Multi-Detector Computed Tomography Imaging Techniques in Arterial Injuries

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Cameron Adler

2018-04-01

Full Text Available Cross-sectional imaging has become a critical aspect in the evaluation of arterial injuries. In particular, angiography using computed tomography (CT is the imaging of choice. A variety of techniques and options are available when evaluating for arterial injuries. Techniques involve contrast bolus, various phases of contrast enhancement, multiplanar reconstruction, volume rendering, and maximum intensity projection. After the images are rendered, a variety of features may be seen that diagnose the injury. This article provides a general overview of the techniques, important findings, and pitfalls in cross sectional imaging of arterial imaging, particularly in relation to computed tomography. In addition, the future directions of computed tomography, including a few techniques in the process of development, is also discussed.

Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

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Shen, Quanli; Yao, Qiong; Hu, Xihong [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China)

2016-09-15

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography. (orig.)

Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

International Nuclear Information System (INIS)

Shen, Quanli; Yao, Qiong; Hu, Xihong

2016-01-01

Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography. (orig.)

Renal Branch Artery Stenosis

DEFF Research Database (Denmark)

Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

2017-01-01

Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...... that perform well in the diagnosis of main renal artery stenosis may fall short when it comes to branch artery stenosis. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography....

Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.

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Siontis, George Cm; Mavridis, Dimitris; Greenwood, John P; Coles, Bernadette; Nikolakopoulou, Adriani; Jüni, Peter; Salanti, Georgia; Windecker, Stephan

2018-02-21

To evaluate differences in downstream testing, coronary revascularisation, and clinical outcomes following non-invasive diagnostic modalities used to detect coronary artery disease. Systematic review and network meta-analysis. Medline, Medline in process, Embase, Cochrane Library for clinical trials, PubMed, Web of Science, SCOPUS, WHO International Clinical Trials Registry Platform, and Clinicaltrials.gov. Diagnostic randomised controlled trials comparing non-invasive diagnostic modalities in patients presenting with symptoms suggestive of low risk acute coronary syndrome or stable coronary artery disease. A random effects network meta-analysis synthesised available evidence from trials evaluating the effect of non-invasive diagnostic modalities on downstream testing and patient oriented outcomes in patients with suspected coronary artery disease. Modalities included exercise electrocardiograms, stress echocardiography, single photon emission computed tomography-myocardial perfusion imaging, real time myocardial contrast echocardiography, coronary computed tomographic angiography, and cardiovascular magnetic resonance. Unpublished outcome data were obtained from 11 trials. 18 trials of patients with low risk acute coronary syndrome (n=11 329) and 12 trials of those with suspected stable coronary artery disease (n=22 062) were included. Among patients with low risk acute coronary syndrome, stress echocardiography, cardiovascular magnetic resonance, and exercise electrocardiograms resulted in fewer invasive referrals for coronary angiography than coronary computed tomographic angiography (odds ratio 0.28 (95% confidence interval 0.14 to 0.57), 0.32 (0.15 to 0.71), and 0.53 (0.28 to 1.00), respectively). There was no effect on the subsequent risk of myocardial infarction, but estimates were imprecise. Heterogeneity and inconsistency were low. In patients with suspected stable coronary artery disease, an initial diagnostic strategy of stress echocardiography or

Case report: Iatrogenic brachial artery dissection with complete anterograde occlusion during elective arterial line placement

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Laurence Weinberg

2018-01-01

Conclusion: We review our diagnostic pathway and treatment of this rare complication. Recommendations to minimise the risks of complications from brachial arterial line insertion are also overviewed. We recommend the routine utilization of ultrasound-guided technique and regular post-insertion neurovascular monitoring for the prevention and early recognition of complications from brachial artery catheter insertion.

Techniques for Non-Invasive Monitoring of Arterial Blood Pressure

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Agnes S. Meidert

2018-01-01

Full Text Available Since both, hypotension and hypertension, can potentially impair the function of vital organs such as heart, brain, or kidneys, monitoring of arterial blood pressure (BP is a mainstay of hemodynamic monitoring in acutely or critically ill patients. Arterial BP can either be obtained invasively via an arterial catheter or non-invasively. Non-invasive BP measurement provides either intermittent or continuous readings. Most commonly, an occluding upper arm cuff is used for intermittent non-invasive monitoring. BP values are then obtained either manually (by auscultation of Korotkoff sounds or palpation or automatically (e.g., by oscillometry. For continuous non-invasive BP monitoring, the volume clamp method or arterial applanation tonometry can be used. Both techniques enable the arterial waveform and BP values to be obtained continuously. This article describes the different techniques for non-invasive BP measurement, their advantages and limitations, and their clinical applicability.

Changing Profiles of Diagnostic and Treatment Options in Subclavian Artery Aneurysms

NARCIS (Netherlands)

Vierhout, B. P.; Zeebregts, C. J.; van den Dungen, J. J. A. M.; Reijnen, M. M. P. J.

Background: Subclavian artery aneurysms (SAAs) are rare and may cause life- and limb-threatening complications. Therapeutic options greatly differ as do access alternatives. The aim of the study was to assess its clinical presentation, diagnostics and therapeutic options as reported in the

A new diagnostic approach to popliteal artery entrapment syndrome

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Williams, Charles; Kennedy, Dominic; Bastian-Jordan, Matthew; Hislop, Matthew; Cramp, Brendan; Dhupelia, Sanjay [Queensland X-Ray, Sunnybank, Queensland, 4109 (Australia)

2015-09-15

A new method of diagnosing and defining functional popliteal artery entrapment syndrome is described. By combining ultrasonography and magnetic resonance imaging techniques with dynamic plantarflexion of the ankle against resistance, functional entrapment can be demonstrated and the location of the arterial occlusion identified. This combination of imaging modalities will also define muscular anatomy for guiding intervention such as surgery or Botox injection.

A new diagnostic approach to popliteal artery entrapment syndrome

International Nuclear Information System (INIS)

Williams, Charles; Kennedy, Dominic; Bastian-Jordan, Matthew; Hislop, Matthew; Cramp, Brendan; Dhupelia, Sanjay

2015-01-01

A new method of diagnosing and defining functional popliteal artery entrapment syndrome is described. By combining ultrasonography and magnetic resonance imaging techniques with dynamic plantarflexion of the ankle against resistance, functional entrapment can be demonstrated and the location of the arterial occlusion identified. This combination of imaging modalities will also define muscular anatomy for guiding intervention such as surgery or Botox injection

Imaging techniques used in the diagnostic workup of acute venous thromboembolic disease.

Science.gov (United States)

Tilve-Gómez, A; Rodríguez-Fernández, P; Trillo-Fandiño, L; Plasencia-Martínez, J M

Early diagnosis is one of the most important factors affecting the prognosis of pulmonary embolism (PE); however, the clinical presentation of PE is often very unspecific and it can simulate other diseases. For these reasons, imaging tests, especially computed tomography angiography (CTA) of the pulmonary arteries, have become the keystone in the diagnostic workup of PE. The wide availability and high diagnostic performance of pulmonary CTA has led to an increase in the number of examinations done and a consequent increase in the population's exposure to radiation and iodinated contrast material. Thus, other techniques such as scintigraphy and venous ultrasonography of the lower limbs, although less accurate, continue to be used in certain circumstances, and optimized protocols have been developed for CTA to reduce the dose of radiation (by decreasing the kilovoltage) and the dose of contrast agents. We describe the technical characteristics and interpretation of the findings for each imaging technique used to diagnose PE and discuss their advantages and limitations; this knowledge will help the best technique to be chosen for each case. Finally, we comment on some data about the increased use of CTA, its clinical repercussions, its "overuse", and doubts about its cost-effectiveness. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques

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Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp, E-mail: mori-h33@xa2.so-net.ne.jp [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp [Kyoto Prefectural University of Medicine, Department of Radiology, North Medical Center (Japan); Ito, Takaaki, E-mail: takaaki@koto.kpu-m.ac.jp [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Hayashi, Natsuko, E-mail: hayashin@koto.kpu-m.ac.jp [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan); Sato, Osamu, E-mail: osamu-sato@kyoto1-jrc.org [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan)

2016-06-15

PurposeThe purpose of the study was to retrospectively evaluate the efficacy and safety of the balloon blocking technique (BBT).Materials and MethodsThe BBT was performed in six patients (all males, mean 73.5 years) in whom superselective catheterization for transcatheter arterial embolization by the conventional microcatheter techniques had failed due to anatomical difficulty, including targeted arteries originating steeply or hooked from parent arteries. All BBT procedures were performed using Seldinger’s transfemoral method. Occlusive balloons were deployed and inflated at the distal side of the target artery branching site in the parent artery via transfemoral access. A microcatheter was delivered from a 5-F catheter via another femoral access and was advanced over the microguidewire into the target artery, under balloon blockage of advancement of the microguidewire into non-target branches. After the balloon catheter was deflated and withdrawn, optimal interventions were performed through the microcatheter.ResultsAfter success of accessing the targeted artery by BBT, optimal interventions were accomplished in all patients with no complications other than vasovagal hypotension, which responded to nominal therapy.ConclusionThe BBT may be useful in superselective catheterization of inaccessible arteries due to anatomical difficulties.

A CLINICAL CASE: DIAGNOSTICS OF SHERESHEVSKY TERNER SYNDROME WITH MULTIPLE CONGENITAL ANOMALIES IN MAIN ARTERIES OF A 4 YEAR OLD CHILD, SUFFERING FROM ARTERIAL HYPERTENSION

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A.N. Tsygin

2007-01-01

Full Text Available The article provides a substantiation for the differential diagnostics of the symptomatic arterial hypertension of a 4 year old child, suffering from the arterial hypertension of the presumably renoparenchymal origin. In the course of the clinical examination, the researchers found out coarctation of aorta and hypoplasia of the right renal artery as a part of Shereshevsky-Terner syndrome.Key words: arterial hypertension, Shereshevsky-Terner syndrome, coarctation of aorta, renovascular hypertension.

Digital arteriography of kidney arteries by intraveinous route. Simplified technique

International Nuclear Information System (INIS)

Guisgand, M.; Dardenne, A.N.

1989-01-01

Of the 1,000 patients addressed to us for intravenous digital angiography (IVDA) of the renal arteries for arterial hypertension, for control of the artery of a transplanted kidney or for preoperative check-up prior to transplantation of a kidney, 738 were examined by a simplified technique. Compared to the standard practice this method simply consists of a manual injection of a standard ionic contrast medium via an antecubital vein punctured with a large catheter needle (caliber 14 G), without preparatory injection of an intestinal antispasmodic. This method has produced a satisfactory arterial opacification in 96 % of the cases. The advantages and disadvantages of the technique are discussed. Of the 262 remaining patients, 250 were also examined by the peripheral venous mode, but the technique had to be modified in at least one of its aspects for one reason or another. Only 12 patients were not examined by the peripheral venous mode (7 puncture failures, 4 permanent venous accesses already installed). The IVDA simplified technique appears to be reliable for detecting reno-vascular arterial hyper-tension and, with certain limitations, for the control of kidney grafts. With regard to the preoperative check-up before kidney transplantation, IVDA still does not seem a suitable replacement for the traditional method of angiography [fr

Flash fluorescence with indocyanine green videoangiography to identify the recipient artery for bypass with distal middle cerebral artery aneurysms: operative technique.

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Rodríguez-Hernández, Ana; Lawton, Michael T

2012-06-01

Distal middle cerebral artery (MCA) aneurysms frequently have nonsaccular morphology that necessitates trapping and bypass. Bypasses can be difficult because efferent arteries lie deep in the opercular cleft and may not be easily identifiable. We introduce the "flash fluorescence" technique, which uses videoangiography with indocyanine green (ICG) dye to identify an appropriate recipient artery on the cortical surface for the bypass, enabling a more superficial and easier anastomosis. Flash fluorescence requires 3 steps: (1) temporary clip occlusion of the involved afferent artery; (2) videoangiography demonstrating fluorescence in uninvolved arteries on the cortical surface; and (3) removal of the temporary clip with flash fluorescence in the involved efferent arteries on the cortical surface, thereby identifying a recipient. Alternatively, temporary clips can occlude uninvolved arteries, and videoangiography will demonstrate initial fluorescence in efferent arteries during temporary occlusion and flash fluorescence in uninvolved arteries during reperfusion. From a consecutive series of 604 MCA aneurysms treated microsurgically, 22 (3.6%) were distal aneurysms and 11 required a bypass. The flash fluorescence technique was used in 3 patients to select the recipient artery for 2 superficial temporal artery-to-MCA bypasses and 1 MCA-MCA bypass. The correct recipient was selected in all cases. The flash fluorescence technique provides quick, reliable localization of an appropriate recipient artery for bypass when revascularization is needed for a distal MCA aneurysm. This technique eliminates the need for extensive dissection of the efferent artery and enables a superficial recipient site that makes the anastomosis safer, faster, and less demanding.

Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals

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Phillips, Grace S.; Vo, Nghia J.; Ishak, Gisele E.; Swanson, Jonathan O.; Otto, Randolph K. [University of Washington, Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States)

2010-07-15

We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm. (orig.)

Splenic artery aneurysm: a diagnostic challenge in the setting of extensive portal venous collaterals

International Nuclear Information System (INIS)

Phillips, Grace S.; Vo, Nghia J.; Ishak, Gisele E.; Swanson, Jonathan O.; Otto, Randolph K.

2010-01-01

We present a 16-year-old boy with autoimmune liver disease and longstanding portal hypertension in whom a CT arteriogram demonstrated a large aneurysm arising from the distal, extra-parenchymal portion of the splenic artery. Because of its location adjacent to multiple venous collaterals, the aneurysm was indistinguishable from splenic varices on initial imaging with Doppler sonography and on portal venous-phase CT. There is an increased risk of rupture of splenic artery aneurysms in the post-liver transplant period, with high associated mortality, and therefore diagnosis of splenic artery aneurysm prior to liver transplantation is clinically important. It is quite possible that the diagnosis of splenic artery aneurysm in this case would have been missed in the absence of dedicated arterial-phase imaging. As radiologists strive to reduce radiation exposure in children, this case highlights a potential diagnostic pitfall of both Doppler sonography and venous or single-acquisition arterial/venous-phase CT angiogram in children with venous collaterals and an undiagnosed splenic artery aneurysm. (orig.)

Digital capillaroscopy as important tool for early diagnostics of arterial hypertension

Science.gov (United States)

Gurfinkel, Yu. I.; Sasonko, M. L.; Priezzhev, A. V.

2015-03-01

The study is aimed to determine the digital capillaroscopy possibilities in early diagnostics of an arterial hypertension. A total of 123 adult persons were examined in the study. The first group consisted of 40 patients with prehypertension (BP 130-139/85-89 mm Hg). The second group included 36 patients with 1-2 stage of hypertension (mean systolic BP 152.7±12 mm Hg). Patients in both groups did not receive regular drug therapy. The group of volunteers (n=47) included healthy adults without signs of cardiovascular pathology. The capillary circulation was examined on the nailbed using the optical digital capillaroscope developed by the company "AET", Russia. Diameters of the arterial and venous segments, perivascular zone size, capillary blood velocity, the degree of arterial loops narrowing and the density of the capillary network were estimated. In patients with arterial hypertension and even in patients with prehypertension remodeling and rarefaction of capillaries and the expressed narrowing their arterial loops were manifested. The results of the study revealed the presence of abnormalities of microcirculation parameters in patients of both groups. The capillaries density in both groups of patients was significantly lower than in healthy persons. The significant narrowing of arterial loops was revealed in patients with both arterial hypertension and prehypertension, in comparison with healthy volunteers. Capillary blood velocity did not differ significantly between healthy volunteers group and the group of prehypertensive patients. However in patients with hypertension this parameter was significantly lower in comparison with control group.

Dual-energy CTA in patients with symptomatic peripheral arterial occlusive disease. Study of diagnostic accuracy and impeding factors

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Klink, Thorsten [Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Bern Univ. (Switzerland). Univ. Inst. of Diagnostic, Interventional, and Pediatric Radiology; Wilhelm, Theresa; Roth, Christine [Univ. Hospital Giessen and Marburg, Marburg (Germany). Dept. of Diagnostic and Interventional Radiology; Heverhagen, Johannes T. [Bern Univ. (Switzerland). Univ. Inst. of Diagnostic, Interventional, and Pediatric Radiology

2017-05-15

The purpose of this study was to assess the diagnostic performance of dual-energy CT angiography (DE-CTA) in patients with symptomatic peripheral artery occlusive disease (PAOD) and to identify factors that impede its diagnostic accuracy. Dual-source DE-CTA scans of the lower extremities of 94 patients were retrospectively compared to the diagnostic reference standard, digital subtraction angiography (DSA). Two independent observers assessed PAOD incidence, image quality, artifacts, and diagnostic accuracy of DE-CTA in 1014 arterial segments on axial, combined 80/140 kVp reconstructions and on 3 D maximum intensity projections (MIP) after automated bone and plaque removal. The impact of calcifications, image quality, and image artifacts on the diagnostic accuracy was evaluated using Fisher's exact test. Furthermore, interobserver agreement was analyzed. Two observers achieved sensitivities of 98.0% and 93.9%, respectively, and specificities of 75.0% and 66.7%, respectively, for detecting stenoses of >50% of the lower extremity arteries. Calcifications impeded specificity, e.g. from 81.2% to 46.2% for reader 1 (p<0.001). Specificity increased with higher image quality, e.g. from 70.0% to 76.4% for reader 1 (p<0.001). Artifacts decreased the specificity of reader 2 (p<0.001). The overall interobserver agreement ranged between moderate and substantial for stenosis detection and calcified plaques. Conclusion DE-CTA is accurate in the detection of arterial stenoses of >50% in symptomatic PAOD patients. Calcified atherosclerotic plaques, image quality, and artifacts may impede specificity.

A successful retrieval of stripped outer coating of J-tip diagnostic guidewire from the left popliteal artery during elective coronary angiography

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Damjanović Miodrag

2014-01-01

Full Text Available Introduction. Entrapment and fracture of diagnostic or therapeutic devices within the coronary circulatory system are a rare, but increasing problem. Case report. A 70-yearold man was admitted in our clinic for coronary angiography before the planned aortic valve replacement. An arterial sheath was inserted in the right common femoral artery. After introducing a J-tip diagnostic coronary guidewire into the aorta and advancing a left Judkins diagnostic catheter over it, suddenly occured peeling off of the wire´s hydrophilic coating at the aortic arch level. Very soon, this outer coating of guidewire carried by the blood stream was entered into the left femoral artery, then into the left popliteal artery. This stripped part of guidewire was successfully caught and extracted out by using a goose-neck snare catheter. Conclusion. A sudden stripping of outer coating of a J-tip diagnostic hydrophilic coronary guidewire during coronary angiography is possible to manage quickly and successfully by the use of a simple cathether.

Diagnostic value of multislice computed tomography angiography in coronary artery disease: A meta-analysis

International Nuclear Information System (INIS)

Sun Zhonghua; Jiang Wen

2006-01-01

Purpose: To perform a meta-analysis of the diagnostic value of 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 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 analyzed at segment-, vessel- and patient-based assessment. Results: 47 studies (67 comparisons) met the criteria and were included in our study. Pooled overall sensitivity, specificity and 95% confidence interval for MSCT angiography in the detection of CAD were 83% (79%, 89%), 93% (91%, 96%) at segment-based analysis; 90% (87%, 94%), 87% (80%, 93%) at vessel-based analysis; and 91% (88%, 95%), 86% (81%, 92%) at patient-based analysis, respectively. Diagnostic accuracy of MSCT angiography in evaluating assessable segments was significantly improved with 64-slice scanners when compared to that with 4- and 16-slice scanners (p < 0.05). Conclusion: Our meta-analysis showed that MSCT angiography has potential diagnostic accuracy in the detection of CAD. Diagnostic performance of MSCT angiography has been significantly improved with the latest 64-slice CT, with resultant high qualitative and quantitative diagnostic accuracy. 16-slice CT was limited in spatial resolution which makes it difficult to perform quantitative assessment of coronary artery stenoses

INSTRUMENTAL AND DIAGNOSTIC CRITERIA OF HEMODYNAMIC DISORDERS AND ENDOTHELIAL DYSFUNCTION CORRECTION IN PREGNANTS WITH ARTERIAL HYPERTENSION

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S. M. Heryak

2014-12-01

Conclusions. It was found that the brachial artery ultrasound measuring and occlusive plethysmography procedure by Dietz is an early and safe method of endothelial dysfunction diagnostic in pregnants with hypertension. Doppler ultrasound of blood flow in uterine, umbilical arteries, and middle cerebral arteries of the fetus allows timely diagnosis of the side effect of antihypertensive drugs on the fetus. The therapy of choice for pregnants with Stage II Arterial Hypertension should be based on methyldopa and calcium channel antagonists or selective beta-blockers combination. Highly selective beta-blockers with vasodilative effect (nebivolol hydrochloride and L-arginine (Tivortin allow to prevent perinatal adverse effects of antihypertensive therapy, to correct hemodynamic disorders and endothelial dysfunction in pregnants with arterial hypertension. KEY WORDS: arterial hypertension, uterine-placental hemodynamics, endothelial dysfunction

Comparison of Machine Learning Methods for the Arterial Hypertension Diagnostics

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Vladimir S. Kublanov

2017-01-01

Full Text Available The paper presents results of machine learning approach accuracy applied analysis of cardiac activity. The study evaluates the diagnostics possibilities of the arterial hypertension by means of the short-term heart rate variability signals. Two groups were studied: 30 relatively healthy volunteers and 40 patients suffering from the arterial hypertension of II-III degree. The following machine learning approaches were studied: linear and quadratic discriminant analysis, k-nearest neighbors, support vector machine with radial basis, decision trees, and naive Bayes classifier. Moreover, in the study, different methods of feature extraction are analyzed: statistical, spectral, wavelet, and multifractal. All in all, 53 features were investigated. Investigation results show that discriminant analysis achieves the highest classification accuracy. The suggested approach of noncorrelated feature set search achieved higher results than data set based on the principal components.

Endovascular diagnostics and treatment of stenosis, acute thrombosis and chronic occlusion of arteries and upper limbs

International Nuclear Information System (INIS)

Tonev, I.; Zechirov, B.; Stanoev, D.; Velikov, C.; Smilkova, D.

2015-01-01

Full text: Diseases of the upper limb arteries are significantly rarer than those of the lower limbs but they are not causes and due to the lack of diagnostic algorithms are often missed. the symptoms are not typical except for those in acute thrombosis. The complaints in acute thrombosis is strong, sudden pain in the limb or part of it, bruising or paleness of the ischemic area and a lack of pulsation. Diagnosis is fairly easy – clinical events, difference in blood pressure or a lack of blood pressure in the affected limb, a total lack of blood pressure or a difference in the pressure in the left and right arm. Then complaints in stenosis and chronic occlusions is significantly less pronounced and is expressed as weakness in the affected limb, heaviness, bluish or paleness. If the proximal segments are affected Still’s syndrome is often observed. The complaints is not decisive for diagnosis. A difference in blood pressure of more than 20 mm Hg and an echodoppler examination of the arteries are the main criteria for directing the patients for angiography. Contrast CT and MRT are not used often. treatment is vascular surgery and endovascular. In acute thrombosis priority takes vascular surgery through extraction of the thrombi with Fogerty catheters, and in chronical stenosis and occlusions – dilation and stenting. Clinical cases: Case 1 – Revascularization of artery brachialis, radialis and ulnaris after acute occlusion L.Y., 77 years old. Complains of sharp pain and bruising of right forearm since two hours before hospitalization. A lack of blood flow was identified using palpation and echodoppler. After a diagnostic angiography , thrombaspiration was undertaken, through a leading catheter, recovering blood flow in both arteries and stenting of the proximal segment of artery radialis. Case 2: Revascularization of Trunkus brachiocefalicus K.P., 65 years old. Suffering from bradypsychia for several months. Bradypsychia becomes worse after manual labor

Diagnostic value of myocardial perfusion SPECT in the prediction of restenosis after coronary artery bypass graft surgery

International Nuclear Information System (INIS)

Paeng, J. C.; Lee, D. S.; Kang, W. J.; Kim, K. B.; Chung, J. K.; Lee, M. C.

2002-01-01

Myocardial SPECT has been reported to be sensitive in the detection of restenosis after revascularization. However, the diagnostic value is not well established in bypass graft surgery (CABG), due to significant influences of characteristics of graft vessels and the time interval between CABG and the SPECT. In this study, we evaluated the diagnostic value of myocardial SPECT for the restenosis after CABG. A total of 160 patients with coronary artery disease (M:F=118:42, 60±8 yr) who had undergone CABG were included. Rest T1-201/ dipyridamole stress Tc-99m-MIBI SPECT was performed 3 months (103±16 days) after CABG. Segmental perfusion was quantified using a 20-segment model, and segments of reversible perfusion defect (REV) were defined. Follow-up coronary angiography was performed 1 year (397±104 days) after CABG. The segments of REV were compared between arterial and venous graft groups. And the diagnostic power of 3-month SPECT was evaluated for the prediction of restenosis. On the 3-month SPECT, 620 segments showed REV. The segments of REV were 37% of artery-grafted segments and 36% of vein-grafted segments (p=n.s.). On 1-year coronary angiography, 113 graft vessels (28%) showed restenosis. The overall sensitivity and specificity of REV on 3-month SPECT for the prediction of restenosis were 46% and 67%, respectively, but 52% and 68%, in artery-graft group. REV detected on 3-month SPECT has a predictive value, especially, high specificity for the prediction of restenosis after CABG, which was more definite in artery-graft group

Noncontrast-enhanced magnetic resonance renal angiography using a repetitive artery and venous labelling technique at 3 T: comparison with contrast-enhanced magnetic resonance angiography in subjects with normal renal function

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Park, Sung Yoon [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Severance Hospital, Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Seoul (Korea, Republic of); Kim, Chan Kyo; Park, Byung Kwan [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Kim, EunJu [Philips Healthcare Korea, Seoul (Korea, Republic of)

2014-09-13

To investigate the feasibility of noncontrast-enhanced MR angiography (NC-MRA) using the repetitive artery and venous labelling (RAVEL) technique to evaluate renal arteries compared to contrast-enhanced MR angiography (CE-MRA). Twenty-five subjects with normal renal function underwent NC-MRA using a RAVEL technique and CE-MRA at 3 T. Two independent readers analysed the MRA images. Image quality, number of renal arteries, presence or absence of an early branching vessel, and diameter of the main renal arteries were evaluated. The overall image quality of NC-MRA was fair or greater in 88 % of right and 92 % of left renal arteries, while it was 96 % in both sides with CE-MRA. On NC-MRA, the number of renal arteries in all subjects was perfectly predicted by both readers. Sensitivity and specificity for predicting early branching vessels were 82 % and 100 % for reader 1 and 82 % and 95 % for reader 2. Inter-modality agreement for comparing the diameters of main renal arteries was good or excellent at all segments for both readers. Inter-reader agreement was moderate or good at all segments except at the right distal segment on NC-MRA. NC-MRA with the RAVEL technique at 3 T may have comparable diagnostic feasibility for evaluating renal arteries compared to CE-MRA. (orig.)

Imaging diagnosis of congenital heart disease with single coronary artery

International Nuclear Information System (INIS)

Zhu Ming; Li Yuhua; Zhong Yumin; Sun Aimin

2003-01-01

Objective: To report 56 cases of congenital heart disease with congenital single coronary artery and to evaluate the imaging diagnostic techniques. Methods: All 56 patients with congenital single coronary artery underwent angiocardiography. Contrast enhancement magnetic resonance angiography (CE MRA) was performed in 4 cases. 48 cases were confirmed by operation. Results: In these 56 cases, single left coronary artery was found in 44 cases and single right coronary artery was found in 12. Conclusion: Congenital heart disease with congenital single coronary artery is not rare and correct diagnosis is very important for surgery

Vascular complications following therapeutic and diagnostic cardiac catheterisation by the femoral artery

DEFF Research Database (Denmark)

Bitsch, M; Liisberg-Larsen, Ole Christian; Schroeder, T V

1994-01-01

Twenty-one of 6327 (0.33%) patients undergoing cardiac catheterisation via the femoral artery had an acute vascular complication requiring surgical intervention. The complication rate was 0.1% after coronary angiography, 2% after PTCA and 6% after aortic ballon dilatation. The size of the cathete...... and evaluation of vascular injuries following diagnostic and therapeutic invasive interventions could have a self limitating effect on the complication rate....

Multislice Helical CT Angiography in Diagnostic of Intracranial and Extracranial Arterial Dissection

International Nuclear Information System (INIS)

Radzina, M.; Krumina, G.; Pupols, J.

2007-01-01

Arterial dissection is detachment of inner layer of the vessel wall. Head-neck trauma, congenital connectives tissue disorders like fibromuscular dysplasia, infectious diseases, hypertension, migraine, alcohol abuse and oral contraception are the typical causes. Urgent, complete, detailed verification is essential for successful treatment decision. Purpose. Aim of the study was to develop new appropriate CTA (angiography) protocols for patients with intracranial and extracranial arterial dissections using high speed multislice CT; to evaluate its clinical value in different locations and stages of disease, perspectives, advantages and disadvantages of new method. Materials and methods. 30 adult patients with suspected intra- or extracranial arterial blood vessels dissections were investigated in the clinical hospital 'Gailezers' using following algorithm: native CT; contrast CTA with post processing on the workstation. 80 ml iodine contrast media was administered intravenously, line speed 3-4 ml/sec, delay 10-15 seconds. For detection of maximum contrast intensity in the vessel the test contrast injection was performed before. Primary scan series were post processed in different kind of reconstructions - MPR (Multiplanar Reconstructions), MIP (Maximal Intensity Projection), VR (Volume Rendering), CR (Curved Reformat) and vessel analysis. Two different types of protocols were used - for intracranial and brachiocefalic arteries examinations. Results and Discussion. Following CTA symptoms of dissection were verified: 1) irregular vessel contour changes - narrowing, 'string' sign above dissection level; 2) tapered stenosis and/or distal occlusion; 3) double contour and/or double lumen sign; 4) fusiform aneurysmal dilatation. Clinical cases of different arterial dissection localization will be demonstrated during the presentation Advantages and disadvantages of CTA will be presented and disputed. Conclusions. CTA is non-invasive radiologic diagnostic method that yields

A coil placement technique to treat intracranial aneurysm with incorporated artery.

Science.gov (United States)

Luo, Chao-Bao; Chang, Feng-Chi; Lin, Chung-Jung; Guo, Wan-Yuo

2018-03-01

Endovascular coil embolization is an accepted treatment option for intracranial aneurysms. However, the coiling of aneurysms with an incorporated artery (IA) poses a high risk of IA occlusion. Here we report our experience of endovascular coil placement using a technique that avoids IA occlusion in aneurysms with IAs. Over a 6-year period, 185 patients harboring 206 intracranial aneurysms underwent endosaccular coiling. Forty-two of these patients with 45 aneurysms were treated by coil placement to avoid IAs occlusion. We assessed the anatomy of the aneurysms and IAs, technical feasibility of the procedure, and degree of aneurysm occlusion. Clinical and angiographic outcomes were assessed as well. Aneurysms were located in the supra-clinoid intracranial internal carotid artery (n = 24), anterior cerebral artery (n = 6), middle cerebral artery (n = 7), and vertebrobasilar artery (n = 8). The IA was at the aneurysm neck in 34 patients, body in 10, and dome in 1. Immediate post-coiling angiogram showed preservation of blood flow through the IA in all aneurysms. Coil compaction with aneurysmal regrowth was found in 7 of 36 patients having follow-up conventional angiography. One patient had an IA territory infarction after embolization. All 42 patients were followed up (mean: 21 months) and showed no re-bleeding. This technique is effective and safe in managing intracranial aneurysms with IAs. Although aneurysmal recurrence may occur in some aneurysms because of insufficient coiling, this technique is simpler to perform and requires less skill than other techniques. It can be an alternative option for treating some selected intracranial aneurysms with IAs. Copyright © 2017. Published by Elsevier Taiwan LLC.

The “SAFARI” Technique Using Retrograde Access Via Peroneal Artery Access

International Nuclear Information System (INIS)

Zhuang, Kun Da; Tan, Seck Guan; Tay, Kiang Hiong

2012-01-01

The “SAFARI” technique or subintimal arterial flossing with antegrade–retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.

Carotid artery dissection on non-contrast CT: Does color improve the diagnostic confidence?

Energy Technology Data Exchange (ETDEWEB)

Saba, Luca, E-mail: lucasaba@tiscali.it [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Argiolas, Giovanni Maria [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Raz, Eytan [Department of Radiology, New York University School of Medicine, New York (United States); Department of Neurology and Psychiatry, Sapienza University of Rome (Italy); Sannia, Stefano [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Suri, Jasjit S. [Diagnostic and Monitoring Division, AtheroPointTM LLC, Roseville, CA (United States); Electrical Engineering Department (Aff.), Idaho State University, ID (United States); Siotto, Paolo [Department of Radiology, Azienda Ospedaliero Brotzu (A.O.B.), di Cagliari, Cagliari 09100 (Italy); Sanfilippo, Roberto; Montisci, Roberto [Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Piga, Mario [Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045 (Italy); Wintermark, Max [Department of Radiology, Neuroradiology Division, University of Virginia, Box 800170, Charlottesville, VA, 22908 (United States)

2014-12-15

Highlights: • The use of a color scale to display the non-contrast CT images in lieu of the classic grayscale improves the diagnostic confidence of the readers. • Radiologists should consider the use of a color scale, rather than the conventional grayscale, to assess non-contrast CT studies for possible carotid artery dissection. - Abstract: Purpose: The purpose of this work was to evaluate if the use of color maps, instead of conventional grayscale images, would improve the observer's diagnostic confidence in the non-contrast CT evaluation of internal carotid artery dissection (ICAD). Materials and methods: One hundred patients (61 men, 39 women; mean age, 51 years; range, 25–78 years), 40 with and 60 without ICAD, underwent non-contrast CT and were included in this the retrospective study. In this study, three groups of patients were considered: patients with MR confirmation of ICAD, n = 40; patients with MR confirmation of ICAD absence, n = 20; patients who underwent CT of the carotid arteries because of atherosclerotic disease, n = 40. Four blinded observers with different levels of expertise (expert, intermediate A, intermediate B and trainee) analyzed the non-contrast CT datasets using a cross model (one case grayscale and the following case using the color scale). The presence of ICAD was scored on a 5-point scale in order to assess the observer's diagnostic confidence. After 3 months the four observers evaluated the same datasets by using the same cross-model for the alternate readings (one case color scale and the following case using the grayscale). Statistical analysis included receiver operating characteristics (ROC) curve analysis, the Cohen weighted test and sensitivity, specificity, PPV, NPV, accuracy, LR+ and LR−. Results: The ROC curve analysis showed that, for all observers, the use of color scale resulted in an improved diagnostic confidence with AUC values increasing from 0.896 to 0.936, 0.823 to 0.849, 0.84 to 0.909 and 0

Treatment of complex internal carotid artery aneurysms using radial artery grafts. Surgical technique, perioperative complications, and results in 17 patients

International Nuclear Information System (INIS)

Murai, Yasuo; Teramoto, Akira; Mizunari, Takayuki; Kobayashi, Shiro; Kamiyama, Hiroyasu

2007-01-01

Complex giant or large internal carotid artery aneurysms present a surgical challenge because limitations and difficulty are encountered with either clipping or endovascular treatment. Our review of previous reports suggests that no current vascular assessment can accurately predict the occurrence of ischemic complications after internal carotid artery ligation. The present study concerns surgical technique, complications, and clinical outcome of radial artery grafting followed by parent artery trapping or proximal occlusion for management of these difficult lesions. Between September 1997 and October 2005, we performed radial artery grafting followed immediately by parent artery occlusion in 17 patients with giant or large complex intracranial carotid aneurysms (3 men, 14 women; mean follow-up duration, 62 months). All patients underwent postoperative digital subtraction angiography to assess graft patency and aneurysm obliteration. All 17 aneurysms were excluded from the cerebral circulation, with all radial artery grafts patent. Among 4 patients with cranial nerve disturbances, dysfunction was temporary in 5; in the others, oculomotor nerve paresis persisted. No perioperative cerebral infarction occurred. Sensory aphasia reflecting cerebral contusions caused by temporal lobe retraction resolved within 2 months, as did hemiparesis from a postoperative epidural hematoma. With appropriate attention to surgical technique, radial artery grafting followed by acute parent artery occlusion is a safe treatment for complex internal carotid artery aneurysms. Graft patency and aneurysm thrombosis were achieved in all patients. Cranial nerve dysfunction (III, VI) caused by altered blood flow from the internal carotid artery after occlusion was the most common complication and typically was temporary. In our experience with these difficult aneurysms, not only clipping but also reconstruction of the internal carotid artery was required, especially for wide-necked symptomatic

A comparison of direct technique with the liquid stylet technique of radial artery cannulation in patients presenting for coronary artery bypass grafting

International Nuclear Information System (INIS)

Younus, U.; Ahmed, I.

2012-01-01

To compare direct technique with the liquid stylet technique of radial artery cannulation in patients undergoing coronary artery byroms grouping. We hypothesized that liquid stylet technique would lead to fewer attempts and save vital time. Study Design: Randomized controlled Trial (RCT). Place and Duration of Study: Department of Anaesthesia and Intensive Care, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, [AFIC-NIHD] Rawalpindi, between 1 July 2007 to 31 Dec 2007. Patients and Methods: One hundred patients of either sex scheduled for CABG were included and were randomized to 2 groups using random number table. Fifty patients in the direct technique group and 50 in the liquid stylet group. Results: These two groups comparable with respect to age, gender and weight were studied. The number of attempts in group 1 were 1.7+-0.5 vs 3.6+-1.6 in groups 2, (p=0.021). The time consumed in group was 3.3 +- 2.2 minutes while in groups 2 it was 8.0 +- 3.6 (p=0.022). Conclusion: We concluded that the liquid stylet technique is safe, quick and is associated with lesser number of attempts at cannulation. Secondly it can be done without fancy guide wires and other technology especially in a developing country like Pakistan. (author)

Selection of suitable diagnostic techniques for an RF atmospheric pressure plasma

International Nuclear Information System (INIS)

Kong, M.G.; Deng, X.T.

2001-01-01

As an early report of our study, this paper summaries the RF atmospheric pressure plasma system we intend to characterize and a number of diagnostic techniques presently under assessment for our plasma rig. By discussing the advantages and disadvantages of these diagnostic techniques at this meeting, we hope to gain feedback and comments to improve our choice of appropriate diagnostic techniques as well as our subsequent application of these techniques to nonthermal RF atmospheric pressure plasmas

Development of process diagnostic techniques for piping and equipment

International Nuclear Information System (INIS)

Yotsutsuji, Mitoshi

1987-01-01

The thing required for using the facilities composing a plant for a long period without anxiety is to quantitatively grasp the quantities of the present condition of the facilities and to take the necessary measures beforehand. For this purpose, the diagnostic techniques for quickly and accurately detect the quantities of the condition of facilities are necessary, and the development of process diagnostic techniques has been desired. The process diagnostic techniques mentioned here mean those for diagnosing the contamination, clogging and performance of towers, tanks, heat exchangers and others. Idemitsu Engineering Co. had developed a simplified diagnostic equipment for detecting the state of fouling in piping in 1982, which is the gamma ray transmission diagnosis named Scale Checker. By further improving it, the process diagnostic techniques for piping and equipment were developed. In this report, the course of development and examination, the principle of detection, the constitution and the examination of remodeling of the Scale Checker are reported. As the cases of process diagnosis in plant facilities, the diagnosis of the clogging in process piping and the diagnosis of the performance of a distillation tower were carried out. The contents of the diagnosis and the results of those cases are explained. (Kako, I.)

Thyroid perfusion imaging as a diagnostic tool in Graves' disease. Arterial spin labeling magnetic resonance imaging vs. colour-coded Doppler ultrasound

Energy Technology Data Exchange (ETDEWEB)

Muessig, K. [University Hospital of Duesseldorf (Germany). Dept. of Metabolic Diseases; Leibniz Center for Diabetes Research, Duesseldorf (Germany). Inst. for Clinical Diabetology; University Hospital of Tuebingen (Germany). Div. of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry; Schraml, C.; Schwenzer, N.F. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Section on Experimental Radiology; University Hospital of Tuebingen (Germany). Dept. of Radiology, Diagnostic and Interventional Radiology; Rietig, R.; Balletshofer, B. [University Hospital of Tuebingen (Germany). Div. of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry; Martirosian, P.; Haering, H.U.; Schick, F. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Section on Experimental Radiology; Claussen, C.D. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Diagnostic and Interventional Radiology

2012-12-15

Purpose: Though increased thyroid perfusion assessed by colour-coded Doppler ultrasound (CDUS) is characteristic of Graves' disease (GD), sometimes perfusion assessment by CDUS is not possible. In these cases, arterial spin labelling (ASL), a novel magnetic resonance imaging (MRI) technique allowing non-invasive thyroid perfusion quantification, may have additional diagnostic value. We aimed to evaluate the potential of ASL-MRI for assessment of increased blood perfusion in patients with GD compared to CDUS. Materials and Methods: Thyroid perfusion was measured by CDUS (volume flow rate calculated from pulsed wave Doppler signals and vessel diameter) and ASL-MRI at 1.5 T in 7 patients with GD and 10 healthy controls. Results: In patients with GD, average perfusion in both thyroid lobes was markedly increased compared to controls. Both techniques applied for volume related perfusion as well as absolute volume flow in thyroid feeding vessels provided similar results (all p = 0.0008). Using a cut-off value of 22 ml/min for the volume flow rate assessed by CDUS in the four feeding vessels allowed discrimination between patients with GD and controls in all cases. After adjusting thyroid perfusion for the differences in organ volume, both CDUS and ASL revealed also complete discrimination between health and disease. Conclusion: Thyroid perfusion measurement by ASL-MRI reliably discriminate GD from normal thyroid glands. In patients in whom thyroid arteries cannot be depicted by CDUS for technical or anatomical reasons, ASL-MRI may have additional diagnostic value. (orig.)

Effect of porous media of the stenosed artery wall to the coronary physiological diagnostic parameter: a computational fluid dynamic analysis.

Science.gov (United States)

Govindaraju, Kalimuthu; Kamangar, Sarfaraz; Badruddin, Irfan Anjum; Viswanathan, Girish N; Badarudin, A; Salman Ahmed, N J

2014-04-01

Functional assessment of a coronary artery stenosis severity is generally assessed by fractional flow reserve (FFR), which is calculated from pressure measurements across the stenosis. The purpose of this study is to investigate the effect of porous media of the stenosed arterial wall on this diagnostic parameter. To understand the role of porous media on the diagnostic parameter FFR, a 3D computational simulations of the blood flow in rigid and porous stenotic artery wall models are carried out under steady state and transient conditions for three different percentage area stenoses (AS) corresponding to 70% (moderate), 80% (intermediate), and 90% (severe). Blood was modeled as a non Newtonian fluid. The variations of pressure drop across the stenosis and diagnostic parameter were studied in both models. The FFR decreased in proportion to the increase in the severity of the stenosis. The relationship between the percentage AS and the FFR was non linear and inversely related in both the models. The cut-off value of 0.75 for FFR was observed at 81.89% AS for the rigid artery model whereas 83.61% AS for the porous artery wall model. This study demonstrates that the porous media consideration on the stenotic arterial wall plays a substantial role in defining the cut-off value of FFR. We conclude that the effect of porous media on FFR, could lead to misinterpretation of the functional severity of the stenosis in the region of 81.89 %-83.61% AS. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Visualization of neonatal coronary arteries on multidetector row CT: ECG-gated versus non-ECG-gated technique

International Nuclear Information System (INIS)

Tsai, I.C.; Lee, Tain; Chen, Min-Chi; Fu, Yun-Ching; Jan, Sheng-Lin; Wang, Chung-Chi; Chang, Yen

2007-01-01

Multidetector CT (MDCT) seems to be a promising tool for detection of neonatal coronary arteries, but whether the ECG-gated or non-ECG-gated technique should be used has not been established. To compare the detection rate and image quality of neonatal coronary arteries on MDCT using ECG-gated and non-ECG-gated techniques. Twelve neonates with complex congenital heart disease were included. The CT scan was acquired using an ECG-gated technique, and the most quiescent phase of the RR interval was selected to represent the ECG-gated images. The raw data were then reconstructed without the ECG signal to obtain non-ECG-gated images. The detection rate and image quality of nine coronary artery segments in the two sets of images were then compared. A two-tailed paired t test was used with P values <0.05 considered as statistically significant. In all coronary segments the ECG-gated technique had a better detection rate and produced images of better quality. The difference between the two techniques ranged from 25% in the left main coronary artery to 100% in the distal right coronary artery. For neonates referred for MDCT, if evaluation of coronary artery anatomy is important for the clinical management or surgical planning, the ECG-gated technique should be used because it can reliably detect the coronary arteries. (orig.)

Diagnostic pitfalls associated with a large true posterior communicating artery aneurysm: a case report.

Science.gov (United States)

Nagatani, Kimihiro; Otani, Naoki; Seno, Soichiro; Takeuchi, Satoru; Wada, Kojiro; Mori, Kentaro

2013-10-01

True posterior communicating artery (PCoA) aneurysm is an aneurysm that originates from the PCoA, and large or giant true PCoA aneurysms are rare. We report a case of a large true PCoA aneurysm successfully clipped after anterior clinoidectomy and discuss the diagnostic pitfalls associated with this rare clinical entity.

Progress in diagnostic techniques for sc cavities

International Nuclear Information System (INIS)

Reece, C.E.

1988-01-01

While routinely achieved performance characteristics of superconducting cavities have now reached a level which makes them useful in large scale applications, achieving this level has come only through the knowledge gained by systematic studies of performance limiting phenomena. Despite the very real progress that has been made, the routine performance of superconducting cavities still falls far short of both the theoretical expectations and the performance of a few exception examples. It is the task of systematically applied diagnostic techniques to reveal additional information concerning the response of superconducting surfaces to applied RF fields. Here recent developments in diagnostic techniques are discussed. 18 references, 12 figures

A systematic review on diagnostic accuracy of CT-based detection of significant coronary artery disease

International Nuclear Information System (INIS)

Janne d'Othee, Bertrand; Siebert, Uwe; Cury, Ricardo; Jadvar, Hossein; Dunn, Edward J.; Hoffmann, Udo

2008-01-01

Objectives: Systematic review of diagnostic accuracy of contrast enhanced coronary computed tomography (CE-CCT). Background: Noninvasive detection of coronary artery stenosis (CAS) by CE-CCT as an alternative to catheter-based coronary angiography (CCA) may improve patient management. Methods: Forty-one articles published between 1997 and 2006 were included that evaluated native coronary arteries for significant stenosis and used CE-CCT as diagnostic test and CCA as reference standard. Study group characteristics, study methodology and diagnostic outcomes were extracted. Pooled summary sensitivity and specificity of CE-CCT were calculated using a random effects model (1) for all coronary segments, (2) assessable segments, and (3) per patient. Results: The 41 studies totaled 2515 patients (75% males; mean age: 59 years, CAS prevalence: 59%). Analysis of all coronary segments yielded a sensitivity of 95% (80%, 89%, 86%, 98% for electron beam CT, 4/8-slice, 16-slice and 64-slice MDCT, respectively) for a specificity of 85% (77%, 84%, 95%, 91%). Analysis limited to segments deemed assessable by CT showed sensitivity of 96% (86%, 85%, 98%, 97%) for a specificity of 95% (90%, 96%, 96%, 96%). Per patient, sensitivity was 99% (90%, 97%, 99%, 98%) and specificity was 76% (59%, 81%, 83%, 92%). Heterogeneity was quantitatively important but not explainable by patient group characteristics or study methodology. Conclusions: Current diagnostic accuracy of CE-CCT is high. Advances in CT technology have resulted in increases in diagnostic accuracy and proportion of assessable coronary segments. However, per patient, accuracy may be lower and CT may have more limited clinical utility in populations at high risk for CAD

Evaluation of blood flow in Allograft Renal Arteries anastomosed with two different techniques

International Nuclear Information System (INIS)

Zomorrodi, A.; Bohluli, A.; Tarzamany, M.K.

2008-01-01

Renal artery stenosis in renal transplantation (TRAS) is an avoidable short or long term surgical complication. The etiology is multifactorial, but faulty anastomosis is a major factor. In our transplant center, we evaluated the incidence of TRAS with the use of two different suturing techniques of the anastomosis site between allograft renal and renal and iliac arteries in two groups of renal transplant recipients, group A: 14 patients (6 males and 8 females with age 16 to 59 and mean age of 38 years) in whom allograft arteries were anastomosed with a continuous suture technique and group B: 14 patients (7 males and 7 females with age 32 to 61 and mean age of 46.6 years) in whom the allograft arteries were anastomosed with a combined suture technique (continuous and uninterrupted. Post transplantation, the velocity of blood flow in the renal and iliac arteries at the site of anastomosis was measured by color Doppler ultrasound. The ultrasonographer was blinded to the surgical technique in both study groups. The ratio of the maximum velocity of blood at the site of anastomosis to that in the iliac artery of less than 2.5 was considered as non-significant stenosis, while a ratio of more than 2.5 was considered significant stenosis. In group A there were 9 cases of non-significant stenosis in comparison to 3 cases in group B, while there were no cases of significant stenosis in group A in comparison to 3 cases in group B; the difference was not statistically significant. We conclude that there was no difference in the compared surgical techniques of anastomosis in our study groups. This suggests that other factors such as gentle handling of tissue, enough spatula, margin reversion and comparable diameter of the anastomosed vessels may be more important in the prevention of renal allograft stenosis than the type of suture technique. (author)

Predictors of diagnostic success with renal artery duplex ultrasonography.

Science.gov (United States)

Hedayati, Nasim; Del Pizzo, David J; Harris, Sean E; Kuskowski, Michael; Pevec, William C; Lee, Eugene S; Pifer, Christy; Dawson, David L

2011-05-01

Renal artery duplex ultrasonography (RA-DUS) is commonly used for the evaluation and follow-up of renal artery atherosclerotic disease. In a complete study, renal artery flow is evaluated from the vessel origin to the intraparenchymal branches. The quality of RA-DUS is in part technologist-dependent, but many factors may affect the ability to complete a diagnostic examination. This study evaluated the clinical and technical factors that predict the ability to obtain a complete RA-DUS examination. A prospective evaluation of all patients undergoing RA-DUS between July 2008 and February 2009 was performed. Factors such as patient age, gender, body mass index, technologists' years of experience, patient care setting (inpatient vs. outpatient), bedside examination, smoking before the examination, fasting status, and recent abdominal surgery were all recorded. Multivariate logistic regression analysis was performed. A p value of ≤ 0.05 was considered significant. During the study period, 250 patients underwent RA-DUS (mean age: 59.9 ± 17.8 years, 57% [143] female). A total of 87 (35%) examinations were incomplete. This included nondiagnostic examinations which did not exhibit any segment of the renal artery. Factors that were associated with an incomplete examination included technologists' years of experience (OR = 0.92, p = 0.042), bedside examination (OR = 4.17, p = 0.016), and recent abdominal surgery (OR = 3.45, p = 0.047). Body mass index, fasting status, and smoking before the examination did not affect the ability to obtain a complete study. One-third of the RA-DUS studies were classified as incomplete by the strict criteria used in this prospective study. An experienced ultrasound technologist is more likely to obtain a complete RA-DUS examination. Recent abdominal surgery and bedside examinations were predictive of a limited examination as well. Vascular laboratories should consider these factors when scheduling examinations so as to obtain complete RA

The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access

Energy Technology Data Exchange (ETDEWEB)

Zhuang, Kun Da, E-mail: zkunda@gmail.com [Singapore General Hospital, Interventional Radiology Centre (Singapore); Tan, Seck Guan [Singapore General Hospital, Department of General Surgery (Singapore); Tay, Kiang Hiong [Singapore General Hospital, Interventional Radiology Centre (Singapore)

2012-08-15

The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.

Visceral angiography with intra-arterial DSA and a programmed 100 mm technique

International Nuclear Information System (INIS)

Triller, J.; Ackermann, B.; Jung, H.

1988-01-01

One hundred and seventy specially selected visceral angiograms were carried out of 96 patients using I-A DSA and 100 mm technique. 85.2% of the I-A DSA and 91.7% of the 100 mm images were of good quality. I-A DSA produced comparable or better quality than the 100 mm technique in 66% during the arterial phase, in 79% during the paranchymatous phase and in 70% during the venous phase. The 100 mm technique produced better quality in a third of the cases during the arterial phase and in a quarter of the cases during the parenchymal and venous phases. The indications for the 100 mm technique are failure of I-A DSA or the need for high spatial resolution. (orig.) [de

Value of duplex scanning compared with angiography and pressure measurement in the assessment of aortoiliac arterial lesions

NARCIS (Netherlands)

Legemate, D. A.; Teeuwen, C.; Hoeneveld, H.; Eikelboom, B. C.

1991-01-01

To detect haemodynamically significant lesions in the aortoiliac arteries, invasive tests such as angiography and intra-arterial pressure measurement (IAPM) are considered valuable diagnostic tools. The value of duplex scanning as a direct non-invasive examination technique was prospectively

Transmural coil embolization—alternative technique for management of arterial perforation during subintimal angioplasty

Directory of Open Access Journals (Sweden)

Karthikeyan Damodharan

2016-01-01

Full Text Available Subintimal angioplasty of lower limb arterial occlusion carries a relatively higher risk of vessel perforation compared to transluminal angioplasty. Vessel perforation is a potentially life threatening complication which requires prompt recognition and management. They are usually managed by endovascular techniques such as low-pressure balloon tamponade, covered stents, and coil embolization of the ruptured artery. We describe a technique of treating vessel perforation following balloon angioplasty. Patient developed a large perforation of the proximal superficial femoral artery (SFA after balloon inflation during subintimal angioplasty of complete SFA occlusion. Following failure of balloon tamponade in sealing the perforation, we successfully treated it by deploying an embolization coil at the site of perforation through the vessel wall followed by balloon tamponade. Our technique could be a useful relatively inexpensive alternative treatment option in the management of vessel perforation compared to covered stents.

Alternative diagnostic technique for carpal tunnel syndrome

International Nuclear Information System (INIS)

Hayakawa, Katsuhiko; Nakane, Takashi; Kobayashi, Shigeru; Shibata, Kunio

2002-01-01

Compressive and entrapment neuropathies are common clinical syndromes characterized by neurologic deficits due to mechanical or dynamic compression of peripheral nerves. However, the definitive diagnosis based on clinical symptoms alone is difficult in many cases, and the electrophysiological diagnostic method is solely used as a supplementary diagnostic method at present. As a new diagnostic method for entrapment neuropathy, the present study investigated the usefulness of gadolinium-enhanced MRI in carpal tunnel syndrome. On enhanced MRI of idiopathic carpal tunnel syndrome, contrast-enhancement in the median nerve was found in 30 of 34 hands (88.2%). Enhanced MRI allows to visualize intraneural edema in the nerve easily on the naked eye. Therefore, this technique supplied useful information for making definitive diagnosis and is promising as a non-invasive diagnostic method for entrapment neuropathy. (author)

Alternative diagnostic technique for carpal tunnel syndrome

Energy Technology Data Exchange (ETDEWEB)

Hayakawa, Katsuhiko; Nakane, Takashi [Aiko Orthopaedic Hospital, Nagoya (Japan); Kobayashi, Shigeru; Shibata, Kunio [Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine

2002-10-01

Compressive and entrapment neuropathies are common clinical syndromes characterized by neurologic deficits due to mechanical or dynamic compression of peripheral nerves. However, the definitive diagnosis based on clinical symptoms alone is difficult in many cases, and the electrophysiological diagnostic method is solely used as a supplementary diagnostic method at present. As a new diagnostic method for entrapment neuropathy, the present study investigated the usefulness of gadolinium-enhanced MRI in carpal tunnel syndrome. On enhanced MRI of idiopathic carpal tunnel syndrome, contrast-enhancement in the median nerve was found in 30 of 34 hands (88.2%). Enhanced MRI allows to visualize intraneural edema in the nerve easily on the naked eye. Therefore, this technique supplied useful information for making definitive diagnosis and is promising as a non-invasive diagnostic method for entrapment neuropathy. (author)

Medical X-ray techniques in diagnostic radiography. 4. ed.

International Nuclear Information System (INIS)

Plaats, G.J. van der; Vijlbrief, P.

1980-01-01

A step by step account is given of every aspect of the technical factors involved in the production of X-ray images. Chapter titles include, methods of image formation and laws of projection, sharpness and unsharpness, contrast, perceptibility of detail in the radiographic image-image quality, properties of fluoroscopic screens, radiographic films, intensifying screens and cassettes, image intensification and X-ray television, processing technique, fluoroscopy and radiographic technique in general, special radiographic techniques, radiographic examinations using contrast media, exposure and exposure tables and automatic density control, diagnostic X-ray apparatus, and diagnostic stands and accessories. (C.F.)

Macrovascular Decompression of the Brainstem and Cranial Nerves: Evolution of an Anteromedial Vertebrobasilar Artery Transposition Technique.

Science.gov (United States)

Choudhri, Omar; Connolly, Ian D; Lawton, Michael T

2017-08-01

Tortuous and dolichoectatic vertebrobasilar arteries can impinge on the brainstem and cranial nerves to cause compression syndromes. Transposition techniques are often required to decompress the brainstem with dolichoectatic pathology. We describe our evolution of an anteromedial transposition technique and its efficacy in decompressing the brainstem and relieving symptoms. To present the anteromedial vertebrobasilar artery transposition technique for macrovascular decompression of the brainstem and cranial nerves. All patients who underwent vertebrobasilar artery transposition were identified from the prospectively maintained database of the Vascular Neurosurgery service, and their medical records were reviewed retrospectively. The extent of arterial displacement was measured pre- and postoperatively on imaging. Vertebrobasilar arterial transposition and macrovascular decompression was performed in 12 patients. Evolution in technique was characterized by gradual preference for the far-lateral approach, use of a sling technique with muslin wrap, and an anteromedial direction of pull on the vertebrobasilar artery with clip-assisted tethering to the clival dura. With this technique, mean lateral displacement decreased from 6.6 mm in the first half of the series to 3.8 mm in the last half of the series, and mean anterior displacement increased from 0.8 to 2.5 mm, with corresponding increases in satisfaction and relief of symptoms. Compressive dolichoectatic pathology directed laterally into cranial nerves and posteriorly into the brainstem can be corrected with anteromedial transposition towards the clivus. Our technique accomplishes this anteromedial transposition from an inferolateral surgical approach through the vagoaccessory triangle, with sling fixation to clival dura using aneurysm clips. Copyright © 2017 by the Congress of Neurological Surgeons

The postprocessing techniques in renal artery reconstructions and clinical application with multidetector spiral CT angiography

International Nuclear Information System (INIS)

Yu Yuanxin; Liang Changhong; Zhang Zhonglin; Xie Shufei; Liu Yubao; Tang Xiangzhou

2005-01-01

Objective: To investigate the value and predominance for imaging postprocessing techniques of renal artery variation and lesions by multidetector spiral CT angiography. Methods: 51 patients with renal artery disease including 12 artery variation, 27 artery stenosis, 3 renal anenrysm, 3 thrombosis of renal artery and 3 dissecting aneurysm of renal artery by SSD, MIP and CPR were enrolled. The effectiveness of these imaging postprocessing methods was compared, 29 of them were confirmed by DSA and 3 by operation, others were checked by MRA and follow up. Results: All abnormalities and diseases were cleariy displayed. The specificity and sensitivity were 100% respectively. In the all imaging postprocessing techniques, MPR can clearly display the calcification of the arteries, stenosis, embolism, aneurysm but do not display the anatomy satisfactorily. MIP can not only clearly display the anatomy but display the different configurations. VR can display the artery figures but can not display the information of lumen of blood vessels. SSD can display the complex vessel anatomy but it was influenced by its threshold selection. CPR can spread and display directly the tortuous renal artery and measure the section area of stenosis. Conclusions: MSCTA is helpful to accurately display the renal artery variation and lesions. Both MIP and VR are the best choice to illustrate the renal artery abnormalities. And MPR and SSD are assistant in the diagnosis of' renal artery lesions. (authors)

Effectiveness of relaxation techniques before diagnostic screening of cancer patients

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Montserrat Aiger

2016-07-01

Full Text Available Psychophysiological arousal was observed in cancer patients during the application of relaxation techniques prior to a diagnostic scan (PET-CT. The aim of the study is twofold: firstly, it is sought to establish whether such techniques can minimize patient arousal before diagnostic screening begins, and secondly to measure which of them are most effective. The dependent variable is electrodermal activity, recording the attentional level and emotional response, and the independent variable comprises the relaxation techniques used, namely Jacobson, breathing and visualization. The 39 patients were split into experimental groups to whom the relaxation techniques (Jacobson, breathing exercises, and visualization were applied before they went for the PET-CT. An activity-module procedure was applied to track electrodermal activity during the relaxation sessions, consisting of instructions, timeout; wait, task; relaxation and end of the recording session. The control group received no relaxation techniques before the PET-CT. Session-end results show that patients who perform relaxation techniques achieve greater attentional focus using Jacobson's technique (M = .212 and enhanced emotional containment using visualization (M = .206. It is concluded that relaxation techniques minimize the state of activation during the waiting period before a diagnostic scan.

Rotational digital subtraction angiography of the renal arteries: technique and evaluation in the study of native and transplant renal arteries.

Science.gov (United States)

Seymour, H R; Matson, M B; Belli, A M; Morgan, R; Kyriou, J; Patel, U

2001-02-01

Rotational digital subtraction angiography (RDSA) allows multidirectional angiographic acquisitions with a single injection of contrast medium. The role of RDSA was evaluated in 60 patients referred over a 7-month period for diagnostic renal angiography and 12 patients referred for renal transplant studies. All angiograms were assessed for their diagnostic value, the presence of anomalies and the quantity of contrast medium used. The effective dose for native renal RDSA was determined. 41 (68.3%) native renal RDSA images and 8 (66.7%) transplant renal RDSA images were of diagnostic quality. Multiple renal arteries were identified in 9/41 (22%) native renal RDSA diagnostic images. The mean volume of contrast medium in the RDSA runs was 51.2 ml and 50 ml for native and transplant renal studies, respectively. The mean effective dose for 120 degrees native renal RDSA was 2.36 mSv, equivalent to 1 year's mean background radiation. Those RDSA images that were non-diagnostic allowed accurate prediction of the optimal angle for further static angiographic series, which is of great value in transplant renal vessels.

Diagnostic and prognostic value of non-invasive imaging in known or suspected coronary artery disease

International Nuclear Information System (INIS)

Schuijf, J.D.; Poldermans, D.; Shaw, L.J.; Jukema, J.W.; Wall, E.E. van der; Lamb, H.J.; Roos, A. de; Wijns, W.; Bax, J.J.

2006-01-01

The role of non-invasive imaging techniques in the evaluation of patients with suspected or known coronary artery disease (CAD) has increased exponentially over the past decade. The traditionally available imaging modalities, including nuclear imaging, stress echocardiography and magnetic resonance imaging (MRI), have relied on detection of CAD by visualisation of its functional consequences (i.e. ischaemia). However, extensive research is being invested in the development of non-invasive anatomical imaging using computed tomography or MRI to allow detection of (significant) atherosclerosis, eventually at a preclinical stage. In addition to establishing the presence of or excluding CAD, identification of patients at high risk for cardiac events is of paramount importance to determine post-test management, and the majority of non-invasive imaging tests can also be used for this purpose. The aim of this review is to provide an overview of the available non-invasive imaging modalities and their merits for the diagnostic and prognostic work-up in patients with suspected or known CAD. (orig.)

Dissecting aneurysms of posterior communicating artery itself: anatomical, diagnostic, clinical, and therapeutical considerations.

Science.gov (United States)

Kocak, Burak; Tureci, Ercan; Kizilkilic, Osman; Islak, Civan; Kocer, Naci

2013-09-01

Posterior communicating artery (PCoA) itself is an unusual location for intracranial aneurysms in that isolated dissections or dissecting aneurysms are extremely rare. In the way of correct diagnosis of dissecting aneurysms of PCoA itself, a proper understanding of (1) the anatomy of the PCoA and its perforator branches, (2) some particular diagnostic features, and (3) related clinical aspects is of significant importance. Although there are no established treatment strategies for this particular type of aneurysms, the endovascular approach might be considered as a plausible one. In this paper, our scope was to report five cases with dissecting aneurysm of the PCoA itself and to discuss this rare vascular pathology from anatomical, diagnostic, clinical, and therapeutical perspectives.

A New Technique for Superselective Catheterization of Arteries: Preshaping of a Micro-Guide Wire into a Shepherd's Hook Form

International Nuclear Information System (INIS)

Baek, Jee Hyun; Chung; Jin Wook; Jae, Hwan Jun; Lee, Whal; Park, Jae Hyung

2007-01-01

We wanted to introduce a new technique for superselective catheterization of arteries with preshaping of a micro-guide wire into a shepherd's hook form, and this is useful for superselection of small arteries branching at an acute angle from a large parent artery for the treatment of tumors and hemorrhages. We developed a superselective catheterization technique by using preshaping of a micro-guide wire into a shepherd's hook form. We encountered six patients in our practice for whom we failed to catheterize the small tumor-feeding arteries that branched at an acute angle from wide parent arteries during chemoembolization of hepatocellular carcinoma; the parent arteries were the right inferior phrenic artery (n = 4) and the left gastric artery (n = 1) from the celiac axis with celiac stenosis due to compression by the median arcuate ligament and the proper hepatic artery from the gastroduodenal artery (n = 1) in a patient who had celiac axis occlusion with collateral circulation via the pancreaticoduodenal arcade from the superior mesenteric artery. In these consecutive six patients, we tested the usefulness of this new technique with employing preshaping of a micro-guide wire into a shepherd's hook form for superselective catheterization of targeted vessels. The target arteries were successfully catheterized and satisfactory transcatheter arterial chemoembolization was performed in all six patients. There were no significant complications such as arterial dissection. We developed a technique that is effective for superselection of vessels with preshaping of micro-guide wire into a shepherd's hook hook form, and we successfully applied it during chemoembolization of hepatocellular carcinoma. This technique can be useful for superselection of small arteries that branch from a large parent artery at acute angles for the treatment of tumors and hemorrhages

Efficacy of double arterial phase dynamic magnetic resonance imaging with the sensitivity encoding technique versus dynamic multidetector-row helical computed tomography for detecting hypervascular hepatocellular carcinoma

International Nuclear Information System (INIS)

Kumano, Seishi; Okada, Masahiro; Murakami, Takamichi; Uemura, Masahiko; Haraikawa, Toyoaki; Hirata, Masaaki; Kikuchi, Keiichi; Mochizuki, Teruhito; Kim, Tonsok

2009-01-01

The aim of this study was to evaluate the efficacy of double arterial phase dynamic magnetic resonance imaging (MRI) with the sensitivity encoding technique (SENSE dynamic MRI) for detection of hypervascular hepatocellular carcinoma (HCC) in comparison with double arterial phase dynamic multidetector-row helical computed tomography (dynamic MDCT). A total of 28 patients with 66 hypervascular HCCs underwent both double arterial SENSE dynamic MRI and dynamic MDCT. The diagnosis of HCC was based on surgical resection (n=7), biopsy (n=10), or a combination of CT during arterial portography (CTAP), CT during hepatic arteriography (CTA), and/or the 6-month follow-up CT (n=49). Based on alternative-free response receiving operating characteristic (ROC) analysis, the diagnostic performance for detecting HCC was compared between double arterial phase SENSE dynamic MRI and double arterial phase dynamic MDCT. The mean sensitivity, positive predictive value, and mean A Z values for hypervascular HCCs were 72%, 80%, and 0.79, respectively, for SENSE dynamic MRI and 66%, 92%, and 0.78, respectively, for dynamic MDCT. The mean sensitivity for double arterial phase SENSE dynamic MRI was higher than that for double arterial phase dynamic MDCT, but the difference was not statistically significant. Double arterial phase SENSE dynamic MRI is as valuable as double arterial phase dynamic MDCT for detecting hypervascular HCCs. (author)

Re-implant of the right coronary artery: a surgical technique for the treatment of ostial lesions

Directory of Open Access Journals (Sweden)

Bongiovani Hércules Lisboa

2002-01-01

Full Text Available Previously described surgical treatment for ostial coronary artery stenosis relied on either venous or arterial bypasses or ostial patch angioplasty. These surgical procedures are performed with bovine pericardium, saphenous vein or internal thoracic artery. We describe a technique of right coronary artery re-implantation into the aorta. The procedure was performed in four patients with right coronary artery ostial stenosis along with other left coronary artery lesions.

Cost analysis of procedures related to the management of renal artery stenosis from various perspectives

International Nuclear Information System (INIS)

Helvoort-Postulart, Debby van; Dirksen, Carmen D.; Kessels, Alfons G.H.; Kroon, Abraham A.; Leeuw, Peter W. de; Nelemans, Patricia J.; Engelshoven, Jos M.A. van; Myriam Hunink, M.G.

2006-01-01

To determine the costs associated with the diagnostic work-up and percutaneous revascularization of renal artery stenosis from various perspectives. A prospective multicenter comparative study was conducted between 1998 and 2001. A total of 402 hypertensive patients with suspected renal artery stenosis were included. Costs were assessed of computed tomography angiography (CTA), magnetic resonance angiography (MRA), digital subtraction angiography (DSA), and percutaneous revascularization. From the societal perspective, DSA was the most costly (EUR 1,721) and CTA the least costly diagnostic technique (EUR 424). CTA was the least costly imaging procedure irrespective of the perspective used. The societal costs associated with percutaneous renal artery revascularization ranged from EUR 2,680 to EUR 6,172. Overall the radiology department incurred the largest proportion of the total societal costs. For the management of renal artery stenosis, performing the analysis from different perspectives leads to the same conclusion concerning the least costly diagnostic imaging and revascularization procedure. (orig.)

Comparison between ultrasound guided technique and digital palpation technique for radial artery cannulation in adult patients: An updated meta-analysis of randomized controlled trials.

Science.gov (United States)

Bhattacharjee, Sulagna; Maitra, Souvik; Baidya, Dalim K

2018-03-22

Possible advantages and risks associated with ultrasound guided radial artery cannulation in-comparison to digital palpation guided method in adult patients are not fully known. We have compared ultrasound guided radial artery cannulation with digital palpation technique in this meta-analysis. Meta-analysis of randomized controlled trials. Trials conducted in operating room, emergency department, cardiac catheterization laboratory. PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) were searched (from 1946 to 20th November 2017) to identify prospective randomized controlled trials in adult patients. Two-dimensional ultrasound guided radial artery catheterization versus digital palpation guided radial artery cannulation. Overall cannulation success rate, first attempt success rate, time to cannulation and mean number of attempts to successful cannulation. Odds ratio (OR) and standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval (CI) were calculated for categorical and continuous variables respectively. Data of 1895 patients from 10 studies have been included in this meta- analysis. Overall cannulation success rate was similar between ultrasound guided technique and digital palpation [OR (95% CI) 2.01 (1.00, 4.06); p = 0.05]. Ultrasound guided radial artery cannulation is associated with higher first attempt success rate of radial artery cannulation in comparison to digital palpation [OR (95% CI) 2.76 (186, 4.10); p guided technique with palpation technique. Radial artery cannulation by ultrasound guidance may increase the first attempt success rate but not the overall cannulation success when compared to digital palpation technique. However, results of this meta-analysis should be interpreted with caution due presence of heterogeneity. Copyright © 2018. Published by Elsevier Inc.

Safety and Efficacy of a Novel Technique in the Use of Fractional Flow Reserve in Complex Coronary Artery Lesions

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Wen-Ming He

2015-01-01

Full Text Available Background: Fractional flow reserve (FFR has become an increasingly important index when making decisions with respect to revascularization of coronary artery stenosis. However, the pressure guidewire used in obtaining FFR measurements is difficult to control and manipulate in certain complex coronary artery lesions, resulting in increased fluoroscopy time and contrast dye usage. This study examined a novel (NOV technique for obtaining FFR measurements in hope of easing the difficulties associated with evaluating and treating complex coronary artery lesions. Methods: Fifty-six patients with complex coronary artery lesions were assigned to a conventional (CON FFR technique group or a NOV FFR technique group. The NOV technique involved the use of a balloon and wire exchange within the coronary artery. The fluoroscopy time, contrast dye usage, and FFR-related complications were assessed after completing the FFR measurement procedure for each patient. Results: The median time required for fluoroscopy in the NOV technique group was significantly less than that in the CON technique group; additionally, lesser amounts of contrast dye were used in the NOV technique group (both P 0.05. Conclusions: Compared to the CON technique used for measuring FFR, the new technique reduced the fluoroscopy time and amount of contrast dye used when evaluating complex coronary artery lesions. The new technique did not increase the risk of operation or decrease the success rate.

Electroencephalography as a diagnostic technique for canine neurological diseases

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Wrzosek Marcin

2016-06-01

Full Text Available Electroencephalography (EEG is a non-invasive examination method for the assessment of functional central nervous system (CNS disturbances. In human medicine it has a special importance as a diagnostic tool for epilepsy. Although many studies were done on the use of EEG for diagnostics of canine central nervous system disorders, the technique is still not applied routinely. The purpose of this paper was to review the use of the electroencephalography in canine neurological disorders of central nervous system diagnosis and assess the future perspectives of this technique in veterinary medicine.

Treatment of celiac artery stenosis with interventional techniques

International Nuclear Information System (INIS)

Wang Maoqiang; Wang Zhijun; Liu Fengyong; Wang Zhongpu

2005-01-01

Objective: To present two cases of celiac artery (CA) stenosis treated successfully by interventional technique. Methods: Two patients characterised by chronic upper abdominal pain after eating, associated with weight loss and an epigastric bruit were treated with interventional procedure. The diagnosis was suggested by color Doppler imaging of the celiac axis and confirmed by aortography. One patient possessed the classic triad of median arcuate ligament syndrome (MALS). Arteriosclerosis was found to be responsible for the CA stenosis in another one. The interventional technique consisted of conventional PTA and stent placement in the CA. Results: Abdominal arteriograms in both patients showed severe stenosis (>90%) of CA. The stenotic segments were dilated and stented during the same session. One patient with balloon expandable Palmaz stent placed in the proximal celiac artery, another with 2 wallstents deployed in the CA trunk. The post procedural arteriograms showed good dilation of the lesions with immediate improvement of CA blood flow. Follow-up Doppler ultrasound scans showed normal flow patterns in the CA. Three months after the procedures, their upper gastrointestinal symptoms had resolved and regained body weights. They remained well and free of symptoms, at 16 months and 26 months follow-up, respectively, after the procedure. Conclusions: CA stenosis can successfully be treated with angioplasty and stenting. (authors)

[Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

Science.gov (United States)

Ying, Bin-Wu

2016-11-01

Over the past 20 years,clinical molecular diagnostic technology has made rapid development,and became the most promising field in clinical laboratory medicine.In particular,with the development of genomics,clinical molecular diagnostic methods will reveal the nature of clinical diseases in a deeper level,thus guiding the clinical diagnosis and treatments.Many molecular diagnostic projects have been routinely applied in clinical works.This paper reviews the advances on application of clinical diagnostic techniques in infectious disease,tumor and genetic disorders,including nucleic acid amplification,biochip,next-generation sequencing,and automation molecular system,and so on.

Massive cerebral arterial air embolism following arterial catheterization

Energy Technology Data Exchange (ETDEWEB)

Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)

2005-12-01

Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

Left main coronary artery disease: pathophysiology, diagnosis, and treatment.

Science.gov (United States)

Collet, Carlos; Capodanno, Davide; Onuma, Yoshinobu; Banning, Adrian; Stone, Gregg W; Taggart, David P; Sabik, Joseph; Serruys, Patrick W

2018-06-01

The advent of coronary angiography in the 1960s allowed for the risk stratification of patients with stable angina. Patients with unprotected left main coronary artery disease have an increased risk of death related to the large amount of myocardium supplied by this vessel. Although coronary angiography remains the preferred imaging modality for the evaluation of left main coronary artery stenosis, this technique has important limitations. Angiograms of the left main coronary artery segment can be difficult to interpret, and almost one-third of patients can be misclassified when fractional flow reserve is used as the reference. In patients with clinically significant unprotected left main coronary artery disease, surgical revascularization was shown to improve survival compared with medical therapy and has been regarded as the treatment of choice for unprotected left main coronary artery disease. Two large-scale clinical trials published in 2016 support the usefulness of catheter-based revascularization in selected patients with unprotected left main coronary artery disease. In this Review, we describe the pathophysiology of unprotected left main coronary artery disease, discuss diagnostic approaches in light of new noninvasive and invasive imaging techniques, and detail risk stratification models to aid the Heart Team in the decision-making process for determining the best revascularization strategy for these patients.

Technique of infrared synchrotron acceleration diagnostics

International Nuclear Information System (INIS)

Mal'tsev, A.A.; Mal'tsev, M.A.

1997-01-01

Techniques of measuring of current and geometric parameters and evaluating of energy parameters of the ring bunch of relativistic low-energy electrons have been presented. They have been based on using the synchrotron radiation effect in its infrared spectral part. Fast infrared detectors have provided radiation detection in the spectral range Δλ ≅ 0.3-45 μm. The descriptions of some data monitoring and measuring systems developed in JINR for the realization of techniques of the infrared synchrotron acceleration diagnostics have been given. Infrared optics elements specially developed have been used in these systems

Pulmonary Artery Size in Interstitial Lung Disease and Pulmonary Hypertension: Association with Interstitial Lung Disease Severity and Diagnostic Utility

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Matthew Chin

2018-06-01

Full Text Available PurposeIt is postulated that ILD causes PA dilatation independent of the presence of pulmonary hypertension (PH, so the use of PA size to screen for PH is not recommended. The aims of this study were to investigate the association of PA size with the presence and severity of ILD and to assess the diagnostic accuracy of PA size for detecting PH.MethodsIncident patients referred to a tertiary PH centre underwent baseline thoracic CT, MRI and right heart catheterisation (RHC. Pulmonary artery diameter was measured on CT pulmonary angiography and pulmonary arterial areas on MRI. A thoracic radiologist scored the severity of ILD on CT from 0 to 4, 0 = absent, 1 = 1–25%, 2 = 26–50%, 3 = 51–75%, and 4 = 76–100% extent of involvement. Receiver operating characteristic analysis and linear regression were employed to assess diagnostic accuracy and independent associations of PA size.Results110 had suspected PH due to ILD (age 65 years (SD 13, M:F 37:73 and 379 had suspected PH without ILD (age 64 years (SD 13, M:F 161:218. CT derived main PA diameter was accurate for detection of PH in patients both with and without ILD - AUC 0.873, p =< 0.001, and AUC 0.835, p =< 0.001, respectively, as was MRI diastolic PA area, AUC 0.897, p =< 0.001, and AUC 0.857, p =< 0.001, respectively Significant correlations were identified between mean pulmonary arterial pressure (mPAP and PA diameter in ILD (r = 0.608, p < 0.001, and non-ILD cohort (r = 0.426, p < 0.001. PA size was independently associated with mPAP (p < 0.001 and BSA (p = 0.001, but not with forced vital capacity % predicted (p = 0.597, Transfer factor of the lungs for carbon monoxide (TLCO % predicted (p = 0.321 or the presence of ILD on CT (p = 0.905. The severity of ILD was not associated with pulmonary artery dilatation (r = 0.071, p = 0.459.ConclusionsPulmonary arterial pressure elevation leads to pulmonary arterial dilation, which is not independently influenced by the presence or severity of

Development of a New Technique for Reconstruction of Hepatic Artery during Liver Transplantation in Sprague-Dawley Rat.

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Xingmu Liu

Full Text Available Sleeve anastomosis is the most common technique used to rearterialize orthotopic liver transplants (OLT. However, this technique has a number of disadvantages, including difficulty of performance of the technique visually unaided. We herein describe a novel rearterialized OLT model in the rat.Forty-six male Sprague Dawley rats (300-400 g were used as donors and recipients. Based on Kamada's cuff technique, the new model involved performing a modified "sleeve" anastomosis between the celiac trunk of the donor and common hepatic artery of the recipient to reconstruct blood flow to the hepatic artery. An additional ten male Sprague Dawley rats underwent liver transplantation without artery reconstruction. Liver grafts were retrieved from the two groups and histological examination was performed following surgery.Total mean operating times were ~42 minutes for the donor liver extraction and 57 minutes for the recipient transplantation. Graft preparation took an additional 15 minutes and the time to fix the arterial bracket was ~3 minutes. During transplantation, the anhepatic phase lasted 18 ± 2.5 min and the artery reconstruction only required ~3 minutes. The patency rate was 94.44% and the 4-week survival rate was 90%. Histology indicated obvious fibrosis in the liver grafts without artery reconstruction, while normal histology was observed in the arterialized graft.This new method allows for the surgical procedure to be performed visually unaided with good survival and patency rates and represents an alternative model investigating OLT in rats.

Feasibility and Diagnostic Accuracy of Whole Heart Coronary MR Angiography Using Free-Breathing 3D Balanced Turbo-Field-Echo with SENSE and the Half-Fourier Acquisition Technique

International Nuclear Information System (INIS)

Kim, Young Jin; Seo, Jae Seung; Choi, Byoung Wook; Choe, Kyu Ok; Jang, Yang Soo; Ko, Young Guk

2006-01-01

We wanted to assess the feasibility and diagnostic accuracy of whole heart coronary magnetic resonance angiography (MRA) with using 3D balanced turbo-field-echo (b-TFE) with SENSE and the half-Fourier acquisition technique for identifying stenoses of the coronary artery. Twenty-one patients who underwent both whole heart coronary MRA examinations and conventional catheter coronary angiography examinations were enrolled in the study. The whole heart coronary MRA images were acquired using a navigator gated 3D b-TFE sequence with SENSE and the half-Fourier acquisition technique to reduce the acquisition time. The imaging slab covered the whole heart (80 contiguous slices with a reconstructed slice thickness of 1.5 mm) along the transverse axis. The quality of the images was evaluated by using a 5-point scale (0 - uninterpretable, 1 - poor, 2 - fair, 3 - good, 4 - excellent). Ten coronary segments of the heart were evaluated in each case; the left main coronary artery (LM), and the proximal, middle and distal segments of the left anterior descending (LAD), the left circumflex (LCX) and the right coronary artery (RCA). The diagnostic accuracy of whole heart coronary MRA for detecting significant coronary artery stenosis was determined on the segment-bysegment basis, and it was compared with the results obtained by conventional catheter angiography, which is the gold standard. The mean image quality was 3.7 in the LM, 3.2 in the LAD, 2.5 in the LCX, and 3.3 in the RCA, respectively (the overall image quality was 3.0 ± 0.1). 168 (84%) of the 201 segments had an acceptable image quality (≥ grade 2). The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of the whole heart coronary MRA images for detecting significant stenosis were 81.3%, 92.1%, 91.1%, 97.9%, and 52.0%, respectively. The mean coronary MRA acquisition time was 9 min 22 sec (± 125 sec). Whole heart coronary MRA is a feasible technique, and it has good potential to

Three dimensional imaging technique for laser-plasma diagnostics

International Nuclear Information System (INIS)

Jiang Shaoen; Zheng Zhijian; Liu Zhongli

2001-01-01

A CT technique for laser-plasma diagnostic and a three-dimensional (3D) image reconstruction program (CT3D) have been developed. The 3D images of the laser-plasma are reconstructed by using a multiplication algebraic reconstruction technique (MART) from five pinhole camera images obtained along different sight directions. The technique has been used to measure the three-dimensional distribution of X-ray of laser-plasma experiments in Xingguang II device, and the good results are obtained. This shows that a CT technique can be applied to ICF experiments

Three dimensional imaging technique for laser-plasma diagnostics

Energy Technology Data Exchange (ETDEWEB)

Shaoen, Jiang; Zhijian, Zheng; Zhongli, Liu [China Academy of Engineering Physics, Chengdu (China)

2001-04-01

A CT technique for laser-plasma diagnostic and a three-dimensional (3D) image reconstruction program (CT3D) have been developed. The 3D images of the laser-plasma are reconstructed by using a multiplication algebraic reconstruction technique (MART) from five pinhole camera images obtained along different sight directions. The technique has been used to measure the three-dimensional distribution of X-ray of laser-plasma experiments in Xingguang II device, and the good results are obtained. This shows that a CT technique can be applied to ICF experiments.

A New Technique for Superselective Catheterization of Arteries: Preshaping of a Micro-Guide Wire into a Shepherd's Hook Form

Energy Technology Data Exchange (ETDEWEB)

Baek, Jee Hyun; Chung; Jin Wook; Jae, Hwan Jun; Lee, Whal; Park, Jae Hyung [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2007-06-15

We wanted to introduce a new technique for superselective catheterization of arteries with preshaping of a micro-guide wire into a shepherd's hook form, and this is useful for superselection of small arteries branching at an acute angle from a large parent artery for the treatment of tumors and hemorrhages. We developed a superselective catheterization technique by using preshaping of a micro-guide wire into a shepherd's hook form. We encountered six patients in our practice for whom we failed to catheterize the small tumor-feeding arteries that branched at an acute angle from wide parent arteries during chemoembolization of hepatocellular carcinoma; the parent arteries were the right inferior phrenic artery (n = 4) and the left gastric artery (n = 1) from the celiac axis with celiac stenosis due to compression by the median arcuate ligament and the proper hepatic artery from the gastroduodenal artery (n = 1) in a patient who had celiac axis occlusion with collateral circulation via the pancreaticoduodenal arcade from the superior mesenteric artery. In these consecutive six patients, we tested the usefulness of this new technique with employing preshaping of a micro-guide wire into a shepherd's hook form for superselective catheterization of targeted vessels. The target arteries were successfully catheterized and satisfactory transcatheter arterial chemoembolization was performed in all six patients. There were no significant complications such as arterial dissection. We developed a technique that is effective for superselection of vessels with preshaping of micro-guide wire into a shepherd's hook hook form, and we successfully applied it during chemoembolization of hepatocellular carcinoma. This technique can be useful for superselection of small arteries that branch from a large parent artery at acute angles for the treatment of tumors and hemorrhages.

A REVIEW ON DIAGNOSTIC TECHNIQUES FOR BRUCELLOSIS

African Journals Online (AJOL)

User

2014-01-01

Jan 1, 2014 ... Brucellosis presents with many clinical manifestation that make its diagnosis a difficult task. Ever since the report of the first serologic test for brucellosis, a definitive diagnostic technique has been actively pursued. The most widely used methods of diagnosis are based on serology, which measures the.

Novel non-intercepting diagnostic techniques for low-emittance relativistic electron beams

International Nuclear Information System (INIS)

Moran, M.J.; Chang, B.

1988-01-01

Relativistic electron beams are being generated with emittances low enough that diffraction radiation can be used for beam diagnostics. Techniques based on diffraction radiation can be used to measure the beam transverse momentum distribution and to measure the transverse spatial distribution. The radiation is intense and can be in the visible spectral region where optical diagnostic techniques can be used to maximum advantage. 4 refs. 3 figs

The Awareness of Health Professionals in Diagnostic Techniques ...

African Journals Online (AJOL)

hanumantp

clear that most reviewed articles used the same conventional methods in ... Knowledge about the possible correlation of occult blood with reasons other than ... diagnostic techniques used in the examination of intestinal parasites in Gaza Strip.

Adaptive techniques for diagnostics of vibrating structures

International Nuclear Information System (INIS)

Skormin, V.A.; Sankar, S.

1983-01-01

An adaptive diagnostic procedure for vibrating structures based on correspondence between current estimates of stiffness matrix and structure status is proposed. Procedure employs adaptive mathematical description of the vibrating structure in frequency domain, statistical techniques for detection and location of changes of structure properties, 'recognition' and prediction of defects. (orig.)

Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

DEFF Research Database (Denmark)

Sørgaard, Mathias; Linde, Jesper James; Kofoed, Klaus Fuglsang

2016-01-01

OBJECTIVES: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. ...... useful tool in risk-stratifying patients with acute-onset chest pain at a low-to-intermediate risk of having CAD. Adding a stress test to PTP does not appear to offer significant diagnostic benefit.......OBJECTIVES: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. We...... investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. METHODS: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We...

Evaluation of the supraaortic arteries using non-contrast-enhanced Velocity MR Angiography ''Inhance''

Energy Technology Data Exchange (ETDEWEB)

Lummel, Nina; Lutz, Juergen; Linn, Jennifer [University of Munich (LMU), Department of Neuroradiology, Munich (Germany); Boeckh-Behrens, Tobias [Technical University Munich, Department of Neuroradiology, Munich (Germany); Burke, Michael [GE Healthcare, Solingen (Germany)

2012-11-15

The aim of this study was to compare the recently developed phase contrast-based Inhance 3D Velocity magnetic resonance angiography technique (Inhance) to the contrast-enhanced standard method (CE-MRA) in the evaluation of the supraaortic arteries. Inhance and CE-MRA were performed in ten consecutive patients with a suspected pathology of the supraaortic arteries on a 3-T MR scanner. Two neuroradiologists evaluated in consensus both sequences regarding the visualisation of the supraaortic arteries and their segments on a five-point score. Diagnostic certainty regarding the overall presence of a vascular pathology was rated on the same five-point score. On CE-MRA as well as on Inhance, a vascular pathology of the supraaortic arteries was detected in seven patients. There was no statistically significant difference in the overall diagnostic certainty regarding the presence or absence of pathologic findings for CE-MRA compared to Inhance. Furthermore, no statistically significant difference was found with regard to visualisation of the distal cervical and intracranial arterial segments, while CE-MRA was superior to Inhance in the visualisation of the origins of the cervical vessels from the aortic arch. Non-contrast Inhance proved useful in the evaluation of the supraaortic arteries with limited assessment of the proximal supraaortic branches. Hence, this technique features a valuable alternative to CE-MRA in the visualisation of the supraaortic arteries, particularly in patients with renal insufficiency. (orig.)

Stent placement with the monorail technique for treatment of mesenteric artery stenosis.

Science.gov (United States)

Schaefer, Philipp J; Schaefer, Fritz K W; Hinrichsen, Holger; Jahnke, Thomas; Charalambous, Nikolas; Heller, Martin; Mueller-Huelsbeck, Stefan

2006-04-01

To analyze the immediate and midterm success of stenting of mesenteric arteries by a monorail technique in patients with chronic mesenteric ischemia. In this prospective case series, 19 patients (11 male, 8 female; mean age, 62.9 +/- 10.4 y; range, 36-82 y) with 23 symptomatic stenoses of mesenteric arteries were treated with stent placement by a monorail technique in a radiologic intervention center over a period of 4.5 years. Clinical examinations and duplex sonography were used to evaluate the stents' patency and clinical success. Kaplan-Meier graphs were calculated to analyze the patency and freedom-from-symptom rate. Initial technical success rate was 22/23 (96%). Mean follow-up was 17 months (range, 1-58 mo). Primary patency and primary clinical success rates were 82% and 78%, respectively. According to Kaplan-Meier tables, the patency rates were 96%, 87%, 76%, and 61% at 0, 1, 15, and 24 months, respectively, and the freedom-from-symptom rates were 95%, 90%, 72%, and 54% at 0, 1, 24, and 30 months, respectively. No peri-interventional complications occurred. Two patients died of cardiac failure in the hospital within 30 days after intervention; deaths were not related to the intervention. Stent placement by a monorail technique in mesenteric arteries is an effective and safe treatment for symptomatic stenoses in patients with chronic mesenteric ischemia after a mean follow-up of 17 months.

Progress in diagnostic techniques for SC [superconducting] cavities

International Nuclear Information System (INIS)

Reece, C.E.

1988-01-01

Despite the very real progress that has been made, the routine performance of superconducting cavities still falls far short of both the theoretical expectations and the performance of afew exceptional examples. It is the task of systematically applied diagnostic techniques to reveal additional information concerning the response of superconducting surfaces to applied RF fields. In this paper we will direct our attention to discussions of recent developments in diagnostic techniqeus, such as thermometry in superfluid helium, and scanning laser acoustic microscopy. 18 refs., 12 figs

The radiation protection optimisation in contrast X-ray diagnostic techniques

International Nuclear Information System (INIS)

Markovic, S.; Pavlovic, R.

1995-01-01

In the class of artificial sources, X-ray diagnostic techniques irradiate global population with more than 90 % share in total dose. At the same time this is the only area with high possibilities in collective dose reduction without important investments. Exposure of the medical team is mainly related to unnecessary irradiation. Eliminating this unnecessary irradiation quality of diagnostic information remains undisturbed. From the radiation protection point of view the most critical X-ray diagnostic method is angiography. This paper presents the radiation protection optimisation calculation of the protective lead thickness using the Cost - Benefit analysis technique. The obtained numerical results are based on calculated collective dose, the estimated prices of the lead and lead glass thickness and the adopted price for monetary value of the collective dose unit α. (author) 3 figs., 10 refs

The radiation protection optimisation in contrast X-ray diagnostic techniques

Energy Technology Data Exchange (ETDEWEB)

Markovic, S; Pavlovic, R [Inst. of Nuclear Science Vinca, Belgrade (Yugoslavia). Radiation and Environmental Protection Lab.; Boreli, F [Fac. of Electrical Engineering, Belgrade (Yugoslavia)

1996-12-31

In the class of artificial sources, X-ray diagnostic techniques irradiate global population with more than 90 % share in total dose. At the same time this is the only area with high possibilities in collective dose reduction without important investments. Exposure of the medical team is mainly related to unnecessary irradiation. Eliminating this unnecessary irradiation quality of diagnostic information remains undisturbed. From the radiation protection point of view the most critical X-ray diagnostic method is angiography. This paper presents the radiation protection optimisation calculation of the protective lead thickness using the Cost - Benefit analysis technique. The obtained numerical results are based on calculated collective dose, the estimated prices of the lead and lead glass thickness and the adopted price for monetary value of the collective dose unit {alpha}. (author) 3 figs., 10 refs.

Identification of coronary artery anatomy on dual-source cardiac computed tomography before arterial switch operation in newborns and young infants. Comparison with transthoracic echocardiography

International Nuclear Information System (INIS)

Goo, Hyun Woo

2018-01-01

Considering inherent limitations of transthoracic echocardiography, the diagnostic accuracy of cardiac CT in identifying coronary artery anatomy before arterial switch operation needs to be investigated with recently improved coronary artery visibility using electrocardiogram (ECG)-synchronized dual-source CT. To compare diagnostic accuracy between cardiac CT using a dual-source scanner and transthoracic echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. The study included 101 infants (median age 4 days, range 0 days to 10 months; M:F=78:23) who underwent ECG-synchronized cardiac dual-source CT and transthoracic echocardiography before arterial switch operation between July 2011 and December 2016. We evaluated and classified coronary artery anatomy on cardiac CT and transthoracic echocardiography. With the surgical findings as the reference standard, we compared the diagnostic accuracy for identifying coronary artery anatomy between cardiac CT and transthoracic echocardiography. The most common coronary artery pattern was the usual pattern (left coronary artery from sinus 1 and right coronary artery from sinus 2; 64.4%, 65/101), followed by a single coronary artery from sinus 2 and a conal branch from sinus 1 (7.9%, 8/101), the inverted pattern (5.9%, 6/101), the right coronary artery and left anterior descending artery from sinus 1 and the left circumflex artery from sinus 2 (5.9%, 6/101), and others. In 96 infants with surgically proven coronary artery anatomy, the diagnostic accuracy of cardiac CT was significantly higher than that of transthoracic echocardiography (91.7%, 88/96 vs. 54.2%, 52/96; P<0.0001). Diagnostic accuracy of cardiac CT is significantly higher than that of echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. (orig.)

Identification of coronary artery anatomy on dual-source cardiac computed tomography before arterial switch operation in newborns and young infants. Comparison with transthoracic echocardiography

Energy Technology Data Exchange (ETDEWEB)

Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

2018-02-15

Considering inherent limitations of transthoracic echocardiography, the diagnostic accuracy of cardiac CT in identifying coronary artery anatomy before arterial switch operation needs to be investigated with recently improved coronary artery visibility using electrocardiogram (ECG)-synchronized dual-source CT. To compare diagnostic accuracy between cardiac CT using a dual-source scanner and transthoracic echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. The study included 101 infants (median age 4 days, range 0 days to 10 months; M:F=78:23) who underwent ECG-synchronized cardiac dual-source CT and transthoracic echocardiography before arterial switch operation between July 2011 and December 2016. We evaluated and classified coronary artery anatomy on cardiac CT and transthoracic echocardiography. With the surgical findings as the reference standard, we compared the diagnostic accuracy for identifying coronary artery anatomy between cardiac CT and transthoracic echocardiography. The most common coronary artery pattern was the usual pattern (left coronary artery from sinus 1 and right coronary artery from sinus 2; 64.4%, 65/101), followed by a single coronary artery from sinus 2 and a conal branch from sinus 1 (7.9%, 8/101), the inverted pattern (5.9%, 6/101), the right coronary artery and left anterior descending artery from sinus 1 and the left circumflex artery from sinus 2 (5.9%, 6/101), and others. In 96 infants with surgically proven coronary artery anatomy, the diagnostic accuracy of cardiac CT was significantly higher than that of transthoracic echocardiography (91.7%, 88/96 vs. 54.2%, 52/96; P<0.0001). Diagnostic accuracy of cardiac CT is significantly higher than that of echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. (orig.)

Dental diagnostics using optical coherence techniques

Energy Technology Data Exchange (ETDEWEB)

Nathel, H. [Lawrence Livermore National Lab., CA (United States); Colston, B. [Univ. of California, San Francisco, CA (United States); Armitage, G. [Univ. of California, Davis, CA (United States)] [and others

1994-11-15

Optical radiation can be used for diagnostic purposes in oral medicine. However, due to the turbid, amorphous, and inhomogeneous nature of dental tissue conventional techniques used to transilluminate materials are not well suited to dental tissues. Optical coherence techniques either in the time- of frequency-domain offer the capabilities of discriminating scattered from unscattered light, thus allowing for imaging through turbid tissue. Currently, using optical time-domain reflectometry we are able to discriminate specular from diffuse reflections occurring at tissue boundaries. We have determined the specular reflectivity of enamel and dentin to be approximately 6.6 x 10{sup -5} and 1.3 x 10{sup -6}, respectively. Implications to periodontal imaging will be discussed.

Improved diagnostic performance of exercise thallium-201 single photon emission computed tomography over planar imaging in the diagnosis of coronary artery disease: a receiver operating characteristic analysis

International Nuclear Information System (INIS)

Fintel, D.J.; Links, J.M.; Brinker, J.A.; Frank, T.L.; Parker, M.; Becker, L.C.

1989-01-01

Qualitative interpretation of tomographic and planar scintigrams, a five point rating scale and receiver operating characteristic analysis were utilized to compare single photon emission computed tomography and conventional planar imaging of myocardial thallium-201 uptake in the accuracy of the diagnosis of coronary artery disease and individual vessel involvement. One hundred twelve patients undergoing cardiac catheterization and 23 normal volunteers performed symptom-limited treadmill exercise, followed by stress and redistribution imaging by both tomographic and planar techniques, with the order determined randomly. Paired receiver operating characteristic curves revealed that single photon emission computed tomography was more accurate than planar imaging over the entire range of decision thresholds for the overall detection and exclusion of coronary artery disease and involvement of the left anterior descending and left circumflex coronary arteries. Tomography offered relatively greater advantages in male patients and in patients with milder forms of coronary artery disease, who had no prior myocardial infarction, only single vessel involvement or no lesion greater than or equal to 50 to 69%. Tomography did not appear to provide improved diagnosis in women or in detection of disease in the right coronary artery. Although overall detection of coronary artery disease was not improved in patients with prior myocardial infarction, tomography provided improved identification of normal and abnormal vascular regions. These results indicate that single photon emission computed tomography provides improved diagnostic performance compared with planar imaging in many clinical subgroups

New diagnostic technique for Zeeman-compensated atomic beam slowing: technique and results

OpenAIRE

Molenaar, P.A.; Straten, P. van der; Heideman, H.G.M.; Metcalf, H.

1997-01-01

We have developed a new diagnostic tool for the study of Zeeman-compensated slowing of an alkali atomic beam. Our time-of-flight technique measures the longitudinal veloc- ity distribution of the slowed atoms with a resolution below the Doppler limit of 30 cm/s. Furthermore, it can map the position and velocity distribution of atoms in either ground hyperfine level inside the solenoid without any devices inside the solenoid. The technique reveals the optical pumping ef- fects, and shows in de...

Diagnostic value of early post-exercise 99Tcm-MIBI ECG-gated myocardial perfusion imaging in severe coronary artery disease

International Nuclear Information System (INIS)

Li Dianfu; Huang Jun; Feng Jianlin; Cheng Xu; Li Xinli; Cao Kejiang

2005-01-01

Objective: To study and compare the diagnostic value in severe coronary artery disease (CAD) of 99 Tc m -methoxyisobutylisonitrile (MIBI) electrocardiogram (ECG)-gated early post-exercise myocardial perfusion imaging (G-MPI) with that of non-ECG-gated myocardial perfusion imaging (NG-MPI). Methods: Two hundred and fifteen suspected CAD patients had undergone G-MPI and coronary artery angiography (CAG) within one month were enrolled and distributed into three-vessel and non-three-vessel CAD groups according to CAG results (≥70%); the diagnostic values in severe CAD of G-MPI and NG-MPI were gained and compared to determine which one of the two protocols would be superior in identification of severe three-vessel CAD. Results: When the ≥70% diameter stenosis CAG was the diagnostic standard of severe CAD, the sensitivity of G-MPI and NG-MPI in the diagnosis of severe CAD were 95.3% (143/150) and 90.7% (136/150, χ 2 =2.509, P=0.113), but when the comparison specifically pinpointed to severe three-vessel CAD, there was significant difference between G-MPI [100%(51/51)] and NG-MPI [92.2% (47/51), χ 2 =4.163, P=0.041]. Diagnostic specificity of G-MPI was 80.0% and that of NG-MPI was 72.3% (χ 2 =1.059, P=0.303). Conclusions: The incremental diagnostic sensitivity of G-MPI adding to the NG-MPI in the diagnosis of severe CAD was mainly from the three-vessel subgroup patients. Exercise stress G-MPI has better diagnostic value in severe three-vessel CAD patients than NG-MPI. (authors)

New diagnostic technique for Zeeman-compensated atomic beam slowing: technique and results

NARCIS (Netherlands)

Molenaar, P.A.; Straten, P. van der; Heideman, H.G.M.; Metcalf, H.

1997-01-01

We have developed a new diagnostic tool for the study of Zeeman-compensated slowing of an alkali atomic beam. Our time-of-flight technique measures the longitudinal veloc- ity distribution of the slowed atoms with a resolution below the Doppler limit of 30 cm/s. Furthermore, it can map

Machine Learning Techniques for Arterial Pressure Waveform Analysis

Directory of Open Access Journals (Sweden)

João Cardoso

2013-05-01

Full Text Available The Arterial Pressure Waveform (APW can provide essential information about arterial wall integrity and arterial stiffness. Most of APW analysis frameworks individually process each hemodynamic parameter and do not evaluate inter-dependencies in the overall pulse morphology. The key contribution of this work is the use of machine learning algorithms to deal with vectorized features extracted from APW. With this purpose, we follow a five-step evaluation methodology: (1 a custom-designed, non-invasive, electromechanical device was used in the data collection from 50 subjects; (2 the acquired position and amplitude of onset, Systolic Peak (SP, Point of Inflection (Pi and Dicrotic Wave (DW were used for the computation of some morphological attributes; (3 pre-processing work on the datasets was performed in order to reduce the number of input features and increase the model accuracy by selecting the most relevant ones; (4 classification of the dataset was carried out using four different machine learning algorithms: Random Forest, BayesNet (probabilistic, J48 (decision tree and RIPPER (rule-based induction; and (5 we evaluate the trained models, using the majority-voting system, comparatively to the respective calculated Augmentation Index (AIx. Classification algorithms have been proved to be efficient, in particular Random Forest has shown good accuracy (96.95% and high area under the curve (AUC of a Receiver Operating Characteristic (ROC curve (0.961. Finally, during validation tests, a correlation between high risk labels, retrieved from the multi-parametric approach, and positive AIx values was verified. This approach gives allowance for designing new hemodynamic morphology vectors and techniques for multiple APW analysis, thus improving the arterial pulse understanding, especially when compared to traditional single-parameter analysis, where the failure in one parameter measurement component, such as Pi, can jeopardize the whole evaluation.

Anomalous Systemic Artery to the Left Lower Lobe: Literature Review and a New Surgical Technique.

Science.gov (United States)

Miller, Jacob R; Lancaster, Timothy S; Abarbanell, Aaron M; Manning, Peter B; Eghtesady, Pirooz

2018-05-01

Anomalous systemic arterial supply to the basal segments of the left lower lobe without coexisting pulmonary artery connection is a rare anomaly. Most feel treatment is necessary; however, the ideal strategy is unclear. Treatments described include embolization, pulmonary resection, or anastomosis to the native pulmonary artery. We recently encountered an infant with this anomaly and present a literature review summarizing all recent reports. Additionally, we describe a novel surgical technique to create a tension-free anastomosis utilizing segmental aortic translocation that we employed in our patient due to a large distance between the anomalous vessel and native left pulmonary artery.

Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow

OpenAIRE

Chung, Joon Ho; Shin, Yong Sam; Lim, Yong Cheol; Park, Minjung

2009-01-01

Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. F...

A Hybrid Neural Network-Genetic Algorithm Technique for Aircraft Engine Performance Diagnostics

Science.gov (United States)

Kobayashi, Takahisa; Simon, Donald L.

2001-01-01

In this paper, a model-based diagnostic method, which utilizes Neural Networks and Genetic Algorithms, is investigated. Neural networks are applied to estimate the engine internal health, and Genetic Algorithms are applied for sensor bias detection and estimation. This hybrid approach takes advantage of the nonlinear estimation capability provided by neural networks while improving the robustness to measurement uncertainty through the application of Genetic Algorithms. The hybrid diagnostic technique also has the ability to rank multiple potential solutions for a given set of anomalous sensor measurements in order to reduce false alarms and missed detections. The performance of the hybrid diagnostic technique is evaluated through some case studies derived from a turbofan engine simulation. The results show this approach is promising for reliable diagnostics of aircraft engines.

Evaluation of techniques for inspection and diagnostics of HWR pressure tubes

International Nuclear Information System (INIS)

Choi, Jong-Ho

2008-01-01

Efficient and accurate inspection and diagnostic techniques for various reactor components and systems, especially pressure tubes for Heavy Water Reactors (HWRs), are an important factor in assuring reliable and safe plant operation. To foster international collaboration in the efficient and safe use of nuclear power, the IAEA conducted a Coordinated Research Project (CRP) on Inter-comparison of Techniques for HWR Pressure Tube Inspection and Diagnostics. The objective of the CRP was to inter-compare inspection and diagnostic techniques, in use and being developed, for structural integrity assessment of HWR pressure tubes. During the first phase of the CRP, participants investigated the capability of different techniques to detect and characterize flaws. During the second phase, participants collaborated to determine the hydrogen concentration and to detect and characterize hydride blisters in zirconium alloy pressure tubes. Eight organizations from six countries, which operate HWRs, have participated in this CRP, Most of the techniques examined are well established and many of them are regularly used during in-service inspection of pressure tubes. The inter-comparison of these techniques provides a platform for identifying a particular technique (or a set of techniques), which is more accurate and reliable as compared to others for a specified task. The CRP also witnessed some new methodologies, which can be implemented on in-service inspection tools. These new techniques could complement the existing ones to overcome their limitations, thereby improving the reliability and accuracy of in-service inspection. This CRP also identified future areas of research and development. (author)

Validation of a basic neurosonology laboratory for detecting cervical carotid artery stenosis.

Science.gov (United States)

de la Cruz Cosme, C; Dawid Milner, M S; Ojeda Burgos, G; Gallardo Tur, A; Márquez Martínez, M; Segura, T

2017-03-24

Most of the cases of ischaemic stroke in our setting are of atherothrombotic origin. Detecting intracranial and cervical carotid artery stenosis in patients with ischaemic stroke is therefore essential. Ultrasonography has become the tool of choice for diagnosing carotid artery stenosis because it is both readily accessibility and reliable. However, use of this technique must be validated in each laboratory. The purpose of this study is to validate Doppler ultrasound in our laboratory as a means of detecting severe carotid artery stenosis. We conducted an observational descriptive study to evaluate diagnostic tests. The results from transcranial and cervical carotid Doppler ultrasound scans conducted by neurologists were compared to those from carotid duplex scans performed by radiologists in patients diagnosed with stroke. Arteriography was considered the gold standard (MR angiography, CT angiography, or conventional arteriography). Our sample included 228 patients. Transcranial and cervical carotid Doppler ultrasound showed a sensitivity of 95% and specificity of 100% for detection of carotid artery stenosis > 70%, whereas carotid duplex displayed a sensitivity of 87% and a specificity of 94%. Transcranial carotid Doppler ultrasound achieved a sensitivity of 78% and a specificity of 98% for detection of intracranial stenosis. Doppler ultrasound in our neurosonology laboratory was found to be a useful diagnostic tool for detecting cervical carotid artery stenosis and demonstrated superiority to carotid duplex despite the lack of B-mode. Furthermore, this technique was found to be useful for detecting intracranial stenosis. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

Energy Technology Data Exchange (ETDEWEB)

Coenen, Adriaan; Lubbers, Marisa M.; Dedic, Admir; Chelu, Raluca G.; Geuns, Robert-Jan M. van; Nieman, Koen [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, Rotterdam (Netherlands); Kurata, Akira; Kono, Atsushi; Dijkshoorn, Marcel L. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Rossi, Alexia [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Barts Health NHS Trust, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London and Department of Cardiology, London (United Kingdom)

2017-06-15

To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model. An absolute MBF value was measured in the suspected perfusion defect. TPR was defined as the ratio between the subendocardial and subepicardial MBF. TPR and MBF results were compared with invasive FFR using a threshold of 0.80. Forty-three patients and 94 territories were analysed. The area under the receiver operator curve was larger for MBF (0.78) compared with TPR (0.65, P = 0.026). No significant differences were found in diagnostic classification between MBF and TPR with a territory-based accuracy of 77 % (67-86 %) for MBF compared with 70 % (60-81 %) for TPR. Combined MBF and TPR classification did not improve the diagnostic classification. Dynamic CT-MPI-based transmural perfusion ratio predicts haemodynamically significant coronary artery disease. However, diagnostic performance of dynamic CT-MPI-derived TPR is inferior to quantified MBF and has limited incremental value. (orig.)

Reliability of diagnostic imaging techniques in suspected acute appendicitis: proposed diagnostic protocol

International Nuclear Information System (INIS)

Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M.

2001-01-01

To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs

Contrast-enhanced peripheral MRA. Technique and contrast agents

International Nuclear Information System (INIS)

Nielsen, Yousef W.; Thomsen, Henrik S.

2012-01-01

In the last decade contrast-enhanced magnetic resonance angiography (CE-MRA) has gained wide acceptance as a valuable tool in the diagnostic work-up of patients with peripheral arterial disease. This review presents current concepts in peripheral CE-MRA with emphasis on MRI technique and contrast agents. Peripheral CE-MRA is defined as an MR angiogram of the arteries from the aortic bifurcation to the feet. Advantages of CE-MRA include minimal invasiveness and lack of ionizing radiation. The basic technique employed for peripheral CE-MRA is the bolus-chase method. With this method a paramagnetic MRI contrast agent is injected intravenously and T1-weighted images are acquired in the subsequent arterial first-pass phase. In order to achieve high quality MR angiograms without interfering venous contamination or artifacts, a number of factors need to be taken into account. This includes magnetic field strength of the MRI system, receiver coil configuration, use of parallel imaging, contrast bolus timing technique, and k-space filling strategies. Furthermore, it is possible to optimize peripheral CE-MRA using venous compression techniques, hybrid scan protocols, time-resolved imaging, and steady-state MRA. Gadolinium(Gd)-based contrast agents are used for CE-MRA of the peripheral arteries. Extracellular Gd agents have a pharmacokinetic profile similar to iodinated contrast media. Accordingly, these agents are employed for first-pass MRA. Blood-pool Gd-based agents are characterized by prolonged intravascular stay, due to macromolecular structure or protein binding. These agents can be used for first-pass, as well as steady-state MRA. Some Gd-based contrast agents with low thermodynamic stability have been linked to development of nephrogenic systemic fibrosis in patients with severe renal insufficiency. Using optimized technique and a stable MRI contrast agent, peripheral CE-MRA is a safe procedure with diagnostic accuracy close to that of conventional catheter X

Usefulness of the classification technique of cerebral artery for 2D/3D registration

International Nuclear Information System (INIS)

Takemura, Akihiro; Suzuki, Masayuki; Kikuchi, Yuzo; Okumura, Yusuke; Harauchi, Hajime

2007-01-01

Several papers have proposed 2D/3D registration methods of the cerebral artery using magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). Since differences between vessels in a DSA image and MRA volume data cause registration failure, we previously proposed a method to extract vessels from MRA volume data using a technique based on classification of the cerebral artery. In this paper, we evaluated the usefulness of this classification technique by evaluating the reliability of this 2D/3D registration method. This classification method divides the cerebral artery in MRA volume data into 12 segments. According to the results of the classification, structures corresponding to vessels on a DSA image can then be extracted. We applied the 2D/3D registration with/without classification to 16 pairs of MRA volume data and DSA images obtained from six patients. The registration results were scored into four levels (Excellent, Good, Fair and Poor). The rates of successful registration (>fair) were 37.5% for registration without classification and 81.3% for that with classification. These findings suggested that there was a low percentage of incorrectly extracted voxels and we could facilitate reliable registration. Thus, the classification technique was shown to be useful for feature-based 2D/3D registration. (author)

Improvement of Railroad Roller Bearing Test Procedures & Development of Roller Bearing Diagnostic Techniques. Volume 2.

Science.gov (United States)

1982-04-01

A comprehensive review of existing basic diagnostic techniques applicable to the railcar roller bearing defect and failure problem was made. Of the potentially feasible diagnostic techniques identified, high frequency vibration was selected for exper...

Renal artery blood flow assessed by video dilution technique before and after percutaneous transluminal angioplasty

International Nuclear Information System (INIS)

Lantz, B.M.T.; Link, D.P.; Lewis, E.L.; Foerster, J.M.; Lee, G.

1981-01-01

Successful percutaneous transluminal angioplasty was performed in 3 cases of renal artery stenosis where the effect upon renal blood flow was quantified by video dilution technique. This technique adds important information to pressure gradients and renin assays obtained during the dilatation procedure. (Auth.)

Textbook of focusing techniques in diagnostic radiography. 5. new rev. ed.

International Nuclear Information System (INIS)

Bosnjakovic-Buescher, S.; Riegler-Bubeck, C.; Zimmer-Brossy, M.; Bast, B.

1998-01-01

This 5th edition of the standard work on focusing techniques in diagnostic radiography is a guide for X-ray medical technicians and radiologists wishing to optimize their skills and produce images of high technical standard and diagnostic value. The major part of the textbook deals with the focusing and imaging techniques for evaluation of the skeleton and inner body organs. The new edition includes the current legal provisions for radiological protection and the latest quality assurance legislation. It is an indispensable source of reference for clinical departments, radiographic practice, and training institutions. (orig./CB) [de

Popliteal versus tibial retrograde access for subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique.

Science.gov (United States)

Hua, W R; Yi, M Q; Min, T L; Feng, S N; Xuan, L Z; Xing, J

2013-08-01

This study aimed to ascertain differences in benefit and effectiveness of popliteal versus tibial retrograde access in subintimal arterial flossing with the antegrade-retrograde intervention (SAFARI) technique. This was a retrospective study of SAFARI-assisted stenting for long chronic total occlusion (CTO) of TASC C and D superficial femoral lesions. 38 cases had superficial femoral artery lesions (23 TASC C and 15 TASC D). All 38 cases underwent SAFARI-assisted stenting. The ipsilateral popliteal artery was retrogradely punctured in 17 patients. A distal posterior tibial (PT) or dorsalis pedis (DP) artery was retrogradely punctured in 21 patients, and 16 of them were punctured after open surgical exposure. SAFARI technical success was achieved in all cases. There was no significant difference in 1-year primary patency (75% vs. 78.9%, p = .86), secondary patency (81.2% vs. 84.2%, p = .91) and access complications (p = 1.00) between popliteal and tibial retrograde access. There was statistical difference in operation time between popliteal (140.1 ± 28.4 min) and tibial retrograde access with PT/DP punctures after surgical vessel exposure (120.4 ± 23.0 min, p = .04). The SAFARI technique is a safe and feasible option for patients with infrainguinal CTO (TASC II C and D). The PT or DP as the retrograde access after surgical vessel exposure is a good choice when using the SAFARI technique. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

MR angiography of the carotid arteries in 3 D TOF-technique with sagittal ''double-slab'' acquisition using a new head-neck coil

International Nuclear Information System (INIS)

Link, J.; Mueller-Huelsbeck, S.; Heller, M.

1996-01-01

Purpose: The aim of the study was to assess the value of MR angiography (MRA) in sagittal technique compared to DSA in the evaluation of carotid artery stenosis. Methods: 80 Carotid arteries in 40 symptomatic patients were prospectively studied with DSA and MRA. MRA was carried out by means of 3D time-of-flight technique with a FISP sequence (T E 6 ms/T R 80 ms, flip angle 25 , FOV 240x210 mm, matrix 157x256 mm, in-plane resolution 1.34x0.94 mm, partition thickness 1.32 mm, slab thickness 45 mm, acquisition time 7 min) using a new head-neck coil. Data acquisition was performed in sagittal orientation with the 'double-slab' technique. Imaging quality of the extracranial carotid arteries and correctness of quantification of stenosis was performed. Results: Imaging quality was good at the origin of the carotid arteries in 65%, at the bifurcation region in 98% and near the skull base in 81%. The agreement of DSA and MRA was 96% of the normal arteries (24/25), 90% of the severe stenoses (28/31) and 100% of the occluded arteries (9/9). Conclusion: MRA in sagittal 'double-slab' technique is a noninvasive technique allowing to detect normal arteries and candidates for surgery with high degree of certainity. (orig.) [de

Imaging and management of atherosclerotic renal artery stenosis

International Nuclear Information System (INIS)

Sarkodieh, J.E.; Walden, S.H.; Low, D.

2013-01-01

Renal artery stenosis (RAS) causes chronic, progressive ischaemic nephropathy and is the most common cause of secondary hypertension. Radiology plays a large part in the diagnosis, with a variety of imaging techniques available. Each has relative advantages and disadvantages depending on each unique clinical setting. We discuss and illustrate the range of diagnostic methods and interventional techniques for diagnosis and management of RAS and review the current evidence base for endovascular therapy compared with optimal medical management. Knowledge of the relative merits of the various forms of imaging and treatment will guide decision making in the multidisciplinary setting

A clinicopathological study of various oral cancer diagnostic techniques

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G Ulaganathan

2017-01-01

Full Text Available Oral cancer is one of the most commonly occurring malignant tumors in the head and neck regions with high incident rate and mortality rate in the developed countries than in the developing countries. Generally, the survival rate of cancer patients may increase when diagnosed at early stage, followed by prompt treatment and therapy. Recently, cancer diagnosis and therapy design for a specific cancer patient have been performed with the advanced computer-aided techniques. The responses of the cancer therapy could be continuously monitored to ensure the effectiveness of the treatment process that hardly requires diagnostic result as quick as possible to improve the quality and patient care. This paper gives an overview of oral cancer occurrence, different types, and various diagnostic techniques. In addition, a brief introduction is given to various stages of immunoanalysis including tissue image preparation, whole slide imaging, and microscopic image analysis.

Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow.

Science.gov (United States)

Chung, Joon Ho; Shin, Yong Sam; Lim, Yong Cheol; Park, Minjung

2009-04-01

Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. For trapping the aneurysm, the first clip was placed at the ICA just proximal to the aneurysm whereas the distal clip was placed obliquely proximal to the origin of the PcoA to preserve blood flow from the PcoA to the distal ICA. The patient was completely recovered with good collaterals filling to the right ICA territories via AcoA and PcoA. This technique may be an effective treatment option for trapping the aneurysm, especially when the PcoA preservation is mandatory.

Interventional radiology in the management of visceral artery pseudoaneurysms: A review of techniques and embolic materials

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Madhusudhan, Kumble Seetharama; Venkatesh, Hosur Ananthashayana; Gamanagatti, Shivanand; Garg, Pramod; Srivastava, Deep Narayan [All India Institute of Medical Sciences, New Delhi (India)

2016-06-15

Visceral artery pseudoaneurysms occur mostly as a result of inflammation and trauma. Owing to high risk of rupture, they require early treatment to prevent lethal complications. Knowledge of the various approaches of embolization of pseudoaneurysms and different embolic materials used in the management of visceral artery pseudoaneurysms is essential for successful and safe embolization. We review and illustrate the endovascular, percutaneous and endoscopic ultrasound techniques used in the treatment of visceral artery pseudoaneurysm and briefly discuss the embolic materials and their benefits and risks.

[CHANGES OF CAROTID AND VERTEBRAL ARTERIES IN PATENTS WITH ARTERIAL HYPERTENSION AND HEPATOBILIARY PATHOLOGY].

Science.gov (United States)

Polyakov, V Ya; Nikolaev, Yu A; Pegova, S V; Matsievskaya, T R; Obukhov, I V

2016-01-01

The study included 1172 patients (410 men and 762 women) at the mean age of 60.3 ± 10.4 years with grade I-II (stage I-II) arterial hypertension (AH) admitted to the clinic of Institute of Experimental Medicine. The patients were divided into 2 groups based on the results of clinical and laboratory diagnostics. Group 1 (n = 525) included patients with AH and hepatobiliary system (HBS) diseases, group 2 (n = 647) patients with AH without HBS diseases. The patients group 1 had a thicker intima-media complex of carotid arteries, higher peak systolic bloodflow rate in the internal and vertebral carotid arteries, more pronounced coiling of internal carotid arteries than patients of group 2. Patients with AH and HBS diseases exhibited correlation between bloodflow rate in external carotid arteries and atherogenicity coefficient. Duplex scanning of neck vessels of in patients with AH without HBS diseases revealed peculiar changes of the intima-media thickness and hemodynamically significant changes of the blood flow in the internal carotid arteries that may be of prognostic value in this nosological syntropy and require the personified approach to diagnostics, treatment, and prevention of these conditions.

Radial pseudoaneurysm following diagnostic coronary angiography

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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

Cardiac CT angiography after coronary artery surgery in children using 64-slice CT scan

International Nuclear Information System (INIS)

Marini, Davide; Agnoletti, Gabriella; Brunelle, Francis; Sidi, Daniel; Bonnet, Damien; Ou, Phalla

2009-01-01

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 surgery.

Evaluation of Contrast MR Angiography in the Study of Internal Carotid Artery Stenosis. Systematic Review of the Literature

International Nuclear Information System (INIS)

Rodriguez Perez, P.; Martinez Cantarero, J.; Ruiz Diaz, M.; Blazquez Morera, J. A.; Llano Senaris, J. E. de

2004-01-01

To evaluate the diagnostic benefit of using contrast MR Angiography (MRA) in the study of extracranial internal carotid artery stenosis as opposed to intraarterial digital subtraction arteriography (LADSA). A search for relevant articles from 1990 to 2000 using MDLINE and EMBASE databases. Initial selection criteria: 1. articles which compare MRA and IADSA in the study of extracranial internal carotid artery stenosis; and 2, sample size of 10 or more subjects. Studies employing contrast MRA were subsequently selected. Contrast MRA diagnostic results were studied, as were those of non-contrast MRA (TOF) if included. Roc curves and 95% confidence intervals were calculated. In the studies, 324 patients and 648 extracranial internal carotid arteries were evaluated (12 articles). The diagnostic results in carotid artery stenosis discrimination using contrast MRA as opposed to IADSA were sensitivity and specificity=97.28% and 96.08%. With regard to contrast MRA vs. non-contrast MRA (TOF), significant differences favoring contrast MRA in both sensitivity and specificity were observed. (p=0.08 and p<0.001, respectively). MRA techniques demonstrate very high diagnostic capabilities in the detection of carotid stenosis, with contrast MRA being more effective than non-contrast. MRA. In spite of not being superior to IADSA, given the morbimortality risk which the latter is associated (0.7-1.2%). many authors defend contrast MRA (in association with Doppler echography) having become the method of choice for presurgical study of extracranial internal carotid artery stenosis. (Author) 53 refs

Coronary artery plaques: Cardiac CT with model-based and adaptive-statistical iterative reconstruction technique

International Nuclear Information System (INIS)

Scheffel, Hans; Stolzmann, Paul; Schlett, Christopher L.; Engel, Leif-Christopher; Major, Gyöngi Petra; Károlyi, Mihály; Do, Synho; Maurovich-Horvat, Pál; Hoffmann, Udo

2012-01-01

Objectives: To compare image quality of coronary artery plaque visualization at CT angiography with images reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model based iterative reconstruction (MBIR) techniques. Methods: The coronary arteries of three ex vivo human hearts were imaged by CT and reconstructed with FBP, ASIR and MBIR. Coronary cross-sectional images were co-registered between the different reconstruction techniques and assessed for qualitative and quantitative image quality parameters. Readers were blinded to the reconstruction algorithm. Results: A total of 375 triplets of coronary cross-sectional images were co-registered. Using MBIR, 26% of the images were rated as having excellent overall image quality, which was significantly better as compared to ASIR and FBP (4% and 13%, respectively, all p < 0.001). Qualitative assessment of image noise demonstrated a noise reduction by using ASIR as compared to FBP (p < 0.01) and further noise reduction by using MBIR (p < 0.001). The contrast-to-noise-ratio (CNR) using MBIR was better as compared to ASIR and FBP (44 ± 19, 29 ± 15, 26 ± 9, respectively; all p < 0.001). Conclusions: Using MBIR improved image quality, reduced image noise and increased CNR as compared to the other available reconstruction techniques. This may further improve the visualization of coronary artery plaque and allow radiation reduction.

Initial experience in perfusion MR imaging of intracranial major artery occlusion with echo-planar technique

International Nuclear Information System (INIS)

Tsuchiya, Kazuhiro; Mizutani, Yoshiyuki; Inaoka, Sayuki; Hachiya, Junichi

1997-01-01

The purpose of this study was to evaluate the usefulness of perfusion MR imaging using a single-shot echo-planar technique in occlusion of intracranial main arteries. Our patient group consisted of 16 patients with internal carotid artery occlusion (n=9), Moyamoya disease (n=4), and middle cerebral artery occlusion (n=3). We performed the echo-planar perfusion studies with a 1.5-T unit using a free-induction-decay-type echo-planar sequence. With a bolus injection of Gd-DTPA, 30 consecutive scans were obtained at 10 sections every 2 seconds. The data were analyzed in three ways: a time-intensity curves in the territory of the involved artery (n=16); semiquantitative flow map of each section representing signal changes due to passage of Gd-DTPA (n=15); and serial images at a selected section (n=7). The time intensity curves were abnormal in 13 patients. The peak of signal drop was delayed in all of them. Flow maps showed focal flow abnormalities in 11 patients, but they were apparently normal in 4 patients probably due to collateral flow. In serial images, delay in appearance and/or disappearance of Gd-DTPA was noted in 6 patients. In patients with occlusion of intracranial main arteries, MR single-shot echo-planar technique is of clinical use because it can provide information about hemodynamic changes in a short examination time, in multiple sections, and with good temporal resolution. (author)

Vascular patterns of upper limb: an anatomical study with accent on superficial brachial artery

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David Kachlik

2011-02-01

Full Text Available The aim of the study was to evaluate the terminal segmentation of the axillary artery and to present four cases of anomalous branching of the axillary artery, the superficial brachial artery (arteria brachialis superficialis, which is defined as the brachial artery that runs superficially to the median nerve. Totally, 130 cadaveric upper arms embalmed by classical formaldehyde technique from collections of the Department of Anatomy, Third Faculty of Medicine, Charles University in Prague, were macroscopically dissected with special focus on the branching arrangement of the axillary artery. The most distal part of the axillary artery (infrapectoral part terminated in four cases as a bifurcation into two terminal branches: the superficial brachial artery and profunda brachii artery, denominated according to their relation to the median nerve. The profunda brachii artery primarily gave rise to the main branches of the infrapectoral part of the axillary artery. The superficial brachial artery descended to the cubital fossa where it assumed the usual course of the brachial artery in two cases and in the other two cases its branches (the radial and ulnar arteries passed superficially to the flexors. The incidence of the superficial brachial artery in our study was 5% of cases. The reported incidence is a bit contradictory, from 0.12% to 25% of cases. The anatomical knowledge of the axillary region is of crucial importance for neurosurgeons and specialists using the radiodiagnostic techniques, particularly in cases involving traumatic injuries. The improved knowledge would allow more accurate diagnostic interpretations and surgical treatment.

[THE CYTOMETRIC TECHNIQUE OF BINDING OF EOSIN-5-MALEIMIDE IN DIAGNOSTIC OF INHERENT SPHEROCYTOSIS].

Science.gov (United States)

Kuzminova, J A; Plyasunova, S A; Jogov, V V; Smetanina, N S

2016-03-01

The laboratory diagnostic of inherent spherocytosis is based on detection of spherocytes in peripheral blood, decreasing of index of sphericity, decreasing of osmotic resistance of erythrocytes. The new test of diagnostic of hereditary spherocytosis build on molecular defect was developed on the basis of binding extracellular fragments of protein of band 3 with eosin-5-maleimide (EMA-test). The study was carried out to implement comparative analysis of sensitivity and specificity of techniques applied to diagnose inherent spherocytosis. The sampling of 94 patients with various forms of anemias was analyzed All patients were applied complex clinical laboratory examination including analysis of osmotic resistance of erythrocytes, erythrocytometry and EMA-test as specific techniques of diagnostic of inherent spherocytosis. In 51 out of 94 patients (54%) decreasing of values of EMA-test was detected and in 47 patients diagnosis of inherent spherocytosis was confirmed. The standard values of EMA-test were established in 43 patients (46%) and 12 patients out of them with established diagnosis of inherent spherocytosis. Therefore, sensitivity of EMA-test made up to 79% and specificity - 80%. The most sensitive techniques of diagnostic remain osmotic resistance of erythrocytes (91%) and index of sphericity (up to 96%). But the highest specificity in this respect has EMA-test (80%). Nowadays, none of implemented techniques of diagnostic of inherent spherocytosis can be applied as a universal one. The implementation of complex examination is needed for proper diagnostic of disease.

The transperiosteal "inside-out" occipital artery harvesting technique.

Science.gov (United States)

Benet, Arnau; Tabani, Halima; Ding, Xinmin; Burkhardt, Jan-Karl; Rodriguez Rubio, Roberto; Tayebi Meybodi, Ali; Nisson, Peyton; Kola, Olivia; Gandhi, Sirin; Yousef, Sonia; Lawton, Michael T

2018-01-26

OBJECTIVE The occipital artery (OA) is a frequently used donor vessel for posterior circulation bypass procedures due to its proximity to the recipient vessels and its optimal caliber, length, and flow rate. However, its tortuous course through multiple layers of suboccipital muscles necessitates layer-by-layer dissection. The authors of this cadaveric study aimed to describe a landmark-based novel anterograde approach to harvest OA in a proximal-to-distal "inside-out" fashion, which avoids multilayer dissection. METHODS Sixteen cadaveric specimens were prepared for surgical simulation, and the OA was harvested using the classic (n = 2) and novel (n = 14) techniques. The specimens were positioned three-quarters prone, with 45° contralateral head rotation. An inverted hockey-stick incision was made from the spinous process of C-2 to the mastoid tip, and the distal part of the OA was divided to lift up a myocutaneous flap, including the nuchal muscles. The OA was identified using the occipital groove (OG), the digastric muscle (DM) and its groove (DG), and the superior oblique muscle (SOM) as key landmarks. The OA was harvested anterogradely from the OG and within the flap until the skin incision was reached (proximal-to-distal technique). In addition, 35 dry skulls were assessed bilaterally (n = 70) to study additional craniometric landmarks to infer the course of the OA in the OG. RESULTS The OA was consistently found running in the OG, which was found between the posterior belly of the DM and the SOM. The mean total length of the mobilized OA was 12.8 ± 1.2 cm, with a diameter of 1.3 ± 0.1 mm at the suboccipital segment and 1.1 ± 0.1 mm at the skin incision. On dry skulls, the occipitomastoid suture (OMS) was found to be medial to the OG in the majority of the cases (68.6%), making it a useful landmark to locate the OG and thus the proximal OA. CONCLUSIONS The anterograde transperiosteal inside-out approach for harvesting the OA is a fast and easy technique

Case-based reasoning diagnostic technique based on multi-attribute similarity

Energy Technology Data Exchange (ETDEWEB)

Makoto, Takahashi [Tohoku University, Miyagi (Japan); Akio, Gofuku [Okayama University, Okayamaa (Japan)

2014-08-15

Case-based diagnostic technique has been developed based on the multi-attribute similarity. Specific feature of the developed system is to use multiple attributes of process signals for similarity evaluation to retrieve a similar case stored in a case base. The present technique has been applied to the measurement data from Monju with some simulated anomalies. The results of numerical experiments showed that the present technique can be utilizes as one of the methods for a hybrid-type diagnosis system.

A semi-automatic technique for measurement of arterial wall from black blood MRI

International Nuclear Information System (INIS)

Ladak, Hanif M.; Thomas, Jonathan B.; Mitchell, J. Ross; Rutt, Brian K.; Steinman, David A.

2001-01-01

Black blood magnetic resonance imaging (MRI) has become a popular technique for imaging the artery wall in vivo. Its noninvasiveness and high resolution make it ideal for studying the progression of early atherosclerosis in normal volunteers or asymptomatic patients with mild disease. However, the operator variability inherent in the manual measurement of vessel wall area from MR images hinders the reliable detection of relatively small changes in the artery wall over time. In this paper we present a semi-automatic method for segmenting the inner and outer boundary of the artery wall, and evaluate its operator variability using analysis of variance (ANOVA). In our approach, a discrete dynamic contour is approximately initialized by an operator, deformed to the inner boundary, dilated, and then deformed to the outer boundary. A group of four operators performed repeated measurements on 12 images from normal human subjects using both our semi-automatic technique and a manual approach. Results from the ANOVA indicate that the inter-operator standard error of measurement (SEM) of total wall area decreased from 3.254 mm2 (manual) to 1.293 mm2 (semi-automatic), and the intra-operator SEM decreased from 3.005 mm2 to 0.958 mm2. Operator reliability coefficients increased from less than 69% to more than 91% (inter-operator) and 95% (intra-operator). The minimum detectable change in wall area improved from more than 8.32 mm2 (intra-operator, manual) to less than 3.59 mm2 (inter-operator, semi-automatic), suggesting that it is better to have multiple operators measure wall area with our semi-automatic technique than to have a single operator make repeated measurements manually. Similar improvements in wall thickness and lumen radius measurements were also recorded. Since the semi-automatic technique has effectively ruled out the effect of the operator on these measurements, it may be possible to use such techniques to expand prospective studies of atherogenesis to multiple

Contrast-Enhanced MR Angiography (CEMRA) in Peripheral Arterial Occlusive Disease (PAOD): conventional moving table technique versus hybrid technique; Kontrastverstaerkte MR-Angiographie (CEMRA) bei peripherer AVK (pAVK): konventionelle Tischverschiebetechnik versus Hybrid-Technik

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Kalle, T. von; Gerlach, A.; Hatopp, A.; Klinger, S.; Prodehl, P.; Arlat, I.P. [Katharinenhospital, Stuttgart (Germany). Radiologisches Inst.

2004-01-01

Patients and Methods: 80 patients (males n = 60, females n = 20, median age = 70 years, diabetics n = 27) with PAOD were examined with a 1,5T system (40 mT/m) using a dedicated phased array peripheral vascular coil. Protocol A consisted of a single injection of Gd-BOPTA with consecutive craniocaudal image acquisition and protocol B of two injections, with the first injection of Gd-BOPTA followed by image acquisition of the popliteocrural and pedal segments and the second injection followed by acquiring the aortoiliac and femoral segments (hybrid technique). The evaluation of the arterial system was directed to the iliac, femoral, popliteocrural and pedal arteries. Results: The visualization of the entire aortopedal vascular system was of diagnostically good or satisfactory quality in 16 of 40 patients using protocol A and in 29 of 40 patients using protocol B (iliac 40 vs. 37, femoral 40 vs. 40, popliteocrural 35 vs. 37, pedal 16 vs. 29); without the pedal station the number increased to 35 of 40 patients for both protocols. The reason of diagnostic limitations was an arteriovenous overlap in 24 of 80 cases, with 19 of 40 cases for protocol A and 5 of 40 for protocol B, located exclusively in the cruropedal region. Conclusion: Moving table hybrid CEMRA is superior to conventional technique in craniocaudal direction by producing less venous overlap of arteries and is especially more suitable for the diagnostic evaluation of the cruropedal region. (orig.) [German] Patienten und Methodik: Untersucht wurden 80 Patienten (maennl. n = 60, weibl. n = 20, mittl. Alter 70 J., Diabetiker n = 27) mit pAVK an einem 1,5-Tesla-Geraet (40 mT/m) mit dedizierter Phased-Array-Oberflaechen-Gefaessspule. Protokoll A beinhaltete eine Kontrastmittel-Injektion (Gd-BOPTA) mit konsekutiver kraniokaudaler Bildakquisition. In Protokoll B erfolgte die Akquisition zunaechst der Unterschenkel- und Fussetage mittels einer ersten, anschliessend der Abdomen-Becken- und Oberschenkeletage mittels

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.

Science.gov (United States)

Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D

2015-01-01

Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Advanced Laser-Based Techniques for Gas-Phase Diagnostics in Combustion and Aerospace Engineering.

Science.gov (United States)

Ehn, Andreas; Zhu, Jiajian; Li, Xuesong; Kiefer, Johannes

2017-03-01

Gaining information of species, temperature, and velocity distributions in turbulent combustion and high-speed reactive flows is challenging, particularly for conducting measurements without influencing the experimental object itself. The use of optical and spectroscopic techniques, and in particular laser-based diagnostics, has shown outstanding abilities for performing non-intrusive in situ diagnostics. The development of instrumentation, such as robust lasers with high pulse energy, ultra-short pulse duration, and high repetition rate along with digitized cameras exhibiting high sensitivity, large dynamic range, and frame rates on the order of MHz, has opened up for temporally and spatially resolved volumetric measurements of extreme dynamics and complexities. The aim of this article is to present selected important laser-based techniques for gas-phase diagnostics focusing on their applications in combustion and aerospace engineering. Applicable laser-based techniques for investigations of turbulent flows and combustion such as planar laser-induced fluorescence, Raman and Rayleigh scattering, coherent anti-Stokes Raman scattering, laser-induced grating scattering, particle image velocimetry, laser Doppler anemometry, and tomographic imaging are reviewed and described with some background physics. In addition, demands on instrumentation are further discussed to give insight in the possibilities that are offered by laser flow diagnostics.

Review of Physicochemical-Based Diagnostic Techniques for Assessing Insulation Condition in Aged Transformers

Directory of Open Access Journals (Sweden)

Janvier Sylvestre N’cho

2016-05-01

Full Text Available A power transformer outage has a dramatic financial consequence not only for electric power systems utilities but also for interconnected customers. The service reliability of this important asset largely depends upon the condition of the oil-paper insulation. Therefore, by keeping the qualities of oil-paper insulation system in pristine condition, the maintenance planners can reduce the decline rate of internal faults. Accurate diagnostic methods for analyzing the condition of transformers are therefore essential. Currently, there are various electrical and physicochemical diagnostic techniques available for insulation condition monitoring of power transformers. This paper is aimed at the description, analysis and interpretation of modern physicochemical diagnostics techniques for assessing insulation condition in aged transformers. Since fields and laboratory experiences have shown that transformer oil contains about 70% of diagnostic information, the physicochemical analyses of oil samples can therefore be extremely useful in monitoring the condition of power transformers.

Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

Science.gov (United States)

Bou, Steven; Day, Carly

2014-11-01

Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

21 CFR 868.1100 - Arterial blood sampling kit.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1100 Arterial blood sampling kit. (a) Identification. An arterial blood sampling kit is a device, in kit form, used to obtain arterial blood samples... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Arterial blood sampling kit. 868.1100 Section 868...

The Use of Cardiac Magnetic Resonance in Patients with Suspected Coronary Artery Disease: A Clinical Practice Perspective

OpenAIRE

Chang, Sung-A; Kim, Raymond J.

2016-01-01

Cardiac magnetic resonance imaging (CMR) is a useful diagnostic imaging modality in patients with known or suspected coronary artery disease (CAD). It provides unique information not available from other modalities, however, it is complex. CMR is not a single technique. Instead, it consists of multiple distinct techniques and a lack of understanding of which techniques to perform and how to interpret the findings in combination limits its efficacy and widespread use. Conversely, its multipara...

Diagnostic techniques used in controlled thermonuclear research at Harwell

Energy Technology Data Exchange (ETDEWEB)

Harding, G N; Dellis, A N; Gibson, A; Jones, B; Lees, D J; McWhirter, R W.P.; Ramsden, S A; Ward, S [UK Atomic Energy Authority, AERE, Harwell (United Kingdom)

1958-07-01

This paper is a general survey of the lines along which diagnostic methods (spectroscopy, electrical measurements, and the study of high energy radiations) are developing at Harwell, and indicates the results which have been obtained so far. Many of the techniques are in a rudimentary state, and most of the Zeta experiments are incomplete.

Electrical-Based Diagnostic Techniques for Assessing Insulation Condition in Aged Transformers

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Issouf Fofana

2016-08-01

Full Text Available The condition of the internal cellulosic paper and oil insulation are of concern for the performance of power transformers. Over the years, a number of methods have been developed to diagnose and monitor the degradation/aging of the transformer internal insulation system. Some of this degradation/aging can be assessed from electrical responses. Currently there are a variety of electrical-based diagnostic techniques available for insulation condition monitoring of power transformers. In most cases, the electrical signals being monitored are due to mechanical or electric changes caused by physical changes in resistivity, inductance or capacitance, moisture, contamination or aging by-products in the insulation. This paper presents a description of commonly used and modern electrical-based diagnostic techniques along with their interpretation schemes.

Comparison of exercise perfusion and ventricular function imaging: an analysis of factors affecting the diagnostic accuracy of each technique

International Nuclear Information System (INIS)

Osbakken, M.D.; Okada, R.D.; Boucher, C.A.; Strauss, H.W.; Pohost, G.M.

1984-01-01

Exercise thallium-201 perfusion scans and gated equilibrium blood pool scans were performed in 120 catheterized patients with a chest pain syndrome. Eighty-six patients had coronary artery disease and 34 patients did not. The effects of gender, propranolol, exercise level, exercise ischemia, history of typical angina, history of previous myocardial infarction, electrocardiographic Q waves, number of diseases vessels and extent of coronary artery obstruction on diagnostic accuracy were evaluated. Thallium scans and anginal history were less sensitive for detecting coronary disease in women (men: thallium 79%; angina 77%; women: 54 and 46%, respectively; p less than 0.05). Exercise level did not significantly affect the diagnostic accuracy of either scan. Thallium and gated scans were both highly sensitive (95%) in detecting disease in 20 patients with a prior myocardial infarction, angina and a positive electrocardiogram. The sensitivity of the thallium scan significantly decreased as the number of diseased vessels decreased. Both thallium and gated scans were less frequently positive in patients with atypical angina or no Q waves, but were not significantly influenced by electrocardiographic ischemia. The sensitivity and specificity of both scans were low in 57 patients with the combination of atypical angina, no history of infarction and equivocal stress electrocardiogram thallium. When stress thallium scan evaluation included the electrocardiogram and thallium scan interpretation, the diagnostic accuracy was 81%. When all the information from gated scans (wall motion, ejection fraction, pulmonary blood volume) was combined for final gated scan evaluation, the diagnostic accuracy was 83%. When electrocardiographic data were added to all three gated scan variables, diagnostic accuracy was 77%

Misdiagnosis and management of iatrogenic pseudoaneurysm of vertebral artery after Harms technique of C1-C2 fixation

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MIN Li

2012-12-01

Full Text Available 【Abstract】 Harms technique of C1-C2 fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury (VAI rate. But considering the unique and variable anatomy of atlanto-axial complex, iatrogenic VAI will result in catastrophic con-sequences and provides particular surgical challenges for surgeons. To our knowledge, comparing with iatrogenic VAI in the screw hole, iatrogenic VAI in the “open space” is much rarer during the Harms technique of C1-C2 fixation. In this article, we present a case of iatrogenic vertebral artery pseudoaneurysm after Harms technique of posterior C1-C2 fixation. This case of iatrogenic VAI effectively treated by endovascular coil occlusion and external local compression was initially misdiagnosed as VAI by pedicle screw perforation. It can be concluded that intraoperative or post-operative computed angiography is very helpful to diag-nose the exact site of VAI and the combination of endovascular coil occlusion as well as external local com-pression can further prevent bleeding and abnormal verte-bral artery flow in the pseudoaneurysm. However, patients treated require further follow-up to confirm that there is no recurrence of the pseudoaneurysm. Key words: Vertebral artery; Aneurysm, false; Endovascular procedures

Preoperative trans-arterial embolization for spinal tumor: embolization techniques and results

International Nuclear Information System (INIS)

Shi Haibin; Xu Daizhe

2000-01-01

Objective: To analyze the technique and to evaluate the safety and value of preoperative trans-arterial embolization of hypervascular spinal tumors. Methods: Eighteen patients with hypervascular spinal tumors underwent trans-arterial embolization before surgery. They arose intradural in six patients and extradural in 12. Thirty-one arteries were embolized with polyvinyl alcohol (PVA) particles (150-500 μm), of which 18 with additional pieces of gelatin sponge for proximal pedicular embolization. The criteria for judging the effectiveness of embolization were the completeness of tumor removal and estimated blood loss during surgery. Results: Tumor embolization with total occlusion was obtained in eight patients, second to total in seven, subtotal in one, and partial in two. There were no symptomatic complications associated with embolization. Tumors were totally removed in 17 patients and nearly totally removed in one. The average estimated blood loss during surgery was 1100 ml (range, 200-6000 ml) for all 18 patients, and 1540 ml in patients with extradural tumors. Conclusions: Preoperative embolization of hypervascular spinal tumors is safe and effective. It can make complete resection of a tumor possible and can make an unresectable tumor resectable. Superselection or flow control is necessary to achieve effective devascularization and avoid complications

A new techniques in the physics of diagnostic radiology

International Nuclear Information System (INIS)

Jennings, R.J.

1987-01-01

The basic physics involved in the generation of X-rays and in the energy dependence of their interaction with matter are reviewed. Some applications of those ideas in both conventional X-ray imaging and in new imaging techniques are studied. Methods for the optimization of X-ray diagnostic imaging system are discussed. (M.A.C.) [pt

The establishment of implanted VX2 liver tumor model in rabbits and discussion on superselective left hepatic arterial catheterization with micro-catheter technique via femoral artery

International Nuclear Information System (INIS)

Jiang Xiongying; Luo Rongguang; Huang Jinhua; Miao Bijian; Wang Yan

2011-01-01

Objective: To establish the implanted VX2 liver tumor model in rabbits and to discuss the feasibility and technical features of superselective left hepatic arterial catheterization by using micro-catheter through the femoral artery catheter sheath. Methods: Forty New Zealand white rabbits were inoculated with fragments of VX2 tumor into the medial left lobe of liver by using a 16G lumbar puncture needle through laparotomy route. Two weeks later, all the rabbits were proved to be successfully inoculated with liver neoplasm on CT scanning. Then, the catheter sheath was inserted into one of the femoral arteries, which was followed by celiac artery angiography and left hepatic artery catheterization with a micro-catheter under DSA guidance in order to evaluate the main branches of celiac artery and the imaging manifestations of VX2 liver tumor. After that, some scheduled interventional experiments were carried out. Results: Imaging examination and histopathologic study showed that the successful rate of implanted rabbit VX2 liver tumor was 100% (40/40). And the successful rate of the catheter sheath inserted to femoral artery was 97.5% (39/40). The successful rate of celiac artery, gastro-hepatic artery, common hepatic artery, proper hepatic artery and left hepatic artery catheterizations was 100% (39/39), 100% (39/39), 100% (39/39), 94.9% (37/39) and 71.2% (28/39) respectively. Conclusion: To implant tumor tissue mass through laparotomy is a stable and reliable method to establish rabbit VX2 liver tumor model. The insertion of micro-catheter through rabbit femoral catheter sheath approach is a convenient and simple technique to be carried out for the left hepatic artery catheterization and it can efficiently solve the technical difficulties when performing the interventional treatment of the rabbit VX2 hepatic tumor via left hepatic artery approach. (authors)

On-line diagnostic techniques for air-operated control valves based on time series analysis

International Nuclear Information System (INIS)

Ito, Kenji; Matsuoka, Yoshinori; Minamikawa, Shigeru; Komatsu, Yasuki; Satoh, Takeshi.

1996-01-01

The objective of this research is to study the feasibility of applying on-line diagnostic techniques based on time series analysis to air-operated control valves - numerous valves of the type which are used in PWR plants. Generally the techniques can detect anomalies by failures in the initial stages for which detection is difficult by conventional surveillance of process parameters measured directly. However, the effectiveness of these techniques depends on the system being diagnosed. The difficulties in applying diagnostic techniques to air-operated control valves seem to come from the reduced sensitivity of their response as compared with hydraulic control systems, as well as the need to identify anomalies in low level signals that fluctuate only slightly but continuously. In this research, simulation tests were performed by setting various kinds of failure modes for a test valve with the same specifications as of a valve actually used in the plants. Actual control signals recorded from an operating plant were then used as input signals for simulation. The results of the tests confirmed the feasibility of applying on-line diagnostic techniques based on time series analysis to air-operated control valves. (author)

TOF technique for laser-driven proton beam diagnostics for the ELIMED beamline

International Nuclear Information System (INIS)

Milluzzo, G.; Scuderi, V.; Amico, A.G.; Cirrone, G.A.P.; Cuttone, G.; Larosa, G.; Leanza, R.; Petringa, G.; Pipek, J.; Romano, F.; Napoli, M. De; Dostal, J.; Margarone, D.; Schillaci, F.; Velyhan, A.

2017-01-01

The Time of Flight (TOF) method for laser-driven ion beam diagnostics has been extensively investigated so far for low energy ion diagnostics and several works, reported in literature [1,2], have shown its efficiency in the measurement of particle beam characteristics such as ion species, energy spectrum and current. Moreover, such technique allows obtaining a shot-to-shot on-line monitoring of optically accelerated particles, necessary to control the reproducibility of the accelerated beam and to deliver a beam suitable for any kind of applications. For this reason, the ELIMED beamline [3,4], which will be entirely developed at INFN-LNS and installed in 2017 within the ion beamline ELIMAIA (ELI Multidisciplinary Applications of laser-Ion Acceleration) experimental hall at ELI-Beamlines in Prague, will be equipped with an on-line diagnostics system composed by silicon carbide and diamond detectors, using the TOF technique. In this contribution, the procedure developed for TOF signal analysis will be briefly reported.

Using Pattern Classification and Recognition Techniques for Diagnostic and Prediction

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MORARIU, N.

2007-04-01

Full Text Available The paper presents some aspects regarding the joint use of classification and recognition techniques for the activity evolution diagnostication and prediction by means of a set of indexes. Starting from the indexes set there is defined a measure on the patterns set, measure representing a scalar value that characterizes the activity analyzed at each time moment. A pattern is defined by the values of the indexes set at a given time. Over the classes set obtained by means of the classification and recognition techniques is defined a relation that allows the representation of the evolution from negative evolution towards positive evolution. For the diagnostication and prediction the following tools are used: pattern recognition and multilayer perceptron. The data set used in experiments describes the pollution due to CO2 emission from the consumption of fuels in Europe. The paper also presents the REFORME software written by the authors and the results of the experiment obtained with this software.

Transluminal recanalization of chronic total occlusion of radial artery using rendezvous technique: a case report and literature review.

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Arabi, Mohammad; Ahmed, Ishtiaq; Qattan, Nabeel

2014-01-01

Although endovascular management of lower extremity peripheral arterial disease (PAD) is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO) using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

Comparison of Ultrasound-Guided and Fluoroscopy-Assisted Antegrade Common Femoral Artery Puncture Techniques

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Slattery, Michael M.; Goh, Gerard S.; Power, Sarah; Given, Mark F.; McGrath, Frank P.; Lee, Michael J., E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

2015-06-15

PurposeTo prospectively compare the procedural time and complication rates of ultrasound-guided and fluoroscopy-assisted antegrade common femoral artery (CFA) puncture techniques.Materials and MethodsHundred consecutive patients, undergoing a vascular procedure for which an antegrade approach was deemed necessary/desirable, were randomly assigned to undergo either ultrasound-guided or fluoroscopy-assisted CFA puncture. Time taken from administration of local anaesthetic to vascular sheath insertion in the superficial femoral artery (SFA), patients’ age, body mass index (BMI), fluoroscopy radiation dose, haemostasis method and immediate complications were recorded. Mean and median values were calculated and statistically analysed with unpaired t tests.ResultsSixty-nine male and 31 female patients underwent antegrade puncture (mean age 66.7 years). The mean BMI was 25.7 for the ultrasound-guided (n = 53) and 25.3 for the fluoroscopy-assisted (n = 47) groups. The mean time taken for the ultrasound-guided puncture was 7 min 46 s and for the fluoroscopy-assisted technique was 9 min 41 s (p = 0.021). Mean fluoroscopy dose area product in the fluoroscopy group was 199 cGy cm{sup 2}. Complications included two groin haematomas in the ultrasound-guided group and two retroperitoneal haematomas and one direct SFA puncture in the fluoroscopy-assisted group.ConclusionUltrasound-guided technique is faster and safer for antegrade CFA puncture when compared to the fluoroscopic-assisted technique alone.

Usefulness of 3D-CE renal artery MRA using parallel imaging with array spatial sensitivity encoding technique (ASSET)

International Nuclear Information System (INIS)

Shibasaki, Toshiro; Seno Masafumi; Takoi, Kunihiro; Sato, Hirofumi; Hino, Tsuyoshi

2003-01-01

In this study of 3D contrast enhanced MR angiography of the renal artery using the array spatial sensitivity encoding technique (ASSET), the acquisition time per 1 phase shortened fairly. And using the technique of spectral inversion at lipids (SPECIAL) together with ASSET, the quality of image was improved by emphasizing the contrast. The timing of acquisition was determined by the test injection. We started acquiring the MR angiography 2 seconds after the arrival of maximum enhancement of the test injection at the upper abdominal aorta near the renal artery. As a result parenchymal enhancement was not visible and depiction of the segmental artery was possible in 14 (82%) of 17 patients. At the present time we consider it better not to use the Fractional number of excitation (NEX) together with ASSET, as it may cause various artifacts. (author)

Type 2 Endoleaks: The Diagnostic Performance of Non-Specialized Readers on Arterial and Venous Phase Multi-Slice CT Angiography.

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Richard Nolz

Full Text Available To define the diagnostic precision of non-specialized readers in the detection of type 2 endoleaks (T2EL in arterial versus venous phase acquisitions, and to evaluate an approach for radiation dose reduction.The pre-discharge and final follow-up multi-slice CT angiographies of 167 patients were retrospectively analyzed. Image data were separated into an arterial and a venous phase reading set. Two radiology residents assessed the reading sets for the presence of a T2EL, feeding vessels, and aneurysm sac size. Findings were compared with a standard of reference established by two experts in interventional radiology. The effective dose was calculated.Overall, experts detected 131 T2ELs, and 331 feeding vessels in 334 examinations. Persistent T2ELs causing aneurysm sac growth > 5 mm were detected in 20 patients. Radiation in arterial and venous phases contributed to a mean of 58.6% and 39.0% of the total effective dose. Findings of reader 1 and 2 showed comparable sensitivities in arterial sets of 80.9 versus 85.5 (p = 0.09, and in venous sets of 73.3 versus 79.4 (p = 0.15, respectively. Reader 1 and 2 achieved a significant higher detection rate of feeding vessels with arterial compared to venous set (p = 0.04, p < 0.01. Both readers correctly identified T2ELs with growing aneurysm sac in all cases, independent of the acquisition phase.Arterial acquisitions enable non-specialized readers an accurate detection of T2ELs, and a significant better identification of feeding vessels. Based on our results, it seems reasonable to eliminate venous phase acquisitions.

Additional diagnostic value of systolic dysfunction induced by dipyridamole stress cardiac magnetic resonance used in detecting coronary artery disease.

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Husser, Oliver; Bodí, Vicente; Sanchís, Juan; Mainar, Luis; Núñez, Julio; López-Lereu, María P; Monmeneu, José V; Ruiz, Vicente; Rumiz, Eva; Moratal, David; Chorro, Francisco J; Llácer, Angel

2009-04-01

Dipyridamole stress perfusion cardiovascular magnetic resonance (CMR) is used to detect coronary artery disease (CAD). However, few data are available on the diagnostic value of the systolic dysfunction induced by dipyridamole. This study investigated whether the induction of systolic dysfunction supplements the diagnostic information provided by perfusion imaging in the detection of CAD. Overall, 166 patients underwent dipyridamole CMR and quantitative coronary angiography, with CAD being defined as a stenosis > or =70%. Systolic dysfunction at rest, systolic dysfunction with dipyridamole, induced systolic dysfunction, and stress first-pass perfussion deficit (PD) and delayed enhancement were quantified. In the multivariate analysis, PD (hazard ratio [HR]=1.6; 95% confidence interval [CI], 1.33-1.91;Pstatistic for predicting CAD (0.81 vs. 0.87; P=.02). Combining induced systolic dysfunction with perfusion imaging increases the diagnostic accuracy of detecting CAD and enables patients with severe ischemia and a high probability of CAD to be identified.

Acute cerebrovascular incident in a young woman: Venous or arterial stroke? – Comparative analysis based on two case reports

International Nuclear Information System (INIS)

Sleiman, Katarzyna; Zimny, Anna; Kowalczyk, Edyta; Sąsiadek, Marek

2013-01-01

Cerebrovascular diseases are the most common neurological disorders. Most of them are arterial strokes, mainly ischemic, less often of hemorrhagic origin. Changes in the course of cerebral venous thrombosis are less common causes of acute cerebrovascular events. Clinical and radiological presentation of arterial and venous strokes (especially in emergency head CT) may pose a diagnostic problem because of great resemblance. However, the distinction between arterial and venous stroke is important from a clinical point of view, as it carries implications for the treatment and determinates patient’s prognosis. In this article, we present cases of two young women (one with an acute venous infarction, the second with an arterial stroke) who presented with similar both clinical and radiological signs of acute vascular incident in the cerebral cortex. We present main similarities and differences between arterial and venous strokes regarding the etiology, clinical symptoms and radiological appearance in various imaging techniques. We emphasize that thorough analysis of CT (including cerebral vessels), knowledge of symptoms and additional clinical information (e.g. risk factors) may facilitate correct diagnosis and allow planning further diagnostic imaging studies. We also emphasize the importance of MRI, especially among young people, in the differential diagnosis of venous and arterial infarcts

Two cases of colossal heamtometra in old women with a difficult preoperative diagnostic technique

International Nuclear Information System (INIS)

Aono, Kaname; Fukumoto, Satoru

1980-01-01

With the progress in diagnostic imaging techniques, the preoperative diagnostic technique for lesion in the pelvic cavity has become comparatively easy and its clinical usefulness is in high estimation. However, in case of an atypical lesion, it is not always easy to recognize the original organ by traditional imaging pattern. In the present report two cases of colossal hematometra in old women which presented a cystic lesion pattern are dealt with and discussed from a point of medical imagings for diagnosis. (author)

A microcosting study of diagnostic tests for the detection of coronary artery disease in the Netherlands

International Nuclear Information System (INIS)

Tan, S.S.; Oppe, M.; Zoet-Nugteren, S.K.; Niezen, R.A.; Kofflard, M.J.M.; Ten Cate, F.J.; Roijen, L. Hakkaart-van

2009-01-01

Objective: The primary aim of the present study was to calculate the actual costs of four diagnostic tests for the detection of coronary artery disease in the Netherlands using a microcosting methodology. As a secondary objective, the cost effectiveness of eight diagnostic strategies was examined, using microcosting and reimbursement fees subsequently as the cost estimate. Design: A multicenter, retrospective cost analysis from a hospital perspective. Setting: The study was conducted in three general hospitals in the Netherlands for 2006. Interventions: Exercise electrocardiography (exECG), stress echocardiography (sECHO), single-photon emission computed tomography (SPECT) and coronary angiography (CA). Results: The actual costs of exECG, sECHO, SPECT and CA were Euro 33, 216, 614 and 1300 respectively. For all diagnostic tests, labour and indirect cost components (overheads and capital) together accounted for over 75% of the total costs. Consumables played a relatively important role in SPECT (14%). Hotel and nutrition were only applicable to SPECT and CA. Diagnostic services were solely performed for CA, but their costs were negligible (2%). Using microcosting estimates, exECG-sECHO-SPECT-CA was the most and CA the least cost effective strategy ( Euro 397 and 1302 per accurately diagnosed patient). Using reimbursement fees, exECG-sECHO-CA was most and SPECT-CA least cost effective ( Euro 147 and 567 per accurately diagnosed patient). Conclusions: The use of microcosting estimates instead of reimbursement fees led to different conclusions regarding the relative cost effectiveness of alternative strategies.

The treatment of tubal pregnancy by interventional technique through uterine artery

International Nuclear Information System (INIS)

Li Lizhao; Zhang Yonghui; Chen Zhu; Ge Xiaobing; Li Jiehua

2004-01-01

Objective: To study the feasibility and the clinical effect of the treatment of tubule pregnancy by using interventional technique through selective uterine artery. Methods: By using seldinger's method, 48 cases received interventional treatment, followed by perfusion of methotrexate (MTX) 100 mg through Tube 4-5 F. The concentration of serum β-HCG, the changes of pelvic cavity, and the open condition of amnion by ultrasonic examination. Results: The cure rate of 47 cases was 97.92%. No serious reaction. After treatment, the mean time that the serum β-HCG concentration returned to normal was 14-28 days and the mean time was 18 days. Conclusion: The treatment of tubule pregnancy by interventional technique proved no harmful effect to reproductive organs and quick recovery. It is worth spreading

New Technique for the Preservation of the Left Common Carotid Artery in Zone 2a Endovascular Repair of Thoracic Aortic Aneurysm

International Nuclear Information System (INIS)

Juszkat, Robert; Kulesza, Jerzy; Zarzecka, Anna; Jemielity, Marek; Staniszewski, Ryszard; Majewski, Wacław

2011-01-01

To describe a technique for the preservation of the left common carotid artery (CCA) in zone 2 endovascular repair of thoracic aortic aneurysm. This technique involves the placement of a guide wire into the left CCA via the right brachial artery before stent graft deployment to enable precise visualization and protection of the left CCA during the whole procedure. Of the 107 patients with thoracic endovascular aortic repair in our study, 32 (30%) had the left subclavian artery intentionally covered (landing zone 2). Eight (25%) of those 32 had landing zone 2a—the segment distally the origin of the left CCA, halfway between the origin of the left CCA and the left subclavian artery. In all patients, a guide wire was positioned into the left CCA via the right brachial artery before stent graft deployment. It is a retrospective study in design. In seven patients, stent grafts were positioned precisely. In the remaining patient, the positioning was imprecise; the origin of the left CCA was partially covered by the graft. A stent was implanted into the left CCA to restore the flow into the vessel. All procedures were performed successfully. The technique of placing a guide wire into the left CCA via the right brachial artery before stent graft deployment is a safe and effective method that enables the precise visualization of the left CCA during the whole procedure. Moreover, in case of inadvertent complete or partial coverage of the origin of the left CCA, it supplies safe and quick access to the artery for stent implantation.

Use of modified Sandwich-graft technique to preserve hypogastric artery in EVAR treatment of complex aortic aneurysm anatomy.

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Mosquera Arochena, N; Rodríguez Feijoo, G; Carballo Fernandez, C; Molina Herrero, F; Fernandez Lebrato, R; Barrios Castro, A; Garcia Fernandez, I

2011-10-01

Since the introduction of the first endoprosthetic devices, continuous development in techniques and implants has occurred, such as the introduction of a stent graft with branches designed to preserve antegrade flow in the hypogastric artery, a stent-graft designed to treat extreme neck angulation and iliac tortuosity, as well as "Sandwich" and "Chimney" techniques used to maintain perfusion in branch vessels originating in the region to be treated. This paper describes how the Sandwich-Graft technique was adapted, as described by Lobato et al., employing the Aorfix™ system (Lombard Medical) and the Viabahn™ (W.L.Gore) to preserve hypogastric flow in cases with extreme neck angulation and iliac tortuosity. The study included four patients treated from April 2010 until November 2010 with the modified Sandwich technique. All patients eligible for this approach were considered unfit for open repair and were not suitable for an iliac branch graft (Z-BIS Zenith™ Cook Medical). A bifurcated endograft was implanted with specific, in-situ, branching to the target hypogastric artery and achieved clinical and technical success, in all the patients. After a 11-month follow-up in two cases and a six-month follow-up in the other two, clinical results were successful. All patients were endoleak-free, had patent hypogastric branches and had shrinking or stable aneurysms. The initial experience shows that the Sandwich technique with the Aorfix™ stent-graft demonstrated to be effective in endovascular repair of abdominal aortic aneurysms in patients with aortoiliac anatomy hostile to preserving hypogastric artery patency. This graft allows a broader group of patients to be treated with endovascular repair without potential complications of hypogastric artery occlusion; however, further studies are needed to evaluate long-term results in larger numbers of patients.

3D CT cerebral angiography technique using a 320-detector machine with a time–density curve and low contrast medium volume: Comparison with fixed time delay technique

International Nuclear Information System (INIS)

Das, K.; Biswas, S.; Roughley, S.; Bhojak, M.; Niven, S.

2014-01-01

Aim: To describe a cerebral computed tomography angiography (CTA) technique using a 320-detector CT machine and a small contrast medium volume (35 ml, 15 ml for test bolus). Also, to compare the quality of these images with that of the images acquired using a larger contrast medium volume (90 or 120 ml) and a fixed time delay (FTD) of 18 s using a 16-detector CT machine. Materials and methods: Cerebral CTA images were acquired using a 320-detector machine by synchronizing the scanning time with the time of peak enhancement as determined from the time–density curve (TDC) using a test bolus dose. The quality of CTA images acquired using this technique was compared with that obtained using a FTD of 18 s (by 16-detector CT), retrospectively. Average densities in four different intracranial arteries, overall opacification of arteries, and the degree of venous contamination were graded and compared. Results: Thirty-eight patients were scanned using the TDC technique and 40 patients using the FTD technique. The arterial densities achieved by the TDC technique were higher (significant for supraclinoid and basilar arteries, p < 0.05). The proportion of images deemed as having “good” arterial opacification was 95% for TDC and 90% for FTD. The degree of venous contamination was significantly higher in images produced by the FTD technique (p < 0.001%). Conclusion: Good diagnostic quality CTA images with significant reduction of venous contamination can be achieved with a low contrast medium dose using a 320-detector machine by coupling the time of data acquisition with the time of peak enhancement

Coronary Anomaly and Coronary Artery Fistula as Cause of Angina Pectoris with Literature Review

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Jayanth Koneru

2011-01-01

Full Text Available Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA, and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.

Transluminal Recanalization of Chronic Total Occlusion of Radial Artery Using Rendezvous Technique: A Case Report and Literature Review

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Mohammad Arabi

2014-01-01

Full Text Available Although endovascular management of lower extremity peripheral arterial disease (PAD is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

Comparison with myocardial perfusion MRI and myocardial perfusion SPECT in the diagnostic performance of coronary artery disease. A meta-analysis

International Nuclear Information System (INIS)

Iwata, Kunihiro; Kubota, Makoto; Ogasawara, Katsuhiko

2008-01-01

We compared the diagnostic abilities of stress myocardial perfusion MRI (myocardial perfusion MRI) and myocardial perfusion single photon emission computed tomography (SPECT), using a meta-analysis method. We investigated the diagnostic abilities of MRI and SPECT in similar subject groups in reports written in English or Japanese. The reports to be used for analysis were selected according to a ''screening standard,'' which was established in advance. After consolidating the data from the selected reports, we compared the integrated odds ratio, the point estimation values of sensibility/specificity, and the summary receiver operating characteristic (ROC) curve. For the analysis, six reports were selected (subjects: 153, coronary-artery target sites: 447). Meta-analysis revealed that the diagnostic ability of myocardial perfusion MRI was superior to that of myocardial perfusion SPECT regarding each of the parameters. This is considered to be supportive evidence of the usefulness of myocardial perfusion MRI. (author)

Diagnostic value of microRNA-143 in predicting in-stent restenosis for patients with lower extremity arterial occlusive disease

OpenAIRE

Yu, Zhi-Hai; Wang, Hai-Tao; Tu, Can

2017-01-01

Purpose This study was conducted to explore the diagnostic value of microRNA-143 (miRNA-143) in predicting in-stent restenosis (ISR) of lower extremity arterial occlusive disease (LEAOD). Methods From February 2012 to March 2015, 165 patients (112 males and 53 females) with LEAOD undergoing interventional treatment were enrolled in this study. Serum miRNA-143 expression was detected using quantitative real-time polymerase chain reaction (qRT-PCR). Patients were assigned into the restenosis an...

Diagnostic ability of Tc-99m MIBI SPECT in coronary artery diseases in not affected by the degree of exercise

International Nuclear Information System (INIS)

Lee, Jae Tae; Kim, Jong Soo; Chun, Kyung Ah; Lee, Sang Woo; Kang, Do Young; Cho, Yong Keun; Chae, Shung Chull; Lee, Kyu Bo

1999-01-01

The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression of exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmil exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease

LeRC rail accelerators: test designs and diagnostic techniques

International Nuclear Information System (INIS)

Zana, L.M.; Kerslake, W.R.; Sturman, J.C.; Wang, S.Y.; Terdan, F.F.

1984-01-01

The feasibility of using rail accelerators for various in-space and to-space propulsion applications was investigated. A 1 meter, 24 sq mm bore accelerator was designed with the goal of demonstrating projectile velocities of 15 km/sec using a peak current of 200 kA. A second rail accelerator, 1 meter long with a 156.25 sq mm bore, was designed with clear polycarbonate sidewalls to permit visual observation of the plasma arc. A study of available diagnostic techniques and their application to the rail accelerator is presented. Specific topics of discussion include the use of interferometry and spectroscopy to examine the plasma armature as well as the use of optical sensors to measure rail displacement during acceleration. Standard diagnostics such as current and voltage measurements are also discussed. 15 references

Fusion alpha loss diagnostic for ITER using activation technique

Czech Academy of Sciences Publication Activity Database

Bonheure, G.; Hult, M.; González de Orduña, R.; Vermaercke, P.; Murari, A.; Popovichev, S.; Mlynář, Jan

2011-01-01

Roč. 86, 6-8 (2011), s. 1298-1301 ISSN 0920-3796. [Symposium on Fusion Technology (SOFT) /26th./. Port o, 27.09.2010-01.10.2010] Institutional research plan: CEZ:AV0Z20430508 Keywords : ITER * fusion product * burning plasma diagnostics * alpha losses * activation technique Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 1.490, year: 2011 http://www.sciencedirect.com/science/article/pii/S0920379611002778

Coronary CT angiography: Diagnostic value and clinical challenges.

Science.gov (United States)

Sabarudin, Akmal; Sun, Zhonghua

2013-12-26

Coronary computed tomography (CT) angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography. Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320- slice CT scanners. Despite the promising diagnostic value, coronary CT angiography is still limited in some areas, such as inferior temporal resolution, motion-related artifacts and high false positive results due to severe calcification. The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners. Prognostic value of coronary CT angiography in coronary artery disease is also discussed, while limitations and challenges of coronary CT angiography are highlighted.

Traumatic intercostal arterial bleeding controlled with a novel surgical technique: a case report

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Miettinen Simo

2012-09-01

Full Text Available Abstract Introduction A blunt thoracic trauma may cause arterial bleeding requiring operative treatment or endovascular embolization or endovascular aortic stenting. A novel damage control technique to stop such bleeding is presented. Case presentation We present the case of an 82-year-old Caucasian man who experienced rib fractures I-VII on the left side and bleeding from damaged intercostal arteries after a blunt thoracic trauma. Emergency thoracotomy was performed. Conclusions Effective hemostasis was achieved by using a rolled surgical swab and inserting it against the chest wall next to the aorta with sutures pulled through the intercostal muscles and then sutured to the back side of the patient. The patient died four days after the surgery due to a head injury sustained in the car crash.

The diagnostic accuracy of TCD for intracranial arterial stenosis/occlusion in patients with acute ischemic stroke: the importance of time interval between detection of TCD and CTA.

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Guan, Jingxia; Zhou, Qin; Ouyang, Huangqing; Zhang, Shaofeng; Lu, Zuneng

2013-11-01

To evaluate prospectively the diagnostic accuracy of transcranial doppler (TCD) as an additional screening tool for intracranial arterial steno-occlusive disease against computed tomography angiography (CTA) in patients with acute ischemic stroke (AIS) if both are performed in a short time interval. Between July 2011 and May 2012, 128 patients who were hospitalized within 24 hours of symptom onset and fulfilled the criteria for the clinical diagnosis of AIS were enrolled. Bedside detection of TCD was accomplished immediately after admission. High-resolution brain CTA was performed within 3 hours after the completion of TCD and the images were interpreted by a neuroradiologist blinded to TCD findings. The accuracy parameters of TCD against CTA were calculated after computation of true-positive, false-positive, true negative, and false-negative values. Among the 128 patients, there were 68 males and 60 females, aged 61.4 ± 17.5 years. The mean time interval between the detection of TCD and CTA was 89.7 (77.8) minutes. In 65% of patients, both examinations were performed with less than a half-hour interval between them. The diagnostic accuracy of TCD for different arteries showed slight distinction. Transcranial doppler demonstrated the most accurate diagnosis for middle cerebral artery (MCA), where TCD showed 35 true-positive, 0 false-negative, 1 false-positive, and 92 true-negative studies compared with CTA. Furthermore, elevated MCA velocities on TCD correlated well with the severity of intracranial stenosis detected on CTA. Vertebral artery (VA) is one of the arteries with the lowest sensitivity for TCD diagnosis (sensitivity 63.4%, specificity 96.5%, positive predictive value (PPV) 89.6%, negative predictive value (NPV) 84.8%, and accuracy 85.9%). In 20 cases (15.6%), TCD showed findings complementary to CTA (real-time embolization, collateral flow patterns, and steal phenomenon). Transcranial doppler shows high diagnostic accuracy against CTA if both are

Successful Rotational Atherectomy for an Angulated Calcified Lesion in an Anomalous Right Coronary Artery Using the “Mother-and-Child” Technique

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Manabu Ogita

2018-01-01

Full Text Available Percutaneous coronary intervention (PCI involving the anomalous coronary artery is challenging with respect to difficulty in achieving stable catheterization. Rotational atherectomy (RA can facilitate severely calcified lesions to improve stent delivery and stent expansion; however, its utility in tortuous and angulated coronary arteries is limited with difficulty in delivery of the RA burr. The mother-and-child technique is effective for complex PCIs with increased backup force for device delivery in such complicated cases. We report a case of successful rotational atherectomy using the “mother-and-child” technique with a Dio thrombus aspiration catheter for an angulated calcified lesion in an anomalous origin of the right coronary artery.

Spiral CT during pharmacoangiography with angiotensin II in patients with pancreatic disease. Technique and diagnostic efficacy

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Kuroda, C.; Mihara, N.; Hosomi, N.; Inoue, E.; Fujita, M. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Diagnostic Radiology; Ohigashi, H.; Ishikawa, O. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Surgery; Nakaizumi, A. [Osaka Medical Center for Cancer and Cardiovascular Deseases (Japan). Dept. of Internal Medicine; Ishiguro, S. [Osaka Medical Center for Cancer and Cardiovascular Diseases (Japan). Dept. of Pathology

1998-03-01

Purpose: To compare the diagnostic efficacy of pancreatic pharmacoangiographic CT using angiotensin II with conventional angiographic CT. Material and Methods: Eighteen patients with space-occupying pancreatic disease were examined in this study. Pharmacoangiographic CT was performed with a 1-3-{mu}/6-ml solution of angiotensin II injected through a catheter into the celiac artery during spiral CT. Results: In 17 of the 18 (94%) patients, the area of pancreatic parenchymal enhancement was the same or larger at pharmacoangiographic CT than at conventional angiographic CT. The attenuation value of the pancreatic parenchyma was significantly increased at pharmacoangiographic CT (p=0.0010). Although the attenuation value of tumors was also increased on images obtained after the injection of angiotensin II, the tumor-to-pancreas contrast was significantly greater at pharmacoangiographic CT (p=0.0479). The mean differences in attenuation between tumor and pancreas at angiographic CT with and without angiotensin II were respectively 182 HU and 115 HU. Conclusion: Pharmacoangiographic CT with angiotensin II proved superior to conventional angiographic CT in the diagnosis of pancreatic disease. We therefore recommend it as a supplementary technique at the angiographic examination of patients with suspected pancreatic tumor. (orig.).

Arterial mapping of lower limbs

International Nuclear Information System (INIS)

Acuna Allen, Rafael

2011-01-01

A bibliographic review is realized in the arterial mapping of lower limbs by ultrasonographic. The physical properties of the Doppler effect applied to diagnostic ultrasound are described. The anatomical characteristics of the general arterial system and specifically of the lower limbs arterial system are mentioned. Pathologies of the ischemic arterial disease of lower limbs are explained. The study characteristics of lower limbs arterial mapping are documented to determine its importance as appropriate method for the assessment of lower limb ischemia. An adequate arterial mapping of lower limbs is recognized in atherosclerotic ischemic disease as a reliable initial method alternative to arteriography. Arteriography is considered as reference pattern for therapeutic decision making in patients with critical ischemia of the lower limbs. Non-invasive methods to assess the arterial system of lower limbs has evidenced the advantages of the arterial mapping with Doppler, according to the consulted literature. The combination morphological and hemodynamic information has been possible and a map of the explored zone is made. The arterial mapping by ultrasonography has offered similar reliability to angiography [es

Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography

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Given Curtis A

2006-04-01

Full Text Available Abstract Background Spontaneous carotid artery dissections have been rarely reported in children. Diagnosis has traditionally been confirmed by catheter arteriography. More recently diagnosis has been made by magnetic resonance imaging and magnetic resonance angiography; however the sensitivity of these techniques has yet to be determined. The authors are unaware of reports of carotid dissection confirmed by dynamic computed tomography (computerized tomographic arteriography in the young. Case presentation We recently evaluated a fourteen year-old male following the development of transient neurologic symptoms. There was no antecedent illness or trauma. Dynamic computed tomography revealed an intracranial dissection involving the supraclinoid segment of the left internal carotid artery (confirmed by catheter arteriography. Studies for vasculitis, pro-thrombotic states, and defects of collagen were negative. Conclusion Spontaneous carotid artery dissection is a potential cause of transient neurological symptoms and ischemic stroke in the pediatric population. Dynamic computed tomography appears to be a reliable diagnostic tool which can lead to early diagnosis.

Use of end-to-side arterial and venous anastomosis techniques for renal transplantation in two dogs.

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Phillips, Heidi; Aronson, Lillian R

2012-02-01

A sexually intact male Old English Sheepdog and a sexually intact female Bull Terrier were evaluated for renal dysplasia and chronic renal failure, respectively. Both dogs were anemic and had high serum concentrations of urea nitrogen and creatinine. Electrolyte abnormalities (calcium and phosphorus) were also evident. The decision was made to pursue renal transplantation, and donor dogs were identified. End-to-side anastomosis of the renal artery and vein of each donor's left kidney to the recipient's ipsilateral external iliac artery and vein, respectively, was performed. The left caudal abdominal musculature was scarified by making an incision, and nephropexy to that musculature was performed with a simple interrupted pattern of polypropylene sutures. No intraoperative or postoperative complications associated with the vascular anastomoses were encountered. Azotemia, anemia, and electrolyte imbalances resolved after transplantation. The end-to-side anastomosis technique described here, which is a preferred method in human medicine, was successful, providing an alternative to other renal transplantation techniques in dogs. Additional studies are needed to determine whether any vascular anastomosis technique is preferable for use in dogs requiring renal transplantation.

Feasibility and Safety of Transradial Arterial Approach for Simultaneous Right and Left Vertebral Artery Angiographic Studies and Stenting

International Nuclear Information System (INIS)

Yip, H.-K.; Youssef, Ali A.; Chang, W.-N.; Lu, C.-H.; Yang, C.-H.; Chen, S.-M.; Wu, C.-J.

2007-01-01

Objectives. This study investigated whether the transradial artery (TRA) approach using a 6-French (F) Kimny guiding catheter for right vertebral artery (VA) angiographic study and stenting is safe and effective for patients with significant VA stenosis. Background. The TRA approach is commonly performed worldwide for both diagnostic cardiac catheterization and catheter-based coronary intervention. However, to our knowledge, the safety and feasibility of left and right VA angiographic study and stenting, in the same procedure, using the TRA approach for patients with brain ischemia have not been reported. Methods. The study included 24 consecutive patients (22 male, 2 female; age, 63-78 years). Indications for VA angiographic study and stenting were (1) prior stroke or symptoms related to vertebrobasilar ischemia and (2) an asymptomatic but vertebral angiographic finding of severe stenosis (>70%). A combination of the ipsilateral and retrograde-engagement technique, which involved a looping 6-F Kimny guiding catheter, was utilized for VA angiographic study. For VA stenting, an ipsilateral TRA approach with either a Kimny guiding catheter or a left internal mammary artery guiding catheter was utilized in 22 patients and retrograde-engagement technique in 2 patients. Results. A technically successful procedure was achieved in all patients, including left VA stenting in 15 patients and right VA stenting in 9 patients. The mean time for stenting (from engagement to stent deployment) was 12.7 min. There were no vascular complications or mortality. However, one patient suffered from a transient ischemic attack that resolved within 3 h. Conclusion. We conclude that TRA access for both VA angiographic study and VA stenting is safe and effective, and provides a simple and useful clinical tool for patients unsuited for femoral arterial access

Sheath rendezvous method: a novel distal protection technique during endovascular treatment of subclavian artery occlusions.

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Haraguchi, Takuya; Urasawa, Kazushi; Nakama, Tatsuya; Nakagawa, Yuya; Tan, Michinao; Koshida, Ryoji; Sato, Katsuhiko

2016-10-01

To describe an innovative distal protection technique, "sheath rendezvous method", during endovascular treatment for subclavian arterial occlusions. 4.5F and 6F guiding sheath were inserted from left brachial and common femoral artery, respectively. 0.014″ guidewire retrogradely passed through occlusion and into antegrade sheath to establish a pull-through system. 3.0 mm balloon was used to expand occlusion and anchor to deliver retrograde sheath into antegrade one. Both sheaths locked by balloon dilatation crossed occlusion until antegrade sheath passed over lesion. Balloon expandable stent was delivered within antegrade sheath. Sheath was removed, and stent was implanted. We obtained an excellent outcome without complications.

CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease

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Matsumoto, Shunsuke; Yamada, Yoshitake; Hashimoto, Masahiro; Okamura, Teppei; Jinzaki, Masahiro [Keio University School of Medicine, Department of Diagnostic Radiology, Shinanomachi, Shinjuku-ku, Tokyo (Japan); Yamada, Minoru [Keio University School of Medicine, Research Park, Tokyo (Japan); Yashima, Fumiaki; Hayashida, Kentaro; Fukuda, Keiichi [Keio University School of Medicine, Department of Cardiology, Tokyo (Japan)

2017-05-15

To evaluate the effectiveness of CT before TAVI using variable helical pitch (VHP) scanning and its diagnostic performance for coronary artery disease (CAD). Sixty patients (84.4 ± 4.6 years) scheduled for TAVI underwent CT using VHP scanning with the contrast material (CM) volume calculated as scanning time x weight [kg] x 0.06 mL. Retrospective electrocardiography (ECG)-gated scanning was utilized to examine the thorax, and non-ECG-gated scanning of the abdomen immediately followed. We analyzed CT attenuation values of the coronary arteries, aorta, iliac and femoral arteries. The coronary CT angiography images were evaluated for the presence of stenosis (≥50 %); invasive coronary angiography served as a reference standard. The average attenuations of all of the arteries were greater than 400 HU. We could evaluate the peripheral access vessels and dimensions of the ascending aorta, aortic root, and aortic annulus in all patients. The average volume of CM was 38.7 ± 8.5 mL. On per-patient and vessel analysis, CT showed 91.7 % and 89.5 % sensitivity, and 91.3 % and 97.4 % negative predictive value (NPV). CT using VHP scanning with an average CM volume of 38.7 mL is useful before TAVI and had a high sensitivity and NPV in excluding obstructive CAD. (orig.)

Role of high resolution contrast-enhanced magnetic resonance angiography (HR CeMRA) in management of arterial complications of the renal transplant

International Nuclear Information System (INIS)

Ismaeel, M. Maged; Abdel-Hamid, Azza

2011-01-01

Introduction: Transplant renal artery (RA) stenosis (TRAS) is the most frequent posttransplantation vascular complication. Contrast enhanced magnetic resonance (CeMRA) angiography has been established as the preferred imaging technique for the evaluation of TRAS because it does not require the use of iodinated contrast material and does not expose the patient to ionizing radiation. Digital subtraction angiography (DSA) is the gold standard in the evaluation of arterial tree of the renal allograft. Aim of the work: This study was carried out to assess the accuracy of CeMRA in the detection of arterial complications after renal transplantation. Patients and methods: Thirty renal transplant patients with suspected arterial complications in which both CeMRA and DSA were performed were included in the study. The HR CeMRA shows 93.7% sensitivity, 80% specificity, 88.2% positive predictive value, 88.9% negative predictive value and 88.5% accuracy. Conclusion: HR CeMRA is an accurate reliable tool in the assessment of arterial complications after renal transplantation. It may replace DSA as a diagnostic modality with reservation of interventional techniques for endovascular treatment of suitable cases.

Role of high resolution contrast-enhanced magnetic resonance angiography (HR CeMRA) in management of arterial complications of the renal transplant

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Ismaeel, M. Maged [Suez Canal University (Egypt); Abdel-Hamid, Azza, E-mail: azza4951@hotmail.com [Suez Canal University (Egypt)

2011-08-15

Introduction: Transplant renal artery (RA) stenosis (TRAS) is the most frequent posttransplantation vascular complication. Contrast enhanced magnetic resonance (CeMRA) angiography has been established as the preferred imaging technique for the evaluation of TRAS because it does not require the use of iodinated contrast material and does not expose the patient to ionizing radiation. Digital subtraction angiography (DSA) is the gold standard in the evaluation of arterial tree of the renal allograft. Aim of the work: This study was carried out to assess the accuracy of CeMRA in the detection of arterial complications after renal transplantation. Patients and methods: Thirty renal transplant patients with suspected arterial complications in which both CeMRA and DSA were performed were included in the study. The HR CeMRA shows 93.7% sensitivity, 80% specificity, 88.2% positive predictive value, 88.9% negative predictive value and 88.5% accuracy. Conclusion: HR CeMRA is an accurate reliable tool in the assessment of arterial complications after renal transplantation. It may replace DSA as a diagnostic modality with reservation of interventional techniques for endovascular treatment of suitable cases.

Interfascial technique for vertebral artery exposure in the suboccipital triangle: the road map.

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Youssef, A Samy; Uribe, Juan S; Ramos, Edwin; Janjua, Rashid; Thomas, L Brannon; van Loveren, Harry

2010-12-01

The extradural portion of the vertebral artery (VA-V3) has a unique anatomy at the craniovertebral junction. The exposure of V3 can be accompanied by profuse bleeding from the venous plexus in addition to the potential risk of inadvertent injury of the VA during surgery at the craniovertebral junction. The natural tissue planes represent a road map to the safe exposure of the VA in the suboccipital triangle. To describe the microsurgical anatomy of the tissue planes in the suboccipital region. The suboccipital region was bilaterally dissected in 6 fresh silicone-injected cadaver heads. An interfascial technique was used to expose the VA-V3 following a tissue plane between the deep suboccipital muscular fascia dorsally and posterior atlantooccipital membrane, the C1 periosteal membrane, and the membrane covering the VA and venous plexus ventrally. The craniovertebral junction was harvested from 2 heads and prepared for histological sections. The same technique was applied in 25 operative cases. The anatomic dissections confirmed the existence of an interfascial plane that can be dissected in a blunt fashion to reach as far lateral as the transverse processes of C1 and C2. Application of the dissection technique did not require diathermy coagulation in the operating room. In 25 cases, there was no injury of the VA or bleeding from the venous plexus. Vertebral artery exposure in the suboccipital triangle (V3) can be achieved safely with minimal blood loss using a technique that follows the natural tissue plane between the deep suboccipital muscle fascia, the posterior atlantooccipital membrane, the membrane covering VA/venous plexus, and the periosteum of the C1 and C2 laminae.

Diagnostic value of the fluoroscopic triggering 3D LAVA technique for primary liver cancer.

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Shen, Xiao-Yong; Chai, Chun-Hua; Xiao, Wen-Bo; Wang, Qi-Dong

2010-04-01

Primary liver cancer (PLC) is one of the common malignant tumors. Liver acquisition with acceleration volume acquisition (LAVA), which allows simultaneous dynamic enhancement of the hepatic parenchyma and vasculature imaging, is of great help in the diagnosis of PLC. This study aimed to evaluate application of the fluoroscopic triggering 3D LAVA technique in the imaging of PLC and liver vasculature. The clinical data and imaging findings of 38 adults with PLC (22 men and 16 women; average age 52 years), pathologically confirmed by surgical resection or biopsy, were collected and analyzed. All magnetic resonance images were obtained with a 1.5-T system (General Electrics Medical Systems) with an eight-element body array coil and application of the fluoroscopic triggering 3D LAVA technique. Overall image quality was assessed on a 5-point scale by two experienced radiologists. All the nodules and blood vessel were recorded and compared. The diagnostic accuracy and feasibility of LAVA were evaluated. Thirty-eight patients gave high quality images of 72 nodules in the liver for diagnosis. The accuracy of LAVA was 97.2% (70/72), and the coincidence rate between the extent of tumor judged by dynamic enhancement and pathological examination was 87.5% (63/72). Displayed by the maximum intensity projection reconstruction, nearly all cases gave satisfactory images of branches III and IV of the hepatic artery. Furthermore, small early-stage enhancing hepatic lesions and the parallel portal vein were also well displayed. Sequence of LAVA provides good multi-phase dynamic enhancement scanning of hepatic lesions. Combined with conventional scanning technology, LAVA effectively and safely displays focal hepatic lesions and the relationship between tumor and normal tissues, especially blood vessels.

Pulmonary artery-to-pulmonary artery anastomoses: angiographic demonstration in patients with chronic thromboembolic pulmonary hypertension

International Nuclear Information System (INIS)

Hodson, J.; Graham, A.; Hughes, J.M.B.; Gibbs, J.S.R.; Jackson, J.E.

2006-01-01

AIM: To describe direct pulmonary artery-to-pulmonary artery anastomoses seen at pulmonary angiography in patients with chronic thromboembolic pulmonary hypertension and discuss their possible significance. MATERIALS AND METHODS: Between 1 August 2000 and 31 July 2004 43 patients (male-to-female ratio 25:18) with a diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) underwent selective pulmonary angiography to assess the extent of disease and suitability for surgical pulmonary endarterectomy. The mean pulmonary artery pressure ranged from 27-84 mmHg (average of 51 mmHg). Selective bilateral digital subtraction pulmonary angiograms performed in all individuals were reviewed for the presence of intrapulmonary collaterals. RESULTS: In 15 of the 43 patients (male-to-female ratio =7:8) definite (n=12) or probable (n=3) pulmonary artery-to-pulmonary artery anastomoses were demonstrated. Of the remaining 28 patients in whom intrapulmonary collaterals were not seen it was felt that in 16 the angiograms were of insufficient diagnostic quality (grades 4-5) to exclude their presence. Twelve patients, eight of whom had angiograms of sufficient diagnostic quality (grades 1-3), demonstrated one or more areas of luxury perfusion but intrapulmonary collaterals were not seen. CONCLUSION: Direct pulmonary artery-to-pulmonary artery anastomoses were demonstrated in patients with chronic thromboembolic pulmonary hypertension, which to our knowledge have not been previously described. The importance of these collateral vessels is unclear but they may play a role in the maintenance of pulmonary parenchymal viability in patients with chronic pulmonary embolic disease. The rate of development of these collaterals and their prognostic significance in patients with chronic thromboembolic pulmonary hypertension are areas worthy of further study

Pulmonary artery-to-pulmonary artery anastomoses: angiographic demonstration in patients with chronic thromboembolic pulmonary hypertension

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Hodson, J. [Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Graham, A. [Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Hughes, J.M.B. [Department of Respiratory Medicine, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Gibbs, J.S.R. [Department of Cardiology, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom); Jackson, J.E. [Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London (United Kingdom)]. E-mail: jejackson@hhnt.org

2006-03-15

AIM: To describe direct pulmonary artery-to-pulmonary artery anastomoses seen at pulmonary angiography in patients with chronic thromboembolic pulmonary hypertension and discuss their possible significance. MATERIALS AND METHODS: Between 1 August 2000 and 31 July 2004 43 patients (male-to-female ratio 25:18) with a diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) underwent selective pulmonary angiography to assess the extent of disease and suitability for surgical pulmonary endarterectomy. The mean pulmonary artery pressure ranged from 27-84 mmHg (average of 51 mmHg). Selective bilateral digital subtraction pulmonary angiograms performed in all individuals were reviewed for the presence of intrapulmonary collaterals. RESULTS: In 15 of the 43 patients (male-to-female ratio =7:8) definite (n=12) or probable (n=3) pulmonary artery-to-pulmonary artery anastomoses were demonstrated. Of the remaining 28 patients in whom intrapulmonary collaterals were not seen it was felt that in 16 the angiograms were of insufficient diagnostic quality (grades 4-5) to exclude their presence. Twelve patients, eight of whom had angiograms of sufficient diagnostic quality (grades 1-3), demonstrated one or more areas of luxury perfusion but intrapulmonary collaterals were not seen. CONCLUSION: Direct pulmonary artery-to-pulmonary artery anastomoses were demonstrated in patients with chronic thromboembolic pulmonary hypertension, which to our knowledge have not been previously described. The importance of these collateral vessels is unclear but they may play a role in the maintenance of pulmonary parenchymal viability in patients with chronic pulmonary embolic disease. The rate of development of these collaterals and their prognostic significance in patients with chronic thromboembolic pulmonary hypertension are areas worthy of further study.

Spiral CT angiography (SCTA) study of celiac artery and superior mesenteric artery

International Nuclear Information System (INIS)

Yuan Zhenguo; Zhou Cunsheng; Xu Zuodong; Shi Hao; Wang Tao

1999-01-01

Objective: To study the visualization capability and scanning technique of SCTA in celiac artery, superior mesenteric artery (SMA) and other branches. Methods: Thirty patients, with normal abdominal SCTA results, were given small injection test dose after plain scan. The abdominal aorta parallel to the body of pancreas was chosen as target vessel, the peak-time plus 2 seconds as the best delay scan time. Iodine contrast medium 90∼110 ml was injected into antecubital vein at the speed of 3.5 ml/s, then scan from cranial to caudal was performed. Pitch 1.0 and slice thickness 3.2 mm were selected as the scan parameters. Maximum intensity projection (MaxIP) was employed in all patients and shaded surface display (SSD) in 23 cases. Results: The display rate using MaxIP and SSD of celiac artery, splenic artery, common hepatic artery, proper hepatic artery and SMA were all 100%, the gastroduodenal artery 100% and 91%, the left gastric artery 83% and 87%, respectively. Conclusions: SCTA as a minimally invasive examination is a valuable method to detect and diagnose disease or variations of celiac artery, its branches and SMA. Spiral scanning technique and image processing have a decisive effect on the image quality

Isolation of the right subclavian artery in a patient with d-transposition of the great arteries.

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Arunamata, Alisa; Perry, Stanton B; Kipps, Alaina K; Vasanawala, Shreyas S; Axelrod, David M

2015-01-01

Isolation of the right subclavian artery (RSCA) is rare, and this finding in association with d-transposition of the great arteries (d-TGA) is extremely unusual. We present a case of an isolated RSCA in a newborn with d-TGA in whom the clinical presentation was diagnostic. We discuss the imaging modalities used to confirm the diagnosis, the embryological basis of the finding, and the surgical repair.

Diagnostic accuracy of new imaging techniques in breast diseases

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Gordenne, W; Bauduin, E [Liege Univ. (Belgium)

1989-01-01

During the last decade, the hypothetical carcinogenic effects of mammography have lead to new technical developments in X-ray diagnosis and to use of other imaging techniques such as ultrasonography (US), transillumination, magnetic resonance imaging (MRI). Many preliminary studies were published but few clinical trials are really convincing. According to the definition of a diagnostic tool, none of these new modalities is supposed to supplant mammography in the diagnosis of breast cancer. Improvements are expected by digital mammography in the near future. (Authors).

[Stress-ECG is adequate to detect myocardial ischemia: when are additional diagnostic tests needed?].

Science.gov (United States)

Baer, F M

2007-09-01

The stress-ECG is the most often adopted and most cost effective initial diagnostic test for the assessment of myocardial ischemia in patients with suspected coronary artery disease (CAD). Prerequisites for the diagnostic usefullness of stress-ECG are a clearly interpretable ST-segment, ability to reach the predicted work load, an intermediate pretest probability for CAD ranging between 10% and 90% and the absence of any contraindications for dynamic exercise. Because of the limited diagnostic sensitivity of about 70%, and a high percentage of patients, who are unable to exercise, a negative stress ECG can definitely not exclude hemodynamically significant CAD. Therefore, stress imaging techniques like myocardial scintigraphy, stress-echocardiography and stress magnetic resonance imaging play a major role in the stepwise diagnostic work-up of patients with suspected CAD. These stress imaging techniques are basically interchangeable since no method is definitely superior to one of the others. However, each method has its specific pros and cons and inherent contraindications. Therefore the choice of the stress imaging method and the form of stress applied should be based on the individual patients characteristics to gain optimal image quality and diagnostic accuracy. Moreover, the decision for one method should take the local availability and institutional expertise of diagnostic centers into account. Although partly substituted by stress imaging techniques the stress-ECG still remains the workhorse for a stepwise diagnostic work-up of patients with suspected CAD.

Electron beam CT diagnosis of congenital unilateral absence of pulmonary artery

International Nuclear Information System (INIS)

Zhou Yuan; Dai Ruping; Cao Cheng; Zhang Gejun; Jing Baolian

2003-01-01

Objective: To evaluate the clinical value of electron beam CT (EBCT) in diagnosing congenital unilateral absence of pulmonary artery (UAPA). Methods: Patients with clinically suspected pulmonary artery disease or primary pulmonary hypertension underwent EBCT scanning. EBCT confirmed the diagnosis of UAPA in 11 patients, who were also evaluated with echocardiography and chest roentgenography. Cardioangiography and nuclear ventilation-perfusion scan were performed in some patients for a comparative study. Results: 4 female adults had UAPA with out associated congenital anomaly. 3 male children with coexisting complex congenital abnormality had unilateral absence of the left pulmonary artery and 4 patients coexisted other simple cardiovascular anomaly. EBCT scanning simultaneously displayed topographic pattern of both unilateral absence of pulmonary artery and coexisting congenital cardiovascular anomaly, as well as lung diseases. Conclusion: UAPA diagnosed in childhood usually has unilateral absence of the left pulmonary artery and associated congenital cardiovascular anomaly, while UAPA diagnosed in adult usually has UAPA on the right side without associated congenital anomaly. EBCT is one of the optimal imaging techniques in diagnosing UAPA and it greatly increases the diagnostic efficacy than echocardiography dose. Both EBCT and cardioangiography have their own advantages, however, EBCT, as a noninvasive method, should be complementary and not exclusive

Surgical techniques and curative effect of carotid endarterectomy for carotid artery stenosis

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Min HAN

2014-02-01

Full Text Available Objective To investigate the surgical techniques of carotid endarterectomy (CEA for treating carotid artery stenosis, in order to improve the surgical efficacy and reduce intraoperative adverse events and complications after operation. Methods Retrospective analysis was carried out on surgical data of 53 cases who were performed CEA from October 2010 to October 2013 in Department of Neurosurgery in Tianjin Huanhu Hospital. There were 39 males and 14 females, aged from 40 to 78 years old and mean age (60.34 ± 8.92 years old; the course of disease was from 2 d to 4 years. Twenty-six cases were diagnosed as right carotid stenosis, 15 cases left carotid stenosis and 12 cases double-sided carotid stenosis. Among all of those cases, 35 cases were diagnosed as moderate stenosis (30%-69%, 16 cases severe stenosis (70%-99% , and 2 cases complete occlusion. Results Among 53 patients, 50 patients underwent CEA; 2 cases underwent CEA and aneurysm clipping; one case underwent stent removal surgery and CEA because restenosis was found after carotid artery stenting (CAS. Postoperative neck CTA and fMRI showed good morphology of carotid artery, fluent blood flow and improved cerebral perfusion after operation. All of those patients were followed up for 3 to 24 months. One case died of myocardial infarction; 2 cases appeared skin numbness on the operating side of the neck, and the symptom disappeared 3 months later; one case appeared hoarseness after operation; 3 cases experienced mild transient ischemic attack (TIA and the symptom disappeared 2 months later. No case of stroke was found. Conclusions CEA is a safe and effective surgical approach to treat carotid stenosis. Correct and reasonable choices of the surgical indications and skilled surgical technique are the key to ensure the success of operation and to improve efficacy of the therapy. doi：10.3969/j.issn.1672-6731.2014.02.006Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v14n2a6

Vibration monitoring/diagnostic techniques, as applied to reactor coolant pumps

International Nuclear Information System (INIS)

Sculthorpe, B.R.; Johnson, K.M.

1986-01-01

With the increased awareness of reactor coolant pump (RCP) cracked shafts, brought about by the catastrophic shaft failure at Crystal River number3, Florida Power and Light Company, in conjunction with Bently Nevada Corporation, undertook a test program at St. Lucie Nuclear Unit number2, to confirm the integrity of all four RCP pump shafts. Reactor coolant pumps play a major roll in the operation of nuclear-powered generation facilities. The time required to disassemble and physically inspect a single RCP shaft would be lengthy, monetarily costly to the utility and its customers, and cause possible unnecessary man-rem exposure to plant personnel. When properly applied, vibration instrumentation can increase unit availability/reliability, as well as provide enhanced diagnostic capability. This paper reviews monitoring benefits and diagnostic techniques applicable to RCPs/motor drives

Imaging mammary diagnostics. Diagnostic techniques, archetypical findings, differential diagnostcs and interventions. 2. rev. and enl. ed.

International Nuclear Information System (INIS)

Heywang-Koebrunner, S.; Schreer, I.

2008-01-01

The book includes the following chapters: I. Methodology: anamnesis and interview; clinical evidence, mammography, sonography, magnetic resonance tomography, new imaging techniques (scintigraphy, PET), transcutaneous biopsy, pre-operative marking; II. phenotypes: normal mammary glands, mastopathics, cysts, benign tumors, inflammatory diseases, in-situ carcinomas, invasive carcinomas, lymphomas, other semi-malign and malign tumors, post-traumatic, post-surgical and post-therapeutic changes, skin changes, male mamma, screening, continuative diagnostics of screening evidence and problem solving for symptomatic patients

Percutaneous transluminal angioplasty in the region of the renal artery: indications, technique and results

Energy Technology Data Exchange (ETDEWEB)

Olbert, F; Ogris, E; Muzika, N; Schlegl, A; Vacariu, O; Diez, W

1985-01-01

The paper reports the results obtained by percutaneous transluminal angioplasty (PTA) in the treatment of renal artery stenosis in 25 patients with secondary hypertension and discusses indications and the technique used. The follow-up period ranged from 0.5 to 12 months. All interventions were performed with the Olbert catheter system. Following PTA a significant decrease in systolic, diastolic and mean arterial pressure was observed in nearly all patients. The response of the plasma renin activity (PRA) to orthostatic stimulation and pharmacological stimulation by furosemide was determined in a subset of 15 patients before and after PTA. A significant decrease in both basal and stimulated PRA values was observed subsequent to PTA. The decrease in PRA values after successful PTA did not, however, correlate with the extent of the blood pressure changes. (Author).

Percutaneous transluminal angioplasty in the region of the renal artery: indications, technique and results

International Nuclear Information System (INIS)

Olbert, F.; Ogris, E.; Muzika, N.; Schlegl, A.; Vacariu, O.; Diez, W.

1985-01-01

The paper reports the results obtained by percutaneous transluminal angioplasty (PTA) in the treatment of renal artery stenosis in 25 patients with secondary hypertension and discusses indications and the technique used. The follow-up period ranged from 0.5 to 12 months. All interventions were performed with the Olbert catheter system. Following PTA a significant decrease in systolic, diastolic and mean arterial pressure was observed in nearly all patients. The response of the plasma renin activity (PRA) to orthostatic stimulation and pharmacological stimulation by furosemide was determined in a subset of 15 patients before and after PTA. A significant decrease in both basal and stimulated PRA values was observed subsequent to PTA. The decrease in PRA values after successful PTA did not, however, correlate with the extent of the blood pressure changes. (Author)

PEEP-ZEEP technique: cardiorespiratory repercussions in mechanically ventilated patients submitted to a coronary artery bypass graft surgery

Directory of Open Access Journals (Sweden)

Auler José

2011-09-01

Full Text Available Abstract Background The PEEP-ZEEP technique is previously described as a lung inflation through a positive pressure enhancement at the end of expiration (PEEP, followed by rapid lung deflation with an abrupt reduction in the PEEP to 0 cmH2O (ZEEP, associated to a manual bilateral thoracic compression. Aim To analyze PEEP-ZEEP technique's repercussions on the cardio-respiratory system in immediate postoperative artery graft bypass patients. Methods 15 patients submitted to a coronary artery bypass graft surgery (CABG were enrolled prospectively, before, 10 minutes and 30 minutes after the technique. Patients were curarized, intubated, and mechanically ventilated. To perform PEEP-ZEEP technique, saline solution was instilled into their orotracheal tube than the patient was reconnected to the ventilator. Afterwards, the PEEP was increased to 15 cmH2O throughout 5 ventilatory cycles and than the PEEP was rapidly reduced to 0 cmH2O along with manual bilateral thoracic compression. At the end of the procedure, tracheal suction was accomplished. Results The inspiratory peak and plateau pressures increased during the procedure (p Conclusion The PEEP-ZEEP technique seems to be safe, without alterations on hemodynamic variables, produces elevated expiratory flow and seems to be an alternative technique for the removal of bronchial secretions in patients submitted to a CABG.

The influence on finite measurement accuracy on the SWE-to-PWE antenna diagnostics technique

DEFF Research Database (Denmark)

Cappellin, Cecilia; Breinbjerg, Olav; Frandsen, Aksel

2006-01-01

A new antenna diagnostics technique based on the transformation of the spherical wave expansion (SWE) into the plane wave expansion (PWE) is proposed. The new technique allows the recovery of the plane wave spectrum in the visible region, and in principle also in part of the invisible region, from...

The use of the inferior epigastric artery for accessory lower polar artery revascularization in live donor renal transplantation.

Science.gov (United States)

El-Sherbiny, M; Abou-Elela, A; Morsy, A; Salah, M; Foda, A

2008-01-01

This study describes the surgical technique and outcomes of live donor renal allografts with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery after declamping. Between 1988 and 2004, 477 consecutive live donor renal transplants were performed, including 429 with single and 48 with multiple arteries. Anastomosis of the lower polar artery to the inferior epigastric artery was used for 15 grafts with multiple arteries. Successful revascularization of all areas of the transplanted graft was confirmed by Doppler ultrasonography in most patients and radionuclide renal scanning +/- MRA in some patients. In live donor renal transplantation with multiple arteries, the anastomosis of the lower polar artery to the inferior epigastric artery after declamping avoids prolongation of the ischemia time that occurs with other surgical and microsurgical techniques of intracorporeal and ex vivo surgeries.

Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

Energy Technology Data Exchange (ETDEWEB)

Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

2015-04-15

Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA.

Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

International Nuclear Information System (INIS)

Pua, Uei

2015-01-01

Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA

Fibromuscular dysplasia of renal arteries

International Nuclear Information System (INIS)

Akhtar, N.; Ahmed, T.M.

2007-01-01

This case reports a young child having uncontrolled hypertension, resulting from bilateral renal artery stenosis due to fibromuscular dysplasia presenting with abdominal pain, headache and visual disturbance. Diagnostic features and management is discussed. (author)

Embolization of Hepatic Arterial Branches to Simplify Hepatic Blood Flow Before Yttrium 90 Radioembolization: A Useful Technique in the Presence of Challenging Anatomy

International Nuclear Information System (INIS)

Karunanithy, Narayan; Gordon, Fabiana; Hodolic, Marina; Al-Nahhas, Adil; Wasan, Harpreet S.; Habib, Nagy; Tait, Nicholas P.

2011-01-01

Purpose: In the presence of variant hepatic arterial anatomy, obtaining whole-liver coverage with yttrium 90 (Y90) radioembolization may be challenging. The purpose of this study was to determine whether a technique whereby variant hepatic arterial branches are embolized and then Y90 is administered selectively into one remaining hepatic arterial branch results in whole-liver coverage and effective therapy. A retrospective comparison of treatment response was made between a group of patients who underwent this technique before Y90 administration and a group of patients who received standard Y90 administration as a single dose into the proper hepatic artery or in divided doses into the immediate hepatic artery branches. The rest of the workup and treatment were identical in both groups, including routine embolization of potential nonhepatic, nontarget vessels (e.g., the gastroduodenal artery). Methods: A total of 32 patients (mean age 56.9 years, range 39–77 years) treated with Y90 between June 2004 and March 2008 were analyzed. The primary malignancy was colorectal in 29, breast in 2, and cholangiocarcinoma in 1. Group 1 comprised 20 patients who had no alterations to their hepatic arterial supply. Group 2 comprised 12 cases who had undergone prior embolization of hepatic arterial branches before administration of Y90. The response to treatment was assessed by comparing standardized uptake value (SUV) on the pre- and postprocedure fludeoxyglucose positron emission tomographic studies of representative lesions within the right and left lobes of the liver. Results: In group 1, significant response (P < 0.001) was seen among right lobe lesions but not among left lobe lesions (P = 0.549). In group 2, there was a significant response among both right (P = 0.028) and left (P = 0.014) lobe lesions. No difference was found in the response of right lobe lesions (P = 0.726) between groups 1 and 2; a significantly greater response was found in group 2 compared to group 1 (P

Isolation of the right subclavian artery in a patient with d-transposition of the great arteries

Directory of Open Access Journals (Sweden)

Alisa Arunamata

2015-01-01

Full Text Available Isolation of the right subclavian artery (RSCA is rare, and this finding in association with d-transposition of the great arteries (d-TGA is extremely unusual. We present a case of an isolated RSCA in a newborn with d-TGA in whom the clinical presentation was diagnostic. We discuss the imaging modalities used to confirm the diagnosis, the embryological basis of the finding, and the surgical repair.

Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings.

Science.gov (United States)

Yuceler, Zeyneb; Kantarci, Mecit; Yuce, Ihsan; Kizrak, Yesim; Bayraktutan, Ummugulsum; Ogul, Hayri; Kiris, Adem; Celik, Omer; Pirimoglu, Berhan; Genc, Berhan; Gundogdu, Fuat

2014-01-01

Our aim was to evaluate the diagnostic accuracy of 256-slice, high-pitch mode multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency. Eighty-eight patients underwent 256-slice MDCT angiography to evaluate their graft patency after CABG surgery using a prospectively synchronized electrocardiogram in the high-pitch spiral acquisition mode. Effective radiation doses were calculated. We investigated the diagnostic accuracy of high-pitch, low-dose, prospective, electrocardiogram-triggering, dual-source MDCT for CABG patency compared with catheter coronary angiography imaging findings. A total of 215 grafts and 645 vessel segments were analyzed. All graft segments had diagnostic image quality. The proximal and middle graft segments had significantly (P < 0.05) better mean image quality scores (1.18 ± 0.4) than the distal segments (1.31 ± 0.5). Using catheter coronary angiography as the reference standard, high-pitch MDCT had the following sensitivity, specificity, positive predictive value, and negative predictive value of per-segment analysis for detecting graft patency: 97.1%, 99.6%, 94.4%, and 99.8%, respectively. In conclusion, MDCT can be used noninvasively with a lower radiation dose for the assessment of restenosis in CABG patients.

Diagnostic performance of stress myocardial perfusion imaging for coronary artery disease: a systematic review and meta-analysis

International Nuclear Information System (INIS)

Jong, Marcus C. de; Genders, Tessa S.S.; Geuns, Robert-Jan van; Moelker, Adriaan; Hunink, M.G.M.

2012-01-01

To determine and compare the diagnostic performance of stress myocardial perfusion imaging (MPI) for the diagnosis of obstructive coronary artery disease (CAD), using conventional coronary angiography (CCA) as the reference standard. We searched Medline and Embase for literature that evaluated stress MPI for the diagnosis of obstructive CAD using magnetic resonance imaging (MRI), contrast-enhanced echocardiography (ECHO), single-photon emission computed tomography (SPECT) and positron emission tomography (PET). All pooled analyses were based on random effects models. Articles on MRI yielded a total of 2,970 patients from 28 studies, articles on ECHO yielded a sample size of 795 from 10 studies, articles on SPECT yielded 1,323 from 13 studies. For CAD defined as either at least 50 %, at least 70 % or at least 75 % lumen diameter reduction on CCA, the natural logarithms of the diagnostic odds ratio (lnDOR) for MRI (3.63; 95 % CI 3.26-4.00) was significantly higher compared to that of SPECT (2.76; 95 % CI 2.28-3.25; P = 0.006) and that of ECHO (2.83; 95 % CI 2.29-3.37; P = 0.02). There was no significant difference between the lnDOR of SPECT and ECHO (P = 0.52). Our results suggest that MRI is superior for the diagnosis of obstructive CAD compared with ECHO and SPECT. ECHO and SPECT demonstrated similar diagnostic performance. (orig.)

Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique

International Nuclear Information System (INIS)

Miyayama, Shiro; Matsui, Osamu; Taki, Keiichi; Minami, Tetsuya; Shinmura, Rieko; Ito, Chiharu; Takamatsu, Shigeyuki; Kobayashi, Miki; Ushiogi, Yashuyuki

2005-01-01

We retrospectively evaluated the usefulness of both arterial and venous access with the pull-through technique in endovascular treatment of totally occluded Brescia-Cimino fistulas. We treated 26 patients (17 men, 9 women; age range 43-82 years, mean age 66 years) with occluded Brescia-Cimino fistulas. First, the occluded segment was traversed from the antegrade brachial arterial access using a microcatheter-guidewire system. Second, the vein was retrogradely punctured after confirmation of all diseased segments, and a 0.014- or 0.016-inch guidewire was pulled through the venous access when the occluded segment was long. All interventions including thrombolysis, thromboaspiration, angioplasty, and stent placement were performed via the venous access. The occlusion was successfully crossed via the brachial arterial access in 23 patients (88%). In 2 patients it was done from the venous approach. In the remaining patient it was not possible to traverse the occluded segment. The pull-through technique was successful in all 19 attempts. Clinical success was achieved in 96%, the primary patency rates at 6, 12, and 18 months were 83%, 78%, and 69%, the primary assisted patency rates were 92%, 92%, and 72%, and the secondary patency rates were 92%, 92%, and 92%, respectively. Minor complications in 5 patients included venous perforation in 2 (8%), venous rupture in 1 (4%), and regional hematoma in 2 (8%). Our study suggests that endovascular treatments with both arterial and venous access using the pull-through technique are highly effective in restoring function in totally occluded Brescia-Cimino fistulas

ICF implosion hotspot ion temperature diagnostic techniques based on neutron time-of-flight method

International Nuclear Information System (INIS)

Tang Qi; Song Zifeng; Chen Jiabin; Zhan Xiayu

2013-01-01

Ion temperature of implosion hotspot is a very important parameter for inertial confinement fusion. It reflects the energy level of the hotspot, and it is very sensitive to implosion symmetry and implosion speed. ICF implosion hotspot ion temperature diagnostic techniques based on neutron time-of-flight method were described. A neutron TOF spectrometer was developed using a ultrafast plastic scintillator as the neutron detector. Time response of the spectrometer has 1.1 ns FWHM and 0.5 ns rising time. TOF spectrum resolving method based on deconvolution and low pass filter was illuminated. Implosion hotspot ion temperature in low neutron yield and low ion temperature condition at Shenguang-Ⅲ facility was acquired using the diagnostic techniques. (authors)

Anomalous Coronary Artery From the Opposite Sinus (ACAOS): Technical Challenges During Percutaneous Coronary Intervention.

Science.gov (United States)

Sinha, Santosh Kumar; Razi, Mahmodula; Mahrotra, Anupam; Aggarwal, Puneet; Singh, Anupam; Rekwal, Lokendra; Tripathi, Sunil; Abhishekh, Nishant Kumar; Krishna, Vinay

2018-04-01

Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Ectopic origin of right coronary artery (RCA) from opposite sinus is one of the most common and they are mainly benign, but at times may be malignant. We report a case of a 69-year-old male who underwent early invasive percutaneous coronary intervention for non-ST-segment elevation myocardial infarction (NSTEMI) where RCA arising from left sinus at the root of left main artery was culprit and various technical challenges were encountered while intervening in form of cannulation to tracking of hardwares. RCA was cannulated with floating wire technique using hockey stick guide catheter and revascularized by deployment of 3.5 × 38 mm Promus Premier Everolimus eluting stent (Boston Scientific, USA). To the best of our knowledge, this is the first ever report of ectopic RCA being revascularized by using hockey stick catheter.

Analysis of deep inferior epigastric perforator (DIEP) arteries by using MDCTA: Comparison between 2 post-processing techniques.

Science.gov (United States)

Saba, Luca; Atzeni, Matteo; Ribuffo, Diego; Mallarini, Giorgio; Suri, Jasjit S

2012-08-01

Our purpose was to compare two post-processing techniques, Maximum-Intensity-Projection (MIP) and Volume Rendering (VR) for the study of perforator arteries. Thirty patients who underwent Multi-Detector-Row CT Angiography (MDCTA) between February 2010 and May 2010 were retrospectively analyzed. For each patient and for each reconstruction method, the image quality was evaluated and the inter- and intra-observer agreement was calculated according to the Cohen statistics. The Hounsfield Unit (HU) value in the common femoral artery was quantified and the correlation (Pearson Statistic) between image quality and HU value was explored. The Pearson r between the right and left common femoral artery was excellent (r=0.955). The highest image quality score was obtained using MIP for both observers (total value 75, with a mean value 2.67 for observer 1 and total value of 79 and a mean value of 2.82 for observer 2). The highest agreement between the two observers was detected using the MIP protocol with a Cohen kappa value of 0.856. The ROC area under the curve (Az) for the VR is 0.786 (0.086 SD; p value=0.0009) whereas the ROC area under the curve (Az) for the MIP is 0.0928 (0.051 SD; p value=0.0001). MIP showed the optimal inter- and intra-observer agreement and the highest quality scores and therefore should be used as post-processing techniques in the analysis of perforating arteries. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Tentorial artery embolization in tentorial dural arteriovenous fistulas

Energy Technology Data Exchange (ETDEWEB)

Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

2006-10-15

The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

Tentorial artery embolization in tentorial dural arteriovenous fistulas

International Nuclear Information System (INIS)

Rooij, Willem Jan van; Sluzewski, Menno; Beute, Guus N.

2006-01-01

The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

Subclavian artery dissection during diagnostic cardiac catheterization: the role of conservative management.

Science.gov (United States)

Frohwein, S; Ververis, J J; Marshall, J J

1995-04-01

Dissection of the subclavian artery during routine cardiac catheterization while obtaining cannulation to the left internal mammary artery is an unusual complication and to our knowledge has never been reported. Conservative management of this vascular injury can avoid the sequelae of high-risk surgical repairs made difficult by a complex operative exposure. We describe a case in which dissection of the left subclavian artery was treated conservatively with an excellent outcome.

Aneurysm of the superior mesenteric artery

Energy Technology Data Exchange (ETDEWEB)

Gebauer, A

1984-11-01

This is a report about 4 patients with aneurysms of the superior mesenteric artery of arteriosclerotic, mycotic and probably congenital etiology together with a review of the literature as to the etiology, diagnostic possibilities and therapy. Arteriography is the method of choice even though a diagnosis may be possible by sonography or CT in special cases. Even though an aneurysm of the superior mesenteric artery is rare, it has to be considered in the differential diagnosis of persisting abdominal problems of unknown origin. This is especially true for patients with a predisposing history such as previous or existing endocarditis, sepsis, arteriosclerosis and hypertension. Because of the possibility of rupture followed by life threating bleeding an adequate diagnostic step such as arteriography has to be considered finally.

Correlative magnetic resonance imaging in the evaluation of aortic and pulmonary artery abnormalities

Energy Technology Data Exchange (ETDEWEB)

Risius, B.; O' Donnell, J.K.; Geisinger, M.A.; Zelch, M.G.; George, C.R.; Graor, R.A.; Moodie, D.S.

1985-05-01

Magnetic resonance imaging (MRI) yields excellent quality images of the cardiovascular system utilizing the inherent natural contrast between flowing blood and the surrounding anatomic structures. To evaluate the clinical usefulness of MRI in the noninvasive diagnosis of large vessel disorders, the authors have performed MRI on 40 pts with either aortic or pulmonary artery abnormalities (18 thoracic or abdominal aortic aneurysms, 8 aorto-occlusive disease, 6 dissecting aneurysms, 4 Marfan's syndrome, 2 pulmonary artery aneurysms 1 pulmonary artery occlusion, 1 aortic coarctation). Images were obtained in the transverse, coronal and sagital body planes utilizing a 0.6T superconductive magnet. Cardiac and/or respiratory gating was employed in most cases. Correlation was made for all studies with conventional or digital subtraction angiography, computed tomography, and/or ultrasound. The diagnostic information obtained by MRI equaled or exceeded that obtained by other imaging techniques except for the few cases where cardiac arrhythmias precluded adequate gated acquisition. All aneurysms and their relationships to adjacent structures were readily demonstrated as were the presence or absence of mural thrombi and dissecting intimal flaps. Angiographically demonstrated atherosclerotic plaques and luminal stenoses were seen by MRI in all patients without arrhythmias. The authors concluded that MRI is a powerful noninvasive diagnostic aid in the delineation of large vessel disorders, especially where knowledge of anatomic interrelationships can guide surgical or other interventional planning.

Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction

DEFF Research Database (Denmark)

Tahvanainen, Minna; Nikus, Kjell C; Holmvang, Lene

2011-01-01

Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored.......Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored....

Intraluminal milrinone for dilation of the radial artery graft.

Science.gov (United States)

García-Rinaldi, R; Soltero, E R; Carballido, J; Mojica, J

1999-01-01

There is renewed interest in the use of the radial artery as a conduit for coronary artery bypass surgery. The radial artery is, however, a very muscular artery, prone to vasospasm. Milrinone, a potent vasodilator, has demonstrated vasodilatory properties superior to those of papaverine. In this report, we describe our technique of radial artery harvesting and the adjunctive use of intraluminal milrinone as a vasodilator in the preparation of this conduit for coronary artery bypass grafting. We have used these techniques in 25 patients who have undergone coronary artery bypass grafting using the radial artery. No hand ischemic complications have been observed in this group. Intraluminal milrinone appears to dilate and relax the radial artery, rendering this large conduit spasm free and very easy to use. We recommend the skeletonization technique for radial artery harvesting and the use of intraluminal milrinone as a radial artery vasodilator in routine myocardial revascularization. PMID:10524740

First Clinical Investigations of New Ultrasound Techniques in Three Patient Groups: Patients with Liver Tumors, Arteriovenous Fistulas, and Arteriosclerotic Femoral Arteries

DEFF Research Database (Denmark)

Hansen, Peter Møller

In this PhD project two newer ultrasound techniques are for the first time used for clinical scans of patients with malignant liver tumors (Study I), arteriovenous fistulas for hemodialysis (Study II) and arteriosclerotic femoral arteries (Study III). The same commercial ultrasound scanner was us...... of the new ultrasound techniques in selected groups of patients. For all three studies the results are promising, and hopefully the techniques will find their way into everyday clinical practice for the benefit of both patients and healthcare practitioners.......In this PhD project two newer ultrasound techniques are for the first time used for clinical scans of patients with malignant liver tumors (Study I), arteriovenous fistulas for hemodialysis (Study II) and arteriosclerotic femoral arteries (Study III). The same commercial ultrasound scanner was used...... in all three studies. Study I was a comparative study of B-mode ultrasound images obtained with conventional technique and the experimental technique Synthetic Aperture Sequential Beamforming (SASB). SASB is a datareducing version of the technique synthetic aperture, which has the potential to produce...

Plasma diagnostic techniques in thermal-barrier tandem-mirror fusion experiments

International Nuclear Information System (INIS)

Silver, E.H.; Clauser, J.F.; Carter, M.R.; Failor, B.H.; Foote, J.H.; Hornady, R.S.; James, R.A.; Lasnier, C.J.; Perkins, D.E.

1986-01-01

We review two classes of plasma diagnostic techniques used in thermal-barrier tandem-mirror fusion experiments. The emphasis of the first class is to study mirror-trapped electrons at the thermal-barrier location. The focus of the second class is to measure the spatial and temporal behavior of the plasma space potential at various axial locations. The design and operation of the instruments in these two categories are discussed and data that are representative of their performance is presented

Laser diagnodent: a comparative study with other diagnostic techniques

International Nuclear Information System (INIS)

Godinho, Reugma Rego

2002-01-01

An evaluation of the Diagnodent equipment (Kavo Company, Germany) for the occlusal caries detection was dane through the comparison with other conventional diagnostic techniques, such as visual inspection, intra-oral micro camera and digital X-ray. The effectiveness of the equipment in the detection of hidden caries and its viability as a diagnosis method for caries in their initial stage was also studied. Fifty eight permanent molars and premolars teeth from patients with age between 6 and 30 years were studied. The obtained results indicated that the conventional methods employed for the caries diagnosis are unable to detect the carious lesion in its initial stage. The Diagnodent equipment has this capability to detect caries presenting a flawless surface, specially the hidden caries, allowing the dentist to decide between a preventive ar a conservative procedure. The main advantage of the Diagnodent is to be an objective method, compared to the visual and radiographic ones, that are dependent on the professional interpretation. The Diagnodent is, therefore, a promising alternative as an objective and standardized diagnosis method for the final diagnostic. (author)

Characterization of gut microbiota profiles in coronary artery disease patients using data mining analysis of terminal restriction fragment length polymorphism: gut microbiota could be a diagnostic marker of coronary artery disease.

Science.gov (United States)

Emoto, Takuo; Yamashita, Tomoya; Kobayashi, Toshio; Sasaki, Naoto; Hirota, Yushi; Hayashi, Tomohiro; So, Anna; Kasahara, Kazuyuki; Yodoi, Keiko; Matsumoto, Takuya; Mizoguchi, Taiji; Ogawa, Wataru; Hirata, Ken-Ichi

2017-01-01

The association between atherosclerosis and gut microbiota has been attracting increased attention. We previously demonstrated a possible link between gut microbiota and coronary artery disease. Our aim of this study was to clarify the gut microbiota profiles in coronary artery disease patients using data mining analysis of terminal restriction fragment length polymorphism (T-RFLP). This study included 39 coronary artery disease (CAD) patients and 30 age- and sex- matched no-CAD controls (Ctrls) with coronary risk factors. Bacterial DNA was extracted from their fecal samples and analyzed by T-RFLP and data mining analysis using the classification and regression algorithm. Five additional CAD patients were newly recruited to confirm the reliability of this analysis. Data mining analysis could divide the composition of gut microbiota into 2 characteristic nodes. The CAD group was classified into 4 CAD pattern nodes (35/39 = 90 %), while the Ctrl group was classified into 3 Ctrl pattern nodes (28/30 = 93 %). Five additional CAD samples were applied to the same dividing model, which could validate the accuracy to predict the risk of CAD by data mining analysis. We could demonstrate that operational taxonomic unit 853 (OTU853), OTU657, and OTU990 were determined important both by the data mining method and by the usual statistical comparison. We classified the gut microbiota profiles in coronary artery disease patients using data mining analysis of T-RFLP data and demonstrated the possibility that gut microbiota is a diagnostic marker of suffering from CAD.

Resonant laser techniques for combustion and flow diagnostics

Energy Technology Data Exchange (ETDEWEB)

Fritzon, Rolf

1998-05-01

This thesis presents results from two areas of research. Firstly, the resonant coherent laser techniques polarization spectroscopy (PS), degenerate four-wave mixing (DFWM) and stimulated emission (SE) have been developed in the general field of combustion diagnostics. Secondly, laser induced fluorescence (LIF) has been developed and applied for the visualization of mixture fractions in turbulent non reacting flows. PS was developed for instantaneous two-dimensional imaging of minor species in flames, the technique being demonstrated on OH and NO. Various aspects of imaging and of detection in general were investigated. Two-photon induced PS was demonstrated for the detection of NH{sub 3}, CO and N{sub 2} molecules. LIF was monitored simultaneously to allow a quantitative comparison between the techniques. Furthermore, PS and DFWM were developed for instantaneous two-dimensional OH temperature imaging. Through a novel experimental approach based on the use of a dual-wavelength dye laser and a diffraction grating the temperature imaging measurements were performed using only one laser and one CCD camera. A comparison between the two techniques was made. SE was through a crossed-beam arrangement developed for spatially resolved detection of flame species. Two-dimensional LIF was developed and applied for measuring mixture fractions in the shear layer between two co-flowing turbulent gaseous jets. The technique was further applied in a study of the mixing of a turbulent water jet impinging orthogonally onto a flat surface. Average concentration fields in the center-plane of the jet was compared with results from large eddy simulations and with data from the literature 221 refs, 48 figs, 5 tabs

A Simplified Technique of Percutaneous Hepatic Artery Port-Catheter Insertion for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Invasion

Energy Technology Data Exchange (ETDEWEB)

Choi, Sun Young [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Kim, Ah Hyun; Lee, Do Yun; Lee, Kwang Hun; Won, Jong Yun [Yonsei University College of Medicine, Severance Hospital, Seoul (Korea, Republic of); Kim, Kyung Ah [Inje University Ilsan Paik Hospital, Ilsan (Korea, Republic of)

2010-12-15

We assessed the outcomes of a simplified technique for the percutaneous placement of a hepatic artery port-catheter system for chemotherapy infusion in advanced hepatocellular carcinoma with portal vein invasion. From February 2003 to February 2008, percutaneous hepatic artery port-catheter insertion was performed in 122 patients who had hepatocellular carcinoma with portal vein invasion. The arterial access route was the common femoral artery. The tip of the catheter was wedged into the right gastroepiploic artery without an additional fixation device. A side hole was positioned at the distal common hepatic artery to allow the delivery of chemotherapeutic agents into the hepatic arteries. Coil embolization was performed only to redistribute to the hepatic arteries or to prevent the inadvertent delivery of chemotherapeutic agents into extrahepatic arteries. The port chamber was created at either the supra-inguinal or infra-inguinal region. Technical success was achieved in all patients. Proper positioning of the side hole was checked before each scheduled chemotherapy session by port angiography. Catheter-related complications occurred in 19 patients (16%). Revision was achieved in 15 of 18 patients (83%). This simplified method demonstrates excellent technical feasibility, an acceptable range of complications, and is hence recommended for the management of advanced hepatocellular carcinoma with portal vein thrombosis

Dual-phase helical CT using bolus triggering technique: optimization of transition time

International Nuclear Information System (INIS)

Choi, Young Ho; Kim, Tae Kyoung; Park, Byung Kwan; Koh, Young Hwan; Han, Joon Koo; Choi, Byung Ihn

1999-01-01

To optimize the transition time between the triggering point in monitoring scanning and the initiation of diagnostic hepatic arterial phase (HAP) scanning in hepatic spiral CT, using a bolus triggering technique. One hundred consecutive patients with focal hepatic lesion were included in this study. Patients were randomized into two groups. Transition times of 7 and 11 seconds were used in group 1 and 2, respectively. In all patients, bolus triggered HAP spiral CT was obtained using a semi-automatic bolus tracking program after the injection of 120mL of non-ionic contrast media at a rate of 3mL/sec. When aortic enhancement reached 90 HU, diagnostic HAP scanning began after a given transition time. From images of group 1 and group 2, the degree of parenchymal enhancement of the liver and tumor-to-liver attenuation difference were measured. Also, for qualitative analysis, conspicuity of the hepatic artery and hypervascular tumor was scored and analyzed. Hepatic parenchymal enhancement on HAP was 12.07 + /-6.44 HU in group 1 and 16.03 + /-5.80 HU in group 2 (p .05). In the evaluation of conspicuity of hepatic artery, there was no statistically significant difference between the two groups (p > .05). The conspicuity of hypervascular tumors in group 2 was higher than in group 1 (p < .05). HAP spiral CT using a bolus triggering technique with a transition time of 11 seconds provides better HAP images than when the transition time is 7 seconds

Aneurysm of the superior mesenteric artery

International Nuclear Information System (INIS)

Gebauer, A.

1984-01-01

This is a report about 4 patients with aneurysms of the superior mesenteric artery of arteriosclerotic, mycotic and probably congenital etiology together with a review of the literature as to the etiology, diagnostic possibilities and therapy. Arteriography is the method of choice even though a diagnosis may be possible by sonography or CT in special cases. Even though an aneurysm of the superior mesenteric artery is rare, it has to be considered in the differential diagnosis of persisting abdominal problems of unknown origin. This is especially true for patients with a predisposing history such as previous or existing endocarditis, sepsis, arteriosclerosis and hypertension. Because of the possibility of rupture followed by life threating bleeding an adequate diagnostic step such as arteriography has to be considered finally. (orig.) [de

Evaluation of the carotid artery stenosis based on minimization of mechanical energy loss of the blood flow.

Science.gov (United States)

Sia, Sheau Fung; Zhao, Xihai; Li, Rui; Zhang, Yu; Chong, Winston; He, Le; Chen, Yu

2016-11-01

Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss. Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss. We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

MR cholangiopancreatography: prospective comparison of a breath-hold 2D projection technique with diagnostic ERCP

International Nuclear Information System (INIS)

Lomas, D.J.; Bearcroft, P.W.P.; Gimson, A.E.

1999-01-01

The aim of this study was to compare prospectively a breath-hold projection magnetic resonance cholangiopancreatography (MRCP) technique with diagnostic endoscopic retrograde cholangiopancreatography (ERCP). Seventy-six patients with suspected strictures or choledocholithiasis were referred for MRCP and subsequent ERCP examination, which were performed within 4 h of each other. The MRCP technique was performed using fat-suppressed rapid acquisition with relaxation enhancement (RARE) projection images obtained in standardised planes with additional targeted projections as required by the supervising radiologist. Two radiologists (in consensus) assessed the MRCP results prospectively and independently for the presence of bile duct calculi, strictures, non-specific biliary dilatation and pancreatic duct dilatation, and recorded a single primary diagnosis. The ERCP was assessed prospectively and independently by a single endoscopist and used as a gold standard for comparison with MRCP. Diagnostic agreement was assessed by the Kappa statistic. The MRCP technique failed in two patients and ERCP in five. In the remaining 69 referrals ERCP demonstrated normal findings in 23 cases, strictures in 19 cases, choledocholithiasis in 9 cases, non-specific biliary dilatation in 14 cases and chronic pancreatitis in 4 cases. The MRCP technique correctly demonstrated 22 of 23 normal cases, 19 strictures with one false positive (sensitivity 100 %, specificity 98 %), all 9 cases of choledocholithiasis with two false positives (sensitivity 100 %, specificity 97 %), 12 of 14 cases of non-specific biliary dilatation and only 1 of 4 cases of chronic pancreatitis. There was overall good agreement for diagnosis based on a kappa value of 0.88. Breath-hold projection MRCP can provide non-invasively comparable diagnostic information to diagnostic ERCP for suspected choledocholithiasis and biliary strictures and may allow more selective use of therapeutic ERCP. (orig.)

Optimized design of shields for diagnostic X rays with NCRP 147 technique

International Nuclear Information System (INIS)

Gama T, G.

2006-01-01

A comparison among the design techniques of shielding for X-ray diagnostic rooms with the NCRP 49 (1976) report technique, AAPM 39 (1993) Y the one of the NCRP 147 (2005) technique. The designs correspond to a room of conventional X-rays, one of fluoroscopy, one of tomography Y one of mammography. In all the cases it demonstrates that the NCRP 49 technique overestimate the shieldings. The causes of the overestimation of the NCRP 49 can be attributed to: a) high values of the work charge that don't consider the spectral fluence of the photons that are present in each room, b) to the differences in the values of the kerma in air without attenuation for the dispersed primary radiation Y of leakage among both reports. (Author)

Assessing the blood pressure waveform of the carotid artery using an ultrasound image processing method

Energy Technology Data Exchange (ETDEWEB)

Soleimani, Effat; Mokhtari-Dizaji, Manijhe [Dept. of Medical Physics, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Fatouraee, Nasser [Dept. of Medical Engineering, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Saben, Hazhir [Dept. Radiology, Imaging Center of Imam Khomaini Hospital, Tehran Medical Sciences University, Tehran (Iran, Islamic Republic of)

2017-04-15

The aim of this study was to introduce and implement a noninvasive method to derive the carotid artery pressure waveform directly by processing diagnostic sonograms of the carotid artery. Ultrasound image sequences of 20 healthy male subjects (age, 36±9 years) were recorded during three cardiac cycles. The internal diameter and blood velocity waveforms were extracted from consecutive sonograms over the cardiac cycles by using custom analysis programs written in MATLAB. Finally, the application of a mathematical equation resulted in time changes of the arterial pressure. The resulting pressures were calibrated using the mean and the diastolic pressure of the radial artery. A good correlation was found between the mean carotid blood pressure obtained from the ultrasound image processing and the mean radial blood pressure obtained using a standard digital sphygmomanometer (R=0.91). The mean absolute difference between the carotid calibrated pulse pressures and those measured clinically was -1.333±6.548 mm Hg. The results of this study suggest that consecutive sonograms of the carotid artery can be used for estimating a blood pressure waveform. We believe that our results promote a noninvasive technique for clinical applications that overcomes the reproducibility problems of common carotid artery tonometry with technical and anatomical causes.

Assessing the blood pressure waveform of the carotid artery using an ultrasound image processing method

International Nuclear Information System (INIS)

Soleimani, Effat; Mokhtari-Dizaji, Manijhe; Fatouraee, Nasser; Saben, Hazhir

2017-01-01

The aim of this study was to introduce and implement a noninvasive method to derive the carotid artery pressure waveform directly by processing diagnostic sonograms of the carotid artery. Ultrasound image sequences of 20 healthy male subjects (age, 36±9 years) were recorded during three cardiac cycles. The internal diameter and blood velocity waveforms were extracted from consecutive sonograms over the cardiac cycles by using custom analysis programs written in MATLAB. Finally, the application of a mathematical equation resulted in time changes of the arterial pressure. The resulting pressures were calibrated using the mean and the diastolic pressure of the radial artery. A good correlation was found between the mean carotid blood pressure obtained from the ultrasound image processing and the mean radial blood pressure obtained using a standard digital sphygmomanometer (R=0.91). The mean absolute difference between the carotid calibrated pulse pressures and those measured clinically was -1.333±6.548 mm Hg. The results of this study suggest that consecutive sonograms of the carotid artery can be used for estimating a blood pressure waveform. We believe that our results promote a noninvasive technique for clinical applications that overcomes the reproducibility problems of common carotid artery tonometry with technical and anatomical causes

Use of paravascular admittance waveforms to monitor relative change in arterial blood pressure

Science.gov (United States)

Zielinski, Todd M.; Hettrick, Doug; Cho, Yong

2010-04-01

Non-invasive methods to monitor ambulatory blood pressure often have limitations that can affect measurement accuracy and patient adherence [1]. Minimally invasive measurement of a relative blood pressure surrogate with an implantable device may provide a useful chronic diagnostic and monitoring tool. We assessed a technique that uses electrocardiogram and paravascular admittance waveform morphology analysis to one, measure a time duration (vascular tone index, VTI in milliseconds) change from the electrocardiogram R-wave to admittance waveform peak and two, measure the admittance waveform minimum, maximum and magnitude as indicators of change in arterial compliance/distensibility or pulse pressure secondary to change in afterload. Methods: Five anesthetized domestic pigs (32 ± 4.2 kg) were used to study the effects of phenylephrine (1-5 ug/kg/min) on femoral artery pressure and admittance waveform morphology measured with a quadrapolar electrode array catheter placed next to the femoral artery to assess the relative change in arterial compliance due to change in peripheral vascular tone. Results: Statistical difference was observed (p blood pressure may be suitable for implantable devices to detect progression of cardiovascular disease such as hypertension.

Local release of ATP into the arterial inflow and venous drainage of human skeletal muscle: insight from ATP determination with the intravascular microdialysis technique

DEFF Research Database (Denmark)

Mortensen, Stefan; Thaning, Pia; Nyberg, Michael Permin

2011-01-01

is released into plasma, we measured plasma [ATP] with the intravascular microdialysis technique at rest and during dynamic exercise (normoxia and hypoxia), passive exercise, thigh compressions and arterial ATP, tyramine and ACh infusion in a total of 16 healthy young men. Femoral arterial and venous...

Development of technique for diagnostics of social reserves of development of collective labour potential

OpenAIRE

Голубєв, Станіслав Миколайович

2015-01-01

The problems of diagnostics of social reserves of the collective labour potential are considered in the article. The aim of this study is to develop diagnostic techniques of social reserves of the collective labour potential in the work and the essence of the concept of "social reserves" as a subject of study of economics and their features in the study of collective labour potential. The use of these reserves can increase the efficiency of the labour collective processes by improving coopera...

Selective intra-arterial administration of 18F-FDG to the rat brain - effects on hemispheric uptake

International Nuclear Information System (INIS)

Arnberg, Fabian; Samen, Erik; Lundberg, Johan; Grafstroem, Jonas; Soederman, Michael; Stone-Elander, Sharon; Holmin, Staffan; Lu, Li

2014-01-01

The purpose of this study was to investigate the radioligand uptake and iodine contrast distribution in the intra- and extracranial circulation of the rat, after intra-arterial injections to the common carotid artery and different parts of the internal carotid artery. All animal experiments were carried out in accordance with Karolinska Institutet's guidelines and were approved by the local laboratory animal ethics committee. We used clinical neurointerventional systems to place microcatheters in the extra- or intracranial carotid artery of 15 Sprague-Dawley rats. Here, injection dynamics of iodine contrast was assessed using digital subtraction angiography. Maintaining the catheter position, the animals were placed in a micro PET and small-animal positron emission tomography (PET) was used to analyze injections [2- 18 F]-2-fluoro-2-deoxy-d-glucose ( 18 F-FDG). Microcatheters had to be placed in the intracranial carotid artery (iICA) for the infusate to distribute to the brain. Selective injection via the iICA resulted in a 9-fold higher uptake of 18 F-FDG in the injected hemisphere (p < 0.005) compared to both intravenous and more proximal carotid artery injections. Furthermore, selective injection gave a dramatically improved contrast between the brain and extracranial tissue. Intra-arterial injection increases the cerebral uptake of a radiotracer dramatically compared to systemic injection. This technique has potential applications for endovascular treatment of malignancies allowing intra-interventional modifications of injection strategy, based on information on tumor perfusion and risk to surrounding normal parenchyma. Furthermore the technique may increase diagnostic sensitivity and avoid problems due to peripheral pharmacological barriers and first passage metabolism of labile tracers. (orig.)

Impact of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in multislice Computed Tomography coronary angiography

International Nuclear Information System (INIS)

Cademartiri, Filippo; Mollet, Nico R.; Kriestin, Gabriel P.; Runza, Giuseppe; Bartolotta, Tommaso Vincenzo; Galia, Massimo; Midiri, Massimo; Belgrano, Manuel; Pozzi Mucelli, Roberto

2005-01-01

Purpose. To assess the effect of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in the detection of significant coronary artery stenosis using 16-row multislice computed tomography (MSCT). Materials and methods. One hundred patients (88 males; 59±11 years) with suspected coronary artery disease who had undergone conventional coronary angiography (CA) and MSCT-CA were retrospectively enrolled for the study. Patients underwent a MSCT-CA, with the following protocol: collimation 16x0.75 mm, gantry rotation time 420 ms, feed/rotation 2.8 mm, kV 120, mAs 400-500. The protocol for contrast material administration was 100 ml of Iodixanol 320 mgI/nl at 4 ml/s and the scan delay was defined with a bolus tracking technique. In all patients vascular enhancement was measured in the aortic root, and the left and the right coronary arteries. The average enhancement was used to divide the population in two groups of 50 patients each, one with lower enhancement (Low), and one with higher enhancement (High). In the two groups diagnostic accuracy (per coronary segment) for the detection of significant stenosis (≥50% lumen reduction) was evaluated in vessels ≥2mm in diameter using quantitative CA as the reference standard. The differences in diagnostic accuracy were compared with a Chi-square test and a p [it

Actual review of diagnostics and endovascular therapy of intracranial arterial stenoses

International Nuclear Information System (INIS)

Gizewski, E.R.; Weber, R.; Forsting, M.

2011-01-01

Approximately 6 - 50 % of all ischemic strokes are caused by intracranial arterial stenosis (IAS). Despite medical prevention, patients with symptomatic IAS have a high annual risk for recurrent ischemic stroke of about 12 %, and up to 19 % in the case of high-grade IAS (≥ 70 %). Digital subtraction angiography remains the gold standard for the diagnosis and grading of IAS. However, noninvasive imaging techniques including CT angiography, MR angiography, or transcranial Doppler and duplex ultrasound examinations are used in the clinical routine to provide additional information about the brain structure and hemodynamic. However, for technical reasons, the grading of stenoses is sometimes difficult and inaccurate. To date, aspirin is recommended as the treatment of choice in the prevention of recurrent ischemic stroke in patients with IAS. IAS patients who suffer a recurrent ischemic stroke or transient ischemic attack while taking aspirin can be treated with endovascular stenting or angioplasty in specialized centers. The periprocedural complication rate of these endovascular techniques is about 2 - 7 % at experienced neuro-interventional centers. The rate of re-stenosis is reported between 10 and 40 % depending on patient age and stenosis location. Further randomized studies comparing medical secondary prevention and endovascular therapy are currently being performed. With regard to the improvement of endovascular methods and lower complication rates, the indication for endovascular therapy in IAS could be broadened especially for stenosis in the posterior circulation. (orig.)

Early results from an angiosome-directed open surgical technique for venous arterialization in patients with critical lower limb ischemia

Directory of Open Access Journals (Sweden)

Kim Houlind

2013-12-01

Full Text Available Background: Patients with critical lower limb ischemia without patent pedal arteries cannot be treated by the conventional arterial reconstruction. Venous arterialization has been suggested to improve limb salvage in this subgroup of patients but has not gained wide acceptance. We report our early experience after implementing deep and superficial venous arterialization of the lower limb. Materials and methods: Ten patients with critical ischemia and without crural or pedal arteries available for conventional bypass surgery or angioplasty were treated with distal venous arterialization. Inflow was from the most distal unobstructed segment. Run-off was the dorsal pedal venous arch (n=5, the dorsal pedal venous arch and a concomitant vein of the posterior tibial artery (n=3, or the dorsal pedal venous arch and a concomitant vein of the common plantar artery (n=2 depending on the location of the ischemic lesion. Venous valves were destroyed using antegrade valvulotomes, guide wires, knob needles, or retrograde valvulotomes via an extra incision. Results: Seven of the operated limbs were amputated after 23 (1–256 days (median [range]. The main reasons for amputation were lack of healing of either the original wound, of incisional wounds on the foot, or persisting pain at rest. In three cases, the bypass was open at the time of amputation. Two patients experienced complete wound healing after 231 and 342 days, respectively. By the end of follow-up, the last patient was ambulating with slow wound healing but without pain 309 days after surgery. Conclusion: Venous arterialization may be used as a treatment of otherwise unsalveable limbs. The success rate is, however, limited. Technical optimization of the technique is warranted.

Techniques in Vascular and Interventional Radiology Drug Delivery Technologies in the Superficial Femoral Artery

Science.gov (United States)

Brahmbhatt, Akshaar; Misra, Sanjay

2016-01-01

Peripheral Arterial Disease (PAD) affects over 8 million people in the United States alone. While great strides have been made in reducing the burden of cardiovascular disease the prevalence of PAD is expected to rise as the global population ages. PAD characterized by narrowing of arterial blood can be asymptomatic or cause acute limb threatening claudication. It has been classically treated with bypass, but these techniques have been supplanted by endovascular therapy. Plain old Balloon Angioplasty (POBA) has been successful in helping revascularize lesions, but its effect has not been durable due to restenosis. This prompted the creation of several technologies aimed at reducing restenosis. These advances slowly improved outcomes and the durability of endovascular management. Amongst the main tools used in current endovascular practice are drug delivery devices aimed at inhibiting the inflammatory and proliferative pathways that lead to restenosis. This review will examine the current drug delivery technologies used in the SFA. PMID:27423996

New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures

NARCIS (Netherlands)

Weinschenk, Stefan; Hollmann, Markus W.; Strowitzki, Thomas

2016-01-01

Pudendal nerve injection is used as a diagnostic procedure in the vulvar region and for therapeutic purposes, such as in vulvodynia. Here, we provide a new, easy-to-perform perineal injection technique. We analyzed 105 perineal injections into the pudendal nerve with a local anesthetic (LA),

Comparing the Effect of Continuous and Intermittent Irrigation Techniques on Complications of Arterial Catheter and Partial Thromboplastin Time in Patients Following Coronary Artery Bypass Grafting Surgery

Directory of Open Access Journals (Sweden)

Sedigheh Arta

2017-04-01

Full Text Available Background: Different approaches are available to irrigate the arterial catheter, such as continuous and intermittent techniques. However, there is a disagreement regarding the most appropriate method. Aim: this study aimed to compare the effect of two continuous and intermittent irrigation methods on complications of arterial catheter and partial thromboplastin time (PTT in patients with coronary artery bypass (CABG surgery. Method: This randomized clinical trial was conducted on 60 participants undergoing coronary artery bypass grafting surgery in open-heart surgery ICU at Imam Reza hospital in Mashhad, Iran, in 2016. In continuous group, the arterial catheter was continuously irrigated with heparin solution at the rate of 2cc/h, and in the intermittent group with a syringe containing 5cc heparin solution every 3 hours. In both groups, catheter was monitored and recorded every 3 hours (until 48 hours and 3 times from enrollment in terms of complications of partial thromboplastin time. Data were analyzed using SPSS version 16. Results: The findingsof independent t-test showed that the two groups are homogeneous in age (P =0.48. The result of Fisher's exact test revealed no significant difference between the two groups in terms of average incidence of complications during the first 24 hours (P=0.55 and second 24 hours (P=0.55 after catheterization. Also during the 48 hours after surgery, independent t-test results showed no statistically significant difference in partial thromboplastin time (P=0.53 between the two groups. Implications for Practice: According to the results of the research based on the lack of difference between continuous and intermittent irrigation methods up to 48 hours after catheter replacement in terms of arterial catheter complications, further long-term follow-up researches are recommended.

Stable coronary syndromes: pathophysiology, diagnostic advances and therapeutic need

Science.gov (United States)

Corcoran, David

2018-01-01

The diagnostic management of patients with angina pectoris typically centres on the detection of obstructive epicardial CAD, which aligns with evidence-based treatment options that include medical therapy and myocardial revascularisation. This clinical paradigm fails to account for the considerable proportion (approximately one-third) of patients with angina in whom obstructive CAD is excluded. This common scenario presents a diagnostic conundrum whereby angina occurs but there is no obstructive CAD (ischaemia and no obstructive coronary artery disease—INOCA). We review new insights into the pathophysiology of angina whereby myocardial ischaemia results from a deficient supply of oxygenated blood to the myocardium, due to various combinations of focal or diffuse epicardial disease (macrovascular), microvascular dysfunction or both. Macrovascular disease may be due to the presence of obstructive CAD secondary to atherosclerosis, or may be dynamic due to a functional disorder (eg, coronary artery spasm, myocardial bridging). Pathophysiology of coronary microvascular disease may involve anatomical abnormalities resulting in increased coronary resistance, or functional abnormalities resulting in abnormal vasomotor tone. We consider novel clinical diagnostic techniques enabling new insights into the causes of angina and appraise the need for improved therapeutic options for patients with INOCA. We conclude that the taxonomy of stable CAD could improve to better reflect the heterogeneous pathophysiology of the coronary circulation. We propose the term ‘stable coronary syndromes’ (SCS), which aligns with the well-established terminology for ‘acute coronary syndromes’. SCS subtends a clinically relevant classification that more fully encompasses the different diseases of the epicardial and microvascular coronary circulation. PMID:29030424

Femoral Artery Stenosis Following Percutaneous Closure Using a Starclose Closure Device

International Nuclear Information System (INIS)

Bent, Clare Louise; Kyriakides, Constantinos; Matson, Matthew

2008-01-01

Starclose (Abbott Vascular Devices, Redwood City, CA) is a new arterial closure device that seals a femoral puncture site with an extravascular star-shaped nitinol clip. The clip projects small tines into the arterial wall which fold inward, causing the arterial wall to pucker, producing a purse-string-like seal closing the puncture site. The case history is that of a 76-year-old female patient who underwent day-case percutaneous diagnostic coronary angiography. A Starclose femoral artery closure device was used to achieve hemostasis with subsequent femoral artery stenosis.

Visibility of the origin and proximal course of coronary arteries on non-ECG-gated heart CT in patients with congenital heart disease

International Nuclear Information System (INIS)

Goo, Hyun Woo; Park, In-Sook; Ko, Jae Kon; Kim, Young Hwee; Seo, Dong-Man; Yun, Tae-Jin; Park, Jeong-Jun

2005-01-01

There is little information on the ability of non-ECG-gated cardiac CT to demonstrate the coronary arteries of children. To evaluate the visibility of the origin and proximal course of coronary arteries on non-ECG-gated cardiac CT, in which the coronary artery was not of primary diagnostic concern, in children with congenital heart disease. From December 2002 to March 2004, 126 cardiac CT examinations from 104 children (median age 11 months; age range 1 day to 15 years) were evaluated. All patients had ventriculo-arterial concordance and no malformations of the great arteries; those with coronary artery anomalies were excluded. Contrast-enhanced 16-slice spiral CT was performed without ECG-gating and multiplanar images for coronary arteries were obtained. The visibility of coronary artery origins was graded on a three-point scale, while nine segments of the arteries were graded on a four-point scale. CT images in which it was possible to trace the coronary arteries were considered diagnostic. The visibility of each whole coronary artery and the origins and proximal four segments of coronary arteries were calculated. The visibility of coronary arteries was also correlated with patient age. The percentage of CT images of diagnostic quality was 49.3% for the whole coronary artery and 81.7% for the origins and proximal four segments. There was a significant positive correlation between the visibility of coronary arteries and age. Non-ECG-gated cardiac CT, in which the coronary artery is not of primary diagnostic concern, is frequently able to visualize the origin and proximal course of coronary arteries and may be helpful in detecting coronary artery anomalies in children with congenital heart disease. (orig.)

Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study.

Science.gov (United States)

Herráiz-Adillo, Ángel; Soriano-Cano, Alba; Martínez-Hortelano, José Alberto; Garrido-Miguel, Miriam; Mariana-Herráiz, Julián Ángel; Martínez-Vizcaíno, Vicente; Notario-Pacheco, Blanca

2018-04-01

Inter-arm systolic blood pressure differences (IASBPD) and inter-leg systolic blood pressure differences (ILSBPD) have arisen as potential tools to detect peripheral artery disease (PAD) and individuals at high cardiovascular risk. This study aims to evaluate the diagnostic accuracy of IASBPD and ILSBPD to detect PAD, and whether IASBPD or ILSBPD improves diagnostic accuracy of the oscillometric ankle-brachial index (ABI). In this prospective study, eligible for inclusion were consecutive adults, with at least one of the following cardiovascular risk factors: diabetes, dyslipidemia, hypertension, smoking habit or age ≥65. IASBPD, ILSBPD and ankle-brachial index (ABI) were measured in all participants through four-limb simultaneous oscillometric measurements and compared with Doppler ABI (reference test, positive cut-off: ≤ 0.9). Of 171 subjects included, PAD was confirmed in 23 and excluded in 148. Thirteen and 38 subjects had IASBPD and ILSBPD ≥10 mmHg, respectively. Pearson correlation with Doppler ABI of IASBPD and ILSBPD was 0.073 (P = .343) and -0.628 (P blood pressure measurements in upper limbs are not possible.

Internal Carotid Artery Hypoplasia: Role of Color-Coded Carotid Duplex Sonography.

Science.gov (United States)

Chen, Pei-Ya; Liu, Hung-Yu; Lim, Kun-Eng; Lin, Shinn-Kuang

2015-10-01

The purpose of this study was to determine the role of color-coded carotid duplex sonography for diagnosis of internal carotid artery hypoplasia. We retrospectively reviewed 25,000 color-coded carotid duplex sonograms in our neurosonographic database to establish more diagnostic criteria for internal carotid artery hypoplasia. A definitive diagnosis of internal carotid artery hypoplasia was made in 9 patients. Diagnostic findings on color-coded carotid duplex imaging include a long segmental small-caliber lumen (52% diameter) with markedly decreased flow (13% flow volume) in the affected internal carotid artery relative to the contralateral side but without intraluminal lesions. Indirect findings included markedly increased total flow volume (an increase of 133%) in both vertebral arteries, antegrade ipsilateral ophthalmic arterial flow, and a reduced vessel diameter with increased flow resistance in the ipsilateral common carotid artery. Ten patients with distal internal carotid artery dissection showed a similar color-coded duplex pattern, but the reductions in the internal and common carotid artery diameters and increase in collateral flow from the vertebral artery were less prominent than those in hypoplasia. The ipsilateral ophthalmic arterial flow was retrograde in 40% of patients with distal internal carotid artery dissection. In addition, thin-section axial and sagittal computed tomograms of the skull base could show the small diameter of the carotid canal in internal carotid artery hypoplasia and help distinguish hypoplasia from distal internal carotid artery dissection. Color-coded carotid duplex sonography provides important clues for establishing a diagnosis of internal carotid artery hypoplasia. A hypoplastic carotid canal can be shown by thin-section axial and sagittal skull base computed tomography to confirm the final diagnosis. © 2015 by the American Institute of Ultrasound in Medicine.

Demonstration of the dorsal pancreatic artery by CTA to facilitate superselective arterial infusion of stem cells into the pancreas

International Nuclear Information System (INIS)

Lin Yuning; Yang Xizhang; Chen Ziqian; Tan Jianming; Zhong Qun; Yang Li; Wu Zhixian

2012-01-01

Purpose: To investigate the diagnostic performance of 64-section CTA in the detection of dorsal pancreatic artery before interventional therapy for patients with diabetes. Materials and methods: The study was approved by the institutional ethics committee; written informed consent was obtained. Forty-two consecutive patients with diabetes received an experimental treatment of autologous bone marrow-derived stem cell transplantation by means of infusion into the dorsal pancreatic artery. All cases underwent abdominal CTA before angiography of pancreatic arteries in order to locate the origin and course of dorsal pancreatic artery. Angiography of coeliac artery, splenic artery, common hepatic artery and superior mesenteric artery were performed both in CTA and DSA. Superselective catheterization of dorsal pancreatic artery was carried out for the infusion of stem cell. Sensitivity, specificity and accuracy for the detection of dorsal pancreatic artery with CTA were calculated using DSA images as the reference standard. Results: Thirty-five and thirty-six dorsal pancreatic arteries were detected by CTA and DSA respectively. Dorsal pancreatic artery was not visualized in either CTA or DSA in 5 patients. The sensitivity, specificity and accuracy for CTA were 94.4%, 83.3% and 92.9%. Conclusion: 64-section CTA is accurate for the detection of dorsal pancreatic artery. It may be useful for the facilitation of superselective arterial infusion of stem cells to pancreas.

Selective intra-arterial administration of {sup 18}F-FDG to the rat brain - effects on hemispheric uptake

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Arnberg, Fabian; Samen, Erik; Lundberg, Johan; Grafstroem, Jonas; Soederman, Michael; Stone-Elander, Sharon; Holmin, Staffan [Karolinska Institutet, Department of Clinical Neuroscience, Stockholm (Sweden); Karolinska University Hospital-Solna, Department of Neuroradiology, Stockholm (Sweden); Lu, Li [Karolinska University Hospital-Solna, KERIC, Stockholm (Sweden)

2014-05-15

The purpose of this study was to investigate the radioligand uptake and iodine contrast distribution in the intra- and extracranial circulation of the rat, after intra-arterial injections to the common carotid artery and different parts of the internal carotid artery. All animal experiments were carried out in accordance with Karolinska Institutet's guidelines and were approved by the local laboratory animal ethics committee. We used clinical neurointerventional systems to place microcatheters in the extra- or intracranial carotid artery of 15 Sprague-Dawley rats. Here, injection dynamics of iodine contrast was assessed using digital subtraction angiography. Maintaining the catheter position, the animals were placed in a micro PET and small-animal positron emission tomography (PET) was used to analyze injections [2-{sup 18}F]-2-fluoro-2-deoxy-d-glucose ({sup 18}F-FDG). Microcatheters had to be placed in the intracranial carotid artery (iICA) for the infusate to distribute to the brain. Selective injection via the iICA resulted in a 9-fold higher uptake of {sup 18}F-FDG in the injected hemisphere (p < 0.005) compared to both intravenous and more proximal carotid artery injections. Furthermore, selective injection gave a dramatically improved contrast between the brain and extracranial tissue. Intra-arterial injection increases the cerebral uptake of a radiotracer dramatically compared to systemic injection. This technique has potential applications for endovascular treatment of malignancies allowing intra-interventional modifications of injection strategy, based on information on tumor perfusion and risk to surrounding normal parenchyma. Furthermore the technique may increase diagnostic sensitivity and avoid problems due to peripheral pharmacological barriers and first passage metabolism of labile tracers. (orig.)

Comparative study of image quality and radiation dose between prospective and retrospective ECG gating technique in coronary artery imaging with 64-slice spiral CT

International Nuclear Information System (INIS)

Liu Jianxin; Liu Jian; Dou Yanbin; Wang Jichen; Sun Hongyue

2009-01-01

Objective: To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods: 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate 0.05). The mean DLP of experimental group (234.4 mGy · cm) was DLP of control group (974.4 mGy · cm) 24.1%. The mean effective dose of prospective ECG gating coronary artery imaging was 3.2 mSv. Effective dose reduced 76.47 %. Conclusions: Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG gating coronary artery imaging has clinical value to peoples who are able to not accept high radiation dose and with low heart rate. (authors)

Diagnostic performance of an acoustic-based system for coronary artery disease risk stratification.

Science.gov (United States)

Winther, Simon; Nissen, Louise; Schmidt, Samuel Emil; Westra, Jelmer Sybren; Rasmussen, Laust Dupont; Knudsen, Lars Lyhne; Madsen, Lene Helleskov; Kirk Johansen, Jane; Larsen, Bjarke Skogstad; Struijk, Johannes Jan; Frost, Lars; Holm, Niels Ramsing; Christiansen, Evald Høj; Botker, Hans Erik; Bøttcher, Morten

2017-11-09

Diagnosing coronary artery disease (CAD) continues to require substantial healthcare resources. Acoustic analysis of transcutaneous heart sounds of cardiac movement and intracoronary turbulence due to obstructive coronary disease could potentially change this. The aim of this study was thus to test the diagnostic accuracy of a new portable acoustic device for detection of CAD. We included 1675 patients consecutively with low to intermediate likelihood of CAD who had been referred for cardiac CT angiography. If significant obstruction was suspected in any coronary segment, patients were referred to invasive angiography and fractional flow reserve (FFR) assessment. Heart sound analysis was performed in all patients. A predefined acoustic CAD-score algorithm was evaluated; subsequently, we developed and validated an updated CAD-score algorithm that included both acoustic features and clinical risk factors. Low risk is indicated by a CAD-score value ≤20. Haemodynamically significant CAD assessed from FFR was present in 145 (10.0%) patients. In the entire cohort, the predefined CAD-score had a sensitivity of 63% and a specificity of 44%. In total, 50% had an updated CAD-score value ≤20. At this cut-off, sensitivity was 81% (95% CI 73% to 87%), specificity 53% (95% CI 50% to 56%), positive predictive value 16% (95% CI 13% to 18%) and negative predictive value 96% (95% CI 95% to 98%) for diagnosing haemodynamically significant CAD. Sound-based detection of CAD enables risk stratification superior to clinical risk scores. With a negative predictive value of 96%, this new acoustic rule-out system could potentially supplement clinical assessment to guide decisions on the need for further diagnostic investigation. ClinicalTrials.gov identifier NCT02264717; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Massive pulmonary embolism: the predisposing and complicating factors, its current diagnostic approaches and critical importance of early diagnostic physical exam

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Filip A. Konecny

2006-12-01

Full Text Available Massive pulmonary embolism (MPE often leads to circulation collapse, a form of shock. The process is set off by thrombus or multiple thrombi dislodgement followed by a rapid perfusion insufficiency of pulmonary arterial system. Patients experience severe hypotension with diastolic and systolic failure with an acute tricuspid regurgitation. On many occasions, release of an obstruction is unattainable and death is occurring frequently within one hour of presentation. A key reported source of MPE is its occurrence as a complication of deep vein thrombosis (DVT. While long-term immobilization and surgery are both directly associated with MPE, others such as previous DVT, malignancy, infectious lung and heart diseases, family thrombophilia, lower limb paralysis and pregnancy have to be considered as risk factors mainly due to its silent nature. Predisposing and complicating risks should be addressed by an early diagnostic physical exam. The clinician might offer a wide variety of diagnostic approaches, combining techniques into algorithms to better deal with the embolism severity. Multiple patient life-style changes and decisions to adhere to the proposed plan should be built up on patient-physician team effort. KEY WORDS: Massive pulmonary embolism, predisposing factors, current diagnostic approaches.

Superselective intra-arterial chemotherapy (SIC) by using the Seldinger technique as the treatment strategy for maxillary sinus carcinoma

International Nuclear Information System (INIS)

Yoshida, Tomoyuki; Nakamura, Kazuhiro; Tukahara, Kiyoaki; Ito, Hiroyuki; Shimizu, Akira; Takata, Daisuke; Okamoto, Isaku; Kondo, Takahito

2010-01-01

We have been applying superselective intra-arterial chemotherapy (SIC) by using the Seldinger technique as the treatment strategy for maxillary sinus carcinoma since 1998 in combination with radiotherapy and surgery. SIC allows delivery of high-dose anticancer drugs to the target tumor at high concentrations through its feeding vessel with few adverse effects by neutralizing and limiting the toxic effects of cisplatin (CDDP) within an acceptable range. We studied the effect of primary treatment and adverse events in 40 patients with squamous cell carcinoma of the maxillary sinus who underwent high-dose SIC combined with radiotherapy in our department between 1998 and 2008. The patients were 30 men and 10 women aged 43 to 75 years (median, 61 years). All carcinomas were advanced and graded as T3 in 17, T4 in 23, and N+ in 8. Some of the carcinomas reached the skull base or extended deep into the orbit. SIC was performed using the Seldinger technique from the femoral artery. Total CDDP dose was 200-300 mg/m 2 (mean, 210 mg/m 2 ). All vessels used for the treatment were those branching from the external carotid arteries; those from internal carotid arteries were not used for intra-arterial infusion. Following arterial infusion chemotherapy, systemic administration of 800 mg 5-fluorouracil (FU) was started on Day 2. Simultaneous radiotherapy was started on Day 2 at a dose of 2 Gy with a goal of increasing up to 60 Gy. Patients enrolled in this treatment arm received two courses of chemotherapy at 1- to 2-week intervals, along with a total dose of 60 Gy of radiotherapy from 1998 to 2007. Since 2008, two courses of SIC with the Seldinger technique, based on the results of postoperative pathological examination, and curative radiation at 60 Gy became the preferred basic treatment strategy irrespective of tumor size, and evaluation of treatment response at the level of 40 Gy was abandoned. For residual or recurrent carcinoma, we took a ''wait and see'' approach and

PREFACE: IX International Conference on Modern Techniques of Plasma Diagnostics and their Application

Science.gov (United States)

Savjolov, A. S.; Dodulad, E. I.

2016-01-01

The IX Conference on ''Modern Techniques of Plasma Diagnosis and their Application'' was held on 5 - 7 November, 2014 at National Research Nuclear University MEPhI (NRNU MEPhI). The goal of the conference was an exchange of information on both high-temperature and low-temperature plasma diagnostics as well as deliberation and analysis of various diagnostic techniques and their applicability in science, industry, ecology, medicine and other fields. The Conference also provided young scientists from scientific centres and universities engaged in plasma diagnostics with an opportunity to attend the lectures given by the leading specialists in this field as well as present their own results and findings. The first workshop titled ''Modern problems of plasma diagnostics and their application for control of chemicals and the environment'' took place at Moscow Engineering and Physics Institute (MEPhI) in June 1998 with the support of the Section on Diagnostics of the Council of Russian Academic of Science on Plasma Physics and since then these forums have been held at MEPhI every two years. In 2008 the workshop was assigned a conference status. More than 150 specialists on plasma diagnostics and students took part in the last conference. They represented leading Russian scientific centres (such as Troitsk Institute of Innovative and Thermonuclear Research, National Research Centre ''Kurchatov Institute'', Russian Federal Nuclear Centre - All-Russian Scientific Research Institute of Experimental Physics and others) and universities from Belarus, Ukraine, Germany, USA, Belgium and Sweden. About 30 reports were made by young researchers, students and post-graduate students. All presentations during the conference were broadcasted online over the internet with viewers in Moscow, Prague, St. Petersburgh and other cities. The Conference was held within the framework of the Centre of Plasma, Laser Research and Technology supported by MEPhI Academic Excellence Project (Russian

A novel application of the culotte stent technique to bail out a jailed common iliac artery

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Hideto Sangen, MD

2017-12-01

Full Text Available Implanting a self-expandable stent at the ostium of the common iliac artery (CIA may lead to coverage of the orifice of the contralateral CIA. Here, we describe a novel application of the culotte stent technique using a balloon-expandable stent to bail out an ostial stenotic legion of a jailed CIA due to prior self-expandable stent placement. The bilateral CIAs were revascularized by culotte stenting, and patency of the stents was confirmed 3 years after the procedure. The culotte stent technique was successfully applied to an ostial stenotic lesion of a jailed CIA.

Bilateral triple renal arteries

International Nuclear Information System (INIS)

Pestemalci, Turan; Yildiz, Yusuf Zeki; Yildirim, Mehmet; Mavi, Ayfer; Gumusburun, Erdem

2009-01-01

Knowledge of the variations of the renal artery has grown in importance with increasing numbers of renal transplants, vascular reconstructions and various surgical and radio logic techniques being performed in recent years. We report the presence of bilateral triple renal arteries, discovered on routine dissection of a male cadaver. On the right side, one additional renal artery originated from the abdominal aorta (distributed to superior pole of the kidney) and one other originated from the right common iliac artery (distributed to lower pole of the kidney). On the left side, both additional renal arteries originated from the abdominal aorta. Our observation has been compared with variations described in the literature and their clinical importance has been emphasized. (author)

Diagnostic accuracy of color Doppler flow imaging and Duplex US in peripheral arterial disease

International Nuclear Information System (INIS)

Karmel, M.I.; Polak, J.F.; Whittemore, A.D.; Mannick, J.A.; Donaldson, M.C.; O'Leary, D.H.

1988-01-01

Color Doppler flow imaging (5 MHz) and Duplex US were used in a prospective examination of 154 arterial segments in the lower extremities of 11 symptomatic patients. Each extremity was divided into seven arterial segments (common femoral, profunda femoral, proximal, middle, and distal superficial femoral, and proximal and distal popliteal arteries). Arterial maps were drawn for each patient and compared with the arteriograms. Seventeen significant stenoses and 18 complete occlusions were predicted and confirmed by means of arteriography. Four significant stenoses and four occlusions were predicted and not confirmed. One hundred nine normal arterial segments were correctly predicted. No significant stenoses or occlusions were missed. Prospective identification of the severity and location of disease can help to optimize both the angiographic approach and hospital services utilization

Circumflex coronary artery with aberrant origin and atherosclerosis

International Nuclear Information System (INIS)

Ozcan, E.; Bozlar, U.; Celik, T.; Tasar, M.

2012-01-01

Full text: Introduction: Circumflex (Cx) coronary artery congenital anomaly is reported to be less than 1% incidence. Coronary arteries with aberrant origin are more likely to have atherosclerosis according to some published literatures. Objectives and tasks: In this study we aim to present computed tomography (CT) angiography findings of a patient, who has Cx artery with aberrant origin and atherosclerotic. Materials and methods: 57-year-old woman without any symptoms who has risk factors to atherosclerosis was referred to our clinic for coronary CT angiography. Results: In CT angiography; we detected Cx coronary artery with aberrant origin (right sinus of valsalva) and retroaortic course. Also we saw intimal irregularities and calcified plaque causing severe narrowing in the proximal segment of artery. Right coronary and left anterior descendant arteries had mild atherosclerosis. Conclusion: Coroner CT angiography, which allows multiplanar imaging with high resolution, is an effective diagnostic tool for coronary artery disease, like not only congenital anomalies but also acquired atherosclerotic disease

MR angiography of the iliofemoral artery system

International Nuclear Information System (INIS)

Steffens, J.C.; Link, J.; Brinkmann, G.; Reuter, M.; Heller, M.

1997-01-01

During the last years, magnetic resonance angiography (MRA) has become a widely used modality for intracerebral and carotid artery imaging. Due to technical limitations, the clinical impact of MRA in the iliofemoral arteries has been rather poor. New developments in MRA like ECG-triggered sequences and the occurrence of contrast-enhanced MRA has overcome most of these limitations. Therefore, a major advance in clinical use of these diagnostic tools can be predicted. This paper discussed the advantages of ECG-gated 2D-Phase contrast, ECG-gated 2D-Time-of-Flight and contrast enhanced FLASH 3D angiography sequences from a clinical point of view. 2D-PC-MRA is a robust technique, which provides an overview of the iliofemoral artery system in less than 5 minutes. Limitations are the true 2D impression of the sequence and the partial venous overlay. 2D-TOF-MRA on the other hand is time consuming, however it enables 3D reconstruction and effective venous suppression can be applied. Contrast enhanced MRA as the third sequence discussed provides high resolution images in less than 30 sec. However contrast bolus timing might be a problem. In conclusion the authors suggest a combination of 2D-PC-MRA and additional 2D-TOF sequences at questionable vacular areas as the modality of choice, due to the fact, that MRA of the iliofemoral arteries is mostly only one step of a complete lower limb examination. Contrast MRA might become the method of choice in the future however problems with multiple contrast injections and upper limits of contrast dose have to be solved. (orig.) [de

Diagnostic techniques

International Nuclear Information System (INIS)

Berquist, T.H.; Bender, C.E.; James, E.M.; Brown, M.L.; McLeod, R.A.; Broderick, D.F.; Welch, T.J.

1989-01-01

Proper application of imaging procedures is essential to obtain needed information for diagnosis and therapy planning in patients with suspected foot and/or ankle pathology. This paper provides basic background data for the numerous imaging techniques

Importance of projections, magnifications, and roentgen techniques in the evaluation of obstructions

International Nuclear Information System (INIS)

Sones, F.M. Jr.

1982-01-01

The authors describe their own technique for coronary angiography, using equipment which facilitates making exposures in craniocaudal or caudo-cranial projections in varying degrees of right or left obliquity up to 60 degrees. Each diagnostic problem must be approached on an individual basis but the usual procedure is two injections into the right coronary artery made in appropriate right and left anterior oblique projections, and four or five injections into the left coronary artery made in appropriate right and left anterior oblique projections. Decisions regarding the conduct of each study must be based on the angiographer's ability to observe and interpret the results of each injection with a properly designed television chain which presents exactly the same image as that being recorded by the cine camera. The problem of differentiating between organic obstruction and functional spasm is discussed and the magnification technique is described. (Auth./C.F.)

Noninvasive assessment of coronary artery disease by multislice spiral computed tomography using a new retrospectively ECG-gated image reconstruction technique. Comparison with angiographic results

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Sato, Yuichi; Matsumoto, Naoya; Kato, Masahiko [Nihon Univ., Tokyo (Japan). Surugadai Hospital] [and others

2003-04-01

The present study was designed to investigate the accuracy of multislice spiral computed tomography (MSCT) in detecting coronary artery disease, compared with coronary angiography (CAG), using a new retrospectively ECG-gated reconstruction method that reduced cardiac motion artifact. The study group comprised 54 consecutive patients undergoing MSCT and CAG. MSCT was performed using a SOMATOM Volume Zoom (4-detector-row, Siemens, Germany) with slice thickness 1.0 mm, pitch 1.5 (table feed: 1.5 mm per rotation) and gantry rotation time 500 ms. Metoprolol (20-60 mg) was administered orally prior to MSCT imaging. ECG-gated image reconstruction was performed with the reconstruction window (250 ms) positioned immediately before atrial contraction in order to reduce the cardiac motion artifact caused by the abrupt diastolic ventricular movement occurring during the rapid filling and atrial contraction periods. Following inspection of the volume rendering images, multiplanar reconstruction images and axial images of the left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) were obtained and evaluated for luminal narrowing. The results were compared with those obtained by CAG. Of 216 coronary arteries, 206 (95.4%) were assessable; 10 arteries were excluded from the analysis because of severe calcification (n=4), stents (n=3) or insufficient contrast enhancement (n=3). The sensitivity to detect coronary stenoses {>=}50% was 93.5% and the specificity to define luminal narrowing <50% was 97.2%. The positive predictive value and the negative predictive value were 93.5% and 97.2%, respectively. The sensitivity was still satisfactory (80.6%) even when non-assessable arteries were included in the analysis. The new retrospectively ECG-gated reconstruction method for MSCT has excellent diagnostic accuracy in detecting significant coronary artery stenoses. (author)

Magnetic resonance angiography of peripheral arteries of the hand and its clinical usefulness

International Nuclear Information System (INIS)

Arikawa, Kouzou

1996-01-01

We established requirements for display of peripheral arteries and veins of the hand on magnetic resonance angiography (MRA) in normal adults. We performed MRA in 20 normal adult volunteers and 3 patients using the same method and parameters and obtained useful clinical examinations. Few studies have evaluated the use of MRA in the hand, especially for peripheral arteries and veins, because of problems of vessel diameter, velocity blood flow, and computer memory capacity. The diagnostic accuracy of MRA is largely dependent on the MR equipment, MR technique, ray-tracing technique, film reading system, and the skill of the MRA film reader. Because MRA methods are not standardized, optimal methods must be determined that produce the accurate information needed for diagnosis of disease. In 20 normal adults, the following MRA parameters allowed us to consistently visualize the peripheral arteries and veins: flip angle, 90deg; TR, 35; TE, 16; slice thickness, 2 mm; FOV, 170; NSA, 2; acquisition matrix, 141 x 256; and room temperature, 22degC. We were able to obtain clear MRA images by the multiple slide slice method, which corrects a weakness of usual methods of display. Results of MRA examinations with our methods and parameters in 20 normal adult volunteers and 3 patients suggest that MRA is safe and useful for clinical examination of the hand. (author)

[Actual review of diagnostics and endovascular therapy of intracranial arterial stenoses].

Science.gov (United States)

Gizewski, E R; Weber, R; Forsting, M

2011-02-01

Approximately 6 - 50% of all ischemic strokes are caused by intracranial arterial stenosis (IAS). Despite medical prevention, patients with symptomatic IAS have a high annual risk for recurrent ischemic stroke of about 12%, and up to 19% in the case of high-grade IAS (≥ 70%). Digital subtraction angiography remains the gold standard for the diagnosis and grading of IAS. However, noninvasive imaging techniques including CT angiography, MR angiography, or transcranial Doppler and duplex ultrasound examinations are used in the clinical routine to provide additional information about the brain structure and hemodynamic. However, for technical reasons, the grading of stenoses is sometimes difficult and inaccurate. To date, aspirin is recommended as the treatment of choice in the prevention of recurrent ischemic stroke in patients with IAS. IAS patients who suffer a recurrent ischemic stroke or transient ischemic attack while taking aspirin can be treated with endovascular stenting or angioplasty in specialized centers. The periprocedural complication rate of these endovascular techniques is about 2 - 7% at experienced neuro-interventional centers. The rate of re-stenosis is reported between 10 and 40% depending on patient age and stenosis location. Further randomized studies comparing medical secondary prevention and endovascular therapy are currently being performed. With regard to the improvement of endovascular methods and lower complication rates, the indication for endovascular therapy in IAS could be broadened especially for stenosis in the posterior circulation. © Georg Thieme Verlag KG Stuttgart · New York.

Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

International Nuclear Information System (INIS)

Yoon, Sang Jin; Shim, Hyung Jin; Jung, Hun Young; Choi, Yong Ho; Kim, Yang Soo; Song, In Sup; Kwak, Byung Kook

1999-01-01

To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

Bland-White-Garland syndrome of anomalous left coronary artery arising from the pulmonary artery (ALCAPA): a historical review

International Nuclear Information System (INIS)

Cowles, Robert A.; Berdon, Walter E.

2007-01-01

The landmark 1933 case report from Massachusetts General Hospital by Bland, White and Garland (Am Heart J 8:787-801) described a 3-month-old child with progressive feeding problems, cardiomegaly on chest radiography, and EKG evidence of left ventricular damage. Of interest was the fact that the vigilant father of the infant was Aubrey Hampton, a radiologist and future chairman of radiology at Massachusetts General Hospital. At autopsy, the left coronary artery originated from the pulmonary artery rather than from the aorta. Effective treatment for this condition was not available until 1960 when Sabiston, Neill and Taussig showed that the blood flowed from the left coronary artery toward the pulmonary artery. The anomalous left coronary artery was ligated at its junction with the pulmonary artery and the child survived. This historical review of Bland-White-Garland syndrome, now known as anomalous left coronary artery arising from the pulmonary artery (ALCAPA), stresses the continued diagnostic significance of cardiomegaly on chest radiography and EKG changes suggesting left ventricular damage in 2- to 3-month-old infants with feeding intolerance or irritability. With a high index of suspicion, an echocardiogram can be obtained to confirm the diagnosis. Modern surgical methods involve left coronary artery translocation and afford excellent outcomes. (orig.)

Evaluation of Contrast MR Angiography in the Study of Internal Carotid Artery Stenosis. Systematic Review of the Literature; Evaluacion de la estenosis de la arteria carotida interna por angiografia REM con contraste: revision sistematica de la bibliografia

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Rodriguez Perez, P.; Martinez Cantarero, J. [Hospital Universitario 12 de Octubre. Madrid (Spain); Ruiz Diaz, M.; Blazquez Morera, J. A. [Universidad Autonoma de Madrid (Spain); Llano Senaris, J. E. de [Fundacion Gaspar Casal. Madrid (Spain)

2004-07-01

To evaluate the diagnostic benefit of using contrast MR Angiography (MRA) in the study of extracranial internal carotid artery stenosis as opposed to intraarterial digital subtraction arteriography (LADSA). A search for relevant articles from 1990 to 2000 using MDLINE and EMBASE databases. Initial selection criteria: 1. articles which compare MRA and IADSA in the study of extracranial internal carotid artery stenosis; and 2, sample size of 10 or more subjects. Studies employing contrast MRA were subsequently selected. Contrast MRA diagnostic results were studied, as were those of non-contrast MRA (TOF) if included. Roc curves and 95% confidence intervals were calculated. In the studies, 324 patients and 648 extracranial internal carotid arteries were evaluated (12 articles). The diagnostic results in carotid artery stenosis discrimination using contrast MRA as opposed to IADSA were sensitivity and specificity=97.28% and 96.08%. With regard to contrast MRA vs. non-contrast MRA (TOF), significant differences favoring contrast MRA in both sensitivity and specificity were observed. (p=0.08 and p<0.001, respectively). MRA techniques demonstrate very high diagnostic capabilities in the detection of carotid stenosis, with contrast MRA being more effective than non-contrast. MRA. In spite of not being superior to IADSA, given the morbimortality risk which the latter is associated (0.7-1.2%). many authors defend contrast MRA (in association with Doppler echography) having become the method of choice for presurgical study of extracranial internal carotid artery stenosis. (Author) 53 refs.

Splenic Artery Pseudoaneurysm Presenting as Massive Hematemesis: A Diagnostic Dilemma

Directory of Open Access Journals (Sweden)

Peeyush Varshney

2014-01-01

Full Text Available Introduction. Splenic artery Pseudoaneurysm, a complication of chronic pancreatitis, presenting as massive hematemesis is a rare presentation. Case Report. We present a case of 38-year-old male admitted with chief complaints of pain in the upper abdomen and massive hematemesis for the last 15 days. On examination there was severe pallor. On investigating the patient, Hb was 4.0 gm/dL, upper GI endoscopy revealed a leiomyoma in fundus of stomach, and EUS Doppler also supported the UGI findings. On further investigation of the patient, CECT of the abdomen revealed a possibility of distal pancreatic carcinoma encasing splenic vessels and infiltrating the adjacent structure. FNA taken at the time of EUS was consistent with inflammatory pathology. Triple phase CT of the abdomen revealed a splenic artery pseudoaneurysm with multiple splenic infarcts. After resuscitation we planned an emergency laparotomy; splenic artery pseudoaneurysm densely adherent to adjacent structures and associated with distal pancreatic necrosis was found. We performed splenectomy with repair of the defect in the stomach wall and necrosectomy. Postoperative course was uneventful and patient was discharged on day 8. Conclusion. Pseudoaneurysm can be at times a very difficult situation to manage; options available are either catheter embolisation if patient is vitally stable, or otherwise, exploration.

Establishing experimental model of human internal carotid artery siphon segment in canine common carotid artery

International Nuclear Information System (INIS)

Cui Xuee; Li Minghua; Wang Yongli; Cheng Yingsheng; Li Wenbin

2005-01-01

Objective: To study the feasibility of establishing experimental model of human internal carotid artery siphon segment in canine common carotid artery (CCA) by end-to-end anastomoses of one side common carotid artery segment with the other side common carotid artery. Methods: Surgical techniques were used to make siphon model in 8 canines. One side CCA was taken as the parent artery and anastomosing with the cut off contra-lateral CCA segment which has passed through within the S-shaped glass tube. Two weeks after the creation of models angiography showed the model siphons were patent. Results: Experimental models of human internal carotid artery siphon segment were successfully made in all 8 dogs. Conclusions: It is practically feasible to establish experimental canine common carotid artery models of siphon segment simulating human internal carotid artery. (authors)

Angiographic diagnosis of the carotid artery pseudoaneurysm

International Nuclear Information System (INIS)

Qi Yueyong; Zou Liguang; Dai Shuhua; Tan Yinghui; Li Zhongyu; Zhou Zheng

2004-01-01

Objective: To create a further understanding of the angiographic features of the carotid artery pseudoaneurysm (CAPA) and to explore the clinical diagnostic value of angiography. Methods: Sixteen cases of CAPA with clinical and angiographic data were analyzed retrospectively. The angiographic appearances in all of the patients were observed dynamically and precisely with a double blind method by two experienced radiologists together and formed a consensus interpretation. Results: Angiography provided a definite diagnosis for all cases. The parent arteries included the common carotid artery (1 case), common carotid artery bifurcation (9 cases), internal carotid artery (5 cases) and external carotid artery (1 case). The angiographic features of the CAPA were: All cases showed the contrast media retension in the aneurysms; turbulent flow within aneurysm in 9 cases; the 'jetting sign' at the leak of the parent artery in 7 cases; increase angulation of the bifurcation of internal and external carotid arteries in 12 cases. Conclusions: Angiography is the most valuable examination method in diagnosis of CAPA, and it can not only provide definite diagnosis, but also play an important role in selection of therapeutic plan. (authors)

Nonenhanced magnetic resonance angiography (MRA) of the calf arteries at 3 Tesla: intraindividual comparison of 3D flow-dependent subtractive MRA and 2D flow-independent non-subtractive MRA

Energy Technology Data Exchange (ETDEWEB)

Knobloch, Gesine; Lauff, Marie-Teres; Hirsch, Sebastian; Hamm, Bernd; Wagner, Moritz [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Schwenke, Carsten [SCO:SSiS Statistical Consulting, Berlin (Germany)

2016-12-15

To prospectively compare 3D flow-dependent subtractive MRA vs. 2D flow-independent non-subtractive MRA for assessment of the calf arteries at 3 Tesla. Forty-two patients with peripheral arterial occlusive disease underwent nonenhanced MRA of calf arteries at 3 Tesla with 3D flow-dependent subtractive MRA (fast spin echo sequence; 3D-FSE-MRA) and 2D flow-independent non-subtractive MRA (balanced steady-state-free-precession sequence; 2D-bSSFP-MRA). Moreover, all patients underwent contrast-enhanced MRA (CE-MRA) as standard-of-reference. Two readers performed a per-segment evaluation for image quality (4 = excellent to 0 = non-diagnostic) and severity of stenosis. Image quality scores of 2D-bSSFP-MRA were significantly higher compared to 3D-FSE-MRA (medians across readers: 4 vs. 3; p < 0.0001) with lower rates of non-diagnostic vessel segments on 2D-bSSFP-MRA (reader 1: <1 % vs. 15 %; reader 2: 1 % vs. 29 %; p < 0.05). Diagnostic performance of 2D-bSSFP-MRA and 3D-FSE-MRA across readers showed sensitivities of 89 % (214/240) vs. 70 % (168/240), p = 0.0153; specificities: 91 % (840/926) vs. 63 % (585/926), p < 0.0001; and diagnostic accuracies of 90 % (1054/1166) vs. 65 % (753/1166), p < 0.0001. 2D flow-independent non-subtractive MRA (2D-bSSFP-MRA) is a robust nonenhanced MRA technique for assessment of the calf arteries at 3 Tesla with significantly higher image quality and diagnostic accuracy compared to 3D flow-dependent subtractive MRA (3D-FSE-MRA). (orig.)

Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

OpenAIRE

Deniz Kamacı Şener; Özlem Taşkapılıoğlu; Nermin Kelebek Girgin; Bahattin Hakyemez; Mustafa Bakar; Yakup Tomak

2012-01-01

Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

Coronary artery anomalies in adults: imaging at dual source CT coronary angiography

International Nuclear Information System (INIS)

Laspas, Fotios; Roussakis, Arkadios; Mourmouris, Christos; Kritikos, Nikolaos; Efthimiadou, Roxani; Andreou, John

2013-01-01

Congenital abnormalities of the coronary arteries have an incidence of 1%, and most of these are benign. However, a small number are associated with myocardial ischaemia and sudden death. Various imaging modalities are available for coronary artery assessment. Recently, multi-detector CT has emerged as an accurate diagnostic tool for defining coronary artery anomalies. The purpose of this pictorial essay is to review the dual source CT appearance of congenital anomalies of the coronary arteries in adults.

A comparison of analogue and digital techniques in upper gastrointestinal examinations: absorbed dose and diagnostic quality of the images

Energy Technology Data Exchange (ETDEWEB)

Axelsson, B.; Hansson, I.B. [Department of Hospital Physics, Karolinska Hospital, Stockholm (Sweden); Boden, K.; Witt, H.H. [Department of Diagnostic Radiology, Karolinska Hospital, Stockholm (Sweden); Fransson, S.G. [Department of Thoracic Radiology, University Hospital, Linkoeping (Sweden); Persliden, J. [Department of Radiation Physics, University Hospital, Linkoeping (Sweden)

2000-08-01

This study was performed to investigate whether patient exposure and diagnostic quality of the image is significantly influenced by the introduction of digital image acquisition techniques. Evaluation was performed for three different techniques (analogue, analogue fluoro+digital radiography, digital) in examination of the upper gastrointestinal tract. The evaluation was done from data acquired in three different departments. Patient exposure was recorded as KERMA-area product (KAP) and the individual patient readings were normalised to a standard size patient. Image quality was assessed using visual grading with a reference image. The recorded KAP values were significantly higher (22.3 Gycm{sup 2}) for the fully digital technique compared to the others (analogue 6.8 Gycm{sup 2}, analogue+digital 3.6 Gycm{sup 2}). This was due mostly to an increased number of exposures. The diagnostic quality of the image was, however, also regarded to be slightly lower for the technique giving the lowest patient dose with the smallest number of exposures (analogue+digital). The digital examination technique, as used in this study, thus resulted in significantly higher patient dose without any significant gain in diagnostic quality of the image. (orig.)

A comparison of analogue and digital techniques in upper gastrointestinal examinations: absorbed dose and diagnostic quality of the images

International Nuclear Information System (INIS)

Axelsson, B.; Hansson, I.B.; Boden, K.; Witt, H.H.; Fransson, S.G.; Persliden, J.

2000-01-01

This study was performed to investigate whether patient exposure and diagnostic quality of the image is significantly influenced by the introduction of digital image acquisition techniques. Evaluation was performed for three different techniques (analogue, analogue fluoro+digital radiography, digital) in examination of the upper gastrointestinal tract. The evaluation was done from data acquired in three different departments. Patient exposure was recorded as KERMA-area product (KAP) and the individual patient readings were normalised to a standard size patient. Image quality was assessed using visual grading with a reference image. The recorded KAP values were significantly higher (22.3 Gycm 2 ) for the fully digital technique compared to the others (analogue 6.8 Gycm 2 , analogue+digital 3.6 Gycm 2 ). This was due mostly to an increased number of exposures. The diagnostic quality of the image was, however, also regarded to be slightly lower for the technique giving the lowest patient dose with the smallest number of exposures (analogue+digital). The digital examination technique, as used in this study, thus resulted in significantly higher patient dose without any significant gain in diagnostic quality of the image. (orig.)

Evaluation of high-pitch dual-source CT angiography for evaluation of coronary and carotid-cerebrovascular arteries

Energy Technology Data Exchange (ETDEWEB)

Sun, Kai [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Li, Kuncheng, E-mail: cjr.likuncheng@vip.163.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Han, Ruijuan [Department of Cardiology, Chaoyang Hospital, Capital Medical University, Beijing 100020 (China); Li, Wenhuan; Chen, Nan; Yang, Qi; Du, Xiangying; Wang, Chen [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Liu, Guorong; Li, Yuechun [Department of Neurology Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Zhou, Maorong [Department of Radiology, Baotou Central Hospital, Inner Mongolia, Baotou 014040 (China); Li, Ligang; Heidrun, Endt [CT BM Clinic Marketing, Siemens Healthcare, Beijing 100102 (China)

2015-03-15

Objectives: To explore the feasibility and diagnostic accuracy of a combined one-step high-pitch dual-source computed tomography angiography (CTA) technique for evaluation of coronary and carotid-cerebrovascular arteries. Materials and methods: 85 symptomatic patients suspected of coronary artery and cerebrovascular disease referred for simultaneous coronary and carotid-cerebrovascular CTA were included. Additional invasive angiography of the coronary and cerebral arteries was performed within 30 days in 23 and 13 patients, respectively. The objective parameters of image quality, the mean CT attenuations, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. The subjective image quality of vessels was also assessed by 2 independent radiologists blinded to the patients’ medical history and scan protocols. The diagnostic performance of CTA including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection or exclusion of significant artery stenosis was calculated using the chi-squared test of contingency and correlated with the results of invasive angiography representing the standard of reference. Results: Image quality was rated excellent (score 1) in 95.3% (1074/1127), good (score 2) in 3.3% (37/1127), adequate (score 3) in 1.0% (11/1127), and non-diagnostic (score 4) in 0.4% (5/1127) of coronary segments. Image quality of carotid and cerebral vessels was rated mostly excellent (score 1, 95.12% [78/82]; score 2, 3.66% [3/82]; score 3, 1.22% [1/82]). The sensitivity, specificity, PPV and NPV for the detection of coronary stenosis were 92.2% (81.1–97.7%), 95.2% (91.7–97.5%), 79.6% (67.1–89.1%) and 98.3% (95.8–99.5%), respectively. For the detection of carotid and cerebral artery stenosis, CTA demonstrated a sensitivity of 92.8% (80.5–98.4%), a specificity of 93.5% (88.3–96.8%), a PPV of 79.6% (65.6–89.7%) and a NPV of 97.9% (94.1–99.5%). The effective

Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

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Toischer Karl

2009-09-01

Full Text Available Abstract Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE, it is still used as an adjunct to coronary artery bypass grafting (CABG. This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA, angina pectoris (CCS and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG with adjunctive coronary endarterectomy (CE in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient. In 98% left internal thoracic artery (LITA was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA (n = 55, on left anterior descending artery (LAD (n = 52 and circumflex artery (RCX (n = 7. Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%. Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5. During follow-up (24.5 ± 13.4 months, which is 96% complete (4 patients were lost caused by unknown address 8 patients died (cardiac

Three-dimensional coronary MR angiography with continuous administration of Gd-DTPA. Delineation and detection of coronary artery stenosis

International Nuclear Information System (INIS)

Yokoyama, Kenichi

1999-01-01

Three-dimensional coronary MR angiography (3D coronary MRA) with Gd-DTPA administration was performed in 19 patients to evaluate the vascular delineation and diagnostic capability for stenotic lesions. A 3D fast low-angle shot (FLASH) with a navigator echo respiratory gating technique was used with a superconducting 1.5 tesla MR system (Vision, Siemens Medical Systems, Erlangen, Germany). Administration of the conventional T 1 contrast agent with extra-cellular distribution produced a significant increase in the SNR and CNR of the proximal coronary arterial images. Visual score of both the source images and the multiplanar reconstruction (MPR) images assessed by three radiologists was superior to those on control images (without contrast enhancement). The MRA findings of stenotic lesions of the coronary artery were compared with the results of the conventional coronary angiographic study. Overall sensitivity and specificity for the detection of stenosis were almost the same as those of control images. In conclusion, 3D coronary MRA with Gd-DTPA administration improved coronary artery delineation. However, further technical improvements are required to enhance the value of the technique in detecting stenoses. (author)

Noncontrast MR angiography (MRA) of infragenual arteries using flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) at 3.0 Tesla: Comparison with contrast-enhanced MRA.

Science.gov (United States)

Zhang, Nan; Fan, Zhaoyang; Luo, Nan; Bi, Xiaoming; Zhao, Yike; An, Jing; Liu, Jiayi; Chen, Zhong; Fan, Zhanming; Li, Debiao

2016-02-01

To evaluate the feasibility and diagnostic performance of flow-sensitive dephasing (FSD)-prepared steady-state free precession (SSFP) MR angiography (MRA) for imaging infragenual arteries at 3.0T, with contrast enhanced MR angiography (CE MRA) as reference. Twenty consecutive patients with suspicion of lower extremity arterial disease undergoing routine CE MRA were recruited. FSD MRA was performed at calf before CE MRA. Image quality and stenosis degree of infragenual arteries from both techniques were independently evaluated and compared. Six patients in this study underwent DSA examination. Three undiagnostic segments were excluded with severe venous contamination in CE MRA. A total of 197 calf arterial segments images were analyzed. No significant difference existed in the relative signal intensity (rSI) of arterial segments between FSD MRA and CE MRA techniques (0.92 ± 0.09 versus 0.93 ± 0.05; P = 0.207). However, the subjective image quality score was slightly higher in FSD MRA (3.66 ± 0.81 versus 3.49 ± 0.87; P = 0.050). With CE MRA images as reference standard, slight overestimation existed in FSD MRA (2.19 ± 1.24 versus 2.09 ± 1.18; P = 0.019), with total agreement of 84.3% on the basis of all arterial segments. The sensitivity, specificity, negative predictive value, and positive predictive value of FSD MRA was 96.4%, 93.0%, 98.5%, and 84.1%. No significant difference in the stenosis degree score was detected between MRA (FSD MRA and CE MRA) and DSA (P > 0.05). FSD MRA performed on at 3.0T without the use of contrast medium provides diagnostic images allowing for arterial stenosis assessment of calf arteries that was highly comparable with CE MRA. Moreover, venous contamination was less problematic with FSD MRA. © 2015 Wiley Periodicals, Inc.

Comprehensive Assessment of Coronary Artery Disease by Using First-Pass Analysis Dynamic CT Perfusion: Validation in a Swine Model.

Science.gov (United States)

Hubbard, Logan; Lipinski, Jerry; Ziemer, Benjamin; Malkasian, Shant; Sadeghi, Bahman; Javan, Hanna; Groves, Elliott M; Dertli, Brian; Molloi, Sabee

2018-01-01

Purpose To retrospectively validate a first-pass analysis (FPA) technique that combines computed tomographic (CT) angiography and dynamic CT perfusion measurement into one low-dose examination. Materials and Methods The study was approved by the animal care committee. The FPA technique was retrospectively validated in six swine (mean weight, 37.3 kg ± 7.5 [standard deviation]) between April 2015 and October 2016. Four to five intermediate-severity stenoses were generated in the left anterior descending artery (LAD), and 20 contrast material-enhanced volume scans were acquired per stenosis. All volume scans were used for maximum slope model (MSM) perfusion measurement, but only two volume scans were used for FPA perfusion measurement. Perfusion measurements in the LAD, left circumflex artery (LCx), right coronary artery, and all three coronary arteries combined were compared with microsphere perfusion measurements by using regression, root-mean-square error, root-mean-square deviation, Lin concordance correlation, and diagnostic outcomes analysis. The CT dose index and size-specific dose estimate per two-volume FPA perfusion measurement were also determined. Results FPA and MSM perfusion measurements (P FPA and P MSM ) in all three coronary arteries combined were related to reference standard microsphere perfusion measurements (P MICRO ), as follows: P FPA_COMBINED = 1.02 P MICRO_COMBINED + 0.11 (r = 0.96) and P MSM_COMBINED = 0.28 P MICRO_COMBINED + 0.23 (r = 0.89). The CT dose index and size-specific dose estimate per two-volume FPA perfusion measurement were 10.8 and 17.8 mGy, respectively. Conclusion The FPA technique was retrospectively validated in a swine model and has the potential to be used for accurate, low-dose vessel-specific morphologic and physiologic assessment of coronary artery disease. © RSNA, 2017.

Evaluation of functional severity of coronary artery disease and fluid dynamics' influence on hemodynamic parameters: A review.

Science.gov (United States)

Govindaraju, Kalimuthu; Badruddin, Irfan Anjum; Viswanathan, Girish N; Ramesh, S V; Badarudin, A

2013-05-01

Coronary Artery Disease (CAD) is responsible for most of the deaths in patients with cardiovascular diseases. Diagnostic coronary angiography analysis offers an anatomical knowledge of the severity of the stenosis. The functional or physiological significance is more valuable than the anatomical significance of CAD. Clinicians assess the functional severity of the stenosis by resorting to an invasive measurement of the pressure drop and flow. Hemodynamic parameters, such as pressure wire assessment fractional flow reserve (FFR) or Doppler wire assessment coronary flow reserve (CFR) are well-proven techniques to evaluate the physiological significance of the coronary artery stenosis in the cardiac catheterization laboratory. Between the two techniques mentioned above, the FFR is seen as a very useful index. The presence of guide wire reduces the coronary flow which causes the underestimation of pressure drop across the stenosis which leads to dilemma for the clinicians in the assessment of moderate stenosis. In such condition, the fundamental fluid mechanics is useful in the development of new functional severity parameters such as pressure drop coefficient and lesion flow coefficient. Since the flow takes place in a narrowed artery, the blood behaves as a non-Newtonian fluid. Computational fluid dynamics (CFD) allows a complete coronary flow simulation to study the relationship between the pressure and flow. This paper aims at explaining (i) diagnostic modalities for the evaluation of the CAD and valuable insights regarding FFR in the evaluation of the functional severity of the CAD (ii) the role of fluid dynamics in measuring the severity of CAD. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Diagnostics of vascular diseases as a cause for acute abdomen

International Nuclear Information System (INIS)

Juchems, M.S.; Aschoff, A.J.

2010-01-01

Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [de

The application of DECnet TTT technique in beam diagnostical system of SSC central region

International Nuclear Information System (INIS)

Zhang Guixu; Huang Tuanhua

1997-01-01

The DECnet TTT technique and the real time network communication based on DECnet TTT are presented. Information can be transferred between console and diagnostical system via DECnet communication, so all kinds of operation can be done on console. The working computer of HIRFL console is VAX8350

Clinical application of multislice spiral CT angiography in evaluation of anomalous vertebral artery

International Nuclear Information System (INIS)

Hua Rui; Liu Jun; Zhang Yu

2008-01-01

Objective: To evaluate the diagnostic value of 16-slice spiral computed tomography angiography (MSCTA) in evaluation of anomalous vertebral artery. Methods: MSCTA data from 32 patients with anomalous vertebral artery were retrospectively analyzed. Results: 22 cases had vertebral artery course variation (bended into the C 5 , C 4 or C 3 foramen transversarium), 7 cases had variation in the prevertebral segments of vertebral arteries, 15 patients had unilateral vertebral congenital stenosis, 1 case had double vertebral artery branch, 1 case had vertebral arterial fenestration, and 2 cases had vertebral artery in one side that did not converged upon basilar artery and unilateral vertebral artery formed basilar artery. Conclusion: MSCTA is a useful noninvasive imaging tool for the diagnosis of vertebral artery variations. (authors)

THE STATE OF ARTERIAL HYPERTENSION DIAGNOSTICS AND TREATMENT, ACCORDING TO THE RESULTS OF THE POLL AMONG PHYSICIANS OF VOLGOGRAD AND VOLGOGRAD REGION

Directory of Open Access Journals (Sweden)

S. Y. Martsevich

2005-01-01

Full Text Available Aim. Assessment and quality of diagnostics of treatment of patients with arterial hypertension (AH and their conformity with international and national recommendations on AH.Material and methods. The poll among physicians of Volgograd and Volgograd region, who took part in the regional conference, devoted to the problems of AH, was carried out in April 2004. The questionnaire included 13 questions about peculiarities of AH patients’ management 128 physicians took part in the poll, from them 90 thetapeutists (general physicians, 24 cardiologists, and 14 physicians of different therapeutic specializations.Results. Variability of conceptions of physicians on some principals of diagnostics and treatment of AH patients is revealed. Insufficient knowledge of criteria for division patients according to the risk category of cardiovascular complications. The same is observed for definition of AH grade according to the blood pressure level, and of the main approaches AH patients treatment. From all the questioned physicians only 25.2% correctly evaluated the risk level of cardiovascular diseases, 21% of physicians wrongly assessed the AH grade according to the blood pressure Level.Conclusion. Results, show that real practice of diagnostics and treatment of AH significantly deviates from international and national recommendations on AH.

THE STATE OF ARTERIAL HYPERTENSION DIAGNOSTICS AND TREATMENT, ACCORDING TO THE RESULTS OF THE POLL AMONG PHYSICIANS OF VOLGOGRAD AND VOLGOGRAD REGION

Directory of Open Access Journals (Sweden)

S. Y. Martsevich

2015-12-01

Full Text Available Aim. Assessment and quality of diagnostics of treatment of patients with arterial hypertension (AH and their conformity with international and national recommendations on AH.Material and methods. The poll among physicians of Volgograd and Volgograd region, who took part in the regional conference, devoted to the problems of AH, was carried out in April 2004. The questionnaire included 13 questions about peculiarities of AH patients’ management 128 physicians took part in the poll, from them 90 thetapeutists (general physicians, 24 cardiologists, and 14 physicians of different therapeutic specializations.Results. Variability of conceptions of physicians on some principals of diagnostics and treatment of AH patients is revealed. Insufficient knowledge of criteria for division patients according to the risk category of cardiovascular complications. The same is observed for definition of AH grade according to the blood pressure level, and of the main approaches AH patients treatment. From all the questioned physicians only 25.2% correctly evaluated the risk level of cardiovascular diseases, 21% of physicians wrongly assessed the AH grade according to the blood pressure Level.Conclusion. Results, show that real practice of diagnostics and treatment of AH significantly deviates from international and national recommendations on AH.

Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

Directory of Open Access Journals (Sweden)

Deniz Kamacı Şener

2012-12-01

Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

Endoscopic Radial Artery Harvest for Coronary Artery Bypass Surgery

Directory of Open Access Journals (Sweden)

Kuan-Ming Chiu

2006-01-01

Conclusion: Endoscopic harvest of the radial artery is technically demanding, but excellent results can be achieved. The endoscopic approach can provide suitable conduits in a less invasive way than the open harvest technique.

A Primary Care Approach to the Diagnosis and Management of Peripheral Arterial Disease

Science.gov (United States)

Dawson, David L.

2000-01-01

The objectives of this work are: (1) Be able to recognize characteristic symptoms of intermittent claudication (2) Diagnose PAD on the basis of history, physical exam, and simple limb blood pressure measurements (3) Recognize the significance of peripheral artery disease as a marker for coronary or cerebrovascular atherosclerosis (4) Provide appropriate medical management of atherosclerosis risk factors-- including use of antiplatelet therapy to reduce risk of myocardial infarction, stroke and death (5) Manage symptoms of intermittent claudication with program of smoking cessation, exercise, and medication The diagnosis of intermittent claudication secondary to peripheral artery disease (PAD) can often be made on the basis of history and physical examination. Additional evaluation of PAD is multi-modal and the techniques used will vary depending on the nature and severity of the patient's presenting problem. Most patients can be appropriately managed without referral for specialized diagnostic services or interventions.

Successful treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique.

Science.gov (United States)

Huynh, Thien J; Morton, Ryan P; Levitt, Michael R; Ghodke, Basavaraj V; Wink, Onno; Hallam, Danial K

2017-08-18

We report successful transvenous treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture. 2017 BMJ Publishing Group Ltd.

Prevalence of breast arterial calcification in hypertensive patients

International Nuclear Information System (INIS)

Cetin, M.; Cetin, R.; Tamer, N.

2004-01-01

AIM: To determine the age-specific prevalence of breast arterial calcifications in patients with systemic hypertension. METHODS: The mammograms and patient records of 2406 women who underwent screening or diagnostic mammography were reviewed retrospectively. Mammograms were evaluated for the presence of arterial calcification and results were coded. Hypertension was defined as use of anti-hypertensive agents and diabetes was defined as use of oral hypoglycaemic agents or insulin. RESULTS: The prevalence of breast arterial calcification among hypertensives (17.6%) was lower than among diabetics (25.4%). The prevalence in the non-diabetic, non-hypertensive group was lowest (7.3%). The prevalence increased with age in all three groups. The highest prevalence was found in diabetics older than 60 years (81.8%). Breast arterial calcification was not found among women younger than 40 years. CONCLUSION: Breast arterial calcification is associated with hypertension and prevalence increases with age. Breast arterial calcification on mammograms may indicate unsuspected hypertension especially in non-diabetic patients

A Brief Journey into the History of the Arterial Pulse

OpenAIRE

A. Maziar Zafari; Nima Ghasemzadeh

2011-01-01

Objective. This paper illustrates the evolution of our knowledge of the arterial pulse from ancient times to the present. Several techniques for arterial pulse evaluation throughout history are discussed. Methods. Using databases including Worldcat, Pubmed, and Emory University Libraries' Catalogue, the significance of the arterial pulse is discussed in three historical eras of medicine: ancient, medieval, and modern. Summary. Techniques used over time to analyze arterial pulse and its charac...

Contrast Media Delivery in the Assessment of Anomalous Left Coronary Artery From the Pulmonary Artery.

Science.gov (United States)

Saade, Charbel; Al-Hamra, Salam; Al-Mohiy, Hussain; El-Merhi, Fadi

2016-05-01

A patient with a history of mitral valve prolapse and regurgitation that was corrected with a mitral ring repair 15 years earlier received a diagnosis of anomalous left coronary artery arising from the pulmonary artery and underwent repair. Coronary computed tomography angiography (CTA) was employed to image the patient before surgical intervention. Synchronizing contrast media administration to opacify the right coronary artery in the arterial phase and the left coronary artery in the venous phase required a test-bolus approach. Matching compromised cardiovascular dynamics with patient-specific contrast media administration protocols was improved considerably with the use of a test-bolus technique during electrocardiography-gated coronary CTA.

Giant pseudoaneurysm from Vieussens' arterial ring.

Science.gov (United States)

Kocica, Mladen J; Vranes, Mile R; Djukic, Petar L; Mikic, Aleksandar Dj; Velinovic, Milos M; Havelka, Marija; Kanjuh, Vladimir I

2004-11-01

A giant coronary pseudoaneurysm of uncertain cause, arising from Vieussens' arterial ring, was preoperatively diagnosed in an oligosymptomatic female patient. Successful off-pump surgical excision without additional bypass grafting was performed. Difficulties in diagnostic algorithm, as well as possible cause and extremely rare localization were discussed.

Endovascular technique using a snare and suture for retrieving a migrated peripherally inserted central catheter in the left pulmonary artery

Science.gov (United States)

Teragawa, Hiroki; Sueda, Takashi; Fujii, Yuichi; Takemoto, Hiroaki; Toyota, Yasushi; Nomura, Shuichi; Nakagawa, Keigo

2013-01-01

We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter (PICC) in a chemotherapy patient. A 62-year-old male received monthly chemotherapy through a central venous port implanted into his right subclavian area. The patient completed chemotherapy without complications 1 mo ago; however, he experienced pain in the right subclavian area during his last chemotherapy session. Computed tomography on that day showed migration of a broken PICC in his left pulmonary artery, for which the patient was admitted to our hospital. We attempted to retrieve the ectopic PICC through the right jugular vein using a gooseneck snare, but were unsuccessful because the catheter was lodged in the pulmonary artery wall. Therefore, a second attempt was made through the right femoral vein using a snare with triple loops, but we could not grasp the migrated PICC. Finally, a string was tied to the top of the snare, allowing us to curve the snare toward the pulmonary artery by pulling the string. Finally, the catheter body was grasped and retrieved. The endovascular suture technique is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters. PMID:24109502

Evaluation of Temporal Diagnostic Techniques for Two-Bunch Facet Beam

Energy Technology Data Exchange (ETDEWEB)

Litos, M.D.; Bionta, M.R.; Dolgashev, V.A.; England, R.J.; Fritz, D.; Gilevich, S.; Hering, Ph.; Hogan, M.J.; /SLAC

2011-08-19

Three temporal diagnostic techniques are considered for use in the FACET facility at SLAC, which will incorporate a unique two-bunch beam for plasma wakefield acceleration experiments. The results of these experiments will depend strongly on the the inter-bunch spacing as well as the longitudinal profiles of the two bunches. A reliable, singleshot, high resolution measurement of the beam's temporal profile is necessary to fully quantify the physical mechanisms underlying the beam driven plasma wakefield acceleration. In this study we show that a transverse deflecting cavity is the diagnostic which best meets our criteria. Based on our laboratory testing, numerical calculations, and simulations of the three single-shot temporal diagnostic devices, the X-band TCAV system is the best candidate for resolving FACET's two-bunch beam, with an estimated resolution of 7 {micro}m. Both the S-band TCAV system and the EO system could resolve the peak-to-peak separation of the two bunches in the FACET beam with estimated resolutions of 25 {micro}m and 30 {micro}m, respectively, but would be unable to resolve the temporal profiles of the individual bunches themselves. Because the TCAV signal is more easily interpreted and because the reliability of the EO system is less well known, however, the S-band TCAV system would be the next preferred option after the X-band TCAV system. The Fesca-200 streak camera, though simple, compact, and reliable, is unable to achieve a resolution that would be of use to FACET.

Simpson's atherectomy in peripheral arteries

International Nuclear Information System (INIS)

Kueffer, G.; Spengel, F.A.; Hansen, R.; Pfluger, T.; Nathrath, W.; Muenchen Univ.; Muenchen Univ.

1990-01-01

Over a seventeen-month period, a percutaneous transluminal removal of stenosing plaque material from leg and pelvic arteries was performed successfully and without complication in 43 patients. A complete atherectomy in the femoropopliteal vessels succeeded in 99% of cases. In the pelvic region, the primary results were much lower (58%). After six months, the angiographically checked restenosis rate was 17% for femoropopliteal vessels and 11% for iliac arteries, and the corresponding Kaplan-Meier cumulative patency rates were 73.8 and 78.7% respectively. Simpson's atherectomy is the only method of its kind that is therapeutically effective and diagnostically significant, since the removed plaque can be used for further tests. (orig.) [de

Multimodal nonlinear microscopy: A powerful label-free method for supporting standard diagnostics on biological tissues

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Riccardo Cicchi

2014-09-01

Full Text Available The large use of nonlinear laser scanning microscopy in the past decade paved the way for potential clinical application of this imaging technique. Modern nonlinear microscopy techniques offer promising label-free solutions to improve diagnostic performances on tissues. In particular, the combination of multiple nonlinear imaging techniques in the same microscope allows integrating morphological with functional information in a morpho-functional scheme. Such approach provides a high-resolution label-free alternative to both histological and immunohistochemical examination of tissues and is becoming increasingly popular among the clinical community. Nevertheless, several technical improvements, including automatic scanning and image analysis, are required before the technique represents a standard diagnostic method. In this review paper, we highlight the capabilities of multimodal nonlinear microscopy for tissue imaging, by providing various examples on colon, arterial and skin tissues. The comparison between images acquired using multimodal nonlinear microscopy and histology shows a good agreement between the two methods. The results demonstrate that multimodal nonlinear microscopy is a powerful label-free alternative to standard histopathological methods and has the potential to find a stable place in the clinical setting in the near future.

The Role of Echocardiography in Coronary Artery Disease and Acute Myocardial Infarction

Science.gov (United States)

Esmaeilzadeh, Maryam; Parsaee, Mozhgan; Maleki, Majid

2013-01-01

Echocardiography is a non-invasive diagnostic technique which provides information regarding cardiac function and hemodynamics. It is the most frequently used cardiovascular diagnostic test after electrocardiography and chest X-ray. However, in a patient with acute chest pain, Transthoracic Echocardiography is essential both for diagnosing acute coronary syndrome, zeroing on the evaluation of ventricular function and the presence of regional wall motion abnormalities, and for ruling out other etiologies of acute chest pain or dyspnea, including aortic dissection and pericardial effusion. Echocardiography is a versatile imaging modality for the management of patients with chest pain and assessment of left ventricular systolic function, diastolic function, and even myocardial and coronary perfusion and is, therefore, useful in the diagnosis and triage of patients with acute chest pain or dyspnea. This review has focused on the current applications of echocardiography in patients with coronary artery disease and myocardial infarction. PMID:23646042

Coronary artery to left ventricle fistula

Directory of Open Access Journals (Sweden)

Kumar Vivek

2005-11-01

Full Text Available Abstract Background Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle. Case Presentation We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow. Conclusion The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.

Mid-cervical flame-shaped pseudo-occlusion: diagnostic performance of mid-cervical flame-shaped extracranial internal carotid artery sign on computed tomographic angiography in hyperacute ischemic stroke

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Prakkamakul, Supada; Pitakvej, Nantaporn [King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Department of Radiology, Bangkok (Thailand); Dumrongpisutikul, Netsiri; Lerdlum, Sukalaya [King Chulalongkorn Memorial Hospital the Thai Red Cross Society, Department of Radiology, Bangkok (Thailand); Chulalongkorn University, Department of Radiology, Faculty of Medicine, Bangkok (Thailand)

2017-10-15

Flame-shaped pseudo-occlusion of the extracranial internal carotid artery (ICA) is a flow-related phenomenon that creates computed tomographic angiography (CTA) and digital subtraction angiography (DSA) findings that mimic tandem intracranial-extracranial ICA occlusion or dissection. We aim to determine the diagnostic performance of mid-cervical flame-shaped extracranial ICA sign on CTA in hyperacute ischemic stroke patients. We retrospectively included consecutive anterior circulation ischemic stroke patients presenting within 6 h of symptom onset who underwent 4D brain CTA and arterial-phase neck CTA using a 320-detector CT scanner during August 2012 to July 2015. Two blinded readers independently reviewed arterial-phase neck CTA and characterized the extracranial ICA configurations into mid-cervical flame-shaped, proximal blunt/beak-shaped, and tubular-shaped groups. 4D whole brain CTA was used as a reference standard for intracranial ICA occlusion detection. Diagnostic performance of the mid-cervical flame-shaped extracranial ICA sign and interobserver reliability were calculated. Of the 81 cases, 11 had isolated intracranial ICA occlusion, and 6 had true extracranial ICA occlusion. Mid-cervical flame-shaped extracranial ICA sign was found in 45.5% (5/11) of isolated intracranial ICA occlusions but none in the true extracranial ICA occlusion group. The sensitivity, specificity, PPV, NPV, and accuracy of the mid-cervical flame-shaped extracranial ICA sign for the detection of isolated intracranial ICA occlusion were 45.5, 100, 100, 92.1, and 92.6%, respectively. Interobserver reliability was 0.90. The mid-cervical flame-shaped extracranial ICA sign may suggest the presence of isolated intracranial ICA occlusion and allow reliable exclusion of tandem extracranial-intracranial ICA occlusion in hyperacute ischemic stroke setting. (orig.)

Mid-cervical flame-shaped pseudo-occlusion: diagnostic performance of mid-cervical flame-shaped extracranial internal carotid artery sign on computed tomographic angiography in hyperacute ischemic stroke

International Nuclear Information System (INIS)

Prakkamakul, Supada; Pitakvej, Nantaporn; Dumrongpisutikul, Netsiri; Lerdlum, Sukalaya

2017-01-01

Flame-shaped pseudo-occlusion of the extracranial internal carotid artery (ICA) is a flow-related phenomenon that creates computed tomographic angiography (CTA) and digital subtraction angiography (DSA) findings that mimic tandem intracranial-extracranial ICA occlusion or dissection. We aim to determine the diagnostic performance of mid-cervical flame-shaped extracranial ICA sign on CTA in hyperacute ischemic stroke patients. We retrospectively included consecutive anterior circulation ischemic stroke patients presenting within 6 h of symptom onset who underwent 4D brain CTA and arterial-phase neck CTA using a 320-detector CT scanner during August 2012 to July 2015. Two blinded readers independently reviewed arterial-phase neck CTA and characterized the extracranial ICA configurations into mid-cervical flame-shaped, proximal blunt/beak-shaped, and tubular-shaped groups. 4D whole brain CTA was used as a reference standard for intracranial ICA occlusion detection. Diagnostic performance of the mid-cervical flame-shaped extracranial ICA sign and interobserver reliability were calculated. Of the 81 cases, 11 had isolated intracranial ICA occlusion, and 6 had true extracranial ICA occlusion. Mid-cervical flame-shaped extracranial ICA sign was found in 45.5% (5/11) of isolated intracranial ICA occlusions but none in the true extracranial ICA occlusion group. The sensitivity, specificity, PPV, NPV, and accuracy of the mid-cervical flame-shaped extracranial ICA sign for the detection of isolated intracranial ICA occlusion were 45.5, 100, 100, 92.1, and 92.6%, respectively. Interobserver reliability was 0.90. The mid-cervical flame-shaped extracranial ICA sign may suggest the presence of isolated intracranial ICA occlusion and allow reliable exclusion of tandem extracranial-intracranial ICA occlusion in hyperacute ischemic stroke setting. (orig.)

Dynamic contrast-enhanced ultrasound and transient arterial occlusion for quantification of arterial perfusion reserve in peripheral arterial disease

International Nuclear Information System (INIS)

Amarteifio, E.; Wormsbecher, S.; Krix, M.; Demirel, S.; Braun, S.; Delorme, S.; Böckler, D.; Kauczor, H.-U.; Weber, M.-A.

2012-01-01

Objective: To quantify muscular micro-perfusion and arterial perfusion reserve in peripheral arterial disease (PAD) with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion. Materials and methods: This study had local institutional review board approval and written informed consent was obtained from all subjects. We examined the dominant lower leg of 40 PAD Fontaine stage IIb patients (mean age, 65 years) and 40 healthy volunteers (mean age, 54 years) with CEUS (7 MHz; MI, 0.28) during continuous intravenous infusion of 4.8 mL microbubbles. Transient arterial occlusion at mid-thigh level simulated physical exercise. With time–CEUS–intensity curves obtained from regions of interest within calf muscles, we derived the maximum CEUS signal after occlusion (max) and its time (t max ), slope to maximum (m), vascular response after occlusion (AUC post ), and analysed accuracy, receiver operating characteristic (ROC) curves, and correlations with ankle-brachial index (ABI) and walking distance. Results: All parameters differed in PAD and volunteers (p max was delayed (31.2 ± 13.6 vs. 16.7 ± 8.5 s, p post as optimal parameter combination for diagnosing PAD and therefore impaired arterial perfusion reserve. Conclusions: Dynamic CEUS with transient arterial occlusion quantifies muscular micro-perfusion and arterial perfusion reserve. The technique is accurate to diagnose PAD.

Diagnostic performance of calcification-suppressed coronary CT angiography using rapid kilovolt-switching dual-energy CT.

Science.gov (United States)

Yunaga, Hiroto; Ohta, Yasutoshi; Kaetsu, Yasuhiro; Kitao, Shinichiro; Watanabe, Tomomi; Furuse, Yoshiyuki; Yamamoto, Kazuhiro; Ogawa, Toshihide

2017-07-01

Multi-detector-row computed tomography angiography (MDCTA) plays an important role in the assessment of patients with suspected coronary artery disease. However, MDCTA tends to overestimate stenosis in calcified coronary artery lesions. The aim of our study was to evaluate the diagnostic performance of calcification-suppressed material density (MD) images produced by using a single-detector single-source dual-energy computed tomography (ssDECT). We enrolled 67 patients with suspected or known coronary artery disease who underwent ssDECT with rapid kilovolt-switching (80 and 140 kVp). Coronary artery stenosis was evaluated on the basis of MD images and virtual monochromatic (VM) images. The diagnostic performance of the two methods for detecting coronary artery disease was compared with that of invasive coronary angiography as a reference standard. We evaluated 239 calcified segments. In all the segments, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for detecting significant stenosis were respectively 88%, 88%, 75%, 95% and 88% for the MD images, 91%, 71%, 56%, 95% and 77% for the VM images. PPV was significantly higher on the MD images than on the VM images (P < 0.0001). Calcification-suppressed MD images improved PPV and diagnostic performance for calcified coronary artery lesions. • Computed tomography angiography tends to overestimate stenosis in calcified coronary artery. • Dual-energy CT enables us to suppress calcification of coronary artery lesions. • Calcification-suppressed material density imaging reduces false-positive diagnosis of calcified lesion.

Diagnostic Value of Myocardial Perfusion SPECT with Dipyridamole in a Female Population

International Nuclear Information System (INIS)

Perez-Iruela, Juan; Pastor, Purificacion; Lumbreras, Luis; Martin, Ana M.; Ruiz, Francisco J.; Posadas, A.; Puentes, Carmen

2009-01-01

Background: Exercise stress scintigraphy is a safe procedure widely used for the diagnosis of ischemic heart disease. Pharmacologic stress testing is an important alternative. The delayed presentation of ischemic heart disease in women, together with a lower diagnostic accuracy of exercise stress testing in this population, has generated interest in the potential benefits provided by myocardial perfusion imaging tests. Objective: To determine the diagnostic value of myocardial perfusion images with 99m Tc-tetrofosmin in a one day protocol after a pharmacologic stress with dipyridamole in a female population, and the relation with the coronary territories using coronary angiography as a reference technique. Material and Methods: In total, 149 clinical charts of women with suspected ischemic heart disease undergoing myocardial perfusion imaging tests and coronary angiography were retrospectively analyzed. Results: Sensitivity and specificity were 94% (93.47%-94.53%) and 82% (80.94%-83.06%), respectively. Values of sensitivity and specificity according to coronary territories were 71.62% (70.88%-72.36%) and 76% (75.27%-76.73%) for the left anterior descending (LAD) artery, 69.09% (68.11%-70.07%) and 76.84% (76.26%-77.42%) for the left circumflex (LCx) coronary artery, and 87.23% (86.11%-88.36%) and 74.51% (73.97%-75.05%) for the right coronary artery (RCA), respectively. Conclusion: Myocardial perfusion scintigraphy with 99m Tc-tetrofosmin and dipyridamole using a one day stress-rest protocol has high sensitivity and specificity for the diagnosis of ischemic heart disease in women. (authors) [es

Diagnostic Accuracy of Dual-Source Computerized Tomography Coronary Angiography in Symptomatic Patients Presenting to a Referral Cardiovascular Center During Daily Clinical Practice

International Nuclear Information System (INIS)

Mahdavi, Arash; Mohammadzadeh, Ali; Joodi, Golsa; Tabatabaei, Mohammad Reza; Sheikholeslami, Farhad; Motevalli, Marzieh

2016-01-01

There are numerous studies that address the diagnostic value of dual-source computed tomography (DSCT) as an alternative to conventional coronary angiography (CCA). However, the benefit of application of DSCT in a real world clinical setting should be evaluated. To determine the diagnostic accuracy of DSCT technique compared with CCA as the gold standard method in detection of coronary artery stenosis among symptomatic patients who are presented to a referral cardiovascular center during daily clinical practice. Evaluating the medical records of a tertiary care referral cardiovascular center, 47 patients who had undergone DSCT and CCA, and also met the inclusion and exclusion criteria of the study were selected. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LRs) of the DSCT imaging technique were calculated. In total, 97.8% of the segments (628/642) could be visualized with diagnostic image quality via DSCT coronary angiography. The mean heart rate during DSCT was 69.2 ± 12.2 bpm (range: 39 - 83 bpm), and the mean Agatston score was 507.7 ± 590.5 (range: 0 - 2328). Per segment analysis of the findings revealed that the sensitivity, specificity, PPV, NPV, positive LR (PLR) and negative LR (NLR) of DSCT technique for evaluation of patients with coronary artery disease were 93.7%, 96.8%, 92.7%, 97.2%, 29.4, and 0.066, respectively. Also per vessel, analysis of the findings showed a sensitivity of 97.1%, a specificity of 94.0%, PPV of 95.3%, NPV of 96.3%, PLR of 16.1, and NLR of 0.030. Our results indicate that DSCT coronary angiography provides high diagnostic accuracy for the evaluation of CAD patients during daily routine practice of a referral cardiovascular setting

Secondary hypertension: Place of imaging techniques

International Nuclear Information System (INIS)

Marichez, M.; Jeunemaitre, X.; Despres, E.; Plouin, P.F.; Melki, J.P.; Taleb, A.

1987-01-01

To determine and illustrate the place of various imaging techniques in the diagnosis of arterial hypertension, a retrospective study of 4,530 patients examined during the past 2 years at Broussals and Saint Joseph Hospitals in Paris was undertaken. Between 1975 and 1984, only 20% of our patients underwent surgery, but in the past 2 years, 6% of patients with hypertension underwent either surgery or transluminal angioplasty. At our institution, imaging studies performed were Doppler US, excretory urography, CT, MR imaging, scintigraphy, adrenal venography, and arteriography. The authors encountered over 156 cases of renovascular hypertension, 23 Conn adenomas, 13 pheochromocytomas, four adrenal carcinomas, and 46 parenchymatous renal anomalies. This paper presents the modalities and the pitfalls of each imaging technique. The authors also indicate the strategies used in the diagnostic approach and the results the authors obtained

Acute Respiratory Distress Syndrome diagnosis after coronary artery bypass: comparison between diagnostic criteria and clinical picture.

Directory of Open Access Journals (Sweden)

Manzar Vakili

2015-01-01

Full Text Available Acute Respiratory Distress Syndrome (ARDS is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2 less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 % in the 24 hours and 4 (1.33% patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937 and sex (P

Evaluation of commissural malalignment of aortic-pulmonary sinus using cardiac CT for arterial switch operation: comparison with transthoracic echocardiography

International Nuclear Information System (INIS)

Bang, Ji Hyun; Park, Jeong-Jun; Goo, Hyun Woo

2017-01-01

There are limited data regarding the influence of commissural malalignment of the aortic-pulmonary sinus on the arterial switch operation. To compare diagnostic accuracy between cardiac CT and echocardiography for evaluating commissural malalignment of aortic-pulmonary sinus in children with complete transposition of the great arteries and to seek potential clinical implication of commissural malalignment on the arterial switch operation. In 37 patients (35 boys; median age: 8 days, range: 3-80 days) with complete transposition of the great arteries who had tricuspid semilunar valves and underwent an arterial switch operation, the degree of the commissural rotation of the aortic-pulmonary sinus was assessed on cardiac CT (n=37) and echocardiography (n=35). With surgical finding as a reference, cardiac CT was compared with echocardiography in identifying commissural malalignment in 35 patients. The influence of the height difference between the semilunar valves measured by cardiac CT on the identification of commissural malalignment with cardiac CT and echocardiography was evaluated. The impact of commissural malalignment on coronary transfer techniques was evaluated. In operative findings, the commissures of the semilunar valves were aligned in 24 patients and malaligned in 13. With surgical findings as a reference, cardiac CT showed higher, but not statistically significant (P>0.05), sensitivity (91.7% vs. 75.0%), specificity (87.0% vs. 78.3%) and accuracy (88.6% vs. 77.1%) for the diagnosis of the malalignment than echocardiography. The measured height difference between the semilunar valves did not affect the identification of the malalignment with cardiac CT and echocardiography. The surgical malalignment group showed a higher requirement of modified coronary transfer techniques than the surgical aligned group (11/13 vs. 11/24, P=0.03). Cardiac CT and echocardiography appear useful for evaluating commissural malalignment of the semilunar valves in patients with

Evaluation of commissural malalignment of aortic-pulmonary sinus using cardiac CT for arterial switch operation: comparison with transthoracic echocardiography

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Bang, Ji Hyun; Park, Jeong-Jun [Asan Medical Center, University of Ulsan College of Medicine, Divisions of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Goo, Hyun Woo [Asan Medical Center, University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

2017-05-15

There are limited data regarding the influence of commissural malalignment of the aortic-pulmonary sinus on the arterial switch operation. To compare diagnostic accuracy between cardiac CT and echocardiography for evaluating commissural malalignment of aortic-pulmonary sinus in children with complete transposition of the great arteries and to seek potential clinical implication of commissural malalignment on the arterial switch operation. In 37 patients (35 boys; median age: 8 days, range: 3-80 days) with complete transposition of the great arteries who had tricuspid semilunar valves and underwent an arterial switch operation, the degree of the commissural rotation of the aortic-pulmonary sinus was assessed on cardiac CT (n=37) and echocardiography (n=35). With surgical finding as a reference, cardiac CT was compared with echocardiography in identifying commissural malalignment in 35 patients. The influence of the height difference between the semilunar valves measured by cardiac CT on the identification of commissural malalignment with cardiac CT and echocardiography was evaluated. The impact of commissural malalignment on coronary transfer techniques was evaluated. In operative findings, the commissures of the semilunar valves were aligned in 24 patients and malaligned in 13. With surgical findings as a reference, cardiac CT showed higher, but not statistically significant (P>0.05), sensitivity (91.7% vs. 75.0%), specificity (87.0% vs. 78.3%) and accuracy (88.6% vs. 77.1%) for the diagnosis of the malalignment than echocardiography. The measured height difference between the semilunar valves did not affect the identification of the malalignment with cardiac CT and echocardiography. The surgical malalignment group showed a higher requirement of modified coronary transfer techniques than the surgical aligned group (11/13 vs. 11/24, P=0.03). Cardiac CT and echocardiography appear useful for evaluating commissural malalignment of the semilunar valves in patients with

Diagnostic performance of calcification-suppressed coronary CT angiography using rapid kilovolt-switching dual-energy CT

Energy Technology Data Exchange (ETDEWEB)

Yunaga, Hiroto; Ohta, Yasutoshi; Kitao, Shinichiro; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Yonago City, Tottori (Japan); Kaetsu, Yasuhiro [Kakogawa Higashi Hospital, Department of Cardiology, Kakogawa (Japan); Watanabe, Tomomi; Furuse, Yoshiyuki; Yamamoto, Kazuhiro [Tottori University, Division of Cardiology, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Yonago (Japan)

2017-07-15

Multi-detector-row computed tomography angiography (MDCTA) plays an important role in the assessment of patients with suspected coronary artery disease. However, MDCTA tends to overestimate stenosis in calcified coronary artery lesions. The aim of our study was to evaluate the diagnostic performance of calcification-suppressed material density (MD) images produced by using a single-detector single-source dual-energy computed tomography (ssDECT). We enrolled 67 patients with suspected or known coronary artery disease who underwent ssDECT with rapid kilovolt-switching (80 and 140 kVp). Coronary artery stenosis was evaluated on the basis of MD images and virtual monochromatic (VM) images. The diagnostic performance of the two methods for detecting coronary artery disease was compared with that of invasive coronary angiography as a reference standard. We evaluated 239 calcified segments. In all the segments, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for detecting significant stenosis were respectively 88%, 88%, 75%, 95% and 88% for the MD images, 91%, 71%, 56%, 95% and 77% for the VM images. PPV was significantly higher on the MD images than on the VM images (P < 0.0001). Calcification-suppressed MD images improved PPV and diagnostic performance for calcified coronary artery lesions. (orig.)

Predictive value of auscultation of femoropopliteal arteries.

Science.gov (United States)

Kaufmann, Carla; Jacomella, Vincenzo; Kovacicova, Ludmila; Husmann, Marc; Clemens, Robert K; Thalhammer, Christopf; Amann-Vesti, Beatrice R

2013-03-05

Femoropopliteal bruits indicate flow turbulences and increased blood flow velocity, usually caused by an atherosclerotic plaque or stenosis. No data exist on the quality of bruits as a means for quantifying the degree of stenosis. We therefore conducted a prospective observational study to investigate the sensitivity and specificity of femoropopliteal auscultation, differentiated on the basis of bruit quality, to detect and quantify clinically relevant stenoses in patients with symptomatic and asymptomatic peripheral arterial disease (PAD). Patients with known chronic and stable PAD were recruited in the outpatient clinic. We included patients with known PAD and an ankle-brachial index (ABI) Auscultation was performed independently by three investigators with varied clinical experience after a 10-minute period of rest. Femoropopliteal lesions were classified as follows: normal vessel wall or slight wall thickening (auscultation were low in all vascular regions and did not differ between investigators. Sensitivity was low in most areas with an increase after exercise. The highest sensitivity in detecting relevant (>50%) stenosis was found in the common femoral artery (86%). Vascular auscultation is known to be of great use in routine clinical practice in recognising arterial abnormalities. Diagnosis of PAD is based on various diagnostic tools (pulse palpation, ABI measurement) and auscultation can localise relevant stenosis. However, auscultation alone is of limited sensitivity and specificity in grading stenosis in femoropopliteal arteries. Where PAD is clinically suspected further diagnostic tools, especially colour-coded duplex ultrasound, should be employed to quantify the underlying lesion.

Estimation of intrathoracic arterial diameter by means of computed tomographic angiography in Hispaniolan Amazon parrots.

Science.gov (United States)

Beaufrère, Hugues; Rodriguez, Daniel; Pariaut, Romain; Gaschen Dvm, Lorrie; Schnellbacher, Rodney; Nevarez, Javier G; Tully, Thomas N

2011-02-01

To establish a computed tomography (CT)-angiography protocol and measure the diameters of major arteries in parrots. 13 Hispaniolan Amazon parrots (Amazona ventralis). 16-slice CT scanning was used to measure the apparent diameter of the ascending aorta, abdominal aorta, pulmonary arteries, and brachiocephalic trunk. Before scanning, all birds underwent ECG and echocardiographic assessment and were considered free of detectable cardiovascular diseases. Each bird was anesthetized, and a precontrast helical CT scan was performed. Peak aortic enhancement was established with a test bolus technique via dynamic axial CT scan over a predetermined single slice. An additional bolus of contrast medium was then injected, and a helical CT-angiography scan was performed immediately afterward. Arterial diameter measurements were obtained by 2 observers via various windows before and after injection, and intra- and interobserver agreement was assessed. Reference limits were determined for arterial diameter measurements before and after contrast medium administration in pulmonary, mediastinal, and manual angiography windows. Ratios of vertebral body diameter to keel length were also calculated. Intraobserver agreement was high (concordance correlation coefficients ≥ 0.95); interobserver agreement was medium to high (intraclass correlation coefficients ≥ 0.65). CT-angiography was safe and is of potential diagnostic value in parrots. We recommend performing the angiography immediately after IV injection of 3 mL of iohexol/kg. Arterial diameter measurements at the described locations were reliable.

Intercomparison of techniques for inspection and diagnostics of heavy water reactor pressure tubes. Additional information

International Nuclear Information System (INIS)

2009-03-01

The reports from Argentina, Canada, India, Korea and Romania are presented concerning the projects carried out under the Coordinated Research Program (CRP) I3.30.10 of the International Agency for Atomic Energy - Vienna related to 'Intercomparison of Techniques for Pressure Tube Inspection and Diagnostics'

Diagnostic value for coronary artery disease of ST depression and chest pain during dipyridamole loading

International Nuclear Information System (INIS)

Yonezawa, Yoshihiro; Doi, Yoshinori; Aono, Tadashi; Odawara, Hiroaki; Chikamori, Taishiro; Yamada, Mitsutoshi; Takata, Jun; Ozawa, Toshio; Hamashige, Naohisa.

1991-01-01

The diagnostic significance of both ST depression and chest pain during dipyridamole loading was assessed in 437 patients with coronary artery disease (CRD) who have received dipyridamole-loading thallium-201 myocardial scintigraphy and coronary arteriography. ST depression and chest pain were induced in 35% and 42%, respectively. ST depression occurred in 23% for one vessel disease, 55% for two-vessel disease, 67% for three-vessel disease, and 11% for non-significant disease. In the absence of myocardial infarction, it occurred in as many as 78% for two-vessel disease and 94% for three-vessel disease. ST depression had a sensitivity of 51% and a specificity of 89%. Chest pain had a lower specificity (77%), whereas the sensitivity remained the same (51%). In 42 (31%) of 134 patients with ST depression, coronary revascularization was necessary in the early stage. With a median follow up of 29 months, 3 patients (2%) died of cardiac events, and 12 (9%) had nonfatal cardiac complications. There was a significant correlation between reversible defects (RD) on myocardial scintigrams and ST depression; RD were seen in 81% of ST depression cases, and ST depression occurred in 51% of 210 RD cases. The more diseased vessels, the more frequently ST depression occurred in accordance with RD on myocardial scintigrams. Both ST depression and chest pain during dipyridamole loading tended to be associated with myocardial ischemia, suggesting the diagnostic value in CRD patients with limited exercise loading. RD on myocardial scintigrams was considered attributable to coronary steal phenomenon for multi-vessel disease and to the difference in the relative increase of the coronary flow for single vessel disease. (N.K.)

A unique branching pattern of the axillary artery: a case report.

Science.gov (United States)

Bagoji, Ishwar B; Hadimani, Gavishiddappa A; Bannur, Balappa M; Patil, B G; Bharatha, Ambadasu

2013-12-01

During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in the arm gave anterior circumflex humeral artery at the surgical neck of humerus, which terminated in the cubital fossa by dividing into radial and ulnar arteries. The superficial brachial artery gave two profunda brachii arteries, both of which passed through spiral groove, along with radial nerve and three muscular branches, to brachialis muscle. This variation is very rare. As per our knowledge, we did not find any literature which explained variations which were similar to this. The normal and abnormal anatomy of the axillary region has practical importance among vascular radiologists and surgeons and it should be known for making an accurate diagnostic interpretation.

Blood-conservation techniques for coronary-artery bypass surgery at a private hospital.

Science.gov (United States)

Davies, M J; Picken, J; Buxton, B F; Fuller, J A

1988-11-21

The utilization of homologous blood and blood products was recorded in 100 consecutive patients who underwent primary coronary-artery bypass surgery. Nine patients underwent saphenous-vein grafts only, 55 patients underwent a single internal-mammary-artery graft that was supplemented by vein grafts and 36 patients underwent bilateral internal-mammary-artery grafts and vein grafts. All patients underwent normovolaemic haemodilution, and autologous blood was collected before bypass surgery. Residual blood was collected from the cardiopulmonary bypass machine and was washed and concentrated in a cell processor, and blood also was scavenged postoperatively from the mediastinal drainage tubes as methods to conserve blood. The mean (+/- SD) utilization of homologous blood was 1.3 +/- 1.5 units with 0.2 +/- 0.7 units of fresh-frozen plasma being used, and 0.8 +/- 2.1 units of platelets being used. The utilization of homologous blood was not different among the three different methods of coronary-artery bypass surgery, but patients who underwent bilateral internal-mammary-artery grafts suffered a greater postoperative loss of blood than did those patients who underwent saphenous-vein grafts or single internal-mammary-artery grafts. A comparison of patients who were taking aspirin or a non-steroidal anti-inflammatory drug preoperatively with those patients who were not showed no difference in the utilization of homologous blood but a statistically-significant difference was found in the loss of blood postoperatively.

Aneurysm of the aberrant right subclavian artery – a case report

International Nuclear Information System (INIS)

Godlewski, Janusz; Widawski, Tomasz; Michalak, Maciej; Kmieć, Zbigniew

2010-01-01

The right subclavian artery, originating not from the brachiocephalic trunk but directly from the aortic arch, is a rare anatomical abnormality. ‘Arteria lusoria’ is the accepted name of the retroesophageal right subclavian artery. Such a vessel location, between the vertebral column and the esophagus, determines its course to the right. This defect may be asymptomatic, found during autopsy or coincidentally during diagnostic procedures. However, it may also be symptomatic. The course of this major blood vessel in the limited anatomical space may cause symptoms of mediastinal organ compression. The aim of this paper was to present two cases of abnormal anatomical course of the right subclavian artery and its aneurismal dilation. In this study, CT scans of the saccular aneurysm of the retroesophageal right subclavian artery were used: of a male patient diagnosed at Euromedic Diagnostics in Olsztyn and of a female patient, from the resources of the Radiological Dept. at MSWiA Hospital in Olsztyn An 85-year-old female was admitted to Hospital ER for congestive heart failure decompensation. Her chest X-ray revealed a round mass in the upper right mediastinum. Chest CT confirmed the presence of a saccular aneurysm of the lusory artery, 6.5 cm in diameter, partially filled with thrombotic material. The patient died in hospital from myocardial infarction that was not related to the aneurysm. A 61-year-old male patient had a chest X-ray which showed a round opacity on the apex of the right lung. The diagnostic process comprised also chest computed tomography. The examination showed an anomalous origin of the right subclavian artery, with aneurysmal dilation and compression of the oesophagus and of the trachea. An intraluminal thrombus was found. The patient remained under observation till the next CT examination, 6 months later. The presented rare cases of arteria lusoria aneurysm are not only casuistic reports. They also show the value of modern MDCT diagnostics

Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves

International Nuclear Information System (INIS)

Habets, Jesse; Mali, Willem P.T.M.; Budde, Ricardo P.J.; Brink, Renee B.A. van den; Uijlings, Ruben; Spijkerboer, Anje M.; Chamuleau, Steven A.J.

2012-01-01

Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT. ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of prosthetic heart valves. The best systolic and diastolic axial reconstructions were selected for coronary assessment. Each present coronary segment was scored for the presence of valve-related artefacts prohibiting coronary artery assessment. Scoring was performed in consensus by two observers. Eighty-two CT angiograms were performed on a 64-slice (n = 27) or 256-slice (n = 55) multidetector CT. Eighty-nine valves and five annuloplasty rings were present. Forty-three out of 1160 (3.7%) present coronary artery segments were non-diagnostic due to valve artefacts (14/82 patients). Valve artefacts were located in right coronary artery (15/43; 35%), left anterior descending artery (2/43; 5%), circumflex artery (14/43; 32%) and marginal obtuse (12/43; 28%) segments. All cobalt-chrome containing valves caused artefacts prohibiting coronary assessment. Biological and titanium-containing valves did not cause artefacts except for three specific valve types. Most commonly implanted prosthetic heart valves do not hamper coronary assessment on multidetector CT. Cobalt-chrome containing prosthetic heart valves preclude complete coronary artery assessment because of severe valve artefacts. circle Most commonly implanted prosthetic heart valves do not hamper coronary artery assessment circle Prosthetic heart valve composition determines the occurrence of prosthetic heart valve-related artefacts circle Bjoerk-Shiley and Sorin tilting disc valves preclude diagnostic coronary artery segment assessment. (orig.)

First clinical experience with Celt ACD(®) : a femoral arterial puncture closure device.

LENUS (Irish Health Repository)

Jan, Aftab

2013-08-01

This prospective nonrandomized study compared the safety and efficacy of a novel arterial closure device (ACD) in common femoral artery procedures to that of the FDA submitted historical manual pressure control group, who underwent either a diagnostic angiogram (DA) or a percutaneous coronary intervention (PCI) procedure.

Unusually Looped and Muzzled Branches of Right Coronary Artery

Directory of Open Access Journals (Sweden)

Anitha Guru

2017-01-01

Full Text Available Coronary artery disease (CAD is the major cause of death in developed countries as it accounts on an average for 1 of every 5 deaths. Morphological variations of coronary arterial system is one of the causative factor for CAD. Anatomical knowledge of all possible variant patterns of coronary arterial system is imperative in the diagnostic and therapeutic approach of CAD. We report here a rare branching pattern of right coronary artery (RCA. The origin of RCA was normal but the course and branching pattern of it were atypical. RCA was not occupying its usual position in atrioventricular (coronary sulcus and its course was incomplete. It gave a ventricular branch to right ventricle, which presented an unusual looping pattern. It terminated as right marginal artery following its muzzled appearance within the musculature of the ventricle.

Multiple vascular anomalies involving renal, testicular and suprarenal arteries

Directory of Open Access Journals (Sweden)

Suresh Rao

2015-09-01

Full Text Available Knowledge of variations of blood vessels of the abdomen is important during operative, diagnostic and endovascular pro- cedures. During routine dissection of the abdominal cavity, we came across multiple vascular anomalies involving renal, suprarenal and testicular arteries. The left kidney was supplied by two renal arteries originating together from the abdomi- nal aorta, and the right kidney was supplied by two accessory renal arteries, one of which was arising from the right renal artery and the other one from the aorta (about 2 inches below the origin of the renal artery. Accessory renal veins were present on both sides. The right testicular artery was arising from the lower accessory renal artery. The left testicular artery was looping around the inferior tributary of the left renal vein, whereby forming a sharp kink. The left middle suprarenal artery was diving into three small branches; the upper two branches were supplying the left suprarenal gland, whereas the lower branch was supplying the left kidney. Furthermore, detailed literature and the clinical and surgical importance of the case are discussed. [Arch Clin Exp Surg 2015; 4(3.000: 168-171

In vitro model of platelet aggregation in stenotic arteries

International Nuclear Information System (INIS)

Morley, D.; Santamore, W.P.

1988-01-01

Clinical and experimental evidence suggest a strong relationship between arterial stenosis, platelet aggregation, and subsequent thrombus formation. To facilitate the study of platelet accumulation in stenotic arteries, we developed an in vitro preparation. Arterial segments were perfused with whole citrated blood. A stenosis was created by applying an external plastic constrictor to the artery. Platelet accumulation within the stenosis was assessed by scanning electron microscopy and by radioactive counts from Indium-111 labeled platelets. Utilizing this preparation, 30 carotid arterial segments from 10 mongrel dogs were perfused at 100 mmHg for 15 min. In 10 arteries without a stenosis, scanning electron microscopy and radioactive counts demonstrated little platelet accumulation. In contrast, extensive platelet aggregation was observed in 10 arteries with stenoses. Moreover, in 10 stenotic arteries exposed to the thromboxane mimetic, U46619 (Upjohn Diagnostic Group), scanning electron microscopy and radioactive counts demonstrated a significant increase in platelet deposition. Conversely, we demonstrated a dimunition of platelet accumulation in stenosed arterial segments exposed to the prostacyclin analogue platelet inhibitor, Iloprost. The in vitro preparation allows precise control of hemodynamic variables and makes it possible to perform multiple tests on segments of the same vessel from the same animal

Sphenopalatine artery ligation: technical note.

Science.gov (United States)

Pothier, David D; Mackeith, Samuel; Youngs, Robin

2005-10-01

Epistaxis is a common problem. Most patients presenting to hospital will stop bleeding with simple first-aid measures or with nasal packing. Those who do not stop will usually require surgical management. For persistent posterior epistaxis, the sphenopalatine artery may be ligated as the artery leaves the sphenopalatine foramen to enter the nasal mucosa of the lateral wall of the nose. This may be performed endoscopically. We describe the anatomy of the area and the surgical technique. We also present a brief review of the literature on this technique.

[Qualitative and quantitative diagnostic performance of 320-slice computed tomography for detecting coronary artery disease with respect to atherosclerotic plaque characteristics].

Science.gov (United States)

Li, Suhua; Liu, Jinlai; Peng, Long; Dong, Ruimin; Wu, Huilan; Wang, Chenlin; Ni, Qiongqiong; Luo, Yanting; Zhu, Jieming; Chen, Lin

2014-10-28

To investigate qualitatively and quantitatively the diagnostic performance of 320-slice CT for detection of coronary artery disease with respect to different atherosclerotic plaque characteristics. A retrospective search was performed for inpatients underwent both coronary CT and further coronary angiography (CAG) from December 1, 2008 to December 31, 2012. The diagnostic performance of 320-slice CTA for detecting significant stenosis ( ≥ 50% diameter) with respect to atherosclerotic plaque characteristics were analyzed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, kappa index (κ), and area under the receiver operating characteristic curve (AUC). Chi-square test was used to evaluate whether there were significant differences of the true-case frequency (true positive + true negative) and false-case frequency (false positive + false negative) among groups. Bland-Altman analysis was used to determine limits of agreement between CTA and CAG. A total of 454 patients and 6 779 segments were analyzed. Diagnostic accuracy was higher in non-calcified segments; whereas they decreased in the presence of both mild-moderately and heavily calcified plaques. Excellent agreement (κ = 0.810) between CT and CAG was observed for non-calcified segments, while good agreement was observed for both mild-moderately (κ = 0.701) and heavily calcified segments (κ = 0.750). Both mild-moderate (P = 0.000) and heavy (P = 0.000) calcification decreased the true-case frequency and increased the false-case frequency when compared to non-calcification. There were no significant underestimation or overestimation for non-calcified (P = 0.087) and mild-moderately calcified (P = 0.704) segments, while there was significant overestimation for heavily calcified segments (P = 0.001). Great qualitative and quantitative diagnostic performances of 320-slice CT were observed in non-calcified coronary segments. However, qualitative

Evaluation of an isotope washout technique to measure skin vascular resistance and skin perfusion pressure: influence of age, site and arterial surgery

International Nuclear Information System (INIS)

Duncan, H.J.; Faris, I.B.

1986-01-01

1. A simplified isotope (sup(99m)Tc) washout technique has been devised to calculate the skin perfusion pressure (SPP) and skin vascular resistance (SVR). This test is simple, requires inexpensive equipment and is well tolerated by patients. 2. SPP and SVR were calculated in 20 patients 30 years of age and in 15 patients with peripheral vascular disease (PVD). With increasing age the SPP and SVP were increased. The SPP was similar to the mean arterial pressure in normal individuals but was decreased in patients with PVD. The SPP is a useful indicator of the severity of the PVD. 3. The SPP and SVR were higher in the calf than in the foot. This is probably related to the decrease in pressure in the distal arterial tree. 4. SPP was increased by 110% and skin blood flow by 190% by arterial reconstructive surgery. This test may be of use in assessing the effectiveness of arterial surgery. (author)

Application of the Polytron 1000 VR for functional diagnosis and interventional examination of arteries of the lower extremity: First clinical results

Energy Technology Data Exchange (ETDEWEB)

Kueffer, G.; Ziegler, L.; Hahn, D.

1989-01-01

The article reports the clinical experience gained with the POLYTRON-1000 VR system which has been used for all functional diagnostic tasks for detection of compression syndrome of the popliteal artery, and for diagnostic preparation and execution of atherectomy of pelvic and leg arteries with the Simpson catheter.

Arterial stiffness

Directory of Open Access Journals (Sweden)

Ursula Quinn

2012-09-01

Full Text Available Measurements of biomechanical properties of arteries have become an important surrogate outcome used in epidemiological and interventional cardiovascular research. Structural and functional differences of vessels in the arterial tree result in a dampening of pulsatility and smoothing of blood flow as it progresses to capillary level. A loss of arterial elastic properties results a range of linked pathophysiological changes within the circulation including increased pulse pressure, left ventricular hypertrophy, subendocardial ischaemia, vessel endothelial dysfunction and cardiac fibrosis. With increased arterial stiffness, the microvasculature of brain and kidneys are exposed to wider pressure fluctuations and may lead to increased risk of stroke and renal failure. Stiffening of the aorta, as measured by the gold-standard technique of aortic Pulse Wave Velocity (aPWV, is independently associated with adverse cardiovascular outcomes across many different patient groups and in the general population. Therefore, use of aPWV has been proposed for early detection of vascular damage and individual cardiovascular risk evaluation and it seems certain that measurement of arterial stiffness will become increasingly important in future clinical care. In this review we will consider some of the pathophysiological processes that result from arterial stiffening, how it is measured and factors that may drive it as well as potential avenues for therapy. In the face of an ageing population where mortality from atheromatous cardiovascular disease is falling, pathology associated with arterial stiffening will assume ever greater importance. Therefore, understanding these concepts for all clinicians involved in care of patients with cardiovascular disease will become vital.

Endovascular Treatment of a Symptomatic Thoracoabdominal Aortic Aneurysm by Chimney and Periscope Techniques for Total Visceral and Renal Artery Revascularization

Energy Technology Data Exchange (ETDEWEB)

Cariati, Maurizio, E-mail: cariati.maurizio@sancarlo.mi.it [San Carlo Borromeo Hospital, Department of Diagnostic Sciences (Italy); Mingazzini, Pietro; Dallatana, Raffaello [San Carlo Borromeo Hospital, Department of Vascular Surgery (Italy); Rossi, Umberto G. [San Carlo Borromeo Hospital, Department of Diagnostic Sciences (Italy); Settembrini, Alberto [San Carlo Borromeo Hospital, Università degli Studi di Milano (Italy); Santuari, Davide [San Carlo Borromeo Hospital, Department of Vascular Surgery (Italy)

2013-05-02

Conventional endovascular therapy of thoracoabdominal aortic aneurysm with involving visceral and renal arteries is limited by the absence of a landing zone for the aortic endograft. Solutions have been proposed to overcome the problem of no landing zone; however, most of them are not feasible in urgent and high-risk patients. We describe a case that was successfully treated by total endovascular technique with a two-by-two chimney-and-periscope approach in a patient with acute symptomatic type IV thoracoabdominal aortic aneurysm with supra-anastomotic aneurysm formation involving the renal and visceral arteries and a pseduaneurismatic sac localized in the left ileopsoas muscle.

Sutura arterial com técnicas contínua e de pontos separados, utilizando-se os fios polipropilene e polidioxanone: estudo experimental em coelhos Arterial suture with continuous and interrupted techniques, using polypropylene and polydioxanone threads: experimental study in rabbits

Directory of Open Access Journals (Sweden)

Nelson Leonardo Kerdahi Leite de Campos

2003-10-01

Full Text Available OBJETIVO: Observar o comportamento da sutura arterial em aortas abdominais de coelhos em crescimento, comparando-se as técnicas contínua e com pontos separados, empregando-se dois tipos de fios: Polipropilene 7-0 (inabsorvível e Polidioxanone 7-0 (absorvível. MÉTODOS: Grupos: GI - Controle (sem sutura; GII - Polipropilene, Pontos Separados; GIII - Polipropilene, Contínua; GIV - Polidioxanone, Pontos Separados e GV - Polidioxanone, Contínua. Cada grupo foi subdividido em quatro Momentos de Eutanásia: aos 7, 14, 30 e 60 dias de pós-operatório. Foram avaliados: peso dos animais, diâmetros e pulsos arteriais, estenose, trombose, aderências, aortografia, visibilidade do fio, cicatrização e microscopia. RESULTADOS: a após 60 dias, o local da linha de sutura cresceu de forma significativa em todos os grupos; b a técnica de sutura com pontos separados causou menor estenose da linha de sutura, observada tanto no ato cirúrgico, como na eutanásia dos animais; c no exame histopatológico, as diferenças encontradas entre grupos foram transitórias, não persistindo após 60 dias de pós-operatório. CONCLUSÃO: O polidioxanone mostrou ser a melhor opção, entre os dois fios, para sutura de artérias em crescimento, pois causa pouca ou nenhuma restrição ao crescimento arterial na linha de sutura, mesmo quando se emprega a técnica contínua.PURPOSE: To assess the arterial suture, comparing continuous and interrupted techniques, in abdominal aorta of growing rabbbits, using two types of suture material: Polypropylene 7-0 (nonabsorbable and Polydioxanone 7-0 (absorbable. METHODS: Groups: GI - Control, without arterial suture; GII - Polypropylene, Interrupted technique; GIII - Polipropilene, Continuous technique; GIV - Polydioxanone, Interrupted technique and GV - Polydioxanone, Continuous technique. Each group was subdivided in four Moments of Euthanasia , according with the number of days after surgery: 7 , 14 , 30 and 60 days. The

Constriction of collateral arteries induced by "head-up tilt" in patients with occlusive arterial disease of the legs

DEFF Research Database (Denmark)

Agerskov, K; Henriksen, O; Tønnesen, K H

1981-01-01

The effect of head-up tilt on leg blood flow and segmental arterial blood pressures was studied in 21 patients with occlusion or severe stenosis of the common or superficial femoral artery. Arterial pressure was measured directly in the brachial artery, common femoral artery and popliteal artery....... Relative change in blood flow in the leg during tilt was estimated by changes in arterio-venous oxygen differences and by the indicator dilution technique in nine patients. Head-up tilt caused a decrease in leg blood flow of 36% corresponding to an increase in total vascular resistance of 57%. Tilt did...... not change the pressure gradient from femoral to popliteal artery in the patients with occlusion of the superficial femoral artery, indicating that the flow resistance offered by the collateral arteries had increased. In a bilateral sympathectomised patient the increase in collateral resistance was almost...

Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines

Energy Technology Data Exchange (ETDEWEB)

Hwang, Ji Young [Dept. of Radiology, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

2017-04-15

Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines

Directory of Open Access Journals (Sweden)

Ji Young Hwang

2017-04-01

Full Text Available Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

Spontaneous dissecting aneurysm of the extracranial vertebral artery (20 cases)

Energy Technology Data Exchange (ETDEWEB)

Chiras, J; Marciano, S; Vega Molina, J; Touboul, J; Poirier, B; Bories, J

1985-07-01

Spontaneous dissecting aneurysm of the vertebral artery is an infrequent cause of vertebro basilar ischemic strokes. Previously reported cases concern essentially occlusion of the basilar artery. Only 14 cases of spontaneous dissecting aneurysm concern the extracranial vertebral artery among these eight were angiographically documented. In this study based upon 15 patients (20 dissecting aneurysms), the authors discuss etiological factors, such as hypertension or fibromuscular dysplasia: on clinical findings they insist upon the diagnostic value of preliminary symptoms, cervical pain or posterior headaches; the most frequent angiographic appearance was a long and irregular stenosis of one or two segments of the vertebral artery. The prognosis of these aneurysms most often appears favourable in this group.

Endovascular management of pancreatitis-related pseudoaneurysms: A review of techniques.

Directory of Open Access Journals (Sweden)

Bartosz Zabicki

Full Text Available To present the various techniques used in the management of pancreatitis-related pseudoaneurysms of visceral vessels.The retrospective clinical study was carried out at the Department of Diagnostic and Interventional Radiology at Poznan University of Medical Sciences from 2011 to 2016. The fifteen patients included in the study were diagnosed with pseudoaneurysms of visceral arteries, as a complication of chronic pancreatitis. The diagnosis was made using contrast-enhanced computed tomography, followed by angiography. On admission, all patients were symptomatic, with varying degrees of abdominal pain. One patient was haemodynamically unstable. Treatments with endovascular techniques were analysed, along with their efficacy and outcomes. Coil embolisation was performed in 5 patients. Stent graft was used in 1 patient. Liquid embolic agents were used in 7 cases, of which 5 patients were treated with thrombin injection and 2 with Squid. A combination of techniques was used in 2 patients.The most common artery affected by pseudoaneurysm formation was the splenic artery (7/15; 46.7%, and the size of the pseudoaneurysms ranged from 27 mm to 85 mm. Primary technical success was achieved in 14 out of 15 patients (93.3%. One patient required reintervention. Two patients required splenectomy after embolisation due to splenic ischemia. No recanalisation was present at the follow-up computed tomography performed after 1 to 3 weeks, and no mortality was observed within 30 days.Vascular complications of pancreatitis require accurate diagnosis and immediate treatment. Endovascular intervention is highly effective and is the preferred treatment option. The technique used is determined based on vascular anatomy and the patient's haemodynamic status.

Value of magnetic resonance imaging for the noninvasive detection of stenosis in coronary artery bypass grafts and recipient coronary arteries

NARCIS (Netherlands)

Langerak, Susan E.; Vliegen, Hubert W.; Jukema, J. Wouter; Kunz, Patrik; Zwinderman, Aeilko H.; Lamb, Hildo J.; van der Wall, Ernst E.; de Roos, Albert

2003-01-01

BACKGROUND: Magnetic resonance imaging (MRI) is a potential noninvasive diagnostic tool to detect coronary artery bypass graft stenosis, but its value in clinical practice remains to be established. We investigated the value of MRI in detecting stenotic grafts, including recipient vessels. METHODS

Delayed Cerebral Ischemia following to Repair of Penetrating Trauma to External Carotid artery Introduction

Directory of Open Access Journals (Sweden)

M. Eskandarlou

2016-01-01

Full Text Available Introduction: Penetrating trauma to anterior neck can induce cerebral ischemia due to carotid artery injury. Brain ischemia also can present after surgical carotid repairs. Early diagnosis and suitable treatment modality prevent from permanent neurologic deficit post operatively. Case Report: A 30 years old man with stab wound to zone two left side of neck underwent exploration and penrose insertion. Due to excessive bleeding through drain tube, patient was transferred to Besat Hospital of Hamadan. Surgical repair of external carotid artery successfully was done. Four days later patient developed right hemiparesis suddenly. According to MRI and color Doppler sonography finding of thrombosis of left common and internal carotid artery, reoperation was done. After thrombectomy cerebral ischemia and hemi-paralysis improved. Conclusions: Surgical approach to symptomatic penetrating neck trauma is oblique cervical incision, control of bleeding, repair of internal carotid, repair or ligature of external carotid artery base on some factors and preferential repair of internal jugular vein. Meticulous and fine surgical technique for both vascular repair and protection of adjacent normal vessels for avoiding to blunt trauma or compression with retractors is noticeable. Exact postoperative care as repeated clinical examination with goal of early diagnosis of internal carotid artery thrombosis and rapid diagnostic and treatment planning of this complication are important factors for taking of good result in treatment of penetrating trauma to carotid. Sci J Hamadan Univ Med Sci . 2016; 22 (4 :353-357

Noninvasive imaging of coronary arteries: current and future role of multidetector row computer tomography

International Nuclear Information System (INIS)

Nedevska, M.; Stoinova, V.

2006-01-01

Full text: This review will present the current and future role of cardiac computer tomography (CCT), and particular multidetector CCT, for imaging of atherosclerotic pathologic changes of the coronary arteries. Atherosclerosis and its cardio-vascular complications represent one of the major issues of public health in industrial countries. Different imaging modalities, including invasive coronarography, have been aimed to the diagnosis of the disease, when it provokes symptomatic decrease of the blood flow. In spite of development of surgical and percutaneous methods for coronary revascularization, coronary artery disease remains the major cause of death in North America and Europe. This demonstrates the need of novel, complementary diagnostic strategies, aimed to identify asymptomatic stages as the basis of pharmacological interventions. Noninvasive coronary angiography with multidetector CT allows both assessment of luminal stenosis and subclinical disease of arterial wall. Large trails are missing now to understand and present what will be the role of this technology in the comprehensive assessment of patients, suspected of having CAD. Based on experience and current potentials we will describe how tomographic coronary imaging may eventually supplement traditional angiographic techniques in understanding the patterns of atherosclerotic CAD development

Intra-arterial Ultra-low-Dose CT Angiography of Lower Extremity in Diabetic Patients

Energy Technology Data Exchange (ETDEWEB)

Özgen, Ali, E-mail: draliozgen@hotmail.com [Yeditepe University Hospital, Department of Radiology (Turkey); Sanioğlu, Soner [Yeditepe University Hospital, Department of Cardiovascular Surgery (Turkey); Bingöl, Uğur Anıl [Yeditepe University Hospital, Department of Plastic Surgery (Turkey)

2016-08-15

PurposeTo image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).Materials and MethodsThree cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatinine levels were followed for possible CIN.ResultsIntra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.ConclusionIntra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.

Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Di Leo, Giovanni [IRCCS Policlinico San Donato, Radiology Unit, San Donato Milanese (Italy); Fisci, Erica [Universita degli Studi di Genova, Scuola di Specializzazione in Radiodiagnostica, Genova (Italy); Secchi, Francesco [IRCCS Policlinico San Donato, Radiology Unit, San Donato Milanese (Italy); Universita degli Studi di Milano, PhD Course in Integrative Biomedical Research, Milan (Italy); Ali, Marco [Universita degli Studi di Milano, PhD Course in Integrative Biomedical Research, Milan (Italy); Ambrogi, Federico [Universita degli Studi di Milano, Department of Clinical Sciences and Community Health, Milan (Italy); Sconfienza, Luca Maria; Sardanelli, Francesco [IRCCS Policlinico San Donato, Radiology Unit, San Donato Milanese (Italy); Universita degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, San Donato Milanese (Italy)

2016-10-15

To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD). Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2. Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86-92 %), the pooled specificity 72 % (63-79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90-97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83-90 %). Specificity of whole-heart acquisition mode (78 %, 72-84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45-69 %). Specificity at 3 T (83 %, 69-92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60-76 %). Risk of bias and concerns regarding applicability were low. Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance. (orig.)

Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis

International Nuclear Information System (INIS)

Di Leo, Giovanni; Fisci, Erica; Secchi, Francesco; Ali, Marco; Ambrogi, Federico; Sconfienza, Luca Maria; Sardanelli, Francesco

2016-01-01

To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD). Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2. Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86-92 %), the pooled specificity 72 % (63-79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90-97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83-90 %). Specificity of whole-heart acquisition mode (78 %, 72-84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45-69 %). Specificity at 3 T (83 %, 69-92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60-76 %). Risk of bias and concerns regarding applicability were low. Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance. (orig.)

The Role of Flow Diagnostic Techniques in Fan and Open Rotor Noise Modeling

Science.gov (United States)

Envia, Edmane

2016-01-01

A principal source of turbomachinery noise is the interaction of the rotating and stationary blade rows with the perturbations in the airstream through the engine. As such, a lot of research has been devoted to the study of the turbomachinery noise generation mechanisms. This is particularly true of fan and open rotors, both of which are the major contributors to the overall noise output of modern aircraft engines. Much of the research in fan and open rotor noise has been focused on developing theoretical models for predicting their noise characteristics. These models, which run the gamut from the semi-empirical to fully computational ones, are, in one form or another, informed by the description of the unsteady flow-field in which the propulsors (i.e., the fan and open rotors) operate. Not surprisingly, the fidelity of the theoretical models is dependent, to a large extent, on capturing the nuances of the unsteady flowfield that have a direct role in the noise generation process. As such, flow diagnostic techniques have proven to be indispensible in identifying the shortcoming of theoretical models and in helping to improve them. This presentation will provide a few examples of the role of flow diagnostic techniques in assessing the fidelity and robustness of the fan and open rotor noise prediction models.

Selective arterial thrombolysis with urokinase

Energy Technology Data Exchange (ETDEWEB)

Park, Jae Hyung; Park, Kil Sun; Chung, Jin Wook; Han, Joon Koo; Kim, Sang Joon [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Young [Choong Buk University College of Medicine, Jeonju (Korea, Republic of)

1991-07-15

Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications.

Selective arterial thrombolysis with urokinase

International Nuclear Information System (INIS)

Park, Jae Hyung; Park, Kil Sun; Chung, Jin Wook; Han, Joon Koo; Kim, Sang Joon; Kim, Dae Young

1991-01-01

Seven patients with thrombotic occlusions of the peripheral arteries or grafts were treated with urokinase by direct intraarterial selective infusion. During the infusion, simultaneous heparin infusion was used to reduce the frequency of thrombus formation on the infusion catheter or recurrent thrombosis. In 4 patients in whom a complete thrombolysis occurred, urokinase was infused by a high-dose transthrombus bolus technique followed by continuous infusion. There other patients, in whom thrombolysis was partially accomplished and then surgical thrombectomy was performed, were treated only by continuous urokinase infusion. Small hematomas developed at the infusion catheter entry site in 2 patients, but transfusion or operation was not required. Other significant complications were not found. Our results suggest that selective arterial infusion of urokinase with a transthrombus bolus technique can accomplish a complete arterial thrombolysis without any significant complications

The clinical safety of dual axis rotational angiography in the diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Liu Huiliang; Jin Zhigeng; Yang Shengli; Ma Dongxing; Luo Jianping; Liu Ying; Wang Lei; Jing Limin; Meng Rongying

2011-01-01

Objective: To observe the clinical safety of dual axis rotational coronary angiography (DARCA) in the diagnosis of coronary artery disease in Chinese population. Methods: From March to December in 2010, 74 patients undergoing diagnostic DARCA were enrolled. The improved isocentering technique was adopted in 34 of the patients at the end of the study during DARCA. Blood pressure, heart rate and symptoms were recorded immediately before-and-after contrast injections. Contrast dose, radiation exposure and procedure time for DARCA were recorded. Continuous variable data were analyzed using Student's t test, if normality assumption was violated, rank sum test would be used. Categorical variables were analyzed using χ 2 test. Results: (1) Clinical safety: There was no chest pain documented during or immediately post-injection for all patients. Only 1 patient (1%) had an attack of ventricular tachycardia immediately after the contrast injection and then relieved automatically. Pre and post-injection systolic blood pressure values of left coronary artery were statistically different [(116±20) mm Hg vs. (111± 18) mm Hg (1 mm Hg = 0.133 kPa), t=3.303, P=0.001], and heart rates differed, too [73 (65- 84) bpm vs. 71 (64-78) bpm, Z=-4.789, P=0.001], but that imposed no clinical significance. (2) Contrast dose, radiation dose and procedure time: The mean contrast utilization, radiation dose and procedure time for DARCA were 28 (25-34) ml, 8979 (6733-12363) mGycm 2 and 200 (164-270) s. Compared with conventional DARCA, improved isocentering technique during DARCA had less radiation exposure and procedure time in left coronary artery angiography and the whole coronary artery angiography left coronary artery angiographic radiation exposure: 4004 (2932-5772) mGycm 2 vs, 5808 (4798- 8838) mGycm 2 , Z=-3.471, P=0.001; total radiation exposure: (8116±2493) mGycm 2 vs. (11371± 4122) mGycm 2 , t=-4.176, P=0.001; left coronary artery angiographic procedure time: 120 (80- 180)s vs

Recent applications of nuclear medicine in diagnostics: II part

Directory of Open Access Journals (Sweden)

Giorgio Treglia

2013-04-01

Full Text Available Introduction: Positron-emission tomography (PET and single photon emission computed tomography (SPECT are effective diagnostic imaging tools in several clinical settings. The aim of this article (the second of a 2-part series is to examine some of the more recent applications of nuclear medicine imaging techniques, particularly in the fields of neurology, cardiology, and infection/inflammation. Discussion: A review of the literature reveals that in the field of neurology nuclear medicine techniques are most widely used to investigate cognitive deficits and dementia (particularly those associated with Alzheimer disease, epilepsy, and movement disorders. In cardiology, SPECT and PET also play important roles in the work-up of patients with coronary artery disease, providing accurate information on the state of the myocardium (perfusion, metabolism, and innervation. White blood cell scintigraphy and FDG-PET are widely used to investigate many infectious/inflammatory processes. In each of these areas, the review discusses the use of recently developed radiopharmaceuticals, the growth of tomographic nuclear medicine techniques, and the ways in which these advances are improving molecular imaging of biologic processes at the cellular level.

Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

International Nuclear Information System (INIS)

Didier, Ryne A.; Vajtai, Petra L.; Hopkins, Katharine L.

2015-01-01

Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI vol ). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI vol . Reduced CTDI vol was achieved primarily by reductions in effective tube current-time product (mAs eff ) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI vol , size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI vol was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI vol and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

Multi-detector row CT of the kidney: Optimizing scan delays for bolus tracking techniques of arterial, corticomedullary, and nephrographic phases

Energy Technology Data Exchange (ETDEWEB)

Goshima, Satoshi [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Kanematsu, Masayuki [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Department of Radiology Services, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Nishibori, Hironori; Kondo, Hiroshi; Tsuge, Yusuke [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Yokoyama, Ryujiro; Miyoshi, Toshiharu [Department of Radiology Services, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Onozuka, Minoru [Department of Physiology and Neuroscience, Kanagawa Dental College, Yokosuka, Kanagawa (Japan); Shiratori, Yoshimune [Department of Medical Informatics, Gifu University School of Medicine, Gifu (Japan); Moriyama, Noriyuki [Department of Diagnostic Radiology, National Cancer Center Hospital, Tsukiji, Chuo-Ku, Tokyo (Japan); Bae, Kyongtae T. [Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States)

2007-09-15

Purpose: To determine optimal scan delays for renal arterial-, corticomedullary-, and nephrographic-phase imaging with multi-detector row computed tomography (MDCT) of the kidney using a bolus-tracking technique. Methods and materials: One hundred and twenty-eight patients underwent three-phase CT scan of the kidney with eight-row MDCT after receiving 2 mL/kg of 300 mg I/mL contrast medium at 4 mL/s. Patients were prospectively randomized into three groups with different scan delays for the three scan phases (arterial, corticomedullary, and nephrographic) after bolus-tracking triggered at 50 HU of aortic contrast enhancement: group 1 (5, 20, 45 s); group 2 (10, 25, 50 s); and group 3 (15, 30, 55 s). Mean CT values (HU) of the abdominal aorta, renal artery, renal vein, renal cortex, and renal medulla were measured; increases in CT values pre- to post-contrast were assessed as contrast enhancement. Renal artery-to-vein and renal cortex-to-medulla contrast differences were also assessed. Qualitative analysis was also performed. Results: Mean renal artery enhancement was 240-288 HU at 5-15 s after the trigger and peaked at 10 s (P < .001). Mean renal cortical enhancement was 195-217 HU at 10-30 s and peaked at 25 s (P < .01). Contrast enhancement in the renal medulla increased gradually and reached mean 145 HU at 55 s. Cortex-to-medulla contrast difference was high (110-140 HU) at 5-30 s and decreased below 30 HU at 45 s after the trigger. Renal artery-to-vein contrast difference was high (121-125 HU) at 5-10 s. Qualitative results correlated well with quantitative results. Conclusion: For the injection protocol used in this study, optimal scan delays after the bolus-tracking trigger were 5-10 s for renal arterial, 15-25 s for corticomedullary, and 50-55 s for nephrographic phases.

Brachial artery approach for outpatient arteriography

International Nuclear Information System (INIS)

You, Jai Kyung; Park, Sung Il; Lee, Do Yun; Won, Jae Hwan

1999-01-01

To evaluate the diagnostic usefulness of brachial approach arteriography for outpatients, with particular regard to safety and image quality. The angiographic findings and follow-up medical records of 131 brachial approach arteriographies in 121 outpatients were retrospectively analysed. 5 F pigtail catheters were used in 125 cases and 5-F OCU-A catheters were used in three cases of renal arteriography, and three of upper extremity arteriography without catheter. Except for three cases of brachial artery puncture failure, all procedures were performed successfully. One hundred and fifteen of 119 lower extremity arteriographies were visualized down to the level of the tibioperoneal artery. The non-visualized cases were three in which there was multiple obstruction at the distal common iliac artery and one with insufficient contrast amount due to renal failure In four cases there were complications : two involved arterial thrombosis, one was an intramuscular hematoma, and one an A-V fistula. For outpatients, brachial approach arteriography can replace the femoral approach. Its image quality is excellent, there are time-cost benefits, and the rate of complications is relatively low

Optical diagnostics of vascular reactions triggered by weak allergens using laser speckle-contrast imaging technique

International Nuclear Information System (INIS)

Kuznetsov, Yu L; Kalchenko, V V; Astaf'eva, N G; Meglinski, I V

2014-01-01

The capability of using the laser speckle contrast imaging technique with a long exposure time for visualisation of primary acute skin vascular reactions caused by a topical application of a weak contact allergen is considered. The method is shown to provide efficient and accurate detection of irritant-induced primary acute vascular reactions of skin. The presented technique possesses a high potential in everyday diagnostic practice, preclinical studies, as well as in the prognosis of skin reactions to the interaction with potentially allergenic materials. (laser biophotonics)

Optical diagnostics of vascular reactions triggered by weak allergens using laser speckle-contrast imaging technique

Energy Technology Data Exchange (ETDEWEB)

Kuznetsov, Yu L; Kalchenko, V V [Department of Veterinary Resources, Weizmann Institute of Science, Rehovot, 76100 (Israel); Astaf' eva, N G [V.I.Razumovsky Saratov State Medical University, Saratov (Russian Federation); Meglinski, I V [N.G. Chernyshevsky Saratov State University, Saratov (Russian Federation)

2014-08-31

The capability of using the laser speckle contrast imaging technique with a long exposure time for visualisation of primary acute skin vascular reactions caused by a topical application of a weak contact allergen is considered. The method is shown to provide efficient and accurate detection of irritant-induced primary acute vascular reactions of skin. The presented technique possesses a high potential in everyday diagnostic practice, preclinical studies, as well as in the prognosis of skin reactions to the interaction with potentially allergenic materials. (laser biophotonics)

Consideration on the diagnostic ability of various imaging techniques in relation to renal tumor

International Nuclear Information System (INIS)

Ike, Katsushi

1984-01-01

Radiological diagnosis of renal tumors is being improved with the increased imaging accuracy which has resulted from advancement in the various equipment used and improvement in techniques. However, at the clinical level, diagnostic procedures based on the characteristics of the delineated images are not yet established and the diverse diagnostic procedures are being conducted currently in a stereotyped manner. In this study, the images of 61 cases diagnosed as renal tumor were analysed retrospectively with the purpose of establishing the imaging accuracy, capacity for diagnosis based on image characteristics and a subseguent proper diagnostic procedure. It was found that CT and Angio gave similar diagnostic accuracy. It was further revealed that US images enabled to differentiate renal tumors from the more commonly experienced renal cystic disease. For determination of tunica involucrum infiltration, which is essential to diagnose Stage I and II renal tumors, CT was proved to be superior to Angio. CT and US were also to be so in the determination of metastasis to para-aortic lymph nodes which is a Stage III criterion. In recent years, CT and US imaging accuracies have increased, hence the improvement in the capacity to diagnose non-observable renal tumors is highly expected. (author)

[Prognostic Doppler ultrasound examination of fetal arteries blood flow].

Science.gov (United States)

Sieroszewski, Piotr; Sabatowska, Małgorzata; Karowicz-Bilińska, Agata; Suzin, Jacek

2002-08-01

Early detection of fetal risk is one of the main issues in today obstetrics. Ultrasound diagnostics plays a significant role, as the introduction of Doppler imaging method in the evaluation of blood flow has enabled non-invasive assessment of uteroplacental circulation. Therefore, we have analysed foetal three arteries: umbilical artery, middle cerebral artery and renal artery after determining the normal range for the analysed parameters. 1. Comparison of the obtained blood flow indices (S/D, RI, PI) in the umbilical artery, middle cerebral artery and renal artery of foetuses from normal and complicated full-term pregnancies. 2. Determination of indices: umbilical-cerebral and renal-cerebral in normal and pathological pregnancy. 3. Evaluation of feasibility of the analysed flow parameters for the detection of intrauterine foetal hypoxia. We have examined 151 women, who were divided into control group--101 pregnant women with normal pregnancy and study group--50 pregnant women with complicated pregnancy. All pregnant women underwent ultrasound examination using the Hitachi EUB 515 C (Japan) scanner with 3.5 MHz convex probe, connected to the colour pulsed Doppler. The study consisted of the biometric measurements and evaluation of the spectrum of blood flow in the umbilical artery, middle cerebral artery and renal artery. We have determined following indices: a) systolic-diastolic ratio S/D, resistance index RI, pulsatility index PI, b) umbilical-cerebral ratio P/M. (PI ua/PI mca), renal--cerebral ratio N/M (PI ra/PI mca). Statistically significant difference was found between the study and control groups for all the flow indices assessed (S/D, RI, PI) for the middle cerebral artery, for the indices P/M and N/M. (p < 0.001) and pulsatility index in the renal artery (p < 0.01). Similar, although slightly smaller difference (p < 0.05) was seen for the values of flow parameters in the umbilical artery. 1) Evaluation of blood flow in the middle cerebral artery, and in

Plasma diagnostics discharge parameters and chemistry

CERN Document Server

Auciello, Orlando

1989-01-01

Plasma Diagnostics, Volume 1: Discharge Parameters and Chemistry covers seven chapters on the important diagnostic techniques for plasmas and details their use in particular applications. The book discusses optical diagnostic techniques for low pressure plasmas and plasma processing; plasma diagnostics for electrical discharge light sources; as well as Langmuir probes. The text also describes the mass spectroscopy of plasmas, microwave diagnostics, paramagnetic resonance diagnostics, and diagnostics in thermal plasma processing. Electrical engineers, nuclear engineers, microwave engineers, che

Veterinary Molecular Diagnostics

NARCIS (Netherlands)

Roest, H.I.J.; Engelsma, M.Y.; Weesendorp, E.; Bossers, A.; Elbers, A.R.W.

2017-01-01

In veterinary molecular diagnostics, samples originating from animals are tested. Developments in the farm animals sector and in our societal attitude towards pet animals have resulted in an increased demand for fast and reliable diagnostic techniques. Molecular diagnostics perfectly matches this

Percutaneous microcrystalline chitosan application for sealing arterial puncture sites

NARCIS (Netherlands)

Hoekstra, A; Struszczyk, H; Kivekas, O

Arterial catheterization is one of the most frequently performed inpatient diagnostic and therapeutic procedures in the development countries. Complications may occur after any catheterization from inadequate hemostasis, particularly in the setting of aggressive anticoagulation. This study suggests

[Application of molecular diagnostic techniques in precision medicine of personalized treatment for colorectal cancer].

Science.gov (United States)

Fu, Ji; Lin, Guole

2016-01-01

Precision medicine is to customize the treatment options for individual patient based on the personal genome information. Colorectal cancer (CRC) is one of the most common cancer worldwide. Molecular heterogeneity of CRC, which includes the MSI phenotype, hypermutation phenotype, and their relationship with clinical preferences, is believed to be one of the main factors responsible for the considerable variability in treatment response. The development of powerful next-generation sequencing (NGS) technologies allows us to further understand the biological behavior of colorectal cancer, and to analyze the prognosis and chemotherapeutic drug reactions by molecular diagnostic techniques, which can guide the clinical treatment. This paper will introduce the new findings in this field. Meanwhile we integrate the new progress of key pathways including EGFR, RAS, PI3K/AKT and VEGF, and the experience in selective patients through associated molecular diagnostic screening who gain better efficacy after target therapy. The technique for detecting circulating tumor DNA (ctDNA) is introduced here as well, which can identify patients with high risk for recurrence, and demonstrate the risk of chemotherapy resistance. Mechanism of tumor drug resistance may be revealed by dynamic observation of gene alteration during treatment.

Arterial and venous revascularization with bifurcation of a single central artery: a reliable strategy for Tamai Zone I replantation.

Science.gov (United States)

Hsu, Chung-Chen; Lin, Yu-Te; Moran, Steven L; Lin, Cheng-Hung; Wei, Fu-Chan; Lin, Chih-Hung

2010-12-01

Replantation of the distal phalanx and pulp can be performed to improve finger function and finger aesthetics; however, establishing adequate venous drainage is a challenge. Slattery et al. reported microsurgical reattachment of a partial distal phalanx with the use of a bifurcated terminal digital artery. The bifurcation was divided into two pedicles, one of which was used for venous drainage. In this article, the authors report their experience with a similar technique and propose a new algorithm for distal finger replantation. From January of 2008 to February of 2009, five replantations were performed using a single central artery. The replanted levels were pulp, avulsed fingertip of the thumb, and distal phalanges. There was no volar vein, dorsal vein, or second artery available in the amputated part for standard venous drainage. Venous drainage in all cases was established by creating an anastomosis from a branch of the solitary terminal artery to a recipient vein. All digits were replanted successfully without evidence of arterial insufficiency or venous congestion. Partial necrosis was not identified postoperatively in any of the five fingers. There were no cases of wound infection. A branch of the central solitary artery may be used successfully to reestablish venous outflow in cases of distal finger tip replantation. This technique allowed for the salvage of all fingers in this study without the use of leeches or other techniques used in cases of venous insufficiency.

Diagnostic accuracy of low-dose 256-slice multi-detector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Hou, Yang; Ma, Yue; Wang, Yuke; Yu, Mei; Guo, Qiyong [Shengjing Hospital of China Medical University, Department of Radiology, Shenyang (China); Fan, Weipeng [Central Hospital of Anshan, Department of Radiology, Anshan (China); Vembar, Mani [CT Clinical Science Philips Healthcare, Cleveland, OH (United States)

2014-01-15

To evaluate the accuracy of low-dose coronary CTA with iterative reconstruction (IR) in the diagnosis of coronary artery disease (CAD) in patients with suspected CAD. Ninety-six patients with suspected CAD underwent low-dose prospective electrocardiogram-gated coronary CTA, with images reconstructed using IR. Image quality (IQ) of coronary segments were graded on a 4-point scale (4, excellent; 1, non-diagnostic). With invasive coronary angiography (ICA) considered the ''gold standard'', the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of coronary CTA were calculated on segment-, vessel- and patient-based levels. The patient data were divided into two groups (Agatston scores of ≥ 400 and <400). The differences in diagnostic performance between the two groups were tested. Diagnostic image quality was found in 98.1 % (1,232/1,256) of segments. The sensitivity, specificity, PPV, NPV and accuracy were 90.8 %, 95.3 %, 81.8 %, 97.8 % and 94.3 % (segment-based) and 97.2 %, 83.3 %, 94.6 %, 90.9 % and 93.8 % (patient-based). Significant differences between the two groups were seen in specificity, PPV and accuracy (92.1 % vs. 97.9 %, 76.0 % vs. 86.7 %, 91.7 % vs. 96.6 %, P < 0.05; segment-based). The average effective dose was 1.30 ± 0.15 mSv. Low-dose prospective coronary CTA with IR can acquire satisfactory image quality and show high diagnostic accuracy in patients with suspected CAD; however, blooming continues to pose a challenge in severely calcified segments. (orig.)

Rare Presentation of Left Lower Lobe Pulmonary Artery Dissection

Directory of Open Access Journals (Sweden)

René Hako

2017-01-01

Full Text Available Background. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. Case Presentation. We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used. Multiplanar reformation (MPR images in sagittal, coronal, oblique sagittal, and curved projections were generated. This case report presents morphologic CT features of rare chronic left lobar pulmonary artery dissection associated with chronic pulmonary hypertension at a place of localised pulmonary artery calcification. CT pulmonary angiography excluded signs of thromboembolism and potential motion or flow artefacts. Conclusion. To the best of our knowledge, no case of lower lobe pulmonary artery dissection with flap calcification has been reported yet. CT imaging of the chest is a key diagnostic tool that is able to detect an intimal flap and a false lumen within the pulmonary arterial tree and is preferred in differential diagnosis of rare complications of sustained pulmonary arterial hypertension.

A Retrograde Transvenous Embolization Technique with Balloon-Assisted Arterial Aspiration for a Peripheral Arteriovenous Malformation with a Venous Pouch

Energy Technology Data Exchange (ETDEWEB)

Kuhara, Asako, E-mail: kuhara-asako@med.kurume-u.ac.jp; Tanaka, Norimitsu; Koganemaru, Masamichi; Kugiyama, Tomoko [Kurume University School of Medicine, Department of Radiology (Japan); Kiyokawa, Kensuke [Kurume University School of Medicine, Department of Plastic & Reconstructive Surgery and Maxillofacial Surgery (Japan); Abe, Toshi [Kurume University School of Medicine, Department of Radiology (Japan)

2017-05-15

Management of arteriovenous malformations (AVMs) is challenging, and there is no consensus regarding either the ideal approach or the treatment timing. Percutaneous embolization is the most frequent approach currently used and is considered the first-line technique for AVMs. There is an ongoing discussion about the best technical approach to embolize AVMs. AVMs associated with a dominant outflow vein (DOV) are rare. Embolization of both the DOV and the nidus is considered more effective. Herein, we report a novel technique of transvenous embolization of a DOV under negative pressure from an arterial balloon catheter in a case of a peripheral AVM. This technique allows the embolization of the DOV and the nidus retrogradely.

Diagnostic evaluation of rolling behavior in ball bearings by ultrasonic technique

International Nuclear Information System (INIS)

Wakabayashi, T

2012-01-01

Failures of machines having rotating parts are mostly caused by damage to bearings and there exist increasing demands for detecting damaged bearings at an early stage. However, conventional diagnostic methods, such as measuring temperature and observing vibration, have found difficulties in performing the early detection, so that more advanced diagnosis is necessary. This study therefore applies an ultrasonic technique as an advanced diagnostic method to bearing life tests. Ultrasonic wave pulses (UWP) emitted from a piezoelectric UWP generator can partially reflect from the interfaces of contact zones within the housing and the bearing with regard to the different acoustic impedance between a solid-to-solid contact and a contact dominated by some fluid layers. Hence, the intensity of the resultant UWP echoes can be determined by the real contact area formed at the interfaces. The experimental results of UWP echoes under the different operating conditions have demonstrated that the time intervals between peaks of UWP echoes varied in accordance with the movement of rolling balls and the lubricating phenomena in bearings. This behavior has further suggested the possibility of the early detection of abnormalities in ball bearings by using the variation in UWP echoes.

Development and applications of laser spectroscopic techniques related to combustion diagnostics

International Nuclear Information System (INIS)

Alden, Marcus

2006-01-01

Thanks to features as non-intrusiveness combined with high spatial and temporal resolution, various laser diagnostic techniques have during the last decades become of utmost importance for characterization of combustion related phenomena. In the following presentation some further development of the techniques will be highlighted aiming at a) surface temperatures using Thermographic Phosphors, TP, b) species specific, spatially and temporally resolved detection of species absorbing in the IR spectral region using polarization spectroscopy and Laser-induced fluorescence, and finally c) high speed visualization using a special designed laser system in combination with a framing camera. In terms of surface thermometry, Thermographic Phosphors have been used for many years for temperature measurements on solid surfaces. We have during the last years further developed and applied this technique for temperature measurements on burning surfaces and on materials going through phase shifts, e.g. pyrolysis and droplets. The basic principle behind this technique is to apply micron size particles to the surface of interest. By exciting the TP with a short pulse UV laser (ns), the phosphorescence will exhibit a behaviour where the spectral emission as well as the temporal decay are dependent on the temperature. It is thus possible to measure the temperature both in one and two dimensions. The presentation will include basic description of the technique as well as various applications, e.g in fire science, IC engines and gasturbines. Several of the species of interest for combustion/flow diagnostics exhibit a molecular structure which inhibits the use of conventional laser-induced fluorescence for spatially and spectrally resolved measurements. We have during the last years investigated the use of excitation and detection in the infrared region of the spectrum. Here, it is possible to detect both carbonmono/dioxide, water as well as species specific hydrocarbons. The techniques

Coronary artery bypass grafts: assessment of graft patency and native coronary artery lesions using 16-slice MDCT

Energy Technology Data Exchange (ETDEWEB)

Stauder, Norbert I.; Drosch, Tanja; Claussen, Claus D.; Kopp, Andreas F. [Eberhard-Karls-University, Department of Diagnostic Radiology, Tuebingen (Germany); Kuettner, Axel [Friedrich-Alexander-University, Department of Diagnostic Radiology, Erlangen (Germany); Schroeder, Stephen; Beck, Torsten [Eberhard-Karls-University, Department of Internal Medicine, Division Cardiology, Tuebingen (Germany); Stauder, Heidrun [Eberhard-Karls-University, Department of Thoracic and Cardiovascular Surgery, Tuebingen (Germany); Blumenstock, Gunnar [Eberhard-Karls-University, Department of Medical Information Processing, Tuebingen (Germany)

2006-11-15

The objective of this study was to evaluate the accuracy of electrocardiography (ECG)-gated 16-slice multidetector-row computed tomography (MDCT) in detection of stenosis of bypass grafts and native coronary arteries in patients who have undergone coronary artery bypass grafting (CABG). ECG-gated contrast-enhanced MDCT using 12 x 0.75-mm collimation was performed in 20 patients with recurrent angina 4.75 years after undergoing CABG. A total of 50 grafts, 16 arterial and 34 venous, were examined. All graft and coronary segments were evaluated for stenosis in comparison with conventional coronary angiography (CCA). Among the 80 arterial graft segments, 62 could be assessed (77.5%). Sensitivity, specificity, and positive and negative predictive values for stenosis were 96.2%, 97.2%, 96.2%, and 97.2%, respectively. In a total of 180 venous graft segments, 167 could be assessed. Sensitivity, specificity, and positive and negative predictive values for stenosis were 98.5%, 93.9%, 91.8%, and 98.9%, respectively. MDCT could assess 179 of 260 native coronary artery segments (68.8%).Sensitivity, specificity, and positive and negative predictive values for stenosis were 92.1%, 76.9%, 87.5%, and 84.7%, respectively. Sixteen-slice MDCT provides excellent image quality and diagnostic accuracy in detection of graft and coronary artery lesions in patients with suspected graft dysfunction. (orig.)

Primary extracranial vertebral artery aneurysms.

Science.gov (United States)

Morasch, Mark D; Phade, Sachin V; Naughton, Peter; Garcia-Toca, Manuel; Escobar, Guillermo; Berguer, Ramon

2013-05-01

Extracranial vertebral artery aneurysms are uncommon and are usually associated with trauma or dissection. Primary cervical vertebral aneurysms are even rarer and are not well described. The presentation and natural history are unknown and operative management can be difficult. Accessing aneurysms at the skull base can be difficult and, because the frail arteries are often afflicted with connective tissue abnormalities, direct repair can be particularly challenging. We describe the presentation and surgical management of patients with primary extracranial vertebral artery aneurysms. In this study we performed a retrospective, multi-institutional review of patients with primary aneurysms within the extracranial vertebral artery. Between January 2000 and January 2011, 7 patients, aged 12-56 years, were noted to have 9 primary extracranial vertebral artery aneurysms. All had underlying connective tissue or another hereditary disorder, including Ehler-Danlos syndrome (n=3), Marfan's disease (n=2), neurofibromatosis (n=1), and an unspecified connective tissue abnormality (n=1). Eight of 9 aneurysms were managed operatively, including an attempted bypass that ultimately required vertebral ligation; the contralateral aneurysm on this patient has not been treated. Open interventions included vertebral bypass with vein, external carotid autograft, and vertebral transposition to the internal carotid artery. Special techniques were used for handling the anastomoses in patients with Ehler-Danlos syndrome. Although endovascular exclusion was not performed in isolation, 2 hybrid procedures were performed. There were no instances of perioperative stroke or death. Primary extracranial vertebral artery aneurysms are rare and occur in patients with hereditary disorders. Operative intervention is warranted in symptomatic patients. Exclusion and reconstruction may be performed with open and hybrid techniques with low morbidity and mortality. Copyright © 2013 Elsevier Inc. All rights

Multiple contemporary arterial dissection in Ehlers-Danlos syndrome type IV

Directory of Open Access Journals (Sweden)

Anna Rocci

2015-03-01

Full Text Available We report a case of multiple spontaneous arteries dissection in a 52-year-old female; the patient had a relevant family history of vascular complications and typical features so we hypothesized vascular Ehlers-Danlos syndrome (EDS that was confirmed by genetic analysis of COL3A1 gene. We adopted a conservative approach: the patient was treated with heparin in the acute phase followed by aspirin and then celiprolol was started on the basis of a recent trial that demonstrates a reduction in arterial events in EDS patient treated. A careful follow-up was done with Doppler ultrasound and computed tomography scan, as non-invasive diagnostic techniques are preferred in these patients, and no other vascular symptomatic events have occurred. We tested all living relatives: half of them had COL3A1 mutation, they were referred to another center specialized in rare diseases and EDS for long-term follow-up and genetic counseling. This case demonstrates as a careful evaluation of clinical signs, clinical history of the patient and his family has allowed a definitive diagnosis, proper management of the patient during the acute event and in terms of prophylaxis of recurrence.

Effect of Heart Rate and Coronary Calcification on the Diagnostic Accuracy of the Dual-Source CT Coronary Angiography in Patients with Suspected Coronary Artery Disease

International Nuclear Information System (INIS)

Meng, Lingdong; Cui, Lianqun; Cheng, Yuntao; Wu, Xiaoyan; Tang, Yuansheng; Wang, Yong; Xu, Fayun

2009-01-01

To evaluate the diagnostic accuracy of a dual-source computed tomography (DSCT) coronary angiography, with a particular focus on the effect of heart rate and calcifications. One hundred and nine patients with suspected coronary disease were divided into 2 groups according to a mean heart rate ( 400). Next, the effect of heart rate and calcification on the accuracy of coronary artery stenosis detection was analyzed by using an invasive coronary angiography as a reference standard. Coronary segments of less than 1.5 mm in diameter in an American Heart Association (AHA) 15-segment model were independently assessed. The mean heart rate during the scan was 71.8 bpm, whereas the mean Agatston score was 226.5. Of the 1,588 segments examined, 1,533 (97%) were assessable. A total of 17 patients had calcium scores above 400 Agatston U, whereas 50 had heart rates ≥ 70 bpm. Overall the sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for significant stenoses were: 95%, 91%, 65%, and 99% (by segment), respectively and 97%, 90%, 81%, and 91% (by artery), respectively (n = 475). Heart rate showed no significant impact on lesion detection; however, vessel calcification did show a significant impact on accuracy of assessment for coronary segments. The specificity, PPV and accuracy were 96%, 80%, and 96% (by segment), respectively for an Agatston score less than 100% and 99%, 96% and 98% (by artery). For an Agatston score of greater to or equal to 400 the specificity, PPV and accuracy were reduced to 79%, 55%, and 83% (by segment), respectively and to 79%, 69%, and 85% (by artery), respectively. The DSCT provides a high rate of accuracy for the detection of significant coronary artery disease, even in patients with high heart rates and evidence of coronary calcification. However, patients with severe coronary calcification (> 400 U) remain a challenge to diagnose

The prognosis and prognostic risk factors of patients with hepatic artery complications after liver transplantation treated with the interventional techniques

International Nuclear Information System (INIS)

Shan Hong; Huang Mingsheng; Jiang Zaipo; Zhu Kangshun; Yang Yang; Chen Guihua

2008-01-01

Objective: To investigate the prognosis and prognostic risk factors of hepatic artery complications after orthotopic liver transplantation (OLT) treated with the interventional techniques. Methods: The clinical data of 21 patients with hepatic artery complication after liver transplantation receiving thrombolysis, PTA, and stent placement in our institute from November 2003 to April 2007 were retrospectively analyzed. Based on the prognosis of grafts, 21 patients were divided into poor-prognosis group and non-poor-prognosis group. Fifteen variables (including biliary complication, hepatic artery restenosis, early or late artery complication, and so on) were analyzed in both groups with binary logistic regression analysis to screen out the risk factors related to prognosis of pereutaneous interventional treatment for hepatic artery complications after OLT. Results: Twenty-one patients were followed for mean 436 days, median 464 days (3-1037 days). The poor-prognosis group included 11 patients (5 cases received retransplantation, and 6 died). The mean survival time of grafts in poor-prognosis group was 191 days, and median survival time was 73 days (3-616 days). The mean survival time of grafts in non-poor-prognosis group which included 10 patients was 706 days, and median survival time was 692 days (245-1037 days). Univariate analysis showed there were significant difference in biliary complication, total bilimbin and indirect bilirubin between the two groups. The binary, logistic regression analysis showed the risk factor related to prognosis was with biliary complication before the interventional management (P=0.027, OR=22.818). Conclusion: Biliary complication before interventional management is the risk factor related to poor prognosis of patients with hepatic artery stenosis or thrombosis receiving interventional treatment. (authors)

Multimodal imaging of vascular network and blood microcirculation by optical diagnostic techniques

International Nuclear Information System (INIS)

Kuznetsov, Yu L; Kalchenko, V V; Meglinski, I V

2011-01-01

We present a multimodal optical diagnostic approach for simultaneous non-invasive in vivo imaging of blood and lymphatic microvessels, utilising a combined use of fluorescence intravital microscopy and a method of dynamic light scattering. This approach makes it possible to renounce the use of fluorescent markers for visualisation of blood vessels and, therefore, significantly (tenfold) reduce the toxicity of the technique and minimise side effects caused by the use of contrast fluorescent markers. We demonstrate that along with the ability to obtain images of lymph and blood microvessels with a high spatial resolution, current multimodal approach allows one to observe in real time permeability of blood vessels. This technique appears to be promising in physiology studies of blood vessels, and especially in the study of peripheral cardiovascular system in vivo. (optical technologies in biophysics and medicine)

Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

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Wen-Ying Jin

2016-01-01

Conclusions: Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients, gender and atypical symptoms might have some influence on its diagnostic accuracy.

Novel Nonlinear Laser Diagnostic Techniques

Science.gov (United States)

1993-07-01

a thermometric probe of reactive flows. Since the two-photon pump laser couples a Doppler broadened ground state velocity distribution to the excited...rism, and passed unfocused into an aluminum cell con- in frequency space. Regions for line fitting are found by taining 99% pure NO. The gas mixture...of ASE as a More recently, ASE has prompted interest as an thermometric probe of combustion environments optical diagnostic of combustion environments

Step-and-shoot prospectively ECG-gated vs. retrospectively ECG-gated with tube current modulation coronary CT angiography using 128-slice MDCT patients with chest pain: diagnostic performance and radiation dose

International Nuclear Information System (INIS)

Kim, Jeong Su; Choo, Ki Seok; Jeong, Dong Wook

2011-01-01

Background With increasing awareness for radiation exposure, the study of diagnostic accuracy of coronary CT angiography (CCTA) with low radiation dose techniques is mandatory to both radiologist and clinician. Purpose To compare diagnostic performance and effective radiation dose between step-and-shoot prospectively ECG-gated and retrospectively ECG-gated with tube current modulation (TCM) CCTA using 128-slice multidetector computed tomography (MDCT). Material and Methods We retrospectively evaluated 60 patients who underwent CCTA with either of two different low-dose techniques using 128-slice MDCT (23 patients for step-and shoot-prospectively ECG-gated and 37 patients for retrospectively ECG-gated with TCM CCTA) followed by conventional coronary angiography. All coronary arteries and all segments thereof, except anatomical variants or small size (< 1.5 mm) ones, were included in analysis. Results In per-segment analysis, sensitivity, specificity, positive predictive value, and negative predictive value were 91/96%, 95/94%, 75/73%, and 98/99% for step-and-shoot prospectively ECG-gated and retrospectively ECG gated with TCM CCTA, respectively, relative to conventional coronary angiography. Effective radiation dose were 1.75 ± 0.83 mSv, 4.91 ± 1.71 mSv in the step-and-shoot prospectively ECG-gated and retrospectively ECG-gated with TCM CCTA groups, respectively. Conclusion The two low-radiation dose CCTA techniques using 128-slice MDCT yields comparable diagnostic performance for coronary artery disease in symptomatic patients with low heart rates

A novel non-invasive diagnostic sampling technique for cutaneous leishmaniasis.

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Yasaman Taslimi

2017-07-01

Full Text Available Accurate diagnosis of cutaneous leishmaniasis (CL is important for chemotherapy and epidemiological studies. Common approaches for Leishmania detection involve the invasive collection of specimens for direct identification of amastigotes by microscopy and the culturing of promastigotes from infected tissues. Although these techniques are highly specific, they require highly skilled health workers and have the inherent risks of all invasive procedures, such as pain and risk of bacterial and fungal super-infection. Therefore, it is essential to reduce discomfort, potential infection and scarring caused by invasive diagnostic approaches especially for children. In this report, we present a novel non-invasive method, that is painless, rapid and user-friendly, using sequential tape strips for sampling and isolation of DNA from the surface of active and healed skin lesions of CL patients. A total of 119 patients suspected of suffering from cutaneous leishmaniasis with different clinical manifestations were recruited and samples were collected both from their lesions and from uninfected areas. In addition, 15 fungal-infected lesions and 54 areas of healthy skin were examined. The duration of sampling is short (less than one minute and species identification by PCR is highly specific and sensitive. The sequential tape stripping sampling method is a sensitive, non-invasive and cost-effective alternative to traditional diagnostic assays and it is suitable for field studies as well as for use in health care centers.

A Case of Midbrain and Thalamic Infarction Involving Artery of Percheron

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Muhammad Almamun

2015-03-01

Full Text Available Blood supply to the thalamus and brainstem have frequent anatomic variations. One of these is where all the perforators to the above areas arise from a single branch of the posterior cerebral artery commonly known as the artery of Percheron. Infarction involving this artery leading to bilateral thalamic and midbrain lesions is not uncommon, but can cause diagnostic difficulties due to the varying clinical presentations possible and the wide differentials. Early brain imaging and diagnosis is important for initiating appropriate treatment. In this case report, we discuss a patient who presented with an artery of Percheron related stroke affecting the mid brain and paramedian thalamic areas. We also discuss the differentials of presentations with similar symptoms.

Preoperative evaluation of hepatic arterial and portal venous anatomy using the time resolved echo-shared MR angiographic technique in living liver donors

International Nuclear Information System (INIS)

Lee, Min Woo; Lee, Jeong Min; Lee, Jae Young; Kim, Se Hyung; Park, Eun-Ah; Han, Joon Koo; Choi, Jin-Young; Choi, Byung Ihn; Kim, Young Jun; Suh, Kyung-Suk

2007-01-01

The purpose of this study was to determine whether MR angiography utilizing the time resolved echo-shared angiographic technique (TREAT) can provide an effective assessment of the hepatic artery (HA) and portal vein (PV) in living donor candidates. MR angiography (MRA)was performed in 27 patients (23 men and 4 women; mean age, 31 years) by using TREAT. Two blinded radiologists evaluated HA anatomy, origin of segment IV feeding artery and PV anatomy in consensus. Qualitative evaluations of MRA images were performed using the following criteria: (a) overall image quality, (b) presence of artifacts, and (c) degree of venous contamination of the arterial phase. Using intraoperative findings as a standard of reference, the accuracy for the HA anatomy, origin of segment IV feeding artery and PV anatomy on TREAT-MRA were 93% (25/27), 85% (23/27), and 96% (26/27), respectively. Overall image qualities were as follows: excellent (n=22, 81%), good (n=4, 15%), and fair (n=1, 4%). Significant artifacts or venous contamination of the arterial phase images was not noted in any patient. TREAT-MRA can provide a complete evaluation of HA and PV anatomy during preoperative evaluation of living liver donors. Furthermore, it provides a more detailed anatomy of the HA without venous contamination. (orig.)

Application of RNB for high sensitive wear diagnostics in medicine technique and industry

International Nuclear Information System (INIS)

Fehsenfeld, P.; Eifrig, C.; Kubat, R.

2002-01-01

The RTM--Radionuclide Technique in Mechanical engineering--is now extended to the solution of world wide problems in medicine technique (prosthetics), and in development of modern materials (synthetic materials, ceramics, hard coatings, etc.) and their industrial application. RNB--Radioactive Nuclear Beams of 7 Be or 22 Na--may enable the required extreme thin radioactive surface labeling (several micrometers) of synthetic materials for wear measurements without producing radiation damages of influence to the wear properties of the material. The function principle and special properties of the RTM on-line wear diagnostics and its components, the measurement methods, the radioactive surface labeling, and the measurement instruments are explained. The quality features of a 7 Be and 22 Na-beam for RTM application are specified

Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

Energy Technology Data Exchange (ETDEWEB)

Didier, Ryne A. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Vajtai, Petra L. [Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Hopkins, Katharine L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States)

2014-07-05

Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI{sub vol}). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI{sub vol}. Reduced CTDI{sub vol} was achieved primarily by reductions in effective tube current-time product (mAs{sub eff}) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI{sub vol}, size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI{sub vol} was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI{sub vol} and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

A relative quantitative assessment of myocardial perfusion by first-pass technique: animal study

Science.gov (United States)

Chen, Jun; Zhang, Zhang; Yu, Xuefang; Zhou, Kenneth J.

2015-03-01

The purpose of this study is to quantitatively assess the myocardial perfusion by first-pass technique in swine model. Numerous techniques based on the analysis of Computed Tomography (CT) Hounsfield Unit (HU) density have emerged. Although these methods proposed to be able to assess haemodynamically significant coronary artery stenosis, their limitations are noticed. There are still needs to develop some new techniques. Experiments were performed upon five (5) closed-chest swine. Balloon catheters were placed into the coronary artery to simulate different degrees of luminal stenosis. Myocardial Blood Flow (MBF) was measured using color microsphere technique. Fractional Flow Reserve (FFR) was measured using pressure wire. CT examinations were performed twice during First-pass phase under adenosine-stress condition. CT HU Density (HUDCT) and CT HU Density Ratio (HUDRCT) were calculated using the acquired CT images. Our study presents that HUDRCT shows a good (y=0.07245+0.09963x, r2=0.898) correlation with MBF and FFR. In receiver operating characteristic (ROC) curve analyses, HUDRCT provides excellent diagnostic performance for the detection of significant ischemia during adenosine-stress as defined by FFR indicated by the value of Area Under the Curve (AUC) of 0.927. HUDRCT has the potential to be developed as a useful indicator of quantitative assessment of myocardial perfusion.

Recent developments in diagnostic imaging techniques and management for acute pulmonary embolism. Multicenter registry by the Japanese Society of Pulmonary Embolism Research

International Nuclear Information System (INIS)

Sakuma, Masahito; Okada, Osamu; Nakamura, Mashio

2003-01-01

There are many reports on the diagnosis and management of acute pulmonary embolism (APE), but there have been no investigations concerning the actual conditions in which recent developments in diagnostic imaging techniques and therapies have been applied in clinical practice. The present study was designed to investigate the changes in diagnostic imaging techniques and therapies for APE. Three hundred and nine APE patients diagnosed during January 1994-October 1997 (Group 1) were compared with 257 APE patients diagnosed during November 1997-October 2000 (Group 2) in terms of the diagnostic imaging techniques and therapies for APE. Compared with Group 1, pulmonary angiography and contrast-enhanced computed tomography were more frequently performed for diagnosis in Group 2 [45.3% vs 56.8% (p=0.0069) and 13.9% vs 57.6% (p<0.0001), respectively]. Heparin and vena cava filter were used more often in Group 2 [74.4% vs 82.1% (p=0.033) and 18.4% vs 33.9% (p<0.0001), respectively]. The frequency of thrombolytic therapy was unchanged between the two groups. Warfarin use in discharged patients increased from 71.9% to 83.8% (p=0.0022). However, the examination rates for deep vein thrombosis (DVT) were low (60.8% in Group 1 and 65.4% in Group 2, p=0.29) and unchanged using any imaging techniques. The diagnostic imaging techniques for APE increased in variety and the management has improved, while the diagnosis for DVT remains unchanged. (author)

A New Flow Control Technique Using Diluted Epinephrine in the N-butyl-2-cyanoacrylate Embolization of Visceral Artery Pseudoaneurysms Secondary to Chronic Pancreatitis

Energy Technology Data Exchange (ETDEWEB)

Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Yamagami, Takuji [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan); Takeuchi, Yoshito [National Cancer Center, Division of Diagnostic Radiology (Japan); Matsumoto, Tomohiro; Asai, Shunsuke; Masui, Koji [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Sato, Hideki [Japan Red Cross Kyoto Daiichi Hospital, Department of Gastroenterology (Japan); Taniguchi, Fumihiro [Japan Red Cross Kyoto Daiichi Hospital, Department of Surgery (Japan); Sato, Osamu [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan)

2012-08-15

Although n-butyl-2-cyanoacrylate (NBCA) has been used as an effective liquid embolization material, its indication for pseudoaneurysms has seemingly been limited because of the technical difficulties of using NBCA, such as reflux to the parent artery and causing significant infarction. Thus, considerable skill in using NBCA or a device to control blood flow during its polymerization is required to achieve embolization without severe complications. We report our new technique for controlling blood flow using diluted epinephrine in transcatheter arterial NBCA embolization of five pseudoaneurysms in four cases secondary to hemosuccus pancreaticus.

Diagnostic use of angiotensin converting enzyme (ACE)-inhibited renal scintigraphy in the identification of selective renal artery stenosis in the presence of multiple renal arteries: A case report

International Nuclear Information System (INIS)

Morton, K.A.; Rose, S.C.; Haakenstad, A.O.; Handy, J.E.; Scuderi, A.J.; Datz, F.L.

1990-01-01

In patients with renovascular hypertension, it is unknown whether the angiotensin converting enzyme-(ACE) inhibited renal scan will identify stenosis of a segmental branch of a single renal artery or of an accessory artery where multiple renal arteries are present. Since multiple renal arteries may be present in approximately 25% of all individuals, it will be important to establish whether the ACE-inhibited renal scan is useful in this population. We report a case of stenosis involving a renal artery in a patient with multiple renal arteries, successfully identified by ACE-inhibited renal scintigraphy

Congenital anomalies of the pulmonary arteries: spectrum of findings on computed tomography.

Science.gov (United States)

Bueno, J; Flors, L; Mejía, M

Congenital anomalies of the pulmonary arteries are uncommon. They can occur in isolation or in association with congenital heart defects. Isolated congenital anomalies remain undiscovered until they are reported as incidental findings on imaging tests, usually not until adolescence. We review the embryological development and normal anatomy of the pulmonary arteries as well as the spectrum of computed tomography findings for various congenital anomalies: unilateral interruption of the pulmonary artery, anomalous origin of the left pulmonary artery (pulmonary artery sling), idiopathic aneurysm of the pulmonary artery, and other anomalies associated with congenital heart defects. Congenital anomalies of the pulmonary arteries represent a diagnostic challenge for clinicians and radiologists. Computed tomography is useful for their diagnosis, and general radiologists need to be familiar with their imaging appearance because they are often discovered incidentally. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Anomalous origin of right coronary artery from left coronary sinus.

Science.gov (United States)

Hamzeh, Gadah; Crespo, Alex; Estarán, Rafael; Rodríguez, Miguel A; Voces, Roberto; Aramendi, José I

2008-08-01

Anomalous aortic origin of the coronary arteries is uncommon but clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe 4 patients, aged 34 to 59 years, who were diagnosed with right coronary artery arising from the left sinus of Valsalva, confirmed by coronary angiography, which was surgically repaired. Three patients presented dyspnea and angina, and one with acute myocardial infarction. At operation, the right coronary artery was dissected at the take-off from the intramural course, and reimplanted into the right sinus of Valsalva. There was no mortality. One patient had associated coronary artery disease that required stent placement postoperatively. This reimplantation technique provides a good physiological and anatomical repair, eliminates a slit-like ostium, avoids compression of the coronary artery between the aorta and the pulmonary artery, and gives superior results to coronary artery bypass grafting or the unroofing technique.

Circulating miR-765 and miR-149: Potential Noninvasive Diagnostic Biomarkers for Geriatric Coronary Artery Disease Patients

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Md Sayed Ali Sheikh

2015-01-01

Full Text Available The purpose of this study was to evaluate the diagnostic value of circulating miR-765 and miR-149 as noninvasive early biomarkers for geriatric coronary artery disease (CAD patients. A total of 69 angiographically documented CAD patients including 37 stable CAD (72.9 ± 4.2 years and 32 unstable CAD (72.03 ± 4.3 years and 20 healthy subjects (71.7 ± 5.2 years, matched for age, sex, smoking habit, hypertension, and diabetes, were enrolled in this study. Compared with healthy subjects, circulating miR-765 levels were increased by 2.9-fold in stable CAD and 5.8-fold in unstable CAD patients, respectively, while circulating miR-149 levels were downregulated by 3.5-fold in stable CAD and 4.2-fold in unstable CAD patients, respectively. Furthermore, plasma levels of miR-765 were found to be positively correlated with ages within control, stable, and unstable groups. The ROC curves of miR-765 and miR-149 represented significant diagnostic values with an area under curve (AUC of 0.959, 0.972 and 0.938, 0.977 in stable CAD patients and unstable CAD patients as compared with healthy subjects, respectively. Plasma levels of miR-765 and miR-149 might be used as noninvasive biomarkers for the diagnosis of CAD in geriatric people.

Incidence and predictors of silent embolic cerebral infarction following diagnostic coronary angiography.

Science.gov (United States)

Kim, In-Cheol; Hur, Seung-Ho; Park, Nam-Hee; Jun, Dong-Hwan; Cho, Yun-Kyeong; Nam, Chang-Wook; Kim, Hyungseop; Han, Seong-Wook; Choi, Sae-Young; Kim, Yoon-Nyun; Kim, Kwon-Bae

2011-04-14

Coronary angiography (CAG) is an invasive diagnostic procedure, which could lead to procedure related complications. One of the well known post-procedural complications is cerebral embolic infarction with or without symptoms. Silent embolic cerebral infarction (SECI) has clinical significance because it can progress to a decline in cognitive function and increase the risk of dementia in the long term. The aim of this study was to detect the incidence and predictors of SECI after diagnostic CAG using diffusion-weighted magnetic resonance imaging (DW-MRI). A total of 197 patients with coronary artery disease who underwent DW-MRI for evaluation of intracranial vasculopathy before coronary artery bypass graft surgery were retrospectively enrolled in the present study. DW-MRI was performed within 48 h after diagnostic CAG. SECI was diagnosed as presence of focal bright high signal intensity in DW-MRI. Patients were divided into groups according to presence/absence of SECI (+ SECI vs. - SECI, respectively). The clinical and angiographic characteristics were analyzed and independent predictors were evaluated. Of the 197 patients, SECI occurred in 20 patients (10.2%) after diagnostic CAG. Age, female gender, frequency of underlying atrial fibrillation, extent of coronary disease, and fluoroscopic time during diagnostic CAG were not different between the + SECI and - SECI groups. Left ventricular ejection fraction was significantly lower in the + SECI group than in the - SECI group (45.9 ± 8.5% vs. 51.4 ± 13.1%, p=0.014) and performance rate of internal mammary artery (IMA) angiography was significantly higher in the + SECI group compared with the - SECI group (85% vs. 37.2%, pSECI (OR=14.642; 95% CI=3.201 to 66.980, p=0.001). The incidence of SECI after diagnostic CAG was not infrequent. Diagnostic CAG with IMA angiography may increase the risk of SECI. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Diagnostics

DEFF Research Database (Denmark)

Donné, A.J.H.; Costley, A.E.; Barnsley, R.

2007-01-01

of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems...... on ITER is a substantial challenge. Because of the harsh environment (high levels of neutron and gamma fluxes, neutron heating, particle bombardment) diagnostic system selection and design has to cope with a range of phenomena not previously encountered in diagnostic design. Extensive design and R......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

Diagnostic imaging capabilities of the Ocelot -Optical Coherence Tomography System, ex-vivo evaluation and clinical relevance

International Nuclear Information System (INIS)

Dohad, Suhail; Shao, John; Cawich, Ian; Kankaria, Manish; Desai, Arjun

2015-01-01

Optical coherence tomography (OCT) is a high-resolution sub-surface imaging modality using near-infrared light to provide accurate and high contrast intra-vascular images. This enables accurate assessment of diseased arteries before and after intravascular intervention. This study was designed to corroborate diagnostic imaging equivalence between the Ocelot and the Dragonfly OCT systems with regards to the intravascular features that are most important in clinical management of patients with atherosclerotic vascular disease. These intravascular features were then corroborated in vivo during treatment of peripheral arterial disease (PAD) pathology using the Ocelot catheter. In order to compare the diagnostic information obtained by Ocelot (Avinger Inc., Redwood City, CA) and Dragonfly (St. Jude Medical, Minneapolis, MN) OCT systems, we utilized ex-vivo preparations of arterial segments. Ocelot and Dragonfly catheters were inserted into identical cadaveric femoral peripheral arteries for image acquisition and interpretation. Three independent physician interpreters assessed the images to establish accuracy and sensitivity of the diagnostic information. Histologic evaluation of the corresponding arterial segments provided the gold standard for image interpretation. In vivo clinical images were obtained during therapeutic interventions that included crossing of peripheral chronic total occlusions (CTOs) using the Ocelot catheter. Strong concordance was demonstrated when matching image characteristics between both OCT systems and histology. The Dragonfly and Ocelot system’s vessel features were interpreted with high sensitivity (91.1–100 %) and specificity (86.7–100 %). Inter-observer concordance was documented with excellent correlation across all vessel features. The clinical benefit that the Ocelot OCT system provided was demonstrated by comparable procedural images acquired at the point of therapy. The study demonstrates equivalence of image acquisition and

Towards diagnostics for a fusion reactor

International Nuclear Information System (INIS)

Costley, A. E.

2009-01-01

The requirements for measurements on modern tokamak fusion plasmas are outlined, and the techniques and systems used to make the measurements, usually referred to as 'diagnostics', are introduced. The basics of three particular diagnostics - magnetics, neutron systems and a laser based optical system - are outlined as examples of modern diagnostic systems, and the implementation of these diagnostics on a current tokamak (JET) are described. The next major step in magnetic confinement fusion is the construction and operation of the International Thermonuclear Experimental Reactor (ITER), which is a joint project of China, Europe, Japan, India, Korea, the Russian Federation, and the United States. Construction has begun in Cadarache, France. It is expected that ITER will operate at the 500 MW level. Because of the harsh environment in the vacuum vessel where many diagnostic components are located, the development of diagnostics for ITER is a major challenge - arguably the most difficult challenge ever undertaken in the field of diagnostics. The main elements in the diagnostic step are outlined using the three chosen techniques as examples. Finally, the step beyond ITER to a demonstration reactor, DEMO, that is expected to produce several GWs of fusion power is considered and the impact on diagnostics outlined. It is shown that the applicability and development steps needed for the individual diagnostics techniques will differ. The challenges for DEMO diagnostics are substantial and a dedicated effort should be made to find and develop new techniques, and especially techniques appropriate to the DEMO environment. It is argued that the limitations and difficulties in diagnostics should be a consideration in the optimization and designs of DEMO. (author)

Arterial stiffness estimation in healthy subjects: a validation of oscillometric (Arteriograph) and tonometric (SphygmoCor) techniques.

Science.gov (United States)

Ring, Margareta; Eriksson, Maria Jolanta; Zierath, Juleen Rae; Caidahl, Kenneth

2014-11-01

Arterial stiffness is an important cardiovascular risk marker, which can be measured noninvasively with different techniques. To validate such techniques in healthy subjects, we compared the recently introduced oscillometric Arteriograph (AG) technique with the tonometric SphygmoCor (SC) method and their associations with carotid ultrasound measures and traditional risk indicators. Sixty-three healthy subjects aged 20-69 (mean 48 ± 15) years were included. We measured aortic pulse wave velocity (PWVao) and augmentation index (AIx) by AG and SC, and with SC also the PWVao standardized to 80% of the direct distance between carotid and femoral sites (St-PWVaoSC). The carotid strain, stiffness index and intima-media thickness (cIMTmean) were evaluated by ultrasound. PWVaoAG (8.00 ± 2.16 m s(-1)) was higher (Pstiffness indices by AG and SC correlate with vascular risk markers in healthy subjects. AIxao results by AG and SC are closely interrelated, but higher values are obtained by AG. In the lower range, PWVao values by AG and SC are similar, but differ for higher values. Our results imply the necessity to apply one and the same technique for repeated studies.

Brainstem ischemic stroke without permanent sequelae during the course of spontaneous internal carotid artery dissection – case report

International Nuclear Information System (INIS)

Nesteruk, Tomasz; Nesteruk, Marta; Bulik-Pasińska, Marta; Boroszko, Dariusz; Ostrowska, Monika

2012-01-01

Internal carotid artery dissection (ICAD) is a frequent cause of a stroke in young patients. Risk factors which can lead to dissection include neck injury and diseases of the inner wall of the artery. Common symptoms in ICAD are cervical pain and headache, Horner’s syndrome, paralysis of the cranial nerves and subsequently cerebral and retinal ischemia. MR angiography in TOF technique and brain MRI in T1- and T2-weighted images, FLAIR and DWI sequences are the method of choice in patients with ICAD but contrast-enhanced multislice computed tomography remains the fastest and the most available diagnostic method. A 39-year old woman, previously healthy, presented to the Hospital Emergency Department because of increasing neck pain on the right side and difficulty in swallowing. The neurological examination revealed: drooping of the right eyelid with narrow palpebral fissure, dysarthria, anisocoria (narrower pupil on the right side), unilateral hypoesthesia on the left side, weak palatal and pharyngeal reflexes on both sides, paresthesia within the left half of the body. Seven days before, the patient felt a sudden, severe neck pain radiating to the temporal apophysis. CT angiography revealed a defect in contrast filling within the left internal carotid artery and right vertebral artery. MRI of the head with MR angiography showed internal carotid artery dissection on the left side and dissection of the right vertebral artery and no ischemic changes within the brain. CT and MR angiography are methods characterized by high sensitivity in detecting dissection of the cervical arteries

The role of early identification of superior mesenteric artery in a modified technique for retrieval of abdominal organs for transplantation

International Nuclear Information System (INIS)

Issa, S.; Al-Bishri, S.

2008-01-01

Abdominal organ recovery has undergone important changes in concepts and practice in recent years, most importantly in the combined approach to retrieve the liver and pancreas by one surgical team. We studied retrospectively 81 organ donors and their respective recipients that were performed from 1996-1997. We compared the results of organ function, morbidity, mortality and operative time of two different surgical techniques. Besides the standard technique (group1), we used a new technique (group2) that involves pre cross-clamp identification of the superior mesenteric artery (SMA). There was no significant difference in organ function parameters between the two groups supporting the safety of new technique. However, there was a 50% reduction in the time needed to achieve aortic cross clamping with the new technique. We conclude that this new technique is safe to apply, distinct in reducing organ retrieval time and easy to learn. (author)

Peripheral occlusive vascular disease: Diagnostic performance of MRA and DSA

International Nuclear Information System (INIS)

Krug, B.; Kugel, H.; Harnischmacher, U.; Heindel, W.; Altenburg, A.; Fischbach, R.; Schmidt, R.

1995-01-01

In 59 patients with arterial flow disturbances 2-D inflow sequence of the abdominal and lower leg arteries were prospectively obtained on a 1.5 T MR-imager and were compared with additional DSA examinations. Supplementary Phase Contraste RSE ('Rapid Sequential Excitation') sequences were carried out in 29 patients. MRA and DSA angiograms were evaluated in random order by 4 readers using a questionnaire. The assessment of image quality were evaluated by variance analysis. Diagnostic performance of MRA and DSA was assessed by comparison of the readers' diagnostic assessments with reference diagnoses established by a radiologist and a vascular surgeon with full knowledge of all data concerning a patient. Image quality of inflow MRA was considered inferior to i.a. DSA (p [de

Intercomparison of techniques for inspection and diagnostics of heavy water reactor pressure tubes. Determination of hydrogen concentration and blister characterization

International Nuclear Information System (INIS)

2009-03-01

Heavy water reactors (HWRs) comprise significant numbers of today's operating nuclear power plants, and more are under construction. Efficient and accurate inspection and diagnostic techniques for various reactor components and systems, especially pressure tubes, are an important factor in ensuring reliable and safe plant operation. To foster international collaboration in the efficient and safe use of nuclear power, the IAEA conducted a Coordinated Research Project (CRP) on Intercomparison of Techniques for HWR Pressure Tube Inspection and Diagnostics. This CRP was carried out within the framework of the IAEA's Technical Working Group on Advanced Technologies for HWRs (the TWG-HWR). The TWG-HWR is a group of experts nominated by their governments and designated by the IAEA to provide advice and to support implementation of IAEA's project on advanced technologies for HWRs. The objective of the CRP was to compare non-destructive inspection and diagnostic techniques, in use and being developed, for structural integrity assessment of HWR pressure tubes. During the first phase of this CRP participants investigated the capability of different techniques to detect and characterize flaws. During the second phase participants collaborated to detect and characterize hydride blisters and to determine the hydrogen concentration in zirconium alloys. The intention was to identify the most effective pressure tube inspection and diagnostic methods and to identify further development needs. The organizations which participated in phase 2 of this CRP are: - Comision Nacional de Energia Atomica (CNEA), Argentina; - Atomic Energy of Canada Ltd. (AECL), Chalk River Laboratories (CRL), Canada; - Bhabha Atomic Research Centre (BARC), India; - Korea Atomic Energy Research Institute (KAERI), Republic of Korea; - National Institute for Research and Development for Technical Physics (NIRDTP), Romania; - Nuclear Non-Destructive Testing Research and Services (NNDT), Romania. IAEA-TECDOC-1499

Peripheral vascular disease in patients with coronary artery disease

International Nuclear Information System (INIS)

Bashir, E. A.; Aslam, N.

2001-01-01

Objective: The prevalence of peripheral vascular disease (PVD) in patients with coronary artery disease (CAD) has been investigated in many different ways. It depends on the diagnostic methods used and definition of atherosclerotic manifestations in the different vascular beds. This study was carried out to determine the prevalence of PVD in the lower limbs in group of patients with CAD. Design: This is a prospective observational study. Place and duration of study: The study was conducted at Combined Military Hospital/Armed Forces institute of Cardiology, Rawalpindi, over a period of one year (January 1998 to January 1999). Subjects and methods: A total number of 200 patient (171 male and 29 females) aged 55-77 years with CAD. Diagnosed by coronary angiography were included in the study. In all patients blood pressure was recorded in both arms by sphygmomanometer and ankle systolic pressure by Doppler ultrasound. Ankle branchial index was calculated. Demographic data were obtained from the patient's hospital files. Results: The prevalence of PVD was 22.5% in patients with CAD in agreement with the results of most previous investigation. There was tendency towards increasing prevalence of PVD with more advanced CAD. Thirty patients (27%) showed evidence of triple vessel disease as compared to 13 patient (18%) with double vessel and 2 patients (1%) with single vessel disease. Conclusion: A non-invasive investigation of peripheral arterial circulation should be included early in the clinical consideration of patients with chest pain or similar symptoms suggesting coronary artery disease. Ankle systolic pressure appears to be simple and cheap technique for evaluation of results. (author)

Development of a diagnostic technique based on Cherenkov effect for measurements of fast electrons in fusion devices

Energy Technology Data Exchange (ETDEWEB)

Plyusnin, V. V.; Duarte, P.; Fernandes, H.; Silva, C. [Association Euratom/IST, Instituto de Plasmas e Fusao Nuclear, Instituto Superior Tecnico, Universidade Tecnica de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa (Portugal); Jakubowski, L.; Zebrowski, J.; Malinowski, K.; Rabinski, M.; Sadowski, M. J. [National Centre for Nuclear Research (NCBJ), 7 Andrzeja Soltana Str., 05-400 Otwock (Poland)

2012-08-15

A diagnostic technique based on the Cherenkov effect is proposed for detection and characterization of fast (super-thermal and runaway) electrons in fusion devices. The detectors of Cherenkov radiation have been specially designed for measurements in the ISTTOK tokamak. Properties of several materials have been studied to determine the most appropriate one to be used as a radiator of Cherenkov emission in the detector. This technique has enabled the detection of energetic electrons (70 keV and higher) and the determination of their spatial and temporal variations in the ISTTOK discharges. Measurement of hard x-ray emission has also been carried out in experiments for validation of the measuring capabilities of the Cherenkov-type detector and a high correlation was found between the data of both diagnostics. A reasonable agreement was found between experimental data and the results of numerical modeling of the runaway electron generation in ISTTOK.

MRI in giant cell (temporal) arteritis; Magnetresonanztomografie der Arteriitis temporalis Horton

Energy Technology Data Exchange (ETDEWEB)

Bley, T.A.; Uhl, M.; Frydrychowicz, A.; Langer, M. [Uniklinik Freiburg (Germany). Roentgendiagnostik; Markl, M. [Uniklinik Freiburg (Germany). Roentgendiagnostik - Medizinische Physik

2007-07-15

Giant cell (temporal) arteritis is a diagnostic challenge. Blindness is a dreaded complication, especially if high-dose steroid treatment is delayed. With an optimized MR protocol, noninvasive diagnosis of giant cell arteritis is facilitated. Submillimeter in-plane resolution makes it possible to distinguish healthy segments from inflamed segments. The lumen and arterial wall can be depicted in high detail. Post-contrast high-resolution MRI visualizes the superficial cranial arteries bilaterally and simultaneously, allowing assessment of the cranial involvement pattern. In combination with MR angiography of the aortic arch and supra-aortic arteries, the extracranial involvement pattern can be demonstrated in a single comprehensive MR examination assessing the cranial, cervical and thoracic vasculature. Good diagnostic image quality can be achieved at 1.5 Tesla and at 3 Tesla. However, due to higher signal-to-noise ratios, image quality seems to be superior at 3 Tesla. Over the course of successful long-term treatment, MR signs of mural inflammation decrease significantly and eventually vanish entirely. In contrast to color-coded Duplex sonography, which is a comparatively cost-efficient imaging modality, acquisition of high-resolution MRI is almost independent of the investigator's expertise. Compared to positron emission tomography with 18F-fluoro-2-deoxy-D-glucose, which is a very sensitive whole-body screening tool for detecting extracranial involvement of large vessel vasculitis, MRI allows visualization and assessment of both the superficial cranial arteries in high detail and the extracranial large artery involvement in the same investigation. (orig.)

Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques.

Directory of Open Access Journals (Sweden)

Maria A Said

Full Text Available Pneumococcal pneumonia causes significant morbidity and mortality among adults. Given limitations of diagnostic tests for non-bacteremic pneumococcal pneumonia, most studies report the incidence of bacteremic or invasive pneumococcal disease (IPD, and thus, grossly underestimate the pneumococcal pneumonia burden. We aimed to develop a conceptual and quantitative strategy to estimate the non-bacteremic disease burden among adults with community-acquired pneumonia (CAP using systematic study methods and the availability of a urine antigen assay.We performed a systematic literature review of studies providing information on the relative yield of various diagnostic assays (BinaxNOW® S. pneumoniae urine antigen test (UAT with blood and/or sputum culture in diagnosing pneumococcal pneumonia. We estimated the proportion of pneumococcal pneumonia that is bacteremic, the proportion of CAP attributable to pneumococcus, and the additional contribution of the Binax UAT beyond conventional diagnostic techniques, using random effects meta-analytic methods and bootstrapping. We included 35 studies in the analysis, predominantly from developed countries. The estimated proportion of pneumococcal pneumonia that is bacteremic was 24.8% (95% CI: 21.3%, 28.9%. The estimated proportion of CAP attributable to pneumococcus was 27.3% (95% CI: 23.9%, 31.1%. The Binax UAT diagnosed an additional 11.4% (95% CI: 9.6, 13.6% of CAP beyond conventional techniques. We were limited by the fact that not all patients underwent all diagnostic tests and by the sensitivity and specificity of the diagnostic tests themselves. We address these resulting biases and provide a range of plausible values in order to estimate the burden of pneumococcal pneumonia among adults.Estimating the adult burden of pneumococcal disease from bacteremic pneumococcal pneumonia data alone significantly underestimates the true burden of disease in adults. For every case of bacteremic pneumococcal pneumonia

Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes

Directory of Open Access Journals (Sweden)

Mojgan Barati

2014-01-01

Full Text Available Background : Increased impedance to flow in the uterine arteries assessed by value of the Doppler is associated with adverse pregnancy outcomes, especially pre-eclampsia. We investigated the predictive value of a uterine artery Doppler in the identification of adverse pregnancy outcomes such as ′pre-eclampsia′ and ′small fetus for gestational age′ (SGA. Materials and Methods: Three hundred and seventy-nine women, with singleton pregnancy, between 18 and 40 years of age, without risk factors, randomly underwent Doppler interrogation of the uterine arteries, between 16-22 weeks of gestation. Those who had a mean pulsatility index (PI of >1.45 were considered to have an abnormal result, and were evaluated and compared with those who had normal results for adverse pregnancy outcomes, including pre-eclampsia and small for gestational age. The relationship between the variables was assessed with the use of the chi-square test. Results : There were 17 cases (4.5% of abnormal uterine artery Doppler results and 15 of them (88.2% developed pre-eclampsia and four cases (23.5% had neonates small for gestational age. For predicting pre-eclampsia, the mean uterine artery PI had to be >1.45, had to have a specificity of 95.5% (95% CI, 70-92%, a sensitivity of 79% (95% CI, 43-82%, a negative predictive value (NPV of 98.9% (95% CI, 72-96%, and a positive predictive value (PPV of 88.2% (95% CI, 68-98%. In the case of ′small for gestational age′ it had to have a specificity of 96.5% (95% CI, 42-68%, a sensitivity of 57% (95% CI, 53-76%, an NPV of 99.2% (95% CI, 70-92%, and a PPV of 23.5% (95% CI, 30-72%. Conclusion : Uterine artery Doppler evaluation at 16-22 weeks of gestation might be an appropriate tool for identifying pregnancies that may be at an increased risk for development of pre-eclampsia and small fetus for gestational age.

Emergency coronary angioplasty with stenting using Cordis® diagnostic coronary catheters when there is difficulty in engaging guide catheters and bench evaluation of diagnostic and guide catheters.

Science.gov (United States)

Arokiaraj, Mark Christopher

2018-02-01

Difficulty in engaging with guide catheters is not uncommon in acute emergencies. We aimed to evaluate the use of Cordis ® INFINITI diagnostic catheters to perform angioplasty in patients in whom the coronaries cannot be engaged using standard guide catheters. In 34 cases of acute coronary syndrome, when difficulty in engagement with two standard guide catheters was encountered with reasonable manipulations, angioplasty was performed using diagnostic catheters. In total, 40 stents were placed by this technique. Pushability and trackability, distal tip flexion and three-point bending tests were performed to evaluate the performance of the guide and diagnostic catheters. Angioplasty was performed easily in a setting where it would have been very difficult to perform. Coronary dissection occurred in one patient, treated by a stent. The stent and dilatation balloons were easily passed through the diagnostic catheters. Pressure tracings were clearly preserved with certain stent delivery systems, and at angioplasty, although there was slightly reduced opacification of the respective artery, the coronary anatomy was sufficiently visualized to perform angioplasty. No periprocedural target lesion complications were seen in any cases. Pushability and trackability tests showed good force transmission along a tortuous path with diagnostic catheters, and balanced force-displacement curves from three-point bending tests and distal tip softness tests. Angioplasty with stenting can be performed safely through 6F Cordis ® infiniti diagnostic catheters when difficulty in engaging guide catheters is encountered. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Rhabdomyosarcoma of the pulmonary artery

International Nuclear Information System (INIS)

Barth, J.; Lehmann, H.; Thermann, M.; Horny, H.P.; Stein, H.; Kiel Univ.; Kiel Univ.; Kiel Univ.

1982-01-01

A case of a 55-year-old man with the histological diagnosis rhabdomyosarcoma of the left pulmonary artery has been seen. Lung scanning and pulmonary arteriography are the clues for the diagnostical procedure. 55 cases from the literature are reviewed and clinical findings of the early and late stages of the diseases are discussed. Surgical treatment is the therapy of choice if ever possible; aggressive chemotherapy might be an acceptable alternative. (orig.) [de

Diagnostic interventions in nuclear medicine

International Nuclear Information System (INIS)

Thrall, J.H.; Swanson, D.P.

1989-01-01

Diagnostic interventions in nuclear medicine may be defined as the coadministration of a nonradioactive drug or application of a physical stimulus or physiologic maneuver to enhance the diagnostic utility of a nuclear medicine test. The rationale for each interventional maneuver follows from the physiology or metabolism of the particular organ or organ system under evaluation. Diagnostic inference is drawn from the pattern of change in the biodistribution of the tracer in response to the intervention-induced change in metabolism or function. In current practice, the most commonly performed interventional maneuvers are aimed at studies of the heart, genitourinary system, hepatobiliary system, and gastrointestinal tract. The single most commonly performed interventional study in the United States is the stress Thallium-201 myocardial perfusion scan aimed at the diagnosis of coronary artery disease. The stress portion of the study is accomplished with dynamic leg exercise on a treadmill and is aimed at increasing myocardial oxygen demands. Areas of myocardium distal to hemodynamically significant lesions in the coronary arteries become ischemic at peak stress due to the inability of the stenotic vessel to respond to the oxygen demand/blood flow needs of the myocardium. Ischemic areas are readily recognized as photopenic defects on scans obtained immediately after exercise, with normalization upon delayed imaging. Diuresis renography is aimed at the differential diagnosis of hydroureteronephrosis. By challenging the urinary tract collecting structures with an augmented urine flow, dilated, unobstructed systems can be differentiated from systems with significant mechanical obstruction. 137 references

Nonenhanced magnetic resonance angiography (MRA) of the calf arteries at 3 Tesla: intraindividual comparison of 3D flow-dependent subtractive MRA and 2D flow-independent non-subtractive MRA.

Science.gov (United States)

Knobloch, Gesine; Lauff, Marie-Teres; Hirsch, Sebastian; Schwenke, Carsten; Hamm, Bernd; Wagner, Moritz

2016-12-01

To prospectively compare 3D flow-dependent subtractive MRA vs. 2D flow-independent non-subtractive MRA for assessment of the calf arteries at 3 Tesla. Forty-two patients with peripheral arterial occlusive disease underwent nonenhanced MRA of calf arteries at 3 Tesla with 3D flow-dependent subtractive MRA (fast spin echo sequence; 3D-FSE-MRA) and 2D flow-independent non-subtractive MRA (balanced steady-state-free-precession sequence; 2D-bSSFP-MRA). Moreover, all patients underwent contrast-enhanced MRA (CE-MRA) as standard-of-reference. Two readers performed a per-segment evaluation for image quality (4 = excellent to 0 = non-diagnostic) and severity of stenosis. Image quality scores of 2D-bSSFP-MRA were significantly higher compared to 3D-FSE-MRA (medians across readers: 4 vs. 3; p Tesla with significantly higher image quality and diagnostic accuracy compared to 3D flow-dependent subtractive MRA (3D-FSE-MRA). • 2D flow-independent non-subtractive MRA (2D-bSSFP-MRA) is a robust NE-MRA technique at 3T • 2D-bSSFP-MRA outperforms 3D flow-dependent subtractive MRA (3D-FSE-MRA) as NE-MRA of calf arteries • 2D-bSSFP-MRA is a promising alternative to CE-MRA for calf PAOD evaluation.

Superior Mesenteric Artery Pseudoaneurysm Associated with Celiac Axis Occlusion Treated Using Endovascular Techniques

International Nuclear Information System (INIS)

Ray, Biswajit; Kuhan, Ganesh; Johnson, Brian; Nicholson, Anthony A.; Ettles, Duncan F.

2006-01-01

The case of a 30-year-old woman with a post-traumatic pseudoaneurysm of the superior mesenteric artery and associated celiac axis occlusion is presented. The patient was successfully treated with celiac artery recanalization and placement of a covered stent within the superior mesenteric artery. Follow-up at 3, 6, and 12 months and 3 years demonstrated patency of the covered stent and continued exclusion of the aneurysm. Although the long-term success of this procedure is unknown this management option should be considered where facilities are available, to reduce the increased morbidity associated with open surgical procedure

Percutaneous transluminal angioplasty of the carotid artery

International Nuclear Information System (INIS)

Numaguchi, Y.; Tulane Univ., New Orleans, LA; Puyau, F.A.; Provenza, L.J.; Richardson, D.E.

1984-01-01

The successful dilatation of postsurgical concentric stenosis of an internal carotid artery using percutaneous transluminal angioplasty (PTA) is reported here. Only one such case has been previously documented. Review of the literature disclosed 16 patients who received transluminal angioplasty for stenosis of carotid arteries by percutaneous or open arteriotomy techniques. The authors feel that PTA may be the treatment of choice for postoperative concentric stenosis of a short segment of the carotid artery as opposed to surgical repair. (orig.)

Contribution of noninvasive imaging methods and angiography to diagnosis of chronic viscero-visceral arterial colateral circulations in stenosis of truncus coeliacus

International Nuclear Information System (INIS)

Lanyi, A.; Kasuba, J.; Mistina, L.; Darmo, V.; Benko, M.; Pokorny, D.

1989-01-01

Stenosis and occlusion of truncus coeliacus represent the most frequent causes in the development of collateral blood circulation with caudiocranial flow through extended pancreatic-duodenal arcades. In a group of 32 patients with such mesenteric-coeliacal collateral circulation the arteriographic picture was evaluated. The differences and specific diagnostic contribution were evaluated of individual visualization methods for the demonstration of arteries. The noninvasive visualization methods are of exceptional significance in the examination of the abdominoretroperitoneal region by considerably decreasing the needs of invasive angiographic examination by the catheterization technique. This leads to a decrease in the number of diagnosed chronically developed viscerovisceral arterial collateral circulations of various etiologies. Ultrasonography and computerized tomography well depict morphological changes in the aorta diameter as well as of the unpaired viscelar arteries in the segment of their branching. The viscerovisceral arterial colateral circulations, however, may not be detected or at least not to a sufficient degree. They are represented in detail in the whole course only by selective arteriography. Attention is drawn to the supplementary role of arteriography within the framework of noninvasive visualization methods. (author). 4 figs., 14 refs