normal study. Our findings show that the yield from MDCTA and conventional angiography was relatively comparable, however, conventional angiography was superior in detection of aneurysms; hence, in cases were the MDCTA result was found to be normal despite a high index of suspicion for a subarachnoid haemorrhage, a follow-up MDCTA study or conventional angiography is useful. Moreover, conventional angiography was superior in detection of multiple aneurysms.

  2. Diagnostic Value of 64-Slice Dual-Source CT Coronary Angiography in Patients with Atrial Fibrillation: Comparison with Invasive Coronary Angiography

    International Nuclear Information System (INIS)

    We wanted to evaluate the image quality and diagnostic value of 64-slice dual-source computed tomography (DSCT) coronary angiography in patients with atrial fibrillation (Afib). The coronary arteries of 22 Afib patients seen on DSCT were classified into 15 segments and the imaging quality (excellent, good, moderate and poor) and significant stenoses (≥ 50%) were evaluated by two radiologists who were blinded to the conventional coronary angiography (CAG) results. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting important coronary artery stenosis were calculated. McNemar test was used to determine any significant difference between DSCT and CAG, and Cohen's Kappa statistics were calculated for the intermodality and interobserver agreement. The mean heart rate was 89 ± 8.3 bpm (range: 80-118 bpm). A range from 250 msec to 300 msec within the RR interval was the optimal reconstruction interval for the patients with Afib. The respective overall sensitivity, specificity, PPV and NPV values were 74%, 97%, 81% and 96% for reader 1 and 72%, 98%, 85% and 96% for reader 2. No significant difference between DSCT and CAG was found for detecting a significant stenosis (reader 1, p = 1.0; reader 2, p = 0.727). Cohen's Kappa statistics demonstrated good intermodality and interobserver agreement. 64-slice DSCT coronary angiography provides good image quality in patients with atrial fibrillation without the need for controlling the heart rate. DSCT can be used for ruling out significant stenosis in patients with atrial fibrillation with its high NPV for detecting in important stenosis.

  3. Diagnostic Value of 64-Slice Dual-Source CT Coronary Angiography in Patients with Atrial Fibrillation: Comparison with Invasive Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian Jun; Liu, Tie; Feng, Yue; Wu, Wei Feng; Mou, Cai Yun; Zhai, Li Hao [Zhejiang Hospital, Hangzhou (China)

    2011-08-15

    We wanted to evaluate the image quality and diagnostic value of 64-slice dual-source computed tomography (DSCT) coronary angiography in patients with atrial fibrillation (Afib). The coronary arteries of 22 Afib patients seen on DSCT were classified into 15 segments and the imaging quality (excellent, good, moderate and poor) and significant stenoses ({>=} 50%) were evaluated by two radiologists who were blinded to the conventional coronary angiography (CAG) results. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting important coronary artery stenosis were calculated. McNemar test was used to determine any significant difference between DSCT and CAG, and Cohen's Kappa statistics were calculated for the intermodality and interobserver agreement. The mean heart rate was 89 {+-} 8.3 bpm (range: 80-118 bpm). A range from 250 msec to 300 msec within the RR interval was the optimal reconstruction interval for the patients with Afib. The respective overall sensitivity, specificity, PPV and NPV values were 74%, 97%, 81% and 96% for reader 1 and 72%, 98%, 85% and 96% for reader 2. No significant difference between DSCT and CAG was found for detecting a significant stenosis (reader 1, p = 1.0; reader 2, p = 0.727). Cohen's Kappa statistics demonstrated good intermodality and interobserver agreement. 64-slice DSCT coronary angiography provides good image quality in patients with atrial fibrillation without the need for controlling the heart rate. DSCT can be used for ruling out significant stenosis in patients with atrial fibrillation with its high NPV for detecting in important stenosis.

  4. CT Angiography May Be a More Useful Modality Than Digital Subtractional Angiography in the Diagnosis of Patients with Subarachnoid Hemorrhage Due to Cerebral Aneurysms

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-05-01

    Full Text Available Background/Objective: The preoperative diagnostic"nvalidity of two radiological modalities (computed"ntomographic angiography and digital subtractional"nangiography in the diagnosis of brain aneurysms were"ncompared."nPatients and Methods: During 2 years of study,"nreferred patients with signs of SAH to the emergency"nward underwent routine CT scan and after SAH was"nfirmly diagnosed, CTA and DSA methods were done"nand patients with correct indications were operated."nAfter surgery and detecting the existence of aneurysms"nand their location, the data were recorded in a"nchecklist. Sensitivity, specificity, positive and negative"npredictive values were calculated and compared in"nboth methods."nResults: The mean age of the 30 patients were"n49.5±9.13 years. 57.9 % of the subjects were female"nand the others were male. On CTA reports 100% true"npositive, 0% false positive, 85% true negative, and 15%"nfalse negative were calculated. DSA reports were true"npositive, false positive, true negative and false negative"nin 100%, 0%, 69% and 31%, respectively. CTA showed"n89% of sensitivity, and 100% of specificity in contrast"nto 74% sensitivity and 100% specificity of DSA."nPositive predictive values of both methods were 100%,"nbut negative predictive values of CTA and DSA were"n85% and 69%, respectively."nConclusion: Based on our data, CTA is more preferable"ndiagnostic modality for the brain aneurysm's site and"nanatomy in patients with subarachnoid hemorrhage"nthan DSA."nKeywords: CT Scan Angiography, Digital Subtraction"nAngiography, Cerebral Aneurysm, Subarachnoid"nHemorrhage

  5. Hybrid CT angiography and quantitative {sup 15}O-water PET for assessment of coronary artery disease: comparison with quantitative coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Thomassen, Anders; Petersen, Henrik; Johansen, Allan; Braad, Poul-Erik; Hoeilund-Carlsen, Mette M.; Hoeilund-Carlsen, Poul F. [OUH, Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark); Diederichsen, Axel C.P.; Mickley, Hans; Jensen, Lisette O.; Thayssen, Per [OUH, Odense University Hospital, Department of Cardiology, Odense (Denmark); Gerke, Oke [OUH, Odense University Hospital, Department of Nuclear Medicine, Odense C (Denmark); University of Southern Denmark, Centre of Health Economics Research, Odense (Denmark); Vach, Werner [University Medical Center Freiburg, Clinical Epidemiology, Institute of Medical Biometry and Medical Informatics, Freiburg (Germany); Knuuti, Juhani [Turku University Hospital and University of Turku, Turku (Finland)

    2013-12-15

    CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combination of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by {sup 15}O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses. The study group comprised 44 outpatients scheduled for invasive coronary angiography (ICA) with an intermediate pretest likelihood of coronary artery disease. The patients underwent 64-slice CTA and baseline and hyperaemic PET before ICA with quantitative coronary angiography analysis. On a per-patient basis, the negative predictive values (NPV; 95 % confidence intervals in parentheses) were 88 % (64 - 97 %) for CTA, 90 % (71 - 97%) for PET and 92 % (74 - 98%) for PET/CTA, and the positive predictive values (PPV) were 71 % (53 - 85%) for CTA, 87 % (68 - 95%) for PET and 100 % (84 - 100%) for PET/CTA. Similarly, on a per-vessel basis the NPVs (which were generally high) were 97 % (94 - 100%) for CTA, 95 % (90 - 99%) for PET and 97 % (95 - 100%) for PET/CTA, and the PPVs (which were lower, but higher with PET/CTA) were 53 % (39 - 66%) for CTA, 53 % (40 - 66%) for PET and 85 % (73 - 97%) for PET/CTA. In six patients, CTA analysis was hampered by the presence of severe calcifications. However, with the addition of the PET data, all six patients were correctly categorized. Cardiac quantitative hybrid PET/CTA imaging has better diagnostic accuracy than CTA alone and PET alone. CTA has a suboptimal PPV, suggesting that hybrid PET/CTA imaging should be used to assess the significance of coronary stenoses diagnosed by CTA. (orig.)

  6. Emergency coronary angiography in comatose cardiac arrest patients:do real-life experiences support the guidelines?

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Wanscher, Michael;

    2012-01-01

    To describe the use of emergency coronary angiography (CAG) and primary percutaneous coronary intervention (PCI) and the association with short- and long-term survival in consecutive comatose survivors after out-of-hospital cardiac arrest (OHCA)....

  7. Prominent porto-systemic collateral pathways in patients with portal hypertension: demonstration by gadolinium-enhanced magnetic resonance angiography

    International Nuclear Information System (INIS)

    To demonstrate the usefulness of gadolinium-enhanced magnetic resonance angiography in the evaluation of prominent porto-systemic collateral pathways. We reviewed the images from 40 patients with portal hypertension studied with gadolinium-enhanced magnetic resonance angiography and selected illustrative cases of prominent porto-systemic collateral pathways. The scans were performed using high field equipment (1.5 Tesla) and a 3 D volume technique. Image were obtained after intravenous injection of paramagnetic contrast media using a power injector. Magnetic resonance angiography demonstrated with precision the porto-systemic collateral pathways, particularly when investigating extensive territories or large vessels. The cases presented show the potential of this method in the investigation of patients with portal hypertension. Gadolinium-enhanced magnetic resonance angiography is a useful method for the evaluation of patients with portal hypertension and prominent collateral pathways. (author)

  8. Low-dose, prospective triggered high-pitch spiral coronary computed tomography angiography: comparison with retrospective spiral technique.

    NARCIS (Netherlands)

    Srichai, M.B.; Lim, R.P.; Donnino, R.; Mannelli, L.; Hiralal, R.; Avery, R.; Ho, C.; Babb, J.S.; Jacobs, J.E.

    2012-01-01

    RATIONALE AND OBJECTIVES: Cardiac computed tomographic angiography algorithms emphasize radiation reduction while maintaining diagnostic image quality (IQ). The aim of this study was to evaluate IQ and interreader variability using prospective electrocardiographically triggered high-pitch spiral car

  9. Use of multi-detector CT angiography in identification and classification of aorto-iliac diseases; clinical and surgical application

    Directory of Open Access Journals (Sweden)

    Reda Abdelsamie Alarabawy

    2016-03-01

    Conclusions: MDCT angiography is excellent noninvasive scanning technique for patients suspected of having aorto-iliac occlusive disease, with higher spatial resolution and faster acquisition times, allowing assessment of the aorta and its branches with greater accuracy than other modalities.

  10. Nationwide trends in use and timeliness of diagnostic coronary angiography in acute coronary syndromes from 2005 to 2011

    DEFF Research Database (Denmark)

    Hansen, Kim Wadt; Sørensen, Rikke; Madsen, Mette;

    2015-01-01

    a register-based cohort study of all patients admitted to Danish hospitals with incident acute coronary syndrome in 2005-2011. Diagnostic coronary angiography within 60 days of admission was investigated according to distance tertiles (DTs) calculated as range from each patient's home to the nearest invasive.......94 (0.90-0.98) for 2010-2011. Length of hospital stay, time to coronary angiography, and 60-day mortality decreased in all DT. CONCLUSIONS: This nationwide study found significant increases in diagnostic coronary angiography use over time in incident acute coronary syndrome patients with a relatively......AIMS: To examine trends in the use of diagnostic coronary angiography according to distance from home to the nearest invasive heart centre following implementation of fast-track protocols and extensive pre-hospital triaging of acute coronary syndrome patients. METHODS AND RESULTS: We performed...

  11. Low radiation dose imaging of myocardial perfusion and coronary angiography with a hybrid PET/CT scanner

    OpenAIRE

    Kajander, S; Ukkonen, H; Sipilä, H.; Teräs, M.; Knuuti, J

    2009-01-01

    Objectives: To test the image quality and feasibility of a sequential low radiation dose protocol for hybrid cardiac PET/CT angiography (CTA). Background: Multidetector computed tomography (MDCT) is a non-invasive method for coronary angiography. The negative predictive value of MDCT is high but perfusion imaging has a role in detecting functional significance of coronary lesions. This has encouraged combining these techniques. However, radiation dose is of concern. We report our first experi...

  12. Apneic oxygenation for elimination of respiratory motion artefact in an intubated patient undergoing helical chest computed tomography angiography.

    Directory of Open Access Journals (Sweden)

    Ioannis Pneumatikos

    2008-10-01

    Full Text Available Respiratory motion artifact in intubated and mechanically ventilated patients often reduces the quality of helical computed tomography pulmonary angiography (CTPA. Apneic oxygenation is a well established intra-operative technique that allows adequate oxygenation for short periods (up to 10 min in sedated and paralyzed patients. We describe the use of the apneic oxygenation for elimination of respiratory motion artefact in an intubated patient undergoing helical chest computed tomography angiography.

  13. Multiple giant coronary aneurysms arising from coronary istula to the pulmonary artery revealed in aorta CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam [Dept. of Radiology, Dong A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of); Lee, Jong Min [Dept. of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    2015-12-15

    Coronary fistula is a rare coronary abnormality through which blood drains into the cardiac chamber, great vessel or other vessels. In addition, giant aneurysm arising from coronary fistula is rare pathologic manifestation. Herein, we presented a rare case of multiple giant coronary artery aneurysms arising from coronary to pulmonary artery fistula in a 79-year-old woman presenting with sudden loss of consciousness. The aneurysms were detected using thoracic computed tomography angiography and consequently confirmed by invasive coronary angiography.

  14. Multislice CT angiography in the selection of patients with ruptured intracranial aneurysms suitable for clipping or coiling

    OpenAIRE

    Westerlaan, H. E.; Gravendeel, J.; Fiore, D; Metzemaekers, J. D. M.; Groen, R. J. M.; Mooij, J.J.A.; Oudkerk, M.

    2007-01-01

    Introduction We sought to establish whether CT angiography (CTA) can be applied to the planning and performance of clipping or coiling in ruptured intracranial aneurysms without recourse to intraarterial digital subtraction angiography (IA-DSA). Methods Over the period April 2003 to January 2006 in all patients presenting with a subarachnoid haemorrhage CTA was performed primarily. If CTA demonstrated an aneurysm, coiling or clipping was undertaken. IA-DSA was limited to patients with negativ...

  15. The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

    International Nuclear Information System (INIS)

    The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment

  16. Melitrast in coronary angiography; Roentgenkontrastmittel Melitrast-300 und Melitrast-270 in der kardiologischen Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Geisler, T.; Funke, B.; Wild, P.; Zotz, R. [Medizinische Klinik, Klinikum Schwalmstadt, Schwalmstadt (Germany); Dietz, G.; Petrov, R. [Dr. F. Koehler Chemie, Alsbach-Haehnlein (Germany); Stefenelli, U. [Fachinstitut fuer Statistik, Wuerzburg (Germany)

    2004-07-01

    The aim of this study was the evaluation of safety and cardiologic efficacy of the non-ionic contrast agent Iosarcol (Melitrast), a contrast agent with low protein affinity in two different iodine concentrations. One hundred patients were prospectively randomized to receive either Melitrast-270 or Melitrast-300 for left heart ventriculography and coronary angiography. Clinical evaluation, blood pressure and pulse measurement were performed and an electrocardiogram was recorded before and after contrast application and the diagnostic efficacy using a score was evaluated. In three patients side effects could be observed 2 hours after the application (vertigo, sickness, sweating). Melitrast in both concentrations led to a good contrast during ventriculography and coronary angiography which could not be differentiated by two experienced observers. Thus a lower iodine concentration and by this a lower viscosity seems to favour Melitrast-270 for invasive cardiologic diagnosis. (orig.)

  17. The significance of MR angiography for the diagnosis of carotid stenoses

    International Nuclear Information System (INIS)

    Arteriosclerosis of the supra-aortic vessels is a known risk factor for cerebrovascular disease. Large multicenter studies like NASCET and ECST have proven the protective effects of the surgical treatment of severe (>70%) carotid artery stenoses. The exact detection and grading of stenoses of the carotid arteries is a prerequisite for a successful therapy. Besides the gold-standard examination, digital subtraction angiography (DSA), MR angiography (MRA) is being used increasingly. MRA allows a non-invasive, high-resolution depiction of the supra-aortic vessels without ionizing radiation in only 20 s. This article first illustrates the MRA-techniques, and the indications and limitations of MRA. Next, the diagnostic accuracy of MRA is compared to DSA and ultrasound. The clinical value of MRA for the detection of stenoses of the carotid arteries is discussed on the basis of clinical examples. (orig.)

  18. Optimizing 64-slice spiral CT angiography in lower extremity arterial disease with individualized injection protocol

    International Nuclear Information System (INIS)

    Objective: To explore the optimal protocol of the 64-slice spiral CT angiography (CTA) in lower extremity arterial disease. Methods: Forty -eight patients with clinically suspected lower extremity arterial disease underwent GE LightSpeed VCT using individual and traditional injection protocols. The clinical value of CTA was evaluated using DSA as the standard reference. Results: Satisfactory images were obtained from 47 of 48 cases. Images fulfilling clinical diagnostic requirements after appropriate post -procession on workstation were obtained from 1 case. The image quality of the group with the individualized injection protocol was significantly superior to that of the group with the traditional image protocol. The sensitivity and specificity of CTA in detecting middle-grade and severe arterial stenosis were 86.1% and 86.6%, respectively. Conclusion: 64-slice spiral CT angiography is a reliable method for evaluating the lower extremity arterial disease, and is a more ideal method if using individualized injection protocol. (authors)

  19. Diagnostic reference levels in angiography and interventional radiology: A Belgian multi-centre study

    International Nuclear Information System (INIS)

    The purpose of this study was to determine diagnostic reference levels (DRLs) for common angiographic and interventional procedures in Belgium. Dose Area Product (DAP) measurements were performed on 21 systems, (13 angiography and 4 vascular surgery centres). Type of procedure, total DAP, patient weight and height were collected on a daily basis during 1 y. The 75. percentile of the distribution of DAP values was defined as DRL. Preliminary DRLs were calculated for the three most frequent procedures for the whole population, for a weight class of patients (65-80 kg) and normalised to the standard size patient. Among them, the DRL for angiography of the lower limbs (30% of the procedures) from the whole population was 74.6 and 63.2 Gy cm2 for the size corrected. The mean DAP values of each room was then compared to these DRLs. (authors)

  20. Anomalous origin of the occipital artery diagnosed by magnetic resonance angiography

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Mizukoshi, Waka; Okada, Yoshitaka [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2011-11-15

    It is well known that the occipital artery (OA) can arise from the internal carotid artery (ICA) or vertebral artery (VA). However, the incidence of an anomalously originating OA has not been reported. We investigate its incidence and characteristic features on magnetic resonance angiography (MRA). We retrospectively reviewed MRA images of 2,866 patients that included the carotid bifurcation; images were obtained using a standard noncontrast MRA protocol and two 1.5-T MR units. We diagnosed six cases (seven arteries) of anomalously originating OA, which represented an incidence of 0.21%. The OA arose from the ICA in four patients (five arteries), from the carotid bifurcation in one, and from the VA in one. Five of the seven arteries occurred on the right. Anomalously originating OA is rare and occurs with right-side predominance. Correct diagnosis is necessary before or during cerebral angiography, especially when selective catheterization to the OA is required. (orig.)

  1. Coronary computed tomography angiography and its increasing application in day to day cardiology practice.

    Science.gov (United States)

    Markham, R; Murdoch, D; Walters, D L; Hamilton-Craig, C

    2016-01-01

    Coronary artery disease (CAD) is the leading single cause of death in Australia affecting around 1.4 million people. Coronary computed tomography angiography has an established role in the assessment of patients with low to intermediate pretest probability for CAD who have chest pain and is typically used with the aim to rule out significant coronary artery stenosis. Use was initially limited because of concerns over radiation exposure, a Medicare rebate restricted to specialist referrals and an absence of data supporting its use as an alternative to functional testing in patients with chest pain. Recent advances in scanner technology and image sequencing, along with data from randomised control trials, have addressed these issues and indicate that coronary computed tomography angiography will play a greater role in the assessment of CAD in the coming years. PMID:26813899

  2. Comparison between scintiscanning and pulmonary angiography in the diagnosis of pulmonary embolism

    International Nuclear Information System (INIS)

    In the diagnosis of pulmonary embolism, radio-isotope scanning is specific when it reveals complete absence of focal, lobar or segmental perfusion. Diffuse reductions in perfusion cannot be considered significant except in patients with healthy heart and lungs. Radio-isotope scanning shows up well peripheral emboli. Angiography provides definite evidence when it shows up intravascular lacunae or definite vascular obstructions, the diagnosis is probable when localised hypovascularisation or asymmetric vascularisation are found. Angiocardiography and pulmonary scintiscanning are neither contrary nor comparable. Radio-isotope scanning is simpler and less dangerous perhaps and may always be carried out. When it is normal, it eliminates definitely the necessity for angiography the results of which are still morphological

  3. Diagnostic role of magnetic resonance angiography in Swyer James syndrome: Case series of two cases

    Directory of Open Access Journals (Sweden)

    Parashari Umesh

    2010-01-01

    Full Text Available Swyer James syndrome is a rare syndrome which occurs due to viral illness in early childhood. The post infective obliterative bronchiolitis results in arrest of lung growth and alveolarization with reduced vascularity resulting in classical radiological features. We describe two cases of patients fulfilling all the criteria of the syndrome - 1 Unilateral hyperlucent small lung in chest radiograph with air trapping on expiration, small ipsilateral hila and pulmonary artery. 2 Diffuse decrease in attenuation of lung parenchyma with bronchiectasis and reduction in vascularity. 3 Unilateral pruned tree appearance on angiography (MRA. The clinical presentation was recurrent chest infection in a child and infrequent bouts of hemoptysis in a middle aged female. The study demonstrates the role of magnetic resonance angiography in diagnosing the condition.

  4. Three-dimensional fusion angiography of a giant basilar aneurysm for coil embolization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joo Yeon; Suh, Dae Chul [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2015-05-15

    A giant aneurysm was unexpectedly found on computed tomography angiogram in a 54-year-old female. Cerebral angiogram showed a giant aneurysm at the ventral side of the lower basilar artery trunk. However, it was difficult to demonstrate the precise relationship between the aneurysmal sac and the parent artery because of the incomplete filling of the contrast medium secondary to the preferential flows from a well-balanced development of both vertebral arteries. Three-dimensional (3D) fusion angiography revealed complete filling of the aneurysm as well as the basilar trunk itself beyond the aneurysm, which was dysplastic. Coiling of the aneurysm was safely and completely accomplished based on the fusion images. In this report, we demonstrate a case of giant basilar aneurysm with 3D fusion angiography proving useful in assisting with treatment planning.

  5. Intracranial arterial anatomy: evaluation by computed tomography angiography; Anatomia arterial intracraniana: avaliacao por angiotomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Regattieri, Neysa Aparecida Tinoco, E-mail: neysa@utfpr.edu.b [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Haetinger, Rainer Guilherme; Liberti, Edson Aparecido [Universidade de Sao Paulo (ICB III/USP), SP (Brazil). Inst. de Ciencias Biomedicas; Piske, Ronie Leo [Hospital Beneficencia Portuguesa de Sao Paulo, SP (Brazil)

    2010-07-01

    By many decades, the intracranial arteries study was realized exclusively by angiography through selective arterial catheterization. Nowadays, with the technologic evaluation of computerized tomography devices with multi detectors allowing acquisitions with even more thinner slices, higher speed and better resolution, it had appeared a new modality of investigation: the computed tomography angiography, less invasive and with minor morbidity than conventional arteriography. Many studies in the literature have been analyzing the sensibility of the new method for the detection of intracranial aneurysms and comparing them with the conventional arteriography. There is a necessity to recognize the normal intracranial arterial anatomy and its variations using images obtained from multiplanar reformations, in order to give important information for surgeries strategies, such as wall calcifications, aneurismatic neck position and relationships with surrounding anatomical structures. (author)

  6. The role of CT angiography in the evaluation of pediatric renovascular hypertension

    International Nuclear Information System (INIS)

    Historically, the evaluation of renovascular hypertension has been accomplished by US, renal scintigraphy and digital subtraction angiography. Based on its high accuracy reported in adults renal CT angiography (CTA) with pediatric-appropriate low radiation dose techniques has become an important tool in the workup of renovascular hypertension in children. Renal CTA has several advantages over more conventional imaging modalities, including rapid and non-invasive acquisition, high resolution and easy reproducibility. Additionally, in our experience high-quality renal CTA can be performed using low-dose radiation exposures and can be acquired without sedation in most instances. This article illustrates by examples the usefulness of renal CTA for diagnosis of childhood renovascular hypertension and provides an overview of renal CTA findings in the most common childhood renovascular diseases. (orig.)

  7. Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography

    DEFF Research Database (Denmark)

    Dankiewicz, J; Nielsen, N; Annborn, M;

    2015-01-01

    PURPOSE: To investigate whether early coronary angiography (CAG) after out-of-hospital cardiac arrest of a presumed cardiac cause is associated with improved outcomes in patients without acute ST elevation. METHODS: The target temperature management after out-of-hospital cardiac arrest (TTM) trial...... early CAG was not significantly associated with survival. CONCLUSIONS: In this post hoc observational study of a large randomized trial, early coronary angiography for patients without acute ST elevation after out-of-hospital cardiac arrest of a presumed cardiac cause was not associated with improved...... showed no difference in all-cause mortality or neurological outcome between an intervention of 33 and 36 °C. In this post hoc analysis, 544 patients where the admission electrocardiogram did not show acute ST elevation were included. Early CAG was defined as being performed on admission or within...

  8. Evaluation of User Performance in Simulation-Based Diagnostic Cerebral Angiography Training.

    Science.gov (United States)

    Zaika, Oleksiy; Nguyen, Ngan; Boulton, Mel; Eagleson, Roy; de Ribaupierre, Sandrine

    2016-01-01

    Simulation of anatomically complex procedures, such as angiography, is becoming more practical, however, computer-based modules require extensive research to assess their effectiveness. We organized two training schemas - alternating cases and consistent cases - and hypothesized that the alternating practice cases would be beneficial to test performance. Eight residents (4 radiology/4 neurosurgery) and 8 anatomy graduate students were trained on the SimbionixTM simulator in order to assess skill acquisition in diagnostic cerebral angiography over 8 sessions. We found that participants improve on total procedure time and total fluoroscopy time (p<0.05), but not on contrast injected or roadmaps created. There were no significant differences between alternating and consistent training types. Additional work needs to be done with higher sample numbers and visuospatial scores as criteria. PMID:27046624

  9. Computed tomography angiography in acute stroke (revisiting the 4Ps of imaging).

    Science.gov (United States)

    Varadharajan, Shriram; Saini, Jitender; Acharya, Ullas V; Gupta, Arun Kumar

    2016-02-01

    Imaging in acute stroke has traditionally focussed on the 4Ps-parenchyma, pipes, perfusion, and penumbra-and has increasingly relied upon advanced techniques including magnetic resonance imaging to evaluate such patients. However, as per European Magnetic Resonance Forum estimates, the availability of magnetic resonance imaging scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and United States (35 per million), with most of them only present in urban cities. On the other hand, computed tomography (CT) is more widely available and has reduced scanning duration. Computed tomography angiography of cervical and intracranial vessels is relatively simpler to perform with extended coverage and can provide all pertinent information required in such patients. This imaging review will discuss relevant imaging findings on CT angiography in patients with acute ischemic stroke through illustrated cases.

  10. Three-dimensional CT angiography with volume rendering for the dignosis of multiple intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    FANG Bing; LI Tie-lin; ZHANG Jian-min; DUAN Chuan-zhi; WANG Qiu-jing; ZAO Qing-ping

    2004-01-01

    Objective:To evaluate the importance of 3D-CTA with volume rendering for the diagnosis of multiple intracranial aneurysms. Methods: Axial source images were obtained by helical CT scanning and reconstruction of 3D-CTA images was done by volume rendering technique in conjunction with multiplanar reformation. Results: In the past one year,there were 10 patients diagnosed as having multiple intracranial aneurysms by 3D-CTA and altogether 24 aneurysms were visualized,including 10 small aneurysms(≤5mm.Three dimensional CT angiography with volume rendering demonstrated aneurysms very well and provided useful information concerning the site,shape,size and spatial relationship with the surrounding vessels and bone anatomy. Conclusion: Three-dimensional CT angiography with volume rendering is a quick,reliable,and relatively noninvasive method for diagnosing multiple intracranial aneurysms.It delineates detailed aneurysmal morphology,and provides useful information for planning microsurgical approaches.

  11. Coronary CT angiography in clinical triage of patients at high risk of coronary artery disease

    DEFF Research Database (Denmark)

    Kühl, J Tobias; Hove, Jens D; Kristensen, Thomas S;

    2016-01-01

    OBJECTIVES: To test if cardiac computed tomography angiography (CCTA) can be used in the triage of patients at high risk of coronary artery disease. DESIGN: The diagnostic value of 64-detector CCTA was evaluated in 400 patients presenting with non-ST segment elevation myocardial infarction using...... in patients with high likelihood of coronary artery disease and could, in theory, be used to triage high risk patients. As many obstacles remain, including logistical and safety issues, our study does not support the use of CCTA as an additional diagnostic test before ICA in an all-comer NSTEMI population....... invasive coronary angiography (ICA) as the reference method. The relation between the severity of disease by CCTA and a combined endpoint of death, re-hospitalization due to new myocardial infarction, or symptom-driven coronary revascularization was assessed. RESULTS: CCTA detects significant (>50...

  12. Optical Coherence Tomography Angiography for Detecting Choroidal Neovascularization Secondary to Choroidal Osteoma.

    Science.gov (United States)

    Szelog, Jason T; Bonini Filho, Marco A; Lally, David R; de Carlo, Talisa E; Duker, Jay S

    2016-01-01

    Choroidal osteoma is an ossifying tumor that is found predominantly in the peripapillary and macular areas. It typically affects otherwise healthy females. Vision loss may occur secondary to the development of choroidal neovascularization (CNV). Fluorescein angiography (FA) remains the gold standard for diagnosing CNV; however, the use of optical coherence tomography angiography (OCTA) as an adjunct to FA is growing. In this report, a 16-year-old female with a large, unilateral peripapillary choroidal osteoma presented with blurred vision. Exam revealed scattered intraretinal hemorrhage, but FA was unable to detect CNV overlying the tumor. OCTA detected abnormal flow in the outer retina corresponding to a type 2 CNV. Following intravitreal anti-vascular endothelial growth factor therapy, the CNV regressed, the hemorrhage resolved, and there was less fluid. OCTA may be helpful in detecting CNV noninvasively in eyes in which FA is equivocal, such as those with choroidal osteoma.

  13. Effect of obesity on coronary artery plaque using 64 slice multidetector cardiac computed tomography angiography.

    Science.gov (United States)

    Isma'eel, Hussain; Tellalian, David; Hamirani, Yasmin S; Kadakia, Jigar; Nasir, Khurram; Budoff, Matthew J

    2010-04-30

    Patients with a coronary artery calcification score (CACS) of zero and an intermediate risk of coronary artery disease have been shown to have a low prevalence of non-calcified coronary artery plaque (NCP). 181 consecutive patients with CAC 'zero', undergoing cardiac computed tomography angiography (CCTA) angiography at our center were evaluated. Presence of detectable NCP on CCTA in these patients was 13.8%. Mild non-obstructive disease (50%). Traditional risk factors were not found to be associated with the presence of NCP. However higher body mass index (BMI) was strongly found to be associated with NCP (31.6 in patients with NCP vs. 27.6 kg/m(2) in patients without NCP, pNCP as compared to normal BMI (p<0.05).

  14. Coronary angiography and pathogenesis of coronary artery disease in young male survivors of myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Szamosi, A.; Hamsten, A.; Walldius, G.; Faire, U. de

    Coronary angiography was performed 3 to 6 months after myocardial infarction in 107 males below the age of 45 (mean age 39.7+-3.9, range 23-44 years). The coronary angiograms were allocated to various groups according to the presence or absence of obvious atheromatous changes. Metabolic evaluation included determination of cholesterol and triglyceride concentrations in the major serum lipoproteins. Marked elevation of low density lipoprotein (LDL) cholesterol concentration was found in patients with angiographic evidence of atheromatosis, in contrast to patients with normal coronary angiograms or with single occlusion and no other abnormalities. Thus, there was a correlation between angiographic appearance of the coronary arteries and disturbances of LDL metabolism. It is proposed that coronary angiography may distinguish between atheromatous and nonatheromatous pathogenesis of myocardial infarction at young age.

  15. Cerebral blood flow imaged with ultrahigh-resolution optical coherence angiography and Doppler tomography

    OpenAIRE

    Ren, Hugang; Du, Congwu; Pan, Yingtian

    2012-01-01

    Speckle contrast based optical coherence angiography (OCA) and optical coherence Doppler tomography (ODT) have been applied to image cerebral blood flow previously. However, the contrast mechanisms of these two methods are not fully studied. Here, we present both flow phantom and in vivo animal experiments using ultrahigh-resolution OCA (μOCA) and ODT (μODT) to investigate the flow sensitivity differences between these two methods. Our results show that the high sensitivity of μOCA for visual...

  16. Contrast-enhanced magnetic resonance angiography. Theory, technique and practical application

    International Nuclear Information System (INIS)

    Contrast enhanced (CE) magnetic resonance angiography affords angiographic depiction of extended vascular territories with high quality and diagnostic value. A prerequiste is the fast acquisition of a three-dimensional gradient-echo data set during the injection of a bolus of a T1-shortening contrast agent. We describe the dependence of the quality of CE-MRA on technical parameters of different MR-scanners and consider some fundamental facts and practical guidelines concerning the contrast agent injection. (orig.)

  17. Computed Tomographic Angiography under Sedation in the Diagnosis of Suspected Canine Pancreatitis: A Pilot Study

    OpenAIRE

    Adrian, A.M.; Twedt, D.C.; Kraft, S L; Marolf, A.J.

    2014-01-01

    Background Computed tomography (CT) is highly accurate for diagnosing pancreatitis in humans. The diagnosis of pancreatitis in dogs is based on clinical signs, laboratory findings, and ultrasonographic (US) changes. There are, however, inherent limitations in relying on laboratory and ultrasound findings for the clinical diagnosis of pancreatitis in dogs. Hypothesis/Objectives We hypothesized that CT angiography would be a rapid and reliable method to confirm pancreatitis in dogs compared to ...

  18. COMMUNICATING ARTERY NOT VISUALIZED BY CEREBRAL ANGIOGRAPHY-REPORT OF FOUR CASES

    Institute of Scientific and Technical Information of China (English)

    张俊延; 王忠诚; 石祥恩

    1994-01-01

    Four cases of anterior communicating aneurysms are reported with clinical presentations of recurrent intracranial hemorrhage undisclosed in their cerbral angiography.Operative exploration revealed anterior communicating aneurysms in these patients.It is thought possible that these patients harbored aneurysms which failed to exhibit on angiograms due to temporary thrombosis or development of abnormal cerebral vessels.CT scanning was important for tdiagnosis of these patients.

  19. The role of simulator training for skills aquisition in coronary angiography

    OpenAIRE

    Jensen, Ulf

    2013-01-01

    Introduction Coronary angiography (CA) is one of our most common invasive techniques in medicine today and is used to investigate coronary anatomy and pathology. The method is crucial and lifesaving in diagnosing acute coronary syndromes and so far not interchangeable to any other modality. The skills of performing a CA are compulsory for the general cardiologist according to present international guidelines but the methods for achieving these skills are not well defined. CA i...

  20. Diagnostic value of ultrasound, computed tomography, and angiography in ruptured aortic aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Landtman, M.; Kivisaari, L.; Bondestam, S.; Taavitsainen, M.; Standertskjoeld-Nordenstam, C.G.; Somer, K.

    1984-11-01

    Some ruptural aneurysms cause nonspecific symptoms and the patients are referred for radiological examination because of the problems of differential diagnosis from conditions such as renal colic, diverticulitis, herniated disc, aortic dissection etc. Seven such patients have been examined either with ultrasonography, computed tomography or angiography. The diagnostic methods are compared. The more recent US and CT imaging methods are sufficiently rapid and reliable for diagnostic purposes, which should improve the prognosis for patients requiring immediate surgery for ruptured aortic aneurysms.

  1. Indocyanine Green Angiography Guided Management of Vogt-Koyanagi-Harada Disease

    OpenAIRE

    Nadia Bouchenaki; Herbort, Carl P.

    2011-01-01

    Purpose: To report the management of Vogt-Koyanagi-Harada (VKH) disease based on indocyanine green angiography (ICGA). Methods: VKH patients with acute episodes of inflammation (inaugural or recurrent) who had received standard ICGA-guided care were studied retrospectively. Standard of care included high dose systemic corticosteroids at presentation and close ICGA follow-up with addition of immunosuppressive agents and/or intensification of ongoing therapy when recurrent choroidal lesions wer...

  2. Role of 320-slice multislice computed tomography coronary angiography in the assessment of coronary artery stenosis

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed Youssef

    2014-06-01

    Conclusion: In conclusion, MSCT coronary angiography is a very helpful and rapid non-invasive coronary imaging modality that was able to detect and grade coronary artery stenosis better than other noninvasive examinations used to detect CAD, such as exercise stress testing. Due to its very high negative predictive value, it may eliminate the need for invasive coronary procedures in the presence of normal coronary imaging.

  3. A model-based reconstruction method for 3-D rotational coronary angiography

    Science.gov (United States)

    Xie, Lizhe; Hu, Yining; Nunes, Jean-Claude; Bellanger, Jean-Jacques; Bedossa, Marc; Luo, Limin; Toumoulin, Christine

    2010-01-01

    This paper presents a model-based reconstruction method of the coronary tree from a few number of projections in rotational angiography imaging. The reconstruction relies on projections acquired at a same cardiac phase and an energy function minimization that aims to lead the deformation of the 3D model to fit projection data whereas preserving coherence both in time and space. Some preliminary results are provided on simulated rotational angiograms. PMID:21096600

  4. Multislice computed tomography angiography in the diagnosis of cardiovascular disease: 3D visualizations

    Institute of Scientific and Technical Information of China (English)

    Zhonghua Sun

    2011-01-01

    Multislice computed tomography (CT) has been widely used in clinical practice for the diagnosis of cardiovascular disease due to its reduced invasiveness and high spatial and temporal resolution.As a reliable alternative to conventional angiography,multislice CT angiography has been recognized as the method of choice for detecting and diagnosing head and neck vascular disease,abdominal aortic aneurysm,aortic dissection,and pulmonary embolism.In patients with suspected coronary artery disease,although invasive coronary angiography still remains as the gold standard technique,multislice CT angiography demonstrates high diagnostic accuracy; in selected patients,it is considered as the first-line technique.The imaging diagnosis of cardiovascular disease is based on a combination of two-dimensional (2D) and three-dimensional (3D) visualization tools to enhance the diagnostic value.This is facilitated by reconstructed visualizations which provide additional information about the extent of the disease,an accurate assessment of the spatial relationship between normal structures and pathological changes,and pre-operative planning and post-procedure follow-up.The aim of the present article is to present an overview of the diagnostic performance of various 2D and 3D CT visualizations in cardiovascular disease,including multiplanar reformation,maximum intensity projection,volume rendering,and virtual intravascular endoscopy.The recognition of the potential value of these visualizations will assist clinicians in efficiently using the muitislice CT imaging modality for the diagnostic management of patients with cardiovascular disease.

  5. Diagnostic Performance of Coronary Computed Tomography Angiography and Myocardial Perfusion Imaging in Kidney Transplantation Candidates

    DEFF Research Database (Denmark)

    Winther, Simon; Svensson, My; Jørgensen, Hanne Mari Skou;

    2014-01-01

    Objectives To compare the diagnostic accuracy of coronary artery calcium score (CACS), coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), and a combination of these in the diagnosis of obstructive coronary artery disease (CAD) in patients...... with chronic kidney disease referred for cardiac evaluation before kidney transplantation. Background The optimal method for the detection of obstructive CAD in potential kidney transplant patients has not yet been identified. Previous studies have shown low diagnostic accuracy of established noninvasive...

  6. An unusual cause of the acute abdomen: computed tomography angiography findings of the intestinal intramural hematoma

    International Nuclear Information System (INIS)

    Full text: Introduction: The intestinal intramural hematoma is a rare abdominal emergency condition resulting from submucosal or subserosal hemorrhage. The various causes of this condition are anticoagulant therapy, trauma, surgery, biopsy and spontaneous. The most common cause of this condition is blunt abdominal trauma. Objectives and tasks: In this report we aimed to present computed tomography (CT) angiography findings of the intestinal wall hematoma which is an unusual cause of acute abdomen. Materials and methods: A 67-year-old man presented to our emergency department complaining of severe abdominal pain, nausea and vomiting. The physical examination revealed right upper quadrant and epigastric abdominal tenderness. Sonographic examination revealed free fluid in the right paracolic area and minor pelvis. Due to these findings, the patient underwent CT angiography examination with suspicion of acute intestinal ischemia. Results: Diffuse atherosclerotic calcified plaques in the abdominal aorta and moderate degree stenosis proximal celiac truncus were determined on CT angiography images. Mesenteric arterial system was patent. On CT images most remarkable finding was diffuse wall thickening reaching up to 1.5 cm at the widest part in small intestinal segments. These findings were seen in the right half of abdomen and pelvis, approximately 12 cm and 20 cm small intestinal segment, respectively. The patient was using warfarin and acetylsalicylic acid medication due to heart valve replacement surgery. This history and CT angiography findings were consistent with intestinal mural hematoma. Conclusion: In the differential diagnosis of the acute abdomen, intestinal intramural hematoma must be kept in mind, especially in patients using anticoagulant drugs. In such cases, CT angiographic examination is rapid, effective and reliable method in both determination of the vascular abnormality and evaluation of the intestinal wall pathologies

  7. Arteriovenous fistula complicating iliac artery pseudo aneurysm: diagnosis by CT angiography.

    Science.gov (United States)

    Huawei, L; Bei, D; Huan, Z; Zilai, P; Aorong, T; Kemin, C

    2002-01-01

    Fistula formation to the inferior vena cava is a rare complication of aortic aneurysm which is often misdiagnosed clinically. In one hundred of reported arteriocaval fistulae, none was originating from the right common iliac artery. We report a case of ileo-caval fistula due to a iatrogenic pseudoaneurysm. High resolution 3D imaging using breath-hold CT angiography is highly specific in identifying the location, extent of the aortocaval fistula as well as the neighbouring anatomic structures.

  8. The Value of Cerebral CT Angiography with Low Tube Voltage in Detection of Intracranial Aneurysms

    OpenAIRE

    Kun Tang; Rui Li; Jie Lin; Xiangwu Zheng; Ling Wang; Weiwei Yin

    2015-01-01

    Objective. The aim of this study is to investigate the value of cerebral CT angiography (CTA) with low tube voltage in detection of intracranial aneurysms. Materials and Methods. A total of 294 consecutive patients with spontaneous subarachnoid hemorrhage (SAH) were enrolled in this study and randomly assigned into conventional voltage CTA (C-CTA) group and low voltage CTA (L-CTA) group. The objective and subjective image qualities were analyzed and compared between C-CTA and L-CTA groups. W...

  9. Effects of Video Instruction on Fatigue and Back Pain in Patients Undergoing Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Nahid Jamshidi

    2010-01-01

    Full Text Available Introduction: : In order to prevent from the complications of the coronary angiography, patients who undergo this procedure need to have absolute rest on bed at least for 6 hours. This restriction to bed leads to patient's fatigue and back pain. The objective of this study is to assess the effect of patients' instruction by video on the levels of fatigue and back pain after angiography.Methods: In a quasi-experimental, pretest-posttest design, 128 patients were randomly assigned to either control or experimental group. Control group received verbal routine education by nurses, and experimental group received an informative video about the required measures before, during and after the coronary angiography procedure. Using visual analogue Scale (VAS, levels of fatigue and back pain were assessed immediately after and at 2, 4 and 6 hours after the procedure. The data were analyzed by descriptive and interpretive statistics such as t-test and ANOVA via SPSS 15.Results: Analysis of data showed that the average score of fatigue and back pain in the first stage of assessment was not statistically significant between the two groups (P>0.05. The study finding also showed that the control group at 2, 4 and 6 hours had significantly higher fatigue and back pain score than the experimental group(P<0.001.Conclusion: The results of this study recommend the use of instructional video as a useful method for decreasing fatigue and back pain in patients undergoing coronary angiography procedure. To increase satisfaction and reduce fatigue and back pain, it is suggested that this method be used as a part of the preparatory program for patients who are to undergo invasive procedures.

  10. Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Marini, Davide; Agnoletti, Gabriella [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Brunelle, Francis [University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France); Sidi, Daniel; Bonnet, Damien [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); Ou, Phalla [Centre de Reference Malformations Cardiaques Congenitales Complexes-M3C, Universite Paris Descartes, UFR Necker-Enfants Malades, Paris (France); University Paris Descartes, UFR Necker-Enfants Malades, Department of Pediatric Radiology, APHP, Paris (France)], E-mail: phalla.ou@nck.aphp.fr

    2009-09-15

    Objective: The purpose of this study was to compare the diagnostic accuracy of 64-slice CT with that of invasive angiography in the detection of graft and/or coronary angioplasty stenosis in children who had undergone coronary artery surgery. Population and methods: Fifteen consecutive children (8 male and 7 female; age 9.2 {+-} 6.1 years) underwent 64-slice CT because of chest pain or ECG changes mean 4.8 {+-} 3.7 years after surgical coronary artery surgery; 10 patients had coronary angioplasty using a patch from the saphenous vein, four had mammary artery bypass, and one had saphenous vein bypass. Six main segments of the coronary arteries and all the bypass graft considered as a single segment were analyzed and compared with invasive angiography used as the reference standard. Results: CT correctly identified the four children with coronary angioplasty and mammary graft lesions that were confirmed by conventional angiography: one patient had a significant stenosis (>50% stenosis) at the mammary bypass graft anastomosis site; three other had non-significant stenosis (<50% stenosis) including a mild lesion of the saphenous vein patch in two patients and a mild lesion at the anastomosis site of the mammary bypass in one. All segments identified as normal by CT in the other 11 children were also found to be normal by conventional angiography. Conclusion: In centers expert in this technique, 64-slice CT scanning is a promising, rapid, and useful diagnostic technique for evaluating both coronary angioplasty and bypass graft lesions in children who had undergone coronary artery surge0008.

  11. Hybrid CT angiography and quantitative (15)O-water PET for assessment of coronary artery disease

    DEFF Research Database (Denmark)

    Thomassen, Anders; Petersen, Henrik; Diederichsen, Axel C P;

    2013-01-01

    CT angiography (CTA) can rule out significant stenoses with a very high reliability, whereas its ability to confirm significant stenoses is suboptimal. In contrast, measurements of myocardial blood flow (MBF) provide information on the haemodynamic consequences of stenoses. Therefore, a combinati...... of the two might improve diagnostic accuracy. We conducted a head-to-head comparison of CTA, measurement of MBF by (15)O-water PET, and hybrid PET/CTA for the detection of significant coronary artery stenoses....

  12. Radiation dose estimates in dual-source computed tomography coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul; Scheffel, Hans; Schertler, Thomas; Frauenfelder, Thomas; Leschka, Sebastian; Husmann, Lars; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Flohr, Thomas G. [Siemens Medical Solutions, Forchheim (Germany); Kaufmann, Philipp A. [Cardiovascular Center, Forchheim (Germany)

    2008-03-15

    The purpose of this study was to quantify radiation dose parameters of dual-source CT coronary angiography. Eighty patients underwent contrast-enhanced, retrospectively ECG-gated dual-source CT coronary angiography with heart rate-adapted ECG pulsing using two algorithms: In 40 patients, the tube current was reduced to 20% (A{sub min1}) of the normal tube current (A{sub max}) outside the pulsing window; in 40 patients tube current was reduced to 4% (A{sub min2}) of A{sub max}. Mean CTDI{sub vol} in the A{sub min1} group was 45.1 {+-} 3.6 mGy; the mean CTDI{sub vol} in the A{sub min2} group was 39.1 {+-} 3.2 mGy, with CTDI{sub vol} in the A{sub min2} group being significantly reduced when compared to the A{sub min1} group (P < 0.001). A significant negative correlation was found between CTDI{sub vol} and heart rate in group A{sub min1} (r = -0.82, P < 0.001), whereas no correlation was found between CTDI{sub vol} and heart rate in group A{sub min2} (r = -0.066). Using the conversion coefficient for the chest, dual-source CT coronary angiography resulted in an estimated mean effective dose of 8.8 mSv in the A{sub min1} group and 7.8 mSv in the A{sub min2}. Radiation exposure of dual-source CT coronary angiography using an ECG-pulsing protocol reducing the tube current to 20% significantly decreases with increasing heart rates, despite using wider pulsing windows at higher heart rates. When using a protocol with reduced tube current of 4%, the radiation dose is significantly lower, irrespective of the heart rate. (orig.)

  13. Recurrent massive bleeding due to dissecting intramural hematoma of the esophagus: Treatment with therapeutic angiography

    Institute of Scientific and Technical Information of China (English)

    Jaejun Shim; Jae Young Jang; Young Hwangbo; Seok Ho Dong; Joo Hyeong Oh; Hyo Jong Kim; Byung-Ho Kim; Young Woon Chang; Rin Chang

    2009-01-01

    Spontaneous or traumatic intramural bleeding of the esophagus, which is often associated with overlying mucosal dissection, constitutes a rare spectrum of esophageal injury called dissecting intramural hematoma of the esophagus (DIHE). Chest pain, swallowing difficulty, and minor hematemesis are common, which resolve spontaneously in most cases. This case report describes a patient with spontaneous DIHE with recurrent massive bleeding which required critical management and highlights a potential role for therapeutic angiography as an alternative to surgery.

  14. Wall-to-lumen ratio of intracranial arteries measured by indocyanine green angiography

    Science.gov (United States)

    Nakagawa, Daichi; Shojima, Masaaki; Yoshino, Masanori; Kin, Taichi; Imai, Hideaki; Nomura, Seiji; Saito, Toki; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito

    2016-01-01

    Background: The wall-to-lumen ratio (WLR) is an important parameter in vascular medicine because it indicates the character of vascular wall as well as the degree of stenosis. Despite the advances in medical imaging technologies, it is still difficult to measure the thin-walled normal intracranial arteries, and the reports on the WLR of normal intracranial artery are limited. It might be possible to calculate the WLR using the indocyanine green (ICG) angiography, which is used to observe intracranial vessels during microsurgery. Purpose: To evaluate the WLR of normal intracranial arteries using ICG angiography. Materials and Methods: From the three cases in which ICG angiography was recorded with a ruler during microsurgery, 20 measurement points were chosen for the analysis. The ICG was injected intravenously with a dose of 0.2 mg/kg, and the vessels were inspected at high magnification using an operating microscope equipped with near-infrared illumination system. The vessel outer diameter and the luminal diameter were measured using the images before and after the ICG arrival based on the pixel ratio method using a ruler as reference, respectively. The WLR was calculated as 0.5 × (vessel outer diameter − vessel luminal diameter). Results: The WLR (mean ± standard deviation) of normal intracranial arteries was 0.086 ± 0.022. The WLR tended to be high in small arteries. Conclusion: The WLR of normal intracranial arteries calculated using ICG angiography was consistent with the WLR reported in the previous reports based on human autopsy.

  15. Diagnosis of Persistent Primitive Olfactory Artery Using CT Angiography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yeo, Soo Hyun; Rho, Byung Hak; Kim, Eal Maan; Chang, Hyuk Won [Keimyung University College of Medicine, Daegu (Korea, Republic of); Sohn, Chul Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2009-09-15

    A persistent primitive olfactory artery is a rare vascular anomaly and is incidentally found without any associated symptom for the most part. However, it has clinical significance in view of its high association with the development of cerebral aneurysms occurring at the hairpin turn. We present a case of a persistent primitive olfactory artery incidentally diagnosed by a CT angiography as well as a literature review of related previous articles

  16. Detection and assessment of circle of Willis aneurysms in acute subarachnoid hemorrhage with three-dimensional computed tomographic angiography: correlation with digital substraction angiography findings.

    Science.gov (United States)

    Lai, P H; Yang, C F; Pan, H B; Chen, C; Ho, J T; Hsu, S S

    1999-10-01

    In this retrospective study, we examined the usefulness of computed tomographic angiography (CTA) for the detection and assessment of circle of Willis aneurysms in patients with acute nontraumatic subarachnoid hemorrhage (SAH), using selective digital substraction angiography (DSA) as the gold standard. Thirty-five patients who presented with acute, nontraumatic SAH, diagnosed on the basis of unenhanced computed tomography or lumbar puncture findings or both, underwent both CTA and DSA. The CTA images were interpreted for the presence, location, size, and shape of the aneurysm, presence of a neck, and relationship of the aneurysm to adjacent arterial branches. The CTA and DSA images were then compared, with the latter images serving as the gold standard. DSA revealed 37 aneurysms in 32 patients and ruled out intracranial aneurysms in the remaining three. The sensitivity and specificity of CTA for aneurysm detection were 97% and 100%, respectively. The size of the smallest aneurysm shown was 4 mm, and the largest aneurysm was 21 mm. The size and lobularity of the aneurysms estimated from CTA images corresponded well with those estimated from DSA images. In addition, CTA provided a three-dimensional representation of the aneurysmal lesion, which was considered useful for surgical planning. Our results confirm the accuracy of CTA in comparison with DSA. Because of its reliability, minimal invasiveness, and rapidity, CTA may become the technique of choice for neuroradiologic work-up of SAH patients. DSA then would be used to diagnose intracranial aneurysms only in selected, questionable cases. PMID:10575836

  17. Sensitivity of computer assisted radionuclide angiography in transient ischemic attack and prolonged reversible ischemic neurological deficit. Comparison with findings in radiographic angiography and transmission computerized axial tomography

    Energy Technology Data Exchange (ETDEWEB)

    Buell, U.; Scheid, K.F.; Lanksch, W.; Kleinhans, E.; Ulbert, V.; Reger, U.; Rath, M.; Moser, E.A.

    Computer assisted radionuclide angiography (CARNA) with 99mTc-DTPA was employed to study 143 patients with transient ischemic attacks (TIA) and 79 patients with prolonged reversible ischemic neurologic deficit (PRIND). The results of CARNA were compared with findings from radiographic angiography (RGA) in 173 patients and with findings in transmission computerized axial tomography (T-CAT) in 154 patients. In patients with TIA, CARNA showed a hemispherical perfusion deficit in 74.8%, and with PRIND 87.3%. This deficit, determined as the relative difference between the involved and the non-involved hemisphere, was significantly (p less than 0.0025) greater in PRIND (minus 23%) than in TIA (minus 17%). Sensitivity of CARNA was independent of the interval from ictus to examination for more than 4 months. RGA in TIA revealed true positives in 82.0%, in PRIND it was 89.5%. T-CAT was positive in TIA in only 16.8% but in PRIND it was 64.4%. Combined sensitivities in TIA (92.4%) and in PRIND (94.0%) were highest with the combination of CARNA and RGA. However, in PRIND the combination of non-invasive methods (CARNA and T-CAT) revealed 93.2% positive findings. Combinations of these evaluation methods may be used to detect cerebrovascular disease in patients with such dysfunction.

  18. Diagnostic accuracy of dual energy CT angiography in patients with diabetes mellitus; Diagnostische Genauigkeit der Dual-energy-CT-Angiographie bei Patienten mit Diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Schabel, C.; Bongers, M.N.; Syha, R. [Klinikum der Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Klinikum der Eberhard-Karls-Universitaet, Sektion fuer Experimentelle Radiologie der Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Ketelsen, D.; Homann, G.; Notohamiprodjo, M.; Nikolaou, K.; Bamberg, F. [Klinikum der Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Thomas, C. [Universitaetsklinikum Duesseldorf, Abteilung fuer Diagnostische und Interventionelle Radiologie, Duesseldorf (Germany)

    2015-04-01

    Peripheral arterial disease (PAD) represents a major and highly prevalent complication in patients with diabetes mellitus. The diagnostic, non-invasive work-up by computed tomography angiography (CTA) is limited in the presence of extensive calcification. The aim of the study was to determine the diagnostic accuracy of dual energy CTA (DE-CTA) for the detection and characterization of PAD in patients with diabetes mellitus. In this study 30 diabetic patients with suspected or known PAD were retrospectively included in the analysis. All subjects underwent DE-CTA (Somatom Definition Flash, Siemens Healthcare, Erlangen, Germany) prior to invasive angiography, which served as the reference standard. Blinded analysis included assessment of the presence and degree of peripheral stenosis on curved multiplanar reformatting (MPR) and maximum intensity projections (MIP). Conventional measures of diagnostic accuracy were derived. Among the 30 subjects included in the analysis (83 % male, mean age 70.0 ± 10.5 years, 83 % diabetes type 2), the prevalence of critical stenosis in 331 evaluated vessel segments was high (30 %). Dual energy CT identified critical stenoses with a high sensitivity and good specificity using curved MPR (100 % and 93.1 %, respectively) and MIP images (99 % and 91.8 %, respectively). In stratified analysis, the diagnostic accuracy was higher for stenosis pertaining to the pelvic and thigh vessels as compared with the lower extremities (curved MPR accuracy 97.1 % vs. 99.2 vs. 90.9 %; respectively, p < 0.001). The use of DE-CTA allows reliable detection and characterization of peripheral arterial stenosis in patients with diabetes mellitus with higher accuracy in vessels in the pelvic and thigh regions compared with the vessels in the lower legs. (orig.) [German] Die periphere arterielle Verschlusskrankheit (PAVK) ist eine wesentliche Komplikation des Diabetes mellitus und stellt aufgrund ausgepraegter Gefaessverkalkungen eine diagnostische

  19. The efficiency of magnetic resonance angiography (MRA) in the diagnosis vertebrobasilar insufficiency (VBI)

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Hiroyuki; Ura, Masaharu; Ganaha, Akira; Yasuda, Shinobu; Noda, Yutaka [Ryukyus Univ., Nishihara, Okinawa (Japan). Faculty of Medicine

    2000-09-01

    Vertebrobasilar insufficiency (VBI) is found in many cases of vertigo in patients who visit otolaryngology clinics. But its symptoms tend to be transitory, and since objective findings cannot be obtained at the first examination it is difficult to diagnose. As a result, it is tentatively diagnosed based only on the past history or the outcome of an equilibrium test. It is useful to diagnose circulation insufficiency, the stenotic position or the degree of the vessels based on the angiography findings. However, an operation is dangerous and overly invasive and therefore surgery is often not performed in many cases. We performed magnetic resonance angiography (MRA) and found it to be easy to perform, safe, it required a short examination time and was not invasive. A total of 12 cases suspected to have VBI based on the findings of an equilibrium test, MRA was performed. We could identify the stenotic or obstructive position of the vessels in the vertebrobasilar system in six of the cases. In conclusion, MRA was found to have many advantages over angiography and thus was considered to be useful in making a definite diagnosis of VBI. (author)

  20. Clinical application of EBCT angiography and three-dimensional reconstruction in the diagnosis of aortic disease

    International Nuclear Information System (INIS)

    Purpose: To work out the routine and three dimensional reconstruction (3D) methods of electron beam computed tomography angiography (EBCTA) and evaluate its clinical application. Materials and methods: In this group, 189 cases with aortic diseases (152 male, 37 female) were studied retrospectively. The EBCT scan methods were enhanced single slice mode (SSM) and continuous volume scan (CVS); The 3D reconstruction methods were shaded surface display (SSD), maximum intensity projection (MIP) and multiple/curved planar reconstruction (MPR/CPR). Results: In 189 cases, including 97 cases with aortic dissection, 26 cases with aortic aneurysm and 8 cases with pseudo aneurysm, others including Marfan's syndrome in 37 cases, Takayasu's arteritis in 5 cases and congenital aortic malformations in 14 cases; 68 cases received operation and the EBCT diagnosis coincided well with the operative findings in 97% of cases. Conclusion: EBCT angiographic images have very high temporal resolution and most artifacts are eliminated. The 3D images are in helpful accurate diagnosis and direct surgical operation. In the management of aortic diseases, EBCT angiography and 3D reconstruction may supplant conventional angiography in the near future

  1. Fenestration of the anterior cerebral artery detected by magnetic resonance angiography

    Institute of Scientific and Technical Information of China (English)

    ZHAO Hong-wei; FU Jie; LU Zhong-lie; L(U) Hai-juan

    2009-01-01

    Background Fenestration of the proximal anterior cerebral artery (ACA) A1 segment is a rare anatomic variation. The purpose of the this study was to report the incidence of fenestration in the proximal segment of the anterior cerebral artery and to delineate its configurations on cranial MR angiography.Methods Magnetic resonance angiography (MRA) was performed in 762 patients using 1.5T imagers during the period July 2007 through September 2008. All images were obtained by the three-dimensional time-of-flight (3D TOF) technique.Volume rendering (VR) images in the horizontal rotation view were displayed stereoscopically. The presence of fenestration in the proximal segment of the anterior cerebral artery was identified and evaluated retrospectively by MRA.Results Six patients (four men and two women, 15 to 63 years of age, median age 50 years) had proximal ACA fenestration. The appearance rate of ACA fenestration was 0.8% (6/762). All 6 fenestrations were located at the A1 segment: three of them were with a slit-like shape and three were with a convex-lens-like shape, 5 of the right A1 segment, 1 of the leftA1 segment.Conclusion Recognizing ACA fenestration is important to interpret cranial MR angiographys and helpful to make a plan for neurosurgical procedures or neurological intervention.

  2. The relationships of carotid arthroscleroses with coronary artery stenosis in candidates for angiography

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Saeidi

    2014-09-01

    Full Text Available Background: Coronary artery and carotid stenosis risk factors are frequently common in these two problems. The present study was aimed to determine the relationships between carotid arthroscleroses and coronary artery stenosis in candidates for cardiovascular angiography. Methods: In a cross sectional study, 218 candidates for cardiovascular angiography, visiting Imam Ali hospital of Kermanshah, were divided into two groups of case (158 subjects and control (60 subjects and were investigated by angiography and Doppler echo. Data were analyzed by Chi-square test (χ2 and multiple logistic regressions. Results: Totally, 47 subjects (21.6% had carotid stenosis with >50% plaque. The frequencies of this value in the case and control groups were 37 (23.4% and 10 (16.7% cases, respectively, indicating no significant difference between groups (P=0.27. There was a significant association between coronary artery and carotid stenosis, and female gender (P=0.008. However, no significant correlation was observed between smoking and history of hypertension in terms of age (P<0.05. Conclusion: There was no significant association between coronary artery and carotid stenosis occurrence. However, among independent risk factors, only females had an effective role in their co-occurrence. Therefore, considering the females with coronary artery or carotid stenosis and conducting preventive measures are recommended to prevent co-occurrence of these two problems.

  3. Evaluation of patients radiation dose from computed tomography during lower peripheral angiography procedure

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate patient radiation doses in lower peripheral angiography CT examinations in Sudan. Survey was conducted in four major hospitals which almost carry out lower peripheral angiography procedures in Sudan at the time of study. All hospitals were equipped with 64 slices multi detectors CT from Toshiba (Japan). The total number of patients was 74. Information on patient's genders and ages, exposure technique factors and radiation dose were collected. The procedures performed in multi phases, up to five phases covering part of the abdomen region, which can make patients exposure reasonably high. CTDI values in the different phases ranged between (13-30) mGy. The total DLP in the four hospitals were 6888.75, 5065.05, 6608.88 and 5754.9 mGy.cm. This study provided first survey for patient dose during lower peripheral angiography procedures in Sudan. Taking into account that the CT machines were similar: the variation between patient's DLP and CTDI values in the different hospitals indicated the need of optimization of radiation protection. Staff training and awareness on factors affecting patient dose are essential.(Author)

  4. Multislice CT angiography in aortic stent grafting: Relationship between image noise and body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Sun Zhonghua [Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box U1987, Perth, Western Australia 6845 (Australia)]. E-mail: z.sun@curtin.edu.au

    2007-03-15

    Purpose: To investigate the correlation between image noise and body mass index (BMI) in multislice CT angiography (MSCT) for patients with abdominal aortic aneurysm (AAA) treated with endovascular stent grafts. Materials and methods: Seventeen patients who underwent MSCT following endovascular repair of AAA were included in the study. Image noise (standard deviation of the CT attenuation: S.D.) and signal to noise ratio (SNR) were plotted against BMI to demonstrate the correlation using a linear regression method. Image quality of 3D reconstructions was correlated to the SNR and BMI. Results: The r-value of linear regression between S.D. and BMI was 0.578 (p < 0.05), 0.835 and 0.802 (p < 0.001), respectively, at the level of renal artery, aortic aneurysm and common iliac artery. The r-value of linear regression between SNR and BMI was 0.332, 0.516 and 0.552 (p < 0.05), respectively, at above three levels. Image quality of 3D reconstructions was compromised in five patients and diagnosis was affected in two patients with BMI more than 30. Conclusion: A significant correlation was observed between image noise and BMI in MSCT angiography of endovascular repair of AAA. Our findings are valuable for optimisation of MSCT angiography scanning protocols and reduction of radiation dose in MSCT examinations.

  5. Modern Perforator Flap Imaging with High-Resolution Blood Pool MR Angiography.

    Science.gov (United States)

    Kagen, Alexander C; Hossain, Rydhwana; Dayan, Erez; Maddula, Soumya; Samson, William; Dayan, Joseph; Smith, Mark L

    2015-01-01

    Advances in microsurgical techniques have improved autologous reconstructions by providing new donor site options while decreasing donor site morbidity. Various preoperative imaging modalities have been studied to assess the relevant vascular anatomic structures, with magnetic resonance (MR) angiography traditionally lagging behind computed tomography (CT) with respect to spatial resolution. Blood pool MR angiography with gadofosveset trisodium, a gadolinium-based contrast agent with extended intravascular retention, has allowed longer multiplanar acquisitions with resultant voxel sizes similar to or smaller than those of CT and with improved signal-to-noise ratio and soft-tissue contrast while maintaining the ability to depict flow with time-resolved imaging. The resultant vascular detail enables precise evaluation of the relevant vascular anatomic structures, including the vessel course, size, and branching pattern, as well as the venous arborization pattern. In addition, any architectural distortion, vessel alteration, or injury from prior surgery can be depicted. The reporting radiologist should be aware of pertinent and incidental findings relevant to the planned surgery and the patient's disease so that he or she can assist the microsurgeon in flap design as a member of the multidisciplinary team. Given the lack of ionizing radiation exposure in patients who often have an elevated body mass index, high-spatial-resolution blood pool MR angiography has become the imaging reference standard for the preoperative assessment of perforator flap vascular and soft-tissue morphology in our practice. PMID:25884098

  6. Iohexol, ioxaglate and iopamidol in coronary angiography. A double-blind comparative study of 300 patients.

    Science.gov (United States)

    Soiva, M; Hekali, P; Keto, P; Karumo, J; Salonen, O; Heikkilä, J

    1991-05-01

    A randomized, double-blind study was carried out in 300 consecutive coronary angiography examinations to investigate the clinical safety of three low osmolar contrast media, iohexol 300, ioxaglate 320 and iopamidol 300, and the electrocardiographic changes that occurred with them. The ECG from electrode V5/V6 or AVF and intra-arterial pressure were monitored continuously, and recorded before and after the first contrast injections into the left and right coronary arteries. Of the variables tested, no statistically significant changes occurred in systolic arterial pressure, PR interval or ventricular extrasystole. The QT interval increased in the ioxaglate group (p = 0.001). Heart rate decreased in all groups, but slightly less in the ioxaglate group than in the iopamidol group (p = 0.02). The ST segment depression (mean 0.67m) was more marked in the ioxaglate group than in the other treatment groups (p = 0.0001) during right coronary angiography. The same characteristics, but less marked, were observed during left coronary angiography, the ioxaglate group (mean 0.251mm) differing from the iopamidol group (mean 0.050mm) (p = 0.04). No significant difference in severe adverse reactions were detected between these groups (ioxaglate 1, iopamidol 1). Ioxaglate produced mild side effects (nausea, vomitus, urticaria) in 16% of the patients, the other two contrast agents producing side effects in 1%.

  7. Hepatic arterial supply in 1297 CT-angiographies; Die arterielle Leberversorgung in 1297 CT-Angiografien

    Energy Technology Data Exchange (ETDEWEB)

    Loeschner, C.; Kausche, S.; Teichgraeber, U. [Jena University Hospital, Jena (Germany). Dept. of Radiology; Nagel, S.N. [Charite Universitaetsmedizin Berlin (Germany). Dept. of Radiology

    2015-04-15

    Analysis, evaluation and classification of hepatic arterial supply variants and determination of their frequency distribution in CT-angiographies. CT-angiographies of 1,568 patients were evaluated retrospectively for the period between January 1, 2010 and August 30, 2012. The hepatic arterial anatomy was assessed and categorized according to Michels's classification. So far unclassified variants were considered separately. Results: CT-angiographies of 1297 patients were included in the study. Type I according to Michels was seen in 937 cases (72.2%), followed by type V in 114 patients (8.8%) and type III in 83 patients (6.4%). Type X could not be found in any of the patients. Not yet classified variants were discovered in 26 patients. The most frequent variant in this connection was a right hepatic artery originating from the superior mesenteric artery with the left hepatic artery originating from the left gastric artery (n=10). Michels's classification could be largely confirmed on the basis of a radiologically examined patient population. Not yet classified variants were categorized into subgroups of the existing classification.

  8. Acute chest pain: The role of MR imaging and MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hunold, Peter, E-mail: peter.hunold@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Bischoff, Peter, E-mail: peter.bischoff@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Barkhausen, Jörg, E-mail: joerg.barkhausen@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany); Vogt, Florian M., E-mail: florian.vogt@uk-sh.de [Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany)

    2012-12-15

    MR imaging (MRI) and MR angiography (MRA) have gained a high level of diagnostic accuracy in cardiovascular disease. MRI in cardiac disease has been established as the non-invasive standard of reference in many pathologies. However, in acute chest pain the situation is somewhat special since many of the patients presenting in the emergency department suffer from potentially life-threatening disease including acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Those patients need a fast and definitive evaluation under continuous monitoring of vital parameters. Due to those requirements MRI seems to be less suitable compared to X-ray coronary angiography and multislice computed tomography angiography (CTA). However, MRI allows for a comprehensive assessment of all clinically stable patients providing unique information on the cardiovascular system including ischemia, inflammation and function. Furthermore, MRI and MRA are considered the method of choice in patients with contraindications to CTA and for regular follow-up in known aortic disease. This review addresses specific features of MRI and MRA for different cardiovascular conditions presenting with acute chest pain.

  9. Digital subtraction angiography: Its use in the diagnosis and management of vascular disease

    International Nuclear Information System (INIS)

    Recent developments in the area of computerized image enhancement have made it possible to visualize the arterial circulation by the intravenous injection of a contrast agent. This technique has been referred to by a variety of terms including digital video angiography (DVA), digital video imaging (DVI), or digital subtraction angiography (DSA). These terms are interchangeably used to describe a process of arterial imaging made possible by computerized fluoroscopy. DSA has generated interest among physicians because of its ability to combine many of the safety features of noninvasive testing with the anatomic information provided by standard angiography. Intravenous DSA significantly reduces the risk of hemorrhage and thrombosis by avoiding arterial catheterization and lowers the potential costs by reducing the need for hospitalization. The patient acceptance is better because there is less discomfort and because the time required to perform the procedure is significantly shorter. However, in order to determine the appropriate clinical applications of DSA, one must look critically not only at its strengths, but at its weaknesses as well

  10. Detection of intracranial aneurysms with multislice CT: comparison with conventional angiography

    Energy Technology Data Exchange (ETDEWEB)

    Dammert, S.; Krings, T.; Moller-Hartmann, W.; Ueffing, E.; Mull, M.; Thron, A. [Department of Neuroradiology, University Hospital of the Technical University Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Hans, F.J. [Department of Neurosurgery, University Hospital of the Technical University Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Willmes, K. [Department of Neurology, University Hospital of the Technical University Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany)

    2004-06-01

    We assessed the diagnostic accuracy of multislice CT in detection of intracranial aneurysms in patients presenting with subarachnoid or intracranial haemorrhage. Multislice CT and multiplanar digital subtraction angiography (DSA) images were obtained in 50 consecutive patients presenting with subarachnoid (SAH) and/or intracranial haemorrhage and reviewed by three neuroradiologists for the number, size and site of any aneurysms. The CT data were assessed using multiplanar reformats (MPR), maximum-intensity projections (MIP), surface-shaded display (SSD) and volume-rendering (VRT). In conventional angiography 51 aneurysms were detected in 41 patients. CT angiography (CTA) showed up to 48 aneurysms in 39 patients, depending on the observer. The overall sensitivity of multislice CT was 83.3% for small (<4 mm), 90.6% for medium-size (5-12 mm) and 100% for large (>13 mm) aneurysms. The sensitivity of multislice CTA to medium-size and large intracranial aneurysm is within the upper part of the range reported for helical single-slice CT. However, as small aneurysms may not be found, DSA remains the standard technique for investigation of SAH. (orig.)

  11. Detection of intracranial aneurysms with multislice CT: comparison with conventional angiography.

    Science.gov (United States)

    Dammert, S; Krings, T; Moller-Hartmann, W; Ueffing, E; Hans, F J; Willmes, K; Mull, M; Thron, A

    2004-06-01

    We assessed the diagnostic accuracy of multislice CT in detection of intracranial aneurysms in patients presenting with subarachnoid or intracranial haemorrhage. Multislice CT and multiplanar digital subtraction angiography (DSA) images were obtained in 50 consecutive patients presenting with subarachnoid (SAH) and/or intracranial haemorrhage and reviewed by three neuroradiologists for the number, size and site of any aneurysms. The CT data were assessed using multiplanar reformats (MPR), maximum-intensity projections (MIP), surface-shaded display (SSD) and volume-rendering (VRT). In conventional angiography 51 aneurysms were detected in 41 patients. CT angiography (CTA) showed up to 48 aneurysms in 39 patients, depending on the observer. The overall sensitivity of multislice CT was 83.3% for small ( 13 mm) aneurysms. The sensitivity of multislice CTA to medium-size and large intracranial aneurysm is within the upper part of the range reported for helical single-slice CT. However, as small aneurysms may not be found, DSA remains the standard technique for investigation of SAH. PMID:15105978

  12. Aortic dissection or renal infarction: Multislice computed tomographic angiography can tell

    Directory of Open Access Journals (Sweden)

    Stojanović Miloš

    2012-01-01

    Full Text Available Introduction. Acute renal infarction as a consequence of renal artery occlusion often goes unrecognized, mostly due to the non-specific clinical features. A quick diagnosis, ideally within three hours of presentation, is a key to renal function recovery. Case Outline. A 62-year-old male patient was admitted with a sudden abdominal pain, right flank pain and nausea. He had a diastolic hypertension at admission and his previous medical history showed atrial fibrillation. Initial clinical diagnosis was aortic dissection. Laboratory findings included elevated lactate dehydrogenase (LDH and serum creatinine levels. There were no signs of aortic dissection or aneurismatic lesions registered during a multislice computed tomographic (MSCT angiography. However, MSCT angiography demonstrated left “upper” renal artery thrombosis and renal infarction - avascular area of the upper two thirds of the left kidney sharply demarcated from the surrounding parenchyma. Both kidneys excreted the contrast. Anticoagulant therapy was initiated, along with antiarrythmic and antihypertensive medications. The follow-up by computed tomography was performed after nine weeks, and it showed a partial revascularization of the previously affected area. Conclusion. Concomitant presence of flank/abdominal pain, an increased risk for thromboembolism and an elevated LDH suggested a possibility of renal infarction. MSCT angiography is a non-invasive and accurate method in the diagnosis of renal artery occlusion and the resulting renal infarction.

  13. [Value of conventional roentgen diagnosis and angiography in evaluating bone tumors].

    Science.gov (United States)

    Pfeiffer, K J; Kierse, R

    1991-01-01

    Plain film radiographs are the basic imaging method for bone neoplasms, as the tumor and its relation to the surrounding tissue are shown in good detail. A classification of the destruction patterns enables us to determine the aggressivity of the lesion. Other criteria for diagnosis are periosteal reactions and calcifications in the surrounding soft tissues. Typical radiographic findings enable use to determine the dignity or even to diagnose a specific tumor in combination with the clinical settings. In case of a suspect scintigraphic finding plain film helps in differentiating metastasis from benign lesions. Angiography provides additional information about the extent of vascularization, the feeding arteries and venous situation. The pattern of vascular changes allows to determine the dignity of the tumor. In addition, angiography displays necrotic and the different degrees of vital tumor tissue enabling to define an appropriate site for needle biopsy. Short term follow up can be performed by angiography as chemotherapy and/or radiation therapy may lead to a decrease in vascularization. PMID:1797244

  14. An Analysis on the Diagnostic Values of Transcranial Doppler and Angiography in Transient Ischemic Attack

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The accuracy and diagnostic values of transcranial Doppler (TCD) in transient ischemic attack (TIA) caused by the stenosis or occlusion of intracranial or extracranial blood vessels were investigated. Of the 50 TIA patients receiving routine TCD examinations, 39 cases (77 %) were diagnosed as having unilateral or bilateral stenosis or occlusion of MCA, ACA, siphon segment of internal carotid artery, which was furthermore confirmed by digital subtraction angiography (DSA) or MRA, 11 (22 %) cases were normal. An analysis on the TCD findings of the flow patterns and hemodynamic changes of the stenotic or occluded blood vessels was made in comparison with that obtained by angiography. It was showed that angiography demonstrated 17 unilateral MCA stenosis, 47 bilateral multi-stenosis, 1 occlusion of the siphon segment of the internal carotid artery, while TCD revealed 17 unilateral stenosis, 64 bilateral stenosis, 1 occlusion respectively, with an accordance rate of 78.7 %. It was concluded that the hemodynamic changes secondary to the stenosis of the basalcranial arteries, especially the moderate to severe stenosis or occlusion, might be an important risk factor for TIA. TCD examination achieved significant clinic values in the diagnosing of TIA.

  15. Mediation and moderation of the effects of watching the angiography screen on patients.

    Science.gov (United States)

    Shiloh, Shoshana; Drori, Erga; Peleg, Shira; Banai, Shmuel; Finkelstein, Ariel

    2016-10-01

    It has been reported that allowing patients to watch the coronary angiography screen during the procedure results in psychological benefits. This study aimed to investigate the roles of illness perceptions as mediators of this outcome and to examine whether individual differences in monitoring coping style moderated these effects. The experiment compared patients who were instructed to watch the monitor screen (n = 57) with those who were not (n = 51). Questionnaires were used to measure the research variables at one day and one month after the procedure. Results showed that watching the angiography screen increased patients' personal and treatment control perceptions that mediated changes in self-assessed health, risk perceptions, negative affect, general and diet outcome expectancies, and diet and physical activity intentions. The behavior-related outcomes were moderated by monitoring coping style. These findings illustrate the significance of illness perceptions, perceived control and monitoring coping style in achieving desirable outcomes among patients undergoing coronary angiography, and reveal opportunities for interventions using medical imaging technologies. PMID:26740003

  16. 64-MSCT coronary angiography with prospective ECG gating at intermediate heart rate

    International Nuclear Information System (INIS)

    Objective: To evaluate robustness of coronary artery computed tomographic (CT) angiography with prospectively gated axial (PGA) CT technique at intermediate heart rate (65-75 beats per minute) using retrospectively gated helical (RGH) CT technique in 64-slice spiral CT. Methods: 63 consecutive patients with heart rates (HR) of 65 to 75 bpm, heart rate variability of below 5 bpm underwent CT angiography with RGH technique (tube voltage was 120 kV and tube current tailored to BMI). The 5% acquired data during each intermediate temporal window in the R-R interval were used to reconstruct images. The intermediate temporal window was 400 ms in the R-R interval at current mean HR, and the centre of the temporal window was 60%. All coronary artery segments were evaluated for image quality with 5-point scale. The mean image quality score and the percentage of assessable coronary artery segments were used to evaluate diagnostic value on the selected temporal window. Results: 822 coronary artery segments were depicted and were evaluated. The mean image quality score was 4.15±0.72. The percentage of assessable coronary artery segments was 97.76%. Conclusion: PCA coronary CT angiography with proper revise image acquisition phase and padding time could offer assessable image quality at intermediate HR. (authors)

  17. En face OCT angiography demonstrates flow in early type 3 neovascularization (retinal angiomatous proliferation)

    Science.gov (United States)

    Dansingani, K K; Naysan, J; Freund, K B

    2015-01-01

    Introduction The characteristics of type 3 neovascularization (NV), also known as retinal angiomatous proliferation, have been well described clinically, as well as with fluorescein angiography (FA), indocyanine green angiography, and optical coherence tomography (OCT). OCT angiography (OCT-A) is a novel and non-invasive technique for imaging retinal microvasculature by detecting changes, with respect to time, in reflectivity related to blood flow. Method In this case series, we describe two patients who presented with type 3 NV and underwent clinical examination and multimodal imaging, including OCT-A. Results In the first patient, OCT-A demonstrated flow within two separate lesions in the same eye, one of which was only weakly detected by FA. In the second patient, sequential OCT-A demonstrated a reduction in intralesional flow following intravitreal therapy. Conclusions OCT-A may have a role in the early diagnosis of type 3 NV and in assessing the response to treatment. Further studies are needed to determine sensitivity and specificity. PMID:25744441

  18. Activity-based cost analysis in catheter-based angiography and interventional radiology

    International Nuclear Information System (INIS)

    The aim of this study was to analyse the costs of the interventional radiology unit and to identify the cost factors in the different activities of catheter-based angiographies and interventional radiology. In 1999 the number of procedures in the interventional radiological unit at Tampere University Hospital was 2968; 1601 of these were diagnostic angiographies, 526 endovascular and 841 nonvascular interventions. The costs were analysed by using Activity Based Cost (ABC) analysis. The budget of the interventional unit was approximately 1.8 million Euro. Material costs accounted for 67%, personnel costs for 17%, equipment costs for 14% and premises costs for 2% of this. The most expensive products were endografting of aortic aneurysms, with a mean price of 5291 Euro and embolizations of cerebral aneurysms (4472 Euro). Endografts formed 87.3% of the total costs in endografting and Guglielmi detachable coils accounted for 63.3% of the total costs in embolizations. The material costs formed the majority of the costs, especially in the newest and most complicated endovascular treatments. Despite the high cost of angiography equipment, its share of the costs is minor. In our experience ABC system is suitable for analysing costs in interventional radiology. (orig.)

  19. Non-contrast-enhanced renal and abdominal MR angiography using velocity-selective inversion preparation.

    Science.gov (United States)

    Shin, Taehoon; Worters, Pauline W; Hu, Bob S; Nishimura, Dwight G

    2013-05-01

    Non-contrast-enhanced MR angiography is a promising alternative to the established contrast-enhanced approach as it reduces patient discomfort and examination costs and avoids the risk of nephrogenic systemic fibrosis. Inflow-sensitive slab-selective inversion recovery imaging has been used with great promise, particularly for abdominal applications, but has limited craniocaudal coverage due to inflow time constraints. In this work, a new non-contrast-enhanced MR angiography method using velocity-selective inversion preparation is developed and applied to renal and abdominal angiography. Based on the excitation k-space formalism and Shinnar-Le-Roux transform, a velocity-selective excitation pulse is designed that inverts stationary tissues and venous blood while preserving inferiorly flowing arterial blood. As the magnetization of the arterial blood in the abdominal aorta and iliac arteries is well preserved during the magnetization preparation, artery visualization over a large abdominal field of view is achievable with an inversion delay time that is chosen for optimal background suppression. Healthy volunteer tests demonstrate that the proposed method significantly increases the extent of visible arteries compared with the slab-selective approach, covering renal arteries through iliac arteries over a craniocaudal field of view of 340 mm. PMID:22711643

  20. Learning-based automatic detection of severe coronary stenoses in CT angiographies

    Science.gov (United States)

    Melki, Imen; Cardon, Cyril; Gogin, Nicolas; Talbot, Hugues; Najman, Laurent

    2014-03-01

    3D cardiac computed tomography angiography (CCTA) is becoming a standard routine for non-invasive heart diseases diagnosis. Thanks to its high negative predictive value, CCTA is increasingly used to decide whether or not the patient should be considered for invasive angiography. However, an accurate assessment of cardiac lesions using this modality is still a time consuming task and needs a high degree of clinical expertise. Thus, providing automatic tool to assist clinicians during the diagnosis task is highly desirable. In this work, we propose a fully automatic approach for accurate severe cardiac stenoses detection. Our algorithm uses the Random Forest classi cation to detect stenotic areas. First, the classi er is trained on 18 CT cardiac exams with CTA reference standard. Then, then classi cation result is used to detect severe stenoses (with a narrowing degree higher than 50%) in a 30 cardiac CT exam database. Features that best captures the di erent stenoses con guration are extracted along the vessel centerlines at di erent scales. To ensure the accuracy against the vessel direction and scale changes, we extract features inside cylindrical patterns with variable directions and radii. Thus, we make sure that the ROIs contains only the vessel walls. The algorithm is evaluated using the Rotterdam Coronary Artery Stenoses Detection and Quantication Evaluation Framework. The evaluation is performed using reference standard quanti cations obtained from quantitative coronary angiography (QCA) and consensus reading of CTA. The obtained results show that we can reliably detect severe stenosis with a sensitivity of 64%.

  1. Minimizing projection artifacts for accurate presentation of choroidal neovascularization in OCT micro-angiography.

    Science.gov (United States)

    Zhang, Anqi; Zhang, Qinqin; Wang, Ruikang K

    2015-10-01

    Current optical coherence tomography (OCT) based micro-angiography is prone to a projection (or tailing) effect due to the high scattering property of blood within overlying patent vessels, creating artifacts that interfere with the interpretation of retinal angiographic results. In this work, the projection effect in OCT micro-angiography is examined and its causality is explained by strong light scattering and photon propagation within blood. A simple practical approach is then introduced to minimize these artifacts presented in the outer retinal avascular space, especially useful for examining clinical cases with choroidal neovascularization (CNV). Demonstrated through in-vivo human posterior eye imaging of healthy and CNV subjects, the proposed method is shown effective to eliminate the projection artifacts in outer retinal space of OCT micro-angiography, resulting in better visualization of the pathological neovascularization when compared with the current common approaches. In addition, it is also shown that the proposed method is applicable to minimize the projection artifacts appearing in deep retinal layers. PMID:26504660

  2. Safety and efficacy of transulnar approach for coronary angiography and intervention

    Institute of Scientific and Technical Information of China (English)

    LI Yun-zhi; NIE Bin; HAN Hong-ya; HU Bin; ZHOU Yu-jie; ZHAO Ying-xin; GUO Yong-he; LIU Yu-yang; SHI Dong-mei; WANG Zhi-jian; JIA De-an; YANG Shi-wei

    2010-01-01

    Background Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention.Methods Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar (TUA) or transradial approach (TRA). Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events (MACE) as secondary end point was recorded till 30 days follow-up.Results Successful puncture was achieved in 98.3% (118/120) of patients in the TUA group, and in 100% (120/120) of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs. 12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively (P=0.949). No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients.Conclusions The transulnar

  3. Preliminary study on non-contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0T to evaluate the coronary stenosis

    Institute of Scientific and Technical Information of China (English)

    周妙平

    2013-01-01

    Objective To evaluate the clinical value of non-contrast-enhanced whole-heart coronary magnetic resonance angiography (CMRA) at 3.0 T to diagnose coronary artery stenosis.Methods Thirty-three consecutive patients with significant coronary artery stenosis (>50%) on coronary computed tomographic angiography (CCTA) who were scheduled for coronary angiography (CAG) were recruited for CMRA.CMRA was performed on a 3.0 T scanner with 32-element matrix coil.A non-contrast

  4. Theoretical and experimental comparison of image signal and noise for dual-energy subtraction angiography and conventional x-ray angiography

    Science.gov (United States)

    Burton, Christiane S.; Mayo, John R.; Cunningham, I. A.

    2015-03-01

    Cardiovascular disease is currently the leading cause of mortality worldwide. Digital subtraction angiography (DSA) is widely used to enhance the visibility of small vessels and vasculature obscurred by overlying bone and lung fields by subtracting a mask and contrast image. However, motion between these mask and contrast images can introduce artifacts that can render a study non-diagnostic. This makes DSA particularly unsuccessful for cardiac imaging. A method called dual-energy, or energy subtraction angiography (ESA), was proposed in the past as an alternative for vascular imaging, however it was not pursued because experimental results suggested that image quality was deemed as poor and inferior to DSA. Image quality for angiography comes down to iodine signal and noise. In this paper we investigate the fundamental iodine signal and noise analysis of ESA and compare it to DSA. Method: We developed a polyenergetic and monoenergetic theoretical model for iodine signal and noise for both ESA and DSA. We validated our polyenergetic model by experiment where ESA and DSA images of a vascular phantom were acquired using an x-ray system with a flat panel CsI Xmaru1215CF-MPTM (Rayence Co., Ltd., Republic of Korea) detector. For ESA low and high applied tube voltages of 50 kV and 120 kV (2.5 mmCu), respectively, and for DSA the applied tube voltage was 80 kV. Iodine signal-to-noise ratio (SNR) per entrance exposure was calculated for each iodine concentration for both ESA and DSA. Results: Our measured iodine SNR agreed well with theoretical calculations. Iodine SNR for ESA was relatively higher than DSA for low iodine mass loadings, and as iodine mass loading increases iodine SNR decreases. Conclusions: We have developed a model for iodine SNR for both DSA and ESA. Our model was validated with experiment and showed excellent agreement. We have shown that there is potential for obtaining iodine-specific images using ESA that are similar to DSA.

  5. Impact of myocardial perfusion imaging on in-hospital coronary angiography and revascularization of patients with suspected coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    HAN Ping-ping; HE Zuo-xiang; TIAN Yue-qin; FANG Wei; YANG Min-fu; ZHANG Xiao-li; SHEN Rui; SUN Xiao-xin; QIAO Shu-bin; YANG Yue-jin

    2011-01-01

    Background Noninvasive cardiac imaging is now central to the diagnosis and management of patients with moderate probability for coronary artery disease. The aim of this study was to assess the impact of stress myocardial perfusion single photon emission computerized tomography (SPECT) on in-hospital coronary angiography and revascularization for such patients.Methods Between January 2005 and June 2007, 1053 consecutive in-hospital patients (423 women, the average age of (57.2±11.2) years) with suspected coronary artery disease but without any prior interventional treatment were retrospectively analyzed. All patients underwent a 2-day stress/rest 99m Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion SPECT, including 984 exercise test and 69 adenosine test.Results Overall, stress/rest myocardial perfusion SPECT was normal in 973 patients (92.4%) and abnormal in 80 patients (7.6%). A total of 190 patients underwent coronary angiography, 46 underwent percutaneous coronary intervention and 10 coronary artery bypass grafting during hospitalization. From the whole perspective, only 14.7% of patients with normal SPECT underwent coronary angiography, so did 58.8% of patients with abnormal SPECT (x2=97.0,P<0.001); furthermore, the rates of revascularization in patients with normal and abnormal SPECT were 2.8% and 36.3%,respectively (27 out of 973 vs. 29 out of 80, x2=157.9, P<0.001). The extent and severity of ischemia did not add more predictive value for subsequent coronary angiography, but did have impact on revascularization. Multivariate analysis showed that reversible perfusion defect was the most predictive variable for referral rate to coronary angiography (odds ratio=7.5, P<0.001).Conclusions Abnormal myocardial perfusion SPECT is a powerful referral for in-hospital coronary angiography and revascularization during the same hospitalization. Thus, stress/rest SPECT is an effective gatekeeper for early coronary angiography and invasive treatment for

  6. Comparison of intra-aortic computed tomography angiography to conventional angiography in the presurgical visualization of the Adamkiewicz artery: first results in patients with thoracoabdominal aortic aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Clarencon, Frederic [Paris VI University, Department of Interventional Neuroradiology, Pitie-Salpetriere Hospital, Paris (France); Pitie-Salpetriere Hospital, Department of Neuroradiology, Paris (France); Maria, Federico di; Cormier, Evelyne; Sourour, Nader; Gabrieli, Joseph; Iosif, Christina; Chiras, Jacques [Paris VI University, Department of Interventional Neuroradiology, Pitie-Salpetriere Hospital, Paris (France); Gaudric, Julien; Koskas, Fabien [Paris VI University, Department of Vascular Surgery, Pitie-Salpetriere Hospital, Paris (France); Jenny, Catherine [Paris VI University, Department of Radiophysics, Pitie-Salpetriere Hospital, Paris (France)

    2013-11-15

    The aim of this study was to compare the sensitivity of intra-aortic computed tomography angiography (IA-CTA) to that of regular spinal digital subtraction angiography for the presurgical location of the Adamkiewicz artery (AKA). Thirty patients (21 males, 9 females; mean age 64 years) had an IA-CTA for the location of the AKA before surgery of aneurysm (n = 24) or dissection (n = 6) of the thoracoabdominal aorta. After femoral artery puncture, a pigtail catheter was positioned at the origin of the descending aorta. CT acquisition was performed with an intra-aortic iodinated contrast media injection (15 mL/s, 120 mL). The visualization of the AKA and the location of the feeder(s) to the AKA were independently evaluated by two observers. Interrater agreement was calculated using a kappa test. Spinal angiogram by selective catheterization was systematically performed to confirm the results of the IA-CTA. The AKA was visualized by the IA-CTA in 27/30 cases (90 %); in 26/31 (84 %) cases, the continuity with the aorta was satisfactorily seen. Interrater agreement was good for the visualization of the AKA and its feeder(s): 0.625 and 0.87, respectively. In 75 % of the cases for which the AKA was visualized, the selective catheterization confirmed the results of the IA-CTA. In the remaining 25 % of the cases, the selective catheterization could not be performed due to marked vessels' tortuosity or ostium stenosis. IA-CTA is a feasible technique in a daily practice that presents a good sensitivity for the location of the AKA. (orig.)

  7. Comparison of Clinical Interpretation with Visual Assessment and Quantitative Coronary Angiography in Patients Undergoing Percutaneous Coronary Intervention in Contemporary Practice: The Assessing Angiography (A2) Project

    Science.gov (United States)

    Nallamothu, Brahmajee K.; Spertus, John A.; Lansky, Alexandra J.; Cohen, David J.; Jones, Philip G.; Kureshi, Faraz; Dehmer, Gregory J.; Drozda, Joseph P.; Walsh, Mary Norine; Brush, John E.; Koenig, Gerald C.; Waites, Thad F.; Gantt, D. Scott; Kichura, George; Chazal, Richard A.; O’Brien, Peter K.; Valentine, C. Michael; Rumsfeld, John S.; Reiber, Johan H.C.; Elmore, Joann G.; Krumholz, Richard A.; Weaver, W. Douglas; Krumholz, Harlan M.

    2013-01-01

    Background Studies conducted decades ago described substantial disagreement and errors in physicians’ angiographic interpretation of coronary stenosis severity. Despite the potential implications of such findings, no large-scale efforts to measure or improve clinical interpretation were subsequently made. Methods & Results We compared clinical interpretation of stenosis severity in coronary lesions with an independent assessment using quantitative coronary angiography (QCA) in 175 randomly selected patients undergoing elective percutaneous coronary intervention (PCI) at 7 U.S. hospitals in 2011. To assess agreement, we calculated mean difference in percent diameter stenosis between clinical interpretation and QCA and a Cohen’s weighted kappa statistic. Of 216 treated lesions, median percent diameter stenosis was 80.0% (Q1 and Q3, 80.0 and 90.0%) with 213 (98.6%) assessed as ≥70%. Mean difference in percent diameter stenosis between clinical interpretation and QCA was +8.2 ± 8.4%, reflecting an average higher percent diameter stenosis by clinical interpretation (P<0.001). A weighted kappa of 0.27 (95% CI, 0.18 to 0.36) was found between the 2 measurements. Of 213 lesions considered ≥70% by clinical interpretation, 56 (26.3%) were <70% by QCA though none was <50%. Differences between the 2 measurements were largest for intermediate lesions by QCA (50 to <70%) with variation existing across sites. Conclusions Physicians tended to assess coronary lesions treated with PCI as more severe than measurements by QCA. Almost all treated lesions were ≥70% by clinical interpretation, while approximately a quarter were <70% by QCA. These findings suggest opportunities to improve clinical interpretation of coronary angiography. PMID:23470859

  8. The Prognosis of Patients With Nonobstructive Coronary Artery Disease Versus Normal Arteries Determined by Invasive Coronary Angiography or Computed Tomography Coronary Angiography: A Systematic Review.

    Science.gov (United States)

    Huang, Fang-Yang; Huang, Bao-Tao; Lv, Wen-Yu; Liu, Wei; Peng, Yong; Xia, Tian-Li; Wang, Peng-Ju; Zuo, Zhi-Liang; Liu, Rui-Shuang; Zhang, Chen; Gui, Yi-Yue; Liao, Yan-Biao; Chen, Mao; Zhu, Ye

    2016-03-01

    Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77-3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79-2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries.

  9. Value of Single-Dose Contrast-Enhanced Magnetic Resonance Angiography Versus Intraarterial Digital Subtraction Angiography in Therapy Indications in Abdominal and Iliac Arteries

    International Nuclear Information System (INIS)

    The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committee was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30o, field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses ≥50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies

  10. Duplex ultrasound and computed tomography angiography in the follow-up of endovascular abdominal aortic aneurysm repair: a comparative study*

    Science.gov (United States)

    Cantador, Alex Aparecido; Siqueira, Daniel Emílio Dalledone; Jacobsen, Octavio Barcellos; Baracat, Jamal; Pereira, Ines Minniti Rodrigues; Menezes, Fábio Hüsemann; Guillaumon, Ana Terezinha

    2016-01-01

    Objective To compare duplex ultrasound and computed tomography (CT) angiography in terms of their performance in detecting endoleaks, as well as in determining the diameter of the aneurysm sac, in the postoperative follow-up of endovascular abdominal aortic aneurysm repair. Materials and Methods This was a prospective study involving 30 patients who had undergone endovascular repair of infrarenal aortoiliac aneurysms. Duplex ultrasound and CT angiography were performed simultaneously by independent radiologists. Measurements of the aneurysm sac diameter were assessed, and the presence or absence of endoleaks was determined. Results The average diameter of the aneurysm sac, as determined by duplex ultrasound and CT angiography was 6.09 ± 1.95 and 6.27 ± 2.16 cm, respectively. Pearson's correlation coefficient showing a statistically significant correlation (R = 0.88; p < 0.01). Comparing the duplex ultrasound and CT angiography results regarding the detection of endoleaks, we found that the former had a negative predictive value of 92.59% and a specificity of 96.15%. Conclusion Our results show that there is little variation between the two methods evaluated, and that the choice between the two would have no significant effect on clinical management. Duplex ultrasound could replace CT angiography in the postoperative follow-up of endovascular aneurysm repair of the infrarenal aorta, because it is a low-cost procedure without the potential clinical complications related to the use of iodinated contrast and exposure to radiation. PMID:27777476

  11. Appearance and impact of post-operative intracranial clips and coils on whole-brain CT angiography and perfusion

    International Nuclear Information System (INIS)

    Background: To evaluate the effect of vascular clips and endovascular coils placed for intracranial aneurysms and arteriovenous malformations on whole-brain computed tomography (CT) angiography and perfusion. Methods: A 320-detector row dynamic volume CT system imaged 11 patients following surgical placement of vascular clips or endovascular coils. The extent of clip and coil subtraction by automated software was evaluated using CT digital subtraction angiography and CT perfusion. Impact on CT perfusion values by retained intracranial devices was compared to age- and gender-matched controls. Results: Clip and coil subtraction on CT angiography was graded as good in 8 and moderate in 3 cases. A residual neck and additional aneurysm were noted in 1 of 11 patients. Post-procedural axial slice level CT perfusion values decreased in reliability with increasing proximity to the metallic devices secondary to beam hardening. However, the intracranial devices did not affect axial slice level CTP values of cerebral blood volume, cerebral blood flow and mean transit time outside of the level of the device. Time to peak values was globally decreased outside of the immediate vascular intervention region. Conclusions: Advances in CT technology have provided clinically useful subtraction of intracranial clips and coils. While CT perfusion values were altered in device subtraction areas and within beam hardening artifact areas; they can provide valuable postoperative information on whole-brain hemodynamics. In selected cases, the combination of CT angiography and whole-brain CT perfusion can offer an alternative to conventional angiography that is a more invasive option.

  12. Magnetic resonance angiography of the brain: review of 100 cases; Angiorresonancia magnetica do cranio: revisao de 100 casos

    Energy Technology Data Exchange (ETDEWEB)

    Amaral, Leonardo Portugal Guimaraes [Hospital da Benficencia Portuguesa de Niteroi, RJ (Brazil). Scan Diagnosticos por Imagem; Santos, Alair Augusto S.M. D. dos; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: lpgamaral@yahoo.com.br

    2004-06-01

    In this study we reviewed the scans of 100 patients submitted to magnetic resonance angiography (MR angiography) of the brain for different clinical indications. The objectives of the study were to discuss the advantages and disadvantages of the 3D TOF in cerebral MR angiography, to review the main indications of MR angiography in the evaluation of intracranial vascular lesions, and to assess the frequency of the most important findings. The main indications for MR angiography were headache (n = 29), stroke (n = 14), transient ischemic attack (n = 11) and other causes (n = 35). In 11 patients the clinical indication could not be recovered from the patients records. Fifty two percent of the exams showed abnormalities. The main findings were vascular stenosis (n = 30), aneurysm (n = 10), anatomical variants (n = 6), vascular malformations (n = 4) and dural sinuses thrombosis (n = 2). The 3D TOF technique, the only technique applied in this study, proved to be efficient in most of the cases, requiring a relatively short acquisition time. One of the disadvantages was the lack of efficiency in covering large volume areas. (author)

  13. Diagnostic accuracy of dual-source CT coronary angiography in patients with atrial fibrillation: Meta analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang, E-mail: cjr.sungang@vip.163.com [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Li, Min [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jiang, Zhi-wei [Department of Health Statistics, School of Public Health, Fourth Military Medical University, No. 169, Changle West Road, Xi’an, Shaanxi 710032 (China); Xu, Lin [Department of Medical Cardiology, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Peng, Zhao-hui; Ding, Juan; Li, Li [Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031 (China); Jin, Zhi-tao [Department of Cardiology, General Hospital of the Second Artillery, Beijing 100088 (China)

    2013-10-01

    Rationale and objective: To synthesize the available data to underscore the diagnostic accuracy of dual-source CT (DSCT) coronary angiography in patients with atrial fibrillation (AF). Materials and methods: We searched in the electronic databases of PubMed for all published studies that examined patients with AF using DSCT. We used an exact binomial rendition of the bivariate mixed-effects regression model to synthesize the diagnostic data. Results: The positive and negative likelihood ratios (LRs) at the patient level were 6.0 (CI, 3.6–10.1) and 0.03(CI, 0.004–0.2), respectively. The negative predictive values higher than 90% were available for a CAD prevalence <78%. The pooled vessel- and segment-level estimates showed higher positive and negative LRs than the patient-level estimates (15.3 [CI, 9.8–23.9] and 0.1 [CI, 0.07–0.3]; 25.1 [CI, 10.8–58.5] and 0.2 [CI, 0.2–0.3], respectively). No statistically significant heterogeneity between studies and publication bias were found at the patient level estimate. A sensitivity analysis showed that no study influenced the pooled results larger than 0.02. Conclusions: Cardiac angiography with DSCT can be applied as an imaging test for ruling out CAD in patient with AF. However, DSCT angiography may be not an effective tool for risk stratification for the high negative LR at the artery and segment levels.

  14. Diagnostic accuracy of dual-source CT coronary angiography in patients with atrial fibrillation: Meta analysis

    International Nuclear Information System (INIS)

    Rationale and objective: To synthesize the available data to underscore the diagnostic accuracy of dual-source CT (DSCT) coronary angiography in patients with atrial fibrillation (AF). Materials and methods: We searched in the electronic databases of PubMed for all published studies that examined patients with AF using DSCT. We used an exact binomial rendition of the bivariate mixed-effects regression model to synthesize the diagnostic data. Results: The positive and negative likelihood ratios (LRs) at the patient level were 6.0 (CI, 3.6–10.1) and 0.03(CI, 0.004–0.2), respectively. The negative predictive values higher than 90% were available for a CAD prevalence <78%. The pooled vessel- and segment-level estimates showed higher positive and negative LRs than the patient-level estimates (15.3 [CI, 9.8–23.9] and 0.1 [CI, 0.07–0.3]; 25.1 [CI, 10.8–58.5] and 0.2 [CI, 0.2–0.3], respectively). No statistically significant heterogeneity between studies and publication bias were found at the patient level estimate. A sensitivity analysis showed that no study influenced the pooled results larger than 0.02. Conclusions: Cardiac angiography with DSCT can be applied as an imaging test for ruling out CAD in patient with AF. However, DSCT angiography may be not an effective tool for risk stratification for the high negative LR at the artery and segment levels

  15. Contrast-enhanced MR angiography utilizing parallel acquisition techniques in renal artery stenosis detection

    Energy Technology Data Exchange (ETDEWEB)

    Slanina, Martin, E-mail: slaninajicin@seznam.c [Department of Radiology, Charles University Prague, Medical Faculty and Teaching Hospital in Hradec Kralove, Sokolska 581, Hradec Kralove 500 05 (Czech Republic); Zizka, Jan; Klzo, Ludovit; Lojik, Miroslav [Department of Radiology, Charles University Prague, Medical Faculty and Teaching Hospital in Hradec Kralove, Sokolska 581, Hradec Kralove 500 05 (Czech Republic)

    2010-07-15

    Significant renal artery stenosis (RAS) is a potentially curable cause of renovascular hypertension and/or renal impairment. It is caused by either atherosclerosis or fibromuscular dysplasia. Correct and timely diagnosis remains a diagnostic challenge. MR angiography (MRA) as a minimally invasive method seems to be suitable for RAS detection, however, its diagnostic value widely differs in the literature (sensitivity 62-100% and specificity 75-100%). The aim of our prospective study was to compare the diagnostic value of contrast-enhanced MRA utilizing parallel acquisition techniques in the detection of significant RAS with digital subtraction angiography (DSA). A total of 78 hypertensive subjects with suspected renal artery stenosis were examined on a 1.5 Tesla MR system using a body array coil. Bolus tracking was used to monitor the arrival of contrast agent to the abdominal aorta. The MRA sequence parameters were as follows: TR 3.7 ms; TE 1.2 ms; flip angle 25{sup o}; acquisition time 18 s; voxel size 1.1 mm x 1.0 mm x 1.1 mm; centric k-space sampling; parallel acquisition technique with acceleration factor of 2 (GRAPPA). Renal artery stenosis of 60% and more was considered hemodynamically significant. The results of MRA were compared to digital subtraction angiography serving as a standard of reference. Sensitivity and specificity of MRA in the detection of hemodynamically significant renal artery stenosis were 90% and 96%, respectively. Prevalence of RAS was 39% in our study population. Contrast-enhanced MRA with high spatial resolution offers sufficient sensitivity and specificity for screening of RAS.

  16. Severity of coronary artery disease in obese patients undergoing coronary angiography

    International Nuclear Information System (INIS)

    Objective: To assess the relationship of severity of coronary artery disease with obesity in patients undergoing coronary angiography. Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology - National Institute of Heart Diseases (AFIC-NIHD), 1st February 2010 to 31st August 2010 Patients and Methods: The study population included 468 patients undergoing coronary angiography. Obesity was classified according to the BMI using the National Institutes of Health (NIH) criteria as normal (BMI 21-24 kg/m2), overweight (BMI 25-29 kg/m2), obesity class I (BMI 30-34 kg/m2), obesity class II (BMI 35 to 39 kg/m2 and obesity class III (BMI 40 or above kg/m2). Coronary angiography data were obtained from the Siemens Queries software system, which maintains the database including detailed angiographic findings of all patients at this institution. Significant lesions were defined as those with >70% diameter narrowing of coronary arteries (>50% for the left main coronary artery). We attempted to quantify the 'severity of CAD' by ascertaining the prevalence of High-Risk Coronary Anatomy (HRCA). Results: Insignificant difference was observed in traditional risk factors i.e. age, diabetes mellitus and smoking except hypertension and gender. Statistically significantly low prevalence of HRCA was encountered in the obese group (57.7%) as compared to normal/overweight group (75.8%) (p < 0.05). Conclusion: We conclude that obesity is associated with less severe coronary artery disease. (author)

  17. Prognostic and accuracy data of multidetector CT coronary angiography in an established clinical service

    Energy Technology Data Exchange (ETDEWEB)

    Van Lingen, R. [Department of Cardiology, Derriford Hospital, Plymouth, Devon (United Kingdom)], E-mail: Robin.vanLingen@rcht.cornwall.nhs.uk; Kakani, N.; Veitch, A.; Manghat, N.E.; Roobottom, C.A. [Department of Clinical Radiology, Derriford Hospital, Plymouth, Devon (United Kingdom); Morgan-Hughes, G.J. [Department of Cardiology, Derriford Hospital, Plymouth, Devon (United Kingdom)

    2009-06-15

    Aim: To assess the accuracy of clinical coronary computed tomography angiography (CTA) data compared to invasive coronary angiography, and to determine the prognostic value of a negative coronary CTA examination in symptomatic, intermediate-risk patients. Methods: Thirty-seven months of coronary CTA data were audited. Seventy-eight patients were identified who had undergone coronary CTA followed by invasive coronary angiography (ICA) to determine the accuracy of CTA versus ICA. One hundred and seventy-eight patients were identified who had a 'negative' coronary CTA to enable evaluation of the prognostic value of a negative CTA examination. Results: Of the 78 patients in the accuracy analysis group there were 43 true-negative, two false-negative, 26 true-positive, and seven false-positive results producing a sensitivity of 92.9%, specificity of 86%, negative predictive value of 95.6%, and positive predictive value of 78.8%. The 178 patients who had a negative coronary CTA examination were followed up for a mean of 366 days and were all alive (0% mortality) with no episodes of myocardial infarction or unstable angina; two patients underwent elective revascularization procedures (1.1%). Conclusion: According to medium-term analysis, the accuracy of the clinical coronary CTA programme is in line with published trial data, producing excellent sensitivity and negative predictive values. The finding of a negative coronary CTA in symptomatic, intermediate-risk patients appears to confer a good prognosis, at mean follow-up of 1 year, with no deaths or episodes of myocardial infarction or unstable angina. This suggests that the prognostic value of a negative coronary CTA may be similar to that conferred by negative myocardial perfusion scintigraphy or stress echocardiography.

  18. Reducing Radiation Dose in Coronary Angiography and Angioplasty Using Image Noise Reduction Technology.

    Science.gov (United States)

    Kastrati, Mirlind; Langenbrink, Lukas; Piatkowski, Michal; Michaelsen, Jochen; Reimann, Doris; Hoffmann, Rainer

    2016-08-01

    This study sought to quantitatively evaluate the reduction of radiation dose in coronary angiography and angioplasty with the use of image noise reduction technology in a routine clinical setting. Radiation dose data from consecutive 605 coronary procedures (397 consecutive coronary angiograms and 208 consecutive coronary interventions) performed from October 2014 to April 2015 on a coronary angiography system with noise reduction technology (Allura Clarity IQ) were collected. For comparison, radiation dose data from consecutive 695 coronary procedures (435 coronary angiograms and 260 coronary interventions) performed on a conventional coronary angiography system from October 2013 to April 2014 were evaluated. Patient radiation dosage was evaluated based on the cumulative dose area product. Operators and operator practice did not change between the 2 evaluated periods. Patient characteristics were collected to evaluate similarity of patient groups. Image quality was evaluated on a 5-grade scale in 30 patients of each group. There were no significant differences between the 2 evaluated groups in gender, age, weight, and fluoroscopy time (6.8 ± 6.1 vs 6.9 ± 6.3 minutes, not significant). The dose area product was reduced from 3195 ± 2359 to 983 ± 972 cGycm(2) (65%, p noise reduction technology. Image quality was graded as similar between the evaluated systems (4.0 ± 0.7 vs 4.2 ± 0.6, not significant). In conclusion, a new x-ray technology with image noise reduction algorithm provides a substantial reduction in radiation exposure without the need to prolong the procedure or fluoroscopy time. PMID:27344273

  19. Effective dose analysis of three-dimensional rotational angiography during catheter ablation procedures

    Science.gov (United States)

    Wielandts, J.-Y.; Smans, K.; Ector, J.; De Buck, S.; Heidbüchel, H.; Bosmans, H.

    2010-02-01

    There is increasing use of three-dimensional rotational angiography (3DRA) during cardiac ablation procedures. As compared with 2D angiography, a large series of images are acquired, creating the potential for high radiation doses. The aim of the present study was to quantify patient-specific effective doses. In this study, we developed a computer model to accurately calculate organ doses and the effective dose incurred during 3DRA image acquisition. The computer model simulates the exposure geometry and uses the actual exposure parameters, including the variation in tube voltage and current that is realized through the automatic exposure control (AEC). We performed 3DRA dose calculations in 42 patients referred for ablation on the Siemens Axiom Artis DynaCT system (Erlangen, Germany). Organ doses and effective dose were calculated separately for all projections in the course of the C-arm rotation. The influence of patient body mass index (BMI), dose-area product (DAP), collimation and dose per frame (DPF) rate setting on the calculated doses was also analysed. The effective dose was found to be 5.5 ± 1.4 mSv according to ICRP 60 and 6.6 ± 1.8 mSv according to ICRP 103. Effective dose showed an inversely proportional relationship to BMI, while DAP was nearly BMI independent. No simple conversion coefficient between DAP and effective dose could be derived. DPF reduction did not result in a proportional effective dose decrease. These paradoxical findings were explained by the settings of the AEC and the limitations of the x-ray tube. Collimation reduced the effective dose by more than 20%. Three-dimensional rotational angiography is associated with a definite but acceptable radiation dose that can be calculated for all patients separately. Their BMI is a predictor of the effective dose. The dose reduction achieved with collimation suggests that its use is imperative during the 3DRA procedure.

  20. Effective dose analysis of three-dimensional rotational angiography during catheter ablation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Wielandts, J-Y; Ector, J; De Buck, S; Heidbuechel, H [Department of Electrophysiology-Cardiology, University Hospital Gasthuisberg, 49, Herestraat, 3000-Leuven (Belgium); Smans, K [Belgian Nuclear Research Centre (SCK-CEN), Radiation Protection, Dosimetry and Calibration, Boeretang, 2400-Mol (Belgium); Bosmans, H [Department of Radiology, University Hospital Gasthuisberg, 49, Herestraat, 3000-Leuven (Belgium)], E-mail: jean-yves.wielandts@uz.kuleuven.ac.be

    2010-02-07

    There is increasing use of three-dimensional rotational angiography (3DRA) during cardiac ablation procedures. As compared with 2D angiography, a large series of images are acquired, creating the potential for high radiation doses. The aim of the present study was to quantify patient-specific effective doses. In this study, we developed a computer model to accurately calculate organ doses and the effective dose incurred during 3DRA image acquisition. The computer model simulates the exposure geometry and uses the actual exposure parameters, including the variation in tube voltage and current that is realized through the automatic exposure control (AEC). We performed 3DRA dose calculations in 42 patients referred for ablation on the Siemens Axiom Artis DynaCT system (Erlangen, Germany). Organ doses and effective dose were calculated separately for all projections in the course of the C-arm rotation. The influence of patient body mass index (BMI), dose-area product (DAP), collimation and dose per frame (DPF) rate setting on the calculated doses was also analysed. The effective dose was found to be 5.5 {+-} 1.4 mSv according to ICRP 60 and 6.6 {+-} 1.8 mSv according to ICRP 103. Effective dose showed an inversely proportional relationship to BMI, while DAP was nearly BMI independent. No simple conversion coefficient between DAP and effective dose could be derived. DPF reduction did not result in a proportional effective dose decrease. These paradoxical findings were explained by the settings of the AEC and the limitations of the x-ray tube. Collimation reduced the effective dose by more than 20%. Three-dimensional rotational angiography is associated with a definite but acceptable radiation dose that can be calculated for all patients separately. Their BMI is a predictor of the effective dose. The dose reduction achieved with collimation suggests that its use is imperative during the 3DRA procedure.

  1. Arterial enhancement at abdominal CT angiography: Low- versus high-osmolality contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, O.; Berger, P.; Pangaud, C.; Lyonnet, D. [Hopital E. Herriot, Lyon (France). Dept. of Vascular and Genitourinary Radiology; Ecochard, R. [Hospices Civils de Lyon (France). Dept of Biostatistics; Fontaine, B. [Laboratoire Guerbet, Roissy (France)

    2000-09-01

    Purpose: To evaluate the effects of contrast media pharmokinetic differences on aortic enhancement at abdominal CT angiography and to determine whether these effects are of clinical relevance. Material and Methods: Two hundred and twelve patients referred for abdominal CT angiography were included in the study. All abdominal CT angiograms were performed with the same parameters (collimation 3 mm, pitch ratio 1.7, scan delay 30 s) after i.v. injection of 120 ml of contrast medium at 3 ml/s. After randomization, patients received either iobitridol 300 (low-osmolar, 300 mg I/ml), iobitridol 350 (low-osmolar, 350 mg I/ml) or ioxithalamate 350 (high-osmolar, 350 mg I/ml). The time attenuation curves obtained with the three contrast media were compared. Results: The time attenuation curve obtained with ioxithalamate 350 was not parallel to those obtained with iobitridol 300 and iobitridol 350. Mean peak enhancements obtained with iobitridol 350 and ioxithalamate 350 were not significantly different but iobitridol 350 provided higher mean peak enhancement than iobitridol 300. Mean delays of the peak enhancements were the same with the three contrast media. After peak enhancement, the decrease of aortic opacification under a selected threshold of 200 HU was significantly slower with iobitridol 350 than with iobitridol 300 and ioxithalamate 350, whereas iobitridol 300 and ioxithalamate 350 showed no significant differences. Conclusion: For a given iodine concentration, low-osmolality contrast media provide longer aortic opacification and may be recommended for CT angiography when long acquisition times are needed.

  2. Comparative Efficacy of Transradial Versus Transfemoral Approach for Coronary Angiography and Percutaneous Coronary Intervention.

    Science.gov (United States)

    Schussler, Jeffrey M; Vasudevan, Anupama; von Bose, Liana J; Won, Jane I; McCullough, Peter A

    2016-08-15

    Transradial artery (TRA) approach is associated with fewer vascular complications and reduced mortality in patients at high risk compared with transfemoral approach (TFA). The objective of our study was to compare the characteristics and outcomes of patients who had coronary angiography by TRA and TFA over the course of hospital implementation of this approach. We included 12,928 patients from Baylor University Medical Center and Baylor Heart and Vascular Hospital, Dallas, Texas, who underwent a coronary angiography from January 2008 to March 2015. To control for selection bias and the learning curve, a nested matched study design was used for patients with percutaneous coronary intervention (PCI) with TRA patients matched with TFA by age (±2 years) and calendar year of the procedure in a ratio of 1:3. TRA for PCI increased from nearly 0% in 2008 to 9% in 2014. Including patients from 2011 to 2015 for the analysis, patients with TFA were older (65 ± 12 vs 64 ± 11) and had lower mean body mass index (30 ± 7 vs 33 ± 9 kg/m(2)) than patients with TRA. Patients with TRA had less bleeding, dialysis, pseudoaneurysm, and access site hematomas than the patients with TRA (0.7% vs 0%; p = 0.02). By a conditional logistic regression, we observed fewer complications, readmissions, and in-hospital deaths among TRA patients than the matched TFA patients. In conclusion, patients undergoing angiography with/without PCI through TRA had fewer complications, readmissions, and a shorter length of hospital stay after procedure versus TFA at our hospital. PMID:27378143

  3. Single Center Retrospective Analysis of Conventional and Radial TIG Catheters for Transradial Diagnostic Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Marc Vorpahl

    2015-01-01

    Full Text Available Current guidelines favor the radial approach for coronary angiography. Therefore, specialty radial diagnostic catheters were designed to engage both coronary arteries with a single device. However, it is unclear if single catheters are superior to conventional catheters. A retrospective analysis was performed of consecutive right radial coronary angiographies to determine catheter use, fluoroscopy time, radiation dosage, and consumption of contrast. Procedures were performed with a single TIG catheter or conventional catheters (CONV. Procedures with coronary artery bypass grafts or ventricular angiographies were excluded. 273 transradial procedures were performed successfully. 95 procedures were performed with CONV and 178 procedures with a TIG. Crossover to additional catheters was higher in TIG (15.2% compared to CONV (5.3%, p=0.02. Fluoroscopy time was comparable between CONV and TIG, without crossover (2.2±1.2 min versus 2.3±1.2 min; n.s., however, greater in the case of crossover for CONV (5.8±0.7 and TIG (7.6±3.0; p=0.0001. Radiation dosage was similar in CONV and the TIG, without crossover (1419±1075, cGy∗cm2 versus 1690±1138; n.s., however, greater for CONV (2374±620 and TIG (3733±2281, p=0.05 with crossover. Overall, the amount of contrast was greater in TIG (56±13 mL versus CONV (48±3 mL; p=0.0003. CONV femoral catheters may be the primary choice for radial approach.

  4. Radiation Dose to the Thyroid and Gonads in Patients Undergoing Cardiac CT Angiography

    International Nuclear Information System (INIS)

    The present data show a global increase in the rate of cardiovascular disease. Cardiac CT angiography has developed as a fast and non-invasive cardiac imaging modality following the introduction of multi-slice computed tomogaraphy. The aim of this study was to measure the radiation dose to the thyroid and pelvis regions in patients undergoing cardiac CT angiography using the Care Dose 4D method of 64-slice scanner. Eighty-one patients (41 males and 40 females) who were diagnosed with suspected coronary artery disease and were referred to Golestan Hospital, Imaging Department were recruited. Inclusion criteria were based on the protocol of multi-slice CT coronary angiography. The radiation dose to the thyroid and pelvis regions was measured using thermo luminescent dosimeters (TLDs). The mean radiation dose to the thyroid in male and female subjects was 0.32 mSv and 0.41 mSv, respectively (P = 0.032) (total mean, 0.36 mSv). The mean radiation dose to the pelvis in male and female subjects was 81 μSv and 112 μSv, respectively (P = 0.026) (total mean, 96.5 μSv), The total mean radiation dose to the thyroid and gonads was 0.36 mSv, and 96.5 μSv, respectively for the subjects. These values were high for one organ in a single study. Gender can affect the radiation dose to the thyroid and gonads. This can be attributed to the anatomical characteristic differences of the male and female subjects

  5. Echocardiography, ventriculography and coronary angiography in patients just recovering from acute myocardial infarction

    International Nuclear Information System (INIS)

    Comparative evaluations were carried out on the basis of ventriculography, echocardiography and corornary angiography that would permit to throw some light on the following issues: Can the changes in overall ventricular function occurring in response to the processes in the infarcted zone be visualised by means of M-mode scans. Which degree of accuracy can be achieved, if attempts are made to establish an echocardiographic diagnosis on the basis of M-mode scans in order to confirm regional contractility disorders revealed by ventriculography. (orig./MG)

  6. Pulmonary embolism: Comparison of ventilation-perfusion lung scintigraphy and helical CT angiography

    International Nuclear Information System (INIS)

    Full text: Objective: Retrospective study of the patients undergoing ventilation-perfusion pulmonary scintigraphy and helical CT angiography from March/ 2000 to July/ 2002, due to suspected pulmonary embolism (PE). Methods: Fifty-four patients were evaluated, with those unable to undergo a ventilation study or whose scintigraphy or CT studies were performed after anticoagulant therapy being excluded. The study group included 40 patients (24 male, 16 female) with an average age of 55,8 ± 18,8 years. Ninety per cent of the patients had a measurement of D-dimers levels and only 5% were submitted to angiography. Results: Both studies were concordant in 32 patients (80%), with concordant positive findings in 25 cases and concordant negative results in 7. In concordant positive cases, main risk factors included venous pathology of the lower extremities (40%) and malignant neoplasms (24%); no risk factors were found in 16% of these patients. Clinical findings included thoracic pain (16 patients), dyspnea (15 cases) and cough (7 patients). In these 25 patients PE was bilateral in 52%, right-sided in 28% and left-sided in the remaining 20%. D-dimers were elevated in 19 patients, normal in 3 and not measured in 3 cases. In concordant negative cases, D-dimers were elevated in 6 patients and not measured in one. Studies were discordant in 8 patients: in 5 of them, lung scintigraphy yielded a high-probability study but CT was negative for PE (revealing parenchymatous consolidation in 3 cases and pleural effusion in 2 patients); two patients had an intermediate-probability lung scintigram but CT was also negative (detecting a pericardial cyst around right hilum in one patient); in the remaining discordant case (a patient with chronic pulmonary hypertension), scintigraphy yielded a low-probability result but CT detected a non-occlusive clot in the right pulmonary artery. The angiographic studies performed in only 2 patients, both with concordant positive studies, confirmed the

  7. A Focal Chorioretinal Bartonella Lesion Analyzed by Optical Coherence Tomography Angiography.

    Science.gov (United States)

    Pichi, Francesco; Srivastava, Sunil K; Levinson, Ashleigh; Baynes, Kimberly M; Traut, Caitlyn; Lowder, Careen Y

    2016-06-01

    Neovascularization may be associated with cat-scratch neuroretinitis in the absence of retinal vascular occlusion. Bartonella organisms establish an intimate relationship with the vascular endothelium, causing angioproliferative lesions, which might represent a dedicated pathogenic strategy for expanding the bacterial host cell habitat. In the eye, pathological angiogenesis caused by Bartonella has been described as peripapillary or macular choroidal neovascularization, but the presence of neovascularization within foci of chorioretinitis has never before been reported. The authors present a case of Bartonella chorioretinitis in which optical coherence tomography angiography, by detecting erythrocyte motion, was able to identify neovessels inside the infectious focus. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:585-588.].

  8. A newly developed technique involving the optimization of flow velocity compensation for lower extremity CT angiography

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lei; XU Dong; LI KunCheng; JIN ErHu; BARNES Bret

    2013-01-01

    Advanced computed tomography (CT) technology has allowed for faster and more robust imaging.However,it has been a technical challenge to correctly synchronize CT acquisition with adequate and uniform arterial enhancement in the entire peripheral arterial tree.In this summary,we introduce a method of injection/acquisition optimization strategy based on a velocity-compensated CT angiography technique for the peripheral artery system,which is currently used in the United States.We believe that this imaging technique will provide additional information for our daily CT services in China.

  9. The multidetector computed tomography angiography (MDCTA) in the diagnosis of splenic artery aneurysm and pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Mallarini, Giorgio (Dept. of Radiology, Azienda Ospedaliero Universitaria (AOU), Cagliari (Italy)), email: lucasaba@tiscali.it; Anzidei, Michele; Lucatelli, Pierleone (Dept. of Radiological Sciences, Univ. of Rome La Sapienza, Rome (Italy))

    2011-06-15

    Splenic artery aneurysm is the most frequent visceral artery aneurysm and rupture of the aneurysm is associated with a high mortality rate. It is important to discriminate between a true aneurysm and a pseudoaneurysm that may be caused by pancreatitis, iatrogenic and postoperative causes, trauma and peptic ulcer disease. Multidetector-row CT angiography (MDCTA) allows detailed visualization of the vascular anatomy and may allow identification of aneurysms and pseudoaneurysms that affect the splenic artery. The objective of this article is to provide a review of the general characteristics of splenic artery aneurysms and pseudoaneurysms and to describe the findings of MDCTA

  10. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols.

    Science.gov (United States)

    Higashigaito, Kai; Schmid, Tabea; Puippe, Gilbert; Morsbach, Fabian; Lachat, Mario; Seifert, Burkhardt; Pfammatter, Thomas; Alkadhi, Hatem; Husarik, Daniela B

    2016-09-01

    Purpose To prospectively develop individualized low-volume contrast media (CM) protocols adapted to tube voltage in patients undergoing computed tomographic (CT) angiography of the aorta. Materials and Methods The study was approved by the institutional review board and local ethics committee. All patients provided written informed consent. CT angiography was performed by using automated attenuation-based tube voltage selection (ATVS) (range, 70-150 kVp; 10-kVp increments). Iodine attenuation curves from an ex vivo experiment in a phantom were used to design CM protocols for CT angiography of the thoracoabdominal aorta in 129 consecutive patients (hereafter, cohort A). Further modified CM protocols based on results in cohort A were designed with the aim of homogeneous vascular attenuation of 300-350 HU across tube voltages and were applied to another 61 consecutive patients (cohort B). Three independent blinded radiologists assessed subjective image quality, and one reader determined objective image quality. The Kruskal-Wallis test was performed to test for differences in subjective image quality, and linear regression was performed to test for differences in objective image quality between the automatically selected tube voltages. Results Experiments revealed tube voltage-dependent iodine attenuation curves, which were used to determine the CM protocols in cohort A; these ranged from 68 mL at 110 kVp to 45 mL at 80 kVp. In both cohorts, ATVS selected 80 kVp in 62 patients, 90 kVp in 84, 100 kVp in 33, and 110 kVp in 11. In cohort A, image quality that was satisfactory or better was attained in 126 (98%) of 129 patients who had no significant differences in subjective image quality between tube voltages (P = .106) but who did have significant differences in attenuation and contrast-to-noise ratio (CNR) (P < .001 for both). In cohort B, the further-modified CM protocol (from 33 mL at 80 kVp to 68 mL at 110 kVp) yielded image quality that was satisfactory or better

  11. [A case of pituitary adenoma progressing to pituitary apoplexy on the occasion of cerebral angiography].

    Science.gov (United States)

    Suga, T; Kagawa, S; Goto, H; Yoshioka, K; Hosoya, T

    1996-05-01

    A case of pituitary adenoma which had progressed from subclinical pituitary apoplexy to subacute pituitary apoplexy on the occasion of cerebral angiography is reported. A 29-year-old man, complaining of bitemporal hemianopsia, was admitted to our department. Plain skull X-p revealed enlargement and double floor of the sella turcica. No abnormal calcification was revealed. CT demonstrated an isodensity mass with a diameter of 4 x 4 cm, and with ring enhancement in the suprasellar region. The mass extended from the intrasellar region to the suprasellar region and had a signal of high intensity on T1-weighted images. Endocrinological examination revealed hyperprolactinemia with a serum level of 422 ng/ml and normal reaction of anterior pituitary hormones. On 3rd March, digital subtraction angiography with 5F catheter was performed with the patient under sedation. The contrast medium was ioxaglic acid (Hexabrix 320). A volume of 6 ml with a speed of 4 ml per second was injected for the internal carotid angiogram. A total volume of 60 ml was used. Serum saline with 10 unit per ml of heparin sodium was also used for flushing. During angiography, the patient's blood pressure was 125/60-115/60mm Hg. DSA revealed upward displacement of the proximal portion of the anterior cerebral artery, pocket formation, and staining of the tumor capsule. Six hours later, he complained of retroorbital headache. Next morning, he noticed complete lack of left visual acuity. On 7th March, right visual acuity degenerated to blindness. CT revealed that the mass had increased its density. With bifrontal osteoplastic craniotomy, the tumor with marked intratumoral hemorrhage was resected. Its histology was chromophobe adenoma. The patient's right visual acuity improved rapidly. On the occasion of cerebral angiography, we could observe that subclinical pituitary apoplexy deteriorated to subacute pituitary apoplexy. Rosenbaum postulated that injection of contrast media increased intravascular

  12. MDCT angiography of the major congenital anomalies of the extracranial arteries: pictorial review

    International Nuclear Information System (INIS)

    Multidetector computed tomographic angiography is becoming the modality of choice for evaluation of the supra-aortic circulation in acute stroke imaging. Variations of the supra-aortic circulation, in particular of the extracranial arteries, are common. This article aims to provide a pictorial description of the variant anatomy of the aortic arch and extracranial arteries. Knowledge of the presence and clinical relevance of normal variants such as anomalies, duplications and embryological persistence plays a clinically relevant role in the diagnosis and management of neurological and surgical conditions, particularly as we enter an era of increasing extracranial intervention.

  13. Quantification of choroidal neovascularization vessel length using optical coherence tomography angiography

    Science.gov (United States)

    Gao, Simon S.; Liu, Li; Bailey, Steven T.; Flaxel, Christina J.; Huang, David; Li, Dengwang; Jia, Yali

    2016-07-01

    Quantification of choroidal neovascularization (CNV) as visualized by optical coherence tomography angiography (OCTA) may have importance clinically when diagnosing or tracking disease. Here, we present an automated algorithm to quantify the vessel skeleton of CNV as vessel length. Initial segmentation of the CNV on en face angiograms was achieved using saliency-based detection and thresholding. A level set method was then used to refine vessel edges. Finally, a skeleton algorithm was applied to identify vessel centerlines. The algorithm was tested on nine OCTA scans from participants with CNV and comparisons of the algorithm's output to manual delineation showed good agreement.

  14. Melatonin mitigate cerebral vasospasm after experimental subarachnoid hemorrhage: a study of synchrotron radiation angiography

    Science.gov (United States)

    Cai, J.; He, C.; Chen, L.; Han, T.; Huang, S.; Huang, Y.; Bai, Y.; Bao, Y.; Zhang, H.; Ling, F.

    2013-06-01

    Cerebral vasospasm (CV) after subarachnoid hemorrhage (SAH) is a devastating and unsolved clinical issue. In this study, the rat models, which had been induced SAH by prechiasmatic cistern injection, were treated with melatonin. Synchrotron radiation angiography (SRA) was employed to detect and evaluate CV of animal models. Neurological scoring and histological examinations were used to assess the neurological deficits and CV as well. Using SRA techniques and histological analyses, the anterior cerebral artery diameters of SAH rats with melatonin administration were larger than those without melatonin treatment (p experimental SAH.

  15. Choroid plexus papilloma of the third ventricle: angiography, preoperative embolization, and histology

    Energy Technology Data Exchange (ETDEWEB)

    Do, H.M. [Interventional Neuroradiology, S-047, Department of Radiology, Stanford University Medical Center (United States); Dept. of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Marx, W.F. [Dept. of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Khanam, H. [Dept. of Pathology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Jensen, M.E. [Dept. of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA (United States); Dept. of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville, VA (United States)

    2001-06-01

    We report a unique case of choroid plexus papilloma of the third ventricle in an 8-month-old girl in which preoperative embolization played a salient role in management. Initial surgery was aborted due to excessive bleeding. Cerebral angiography demonstrated enlarged posterior choroidal arteries feeding the tumor, and intense, persistent tumor staining. These vessels were effectively embolized to stasis with polyvinyl alcohol particles. The patient underwent a second craniotomy and complete resection of the tumor with minimal blood loss. Postsurgical histology showed postembolization iatrogenic intratumoral necrosis. (orig.)

  16. Safety of contrast media in cerebral angiography: iopamidol vs. methylglucamine iothalamate.

    Science.gov (United States)

    Bird, C R; Drayer, B P; Velaj, R; Triolo, P J; Allen, S; Bates, M; Yeates, A E; Heinz, E R; Osborne, D R

    1984-01-01

    A randomized double-blind study was performed in 27 patients to compare the clinical safety, incidence of pain and warmth, and film quality produced by iopamidol and Conray-60 in selective cerebral angiography. No complications or adverse reactions occurred in either group. Iopamidol was significantly less painful than was methylglucamine iothalamate for common carotid artery injections and caused significantly less heat in both common carotid and internal carotid artery injections. Film quality and diagnostic accuracy were excellent in both groups. These results, when viewed in conjunction with laboratory data demonstrating the decreased neurotoxicity of nonionic contrast agents, suggest that iopamidol is an important advance in the development of angiographic contrast media.

  17. Spiral CT angiography and surgical correlations in the evaluation of intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Preda, L.; Di Maggio, E.M.; La Fianza, A.; Dore, R.; Fulle, I.; Solcia, M.; Campani, R. [Istituto di Radiologia, IRCCS Policlinico S. Matteo, p.le C. Golgi, 2, I-27 100 Pavia (Italy); Gaetani, P.; Rodriguez y Baena, R. [Neurosurgery, Istituto Clinico ``Humanitas``, I-20089 Rozzano (Midway Islands) (Italy); Cecchini, A. [Servizio di Radiodiagnostica, IRCCS Policlinico S. Matteo, p.le C. Golgi, 2, I-27 100 Pavia (Italy); Infuso, L. [Neurochirurgia, Dipartimento di Chirurgia, IRCCS Policlinico S. Matteo, p.le C. Golgi, 2, I-27 100 Pavia (Italy)

    1998-06-02

    We investigated the accuracy of spiral computed tomography angiography (CTA) in the detection and study of intracranial aneurysms by comparing CTA with selective angiograms and surgical findings. Twenty-six patients (9 men and 17 women; mean age 53.1 {+-} 1.8 years) with suspected intracranial aneurysms were submitted to CTA (1- to 2-mm slices, pitch 1:1, 24 s, RI = 1) after a conventional CT examination showing subarachnoid hemorrhage (SAH) in 19 cases and during neuroradiological investigations performed for other reasons in 7 cases. One hundred twenty to 150 ml iodate contrast agent (0.3-0.4 gI/ml) were injected intravenously at 5 ml/s rate and with 12- to 25-s delay calculated with a preliminary test bolus. Three-dimensional shaded surface display (3D SSD) and maximum intensity projection (MIP) reconstructions were obtained from axial images. Then, within 48 h, all patients were submitted to digital subtraction angiography (DSA), with separate assessment of CTA and DSA findings. Twenty-two aneurysms shown by CTA were confirmed at DSA and surgery (true positives), whereas the vascular lesion was not confirmed at DSA in 2 cases (false positives). The presence of intracranial aneurysms was excluded at both CTA and subsequent DSA in 7 cases (true negatives) and there were no false negatives; sensitivity was 100 %, specificity 77.8 %, and diagnostic accuracy 93.5 %. Computed tomography angiography aneurysm location was confirmed at surgery in all cases, with very high accuracy in assessing the presence of an aneurysm neck (100 %). Computed tomography angiography accurately depicted the aneurysm shape in 20 of 22 cases, but failed to depict its multilobed nature in 2 cases. The mean aneurysm diameter calculated at CTA was 0.99 {+-} 0.12 cm vs 1.09 {+-} 0.11 cm at surgery (p < 0.01). The present results suggest that the high sensitivity of CTA, if confirmed by further studies, might help in avoiding having to resort to arteriography after negative CTA in SAH patients

  18. CT, MR, and Angiography Findings of a Solitary Fibrous Tumor of the Larynx: a Case Report

    OpenAIRE

    Chang, Suk Ki; Yoon, Dae Young; Choi, Chul Soon; Yun, Eun Joo; Seo, Young Lan; Nam, Eun suk

    2008-01-01

    This report details the CT, MR, and angiography findings of a solitary fibrous tumor involving the larynx of a 34-year-old man. A precontrast CT scan revealed a well-defined isodense mass in the submucosal region of the supraglottic larynx. The tumor appeared as a mixed intensity lesion on the T1- and T2-weighted MR images. A T2-weighted MR image showed a central, round, and low signal intensity area within the mass. For both the CT and MR images, the mass demonstrated heterogeneous enhanceme...

  19. Use of diagnostic coronary angiography in women and men presenting with acute myocardial infarction

    DEFF Research Database (Denmark)

    Bjerking, Louise Hougesen; Hansen, Kim Wadt; Madsen, Mette;

    2016-01-01

    Background: Based on evident sex-related differences in the invasive management of patients presenting with acute myocardial infarction (AMI), we sought to identify predictors of diagnostic coronary angiography (DCA) and to investigate reasons for opting out an invasive strategy in women and men.......4 %). Type 2 myocardial infarction was noted in 11 patients (women versus men; 14.5 % vs. 3.8 %, p = 0.06) and identified as a potential confounder of the sex-DCA relationship. Receipt of DCA was predicted by traditional risk factors for ischaemic heart disease (family history of cardiovascular disease...

  20. MDCT coronary angiography, postprocessing, reading, and reporting - Last but not least

    Energy Technology Data Exchange (ETDEWEB)

    Marano, Riccardo [Dept. of Bioimaging and Radiological Sciences, Inst. of Radiology, Catholic Univ. - ' A. Gemelli' Univ. Hospital, Rome (Italy)], e-mail: riccardo.marano@rm.unicatt.it; Savino, Giancarlo; Merlino, Biagio; Verrillo, Gemma; Silvestri, Valentina; Tricarico, Francesco; Meduri, Agostino; Natale, Luigi; Bonomo, Lorenzo [Dept. of Bioimaging and Radiological Sciences, Inst. of Radiology, Catholic Univ. - ' A. Gemelli' Univ. Hospital, Rome (Italy)

    2013-04-15

    Significant literature on MDCT coronary angiography (MDCT-CA) has emerged in the last decade concerning patient's selection, technical aspects of different generations of CT equipment, ECG gating, contrast material and beta-blockade administration, acquisition parameters, and radiation dose. However, the literature regarding postprocessing, reading, and reporting is not so extensive. This review highlights the main elements of MDCT-CA data analysis, thereby allowing the radiologist to take full advantage of this technology and enable a structured report to be generated, promoting best practice with high-quality results.

  1. Inferior vena cava leiomyosarcoma confirmed by catheter suction biopsy during digital subtraction angiography.

    Science.gov (United States)

    Wei, Ning; Xu, Xiang-Dong; Xu, Hao; Zu, Mao-Heng

    2014-01-01

    Leiomyosarcoma of vascular origin is a rare disease and most cases arise in the inferior vena cava. Inferior vena cava leiomyosarcoma (IVCLMS) usually presents in females in their sixth decade of life. The clinical symptoms are often non-specific and the diagnosis is often delayed. Current imaging techniques can accurately differentiate inferior vena cava neoplasms from other non-neoplastic lesions. However, definitive diagnosis of IVCLMS needs histologic evidence. We report a case of IVCLMS in a 61-year old Chinese woman. This is the first IVCLMS case confirmed by catheter suction biopsy during digital subtraction angiography. PMID:25232438

  2. Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers

    Institute of Scientific and Technical Information of China (English)

    Gitsios; Gitsioudis; Hugo; A; Katus; Grigorios; Korosoglou

    2014-01-01

    Chronic inflammatory mechanisms in the arterial wall lead to atherosclerosis,and include endothelial cell damage,inflammation,apoptosis,lipoprotein deposition,calcification and fibrosis.Cardiac computed tomography angiography(CCTA)has been shown to be a promising tool for non-invasive assessment of theses specific compositional and structural changes in coronary arteries.This review focuses on the technical background of CCTA-based quantitative plaque characterization.Furthermore,we discuss the available evidence for CCTA-based plaque characterization and the potential role of CCTA for risk stratification of patients with coronary artery disease.

  3. Transient Global Amnesia After Cerebral Angiography With Iomeprol: A Case Report.

    Science.gov (United States)

    Tiu, Cristina; Terecoasă, Elena Oana; Grecu, Nicolae; Dorobăţ, Bogdan; Marinescu, Andreea Nicoleta; Băjenaru, Ovidiu Alexandru

    2016-05-01

    Transient global amnesia is now considered a very rare complication of cerebral angiography. Various etiological mechanisms have been suggested to account for this complication, but no consensus has been reached yet. This case report documents one of the few reported cases of cerebral angiography-related transient global amnesia associated with magnetic resonance imaging (MRI) evidence of unilateral hippocampal ischemia, most probably as a consequence of a transient reduction in regional hippocampal blood flow. However, the possibility of a direct neurotoxic effect of the nonionic contrast media Iomeprol on the Cornu ammonis - field 1 neurons cannot be firmly ruled out.We describe the case of a 54-year-old woman admitted to our department for left upper limb weakness with acute onset 8 days before. The brain computed tomography (CT) scan performed at admission revealed subacute ischemic lesions in the right watershed superficial territories and a right thalamic lacunar infarct. Diagnostic digital subtraction cerebral angiography was performed 4 days after admission with the nonionic contrast media Iomeprol. A few minutes after completion of the procedure, the patient developed symptoms suggestive for transient global amnesia. The brain MRI performed 22 hours after the onset of symptoms demonstrated increased signal within the lateral part of the right hippocampus on the diffusion-weighted imaging (DWI) sequences, associated with a corresponding reduction in the apparent diffusion coefficient (ADC) and increased signal on the fluid-attenuated inversion recovery (FLAIR) sequences, consistent with acute hippocampal ischemia and several T2/FLAIR hyperintensities in the right watershed superficial territories and in the right thalamus, corresponding to the lesions already identified on the CT scan performed at admission. A follow-up MRI, performed 2 months later, demonstrated the disappearance of the increased signal within the right hippocampus on the DWI, T2/FLAIR

  4. Assessing portal hypertension in post-operative biliary atresia patients using 2D magnetic resonance angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hiki, Saori; Horikoshi, Kentarou; Kobayashi, Hiroyuki; Yamataka, Atsuyuki; Miyano, Takeshi; Kuwatsuru, Ryouhei; Katayama, Hitoshi [Juntendo Univ., Tokyo (Japan). School of Medicine

    2000-01-01

    2D magnetic resonance angiography (MRA) was performed in 38 post-operative biliary atresia (BA) patients. Collateral circulation other than esophageal varices that could not be observed with endoscopy was detected. By using contrast, the portal vasculature could be clearly delineated. MRA can be performed without using general anesthesia obviating the nead for hospitalization. At present, MRA alone is not sufficient for the complete assessment of varices in post-operative BA patients, and mucosal changes cannot be detected without endoscopy. However, combined with endoscopy, it provides valuable additional follow-up information without the need for general anesthesia or hospitalization. (author)

  5. Coronary Abnormalities in Hyper-IgE Recurrent Infection Syndrome: Depiction at Coronary MDCT Angiography

    Science.gov (United States)

    Gharib, Ahmed M.; Pettigrew, Roderic I.; Elagha, Abdalla; Hsu, Amy; Welch, Pam; Holland, Steven M.; Freeman, Alexandra F.

    2014-01-01

    OBJECTIVE Hyper-IgE recurrent infection syndrome (HIES or Job’s syndrome) is a rare disorder affecting the immune system and connective tissues. The purpose of this study is to describe the coronary abnormalities in genetically confirmed HIES patients as depicted by coronary MDCT angiography (MDCTA). CONCLUSION Coronary MDCTA has provided an opportunity for noninvasive evaluation of the coronary arteries in patients with HIES. These coronary abnormalities vary from tortuosity to ectatic dilation and focal aneurysms of the coronary arteries. Such an evaluation has potential value in identifying new aspects of this disease and thereby providing better understanding of the pathophysiology of the disorder. PMID:21494893

  6. Non-ECG-gated CT pulmonary angiography and the prediction of right ventricular dysfunction in patients suspected of pulmonary embolism

    DEFF Research Database (Denmark)

    Gutte, Henrik; Mortensen, Jann; Mørk, Mette Louise;

    2016-01-01

    PURPOSE: Right ventricular dysfunction (RVD) is an important prognostic factor of 30-day mortality in patients with acute pulmonary embolism (PE). The aim of our study was to evaluate whether non-electrocardiogram (ECG)-gated cardiovascular parameters attained during computed tomography pulmonary...... angiography (CTPA) could predict RVD in patients suspected of PE using ECG-gated cardiac CT angiography as reference. METHODS: Consecutive patients suspected of PE were referred to a ventilation/perfusion single-photon emission tomography (V/Q-SPECT) as first-line imaging procedure. Patients had a V....../Q-SPECT/CT, a CTPA and an ECG-gated cardiac CT angiography performed the same day. RESULTS: A total of 71 patients were available for analysis. Seventeen patients (24%) had RVD. The non-ECG-gated dimensions of left and right ventricle and the major vessels were correlated with ECG-gated cardiac dimensions. The size...

  7. First clinical results of ultrafast, gadolinium-enhanced dual-phase 3D MR-angiography in the abdomen

    International Nuclear Information System (INIS)

    To assess the utility of breath-hold abdominal ultrafast three-dimensional (3D) gadolinium-enhanced dual-phase magnetic resonance angiography (MRA). Material and methods: 125 patients with various abdominal pathologies were imaged using a breath-hold ultrafast gadolinium-enhanced dual-phase 3D-MRA technique. Results: 119 (95%) of 125 MRA's were of good or excellent quality. The sensitivity in the detection of renal artery stenoses as well as stenoses of the celiac trunk and the superior mesenteric artery was 100%. Accessory renal arteries (n=9) and replaced hepatic arteries (n=4) were reliably detected by MRA. In 24 (71%) of 34 cases MR-angiographic delineation of the spleno-portal system and hepatic veins was superior compared to conventional angiography. Conclusion: Breath-hold gadolinium-enhanced dual-phase 3D-MRA has the potential to replace conventional angiography in the abdomen. (orig.)

  8. Anomalous origin of coronary artery: the role of multislice CT Angiography: a case report and literature review

    International Nuclear Information System (INIS)

    Anomalous origin of coronary arteries is a relatively rare entity and can present different clinical forms. Recently, CT angiography of the coronary arteries have demonstrated an important role in the diagnosis and management of these anomalies. We present the case of a young female without significant comorbidities who presented with cardiopulmonary arrest, being revived by a team of customer service mobile emergency. After completion of multislice CT angiography of the coronary arteries was observed anomalous origin of left main coronary artery in the right coronary artery, no signs of extrinsic compression. Patient received a defibrillator and had an uneventful follow-up performed. Multislice CT angiography is minimally invasive diagnostic methods to detect the origin and trajectory of the coronary arteries, allowing an alternative to cardiac catheterization for evaluation of patients with anomalous origin of coronary arteries. (author)

  9. Anomalous origin of coronary artery: the role of multislice CT Angiography: a case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Rabelo, Daniel Rocha; Barros, Marcio Vinicius Lins; Nunes, Maria do Carmo Pereira; Siqueira, Maria Helena Albernaz, E-mail: marciovlbarros@uol.com.br [Hospital Mater Dei, Belo Horizonte, MG (Brazil)

    2012-07-15

    Anomalous origin of coronary arteries is a relatively rare entity and can present different clinical forms. Recently, CT angiography of the coronary arteries have demonstrated an important role in the diagnosis and management of these anomalies. We present the case of a young female without significant comorbidities who presented with cardiopulmonary arrest, being revived by a team of customer service mobile emergency. After completion of multislice CT angiography of the coronary arteries was observed anomalous origin of left main coronary artery in the right coronary artery, no signs of extrinsic compression. Patient received a defibrillator and had an uneventful follow-up performed. Multislice CT angiography is minimally invasive diagnostic methods to detect the origin and trajectory of the coronary arteries, allowing an alternative to cardiac catheterization for evaluation of patients with anomalous origin of coronary arteries. (author)

  10. Original Protocol Using Computed Tomographic Angiography for Diagnosis of Brain Death: A Better Alternative to Standard Two-Phase Technique?

    Science.gov (United States)

    Sawicki, Marcin; Sołek-Pastuszka, Joanna; Jurczyk, Krzysztof; Skrzywanek, Piotr; Guziński, Maciej; Czajkowski, Zenon; Mańko, Witold; Burzyńska, Małgorzata; Safranow, Krzysztof; Poncyljusz, Wojciech; Walecka, Anna; Rowiński, Olgierd; Walecki, Jerzy; Bohatyrewicz, Romuald

    2015-01-01

    BACKGROUND The application of computed tomographic angiography (CTA) for the diagnosis of brain death (BD) is limited because of the low sensitivity of the commonly used two-phase method consisting of assessing arterial and venous opacification at the 60th second after contrast injection. The hypothesis was that a reduction in the scanning delay might increase the sensitivity of the test. Therefore, an original technique using CTA was introduced and compared with catheter angiography as a reference. MATERIAL AND METHODS In a prospective multicenter trial, 84 clinically brain-dead patients were examined using CTA and catheter angiography. The sensitivities of original CTA technique, involving an arterial assessment at the 25th second and a venous assessment at the 40th second, and the standard CTA, involving an arterial and venous assessment at the 60th second, were compared to catheter angiography. RESULTS Catheter angiography results were consistent with the clinical diagnosis of BD in all cases. In comparison to catheter angiography, the sensitivity of original CTA technique was 0.93 (95%CI, 0.85-0.97; p<0.001) and 0.57 (95%CI, 0.46-0.68; p<0.001) for the standard protocol. The differences were statistically significant (p=0.03 for original CTA and p<0.001 for standard CTA). Decompressive craniectomy predisposes to a false-negative CTA result with a relative risk of 3.29 (95% CI, 1.76-5.81; p<0.001). CONCLUSIONS Our original technique using CTA for the assessment of the cerebral arteries during the arterial phase and the deep cerebral veins with a delay of 15 seconds is a highly sensitive test for the diagnosis of BD. This method may be a better alternative to the commonly used technique. PMID:26250464

  11. High-resolution coronary MR angiography for evaluation of patients with anomalous coronary arteries: visualization of the intramural segment

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [UCSF Benioff Children' s Hospital Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Chung, Claudia; Chung, Taylor [UCSF Benioff Children' s Hospital Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Hitt, David M. [Philips Healthcare, Cleveland, OH (United States); Kurio, Gregory [UCSF Benioff Children' s Hospital Oakland, Department of Cardiology, Oakland, CA (United States); Reinhartz, Olaf [UCSF Benioff Children' s Hospital Oakland, Department of Cardiac Surgery, Oakland, CA (United States)

    2015-08-15

    Anomalous origin of the coronary artery from the contralateral coronary sinus is a rare coronary anomaly associated with sudden death. The inter-arterial course is most closely associated with sudden death, but it has been suggested that the presence of an intramural segment of a right anomalous coronary is associated with more symptoms and therefore may be an important criterion for intervention in these patients. To demonstrate that MR angiography can accurately determine the presence or absence of an intramural segment in an anomalous coronary artery. All studies of children who underwent MR angiography for the evaluation of an anomalous coronary artery were retrospectively reviewed by two pediatric radiologists in consensus. Criteria for an intramural anomalous coronary artery were the presence of a small or slit-like ostium and the relative smaller size of the proximal intramural portion of the coronary artery in relation to the more distal epicardial coronary artery. The anomalous coronary artery was classified as not intramural if these two findings were absent. These findings were correlated with operative reports confirming the presence or absence of an intramural segment. Twelve patients (86%) met MR angiography criteria for the presence of an intramural course. Only 2 patients (14%) met MR angiography criteria for a non-intramural course. When correlating with intraoperative findings, MR angiography was successful in distinguishing between intramural and non-intramural anomalous coronary arteries in all cases (P = 0.01). MR angiography may be able to reliably identify the intramural segment of an anomalous coronary artery in older children using the imaging criteria of a small or slit-like ostium and relative decrease in size of the proximal portion of the anomalous coronary artery compared to the distal portion of the anomalous coronary artery. Determining the presence of the intramural segment may help with surgical planning and may be an important

  12. 3D rotational angiography after non-traumatic SAH; 3D-Rotationskatheterangiografie nach nicht traumatischer SAB

    Energy Technology Data Exchange (ETDEWEB)

    Ringelstein, A.; Moenninghoff, C.; Hahnemann, M.L.; Forsting, M.; Schlamann, M. [Univ. Duisburg-Essen, Essen (Germany). Dept. of Diagnostic nd Interventional Radiology and Neuroradiology; Mueller, O.; Sure, U. [Univ. Hopsital, Essen (Germany). Hospital of Neurosurgery

    2014-07-15

    In about 15 % of patients with SAH no causative vascular lesions can be found in acute imaging with CTA and DSA. Usually, repeat DSA is mandatory and bears the usual risk of invasive angiography. The present study attempts to assess the diagnostic impact of 3 D rotational angiography in order to avoid repeat DSA. From January 2004 to December 2012, 649 patients with an acute non-traumatic SAH were examined. 91 patients with negative initial imaging diagnostics concerning the bleeding source were included in this study. These patients underwent a second angiography scan: 61 in 4-plane technique, and 30 with 2-plane technique and additional 3 D DSA. Two cohorts were compared: patients with repeat angiography in conventional 4-plane technique from 2004 to July 2008 and 2-plane technique with additional 3 D rotational DSA from 2008 to 2012. Statistical significance was verified by means of Fisher's exact test. In the second DSA scan, 4 aneurysms in 4 patients (4/91; 4.4 %) were found and treated subsequently. Within the first 4.5 years of this study, 401 patients with SAH were treated and 61 of them underwent repeat angiography (15.2 %) compared to 30 of 248 patients (12.1 %) in the last 4.5 years of this study. In the first group we found 3 aneurysms during repeat angiography, and in the second group we found 1. No significance was reached (p = 0.29) but there was a tendency towards higher diagnostic security using 3D-DSA. Using 3 D rotational DSA in initial imaging workup might help to reduce false-negative results concerning the bleeding source of acute SAH. At least because of this fact, 3 D rotational DSA should be part of the diagnostic workup after acute SAH.

  13. Use of coronary CT angiography in the diagnosis of patients with suspected coronary artery disease: findings and clinical indications

    Institute of Scientific and Technical Information of China (English)

    Zhong-Hua Sun; Yu-Pin Liu; Dong-Jin Zhou; Yan Qi

    2012-01-01

    Objective To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings. Methods Medical records of patients suspected of coronary artery disease over a period of 12 months from a tertiary teaching hospital were retrospectively reviewed. Patient age, sex (male/female), duration of symptoms and abnormal rates of coronary CT angiography scans were analysed to investigate the relationship among these parameters. The patients by age were duration of symptoms was also classified into five groups: less than one week, one week to one month, one to three months, three to six months and more than six months. Results Of the 880 patient records reviewed, 800 met the above study criteria. Five hundred and forty nine patients demonstrated abnormal CT findings (68.6%). There was no significant difference in the percentage of abnormal CT findings based on patient sex and the duration of symptoms (P = 0.14). The abnormal rates of coronary CT angiography, however, increased significantly with increasing age (P < 0.001); with patients over 65 years of age 2.5 times more likely to have an abnormal CT scan relative to a patient under 45 years. A significant difference was found between abnormal coronary CT angiography and the duration of symptoms (P = 0.012). Conclusions Our results indicate coronary CT angiography findings are significantly related to the patient age group and duration of symptoms. Clinical referral for coronary CT angiography of patients with suspected coronary artery disease needs to be justified with regard to the judicious use of this imaging modality.

  14. Renoprotective effect of alprostadil in combination with statins in patients with mild to moderate renal failure undergoing coronary angiography

    Institute of Scientific and Technical Information of China (English)

    LIU Wei-jing; ZHANG Bu-chun; GUO Rong; WEI Yi-dong; LI Wei-ming; XU Ya-wei

    2013-01-01

    Background The role of alprostadil and statins in contrast-induced acute kidney injury (CI-AKI) is controversial.The purpose of this study was to explore the efficacy of combined therapy with alprostadil and statins in protecting renal function and preventing contrast-induced nephropathy (CIN) in patients undergoing coronary angiography.Methods A total of 156 consecutive patients with mild to moderate renal failure who underwent coronary angiography were enrolled in our study,and randomly categorized into two groups.In the statins group,80 patients were treated with statins before and after coronary angiography.in the alprostadil plus statins group,76 patients were treated with statins and alprostadil before and after coronary angiography.Serum creatinine (SCr),serum cystatin (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) were detected after administration of contrast media,and adverse events were evaluated within six months.Results In both groups,the SCr,CysC and NGAL significantly increased after coronary angiography and peaked at 48,24 and 6 hours,respectively.SCr,CysC and NGAL were significantly lower in the alprostadil plus statins group than in the statins group (P<0.05).The incidence of CIN in the alprostadil plus statins group was slightly lower than in the statins group.The incidence of adverse events within six months in the alprostadil plus statins group was significantly lower than in the statins group (P=0.034).Conclusions Intravenous alprostadil in combination with oral statins is superior to statins alone for protecting renal function in patients with mild to moderate renal dysfunction who undergo coronary angiography,and can reduce the incidence of adverse events seen within six months.

  15. Repeat digital subtraction angiography after a negative baseline assessment in nonperimesencephalic subarachnoid hemorrhage : A pooled data meta-analysis. A systematic review

    NARCIS (Netherlands)

    Bakker, Nicolaas A.; Groen, Rob J. M.; Foumani, Mahrouz; Uyttenboogaart, Maarten; Eshghi, Omid S.; Metzemaekers, Jan D. M.; Lammers, Natasja; Luijckx, Gert-Jan; Van Dijk, J.M.C.

    2014-01-01

    Object. A repeat digital subtraction angiography (DSA) study of the cranial vasculature is routinely performed in patients with diffuse nonperimesencephalic subarachnoid hemorrhage (SAH) after negative baseline CT angiography (CTA) and DSA studies. However, DSA carries a low but substantial risk of

  16. Complications following transfemoral cerebral angiography for cerebral ischemia. Report of 159 angiograms and correlation with surgical risk.

    Science.gov (United States)

    Theodotou, B C; Whaley, R; Mahaley, M S

    1987-08-01

    One hundred fifty-nine transfemoral cerebral angiograms for patients with carotid stenosis who subsequently underwent carotid endarterectomy were reviewed. No patient with an asymptomatic carotid bruit developed cerebrovascular complications during angiography. Patients with transient ischemic attacks (TIAs) had a 4.5% incidence of complications. Patients with stroke in evolution had a complication rate of 7.7%. Patients with completed strokes had no angiographic complications. No complication lasted more than 1 hour; all occurred during angiography or immediately afterwards. Stroke in progress has too high a surgical and angiographic risk to warrant study. Transient ischemic attacks have an acceptable morbidity both surgically and angiographically. PMID:3603359

  17. The ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography

    OpenAIRE

    Liu, Ying; Xu, Jian; Jian LI; Ren, Jing; LIU, HONGTAO; Xu, Junqing; Wei, Mengqi; Hao, Yuewen; Zheng, Minwen

    2013-01-01

    Background Aortic dissection is a lift-threatening medical emergency associated with high rates of morbidity and mortality. The incidence rate of aortic dissection is estimated at 5 to 30 per 1 million people per year. The prompt and correct diagnosis of aortic dissection is critical. This study was to compare the ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography and conventional dual-source CT angiography. Methods A total of 110 conse...

  18. Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME)

    DEFF Research Database (Denmark)

    van Nunen, Lokien X; Zimmermann, Frederik M; Tonino, Pim A L;

    2015-01-01

    BACKGROUND: In the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) study, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) improved outcome compared with angiography-guided PCI for up to 2 years of follow-up. The aim in this study was to...... investigate whether the favourable clinical outcome with the FFR-guided PCI in the FAME study persisted over a 5-year follow-up. METHODS: The FAME study was a multicentre trial done in Belgium, Denmark, Germany, the Netherlands, Sweden, the UK, and the USA. Patients (aged ≥ 18 years) with multivessel coronary...

  19. Comparison between a linear versus a macrocyclic contrast agent for whole body MR angiography in a clinical routine setting

    OpenAIRE

    Rittig Kilian; Tepe Gunnar; Klumpp Bernhard; Döring Jörg; Bretschneider Christiane; Grimm Florian; Fenchel Michael; Kramer Ulrich; Seeger Achim; Seidensticker Peter R; Claussen Claus D; Miller Stephan

    2008-01-01

    Abstract Background Previous experiences of whole body MR angiography are predominantly available in linear 0.5 M gadolinium-containing contrast agents. The aim of this study was to compare image quality on a four-point scale (range 1–4) and diagnostic accuracy of a 1.0 M macrocyclic contrast agent (gadobutrol, n = 80 patients) with a 0.5 M linear contrast agent (gadopentetate dimeglumine, n = 85 patients) on a 1.5 T whole body MR system. Digital subtraction angiography served as standard of ...

  20. Bolus timing in high-pitch CT angiography of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Beeres, Martin, E-mail: beeres@gmx.net [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Loch, Matthias, E-mail: MatthiasLoch@gmx.net [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Schulz, Boris, E-mail: boris.schell@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Kerl, Matthias, E-mail: matthias.kerl@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Al-Butmeh, Firas, E-mail: Firas.Albutmeh@gmail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Bodelle, Boris, E-mail: bbodelle@googlemail.com [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Herrmann, Eva, E-mail: Herrmann@Med.Uni-Frankfurt.de [Clinic of the Goethe University, Department of Biostatistics, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Gruber-Rouh, Tatjana, E-mail: tatjanagruber2004@yahoo.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Lee, Clara, E-mail: Clara.Lee@kgu.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Jacobi, Volkmar, E-mail: Volkmar.Jacobi@kgu.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Vogl, Thomas J., E-mail: T.Vogl@em.uni-frankfurt.de [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); and others

    2013-06-15

    Objective: To investigate the bolus geometry in high-pitch CT angiography (CTA) of the aorta without ECG synchronisation in comparison to single-source CT. Methods: Overall 160 consecutive patients underwent CTA either in conventional single-source mode with a pitch of 1.2 (group 1), or in dual-source mode with a pitch of 3.0 (groups 2, 3 and 4) using different contrast media timings with bolus triggering at 140 HU (5 s, group 1; 10 s, group 2; 12 s, group 3; 14 s, group 4). Contrast material, saline flush, flow rate and kV/mAs settings were kept equal for optimum comparability. Aortic attenuation was measured along the z-axis of the patient at different anatomic landmarks and subjective image quality was compared. Results: The most homogeneous enhancement of the aorta was reached with a delay of 10 s after reaching the trigger threshold. The imaging length was not significantly different, but the examination time was significantly (p < 0.001) shorter in the high-pitch group (7.7 s vs. 1.7 s for group 1 vs. 2, 3 and 4). Conclusion: In high-pitch CT angiography using a start delay of 10 s after a trigger threshold of 140 HU in the descending aorta is reached, a homogenous contrast along the z-axis is accomplished.