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Sample records for vascular malformations imaging

  1. [Vascular tumours and malformations, classification, pathology and imaging].

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    Wassef, M; Vanwijck, R; Clapuyt, P; Boon, L; Magalon, G

    2006-01-01

    The understanding of vascular anomalies (vascular tumours and vascular malformations) was obscured, for a long time, by confusion and uncertainties in nosology and terminology. The International Society for the Study of Vascular Anomalies (ISSVA) recently adopted a classification scheme, clearly separating vascular tumours (hemangiomas of different types) which result from active cell proliferation, from vascular malformations, which are inborn defects in vascular morphogenesis. These two types of lesions have different clinical behaviour and require different diagnostic and therapeutic strategies. The most frequent vascular tumour is infantile hemangioma. Its clinical aspects and evolution are well-known. New data have been recently obtained concerning the phenotype of tumour cells and its histogenesis. Of the numerous new vascular tumours, which have been recently described, only the congenital hemangiomas, the vascular tumours associated with the Maffucci syndrome and the tumours that may be complicated by a profound thrombocytopenia (Kasabach and Merritt phenomenon) will be considered. Vascular malformations can be classified according to the vessel(s) types they are composed of. A classification table is presented, separating the malformations of vascular trunks from tissular malformations which are more intimately embedded in the surrounding tissues. The different syndromes associated with vascular anomalies take also place in this table. The clinical, imaging and histological aspects of the most frequent malformations (capillary, venous, lymphatic and arteriovenous) are presented. This classification intend to clarify the nosology and terminology of the complex field of vascular tumours and malformation and to offer a common language to the different physicians and specialists contributing, preferably with a interdisciplinary approach, to the diagnosis and treatment of these difficult lesions.

  2. Magnetic resonance imaging findings of vascular malformations of the lower extremity

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    Breugem, C. C.; Maas, M.; van der Horst, C. M.

    2001-01-01

    Vascular malformations are congenital lesions resulting from a defect during embryogenesis. Magnetic resonance imaging (MRI) is a very effective method for demonstrating detailed information regarding involved structures, extent, and flow characteristics of vascular malformations. In previous MRI

  3. Cerebral vascular malformations: Applications of magnetic resonance imaging to differential diagnosis

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    Imakita, S.; Nishimura, T.; Yamada, N.; Naito, H.; Takamiya, M.; Yamada, Y.; Kikuchi, H.; Yonekawa, Y.; Sawada, T.; Yamaguchi, T.

    1989-09-01

    Twelve patients with cerebral vascular malformations (5 cavernous angiomas, 1 thrombosed arteriovenous malformation, and 6 venous angiomas) were studied with magnetic resonance (MR) imaging. All lesions were clearly depicted. Characteristic MR findings were obtained mainly on T2-weighted images: A markedly low intensity area was always seen. The margins of arteriovenous malformation (AVM) and venous angioma were irregular while those of cavernous angioma were smooth in all planes on T2-weighted images. Gradient-echo (GrE) pulse sequence were more sensitive than T2-weighted spin echo (SE) in AVM detection. MR imaging could play an important role in the differential diagnosis of cerebral vascular malformations. (orig.).

  4. Multispectral imaging of pigmented and vascular cutaneous malformations: the influence of laser treatment

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    Kuzmina, Ilona; Diebele, Ilze; Asare, Lasma; Kempele, Anna; Abelite, Anita; Jakovels, Dainis; Spigulis, Janis

    2010-11-01

    The paper investigates influence and efficacy of laser therapy on pigmented and vascular cutaneous malformations by multispectral imaging technique. Parameter mapping of skin pigmented and vascular lesions and monitoring of the laser therapy efficacy are performed by multispectral imaging in wavelength range 450-700nm by scanning step - 10nm. Parameter maps of the oxyhemoglobin deoxyhemoglobin and melanin derived from the images are presented. Possibility of laser therapy efficacy monitoring by comparison of the parameter maps before and after laser treatment has been demonstrated. As both cutaneous pigmented and vascular malformations are commonly found lesions, the parameter mapping would be a valuable method to use routinely.

  5. Thermographic Assessment of a Vascular Malformation of the Hand: A New Imaging Modality

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    Joseph T Hardwicke

    2016-01-01

    Full Text Available Vascular malformations of the hand are rare. Angiography is the current Gold Standard imaging modality. Thermal imaging is an emerging noninvasive, noncontact technology that does not require intravenous contrast agents. We present the case of a patient with an arteriovenous malformation affecting the hand in which thermal imaging has been used as an adjunct to capture baseline images to allow monitoring of progression. We suggest that thermal imaging provides an adjunct that can be used in addition to clinical examination and/or angiography for the diagnosis and routine follow-up of conservatively managed arteriovenous malformations, to monitor progression or vascular steal, and also for recording recurrence after surgical excision for which there is known to be a significant incidence. With the benefit of being a noninvasive imaging modality that does not require intravenous contrast, or ionizing radiation exposure, office-based thermal imaging may become commonplace.

  6. Vascular malformations in the extremities: emphasis on MR imaging features that guide treatment options

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    Fayad, Laura; Hazirolan, Tuncay; Bluemke, David; Mitchell, Sally [Johns Hopkins Medical Institutions, Radiology and Radiological Science, Baltimore, MD (United States)

    2006-03-15

    Vascular malformations can be classified into high-flow arteriovenous malformations (AVM) and low-flow venous or lymphatic malformations (VM/LM). VMs and LMs have the ability to cross multiple tissue boundaries. Not only is subcutaneous tissue often involved, but multiple muscle groups, tendons, bone cortex and bone marrow are also not uncommonly violated. Magnetic resonance imaging (MRI) provides valuable information for the assessment and treatment of malformations. Firstly, MRI can characterize the flow pattern of these malformations to guide treatment towards trans-arterial embolization for AVMs and percutaneous embolization for low flow malformations. MRI is essential to define the anatomic extent and in-volvement of various tissue layers (a distinct advantage over ultrasound), and to correlate treatable components of the malformation with patient symptoms. Treatment is decided by the need to alleviate clinical symptoms, and is dependent on the extent of the malformation as defined by MRI. We present MRI features of vascular malformations to demonstrate the potential spectrum of in-volvement of these lesions, illustrating the value of MRI in treatment planning. (orig.)

  7. Angioembolisation in vaginal vascular malformation.

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    Srivastava D

    2001-01-01

    Full Text Available Vaginal arteriovenous malformations are rare entities and their most common presentation is vaginal haemorrhage. This case report describes a 22-year-old woman who presented at 20 weeks of gestation with slow growing soft and tender swelling at anterior vaginal wall. Diagnosis was confirmed as vaginal vascular malformation on contrast enhanced magnetic resonance imaging. The mass did not subside after delivery and patient developed dyspareunia. It was successfully treated by angioembolisation using polyvinyl alcohol particles. Angioembolisation being safe and effective should be the treatment of first choice for symptomatic vaginal vascular malformation.

  8. Unexpected diagnosis of superficial neurofibroma in a lesion with imaging features of a vascular malformation

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    O' Keefe, Patrick; Reid, Janet; Morrison, Stuart [Cleveland Clinic Foundation, Department of Radiology, Cleveland, OH (United States); Vidimos, Allison [Cleveland Clinic Foundation, Department of Dermatology, Cleveland, OH (United States); DiFiore, John [Cleveland Clinic Foundation, Department of Pediatric Surgery, Cleveland, OH (United States)

    2005-12-01

    Plexiform neurofibroma is a pathognomonic, often disabling feature of neurofibromatosis type I. Although the target-like appearance of deep plexiform neurofibroma on T2-weighted MRI has been well-described, a second superficial form of plexiform neurofibroma has differing imaging features. We report a 15-year-old boy who presented with multiple cutaneous lesions exhibiting clinical and imaging characteristics of a venolymphatic malformation. These lesions were histologically proved to represent superficial plexiform neurofibromas. We wish to emphasize the unique MR findings of superficial plexiform neurofibromas; these findings are different from the imaging characteristics of the deep form and can be confused with a low-flow vascular malformation. (orig.)

  9. Arteriovenous Malformations and Other Vascular Malformation Syndromes

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    Whitehead, Kevin J.; Smith, Matthew C. P.; Li, Dean Y.

    2013-01-01

    Vascular malformations are a disruption of the normal vascular pattern in which it is expected that a capillary network of microscopic vessels lies interposed between high-pressure arteries that deliver blood and thin-walled veins that collect low-pressure blood for return to the heart. In the case of arteriovenous malformations, arteries or arterioles connect directly to the venous collection system, bypassing any capillary bed. Clinical consequences result from rupture and hemorrhage, from dramatically increased blood flow, or from the loss of capillary functions such as nutrient exchange and filtering function. These malformations can occur sporadically or as a component of inherited vascular malformation syndromes. In these and other hereditary vascular malformation syndromes, genetic studies have identified proteins and pathways involved in vascular morphogenesis and development. A common theme observed is that vascular malformations result from disruption in pathways involved in vascular stability. Here we review the vascular malformations and pathways involved in hereditary hemorrhagic telangiectasia, capillary malformation–arteriovenous malformation, cerebral cavernous malformations, and mucocutaneous venous malformations. PMID:23125071

  10. Vascular malformations of the orbit: classification and the role of imaging in diagnosis and treatment strategies*.

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    Rootman, Jack; Heran, Manraj K S; Graeb, Douglas A

    2014-01-01

    To describe the authors' experience with orbital vascular malformations using the International Society for the Study of Vascular Anomalies (ISSVA) classification and the preferred radiologic techniques. Review of clinical and radiologic experience from 1976 to 2012. This article presents the findings from several studies conducted on vascular malformations of the orbit, all of which received institutional review board approval when needed. The orbital vascular malformations can be evaluated, classified, and managed according to the ISSVA classification to provide a common language of communication between specialties, which takes into account flow dynamics. The ISSVA can be applied for vascular malformations of the orbit.

  11. Spinal vascular malformations; Spinale Gefaessmalformationen

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    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal vascular malformations are a group of rare diseases with different clinical presentations ranging from incidental asymptomatic findings to progressive tetraplegia. This article provides an overview about imaging features as well as clinical and therapeutic aspects of spinal arteriovenous malformations, cavernomas and capillary telangiectasia. (orig.) [German] Spinale Gefaessmalformationen sind eine Gruppe seltener Erkrankungen mit unterschiedlichen klinischen Praesentationen, die vom asymptomatischen Zufallsbefund bis zur progredienten Tetraparese reichen. Dieser Artikel gibt einen Ueberblick ueber radiologische Befunde sowie klinische und therapeutische Aspekte von spinalen arteriovenoesen Malformationen, Kavernomen und kapillaeren Teleangiektasien. (orig.)

  12. Low-Flow Vascular Malformation Pitfalls: From Clinical Examination to Practical Imaging Evaluation--Part 1, Lymphatic Malformation Mimickers.

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    White, Candace L; Olivieri, Brandon; Restrepo, Ricardo; McKeon, Brett; Karakas, S Pinar; Lee, Edward Y

    2016-05-01

    Palpable subcutaneous masses present in various shapes and sizes in the pediatric population and, accordingly, represent a variety of underlying causes. Lymphatic and venous malformations are among the most common pediatric subcutaneous lesions. However, there are congenital and acquired, as well as benign and malignant, soft-tissue masses that can mimic them clinically and at imaging. Here, we review the natural history, wide range of clinical presentations, and varied but characteristic imaging appearance of lymphatic malformations that can pose diagnostic difficulties in children. In addition, the clinical and imaging characteristics of some pediatric soft-tissue pathologies that can mimic lymphatic malformations and clues to reach a proper diagnosis are highlighted.

  13. Intracranial Vascular Malformations and Epilepsy.

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    Josephson, Colin B; Rosenow, Felix; Al-Shahi Salman, Rustam

    2015-06-01

    Among the spectrum of intracranial vascular malformations (IVMs), arteriovenous malformations (AVMs), and cavernous malformations (CCMs) are of particular importance for epilepsy. Seizures are a common mode of presentation for both conditions. Seizures may occur de novo or secondary to intracerebral hemorrhage. Timely imaging is thus crucial for patients with seizures and AVMs or CCMs. Patients with a first-ever AVM- or CCM-related seizure can now be considered to have epilepsy according to the International League Against Epilepsy criteria. Observational studies and case series suggest that between 45 to 78% of patients with AVM-related epilepsy and 47 to 60% of patients with CCM-related epilepsy may achieve seizure freedom through antiepileptic drugs (AEDs) alone. Invasive procedures are available although current evidence suggests that epilepsy-specific preintervention evaluations are underused. Randomized controlled trials and population-based studies have demonstrated worse short-term functional outcomes after routine intervention on unruptured AVMs or CCMs when compared with conservative management. The role of invasive therapy for IVM-related epilepsy has yielded mixed results. Case series have reported high estimates of seizure freedom although these results have not been replicated in controlled observational studies. Randomized controlled trials of immediate invasive therapy versus conservative management, in addition to usual care with AEDs and of different types of treatment and their timing, are warranted for AVMs and CCM-related epilepsy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Pediatric central nervous system vascular malformations

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    Burch, Ezra A. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Orbach, Darren B. [Boston Children' s Hospital, Neurointerventional Radiology, Boston, MA (United States)

    2015-09-15

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  15. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

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    Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

    2013-06-15

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  16. Syndromes associated with vascular tumors and malformations: a pictorial review.

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    Nozaki, Taiki; Nosaka, Shunsuke; Miyazaki, Osamu; Makidono, Akari; Yamamoto, Asako; Niwa, Tetsu; Tsutsumi, Yoshiyuki; Aida, Noriko; Masaki, Hidekazu; Saida, Yukihisa

    2013-01-01

    Use of the International Society for the Study of Vascular Anomalies (ISSVA) classification system has been strongly recommended in recent years because of the need for separate therapeutic measures for patients with vascular tumors and malformations. In the ISSVA classification system, vascular tumors, which are neoplastic, are distinguished from vascular malformations, which are caused by vascular structural anomalies and are not neoplastic, on the basis of the presence or absence of neoplastic proliferation of vascular endothelial cells. It is important that radiologists be familiar with the development, diagnosis, and treatment of vascular tumors and malformations, especially the imaging features of low- and high-flow vascular malformations. Some vascular tumors and malformations develop in isolation, whereas others develop within the phenotype of a syndrome. Syndromes that are associated with vascular tumors include PHACE syndrome. Syndromes that are associated with vascular malformations include Sturge-Weber, Klippel-Trénaunay, Proteus, blue rubber bleb nevus, Maffucci, and Gorham-Stout syndromes, all of which demonstrate low flow, and Rendu-Osler-Weber, Cobb, Wyburn-Mason, and Parkes Weber syndromes, all of which demonstrate high flow. Because imaging findings may help identify such syndromes as systemic, it is important that radiologists familiarize themselves with these conditions.

  17. Distinguishing high-flow from low-flow vascular malformations using maximum intensity projection images in dynamic magnetic resonance angiography - comparison to other MR-based techniques.

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    Kociemba, Anna; Karmelita-Katulska, Katarzyna; Stajgis, Marek; Oszkinis, Grzegorz; Pyda, Małgorzata

    2016-05-01

    In addition to ultrasound, magnetic resonance imaging (MRI) is considered a suitable, non-invasive technique to assess the type and extent of vascular malformations. The distinction between low- and high-flow lesions is crucial because it determines appropriate patient treatment. To distinguish high-flow from low-flow lesions on the basis of the enhancement pattern on MIP images acquired from dynamic time-resolved MR angiography (MRA) and compare it with previously described MR-based methods. We examined 25 consecutive patients with previously diagnosed vascular malformations. Next, each malformation was classified as "high-flow" or "low-flow" using the following criteria: (i) findings on T1-weighted (T1W) and T2-weighted (T2W) imaging (signal voids, signal intensity); (ii) the time interval between the start of arterial enhancement and the onset of lesion enhancement (artery-lesion time); (iii) the time of maximum lesion enhancement; and (iv) analysis of the slope of the enhancement curve. Of the 25 patients, seven had high-flow and 18 had low-flow malformations. Signal voids on spin-echo T1W images were observed only in four of seven high-flow malformations and in two of 18 low-flow malformations. Analysis of signal intensity on T2W images showed increased signal intensity in 17 of 18 low-flow malformations, and in two of seven high-flow lesions. Calculation of the artery-lesion time, maximum enhancement time, and slope revealed significant differences between the high- and low-flow groups. In conclusion, the slope of the enhancement curve appears to be useful in distinguishing between high- and low-flow vascular malformations. Standardization of MR image evaluation criteria is essential. © The Foundation Acta Radiologica 2015.

  18. Vascular malformation mimicking multiple sclerosis active plaque: Usefulness of susceptibility weighted imaging (SWI) to perform correct diagnosis

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    Perri, Marco; Michelini, Giulia; Varrassi, Marco; Splendiani, Alessandra; di Cesare, Ernesto; Masciocchi, Carlo; Gallucci, Massimo

    2015-01-01

    Brain focal hyperdensity areas are common findings in computed tomography examinations, often further evaluated in magnetic resonance imaging exams. These are usually haemosiderin and calcified perivascular clusters known as cerebral microbleeds and may be secondary signs of brain disorders. Cerebral microbleeds are paramagnetic and ferromagnetic substances determining magnetic field inhomogeneity. Susceptibility weighted imaging (SWI) performed at 3T with phase post-processing is very useful in evaluating this field variation. In fact in the past decade SWI has been increasingly reported for its clinical value in adults with neurologic disorders, traumas, arterial venous malformations, occult venous diseases, tumours and functional brain imaging. The occasional computed tomography findings of single or multiple focal hyperdense areas can mimic many of these brain disorders and lead to misinterpretations. For these reason it is useful to have a more detailed diagnosis with MRI brain examination. The authors highlight the role of SWI sequence in the differential diagnosis among active plaque, vascular malformation and haemorrhagic lesion in a case report of a 41-year-old woman suffering from multiple sclerosis with a focal hyperdense area reported in a computed tomography brain examination. PMID:26450102

  19. Cerebral dysplastic vascular malformation: a developmental arrest

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    Wortzman, G.; Sima, A.A.F.; Morley, T.P.

    1983-08-01

    A cryptic malformation of the brain was found to represent an arrest in vascular development. Microscopy showed plump endothelium of blood vessels, which did not have a normal lumen and consisted of solid cords of cells. The microscopic, angiographic, and computed tomographic appearance of this anomaly are discussed and compared with cavernous angiomas, arteriovenous malformations, and venous angiomas.

  20. Abdominal lymphatic malformation: Spectrum of imaging findings

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    Anupam Lal

    2016-01-01

    Full Text Available Lymphatic malformations are congenital vascular malformations with lymphatic differentiation. Although the most common locations for lymphatic malformation are the neck and axilla, they can occur at several locations in the body including the abdomen. The abdominal location is rather rare and accounts for approximately 5% of all lymphatic malformation. Abdominal lymphatic malformation can arise from mesentery, omentum, gastrointestinal tract, and retroperitoneum. Clinical presentation includes an abdominal lump, vague abdominal discomfort, and secondary complications including intestinal obstruction, volvulus, ischemia, and bleeding. There is a broad spectrum of radiological manifestation. In the present review, we discuss the imaging appearance of abdominal lymphatic malformation. The diagnosis of lymphatic malformation in our series was based on the histopathological examination (in cases who underwent surgery and fine needle aspiration cytology.

  1. Abdominal lymphatic malformation: Spectrum of imaging findings.

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    Lal, Anupam; Gupta, Pankaj; Singhal, Manphool; Sinha, Saroj K; Lal, Sadhana; Rana, Surinder; Khandelwal, Niranjan

    2016-01-01

    Lymphatic malformations are congenital vascular malformations with lymphatic differentiation. Although the most common locations for lymphatic malformation are the neck and axilla, they can occur at several locations in the body including the abdomen. The abdominal location is rather rare and accounts for approximately 5% of all lymphatic malformation. Abdominal lymphatic malformation can arise from mesentery, omentum, gastrointestinal tract, and retroperitoneum. Clinical presentation includes an abdominal lump, vague abdominal discomfort, and secondary complications including intestinal obstruction, volvulus, ischemia, and bleeding. There is a broad spectrum of radiological manifestation. In the present review, we discuss the imaging appearance of abdominal lymphatic malformation. The diagnosis of lymphatic malformation in our series was based on the histopathological examination (in cases who underwent surgery) and fine needle aspiration cytology.

  2. Management of vascular malformations of the parotid area.

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    Achache, M; Fakhry, N; Varoquaux, A; Coulibaly, B; Michel, J; Lagier, A; Antonini, F; Turner, F; Dessi, P; Giovanni, A

    2013-04-01

    To describe our experience in the management of vascular malformations of the parotid area. This was a retrospective study. Among 614 parotidectomy performed between 1998 and 2008 at our institution, 10 cases (1.6%) of vascular malformations have been identified. Clinical features and management of these patients were analyzed. Clinical presentation was usually related to that of a benign, slow-growing and asymptomatic tumor. There was a marked female predominance (90%). In any case, the diagnosis of vascular malformation could be obtained with certainty preoperatively. Surgical excision was performed most often referred to diagnosis. Sixty percent of vascular malformations were located in the superficial lobe of the parotid gland. On the histological we found a classic look with benign vascular proliferation of endothelial cells in the walls. The vessel lumen was either the head of a congestion or thrombosis or calcification (phleboliths). Vascular malformations of the parotid gland, rare disease, are mainly venous. The terminology is based on clinical data, scalable, histological and hemodynamic as classified by the International Society of Study of Vascular Anomaly (ISSVA). Despite advances in imaging including MRI they remain difficult to diagnose. The treatment of reference is surgical excision. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  3. Percutaneous Treatment of Peripheral Vascular Malformations

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    E. van der Linden (Edwin)

    2011-01-01

    textabstractVascular malformations arise from errors in the morphological processes that shape the embryonic vascular system during fetal development. These developmental errors result in abnormal clusters of blood vessels. Although these lesions are present at birth, they might not become visible

  4. Retroperitoneal vascular malformation mimicking incarcerated inguinal hernia

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    Dubey Indu

    2011-01-01

    Full Text Available A 30-year-old man presented to the Department of Surgery with a painful groin swelling on right side. Exploration revealed a reddish-blue hemangiomatous mass in the scrotum extending through inguinal canal into the retroperitoneum. On further dissection swelling was found to be originating from right external iliac vein. The swelling was excised after ligating all vascular connections. The histopathological examination of excised mass confirmed the diagnosis of venous variety of vascular malformation. This is the first reported case of vascular malformation arising from retroperitoneum and extending into inguinoscrotal region, presenting as incarcerated inguinal hernia.

  5. Radiology and imaging for cavernous malformations.

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    Wang, Kevin Y; Idowu, Oluwatoyin R; Lin, Doris D M

    2017-01-01

    Cavernous malformations are low-flow vascular malformations that are histologically characterized by the lack of mural elements of mature vascular structures and intervening parenchymal neural tissue. They are often clinically quiescent, and may grow, bleed, and regress, but can also manifest clinically as neurologic deficits or seizures in the setting of an acute hemorrhage. The low-flow nature of cavernous malformations renders them inherently occult on cerebral angiography. Magnetic resonance imaging has become the mainstay imaging modality in evaluating cavernous malformations, producing characteristic imaging features that usually provide a straightforward diagnosis. Features on magnetic resonance imaging include a reticulated pattern of mixed hyper- and hypointensity on T1- and T2-weighted imaging, with a characteristic hypointense rim best appreciated on T2-weighted imaging or gradient-echo sequences. Contrast enhancement is useful for revealing coexisting developmental venous anomalies that are frequently associated with sporadic cavernous malformations, and may further support the diagnosis. Susceptibility-weighted imaging is highly sensitive for cavernous malformations and accompanying developmental venous anomalies, and is superior to gradient-echo sequences in screening for multifocal, familial cavernous malformations. © 2017 Elsevier B.V. All rights reserved.

  6. Vascular permeability in cerebral cavernous malformations.

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    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

  7. Vascular permeability in cerebral cavernous malformations

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    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik BW; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-01-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy. PMID:25966944

  8. Nonsurgical management of vascular malformation of masseter

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    Venkatesh Jayaraman

    2015-01-01

    Full Text Available Intramuscular vascular anomalies are rare congenital hamartomatous lesions. Less than 1% of these occur in skeletal muscle out of which 15% arise in head and neck musculature. In the head and neck region, masseter muscle is the most common site. It accounts for about 5% of intramuscular vascular malformations. They are present from birth but are clinically apparent during infancy and childhood and occasionally during adulthood. Due to its location it is often mistaken for a parotid swelling. The usual treatment of choice is surgical excision with a margin. This is associated with loss of motor function, hemorrhage, nerve damage. Intralesional sclerotherapy, embolization are nonsurgical alternatives for treatment of slow flow venous malformations. Sclerotherapy can be used solely in multiple sittings or as an adjunct to surgery. This article presents a case report of a 28-year-old male with recurrent intramuscular vascular malformation in the masseter muscle, which was successfully treated by ethanol sclerotherapy.

  9. [High flow vascular malformations in children].

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    López Gutiérrez, J C; Ros, Z; Martínez, L; Díaz, M; Leal, N; Rivas, S; Hernández, F

    2002-10-01

    Unlike hemangiomas and low-flow vascular malformations which are very common in children, arterial anomalies have small incidence. Differential diagnosis is difficult, and needs a physician familiarized with vascular anomalies. Appropriate treatment must be planned by multidisciplinary team considering the patient's age, and anatomical location. Twenty-eight children with high flow vascular malformations have been treated since 1990 at La Paz Children's Hospital Vascular Anomalies Program. We excluded of the study group patients with central nervous system lesions. 85% of the patients had malformation in stage I or II (according the ISSVA accepted Schöbinger stating) and most of them were erroneously diagnosed as hemangioms with a variety of inappropriate treatments previously performed. Doppler Ultrasound and Magnetic Resonance confirmed malformation flow and extension. Angiography and selective embolization was only considered as therapeutic approach in candidates to surgical resection. 16 patients underwent complete resection of the malformation including one foot and two fingers amputation and five more incomplete resection of the ulcerate area. In conclusion, we did not find age at onset, sex and symptoms relationship. Laser, radiotherapy, surgical ligation or partial resection must be considered inappropriate therapies which may stimulate AVM exacerbation. Only radical surgical procedure after selective endovascular embolization will be successful but then reconstructive surgery should be performed to achieve good aesthetic and functional results.

  10. Progressive melorheostosis in the peripheral and axial skeleton with associated vascular malformations: imaging findings over three decades

    Energy Technology Data Exchange (ETDEWEB)

    Kalbermatten, N.T.; Vock, P.; Anderson, S.E. [Dept. of Diagnostic Radiology, University Hospital, Bern (Switzerland); Ruefenacht, D. [Dept. of Diagnostic Radiology, University Hospital, Geneva (Switzerland)

    2001-01-01

    A 28-year old woman presented with Leri's disease (melorheostosis) and the rare combination of complex vascular malformations and lymphatic anomalies. Multifocal melorheostosis was segmental and unilateral, located in the left axial and peripheral skeleton, fifth thoracic vertebral body, fifth rib, left upper limb and lumbosacral spine (third lumbar body to first sacral segment). Sacral involvement was associated with spinal canal stenosis. Additionally the patient had multiple nevi and had suffered from left hemiplegia since birth. Lymphangiectasia of the mesentery and thorax led to chylothorax resistant to therapy for which the patient underwent a pleuropericardiectomy. Death ensued due to respiratory failure. (orig.)

  11. Oral vascular malformations: laser treatment and management

    Science.gov (United States)

    Romeo, U.; Rocchetti, F.; Gaimari, G.; Tenore, G.; Palaia, G.; Lo Giudice, G.

    2016-03-01

    Vascular malformations are a very heterogeneous group of circulatory system's diseases that can involve different kind of vessels: arterial, venous or lymphatic ones. Many treatments, such as conventional surgery, embolization, steroid therapy and laser therapy, are available for vascular lesions. The laser approach relies more therapeutic techniques: the transmucosal thermophotocoagulation, intralesional photocoagulation, the excisional biopsy. Today laser is demonstrated to be the gold standard technique to treat vascular lesions that allows a safe and efficient treatment and a lower post-operative healing time. The only disadvantage is the risk of carbonization that could be avoided by using the multiple-spot single pulsed wave technique.

  12. Abdominal lymphatic malformation: Spectrum of imaging findings

    OpenAIRE

    Anupam Lal; Pankaj Gupta; Manphool Singhal; Saroj K Sinha; Sadhana Lal; Surinder Rana; Niranjan Khandelwal

    2016-01-01

    Lymphatic malformations are congenital vascular malformations with lymphatic differentiation. Although the most common locations for lymphatic malformation are the neck and axilla, they can occur at several locations in the body including the abdomen. The abdominal location is rather rare and accounts for approximately 5% of all lymphatic malformation. Abdominal lymphatic malformation can arise from mesentery, omentum, gastrointestinal tract, and retroperitoneum. Clinical presentation include...

  13. Vascular malformations of the spine; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Thron, A.; Mull, M. [Universitaetsklinikum der RWTH Aachen (Germany). Abt. Neuroradiologie; Reith, W. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. fuer Neuroradiologie

    2001-11-01

    The vascular malformations of the spine and spinal cord are rare diseases. Possible symptoms may consist in a transient neurological deficit, a progressive sensorimotor transverse lesion or an acute para- or tetraplegia. Damage to the spinal cord occurs by bleeding, space-occupying effects and venous congestion, rarely by steal effects. Classification of the true inborn malformations differentiates between arteriovenous malformations (AVMs), cavernomas and capillary teleangiectasias. The more frequent spinal dural arteriovenous fistula (SDAVF) of the elderly patient is a probably acquired lesion which is presented in a separate paper. Capillary teleangiectasias are mostly incidental findings but may cause differential diagnostic problems. Cavernomas are important causes of hemorrhage and may initially be obscured within the bleeding. MRI is the most relevant imaging procedure in the early diagnostic workup. In case of an AVM selective spinal angiography is required to define the type of the lesion and to decide about the appropriate therapy which may be endovascular-interventional, neurosurgical, combined or attentive. (orig.) [German] Die Gefaessmalformationen des Spinalkanals und Rueckenmarks sind seltene Erkrankungen, deren moegliche Symptome von transienten neurologischen Ausfaellen bis zur akuten Querschnittlaehmung reichen. Eine Schaedigung des Rueckenmarks kann durch Blutungen, Raumforderungswirkung, venoese Kongestion oder ''Steal-Effekte'' entstehen. Haeufiger als die echten (angeborenen) Malformationen, wozu arteriovenoese Malformationen (AVMs), Kavernome und kapillaere Teleangiektasien gerechnet werden, sind die vermutlich erworbenen spinalen duralen arteriovenoesen Fisteln (SDAVF) des aelteren Patienten, die gesondert dargestellt werden. Die kapillaeren Teleangiektasien sind meist Zufallsbefunde, koennen aber differenzialdiagnostische Verwirrung verursachen. Kavernome sind eine wichtige Ursache fuer Blutungen, wobei sie sich

  14. Extracranial vascular malformations (hemangiomas and vascular malformations) in children and adolescents - diagnosis, clinic, and therapy.

    Science.gov (United States)

    Eivazi, Behfar; Werner, Jochen A

    2014-01-01

    The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be

  15. Extracranial vascular malformations (hemangiomas and vascular malformations) in children and adolescents – diagnosis, clinic, and therapy

    Science.gov (United States)

    Eivazi, Behfar; Werner, Jochen A.

    2014-01-01

    The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be

  16. Alcohol sclerotherapy to treat vascular malformations in the oral cavity.

    Science.gov (United States)

    Talens Ferrando, A; Ferrer Mengual, S; González-Cruz Soler, A; Martínez Sanjuán, V; Poveda Roda, R; Sanchis Bielsa, J M; Bagán Sebastián, J V

    2013-01-01

    To present our experience in treating vascular malformations in the oral cavity solely by injecting ethanol into the lesions. We treated 26 patients (12 men and 14 women) with oral malformations. The diagnosis was based on clinical findings (n=26), magnetic resonance imaging studies (n=19), angiography findings (n=5), and direct puncture venography (n=2). To achieve sclerosis, we administered absolute ethanol through direct puncture. All interventions were performed under deep sedation. The vascular malformations treated ranged from 7mm to 60mm (median: 24.5mm) in maximum diameter and had been present in the oral cavity for 0.2 to 54 years (mean: 13.6 years). The median age of the patients was 44.5 years (range: 12-87 years). The reason for treatment of the malformation was: an increase in size (n=8), local bleeding (n=11), risk of bleeding during dental extraction (n=5), pain (n=1), and esthetic purposes (n=3). Lesions were located in the mucosa of the cheek (n=12), in the facial gingiva (n=5), in the labial mucosa (n=6), in the tongue (n=3), in the pterygomandibular region (n=1), and in the palate (n=1). The median dose of ethanol was 3.2mL. Twenty lesions disappeared after a single injection session, five after two sessions, two after three sessions, and one after five sessions. In 20 cases all signs of the lesions disappeared, in 6 a bluish macule persisted, and in 2 a mass effect persisted. The symptoms improved in all patients. Only transient complications of sclerotherapy were observed: local inflammation, perioral paresthesia in two patients, and necrosis of the mucosa of the cheek in one. Alcohol sclerotherapy is an efficacious procedure for treating vascular malformations in the oral cavity. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  17. Monozygotic twins discordant for vascular malformations and dysregulated growth

    NARCIS (Netherlands)

    Oduber, Charlène E. U.; Bliek, Jet; van der Horst, Chantal M. A. M.; van Steensel, Maurice A. M.; Hennekam, Raoul C. M.

    2010-01-01

    There is a large group of disorders characterized by non-cranial vascular malformations and a dysregulated growth, of which the prototype may be Klippel-Trenaunay syndrome (KTS). The aetiology of KTS and vascular malformations-dysregulated growth (VM-DG) syndromes resembling KTS is obscure, but

  18. Extracranial vascular malformation: value of antenatal and postnatal MRI in management

    Energy Technology Data Exchange (ETDEWEB)

    Roche, C.J.; Pilling, D.W. [Dept. of Radiology, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom); Walkinshaw, S.A. [Dept. of Fetal Medicine, Liverpool Women' s Hospital (United Kingdom); May, P.L. [Dept. of Neurosurgery, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom)

    2001-10-01

    We report a case where fetal MRI using a low-field-strength magnet (0.5 T) accurately confirmed a large extracranial vascular malformation, which was suspected on antenatal US. Fetal MRI enabled better counselling of the parents and allowed suitable plans to be made regarding method of delivery and early management of the neonate. To our knowledge this is the first case of an extracranial vascular malformation imaged using fetal MRI. (orig.)

  19. Cardiac and vascular malformations; Fehlbildungen von Herz und Gefaessen

    Energy Technology Data Exchange (ETDEWEB)

    Ley, S. [Chirurgische Klinik Dr. Rinecker, Abteilung fuer Diagnostische und Interventionelle Radiologie, Muenchen (Germany); Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Ley-Zaporozhan, J. [Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Abteilung Paediatrische Radiologie, Muenchen (Germany)

    2015-07-15

    Malformations of the heart and great vessels show a high degree of variation. There are numerous variants and defects with only few clinical manifestations and are only detected by chance, such as a persistent left superior vena cava or a partial anomalous pulmonary venous connection. Other cardiovascular malformations are manifested directly after birth and need prompt mostly surgical interventions. At this point in time echocardiography is the diagnostic modality of choice for morphological and functional characterization of malformations. Additional imaging using computed tomography (CT) or magnetic resonance imaging (MRI) is only required in a minority of cases. If so, the small anatomical structures, the physiological tachycardia and tachypnea are a challenge for imaging modalities and strategies. This review article presents the most frequent vascular, cardiac and complex cardiovascular malformations independent of the first line diagnostic imaging modality. (orig.) [German] Fehlbildungen von Herz und Gefaessen zeigen einen erheblichen Variationsspielraum. Es gibt zahlreiche Varianten und Defekte mit geringer Auspraegung, welche nur per Zufall im Lauf des Lebens detektiert werden; hierzu zaehlen z. B. die persistierende linke obere Hohlvene oder partielle Lungenvenenfehlmuendungen. Andere kardiovaskulaere Fehlbildungen zeigen sich frueh post partum und muessen zeitnah, meist operativ, versorgt werden. Zu diesem Zeitpunkt ist die Echokardiographie ein etabliertes und vollstaendig ausreichendes Verfahren zur morphologischen und funktionellen Charakterisierung. Nur in seltenen Faellen wird eine zusaetzliche Bildgebung mittels CT oder MRT benoetigt. Wenn ja, stellen die kleinen anatomischen Strukturen, die physiologische Tachykardie und Tachypnoe eine besondere Herausforderung fuer die Diagnostik dar. In dieser Uebersicht werden, unabhaengig vom diagnostischen Verfahren, die haeufigsten vaskulaeren, kardialen und komplexen kardiovaskulaeren Malformationen

  20. Role of histochemical stains in differentiating hemangioma and vascular malformation

    Directory of Open Access Journals (Sweden)

    Ruchir Jitendra Patel

    2016-01-01

    Full Text Available Background: Benign vascular lesions such as vascular malformation and hemangioma at times pose difficulty in diagnosis both for clinicians and pathologists. Vascular malformations are difficult to treat while hemangiomas resolve spontaneously in most instances. There are instances when vascular malformations, especially arteriovenous malformations (AVMs have been misdiagnosed as hemangiomas and vice-versa. Clinical and radiological correlation with histopathological confirmation of these anomalies is important for the management of these lesionsAim: The aim was to study the histological characteristics of hemangiomas and vascular malformations and to study the utility of histochemical stains in their diagnosis. Materials and Methods: We retrospectively studied fifty cases retrieved from the records of Department of Pathology which were diagnosed as hemangioma (n=32 and vascular malformation (n=18 on Hematoxylin and Eosin (H and E stain over a period of 18 months. The cases were analyzed based on findings of histochemical stains such as Verhoeff-van Gieson (VVG, Masson's trichrome (MT, and toluidine blue. Results: After reviewing all the cases with the use of histochemical stains, two of the three cases originally diagnosed as hemangioma turned out to be AVM and one to be venous malformation. An increased number of intra-lesional nerves were found in 16 of 19 cases of AVM and in both cases of venous and lymphatic malformation. Hemangiomas did not show increase in nerve bundles. Mast cells were found to be increased in proliferating hemangiomas and pyogenic granulomas as compared to AVMs. Conclusion: Hemangiomas and vascular malformations should be clearly differentiated to reduce the risk of treatment failure and recurrence. With the use of histochemical stains such as VVG, MT and toluidine blue, the diagnostic difficulty can be reduced and definitive diagnosis is possible.

  1. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao

    2015-01-01

    -controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy....... correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive...

  2. Imaging evaluation of fetal vascular anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Koch, Bernadette L.; Laor, Tal [MLC 5031 Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Adams, Denise M. [Cincinnati Children' s Hospital Medical Center, Department of Pediatrics and Hemangioma and Vascular Malformation Center, Cincinnati, OH (United States); Gupta, Anita [Cincinnati Children' s Hospital Medical Center, Department of Pathology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Pediatric Surgery and Fetal Center of Cincinnati, Cincinnati, OH (United States)

    2015-08-15

    Vascular anomalies can be detected in utero and should be considered in the setting of solid, mixed or cystic lesions in the fetus. Evaluation of the gray-scale and color Doppler US and MRI characteristics can guide diagnosis. We present a case-based pictorial essay to illustrate the prenatal imaging characteristics in 11 pregnancies with vascular malformations (5 lymphatic malformations, 2 Klippel-Trenaunay syndrome, 1 venous-lymphatic malformation, 1 Parkes-Weber syndrome) and vascular tumors (1 congenital hemangioma, 1 kaposiform hemangioendothelioma). Concordance between prenatal and postnatal diagnoses is analyzed, with further discussion regarding potential pitfalls in identification. (orig.)

  3. Arteriovenous Malformations and Other Vascular Lesions of the Central Nervous System

    Science.gov (United States)

    ... Malformations and Other Vascular Lesions of the Central Nervous System Fact Sheet What are arteriovenous malformations? What are ... other types of vascular lesions affect the central nervous system? Besides AVMs, three other main types of vascular ...

  4. [Hereditary vascular malformations: classification, symptoms, diagnostics and prognosis].

    Science.gov (United States)

    Wohlgemuth, W A; Wölfle, K; Schuster, T; Schlimok, G; Bohndorf, K

    2012-10-01

    The understanding of hereditary vascular anomalies was hampered for a long time by unclear und unspecific terminology. Today, the classification of the International Society for the Study of Vascular Anomalies (ISSVA) differentiates between vascular tumours (mostly infantile haemangioma) with active endothelial proliferation and regression and vascular malformations (VM), which are defects of the vascular morphogenesis and are distinguished in predominantly venous, arterial, capillary, lymphatic, arteriovenous or combined VM. Symptoms are pain, swelling and restricted movement, accompanied by skin signs like dys-plastic veins and capillary VM (naevus flammeus). Thrombophlebitis and chronic venous insufficiency are related to venous VM. Arteriovenous VM are progressive and can cause ischaemic necroses, in rare cases even a high-output cardiac fail-ure. Lymphatic VM lead to localised swelling, in the long run often to recurrent erysipelas and lymphorroea. Primary imaging is provided by -ul-trasound including flow measurements. Mor-phol-ogy and organ involvement is best delineated by magnetic resonance imaging. Phlebography is used to image deep venous system anomalies and is always accompanied by varicography of the dysplastic parts of the venous VM. Digital subtraction angiography is performed to demon-strate the flow pattern in feeding arteries, the nidus and the drainage veins of arteriovenous VM. Besides size and localisation the prognosis of the patients is determined by the pressure (the high-er the pressure, the poorer the prognosis) and the flow rate (the higher the flow rate, the poorer the prognosis) in the VM. Diagnosis and treatment of these rare diseases are best performed in special-ised, interdisciplinary centres. © Georg Thieme Verlag KG Stuttgart ˙ New York.

  5. Vascular malformations of the lower limb with osseous involvement

    NARCIS (Netherlands)

    Breugem, C. C.; Maas, M.; Breugem, S. J. M.; Schaap, G. R.; van der Horst, C. M. A. M.

    2003-01-01

    Vascular malformations are rare congenital lesions which often have associated skeletal changes. Over a period of ten years, 90 patients at our clinic had a vascular anomaly of the lower limb, examined by either CT or MRI. Of these, 18 (20%) had bony involvement. A questionnaire was sent to these

  6. [Vascular malformations (I). Concept, classification, pathogenesis and clinical features].

    Science.gov (United States)

    Redondo, P

    2007-04-01

    Vascular malformations are anomalies always present at birth that, contrary to hemangiomas, never regress and may grow during lifetime. Clinical presentation of vascular malformations is extremely variable and ranges from asymptomatic spots of mere aesthetic concern to lesions with high blood flow or located in critical sites that may be life-threatening. Given the low incidence of these disorders it is difficult to establish therapeutic guidelines. In addition to a correct classification of vascular anomalies, it is necessary a multidisciplinary approach for the follow-up and management of these patients. The first part of this review focuses on the different classifications of vascular anomalies, maintaining as reference the one proposed by the International Society for the Study of Vascular Anomalies (ISSVA). Additionally, clinical features of the different subtypes of vascular anomalies as well as their association in certain syndromes are reviewed.

  7. Vascular malformation mimicking multiple sclerosis active plaque: Usefulness of susceptibility weighted imaging (SWI) to perform correct diagnosis

    OpenAIRE

    Marsecano, Claudia; Perri, Marco; Michelini, Giulia; Varrassi, Marco; Splendiani, Alessandra; Di Cesare, Ernesto; Masciocchi, Carlo; Gallucci, Massimo

    2015-01-01

    Brain focal hyperdensity areas are common findings in computed tomography examinations, often further evaluated in magnetic resonance imaging exams. These are usually haemosiderin and calcified perivascular clusters known as cerebral microbleeds and may be secondary signs of brain disorders. Cerebral microbleeds are paramagnetic and ferromagnetic substances determining magnetic field inhomogeneity. Susceptibility weighted imaging (SWI) performed at 3T with phase post-processing is very useful...

  8. Malformaciones vasculares: claves diagnósticas para el radiólogo Vascular malformations: diagnostic clues for the radiologist

    Directory of Open Access Journals (Sweden)

    Ricardo García Mónaco

    2012-12-01

    Full Text Available Las malformaciones vasculares son enfermedades raras ocasionadas por errores en el desarrollo embriológico de los vasos sanguíneos. Estas lesiones, junto con los tumores vasculares, constituyen las anomalías vasculares. En el caso de las malformaciones vasculares, éstas se denominan de acuerdo al vaso que conforma la lesión y se clasifican según las características del flujo en malformaciones de bajo o alto flujo. Si bien la mayor parte son diagnosticadas según criterios clínicos, algunas lesiones requieren de estudios complementarios tanto para el establecimiento de un correcto diagnóstico como para la evaluación de su extensión. La ecografía Doppler suele ser el estudio inicial para conocer las características hemodinámicas y contribuir al diagnóstico diferencial entre un tumor y una malformación vascular. La resonancia magnética (RM es el mejor método para evaluar la extensión de las lesiones y su relación con estructuras adyacentes. El diagnóstico preciso del tipo de malformación vascular es importante por su pronóstico y tratamiento diferentes. La Radiología Intervencionista constituye uno de los pilares fundamentales en el manejo terapéutico. Es altamente recomendable un abordaje multidisciplinario dada la complejidad de estas lesiones, particularmente en la elección de las opciones terapéuticas y en el seguimiento clínico de los pacientes.Vascular malformations are rare conditions resulting from the abnormal development of blood vessels. These lesions, together with vascular tumors, represent the vascular anomalies. Vascular malformations are named according to which type of vessel is affected and are classified into high- or low-flow malformations on the basis of flow characteristics. Most vascular malformations are diagnosed according to clinical criteria. However, some require imaging studies to confirm the diagnosis or assess its extension. Doppler ultrasound is the usual initial study for hemodynamic

  9. Hyper-vascular giant cavernous malformation in a child: a case report and review.

    Science.gov (United States)

    Hirata, Koji; Ihara, Satoshi; Sato, Masayuki; Matsumaru, Yuji; Yamamoto, Tetsuya

    2017-02-01

    Giant cavernous malformation (GCM) in children is a rare vascular anomaly, and its natural history is unclear. Despite their giant size, intraparenchymal GCMs are low-flow vascular malformations. Herein, we report a case of hyper-vascular intraparenchymal GCM with an AV shunt in a child. A 3-year-old boy had had an enlarged head since infancy. Magnetic resonance (MR) images on admission showed a strikingly enhanced mass lesion, 6 cm in size. A 4-vessel CAG demonstrated a hyper-vascular mass with an AV shunt. After transarterial embolization, the patient underwent total excision of the mass. The tumor bled easily, during surgery the patient lost 400 cm3 in blood. Histopathological examination confirmed the diagnosis of cavernous hemangioma. The differential diagnosis of intraparenchymal, strikingly-enhanced tumors with an AV shunt include hyper-vascular GCMs. Consideration of potential for bleeding during the operation is also important.

  10. Epidemiology, diagnostics and treatment of vascular tumours and malformations.

    Science.gov (United States)

    Wójcicki, Piotr; Wójcicka, Karolina

    2014-01-01

    Vascular tumours and vascular malformations are common vasculose anomalies characteristic for dissimilar clinical course, specific biological as well as immune cytological and histological properties. Vascular lesions classification system and their detailed division into groups and subgroups were elaborated and implemented in Rome, in 1996, during meeting of the International Society for the Study of Vascular Anomalies (ISSVA). It was based on modification of an earlier going division by Mullikien and Głowacki from 1982. Infantile hemangiomas are the most numerous group of benign tumours of mesenchymal origin. Vascular malformations appear definitely less often. They are composed of normal endothelium lined displastic vessels which originate from vascular tissue abnormal morphogenesis. In contrast, in hemangiomas, at the proliferation stage, increased, multiplication of endothelial cells is observed as well as of fibroblasts, mastocytes and macrophages. Infantile hemangiomas are usually not present at the moment of birth and white chloasma with superficial teleangiectasis appears which increases within 3-4 weeks and gets bright red colour and reveal very characteristic clinical course basing on intensive growth period and involution long process. Vascular malformations are observed most often at the delivery moment or they may appear at an early childhood. They enlarge proportionally along with the child's growth and their sudden expansion may be triggered by an infection, hormonal changes or trauma. Contrary to hemangiomas, they do not subside spontaneously and their abrupt increase may result in impairment or deformation of important anatomical structures. Infantile hemangiomas and vascular malformations require different and individual treatments which are often multi-stage procedures carried on in specialistic centres of plastic surgery, vascular surgery or maxillofacial surgery.

  11. Percutaneous Sclerotherapy of Congenital Slow-Flow Vascular Malformations of the Orbit

    Energy Technology Data Exchange (ETDEWEB)

    Chiramel, George Koshy, E-mail: gkchiramel@gmail.com; Keshava, Shyamkumar Nidugala, E-mail: aparna-shyam@yahoo.com; Moses, Vinu, E-mail: vinu@cmcvellore.ac.in; Mammen, Suraj, E-mail: surajmammen77@gmail.com [Christian Medical College, Department of Radiology (India); David, Sarada, E-mail: saradadavid@gmail.com [Christian Medical College, Department of Ophthalmology (India); Sen, Sudipta, E-mail: paedsur@cmcvellore.ac.in [Christian Medical College, Department of Pediatric Surgery (India)

    2015-04-15

    PurposeThis manuscript describes the clinical features, imaging findings, treatment details, and short-term outcomes of a series of congenital slow-flow vascular malformations.MethodsThis was a prospective study of congenital slow-flow vascular malformations involving the orbital region treated at a single institution with percutaneous sclerotherapy.ResultsTen patients presented during the study period, comprising eight venous malformations, one lymphatic malformation, and one veno-lymphatic malformation. Nine patients underwent percutaneous sclerotherapy under digital subtraction angiography guidance, of which three developed marked rise in intraocular pressure requiring lateral canthotomy. The treatments were performed in the presence of an ophthalmologist who measured the intraorbital pressure during and after the procedure. On follow-up, some of the patients required repeat sessions of sclerotherapy. All patients had improvement of symptoms on follow up after the procedure.ConclusionCongenital slow-flow vascular malformations of the orbital region are rare lesions that should be treated using a multidisciplinary approach. Monitoring of the intraorbital pressure is required both during and after the procedure to decide about the need for lateral canthotomy to reduce the transiently increased intraorbital pressure.

  12. [Congenital vascular malformations: epidemiology, classification and therapeutic basis].

    Science.gov (United States)

    Pereira Albino, J

    2010-01-01

    Congenital vascular malformations are part of the rare diseases of angiology and vascular surgery and can present in a variety of forms. They rise a lot of doubts and many diagnostic and therapeutic challenges. Treatment options are widely variable and often debated; surgeons usually have doubts about the best procedure to adopt. It is also an area of great anatomic and functional variability where the confusion regarding the nomenclature and classifications has been frequent, rendering difficult to adopt standardized measures. There have been significant advances in the recent years towards reaching a consensus. Based on his practical clinical experience and past work on these issues, the author reviews the epidemiology, the classifications and the therapeutic basis of this pathology. The author emphasizes the fact that the International Society for the Study of Vascular Anomalies (ISSVA) classification provides a useful framework for classifying vascular anomalies, as well as the therapeutic percutaneous embolization using polidocanol foam to control venous malformations.

  13. Vascular tumors and malformations in children, Introduction.

    Science.gov (United States)

    Maguiness, Sheilagh M

    2016-03-01

    Over the past decade, I have been amazed at the growth in the field of vascular anomalies. The recognition of vascular birthmarks as a defined area of medicine is a relatively recent event. The International Society for the Study of Vascular Anomalies (ISSVA) was founded by Drs John Mulliken and Anthony Young in the late 1970s. Mulliken and Glowacki's sentinel 1982 paper on the biologic classification of vascular anomalies further established the field, by providing clarity of nomenclature and unifying concepts that had previously been lacking. ©2016 Frontline Medical Communications.

  14. Ultrastructural analysis of vascular features in cerebral cavernous malformations.

    Science.gov (United States)

    Tanriover, Gamze; Sozen, Berna; Seker, Askin; Kilic, Turker; Gunel, Murat; Demir, Necdet

    2013-04-01

    Investigation of the structure of vascular malformations highlights the pathogenic mechanisms underlying their clinical behavior. One of the vascular malformations is called cerebral cavernous malformation (CCM). However, the ultrastructural features of the vascular malformations are not defined in detail. We aimed to investigate the ultrastructural features of CCMs using transmission (TEM), scanning (SEM) electron microscopy, and also immunohistochemistry methods with antibodies against CCM proteins such as CCM2 and CCM3. CCM tissues (n=6) microsurgically excised from patients for conventional indications. CCM2 and CCM3 were strongly detected in the vascular endothelium. However, there was a very weak immunostaining in stroma. SEM observations revealed that there were ruptures and damages in the luminal endothelium, possibly due to the damage of intercellular junctions. TEM observations also showed a few ruptures and detachments between the endothelium and basal lamina as observed with partially damages and disconnections. The architecture of pericytes showed protrusions and shrinkages. Our results suggest that the thin vessel walls of CCMs were lacking of subendothelial support and intact basal lamina underlying the endothelial cells. This study is so far the first study attempting to show human CCM lesions with SEM. We believe that an understanding of the ultrastructural features of these lesions by light and electron microscopy techniques would help to understand the pathology of these diseases. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Occlusion of Pulmonary Arteriovenous Malformations by Use of Vascular Plug

    DEFF Research Database (Denmark)

    Andersen, P E; Kjeldsen, A D

    2007-01-01

    Pulmonary arteriovenous malformations are commonly treated by embolization with coils or balloons to prevent cerebral complications and to raise the oxygenation of the blood. The Amplatzer vascular plug is a new occlusive device made of a self-expanding cylindrical nitinol mesh. It is fast and safe...

  16. [Low-flow synovial vascular malformation of the knee (hemangiolymphangioma) - Case report].

    Science.gov (United States)

    Parra, B Andrea; Valencia, Z Natalia Andrea; Espinal, B David Andrés; Maya, A Isabel Cristina

    2015-01-01

    Low-flow vascular malformation, which usually develops during the first stage of infancy, is a rare cause of recurrent effusion of the knee. History, laboratory and X-rays are usually non-specific. To describe a rare disease in pediatrics, emphasizing the correct classification and suspicion. A case is presented of a two-year-old patient with a history of effusion of the right knee who required multiple hospitalizations and antibiotic treatments. Laboratory work-up was normal. Plain X-rays of the knee revealed no bone changes. MR imaging reported low-flow vascular malformation. Surgical resection was performed, evidencing vascular lesion among the muscle fibers of the vastus lateralis of quadriceps until the capsule of the knee, as well as dissection of the fibers until the vastus lateralis of the right leg. Histology was consistent with low-flow vascular malformation. Due to the benign outcome and favorable evolution, an outpatient management was possible. Although low-flow synovial vascular malformation is a rare disease among the pediatric population, it should be considered in the differential diagnosis of patients with repeated hemarthrosis and no history of either coagulopathy or hemophilia. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  17. Ultrasound-guided Intralesional Bleomycin Injection (IBI for Treatment of Cutaneous Hemangiomas and Vascular Malformations

    Directory of Open Access Journals (Sweden)

    Yousuf Memon

    2016-06-01

    Full Text Available Purpose: To report the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin in the treatment of cutaneous hemangiomas and vascular malformations.Material & Methods: The medical records of patients with cutaneous hemangiomas and vascular malformations treated with the intralesional injection of bleomycin under ultrasound guidance between August 2009 and June 2013 at the Indus Hospital, Karachi were reviewed retrospectively using a computerized medical record information management system. Data were extracted using a pre-coded performa that included patient demographics, type and location of lesion, number of treatments, presenting/pre- and post-treatment clinical symptoms (pain, swelling, heaviness, size, discoloration, ultrasound appearance and vascularity, and post-treatment side effects. The dose range of bleomycin was 0.5-1.0 mg/kg, but not exceeding 15 mg in a single session. A maximum of four treatments were given in any given patient except for one, who presented with recurrence after a year of complete resolution. Therapeutic outcome was determined using review of ultrasound images and recorded clinical assessment. Treatment response was categorized as: (i complete resolution [more than 90% reduction]; (ii substantial reduction [more than 50% reduction]; (iii mild reduction [25% reduction]; or, (iv no improvement [ < 10% reduction]. Results: A total of 30 patients (16 female, 14 male, ranging in age from 8 months to 48 years (mean age 10.2 years, were treated from 2009 to 2013. There were 23 hemangiomas. Seven were vascular malformations, of which five were lymphatic malformations and two were venous malformations. Twenty-eight lesions were located in the head and neck region, and two were peripheral. In 24 of the 30 patients (76%, treatment had been completed. In six patients (21% treatment was ongoing at the time of this report. Seventeen of the 23 hemangiomas (74% were completely resolved clinically and on

  18. Management of extensive intraparotid vascular malformation: a case report

    Directory of Open Access Journals (Sweden)

    Katerina Anesti

    2014-06-01

    Full Text Available Treatment of large soft tissue vascular lesions remains one of the greatest challenges in modern plastic surgery. The extent of the disease and the involved structures, but also the expectations of the patients are important in determining the way of treatment. The effective management of hemangiomas and vascular malformations of the head and neck requires a team approach, in order to understand the biologic behavior of the lesion, complete the diagnostic studies necessary to define the area of involvement, and understand the benefits and limitations of interventional radiologic and surgical procedures. The synthesis of this knowledge can help determine the best treatment. The strategic plan and subsequent management of a 34-year-old Maori man with an extensive arteriovenous intraparotid malformation is presented.

  19. [Hemangiomas and superficial vascular malformations of the face and neck].

    Science.gov (United States)

    De Minteguiaga, C; Casasco, A; Guimaraens, L; Deffrennes, D; Herbreteau, D; Racy, E; Pérez Rull, J; Huy, P Tran Ba

    2002-01-01

    Hemangiomas and superficial vascular anomalies of the head and neck form what usually calls the angiomas. Many terms exist in the literature for that reason the classification of the ISSVA, admitted by most of the doctors, helps us in naming the different anomalies. The processing of this pathology needs a multidisciplinary collaboration with doctors of different specialties. The evolution of the radiological, surgical techniques of laser, and who knows, of the research, allows to hope us to cure some of the particularly dangerous anomalies like the arteriovenous malformations. We presented here the different technics used in 2001 in the management of hemangioma and superficial vascular anomalies insisting on a multidisciplinary approach.

  20. Radiologic evaluation of the therapeutic effect of gamma knife radiosurgery in cerebral vascular malformation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ig Dae; Kim, Il; Jeon, Young Seup; Lee, Jong Yuk; Lee, Young Jun; Cha, Seong Suk; Eun, Choong Ki; Kim, Mu Seong; Sim, Jae Hong [Inje Univ. College of Medicine, Pusan (Korea, Republic of)

    1998-11-01

    To evaluate the therapeutic effect of gamma knife radiosurgery in cerebral vascular malformation using a radiologic imaging method such as MRI or angiography. We retrospectively reviewed MRIs, CT scans and angiograms of 29 cases of arteriovenous malformation and 15 of cavernous malformation before and after gamma knife radiosurgery. The patients underwent follow-up radiologic studies for between 6 and 35 months after radiosurgery. No patient underwent other surgery or embolization. Radiological imaging analysis focused on changes in the volume of the nidus or central core. Other findings of edema, cystic change, hemorrhage, signal intensity, enhancement and distributional vascular markings were also studied. The volume of the AVM nidus was measured and assigned to one of four groups:<1cc, 1-4cc,>4-10cc and >10cc. In arteriovenous malformation cases, the volume of the nidus decreased by mean 60.2%;reduction was greatest(68.1%) in the 1-4cc group. Three cases showed complete loss of the nidus at 9, 12 and 25 months after radiosurgery, respectively. In nine cases, decreased caliber or loss of draining vein was noted. High signal intensity on T2-weighted MR images, suggesting either edema or demyelination, was observed in four cases. In cavernous angioma cases, core volume was reduced by 36.8%. Transient cerebral edema and presumed radiation necrosis were observed in two cases and one, respectively. Gamma knife surgery was effective in nearly all cases of arteriovenous malformation and some cases of cavernous malformation. More than two years follow-up involving radiologic imaging such as MRI is needed for the evaluation of therapeutic effect and diagnosis of complications.=20.

  1. Efficacy of embolization in traumatic uterine vascular malformations.

    Science.gov (United States)

    Ghai, Sangeet; Rajan, Dheeraj K; Asch, Murray R; Muradali, Derek; Simons, Martin E; TerBrugge, Karel G

    2003-11-01

    To evaluate the efficacy of embolotherapy in patients with bleeding traumatic uterine arteriovenous malformations (AVMs). A retrospective review of all patients who underwent pelvic arterial embolization at our institution between July 1992 and September 2002 was performed. Fifteen patients were diagnosed with a uterine vascular malformation on duplex ultrasonography and correlative MR imaging. Serial beta-human chorionic gonadotropin levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of the uterine arteries. Embolizations were performed with use of standard 4-5-F catheters and microcatheters when necessary. Embolic agents in the 25 procedures included glue only (n = 13), polyvinyl alcohol (PVA) particles and glue (n = 4), PVA particles (n = 2), Gelfoam (n = 2), coils (n = 1), PVA particles and coils (n = 1), glue and Gelfoam (n = 1), and glue and coils (n = 1). PVA particle size ranged from 350 to 1,000 micro m. Outcomes assessed were cessation of bleeding, persistence or resolution of the AVM, complications, and pregnancy after embolization. These were assessed by chart, laboratory, and imaging reviews. A total of 25 embolization procedures were performed in 15 patients. Six patients required repeat embolization (one patient underwent embolization on six occasions; five patients had two embolization procedures each) for recurrence of bleeding. Sixteen procedures were performed on an elective basis and nine were performed on an emergent basis. The technical success rate of embolization was 100%. The clinical success rate was 93%: bleeding was controlled in 14 of 15 patients and one patient underwent a hysterectomy. Four of the 15 patients subsequently had a total of five uneventful intrauterine pregnancies carried to term. The 14 patients who underwent successful embolization had no recurrence of bleeding at a median follow-up of 53 months (range, 3-124 months) after treatment. Three patients were

  2. The use of 3D computer graphics in the diagnosis and treatment of spinal vascular malformations.

    Science.gov (United States)

    Takai, Keisuke; Kin, Taichi; Oyama, Hiroshi; Iijima, Akira; Shojima, Masaaki; Nishido, Hajime; Saito, Nobuhito

    2011-12-01

    Digital subtraction (DS) angiography is the gold standard for diagnosing spinal vascular malformations. Recently, multidetectorrow spiral CT and contrast-enhanced MR angiography have been introduced as screening examinations before DS angiography. These methods, however, do not always determine the accurate location of an arteriovenous shunt because the resulting images lack information about the spinal cord or the dura mater. Between April 2009 and December 2010, 13 patients underwent imaging evaluations for spinal vascular malformations at the authors' university hospital. This group included 8 patients with spinal dural arteriovenous fistulas (AVFs), 3 with perimedullary AVFs, and 2 with intramedullary arteriovenous malformations. Using data from these patients, the authors attempted to develop 3D computer graphics (CG) based upon the fusion of 3D rotational angiography and postmyelographic CT. They subsequently verified the accuracy of this imaging method. Ten of these 13 patients underwent surgical treatment for their lesions (11 AVFs), and for these 11 lesions the authors compared the diagnoses obtained using 3D CG with those obtained using conventional DS angiography. In all 13 cases, 3D CG images of the spinal lesions were successfully developed using the patients' actual data. Four (36%) of 11 AVFs were correctly identified using DS angiography, whereas 10 (91%) were correctly identified using 3D CG. Results from 3D CG of spinal AVFs corresponded well with operative findings, and 3D CG was significantly better than conventional DS angiography at predicting AVF location (p = 0.024, Fisher exact test). To the authors' knowledge, this is the first reported case series in which 3D CG of spinal vascular malformations was used to provide simultaneous, stereoscopic visualization of the spinal vascular system, spinal cord, dura mater, and bone. The 3D CG method provides precise visual images for the diagnosis and treatment of these lesions.

  3. Imaging of vascular tumors with an emphasis on ISSVA classification.

    Science.gov (United States)

    Nozaki, Taiki; Matsusako, Masaki; Mimura, Hidefumi; Osuga, Keigo; Matsui, Mizuko; Eto, Hikaru; Ohtake, Naoyuki; Manabe, Atsushi; Kusakawa, Isao; Tsutsumi, Yoshiyuki; Nosaka, Shunsuke; Kamo, Minobu; Saida, Yukihisa

    2013-12-01

    The International Society for the Study of Vascular Anomalies (ISSVA) classification is becoming the international standard classification system for vascular tumors and vascular malformations. The ISSVA classification strictly distinguishes vascular tumors (neoplastic lesions) from vascular malformations (non-neoplastic lesions) based on whether there is a proliferation of vascular endothelial cells present, and it is an extremely useful classification system for determining therapeutic measures. For vascular tumors, it is clinically significant in terms of discriminating infantile hemangioma and rapidly involuting congenital hemangioma, which are expected to spontaneously regress, from other vascular tumors requiring treatment. Needless to say, clinical courses are important for diagnosis, and it is also important for radiologists to understand imaging findings on vascular tumors because such tumors have unique findings on diagnostic images. In this paper, vascular tumors are classified based on the ISSVA classification, and clinical and imaging findings are reviewed.

  4. [Extracranial vascular anomalies (hemangiomas and vascular malformations) in children and adolescents--diagnosis, clinic, and therapy].

    Science.gov (United States)

    Eivazi, B; Werner, J A

    2014-03-01

    The field of extracranial vascular anomalies is considered as special focus of pediatric otolaryngology and it has shown a rapid development during the last years. The reason for this interest is finally also due to the global acceptance of the classification introduced by the ISSVA (International Society for the Study of Vascular Anomalies). Hemangiomas are the most frequently observed vascular tumors. Today the systemic propranolol therapy is mostly used for therapy of hemangiomas requiring treatment. Increasingly, the topical application of beta blocker is discussed while the benefit in the head and neck seems to be limited. Vascular malformations are classified according to the morphology of the affected part of the vascular system in arterial, venous, arterio-venous, lymphatic, capillary, and combined vascular malformations. Conventional surgery, sclerosing therapy, and laser treatment are invasive options for the treatment of lymphatic malformations. The options for the treatment of venous malformations could be significantly improved during the last years. In this context, the use of Nd:YAG laser, the conservative treatment of the localized disseminated intravascular coagulation with low-molecular weight heparin, the re-discovery of bleomycin as effective sclerosing agent, and the improvement of alcohol-based embolization agents must be mentioned. Today the treatment with dye laser is the preferred therapy for capillary malformations and it is superior to other therapeutic options as for example photodynamic therapy. Arterio-venous malformations as representatives for high-flow lesions are the high-risk lesions. Frequently they are compared to malignant head and neck tumors, in particular when a curative treatment can no longer be assured because of diffuse or multifocal extent and when the disease shows a progressive course. The combined treatment of embolization and surgical resection and if necessary consecutive defect reconstruction have turned out to be

  5. A Diagnostic Program of Vascular Tumor and Vascular Malformations in Children According to Modern Classification.

    Science.gov (United States)

    Benzar, Iryna

    The aim of the study was to analyze the cohort of inpatient children with vascular anomalies according to the globally accepted classification introduced by the ISSVA. The study included 205 inpatient children within the time period of the years 2010-2015. Types of vascular anomalies (VAs), age of patients, diagnostic procedures, and anatomical localization of VAs were analyzed. 65 patients of first year of life had vascular tumors, with prevalence of infantile hemangiomas (IHs) in 57 (87.7%) patients. 45 children had IHs localized within soft tissues, whereas 7 patients suffered from IHs of the liver, and 5 children from IHs of the respiratory tract. Most patients with soft tissue IHs were diagnosed only with ultrasound; СT or MRI diagnostics were performed on 5 (8.8%) patients, and biopsy was carried out in 2 (4.4%) children. Vascular malformations (VM) were diagnosed in 140 (68.3%) patients. Ultrasound investigation (US) was the screening method. MRI was performed to confirm the diagnosis of low-flow VM, whereas for high-flow VM CT angiography and selective angiography were useful. Venous malformations were diagnosed in 17 (12.1%) patients, and 112 (80.0%) had cystic LM, among them children under the age of 2 years prevailed. Arteriovenous malformations were diagnosed in 5 (3.8%) patients, ages 2-14 years. Clinical manifestations of vascular anomalies have clear age features. Among hospitalized children vascular tumors add up to 31.7% and VM - up to 68.3%.

  6. Magnetic resonance imaging features of complex Chiari malformation variant of Chiari 1 malformation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Hannah E. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Moore, Kevin R. [University of Utah School of Medicine, Department of Radiology, Salt Lake City, UT (United States); Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States)

    2014-11-15

    Complex Chiari malformation is a subgroup of Chiari 1 malformation with distinct imaging features. Children with complex Chiari malformation are reported to have a more severe clinical phenotype and sometimes require more extensive surgical treatment than those with uncomplicated Chiari 1 malformation. We describe reported MR imaging features of complex Chiari malformation and evaluate the utility of craniometric parameters and qualitative anatomical observations for distinguishing complex Chiari malformation from uncomplicated Chiari 1 malformation. We conducted a retrospective search of the institutional imaging database using the keywords ''Chiari'' and ''Chiari 1'' to identify children imaged during the 2006-2011 time period. Children with Chiari 2 malformation were excluded after imaging review. We used the first available diagnostic brain or cervical spine MR study for data measurement. Standard measurements and observations were made of obex level (mm), cerebellar tonsillar descent (mm), perpendicular distance to basion-C2 line (pB-C2, mm), craniocervical angle (degrees), clivus length, and presence or absence of syringohydromyelia, basilar invagination and congenital craniovertebral junction osseous anomalies. After imaging review, we accessed the institutional health care clinical database to determine whether each subject clinically met criteria for Chiari 1 malformation or complex Chiari malformation. Obex level and craniocervical angle measurements showed statistically significant differences between the populations with complex Chiari malformation and uncomplicated Chiari 1 malformation. Cerebellar tonsillar descent and perpendicular distance to basion-C2 line measurements trended toward but did not meet statistical significance. Odontoid retroflexion, craniovertebral junction osseous anomalies, and syringohydromyelia were all observed proportionally more often in children with complex Chiari malformation than in

  7. Case series on vascular malformation and their review with regard to terminology and categorization

    Directory of Open Access Journals (Sweden)

    Devi Charan Shetty

    2010-01-01

    Full Text Available Malformations of vascular nature originate as anomalies caused due to errors in vasculogenesis. These tumors are generally broadly classified into vascular tumors (hemangiomas and vascular malformations (venous malformations, arteriovenous malformations, lymphatic malformations. These descriptive tumors and malformations have been categorized based on the architectural assembly of vessels. Lymphangiomas are further subclassified microscopically into capillary, cavernous, cystic and lymphangioendothelioma, depending upon their histopathological features. Lymphatic malformations or lymphangiomas are uncommon congenital malformations of the lymphatic system, usually occurring in the head and neck region, characterized by collections of ectatic lymph vessels that form endothelial lined cystic spaces. Advancements in the knowledge of pathogenesis of such vascular malformations are continuously changing their treatment protocols. Early recognition is of utmost importance for initiation of proper treatment and avoiding serious complications. Hemangiolymphangioma is a variant of lymphangioma showing vascular component. Herewith, we present a case of vascular malformation diagnosed as hemangiolymphangioma histopathologically in a 9-year-old girl, along with a review of literature regarding its categorization.

  8. Discrepancy between the clinical and histopathologic diagnosis of soft tissue vascular malformations

    NARCIS (Netherlands)

    Horbach, Sophie E. R.; Utami, Amalia M.; Meijer-Jorna, Lorine B.; Sillevis Smitt, J. H.; Spuls, Phyllis I.; van der Horst, Chantal M. A. M.; van der Wal, Allard C.

    2017-01-01

    Soft tissue vascular malformations are generally diagnosed clinically, according to the International Society for the Study of Vascular Anomalies (ISSVA) classification. Diagnostic histopathologic examination is rarely performed. We sought to evaluate the validity of the current diagnostic workup

  9. Vascular malformations in pediatrics; Vaskulaere Erkrankungen bei Neugeborenen, Saeuglingen und Kindern

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W. [Abteilung fuer Neuroradiologie, Radiologische Universitaetsklinik Homburg/Saar (Germany); Abteilung fuer Neuroradiologie, Radiologische Universitaetsklinik, 66421, Homburg/Saar (Germany); Shamdeen, M.G. [Kinderklinik, Universitaetsklinikum Homburg/Saar (Germany)

    2003-11-01

    Vascular malformations are the cause of nearly all non-traumatic intracranial hemorrhage in children beyond the neonatal stage. Therefore, any child presenting with spontaneous intracranial hemorrhage should be evaluated for child abuse and for vascular malformations. Intracerebral malformations of the cerebral vasculature include vein of Galen malformations, arteriovenous malformation (AVM), cavernomas, dural arteriovenous fistulas, venous anomalies (DVA), and capillary teleangiectasies. Although a few familial vascular malformation have been reported, the majority are sporadic. Clinical symptoms, diagnostic and therapeutic options are discussed. (orig.) [German] Vaskulaere Malformationen sind die haeufigste Ursache einer intrakraniellen Blutung im Saeuglings- und Kindesalter. Deswegen sollte jedes Kind mit einer intrakraniellen Blutung auf eine vaskulaere Malformation und Kindesmisshandlung untersucht werden. Intrazerebrale Gefaessmalformationen beinhalten Vena-Galeni-Anomalien, arteriovenoese Malformationen (AVM), Kavernome, durale arteriovenoese Fisteln, kapillaere Teleangiektasien und venoese Anlagevarianten (DVA). Obwohl einige familiaere Gefaessmalformationen beschrieben sind, tritt die ueberwiegende Mehrzahl spontan auf. Die Klinik, Diagnostik und therapeutischen Optionen werden diskutiert. (orig.)

  10. Development of an international core outcome set for peripheral vascular malformations (OVAMA project)

    NARCIS (Netherlands)

    Horbach, S. E. R.; van der Horst, C. M. A. M.; Blei, F.; van der Vleuten, C. J. M.; Frieden, I. J.; Richter, G. T.; Tan, S. T.; Muir, T.; Penington, A.; Boon, L. M.; Spuls, P. I.

    2017-01-01

    An important limitation in vascular malformation research is the heterogeneity in outcome measures used for the evaluation of treatment outcome. The Outcome measures for VAscular MAlformations (OVAMA) project aimed to reach international consensus on a core outcome set (COS) for clinical research on

  11. Compression therapy for congenital low-flow vascular malformations of the extremities: A systematic review

    NARCIS (Netherlands)

    Langbroek, Ginger B.; Horbach, Sophie E. R.; van der Vleuten, Carine J. M.; Ubbink, Dirk T.; van der Horst, Chantal M. A. M.

    2018-01-01

    Introduction Low-flow vascular malformations are congenital abnormalities of the veins, capillaries or lymphatic vessels or a combination of the previous. Compressive garments are frequently used as a first-line treatment option for low-flow vascular malformations of the extremities with the purpose

  12. A Diagnostic Program of Vascular Tumor and Vascular Malformations in Children According to Modern Classification

    Directory of Open Access Journals (Sweden)

    Iryna Benzar

    2017-06-01

    Full Text Available The aim of the study was to analyze the cohort of inpatient children with vascular anomalies according to the globally accepted classification introduced by the ISSVA. Methods: The study included 205 inpatient children within the time period of the years 2010–2015. Types of vascular anomalies (VAs, age of patients, diagnostic procedures, and anatomical localization of VAs were analyzed. Results: 65 patients of first year of life had vascular tumors, with prevalence of infantile hemangiomas (IHs in 57 (87.7% patients. 45 children had IHs localized within soft tissues, whereas 7 patients suffered from IHs of the liver, and 5 children from IHs of the respiratory tract. Most patients with soft tissue IHs were diagnosed only with ultrasound; СT or MRI diagnostics were performed on 5 (8.8% patients, and biopsy was carried out in 2 (4.4% children. Vascular malformations (VM were diagnosed in 140 (68.3% patients. Ultrasound investigation (US was the screening method. MRI was performed to confirm the diagnosis of low-flow VM, whereas for high-flow VM CT angiography and selective angiography were useful. Venous malformations were diagnosed in 17 (12.1% patients, and 112 (80.0% had cystic LM, among them children under the age of 2 years prevailed. Arteriovenous malformations were diagnosed in 5 (3.8% patients, ages 2–14 years. Conclusions: Clinical manifestations of vascular anomalies have clear age features. Among hospitalized children vascular tumors add up to 31.7% and VM – up to 68.3%.

  13. Acquire uterine vascular malformation: Clinical outcome of transarterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Chae Hoon [Dept. of Radiology, Gangneung Asan Hospital, Gangneung (Korea, Republic of); Yang, Seung Boo; Goo, Dong Erk; Kim, Yong Jae; Lee, Jae Myung; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of)

    2017-02-15

    To evaluate clinical outcomes of transarterial embolization of bilateral uterine arteries (UAE) in patients with acquired uterine vascular malformation (UVM). This retrospective study was performed on the medical records of all 19 patients who underwent transarterial embolization of bilateral UAE for the treatment of symptomatic UVMs from January 2003 to June 2011. Embolization was performed via the unilateral femoral artery approach with a catheter and angiographic techniques. Clinical success was defined as definitive resolution of abnormal vaginal bleeding. Post-procedural complications included all adverse events related to the embolization procedure. A total of 20 procedures were performed in 19 patients. One patient required repeat embolization because of incomplete embolization related to prominent high flow malformation. Clinically, in all patients, bleeding was controlled immediately after embolization. No complications occurred in all patients during the follow up period. In all patients who underwent successful UAE, menstrual cycles were normally restored within 1-2 months. Normal pregnancy with term delivery was observed in two of the 19 cases. Transarterial bilateral UAE is a safe and effective treatment in patients with vaginal bleeding caused by acquired UVM, and it allows the possibility of future pregnancy.

  14. Factors predicting language lateralization in patients with perisylvian vascular malformations

    Science.gov (United States)

    Lee, Darrin J.; Pouratian, Nader; Bookheimer, Susan Y.; Martin, Neil A.

    2017-01-01

    Object The authors conducted a study to determine the factors associated with right-sided language dominance in patients with cerebrovascular malformations. Methods Twenty-two patients with either arteriovenous malformations (AVMs [15 cases]) or cavernous malformations (7 cases) underwent functional MR (fMR) imaging studies of language function; a 3.0-T head-only unit was used. Lateralization indices were calculated separately for Broca and Wernicke areas. Lesion size, Spetzler-Martin grade, and the distance between the lesion and anatomically defined language cortex were calculated for each patient. Results Right-sided language dominance occurred in 5 patients, all of whom had AVMs within 10 mm of canonical language areas. Three patients had right-sided language dominance in the Wernicke area alone whereas 2 had right-sided language dominance in both Broca and Wernicke areas. Wada testing and intraoperative electrocortical stimulation were performed as clinically indicated to corroborate fMR imaging findings. Conclusions The primary factor associated with right-sided language dominance was the AVM being within 10 mm of anatomically defined language areas. The lesion size and the Spetzler-Martin grade were not significant factors. Anomalous fMR imaging laterality was typically confined to the language area proximate to the lesion, with the distal language area remaining in the left hemisphere dominant. This study emphasizes the need to map each case individually in patients with left perisylvian AVMs. Assumptions about eloquent cortex based on anatomical landmarks (a key component of Spetzler-Martin grading) may have to be reconsidered. PMID:20302390

  15. Acquired progressive ataxia and palatal tremor: importance of MRI evidence of hemosiderin deposition and vascular malformations.

    Science.gov (United States)

    Kumar, Neeraj; Eggers, Scott D Z; Milone, Margherita; Keegan, B Mark

    2011-08-01

    Oculopalatal tremor is frequently accompanied by progressive ataxia. In symptomatic oculopalatal tremor the ataxia frequently is delayed in onset. Progressive ataxia is a defining clinical feature of superficial siderosis. We report 5 cases with palatal tremor and ataxia. Four cases had evidence of intraparenchymal hemosiderin deposition on T2-gradient-echo imaging. Three cases had a brainstem vascular malformation. In two cases the hemosiderin deposition was likely due to prior trauma. The significance of these associations and possible similarities between ataxia related to superficial siderosis and ataxia and intraparenchymal hemosiderin is discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Polypoid vascular and lymphatic malformation of the duodenum: a case report.

    Science.gov (United States)

    Kim, Jeong Wook; Oh, Hyoung Chul; Kim, Mi Kyung; Kim, Jae Gyu

    2010-03-01

    Polypoid vascular and lymphatic malformation of the small intestine is rare. We report the case of a polypoid vascular and lymphatic malformation of the duodenum in a 58-year-old woman presenting with post-prandial epigastric discomfort. She did not have common symptoms of intestinal vascular and lymphatic malformation, such as gastrointestinal bleeding, steatorrhea, and hypoalbuminemia. A 5.0x0.8-cm semipedunculated polypoid lesion was found in the duodenal bulb with protrusion into the prepyloric antrum and was successfully removed using an endoscopic snare.

  17. Laser therapy and sclerotherapy in the treatment of oral and maxillofacial hemangioma and vascular malformations

    Science.gov (United States)

    Crişan, Bogdan; BǎciuÅ£, Mihaela; BǎciuÅ£, Grigore; Crişan, Liana; Bran, Simion; Rotar, Horatiu; Moldovan, Iuliu; Vǎcǎraş, Sergiu; Mitre, Ileana; Barbur, Ioan; Magdaş, Andreea; Dinu, Cristian

    2016-03-01

    Hemangioma and vascular malformations in the field of oral and maxillofacial surgery is a pathology more often found in recent years in patients. The aim of this study was to evaluate the efficacy of the laser photocoagulation performed with a diode laser (Ga-Al-As) 980 nm wavelength in the treatment of vascular lesions which are located on the oral and maxillofacial areas, using color Doppler ultrasonography for evaluation of the results. We also made a comparison between laser therapy and sclerotherapy in order to establish treatment protocols and recommendations associated with this pathology. We conducted a controlled study on a group of 92 patients (38 male and 54 female patients, with an average age of 36 years) having low flow hemangioma and vascular malformations. Patients in this trial received one of the methods of treatment for vascular lesions such as hemangioma and vascular malformations: laser therapy or sclerotherapy. After laser therapy we have achieved a reduction in size of hemangioma and vascular malformations treated with such a procedure, and the aesthetic results were favorable. No reperfusion or recanalization of laser treated vascular lesions was observed after an average follow-up of 6 to 12 months. In case of sclerotherapy a reduction in the size of vascular lesions was also obtained. The 980 nm diode laser has been proved to be an effective tool in the treatment of hemangioma and vascular malformations in oral and maxillofacial area. Laser therapy in the treatment of vascular lesions was more effective than the sclerotherapy procedure.

  18. Prenatal diagnosis of concurrent facial and cerebral vascular malformation which caused congestive heart failure

    Directory of Open Access Journals (Sweden)

    Behnaz Moradi

    2017-12-01

    Full Text Available Arteriovenous malformations (AVMs are rarely reported antenatally. Most in utero diagnosis of vascular malformation is related to vein of Galen malformation (VGM. We describe a case of simultaneously diagnosed pial arteriovenous fistula (AVF and facial vascular malformation in a 20 weeks old fetus. The dilated intracranial venous pouch appeared as a midline anechoic structure which was misdiagnosed as a VGM in her previous ultrasound exam. Another AVM was diagnosed in the same side of fetal face which fed by a branch of external carotid artery and communicated with the mentioned pial AVF. High output cardiac failure and hydrops were evident. To our knowledge this is the first report of prenatally detected combination of facial and cerebral vascular malformations at such as early pregnancy week.

  19. Diagnostic dilemma in vascular mal-formation of the upper lip: a ...

    African Journals Online (AJOL)

    Background: Vascular lesions are broad term used for a wide range of conditions that results in abnormal number, structure, or position of blood vessels now widely divided in two groups; vascular tumors and vascular malformations. These lesions could be clinically diagnosed with 90% accuracy, however radiographic ...

  20. Microvascular proliferation in congenital vascular malformations of skin and soft tissue

    NARCIS (Netherlands)

    Meijer-Jorna, Lorine B.; van der Loos, Chris M.; de Boer, Onno J.; van der Horst, Chantal M. A. M.; van der Wal, Allard C.

    2007-01-01

    BACKGROUND: Congenital vascular malformations (VMs) are mass-forming lesions that usually progress slowly, but may become symptomatic because of episodes of sudden growth and pain, particularly those with a substantial component of arteriovenous shunting. AIM: To systematically investigate the

  1. Vein of Galen malformation: What to do when vascular access is not feasible?

    Directory of Open Access Journals (Sweden)

    Zenteno Marco

    2014-06-01

    Full Text Available Background: The vein of Galen aneurysmal malformation (GVAM is a rare congenital vascular lesion, with high morbidity and mortality without treatment, endovascular management is the best alternative available today.

  2. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A

    2017-01-01

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability...

  3. Bleeding recurrence in patients with gastrointestinal vascular malformation after thalidomide.

    Science.gov (United States)

    Chen, Haiying; Fu, Sengwang; Feng, Nan; Chen, Huimin; Gao, Yunjie; Zhao, Yunjia; Xue, Hanbing; Zhang, Yao; Li, Xiaobo; Dai, Jun; Fang, Jingyuan; Ge, Zhizheng

    2016-08-01

    Thalidomide may be used for the treatment of gastrointestinal vascular malformation (GIVM), but the long-term response and adverse effects are unknown. Aim to study the recurrence rate of GIVM bleeding after thalidomide treatment, the response to treatment, and the adverse effects.This was a retrospective study of 80 patients with GIVM treated with thalidomide between November 2003 and November 2013. Patients received a course of 100 mg/day of thalidomide for 4 months and were followed up for at least 1 year. The response rate during follow-up, the recurrence rate after the 1st course of treatment, and the rate of retreatment were assessed. Comorbidities, the need for blood transfusion, yearly bleeding episodes, hemoglobin levels, hospitalization after thalidomide treatment, and the rate of adverse effects were also examined.The overall response rate during follow-up was 79.5% (62/78). The recurrence rate was 21.0% after the 1st course of thalidomide. The response rate of retreatment was 100%. After thalidomide treatment, yearly blood transfusion amounts, yearly bleeding episodes, and yearly hospitalization numbers were significantly decreased, while hemoglobin levels were significantly increased (P Thalidomide showed a good response rate and low adverse effect rate in patients with recurrent gastrointestinal bleeding due to GIVM.

  4. Pharmacological Therapy of Vascular Malformations of the Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    Andrew Szilagyi

    2006-01-01

    Full Text Available Vascular malformation (AVM in the gastrointestinal tract is an uncommon, but not rare, cause of bleeding and iron deficiency anemia, especially in an aging population. While endoscopic coagulative therapy is the method of choice for controlling bleeding, a substantial number of cases require additional therapy. Adjunctive or even primary phamacotherapy may be indicated in recurrent bleeding. However, there is little evidence-based proof of efficacy for any agent. The bulk of support is derived from anecdotal reports or case series. The present review compares the outcome of AVM after no intervention, coagulative therapy or focus on pharmacological agents. Most of the literature encompasses two common AVMs, angiodysplasia and hereditary hemorrhagic telangiectasia. Similarly, the bulk of information evaluates two therapies, hormones (estrogen and progesterone and the somatostatin analogue octreotide. Of these, the former is the only therapy evaluated in randomized trials, and the results are conflicting without clear guidelines. The latter therapy has been reported only as case reports and case series without prospective trials. In addition, other anecdotally used medications are discussed.

  5. [Classification of vascular tumors and malformations: basis for classification and clinical purpose].

    Science.gov (United States)

    Moure, C; Reynaert, G; Lehmman, P; Testelin, S; Devauchelle, B

    2007-06-01

    Vascular anomalies are a complex pathological group. They are especially difficult to study because of confusion in the terminology used. The classification developed by the ISSVA (International Society for the Study of Vascular Anomalies) now allows using a common scientific language. The classification is based on clinical, radiological, hemodynamic, and histological arguments. There are two groups of lesions: vascular tumors and vascular malformations. Vascular tumors are associated to vascular proliferation. They are called hemangioma and can be infantile or congenital. Vascular malformations are associated to vessels with morphologic anomalies. They are classified according to the distorted vessel type, capillary, venous, lymphatic, and arteriovenous). Such a classification has many implications. It is a guide for the orientation of radiological exams and treatment of vascular anomalies. The management of these anomalies is still difficult and must involve an interdisciplinary approach.

  6. Brain Vascular Imaging Techniques

    Directory of Open Access Journals (Sweden)

    Bàrbara Laviña

    2016-12-01

    Full Text Available Recent major improvements in a number of imaging techniques now allow for the study of the brain in ways that could not be considered previously. Researchers today have well-developed tools to specifically examine the dynamic nature of the blood vessels in the brain during development and adulthood; as well as to observe the vascular responses in disease situations in vivo. This review offers a concise summary and brief historical reference of different imaging techniques and how these tools can be applied to study the brain vasculature and the blood-brain barrier integrity in both healthy and disease states. Moreover, it offers an overview on available transgenic animal models to study vascular biology and a description of useful online brain atlases.

  7. Imaging in spine and spinal cord malformations

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Andrea E-mail: a.rossi@panet.itandrearossi@ospedale-gaslini.ge.it; Biancheri, Roberta; Cama, Armando; Piatelli, Gianluca; Ravegnani, Marcello; Tortori-Donati, Paolo

    2004-05-01

    Spinal and spinal cord malformations are collectively named spinal dysraphisms. They arise from defects occurring in the early embryological stages of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal dysraphisms are categorized into open spinal dysraphisms (OSDs), in which there is exposure of abnormal nervous tissues through a skin defect, and closed spinal dysraphisms (CSD), in which there is a continuous skin coverage to the underlying malformation. Open spinal dysraphisms basically include myelomeningocele and other rare abnormalities such as myelocele and hemimyelo(meningo)cele. Closed spinal dysraphisms are further categorized based on the association with low-back subcutaneous masses. Closed spinal dysraphisms with mass are represented by lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category further comprises defects of midline notochordal integration (basically represented by diastematomyelia) and defects of segmental notochordal formation (represented by caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging (MRI) is the preferred modality for imaging these complex abnormalities. The use of the aforementioned classification scheme is greatly helpful to make the diagnosis.

  8. Vascular anomalies in pediatric patients: updated classification, imaging, and therapy.

    Science.gov (United States)

    Kollipara, Ramya; Odhav, Ashika; Rentas, Kenny E; Rivard, Douglas C; Lowe, Lisa H; Dinneen, Laura

    2013-07-01

    Recent advances in knowledge regarding histopathology, cause, and treatment of pediatric vascular anomalies have led to substantial changes in classification and terminology. Over the past two decades, various subspecialists have adopted a new classification system proposed by the International Society for the Study of Vascular Anomalies (ISSVA). The ISSVA classification of vascular anomalies divides vascular anomalies into two categories: vascular neoplasms and malformations. It has been widely adopted by various pediatric subspecialists, because it reliably correlates patient presentation and disease progression, with more accurate histology, diagnosis, imaging, and treatment. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Hereditary intraosseous vascular malformation of the craniofacial region: an apparently novel disorder.

    Science.gov (United States)

    Vargel, Ibrahim; Cil, Barbaros E; Er, Nuray; Ruacan, Sevket; Akarsu, A Nurten; Erk, Yucel

    2002-04-15

    Primary intraosseous vascular anomaly, previously called intraosseous hemangioma, is a very rare malformation that is usually seen in the vertebral column and in the skull. It is exclusively described in sporadic cases and no hereditary component has yet been reported. The most commonly affected bones in the skull are the mandible and the maxilla, and life-threatening bleeding after a simple tooth extraction is frequently observed. Here, we report two consanguineous families containing a total of four affected patients manifesting primary intraosseous vascular malformation (VMOS (vascular malformation osseous)) of the craniofacial region. The phenotypic expression is remarkably similar in both families. The characteristic findings include severe blood vessel expansions within the craniofacial bones and midline abnormalities such as diastasis recti, supraumbilical raphe, and hiatus hernia. Malformation is restricted to the mandibular and maxillary area in the prepubertal age, and rapid expansion starts after age 12 or 13. A 15-year follow-up of one of the patients demonstrated that the vascular malformation did not extend beyond the craniofacial region despite severe involvement of almost all bones in the skull. Detailed clinical and radiological evaluation provided neither evidence of soft-tissue involvement nor any sign of gross arterial, venous, or combined malformations, indicating that bone changes are a primary rather than a secondary effect due to any other vascular anomaly in the craniofacial region. An antibody against a universal proliferation marker, Ki-67, detected nonproliferative, single-layered endothelial cells, suggesting that this abnormality is a vascular malformation rather than a hemangioma. alpha-actin staining (antibody against perivascular tissue such as smooth muscle cells (SMCs) and/or pericytes) demonstrated that pathologic vessels lost their surrounding supportive tissues, as was previously seen in other types of vascular anomaly

  10. Pulmonary vascular imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fedullo, P.F.; Shure, D.

    1987-03-01

    A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any ideal technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the gold standard for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques.

  11. Discrepancy between the clinical and histopathologic diagnosis of soft tissue vascular malformations.

    Science.gov (United States)

    Horbach, Sophie E R; Utami, Amalia M; Meijer-Jorna, Lorine B; Sillevis Smitt, J H; Spuls, Phyllis I; van der Horst, Chantal M A M; van der Wal, Allard C

    2017-11-01

    Soft tissue vascular malformations are generally diagnosed clinically, according to the International Society for the Study of Vascular Anomalies (ISSVA) classification. Diagnostic histopathologic examination is rarely performed. We sought to evaluate the validity of the current diagnostic workup without routinely performed diagnostic histopathology. We retrospectively determined whether there were discrepancies between clinical and histopathologic diagnoses of patients with clinically diagnosed vascular malformations undergoing therapeutic surgical resections in our center (2000-2015). Beforehand, a pathologist revised the histopathologic diagnoses according to the ISSVA classification. Clinical and histopathologic diagnoses were discrepant in 57% of 142 cases. In these cases, the pathologist indicated the diagnosis was not at all a vascular malformation (n = 24; 17%), a completely different type of vascular malformation (n = 26; 18%), or a partially different type with regard to the combination of vessel-types involved (n = 31; 22%). Possible factors associated with the discrepancies were both clinician-related (eg, diagnostic uncertainty) and pathology-related (eg, lack of immunostaining). Retrospective analysis of a subgroup of patients undergoing surgery. The large discrepancy between clinical and histopathologic diagnoses raises doubt about the validity of the current diagnostic workup for vascular malformations. Clear clinical and histopathologic diagnostic criteria might be essential for a uniform diagnosis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Percutaneous angio-embolization of a post laparoscopy complex utero-adenexal vascular malformation

    Directory of Open Access Journals (Sweden)

    Verma Ashish

    2008-01-01

    Full Text Available Vascular abnormalities are uncommon causes of uterine bleeding. Laparoscopic surgeries, however, require expertise and improper techniques can lead to major vascular complications. We report an unusual case of utero-adenexal arterio- venous fistula with arterio - venous malformation due to pelvic trauma caused during laparoscopic sterilisation procedure, which was treated by percutaneous embolisation technique. To the best of our knowledge, this is the first documentation of such a complex vascular injury caused by laparoscopic sterilisation and its endovascular management

  13. MR imaging of anorectal malformations and associated anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Nievelstein, R.A.J.; Valk, J. [Department of Diagnostic Radiology, Free University Hospital, Amsterdam (Netherlands); Vos, A. [Department of Pediatric Surgery, Free University Hospital, Amsterdam (Netherlands)

    1998-05-01

    Congenital anorectal malformations are found in many forms, and are frequently associated with other anomalies, especially of the spinal cord, spine, and urogenital system. Decisions concerning initial management of children with anorectal malformations can be made only after accurate determination of (a) the level and type of malformation, (b) the type of fistula, (c) the developmental state of the sphincter muscle complex, and (d) the presence of associated anomalies. Magnetic resonance imaging has proven to be the only modality to answer all these crucial questions, and has contributed to a better insight in the morphology and pathogenesis of such complex congenital malformations. (orig.) With 18 figs., 4 tabs., 58 refs.

  14. Novel Vascular Malformation in an Affected Newborn with Deletion Del(4)(q31.3)

    OpenAIRE

    de León Ojeda, Norma Elena; Soriano-Torres, Michel; Cabrera, Mercedes J.; Benítez Ramos, Dunia Bárbara

    2012-01-01

    We report on a newborn male patient with a terminal deletion in the long arm of the chromosome 4 with a congenital heart defect unreported before in association with this syndrome. The patient had multiple congenital anomalies including a pointed duplicated fingernail, low set posteriorly rotated ears, large anterior fontanel, micrognathia, glabellar capillary vascular malformation, and Interrupted Aortic Arch type C. The patient died due to multiple congenital malformations; a peripheral chr...

  15. Pulmonary hypertensive crisis following ethanol sclerotherapy for a complex vascular malformation.

    Science.gov (United States)

    Cordero-Schmidt, G; Wallenstein, M B; Ozen, M; Shah, N A; Jackson, E; Hovsepian, D M; Palma, J P

    2014-09-01

    Anhydrous ethanol is a commonly used sclerotic agent for treating vascular malformations. We describe the case of a full-term 15-day-old female with a complex venolymphatic malformation involving the face and orbit. During treatment of the lesion with ethanol sclerotherapy, she suffered acute pulmonary hypertensive crisis. We discuss the pathophysiology of pulmonary hypertension related to ethanol sclerotherapy, and propose that hemolysis plays a significant role. Recommendations for evaluation, monitoring and management of this complication are also discussed.

  16. Atypical MRI features in soft-tissue arteriovenous malformation: a novel imaging appearance with radiologic-pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Anand S. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); University of California, San Francisco, Department of Interventional Radiology, San Francisco, CA (United States); Schulman, Joshua M.; Ruben, Beth S. [University of California, San Francisco, Departments of Pathology and Dermatology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Plastic Surgery, Birthmarks and Vascular Anomalies Clinic, San Francisco, CA (United States); Dowd, Christopher F. [University of California, San Francisco, Department of Interventional Neuroradiology, Birthmarks and Vascular Anomalies Clinic, San Francisco, CA (United States); Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, Birthmarks and Vascular Anomalies Clinic, San Francisco, CA (United States); Hess, Christopher P. [University of California, San Francisco, Department of Neuroradiology, Birthmarks and Vascular Anomalies Clinic, San Francisco, CA (United States)

    2015-09-15

    The absence of a discrete mass, surrounding signal abnormality and solid enhancement are imaging features that have traditionally been used to differentiate soft-tissue arteriovenous malformations from vascular tumors on MRI. We have observed that these findings are not uncommon in arteriovenous malformations, which may lead to misdiagnosis or inappropriate treatment. To estimate the frequency of atypical MRI features in soft-tissue arteriovenous malformations and assess their relationship to lesion size, location, tissue type involved and vascular architecture. Medical records, MRI and histopathology were reviewed in consecutive patients with soft-tissue arteriovenous malformations in a multidisciplinary vascular anomalies clinic. Arteriovenous malformations were divided into those with and without atypical MRI findings (perilesional T2 signal abnormality, enhancement and/or a soft-tissue mass). Lesion location, size, tissue involved and vascular architecture were also compared between groups. Tissue stains were reviewed in available biopsy or resection specimens to assess relationships between MRI findings and histopathology. Thirty patients with treatment-naive arteriovenous malformations were included. Fifteen lesions demonstrated atypical MRI. There was no difference in age, gender, lesion size or involved body part between the groups. However, more than half of the atypical lesions demonstrated multicompartmental involvement, and tiny intralesional flow voids were more common in atypical arteriovenous malformations. Histopathology also differed in atypical cases, showing densely packed endothelial cells with connective tissue architectural distortion and edema. Arteriovenous malformations may exhibit features of a vascular tumor on MRI, particularly when multicompartmental and/or containing tiny internal vessels. These features are important to consider in suspected fast-flow vascular malformations and may have implications with respect to their treatment

  17. Development of an international core outcome set for peripheral vascular malformations: the OVAMA project.

    Science.gov (United States)

    Horbach, S E R; van der Horst, C M A M; Blei, F; van der Vleuten, C J M; Frieden, I J; Richter, G T; Tan, S T; Muir, T; Penington, A J; Boon, L M; Spuls, P I

    2018-02-01

    An important limitation in vascular malformation research is the heterogeneity in outcome measures used for the evaluation of treatment outcome. To reach international consensus on a core outcome set (COS) for clinical research on peripheral vascular malformations: lymphatic (LM), venous (VM) and arteriovenous malformations (AVM). In this consensus study, we determined what domains should constitute the COS. Thirty-six possibly relevant outcome domains were proposed to an international group of physicians, patients and the parents of patients. In a three-round e-Delphi process using online surveys, participants repeatedly rated the importance of these domains on a five-point Likert scale. Participants could also propose other relevant domains. This process was performed for LM, VM and AVM separately. Consensus was predefined as 80% agreement on the importance of a domain among both the physician group and the patient/parent group. Outcomes were then re-evaluated in an online consensus meeting. 167 physicians and 134 patients and parents of patients with LM (n = 50), VM (n = 71) and AVM (n = 29) participated in the study. After three rounds and a consensus meeting, consensus was reached for all three types of vascular malformations on the core domains of radiological assessment, physician-reported location-specific signs, patient-reported severity of symptoms, pain, quality of life, satisfaction and adverse events. Vascular malformation type-specific signs and symptoms were included for LM, VM and AVM, separately. Our recommendation is that therapeutic-efficacy studies on peripheral vascular malformations should measure at least these core outcome domains. © 2017 British Association of Dermatologists.

  18. Clinical results of stereotactic heavy-charged-particle radiosurgery for intracranial angiographically occult vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Levy, R.P.; Fabrikant, J.I.; Phillips, M.H.; Frankel, K.A.; Steinberg, G.K.; Marks, M.P.; DeLaPaz, R.L.; Chuang, F.Y.S.; Lyman, J.T.

    1989-12-01

    Angiographically occult vascular malformations (AOVMs) of the brain have been recognized for many years to cause neurologic morbidity and mortality. They generally become symptomatic due to intracranial hemorrhage, focal mass effect, seizures or headaches. The true incidence of AOVMs is unknown, but autopsy studies suggest that they are more common than high-flow angiographically demonstrable arteriovenous malformations (AVMs). We have developed stereotactic heavy-charged-particle Bragg peak radiosurgery for the treatment of inoperable intracranial vascular malformations, using the helium ion beams at the Lawrence Berkeley Laboratory 184-inch Synchrocyclotron and Bevatron. This report describes the protocol for patient selection, radiosurgical treatment planning method, clinical and neuroradiologic results and complications encountered, and discusses the strengths and limitations of the method. 10 refs., 1 fig.

  19. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations.

    Science.gov (United States)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A; Tan, Huan; Mikati, Abdul Ghani; Shi, Changbin; Jesselson, Michael; Shenkar, Robert; Wu, Meijing; Cao, Ying; Hobson, Nicholas; Larsson, Henrik B W; Christoforidis, Gregory A; Awad, Issam A

    2017-07-01

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (DCEQP) and quantitative susceptibility mapping (QSM) assessed by MRI. METHODS Forty-six patients with CCMs underwent 2 or more permeability and/or susceptibility studies in conjunction with baseline and follow-up imaging and clinical surveillance during a mean 12.05 months of follow-up (range 2.4-31.27 months). Based on clinical and imaging features, cases/lesions were classified as stable, unstable, or recovering. Associated and predictive changes in quantitative permeability and susceptibility were investigated. RESULTS Lesional mean permeability and QSM values were not significantly different in stable versus unstable lesions at baseline. Mean lesional permeability in unstable CCMs with lesional bleeding or growth increased significantly (+85.9% change; p = 0.005), while mean permeability in stable and recovering lesions did not significantly change. Mean lesional QSM values significantly increased in unstable lesions (+44.1% change; p = 0.01), decreased slightly with statistical significance in stable lesions (-3.2% change; p = 0.003), and did not significantly change in recovering lesions. Familial cases developing new lesions during the follow-up period showed a higher background brain permeability at baseline (p = 0.001), as well as higher regional permeability (p = 0.003) in the area that would later develop a new lesion as compared with the homologous contralateral brain region. CONCLUSIONS In vivo assessment of vascular permeability and iron deposition on MRI can serve as objective and quantifiable biomarkers of disease activity in CCMs. This may be applied in natural history studies and may help calibrate clinical trials. The 2 techniques are likely applicable in

  20. The Use of Cyanoacrylate Adhesives in the Management of Congenital Vascular Malformations

    OpenAIRE

    Rosen, Robert J.; Contractor, Sohail

    2004-01-01

    This article outlines the use of liquid acrylic adhesives in the management of congenital vascular malformations. Specifically, the chemical features of cyanoacrylates, including the physical and chemical properties, exovascular use of cyanoacrylates, and the techniques for use of these agents, are discussed.

  1. Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Maleux, Geert; Heye, Sam; Wilms, Guy [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Timmerman, Dirk [University Hospitals Gasthuisberg, Department of Obstetrics and Gynecology, Leuven (Belgium)

    2006-02-01

    The purpose of this retrospective study is to assess the radiological and clinical outcome of transcatheter embolization of acquired uterine vascular malformations in patients presenting with secondary postpartum or postabortion vaginal hemorrhage. In a cohort of 17 patients (mean age: 29.7 years; standard deviation: 4.23; range: 25-38 years) 18 embolization procedures were performed. Angiography demonstrated a uterine parenchymal hyperemia with normal drainage into the large pelvic veins (''low-flow uterine vascular malformation'') in 83% (n=15) or a direct arteriovenous fistula (''high-flow uterine vascular malformation'') in 17% (n=3). Clinically, in all patients the bleeding stopped after embolization but in 1 patient early recurrence of hemorrhage occurred and was treated by hysterectomy. Pathological analysis revealed a choriocarcinoma. During follow-up (mean time period: 18.8 months; range: 1-36 months) 6 patients became pregnant and delivered a healthy child. Transcatheter embolization of the uterine arteries, using microparticles, is safe and highly effective in the treatment of a bleeding acquired uterine vascular malformation. In case of clinical failure, an underlying neoplastic disease should be considered. Future pregnancy is still possible after embolization. (orig.)

  2. [Classification of vascular anomalies (tumours and malformations). Clinical characteristics and natural history].

    Science.gov (United States)

    Redondo, P

    2004-01-01

    Vascular anomalies are divided into tumours and malformations. Haemangiomas are the most frequent amongst the former. Not normally present at birth, except in a premonitory form, they grow for 10-12 months due to hyperplasia, to subsequently undergo a progressive involution for a period that might last from ten to twelve years. They have an incidence of up to 12% in newborns; they are more common amongst girls; and are divided into superficial, deep and compound. Congenital haemangiomas and those that do not undergo involution are considered to be rare entities. Vascular malformations, with a lower incidence than haemangiomas, are always present at birth, they grow by hypertrophy and never undergo involution. According to the classification of the ISSVA, vascular malformations are divided - depending on the vessel affected - into capillary or venular (port-wine stain), venous, lymphatic, arteriovenous and combined or complex. Each of these has certain defining clinical and haemodynamic peculiarities. Within the final group are included some with a low flow, such as the Klippel-Trenaunay syndrome (venous and lymphatic venular vascular malformation associated with the muscular-skeletal hypertrophy of an extremity), and others with a high flow, such as the Parkes-Weber syndrome.

  3. Vascular malformations : A review of 10 years' management in a university hospital

    NARCIS (Netherlands)

    Zwerver, J.; Rieu, P.N.M.A.; Koopman, R.J.J.; Spauwen, P.H.M.; Buskens, F.G.M.; Boetes, C.; Veth, R.P.H.; Van Oostrom, C.G.

    In order to gain insight into the management of patients with vascular malformations (VM) in the University Hospital Nijmegen in the past 10 years, 151 cases managed by different specialists were reviewed. To avoid the usual confusion in terminology, all recorded diagnoses were reclassified

  4. [Therapeutic indications for percutaneous laser in patients with vascular malformations and tumors].

    Science.gov (United States)

    Labau, D; Cadic, P; Ouroussoff, G; Ligeron, C; Laroche, J-P; Guillot, B; Dereure, O; Quéré, I; Galanaud, J-P

    2014-12-01

    Lasers are increasingly used to treat vascular abnormalities. Indeed, this technique is non-invasive and allows a specific treatment. The aim of this review is to present some biophysical principles of the lasers, to describe the different sorts of lasers available for treatment in vascular medicine indications. Three principal lasers exist in vascular medicine: the pulsed-dye laser, for the treatment of superficial pink lesions, the NdYAG-KTP laser for purple and bigger lesions, and the NdYAG long pulse laser for even deeper and bigger vascular lesions. In vascular malformations, port wine stains can also be treated by pulsed-dye laser, KTP or NdYAG when they are old and thick. Telangiectasias are good indications for the three sorts of lasers, depending on their depth, color and size. Microcystic lymphatic malformations can be improved by laser treatment. Arterio-venous malformations constitute a contraindication of laser treatment. In vascular tumors, involuted infantile hemangiomas constitute an excellent indication of pulsed-dye laser treatment. Controlled studies are necessary to evaluate and to compare the efficacy of each laser, in order to determine their optimal indications and optimal parameters for each machine. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. [Diagnosis and therapy on hemangiomas and vascular malformation in view of the new classification].

    Science.gov (United States)

    Zhao, Fu-yun; Gao, Yan; Wu, Mei-juan; Luo, Quan-feng; Liu, Yu; Xu, Zhen-qi

    2009-02-18

    Vascular birthmarks are the most common disease. The morbidity is about 2.5%, most of the lesions occur in oral and maxillofacial regions which accounts for 40%-60% of the total lesions. In 1982, Mulliken and Glowacki proposed a biologic classification of vascular birthmarks on the basis of their clinical manifestations, histopathological features, and natural history. They defined hemangiomas as vascular tumors with a growth phase, marked by endothelial proliferation and hypercellularity, and an involutional phase. They recognized that many entities referred to as hemangiomas are actually structural malformations of the vasculature, derived from capillaries, veins, lymph vessels, or arteries or from a combination of these sources. The classification was confirmed and issued by International Society for the study of vascular anomaly (ISSVA) in 1988. Waner and Suen amended the above category in 1995. This paper presents the new classification of vascular birthmarks and the developments in this field in recent years, including the pathology, clinical features and the therapy. For example, the classification of venular malformation categorized by Waner in 1989; the classification of lymphous malformation by Waner and Suen in 1995; and the treatments according to above classifications.

  6. Intraoperative Localization of Vascular Malformation of Small Bowel by Selective Intra-arterial Dye Injection

    Science.gov (United States)

    Eshpuniyani, Priya B.; Kantharia, Chetan V.; Prabhu, RamKrishna Y.; Supe, Avinash N.

    2010-01-01

    Angiomatous malformation is the most common vascular abnormality, accounting for 30-40% cases of obscure GI bleeding from small bowel. Surgical resection is the treatment of choice in severe or recurrent hemorrhage requiring multiple blood transfusions. However, the diffuse nature of the lesions poses a challenge to localize them accurately preoperatively, for exact resection. We present a case in which we have used selective mesenteric angiography with selective cannulation and exact localization of the lesion by injecting dye such as methylene blue, indigo carmine, and fluorescein, to localize the angiomatous malformation before surgical resection and also to determine the exact resection to be done. PMID:20871200

  7. Vascular malformations of upper and lower extremity - from radiological interventional therapy to surgical soft tissue reconstruction - an interdisciplinary treatment.

    Science.gov (United States)

    Ranieri, M; Wohlgemuth, W; Müller-Wille, R; Prantl, L; Kehrer, A; Geis, S; Klein, S; Lamby, P; Schiltz, D; Uller, W; Aung, T; Dolderer, J H

    2017-01-01

    This article presents our experience in managing peripheral vascular malformations of upper and lower extremities over a 4-year period in a series of 46 patients of the Department of Plastic Surgery treated in the Interdisciplinary Center of Vascular Anomalies (ICVA) at the University of Regensburg. The patients presented vascular malformations of upper and lower extremity and were selected from our prospective vascular anomalies file archive from 2012 to 2016. During this period in the ICVA at University of Regensburg were performed more than 1400 radiological interventional treatments in patients with vascular malformations.The purpose of this retrospective study was to review combined embolotherapy, sclerotherapy (embolo/sclerotherapy), and surgical procedures (surgical excision and soft tissue reconstruction) to manage vascular malformations. Treatments were principally induced to reduce pain, daily physical limitations, social discomfort and recover tegument continuity after ulceration.The 46 patients were first examined with noninvasive radiological procedures. After diagnosis was posed, embolo/sclerotherapy, surgical procedures and clinically as well as radiological follow-ups were coordinated and established by the multidisciplinary team. All vascular malformations were categorized according to the classification approved at the April 2014 General Assembly of International Society for the Study of Vascular Anomalies (ISSVA) in Melbourne, Australia. Arteriovenous malformations (AVMs) were further classified following the Cho-Do and Schobinger classification.Embolo/sclerotherapy shows to be the most appropriate procedure in vascular malformations treatment. Nevertheless was found that in case of complications or lack of improvement as well as to improve functional or aesthetical results, a following partial or complete surgical excision and immediate soft tissue reconstruction seems to be the gold-standard treatment. In addition, the precise clinical and

  8. Imaging in anorectal malformations: What does the surgeon need to ...

    African Journals Online (AJOL)

    2015-12-11

    Dec 11, 2015 ... Imaging is essential in the diagnosis, management, surgical planning and eventual outcome in patients with anorectal malformation (ARM). This article outlines the imaging that may be required and the information needed by the surgeon to attain the best possible surgical outcome. ARM encompasses a ...

  9. The Usefulness of Surgical Treatment in Slow-Flow Vascular Malformation Patients

    Directory of Open Access Journals (Sweden)

    Gyu Bin Kang

    2017-07-01

    Full Text Available Background Many difficulties exist in establishing a treatment plan for slow-flow vascular malformation (SFVM. In particular, little research has been conducted on the surgical treatment of SFVMs. Thus, we investigated what proportion of SFVM patients were candidates for surgical treatment in clinical practice and how useful surgical treatment was in those patients. Methods This study included 109 SFVM patients who received care at the authors’ clinic from 2007 to 2015. We classified the patients as operable or non-operable, and analyzed whether the operability and the extent of the excision varied according to the subtype and location of the SFVM. Additionally, we investigated complications and self-assessed satisfaction scores. Results Of the 109 SFVM patients, 59 (54% were operable, while 50 (46% were nonoperable. Total excision could be performed in 44% of the operable SFVM patients. Lymphatic malformations were frequently non-operable, while capillary malformations were relatively operable (P=0.042. Total excision of venous malformations could generally be performed, while lymphatic malformations and combined vascular malformations generally could only undergo partial excision (P=0.048. Complications occurred in 11% of the SFVM patients who underwent surgery; these were minor complications, except for 1 case. The average overall satisfaction score was 4.19 out of 5. Conclusions Based on many years of experience, we found that approximately half (54% of SFVM patients were able to undergo surgery, and around half (44% of those patients were able to fully recover after a total excision. Among the patients who underwent surgical treatment, high satisfaction was found overall and relatively few complications were reported.

  10. Site-specific induction of lymphatic malformations in a rat model for image-guided therapy

    Energy Technology Data Exchange (ETDEWEB)

    Short, Robert F.; Shiels, William E. [Ohio State University College of Medicine and Public Health, Department of Radiology, The Children' s Radiological Institute, Children' s Hospital, Columbus, OH (United States); Sferra, Thomas J. [Ohio State University College of Medicine and Public Health, Department of Gastroenterology, The Columbus Children' s Research Institute, Children' s Hospital, Columbus, OH (United States); Nicol, Kathleen K. [Ohio State University College of Medicine and Public Health, Department of Pathology, Children' s Hospital, Columbus, OH (United States); Schofield, Minka; Wiet, Gregory J. [Ohio State University College of Medicine and Public Health, Department of Otolaryngology, Children' s Hospital, Columbus, OH (United States)

    2007-06-15

    Lymphatic malformation is a common benign mass in children and adults and is representative of a derangement in lymphangiogenesis. These lesions have high recurrence rates and significant morbidity associated with surgery. Several sclerotherapy regimens have been developed clinically to treat lymphatic malformations; however, an animal model has not been developed that is adequate to test the efficacy of image-guided therapeutic interventions. To develop an animal model suitable for evaluation of percutaneous treatments of lymphatic malformations. Male Harlan Sprague-Dawley rats (n = 9) received two US-guided injections of Incomplete Freund's Adjuvant (IFA) over a 2-week period. All nine rats were injected twice into the peritoneum (IP); a subgroup (n = 3) received additional injections into the neck. Three animals that received IP injections of saline were used as controls. The injection sites were monitored for the development of lesions by high-resolution ultrasonography at 2-week intervals for 100 days. High-resolution (4.7 Tesla) magnetic resonance imaging was then performed on two animals noted to have developed masses. The rats were sacrificed and histologic examination of the identified lesions was performed, including immunohistochemical staining for vascular (CD31) and lymphatic (Flt-4 and Prox-1) endothelium. All animals injected with IFA developed cystic lesions. The three animals injected at dual sites were noted to have both microcystic and macrocystic malformations in the neck and microcystic plaque-like lesions in the peritoneum. The macrocystic malformations ({>=}5 mm) in the neck were detected by ultrasonography and grossly later during necropsy. Histopathologic analysis revealed the cystic spaces to be lined by lymphatic endothelium supported by a connective tissue stroma. Control animals did not exhibit detectable lesions with either ultrasonography or necropsy. This model represents a promising tool for translational development of image

  11. Smell and taste in patients with vascular malformation of the extracranial head and neck region.

    Science.gov (United States)

    Steinbach, Silke; Fasunla, Ayotunde J; Lahme, Carolin M E; Schäfers, Sophia P; Hundt, Walter; Wolf, Petra; Mandic, Robert; Werner, Jochen A; Eivazi, Behfar

    2014-01-01

    Olfactory and gustatory functions have not been investigated in patients with vascular malformation of the extracranial head and neck region with validated smell and taste tests. Although olfactory and gustatory deficiencies are often not outwardly apparent, they substantially affect daily life. Smell and taste tests using sniffin sticks and taste strips were administered in 40 patients. For all age groups and both sexes, odor threshold (THR) values were, on average, lower in patients than in healthy individuals; whereas, values of odor identification and discrimination were not significantly lower. Regarding odor THR, 33 (82.5%) patients were hyposmic. Taste values (sweet, sour, salty, bitter, and total taste) were, on average, lower in patients than in healthy individuals; 21 (52.5%) patients were hypogeusic. Disease duration did not correlate with smell and taste test values. Patients with and without tongue involvement had decreased odor threshold and taste values. No significant differences were identified when taste values on the left and right sides of the tongue were compared in patients without tongue involvement and with unilateral and bilateral tongue involvement. Patients with venous malformations had lower smell test values, and patients with lymphatic malformations had lower taste test values than patients with other malformations. Patients exhibit significantly reduced olfactory and gustatory function even when the nose and/or tongue are not malformed. Patients should be tested with validated smell and taste tests to adequately inform and advise them about overcoming smell and taste deficits.

  12. Imaging of peripheral vascular disease

    Directory of Open Access Journals (Sweden)

    Mo Al-Qaisi

    2009-03-01

    Full Text Available Mo Al-Qaisi1, David M Nott1, David H King1, Sam Kaddoura2, Mo Hamady31Charing Cross Hospital, London, UK; 2Royal Brompton Hospital, London, UK; 3St. Mary’s Hospital, London, UKAbstract: This illustrated review article gives an evidence-based update on the different modalities used for imaging peripheral vascular disease (duplex ultrasound, computed tomography angiography, magnetic resonance angiography, and digital subtraction angiography. After discussing the latest technological developments for each modality, their limitations are also highlighted. The evidence is presented for the various modalities’ roles in the imaging of peripheral vascular disease, including problem-solving applications. The strengths and weaknesses of each modality are therefore critically appraised, including the salient technological, clinical, and financial aspects. This review allows the general and specialist practitioner to make an informed decision on how best to deploy imaging tests in peripheral vascular disease as part of an evidence-based approach. The article concludes with a rational imaging algorithm for the investigation of peripheral vascular disease.Keywords: imaging, peripheral, vascular, duplex, angiography, arterial 

  13. Circumferential flow reduction during percutaneous embolotherapy of extracranial vascular malformations: the "cookie-cutter" technique.

    Science.gov (United States)

    Duncan, Ian C; Fourie, Pieter A

    2003-08-01

    We describe a simple, inexpensive, and very effective method of achieving circumferential flow reduction during direct percutaneous cyanoacrylate embolization of a high-flow vascular malformation of the scalp. By using a plastic "cookie cutter" placed over the lesion and applying various degrees of pressure, both venous outflow from and arterial inflow into the lesion were limited. This flow reduction technique improved both the efficacy and safety of the procedure.

  14. [State of the art of classification, diagnostics and therapy for cervicofacial hemangiomas and vascular malformations].

    Science.gov (United States)

    Werner, J A; Eivazi, B; Folz, B J; Dünne, A-A

    2006-12-01

    The successful treatment of vascular anomalies depends on profound knowledge of the biologic behavior of vascular lesions and their correct classification. On the base of the clinical course Mulliken and Glowacki developed a biologic classification that was accepted as official classification by the ISSVA (International Society for the Study of Vascular Anomalies). Based on an extended literature research, this manuscript will give an overview of different internationally accepted treatment concepts. Even if a wait-and-see strategy can be recommended in many cases of uneventful hemangiomas in infants the proliferative growth of such lesions requires an adequate treatment indication. Vascular malformations that persist lifelong require treatment in the majority of the cases, especially when clinical symptoms occur. Based on individual parameters such as the diameter, location or growth behavior, different therapeutic options as cryotherapy, corticosteroids, laser therapy, sclerotherapy, surgical intervention and/or embolisation can be performed successfully. None of those treatment concepts, however, represents the only treatment method of choice.

  15. Digital vascular imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, J.W.; Engels, B.C.H.

    1981-01-01

    Digitalizing videosignals from an image intensifying TV-chain, followed by subtraction, contrast intensifying, and reformation to analogous signal deliver angiography pictures of high quality after intravenous injection of the contrast medium. As the examination is only little invasive it can be carried out on outdoor patients or in the polyclinics. The possibilities of the digital vessel imagination (DVI) are shown at vessel images of different parts of the body; a 36 cm image intensifyer which can be switched to 3 different sorts of operation and has a plumbicon-TV recording tube is used as receiver.

  16. Imaging features of ductal plate malformations in adults

    Energy Technology Data Exchange (ETDEWEB)

    Venkatanarasimha, N., E-mail: nandashettykv@yahoo.com [Department of Radiology, Derriford Hospital, Plymouth (United Kingdom); Thomas, R.; Armstrong, E.M.; Shirley, J.F.; Fox, B.M.; Jackson, S.A. [Department of Radiology, Derriford Hospital, Plymouth (United Kingdom)

    2011-11-15

    Ductal plate malformations, also known as fibrocystic liver diseases, are a group of congenital disorders resulting from abnormal embryogenesis of the biliary ductal system. The abnormalities include choledochal cyst, Caroli's disease and Caroli's syndrome, adult autosomal dominant polycystic liver disease, and biliary hamartoma. The hepatic lesions can be associated with renal anomalies such as autosomal recessive polycystic kidney disease (ARPKD), medullary sponge kidney, and nephronophthisis. A clear knowledge of the embryology and pathogenesis of the ductal plate is central to the understanding of the characteristic imaging appearances of these complex disorders. Accurate diagnosis of ductal plate malformations is important to direct appropriate clinical management and prevent misdiagnosis.

  17. [Diagnostic value of high-resolution computed tomography imaging in congenital inner ear malformations].

    Science.gov (United States)

    Sun, Xiaowei; Ding, Yuanping; Zhang, Jianji; Chen, Ying; Xu, Anting; Dou, Fenfen; Zhang, Zihe

    2007-02-01

    To observe the inner ear structure with volume rendering (VR) reconstruction and to evaluate the role of high-resolution computed tomography (HRCT) in congenital inner ear malformations. HRCT scanning was performed in 10 patients (20 ears) without ear disease (control group) and 7 patients (11 ears) with inner ear malformations (IEM group) and the original data was processed with VR reconstruction. The inner ear osseous labyrinth structure in the images generated by these techniques was observed respectively in the normal ears and malformation ears. The inner ear osseous labyrinth structure and the relationship was displayed clearly in VR imaging in the control group,meanwhile, characters and degree of malformed structure were also displayed clearly in the IEA group. Of seven patients (11 ears) with congenital inner ear malformations, the axial, MPR and VR images can display the site and degree in 9 ears. VR images were superior to the axial images in displaying the malformations in 2 ears with the small lateral semicircular canal malformations. The malformations included Mondini deformity (7 ears), vestibular and semicircular canal malformations (3 ears), vestibular aqueduct dilate (7 ears, of which 6 ears accompanied by other malformations) , the internal auditory canal malformation (2 ears, all accompanied by other malformations). HRCT can display the normal structure of bone inner ear through high quality VR reconstructions. VR images can also display the site and degree of the malformations three-dimensionally and intuitively. HRCT is valuable in diagnosing the inner ear malformation.

  18. Uterine arteriovenous malformation, images, and management.

    Science.gov (United States)

    Ore, Robert M; Lynch, David; Rumsey, Christopher

    2015-01-01

    Uterine arteriovenous malformation (AVM) is an infrequently described cause of severe genital tract bleeding. This is an important diagnostic consideration as therapeutic options differ significantly from those utilized with alternate etiologies of genital tract bleeding. A 30-year-old multiparous female presented initially with vaginal bleeding, and subsequently with intra-abdominal hemorrhage. She was diagnosed with uterine AVM, and was managed with uterine artery embolization followed by eventual hysterectomy. AVMs, both congenital and acquired, are diagnosed utilizing a range of radiographic tools. Management modalities include embolization and hysterectomy. Our patient presented uniquely with intra-abdominal hemorrhage. Previously managed with uterine artery embolization, hysterectomy became necessary because of her clinical presentation. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  19. Stabiliztin of VEGFR2 Signaling by Cerebral Cavernous Malformation 3 is Critical for Vascular Development

    Energy Technology Data Exchange (ETDEWEB)

    Y He; H Zhang; L Yu; M Gunel; T Boggon; H Chen; W Min

    2011-12-31

    Cerebral cavernous malformations (CCMs) are human vascular malformations caused by mutations in three genes of unknown function: CCM1, CCM2, and CCM3. CCM3, also known as PDCD10 (programmed cell death 10), was initially identified as a messenger RNA whose abundance was induced by apoptotic stimuli in vitro. However, the in vivo function of CCM3 has not been determined. Here, we describe mice with a deletion of the CCM3 gene either ubiquitously or specifically in the vascular endothelium, smooth muscle cells, or neurons. Mice with global or endothelial cell-specific deletion of CCM3 exhibited defects in embryonic angiogenesis and died at an early embryonic stage. CCM3 deletion reduced vascular endothelial growth factor receptor 2 (VEGFR2) signaling in embryos and endothelial cells. In response to VEGF stimulation, CCM3 was recruited to and stabilized VEGFR2, and the carboxyl-terminal domain of CCM3 was required for the stabilization of VEGFR2. Indeed, the CCM3 mutants found in human patients lacking the carboxyl-terminal domain were labile and were unable to stabilize and activate VEGFR2. These results demonstrate that CCM3 promotes VEGFR2 signaling during vascular development.

  20. Effects of physiotherapy combined with sirolimus in a patient with vascular malformation: A case report.

    Science.gov (United States)

    Akbayrak, Türkan; Orhan, Ceren; Baran, Emine; Kaya, Serap; Coskun, Gürsoy; Varan, Ali

    2016-01-01

    The aim of the present case report was to investigate the effects of a physiotherapy program combined with sirolimus in a child patient with upper extremity edema and joint limitation due to low-flow vascular malformation. This case report included an 11-year-old male patient (26 kg, 130 cm) diagnosed with congenital lymphovascular malformation on the left and right chest. The patient, who had edema on the upper left extremity and experienced joint limitations, was administered complete decongestive therapy (CDT) and manual therapy in combination with sirolimus. Physiotherapy included a total of 24 sessions, 3 sessions a week for 8 weeks. Following the physiotherapy, the patient was assigned to a home therapy program, and then the maintenance phase of the CDT was initiated. Evaluations were carried out at baseline, at the end of week 8, and after 12 months. Following the physiotherapy program combined with sirolimus, a decrease in extremity volume, an increase in joint movement range, and an improvement in disease-related complaints were observed. Physiotherapy methods combined with sirolimus may be an effective treatment method in patients with vascular malformations. However, further studies with larger sample size are warranted.

  1. Novel Vascular Malformation in an Affected Newborn with Deletion Del(4(q31.3

    Directory of Open Access Journals (Sweden)

    Norma Elena de León Ojeda

    2012-01-01

    Full Text Available We report on a newborn male patient with a terminal deletion in the long arm of the chromosome 4 with a congenital heart defect unreported before in association with this syndrome. The patient had multiple congenital anomalies including a pointed duplicated fingernail, low set posteriorly rotated ears, large anterior fontanel, micrognathia, glabellar capillary vascular malformation, and Interrupted Aortic Arch type C. The patient died due to multiple congenital malformations; a peripheral chromosome analysis showed 46, XY, del(4(q31.3 de novo. The only reported case with the same deletion was a male newborn that exhibited the pattern of minor anomalies of deletion 4q31 syndrome. The parents were cytogenetically normal. We compare clinical signs to other cases with a deletion in long arm of chromosome 4.

  2. [Diagnosis and differential diagnosis of cerebro-vascular malformations by CT (author's transl)].

    Science.gov (United States)

    Schumacher, M; Stoeter, P; Voigt, K

    1980-03-01

    In 38 patients, the diagnosis of a cerebrovascular malformation (17 arteriovenous agniomas including one low-flow- and two venous angiomas; 10 aneurysms; 4 arteriovenous fistulae of the cavernous sinus, the tentorium and one of the Great Vein of Galen; 6 megadolical basilar arteries) was initially made by computertomographic (CT) examination, including contrast enhancement. The characteristic and pathognomonic CT findings are described and compared with those of cerebral angiography also done in these cases. The problems of differential diagnosis and the reasons for a false CT diagnosis in 5 other patients with a cerebro-vascular malformation are investigated; and the diagnostic value of cerebral angiography and CT is discussed and their complementary functions are being pointed out.

  3. Interobserver reliability and diagnostic performance of Chiari II malformation measures in MR imaging-part 2

    NARCIS (Netherlands)

    Geerdink, Niels; van der Vliet, Ton; Rotteveel, Jan J.; Feuth, Ton; Roeleveld, Nel; Mullaart, Reinier A.

    Brain MR imaging is essential in the assessment of Chiari II malformation in clinical and research settings concerning spina bifida. However, the interpretation of MR images of the malformation is not always straightforward. Morphometric analyses of the extent of Chiari II malformation may improve

  4. Interobserver reliability and diagnostic performance of Chiari II malformation measures in MR imaging--part 2.

    NARCIS (Netherlands)

    Geerdink, N.; Vliet, T. van der; Rotteveel, J.J.; Feuth, T.; Roeleveld, N.; Mullaart, R.A.

    2012-01-01

    PURPOSE: Brain MR imaging is essential in the assessment of Chiari II malformation in clinical and research settings concerning spina bifida. However, the interpretation of MR images of the malformation is not always straightforward. Morphometric analyses of the extent of Chiari II malformation may

  5. Novel image-guided management of a uterine arteriovenous malformation.

    Science.gov (United States)

    Przybojewski, Stefan J; Sadler, David J

    2011-02-01

    The investigators present a novel image-guided embolization, not previously described, of a uterine arteriovenous malformation (AVM) resistant to endovascular management. The uterus was exposed surgically, and Histoacryl (Braun, Fulda, Germany) was injected directly into the nidus using ultrasound guidance and fluoroscopy. The patient had a successful full-term pregnancy after this procedure. This technique may be a useful alternative management strategy in patients with uterine AVM who fail traditional endovascular embolization and who still desire fertility.

  6. Cerebral cavernous malformations. Serial magnetic resonance imaging findings in patients with and without gamma knife surgery

    Energy Technology Data Exchange (ETDEWEB)

    Yoon Pyeong-Ho; Kim, Dong-Ik; Jeon Pyoung; Ryu, Young-Hoon; Hwang, Geum-Joo; Park, Sang-Joon [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-10-01

    To classify the cerebral cavernous malformations and to investigate the natural history of cavernous malformations according to the classification, 41 patients with 61 cavernous malformations (40 cavernous malformations from 22 patients treated with gamma knife surgery) were regularly followed up using MR imaging for a mean period of 25.5 months in treated cavernous malformations and 20.7 months in untreated cavernous malformations, respectively. Cavernous malformations were classified into four types. Follow-up MR images were analyzed to evaluate changes in size, signal intensity, rebleeding, and perilesional adverse reaction of irradiation. A total of 61 cavernous malformations including 17 in type I, 23 in type II, 10 in type III, and 11 in type IV showed usual degradation of blood product in 22 cavernous malformations, no change in shape and signal intensity in 31 cavernous malformations, and eight cavernous malformations with rebleedings in the serial MR images. In these eight cavernous malformations with rebleedings, six occurred in type II and two in type III, but none in type I or IV. Rebleedings were more frequent in type II than in other types. Adverse reaction of irradiation was observed in five of 22 patients treated with gamma knife surgery. Although most cerebral cavernous malformations showed evolution of hemorrhage or no change in size or shape on follow-up MR images, cerebral cavernous malformations represented as mixture of subacute and chronic hemorrhage with hemosiderin rim (type II) have a higher frequency to rebleed than other types of cerebral cavernous malformations. Cerebral cavernous malformations represented as hemosiderin deposition without central core (type IV) have a lower tendency to rebleed than other types and do not need any treatment. Most of the adverse reaction of irradiation after gamma knife surgery around cavernous malformations are transient findings and are considered to be perilesional edema. (K.H)

  7. Imaging features of lower limb malformations above the foot.

    Science.gov (United States)

    Bergère, A; Amzallag-Bellenger, E; Lefebvre, G; Dieux-Coeslier, A; Mezel, A; Herbaux, B; Boutry, N

    2015-09-01

    Lower limb malformations are generally isolated or sporadic events. However, they are sometimes associated with other anomalies of the bones and/or viscera in patients with constitutional syndromes or disorders of the skeleton. This paper reviews the main imaging features of these abnormalities, which generally exhibit a broad spectrum. This paper focuses on several different bone malformations: proximal focal femoral deficiency, congenital short femur and femoral duplication for the femur, tibial hemimelia (aplasia/hypoplasia of the tibia) and congenital bowing for the tibia, fibular hemimelia (aplasia/hypoplasia) for the fibula, and aplasia, hypoplasia and congenital dislocation for the patella. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  8. High-Flow Vascular Malformation in the Sigmoid Mesentery Successfully Treated with a Combination of Transarterial and Transvenous Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kamo, Minobu, E-mail: kamomino@luke.ac.jp; Yagihashi, Kunihiro [St. Luke’s International Hospital, Department of Radiology (Japan); Okamoto, Takeshi; Nakamura, Kenji; Fujita, Yoshiyuki [St. Luke’s International Hospital, Department of Gastroenterology (Japan); Kurihara, Yasuyuki [St. Luke’s International Hospital, Department of Radiology (Japan)

    2016-12-15

    Mesenteric high-flow vascular malformation can cause various clinical symptoms and demand specific therapeutic interventions owing to its peculiar hemodynamics. We report a case of high-flow vascular malformation in the sigmoid mesentery which presented with ischemic colitis. The main trunk of the inferior mesenteric vein was occluded. After partially effective transarterial embolization, transvenous embolization was performed using a microballoon catheter advanced to the venous component of the lesion via the marginal vein. Complete occlusion of the lesion was achieved. Combination of transarterial and transvenous embolization may allow us to apply endovascular treatment to a wider variety of high-flow lesions in the area and possibly avoid the bowel resection.

  9. Twenty-seven years follow-up of a patient with congenital retinocephalofacial vascular malformation syndrome and additional congenital malformations (Bonnet-dechaume-blanc syndrome or wyburn-mason syndrome

    Directory of Open Access Journals (Sweden)

    Schmidt D

    2010-02-01

    Full Text Available Abstract Purpose Follow-up of vascular changes in a patient with congenital retinocephalofacial vascular malformation syndrome. Methods MRI and cerebral angiography. Results In a 36-year-old man, magnetic resonance im aging of the skull and cerebral angiography revealed left intracranial arteriovenous malformations. Follow-up observation of 27 years revealed no essential change of retinal and cerebral arteriovenous malformations. Additional congenital deficits in this patient were described. Conclusion Patients with retinal arteriovenous malformations should be early examined with neuroradiological methods.

  10. Early experience with X-ray magnetic resonance fusion for low-flow vascular malformations in the pediatric interventional radiology suite

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Tiffany J. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Keck School of Medicine of the University of Southern California, Los Angeles, CA (United States); Girard, Erin [Siemens Corporation, Corporate Technology, Princeton, NJ (United States); Shellikeri, Sphoorti; Vossough, Arastoo; Ho-Fung, Victor; Cahill, Anne Marie [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Setser, Randolph [Siemens Medical Solutions USA, Inc., Hoffman Estates, IL (United States)

    2016-03-15

    This technical innovation describes our experience using an X-ray magnetic resonance fusion (XMRF) software program to overlay 3-D MR images on real-time fluoroscopic images during sclerotherapy procedures for vascular malformations at a large pediatric institution. Five cases have been selected to illustrate the application and various clinical utilities of XMRF during sclerotherapy procedures as well as the technical limitations of this technique. The cases demonstrate how to use XMRF in the interventional suite to derive additional information to improve therapeutic confidence with regards to the extent of lesion filling and to guide clinical management in terms of intraprocedural interventional measures. (orig.)

  11. Co-occurrence of a cerebral cavernous malformation and an orbital cavernous hemangioma in a patient with seizures and visual symptoms: Rare crossroads for vascular malformations

    Science.gov (United States)

    Choudhri, Omar; Feroze, Abdullah H.; Lad, Eleonora M.; Kim, Jonathan W.; Plowey, Edward D.; Karamchandani, Jason R.; Chang, Steven D.

    2014-01-01

    Background: Cerebral cavernous malformations (CCMs) are angiographically occult vascular malformations of the central nervous system. As a result of hemorrhage and mass effect, patients may present with focal neurologic deficits, seizures, and other symptoms necessitating treatment. Once symptomatic, most often from hemorrhage, CCMs are treated with microsurgical resection. Orbital cavernous hemangiomas (OCHs) are similar but distinct vascular malformations that present within the orbital cavity. Even though CCMs and OCHs are both marked by dilated endothelial-lined vascular channels, they are infrequently seen in the same patient. Case Description: We provide a brief overview of the two related pathologies in the context of a patient presenting to our care with concomitant lesions, which were both resected in full without complication. Conclusion: This is the first known report that describes a case of concomitant CCM and OCH and explores the origins of two pathologies that are rarely encountered together in neurosurgical practice. Recognition of disparate symptomatologies is important for properly managing these patients. PMID:25071938

  12. Congenital vascular malformations - cerebral lesions differ from extracranial lesions by their immune expression of the glucose transporter protein GLUT1

    NARCIS (Netherlands)

    Meijer-Jorna, Lorine B.; Aronica, Eleonora; van der Loos, Chris M.; Troost, Dirk; van der Wal, Allard C.

    2012-01-01

    Background: Cerebral vascular malformations were investigated for the presence of the glucose transporter protein GLUT I, which is normally expressed in endothelial cells of the pre-existing microvasculature of the brain and absent in the vasculature of the choroid plexus and extracranial

  13. Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg

    NARCIS (Netherlands)

    Simmelink, Elisabeth K.; Rommers, Gerardus M.; Gardeniers, Jean W. M.; Zijlstra, Henk

    Background: The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Case description and methods: Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a

  14. Hereditary hemorrhagic telangiectasia with bilateral pulmonary vascular malformations: A case report

    Directory of Open Access Journals (Sweden)

    Lončarević Olivera

    2016-01-01

    Full Text Available Introduction. Hereditary hemorrhagic telangiectasia (HHT also known as Osler-Weber-Rendu syndrome is an autosomal dominant disease that occurs due to vascular dysplasia associated with the disorder in the signaling pathway of transforming growth factor β (TGF-β. The clinical consequence is a disorder of blood vessels in multiple organ systems with the existence of telangiectasia which causes dilation of capillaries and veins, are present from birth and are localized on the skin and mucosa of the mouth, respiratory, gastrointestinal and urinary tract. They can make a rupture with consequent serious bleeding that can end up with fatal outcome. Since there is a disruption of blood vessels of more than one organic system, the diagnosis is very complex and requires a multidisciplinary approach. Case report. We reported a 40-year-old female patient with a long-time evolution of problems, who was diagnosed and treated at the Clinic for Lung Diseases of the Military Medical Academy in Belgrade, Serbia, because of bilaterally pulmonary arteriovenous malformations associated with HHT. Embolization was performed in two acts, followed with normalization of clinical, radiological and functional findings with the cessation of hemoptysis, effort intolerance with a significant improvement of the quality of life. Conclusion. HHT is a rare dominant inherited multisystem disease that requires multidisciplinary approach to diagnosis and treatment. Embolization is the method of choice in the treatment of arteriovenous malformations with minor adverse effects and very satisfying therapeutic effect.

  15. Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Z.; Chen, J.; Shi, H.; Zhou, K.; Sun, H. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Li, X., E-mail: pumch005@sina.com [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Pan, J.; Zhang, X.; Liu, W.; Yang, N.; Jin, Z. [Department of Radiology, Peking Union Medical College Hospital, Beijing (China)

    2012-06-15

    Aim: To retrospectively evaluate the efficacy of embolotherapy in patients with iatrogenic traumatic uterine arteriovenous malformations (AVMs). Materials and methods: A retrospective review of all patients who underwent uterine arterial embolization in Peking Union Medical College Hospital between January 2000 and December 2010 was performed. Forty-two patients were diagnosed with a uterine vascular malformation. All patients had obstetric manipulations before. Serial beta-human chorionic gonadotropin ({beta}-HCG) levels were measured to exclude gestational trophoblastic neoplasia. All patients underwent transcatheter embolization of bilateral uterine arteries. The complications, control of haemorrhage, and outcome of subsequent pregnancies were assessed. Results: A total of 49 embolization procedures were performed in 42 patients. Seven patients required repeated embolizations for recurrence of bleeding. The technical success rate of embolization was 100%. Bleeding was controlled in 35 of 42 patients (83%) after the first embolization procedures, and bleeding was controlled in another two patients who underwent repeat embolization at a median follow-up of 29 months (range 3 months to 5 years). The overall clinical success rate was 88% (37/42). Thirteen patients subsequently became pregnant and eight of 13 patients had uneventful intrauterine pregnancies carried to term. Seven patients had post-embolization syndrome and no other complication occurred. Conclusion: Percutaneous embolotherapy is a safe and effective treatment for traumatic AVMs. Future pregnancy is still possible after embolization.

  16. Essential features of Chiari II malformation in MR imaging : an interobserver reliability study-part 1

    NARCIS (Netherlands)

    Geerdink, Niels; van der Vliet, Ton; Rotteveel, Jan J.; Feuth, Ton; Roeleveld, Nel; Mullaart, Reinier A.

    Brain MR imaging is essential in the assessment of Chiari II malformation in clinical and research settings concerning spina bifida. However, the interpretation of morphological features of the malformation on MR images may not always be straightforward. In an attempt to select those features that

  17. Essential features of Chiari II malformation in MR imaging: an interobserver reliability study--part 1.

    NARCIS (Netherlands)

    Geerdink, N.; Vliet, T. van der; Rotteveel, J.J.; Feuth, T.; Roeleveld, N.; Mullaart, R.A.

    2012-01-01

    PURPOSE: Brain MR imaging is essential in the assessment of Chiari II malformation in clinical and research settings concerning spina bifida. However, the interpretation of morphological features of the malformation on MR images may not always be straightforward. In an attempt to select those

  18. Imaging in anorectal malformations: What does the surgeon need to ...

    African Journals Online (AJOL)

    ARM encompasses a wide spectrum of congenital malformations relating to the distal rectum and anus as well as the urinary and or gynaecological systems. The malformations range from a relatively simple perineal fistula with the potential for an excellent functional outcome, to complex cloacal malformation that requires ...

  19. Congenital frontonasal masses: developmental anatomy, malformations, and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hedlund, Gary [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States)

    2006-07-15

    The newborn, infant, or young child who presents with a midline frontonasal mass often poses a diagnostic challenge to the clinician. The most pressing issue is whether the mass extends intracranially. The development of the frontonasal region or anterior neuropore is complex. Aberrant embryogenesis leads to three main types of anomalies: nasal dermal sinus, anterior cephalocele, and nasal glioma. Understanding the developmental anatomy of the anterior neuropore and postnatal maturation will serve the radiologist well when it comes to imaging frontonasal masses. Pitfalls particularly common to CT imaging interpretation include the evolving ossification of the frontal, nasal and ethmoid bones in the first year of life, morphology and size of the foramen cecum, and the natural intumescence of the anterior nasal septum. Determination of the presence of a connection between the frontonasal mass and the anterior cranial fossae is crucial in the imaging assessment and clinical management. In the case of the nasal dermal sinus, failure to appreciate the intracranial components of the malformation can lead to fatal meningitis. MR imaging is the modality of choice for assessing the pediatric frontonasal region. Its advantages include multiplanar imaging, distinguishing the interface among cartilage, bone, brain and fluid, diffusion imaging to detect epidermoid tumors, and the capacity to evaluate the brain for associated cerebral anomalies. (orig.)

  20. [Diagnostic significance of multi-slice computed tomography imaging in congenital inner ear malformations].

    Science.gov (United States)

    Ma, Hui; Han, Ping; Liang, Bo; Liu, Fang; Tian, Zhi-Liang; Lei, Zi-Qiao; Li, You-Lin; Kong, Wei-Jia

    2005-04-01

    To evaluate the feasibility and usability of multi-slice computed tomography (MSCT) in congenital inner ear malformations. Fourty-four patients with sensorineural hearing loss (SNHL) were examined by a Somatom Sensation 16 (siemens, Germany) CT scanner with following parameters: 120 kV, 100 mAs, 0.75 mm collimation, 1 mm reconstruction increment, a pitch factor of 1 and a field of view of 100 mm. The axial images of interested ears were reconstructed with 0.1 mm reconstruction increment, and a field of view of 50 mm. The 3D reconstructions were done with volume rendering technique (VRT) on the workstation (3D Virtuoso and Wizard,siemens). Twenty-five patients were normal and 19 patients (36 ears) were congenital inner ear malformations among 44 patients scanned with MSCT. Of the malformations, all the axial, MPR and VRT images can display the site and degree in 33 ears. VRT images were superior to the axial images in displaying the malformations in 3 ears with the small lateral semicircular canal malformations. The malformations were Michel deformity (1 ear), common cavity deformity (3 ears), incomplete partition I (3 ears), incomplete partition II (Mondini deformity, 5 ears), vestibular and semicircular canal malformations( 14 ears), vestibular aqueduct dilate( 16 ears, of which 6 ears accompanied by other malformations), the internal auditory canal malformation(8 ears, all accompanied by other malformations). MSCT allows a comprehensively assessing various congenital ear malformations through high quality MPR and VRT reconstructions. VRT images can display the site and degree of the malformations three-dimensionally and intuitionisticly. It is very useful to the cochlear implantation.

  1. Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yildiz, Harun; Yazici, Zeynep; Hakyemez, Bahattin; Erdogan, Cuneyt; Parlak, Mufit [University of Uludag, Department of Radiology, School of Medicine, Bursa (Turkey)

    2006-09-15

    Differential radiologic diagnosis of cystic malformations of the posterior fossa is often difficult with conventional imaging techniques because of overlapping features of these entities. Posterior fossa cystic malformations occupy the cerebrospinal fluid (CSF) spaces. They may create secondary dynamic effects on the movements of CSF. The aim of this study was to investigate CSF flow alterations in posterior fossa cystic malformations with CSF flow MR imaging. The study included 40 patients with cystic malformations of the posterior fossa. The patients underwent cardiac-gated phase-contrast cine MR imaging. CSF flow was qualitatively evaluated using an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Twelve of the patients had communicating arachnoid cyst, seven had non-communicating arachnoid cyst, ten had mega cisterna magna, six had Dandy-Walker malformation, two had Dandy-Walker variant, and three had Blake's pouch cyst. CSF flow MR imaging indicated the regions of no, slow or higher flow, direction of flow, and abnormal cystic fluid motion. Each malformation displayed a distinct CSF flow pattern. Phase-contrast cine MR imaging for CSF flow evaluation may be a useful adjunct to routine MR imaging in the evaluation of the cystic malformations of the posterior fossa because it can improve the specificity in differentiating such malformations. (orig.)

  2. Role of intraoperative indocyanine green video-angiography to identify small, posterior fossa arteriovenous malformations mimicking cavernous angiomas. Technical report and review of the literature on common features of these cerebral vascular malformations.

    Science.gov (United States)

    Barbagallo, Giuseppe M V; Certo, Francesco; Caltabiano, Rosario; Chiaramonte, Ignazio; Albanese, Vincenzo; Visocchi, Massimiliano

    2015-11-01

    To illustrate the usefulness of intraoperative indocyanine green videoangiography (ICG-VA) to identify the nidus and feeders of a small cerebellar AVM resembling a cavernous hemangioma. To review the unique features regarding the overlay between these two vascular malformations and to highlight the importance to identify with ICG-VA, and treat accordingly, the arterial and venous vessels of the AVM. A 36-year old man presented with bilateral cerebellar hemorrhage. MRI was equivocal in showing an underlying vascular malformation but angiography demonstrated a small, Spetzler-Martin grade I AVM. Surgical resection of the AVM with the aid of intraoperative ICG-VA was performed. After hematoma evacuation, pre-resection ICG-VA did not reveal tortuous arterial and venous vessels in keeping with a typical AVM but rather an unusual blackberry-like image resembling a cavernous hemangioma, with tiny surrounding vessels. Such intraoperative appearance, which could also be the consequence of a "leakage" of fluorescent dye from the nidal pathological vessels, with absent blood-brain barrier, into the surrounding parenchymal pathological capillary network, is important to be recognized as an unusual AVM appearance. Post-resection ICG-VA confirmed the AVM removal, as also shown by postoperative and 3-month follow-up DSAs. Despite technical limitations associated with ICG-VA in post-hemorrhage AVMs, this case together with the intraoperative video, demonstrates the useful role of ICG-VA in identifying small AVMs with peculiar features. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Medical image of the week: pulmonary arteriovenous malformations

    Directory of Open Access Journals (Sweden)

    Stawter C

    2014-10-01

    Full Text Available A 34 year old woman presented to the clinic with exertional dyspnea since childhood. Oxygen saturations in clinic were 92% on room air. On review of systems she admitted to recurrent epistaxis and her daughter also suffered from frequent epistaxis. Bubble contrast echocardiography showed severe right to left shunting without evidence of intracardiac shunt (Figure 1. Computed tomography angiogram of the chest revealed multiple bilateral arteriovenous malformations (AVM’s, the largest measuring 9mm on coronal images (Figure 2. MRI brain was negative for AVM’s. She was referred to interventional radiology for microcoil embolization. She met two of four Curaçao criteria for the diagnosis of hereditary hemorrhagic telangiectasia (HHT, giving her “possible HHT”. She was referred for genetic testing to confirm the diagnosis.

  4. Infantile fibrosarcoma-a clinical and histologic mimicker of vascular malformations: case report and review of the literature.

    Science.gov (United States)

    Hu, Zhihong; Chou, Pauline M; Jennings, Lawrence J; Arva, Nicoleta C

    2013-01-01

    Infantile fibrosarcoma is a rare soft tissue tumor that usually presents either at birth or in the 1st year of life. Here we describe a case of a 4-month-old female who presented with a congenital right axillary mass. The initial clinical impression was benign vascular/lymphatic malformation. The core biopsy showed a spindle cell lesion with abundant vasculature represented by small vascular channels. However, immunohistochemical analysis did not support a diagnosis of vascular lesion/tumor. Polymerase chain reaction study for ETS Translocation Variant 6/neurotrophic tyrosine kinase receptor, type 3 fusion transcript was positive, and the diagnosis of infantile fibrosarcoma was established. The patient underwent resection of the axillary mass. Microscopic examination of the resection specimen showed numerous vascular channels. Intermixed there were also cellular areas composed of spindle cells similar to those seen in the biopsy material. Molecular studies were repeated and confirmed the diagnosis of infantile fibrosarcoma. Infantile fibrosarcoma has been previously reported in the literature to clinically masquerade as hemangioma. In addition, this case proves that infantile fibrosarcoma could also mimic vascular malformations on clinical, radiologic, and pathologic exams. In fact, the vascular component of the tumor is very unusual in our patient and represents a histologic feature that has not been described before. The case highlights the diagnostic challenges at clinical, radiologic, and pathologic levels in some cases of infantile fibrosarcoma and raises awareness among clinicians and pathologists related to another peculiar pattern that can be encountered in this disease.

  5. A case of pancreatic AV malformation in an elderly man.

    Science.gov (United States)

    Gupta, Vipin; Kedia, Saurabh; Sonika, Ujjwal; Madhusudhan, Kumble Seetharama; Pal, Sujoy; Garg, Pramod

    2018-02-05

    A 60-year-old man presented with recurrent abdominal pain and weight loss for 6 months. Abdominal imaging showed a large vascular lesion in the head and neck of pancreas suggestive of arteriovenous malformation (AV malformation). Endoscopic ultrasound was done which showed features of AV malformation with no evidence of pancreatic malignancy. Surgery was planned for definitive treatment of malformation. Digital subtraction angiography with angioembolization was done prior to surgery to reduce vascularity of the lesion. He recovered after a pylorus preserving pancreaticoduodenectomy. Histopathology of the resected specimen confirmed the pancreatic AV malformation. There has been no recurrence at 2 years of follow-up.

  6. Evaluation of intra-aortic CT angiography performances for the visualisation of spinal vascular malformations' angioarchitecture

    Energy Technology Data Exchange (ETDEWEB)

    Clarencon, Frederic; Gabrieli, Joseph; Chiras, Jacques [Pitie-Salpetriere Hospital, Department of Interventional Neuroradiology, Paris (France); Paris VI University, Pierre et Marie Curie University, Paris (France); Di Maria, Federico; Sourour, Nader-Antoine; Shotar, Eimad; Cormier, Evelyne; Fahed, Robert [Pitie-Salpetriere Hospital, Department of Interventional Neuroradiology, Paris (France); Nouet, Aurelien [Pitie-Salpetriere Hospital, Department of Neurosurgery, Paris (France); Cornu, Philippe [Paris VI University, Pierre et Marie Curie University, Paris (France); Pitie-Salpetriere Hospital, Department of Neurosurgery, Paris (France)

    2016-10-15

    To evaluate the performances of the CT-angiography by direct intra-aortic contrast media injection (IA-CTA) for spinal vascular malformations (SVMs)' imaging. Thirteen patients (8 males, 5 females, mean age: 56 y) with suspected SVM underwent IA-CTAs by direct intra-aortic iodinated contrast media injection (5 cc/s; 100 cc) via an arterial femoral or humeral access. Two independent observers evaluated the angioarchitecture of the SVMs and the visualisation of both the Adamkiewicz artery and the anterior spinal artery. Then a consensus was obtained between the 2 reviewers; the results of the IA-CTA were finally compared with those of the full spinal DSA evaluated in consensus. The IA-CTA was feasible in all cases and depicted the SVM in all except one case (92 %). Interrater agreement was good for the location of the SVMs' level. Intermodality (IA-CTA/DSA) agreement was excellent for the level and side of the shunt point, as well as for the SVM subtype evaluation. In 77 % of the cases, the Adamkiewicz artery was satisfactorily seen at the same time on IA-CTA. IA-CTA is a new technique that seems helpful to reach a better understanding of SMVs and may help to tailor more precisely their treatment. (orig.)

  7. Non-invasive magnetic resonance-guided high intensity focused ultrasound ablation of a vascular malformation in the lower extremity : a case report

    NARCIS (Netherlands)

    van Breugel, Marjolein; Nijenhuis, Robbert J; Ries, Mario G; Toorop, RJ; Vonken, EPA; Wijlemans, JW; van den Bosch, Maurice A A J

    2015-01-01

    INTRODUCTION: Therapy of choice for symptomatic vascular malformations consists of surgery, sclerotherapy, or embolization. However, these techniques are invasive with possible complications and require hospitalization. We present a novel non-invasive technique, i.e., magnetic resonance-guided

  8. Structure and vascular function of MEKK3–cerebral cavernous malformations 2 complex

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Oriana S. [Yale Univ., New Haven, CT (United States); Deng, Hanqiang [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Liu, Dou [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Ya [Yale Univ. School of Medicine, New Haven, CT (United States); Wei, Rong [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Deng, Yong [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Fan [Yale Univ. School of Medicine, New Haven, CT (United States); Louvi, Angeliki [Yale Univ. School of Medicine, New Haven, CT (United States); Turk, Benjamin E. [Yale Univ., New Haven, CT (United States); Boggon, Titus J. [Yale Univ., New Haven, CT (United States); Su, Bing [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China)

    2015-08-03

    Cerebral cavernous malformations 2 (CCM2) loss is associated with the familial form of CCM disease. The protein kinase MEKK3 (MAP3K3) is essential for embryonic angiogenesis in mice and interacts physically with CCM2, but how this interaction is mediated and its relevance to cerebral vasculature are unknown. Here we report that Mekk3 plays an intrinsic role in embryonic vascular development. Inducible endothelial Mekk3 knockout in neonatal mice is lethal due to multiple intracranial haemorrhages and brain blood vessels leakage. We discover direct interaction between CCM2 harmonin homology domain (HHD) and the N terminus of MEKK3, and determine a 2.35 Å cocrystal structure. We find Mekk3 deficiency impairs neurovascular integrity, which is partially dependent on Rho–ROCK signalling, and that disruption of MEKK3:CCM2 interaction leads to similar neurovascular leakage. We conclude that CCM2:MEKK3-mediated regulation of Rho signalling is required for maintenance of neurovascular integrity, unravelling a mechanism by which CCM2 loss leads to disease.

  9. Early diagnosis of congenital vascular malformation as a condition to rapid prevention of complications – case study

    Directory of Open Access Journals (Sweden)

    Dominika Jaguś

    2017-06-01

    Full Text Available Klippel–Trénaunay syndrome is a rare congenital condition characterised by a triad of symptoms: capillary-lymphatic-venous malformations, varicose veins and venous malformations as well as soft tissue and skeletal hypertrophy of the affected limb. In this article, we present a case of a 5-year-old boy with extensive vascular malformations of the lower limbs and the buttock region. In this case, manifestation of all three symptoms was gradual. At the age of 4 years, the patient was admitted to the Department of Imaging Diagnostics for further diagnosis, where the triad characteristic for Klippel–Trénaunay syndrome and popliteal vein agenesis were diagnosed. Currently, a multidisciplinary team takes care of the boy in the Children’s Memorial Health Institute. Early and accurate diagnosis allows for rapid prevention of complications associated with Klippel–Trénaunay syndrome and enables patient-tailored treatment.

  10. Associação de malformação vascular e gliomas: estudo de quatro casos Arteriovenous malformation-glioma association: study of four cases

    Directory of Open Access Journals (Sweden)

    Lia Raquel R. Borges

    2003-06-01

    Full Text Available Entre os pacientes operados no Hospital São Paulo e acompanhados pelo setor de neuro-oncologia no período de 1991 a 2000, avaliamos a apresentação clínica, aspectos de imagem e características histopatológicas de 4 pacientes (2 homens; idade entre 15 e 52 anos cujo diagnóstico histológico foi malformação vascular associada a glioma. O quadro inicial foi cefaléia progressiva com características de hipertensão intracraniana (em 3 e crises parciais motoras (em 1. O diagnóstico tomográfico inicial foi processo expansivo, sem que houvesse suspeita de malformação vascular pelo aspecto da imagem em nenhum caso. O exame histológico mostrou neoplasias de linhagem astrocítica associadas a malformações vasculares. Em nenhum paciente o componente vascular esteve localizado na intimidade da neoplasia. A associação de malformação vascular e gliomas é rara e deve ser caracterizada por nítida separação entre a malformação e a neoplasia, independente da vascularização própria do tumor.We reviewed the clinical presentation, imaging and histopathologic findings in 4 patients with the diagnosis of arteriovenous malformation associated with glioma that were operated on from 1991 to 2000 in our institution. Four patients (2 males; age between 15 and 52 years presented with progressive headache with clinical evidence of intracranial hypertension (in 3 and partial seizures (in 1. CT scan showed a brain tumor without any detectable pathologic vessels. Histologic examination revealed astrocytic tumors associated with arteriovenous malformation. No patient presented the vascular component intermixed with the tumor. The arteriovenous-glioma association is rare and must be identified by a clear demarcation between the malformation and the tumor.

  11. Vascular ultrasound for atherosclerosis imaging

    NARCIS (Netherlands)

    C.L. de Korte (Chris); H.H.G. Hansen (Hendrik); A.F.W. van der Steen (Ton)

    2011-01-01

    textabstractCardiovascular disease is a leading cause of death in the Western world. Therefore, detection and quantification of atherosclerotic disease is of paramount importance to monitor treatment and possible prevention of acute events. Vascular ultrasound is an excellent technique to assess the

  12. Diode laser to treat small oral vascular malformations: A prospective case series study.

    Science.gov (United States)

    Bacci, Christian; Sacchetto, Luca; Zanette, Gastone; Sivolella, Stefano

    2017-09-14

    The current work examined a consecutive series of patients presenting vascular malformations (VMs) and venous lakes (VLs) of the lip and oral mucosa who were treated with transmucosal diode laser applications and assessed over a 1 year period. Fifty-nine patients (31 males and 28 females) presenting low-flow VMs or VLs of the oral cavity were treated transmucosally using a diode laser (with an 830 nm operating wavelength and 1.6 W output power) with a 320 µm diameter flexible fiber. All the lesions were assessed 7 days, 30 days, and 1 year after the laser treatment, and the lesion reduction percentage was scored on a one to five scale. The patients were also asked to assess their pain perception daily during the 7 days following the treatment using a visual analog scale (VAS). There were no procedure-related intra- or post-operative complications; only modest pain intensity was reported. Thirty days after the treatment, lesion reduction was described as excellent or good in 52 cases; it was fair or poor in 7. Six patients (F:M ratio 2:4) required a second diode laser application. At the 1 year follow-up, volume reduction was complete in 48 out of 59 patients; there were five recurrences (F:M ratio 3:2). No relevant gender-related differences were noted. The use of diode laser application to treat small oral VMs and VLs was associated to shorter operating times and fewer postoperative complications with respect to the scapel surgery approach. More than one session may nevertheless be required if the anomaly is larger than 10 mm. Lasers Surg. Med. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  13. Psychological comorbidities and compliance to interventional treatment of patients with cutaneous vascular malformations.

    Science.gov (United States)

    Kenny, Stephanie A; Majeed, Nevin; Zhand, Naista; Glikstein, Rafael; Agid, Ronit; Dos Santos, Marlise P

    2016-08-01

    The aim of this study was to assess qualitatively the psychological stressors affecting patients with cutaneous vascular malformations and hemangiomas (CVM-H) and their impact on compliance to interventional treatment. A retrospective chart review was conducted of all patients with CVM-H treated by interventional neuroradiology at a single academic institution during a five-year period (2009-2014). Psychological complaints were documented during each clinic visit by a neuroradiologist. Compliance to interventional treatment was defined by adherence to the scheduled treatment sessions. Fisher's exact test was used to assess for associations between psychological complaints and compliance. Seventy-five patients were assessed, of whom 49 (65.3%) were female, with an age range of 2-78 years (mean age 30.2 years). All except one patient older than seven years of age (n = 71; 94.6%) had a psychological complaint, including fear of negative appearance (n = 53; 70.6%), dissatisfaction with appearance (n = 46; 61.3%), low self-esteem (n = 35; 46.6%), anxiety (n = 16; 21.3%), stress (n = 13; 17.3%), bullying (n = 5; 6.6%), and low mood (n = 4; 5.3%). Twenty-three (31%) patients were non-compliant. Low self-esteem was significantly associated with non-compliance (p = 0.0381). There is a high prevalence of psychological comorbidities among patients treated for CVM-H. This has potential implications for interventional treatment, as it was found that low self-esteem is significantly associated with non-compliance. These results suggest the need for early psychological support in these patients in order to maximize compliance to interventional treatment. © The Author(s) 2016.

  14. Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience

    Energy Technology Data Exchange (ETDEWEB)

    Boatta, Emanuele, E-mail: emanuele.boatta@yahoo.it; Jahn, Christine, E-mail: christine.jahn@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France); Canuet, Matthieu, E-mail: matthieu.canuet@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, Service Service de Pneumologie, Nouvel Hôpital Civil (France); Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France)

    2017-02-15

    AIMTo report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT).Materials and MethodsFour consecutive female patients (mean age 38.0 years; range 25–55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization. One patient was symptomatic with recent transient ischaemic attack. Follow-up was undertaken at 1-month post-procedure with CECT to assess PAVMs permeability and MVP positioning and at 1-, 6-, and 12-month post-procedure, with echocardiography/bubble test and standard neurological history, to confirm absence of right-to-left shunts and recurrent symptoms.ResultsEight PAVMs were treated in 4 patients over 5 interventional sessions (mean 1.6 PAVMs per session). All PAVMs were simple, with mean feeding artery diameter of 4.25 mm. Eight 6.5 mm MVPs were deployed in total (one per lesion). Technical success was 100%. Mean procedural time and patient dose per session were 70 min (range 40–70 min) and 53418 mGy.cm{sup 2} (range 6113–101628 mGy.cm{sup 2}), respectively. No signs of reperfusion neither of MPV migration were noted at 1-month CECT follow-up. At early follow-up (mean 3.75 months; range 1–12 months), clinical success was 100% with no evidence of recurrent right-to-left shunt, and no neurological symptoms. No immediate or late complications were observed.ConclusionsMVP embolization of PAVMs appears technically feasible, safe, and effective at early follow-up. Further prospective studies are required to confirm long-term safety and efficacy of this promising technique.

  15. Occlusive vascular Ehlers-Danlos syndrome accompanying a congenital cystic adenomatoid malformation of the lung: report of a case.

    Science.gov (United States)

    Sa, Young Jo; Kim, Young Du; Moon, Seok-Whan; Kim, Chi-Kyung; Ki, Chang Seok

    2013-12-01

    An 8-year-old male presented with a cystic lung lesion in the left lower lobe, which was initially detected during surgery for a spontaneous rupture of the sigmoid colon at the age of 6 years. Tissue fragility and a tendency to bleed easily were noted during the surgery, which strongly suggested vascular Ehlers-Danlos syndrome. Although there was no abnormality in the hemostasis screening test, or any suspicious hereditary problem in his pedigree, genetic gene testing for vascular Ehlers-Danlos syndrome was recommended, and showed a de novo mutation in the COL3A1 gene. This report presents the case of patient with occlusive vascular Ehlers-Danlos syndrome accompanying a congenital cystic adenomatoid malformation of lung, in addition to a duplicated infrarenal vena cava.

  16. Balloon-Occluded Retrograde Transvenous Obliteration of a Gastric Vascular Malformation: An Innovative Approach to Treatment of a Rare Condition

    Energy Technology Data Exchange (ETDEWEB)

    Hansing, Catherine E., E-mail: catherine.e.hansing.mil@mail.mil [Naval Medical Center Portsmouth, Transitional Year/Graduate Medical Education Department, Medical Corps, United States Navy (United States); Marquardt, Joseph P.; Sutton, Daniel M.; York, John D. [Naval Medical Center Portsmouth, Radiology Department, Medical Corps, United States Navy (United States)

    2017-02-15

    Arteriovenous malformations (AVMs) are a high-flow form of a vascular malformation, which can be found anywhere in the body. While historically treated surgically, a multidisciplinary approach utilizing multiple specialties and treatment modalities is now commonly employed. In order to effectively treat an AVM, the nidus must be targeted and eradicated, which can be done via multiple approaches. We present the case of a 43-year-old male with a gastric wall AVM, which was initially incompletely treated using a percutaneous transarterial approach. The gastric AVM was noted to have dominant drainage through a gastrorenal shunt; therefore, Balloon-occluded Retrograde Transvenous Obliteration (BRTO) was utilized to eradicate the AVM nidus. This case illustrates the utility of Interventional Radiology, specifically BRTO, as another treatment option for challenging AVMs.

  17. Brainstem and cerebellar cavernous malformations.

    Science.gov (United States)

    Atwal, Gursant S; Sarris, Christina E; Spetzler, Robert F

    2017-01-01

    Cavernous malformations are vascular lesions that occur throughout the central nervous system, most commonly in the supratentorial location, with brainstem and cerebellar cavernous malformations occurring more rarely. Cavernous malformations are associated with developmental venous anomalies that occur sporadically or in familial form. Patients with a cavernous malformation can present with headaches, seizures, sensorimotor disturbances, or focal neurologic deficits based on the anatomic location of the lesion. Patients with infratentorial lesions present more commonly with a focal neurologic deficit. Cavernous malformations are increasingly discovered incidentally due to the increasing use of magnetic resonance imaging. Understanding the natural history of these lesions is essential to their management. Observation and surgical resection are both reasonable options in the treatment of patients with these lesions. The clinical presentation of the patient, the location of the lesion, and the surgical risk assessment all play critical roles in management decision-making. © 2017 Elsevier B.V. All rights reserved.

  18. Venous malformations: MR imaging features that predict skin burns after percutaneous alcohol embolization procedures.

    Science.gov (United States)

    Fayad, Laura M; Hazirolan, Tuncay; Carrino, John A; Bluemke, David A; Mitchell, Sally

    2008-10-01

    To examine the value of magnetic resonance (MR) imaging for predicting the occurrence of skin burns in patients with venous malformations who undergo percutaneous alcohol embolization was the objective of the study. Pre-procedural MR imaging at 1.5 T from 40 patients with venous malformations who had undergone percutaneous alcohol embolization was retrospectively reviewed by two observers for these features: anatomic location, definition (well-defined or ill-defined), and the presence of skin, subcutaneous tissue, muscle, tendon, bone, joint, and deep venous system involvement. One observer recorded the length of skin involvement and volume of the malformation. Univariate and multivariate analysis tests were used to determine whether an association between the occurrence of skin burns and MR imaging features existed. The anatomic locations of the venous malformations were the lower extremity (20 out of 40), upper extremity (11 out of 40), trunk (four out of 40), head/neck (three out of 40) and pelvis (two out of 40). Of the 40 subjects, 15% (six out of 40) experienced skin burns. There was a significant association between the absence of muscle involvement (p = 0.0198) as well as the length of skin involvement (p = 0.027), with the occurrence of skin burns. Malformation size and all other features were not significantly associated with skin burns. Skin burns in patients with venous malformations treated with alcohol embolization are associated with the length of skin involvement and with the absence of deeper tissue involvement, as depicted on MR imaging.

  19. Imaging findings of arteriovenous malformations involving lung and liver in hereditary hemorrhagic telangiectasia(Osler-weber-rendu disease): two cases report

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Jeong Geun; Lee, Joo Hyuk; Seong, Su Ok [Cheongju St. Mary' s Hospital, Cheongju (Korea, Republic of)

    1999-09-01

    Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant disorder characterized by repeated episodes of bleeding. Multiple telangiectases consisting of thin-walled, dilated vascular channels with arteriovenous communication may involve, for example, mucocutaneous tissue, the gastrointestinal tract, and the liver, lung, and brain. We report the imaging findings of two cases of HHT involving arteriovenous malformation of both the lungs and liver, a rare condition. Chest radiography revealed a round mass, while helical CT showed a feeding artery and draining vein with arteriovenous malformation in the lung. Color Doppler sonography revealed an enlarged and tortuous hepatic artery with high systolic velocity. CT demonstrated an enlarged hepatic artery, arteriovenous shunt, and early draining hepatic vein in the liver. Celiac angiography showed arteriovenous malformation.

  20. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    Directory of Open Access Journals (Sweden)

    Sherry M. Zakhary, DO

    2017-06-01

    Full Text Available A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  1. S.E. Mitchell Vascular Anomalies Flow Chart (SEMVAFC): a visual pathway combining clinical and imaging findings for classification of soft-tissue vascular anomalies.

    Science.gov (United States)

    Tekes, A; Koshy, J; Kalayci, T O; Puttgen, K; Cohen, B; Redett, R; Mitchell, S E

    2014-05-01

    Classification of vascular anomalies (VAs) is challenging due to overlapping clinical symptoms, confusing terminology in the literature and unfamiliarity with this complex entity. It is important to recognize that VAs include two distinct entities, vascular tumours (VTs) and vascular malformations (VaMs). In this article, we describe SE Mitchell Vascular Anomalies Flow Chart (SEMVAFC), which arises from a multidisciplinary approach that incorporates clinical symptoms, physical examination and magnetic resonance imaging (MRI) findings to establish International Society for the Study of Vascular Anomalies (ISSVA)-based classification of the VAs. SEMVAFC provides a clear visual pathway for physicians to accurately diagnose Vas, which is important as treatment, management, and prognosis differ between VTs and VaMs. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Real-time imaging of de novo arteriovenous malformation in a mouse model of hereditary hemorrhagic telangiectasia.

    Science.gov (United States)

    Park, Sung Ok; Wankhede, Mamta; Lee, Young Jae; Choi, Eun-Jung; Fliess, Naime; Choe, Se-Woon; Oh, Seh-Hoon; Walter, Glenn; Raizada, Mohan K; Sorg, Brian S; Oh, S Paul

    2009-11-01

    Arteriovenous malformations (AVMs) are vascular anomalies where arteries and veins are directly connected through a complex, tangled web of abnormal arteries and veins instead of a normal capillary network. AVMs in the brain, lung, and visceral organs, including the liver and gastrointestinal tract, result in considerable morbidity and mortality. AVMs are the underlying cause of three major clinical symptoms of a genetic vascular dysplasia termed hereditary hemorrhagic telangiectasia (HHT), which is characterized by recurrent nosebleeds, mucocutaneous telangiectases, and visceral AVMs and caused by mutations in one of several genes, including activin receptor-like kinase 1 (ALK1). It remains unknown why and how selective blood vessels form AVMs, and there have been technical limitations to observing the initial stages of AVM formation. Here we present in vivo evidence that physiological or environmental factors such as wounds in addition to the genetic ablation are required for Alk1-deficient vessels to develop to AVMs in adult mice. Using the dorsal skinfold window chamber system, we have demonstrated for what we believe to be the first time the entire course of AVM formation in subdermal blood vessels by using intravital bright-field images, hyperspectral imaging, fluorescence recordings of direct arterial flow through the AV shunts, and vascular casting techniques. We believe our data provide novel insights into the pathogenetic mechanisms of HHT and potential therapeutic approaches.

  3. Abdominal vascular syndromes: characteristic imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D' Ippolito, Giuseppe, E-mail: leandrocleite@gmail.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Mediciana. Departmento de Diagnostico por Imagem

    2016-07-15

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital - including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) - compressive - including 'nutcracker' syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. (author)

  4. Vascular malformations of the small intestine manifesting as chronic anemia: Two pediatric cases managed by single-site umbilical laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Soo-Hong Kim

    2017-01-01

    Conclusion: Considering the rarity and possibility of gastrointestinal bleeding due to vascular malformations, it is necessary to be regarded as one of differential diagnosis when managing a lower gastrointestinal bleeding in pediatric patients. Besides, a minimal invasive procedure could be suggested as a good surgical option when necessary.

  5. The Role of Cine Flow Magnetic Resonance Imaging in Patients with Chiari 0 Malformation.

    Science.gov (United States)

    Ozsoy, Kerem Mazhar; Oktay, Kadir; Cetinalp, Nuri Eralp; Gezercan, Yurdal; Erman, Tahsin

    2016-12-14

    The aim of this study was to define the role of phase-contrast cine magnetic resonance imaging in deciding the therapeutic strategy and underlying pathophysiology resulting in syrinx formation in patients with Chiari type 0 malformation. Seven patients admitted to our clinic with diagnosis of Chiari 0 malformations during the period January 2005 to July 2016 were enrolled in the study. All patients underwent a detailed preoperative neurological examination. The entire neuroaxis magnetic resonance imaging and phase-contrast cine magnetic resonance imaging was obtained preoperatively and postoperatively. Seven patients (5 female and 2 male) cover the inclusion criteria of the Chiari type 0. All of the patients with Chiari type 0 malformation had absent cine flow at the craniovertebral junction except two patients. All these five patients underwent surgical interventions; suboccipital decompression and duraplasty. All of them showed both clinical and imaging improvements postoperatively. Cine flow magnetic resonance imaging appears to be a useful tool in the management of patients with Chiari 0 malformations. There was a good correlation between the clinical presentation and cine flow preoperatively, and between clinical improvement and cine flow postoperatively.

  6. BRAIN ARTERIOVENOUS MALFORMATIONS

    African Journals Online (AJOL)

    DR ADEYINKA

    Brain Arteriovenous Malformation (BAVM) is a form of congenital vascular malformation that are present at birth, and may be evident clinically, and usually will grow commensurately with the child. We report an adult ,a 40-year-old woman with brain arteriovenous malformation presenting with headache and epileptic.

  7. Congenital pseudoarthrosis associated with venous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hadidy, A.; Haroun, A.; Al-Ryalat, N. [Jordan University Hospital, Radiology Department, P.O. Box 340621, Amman (Jordan); Hamamy, H. [Endocrinology and Genetics, National Center for Diabetes, Amman (Jordan); Al-Hadidi, S. [Jordan University Hospital, Departments of Orthopedics, Amman (Jordan)

    2007-06-15

    Congenital pseudoarthrosis is a pathologic entity that may be isolated, or may be associated with neurofibromatosis. We report the case of a 3-year-old female with congenital pseudoarthrosis involving the right tibia and fibula. Magnetic resonance imaging (MRI) and complementary magnetic resonance angiogram (MRA) revealed a lobulated mass with vivid enhancement, which led to the diagnosis of venous malformation. This is the first report of congenital pseudoarthrosis caused by the presence of a vascular malformation. (orig.)

  8. Cardiac Computed Tomography Angiography for Imaging Coronary Arteriovenous Malformation: a Case Report

    Directory of Open Access Journals (Sweden)

    Zsuzsanna Suciu

    2014-02-01

    Full Text Available Background: Coronary arteriovenous malformation is a rare congenital disease consisting mainly in a direct communication between a coronary artery and any one of the four cardiac chambers, coronary sinus, pulmonary arteries or veins. This disease can lead to various cardiovascular events, their severity depending on the degree of the malformation. Case report: We present the case of a 56-year-old male patient, who was admitted to our institution with dyspnea, palpitation and chest pain, having a history of hypertension and hyperlipidemia, and an abnormal electrocardiogram. Physical examination did not reveal any alterations and the cardiac enzymes were in normal ranges. Cardiac computed tomography was performed before any other invasive studies, with a 64-row scanner (Somatom Sensation multislice 64 equipment, Siemens after intravenous administration of non-ionic contrast material. CT scan revealed a large (2-2.5 mm coronary fistula originating from the LAD to the main pulmonary artery, and multiple significant atherosclerotic coronary lesions. Coronary angiography confirmed the arteriovenous malformation between LAD and pulmonary artery, associated with three vascular coronary artery disease. Conclusions: Cardiac computed tomography angiography can help for a non-invasive diagnosis of the coronary artery malformations, in the same time revealing anatomic details which can be particulary useful for choosing the appropriate management strategy (surgical planning, interventional treatment or optimum medical treatment

  9. Floseal® use in dermatologic surgical management of vascular malformations: A novel haemostatic agent in Côte d’Ivoire

    Directory of Open Access Journals (Sweden)

    Komenan Kassi

    2017-10-01

    Full Text Available A vascular malformation is a congenital growth of artery, venous, capillary or lymphatic vessels leading to functional and aesthetic problems. Although surgical maneuvers allow correction of abnormalities, it poses risk of intra and post-operative blood loss. Sealants have been used during surgical procedures to reduce blood loss. A descriptive study was conducted on a new generation Floseal® to demonstrate its effectiveness to reduce intra and post-operative bleeding during vascular malformation corrective surgery. A group of 19 patients presented with vascular malformations and underwent surgical correction associated with Floseal® use. The mean age of our patients’ was 12.3 years (1 to 33 years. The majority of them (57.6% were aged between 5 to 15 years. The most common vascular malformation treated was hemangioma (45.5%. Majority of these lesions were located on the head (72.7%. Blood transfusion was not accounted for in any of the cases as average blood loss was 18.18 mL (5 to 70 mL. The average length of hospital stay was 2.4 days. Ten patients (90.9% were discharged in 2 days after drain was removed. Floseal®, a new generation local haemostatic, is easy to use and efficient to achieve haemostasis for treatment of vascular malformation. Haemostasis was achieved in a short time and blood loss was minimal. However, caution should be taken to reduce allergic reactions and potential viral transmissions, and further study should be done to recommend its use.

  10. Digital image processing of vascular angiograms

    Science.gov (United States)

    Selzer, R. H.; Beckenbach, E. S.; Blankenhorn, D. H.; Crawford, D. W.; Brooks, S. H.

    1975-01-01

    The paper discusses the estimation of the degree of atherosclerosis in the human femoral artery through the use of a digital image processing system for vascular angiograms. The film digitizer uses an electronic image dissector camera to scan the angiogram and convert the recorded optical density information into a numerical format. Another processing step involves locating the vessel edges from the digital image. The computer has been programmed to estimate vessel abnormality through a series of measurements, some derived primarily from the vessel edge information and others from optical density variations within the lumen shadow. These measurements are combined into an atherosclerosis index, which is found in a post-mortem study to correlate well with both visual and chemical estimates of atherosclerotic disease.

  11. Time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla for evaluation of hemodynamic characteristics of vascular malformations: description of distinct subgroups.

    Science.gov (United States)

    Hammer, Simone; Uller, Wibke; Manger, Florentine; Fellner, Claudia; Zeman, Florian; Wohlgemuth, Walter A

    2017-01-01

    Quantitative evaluation of hemodynamic characteristics of arteriovenous and venous malformations using time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla. Time-resolved MRA with interleaved stochastic trajectories (TWIST) at 3.0 Tesla was studied in 83 consecutive patients with venous malformations (VM) and arteriovenous malformations (AVM). Enhancement characteristics were calculated as percentage increase of signal intensity above baseline over time. Maximum percentage signal intensity increase (signalmax), time intervals between onset of arterial enhancement and lesion enhancement (tonset), and time intervals between beginning of lesion enhancement and maximum percentage of lesion enhancement (tmax) were analyzed. All AVMs showed a high-flow hemodynamic pattern. Two significantly different (p < 0.001) types of venous malformations emerged: VMs with arteriovenous fistulas (AVF) (median signalmax 737 %, IQR [interquartile range] = 511 - 1182 %; median tonset 5 s, IQR = 5 - 10 s; median tmax 35 s, IQR = 26 - 40 s) and without AVFs (median signalmax 284 %, IQR = 177-432 %; median tonset 23 s, IQR = 15 - 30 s; median tmax 60 s, IQR = 55 - 75 s). Quantitative evaluation of time-resolved MRA at 3.0 Tesla provides hemodynamic characterization of vascular malformations. VMs can be subclassified into two hemodynamic subgroups due to presence or absence of AVFs. • Time-resolved MRA at 3.0 Tesla provides quantitative hemodynamic characterization of vascular malformations. • Malformations significantly differ in time courses of enhancement and signal intensity increase. • AVMs show a distinctive high-flow hemodynamic pattern. • Two significantly different types of VMs emerged: VMs with and without AVFs.

  12. Proteus Syndrome with Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Ali Asilian

    2017-01-01

    Full Text Available Proteus syndrome is a rare sporadic disorder that appears with localized macrosomia, congenital lipomatosis, and slow flow vascular malformations, connective tissue nevus, and epidermal nevus. There are usually some manifestations at birth. The vascular abnormalities that have been reported in Proteus syndrome are capillary and slow flow venous malformation. We report a case of a 10-year-old boy with confirmed Proteus syndrome characterized by high flow vascular malformation (arteriovenous [AV] malformation unlike the usual vascular malformations seen in this syndrome. This case adds a new perspective to the established clinical findings of the Proteus syndrome.

  13. Shared Decision-Making in the Management of Congenital Vascular Malformations

    NARCIS (Netherlands)

    Horbach, S.E.; Ubbink, D.T.; Stubenrouch, F.E.; Koelemay, M.J.; Vleuten, C.J.M. van der; Verhoeven, B.H.; Reekers, J.A.; Schultze Kool, L.J.; Horst, C.M. van der

    2017-01-01

    BACKGROUND: In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular

  14. Diagnostic dilemma in vascular mal-formation of the upper lip: a ...

    African Journals Online (AJOL)

    richard

    2014-09-08

    Sep 8, 2014 ... (http://creativecommons.org/licenses/by-nc-sa/3.0/) which permits unrestricted, non-commercial, share-alike use, distribution, and reproduction in ... To present a case of vascular lesion on the upper lip and its management. ... diagnostic and management challenge initially diagnosed as haemangioma, but.

  15. Structural and functional imaging for vascular targeted photodynamic therapy

    Science.gov (United States)

    Li, Buhong; Gu, Ying; Wilson, Brian C.

    2017-02-01

    Vascular targeted photodynamic therapy (V-PDT) has been widely used for the prevention or treatment of vascular-related diseases, such as localized prostate cancer, wet age-related macular degeneration, port wine stains, esophageal varices and bleeding gastrointestinal mucosal lesions. In this study, the fundamental mechanisms of vascular responses during and after V-PDT will be introduced. Based on the V-PDT treatment of blood vessels in dorsal skinfold window chamber model, the structural and functional imaging, which including white light microscopy, laser speckle imaging, singlet oxygen luminescence imaging, and fluorescence imaging for evaluating vascular damage will be presented, respectively. The results indicate that vessel constriction and blood flow dynamics could be considered as the crucial biomarkers for quantitative evaluation of vascular damage. In addition, future perspectives of non-invasive optical imaging for evaluating vascular damage of V-PDT will be discussed.

  16. Deep tissue near-infrared imaging for vascular network analysis

    Directory of Open Access Journals (Sweden)

    Kübra Seker

    2017-05-01

    Full Text Available Subcutaneous vein network plays important roles to maintain microcirculation that is related to some diagnostic aspects. Despite developments of optical imaging technologies, still the difficulties about deep skin vascular imaging have been continued. On the other hand, since hemoglobin concentration of human blood has key role in the veins imaging by optical manner, the used wavelength in vascular imaging, must be chosen considering absorption of hemoglobin. In this research, we constructed a near infrared (NIR light source because of lower absorption of hemoglobin in this optical region. To obtain vascular image, reflectance geometry was used. Next, from recorded images, vascular network analysis, such as calculation of width of vascular of interest and complexity of selected region were implemented. By comparing with other modalities, we observed that proposed imaging system has great advantages including nonionized radiation, moderate penetration depth of 0.5–3mm and diameter of 1mm, cost-effective and algorithmic simplicity for analysis.

  17. Escleroterapia con bleomicina en malformaciones vasculares de bajo flujo: Experiencia y revisión del tema Bleomycin sclerotherapy for low-flow vascular malformations: our experience and literature review

    Directory of Open Access Journals (Sweden)

    F. Lobo Bailón

    2012-12-01

    Full Text Available Las anomalías vasculares son lesiones típicas de los pacientes pediátricos y se dividen en dos categorías: tumores vasculares y malformaciones vasculares de alto y bajo flujo. Estas últimas pueden tratarse de diversos modos: laserterapia, drenaje, aspiración, cirugía o escleroterapia, dependiendo del tipo de lesión y de su localización. Entre los agentes esclerosantes utilizados, la bleomicina ha demostrado tener buenos resultados en el tratamiento de estas lesiones. En este artículo presentamos nuestra experiencia en el tratamiento de las malformaciones vasculares de bajo flujo mediante escleroterapia con bleomicina intralesional. Desarrollamos un estudio descriptivo retrospectivo sobre 30 pacientes que presentaban malformación vascular de bajo flujo y fueron tratados con bleomicina intralesional. Los resultados fueron buenos o excelentes en 22 pacientes y regulares o malos en los 8 restantes. De acuerdo a nuestra casuística y a la literatura revisada, la escleroterapia con bleomicina es una alternativa terapéutica eficaz y segura en el tratamiento de las malformaciones vasculares de bajo flujo.Vascular anomalies are common in children and can be divided into two categories, vascular tumours and vascular malformations: high-flow or low-flow. The latter can be treated in different ways such as lasertherapy, drainage, aspiration, surgery or sclerotherapy depending on the type and location of the lesion. Among the accepted sclerosing agents, bleomycin has proven good results in the treatment of this condition. Herein we present our experience in the treatment of low-flow vascular malformations with intralesional bleomycin injection. This is a retrospective, descriptive study with 30 patients presenting a low-flow vascular malformation treated with intralesional bleomycin injection. Our results are good or excellent in 22 patients and poor in the other 8. According to our case series and the consulted literature, sclerotherapy with

  18. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Picel, Andrew C., E-mail: apicel@ucsd.edu [University of California, San Diego, Department of Radiology (United States); Koo, Sonya J. [University of Texas Southwestern Medical Center, Department of Radiology (United States); Roberts, Anne C. [University of California, San Diego, Department of Radiology (United States)

    2016-08-15

    PurposeThe purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs).Materials and methodsA retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %).ResultsEmbolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization.ConclusionsTAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

  19. Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate for the Treatment of Acquired Uterine Vascular Malformations.

    Science.gov (United States)

    Picel, Andrew C; Koo, Sonya J; Roberts, Anne C

    2016-08-01

    The purpose of the study was to evaluate the technique and outcomes of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for the treatment of acquired uterine arteriovenous malformations (AVMs). A retrospective review identified five women treated for suspected acquired uterine AVMs with TAE at our institution. Four women (80 %) presented with heavy or intermittent vaginal bleeding after obstetric manipulation. One woman (20 %) was treated for an incidental AVM discovered on ultrasound after an uncomplicated cesarean section. Three women underwent one embolization procedure and two women required two procedures. Embolization material included NBCA in six procedures (80 %) and gelatin sponge in one procedure (20 %). Embolization resulted in angiographic stasis of flow in all seven procedures. Four women (80 %) presented with vaginal bleeding which was improved after treatment. One woman returned 24 days after unilateral embolization with recurrent bleeding, which resolved after retreatment. One woman underwent two treatments for an asymptomatic lesion identified on ultrasound. There were no major complications. Three women (60 %) experienced mild postembolization pelvic pain that was controlled with non-steroidal anti-inflammatory drugs. Three women (60 %) had pregnancies and deliveries after embolization. TAE is a safe alternative to surgical therapy for acquired uterine AVMs with the potential to maintain fertility. Experience from this case series suggests that NBCA provides predictable and effective occlusion.

  20. Crystal Structure of CCM3, a Cerebral Cavernous Malformation Protein Critical for Vascular Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Li, X.; Zhang, R; Zhang, H; He, Y; Ji, W; Min, W; Boggon, T

    2010-01-01

    CCM3 mutations are associated with cerebral cavernous malformation (CCM), a disease affecting 0.1-0.5% of the human population. CCM3 (PDCD10, TFAR15) is thought to form a CCM complex with CCM1 and CCM2; however, the molecular basis for these interactions is not known. We have determined the 2.5 {angstrom} crystal structure of CCM3. This structure shows an all {alpha}-helical protein containing two domains, an N-terminal dimerization domain with a fold not previously observed, and a C-terminal focal adhesion targeting (FAT)-homology domain. We show that CCM3 binds CCM2 via this FAT-homology domain and that mutation of a highly conserved FAK-like hydrophobic pocket (HP1) abrogates CCM3-CCM2 interaction. This CCM3 FAT-homology domain also interacts with paxillin LD motifs using the same surface, and partial CCM3 co-localization with paxillin in cells is lost on HP1 mutation. Disease-related CCM3 truncations affect the FAT-homology domain suggesting a role for the FAT-homology domain in the etiology of CCM.

  1. When a lymphatic malformation determines a bowel volvulus: Are clinical status and images always reliable?

    Science.gov (United States)

    Guida, Edoardo; Di Grazia, Massimo; Cattaruzzi, Elisabetta; Bussani, Rossana; Rigamonti, Waifro; Lembo, Maria Antonietta

    2016-01-01

    An acute abdomen in the form of small-bowel volvulus could be a presentation of a lymphatic malformation in childhood. A 5year old male was admitted to our Institute for an acute abdomen. Clinical aspects and radiological images were not specific for a certain diagnosis. Laparotomy revealed a big soft mass, with a milky content, completely involving about 50cm of ileus with a partial volvulus of the intestinal loop. A complete mass excision and also a bowel involved resection were performed. After a histological examination, a lymphatic malformation was diagnosed. The diagnosis of a mesenteric lymphatic malformation could be intraoperative and a complete resection should be the treatment of choice. Sometimes it could be necessary to perform an involved bowel tract resection in the case of volvolus with ischemia. Paediatricians and surgeons should bare in mind that an intrabdominal lymphatic malformation may present as a nonspecific an acute abdomen caused by a bowel volvolus and diagnosis may not be so simple preoperatively. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla for evaluation of hemodynamic characteristics of vascular malformations: description of distinct subgroups

    Energy Technology Data Exchange (ETDEWEB)

    Hammer, Simone; Fellner, Claudia; Wohlgemuth, Walter A. [University Hospital Regensburg, Department of Radiology, Regensburg (Germany); Uller, Wibke [Boston Children' s Hospital and Harvard Medical School, Division of Vascular and Interventional Radiology, Boston, MA (United States); University Hospital Regensburg, Department of Radiology, Regensburg (Germany); Manger, Florentine [University Hospital Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Zeman, Florian [University Hospital Regensburg, Center for Clinical Trials, Regensburg (Germany)

    2017-01-15

    Quantitative evaluation of hemodynamic characteristics of arteriovenous and venous malformations using time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla. Time-resolved MRA with interleaved stochastic trajectories (TWIST) at 3.0 Tesla was studied in 83 consecutive patients with venous malformations (VM) and arteriovenous malformations (AVM). Enhancement characteristics were calculated as percentage increase of signal intensity above baseline over time. Maximum percentage signal intensity increase (signal{sub max}), time intervals between onset of arterial enhancement and lesion enhancement (t{sub onset}), and time intervals between beginning of lesion enhancement and maximum percentage of lesion enhancement (t{sub max}) were analyzed. All AVMs showed a high-flow hemodynamic pattern. Two significantly different (p < 0.001) types of venous malformations emerged: VMs with arteriovenous fistulas (AVF) (median signal{sub max} 737 %, IQR [interquartile range] = 511 - 1182 %; median t{sub onset} 5 s, IQR = 5 - 10 s; median t{sub max} 35 s, IQR = 26 - 40 s) and without AVFs (median signal{sub max} 284 %, IQR = 177-432 %; median t{sub onset} 23 s, IQR = 15 - 30 s; median t{sub max} 60 s, IQR = 55 - 75 s). Quantitative evaluation of time-resolved MRA at 3.0 Tesla provides hemodynamic characterization of vascular malformations. VMs can be subclassified into two hemodynamic subgroups due to presence or absence of AVFs. (orig.)

  3. Complex Genital Malformation in a Female with Congenital Adrenal Hyperplasia: Evaluation with Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Klessen, C.; Asbach, P.; Hein, P. A.; Beyersdorff, D.; Hamm, B.; Taupitz, M. [Humboldt-Univ. of Berlin, Campus Charite Mitte (Germany). Dept. of Radiology

    2005-12-01

    This is a case of complex genital malformation in a young patient with congenital adrenal hyperplasia. The magnetic resonance imaging (MRI) findings included ostium of the vagina into the urethra (common urogenital opening), prostate-like tissue surrounding the urethra, and hyperplasia of the left adrenal gland. The report provides information on the clinical findings, the MRI examination, including the applied sequences and the MR findings, and gives an overview of the disease pattern and its frequency of occurrence.

  4. The role of magnetic resonance imaging in the prenatal management of a lymphatic malformation.

    Science.gov (United States)

    Liu, Y-P; Su, W-K; Lin, Y-L; Fan, Y-K

    2014-01-01

    We report the magnetic resonance imaging (MRI) findings in a case of extensive fetal lymphatic malformation involving the upper left arm and axillo-thoraco-abdominal wall found on routine prenatal ultrasound (US) examination at 22 weeks of gestation. MRI clearly reveals the tumor extent and tissue characteristics, and thick-slab T2-weighted MRI has the capacity to provide more information on the cystic lesion on global overview.

  5. Prenatal diagnosis of 'isolated' Dandy-Walker malformation: imaging findings and prenatal counselling.

    Science.gov (United States)

    Guibaud, Laurent; Larroque, Anne; Ville, Dorothée; Sanlaville, Damien; Till, Marianne; Gaucherand, Pascal; Pracros, Jean-Pierre; des Portes, Vincent

    2012-02-01

    The purpose of this article is to improve prenatal imaging diagnosis and counselling for cases of 'isolated' Dandy-Walker malformation (DWM) in the light of recent literature, which has demonstrated a potential good clinical and intellectual outcome of fetuses presenting with DWM characterised by partial vermian agenesis (identification of two fissures and three lobes) and absence of associated anatomical anomalies. This is a retrospective observational study of six consecutive prenatal cystic posterior fossa malformations, diagnosed as DWM, encountered in a national reference centre for posterior fossa malformations over a 2-year period. In all cases, DWM was diagnosed as isolated (without any associated central nervous system or extra-central nervous system malformations and normal standard karyotype). Despite good-quality imaging, including fetal magnetic resonance imaging (MRI), prenatal analysis of the vermis was impossible because of limited identification of fissuration and lobulation. In three cases, a cytogenetic anomaly was found, including 6p subtelomeric deletion (n = 2) and partial 4 qter deletion associated with partial 7p trisomy (n = 1). One fetus with 6p deletion was terminated. In four of the five postnatal cases, MRI confirmed the diagnosis of DWM but provided only limited information for vermian analysis. In one case, postnatal MRI showed a large Blake's pouch cyst with rotated but complete vermis associated with a marked mass effect on the distal part of the tentorium. Of the four babies born with postnatal diagnosis of DWM, all required ventriculoperitoneal shunting because of early postnatal hydrocephalus. When fetal MRI is necessary to exclude additional cerebral lesions in the diagnosis of DWM, we highlight the inaccuracy of magnetic resonance for anatomical analysis of the vermis. We also emphasise the potential high incidence of subtelomeric anomalies in isolated DWM, especially 6p deletion. In the postnatal period, paediatricians should

  6. Fetal magnetic resonance imaging of thoracic and abdominal malformations; Fetale Magnetresonanztomographie thorakaler und abdomineller Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Woitek, R.; Asenbaum, U.; Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Brugger, P.C. [Medizinische Universitaet Wien, Zentrum fuer Anatomie und Zellbiologie, Wien (Austria)

    2013-02-15

    Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.) [German] Diagnose und Differenzialdiagnose fetaler thorakaler und abdomineller Malformationen. Ultraschall, MRT. MRT zur weiteren Abklaerung und genaueren Differenzierung bei vielen im Ultraschall gestellten Verdachtsdiagnosen. Verbesserte anatomische Darstellung mittels MRT und Darstellung unterschiedlicher Gewebezusammensetzung mittels verschiedener MR-Sequenzen. Die fetale MRT ist bei der angegebenen Fragestellung in die klinische Routine eingegangen und liefert weiterhin die Basis fuer wissenschaftliche Untersuchungen in diesem Bereich. Die fetale MRT liefert beim Vorliegen thorakaler oder abdomineller Malformationen komplementaer zum Ultraschall wichtige Zusatzinformationen, um die diagnostische Genauigkeit zu erhoehen, die Prognoseabschaetzung zu verbessern und ggf. eine bessere chirurgische Planung zu ermoeglichen. (orig.)

  7. The Usefulness of Diffusion Tensor Imaging and Tractography in Surgery of Brainstem Cavernous Malformations.

    Science.gov (United States)

    Januszewski, Jacob; Albert, Lauren; Black, Karen; Dehdashti, Amir R

    2016-09-01

    Diffusion tensor imaging (DTI) estimates the course and connectivity patterns of white matter tracts. The objective of this study is to evaluate whether findings in the brain stem modify the preoperative surgical trajectory planning or postoperative outcome in patients with brain stem cavernous malformations. Ten patients with symptomatic brainstem cavernous malformation underwent surgical resection. Five patients received preoperative DTI evaluation and the remaining 5 did not. Reconstructed DTI tracts consisted of corticospinal, medial lemnisci, and cerebellar peduncles. The surgical planning and postoperative outcome were evaluated. In 5 patients with no preoperative DTI evaluation, surgical planning was based on anatomic landmark and the 2-point technique. The other 5 patients underwent preoperative DTI, and findings were factored into the selection of the surgical approach. In 3 of the 5 cases with DTI evaluation, the 2-point technique suggested a similar trajectory. In the other 2, the DTI findings suggested a different approach to avoid damage to the white matter tract. Two patients in the group with no DTI had immediate postoperative new or worsened deficit, which improved at long-term follow-up. No patient in the DTI group had a new neurologic deficit. Compared with the standard magnetic resonance imaging, DTI provided improved visualization of cavernous malformation involvement in eloquent fiber tracts of the brainstem. This additional information might help in selecting a more appropriate surgical trajectory in selected lesions. Larger patient cohorts are needed to assess the effect of this modality in patients' outcome. Published by Elsevier Inc.

  8. Imaging Findings in Chiari I Malformation with Syringomyelia in a Case of Charcot Shoulder

    Directory of Open Access Journals (Sweden)

    Shantanu Kumar

    2011-01-01

    Full Text Available Neuropathic arthropathy of the shoulder is reported in only 5% of cases. Here, we report a rare case of neuropathic arthropathy of the shoulder, secondary to Chiari malformation Type I with associated syringomyelia, that remained undetected for four years. A 38-year-old female presented to our Department with a swelling over the right shoulder that had persisted for four years. X-ray of the joint showed destruction of the head of the right humerus, with typical blunt amputated appearance of the bone and increased joint space. Magnetic resonance imaging showed destruction and lateral dislocation of the head of the humerus. Large amount of fluid collection was seen in and around the right shoulder joint. Neuropathic osteoarthropathy can be defined as bone and joint changes that occurs secondary to loss of sensation. In our case, neuropathic shoulder joint was secondary to syringomyelia associated with Chiari I malformation.

  9. In vivo imaging of endothelial cell adhesion molecule expression after radiosurgery in an animal model of arteriovenous malformation.

    Directory of Open Access Journals (Sweden)

    Newsha Raoufi-Rad

    Full Text Available Focussed radiosurgery may provide a means of inducing molecular changes on the luminal surface of diseased endothelium to allow targeted delivery of novel therapeutic compounds. We investigated the potential of ionizing radiation to induce surface expression of intercellular adhesion molecule 1 (ICAM-1 and vascular cell adhesion molecule 1 (VCAM-1 on endothelial cells (EC in vitro and in vivo, to assess their suitability as vascular targets in irradiated arteriovenous malformations (AVMs. Cultured brain microvascular EC were irradiated by linear accelerator at single doses of 0, 5, 15 or 25 Gy and expression of ICAM-1 and VCAM-1 measured by qRT-PCR, Western, ELISA and immunocytochemistry. In vivo, near-infrared (NIR fluorescence optical imaging using Xenolight 750-conjugated ICAM-1 or VCAM-1 antibodies examined luminal biodistribution over 84 days in a rat AVM model after Gamma Knife surgery at a single 15 Gy dose. ICAM-1 and VCAM-1 were minimally expressed on untreated EC in vitro. Doses of 15 and 25 Gy stimulated expression equally; 5 Gy was not different from the unirradiated. In vivo, normal vessels did not bind or retain the fluorescent probes, however binding was significant in AVM vessels. No additive increases in probe binding were found in response to radiosurgery at a dose of 15 Gy. In summary, radiation induces adhesion molecule expression in vitro but elevated baseline levels in AVM vessels precludes further induction in vivo. These molecules may be suitable targets in irradiated vessels without hemodynamic derangement, but not AVMs. These findings demonstrate the importance of using flow-modulated, pre-clinical animal models for validating candidate proteins for vascular targeting in irradiated AVMs.

  10. In vivo imaging of endothelial cell adhesion molecule expression after radiosurgery in an animal model of arteriovenous malformation.

    Science.gov (United States)

    Raoufi-Rad, Newsha; McRobb, Lucinda S; Lee, Vivienne S; Bervini, David; Grace, Michael; Ukath, Jaysree; Mchattan, Joshua; Sreenivasan, Varun K A; Duong, T T Hong; Zhao, Zhenjun; Stoodley, Marcus A

    2017-01-01

    Focussed radiosurgery may provide a means of inducing molecular changes on the luminal surface of diseased endothelium to allow targeted delivery of novel therapeutic compounds. We investigated the potential of ionizing radiation to induce surface expression of intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1) on endothelial cells (EC) in vitro and in vivo, to assess their suitability as vascular targets in irradiated arteriovenous malformations (AVMs). Cultured brain microvascular EC were irradiated by linear accelerator at single doses of 0, 5, 15 or 25 Gy and expression of ICAM-1 and VCAM-1 measured by qRT-PCR, Western, ELISA and immunocytochemistry. In vivo, near-infrared (NIR) fluorescence optical imaging using Xenolight 750-conjugated ICAM-1 or VCAM-1 antibodies examined luminal biodistribution over 84 days in a rat AVM model after Gamma Knife surgery at a single 15 Gy dose. ICAM-1 and VCAM-1 were minimally expressed on untreated EC in vitro. Doses of 15 and 25 Gy stimulated expression equally; 5 Gy was not different from the unirradiated. In vivo, normal vessels did not bind or retain the fluorescent probes, however binding was significant in AVM vessels. No additive increases in probe binding were found in response to radiosurgery at a dose of 15 Gy. In summary, radiation induces adhesion molecule expression in vitro but elevated baseline levels in AVM vessels precludes further induction in vivo. These molecules may be suitable targets in irradiated vessels without hemodynamic derangement, but not AVMs. These findings demonstrate the importance of using flow-modulated, pre-clinical animal models for validating candidate proteins for vascular targeting in irradiated AVMs.

  11. The incidence of imaging abnormalities after stereotactic radiosurgery for cerebral arteriovenous and cavernous malformations.

    Science.gov (United States)

    Blamek, Sławomir; Boba, Marek; Larysz, Dawid; Rudnik, Adam; Ficek, Kornelia; Eksner, Bartosz; Miszczyk, Leszek; Tarnawski, Rafał

    2010-01-01

    The aim of the study was to evaluate the incidence of postirradiation imaging changes after stereotactic radiosurgery for arteriovenous malformations (AVM) and cerebral cavernous malformations (CCM). A group of 85 patients treated for arteriovenous malformations (62 patients, 73%) and cavernomas (23 patients, 27%) between October 2001 and December 2005 was analyzed. All patients were treated with stereotactic radiosurgery with doses ranging from 8-28 Gy. After the irradiation, magnetic resonance imaging (MRI) or computed tomography (CT) was performed at 6 to 12-month intervals to assess the effects of the treatment. The mean follow-up time for the whole group was 27.3 months; AVM group -- 26 months; CCM group -- 30.9 months. All the imaging data were carefully reviewed to identify the radiological symptoms of postradiosurgical damage. T2 or FLAIR hyperintensity, T1-hypointensity and contrast enhancement on MRI and the presence of hypodense areas and contrast enhancement on CT examinations were assessed. Imaging abnormalities were found in 28 (33%) patients. The symptoms of postradiosurgical damage were observed in 21 (33.9%) patients in the AVM group and 7 (30.4%) patients in the CCM group. Radiological symptoms of radiation necrosis associated with neurological deterioration were identified in two patients with cavernomas, while no radiation necrosis was found in the AVM group. Patients in whom radiological signs of focal brain edema or gliosis existed were asymptomatic. Radiological symptoms of postradiosurgical damage affected about one third of the irradiated patients, typically without any clinical manifestations. Patients irradiated for CCMs seem to be more prone to develop symptomatic postradiosurgical necrosis; this observation, however, requires further investigation.

  12. A large retroperitoneal cystic venous malformation mimicking bilateral ovarian cystic tumors.

    Science.gov (United States)

    Nakatsuka, Shin-Ichi; Shigeta, Naoya; Ojima, Yojiro; Kimura, Hayato; Nagano, Teruaki; Ito, Kimihiko

    2012-10-01

    Retroperitoneal cysts are a rare disease. Most retroperitoneal cysts of vascular origin have been reported as hemangiomas. However, according to the recent classification of vascular anomalies accepted by the International Society for Study of Vascular Anomalies (ISSVA), these previously reported retroperitoneal hemangiomas should rather have been classified as vascular malformations. A 65-year-old woman visited our hospital complaining of a sense of unexplained abdominal fullness. Magnetic resonance imaging suggested a uterine leiomyoma and bilateral ovarian cystic tumors. However, abdominal surgery revealed normal bilateral ovaries, but huge cystic masses in the retroperitoneum. Postoperative histological diagnosis of the retroperitoneal cysts demonstrated that they were venous malformations. This is a rare case in which large cystic retroperitoneal venous malformations were preoperatively diagnosed as ovarian cystic tumors. Retroperitoneal hemangiomas should be renamed as vascular malformations following the ISSVA classification.

  13. Spinal dural arteriovenous fistulas: the most frequent vascular malformations of the spinal cord.

    Science.gov (United States)

    Iglesias Gordo, J; Martínez García, R

    2017-10-27

    Spinal dural arteriovenous fistulas are produced by direct communication between the arterial and venous systems of the spinal cord, causing hypertension in the latter with spinal cord dysfunction. It is a rare pathology with unknown etiology and non-specific clinical symptoms that usually results in a delayed diagnosis. Often radiologists are the first to guide the disease towards an adequate diagnosis. Characteristic findings can be seen through MR or MR angiography, and may even locate the fistula in a high percentage of cases, although the pathology must be confirmed by spinal angiography. There are two treatment modalities: endovascular and surgical therapy. Endovascular treatment has improved in recent years with the advantages of a less invasive approach and is therefore usually chosen as primary therapy. In this article we review the main clinical manifestations, imaging findings and treatment of this pathology. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Arteriovenous Malformation of the Oral Cavity

    Directory of Open Access Journals (Sweden)

    S. M. Manjunath

    2014-01-01

    Full Text Available Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as birthmarks. Subcategorized into vascular tumors and malformations, each anomaly is characterized by specific morphology, pathophysiology, clinical behavior, and management approach. Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. Arteriovenous malformation of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease. Here we present a case report of a 25-year-old male patient with arteriovenous malformation involving the base of tongue.

  15. Unusual signal intensity of congenital pulmonary airway malformation on fetal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Owada, Keiho; Miyazaki, Osamu; Nosaka, Shunsuke [National Center for Child Health and Development, Department of Radiology, Tokyo (Japan); Matsuoka, Kentaro [National Center for Child Health and Development, Department of Pathology, Tokyo (Japan); Sago, Haruhiko [National Center for Child Health and Development, Department of Perinatal Medicine and Maternal Care, Tokyo (Japan)

    2015-05-01

    Congenital pulmonary airway malformation (CPAM) is classified into pathologically different types. These types are sometimes distinguishable by fetal lung MRI and are usually observed as higher-signal lesions on T2-weighted images than normal lung. We describe a case of unusual CPAM resembling neoplasms, with a lower signal than is found in normal lung. Histopathology showed a large number of mucogenic cells but found no evidence that could explain this feature on fetal MRI. An unusual low-signal mass associated with a pulmonary cyst in fetal lung on MRI may suggest an unusual type 1 CPAM. (orig.)

  16. Fiber 1.56-1.9 μm lasers in treatment of vascular malformations in children and adults

    Science.gov (United States)

    Abushkin, Ivan A.; Privalov, Valeriy A.; Lappa, Alexander V.; Minaev, Vladimir P.

    2013-03-01

    A few new low invasive fiber laser technologies for treatment of 1) capillary malformations (port-wine stains), 2) venous, arterial, and arteriovenous malformations, 3) lymphatic malformations of 3 types: micro, small and large-cystic lymphangiomas are presented in this work. There were applied 1.56 μm laser distant photocoagulation, 1.56 μm laser endovascular thermotherapy, 1.9 μm laser instant ablation, 1.9 μm laser interstitial thermotherapy, and 1.9 μm laser excision. The technologies were applied to about 300 patients. Good clinical and esthetic results have been achieved in great majority cases.

  17. Magnetic resonance imaging of head and neck vascular anomalies ...

    African Journals Online (AJOL)

    Magnetic resonance imaging of head and neck vascular anomalies: pearls and pitfalls. Shaimaa Abdelsattar Mohammad, Amr Abdelhamid Abou Zeid, Ahmed M. Fawzi, Mohamed M. Dahab, Iman A. Ragab, Osama El-Naggar ...

  18. Vascular tumors of bone : Imaging findings

    NARCIS (Netherlands)

    Vermaat, Marieke; Vanel, Daniel; Kroon, Herman M.; Verbeke, Sofie L. J.; Alberghini, Marco; Bovee, Judith V. M. G.; Bloem, Johan L.

    Purpose: To identify radiological features of malignant vascular tumors of bone, which can be used to avoid erroneously diagnosing metastases based on radiological multifocality, and histological epitheloid phenotype. Materials and methods: From the databases of the Bologna & Netherlands Committee

  19. Amplatzer Vascular Plugs Versus Coils for Embolization of Pulmonary Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia

    Energy Technology Data Exchange (ETDEWEB)

    Tau, Noam, E-mail: taunoam@gmail.com; Atar, Eliyahu [Rabin Medical Center – Beilinson and HaSharon Campuses, Department of Diagnostic Imaging (Israel); Mei-Zahav, Meir [Schneider Children’s Medical Center of Israel, Department of Pulmonology and National HHT Center (Israel); Bachar, Gil N. [Rabin Medical Center – Beilinson and HaSharon Campuses, Department of Diagnostic Imaging (Israel); Dagan, Tamir; Birk, Einat; Bruckheimer, Elchanan [Schneider Children’s Medical Center of Israel, Institute of Pediatric Cardiology (Israel)

    2016-08-15

    PurposeCoil embolization of pulmonary arteriovenous malformations (PAVMs) has a high re-canalization/re-perfusion rate. Embolization with Amplatzer plugs has been previously described, but the long-term efficacy is not established. This study reports the experience of a referral medical center with the use of coils and Amplatzer plugs for treating PAVMs in patients with hereditary hemorrhagic telangiectasia.MethodsThe study was approved by the Institutional Review Board with waiver of informed consent. The cohort included all patients who underwent PAVM embolization in 2004–2014 for whom follow-up imaging scans were available. The medical files were retrospectively reviewed for background data, embolization method (coils, Amplatzer plugs, both), and complications. Re-canalization of treated PAVMs was assessed from intrapulmonary angiograms (following percutaneous procedures) or computed tomography angiograms. Fisher’s exact test and Pearson Chi-squared test or t test were used for statistical analysis, with significance at p < 0.05.Results16 patients met the study criteria. Imaging scans were available for 63 of the total 110 PAVMs treated in 41 procedures. Coils were used for embolization in 37 PAVMs, Amplatzer plugs in 21, and both in five. Median follow-up time was 7.7 years (range 1.4–18.9). Re-canalization was detected in seven vessels, all treated with coils; there were no cases of re-canalization in plug-occluded vessels (p = 0.0413).ConclusionThe use of Amplatzer plugs for the embolization of PAVMs in patients with hemorrhagic telangiectasia is associated with a significantly lower rate of re-canalization of feeding vessels than coils. Long-term prospective studies are required to confirm these findings.

  20. Imaging features of non-traumatic vascular liver emergencies.

    Science.gov (United States)

    Onur, Mehmet Ruhi; Karaosmanoglu, Ali Devrim; Akca, Onur; Ocal, Osman; Akpinar, Erhan; Karcaaltincaba, Musturay

    2017-05-01

    Acute non-traumatic liver disorders can originate from abnormalities of the hepatic artery, portal vein and hepatic veins. Ultrasonography and computed tomography can be used in non-traumatic acute vascular liver disorders according to patient status, indication and appropriateness of imaging modality. Awareness of the imaging findings, in the appropriate clinical context, is crucial for prompt and correct diagnosis, as delay may cause severe consequences with significant morbidity and mortality. This review article will discuss imaging algorithms, and multimodality imaging findings for suspected acute vascular disorders of the liver.

  1. Imaging and CFD in the analysis of vascular disease progression

    Science.gov (United States)

    Saloner, David; Acevedo-Bolton, Gabriel; Rayz, Vitaliy; Wintermark, Max; Martin, Alastair; Dispensa, Brad; Young, William; Lawton, Michael; Rapp, Joseph; Jou, Liang-Der

    2006-03-01

    Conventional evaluation of the significance of vascular disease has focused on estimates of geometric factors. There is now substantial interest in investigating whether the onset and progression of vascular pathology can be related to hemodynamic factors. Current imaging modalities have excellent capabilities in delineating the geometric boundaries of the vascular lumen. Advanced non-invasive imaging modalities such as Multi Detector CT and MRI are also able to define the extent of disease within the vessel wall and to provide information on the composition of thrombotic and atherosclerotic components. Finally, it is also possible to use imaging techniques to measure flow velocities across the lumen of vessels of interest, and to determine the pulsatile variation of these velocities through the cardiac cycle. Despite these advanced capabilities, imaging alone is unable to determine important features of the vascular hemodynamics such as wall shear stress or pressure distributions. However, the information on lumenal geometry and the inlet and outlet flow conditions can be used as input into numerical simulation models that are able to predict those quantities. These Computational Fluid Dynamics models can be used to predict hemodynamic parameters on a patient-specific basis. It is therefore possible to use non-invasive imaging methods to follow the progression of vascular disease over time, and to relate changes in lumenal and wall structure to calculated hemodynamic descriptors. This approach can be used not only to understand the natural progression of vascular disease, but as a tool to predict the likely outcome of a surgical intervention.

  2. tion of vascular malformations

    African Journals Online (AJOL)

    Names utilising a mixture of descriptive and histologic terms, such as 'strawberry angioma', 'nevus flam- .... logical origins into the capillary, venous, lymphatic or mixed malfor- mations (Table II). Haemangiomas ..... Lasjaunias P, Burrows P, Planet C. Develop- mental venous anomalies (DVA): the so-called venous angioma.

  3. Chiari-like malformation and syringomyelia in normal cavalier King Charles spaniels: a multiple diagnostic imaging approach.

    Science.gov (United States)

    Couturier, J; Rault, D; Cauzinille, L

    2008-09-01

    The objectives of the study were (1) to report the incidence of Chiari-like malformation and syringomyelia in a normal French cavalier King Charles spaniel breeding population; (2) to precise the standard computed tomography dimensions of the caudal fossa and (3) to investigate the use of ultrasonography in diagnosis of this syndrome. Clinically normal adult cavalier King Charles spaniel underwent ultrasonographic examination of the spinal cord and caudal fossa. Computed tomography was used to measure the caudal fossa and magnetic resonance imaging allowed syringomyelia and cerebellar herniation identification. Of the 16 dogs in the study, seven had syringomyelia (43.7 per cent). All dogs had cerebellar herniation, suggesting Chiari-like malformation and also a tendency to occipital dysplasia. Computed tomography measurements of the caudal fossa are reported. In one dog, a syrinx was identified by ultrasonography. The only difference between dogs with or without syringomyelia was that dogs with Chiari-like malformation/syringomyelia were statistically older. The incidence of Chiari-like malformation and syringomyelia may be high in an asymptomatic population of cavalier King Charles spaniel . Computed tomography measurements reported in this study should now be compared with those of a symptomatic population to evaluate the hypothesis that dogs with Chiari-like malformation/syringomyelia syndrome have a smaller caudal fossa. This study did not identify a smaller caudal fossa in an asymptomatic cavalier King Charles spaniel population with syringomyelia. Ultrasonography probably has a low sensitivity for diagnosis of Chiari-like malformation/syringomyelia.

  4. Perilesional Hyperintensity on T1-Weighted Images in Intra-Axial Brain Masses other than Cavernous Malformations.

    Science.gov (United States)

    Nabavizadeh, S Ali; Pechersky, Dasha; Schmitt, J Eric; Nasrallah, MacLean; Wolf, Ronald; Loevner, Laurie; Mamourian, Alexander C

    2017-09-01

    Hyperintensity on T1-weighted imaging in perilesional vasogenic edema has been reported as a useful sign for differentiating cavernous malformation from other hemorrhagic intra-axial masses. In this study, we investigated the frequency of perilesional hyperintensity on T1-weighted imaging in patients with intra-axial hemorrhagic and nonhemorrhagic brain masses. The study was performed with the approval of the institutional review board. Magnetic resonance images of 218 patients with 282 intra-axial brain masses (129 metastases, 46 gliomas, 18 primary central nervous system lymphomas [PCNSLs], 25 intracerebral hemorrhages, 50 cavernous malformations, and 14 patients with brain abscesses) were evaluated. The signal intensity in perilesional area was qualitatively evaluated on T1-weighted sequences. In addition, signal intensity in perilesional area was quantitatively measured on T1-weighted sequences and normalized to the contralateral white matter. Hyperintensity on T1-weighted imaging in perilesional vasogenic edema was found in 12 (9%) of 129 metastases, 8 (16%) of 50 cavernous malformations, 1 (4%) in 25 nonneoplastic intracerebral hemorrhages, and none of the patients with high-grade glioma, PCNSL, or abscess. All of the lesions with perilesional hyperintensity showed either acute or subacute hemorrhage. Pairwise comparison of qualitative hyperintensity on T1-weighted imaging demonstrated no significant difference between the groups. Perilesional hyperintensity on T1-weighted imaging showed high specificity in both metastasis and cavernous malformation groups (94%). Perilesional hyperintensity on T1-weighted imaging is not limited to cavernous malformations and frequently evident with melanoma and other hemorrhagic metastasis to the brain. In our experience, it was not seen in high-grade glioma, PCNSL, and brain abscess. Copyright © 2017 by the American Society of Neuroimaging.

  5. Vascular targeting of nanoparticles for molecular imaging of diseased endothelium.

    Science.gov (United States)

    Atukorale, Prabhani U; Covarrubias, Gil; Bauer, Lisa; Karathanasis, Efstathios

    2017-04-01

    This review seeks to highlight the enormous potential of targeted nanoparticles for molecular imaging applications. Being the closest point-of-contact, circulating nanoparticles can gain direct access to targetable molecular markers of disease that appear on the endothelium. Further, nanoparticles are ideally suitable to vascular targeting due to geometrically enhanced multivalent attachment on the vascular target. This natural synergy between nanoparticles, vascular targeting and molecular imaging can provide new avenues for diagnosis and prognosis of disease with quantitative precision. In addition to the obvious applications of targeting molecular signatures of vascular diseases (e.g., atherosclerosis), deep-tissue diseases often manifest themselves by continuously altering and remodeling their neighboring blood vessels (e.g., cancer). Thus, the remodeled endothelium provides a wide range of targets for nanoparticles and molecular imaging. To demonstrate the potential of molecular imaging, we present a variety of nanoparticles designed for molecular imaging of cancer or atherosclerosis using different imaging modalities. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Uterine arteriovenous malformations: gray-scale and Doppler US features with MR imaging correlation.

    Science.gov (United States)

    Huang, M W; Muradali, D; Thurston, W A; Burns, P N; Wilson, S R

    1998-01-01

    To describe the gray-scale and color and duplex Doppler ultrasound (US) and the magnetic resonance (MR) imaging features of uterine arteriovenous malformations (AVMs). Uterine AVMs in 10 patients were retrospectively evaluated. All patients underwent gray-scale US and color and duplex Doppler US. Nine underwent angiography with therapeutic embolization; four, MR imaging. The resistance index (RI), pulsatility index (PI), and peak systolic velocities (PSVs) were evaluated. At gray-scale US, uterine AVMs were nonspecific and manifested as subtle myometrial inhomogeneity, tubular spaces within the myometrium, intramural uterine mass, endometrial mass, or cervical mass or sometimes as prominent parametrial vessels. Color Doppler features were consistent and included intense juxtaposed signals with aliasing and apparent flow reversals. Spectral Doppler US revealed low-resistance flow (RI, 0.25-0.55; PI, 0.3-0.6) and PSVs greater than 96 cm/sec, which suggests arteriovenous shunting. MR imaging showed a bulky uterus, a focal uterine mass, disruption of the junctional zones, serpiginous flow-related signal voids, and prominent parametrial vessels. Gray-scale morphology and Doppler US features should allow noninvasive diagnosis of uterine AVMs. Doppler and MR imaging features of uterine AVMs may overlap with other causes of arteriovenous shunting, including abnormal placentation and gestational trophoblastic disease (GTD). These can be differentiated with serum beta human chorionic gonadotropin test results (negative with AVM, positive with GTD).

  7. Non-enhanced MR imaging of cerebral arteriovenous malformations at 7 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Wrede, Karsten H.; Dammann, Philipp [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Neurosurgery, Essen (Germany); Johst, Soeren; Maderwald, Stefan [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); Moenninghoff, Christoph; Forsting, Michael [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schlamann, Marc [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); University Hospital Giessen, Department of Neuroradiology, Giessen (Germany); Sandalcioglu, I.E. [University Hospital Essen, Department of Neurosurgery, Essen (Germany); Nordstadtkrankenhaus Hannover, Department of Neurosurgery, Hannover (Germany); Ladd, Mark E. [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology (E020), Heidelberg (Germany); Sure, Ulrich [University Hospital Essen, Department of Neurosurgery, Essen (Germany); Umutlu, Lale [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2016-03-15

    To evaluate prospectively 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) and 7 Tesla non-contrast-enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of intracerebral arteriovenous malformations (AVMs) in comparison to 1.5 Tesla TOF MRA and digital subtraction angiography (DSA). Twenty patients with single or multifocal AVMs were enrolled in this trial. The study protocol comprised 1.5 and 7 Tesla TOF MRA and 7 Tesla non-contrast-enhanced MPRAGE sequences. All patients underwent an additional four-vessel 3D DSA. Image analysis of the following five AVM features was performed individually by two radiologists on a five-point scale: nidus, feeder(s), draining vein(s), relationship to adjacent vessels, and overall image quality and presence of artefacts. A total of 21 intracerebral AVMs were detected. Both sequences at 7 Tesla were rated superior over 1.5 Tesla TOF MRA in the assessment of all considered AVM features. Image quality at 7 Tesla was comparable with DSA considering both sequences. Inter-observer accordance was good to excellent for the majority of ratings. This study demonstrates excellent image quality for depiction of intracerebral AVMs using non-contrast-enhanced 7 Tesla MRA, comparable with DSA. Assessment of untreated AVMs is a promising clinical application of ultra-high-field MRA. (orig.)

  8. Application of superb micro-vascular imaging (SMI) in obstetrics.

    Science.gov (United States)

    Hasegawa, Junichi; Yamada, Hikari; Kawasaki, Eiko; Matsumoto, Tomohiro; Takahashi, Shinobu; Suzuki, Nao

    2017-01-23

    Superb Micro-vascular Imaging (SMI; Toshiba Medical Systems, Tokyo) is a new blood flow imaging technique that employs a unique algorithm to minimize motion artifacts by eliminating signals based on analysis of tissue movement. Compared to conventional blood flow imaging such as color and power Doppler imaging, SMI significantly reduces motion artifacts and can visualize low-velocity blood flow in small vessels. In the present report, the clinical value and future potential of SMI in obstetrics have been demonstrated for the first time. We believe this new blood flow imaging technique is acceptable for obstetricians for the purpose of perinatal clinical assessments.

  9. PET/MR Imaging in Vascular Disease

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten; Pedersen, Sune Folke; Kjær, Andreas

    2016-01-01

    For imaging of atherosclerotic disease, lumenography using computed tomography, ultrasonography, or invasive angiography is still the backbone of evaluation. However, these methods are less effective to predict the likelihood of future thromboembolic events caused by vulnerability of plaques. PET...

  10. Disorganized vascular structures in sporadic venous malformations: a possible correlation with balancing effect between Tie2 and TGF-[beta

    National Research Council Canada - National Science Library

    Gang Chen; Jian-gang Ren; Wei Zhang; Yan-fang Sun; Feng-qin Wang; Rui-fang Li; Jian Zhang; Yi-fang Zhao

    2014-01-01

    .... To systematically manifest the disorganized vascular structures in sporadic VMs, we initially evaluated histopathological characteristics, perivascular cell coverage, adhesion molecules expression...

  11. MR-Guided Sclerotherapy of Low-Flow Vascular Malformations Using T2-Weighted Interrupted bSSFP (T2W-iSSFP): Comparison of Pulse Sequences for Visualization and Needle Guidance

    Science.gov (United States)

    Xu, Di; Herzka, Daniel A.; Gilson, Wesley D.; McVeigh, Elliot R.; Lewin, Jonathan S.; Weiss, Clifford R.

    2017-01-01

    Purpose Image-guided treatment of low-flow vascular (venous or lymphatic) malformations presents a challenging visualization problem, regardless of the imaging modality being used for guidance. The purpose of this study was to employ a new magnetic resonance imaging (MRI) sequence, T2-weighted interrupted balanced steady-state free precession (T2W-iSSFP), for real-time image guidance of needle insertion. Materials and Methods T2W-iSSFP uses variable flip angle balanced steady-state free precession (bSSFP, a.k.a. SSFP) to establish T2-weighting and fat suppression. Swine (n = 3) and patients (n = 4, three female, all with venous malformations) were enrolled in the assessment. T2-weighted turbo spin echo (T2-TSE) with spectral adiabatic inversion recovery (SPAIR), SPAIR-T2-TSE or T2-TSE for short, was used as the reference. T2-weighted half Fourier acquired single shot turbo spin echo (T2-HASTE) with SPAIR (SPAIR-T2-HASTE, T2-HASTE for short), fat saturated bSSFP (FS-SSFP), and T2W-iSSFP were imaged. Numeric metrics, namely, contrast-to-noise ratio (CNR) efficiency (CNR divided by the square root of acquisition time) and local sharpness (the reciprocal of edge width), were used to assess image quality. MR-guided sclerotherapy was performed on the same patients using real-time T2W-iSSFP to guide needle insertion. Results Comparing the visualization of needles in the images of swine, the local sharpness (mm−1) was: 0.21 ± 0.06 (T2-HASTE), 0.48 ± 0.02 (FS-SSFP), and 0.49 ± 0.03 (T2W-iSSFP). T2W-iSSFP is higher than T2-HASTE (P images, their CNR efficiencies were: 797 ± 66 (T2-HASTE), 281 ± 44 (FS-SSFP), and 860 ± 29 (T2W-iSSFP). T2W-iSSFP is higher than FS-SSFP (P images are needed. PMID:24395498

  12. Enhancement of Vascular Structures in 3D and 2D Angiographic Images.

    Science.gov (United States)

    Jerman, Tim; Pernus, Franjo; Likar, Bostjan; Spiclin, Ziga

    2016-09-01

    A number of imaging techniques are being used for diagnosis and treatment of vascular pathologies like stenoses, aneurysms, embolisms, malformations and remodelings, which may affect a wide range of anatomical sites. For computer-aided detection and highlighting of potential sites of pathology or to improve visualization and segmentation, angiographic images are often enhanced by Hessian based filters. These filters aim to indicate elongated and/or rounded structures by an enhancement function based on Hessian eigenvalues. However, established enhancement functions generally produce a response, which exhibits deficiencies such as poor and non-uniform response for vessels of different sizes and varying contrast, at bifurcations and aneurysms. This may compromise subsequent analysis of the enhanced images. This paper has three important contributions: i) reviews several established enhancement functions and elaborates their deficiencies, ii) proposes a novel enhancement function, which overcomes the deficiencies of the established functions, and iii) quantitatively evaluates and compares the novel and the established enhancement functions on clinical image datasets of the lung, cerebral and fundus vasculatures.

  13. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... image the breasts and guide biopsy of breast cancer ( see the Ultrasound-Guided Breast Biopsy page . diagnose ... blood flow (such as clots) narrowing of vessels tumors and congenital vascular malformations reduced or absent blood ...

  14. Non-Enhanced MR Imaging of Cerebral Arteriovenous Malformations at 7 Tesla.

    Science.gov (United States)

    Wrede, Karsten H; Dammann, Philipp; Johst, Sören; Mönninghoff, Christoph; Schlamann, Marc; Maderwald, Stefan; Sandalcioglu, I Erol; Ladd, Mark E; Forsting, Michael; Sure, Ulrich; Umutlu, Lale

    2016-03-01

    To evaluate prospectively 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) and 7 Tesla non-contrast-enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of intracerebral arteriovenous malformations (AVMs) in comparison to 1.5 Tesla TOF MRA and digital subtraction angiography (DSA). Twenty patients with single or multifocal AVMs were enrolled in this trial. The study protocol comprised 1.5 and 7 Tesla TOF MRA and 7 Tesla non-contrast-enhanced MPRAGE sequences. All patients underwent an additional four-vessel 3D DSA. Image analysis of the following five AVM features was performed individually by two radiologists on a five-point scale: nidus, feeder(s), draining vein(s), relationship to adjacent vessels, and overall image quality and presence of artefacts. A total of 21 intracerebral AVMs were detected. Both sequences at 7 Tesla were rated superior over 1.5 Tesla TOF MRA in the assessment of all considered AVM features. Image quality at 7 Tesla was comparable with DSA considering both sequences. Inter-observer accordance was good to excellent for the majority of ratings. This study demonstrates excellent image quality for depiction of intracerebral AVMs using non-contrast-enhanced 7 Tesla MRA, comparable with DSA. Assessment of untreated AVMs is a promising clinical application of ultra-high-field MRA. • Non-contrast-enhanced 7 Tesla MRA demonstrates excellent image quality for intracerebral AVM depiction. • Image quality at 7 Tesla was comparable with DSA considering both sequences. • Assessment of intracerebral AVMs is a promising clinical application of ultra-high-field MRA.

  15. Dynamic, nondestructive imaging of a bioengineered vascular graft endothelium.

    Directory of Open Access Journals (Sweden)

    Bryce M Whited

    Full Text Available Bioengineering of vascular grafts holds great potential to address the shortcomings associated with autologous and conventional synthetic vascular grafts used for small diameter grafting procedures. Lumen endothelialization of bioengineered vascular grafts is essential to provide an antithrombogenic graft surface to ensure long-term patency after implantation. Conventional methods used to assess endothelialization in vitro typically involve periodic harvesting of the graft for histological sectioning and staining of the lumen. Endpoint testing methods such as these are effective but do not provide real-time information of endothelial cells in their intact microenvironment, rather only a single time point measurement of endothelium development. Therefore, nondestructive methods are needed to provide dynamic information of graft endothelialization and endothelium maturation in vitro. To address this need, we have developed a nondestructive fiber optic based (FOB imaging method that is capable of dynamic assessment of graft endothelialization without disturbing the graft housed in a bioreactor. In this study we demonstrate the capability of the FOB imaging method to quantify electrospun vascular graft endothelialization, EC detachment, and apoptosis in a nondestructive manner. The electrospun scaffold fiber diameter of the graft lumen was systematically varied and the FOB imaging system was used to noninvasively quantify the affect of topography on graft endothelialization over a 7-day period. Additionally, results demonstrated that the FOB imaging method had a greater imaging penetration depth than that of two-photon microscopy. This imaging method is a powerful tool to optimize vascular grafts and bioreactor conditions in vitro, and can be further adapted to monitor endothelium maturation and response to fluid flow bioreactor preconditioning.

  16. Small renal mass cryosurgery: Imaging and vascular changes

    NARCIS (Netherlands)

    Lagerveld, B.W.

    2014-01-01

    The combined use of a fluorescent casting technique, cryomicrotome imaging, and 3-D computer analysis as a new static method for visualizing and reconstructing the vascular anatomy in a porcine renal model was studied. The arterial blood supply in 3-D at a resolution of up to 50μm of the whole could

  17. A new strategic neurosurgical planning tool for brainstem cavernous malformations using interactive computer graphics with multimodal fusion images.

    Science.gov (United States)

    Kin, Taichi; Nakatomi, Hirofumi; Shojima, Masaaki; Tanaka, Minoru; Ino, Kenji; Mori, Harushi; Kunimatsu, Akira; Oyama, Hiroshi; Saito, Nobuhito

    2012-07-01

    In this study, the authors used preoperative simulation employing 3D computer graphics (interactive computer graphics) to fuse all imaging data for brainstem cavernous malformations. The authors evaluated whether interactive computer graphics or 2D imaging correlated better with the actual operative field, particularly in identifying a developmental venous anomaly (DVA). The study population consisted of 10 patients scheduled for surgical treatment of brainstem cavernous malformations. Data from preoperative imaging (MRI, CT, and 3D rotational angiography) were automatically fused using a normalized mutual information method, and then reconstructed by a hybrid method combining surface rendering and volume rendering methods. With surface rendering, multimodality and multithreshold techniques for 1 tissue were applied. The completed interactive computer graphics were used for simulation of surgical approaches and assumed surgical fields. Preoperative diagnostic rates for a DVA associated with brainstem cavernous malformation were compared between conventional 2D imaging and interactive computer graphics employing receiver operating characteristic (ROC) analysis. The time required for reconstruction of 3D images was 3-6 hours for interactive computer graphics. Observation in interactive mode required approximately 15 minutes. Detailed anatomical information for operative procedures, from the craniotomy to microsurgical operations, could be visualized and simulated three-dimensionally as 1 computer graphic using interactive computer graphics. Virtual surgical views were consistent with actual operative views. This technique was very useful for examining various surgical approaches. Mean (±SEM) area under the ROC curve for rate of DVA diagnosis was significantly better for interactive computer graphics (1.000±0.000) than for 2D imaging (0.766±0.091; pgraphic. The diagnostic rate of DVA associated with brainstem cavernous malformation was significantly better using

  18. Vascular image registration techniques: A living review.

    Science.gov (United States)

    Matl, Stefan; Brosig, Richard; Baust, Maximilian; Navab, Nassir; Demirci, Stefanie

    2017-01-01

    Registration of vascular structures is crucial for preoperative planning, intraoperative navigation, and follow-up assessment. Typical applications include, but are not limited to, Trans-catheter Aortic Valve Implantation and monitoring of tumor vasculature or aneurysm growth. In order to achieve the aforementioned goals, a large number of various registration algorithms has been developed. With this review paper we provide a comprehensive overview over the plethora of existing techniques with a particular focus on the suitable classification criteria such as the involved modalities of the employed optimization methods. However, we wish to go beyond a static literature review which is naturally doomed to be outdated after a certain period of time due to the research progress. We augment this review paper with an extendable and interactive database in order to obtain a living review whose currency goes beyond the one of a printed paper. All papers in this database are labeled with one or multiple tags according to 13 carefully defined categories. The classification of all entries can then be visualized as one or multiple trees which are presented via a web-based interactive app (http://livingreview.in.tum.de) allowing the user to choose a unique perspective for literature review. In addition, the user can search the underlying database for specific tags or publications related to vessel registration. Many applications of this framework are conceivable, including the use for getting a general overview on the topic or the utilization by physicians for deciding about the best-suited algorithm for a specific application. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Contemporary diagnosis of venous malformation

    Directory of Open Access Journals (Sweden)

    Lee BB

    2013-11-01

    Full Text Available BB Lee,1 I Baumgartner21Department of Surgery, George Washington University, Washington, DC, USA; 2Swiss Cardiovascular Center, University Hospital Bern, Bern, SwitzerlandAbstract: Venous malformation is a congenital vascular malformation resulting from defective development during various stages of embryogenesis and selectively affecting the venous system. Depending on the embryologic stage when the developmental arrest occurred, the clinical presentation of venous malformation is extremely variable in location, extent, severity, natural progression, and hemodynamic impact. Extratruncular lesions occur in the earlier stages of embryonic life, and retain characteristics unique to mesenchymal cells (angioblasts, growing and proliferating when stimulated internally (eg, by menarche, pregnancy, and hormones or externally (eg, by trauma or surgery. These lesions also have a significant hemodynamic impact on the venous system involved, in addition to the risk of localized intravascular coagulopathy. However, truncal lesions, as defective developments along the late stage, no longer carry the risk of proliferation and recurrence due to lack of mesenchymal characteristics. Although, they often have serious hemodynamic consequences due to direct involvement of the main vein trunk. Therefore, a thorough clinical history and careful physical examination should be followed by an appropriate combination of noninvasive and less invasive tests (eg, Doppler ultrasonography, magnetic resonance imaging, computed tomography to confirm the clinical impression as well as to define the extent and severity of the venous malformation. Invasive tests, eg, phlebography or angiography, are seldom needed for the diagnosis per se. Additional evaluation for coagulation abnormalities, eg, D-dimer and fibrinogen levels, is generally recommended, especially for the treatment of surgery and endovascular candidates with extensive lesions to assess the localized intravascular

  20. Non-invasive vascular imaging in perforator flap surgery

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Dept. of Radiology, Azienda Ospedaliero Univ. (AOU), di Cagliari-Polo di Monserrato, Cagliari (Italy)], e-mail: lucasaba@tiscali.it; Atzeni, Matteo; Ribuffo, Diego [Dept. of Surgery, Section of Plastic Surgery, Azienda Ospedaliero Univ. (AOU), di Cagliari-Polo di Monserrato, Cagliari (Italy); Rozen, Warren Matthew [Jack Brockhov Reconstructive Plastic Surgery Research Unit, Dept. of Anatomy and Cell Biology, The Univ. of Melbourne, Parkville, Victoria (Australia); Alonso-Burgos, Alberto [Dept. of Radiology, Clinica Univ., Univ. de Navarra, Pamplona (Spain); Bura, Raffaella [Dept. of Surgery, Section of Vascular Surgery, Azienda Ospedaliero Univ. (AOU), di Cagliari-Polo di Monserrato, Cagliari (Italy)

    2013-02-15

    Preoperative imaging using a range of imaging modalities has become increasingly popular for preoperative planning in plastic surgery, in particular in perforator flap surgery. Modalities in this role include ultrasound (US), magnetic resonance angiography (MRA), and computed tomographic angiography (CTA). The evidence for the use of these techniques has been reported in only a handful of studies. In this paper we conducted a non-systematic review of the literature to establish the role for each of these modalities. The role of state-of-the-art vascular imaging as an application in perforator flap surgery is thus offered.

  1. Deletions in PITX1 cause a spectrum of lower-limb malformations including mirror-image polydactyly.

    Science.gov (United States)

    Klopocki, Eva; Kähler, Christian; Foulds, Nicola; Shah, Hitesh; Joseph, Benjamin; Vogel, Hermann; Lüttgen, Sabine; Bald, Rainer; Besoke, Regina; Held, Karsten; Mundlos, Stefan; Kurth, Ingo

    2012-06-01

    PITX1 is a bicoid-related homeodomain transcription factor implicated in vertebrate hindlimb development. Recently, mutations in PITX1 have been associated with autosomal-dominant clubfoot. In addition, one affected individual showed a polydactyly and right-sided tibial hemimelia. We now report on PITX1 deletions in two fetuses with a high-degree polydactyly, that is, mirror-image polydactyly. Analysis of DNA from additional individuals with isolated lower-limb malformations and higher-degree polydactyly identified a third individual with long-bone deficiency and preaxial polydactyly harboring a heterozygous 35 bp deletion in PITX1. The findings demonstrate that mutations in PITX1 can cause a broad spectrum of isolated lower-limb malformations including clubfoot, deficiency of long bones, and mirror-image polydactyly.

  2. Vascular applications of contrast-enhanced ultrasound imaging.

    Science.gov (United States)

    Mehta, Kunal S; Lee, Jake J; Taha, Ashraf A; Avgerinos, Efthymios; Chaer, Rabih A

    2017-07-01

    Contrast-enhanced ultrasound (CEUS) imaging is a powerful noninvasive modality offering numerous potential diagnostic and therapeutic applications in vascular medicine. CEUS imaging uses microbubble contrast agents composed of an encapsulating shell surrounding a gaseous core. These microbubbles act as nearly perfect intravascular reflectors of ultrasound energy and may be used to enhance the overall contrast and quality of ultrasound images. The purpose of this narrative review is to survey the current literature regarding CEUS imaging and discuss its diagnostic and therapeutic roles in current vascular and selected nonvascular applications. The PubMed, MEDLINE, and Embase databases were searched until July 2016 using the PubMed and Ovid Web-based search engines. The search terms used included contrast-enhanced, microbubble, ultrasound, carotid, aneurysm, and arterial. The diagnostic and therapeutic utility of CEUS imaging has grown exponentially, particularly in the realms of extracranial carotid arterial disease, aortic disease, and peripheral arterial disease. Studies have demonstrated that CEUS imaging is diagnostically superior to conventional ultrasound imaging in identifying vessel irregularities and measuring neovascularization to assess plaque vulnerability and end-muscle perfusion. Groups have begun to use microbubbles as agents in therapeutic applications for targeted drug and gene therapy delivery as well as for the enhancement of sonothrombolysis. The emerging technology of microbubbles and CEUS imaging holds considerable promise for cardiovascular medicine and cancer therapy given its diagnostic and therapeutic utility. Overall, with proper training and credentialing of technicians, the clinical implications are innumerable as microbubble technology is rapidly bursting onto the scene of cardiovascular medicine. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  3. Vascular wall stress during intravascular optical coherence tomography imaging

    Science.gov (United States)

    Sun, Cuiru; Yang, Victor

    2015-03-01

    Biomechanical properties of arterial wall is crucial for understanding the changes in the cardiovascular system. Catheters are used during intravascular optical coherence tomography (IVOCT) imaging. The presence of a catheter alters the flow field, pressure distribution and frictional resistance to flow in an artery. In this paper, we first study the transmural stress distribution of the catheterized vessel. COMSOL (COMSOL 4.4) was used to simulate the blood flow induced deformation in a catheterized vessel. Blood is modeled as an incompressible Newtonian fluid. Stress distribution from an three-layer vascular model with an eccentric catheter are simulated, which provides a general idea about the distribution of the displacement and the stress. Optical coherence elastography techniques were then applied to porcine carotid artery samples to look at the deformation status of the vascular wall during saline or water injection. Preliminary simulation results show nonuniform stress distribution in the circumferential direction of the eccentrically catheterized vascular model. Three strain rate methods were tested for intravascular OCE application. The tissue Doppler method has the potential to be further developed to image the vascular wall biomechnical properties in vivo. Although results in this study are not validated quantitatively, the experiments and methods may be valuable for intravascular OCE studies, which may provide important information for cardiovascular disease prevention, diagnosis and treatment.

  4. Dynamic permeability and quantitative susceptibility: related imaging biomarkers in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul Ghani; Tan, Huan; Shenkar, Robert; Li, Luying; Zhang, Lingjiao; Guo, Xiaodong; Larsson, Henrik B W; Shi, Changbin; Liu, Tian; Wang, Yi; Shah, Akash; Edelman, Robert R; Christoforidis, Gregory; Awad, Issam

    2014-02-01

    Hyperpermeability and iron deposition are 2 central pathophysiological phenomena in human cerebral cavernous malformation (CCM) disease. Here, we used 2 novel MRI techniques to establish a relationship between these phenomena. Subjects with CCM disease (4 sporadic and 17 familial) underwent MRI imaging using the dynamic contrast-enhanced quantitative perfusion and quantitative susceptibility mapping techniques that measure hemodynamic factors of vessel leak and iron deposition, respectively, previously demonstrated in CCM disease. Regions of interest encompassing the CCM lesions were analyzed using these techniques. Susceptibility measured by quantitative susceptibility mapping was positively correlated with permeability of lesions measured using dynamic contrast-enhanced quantitative perfusion (r=0.49; P≤0.0001). The correlation was not affected by factors, including lesion volume, contrast agent, and the use of statin medication. Susceptibility was correlated with lesional blood volume (r=0.4; P=0.0001) but not with lesional blood flow. The correlation between quantitative susceptibility mapping and dynamic contrast-enhanced quantitative perfusion suggests that the phenomena of permeability and iron deposition are related in CCM; hence, more leaky lesions also manifest a more cumulative iron burden. These techniques might be used as biomarkers to monitor the course of this disease and the effect of therapy.

  5. Cerebellar arteriovenous malformations in children

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, P.D. [Sheffield Univ. (United Kingdom). Acad. Dept. of Radiol.; Blaser, S.; Armstrong, D.; Chuang, S.; Harwood-Nash, D. [Division of Neuroradiology, The Hospital for Sick Children and University of Toronto, Toronto (Canada); Humphreys, R.P. [Division of Neurosurgery, The Hospital for Sick Children and University of Toronto, Toronto (Canada)

    1998-05-01

    We review the presentation, imaging findings and outcome in 18 children with cerebellar arteriovenous malformations (AVM). This group is of particular interest because of the reported poor outcome despite modern imaging and neurosurgical techniques. All children had CT and 15 underwent catheter angiography at presentation. Several of the children in the latter part of the study had MRI. Of the 18 children, 17 presented with a ruptured AVM producing intracranial haemorrhage. The remaining child presented with temporal lobe epilepsy and was shown to have temporal, vermian and cerebellar hemisphere AVM. This child had other stigmata of Osler-Weber-Rendu syndrome. Three other children had pre-existing abnormalities of possible relevance. One had a vascular malformation of the cheek and mandible, one a documented chromosomal abnormality and another a midline cleft upper lip and palate. Six of the 17 children with a ruptured cerebellar AVM died within 7 days of the ictus. Vascular pathology other than an AVM was found in 10 of the 14 children with a ruptured cerebellar AVM who had angiography: 4 intranidal aneurysms, 5 venous aneurysms and 2 cases of venous outflow obstruction (one child having both an aneurysm and obstruction). The severity of clinical presentation was directly related to the size of the acute haematoma, which was a reasonable predictor of outcome. (orig.) With 4 figs., 4 tabs., 23 refs.

  6. Arteriovenous malformations of the uterus.

    Science.gov (United States)

    Cura, M; Martinez, N; Cura, A; Dalsaso, T J; Elmerhi, F

    2009-09-01

    Arterial venous malformations (AVM) of the uterus are uncommon entities and should be considered in patients who present with profuse genital bleeding. There are two types of uterine AVM: acquired and congenital. Acquired uterine AVMs are conformed by communications between the uterine arteries and the myometrial veins, and are caused by an iatrogenic event or a pathological condition. Congenital AVMs are the result of abnormal development of primitive vessels that result in connections between pelvic arteries and veins in the uterus without an interconnecting capillary bed. Ultrasonography is a noninvasive diagnostic method able to demonstrate and characterize AVMs of the uterus. AVM in the pelvis may be noted incidentally by computed tomography (CT) of the pelvis, and magnetic resonance imaging (MRI) is frequently used to confirm and further characterize the sonographic findings of uterine AVM. Catheter angiography and embolization are very effective in defining the vascular anatomy and treating uterine vascular abnormalities.

  7. Diffusion tensor imaging in patients with epilepsy and malformations of cortical development

    National Research Council Canada - National Science Library

    Eriksson, S H; Rugg-Gunn, F J; Symms, M R; Barker, G J; Duncan, J S

    2001-01-01

    Malformations of cortical development (MCD) are a common cause of epilepsy. Studies of structural MRIs and PET data in patients with MCD have found widespread changes outside the visually identified lesions...

  8. When a lymphatic malformation determines a bowel volvulus: Are clinical status and images always reliable?

    Directory of Open Access Journals (Sweden)

    Edoardo Guida

    2016-01-01

    Conclusions: Paediatricians and surgeons should bare in mind that an intrabdominal lymphatic malformation may present as a nonspecific an acute abdomen caused by a bowel volvolus and diagnosis may not be so simple preoperatively.

  9. New and evolving concepts in CT for abdominal vascular imaging.

    Science.gov (United States)

    Fuentes-Orrego, Jorge M; Pinho, Daniella; Kulkarni, Naveen M; Agrawal, Mukta; Ghoshhajra, Brian B; Sahani, Dushyant V

    2014-01-01

    Computed tomographic (CT) angiography has become the standard of care, supplanting invasive angiography for comprehensive initial evaluation of acute and chronic conditions affecting the vascular system in the abdomen and elsewhere. Over the past decade, the capabilities of CT have improved substantially; simultaneously, the expectations of the referring physician and vascular surgeons have also evolved. Increasingly, CT angiography is used as an imaging biomarker for treatment selection and assessment of effectiveness. However, the growing use of CT angiography has also introduced some challenges, as potential radiation-associated and contrast media-induced risks need to be addressed. These concerns can be partly confronted by modifying scanning parameters (applying a low tube voltage) with or without using software-based solutions. Most recently, multienergy technology has endowed CT with new capabilities offering improved CT angiographic image quality and novel plaque characterization while decreasing radiation and iodine dose. In this article, we discuss current and new approaches using both conventional and multienergy CT for studying vascular disease in the abdomen. We propose various approaches to overcoming commonly encountered image quality challenges in CT angiography. In addition, we describe supplemental strategies for improving patient safety that leverage the available technology. ©RSNA, 2014.

  10. Case report: Combined transarterial and direct approaches for embolization of a large mandibular arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Chiramel George Koshy

    2011-01-01

    Full Text Available Arteriovenous malformations (AVMs that involve the mandible are difficult lesions to treat, with traditional options being surgery and embolization. This article describes a large mandibular AVM that was treated with embolization using transarterial as well as direct puncture approaches. Follow-up imaging showed thrombosis of the vascular spaces of the malformation. There were no complications. The patient is doing well and is on follow-up.

  11. Uterine arteriovenous malformation

    OpenAIRE

    Alessandrino, F.; Di Silverio, E.; Moramarco, L. P.

    2013-01-01

    Uterine arteriovenous vascular malformations (UAVM) are uncommon vascular diseases, occurring during reproductive age. Patients affected by UAMVs usually present with recurrent pregnancy loss or menorrhagia. Initial evaluation of UAVMs is made with ultrasonography (US) and US-Doppler. Magnetic resonance is used when a UAMV is suspected at US. Treatment can be surgical (hysterectomy or surgical removal of AVM), or with selective uterine arterial embolization. We report a case of UAMV, from its...

  12. Uterine arteriovenous malformation.

    Science.gov (United States)

    Alessandrino, F; Di Silverio, E; Moramarco, L P

    2013-01-01

    Uterine arteriovenous vascular malformations (UAVM) are uncommon vascular diseases, occurring during reproductive age. Patients affected by UAMVs usually present with recurrent pregnancy loss or menorrhagia. Initial evaluation of UAVMs is made with ultrasonography (US) and US-Doppler. Magnetic resonance is used when a UAMV is suspected at US. Treatment can be surgical (hysterectomy or surgical removal of AVM), or with selective uterine arterial embolization. We report a case of UAMV, from its clinical signs to diagnostic confirmation and subsequent treatment.

  13. Interventional C-arm tomosynthesis for vascular imaging: initial results

    Science.gov (United States)

    Langan, David A.; Claus, Bernhard E. H.; Al Assad, Omar; Trousset, Yves; Riddell, Cyril; Avignon, Gregoire; Solomon, Stephen B.; Lai, Hao; Wang, Xin

    2015-03-01

    As percutaneous endovascular procedures address more complex and broader disease states, there is an increasing need for intra-procedure 3D vascular imaging. In this paper, we investigate C-Arm 2-axis tomosynthesis ("Tomo") as an alternative to C-Arm Cone Beam Computed Tomography (CBCT) for workflow situations in which the CBCT acquisition may be inconvenient or prohibited. We report on our experience in performing tomosynthesis acquisitions with a digital angiographic imaging system (GE Healthcare Innova 4100 Angiographic Imaging System, Milwaukee, WI). During a tomo acquisition the detector and tube each orbit on a plane above and below the table respectively. The tomo orbit may be circular or elliptical, and the tomographic half-angle in our studies varied from approximately 16 to 28 degrees as a function of orbit period. The trajectory, geometric calibration, and gantry performance are presented. We overview a multi-resolution iterative reconstruction employing compressed sensing techniques to mitigate artifacts associated with incomplete data reconstructions. In this work, we focus on the reconstruction of small high contrast objects such as iodinated vasculature and interventional devices. We evaluate the overall performance of the acquisition and reconstruction through phantom acquisitions and a swine study. Both tomo and comparable CBCT acquisitions were performed during the swine study thereby enabling the use of CBCT as a reference in the evaluation of tomo vascular imaging. We close with a discussion of potential clinical applications for tomo, reflecting on the imaging and workflow results achieved.

  14. Mouse Hepatic Tumor Vascular Imaging by Experimental Selective Angiography.

    Directory of Open Access Journals (Sweden)

    Sang Kyum Kim

    Full Text Available Human hepatocellular carcinoma (HCC has unique vascular features, which require selective imaging of hepatic arterial perfusion and portal venous perfusion with vascular catheterization for sufficient evaluation. Unlike in humans, vessels in mice are too small to catheterize, and the importance of separately imaging the feeding vessels of tumors is frequently overlooked in hepatic tumor models. The purpose of this study was to perform selective latex angiography in several mouse liver tumor models and assess their suitability.In several ectopic (Lewis lung carcinoma, B16/F10 melanoma cell lines and spontaneous liver tumor (Albumin-Cre/MST1fl/fl/MST2fl/fl, Albumin-Cre/WW45fl/fl, and H-ras12V genetically modified mouse models, the heart left ventricle and/or main portal vein of mice was punctured, and latex dye was infused to achieve selective latex arteriography and/or portography.H-ras12V transgenic mice (a HCC and hepatic adenoma model developed multiple liver nodules that displayed three different perfusion patterns (portal venous or hepatic artery perfusion predominant, mixed perfusion, indicating intra-tumoral vascular heterogeneity. Selective latex angiography revealed that the Lewis lung carcinoma implant model and the Albumin-Cre/WW45fl/fl model reproduced conventional angiography findings of human HCC. Specifically, these mice developed tumors with abundant feeding arteries but no portal venous perfusion.Different hepatic tumor models showed different tumor vessel characteristics that influence the suitability of the model and that should be considered when designing translational experiments. Selective latex angiography applied to certain mouse tumor models (both ectopic and spontaneous closely simulated typical characteristics of human HCC vascular imaging.

  15. Reliable? The Value of Early Postoperative Magnetic Resonance Imaging after Cerebral Cavernous Malformation Surgery.

    Science.gov (United States)

    Chen, Bixia; Göricke, Sophia; Wrede, Karsten; Jabbarli, Ramazan; Wälchli, Thomas; Jägersberg, Max; Sure, Ulrich; Dammann, Philipp

    2017-07-01

    Cerebral cavernous malformations (CCM) can cause intracerebral hemorrhage. The lesions themselves are frequently associated with perifocal hemosiderin deposits caused by repetitive microhemorrhages. Main indications for a surgical treatment are recurrent symptomatic hemorrhages or cavernoma-related epilepsy. After surgical resection, follow-up magnetic resonance imaging (MRI) is usually performed to confirm 1) the complete resection of the CCM and, especially in cases of cavernoma-related epilepsy, 2) the complete resection of the hemosiderin deposits. This prospective study evaluates the value of early postoperative MRI (within 72 hours) regarding the detection of CCM or hemosiderin remnants compared with a standard 3-6 months postoperative MRI control in 61 CCM cases. Sensitivity of early postoperative MRI for CCM remnant detection was 66.67% (95% confidence interval [CI], 9.43%-99.16%), specificity was 76.74% (95% CI, 61.37%-88.24%), positive predictive value was 16.67% (95% CI, 2.09%-48.41%), and negative predictive value was 97.06% (95% CI, 84.67%-99.93%). Because of the high number of patients who could not be evaluated because of imaging artifacts, sensitivity and specificity analysis was not performed for early postoperative MRI using T2*/susceptibility-weighted imaging to assess hemosiderin remnants. Sensitivity of early postoperative MRI for hemosiderin remnant detection using T2-weighted sequences was 85.71% (95% CI, 63.66%-96.95%), specificity was 66.67% (95% CI, 44.68%-84.37%), positive predictive value was 69.23% (95% CI, 55.45%-80.27%), and negative predictive value was 84.21% (95% CI, 64.31%-94.04%). Our data suggest that early postoperative MRI after CCM surgery is often hampered by imaging artifacts creating false-positive results and therefore ineligible for a resection control. However, reliability of a negative result on early postoperative T2-weighted MRI is relatively high regarding both CCM and hemosiderin remnants. Copyright © 2017

  16. Capillary-lymphatic malformation, kaposiform hemangioendothelioma and delayed Kasabach-Merritt phenomenon.

    Science.gov (United States)

    del Pozo, Jesús; López-Gutiérrez, Juan Carlos; Gómez-Tellado, Manuel; Nistal, Manuel; Soler, Rafaela; Sacristán, Felipe; Tovar, J A

    2011-01-01

    According to International Society for the Study of Vascular Anomalies classification, vascular anomalies are mainly divided into two groups: vascular tumors and vascular malformations. Nevertheless, a small group of patients present clinical and/or histopathologic overlapping features. We report a case of a 4-month-old boy that presented a vascular lesion on his right buttock with involvement of abdominal wall muscles, abdominal cavity and drainage to primitive iliac by a tortuous drainage vein. Surgery was performed and histopathology demonstrated a combined vascular malformation. Six months later he developed a thrombocytopenia and repeat magnetic resonance imaging revealed a new solid mass involving the majority of the abdominal cavity. At 18 months of age the patient developed a Kasabach-Merrit phenomenon and treatment with vincristine, interferon and then acetyl-salicilic acid and dypiridamol was started. No response in platelet counts was obtained and one more surgery was perfomed. On this occasion a histopathologic study revealed vascular malformation areas intermingled with areas of kaposiform hemangioendothelioma. This patient demonstrates the Kasabach-Merritt phenomenon with kaposiform hemangioendothelioma arising within a pre-existing combined vascular malformation. © 2010 Wiley Periodicals, Inc.

  17. Split Cord Malformations

    Directory of Open Access Journals (Sweden)

    Yurdal Gezercan

    2015-06-01

    Full Text Available Split cord malformations are rare form of occult spinal dysraphism in children. Split cord malformations are characterized by septum that cleaves the spinal canal in sagittal plane within the single or duplicated thecal sac. Although their precise incidence is unknown, split cord malformations are exceedingly rare and represent %3.8-5 of all congenital spinal anomalies. Characteristic neurological, urological, orthopedic clinical manifestations are variable and asymptomatic course is possible. Earlier diagnosis and surgical intervention for split cord malformations is associated with better long-term fuctional outcome. For this reason, diagnostic imaging is indicated for children with associated cutaneous and orthopedic signs. Additional congenital anomalies usually to accompany the split cord malformations. Earlier diagnosis, meticuolus surgical therapy and interdisciplinary careful evaluation and follow-up should be made for good prognosis. [Cukurova Med J 2015; 40(2.000: 199-207

  18. Notch1 and 4 Signaling Responds to an Increasing Vascular Wall Shear Stress in a Rat Model of Arteriovenous Malformations

    Directory of Open Access Journals (Sweden)

    Jian Tu

    2014-01-01

    Full Text Available Notch signaling is suggested to promote the development and maintenance of cerebral arteriovenous malformations (AVMs, and an increasing wall shear stress (WSS contributes to AVM rupture. Little is known about whether WSS impacts Notch signaling, which is important for understanding the angiogenesis of AVMs. WSS was measured in arteriovenous fistulas (AVF surgically created in 96 rats at different time points over a period of 84 days. The expression of Notch receptors 1 and 4 and their ligands, Delta1 and 4, Jagged1, and Notch downstream gene target Hes1 was quantified in “nidus” vessels. The interaction events between Notch receptors and their ligands were quantified using proximity ligation assay. There was a positive correlation between WSS and time (r=0.97; P<0.001. The expression of Notch receptors and their ligands was upregulated following AVF formation. There was a positive correlation between time and the number of interactions between Notch receptors and their ligands aftre AVF formation (r=0.62, P<0.05 and a positive correlation between WSS and the number of interactions between Notch receptors and their ligands (r=0.87, P<0.005. In conclusion, an increasing WSS may contribute to the angiogenesis of AVMs by activation of Notch signaling.

  19. Magnetic resonance diffusion tensor imaging and tractography of intracranial cavernous malformations: preliminary observations and characterization of the hemosiderin rim.

    Science.gov (United States)

    Cauley, Keith A; Andrews, Trevor; Gonyea, Jay V; Filippi, Christopher G

    2010-04-01

    Cavernous malformations (CMs) can cause symptoms that appear out of proportion to the lesion size, leading one to hypothesize that they may have an effect on adjacent white matter that is not fully explained by local mass effect. The goal of this study was to investigate the diffusion tensor (DT) properties of CMs, the hemosiderin rim, and normal-appearing adjacent white matter. Eighteen cavernous malformations were characterized using standard MR imaging sequences as well as 6-direction DT imaging with single-shot echo planar-gradient echo imaging at 3 tesla. Diffusion tensor imaging demonstrated that CMs have a characteristic signature on DT imaging, with low fractional anisotropy (FA) and high mean diffusivity centrally within the lesion. The hemosiderin rim had a high FA value relative to the central lesion or adjacent white matter. Tractography revealed that tracts neatly deviate around CMs. Tracts were typically seen to pass through the hemosiderin rim. The hemosiderin rim of CMs was intimately associated with white matter tracts that were deviated by the central lesion. These findings are consistent with histopathological reports that the hemosiderin rim is composed of blood breakdown products deposited in viable white matter.

  20. Complete Familial Currarino Triad in Association with Hirschsprung's Disease: Magnetic Resonance Imaging Features and the Spectrum of Anorectal Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Kilickesmez, O.; Hakki Gol, I.; Uzun, M.; Oruk, C. [Diyarbakir Military Hospital (Turkey). Dept. of Radiology

    2006-07-15

    Currarino syndrome, a rare hereditary condition, is defined as a partial sacral agenesis associated with a presacral mass and anorectal malformation. The authors present two siblings with complete Currarino triad and their mother with incomplete triad. The complete Currarino triad in the older sibling was associated with Hirschsprung's disease as the second reported case in the literature. Anorectal malformations, whether suspected of Currarino syndrome or not, should be examined with lumbosacral magnetic resonance imaging.

  1. Transcranial optical vascular imaging (TOVI) during cardiac arrest (Conference Presentation)

    Science.gov (United States)

    Kalchenko, Vyacheslav; Kuznetsov, Yuri; Meglinski, Igor; Harmelin, Alon

    2017-03-01

    Based on the recent studies the prognosis of patients after cardiac arrest (CA) remains poor. Thus it is extremely important to understand fine mechanisms related to the influence of CA on the brain and Cerebral Blood Flow (CBF) during and after cardiac arrest. Recently our group introduced Transcranial Optical Vascular Imaging (TOVI) approach that combines laser speckle and dynamic fluorescent imaging. TOVI proved to be useful during various preclinical brain research applications. For example it allows imaging of brain blood vessels of a mouse in vivo through the intact cranium. Herein for the first time we present the use of TOVI during cardiac arrest. TOVI possibly could be a useful tool for preclinical studies of CBF during and after CA.

  2. Photoacoustic image patterns of breast carcinoma and comparisons with Magnetic Resonance Imaging and vascular stained histopathology

    Science.gov (United States)

    Heijblom, M.; Piras, D.; Brinkhuis, M.; van Hespen, J. C. G.; van den Engh, F. M.; van der Schaaf, M.; Klaase, J. M.; van Leeuwen, T. G.; Steenbergen, W.; Manohar, S.

    2015-07-01

    Photoacoustic (optoacoustic) imaging can visualize vasculature deep in tissue using the high contrast of hemoglobin to light, with the high-resolution possible with ultrasound detection. Since angiogenesis, one of the hallmarks of cancer, leads to increased vascularity, photoacoustics holds promise in imaging breast cancer as shown in proof-of-principle studies. Here for the first time, we investigate if there are specific photoacoustic appearances of breast malignancies which can be related to the tumor vascularity, using an upgraded research imaging system, the Twente Photoacoustic Mammoscope. In addition to comparisons with x-ray and ultrasound images, in subsets of cases the photoacoustic images were compared with MR images, and with vascular staining in histopathology. We were able to identify lesions in suspect breasts at the expected locations in 28 of 29 cases. We discovered generally three types of photoacoustic appearances reminiscent of contrast enhancement types reported in MR imaging of breast malignancies, and first insights were gained into the relationship with tumor vascularity.

  3. Photoacoustic image patterns of breast carcinoma and comparisons with Magnetic Resonance Imaging and vascular stained histopathology

    Science.gov (United States)

    Heijblom, M.; Piras, D.; Brinkhuis, M.; van Hespen, J. C. G.; van den Engh, F. M.; van der Schaaf, M.; Klaase, J. M.; van Leeuwen, T. G.; Steenbergen, W.; Manohar, S.

    2015-01-01

    Photoacoustic (optoacoustic) imaging can visualize vasculature deep in tissue using the high contrast of hemoglobin to light, with the high-resolution possible with ultrasound detection. Since angiogenesis, one of the hallmarks of cancer, leads to increased vascularity, photoacoustics holds promise in imaging breast cancer as shown in proof-of-principle studies. Here for the first time, we investigate if there are specific photoacoustic appearances of breast malignancies which can be related to the tumor vascularity, using an upgraded research imaging system, the Twente Photoacoustic Mammoscope. In addition to comparisons with x-ray and ultrasound images, in subsets of cases the photoacoustic images were compared with MR images, and with vascular staining in histopathology. We were able to identify lesions in suspect breasts at the expected locations in 28 of 29 cases. We discovered generally three types of photoacoustic appearances reminiscent of contrast enhancement types reported in MR imaging of breast malignancies, and first insights were gained into the relationship with tumor vascularity. PMID:26159440

  4. Nanoparticles as magnetic resonance imaging contrast agents for vascular and cardiac diseases

    NARCIS (Netherlands)

    Chen, Wei; Cormode, David P.; Fayad, Zahi A.; Mulder, Willem J. M.

    2011-01-01

    Advances in nanoparticle contrast agents for molecular imaging have made magnetic resonance imaging a promising modality for noninvasive visualization and assessment of vascular and cardiac disease processes. This review provides a description of the various nanoparticles exploited for imaging

  5. Real time laser speckle imaging monitoring vascular targeted photodynamic therapy

    Science.gov (United States)

    Goldschmidt, Ruth; Vyacheslav, Kalchenko; Scherz, Avigdor

    2017-02-01

    Laser speckle imaging is a technique that has been developed to non-invasively monitor in vivo blood flow dynamics and vascular structure, at high spatial and temporal resolution. It can record the full-field spatio-temporal characteristics of microcirculation and has therefore, often been used to study the blood flow in tumors after photodynamic therapy (PDT). Yet, there is a paucity of reports on real-time laser speckle imaging (RTLSI) during PDT. Vascular-targeted photodynamic therapy (VTP) with WST11, a water-soluble bacteriochlorophyll derivative, achieves tumor ablation through rapid occlusion of the tumor vasculature followed by a cascade of events that actively kill the tumor cells. WST11-VTP has been already approved for treatment of early/intermediate prostate cancer at a certain drug dose, time and intensity of illumination. Application to other cancers may require different light dosage. However, incomplete vascular occlusion at lower light dose may result in cancer cell survival and tumor relapse while excessive light dose may lead to toxicity of nearby healthy tissues. Here we provide evidence for the feasibility of concomitant RTLSI of the blood flow dynamics in the tumor and surrounding normal tissues during and after WST11-VTP. Fast decrease in the blood flow is followed by partial mild reperfusion and a complete flow arrest within the tumor by the end of illumination. While the primary occlusion of the tumor feeding arteries and draining veins agrees with previous data published by our group, the late effects underscore the significance of light dose control to minimize normal tissue impairment. In conclusion- RTSLI application should allow to optimize VTP efficacy vs toxicity in both the preclinical and clinical arenas.

  6. Rapid prototyping of biomimetic vascular phantoms for hyperspectral reflectance imaging.

    Science.gov (United States)

    Ghassemi, Pejhman; Wang, Jianting; Melchiorri, Anthony J; Ramella-Roman, Jessica C; Mathews, Scott A; Coburn, James C; Sorg, Brian S; Chen, Yu; Pfefer, T Joshua

    2015-01-01

    The emerging technique of rapid prototyping with three-dimensional (3-D) printers provides a simple yet revolutionary method for fabricating objects with arbitrary geometry. The use of 3-D printing for generating morphologically biomimetic tissue phantoms based on medical images represents a potentially major advance over existing phantom approaches. Toward the goal of image-defined phantoms, we converted a segmented fundus image of the human retina into a matrix format and edited it to achieve a geometry suitable for printing. Phantoms with vessel-simulating channels were then printed using a photoreactive resin providing biologically relevant turbidity, as determined by spectrophotometry. The morphology of printed vessels was validated by x-ray microcomputed tomography. Channels were filled with hemoglobin (Hb) solutions undergoing desaturation, and phantoms were imaged with a near-infrared hyperspectral reflectance imaging system. Additionally, a phantom was printed incorporating two disjoint vascular networks at different depths, each filled with Hb solutions at different saturation levels. Light propagation effects noted during these measurements—including the influence of vessel density and depth on Hb concentration and saturation estimates, and the effect of wavelength on vessel visualization depth—were evaluated. Overall, our findings indicated that 3-D-printed biomimetic phantoms hold significant potential as realistic and practical tools for elucidating light–tissue interactions and characterizing biophotonic system performance.

  7. Imaging Tumor Vascularity and Response to Anti-Angiogenic Therapy Using Gaussia Luciferase.

    Science.gov (United States)

    Kantar, Rami S; Lashgari, Ghazal; Tabet, Elie I; Lewandrowski, Grant K; Carvalho, Litia A; Tannous, Bakhos A

    2016-05-20

    We developed a novel approach to assess tumor vascularity using recombinant Gaussia luciferase (rGluc) protein and bioluminescence imaging. Upon intravenous injection of rGluc followed by its substrate coelenterazine, non-invasive visualization of tumor vascularity by bioluminescence imaging was possible. We applied this method for longitudinal monitoring of tumor vascularity in response to the anti-angiogenic drug tivozanib. This simple and sensitive method could be extended to image blood vessels/vasculature in many different fields.

  8. Advantages of T2 reversed fast spin-echo image and enhanced three-dimensional surface MR angiography for the diagnosis of cerebral arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Sumiyoshi; Honmou, Osamu; Minamida, Yoshihiro; Hashi, Kazuo [Sapporo Medical Univ. (Japan). School of Medicine

    2001-09-01

    Although the anatomical investigation of cerebral arteriovenous malformation (AVM) with conventional neuro-imagings considerably supports the preoperative evaluation, it is still hard to dissect the detailed anatomical conformations of AVMs such as location of nidus, identification of feeding arteries or draining veins, and the three-dimensional configuration of nidus in sulci or gyri. In this study, we investigated the efficacy of enhanced three-dimensional surface MR angiography (surface MRA) and T2 reversed image (T2R image) in the diagnosis and surgical planning for cerebral AVMs. The diagnostic accuracy was studied in twelve AVMs: four AVMs closed to motor area, one to Broca area, one to Wernicke area, four in temporal lobe, and two in occipital lobe. Images were obtained with a SIGNA HORIZON LX 1.5T VER 8.2. To construct T2R, the brain is scanned by fast SE method with long TR and was displayed with the reversed gray scale, which seemed similar to T1WI. Surface MRA is a fusion image of MRA and surface image in the workstation. The original data was obtained by enhanced 3D-SPGR method. MRA image was reconstructed with MIP method, and surface image was manipulated with a volume rendering method. T2R images demonstrated seven sulcal AVMs, three gyral AVMs, and two sulco-gyral AVMs; five AVMs located on cortex, four extended to subcortex, and three to paraventricular brain. The images clearly showed six AVMs had hypervascular network such as modja-modja vascular formation. Surface MRA represented nidus adjacent to eloquent area. They were present in central sulcus, precentral sulcus, intraparietal sulcus, inferior frontal sulcus, sylvian fissure, superior temporal sulcus, inferior temporal sulcus, superior temporal gyrus, inferior temporal gyrus, medial temporal gyrus, premotor area and superior frontal sulcus, precuneus and parieto-occipital sulcus. It was easy to identify the point of feeding arteries going down into the sulcus and the junction-point of nidus

  9. Radiological features of childhood giant cavernous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Ozgen, Burce; Senocak, Efsun; Oguz, Kader K. [Hacettepe University, Department of Radiology, Faculty of Medicine, Ankara (Turkey); Soylemezoglu, Figen [Hacettepe University, Department of Pathology, School of Medicine, Ankara (Turkey); Akalan, Nejat [Hacettepe University, Department of Neurosurgery, School of Medicine, Ankara (Turkey)

    2011-04-15

    Giant cavernous malformations (GCM) are very large, low-flow vascular malformations, which usually have atypical imaging features and are commonly misdiagnosed preoperatively as neoplasms or vascular malformations. These lesions have mostly been reported in children. As cavernomas show different features in children compared to adults, we evaluated the imaging features of pediatric GCMs in order to help in the preoperative diagnosis of these malformations. Brain MR studies of nine children (mean age of 4 years; 8 months-9 years) with biopsy-proven GCM were retrospectively evaluated. We defined GCMs as cavernomas of {>=}4 cm. Lesions were evaluated regarding their size, location, signal characteristics, general appearance (uni/multilocular) as well as regarding the presence of mass effect, edema, and fluid-fluid levels and were classified according to the Mottolese classification of pediatric cavernomas. Lesion locations were parietal (n = 5), frontal (n = 2), temporal, and intraventricular. Seven lesions were in the periventricular region (with five in the periatrial region). Six patients had T1 hyperintense multilobulated lesions with ''bubbles of blood'' appearance and three patients had heterogeneous lesions with reticular core. All lesions had mass effect, edema (marked in four cases), and peripheral hemosiderin rim. Fluid-fluid levels were also common (n = 7). Most of our lesions (six of nine) were classified as type IIIA, two as type IIIC, and one as type IA. In children, a GCM should be considered in case of very large hemorrhagic intra-axial mass with ''bubbles of blood'' multicystic appearance, surrounding hemosiderin ring, fluid-fluid levels, and accompanying edema-mass effect, especially in the periatrial location. (orig.)

  10. Photoacoustic image patterns of breast carcinoma and comparisons with Magnetic Resonance Imaging and vascular stained histopathology

    NARCIS (Netherlands)

    Heijblom, M.; Piras, D.; Brinkhuis, M.; van Hespen, Johannes C.G.; van den Engh, F.M.; van der Schaaf, M.; Klaase, J.M.; van Leeuwen, Ton; Steenbergen, Wiendelt; Manohar, Srirang

    2015-01-01

    Photoacoustic (optoacoustic) imaging can visualize vasculature deep in tissue using the high contrast of hemoglobin to light, with the high-resolution possible with ultrasound detection. Since angiogenesis, one of the hallmarks of cancer, leads to increased vascularity, photoacoustics holds promise

  11. In vivo mapping of vascular inflammation using multimodal imaging.

    Directory of Open Access Journals (Sweden)

    Benjamin R Jarrett

    2010-10-01

    Full Text Available Plaque vulnerability to rupture has emerged as a critical correlate to risk of adverse coronary events but there is as yet no clinical method to assess plaque stability in vivo. In the search to identify biomarkers of vulnerable plaques an association has been found between macrophages and plaque stability--the density and pattern of macrophage localization in lesions is indicative of probability to rupture. In very unstable plaques, macrophages are found in high densities and concentrated in the plaque shoulders. Therefore, the ability to map macrophages in plaques could allow noninvasive assessment of plaque stability. We use a multimodality imaging approach to noninvasively map the distribution of macrophages in vivo. The use of multiple modalities allows us to combine the complementary strengths of each modality to better visualize features of interest. Our combined use of Positron Emission Tomography and Magnetic Resonance Imaging (PET/MRI allows high sensitivity PET screening to identify putative lesions in a whole body view, and high resolution MRI for detailed mapping of biomarker expression in the lesions.Macromolecular and nanoparticle contrast agents targeted to macrophages were developed and tested in three different mouse and rat models of atherosclerosis in which inflamed vascular plaques form spontaneously and/or are induced by injury. For multimodal detection, the probes were designed to contain gadolinium (T1 MRI or iron oxide (T2 MRI, and Cu-64 (PET. PET imaging was utilized to identify regions of macrophage accumulation; these regions were further probed by MRI to visualize macrophage distribution at high resolution. In both PET and MR images the probes enhanced contrast at sites of vascular inflammation, but not in normal vessel walls. MRI was able to identify discrete sites of inflammation that were blurred together at the low resolution of PET. Macrophage content in the lesions was confirmed by histology.The multimodal

  12. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  13. Usefulness of Preoperative Surgical Simulation with Three-Dimensional Fusion Images for Resection of Cerebral Cavernous Malformations Near Broca's Area

    Science.gov (United States)

    Akaji, Kazunori; Kano, Tadashige; Hiraga, Kenji

    2014-01-01

    Treating subcortical brain lesions in or near eloquent areas is challenging not only because lesions must be resected while preserving brain tissue involved in essential functions, but also because lesions often cannot be easily identified from the surface of the brain. Here, we report 2 cases of cerebral cavernous malformations near Broca's area. In both cases, lesions were surgically removed by utilizing three-dimensional fusion images created using preoperative magnetic resonance imaging and computed tomography data. Excisions were completed without any worsening of speech function, and the use of presurgical simulations was found to be useful in the design and execution of the actual operations. The technique described in this report serves as a useful tool in simulating surgical strategies by using brain gyri and sulci as surgical landmarks. Furthermore, in contrast to other intraoperative techniques, this method can aid in shortening the duration of surgery and can help limit damage to eloquent areas of the brain. PMID:24822138

  14. MR molecular imaging of tumor vasculature and vascular targets.

    Science.gov (United States)

    Pathak, Arvind P; Penet, Marie-France; Bhujwalla, Zaver M

    2010-01-01

    Tumor angiogenesis and the ability of cancer cells to induce neovasculature continue to be a fascinating area of research. As the delivery network that provides substrates and nutrients, as well as chemotherapeutic agents to cancer cells, but allows cancer cells to disseminate, the tumor vasculature is richly primed with targets and mechanisms that can be exploited for cancer cure or control. The spatial and temporal heterogeneity of tumor vasculature, and the heterogeneity of response to targeting, make noninvasive imaging essential for understanding the mechanisms of tumor angiogenesis, tracking vascular targeting, and detecting the efficacy of antiangiogenic therapies. With its noninvasive characteristics, exquisite spatial resolution and range of applications, magnetic resonance imaging (MRI) techniques have provided a wealth of functional and molecular information on tumor vasculature in applications spanning from "bench to bedside". The integration of molecular biology and chemistry to design novel imaging probes ensures the continued evolution of the molecular capabilities of MRI. In this review, we have focused on developments in the characterization of tumor vasculature with functional and molecular MRI. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  15. Quantitative ultrasound and photoacoustic imaging for the assessment of vascular parameters

    CERN Document Server

    Meiburger, Kristen M

    2017-01-01

    This book describes the development of quantitative techniques for ultrasound and photoacoustic imaging in the assessment of architectural and vascular parameters. It presents morphological vascular research based on the development of quantitative imaging techniques for the use of clinical B-mode ultrasound images, and preclinical architectural vascular investigations on quantitative imaging techniques for ultrasounds and photoacoustics. The book is divided into two main parts, the first of which focuses on the development and validation of quantitative techniques for the assessment of vascular morphological parameters that can be extracted from B-mode ultrasound longitudinal images of the common carotid artery. In turn, the second part highlights quantitative imaging techniques for assessing the architectural parameters of vasculature that can be extracted from 3D volumes, using both contrast-enhanced ultrasound (CEUS) imaging and photoacoustic imaging without the addition of any contrast agent. Sharing and...

  16. In vivo imaging of tumor vascular endothelial cells

    Science.gov (United States)

    Zhao, Dawen; Stafford, Jason H.; Zhou, Heling; Thorpe, Philip E.

    2013-02-01

    Phosphatidylserine (PS), normally restricted to the inner leaflet of the plasma membrane, becomes exposed on the outer surface of viable (non-apoptotic) endothelial cells in tumor blood vessels, probably in response to oxidative stresses present in the tumor microenvironment. In the present study, we optically imaged exposed PS on tumor vasculature in vivo using PGN635, a novel human monoclonal antibody that targets PS. PGN635 F(ab')2 was labeled with the near infrared (NIR) dye, IRDye 800CW. Human glioma U87 cells or breast cancer MDA-MB-231 cells were implanted subcutaneously or orthotopically into nude mice. When the tumors reached ~5 mm in diameter, 800CW- PGN635 was injected via a tail vein and in vivo dynamic NIR imaging was performed. For U87 gliomas, NIR imaging allowed clear detection of tumors as early as 4 h later, which improved over time to give a maximal tumor/normal ratio (TNR = 2.9 +/- 0.5) 24 h later. Similar results were observed for orthotopic MDA-MB-231 breast tumors. Localization of 800CW-PGN635 to tumors was antigen specific since 800CW-Aurexis, a control probe of irrelevant specificity, did not localize to the tumors, and pre-administration of unlabeled PGN635 blocked the uptake of 800CW-PGN635. Fluorescence microscopy confirmed that 800CW-PGN635 was binding to PS-positive tumor vascular endothelium. Our studies suggest that tumor vasculature can be successfully imaged in vivo to provide sensitive tumor detection.

  17. Three-dimensional ultrasound and magnetic resonance imaging assessment of cervix and vagina in women with uterine malformations.

    Science.gov (United States)

    Bermejo, C; Martínez-Ten, P; Recio, M; Ruiz-López, L; Díaz, D; Illescas, T

    2014-03-01

    To investigate the accuracy of three-dimensional ultrasound (3D-US) with respect to magnetic resonance imaging (MRI), and compared to clinical examination, in the assessment of cervix and vagina in women with uterine malformations. In this prospective study, 16 patients diagnosed with uterine malformation with cervical involvement underwent 3D-US examination. The acquisition of cervical volumes was transvaginal, with four cases repeated in the peri-ovulation period, while vaginal volumes were acquired by transperineal imaging following filling of the vagina with gel. MRI was performed in 13 patients using endovaginal gel. All cases underwent clinical examination, comprising bimanual gynecological examination and speculoscopy. Diagnostic concordance of each of the methods with the gold standard was calculated. 3D-US cervical examinations revealed 12 cases of duplicate cervix, two of complete septate cervix and two of incomplete septate cervix. Images of the cervical canal in the peri-ovulation period were judged subjectively to be better in quality, but did not lead us to change any diagnosis. 3D-US vaginal examinations revealed four cases with a vaginal dividing wall and two with a blind hemivagina. None of the 3D-US findings contradicted the clinical findings of the cervix; however, clinically we observed two cases with vaginal dividing wall that had not been diagnosed with 3D-US. MRI diagnosed nine cases of duplicate cervix, three of complete septate cervix, one of incomplete septate cervix, five of vaginal dividing wall and two of blind hemivagina. One case diagnosed as complete septate cervix was in fact a duplicate cervix on 3D-US and on clinical examination. Compared with the gold standard, both 3D-US and MRI were highly efficient in the diagnosis of anomalies of the cervix and vagina. The overall diagnostic concordance of 3D-US with clinical examination (kappa, 0.84; 95% CI, 0.62-1) was slightly inferior to that of MRI with clinical examination (kappa, 0

  18. Proposal for future diagnosis and management of vascular tumors by using automatic software for image processing and statistic prediction

    Science.gov (United States)

    Popescu, MD; Draghici, L; Secheli, I; Secheli, M; Codrescu, M; Draghici, I

    2015-01-01

    Rationale. Infantile Hemangiomas (IH) are the most frequent tumors of vascular origin, and the differential diagnosis from vascular malformations is difficult to establish. Specific types of IH due to the location, dimensions and fast evolution, can determine important functional and esthetic sequels. To avoid these unfortunate consequences it is necessary to establish the exact appropriate moment to begin the treatment and decide which the most adequate therapeutic procedure is. Objective. Based on clinical data collected by a serial clinical observations correlated with imaging data, and processed by a computer-aided diagnosis system (CAD), the study intended to develop a treatment algorithm to accurately predict the best final results, from the esthetical and functional point of view, for a certain type of lesion. Methods and Results. The preliminary database was composed of 75 patients divided into 4 groups according to the treatment management they received: medical therapy, sclerotherapy, surgical excision and no treatment. The serial clinical observation was performed each month and all the data was processed by using CAD. Discussions. The project goal was to create a software that incorporated advanced methods to accurately measure the specific IH lesions, integrated medical information, statistical methods and computational methods to correlate this information with that obtained from the processing of images. Based on these correlations, a prediction mechanism of the evolution of hemangioma, which helped determine the best method of therapeutic intervention to minimize further complications, was established. Abbreviations: Infantile Hemangiomas = IH, Computer Aided Diagnosis = CAD, Society for the Study of Vascular Anomalies = ISSVA, Color-coded duplex sonography = CCDS PMID:25914738

  19. Surveillance of hemodialysis vascular access with ultrasound vector flow imaging

    Science.gov (United States)

    Brandt, Andreas H.; Olesen, Jacob B.; Hansen, Kristoffer L.; Rix, Marianne; Jensen, Jørgen A.; Nielsen, Michael B.

    2015-03-01

    The aim of this study was prospectively to monitor the volume flow in patients with arteriovenous fistula (AVF) with the angle independent ultrasound technique Vector Flow Imaging (VFI). Volume flow values were compared with Ultrasound dilution technique (UDT). Hemodialysis patients need a well-functioning vascular access with as few complications as possible and preferred vascular access is an AVF. Dysfunction due to stenosis is a common complication, and regular monitoring of volume flow is recommended to preserve AVF patency. UDT is considered the gold standard for volume flow surveillance, but VFI has proven to be more precise, when performing single repeated instantaneous measurements. Three patients with AVF were monitored with UDT and VFI monthly for five months. A commercial ultrasound scanner with a 9 MHz linear array transducer with integrated VFI was used to obtain data. UDT values were obtained with Transonic HD03 Flow-QC Hemodialysis Monitor. Three independent measurements at each scan session were obtained with UDT and VFI each month. Average deviation of volume flow between UDT and VFI was 25.7 % (Cl: 16.7% to 34.7%) (p= 0.73). The standard deviation for all patients, calculated from the mean variance of each individual scan sessions, was 199.8 ml/min for UDT and 47.6 ml/min for VFI (p = 0.002). VFI volume flow values were not significantly different from the corresponding estimates obtained using UDT, and VFI measurements were more precise than UDT. The study indicates that VFI can be used for surveillance of volume flow.

  20. Imaging features of vascular compression in abdomen: Fantasy, phenomenon, or true syndrome

    Science.gov (United States)

    Srisajjakul, Sitthipong; Prapaisilp, Patcharin; Bangchokdee, Sirikan

    2017-01-01

    Vascular structures in the abdomen can compress or be compressed by adjacent structures. Classic imaging findings of vascular compressions, including median arcuate ligament syndrome, superior mesenteric artery syndrome, nutcracker syndrome, portal biliopathy, May-Thurner syndrome, and ureteropelvic junction obstruction will be discussed here. It is important to correlate imaging findings and clinical data to identify asymptomatic vascular compression which requires no treatment, intermittent vascular compression with nonspecific or vague clinical manifestation, and the subset of patients with true syndromes who will benefit from treatment. PMID:28744083

  1. Imaging features of vascular compression in abdomen: Fantasy, phenomenon, or true syndrome

    Directory of Open Access Journals (Sweden)

    Sitthipong Srisajjakul

    2017-01-01

    Full Text Available Vascular structures in the abdomen can compress or be compressed by adjacent structures. Classic imaging findings of vascular compressions, including median arcuate ligament syndrome, superior mesenteric artery syndrome, nutcracker syndrome, portal biliopathy, May-Thurner syndrome, and ureteropelvic junction obstruction will be discussed here. It is important to correlate imaging findings and clinical data to identify asymptomatic vascular compression which requires no treatment, intermittent vascular compression with nonspecific or vague clinical manifestation, and the subset of patients with true syndromes who will benefit from treatment.

  2. Vascular anomalies of the upper limb

    Directory of Open Access Journals (Sweden)

    G Balakrishnan

    2011-01-01

    Full Text Available Vascular anomalies of the upper extremity are a surgical challenge to the hand surgeons. The treatment modality varies with respect to the presentation, extent of the lesion, progression and their complications. Based on our experience in treating patients with vascular malformations, a protocol has been formulated for their management, which we have found to be very useful and successful. With the use of the tumescent technique and good planning, haemangiomas are best excised in infancy or early childhood. Investigations like contrast computed tomography and magnetic resonance imaging have been found to be a useful tool in the diagnosis and planning of surgery for venous malformations. Embolisation seems to be a safe option in arteriovenous malformations.

  3. Live-cell imaging to detect phosphatidylserine externalization in brain endothelial cells exposed to ionizing radiation: implications for the treatment of brain arteriovenous malformations.

    Science.gov (United States)

    Zhao, Zhenjun; Johnson, Michael S; Chen, Biyi; Grace, Michael; Ukath, Jaysree; Lee, Vivienne S; McRobb, Lucinda S; Sedger, Lisa M; Stoodley, Marcus A

    2016-06-01

    OBJECT Stereotactic radiosurgery (SRS) is an established intervention for brain arteriovenous malformations (AVMs). The processes of AVM vessel occlusion after SRS are poorly understood. To improve SRS efficacy, it is important to understand the cellular response of blood vessels to radiation. The molecular changes on the surface of AVM endothelial cells after irradiation may also be used for vascular targeting. This study investigates radiation-induced externalization of phosphatidylserine (PS) on endothelial cells using live-cell imaging. METHODS An immortalized cell line generated from mouse brain endothelium, bEnd.3 cells, was cultured and irradiated at different radiation doses using a linear accelerator. PS externalization in the cells was subsequently visualized using polarity-sensitive indicator of viability and apoptosis (pSIVA)-IANBD, a polarity-sensitive probe. Live-cell imaging was used to monitor PS externalization in real time. The effects of radiation on the cell cycle of bEnd.3 cells were also examined by flow cytometry. RESULTS Ionizing radiation effects are dose dependent. Reduction in the cell proliferation rate was observed after exposure to 5 Gy radiation, whereas higher radiation doses (15 Gy and 25 Gy) totally inhibited proliferation. In comparison with cells treated with sham radiation, the irradiated cells showed distinct pseudopodial elongation with little or no spreading of the cell body. The percentages of pSIVA-positive cells were significantly higher (p = 0.04) 24 hours after treatment in the cultures that received 25- and 15-Gy doses of radiation. This effect was sustained until the end of the experiment (3 days). Radiation at 5 Gy did not induce significant PS externalization compared with the sham-radiation controls at any time points (p > 0.15). Flow cytometric analysis data indicate that irradiation induced growth arrest of bEnd.3 cells, with cells accumulating in the G2 phase of the cell cycle. CONCLUSIONS Ionizing radiation

  4. Brain Malformations

    Science.gov (United States)

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  5. Current concepts in the classification, diagnosis and treatment of vascular anomalies.

    Science.gov (United States)

    Ernemann, Ulrike; Kramer, Ulrich; Miller, Stephan; Bisdas, Sotirios; Rebmann, Hans; Breuninger, Helmut; Zwick, Christine; Hoffmann, Jürgen

    2010-07-01

    Patients with extended vascular anomalies may suffer from significant aesthetic and functional impairment and represent a challenge to therapeutic planning, which is best met by an interdisciplinary concept. In agreement with the International Society for the Study of Vascular Anomalies (ISSVA), vascular lesions are classified into haemangiomas as proliferating endothelial tumours on the one hand and congenital vascular malformations on the other. According to the preponderant vascular channels and hemodynamic characteristics, malformations are subdivided into low flow (venous, lymphatic and capillary) lesions and high-flow malformations. Diagnostic imaging should be targeted at the specific structural and functional informations required for treatment planning. The imaging modality of choice to provide these informations is magnetic resonance imaging (MRI) supplemented by magnetic resonance angiography (MRA) with high spatial and temporal resolution. Treatment indications for haemangiomas depend on the proliferative behaviour of the lesion and comprise beta-blockers in order to induce involution as well as cryotherapy, laser and open surgery. Interventional radiological procedures have evolved as an essential element in an interdisciplinary treatment plan for vascular malformations and include percutaneous sclerotherapy with ethanol and OK-432 for venous and lymphatic malformations and transarterial embolization for high-flow lesions. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Current concepts in the classification, diagnosis and treatment of vascular anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ernemann, Ulrike, E-mail: ulrike.ernemann@med.uni-tuebingen.d [Department of Diagnostic and Interventional Neuroradiology, Radiological Clinic, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Kramer, Ulrich; Miller, Stephan [Department of Diagnostic and Interventional Radiology, Radiological Clinic, University Hospital Tuebingen (Germany); Bisdas, Sotirios [Department of Diagnostic and Interventional Neuroradiology, Radiological Clinic, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Rebmann, Hans [Department of Paediatrics, Children' s Hospital, University Hospital Tuebingen (Germany); Breuninger, Helmut [Department of Dermatology, University Hospital Tuebingen (Germany); Zwick, Christine [Department of Hand, Plastic, Reconstructive and Burns Surgery, BG Trauma Clinic Tuebingen, University Hospital Tuebingen (Germany); Hoffmann, Juergen [Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen (Germany)

    2010-07-15

    Patients with extended vascular anomalies may suffer from significant aesthetic and functional impairment and represent a challenge to therapeutic planning, which is best met by an interdisciplinary concept. In agreement with the International Society for the Study of Vascular Anomalies (ISSVA), vascular lesions are classified into haemangiomas as proliferating endothelial tumours on the one hand and congenital vascular malformations on the other. According to the preponderant vascular channels and hemodynamic characteristics, malformations are subdivided into low flow (venous, lymphatic and capillary) lesions and high-flow malformations. Diagnostic imaging should be targeted at the specific structural and functional informations required for treatment planning. The imaging modality of choice to provide these informations is magnetic resonance imaging (MRI) supplemented by magnetic resonance angiography (MRA) with high spatial and temporal resolution. Treatment indications for haemangiomas depend on the proliferative behaviour of the lesion and comprise {beta}-blockers in order to induce involution as well as cryotherapy, laser and open surgery. Interventional radiological procedures have evolved as an essential element in an interdisciplinary treatment plan for vascular malformations and include percutaneous sclerotherapy with ethanol and OK-432 for venous and lymphatic malformations and transarterial embolization for high-flow lesions.

  7. Hemifacial spasm and trigeminal neuralgia in Chiari's I malformation with hydrocephalus: case report and literature review.

    Science.gov (United States)

    Liu, Jiang; Yuan, Yue; Zang, Li; Fang, Ying; Liu, Hongjun; Yu, Yanbing

    2014-07-01

    Chiari's I malformation with hydrocephalus is commonly seen in clinical experience. Trigeminal neuralgia (TN) and hemifacial spasm (HFS) are most commonly related to vascular compression of the root entry/enter zone (REZ). Until now, TN and HFS associated with hydrocephalus caused by Chiari's malformation have not been reported. The patient was a 24-year old male with left HFS and ipsilateral TN. Arnold-Chiari's I malformation with hydrocephalus and platybasia were found in magnetic resonance imaging (MRI) of brain. We underwent a programmable ventriculoperitoneal shunt with complete resolution of all symptoms. This is the first report of one case only presenting as coexistent ipsilateral TN and HFS secondary to Chiari's I malformation with hydrocephalus. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Vascular uterine abnormalities: Comparison of imaging findings and clinical outcomes.

    Science.gov (United States)

    Hugues, Clara; Le Bras, Yann; Coatleven, Frederic; Brun, Jean-Luc; Trillaud, Hervé; Grenier, Nicolas; Cornelis, François

    2015-12-01

    To retrospectively compare the imaging findings and the outcomes for patients with vascular uterine abnormalities (VUA) and to identify prognostic factors. Between 2007 and 2012, 38 patients with vaginal bleeding and abnormal ultrasonographic (US) findings consistent with acquired VUA were consecutively included (mean age 31.6 years, range 19-62). Follow-up was 32 months in mean (1-78 months). Seventeen women (44.7%) started bleeding immediately after curettage, spontaneous miscarriage, trophoblastic disease, or section scars, with the remainder starting bleeding after 8 days to 2 years. All US, CT (n=2), MR (n=5) and angiographic (n=26) images were reviewed and compared to medical reports in order to identify severe VUA requiring treatment, and predictive factors. No information about severity was provided by US, MRI or CT. Twelve patients were successfully managed conservatively. Angiography identified 6 non-severe VUA, corresponding to an isolated uterine hyperemia, and 20 severe VUA, corresponding to an association of a nidus and early venous drainage. Recurrences were more often observed for severe VUA (p=0.001). The hemoglobin level was significantly lower (below 11 g/L) in these cases (p=0.004). Recurrences were significantly more frequently observed for patients with history of dilatation and curettage (p=0.02). Hysterectomy was performed for three patients only (8%). Among the women who wished to have children, 14 (77.8%) were pregnant after 9 months in mean (range 2-23). Recurrence happens more frequently after curettage and in case of anemia or severe VUA findings on angiography, justifying adequate embolization for these patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Multiple intracranial arteriovenous malformations: case report.

    Science.gov (United States)

    Zellem, R T; Buchheit, W A

    1985-07-01

    The authors describe a case of multiple supratentorial intracranial arteriovenous malformations in a patient with a family history of cerebrovascular disease. There was no sign of any other vascular dysplasia. A brief review of this rare entity is given.

  10. Acral hemosideric lymphatic malformation.

    Science.gov (United States)

    Wang, Lei; Gao, Tianwen; Wang, Gang

    2013-07-01

    Cutaneous lymphatic malformations represent a group of heterogeneous diseases caused by developmental defects of lymphatic system. The purpose of this study was to report the clinical, histopathological and immunohistochemical features of a distinctive lymphatic malformation. Twelve patients with similar clinical and histopathological features were included in this study. Immunohistochemical staining of CD31, D2-40, Prox1 and Wilms tumor 1 (WT-1) were performed on all lesions. All cases were either congenital lesions or developed during the first 2 years of life. All presented as red to brown papules or nodules on acral sites. Histopathologically, the lesions consisted of a dermal proliferation of flat or slit-like vessels lined with a single layer of endothelial cells. Hemosiderin or extravascular red blood cells were present in all cases. The constituent vessels expressed CD31, D2-40 and Prox1 and lacked expression of WT-1. On the basis of the clinical, histopathological and immunohistochemical findings, our cases represent a unique type of lymphatic malformation that we believe is distinct from previously reported vascular proliferations. We propose the name of acral hemosideric lymphatic malformation for this entity. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Using biplanar fluoroscopy to guide radiopaque vascular injections: a new method for vascular imaging.

    Directory of Open Access Journals (Sweden)

    Haley D O'Brien

    Full Text Available Studying vascular anatomy, especially in the context of relationships with hard tissues, is of great interest to biologists. Vascular studies have provided significant insight into physiology, function, phylogenetic relationships, and evolutionary patterns. Injection of resin or latex into the vascular system has been a standard technique for decades. There has been a recent surge in popularity of more modern methods, especially radiopaque latex vascular injection followed by CT scanning and digital "dissection." This technique best displays both blood vessels and bone, and allows injections to be performed on cadaveric specimens. Vascular injection is risky, however, because it is not a standardizable technique, as each specimen is variable with regard to injection pressure and timing. Moreover, it is not possible to view the perfusion of injection medium throughout the vascular system of interest. Both data and rare specimens can therefore be lost due to poor or excessive perfusion. Here, we use biplanar video fluoroscopy as a technique to guide craniovascular radiopaque latex injection. Cadaveric domestic pigs (Sus scrofa domestica and white-tailed deer (Odocoileus virginianus were injected with radiopaque latex under guidance of fluoroscopy. This method was found to enable adjustments, in real-time, to the rate, location, and pressure at which latex is injected in order to avoid data and specimen loss. In addition to visualizing the injection process, this technique can be used to determine flow patterns, and has facilitated the development of consistent markers for complete perfusion.

  12. Surveillance of Hemodialysis Vascular Access with Ultrasound Vector Flow Imaging

    DEFF Research Database (Denmark)

    Brandt, Andreas Hjelm; Olesen, Jacob Bjerring; Lindskov Hansen, Kristoffer

    2015-01-01

    -functioning vascular access with as few complications as possible and preferred vascular access is an AVF. Dysfunction due to stenosis is a common complication, and regular monitoring of volume flow is recommended to preserve AVF patency. UDT is considered the gold standard for volume flow surveillance, but VFI has...

  13. Brain arteriovenous malformations: Report of a case | Adeyinka ...

    African Journals Online (AJOL)

    Brain Arteriovenous Malformation (BAVM) is a form of congenital vascular malformation that are present at birth, and may be evident clinically, and usually will grow commensurately with the child. We report an adult ,a 40-year-old woman with brain arteriovenous malformation presenting with headache and epileptic ...

  14. The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging.

    Science.gov (United States)

    Meng, Guolu; Bai, Chuanfeng; Yu, Tengfei; Wu, Zhen; Liu, Xing; Zhang, Junting; zhao, Jizong

    2014-03-15

    Some studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But there is lack of statistical evidence and study of bulk cases. The factors associated with concurrency are still unknown. The purpose of this study was to determine the prevalence of concomitant DVA and CM using observational data on Chinese patients and analyze the factors associated with the concurrency. The records of all cranial magnetic resonance imaging (MRI) performed between January 2001 and December 2012 in Beijing Tiantan Hospital were reviewed retrospectively. The DVA and CM cases were selected according to imaging reports that met diagnostic criteria. Statistical analysis was performed using the Pearson chi-square statistic for binary variables and multivariable logistic regression analysis for predictors associated with the concurrent CM. We reviewed a total of 165,230 cranial MR images performed during the previous 12 year period, and identified 1,839 cases that met DVA radiographic criteria. There were 205 patients who presented concomitant CM among the 1,839 DVAs. The CM prevalence in DVA cases (11.1%) was significantly higher than that in the non-DVA cases (2.3%) (PDVA. There is a higher chance of concurrent CM with DVA when the DVA has three or more medullary veins in the same MRI scanning section, when the DVA is infratentorial, and when there are multiple DVAs. When diagnosing DVA cases, physicians should be alerted to the possibility of concurrent CM.

  15. Familial Cerebral Cavernous Malformations Are Associated with Adrenal Calcifications on CT Scans: An Imaging Biomarker for a Hereditary Cerebrovascular Condition.

    Science.gov (United States)

    Strickland, Corinne D; Eberhardt, Steven C; Bartlett, Mary R; Nelson, Jeffrey; Kim, Helen; Morrison, Leslie A; Hart, Blaine L

    2017-08-01

    Purpose To determine if adrenal calcifications seen at computed tomography (CT) are associated with familial cerebral cavernous malformations (fCCMs) in carriers of the CCM1 Common Hispanic Mutation. Materials and Methods This study was approved by the institutional review board. The authors retrospectively reviewed abdominal CT scans in 38 patients with fCCM, 38 unaffected age- and sex-matched control subjects, and 13 patients with sporadic, nonfamilial cerebral cavernous malformation (CCM). The size, number, and laterality of calcifications and the morphologic characteristics of the adrenal gland were recorded. Brain lesion count was recorded from brain magnetic resonance (MR) imaging in patients with fCCM. The prevalence of adrenal calcifications in patients with fCCM was compared with that in unaffected control subjects and those with sporadic CCM by using the Fisher exact test. Additional analyses were performed to determine whether age and brain lesion count were associated with adrenal findings in patients with fCCM. Results Small focal calcifications (SFCs) (≤5 mm) were seen in one or both adrenal glands in 19 of the 38 patients with fCCM (50%), compared with 0 of the 38 unaffected control subjects (P < .001) and 0 of the 13 subjects with sporadic CCM (P = .001). Adrenal calcifications in patients with fCCM were more frequently left sided, with 17 of 19 patients having more SFCs in the left adrenal gland than the right adrenal gland and 50 of the 61 observed SFCs (82%) found in the left adrenal gland. No subjects had SFCs on the right side only. In patients with fCCM, the presence of SFCs showed a positive correlation with age (P < .001) and number of brain lesions (P < .001). Conclusion Adrenal calcifications identified on CT scans are common in patients with fCCM and may be a clinically silent manifestation of disease. (©) RSNA, 2017.

  16. [Mixed facial lymphatic malformation: case report].

    Science.gov (United States)

    Morovic I, Carmen Gloria; Vidal T, Claudia; Leiva V, Noemí; Véliz M, Sebastián

    2014-12-01

    Lymphangiomas are a common form of vascular malformation of the lymphatic vessels, mainly in the head and neck region. Most cases are progressive evolution and require a multidisciplinary approach. Currently, the first therapeutic option is sclerotherapy, leaving surgery for the treatment of remaining lesions. To present a case of facial lymphatic malformation (LM) treated with sclerotherapy, surgery and orthodontics in a 15-year follow up. A one-year-old female patient who consulted health professionals due to a progressive volume increase of the soft parts of her right cheek. The imaging study confirmed the diagnosis of microcystic lymphatic malformation. It was managed with OK-432 sclerotherapy and Bleomycin. At 2 years of age, the patient response was considered adequate; an intralesional submandibular surgical excision was then performed, with partial resection of the lesion. The biopsy confirmed the diagnosis of microcystic LM. Six months after, a re-resection was planned using the same approach and removing the remaining lesion, with favorable development until the age of 9 years when the patient required surgery and orthodontic management due to intraoral recurrence. No major developments until the age of 13 when a new orthodontic surgery and handling are planned to perform right oral commissure suspension. LM management by sclerotherapy, surgery, and orthodontics has shown the advantages of a multidisciplinary long-term treatment in this case.

  17. Calcium micro-depositions in jugular truncular venous malformations revealed by Synchrotron-based XRF imaging.

    Science.gov (United States)

    Pascolo, Lorella; Gianoncelli, Alessandra; Rizzardi, Clara; Tisato, Veronica; Salomé, Murielle; Calligaro, Carla; Salvi, Fabrizio; Paterson, David; Zamboni, Paolo

    2014-10-07

    It has been recently demonstrated that the internal jugular vein may exhibit abnormalities classified as truncular venous malformations (TVMs). The investigation of possible morphological and biochemical anomalies at jugular tissue level could help to better understand the link between brain venous drainage and neurodegenerative disorders, recently found associated with jugular TVMs. To this end we performed sequential X-ray Fluorescence (XRF) analyses on jugular tissue samples from two TVM patients and two control subjects, using complementary energies at three different synchrotrons. This investigation, coupled with conventional histological analyses, revealed anomalous micro-formations in the pathological tissues and allowed the determination of their elemental composition. Rapid XRF analyses on large tissue areas at 12.74 keV showed an increased Ca presence in the pathological samples, mainly localized in tunica adventitia microvessels. Investigations at lower energy demonstrated that the high Ca level corresponded to micro-calcifications, also containing P and Mg. We suggest that advanced synchrotron XRF micro-spectroscopy is an important analytical tool in revealing biochemical changes, which cannot be accessed by conventional investigations. Further research on a larger number of samples is needed to understand the pathogenic significance of Ca micro-depositions detected on the intramural vessels of vein walls affected by TVMs.

  18. [Management of vascular anomalies in children].

    Science.gov (United States)

    Elajmi, A; Clapuyt, P; Hammer, F; Bataille, A-C; Lengele, B; Boon, L M

    2016-10-01

    Vascular anomalies, which are broadly identified as "angiomas", are rare entities and often unknown by the medical sphere. They are divided in two different categories which carry different prognosis and management: "vascular tumors" and "vascular malformations". Their precise identification is crucial and involves a good knowledge of the biological classification published by Mulliken and Glowacki and that has recently been updated by the International Society for the Study of Vascular Anomalies (ISSVA). Vascular tumors are benign, common, inborn or not and most of the time disappear with growth. Vascular malformations are always congenital and growth with the child. They can involve type of vessels solely or combined with others. A rheologic differentiation between slow and fast flow malformations is essential in order to characterize the seriousness of the lesion. Frequently, their diagnosis is clinically established and the anamnesis is conducted to answer three questions that are the time of revelation of the lesion ("When?"), its aspect ("What?") and its evolution ("How?"). Further investigations are usually not required but a non-invasive imaging technique such as Doppler ultrasound could be useful if a doubt exists. Surgery is not mandatory and must always be well thought because its consequences might be disastrous. It must be left to cosmetic sequelae of these lesions or to lesions that are totally resectable without causing any unacceptable deformation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Tumor Vascularity Assessed By Magnetic Resonance Imaging and Intravital Microscopy Imaging

    Directory of Open Access Journals (Sweden)

    Jon-Vidar Gaustad

    2008-04-01

    Full Text Available Gadopentetate dimeglumine (Gd-DTPA-based dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI is considered to be a useful method for characterizing the vascularity of tumors. However, detailed studies of experimental tumors comparing DCE-MRI-derived parametric images with images of the morphology and function of the microvascular network have not been reported. In this communication, we describe a novel MR-compatible mouse dorsal window chamber and report comparative DCE-MRI and intravital microscopy studies of A-07-GFP tumors xenografted to BALB/c nu/nu mice. Blood supply time (BST images (i.e., images of the time from when arterial blood enters a tumor through the supplying artery until it reaches a vessel segment within the tumor and morphologic images of the microvascular network were produced by intravital microscopy. Images of E·F (E is the initial extraction fraction of Gd-DTPA and F is perfusion were produced by subjecting DCE-MRI series to Kety analysis. The E·F images mirrored the morphology (microvascular density and the function (BST of the microvascular networks well. Tumor regions showing high E·F values colocalized with tumor regions showing high microvascular density and low BST values. Significant correlations were found between E·F and microvascular density and between E·F and BST, both within and among tumors.

  20. Tumor Vascularity Assessed By Magnetic Resonance Imaging and Intravital Microscopy Imaging1

    Science.gov (United States)

    Gaustad, Jon-Vidar; Brurberg, Kjetil G; Simonsen, Trude G; Mollatt, Camilla S; Rofstad, Einar K

    2008-01-01

    Gadopentetate dimeglumine (Gd-DTPA)-based dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is considered to be a useful method for characterizing the vascularity of tumors. However, detailed studies of experimental tumors comparing DCE-MRI-derived parametric images with images of the morphology and function of the microvascular network have not been reported. In this communication, we describe a novel MR-compatible mouse dorsal window chamber and report comparative DCE-MRI and intravital microscopy studies of A-07-GFP tumors xenografted to BALB/c nu/nu mice. Blood supply time (BST) images (i.e., images of the time from when arterial blood enters a tumor through the supplying artery until it reaches a vessel segment within the tumor) and morphologic images of the microvascular network were produced by intravital microscopy. Images of E·F (E is the initial extraction fraction of Gd-DTPA and F is perfusion) were produced by subjecting DCE-MRI series to Kety analysis. The E·F images mirrored the morphology (microvascular density) and the function (BST) of the microvascular networks well. Tumor regions showing high E·F values colocalized with tumor regions showing high microvascular density and low BST values. Significant correlations were found between E·F and microvascular density and between E·F and BST, both within and among tumors. PMID:18392132

  1. Arms Down Cone Beam CT Hepatic Angiography Performance Assessment: Vascular Imaging Quality and Imaging Artifacts.

    Science.gov (United States)

    Gonzalez-Aguirre, Adrian J; Petre, Elena N; Hsu, Meier; Moskowitz, Chaya S; Solomon, Stephen B; Durack, Jeremy C

    2018-01-11

    The practice of positioning patients' arms above the head during catheter-injected hepatic arterial phase cone beam CT (A-CBCT) imaging has been inherited from standard CT imaging due to image quality concerns, but interrupts workflow and extends procedure time. We sought to assess A-CBCT image quality and artifacts with arms extended above the head versus down by the side. We performed an IRB approved retrospective evaluation of reformatted and 3D-volume rendered images from 91 consecutive A-CBCTs (43 arms up, 48 arms down) acquired during hepatic tumor arterial embolization procedures. Two interventional radiologists reviewed all A-CBCT imaging and assigned vessel visualization scores (VVS) from 1 to 5, ranging from non-diagnostic to optimal visualization. Streak artifacts across axial images were rated from 1 to 3 based on resulting image quality (none to significant). Presence of respiratory or cardiac motion during acquisition, body mass index and radiation dose area product (DAP) were also recorded and analyzed. Univariate and multivariate analyses were used to assess the impact of arm position on VVS and imaging artifacts. VVS were not significantly associated with arm position during A-CBCT imaging. One reader reported more streak artifacts across axial images in the arms down group (p = 0.005). DAP was not statistically different between the groups (23.9 Gy cm2 [6.1-73.4] arms up, 26.1 Gy cm2 [4.2-102.6] arms down, p = 0.54). A-CBCT angiography performed with the arms above the head is not superior for clinically relevant hepatic vascular visualization compared to imaging performed with the arms by the patient's side.

  2. Gastrointestinal malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Loane, Maria; Dolk, Helen

    2007-01-01

    malformations, although not statistically significant for gastroschisis. There was little difference in median birthweight by GA for the pre- and postnatally diagnosed infants. The difference in GA at birth between prenatally and postnatally diagnosed infants with GIMs is enough to increase the risk......The aim of the study was to analyse the degree to which gestational age (GA) has been shortened due to prenatal diagnosis of gastrointestinal malformations (GIM). The data source for the study was 14 population-based registries of congenital malformations (EUROCAT). All liveborn infants with GIMs...... and without chromosomal anomalies, born 1997-2002, were included. The 14 registries identified 1047 liveborn infants with one or more GIMs (oesophageal atresia, duodenal atresia, omphalocele, gastroschisis and diaphragmatic hernia). Median GA at birth was lower in prenatally diagnosed cases for all five...

  3. Multimodality imaging of normal hepatic transplant vasculature and graft vascular complications

    National Research Council Canada - National Science Library

    Roberts, Jeffrey H; Mazzariol, Fernanda S; Frank, Susan J; Oh, Sarah K; Koenigsberg, Mordecai; Stein, Marjorie W

    2011-01-01

    .... Post-operative complications, however, can limit this success. Ultrasound is the primary imaging modality for evaluation of hepatic transplants, providing real-time information about vascular flow in the graft...

  4. Contemporary diagnosis and management of a uterine arteriovenous malformation.

    Science.gov (United States)

    Brown, John V; Asrat, Tamerou; Epstein, Howard D; Oglevie, Steven; Goldstein, Bram H

    2008-08-01

    Uterine arteriovenous malformations (AVMs) are extremely rare and can result in severe complications. Experience with diagnosis and management of these vascular malformations is very limited. We report on a patient with a history of nonmetastatic gestational trophoblastic disease. The patient developed a concomitant 4.4-cm intrauterine mass, suggestive of a molar pregnancy, during her second pregnancy. Despite suction and sharp curettage, the mass and menorrhagia persisted. After complex diagnostic imaging, the diagnosis of a uterine AVM was made. Subsequently, the patient underwent uterine arterial embolization and laparoscopic surgery to resect the mass. Because uterine AVMs are infrequently encountered, they initially may not be included in the differential diagnosis. The use of contemporary imaging, interventional radiology, and surgery can optimize patient outcome.

  5. Multimodality Imaging of Normal Hepatic Transplant Vasculature and Graft Vascular Complications

    Directory of Open Access Journals (Sweden)

    Jeffrey H Roberts

    2011-01-01

    Full Text Available Orthotopic liver transplantation is an important treatment option for patients with end-stage liver disease. Advances in surgical technique, along with improvements in organ preservation and immunosuppression have improved patient outcomes. Post-operative complications, however, can limit this success. Ultrasound is the primary imaging modality for evaluation of hepatic transplants, providing real-time information about vascular flow in the graft. Graft vascular complications are not uncommon, and their prompt recognition is crucial to allow for timely graft salvage. A multimodality approach including CT angiography, MRI, or conventional angiography may be necessary in cases of complex transplant vascular anatomy or when sonography and Doppler are inconclusive to diagnose the etiologies of these complications. The purpose of this article is to familiarize radiologists with the normal post-transplant vascular anatomy and the imaging appearances of the major vascular complications that may occur within the hepatic artery, portal vein, and venous outflow tract, with an emphasis on ultrasound.

  6. Incidentally Diagnosed Multiple Vascular Lesions of the Spleen: Littoral Cell Angioma or Hemangioma?

    Science.gov (United States)

    Aydin, Emrah

    2016-01-01

    Vascular lesions of the solid abdominal viscera may pose diagnostic and management issues. A 16-year old girl admitted to emergency department due to recurrent abdominal pain and diagnosed to have multiple vascular malformations of the spleen on imaging investigations. Littoral cell angioma was preoperative suspicion owing to no response of the vascular lesion to the propranolol. It turned out to be cavernous hemangioma on histopathology.

  7. Chiari Malformation

    Science.gov (United States)

    ... Parents Are Reading How to Talk to Your Child About the News Brain and Nervous System Cancers When Your Child Needs ... spine that can lead to nerve damage or paralysis). Chiari malformations also can happen after brain or spinal surgery. A gene that causes Chiari ...

  8. A vascular image registration method based on network structure and circuit simulation.

    Science.gov (United States)

    Chen, Li; Lian, Yuxi; Guo, Yi; Wang, Yuanyuan; Hatsukami, Thomas S; Pimentel, Kristi; Balu, Niranjan; Yuan, Chun

    2017-05-02

    Image registration is an important research topic in the field of image processing. Applying image registration to vascular image allows multiple images to be strengthened and fused, which has practical value in disease detection, clinical assisted therapy, etc. However, it is hard to register vascular structures with high noise and large difference in an efficient and effective method. Different from common image registration methods based on area or features, which were sensitive to distortion and uncertainty in vascular structure, we proposed a novel registration method based on network structure and circuit simulation. Vessel images were transformed to graph networks and segmented to branches to reduce the calculation complexity. Weighted graph networks were then converted to circuits, in which node voltages of the circuit reflecting the vessel structures were used for node registration. The experiments in the two-dimensional and three-dimensional simulation and clinical image sets showed the success of our proposed method in registration. The proposed vascular image registration method based on network structure and circuit simulation is stable, fault tolerant and efficient, which is a useful complement to the current mainstream image registration methods.

  9. Changes in a cerebellar peduncle lesion in a patient with Dandy-Walker malformation: A diffusion tensor imaging study.

    Science.gov (United States)

    Lee, Ah Young; Jang, Sung Ho; Yeo, Sang Seok; Lee, Ensil; Cho, Yun Woo; Son, Su Min

    2013-02-15

    We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was diagnosed with Dandy-Walker syndrome and six age- and sex-matched healthy control subjects were enrolled. The superior cerebellar peduncle, the middle cerebellar peduncle, and the inferior cerebellar peduncle were evaluated using fractional anisotropy and the apparent diffusion coefficient. The patients' functional ambulation category was 0 at the initial visit, but improved to 2 at the follow-up evaluation, and Berg's balance scale score also improved from 0 to 7. Initial diffusion tensor tractography revealed that the inferior cerebellar peduncle was not detected, that the fractional anisotropy of the superior cerebellar peduncle and middle cerebellar peduncle decreased by two standard deviations below, and that the apparent diffusion coefficient increased by two standard deviations over normal control values. However, on follow-up diffusion tensor tractography, both inferior cerebellar peduncles could be detected, and the fractional anisotropy of superior cerebellar peduncle increased to within two standard deviations of normal controls. The functional improvement in this patient appeared to correspond to changes in these cerebellar peduncles. We believe that evaluating cerebellar peduncles using diffusion tensor imaging is useful in cases when a cerebellar peduncle lesion is suspected.

  10. Rare malformation of glans penis: arteriovenous malformation.

    Science.gov (United States)

    Akin, Y; Sarac, M; Yucel, S

    2013-01-01

    Pediatric glans penis malformations, especially arteriovenous malformations (AVM), are very rare. Herein, we report two rare cases. A 14-year-old boy attended our outpatient clinic with chief complaints of purple swelling and rapidly growing lesion on the glans penis. The lesion was excised surgically after physical and radiological evaluations. Pathology reported AVM and the patient is being followed up. The second case is a 2-year-old boy who was admitted with a big lesion involving glans penis and genital area that has been present since birth. In physical and radiological evaluations, lesion on the glans penis was pulsatile. Parents of the patient did not want any surgery and patient has been in follow-up. Diagnosis of the vascular lesions on glans penis is very easy by physical and radiological examinations today. Long-term follow-up is very important for AVM. Clinicians must make a careful effort to document new glans lesions in the pediatric population and decrease anxiety in the parents of affected children.

  11. CASE REPORT CASE Multimodality imaging and interventional ...

    African Journals Online (AJOL)

    sequestration was considered at this stage. An angiogram was thereafter performed to further characterise the vascularity, as well as allow embolisation of the lesion prior to surgery. (Fig. 5). Multimodality imaging and interventional management of a complex congenital vascular malformation. Aadil Ahmed, MB BCh, FCRad ...

  12. Significance of CT scan and color Doppler duplex ultrasound in the assessment of Abernethy malformation.

    Science.gov (United States)

    Nacif, Lucas Souto; Paranaguá-Vezozzo, Denise Cerqueira; Galvão, Flávio Henrique Ferreira; Rocha, Manoel S; Andraus, Wellington; Carrilho, Flair Jose; D'Albuquerque, Luiz Carneiro

    2015-09-18

    Abernethy malformation is a rare congenital vascular abnormality in which the portal vein bypasses the liver and drains directly into the inferior vena cava. Diagnosis is complex and requires good quality imaging methods to identify details in systemic and portal circulation in order to establish diagnostic confirmation and treatment strategy. In this study we highlight the significance of the use of CT scans and Color Doppler Duplex Ultrasound for the diagnosis, treatment and evolution assessment in two adults with Abernethy malformation. The diagnosis and the treatment of two patients with Abernethy malformation by CT scan and Color Doppler Duplex Ultrasound is described. One patient was submitted to liver transplantation due to chronic liver disease and multiple nodules diagnosed as adenoma. The other patient had normal liver function and a mild neurological and psychomotor dysfunction, therefore we adopted clinical treatment and close liver parenchyma evaluation and nodule surveillance, using an imaging approach involving intercalating CT scan and Color Doppler Duplex Ultrasound every 6 months. We highlight some important direct and indirect findings of non-invasive imaging methods. Abernethy malformation requires meticulous image diagnosis to improve treatment and avoid iatrogenic procedures. CT scans and Color Doppler Duplex Ultrasound are both efficient methods for diagnosis, treatment planning and evolution assessment of patients with Abernethy malformation.

  13. Update on pediatric extracranial vascular anomalies of the head and neck.

    Science.gov (United States)

    Puttgen, Katherine B; Pearl, Monica; Tekes, Aylin; Mitchell, Sally E

    2010-10-01

    Vascular anomalies most frequently present at birth or in early childhood, and the craniofacial region is the most common site of involvement. A long history of misleading nomenclature born of confusion about the presentation and natural history of various vascular anomalies has made appropriate diagnosis difficult. The present article emphasizes the importance of clarity of nomenclature for proper diagnosis, both clinically and radiographically, to guide appropriate therapy. In addition, updates on clinical concepts, imaging, and treatment strategies will be discussed. Pediatric vascular anomalies can be divided into two broad categories: vascular tumors and vascular malformations. This biologic classification is based on differences in natural history, cellular turnover, and histology. An updated classification was introduced in 1996 by the International Society for the Study of Vascular Anomalies (ISSVA) to include infantile hemangioma variants, other benign vascular tumors, and combined lesions. Widespread confusion propagated throughout the literature and in clinical practice stems from the continued improper use of many of the terms used to describe vascular tumors and malformations ignoring their pathophysiology. This leads to errors in diagnosis and the dissemination of misinformation to patients and clinicians. Certain terms should be abandoned for more appropriate terms. The clinical presentation usually identifies what general type of vascular anomaly is present, either vascular tumor or vascular malformation. Imaging provides crucial information about the initial diagnosis and aids in follow-up. Adoption and use of uniform nomenclature in the ISSVA classification system is the first vital step in correct diagnosis and treatment of often complicated vascular tumors and vascular malformations. A multidisciplinary team approach is necessary to provide optimal care for patients, and the necessity for specialists in all areas to communicate using

  14. A critical review of benefits and limitations of magnetic resonance imaging as a complementary method in the diagnosis of fetal malformations

    Energy Technology Data Exchange (ETDEWEB)

    Ximenes, Renato Luis da Silveira; Ximenes, Andrea Regina da Silveira [Centrus - Centro de Ultra-Sonografia e Medicina Fetal de Campinas, Campinas, SP (Brazil); Szejnfeld, Jacob; Zanderigo, Valdir [Cura - Diagnostico e Imagem, Sao Paulo, SP (Brazil)

    2008-09-15

    Objective: The present study was aimed at evaluating by means of magnetic resonance imaging a series of fetuses with sonographic diagnosis of malformation, establishing the diagnostic benefits and limitations of fetal magnetic resonance imaging as compared with ultrasonography. Materials and methods: Forty women between 15-35 gestational weeks and previously diagnosed with fetal abnormality by ultrasonography were referred to undergo complementary fetal magnetic resonance imaging, particularly for evaluating abnormalities in the fetal central nervous system, thorax, abdomen, renal system, skeletal system, and tumors. The whole evaluation process included a review of the fetal ultrasonography and magnetic resonance images, postnatal follow-up, laboratory tests, imaging studies and necropsy. Results: The present study has demonstrated that complementary magnetic resonance imaging did provide further information in 60% of cases, with the following benefits: improved information on the fetus as a whole, with a large field of view, higher anatomic resolution provided by fast sequences, superior soft tissue contrast resolution, besides the fact that the visualization of the fetus is not significantly affected by maternal obesity or oligohydramnios. Limitations of the method include contraindication in the first gestational trimester and in cases of maternal claustrophobia, sensitivity to fetal motion, low sensitivity for detecting cardiovascular and skeletal malformations. Conclusion: Fetal magnetic resonance imaging plays a significant role as a complementary method for the diagnosis of fetal anomalies. (author)

  15. Cerebral and pulmonary arteriovenous malformations CASE REPORT

    African Journals Online (AJOL)

    This assumes that vascular malforma- tions are congenital or developmental hamartomas, rather than neo- plasms. This classification is based on microscopic and gross pathologi- cal features of the lesions. Although most CNS vascular malformations occur in isolation, some are also found in association with cutaneous.

  16. IMAGING DIAGNOSIS-COMPUTED TOMOGRAPHIC ANGIOGRAPHY CHARACTERISTICS OF MULTIPLE VASCULAR ANOMALIES IN A SENIOR DOG WITH LATE-ONSET REGURGITATION.

    Science.gov (United States)

    Yoon, Hakyoung; Kim, Jaehwan; Kwon, Gi Bum; Lim, Jin Hyuk; Eom, Kidong

    2017-02-08

    A 10-year-old dog weighing 3.4 kg presented with intermittent regurgitation. Esophagography revealed that the thoracic esophagus was compressed dorsally at the region of the fourth intercostal space and segmentally dilated from the second to third intercostal region. Three-dimensional computed tomographic (CT) angiography confirmed a suspected vascular ring anomaly and also revealed multiple other vascular anomalies. These included aberrant right subclavian artery, absence of bilateral external jugular veins, right-gastric caval shunt, and a completely duplicated caudal vena cava. Findings supported the use of thoracic CT angiography to rule out additional vascular malformations in dogs with suspected vascular ring anomaly. © 2017 American College of Veterinary Radiology.

  17. Cavernous venous malformation (cavernous hemangioma) of the orbit: Current concepts and a review of the literature.

    Science.gov (United States)

    Calandriello, Luigi; Grimaldi, Gabriela; Petrone, Gianluigi; Rigante, Mario; Petroni, Sergio; Riso, Monica; Savino, Gustavo

    The cavernous venous malformation of the orbit, previously called cavernous hemangioma, is the most common primary orbital lesion of adults. Cavernous venous malformation occurs more often in women and typically presents in the fourth and fifth decades of life. It is a benign vascular malformation characterized by a well-defined capsule and numerous large vascular channels. The most common sign of cavernous venous malformation is progressive axial proptosis from the preferential involvement of the intraconal orbital space. Optic nerve damage and other signs of orbital pathology may be present, with a variable degree of visual impairment. The combination of ultrasound, computed tomography, and magnetic resonance imaging leads to an accurate diagnosis in the vast majority of cases. Surgical and nonsurgical treatments are required in case of symptomatic lesions, with a characteristic multidisciplinary management influencing optimal outcome. Orbitotomy represents the traditional surgical approach. Recently, the endoscopic transnasal approach to the orbital cavity has gained interest, representing a feasible and safe, less-invasive surgical technique for the management of cavernous venous malformation. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Malformation lymphatic abdominal

    OpenAIRE

    Sebastião Ribeiro do Carmo Filho; Poliana de Paula Vieira Borges dos Reis Soares; Fabiano Souza Soares; Erivanea Garcia Ribeiro; Willy Pereira da Silva Filho; Rafael Naves Tomás; Yara Rocha Ximenes

    2015-01-01

    Abdominal lymphangiomas are benign malformations of the lymphatic system. The diagnosis is established due to patient's clinical manifestations associated with imaging. The clinical presentation of cystic lymphangiomas is much variable and depends on the symptoms, mostly caused by the abdominal mass, it´s size and location. It is accepted that the incidence of mesenteric cysts in the american population is somehow between 1:100.000 and 1:250.000, causing hospital admissions. Surgical treatmen...

  19. Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Nikolaos Mouchtouris

    2015-01-01

    Full Text Available Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics.

  20. Management of cerebral cavernous malformations: from diagnosis to treatment.

    Science.gov (United States)

    Mouchtouris, Nikolaos; Chalouhi, Nohra; Chitale, Ameet; Starke, Robert M; Tjoumakaris, Stavropoula I; Rosenwasser, Robert H; Jabbour, Pascal M

    2015-01-01

    Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment--microsurgical resection, stereotactic radiosurgery, and conservative management--depending on the lesion characteristics.

  1. Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

    Science.gov (United States)

    Mouchtouris, Nikolaos; Chitale, Ameet; Starke, Robert M.; Tjoumakaris, Stavropoula I.; Rosenwasser, Robert H.; Jabbour, Pascal M.

    2015-01-01

    Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics. PMID:25629087

  2. Diagnostic imaging of vascular leiomyosarcomas; Bildgebende Diagnostik von vaskulaeren Leiomyosarkomen

    Energy Technology Data Exchange (ETDEWEB)

    Kreft, B.; Flacke, S.; Textor, J.; Schild, H.H. [Bonn Univ., Radiologische Klinik (Germany); Zhou, H. [Bonn Univ., Pathologisches Inst. (Germany); Remig, J. [Chirurgische Klinik, Univ. Bonn (Germany)

    2004-02-01

    Primary vascular leiomyosarcomas are very rare tumors, with the venous variety most often arising from the inferior caval vein and the arterial variety from the pulmonal artery. The tumors show either an exclusive intra- or extravascular pattern or a mixed growth pattern. The clinical symptoms depend on tumor location, with intraluminal tumors of the inferior caval vein causing edema or a Budd-Chiari syndrome. Leiomyosarcomas of the pulmonal artery can mimic chronic central or recurrent peripheral pulmonary embolism. Contrast enhanced spiral CT with multiplanar reconstruction is the diagnostic method of choice when a vascular leiomyosarcoma is suspected. MRI with MR-angiography can be added. If a tumor of undetermined origin shows a broad contact with a vessel and/or an intraluminal component, possible primary vascular leiomyosarcoma should be included in the differential diagnosis. (orig.) [German] Primaere vaskulaere Leiomyosarkome sind sehr seltene Tumoren, die venoes meistens von der Vena cava inferior und arteriell von der Pulmonalarterie ausgehen. Die Tumoren zeigen entweder ein komplett extra- bzw. intravaskulaeres oder ein gemischtes Wachstum. Die klinischen Symptome der venoesen Tumoren richten sich nach der Lokalisation der Tumoren, wobei intraluminale Tumoren im Bereich der Vena cava inferior durch Oedeme oder ein Budd-Chiari-Syndrom auffallen koennen. Leiomyosarkome der Pulmonalarterien koennen chronische zentrale oder rezidivierende periphere Lungenembolie imitieren. Die kontrastverstaerkte Spiral-CT mit multiplanaren Rekonstruktionen ist die diagnostische Methode der Wahl bei V.a. ein vaskulaeres Leiomyosarkom, die durch die MRT in Kombination mit der MR-Angiographie ergaenzt werden kann. Differenzialdiagnostisch sollte bei unklarer Organzugehoerigkeit von Tumoren mit Kontakt zu Venen und/oder intraluminalem Anteil an die Moeglichkeit eines primaeren vaskulaeren Leiomyosarkoms gedacht werden. (orig.)

  3. Anaesthetic management of a child with massive extracranial arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Faisal Shamim

    2012-01-01

    Full Text Available Vascular tumors affect the head and neck commonly but arteriovenous malformations are rare. Vascular malformations are often present at birth and grow with the patient, usually only becoming significant later in childhood. Embolization has been the mainstay of treatment in massive and complex arteriovenous malformations. We present a case of massive extracranial arteriovenous malformation in a 7-year-old boy causing significant workload on right heart and respiratory distress. The management of angioembolization under general anaesthesia and anaesthetic concerns are presented.

  4. Usefulness of Diffusion Tensor Imaging of White Matter in Alzheimer Disease and Vascular Dementia

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, S.; Kinoshita, T.; Matsusue, E.; Fujii, S.; Ogawa, T. [Tottori Univ., Yonago (Japan). Dept. of Radiology

    2004-10-01

    Purpose: To evaluate the usefulness of diffusion tensor imaging in detecting the water diffusivity caused by neuro pathological change in Alzheimer disease and vascular dementia. Material and Methods: Twenty patients with Alzheimer disease, 20 with vascular dementia, and 10 control subjects were examined. Diffusion tensor imaging applied diffusion gradient encoding in six non-collinear directions. Fractional anisotropy values were compared in the genu and splenium of the corpus callosum, and anterior and posterior white matter among the three groups. Results: In the patients with Alzheimer disease, fractional anisotropy values of the posterior white matter were significantly lower than those of controls. In patients with vascular dementia, fractional anisotropy values of the anterior white matter tended to be lower than those of the posterior white matter (P=0.07). Conclusion: Diffusion tensor imaging reflects the neuro pathological changes in the white matter, and may be useful in the diagnosis of Alzheimer disease and vascular dementia. Keywords: Alzheimer disease, .; diffusion tensor imaging, .; vascular dementia.

  5. Clinical validation of semi-automated software for volumetric and dynamic contrast enhancement analysis of soft tissue venous malformations on magnetic resonance imaging examination

    Energy Technology Data Exchange (ETDEWEB)

    Caty, Veronique [Hopital Maisonneuve-Rosemont, Universite de Montreal, Department of Radiology, Montreal, QC (Canada); Kauffmann, Claude; Giroux, Marie-France; Oliva, Vincent; Therasse, Eric [Centre Hospitalier de l' Universite de Montreal (CHUM), Universite de Montreal and Research Centre, CHUM (CRCHUM), Department of Radiology, Montreal, QC (Canada); Dubois, Josee [Centre Hospitalier Universitaire Sainte-Justine et Universite de Montreal, Department of Radiology, Montreal, QC (Canada); Mansour, Asmaa [Institut de Cardiologie de Montreal, Heart Institute Coordinating Centre, Montreal, QC (Canada); Piche, Nicolas [Object Research System, Montreal, QC (Canada); Soulez, Gilles [Centre Hospitalier de l' Universite de Montreal (CHUM), Universite de Montreal and Research Centre, CHUM (CRCHUM), Department of Radiology, Montreal, QC (Canada); CHUM - Hopital Notre-Dame, Department of Radiology, Montreal, Quebec (Canada)

    2014-02-15

    To evaluate venous malformation (VM) volume and contrast-enhancement analysis on magnetic resonance imaging (MRI) compared with diameter evaluation. Baseline MRI was undertaken in 44 patients, 20 of whom were followed by MRI after sclerotherapy. All patients underwent short-tau inversion recovery (STIR) acquisitions and dynamic contrast assessment. VM diameters in three orthogonal directions were measured to obtain the largest and mean diameters. Volumetric reconstruction of VM was generated from two orthogonal STIR sequences and fused with acquisitions after contrast medium injection. Reproducibility (interclass correlation coefficients [ICCs]) of diameter and volume measurements was estimated. VM size variations in diameter and volume after sclerotherapy and contrast enhancement before sclerotherapy were compared in patients with clinical success or failure. Inter-observer ICCs were similar for diameter and volume measurements at baseline and follow-up (range 0.87-0.99). Higher percentages of size reduction after sclerotherapy were observed with volume (32.6 ± 30.7 %) than with diameter measurements (14.4 ± 21.4 %; P = 0.037). Contrast enhancement values were estimated at 65.3 ± 27.5 % and 84 ± 13 % in patients with clinical failure and success respectively (P = 0.056). Venous malformation volume was as reproducible as diameter measurement and more sensitive in detecting therapeutic responses. Patients with better clinical outcome tend to have stronger malformation enhancement. (orig.)

  6. Between a rock and a hard place: clinical and imaging features of vascular compression syndromes.

    Science.gov (United States)

    Eliahou, Ruth; Sosna, Jacob; Bloom, Allan I

    2012-01-01

    Vascular compression syndromes are caused by the entrapment of vessels between rigid or semirigid surfaces in a confined anatomic space. Chronic entrapment may lead to arterial ischemia and embolism, venous stasis and thrombosis, and hematuria. These syndromes are usually seen in otherwise healthy young patients, among whom underdiagnosis is common. Most occurrences of vascular compression are associated with an underlying anatomic abnormality. In a small percentage of cases, other contributing factors, including repetitive microtrauma, may cause pathologic changes leading to the onset of pain and other symptoms of vascular and neural compression. Hence, the diagnosis must be based on both clinical and radiologic findings. Because some cases of vascular entrapment become symptomatic only when specific physical maneuvers are performed, dynamic diagnostic imaging methods are especially useful. Digital subtraction angiography has been the mainstay of imaging-based diagnosis for most vascular compression syndromes, but other methods (eg, color Doppler ultrasonography, computed tomographic angiography, and magnetic resonance angiography) are used with increasing frequency for initial diagnostic evaluation. Because vascular compression syndromes are caused by the external compression of vessels, endoluminal treatment alone is rarely adequate and surgical decompression is likely to be required for optimal and durable clinical benefit. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.321115011/-/DC1.

  7. Breast contrast-enhanced MR imaging: semiautomatic detection of vascular map.

    Science.gov (United States)

    Fusco, Roberta; Sansone, Mario; Filice, Salvatore; Petrillo, Antonella

    2016-03-01

    The diagnostic value of breast vascular maps using contrast-enhanced MR imaging has recently been explored. We propose a semiautomatic method to obtain breast vascular maps and to measure the number of blood vessels in the breast. From January 2011 to December 2013, 188 patients underwent breast contrast-enhanced MRI; patients with unilateral and histopathologically confirmed breast lesions were included in this study; 123 patients had malignant lesions and 65 patients had benign tissue diagnoses. Breast semiautomatic vascular map detection was performed using Hessian matrix-based method and morphologic operators. Blood vessels detection was compared with radiologic interpretation findings to evaluate algorithm goodness. Increase in vascularity associated with ipsilateral cancer was also assessed. Chi square test was used to observe statistically significant difference. A total of 1315 blood vessels were identified using semiautomatic procedure; 1034 were correctly classified (78.7 %), 261 (19.8 %) were incorrectly classified, and 20 (1.5 %) were missing. A significant association was found between one-sided increased breast vascularity and ipsilateral malignancy (p breast cancer could be performed with semiautomatic vascular mapping of contrast-enhanced MR imaging.

  8. Functional imaging of the vascular bed by dynamic optical tomography

    Science.gov (United States)

    Barbour, Randall L.; Graber, Harry L.; Pei, Yaling; Schmitz, Christoph H.; Xu, Yong; Di Martino, Adriana; Castellanos, F. Xavier; Klemer, David P.; Hardin, Rosemarie E.; Franco, Nelson A.; Katz, Michael S.; Zenilman, M. E.; Smeraldi, Alessandro G.; Panetta, Thomas F.

    2004-04-01

    In this report we present a brief outline of our technological approaches to developing a comprehensive imaging platform suitable for the investigation of the dynamics of the hemoglobin signal in large tissue structures using NIRS imaging techniques. Our approach includes a combined hardware and software development effort that provides for i) hardware integration, ii) system calibration, iii) data integrity checks, iv) image recovery, v) image enhancement and vi) signal processing. Presented are representative results obtained from human subjects that explore the sensitivity and other capabilities of the measuring system to detect focal hemodynamic responses in the head, breast and limb of volunteers. Results obtained support the contention that time-series NIRS imaging is a powerful and sensitive technique for exploring the hemodynamics of healthy and diseased tissues.

  9. Time-resolved 3D contrast-enhanced MRA with GRAPPA on a 1.5-T system for imaging of craniocervical vascular disease: initial experience.

    Science.gov (United States)

    Meckel, Stephan; Mekle, Ralf; Taschner, Christian; Haller, Sven; Scheffler, Klaus; Radue, Ernst-Wilhelm; Wetzel, Stephan G

    2006-05-01

    For three-dimensional (3D) imaging with magnetic resonance angiography (MRA) of the cerebral and cervical circulation, both a high temporal and a high spatial resolution with isovolumetric datasets are of interest. In an initial evaluation, we analyzed the potential of contrast-enhanced (CE) time-resolved 3D-MRA as an adjunct for neurovascular MR imaging. In ten patients with various cerebrovascular disorders and vascularized tumors in the cervical circulation, high-speed MR acquisition using parallel imaging with the GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) algorithm on a 1.5-T system with a temporal resolution of 1.5 s per dataset and a nearly isovolumetric spatial resolution was applied. The results were assessed and compared with those from conventional MRA and digital subtraction angiography (DSA). CE time-resolved 3D-MRA enabled the visualization and characterization of high-flow arteriovenous shunts in cases of vascular malformations or hypervascularized tumors. In steno-occlusive disease, the method provided valuable additional information about altered vessel perfusion compared to standard MRA techniques such as time-of-flight (TOF) MRA. The use of a nearly isovolumetric voxel size allowed a free-form interrogation of 3D datasets. Its comparatively low spatial resolution was found to be the major limitation. In this preliminary analysis, CE time-resolved 3D-MRA was revealed to be a promising complementary MRA sequence that enabled the visualization of contrast flow dynamics in various types of neurovascular disorders and vascularized cervical tumors.

  10. Interventional treatment of pulmonary arteriovenous malformations

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Kjeldsen, Anette Drøhse

    2010-01-01

    Pulmonary arteriovenous malformations (PAVM) are congenital vascular communications in the lungs. They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered. These patients are typically hypoxaemic with exercise intolerance and are at high...... to the arteriovenous malformations. It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success, high effectiveness and low morbidity and mortality. Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises...

  11. GIANT CYSTIC CERVICAL LYMPHATIC MALFORMATION

    OpenAIRE

    N. Danila; D. Andronic; Luca Beatrice; Popa, E.; A. Nistor; D. Ferariu

    2006-01-01

    The lymphatic malformations of the neck (LMN) are rare diseases, which increase progressively until very large size. The clinical symptoms are pressure signs, due to the compression to the respiratory, digestive and vascular structures of the neck. The authors are presenting the clinical case of a 77 yo male patient with history of simple diffuse goiter. During the evolution, the cervical mass increases progressively its sizes, but in the last 2-3 months before the admission in our clinic t...

  12. Brain vascular image segmentation based on fuzzy local information C-means clustering

    Science.gov (United States)

    Hu, Chaoen; Liu, Xia; Liang, Xiao; Hui, Hui; Yang, Xin; Tian, Jie

    2017-02-01

    Light sheet fluorescence microscopy (LSFM) is a powerful optical resolution fluorescence microscopy technique which enables to observe the mouse brain vascular network in cellular resolution. However, micro-vessel structures are intensity inhomogeneity in LSFM images, which make an inconvenience for extracting line structures. In this work, we developed a vascular image segmentation method by enhancing vessel details which should be useful for estimating statistics like micro-vessel density. Since the eigenvalues of hessian matrix and its sign describes different geometric structure in images, which enable to construct vascular similarity function and enhance line signals, the main idea of our method is to cluster the pixel values of the enhanced image. Our method contained three steps: 1) calculate the multiscale gradients and the differences between eigenvalues of Hessian matrix. 2) In order to generate the enhanced microvessels structures, a feed forward neural network was trained by 2.26 million pixels for dealing with the correlations between multi-scale gradients and the differences between eigenvalues. 3) The fuzzy local information c-means clustering (FLICM) was used to cluster the pixel values in enhance line signals. To verify the feasibility and effectiveness of this method, mouse brain vascular images have been acquired by a commercial light-sheet microscope in our lab. The experiment of the segmentation method showed that dice similarity coefficient can reach up to 85%. The results illustrated that our approach extracting line structures of blood vessels dramatically improves the vascular image and enable to accurately extract blood vessels in LSFM images.

  13. Is Presence of Vascular Loop in Magnetic Resonance Imaging Always Related to Tinnitus?

    Science.gov (United States)

    Ensari, Nuray; Gür, Özer Erdem; Selçuk, Ömer Tarik; Renda, Levent; Osma, Üstün; Eyigör, Hülya; Çekiç, Bülent

    2017-05-01

    One of the most common otological complaints is tinnitus in adults. When there is a complaint of unilateral tinnitus and retrocochlear pathology is suspected, imaging methods are applied. However, the imaging findings obtained may not always be compatible with the severity and localization of the tinnitus. The aim of the present study was to determine whether or not there was a significant correlation between the findings on magnetic resonance imaging (MRI) and the presence and severity of tinnitus in patients with the complaint of unilateral tinnitus. The study included 44 patients with no loss of hearing who presented with the complaint of unilateral tinnitus. The relationship between tinnitus severity and vascular loop presence was investigated. Various types of vascular loop were determined in 14 patients. No statistically significant relationship was determined between the presence of vascular loop and the Tinnitus Handicap Inventory scores. The results of this study showed no significant difference in respect of the presence of vascular loop on the MRI findings of symptomatic and healthy ears. The presence of vascular loop on MRI is not always a pathological event and should be considered only as an examination finding that could be an anatomic variation.

  14. Multiple cerebral cavernous malformations: typical pattern on MR imaging and appearance of a new lesion in the follow-up MRI; Multiple zerebrale kavernoese Angiome - Klassischer MRT-Befund mit Nachweis einer de-novo Gefaessmalformation im Verlauf

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, J.; Bewermeyer, H. [Neurologische Klinik, Kliniken der Stadt Koeln, Krankenhaus Merheim (Germany); Knitelius, H.O. [Radiologische Klinik, Kliniken der Stadt Koeln, Krankenhaus Merheim (Germany)

    2004-07-01

    Cerebral cavernous malformations (CCM) are common, mostly benign vascular anomalies of the CNS. Clinical features are seizures, headache and focal neurological signs. Often they are asymptomatic. Apart from sporadically cases CCM occur as an autosomal dominant condition. Familial cases are associated with a high frequency of multiple lesions. MRI is most sensitive in the detection of cavernous malformations. The MRI findings of CCM are variable, depending on hemorrhage and calcifications. The typical appearance of CCM are heterogenous ''popcorn-like'' lesions of different size with a mixed signal core and a hypointense hemosiderin rim. Our report concerns a 22 year old man with multiple cerebral cavernous malformations whose follow-up MRI of brain showed the appearance of a new lesion. (orig.)

  15. New imaging markers for preconceptional and first-trimester utero-placental vascularization.

    Science.gov (United States)

    Reijnders, I F; Mulders, A G M G J; Koster, M P H; Koning, A H J; Frudiger, A; Willemsen, S P; Jauniaux, E; Burton, G J; Steegers-Theunissen, R P M; Steegers, E A P

    2018-01-01

    The availability of imaging makers of early placental circulation development is limited. This study aims to develop a feasible and reliable method to assess preconceptional and early first-trimester utero-placental vascular volumes using three-dimensional power Doppler (3D PD) ultrasound on two different Virtual Reality (VR) systems. 3D PD ultrasound images of the uterine and placental vasculature were obtained in 35 women, either preconceptionally (n = 5), or during pregnancy at 7 (n = 10), 9 (n = 10) or 11 (n = 10) weeks of gestation. Preconceptional uterine vascular volume (UVV), first-trimester placental vascular volume (PVV) and embryonic vascular volume (EVV) were measured by two observers on two VR systems, i.e., a Barco I-Space and VR desktop. Intra- and inter-observer agreement and intersystem agreement were assessed by intra-class correlation coefficients (ICC) and absolute and relative differences. Uterine-, embryonic- and placental vascular volume measurements showed good to excellent intra- and inter-observer agreement and inter-system reproducibility with most ICC above 0.80 and relative differences of less than 20% preconceptionally and almost throughout the entire gestational age range. Inter-observer agreement of PVV at 11 weeks gestation was suboptimal (ICC 0.69, relative difference 50.1%). Preconceptional and first-trimester 3D PD ultrasound utero-placental and embryonic vascular volume measurements using VR are feasible and reliable. Longitudinal cohort studies with repeated measurements are needed to further validate this and assess their value as new imaging markers for placental vascular development and ultimately for the prediction of placenta-related pregnancy complications. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  16. The Association between Sleep-Disordered Breathing and Magnetic Resonance Imaging Findings in a Pediatric Cohort with Chiari 1 Malformation

    Directory of Open Access Journals (Sweden)

    Reshma Amin

    2015-01-01

    Full Text Available BACKGROUND: The prevalence of sleep-disordered breathing (SDB reported in the literature for Chiari malformation type 1 (CM1 is uniformly high (24% to 70%. In Canada, there is limited access to pediatric polysomnography (PSG. Therefore, the identification of clinical features would be invaluable for triaging these children.

  17. Optimisation of coronary vascular territorial 3D echocardiographic strain imaging using computed tomography

    DEFF Research Database (Denmark)

    de Knegt, Martina Chantal; Fuchs, A; Weeke, P

    2016-01-01

    Current echocardiographic assessments of coronary vascular territories use the 17-segment model and are based on general assumptions of coronary vascular distribution. Fusion of 3D echocardiography (3DE) with multidetector computed tomography (MDCT) derived coronary anatomy may provide a more...... accurate assessment of left ventricular (LV) territorial function. We aimed to test the feasibility of MDCT and 3DE fusion and to compare territorial longitudinal strain (LS) using the 17-segment model and a MDCT-guided vascular model. 28 patients underwent 320-slice MDCT and transthoracic 3DE on the same...... day followed by invasive coronary angiography. MDCT (Aquilion ONE, ViSION Edition, Toshiba Medical Systems) and 3DE apical full-volume images (Artida, Toshiba Medical Systems) were fused offline using a dedicated workstation (prototype fusion software, Toshiba Medical Systems). 3DE/MDCT image...

  18. Postmortem angiography in computed tomography and magnetic resonance imaging in a case of fatal hemorrhage due to an arterio-venous malformation in the brain.

    Science.gov (United States)

    Franckenberg, Sabine; Schulze, Claudia; Bolliger, Stephan A; Gascho, Dominic; Thali, Michael J; Flach, Patricia M

    2015-05-01

    Autopsy is the traditional gold standard for determining the cause and manner of death in a forensic death investigation. However, postmortem imaging plays an ever-growing role in preliminary examination, even replacing conventional autopsy in some cases. This case report presents a case of massive intra-axial brain hemorrhage due to an arterio-venous malformation. The cause and manner of death were exclusively determined by postmortem radiology. Based on radiological findings, the autopsy was considered redundant and cancelled by the public prosecutor. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Compensatory UTE/T2W Imaging of Inflammatory Vascular Wall in Hyperlipidemic Rabbits.

    Science.gov (United States)

    Kim, Bongjune; Yang, Jaemoon; Lee, Young Han; Kim, Myeong-Hoon; Heo, Dan; Lee, Eugene; Suh, Jin-Suck; Haam, Seungjoo; Huh, Yong-Min

    2015-01-01

    To obtain compensatory ultra-short echo time (UTE) imaging and T2-weighted (T2W) imaging of Watanabe heritable hyperlipidemic (WHHL) rabbits following dextran-coated magnetic nanocluster (DMNC) injection for the effective in vivo detection of inflammatory vascular wall. Magnetic nanoparticle was synthesized by thermal decomposition and encapsulated with dextran to prepare DMNC. The contrast enhancement efficiency of DMNC was investigated using UTE (repetition time [TR] = 5.58 and TE = 0.07 ms) and T2W (TR = 4000 and TE = 60 ms) imaging sequences. To confirm the internalization of DMNC into macrophages, DMNC-treated macrophages were visualized by cellular transmission electron microscope (TEM) and magnetic resonance (MR) imaging. WHHL rabbits expressing macrophage-rich plaques were subjected to UTE and T2W imaging before and after intravenous DMNC (120 μmol Fe/kg) treatment. Ex vivo MR imaging of plaques and immunostaining studies were also performed. Positive and negative contrast enhancement of DMNC solutions with increasing Fe concentrations were observed in UTE and T2W imaging, respectively. The relative signal intensities of the DMNC solution containing 2.9 mM Fe were calculated as 3.53 and 0.99 in UTE and T2W imaging, respectively. DMNC uptake into the macrophage cytoplasm was visualized by electron microscopy. Cellular MR imaging of DMNC-treated macrophages revealed relative signals of 3.00 in UTE imaging and 0.98 in T2W imaging. In vivo MR images revealed significant brightening and darkening of plaque areas in the WHHL rabbit 24 h after DMNC injection in UTE and T2W imaging, respectively. Ex vivo MR imaging results agreed with these in vivo MR imaging results. Histological analysis showed that DMNCs were localized to areas of inflammatory vascular wall. Using compensatory UTE and T2W imaging in conjunction with DMNC is an effective approach for the noninvasive in vivo imaging of atherosclerotic plaque.

  20. Overdiagnosing Vascular Dementia using Structural Brain Imaging for Dementia Work-Up

    NARCIS (Netherlands)

    Niemantsverdriet, Ellis; Feyen, Bart F. E.; Le Bastard, Nathalie; Martin, Jean-Jacques; Goeman, Johan; De Deyn, Peter Paul; Engelborghs, Sebastiaan

    2015-01-01

    Hypothesizing that non-significant cerebrovascular lesions on structural brain imaging lead to overdiagnosis of a vascular etiology of dementia as compared to autopsy-confirmed diagnosis, we set up a study including 71 patients with autopsy-confirmed diagnoses. Forty-two patients in the population

  1. Vascular fluorescence casting and imaging cryomicrotomy for computerized three-dimensional renal arterial reconstruction

    NARCIS (Netherlands)

    Lagerveld, Brunolf W.; ter Wee, Rene D.; de La Rosette, Jean J. M. C. H.; Spaan, Jos A. E.; Wijkstra, Hessel

    2007-01-01

    OBJECTIVES To assess the combined use of a casting technique, cryomicrotomy imaging, and three-dimensional (3D) computer analysis as a method for visualizing and reconstructing the arterial vascular tree in a porcine renal model. MATERIAL AND METHODS The arterial branches of two porcine kidneys were

  2. New imaging markers for preconceptional and first-trimester utero-placental vascularization

    NARCIS (Netherlands)

    Reijnders, I.F. (I. F.); A.G.M.G.J. Mulders (Annemarie); Koster, M.P.H. (M. P.H.); A.H.J. Koning (Anton); Frudiger, A. (A.); S.P. Willemsen (Sten); E. Jauniaux; Burton, G.J. (G. J.); R.P.M. Steegers-Theunissen (Régine); E.A.P. Steegers (Eric)

    2018-01-01

    textabstractIntroduction The availability of imaging makers of early placental circulation development is limited. This study aims to develop a feasible and reliable method to assess preconceptional and early first-trimester utero-placental vascular volumes using three-dimensional power Doppler (3D

  3. Multi-spectral imaging analysis of pigmented and vascular skin lesions: results of a clinical trial

    Science.gov (United States)

    Kuzmina, Ilona; Diebele, Ilze; Valeine, Lauma; Jakovels, Dainis; Kempele, Anna; Kapostinsh, Janis; Spigulis, Janis

    2011-03-01

    A clinical trial comprising 266 pigmented lesions and 49 vascular lesions has been performed in three Riga clinics by means of multi-spectral imaging analysis. The imaging system Nuance 2.4 (CRI) and self-developed software for mapping of the main skin chromophores were used. The obtained results confirm clinical potential of this technology for non-contact quantitative assessment of skin pathologies.

  4. Magnetic resonance imaging of head and neck vascular anomalies ...

    African Journals Online (AJOL)

    In addition, imaging can provide a useful tool for assessing the response to ... anomalies (affecting the head and neck region), in referral to the different .... infantile hemangioma of the left parotid gland; note the prominent intralesional flow voids in (b) and the presence of ipsilateral prominent feeding arteries (white arrow) in ...

  5. The current approach to the diagnosis of vascular anomalies of the head and neck: A pictorial essay.

    Science.gov (United States)

    Goel, Sinny; Gupta, Swati; Singh, Aarti; Prakash, Anjali; Ghosh, Sujoy; Narang, Poonam; Gupta, Sunita

    2015-06-01

    Throughout the years, various classifications have evolved for the diagnosis of vascular anomalies. However, it remains difficult to classify a number of such lesions. Because all hemangiomas were previously considered to involute, if a lesion with imaging and clinical characteristics of hemangioma does not involute, then there is no subclass in which to classify such a lesion, as reported in one of our cases. The recent classification proposed by the International Society for the Study of Vascular Anomalies (ISSVA, 2014) has solved this problem by including non-involuting and partially involuting hemangioma in the classification. We present here five cases of vascular anomalies and discuss their diagnosis in accordance with the ISSVA (2014) classification. A non-involuting lesion should not always be diagnosed as a vascular malformation. A non-involuting lesion can be either a hemangioma or a vascular malformation depending upon its clinicopathologic and imaging characteristics.

  6. The current approach to the diagnosis of vascular anomalies of the head and neck: A pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Goei, Sinny; Singh, Aarti; Ghosh, Sujoy; Gupta, Sunta [Dept. of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, Delhi (India); Gupta, Swati; Prakash, Anjali [Dept. of Radiodiagnosis, Lok Nayak Jaiprakash Hospital, Delhi (India); Narang, Poonam [Dept. of Radiodiagnosis, Govind Ballabh Pant Hospital, Delhi (India)

    2015-06-15

    Throughout the years, various classifications have evolved for the diagnosis of vascular anomalies. However, it remains difficult to classify a number of such lesions. Because all hemangiomas were previously considered to involute, if a lesion with imaging and clinical characteristics of hemangioma does not involute, then there is no subclass in which to classify such a lesion, as reported in one of our cases. The recent classification proposed by the International Society for the Study of Vascular Anomalies (ISSVA, 2014) has solved this problem by including non-involuting and partially involuting hemangioma in the classification. We present here five cases of vascular anomalies and discuss their diagnosis in accordance with the ISSVA (2014) classification. A non-involuting lesion should not always be diagnosed as a vascular malformation. A non-involuting lesion can be either a hemangioma or a vascular malformation depending upon its clinicopathologic and imaging characteristics.

  7. Brain vascular image enhancement based on gradient adjust with split Bregman

    Science.gov (United States)

    Liang, Xiao; Dong, Di; Hui, Hui; Zhang, Liwen; Fang, Mengjie; Tian, Jie

    2016-04-01

    Light Sheet Microscopy is a high-resolution fluorescence microscopic technique which enables to observe the mouse brain vascular network clearly with immunostaining. However, micro-vessels are stained with few fluorescence antibodies and their signals are much weaker than large vessels, which make micro-vessels unclear in LSM images. In this work, we developed a vascular image enhancement method to enhance micro-vessel details which should be useful for vessel statistics analysis. Since gradient describes the edge information of the vessel, the main idea of our method is to increase the gradient values of the enhanced image to improve the micro-vessels contrast. Our method contained two steps: 1) calculate the gradient image of LSM image, and then amplify high gradient values of the original image to enhance the vessel edge and suppress low gradient values to remove noises. Then we formulated a new L1-norm regularization optimization problem to find an image with the expected gradient while keeping the main structure information of the original image. 2) The split Bregman iteration method was used to deal with the L1-norm regularization problem and generate the final enhanced image. The main advantage of the split Bregman method is that it has both fast convergence and low memory cost. In order to verify the effectiveness of our method, we applied our method to a series of mouse brain vascular images acquired from a commercial LSM system in our lab. The experimental results showed that our method could greatly enhance micro-vessel edges which were unclear in the original images.

  8. Optimisation of coronary vascular territorial 3D echocardiographic strain imaging using computed tomography: a feasibility study using image fusion.

    Science.gov (United States)

    de Knegt, Martina Chantal; Fuchs, A; Weeke, P; Møgelvang, R; Hassager, C; Kofoed, K F

    2016-12-01

    Current echocardiographic assessments of coronary vascular territories use the 17-segment model and are based on general assumptions of coronary vascular distribution. Fusion of 3D echocardiography (3DE) with multidetector computed tomography (MDCT) derived coronary anatomy may provide a more accurate assessment of left ventricular (LV) territorial function. We aimed to test the feasibility of MDCT and 3DE fusion and to compare territorial longitudinal strain (LS) using the 17-segment model and a MDCT-guided vascular model. 28 patients underwent 320-slice MDCT and transthoracic 3DE on the same day followed by invasive coronary angiography. MDCT (Aquilion ONE, ViSION Edition, Toshiba Medical Systems) and 3DE apical full-volume images (Artida, Toshiba Medical Systems) were fused offline using a dedicated workstation (prototype fusion software, Toshiba Medical Systems). 3DE/MDCT image alignment was assessed by 3 readers using a 4-point scale. Territorial LS was assessed using the 17-segment model and the MDCT-guided vascular model in territories supplied by significantly stenotic and non-significantly stenotic vessels. Successful 3DE/MDCT image alignment was obtained in 86 and 93 % of cases for reader one, and reader two and three, respectively. Fair agreement on the quality of automatic image alignment (intra-class correlation = 0.40) and the success of manual image alignment (Fleiss' Kappa = 0.40) among the readers was found. In territories supplied by non-significantly stenotic left circumflex arteries, LS was significantly higher in the MDCT-guided vascular model compared to the 17-segment model: -15.00 ± 7.17 (mean ± standard deviation) versus -11.87 ± 4.09 (p < 0.05). Fusion of MDCT and 3DE is feasible and provides physiologically meaningful displays of myocardial function.

  9. Medical image of the week: lung cancer with vascular invasion

    OpenAIRE

    Malo J; Rischard F

    2014-01-01

    A 73-year-old woman presented to the emergency department with seizures and a subacute history of mild dyspnea on exertion. Her admission chest x-ray demonstrated a large right upper lobe lung mass, and MRI of the brain demonstrated multiple bilateral enhancing lesions concerning for a cardiac embolic source. Representative axial (Figure 1A) and coronal (Figure 1B) images from her chest CT scan demonstrate tumor invading the left atrium via the right superior pulmonary vein (arrow). The tumor...

  10. Useful signs for the assessment of vascular rings on cross-sectional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gould, Sharon W. [Nemours/Alfred I. duPont Hospital for Children, Medical Imaging, P.O. Box 269, Wilmington, DE (United States); Rigsby, Cynthia K. [Ann and Robert H. Lurie Children' s Hospital, Medical Imaging, Chicago, IL (United States); Donnelly, Lane F. [Texas Children' s Hospital, Pediatric Radiology, Houston, TX (United States); McCulloch, Michael [Nemours/Alfred I. duPont Hospital for Children, Pediatric Cardiology, P.O. Box 269, Wilmington, DE (United States); Pizarro, Christian [Nemours/Alfred I. duPont Hospital for Children, Pediatric Cardiac Surgery, P.O. Box 269, Wilmington, DE (United States); Epelman, Monica [Nemours Children' s Hospital, Medical Imaging, Orlando, FL (United States)

    2015-12-15

    Vascular rings can be challenging to diagnose because they can contain atretic portions not detectable with current imaging modalities. In these cases, where the compressed airway and esophagus are not encircled by patent, opacified vessels, there are useful secondary signs that should be considered and should raise suspicion for the presence of a vascular ring. These signs include a double aortic arch, the four-vessel sign, the distorted subclavian artery sign, a diverticulum of Kommerell, a ductal diverticulum contralateral to the aortic arch, and a descending aorta contralateral to the arch or circumflex aorta. If none of these findings is present, a ring can be excluded with confidence. (orig.)

  11. 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)

  12. Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Haage, Patrick; Schmitz-Rode, Thomas [Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krings, Timo [Department of Neuroradiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2002-11-01

    Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting. First, diagnosis and treatment of the most common form of venous occlusion, at the level of the lower extremities, is presented, followed by pelvic vein and inferior vena cava occlusion, mesenteric venous thrombosis, upper extremity occlusion, acute cerebral vein thrombosis, and finally acute venous occlusion of hemodialysis access. In acute venous occlusion of the lower extremity phlebography is still the reference gold standard. Presently, duplex ultrasound with manual compression is the most sensitive and specific noninvasive test. Limitations of ultrasonography include isolated distal calf vein occlusion, obesity, and patients with lower extremity edema. If sonography is nondiagnostic, venography should be considered. Magnetic resonance venography can differentiate an acute occlusion from chronic thrombus, but because of its high cost and limited availability, it is not yet used for the routine diagnosis of lower extremity venous occlusion only. Regarding interventional treatment, catheter-directed thrombolysis can be applied to dissolve thrombus in charily selected patients with symptomatic occlusion and no contraindications to therapy. Acute occlusion of the pelvic veins and the inferior vena cava, often due to extension from the femoropopliteal system, represents a major risk for pulmonary embolism. Color flow Doppler imaging is often limited owing to obesity and bowel gas. Venography has long been considered the gold standard for identifying proximal venous occlusion. Both CT scanning and MR imaging, however, can even more accurately diagnose acute pelvis vein or inferior vena cava occlusion. MRI is

  13. Medical image of the week: lung cancer with vascular invasion

    Directory of Open Access Journals (Sweden)

    Malo J

    2014-04-01

    Full Text Available A 73-year-old woman presented to the emergency department with seizures and a subacute history of mild dyspnea on exertion. Her admission chest x-ray demonstrated a large right upper lobe lung mass, and MRI of the brain demonstrated multiple bilateral enhancing lesions concerning for a cardiac embolic source. Representative axial (Figure 1A and coronal (Figure 1B images from her chest CT scan demonstrate tumor invading the left atrium via the right superior pulmonary vein (arrow. The tumor was confirmed to be small cell carcinoma of the lung.

  14. Evaluation and management of peripheral venous and lymphatic malformations.

    Science.gov (United States)

    Nassiri, Naiem; Thomas, Jones; Cirillo-Penn, Nolan C

    2016-04-01

    The International Society for Study of Vascular Anomalies (ISSVA) broadly categorizes vascular anomalies as vascular tumors or vascular malformations. The latter are congenital lesions that are further categorized by their flow properties and include high-flow arteriovenous malformations, slow-flow venous and lymphatic malformations, and congenital mixed syndromes, which can include a combination of malformations. Unlike vascular tumors, vascular malformations never regress and can persist and grow for the duration of the patient's lifespan. As our understanding of the natural history, hemodynamics, and treatment outcomes of these lesions has expanded and evolved over the last few decades, certain fundamental diagnostic and therapeutic principles have been established and are considered standard of care. These overarching principles are crucial to adhere to in the overall management of these lesions and are highlighted and expanded on in this report, which focuses exclusively on peripheral slow-flow venous and lymphatic malformations. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  15. Malformation lymphatic abdominal

    Directory of Open Access Journals (Sweden)

    Sebastião Ribeiro do Carmo Filho

    2015-06-01

    Full Text Available Abdominal lymphangiomas are benign malformations of the lymphatic system. The diagnosis is established due to patient's clinical manifestations associated with imaging. The clinical presentation of cystic lymphangiomas is much variable and depends on the symptoms, mostly caused by the abdominal mass, it´s size and location. It is accepted that the incidence of mesenteric cysts in the american population is somehow between 1:100.000 and 1:250.000, causing hospital admissions. Surgical treatment, in most cases, has good prognosis. This procedure is followed by the necessary resection, biopsy and cytology of the mass.

  16. Comparison between Alzheimer's disease and subcortical vascular dementia: attentional cortex study in functional magnetic resonance imaging.

    Science.gov (United States)

    Li, C; Zheng, J; Wang, J; Gui, L

    2011-01-01

    Blood oxygen level dependent functional magnetic resonance imaging (fMRI) and the Stroop test were used to assess attentional cortex activation in patients with Alzheimer's disease, subcortical vascular dementia, and normal control subjects. Patients with Alzheimer's disease and subcortical vascular dementia demonstrated similar locations of cortical activation, including the bilateral middle and inferior frontal gyri, anterior cingulate and inferior parietal lobule in response to Stroop colour word stimuli. This activation was distinctly decreased in patients with dementia compared with normal control subjects. Different regions of the brain were activated in patients with Alzheimer's disease and subcortical vascular dementia compared with normal controls. fMRI is a useful tool for the study of dementia in humans and has some potential diagnostic value. Further studies with larger numbers of participants are required.

  17. Verrucous lymphovascular malformation versus verrucous hemangioma: controversial nomenclature.

    Science.gov (United States)

    Brown, Allison; Warren, Simon; Losken, H Wolfgang; Morrell, Dean S

    2008-05-01

    The International Society for the Study of Vascular Anomalies (ISSVA) divides congenital vascular anomalies into malformations and tumors and subclassified hemangiomas under tumors. However, evidence shows this accepted classification has not been widely employed. Particularly troublesome is the use of the term hemangioma, commonly used to describe a variety of vascular lesions (both malformations and tumors). The term verrucous hemangioma has been used to describe a congenital vascular anomaly with a progressive verrucous epidermal surface persisting throughout life unless surgically excised. Recent evidence suggests that some of these lesions may share histologic features of both hemangiomas and malformations, thereby causing nosologic confusion. We report a 15-year-old adolescent girl with such a lesion and review the literature and controversy of verrucous hemangiomas. In our case, the most appropriate diagnosis is verrucous lymphovascular malformation. Further testing of similar lesions will be necessary to fully understand the nature and classification of these lesions.

  18. Rare lymphatic malformation in an extreme premature infant: answer

    National Research Council Canada - National Science Library

    Veronica Mugarab Samedi; Adel Elsharkawy

    2017-01-01

    .... No other anomalies were detected, genetic screening for infant was normal. Despite of size of lymphatic malformation at birth, it was an isolated finding with minimal vascularity, thus the prognosis for self-resolution was very good...

  19. Abernethy malformation: a case report

    Directory of Open Access Journals (Sweden)

    Pathak Ashish

    2012-05-01

    Full Text Available Abstract Background Abernethy malformation is a very rare congenital vascular malformation defined by diversion of portal blood away from liver. It is commonly associated with multiple congenital anomalies. We present a case of Abernethy malformation, without associated congenital anomalies from India. Case presentation A 5-year-old female child presented with short history of jaundice. A provisional diagnosis of acute viral hepatitis was made in view of clinical presentation and local endemicity of viral hepatitis A. Persistence of jaundice on follow up after 4 weeks led to detailed investigations. Ultrasound and doppler study of abdomen revealed drainage of portal vein into inferior vena cava. CT angiography was performed which confirmed the diagnosis of Type 1 b Abernethy malformation without associated major anomalies. We discuss the common clinical presentations, associated anomalies, diagnostic workup and treatment options of this disorder. Conclusion The treatment of the patients with congenital porto-systemic shunts depends on the site of the shunt, associated congenital anomalies and the extent of liver damage but the prognosis depends on the complications irrespective of anatomical type. However, the extent of associated abnormalities should not deter paediatricians to refer patients for treatment. Whenever possible closure of the shunt should be advised for cure or to prevent complications. Only symptomatic type I patients with absence of possibility to close the shunt may require liver transplant. Long-term follow-up is indicated for all patients.

  20. Development of an Open Source Image-Based Flow Modeling Software - SimVascular

    Science.gov (United States)

    Updegrove, Adam; Merkow, Jameson; Schiavazzi, Daniele; Wilson, Nathan; Marsden, Alison; Shadden, Shawn

    2014-11-01

    SimVascular (www.simvascular.org) is currently the only comprehensive software package that provides a complete pipeline from medical image data segmentation to patient specific blood flow simulation. This software and its derivatives have been used in hundreds of conference abstracts and peer-reviewed journal articles, as well as the foundation of medical startups. SimVascular was initially released in August 2007, yet major challenges and deterrents for new adopters were the requirement of licensing three expensive commercial libraries utilized by the software, a complicated build process, and a lack of documentation, support and organized maintenance. In the past year, the SimVascular team has made significant progress to integrate open source alternatives for the linear solver, solid modeling, and mesh generation commercial libraries required by the original public release. In addition, the build system, available distributions, and graphical user interface have been significantly enhanced. Finally, the software has been updated to enable users to directly run simulations using models and boundary condition values, included in the Vascular Model Repository (vascularmodel.org). In this presentation we will briefly overview the capabilities of the new SimVascular 2.0 release. National Science Foundation.

  1. Usefulness of Preoperative Surgical Simulation with Three-Dimensional Fusion Images for Resection of Cerebral Cavernous Malformations Near Broca’s Area

    Directory of Open Access Journals (Sweden)

    Satoshi Takahashi

    2014-01-01

    Full Text Available Treating subcortical brain lesions in or near eloquent areas is challenging not only because lesions must be resected while preserving brain tissue involved in essential functions, but also because lesions often cannot be easily identified from the surface of the brain. Here, we report 2 cases of cerebral cavernous malformations near Broca’s area. In both cases, lesions were surgically removed by utilizing three-dimensional fusion images created using preoperative magnetic resonance imaging and computed tomography data. Excisions were completed without any worsening of speech function, and the use of presurgical simulations was found to be useful in the design and execution of the actual operations. The technique described in this report serves as a useful tool in simulating surgical strategies by using brain gyri and sulci as surgical landmarks. Furthermore, in contrast to other intraoperative techniques, this method can aid in shortening the duration of surgery and can help limit damage to eloquent areas of the brain.

  2. Grading vascularity from histopathological images based on traveling salesman distance and vessel size

    Science.gov (United States)

    Niazi, M. Khalid Khan; Hemminger, Jessica; Kurt, Habibe; Lozanski, Gerard; Gurcan, Metin

    2014-03-01

    Vascularity represents an important element of tissue/tumor microenvironment and is implicated in tumor growth, metastatic potential and resistence to therapy. Small blood vessels can be visualized using immunohistochemical stains specific to vascular cells. However, currently used manual methods to assess vascular density are poorly reproducible and are at best semi quantitative. Computer based quantitative and objective methods to measure microvessel density are urgently needed to better understand and clinically utilize microvascular density information. We propose a new method to quantify vascularity from images of bone marrow biopsies stained for CD34 vascular lining cells protein as a model. The method starts by automatically segmenting the blood vessels by methods of maxlink thresholding and minimum graph cuts. The segmentation is followed by morphological post-processing to reduce blast and small spurious objects from the bone marrow images. To classify the images into one of the four grades, we extracted 20 features from the segmented blood vessel images. These features include first four moments of the distribution of the area of blood vessels, first four moments of the distribution of 1) the edge weights in the minimum spanning tree of the blood vessels, 2) the shortest distance between blood vessels, 3) the homogeneity of the shortest distance (absolute difference in distance between consecutive blood vessels along the shortest path) between blood vessels and 5) blood vessel orientation. The method was tested on 26 bone marrow biopsy images stained with CD34 IHC stain, which were evaluated by three pathologists. The pathologists took part in this study by quantifying blood vessel density using gestalt assessment in hematopoietic bone marrow portions of bone marrow core biopsies images. To determine the intra-reader variability, each image was graded twice by each pathologist with two-week interval in between their readings. For each image, the ground

  3. Imaging separation of neuronal from vascular effects of cocaine on rat cortical brain in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Z.; Du, C.; Yuan, Z.; Luo, Z.; Volkow, N.D.; Pan, Y.; Du, C.

    2010-09-08

    MRI techniques to study brain function assume coupling between neuronal activity, metabolism and flow. However, recent evidence of physiological uncoupling between neuronal and cerebrovascular events highlights the need for methods to simultaneously measure these three properties. We report a multimodality optical approach that integrates dual-wavelength laser speckle imaging (measures changes in blood flow, blood volume and hemoglobin oxygenation), digital-frequency-ramping optical coherence tomography (images quantitative 3D vascular network) and Rhod2 fluorescence (images intracellular calcium for measure of neuronal activity) at high spatiotemporal resolutions (30 {micro}m, 10 Hz) and over a large field of view (3 x 5 mm{sup 2}). We apply it to assess cocaine's effects in rat cortical brain and show an immediate decrease 3.5 {+-} 0.9 min, phase (1) in the oxygen content of hemoglobin and the cerebral blood flow followed by an overshoot 7.1 {+-} 0.2 min, phase (2) lasting over 20 min whereas Ca{sup 2+} increased immediately (peaked at t = 4.1 {+-} 0.4 min) and remained elevated. This enabled us to identify a delay (2.9 {+-} 0.5 min) between peak neuronal and vascular responses in phase 2. The ability of this multimodality optical approach for simultaneous imaging at high spatiotemporal resolutions permits us to distinguish the vascular versus cellular changes of the brain, thus complimenting other neuroimaging modalities for brain functional studies (e. g., PET, fMRI).

  4. Molecular imaging of vascular endothelial growth factor receptors in graft arteriosclerosis.

    Science.gov (United States)

    Zhang, Jiasheng; Razavian, Mahmoud; Tavakoli, Sina; Nie, Lei; Tellides, George; Backer, Joseph M; Backer, Marina V; Bender, Jeffrey R; Sadeghi, Mehran M

    2012-08-01

    Vascular endothelial growth factor (VEGF) signaling plays a key role in the pathogenesis of vascular remodeling, including graft arteriosclerosis. Graft arteriosclerosis is the major cause of late organ failure in cardiac transplantation. We used molecular near-infrared fluorescent imaging with an engineered Cy5.5-labeled single-chain VEGF tracer (scVEGF/Cy) to detect VEGF receptors and vascular remodeling in human coronary artery grafts by molecular imaging. VEGF receptor specificity of probe uptake was shown by flow cytometry in endothelial cells. In severe combined immunodeficiency mice, transplantation of human coronary artery segments into the aorta followed by adoptive transfer of allogeneic human peripheral blood mononuclear cells led to significant neointima formation in the grafts over a period of 4 weeks. Near-infrared fluorescent imaging of transplant recipients at 4 weeks demonstrated focal uptake of scVEGF/Cy in remodeling artery grafts. Uptake specificity was demonstrated using an inactive homolog of scVEGF/Cy. scVEGF/Cy uptake predominantly localized in the neointima of remodeling coronary arteries and correlated with VEGF receptor-1 but not VEGF receptor-2 expression. There was a significant correlation between scVEGF/Cy uptake and transplanted artery neointima area. Molecular imaging of VEGF receptors may provide a noninvasive tool for detection of graft arteriosclerosis in solid organ transplantation.

  5. Gap-free segmentation of vascular networks with automatic image processing pipeline.

    Science.gov (United States)

    Hsu, Chih-Yang; Ghaffari, Mahsa; Alaraj, Ali; Flannery, Michael; Zhou, Xiaohong Joe; Linninger, Andreas

    2017-03-01

    Current image processing techniques capture large vessels reliably but often fail to preserve connectivity in bifurcations and small vessels. Imaging artifacts and noise can create gaps and discontinuity of intensity that hinders segmentation of vascular trees. However, topological analysis of vascular trees require proper connectivity without gaps, loops or dangling segments. Proper tree connectivity is also important for high quality rendering of surface meshes for scientific visualization or 3D printing. We present a fully automated vessel enhancement pipeline with automated parameter settings for vessel enhancement of tree-like structures from customary imaging sources, including 3D rotational angiography, magnetic resonance angiography, magnetic resonance venography, and computed tomography angiography. The output of the filter pipeline is a vessel-enhanced image which is ideal for generating anatomical consistent network representations of the cerebral angioarchitecture for further topological or statistical analysis. The filter pipeline combined with computational modeling can potentially improve computer-aided diagnosis of cerebrovascular diseases by delivering biometrics and anatomy of the vasculature. It may serve as the first step in fully automatic epidemiological analysis of large clinical datasets. The automatic analysis would enable rigorous statistical comparison of biometrics in subject-specific vascular trees. The robust and accurate image segmentation using a validated filter pipeline would also eliminate operator dependency that has been observed in manual segmentation. Moreover, manual segmentation is time prohibitive given that vascular trees have more than thousands of segments and bifurcations so that interactive segmentation consumes excessive human resources. Subject-specific trees are a first step toward patient-specific hemodynamic simulations for assessing treatment outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Analysis of vascular homogeneity and anisotropy on high-resolution primate brain imaging.

    Science.gov (United States)

    Kennel, Pol; Fonta, Caroline; Guibert, Romain; Plouraboué, Franck

    2017-11-01

    Using a systematic investigation of brain blood volume, in high-resolution synchrotron 3D images of microvascular structures within cortical regions of a primate brain, we challenge several basic questions regarding possible vascular bias in high-resolution functional neuroimaging. We present a bilateral comparison of cortical regions, where we analyze relative vascular volume in voxels from 150 to 1000 μm side lengths in the white and grey matter. We show that, if voxel size reaches a scale smaller than 300 µm, the vascular volume can no longer be considered homogeneous, either within one hemisphere or in bilateral comparison between samples. We demonstrate that voxel size influences the comparison between vessel-relative volume distributions depending on the scale considered (i.e., hemisphere, lobe, or sample). Furthermore, we also investigate how voxel anisotropy and orientation can affect the apparent vascular volume, in accordance with actual fMRI voxel sizes. These findings are discussed from the various perspectives of high-resolution brain functional imaging. Hum Brain Mapp 38:5756-5777, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. A series of parapharyngeal glial heterotopia mimicking lymphatic malformation.

    Science.gov (United States)

    Haloob, Nora; Pepper, Christopher; Hartley, Benjamin

    2015-12-01

    Otolaryngologists will most frequently encounter extra-cranial glial tissue within the nasal cavity, where it is known as a 'nasal glioma', and may communicate with the dura. However, glial tissue can also present extra-nasally in the form of a neck mass with no intracranial connection. In these rare cases, they can present soon after birth as an enlarging neck mass, causing compressive symptoms with airway obstruction and feeding difficulties. In this way, it is often initially misdiagnosed as a more common lesion such as a lymphatic malformation, teratoma, branchial anomaly or vascular malformation. As with many congenital head and neck masses, offering the most the appropriate management relies heavily on radiological imaging and, where possible, histopathology from a diagnostic biopsy. Once the diagnosis of extra-nasal glial heterotopia has been confirmed, the gold standard management is complete surgical excision. We review three cases of extra-nasal glial heterotopia presenting to our institution over an eleven year period as a large neck mass, which mimicked other congenital neck lumps, and discuss them in the context of those in the literature. We highlight how their clinical and radiological features can easily be confused with lymphatic malformations, and the potential implications of misdiagnosis. Raising awareness of this diagnostic confusion will highlight the need for management of these cases within an appropriate paediatric multidisciplinary setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Surgical management of scalp arterio-venous malformation and scalp venous malformation: An experience of eleven cases

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2013-01-01

    Full Text Available Aims: Scalp arterio-venous malformation (AVM and scalp venous malformation (SVM are rare conditions that usually need surgical treatment. Here, we have reported our experience of the surgical management of such lesions with a short review of the literature. Materials and Methods: In this prospective study, 11 patients with scalp AVM and SVM, who underwent surgical excision of lesion in our hospital from 2006 to 2012, were included. All suspected high-flow AVM were investigated with the selective internal and external carotid digital subtraction angiogram (DSA ± computed tomography (CT scan of brain with CT angiogram or magnetic resonance imaging (MRI of brain with MR angiogram, and all suspected low-flow vascular malformation (VM was investigated with MRI of brain + MR angiogram. Eight were high-flow and three were low-flow VM. Results: All lesions were successfully excised. Scalp cosmetic aspects were acceptable in all cases. There was no major post-operative complication or recurrence till last follow-up. Conclusions: With preoperative appropriate surgical planning, scalp AVM and SVM can be excised without major complication.

  9. Diffusion tensor imaging differentiates vascular parkinsonism from parkinsonian syndromes of degenerative origin in elderly subjects

    Energy Technology Data Exchange (ETDEWEB)

    Deverdun, Jérémy [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier (France); I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier (France); Menjot de Champfleur, Sophie [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Clinique du Parc, Castelnau-le-Lez (France); Cabello-Aguilar, Simon [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier (France); Maury, Florence [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Molino, François [Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier (France); Institut de Génomique Fonctionnelle, UMR 5203 - INSERM U661 - Université Montpellier II - Université, Montpellier I (France); Charif, Mahmoud [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Leboucq, Nicolas [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Ayrignac, Xavier; Labauge, Pierre [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); and others

    2014-11-15

    Background and Purpose: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. Materials and Methods: Thirty-five patients were prospectively included (multiple-system atrophy, n = 5; Parkinson's disease, n = 15; progressive supranuclear palsy, n = 9; vascular parkinsonism, n = 6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. Results: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p = 0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p = 0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. Conclusion: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data.

  10. Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Malojcic, Branko; Giannakopoulos, Panteleimon; Sorond, Farzaneh A; Azevedo, Elsa; Diomedi, Marina; Oblak, Janja Pretnar; Carraro, Nicola; Boban, Marina; Olah, Laszlo; Schreiber, Stephan J; Pavlovic, Aleksandra; Garami, Zsolt; Bornstein, Nantan M; Rosengarten, Bernhard

    2017-02-09

    The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. US and ASL are

  11. Compensatory UTE/T2W Imaging of Inflammatory Vascular Wall in Hyperlipidemic Rabbits.

    Directory of Open Access Journals (Sweden)

    Bongjune Kim

    Full Text Available To obtain compensatory ultra-short echo time (UTE imaging and T2-weighted (T2W imaging of Watanabe heritable hyperlipidemic (WHHL rabbits following dextran-coated magnetic nanocluster (DMNC injection for the effective in vivo detection of inflammatory vascular wall.Magnetic nanoparticle was synthesized by thermal decomposition and encapsulated with dextran to prepare DMNC. The contrast enhancement efficiency of DMNC was investigated using UTE (repetition time [TR] = 5.58 and TE = 0.07 ms and T2W (TR = 4000 and TE = 60 ms imaging sequences. To confirm the internalization of DMNC into macrophages, DMNC-treated macrophages were visualized by cellular transmission electron microscope (TEM and magnetic resonance (MR imaging. WHHL rabbits expressing macrophage-rich plaques were subjected to UTE and T2W imaging before and after intravenous DMNC (120 μmol Fe/kg treatment. Ex vivo MR imaging of plaques and immunostaining studies were also performed.Positive and negative contrast enhancement of DMNC solutions with increasing Fe concentrations were observed in UTE and T2W imaging, respectively. The relative signal intensities of the DMNC solution containing 2.9 mM Fe were calculated as 3.53 and 0.99 in UTE and T2W imaging, respectively. DMNC uptake into the macrophage cytoplasm was visualized by electron microscopy. Cellular MR imaging of DMNC-treated macrophages revealed relative signals of 3.00 in UTE imaging and 0.98 in T2W imaging. In vivo MR images revealed significant brightening and darkening of plaque areas in the WHHL rabbit 24 h after DMNC injection in UTE and T2W imaging, respectively. Ex vivo MR imaging results agreed with these in vivo MR imaging results. Histological analysis showed that DMNCs were localized to areas of inflammatory vascular wall.Using compensatory UTE and T2W imaging in conjunction with DMNC is an effective approach for the noninvasive in vivo imaging of atherosclerotic plaque.

  12. Anthelmintic induced congenital malformations in sheep embryos using netobimin.

    Science.gov (United States)

    Navarro, M; Cristofol, C; Carretero, A; Arboix, M; Ruberte, J

    1998-01-24

    Benzimidazole compounds have teratogenic effects in domestic and experimental animals. In this study, 14 Manchega ewes were treated orally, under controlled conditions, with 20 mg netobimin (a prodrug of a benzimidazole compound) per/kg bodyweight on the 17th day of pregnancy. Congenital malformations and abortions affected 60 per cent of the lambs. The main malformations were skeletal and renal, but vascular malformations were observed for the first time. The abnormalities were investigated using radiological, dissection and vascular injection techniques, and associations among them were recorded. The anomalies are discussed in terms of embryological considerations.

  13. [Vascular anomaly in the midcheek region of an infant--review of the diagnostic procedure].

    Science.gov (United States)

    Rossler, L; Sander, V; Teuber, I; Stücker, M; Kreuter, A; Stricker, I; Hamelmann, E

    2015-05-01

    Clinical history, physical examination, evolution and imaging findings (Colour Doppler sonography, MRI if available) are of pivotal importance in the diagnostic pathway of an infantile vascular anomaly. Histopathology with specific stains and markers is contributive in difficult cases. Differentiation between vascular tumors (hemangioma) and vascular malformations is now well known and integrated into the ISSVA classification. We report here a 6-months-old boy, who presented with a localized cutaneous and expansive vascular birthmark in the left cheek and developed bleedings at the age of 18 months. Diagnostic features of a hemangioma were not evident, and the final diagnosis of a venous malformation was confirmed by histopathology. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Clasificación de las anomalías vasculares (tumores y malformaciones): Características clínicas e historia natural Classification of vascular anomalies (tumours and malformations): Clinical characteristics and natural history

    OpenAIRE

    P. Redondo

    2004-01-01

    Las anomalías vasculares se dividen en tumores y malformaciones. Dentro de los primeros, los más frecuentes son los hemangiomas, habitualmente no presentes, aunque sí de forma premonitoria en el nacimiento, que durante 10-12 meses crecen por hiperplasia, para posteriormente involucionar de forma progresiva durante un período que puede llegar a durar entre 10 y 12 años. Su incidencia es de hasta un 12% de los recién nacidos, ocurre más en las niñas y se dividen en superficiales, profundos y co...

  15. Evaluation and management of congenital peripheral arteriovenous malformations.

    Science.gov (United States)

    Nassiri, Naiem; Cirillo-Penn, Nolan C; Thomas, Jones

    2015-12-01

    The International Society for Study of Vascular Anomalies (ISSVA) broadly categorizes vascular anomalies into vascular tumors and vascular malformations. Vascular malformations are further divided based on their flow properties into slow-flow venous and lymphatic malformations, high-flow arteriovenous malformations (AVMs), and congenital mixed syndromes, which can include combinations thereof. Whether occurring in isolation or as part of a broader syndrome, congenital high-flow AVMs are arguably the most complicated, challenging, and gratifying of all vascular malformations to diagnose and manage. Various configurations exist depending on location and coexisting clinical features. Transcatheter embolization has evolved into the mainstay of treatment for most congenital peripheral AVMs with surgical excision playing a growingly limited role as an adjunctive modality. Successful treatment requires technical precision, creativity, patience, and persistence given the ever-evolving angioarchitecture and hemodynamic profile of these lesions. Despite these challenges, certain fundamental principles have been established as our understanding of the pathogenesis, natural history, hemodynamics, and treatment outcomes has expanded and evolved over the last few decades. These principles are crucial to adhere to in the overall management of these lesions and are highlighted and expanded upon herein. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  16. Klippel-Trénaunay Syndrome with Intracranial Arteriovenous Malformation: A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Mahniya F. Sadiq

    2014-01-01

    Full Text Available Klippel-Trénaunay syndrome (KTS is a rare vascular congenital anomaly affecting less than 200,000 people in the United States. Vascular malformations associated with KTS tend to affect slow flow systems: venous, capillary, and lymphatic systems. The nature of the syndrome leads to a higher risk for the development of arteriovenous malformations. Our case presentation describes a patient with KTS and an associated rare presentation of intraventricular arteriovenous malformation (AVM.

  17. 18F-FDG PET imaging in detection of radiation-induced vascular disease in lymphoma survivors

    DEFF Research Database (Denmark)

    Ripa, Rasmus S.; Hag, Anne Mette; Knudsen, Andreas

    2015-01-01

    Radiation therapy (RT) induces vascular changes that increase the risk of cardiovascular diseases in some patients. The objective was to determine if in vivo positron emission tomography (PET) with fluorodeoxyglucose (18F-FDG) can identify increased vascular inflammation in patients without changes...... in vascular intima media thickness (IMT). Patients previously receiving unilateral RT due to lymphoma were prospectively recruited (N=10). The untreated contralateral artery functioned as control. All patients underwent a dedicated vascular PET/CT. Vascular tracer uptake was quantified by drawing regions...... (P=0.04). Measurement of IMT showed that 4 patients had the highest thickness in the irradiated side, while the other 4 patients had the highest thickness in the non-irradiated side (P=0.8). In conclusion, we found that (18)F-FDG PET imaging may be used to detect vascular changes induced by RT...

  18. (18)F-FDG PET imaging in detection of radiation-induced vascular disease in lymphoma survivors

    DEFF Research Database (Denmark)

    Ripa, Rasmus S; Hag, Anne Mette; Knudsen, Andreas

    2015-01-01

    Radiation therapy (RT) induces vascular changes that increase the risk of cardiovascular diseases in some patients. The objective was to determine if in vivo positron emission tomography (PET) with fluorodeoxyglucose ((18)F-FDG) can identify increased vascular inflammation in patients without...... changes in vascular intima media thickness (IMT). Patients previously receiving unilateral RT due to lymphoma were prospectively recruited (N=10). The untreated contralateral artery functioned as control. All patients underwent a dedicated vascular PET/CT. Vascular tracer uptake was quantified by drawing......- irradiated side (P=0.04). Measurement of IMT showed that 4 patients had the highest thickness in the irradiated side, while the other 4 patients had the highest thickness in the non-irradiated side (P=0.8). In conclusion, we found that (18)F-FDG PET imaging may be used to detect vascular changes induced...

  19. Evaluation of the degree of arteriovenous shunting in intracranial arteriovenous malformations using pseudo-continuous arterial spin labeling magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sunwoo, Leonard; Park, Sun-Won [Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Sohn, Chul-Ho; Yun, Tae Jin; Choi, Seung Hong; Cho, Young Dae; Kim, Ji-hoon; Han, Moon Hee [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Lee, Jong Young [Kangdong Sacred Heart Hospital, Department of Neurosurgery, Seoul (Korea, Republic of); Yi, Kyung Sik [Chungbuk National University Hospital, Department of Radiology, Cheongju (Korea, Republic of); Paek, Sun Ha; Kim, Yong Hwy; Kim, Jin Wook; Chung, Hyun-Tai; Kim, Dong Gyu [Seoul National University Hospital, Department of Neurosurgery, Seoul (Korea, Republic of)

    2015-08-15

    Intracranial arteriovenous malformations (AVMs) display venous signals on arterial spin labeling (ASL) magnetic resonance (MR) imaging due to the presence of arteriovenous shunting. Our aim was to quantitatively correlate AVM signal intensity on ASL with the degree of arteriovenous shunting estimated on digital subtraction angiography (DSA) in AVMs. MR imaging including pseudo-continuous ASL at 3 T and DSA were obtained on the same day in 40 patients with intracranial AVMs. Two reviewers assessed the nidus and venous signal intensities on ASL images to determine the presence of arteriovenous shunting. Interobserver agreement on ASL between the reviewers was determined. ASL signal intensity of the AVM lesion was correlated with AVM size and the time difference between normal and AVM venous transit times measured from the DSA images. Interobserver agreement between two reviewers for nidus and venous signal intensities was excellent (κ = 0.80 and 1.0, respectively). Interobserver agreement regarding the presence of arteriovenous shunting was perfect (κ = 1.0). AVM signal intensity showed a positive relationship with the time difference between normal and AVM venous transit times (r = 0.638, P < 0.001). AVM signal intensity also demonstrated a positive relationship with AVM size (r = 0.561, P < 0.001). AVM signal intensity on ASL in patients with AVM correlates well with the degree of early vein opacification on DSA, which corresponds to the degree of arteriovenous shunting. (orig.)

  20. White matter lesions and vascular vertigo: clinical correlation and findings on cranial magnetic resonance imaging.

    Science.gov (United States)

    Gamba, P; Pavia, M

    2016-07-01

    Vestibular disorders and anxiety are closely related, probably because they share some neuronal pathways. Ageing and patient comorbidities are important facilitating factors, and multiple vascular risk factors could contribute to the onset of a vestibular syndrome called vascular vertigo. White matter lesions (WMLs) are often seen on magnetic resonance imaging (MRI) scans of elderly people and are related to various geriatric disorders, including dizziness. The cause of this correlation could be the disruption of neuronal networks that mediate higher vestibular cortical function. Numerous neuronal pathways link the vestibular network with limbic structures and the prefrontal cortex modulates anxiety through its connections to the amygdala. These could also explain nausea and sickness. The aim of the present work was to investigate the correlation between WML, vascular vertigo and cognitive functions. Our team at the Poliambulanza Foundation Hospital of Brescia studied 90 patients (mean age 75 years) suffering from vascular vertigo with positive WML on MRI, by mapping the lesions and by grading anxiety and sickness symptoms. Furthermore, the same patients were treated with sulodexide (a glycosaminoglycan with antithrombotic activity) for 90 days (500 LSU/day for the first 45 days and 250 LSU/day for the following 45 days) to evaluate the efficacy on the vestibular symptoms. The results showed that the most frequent WML sites were frontal (n=34) and capsule (n=30) areas. Patients had a significant improvement on anxiety and sickness scores (p=0.0001 and p=0.02 respectively) after sulodexide treatment. In patients with vascular vertigo we confirmed the correlation between dizziness and anxiety and showed preliminary data regarding the efficacy of sulodexide in relieving in these patients anxiety and sickness.

  1. Cortical and subcortical vascular hypointensity on T2* weighted imaging in moyamoya disease.

    Science.gov (United States)

    Noshiro, Shouhei; Mikami, Takeshi; Komatsu, Katsuya; Miyata, Kei; Akiyama, Yukinori; Wanibuchi, Masahiko; Mikuni, Nobuhiro

    2016-02-01

    Decreased cortical and subcortical vascular signals in gradient echo T2* weighted imaging have been reported in acute stroke due to major artery occlusion. The purpose of this study was to evaluate this cortical and subcortical vascular hypointensity (CSVH) in patients with moyamoya disease. Subjects were 20 consecutive patients with moyamoya disease. The numbers of CSVH in each hemisphere were counted and the numbers were compared between patients with moyamoya disease and controls. The distribution of CSVH, clinical features of cases exhibiting large numbers of CSVH and post-operative changes were analysed. Patients with moyamoya disease had significantly more CSVH in the middle cerebral artery territory (p moyamoya disease. Our small series study shows that revascularization surgery can decrease the number of CSVH.

  2. Aneurysmal angiosarcoma associated with vascular graft revealed by 18F-FDG-PET imaging.

    Science.gov (United States)

    Chetouani, Ahmed; Perrin, Mathieu; Drouet, Clément; Marie, Pierre-Yves; Verger, Antoine

    2017-06-01

    We report a rare case of vascular graft-associated aneurysmal angiosarcoma by 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET). An 81-year-old male patient, with a prior history of graft interposition 1 year previously, was referred to 18F-FDG-PET because of an inflammatory syndrome of unknown origin. FDG-PET images revealed a particular pattern of intense circular uptake within the arterial wall (SUVmax = 10) in a popliteal aneurysm and, additionally, a large hypermetabolic mass centered by the graft. Remote hypermetabolisms in lung nodules and pleural thickenings were also detected. The diagnosis of angiosarcoma was ascertained through histopathological analysis of surgical samples. Development of an aneurysmal angiosarcoma at the site of a vascular graft is a rare entity, often misdiagnosed. 18F-FDG-PET appears to be useful in its detection with a PET pattern of intense circular uptake within the arterial wall. Such finding should lead to the search for distant metastasis.

  3. Early Detection of Complete Vascular Occlusion in a Pedicle Flap Model Using Quantitation Spectral Imaging

    Science.gov (United States)

    Pharaon, Michael R.; Scholz, Thomas; Bogdanoff, Scott; Cuccia, David; Durkin, Anthony J.; Hoyt, David B.; Evans, Gregory R. D.

    2012-01-01

    Background Vascular occlusion after tissue transfer is a devastating complication that can lead to complete flap loss. Spatial frequency domain imaging is a new, noncontact, noninvasive, wide-field imaging technology capable of quantifying oxygenated and deoxygenated hemoglobin levels, total hemoglobin, and tissue saturation. Methods Pedicled fasciocutaneous flaps on Wistar rats (400 to 500 g) were created and underwent continuous imaging using spatial frequency domain imaging before and after selective vascular occlusion. Three flap groups (control, selective arterial occlusion, and selective venous occlusion) and a fourth group composed of native skin between the flaps were measured. Results There were no statistically significant differences between the control flap group and the experimental flap groups before selective vascular occlusion: oxyhemoglobin (p = 0.2017), deoxyhemoglobin (p = 0.3145), total hemoglobin (p = 0.2718), and tissue saturation,(p = 0.0777). In the selective arterial occlusion flap group, percentage change in total hemoglobin was statistically different from that of the control flap group (p = 0.0218). The remaining parameters were not statistically different from those of the control flap: percentage change in oxyhemoglobin (p = 0.0888), percentage change in deoxyhemoglobin (p = 0.5198), and percentage change in tissue saturation (p = 0.4220). The selective venous occlusion flap group demonstrated changes statistically different compared with the control flap group: percentage change in oxyhemoglobin (p = 0.0029) and deoxyhemoglobin, total hemoglobin, and tissue saturation (p oxyhemoglobin, deoxyhemoglobin, total hemoglobin, and tissue saturation. Results presented here indicate that this can be used to quantify and detect physiologic changes that occur after arterial and venous occlusion in a rodent tissue transfer flap model. This portable, noncontact, noninvasive device may have a high clinical applicability in monitoring postoperative

  4. Early detection of complete vascular occlusion in a pedicle flap model using quantitative [corrected] spectral imaging.

    Science.gov (United States)

    Pharaon, Michael R; Scholz, Thomas; Bogdanoff, Scott; Cuccia, David; Durkin, Anthony J; Hoyt, David B; Evans, Gregory R D

    2010-12-01

    Vascular occlusion after tissue transfer is a devastating complication that can lead to complete flap loss. Spatial frequency domain imaging is a new, noncontact, noninvasive, wide-field imaging technology capable of quantifying oxygenated and deoxygenated hemoglobin levels, total hemoglobin, and tissue saturation. Pedicled fasciocutaneous flaps on Wistar rats (400 to 500 g) were created and underwent continuous imaging using spatial frequency domain imaging before and after selective vascular occlusion. Three flap groups (control, selective arterial occlusion, and selective venous occlusion) and a fourth group composed of native skin between the flaps were measured. There were no statistically significant differences between the control flap group and the experimental flap groups before selective vascular occlusion: oxyhemoglobin (p=0.2017), deoxyhemoglobin (p=0.3145), total hemoglobin (p=0.2718), and tissue saturation, (p=0.0777). In the selective arterial occlusion flap group, percentage change in total hemoglobin was statistically different from that of the control flap group (p=0.0218). The remaining parameters were not statistically different from those of the control flap: percentage change in oxyhemoglobin (p=0.0888), percentage change in deoxyhemoglobin (p=0.5198), and percentage change in tissue saturation (p=0.4220). The selective venous occlusion flap group demonstrated changes statistically different compared with the control flap group: percentage change in oxyhemoglobin (p=0.0029) and deoxyhemoglobin, total hemoglobin, and tissue saturation (poxyhemoglobin, deoxyhemoglobin, total hemoglobin, and tissue saturation. Results presented here indicate that this can be used to quantify and detect physiologic changes that occur after arterial and venous occlusion in a rodent tissue transfer flap model. This portable, noncontact, noninvasive device may have a high clinical applicability in monitoring postoperative patients.

  5. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

    2015-10-15

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  6. Familial form of cerebral cavernous malformations: evaluation of gradient-spin-echo (GRASE) imaging in lesion detection and characterization at 1.5 T

    Energy Technology Data Exchange (ETDEWEB)

    Brunereau, L. [Service de Radiologie Adultes Bretonneau, CHRU Tours (France); INSERM Faculte de Medecine, Tours (France); Leveque, C.; Cordoliani, Y. [Service de Radiologie et d' Imagerie Medicale, HIA Val de Grace, Paris (France); Bertrand, P.; Rouleau, P. [Service de Radiologie Adultes Bretonneau, CHRU Tours (France); Tranquart, F. [INSERM Faculte de Medecine, Tours (France); Labauge, P. [INSERM EPI Faculte de Medecine Lariboisiere-Saint-Louis, Paris (France)

    2001-11-01

    The purpose of this study was to evaluate the turbo gradient-spin-echo sequence (GRASE) in the MR assessment of the familial form of cerebral cavernous malformations (CCM). Twenty-one patients (15 male, six female) aged from 21 to 68 years (mean = 42.2 years) were prospectively examined with cerebral MR imaging, including T2-weighted turbo gradient-spin-echo (TGSE), turbo spin-echo (TSE) and gradient-echo (GRE) sequences. All sequences were performed in the same plane, the same matrix and the same field of view and were analyzed for signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), susceptibility effects, number of CCM, size of CCM and signal of CCM. It was found that SNR and CNR in the TGSE sequence were significantly inferior to those in both TSE and GRE sequences. TGSE and TSE sequences were significantly less prone to susceptibility effects than the GRE sequence. The sensitivity of TGSE and TSE sequences in detecting CCM was significantly lower than that of the GRE sequence. TGSE and TSE sequences provided comparable information about CCM size and signal. It was concluded that GRASE imaging was less sensitive than the GRE sequence in the detection of CCM and provided information similar to that yielded by the TSE sequence in the characterization of lesions, but with a higher number of artifacts. GRASE imaging cannot therefore replace TSE or GRE sequences in the MR evaluation of the familial form of CCM. (orig.)

  7. The diagnostic value of contrast-enhanced ultrasound (CEUS) as a new technique for imaging of vascular complications in renal transplants compared to standard imaging modalities.

    Science.gov (United States)

    Mueller-Peltzer, K; Rübenthaler, J; Fischereder, M; Habicht, A; Reiser, M; Clevert, D-A

    2017-01-01

    Vascular complications in renal transplant patients are a well-known issue in post transplant patient care. If malfunctioning of the renal transplant is suspected to be caused by vascular complications an early diagnosis and therapy is required to maintain the renal transplant. Computed tomography (CT), digital substraction angiography (DSA) and radioisotope renography are the gold standard imaging modalities to diagnose vascular complications. To analyse the sensitivity and specificity of contrast-enhanced ultrasound (CEUS) in comparison to the standard imaging modalities CT, DSA and radioisotope renography in the diagnosis of vascular complications in renal transplant patients. A total of 33 renal transplant recipients with elevated kidney function parameters with initial diagnostic imaging between 2006 and 2017 were included in the study. The imaging studies and clinical data were analysed retrospectively. The diagnostic accuracy of CEUS was compared to CT, DSA and renal scintigraphy respectively which are classified as gold standard for diagnosis of vascular complications in renal transplant patients. Out of 23 patients 15 patients showed vascular complications in CT, DSA or radioisotope renography and in 15 out of 15 patients CEUS detected the vascular complication. CEUS showed a sensitivity of 100%, a specificity of 66.7%, a positive predictive value (PPV) of 71.4%, and a negative predictive value (NPV) of 100%. CEUS is a non-nephrotoxic and safe method for the initial imaging of vascular complications in renal transplant recipients. Compared to the gold standard imaging modalities CT, DSA and radioisotope renography CEUS shows a high sensitivity and NPV in detecting vascular complications. In cases with suspected stenosis of the transplant renal artery additional DSA might be needed.

  8. Assessment of cerebellar pulsation in dogs with and without Chiari-like malformation and syringomyelia using cardiac-gated cine magnetic resonance imaging.

    Science.gov (United States)

    Driver, C J; Watts, V; Bunck, A C; Van Ham, L M; Volk, H A

    2013-10-01

    Canine Chiari-like malformation (CM) is characterised by herniation of part of the cerebellum through the foramen magnum. In humans with Chiari type I malformation (CM-I), abnormal pulsation of the cerebellum during the cardiac cycle has been documented and is pivotal to theories for the pathogenesis of syringomyelia (SM). In this retrospective study, cardiac-gated cine balanced fast field echo (bFEE) magnetic resonance imaging (MRI) was used to assess pulsation of the brain in dogs and to objectively measure the degree of cerebellar pulsation with the neck in a flexed position. Overall, 17 Cavalier King Charles Spaniels (CKCS) with CM, including eight with SM and nine without SM, were compared with six small breed control dogs. Linear regions of interest were generated for the length of cerebellar herniation from each phase of the cardiac cycle and the degree of cerebellar pulsation was subsequently calculated. Age, bodyweight and angle of neck flexion were also compared. CKCS with CM and SM had significantly greater pulsation of the cerebellum than control dogs (P=0.003) and CKCS with CM only (P=0.031). There was no significant difference in age, bodyweight and angle of neck flexion between the three groups. Cardiac-gated cine bFEE MRI permitted the dynamic visualisation of cerebellar pulsation in dogs. These findings support the current theories regarding the pathogenesis of SM secondary to CM and further highlight the similarities between canine CM and human CM-I. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Invasive and transcranial photoacoustic imaging of the vascular response to brain electrical stimulation

    Science.gov (United States)

    Tsytsarev, Vassiliy; Yao, Junjie; Hu, Song; Li, Li; Favazza, Christopher P.; Maslov, Konstantin I.; Wang, Lihong V.

    2010-02-01

    Advances in the brain functional imaging greatly facilitated the understanding of neurovascular coupling. For monitoring of the microvascular response to the brain electrical stimulation in vivo we used optical-resolution photoacoustic microscopy (OR-PAM) through the cranial openings as well as transcranially. Both types of the vascular response, vasoconstriction and vasodilatation, were clearly observed with good spatial and temporal resolution. Obtained results confirm one of the primary points of the neurovascular coupling theory that blood vessels could present vasoconstriction or vasodilatation in response to electrical stimulation, depending on the balance between inhibition and excitation of the different parts of the elements of the neurovascular coupling system.

  10. Determining the optimal age for recording the retinal vascular pattern image of lambs.

    Science.gov (United States)

    Rojas-Olivares, M A; Caja, G; Carné, S; Salama, A A K; Adell, N; Puig, P

    2012-03-01

    Newborn Ripollesa lambs (n = 143) were used to assess the optimal age at which the vascular pattern of the retina can be used as a reference for identification and traceability. Retinal images from both eyes were recorded from birth to yearling (d 1, 8, 30, 82, 180, and 388 of age) in duplicate (2,534 images) using a digital camera specially designed for livestock (Optibrand, Fort Collins, CO). Intra- and inter-age image comparisons (9,316 pairs of images) were carried out, and matching score (MS) was used as the exclusion criterion of lamb identity (MS ovino mayor," 6 mo of age and ~35 kg of BW, n = 59); and yearling replacement lambs (YR; >12 mo of age and ~50 kg of BW, n = 25). Values of MS were treated with a model based on the 1-inflated bivariate beta distribution, and treated data were compared by using a likelihood ratio test. Intra-age image comparisons showed that average MS and percentage of images with MS ≥70 increased (P 0.05); no differences were detected for 30-d images (97.4 and 98.0%, respectively, for RR and YR lambs; P > 0.05). Total percentage of matching was achieved when images were obtained from older lambs (180 and 388 d). In conclusion, retinal imaging was a useful tool for verifying the identity and auditing the traceability of live lambs from suckling to yearling. Matching scores were satisfactory when the reference retinal images were obtained from 1-mo-old or older lambs.

  11. Micro-CT Imaging Reveals Mekk3 Heterozygosity Prevents Cerebral Cavernous Malformations in Ccm2-Deficient Mice.

    Science.gov (United States)

    Choi, Jaesung P; Foley, Matthew; Zhou, Zinan; Wong, Weng-Yew; Gokoolparsadh, Naveena; Arthur, J Simon C; Li, Dean Y; Zheng, Xiangjian

    2016-01-01

    Mutations in CCM1 (aka KRIT1), CCM2, or CCM3 (aka PDCD10) gene cause cerebral cavernous malformation in humans. Mouse models of CCM disease have been established by deleting Ccm genes in postnatal animals. These mouse models provide invaluable tools to investigate molecular mechanism and therapeutic approaches for CCM disease. However, the full value of these animal models is limited by the lack of an accurate and quantitative method to assess lesion burden and progression. In the present study we have established a refined and detailed contrast enhanced X-ray micro-CT method to measure CCM lesion burden in mouse brains. As this study utilized a voxel dimension of 9.5μm (leading to a minimum feature size of approximately 25μm), it is therefore sufficient to measure CCM lesion volume and number globally and accurately, and provide high-resolution 3-D mapping of CCM lesions in mouse brains. Using this method, we found loss of Ccm1 or Ccm2 in neonatal endothelium confers CCM lesions in the mouse hindbrain with similar total volume and number. This quantitative approach also demonstrated a rescue of CCM lesions with simultaneous deletion of one allele of Mekk3. This method would enhance the value of the established mouse models to study the molecular basis and potential therapies for CCM and other cerebrovascular diseases.

  12. Ultra-high field upper extremity peripheral nerve and non-contrast enhanced vascular imaging.

    Directory of Open Access Journals (Sweden)

    Shailesh B Raval

    proper digital palmar arteries and superficial palmar arch could also be clearly visualized using TOF nCE 7T MRI.Ultra-high resolution neurovascular imaging in upper extremities is possible at 7T without use of renal toxic intravenous contrast. 7T MRI can provide superior peripheral nerve [based on fiber anisotropy and diffusion coefficient parameters derived from diffusion tensor/spectrum imaging] and vascular [nCE MRA and vessel segmentation] imaging.

  13. Retinal and choroidal vascular features in patients with retinitis pigmentosa imaged by OCT based microangiography.

    Science.gov (United States)

    Rezaei, Kasra A; Zhang, Qinqin; Chen, Chieh-Li; Chao, Jennifer; Wang, Ruikang K

    2017-07-01

    To image vascular features of retinitis pigmentosa (RP) using optical coherence tomography angiography (OCTA). Patients with RP were imaged by spectral domain optical coherence tomography based angiography (OCTA). The optical microangiography (OMAG) algorithm was applied to scanned datasets to generate 3D OCTA retinal angiograms, i.e., OMAG angiograms. Motion tracking was used to minimize artifacts due to eye movement, and large field of view OMAG angiograms were achieved through a montage scanning protocol. For better visualization, depth volumes were segmented to separate the superficial retinal layers from deep outer retinal layers. The choriocapillaris and other choroidal layers were also segmented. To investigate the changes in retinal architecture, the inner segment/outer segment (IS/OS) junction to RPE layer was segmented to generate en face structural images through averaging intensity projection. Color fundus images and/or Goldmann visual fields were available for comparison of the findings to OMAG images. A total of 25 eyes (13 patients, seven women and six men) diagnosed with RP at various stages were enrolled in this study from October 2014 to January 2016 and imaged by OCTA. The resulting OMAG angiograms provided detailed visualization of retinal and choroidal vascular networks presented within the retina and choroid in a large field of view (FOV) (∼6.7 mm × 6.7 mm). All patients with a severity score greater than 3 showed abnormal microvasculature in both deep retinal and choroidal layers on OMAG images. Images of patients with a score of 4 indicating only peripheral abnormalities demonstrated relatively normal vasculature networks. Microvascular changes in the retinal and choroidal vasculature correlate with structural changes in the slab from IS/OS junction to RPE layer. OCTA is useful in evaluating the microvascular changes in a large FOV encompassing the maculae of patients with RP. The large FOV of OMAG angiograms, enabled by the motion

  14. Uterine vascular lesions.

    Science.gov (United States)

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management.

  15. Quantitative analysis of vascular heterogeneity in breast lesions using contrast-enhanced 3-D harmonic and subharmonic ultrasound imaging.

    Science.gov (United States)

    Sridharan, Anush; Eisenbrey, John R; Machado, Priscilla; Ojeda-Fournier, Haydee; Wilkes, Annina; Sevrukov, Alexander; Mattrey, Robert F; Wallace, Kirk; Chalek, Carl L; Thomenius, Kai E; Forsberg, Flemming

    2015-03-01

    Ability to visualize breast lesion vascularity and quantify the vascular heterogeneity using contrast-enhanced 3-D harmonic (HI) and subharmonic (SHI) ultrasound imaging was investigated in a clinical population. Patients (n = 134) identified with breast lesions on mammography were scanned using power Doppler imaging, contrast-enhanced 3-D HI, and 3-D SHI on a modified Logiq 9 scanner (GE Healthcare). A region of interest corresponding to ultrasound contrast agent flow was identified in 4D View (GE Medical Systems) and mapped to raw slice data to generate a map of time-intensity curves for the lesion volume. Time points corresponding to baseline, peak intensity, and washout of ultrasound contrast agent were identified and used to generate and compare vascular heterogeneity plots for malignant and benign lesions. Vascularity was observed with power Doppler imaging in 84 lesions (63 benign and 21 malignant). The 3-D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3-D SHI visualized flow in 68 lesions (49 benign and 19 malignant). Analysis of vascular heterogeneity in the 3-D SHI volumes found benign lesions having a significant difference in vascularity between central and peripheral sections (1.71 ± 0.96 vs. 1.13 ± 0.79 dB, p < 0.001, respectively), whereas malignant lesions showed no difference (1.66 ± 1.39 vs. 1.24 ± 1.14 dB, p = 0.24), indicative of more vascular coverage. These preliminary results suggest quantitative evaluation of vascular heterogeneity in breast lesions using contrast-enhanced 3-D SHI is feasible and able to detect variations in vascularity between central and peripheral sections for benign and malignant lesions.

  16. Vascular loops in the anterior inferior cerebellar artery, as identified by magnetic resonance imaging, and their relationship with otologic symptoms

    Directory of Open Access Journals (Sweden)

    Luiz de Abreu Junior

    Full Text Available Abstract Objective: To use magnetic resonance imaging to identify vascular loops in the anterior inferior cerebellar artery and to evaluate their relationship with otologic symptoms. Materials and Methods: We selected 33 adults with otologic complaints who underwent magnetic resonance imaging at our institution between June and November 2013. Three experienced independent observers evaluated the trajectory of the anterior inferior cerebellar artery in relation to the internal auditory meatus and graded the anterior inferior cerebellar artery vascular loops according to the Chavda classification. Kappa and chi-square tests were used. Values of p < 0.05 were considered significant. Results: The interobserver agreement was moderate. Comparing ears that presented vascular loops with those that did not, we found no association with tinnitus, hearing loss, or vertigo. Similarly, we found no association between the Chavda grade and any otological symptom. Conclusion: Vascular loops do not appear to be associated with otoneurological manifestations.

  17. Vascular lesions of bone in children, adolescents, and young adults. A clinicopathologic reappraisal and application of the ISSVA classification.

    Science.gov (United States)

    Bruder, Elisabeth; Perez-Atayde, Antonio R; Jundt, Gernot; Alomari, Ahmad I; Rischewski, Johannes; Fishman, Steven J; Mulliken, John B; Kozakewich, Harry P W

    2009-02-01

    Vascular lesions of bone are rare and their terminology is not standardized. Herein, we report 77 patients with such lesions in order to characterize their morphologic spectrum and the applicability of the International Society for the Study of Vascular Anomalies (ISSVA) classification. In this system, malformations are structural anomalies distinguishable from tumors, which are proliferative. The radiologic images/reports and pathologic materials from all patients were reviewed. All lesions were either restricted to bone or had minimal contiguous soft tissue involvement with the exception of some multifocal lymphatic lesions that extensively affected soft tissue and/or viscera. We found that certain lesions of bone often regarded as tumors should be classified as malformations. Malformations (n = 46) were more common than tumors (n = 31); lymphatic and venous malformations were equally frequent. In the tumor category, hemangioendothelioma and epithelioid hemangioma were the most common. We also describe new vascular entities that arise in or involve bone. Utilizing the ISSVA approach, the diverse and often contradictory terminology of vascular lesions of bone can be largely eliminated. Standardized nomenclature is critical for scientific communication and patient management, and we hereby recommend the ISSVA classification be applied to vascular lesions of bone, just as for skin, soft tissue, and viscera.

  18. Correlation of the venous angioarchitecture of multiple cerebral cavernous malformations with familial or sporadic disease: a susceptibility-weighted imaging study with 7-Tesla MRI.

    Science.gov (United States)

    Dammann, Philipp; Wrede, Karsten; Zhu, Yuan; Matsushige, Toshinori; Maderwald, Stefan; Umutlu, Lale; Quick, Harald H; Hehr, Ute; Rath, Matthias; Ladd, Mark E; Felbor, Ute; Sure, Ulrich

    2017-02-01

    OBJECTIVE Multiple cerebral cavernous malformations (CCMs) are rare lesions that occur in sporadic or familial form. Depending on the disease form, the natural history and treatment of the lesions strongly vary. Molecular analysis of an underlying germline mutation (CCM1-3) is the most sensitive screening method to distinguish between sporadic and familial cases. However, based on the different pathomechanisms that are believed to be involved in either form, significant distinctions in the CCM-associated cerebral venous angioarchitecture should be detectable. This has not been systematically studied. METHODS A consecutive series of 28 patients with multiple CCMs (681 total) diagnosed on 1.5-T MRI underwent genetic screening for CCM1-3 mutations and high-resolution susceptibility-weighted imaging (SWI) of the cerebral venous angioarchitecture with 7-T MRI. Imaging data were analyzed to examine the CCM-associated venous angioarchitecture. Results were correlated with findings of molecular analysis for CCM1-3 mutations. RESULTS Two different SWI patterns (sporadic and familial) were found. The presence of associated developmental venous anomalies correlated with negative screening for germline mutations (11 sporadic) in all cases. All patients with confirmed familial disease showed normal underlying venous angioarchitecture. Additionally, a very unusual case of a probable somatic mutation is presented. CONCLUSIONS The SWI results of the venous angioarchitecture of multiple CCMs correlate with sporadic or familial disease. These results are consistent with the theory that venous anomalies are causative for the sporadic form of multiple CCMs.

  19. Giant cerebral cavernous malformation causing raised intracranial pressure in an adult: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Rajeev Sharma

    2013-01-01

    Full Text Available Giant cerebral cavernous malformations (GCCMs are very rare malformations in adults, and they rarely present with raised intracranial pressure due to obstructive hydrocephalus. Around 20 cases of GCCMs have been reported in available literature. We report such a case, discuss and review the available literature regarding this eminently treatable group of vascular malformations.

  20. Detection of Novel Mutation in Ccm3 Causes Familial Cerebral Cavernous Malformations.

    Science.gov (United States)

    Scimone, Concetta; Bramanti, Placido; Ruggeri, Alessia; Katsarou, Zoe; Donato, Luigi; Sidoti, Antonina; D'Angelo, Rosalia

    2015-11-01

    Cerebral cavernous malformations are vascular lesions that usually involve brain micro-vessels. They can occur both in a sporadic form and familial one. Causes of familial forms are mutations at three loci: CCM1/KRIT1, CCM2/MGC4607, and CCM3/PDCD10. Here, we describe a novel CCM3 missense mutation (c.422T>G) detected in two Greek brothers showing multiple lesions at magnetic resonance imaging; to date, only the youngest is symptomatic. Bioinformatics tools showed this novel variant causes a loss of function in Pdcd10 protein due to its localization in the eighth helix and, particularly, affects Leu141, a highly conserved amino acid. Roles of Pdcd10 in angiogenesis regulation and its association with early development of cerebral cavernous malformations were also considered.

  1. Vascular endothelial growth factor blockade alters magnetic resonance imaging biomarkers of vascular function and decreases barrier permeability in a rat model of lung cancer brain metastasis.

    Science.gov (United States)

    Pishko, Gregory L; Muldoon, Leslie L; Pagel, Michael A; Schwartz, Daniel L; Neuwelt, Edward A

    2015-02-17

    Blockade of vascular endothelial growth factor (VEGF) to promote vascular normalization and inhibit angiogenesis has been proposed for the treatment of brain metastases; however, vascular normalization has not been well-characterized in this disease. We investigated the effect of treatment with bevacizumab anti-VEGF antibody on magnetic resonance imaging (MRI) biomarkers of brain tumor vascular characteristics in comparison to small molecule delivery in a rat model of human lung cancer brain metastasis. Athymic rats with A549 human lung adenocarcinoma intracerebral xenografts underwent MRI at 11.75 T before and one day after treatment with bevacizumab (n = 8) or saline control (n = 8) to evaluate tumor volume, free water content (edema), blood volume and vascular permeability (Ktrans). One day later, permeability to 14C-aminoisobutyric acid (AIB) was measured in tumor and brain to assess the penetration of a small drug-like molecule. In saline control animals, tumor volume, edema and permeability increased over the two day assessment period. Compared to controls, bevacizumab treatment slowed the rate of tumor growth (P = 0.003) and blocked the increase in edema (P = 0.033), but did not alter tumor blood volume. Bevacizumab also significantly reduced Ktrans (P = 0.033) and AIB passive permeability in tumor (P = 0.04), but not to peritumoral tissue or normal brain. Post-treatment Ktrans correlated with AIB levels in the bevacizumab-treated rats but not in the saline controls. The correlation of an MRI biomarker for decreased vascular permeability with decreased AIB concentration in tumor after antiangiogenic treatment suggests that bevacizumab partially restored the normal low permeability characteristics of the blood-brain barrier in a model of human lung cancer brain metastasis.

  2. Computerized evaluation method of white matter hyperintensities related to subcortical vascular dementia in brain MR images

    Science.gov (United States)

    Arimura, Hidetaka; Kawata, Yasuo; Yamashita, Yasuo; Magome, Taiki; Ohki, Masafumi; Toyofuku, Fukai; Higashida, Yoshiharu; Tsuchiya, Kazuhiro

    2010-03-01

    We have developed a computerized evaluation method of white matter hyperintensity (WMH) regions for the diagnosis of vascular dementia (VaD) based on magnetic resonance (MR) images, and implemented the proposed method as a graphical interface program. The WMH regions were segmented using either a region growing technique or a level set method, one of which was selected by using a support vector machine. We applied the proposed method to MR images acquired from 10 patients with a diagnosis of VaD. The mean similarity index between WMH regions determined by a manual method and the proposed method was 78.2+/-11.0%. The proposed method could effectively assist neuroradiologists in evaluating WMH regions.

  3. Numerical modeling process of embolization arteriovenous malformation

    Science.gov (United States)

    Cherevko, A. A.; Gologush, T. S.; Petrenko, I. A.; Ostapenko, V. V.

    2017-10-01

    Cerebral arteriovenous malformation is a difficult, dangerous, and most frequently encountered vascular failure of development. It consists of vessels of very small diameter, which perform a discharge of blood from the artery to the vein. In this regard it can be adequately modeled using porous medium. Endovascular embolization of arteriovenous malformation is effective treatment of such pathologies. However, the danger of intraoperative rupture during embolization still exists. The purpose is to model this process and build an optimization algorithm for arteriovenous malformation embolization. To study the different embolization variants, the initial-boundary value problems, describing the process of embolization, were solved numerically by using a new modification of CABARET scheme. The essential moments of embolization process were modeled in our numerical experiments. This approach well reproduces the essential features of discontinuous two-phase flows, arising in the embolization problems. It can be used for further study on the process of embolization.

  4. Magnetic Particle Imaging: A Resovist Based Marking Technology for Guide Wires and Catheters for Vascular Interventions.

    Science.gov (United States)

    Haegele, Julian; Panagiotopoulos, Nikolaos; Cremers, Sjef; Rahmer, Jurgen; Franke, Jochen; Duschka, Robert L; Vaalma, Sarah; Heidenreich, Michael; Borgert, Jorn; Borm, Paul; Barkhausen, Jorg; Vogt, Florian M

    2016-10-01

    Magnetic particle imaging (MPI) is able to provide high temporal and good spatial resolution, high signal to noise ratio and sensitivity. Furthermore, it is a truly quantitative method as its signal strength is proportional to the concentration of its tracer, superparamagnetic iron oxide nanoparticles (SPIOs), over a wide range practically relevant concentrations. Thus, MPI is proposed as a promising future method for guidance of vascular interventions. To implement this, devices such as guide wires and catheters have to be discernible in MPI, which can be achieved by coating already commercially available devices with SPIOs. In this proof of principle study the feasibility of that approach is demonstrated. First, a Ferucarbotran-based SPIO-varnish was developed by embedding Ferucarbotran into an organic based solvent. Subsequently, the biocompatible varnish was applied to a commercially available guidewire and diagnostic catheter for vascular interventional purposes. In an interventional setting using a vessel phantom, the coating proved to be mechanically and chemically stable and thin enough to ensure normal handling as with uncoated devices. The devices were visualized in 3D on a preclinical MPI demonstrator using a system function based image reconstruction process. The system function was acquired with a probe of the dried varnish prior to the measurements. The devices were visualized with a very high temporal resolution and a simple catheter/guide wire maneuver was demonstrated.

  5. White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging

    OpenAIRE

    Barber, R; Scheltens, P.; Gholkar, A.; Ballard, C; McKeith, I; Ince, P.; Perry, R.; O'Brien, J

    1999-01-01

    OBJECTIVES—Alzheimer's disease and vascular dementia are associated with an increase in changes in white matter on MRI. The aims were to investigate whether white matter changes also occur in dementia with Lewy bodies and to examine the relation between white matter lesions and the cognitive and non-cognitive features of dementia with Lewy bodies, Alzheimer's disease, and vascular dementia.
METHODS—Proton density and T2 weighted images were obtained on a 1.0 Tesla MRI sca...

  6. The utility of ultrasound superb microvascular imaging for evaluation of breast tumour vascularity: comparison with colour and power Doppler imaging regarding diagnostic performance.

    Science.gov (United States)

    Park, A Y; Seo, B K; Woo, O H; Jung, K S; Cho, K R; Park, E K; Cha, S H; Cha, J

    2017-11-06

    To investigate the utility of superb microvascular imaging (SMI) for evaluating the vascularity of breast masses in comparison with colour or power Doppler ultrasound (US) and the effect on diagnostic performance. A total of 191 biopsy-proven masses (99 benign and 92 malignant) in 166 women with greyscale, colour Doppler, power Doppler, and SMI images were enrolled in this retrospective study. Three radiologists analysed the vascular images using a three-factor scoring system to evaluate the number, morphology, and distribution of tumour vessels. They assessed the Breast Imaging-Reporting and Data System categories for greyscale US alone and combinations of greyscale US and each type of vascular US. The Kruskal-Wallis test was performed and the area under the receiver-operating characteristic curve (AUC) measured. On SMI, vascular scores were compared between benign and malignant masses and the optimal cut-off value for the overall score was determined. SMI showed higher vascular scores than colour or power Doppler US and malignant masses had higher scores than benign masses (pDoppler US (AUC, 0.815 versus 0.774, 0.789, 0.791; pDoppler US for characterising the vascularity in breast masses and improving diagnostic performance. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  7. Chiari I malformation associated with turner syndrome

    Directory of Open Access Journals (Sweden)

    Kamble Jayaprakash Harsha

    2017-01-01

    Full Text Available Turner syndrome (TS is a rare genetic disease due to the absence of one X chromosome. Patients with TS have more subtle neurological/neuropsychiatric problems, while headache is an uncommon clinical presentation which needs attention. We report a 12-year-old child presenting with typical cough headache. Her magnetic resonance imaging revealed Chiari I malformation associated with TS. To the best of our knowledge, Chiari I malformation associated with TS is not described in literature. We report the first case of TS associated with Chiari I malformation. Interestingly, Chiari I malformation is also associated with Noonan's syndrome, which is a close morphological mimicker of TS, raising the possibility of sharing similar pathogenesis in both conditions.

  8. Superficial Siderosis Associated with Pineal Cavernous Malformation.

    Science.gov (United States)

    Ogura, Takafumi; Kambe, Atsushi; Sakamoto, Makoto; Shinohara, Yuki; Ogawa, Toshihide; Kurosaki, Masamichi

    2018-01-01

    Cavernous malformations in the pineal region are rare and difficult to anticipate from preoperative evaluation in patients with pineal apoplexy. We herein report the first case of a pineal cavernous malformation with superficial siderosis. Radiological findings were helpful in identifying the presence of the cavernous malformation. A 47-year-old female presented with a 4-month history of progressive headache, nausea, and dizziness. She complained of double vision and exhibited upward gaze palsy and papilledema on fundoscopy. Radiological examination revealed subacute hemorrhage in the pineal region and enlarged lateral ventricles. Furthermore, T2-star-weighted gradient-echo magnetic resonance imaging demonstrated a linear hypointensity along the pial surface of the cerebral cortex, brainstem, and cerebellum, indicating hemosiderin deposition consistent with superficial siderosis. Suspecting the presence of a cavernous malformation based on the radiological findings of superficial siderosis, we performed total mass resection. The postoperative course was uneventful and her preoperative symptoms resolved completely. Radiological findings of superficial siderosis on T2-star-weighted gradient-echo imaging are useful to making a diagnosis of cavernous malformation in cases of pineal apoplexy. They are also important for making the treatment decision to perform total mass resection, which is the best curative method for pineal cavernous malformations. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Ultrasound Molecular Imaging of Vascular Endothelial Growth Factor Receptor 2 Expression for Endometrial Receptivity Evaluation

    Science.gov (United States)

    Liu, Hongmei; Chen, Yihan; Yan, Fei; Han, Xiaohua; Wu, Junru; Liu, Xin; Zheng, Hairong

    2015-01-01

    Purpose: Ultrasound (US) molecular imaging by examining the expression of vascular endothelial growth factor receptor 2 (VEGFR2) on uterus vascular endothelium was applied to evaluate the endometrial receptivity. Methods: VEGFR2-targeted ultrasound contrast agents (UCA) and the control UCA (without VEGFR2) were prepared and characterized. Adhesion experiment in vitro was performed with mouse microvascular endothelial cells (bEnd.3) and the ratio of the number of UCA to that of cells at the same field was compared. In vivo study, randomized boluses of targeted or control UCA were injected into the animals of non-pregnancy (D0), pregnancy on day 2 (D2) and day 4 (D4), respectively. Sonograms were acquired by an ultrasound equipment with a 40-MHz high-frequency transducer (Vevo 2100; VisualSonics, Toronto, Canada). The ultrasonic imaging signals were quantified as the video intensity amplitudes generated by the attachment of VEGFR2-targeted UCA. Immunoblotting and immunofluorescence assays were used for confirmation of VEGFR2 expression. Results: Our results showed that VEGFR2-targeted UCA could bind to bEnd.3 cells with significantly higher affinity than the control UCA (9.8 ± 1.0 bubbles/cell versus 0.7 ± 0.3 bubbles/cell, P 0.05). Moreover, D4 mice showed the highest video intensity amplitude, indicating the highest VEGFR2 expression when compared with D2 and D0 mice (P < 0.01). This was further confirmed by our immunoblotting and immunofluorescence experiments. Conclusion: Ultrasound molecular imaging with VEGFR2-targeted UCA may be used for noninvasive evaluation of endometrial receptivity in murine models. PMID:25553109

  10. Noninvasive Vascular Elastography With Plane Strain Incompressibility Assumption Using Ultrafast Coherent Compound Plane Wave Imaging.

    Science.gov (United States)

    Porée, Jonathan; Garcia, Damien; Chayer, Boris; Ohayon, Jacques; Cloutier, Guy

    2015-12-01

    Plane strain tensor estimation using non-invasive vascular ultrasound elastography (NIVE) can be difficult to achieve using conventional focus beamforming due to limited lateral resolution and frame rate. Recent developments in compound plane wave (CPW) imaging have led to high speed and high resolution imaging. In this study, we present the performance of NIVE using coherent CPW. We show the impact of CPW beamforming on strain estimates compared to conventional focus sequences. To overcome the inherent variability of lateral strains, associated with the low lateral resolution of linear array transducers, we use the plane strain incompressibility to constrain the estimator. Taking advantage of the approximate tenfold increase in frame rate of CPW compared with conventional focus imaging, we introduce a time-ensemble estimation approach to further improve the elastogram quality. By combining CPW imaging with the constrained Lagrangian speckle model estimator, we observe an increase in elastography quality (∼ 10 dB both in signal-to-noise and contrast-to-noise ratios) over a wide range of applied strains (0.02 to 3.2%).

  11. Multichannel optical brain imaging to separate cerebral vascular, tissue metabolic, and neuronal effects of cocaine

    Science.gov (United States)

    Ren, Hugang; Luo, Zhongchi; Yuan, Zhijia; Pan, Yingtian; Du, Congwu

    2012-02-01

    Characterization of cerebral hemodynamic and oxygenation metabolic changes, as well neuronal function is of great importance to study of brain functions and the relevant brain disorders such as drug addiction. Compared with other neuroimaging modalities, optical imaging techniques have the potential for high spatiotemporal resolution and dissection of the changes in cerebral blood flow (CBF), blood volume (CBV), and hemoglobing oxygenation and intracellular Ca ([Ca2+]i), which serves as markers of vascular function, tissue metabolism and neuronal activity, respectively. Recently, we developed a multiwavelength imaging system and integrated it into a surgical microscope. Three LEDs of λ1=530nm, λ2=570nm and λ3=630nm were used for exciting [Ca2+]i fluorescence labeled by Rhod2 (AM) and sensitizing total hemoglobin (i.e., CBV), and deoxygenated-hemoglobin, whereas one LD of λ1=830nm was used for laser speckle imaging to form a CBF mapping of the brain. These light sources were time-sharing for illumination on the brain and synchronized with the exposure of CCD camera for multichannel images of the brain. Our animal studies indicated that this optical approach enabled simultaneous mapping of cocaine-induced changes in CBF, CBV and oxygenated- and deoxygenated hemoglobin as well as [Ca2+]i in the cortical brain. Its high spatiotemporal resolution (30μm, 10Hz) and large field of view (4x5 mm2) are advanced as a neuroimaging tool for brain functional study.

  12. A multimodality vascular imaging phantom of an abdominal aortic aneurysm with a visible thrombus

    Energy Technology Data Exchange (ETDEWEB)

    Allard, Louise; Chayer, Boris; Qin Zhao [Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital (CRCHUM), Quebec H2L 2W5 (Canada); Soulez, Gilles [Department of Radiology, University of Montreal Hospital (CHUM), Quebec H2L 2M1 (Canada); Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Quebec H3T 1J4 (Canada); Institute of Biomedical Engineering, University of Montreal, Quebec H3T 1J4 (Canada); Roy, David [Institute of Biomedical Engineering, University of Montreal, Quebec H3T 1J4 (Canada); Cloutier, Guy [Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital (CRCHUM), Quebec H2L 2W5 (Canada); Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Quebec H3T 1J4 (Canada); Institute of Biomedical Engineering, University of Montreal, Quebec H3T 1J4 (Canada)

    2013-06-15

    Purpose: With the continuous development of new stent grafts and implantation techniques, it has now become technically feasible to treat abdominal aortic aneurysms (AAA) with challenging anatomy using endovascular repair with standard, fenestrated, or branched stent-grafts. In vitro experimentations are very useful to improve stent-graft design and conformability or imaging guidance for stent-graft delivery or follow-up. Vascular replicas also help to better understand the limitation of endovascular approaches in challenging anatomy and possibly improve surgical planning or training by practicing high risk clinical procedures in the laboratory to improve outcomes in the operating room. Most AAA phantoms available have a very basic anatomy, which is not representative of the clinical reality. This paper presents a method of fabrication of a realistic AAA phantom with a visible thrombus, as well as some mechanical properties characterizing such phantom. Methods: A realistic AAA geometry replica of a real patient anatomy taken from a multidetector computed tomography (CT) scan was manufactured. To demonstrate the multimodality imaging capability of this new phantom with a thrombus visible in magnetic resonance (MR) angiography, CT angiography (CTA), digital subtraction angiography (DSA), and ultrasound, image acquisitions with all these modalities were performed by using standard clinical protocols. Potential use of this phantom for stent deployment was also tested. A rheometer allowed defining hyperelastic and viscoelastic properties of phantom materials. Results: MR imaging measurements of SNR and CNR values on T1 and T2-weighted sequences and MR angiography indicated reasonable agreement with published values of AAA thrombus and abdominal components in vivo. X-ray absorption also lay within normal ranges of AAA patients and was representative of findings observed on CTA, fluoroscopy, and DSA. Ultrasound propagation speeds for developed materials were also in

  13. Dandy-Walker malformation

    Directory of Open Access Journals (Sweden)

    Maria Silian Mandu Fonseca

    2017-03-01

    Full Text Available Dandy-Walker malformation is characterized by complete or partial agenesis of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa with displacement of the lateral sinuses. This article aims to present current, anatomical, etiological, pathophysiological, syndromic and treatment aspects of this malformation.

  14. Imaging vascular function for early stage clinical trials using dynamic contrast-enhanced magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leach, M.O.; Orton, M. [Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Morgan, B. [Univ. of Leicester, College of Medicine, Biological Sciences and Psychology, Leicester (United Kingdom); Tofts, P.S. [Brighton and Sussex Medical School, Univ. of Sussex, Clinical Imaging Sciences Centre, Sussex (United Kingdom); Buckley, D.L. [University of Leeds, Division of Medical Physics, Leeds (United Kingdom); Huang, W. [Oregon Health and Science Univ., Advanced Imaging Research Centre, Portland, OR (United States); Horsfield, M.A. [Medical Physics Section, Leicester Royal Infirmary, Dept. of Cardiovascular Sciences, Leicester (United Kingdom); Chenevert, T.L. [Univ. of Michigan Health System, Ann Arbor, MI (United States); Collins, D.J. [Royal Marsden Hospital NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Jackson, A. [Univ. of Manchester, Wolfson Molecular Imaging Centre, Withington, Manchester, M20 3LJ (United Kingdom); Lomas, D. [Univ. of Cambridge, Dept. of Radiology, Cambridge (United Kingdom); Whitcher, B. [Unit 2 Greenways Business Park, Mango Solutions, Chippenham (United Kingdom); Clarke, L. [Cancer Imaging Program, Imaging Technology Development Branch, Rockville, MD (United States); Plummer, R. [Univ. of Newcastle Upon Tyne, The Medical School, Medical Oncology, Northern Inst. for Cancer Research, Newcastle Upon Tyne (United Kingdom); Judson, I. [Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Jones, R. [Beatson West of Scotland Cancer Centre, Glasgow (United Kingdom); Alonzi, R. [Mount Vernon Cancer Centre, Northwood (United Kingdom); Brunner, T. [Gray Inst. for Radiation, Oncology and Biology, Oxford (United Kingdom); Koh, D.M. [Royal Marsden NHS Foundation Trust, Diagnostic Radiology, Sutton, Surrey (United Kingdom)] [and others

    2012-07-15

    Many therapeutic approaches to cancer affect the tumour vasculature, either indirectly or as a direct target. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important means of investigating this action, both pre-clinically and in early stage clinical trials. For such trials, it is essential that the measurement process (i.e. image acquisition and analysis) can be performed effectively and with consistency among contributing centres. As the technique continues to develop in order to provide potential improvements in sensitivity and physiological relevance, there is considerable scope for between-centre variation in techniques. A workshop was convened by the Imaging Committee of the Experimental Cancer Medicine Centres (ECMC) to review the current status of DCE-MRI and to provide recommendations on how the technique can best be used for early stage trials. This review and the consequent recommendations are summarised here. (orig.)

  15. Role of sodium tetradecyl sulfate in venous malformations

    Directory of Open Access Journals (Sweden)

    Saraf Sanjay

    2006-01-01

    Full Text Available Venous malformations are one of the commonest anomalies of the vascular tree and their management has always remained a major challenge. Surgery and other treatment modalities are not always satisfactory and have a higher morbidity, recurrence and complication rate. The author retrospectively analyzed 40 patients of venous malformations who underwent sclerotherapy with sodium tetradecyl sulfate solely or as an adjunct to surgery. The purpose of the study was to evaluate the efficacy and safety of sodium tetradecyl sulfate sclerotherapy in the treatment of venous malformations.

  16. Aneurysmal angiosarcoma associated with vascular graft revealed by 18F-FDG-PET imaging

    Directory of Open Access Journals (Sweden)

    Ahmed Chetouani, MD

    2017-06-01

    Full Text Available We report a rare case of vascular graft-associated aneurysmal angiosarcoma by 18F-Fluorodeoxyglucose (FDG positron emission tomography (PET. An 81-year-old male patient, with a prior history of graft interposition 1 year previously, was referred to 18F-FDG-PET because of an inflammatory syndrome of unknown origin. FDG-PET images revealed a particular pattern of intense circular uptake within the arterial wall (SUVmax = 10 in a popliteal aneurysm and, additionally, a large hypermetabolic mass centered by the graft. Remote hypermetabolisms in lung nodules and pleural thickenings were also detected. The diagnosis of angiosarcoma was ascertained through histopathological analysis of surgical samples. Development of an aneurysmal angiosarcoma at the site of a vascular graft is a rare entity, often misdiagnosed. 18F-FDG-PET appears to be useful in its detection with a PET pattern of intense circular uptake within the arterial wall. Such finding should lead to the search for distant metastasis.

  17. Bioluminescence imaging of energy depletion in vascular pathology: patent ductus arteriosus and atherosclerosis.

    Science.gov (United States)

    Leppänen, Olli; Ekstrand, Matias; Bräsen, Jan Hinrich; Levin, Max

    2012-04-01

    The artery wall may develop energy depletion due to insufficient nutritional supply. However, until recently it has not been possible to validate this hypothesis because no available technology has allowed assessment of energy metabolism with sufficient spatial resolution. We use high resolution bioluminescence metabolic imaging to study energy metabolism in two mechanistically different vascular pathologies: patent ductus arteriosus and atherosclerosis. Physiological energy depletion in postnatally constricting ductus arteriosus promotes permanent closure. Insufficient ductus energy depletion, common in preterm infants, is associated with persistent patent ductus arteriosus, a condition with significantly increased morbidity and mortality. In contrast, in atherosclerosis, energy depletion in the macrophage-rich lesion core promotes cell death contributing to lesion instability and disease progression. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. In-vivo imaging of the sentinel vein using the near-infrared vascular imaging system in hallux valgus patients.

    Science.gov (United States)

    Nakasa, Tomoyuki; Ishikawa, Masakazu; Ikuta, Yasunari; Yoshikawa, Masahiro; Sawa, Mikiya; Tsuyuguchi, Yusuke; Adachi, Nobuo

    2017-08-08

    A high incidence of dorsomedial cutaneous nerve (DMCN) damage in hallux valgus surgery has been reported. Identification of the vein around 1st metatarsal head is reported to be helpful to reduce the DMCN damage during surgery. The near-infrared (NIR) vascular imaging system, the VeinViewer(®) Flex, projects the vein onto the skin. The purpose of this study was to investigate the difference of the vein course between normal and hallux valgus foot using the VeinViewer(®) Flex, and to validate that the DMCN was accompanied with its vein. Twenty-seven feet with the hallux valgus and 27 feet in healthy subjects were included. The vein was projected onto the skin at the metatarsal head by the VeinViewer(®) Flex. The distance between the vein and the mid-line of the metatarsal head was measured. The correlation of the distance and hallux valgus angle or 1-2 intermetatarsal angle (IMA) was analyzed. The vein depicted by the VeinViewer(®) Flex and operative findings was compared in 4 patients during surgery. The vein in the hallux valgus patients shifted toward the dorsolateral side on the metatarsal bone head compared to that in healthy subjects. The distance from the midline of the 1st metatarsal bone to the vein in the hallux valgus (12.1 mm) was significantly higher than that in healthy subjects (2.7 mm) (p hallux valgus patients shifted toward the dorsolateral on the metatarsal bone and it could be a landmark to identify DMCN. The NIR vascular imaging system would be useful to reduce the risk of nerve damage in great toe surgery. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  19. PDCD10 gene mutations in multiple cerebral cavernous malformations.

    Science.gov (United States)

    Cigoli, Maria Sole; Avemaria, Francesca; De Benedetti, Stefano; Gesu, Giovanni P; Accorsi, Lucio Giordano; Parmigiani, Stefano; Corona, Maria Franca; Capra, Valeria; Mosca, Andrea; Giovannini, Simona; Notturno, Francesca; Ciccocioppo, Fausta; Volpi, Lilia; Estienne, Margherita; De Michele, Giuseppe; Antenora, Antonella; Bilo, Leda; Tavoni, Antonietta; Zamponi, Nelia; Alfei, Enrico; Baranello, Giovanni; Riva, Daria; Penco, Silvana

    2014-01-01

    Cerebral cavernous malformations (CCMs) are vascular abnormalities that may cause seizures, intracerebral haemorrhages, and focal neurological deficits. Familial form shows an autosomal dominant pattern of inheritance with incomplete penetrance and variable clinical expression. Three genes have been identified causing familial CCM: KRIT1/CCM1, MGC4607/CCM2, and PDCD10/CCM3. Aim of this study is to report additional PDCD10/CCM3 families poorly described so far which account for 10-15% of hereditary cerebral cavernous malformations. Our group investigated 87 consecutive Italian affected individuals (i.e. positive Magnetic Resonance Imaging) with multiple/familial CCM through direct sequencing and Multiplex Ligation-Dependent Probe Amplification (MLPA) analysis. We identified mutations in over 97.7% of cases, and PDCD10/CCM3 accounts for 13.1%. PDCD10/CCM3 molecular screening revealed four already known mutations and four novel ones. The mutated patients show an earlier onset of clinical manifestations as compared to CCM1/CCM2 mutated patients. The study of further families carrying mutations in PDCD10/CCM3 may help define a possible correlation between genotype and phenotype; an accurate clinical follow up of the subjects would help define more precisely whether mutations in PDCD10/CCM3 lead to a characteristic phenotype.

  20. PDCD10 gene mutations in multiple cerebral cavernous malformations.

    Directory of Open Access Journals (Sweden)

    Maria Sole Cigoli

    Full Text Available Cerebral cavernous malformations (CCMs are vascular abnormalities that may cause seizures, intracerebral haemorrhages, and focal neurological deficits. Familial form shows an autosomal dominant pattern of inheritance with incomplete penetrance and variable clinical expression. Three genes have been identified causing familial CCM: KRIT1/CCM1, MGC4607/CCM2, and PDCD10/CCM3. Aim of this study is to report additional PDCD10/CCM3 families poorly described so far which account for 10-15% of hereditary cerebral cavernous malformations. Our group investigated 87 consecutive Italian affected individuals (i.e. positive Magnetic Resonance Imaging with multiple/familial CCM through direct sequencing and Multiplex Ligation-Dependent Probe Amplification (MLPA analysis. We identified mutations in over 97.7% of cases, and PDCD10/CCM3 accounts for 13.1%. PDCD10/CCM3 molecular screening revealed four already known mutations and four novel ones. The mutated patients show an earlier onset of clinical manifestations as compared to CCM1/CCM2 mutated patients. The study of further families carrying mutations in PDCD10/CCM3 may help define a possible correlation between genotype and phenotype; an accurate clinical follow up of the subjects would help define more precisely whether mutations in PDCD10/CCM3 lead to a characteristic phenotype.

  1. Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part II: synthesis of the literature and patient management.

    Science.gov (United States)

    Yang, Edward; Storey, Armide; Olson, Heather E; Soul, Janet; Estroff, Judy A; Trenor, Cameron C; Cooper, Benjamin K; Smith, Edward R; Orbach, Darren B

    2017-09-30

    Torcular dural sinus malformations (tDSMs) are described as slow flow dural arteriovenous fistulae with frequently poor outcomes in the neuroangiographic literature, but other etiologies have been proposed in the obstetric literature, where outcomes have been more favorable. To review tDSMs reported in the literature of multiple specialties for features that support a common etiology, and to identify key prognostic factors, with an emphasis on tDSM trajectory highlighted in part I. Analysis of imaging features and clinical outcome for 77 prenatal and 22 postnatal tDSMs reported in 37 papers from the literature. In addition to large venous lakes, 36% of prenatal and 96% of postnatal tDSMs had evidence of arterialization, where specifically assessed. For fetal cases, where there was an observable natural history, 97% underwent a spontaneous decrease-13% after an initial increase and only 1 case with subsequent enlargement after a decrease. Prenatal cases had 83% survival (62% with a favorable outcome) whereas postnatal cases had 59% survival (29% favorable). In addition to a postnatal diagnosis, unfavorable features included ventriculomegaly, parenchymal injury, arterialization, and need for intervention. Favorable features included decreasing tDSM size, presence of clot, and increasing clot percentage. Neonatal and fetal tDSMs have overlapping imaging appearances, suggesting a common etiology, where neonatal tDSMs represent those rare fetal tDSMs that do not undergo spontaneous regression and have a propensity for worse outcomes. Decrease in tDSM size is a critical observation when managing a tDSM because it is generally irreversible and associated with a favorable outcome. © 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.

  2. Tonsillar pulsatility before and after surgical decompression for children with Chiari malformation type 1: an application for true fast imaging with steady state precession

    Energy Technology Data Exchange (ETDEWEB)

    Radmanesh, Alireza [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Washington University School of Medicine, Mallinckrodt Institute of Radiology, St Louis, MO (United States); Greenberg, Jacob K.; Smyth, Matthew D.; Limbrick, David D. [Washington University School of Medicine, Department of Neurosurgery, St Louis, MO (United States); Chatterjee, Arindam; Sharma, Aseem [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

    2015-04-01

    We hypothesize that surgical decompression for Chiari malformation type 1 (CM-1) is associated with statistically significant decrease in tonsillar pulsatility and that the degree of pulsatility can be reliably assessed regardless of the experience level of the reader. An Institutional Review Board (IRB)-approved Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study was performed on 22 children with CM-1 (8 males; mean age 11.4 years) who had cardiac-gated true-FISP sequence and phase-contrast cerebrospinal fluid (CSF) flow imaging as parts of routine magnetic resonance (MR) imaging before and after surgical decompression. The surgical technique (decompression with or without duraplasty) was recorded for each patient. Three independent radiologists with different experience levels assessed tonsillar pulsatility qualitatively and quantitatively and assessed peritonsillar CSF flow qualitatively. Results were analyzed. To evaluate reliability, Fleiss kappa for multiple raters on categorical variables and intra-class correlation for agreement in pulsatility ratings were calculated. After surgical decompression, the degree of tonsillar pulsatility appreciably decreased, confirmed by t test, both qualitatively (p values <0.001, <0.001, and 0.045 for three readers) and quantitatively (amount of decrease/p value for three readers 0.7 mm/<0.001, 0.7 mm/<0.001, and 0.5 mm/0.022). There was a better agreement among the readers in quantitative assessment of tonsillar pulsatility (kappa 0.753-0.834), compared to qualitative assessment of pulsatility (kappa 0.472-0.496) and qualitative assessment of flow (kappa 0.056 to 0.203). Posterior fossa decompression with duraplasty led to a larger decrease in tonsillar pulsatility, compared to posterior fossa decompression alone. Tonsillar pulsatility in CM-1 is significantly reduced after surgical decompression. Quantitative assessment of tonsillar pulsatility was more reliable across readers than

  3. High-resolution label-free vascular imaging using a commercial, clinically approved dermatological OCT scanner

    Science.gov (United States)

    Byers, R. A.; Tozer, G.; Brown, N. J.; Matcher, S. J.

    2016-02-01

    Background and Aim: Recently developed decorrelative techniques such as speckle-variance optical coherence tomography (svOCT) have demonstrated non-invasive depth-resolved imaging of the microcirculation in-vivo. However, bulk tissue motion (BTM) originating from the subject's breathing or heartbeat remains problematic at low imaging speeds, often resulting in full frame decorrelation and a loss of vascular contrast. The aim of this study was to build upon existing svOCT techniques through utilisation of a commercially available, probe-based VivoSight OCT system running at 20 kHz Axial-scan rate. Methods and results: Custom four-dimensional scanning strategies were developed and utilised in order to maximise the interframe correlation during image acquisition. Volumes of structural OCT data were collected from various anatomical regions and processed using the aforementioned svOCT algorithm to reveal angiographic information. Following data collection, three dimensional image registration and novel filtering algorithms were applied to each volume in order to ensure that BTM artefacts were sufficiently suppressed. This enabled accurate visualisation of the microcirculation within the papillary dermis, to a depth of approximately 2mm. Applications of this technique, including quantitative capillary loop density measurement and visualisation of wound healing are demonstrated and enhanced through widefield mosaicing of the svOCT data. Conclusions: Non-invasive microcirculation imaging using an FDA 510(k) approved OCT scanner such as the VivoSight allows direct clinical utilisation of these techniques, in particular for the pathological analysis of skin diseases. This research was supported by BBSRC Doctoral Training Grant: BB/F016840/1. The authors also gratefully acknowledge the use of equipment funded by MRC grant: MR/L012669/1.

  4. Termination of pregnancy for renal malformations.

    Science.gov (United States)

    Simoens, Eva; Hindryckx, An; Moerman, Philippe; Claus, Filip; De Catte, Luc

    2015-09-01

    We studied the correlation between prenatal diagnosis and postmortem investigations in pregnancies terminated for renal malformations. Over a 5-year period, 77 cases of termination of pregnancy (TOP) for renal malformations were reviewed. Chromosomal anomalies (n = 9) and cases without conventional or virtual autopsy were excluded (n = 15). In 53 cases, prenatal ultrasound diagnosis and conventional autopsy findings were compared. In addition, we compared the accuracy of conventional and virtual autopsy findings in 17 cases. Full agreement was observed in 60.4% (32/53) of cases. In 26.4% (14/53) of the cases, the presence of additional malformations did not alter the final diagnosis. However, in 11.3% (6/53) the final diagnosis was adjusted because of major additional findings. One case showed a total disagreement. Conventional and virtual autopsy were in full agreement in 52.9% (9/17). Postmortem magnetic resonance imaging (MRI) description and detection of malformations was less complete and failed to correctly diagnose 5/17 cases (29.4%). In 17.6% (3/17) of the cases, postmortem MRI revealed malformations not confirmed by conventional autopsy. A high correlation between prenatal ultrasound and postmortem investigations was observed. Conventional autopsy remains the gold standard to reveal additional major and minor malformations, leading to a correct final diagnosis. The added value of virtual necropsy for renal pathology was limited.

  5. Up-to-date Doppler techniques for breast tumor vascularity: superb microvascular imaging and contrast-enhanced ultrasound.

    Science.gov (United States)

    Park, Ah Young; Seo, Bo Kyoung

    2017-08-19

    Ultrasonographic Doppler techniques have improved greatly over the years, allowing more sophisticated evaluation of breast tumor vascularity. Superb microvascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) with second-generation contrast agents are two representative up-to-date techniques. SMI is a sensitive Doppler technique that adopts an intelligent filter system to separate low-flow signals from artifacts. With the development of second-generation contrast agents, CEUS has also emerged as a useful Doppler technique for evaluating tumor microcirculation. Both techniques can improve the diagnostic performance of gray-scale ultrasonography by providing vascular information useful not only for the morphologic assessment of microvessels, but also for the quantitative analysis of perfusion. In this review, we explain the imaging principles and previous research underlying these two vascular techniques, and describe our clinical experiences.

  6. Is diffusion-weighted imaging a significant indicator of the development of vascularization in hypovascular hepatocellular lesions?

    Science.gov (United States)

    Takara, Kenichi; Saito, Kazuhiro; Saguchi, Toru; Sugimoto, Katsutoshi; Taira, Junichi; Imai, Yasuharu; Moriyasu, Fuminori; Akata, Soichi; Tokuuye, Koichi

    2014-01-01

    The objective was to evaluate the efficacy of diffusion-weighted imaging (DWI) in predicting the development of vascularization in hypovascular hepatocellular lesions (HHLs). Forty-two HHLs that were diagnosed by computed tomographic (CT) arteriography were evaluated retrospectively. The lesion on DWI was classified as isointense, hypointense, or hyperintense. Follow-up studies that included intravenous dynamic CT or magnetic resonance imaging were performed. The 730-day cumulative developments of vascularization in hypointense, isointense, and hyperintense lesions were 17%, 30%, and 40%, respectively. The differences among these developments were not statistically significant. The signal intensity on DWI showed no significant difference in the development of vascularization. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Mid-hindbrain malformations due to drugs taken during pregnancy.

    Science.gov (United States)

    Merlini, Laura; Fluss, Joël; Dhouib, Amira; Vargas, Maria I; Becker, Minerva

    2014-04-01

    Although genetic defects are the leading cause of central nervous system malformations including in the posterior fossa, specific malformative patterns should alert the clinician to consider rather a teratogenic etiology. We discuss the imaging features of 2 mid-hindbrain malformations consecutive to the intake of isotretinoin (Roaccuatane®; case 1) and misoprostol (Cytotec®; case 2) during pregnancy and review the pertinent literature. We correlate the morphological appearance of the mid-hindbrain malformation, as seen on high-resolution magnetic resonance imaging to possible drug-induced pathogenetical mechanisms. The recognition of characteristic imaging patterns enables diagnosis of and/or confirmation of suspected drug-induced hindbrain malformations. This has important medicolegal implications and also clinical significance to avoid unsuccessful and misleading genetic testing.

  8. Hydrophobic cyanine dye-doped micelles for optical in vivo imaging of plasma leakage and vascular disruption

    Science.gov (United States)

    Botz, Bálint; Bölcskei, Kata; Kemény, Ágnes; Sándor, Zoltán; Tékus, Valéria; Sétáló, György, Jr.; Csepregi, Janka; Mócsai, Attila; Pintér, Erika; Kollár, László; Helyes, Zsuzsanna

    2015-01-01

    Vascular leakage is an important feature of various disease conditions. In vivo optical imaging provides a great opportunity for the evaluation of this phenomenon. In the present study, we focus on the development and validation of a near-infrared (NIR) imaging formula to allow reliable, cost-efficient evaluation of vascular leakage in diverse species using the existing small-animal fluorescence imaging technology. IR-676, a moderately hydrophobic NIR cyanine dye, was doped into self-assembling aqueous micelles using a widely employed and safe nonionic emulsifier (Kolliphor HS 15), and was tested in several acute and chronic inflammatory disease models in both mice and rats. The imaging formula is stable and exerts no acute toxic effects in vitro. It accumulated specifically in the inflamed regions in all models, which could be demonstrated by both conventional epifluorescence imaging, and fluorescence tomography both as a standalone technique and also by merging it with computed tomography scans. Ex vivo verification of dye accumulation by confocal fluorescence microscopy was also possible. The present formula allows sensitive and specific detection of inflammatory plasma leakage in diverse models. Its potential for imaging larger animals was also demonstrated. IR-676-doped micelles offer an excellent opportunity to image inflammatory vascular leakage in various models and species.

  9. Outpatient percutaneous treatment of deep venous malformations using pure ethanol at low doses under local anesthesia

    Directory of Open Access Journals (Sweden)

    José Luiz Orlando

    2010-01-01

    Full Text Available INTRODUCTION: Venous malformations are the most frequent vascular malformation. Deep venous malformations are located in subcutaneous tissue or in the muscles. Percutaneous sclerotherapy is the treatment of choice, and the use of ethanol at low doses has not yet been described. OBJECTIVE: To analyze the results of treating Deep venous malformations patients with low doses of ethanol. METHODS: Thirty-nine patients treated between July 1995 and June 2007 were followed up prospectively over a median period of 18 months. Twenty-nine were female (74.4% and 10 were male (25.6%, with ages ranging from 11 to 59 years (median of 24 years. All of the lesions affected limbs, and the main symptom reported was pain (97.4%. Each patient underwent fortnightly alcohol application sessions under local anesthesia on an outpatient basis. The lesions were classified into three groups according to size using nuclear magnetic resonance imaging: small, up to 3 cm (4 patients; medium, between 3 and 15 cm (27 patients; and large, greater than 15 cm (8 patients. RESULTS: The symptoms completely disappeared in 14 patients (35.9% and improved in 24 (61.5%. The lesion size reduced to zero in 6 patients (15.4% and decreased in 32 (82%. The median number of sessions was 7. There were no complications in 32 patients (82%, while 3 presented local paresthesia (7.7%, 2 superficial trombophlebites (5.1%, 1 skin ulcer (2.6%, and 1 case of hyperpigmentation (2.6%. CONCLUSION: Outpatient treatment for Deep venous malformations patients using ethanol at low doses was effective, with a low complication rate.

  10. Vascular lesions of the lumbar epidural space: magnetic resonance imaging features of epidural cavernous hemangioma and epidural hematoma

    Directory of Open Access Journals (Sweden)

    Basile Júnior Roberto

    1999-01-01

    Full Text Available The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scans showed hyperintense signal.

  11. USPIO-labeled textile materials for non-invasive MR imaging of tissue-engineered vascular grafts

    NARCIS (Netherlands)

    Mertens, Marianne E.; Koch, Sabine; Lammers, Twan Gerardus Gertudis Maria; Schuster, Philipp; Wehner, Jakob; Wu, Zhuojun; Gremse, Felix; Schulz, Volkmar; Rongen, Lisanne; Wolf, Frederic; Frese, Julia; Gesche, Valentine N.; van Zandvoort, Marc; Mela, P.; Jockenhoeve, Stefan; Kiessling, Fabian

    2015-01-01

    Non-invasive imaging might assist in the clinical translation of tissue-engineered vascular grafts (TEVG). It can e.g. be used to facilitate the implantation of TEVG, to longitudinally monitor their localization and function, and to provide non-invasive and quantitative feedback on their remodeling

  12. Web-like malformation of the carotid artery and multicystic encephalomalacia.

    Science.gov (United States)

    Sendelbach, K M; Gujrati, M; Husain, A N

    1992-01-01

    Multicystic encephalomalacia and hydranencephaly lie within a spectrum of brain lesions linked to ischemic cerebral damage. Causes include vascular malformation, thrombosis, embolism, infection, and toxins. We describe an infant with multicystic encephalomalacia associated with a peculiar web-like malformation of the right common carotid and left subclavian arteries. We postulate that this luminal bridging is a congenital malformation resulting from defective canalization of the medium-sized blood vessels but could represent organized and recanalized thrombi, the etiology of which remains unknown.

  13. Telemedicine in vascular surgery: feasibility of digital imaging for remote management of wounds.

    Science.gov (United States)

    Wirthlin, D J; Buradagunta, S; Edwards, R A; Brewster, D C; Cambria, R P; Gertler, J P; LaMuraglia, G M; Jordan, D E; Kvedar, J C; Abbott, W M

    1998-06-01

    Telemedicine coupled with digital photography could potentially improve the quality of outpatient wound care and decrease medical cost by allowing home care nurses to electronically transmit images of patients' wounds to treating surgeons. To determine the feasibility of this technology, we compared bedside wound examination by onsite surgeons with viewing digital images of wounds by remote surgeons. Over 6 weeks, 38 wounds in 24 inpatients were photographed with a Kodak DC50 digital camera (resolution 756 x 504 pixels/in2). Agreements regarding wound description (edema, erythema, cellulitis, necrosis, gangrene, ischemia, and granulation) and wound management (presence of healing problems, need for emergent evaluation, need for antibiotics, and need for hospitalization) were calculated among onsite surgeons and between onsite and remote surgeons. Sensitivity and specificity of remote wound diagnosis compared with bedside examination were calculated. Potential correlates of agreement, level of surgical training, certainty of diagnosis, and wound type were evaluated by multivariate analysis. Agreement between onsite and remote surgeons (66% to 95% for wound description and 64% to 95% for wound management) matched agreement among onsite surgeons (64% to 85% for wound description and 63% to 91% for wound management). Moreover, when onsite agreement was low (i.e., 64% for erythema) agreement between onsite and remote surgeons was similarly low (i.e., 66% for erythema). Sensitivity of remote diagnosis ranged from 78% (gangrene) to 98% (presence of wound healing problem), whereas specificity ranged from 27% (erythema) to 100% (ischemia). Agreement was influenced by wound type (p 0.01) or level of surgical training (p > 0.01). Wound evaluation on the basis of viewing digital images is comparable with standard wound examination and renders similar diagnoses and treatment in the majority of cases. Digital imaging for remote wound management is feasible and holds significant

  14. Mental foramen and lingual vascular canals of mandible on MDCT images: anatomical study and review of the literature.

    Science.gov (United States)

    Direk, Filiz; Uysal, Ismihan Ilknur; Kivrak, Ali Sami; Fazliogullari, Zeliha; Unver Dogan, Nadire; Karabulut, Ahmet Kagan

    2017-04-13

    The mental foramen and lingual vascular canals are related to vessels and nerves in the mandibular body. The aim of the present study was to determine the number and location of these structures and to make measurements of them. The archived Multidetector Computed Tomography images of 100 adult (15- to 70-year-old) patients were evaluated retrospectively. The diameters of the mental foramens and their distances from the front, back, upper and lower reference points were measured. The distribution of mental foramens with respect to the teeth was also researched. The presence of lingual vascular canals, and the number of median and lateral canals was determined, and the length of the median lingual vascular canals measured. All measurement parameters were analyzed by gender, side and age group. Eleven patients demonstrated a total of 15 accessory mental foramen. Median lingual vascular canals were observed in 100% of cases, with lateral lingual vascular canals determined in 32%. Significant differences were observed in the results of different gender groups (P foramen was determined mostly in males, and unilaterally on the right side; also, the distances of mental foramen, except the distance from the back border of the mandible (P foramen, as well as the presence, position and size of lingual vascular canals can be clearly investigated by multidetector computed tomography. A preoperative knowledge of the positions of neurovascular and bone structures is very important for preventing complications that may occur during or after operations.

  15. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  16. Neuroradiological findings in vascular dementia

    Energy Technology Data Exchange (ETDEWEB)

    Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

    2007-01-15

    There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

  17. Breast Contrast Enhanced MR Imaging: Semi-Automatic Detection of Vascular Map and Predominant Feeding Vessel.

    Science.gov (United States)

    Petrillo, Antonella; Fusco, Roberta; Filice, Salvatore; Granata, Vincenza; Catalano, Orlando; Vallone, Paolo; Di Bonito, Maurizio; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Sansone, Mario

    2016-01-01

    To obtain breast vascular map and to assess correlation between predominant feeding vessel and tumor location with a semi-automatic method compared to conventional radiologic reading. 148 malignant and 75 benign breast lesions were included. All patients underwent bilateral MR imaging. Written informed consent was obtained from the patients before MRI. The local ethics committee granted approval for this study. Semi-automatic breast vascular map and predominant vessel detection was performed on MRI, for each patient. Semi-automatic detection (depending on grey levels threshold manually chosen by radiologist) was compared with results of two expert radiologists; inter-observer variability and reliability of semi-automatic approach were assessed. Anatomic analysis of breast lesions revealed that 20% of patients had masses in internal half, 50% in external half and the 30% in subareolar/central area. As regards the 44 tumors in internal half, based on radiologic consensus, 40 demonstrated a predominant feeding vessel (61% were supplied by internal thoracic vessels, 14% by lateral thoracic vessels, 16% by both thoracic vessels and 9% had no predominant feeding vessel-pfeeding vessel (66% were supplied by internal thoracic vessels, 11% by lateral thoracic vessels, 9% by both thoracic vessels and 14% had no predominant feeding vessel-pfeeding vessel (25% were supplied by internal thoracic vessels, 39% by lateral thoracic vessels, 18% by both thoracic vessels and 18% had no predominant feeding vessel-pfeeding vessel (27% were supplied by internal thoracic vessels, 45% by lateral thoracic vessels, 4% by both thoracic vessels and 24% had no predominant feeding vessel-pfeeding vessel. An excellent reliability for semi-automatic assessment (Cronbach's alpha = 0.96) was reported. Predominant feeding vessel location was correlated with breast lesion location: internal thoracic artery supplied the highest proportion of breasts with tumor in internal half and lateral thoracic

  18. Molecular Ultrasound Imaging of Early Vascular Response in Prostate Tumors Irradiated with Carbon Ions

    Directory of Open Access Journals (Sweden)

    Moritz Palmowski

    2009-09-01

    Full Text Available Individualized treatments with combination of radiotherapy and targeted drugs require knowledge about the behavior of molecular targets after irradiation. Angiogenic marker expression has been studied after conventional radiotherapy, but little is known about marker response to charged particles. For the very first time, we used molecular ultrasound imaging to intraindividually track changes in angiogenic marker expression after carbon ion irradiation in experimental tumors. Expression of intercellular adhesion molecule-1 (ICAM-1 and of αvβ3-integrin in subcutaneous AT-1 prostate cancers in rats treated with carbon ions (16 Gy was studied using molecular ultrasound and immunohistochemistry. For this purpose, cyanoacrylate microbubbles were synthesized and linked to specific ligands. The accumulation of targeted microbubbles in tumors was quantified before and 36 hours after irradiation. In addition, tumor vascularization was analyzed using volumetric Doppler ultrasound. In tumors, the accumulation of targeted microbubbles was significantly higher than in nonspecific ones and could be inhibited competitively. Before irradiation, no difference in binding of αvβ3-integrin-specific or ICAM-1-specific microbubbles was observed in treated and untreated animals. After irradiation, however, treated animals showed a significantly higher binding of αvβ3-integrin-specific microbubbles and an enhanced binding of ICAM-1-specific microbubbles than untreated controls. In both groups, a decrease in vascularization occurred during tumor growth, but no significant difference was observed between irradiated and nonirradiated tumors. In conclusion, carbon ion irradiation upregulates ICAM-1 and αvβ3-integrin expression in tumor neovasculature. Molecular ultrasound can indicate the regulation of these markers and thus may help to identify the optimal drugs and time points in individualized therapy regimens.

  19. Mid-Term Vascular Safety of Renal Denervation Assessed by Follow-up MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, Axel, E-mail: axel.schmid@uk-erlangen.de; Schmieder, Raphael; Lell, Michael; Janka, Rolf [Friedrich-Alexander University Erlangen-Nuremberg, Department of Radiology (Germany); Veelken, Roland; Schmieder, Roland E. [Friedrich-Alexander University Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany); Uder, Michael [Friedrich-Alexander University Erlangen-Nuremberg, Department of Radiology (Germany); Ott, Christian [Friedrich-Alexander University Erlangen-Nuremberg, Department of Nephrology and Hypertension (Germany)

    2016-03-15

    Background/AimsRenal denervation (RDN) emerged as a treatment option for reducing blood pressure (BP) in patients with treatment-resistant hypertension (TRH). However, concerns have been raised regarding the incidence of late renal artery stenosis or thromboembolism after RDN. The goal of the current study was, therefore, to conduct a prospective clinical trial on the mid-term vascular integrity of the renal arteries and the perfusion of the renal parenchyma assessed by magnetic resonance imaging (MRI) in the follow-up after catheter-based RDN.MethodsIn our single-centre investigator initiated study, 51 patients with true TRH underwent catheter-based RDN using the Symplicity Flex{sup TM} catheter (Medtronic Inc., Palo Alto, CA). Follow-up MRI was performed at a median of 11 months (interquartile range 6–18 months) after RDN on a 1.5T MR unit. High-resolution MR angiography (MRA) and MRI results were compared to the baseline digital angiography of renal arteries obtained at time of RDN. In case of uncertainties (N = 2) catheter angiography was repeated.ResultsBoth office and 24-h ambulatory BP were significantly reduced 6 and 12 months after RDN. Renal function remained unchanged 6 and 12 months after RDN. In all patients, MRA excluded new or progression of pre-existing low grade renal artery stenosis as well as focal aneurysms at the sites of radiofrequency ablation. In none of the patients new segmental perfusion deficits in either kidney were detected on MRI.ConclusionsNo vascular or parenchymal complications after radiofrequency-based RDN were detected in 51 patients followed up by MRI.

  20. Cerebral Cavernous Malformation

    Science.gov (United States)

    ... Division of Neuroscience Director, NIH BRAIN Initiative® Health Scientist Administrator Channels Synapses Circuits Cluster Scientific Director, Division of Intramural Research Featured Director's Message menu search Enter Search Term Submit Search Cerebral Cavernous Malformation ...

  1. Dandy-Walker malformation

    National Research Council Canada - National Science Library

    Maria Silian Mandu Fonseca; Marta Wey Vieira; Sandra Regina Dantas Nascimento; Sandro Blasi Esposito

    2017-01-01

    Dandy-Walker malformation is characterized by complete or partial agenesis of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa with displacement...

  2. Cervicofacial Lymphatic Malformations: A Retrospective Review of 40 Cases

    Directory of Open Access Journals (Sweden)

    Byung Chae Cho

    2016-01-01

    Full Text Available BackgroundLymphatic malformation (LM is a form of congenital vascular malformation with a low incidence. Although LM has been studied, no consensus has emerged regarding its cause or treatment.MethodsIn this study, we retrospectively evaluated 40 patients who visited our vascular anomalies center for the treatment of cervicofacial LM, which is a common manifestation of LM. The medical records of patients over a period of 12 years were reviewed and analyzed for commonalities regarding the diagnosis and the results of treatment.ResultsSuspected cervicofacial LM was confirmed through imaging studies. No difference in incidence was observed according to sex, and 73% of patients first presented with symptoms before the age of two years. The left side and the V2–V3 area were most commonly affected. No significant differences in incidence were observed among the macrocystic, microcystic, and combined types of LM. A total of 28 out of 36 patients received sclerotherapy as the first choice of treatment, regardless of the type of lesion. Complete resolution was achieved in only 25% of patients.ConclusionsLM is important to confirm the diagnosis early and to choose an appropriate treatment strategy according to the stage of the disease and each individual patient's symptoms. When treatment is delayed or an incorrect treatment is administered, patient discomfort increases as the lesion gradually spreads. Therefore, more so than is the case for most other diseases, a team approach on a case-by-case basis is important for the accurate and appropriate treatment of LM.

  3. Pulmonary Arteriovenous Malformations

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Oxhøj, H; Andersen, P E

    1999-01-01

    Hereditary hemorrhagic telangiectasia (HHT) is a dominantly inherited disease with a high prevalence of pulmonary arteriovenous malformations (PAVMs). The first symptom of HHT may be stroke or fatal hemoptysis associated with the presence of PAVM.......Hereditary hemorrhagic telangiectasia (HHT) is a dominantly inherited disease with a high prevalence of pulmonary arteriovenous malformations (PAVMs). The first symptom of HHT may be stroke or fatal hemoptysis associated with the presence of PAVM....

  4. High-flow paediatric mandibular arteriovenous malformations: case reports and a review of current management.

    Science.gov (United States)

    Kaderbhai, J; Breik, O; Heggie, A A; Penington, A J

    2017-12-01

    High-flow vascular malformations in the paediatric population are potentially life-threatening and are challenging to treat. This paper describes the management of three cases of mandibular arteriovenous malformations and reviews the contemporary management options for these serious lesions. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Label-free fast 3D coherent imaging reveals pancreatic islet micro-vascularization and dynamic blood flow

    DEFF Research Database (Denmark)

    Berclaz, Corinne; Szlag, Daniel; Nguyen, David

    2016-01-01

    regulation of blood glucose homeostasis and is known to be affected from the early stage of diabetes. The deep localization of these islets inside the pancreas in the abdominal cavity renders their in vivo visualization a challenging task. A fast label-free imaging method with high spatial resolution......In diabetes, pancreatic β-cells play a key role. These cells are clustered within structures called islets of Langerhans inside the pancreas and produce insulin, which is directly secreted into the blood stream. The dense vascularization of islets of Langerhans is critical for maintaining a proper...... is required to study the vascular network of islets of Langerhans. Based on these requirements, we developed a label-free and three-dimensional imaging method for observing islets of Langerhans using extended-focus Fourier domain Optical Coherence Microscopy (xfOCM). In addition to structural imaging...

  6. FAM222B Is Not a Likely Novel Candidate Gene for Cerebral Cavernous Malformations

    NARCIS (Netherlands)

    Spiegler, Stefanie; Kirchmaier, Bettina; Rath, Matthias; Korenke, G. Christoph; Tetzlaff, Fabian; Van De Vorst, Maartje; Neveling, Kornelia; Acker-Palmer, Amparo; Kuss, Andreas W.; Gilissen, Christian; Fischer, Andreas; Schulte-Merker, Stefan; Felbor, Ute

    2016-01-01

    Cerebral cavernous malformations (CCMs) are prevalent slow-flow vascular lesions which harbour the risk to develop intracranial haemorrhages, focal neurological deficits, and epileptic seizures. Autosomal dominantly inherited CCMs were found to be associated with heterozygous inactivating mutations

  7. Venous malformations of the female lower genital tract.

    Science.gov (United States)

    Wang, Shu; Lang, Jing He; Zhou, Hui Mei

    2009-08-01

    Vascular malformations are rarely located in the female lower genital tract. We present the specific clinicopathologic features of venous malformation in the lower genital tract and highlight the surgical management of these lesions. Between the years 1998 and 2008, 8 of 646 female patients were retrospectively defined as venous malformation in the lower genital tract according to the classification of the International Society for the Study of Vascular Anomalies (ISSVA). Clinical and pathologic information was analyzed according to the medical records and archived pathological sections. Venous malformations were located in the vagina in three women, and in two of these cases extended to the cervix, and were found at the vulva in five patients. The age of the patients ranged from 15 to 85. The clinical presentations were abnormal vaginal bleeding or vaginal mass in cases with cervicovaginal lesions, and non-specific vulvar nodules in women with vulvar lesions. The abnormalities were found shortly after birth and increased in size gradually thereafter, or become significantly enlarged during or following pregnancy. Postmenopausal episodes could occur, although rarely. Doppler ultrasound, MRI and angiography were available to help define the type of vascular anomalies. The therapeutic approach consisted of interventional embolization and surgical excision. In rare cases of refractory and diffuse cervicovaginal lesions, hysterectomy might be ultimately inevitable. Venous malformations in the lower female genital tract are rarely reported. Their clinical presentations mimic other genital tract neoplasms, including malignancies. Surgical excision is the curative procedure and is helpful to reach a definite pathological diagnosis.

  8. Doppler Sonography and 3D CT Angiography of Acquired Uterine Arteriovenous Malformations (AVMs): Report of Two Cases.

    Science.gov (United States)

    Aiyappan, Senthil Kumar; Ranga, Upasana; Veeraiyan, Saveetha

    2014-02-01

    Uterine Arteriovenous Malformations (AVMs) are rare but life threatening causes of abnormal vaginal bleeding. Accurate clinical and radiological diagnosis is essential because uterine instrumentation that is often used for management of other sources of abnormal bleeding, can lead to massive hemorrhage. Timely diagnosis and early proper treatment can markedly reduce the associated disease mortality. Ultrasound with colour and spectral doppler is the initial imaging modality of choice. Three-dimensional computed tomography (CT) angiography can determine the actual extent of the vascular malformation and helps in pre-interventional planning noninvasively. Uterine AVM can be either congenital or acquired in nature with latter being more common. We hereby report two cases of acquired AVMs diagnosed by color doppler sonography and confirmed by three-dimensional CT angiography. Both the cases reported here had previous history of dilation and curettage for abortion. Clinically one patient presented with profuse uterine bleeding and another with meno-metrorrhagia and both cases underwent surgical removal of uterus.

  9. Vascular Anomalies Classification: Recommendations From the International Society for the Study of Vascular Anomalies.

    Science.gov (United States)

    Wassef, Michel; Blei, Francine; Adams, Denise; Alomari, Ahmad; Baselga, Eulalia; Berenstein, Alejandro; Burrows, Patricia; Frieden, Ilona J; Garzon, Maria C; Lopez-Gutierrez, Juan-Carlos; Lord, David J E; Mitchel, Sally; Powell, Julie; Prendiville, Julie; Vikkula, Miikka

    2015-07-01

    Vascular anomalies represent a spectrum of disorders from a simple "birthmark" to life- threatening entities. Incorrect nomenclature and misdiagnoses are commonly experienced by patients with these anomalies. Accurate diagnosis is crucial for appropriate evaluation and management, often requiring multidisciplinary specialists. Classification schemes provide a consistent terminology and serve as a guide for pathologists, clinicians, and researchers. One of the goals of the International Society for the Study of Vascular Anomalies (ISSVA) is to achieve a uniform classification. The last classification (1997) stratified vascular lesions into vascular malformations and proliferative vascular lesions (tumors). However, additional disease entities have since been identified that are complex and less easily classified by generic headings, such as capillary malformation, venous malformation, lymphatic malformation, etc. We hereby present the updated official ISSVA classification of vascular anomalies. The general biological scheme of the classification is retained. The section on tumors has been expanded and lists the main recognized vascular tumors, classified as benign, locally aggressive or borderline, and malignant. A list of well-defined diseases is included under each generic heading in the "Simple Vascular Malformations" section. A short definition is added for eponyms. Two new sections were created: one dealing with the malformations of individually named vessels (previously referred to as "truncular" malformations); the second groups lesions of uncertain or debated nature (tumor versus malformation). The known genetic defects underlying vascular anomalies are included in an appendix. This classification is meant to be a framework, acknowledging that it will require modification as new scientific information becomes available. Copyright © 2015 by the American Academy of Pediatrics.

  10. Facial nerve anatomy, dissection and preservation in lymphatic malformation management.

    Science.gov (United States)

    Lee, Gi Soo; Perkins, Jonathan A; Oliaei, Sepehr; Manning, Scott C

    2008-06-01

    To describe facial nerve anatomy and surgical techniques used for safe lymphatic malformation resection of malformation involving the facial nerve. retrospective case series. tertiary pediatric hospital. record review of lymphatic malformation patients after facial nerve dissection, from 1996 to 2005. Data collected included: facial nerve function, relationship of lymphatic malformation to facial nerve, facial nerve anatomy, dissection extent and clinical outcome. Sixteen patients who met inclusion criteria underwent a total of 21 facial nerve dissections. Mean age at dissection was 48 months (range 1-72 months). Mean follow-up was 38 months (range 8-144 months). Pre-operative lymphatic malformation stage by patient: II=7/16, III=4/16, IV=2/16 and V=3/16. Higher stage lymphatic malformations required more extensive dissections (p=0.026). Pre-operative facial nerve function was House-Brackmann grade (HBG)-1 in 20, and HBG-6 in 1. Eight months postoperatively, facial nerve function was HBG-1 in 18, HBG-2 in 1, and HBG-6 in 2. The facial nerve was surrounded by lymphatic malformation in 10/21, deep to the lymphatic malformation in 5/21, superficial to the lymphatic malformation in 4/21, and not identified in 2/21. Imaging studies predicted facial nerve position in 15/21 procedures. Antegrade nerve dissection was performed in 10/21, retrograde in 7/21 and not done in 2/21. Abnormally elongated facial nerve was identified in 11/21 cases and required more extensive dissection (p=0.040). Facial nerve monitoring was used in 15/21 dissections. Clinical outcomes were felt to be good in 19/21 dissections. In lymphatic malformation surgery, the facial nerve is often abnormally elongated and encompassed by malformation. Pre-operative imaging, facial nerve identification and dissection allow excellent postoperative facial nerve function.

  11. Magnetic Particle Imaging (MPI): Experimental Quantification of Vascular Stenosis Using Stationary Stenosis Phantoms.

    Science.gov (United States)

    Vaalma, Sarah; Rahmer, Jürgen; Panagiotopoulos, Nikolaos; Duschka, Robert L; Borgert, Jörn; Barkhausen, Jörg; Vogt, Florian M; Haegele, Julian

    2017-01-01

    Magnetic Particle Imaging (MPI) is able to provide high temporal and good spatial resolution, high signal-to-noise ratio and sensitivity. Furthermore, it is a truly quantitative method as its signal strength is proportional to the concentration of its tracer, superparamagnetic iron oxide nanoparticles (SPIOs). Because of that, MPI is proposed to be a promising future method for cardiovascular imaging. Here, an interesting application may be the quantification of vascular pathologies like stenosis by utilizing the proportionality of the SPIO concentration and the MPI signal strength. In this study, the feasibility of MPI based stenosis quantification is evaluated based on this application scenario. Nine different stenosis phantoms with a normal diameter of 10 mm each and different stenoses of 1-9 mm and ten reference phantoms with a straight diameter of 1-10 mm were filled with a 1% Resovist dilution and measured in a preclinical MPI-demonstrator. The MPI signal intensities of the reference phantoms were compared to each other and the change of signal intensity within each stenosis phantom was used to calculate the degree of stenosis. These values were then compared to the known diameters of each phantom. As a second measurement, the 5 mm stenosis phantom was used for a serial dilution measurement down to a Resovist dilution of 1:3200 (0.031%), which is lower than a first pass blood concentration of a Resovist bolus in the peripheral arteries of an average adult human of at least about 1:1000. The correlation of the stenosis values based on MPI signal intensity measurements and based on the known diameters showed a very good agreement, proving the high precision of quantitative MPI in this regard.

  12. COnstrained Data Extrapolation (CODE): A new approach for high definition vascular imaging from low resolution data.

    Science.gov (United States)

    Song, Yang; Hamtaei, Ehsan; Sethi, Sean K; Yang, Guang; Xie, Haibin; Mark Haacke, E

    2017-12-01

    To introduce a new approach to reconstruct high definition vascular images using COnstrained Data Extrapolation (CODE) and evaluate its capability in estimating vessel area and stenosis. CODE is based on the constraint that the full width half maximum of a vessel can be accurately estimated and, since it represents the best estimate for the width of the object, higher k-space data can be generated from this information. To demonstrate the potential of extracting high definition vessel edges using low resolution data, both simulated and human data were analyzed to better visualize the vessels and to quantify both area and stenosis measurements. The results from CODE using one-fourth of the fully sampled k-space data were compared with a compressed sensing (CS) reconstruction approach using the same total amount of data but spread out between the center of k-space and the outer portions of the original k-space to accelerate data acquisition by a factor of four. For a sufficiently high signal-to-noise ratio (SNR) such as 16 (8), we found that objects as small as 3 voxels in the 25% under-sampled data (6 voxels when zero-filled) could be used for CODE and CS and provide an estimate of area with an error 200 (30) times faster for CODE compared to CS in the simulated (human) data. CODE was capable of producing sharp sub-voxel edges and accurately estimating stenosis to within 5% for clinically relevant studies of vessels with a width of at least 3pixels in the low resolution images. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Dynamic Measurement of Tumor Vascular Permeability and Perfusion using a Hybrid System for Simultaneous Magnetic Resonance and Fluorescence Imaging.

    Science.gov (United States)

    Ren, Wuwei; Elmer, Andreas; Buehlmann, David; Augath, Mark-Aurel; Vats, Divya; Ripoll, Jorge; Rudin, Markus

    2016-04-01

    Assessing tumor vascular features including permeability and perfusion is essential for diagnostic and therapeutic purposes. The aim of this study was to compare fluorescence and magnetic resonance imaging (MRI)-based vascular readouts in subcutaneously implanted tumors in mice by simultaneous dynamic measurement of tracer uptake using a hybrid fluorescence molecular tomography (FMT)/MRI system. Vascular permeability was measured using a mixture of extravascular imaging agents, GdDOTA and the dye Cy5.5, and perfusion using a mixture of intravascular agents, Endorem and a fluorescent probe (Angiosense). Dynamic fluorescence reflectance imaging (dFRI) was integrated into the hybrid system for high temporal resolution. Excellent correspondence between uptake curves of Cy5.5/GdDOTA and Endorem/Angiosense has been found with correlation coefficients R > 0.98. The two modalities revealed good agreement regarding permeability coefficients and centers-of-gravity of the imaging agent distribution. The FMT/dFRI protocol presented is able to accurately map physiological processes and poses an attractive alternative to MRI for characterizing tumor neoangiogenesis.

  14. Chiari type I malformation in children.

    Science.gov (United States)

    Massimi, L; Novegno, F; di Rocco, C

    2011-01-01

    The diagnosis of Chiari type I malformation (CIM) is more and more frequent in clinical practice due to the wide diffusion of magnetic resonance imaging. In many cases, such a diagnosis is made incidentally in asymptomatic patients, as including children investigated for different reasons such as mental development delay or sequelae of brain injury. The large number of affected patients, the presence of asymptomatic subjects, the uncertainties surrounding the pathogenesis of the malformation, and the different options for its surgical treatment make the management of CIM particularly controversial.This paper reports on the state of the art and the recent achievements about CIM aiming at providing further information especially on the pathogenesis, the natural history, and the management of the malformation, which are the most controversial aspects. A historial review introduces and explains the current classification. Furthermore, the main clinical, radiological, and neurophysiological findings of CIM are described to complete the picture of this heterogeneous and complex disease.

  15. Bleomycin sclerotherapy for lymphatic malformation after unsuccessful surgical excision: case report.

    Science.gov (United States)

    Vlahovic, A; Gazikalovic, A; Adjic, O

    2015-10-01

    Lymphatic malformations (LMs) are benign cystic masses resulting from the abnormal development of lymphatic channels. Lymphatic malformations occur primarily in the head and neck region. Surgical excision of lymphatic malformation is followed by high rate of recurrence and a high risk of complications. Bleomycin is an established antineoplastic drug. It can be used as a sclerosing agent in vascular anomalies. We present a child who was unsuccessfully treated with four surgical resections, with peripheral palsy of facial nerve as complication. The lymphatic malformation was successfully treated in our institution with intralesional administration of bleomycin.

  16. Study of diffusion tensor imaging in subcortical ischemic vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    Hui-ying GUO

    2014-04-01

    Full Text Available Objective Using diffusion tensor imaging (DTI to explore the microstructure changes of white matter in subcortical ischemic vascular cognitive impairment (SIVCI and its correlation with cognitive function.  Methods Forty-nine patients with subcortical ischemic cerebrovascular diseases were collected. By using Clinical Dementia Rating Scale (CDR, they were classified into 10 cases of vascular dementia (VaD group, 20 cases of vascular cognitive impairment-no dementia (VCIND group and 19 cases of normal cognitive function (control group. Conventional MRI and DTI were performed in all cases. Based on the DTI data, voxel-based analysis was used to assess the whole brain region. Correlation analysis was applied to illustrate the relationship between DTI parameters and cognitive scale in VaD patients.  Results Compared with the control group, fractional anisotropy (FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes, right temporal lobe and bilateral orbitofrontal lobes (P = 0.000, for all, and FA values of patients in VCIND group decreased in right inferior frontal gyrus, right hippocampus and bilateral precuneus (P = 0.000, for all. Compared with VCIND group, FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate, corpus callosum, bilateral parietal lobes and right temporal lobe (P = 0.000, for all. Compared with the control group, mean diffusivity (MD values in VaD group increased in medial prefrontal cortex, corpus callosum, bilateral parietal lobes, bilateral temporal lobes and anterior cingulate (P = 0.000, for all, while in VCIND group increased in bilateral precuneus and right hippocampus (P = 0.000, for all. Compared with VCIND group, MD values in VaD group increased in right medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes and bilateral temporal lobes (P = 0

  17. Novel Gd nanoparticles enhance vascular contrast for high-resolution magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Tot Bui

    2010-09-01

    Full Text Available Gadolinium (Gd, with its 7 unpaired electrons in 4f orbitals that provide a very large magnetic moment, is proven to be among the best agents for contrast enhanced MRI. Unfortunately, the most potent MR contrast agent based on Gd requires relatively high doses of Gd. The Gd-chelated to diethylene-triamine-penta-acetic acid (DTPA, or other derivatives (at 0.1 mmole/kg recommended dose, distribute broadly into tissues and clear through the kidney. These contrast agents carry the risk of Nephrogenic Systemic Fibrosis (NSF, particularly in kidney impaired subjects. Thus, Gd contrast agents that produce higher resolution images using a much lower Gd dose could address both imaging sensitivity and Gd safety.To determine whether a biocompatible lipid nanoparticle with surface bound Gd can improve MRI contrast sensitivity, we constructed Gd-lipid nanoparticles (Gd-LNP containing lipid bound DTPA and Gd. The Gd-LNP were intravenously administered to rats and MR images collected. We found that Gd in Gd-LNP produced a greater than 33-fold higher longitudinal (T(1 relaxivity, r(1, constant than the current FDA approved Gd-chelated contrast agents. Intravenous administration of these Gd-LNP at only 3% of the recommended clinical Gd dose produced MRI signal-to-noise ratios of greater than 300 in all vasculatures. Unlike current Gd contrast agents, these Gd-LNP stably retained Gd in normal vasculature, and are eliminated predominately through the biliary, instead of the renal system. Gd-LNP did not appear to accumulate in the liver or kidney, and was eliminated completely within 24 hrs.The novel Gd-nanoparticles provide high quality contrast enhanced vascular MRI at 97% reduced dose of Gd and do not rely on renal clearance. This new agent is likely to be suitable for patients exhibiting varying degrees of renal impairment. The simple and adaptive nanoparticle design could accommodate ligand or receptor coating for drug delivery optimization and in vivo drug

  18. Computer-based automated estimation of breast vascularity and correlation with breast cancer in DCE-MRI images.

    Science.gov (United States)

    Kostopoulos, Spiros A; Vassiou, Katerina G; Lavdas, Eleftherios N; Cavouras, Dionisis A; Kalatzis, Ioannis K; Asvestas, Pantelis A; Arvanitis, Dimitrios L; Fezoulidis, Ioannis V; Glotsos, Dimitris T

    2017-01-01

    Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) with gadolinium constitutes one of the most promising protocols for boosting up the sensitivity in breast cancer detection. The aim of this study was twofold: first to design an image processing methodology to estimate the vascularity of the breast region in DCE-MRI images and second to investigate whether the differences in the composition/texture and vascularity of normal, benign and malignant breasts may serve as potential indicators regarding the presence of the disease. Clinical material comprised thirty nine cases examined on a 3.0-T MRI system (SIGNA HDx; GE Healthcare). Vessel segmentation was performed using a custom made modification of the Seeded Region Growing algorithm that was designed in order to identify pixels belonging to the breast vascular network. Two families of features were extracted: first, morphological and textural features from segmented images in order to quantify the extent and the properties of the vascular network; second, textural features from the whole breast region in order to investigate whether the nature of the disease causes statistically important changes in the texture of affected breasts. Results have indicated that: (a) the texture of vessels presents statistically significant differences (pbreast region for malignant and non-malignant breasts, produced statistically significant differences (pbreasts may be used for the discrimination of non-malignant from malignant patients, and (d) an area under the receiver operating characteristic curve of 0.908 (AUC) was found when features were combined in a logistic regression prediction rule according to ROC analysis. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Dandy–Walker malformation: An incidental finding

    Science.gov (United States)

    Tadakamadla, Jyothi; Kumar, Santhosh; Mamatha, G. P.

    2010-01-01

    Dandy–Walker malformation (DWM) is a rare intracranial congenital abnormality that affects the cerebellum and some of its components; particularly cerebellar vermis, fourth ventricle and is characterized by an enlarged posterior fossa. Although there is an extensive list of signs attributed to DWM, final diagnosis is solely dependent on imaging techniques as there are no signs that are characteristic of DWM. This article reports a case with DWM who was diagnosed by magnetic resonance imaging. PMID:20838490

  20. Endoscopic Endonasal Approach to Mesencephalic Cavernous Malformations.

    Science.gov (United States)

    He, Shi-Ming; Wang, Yuan; Zhao, Tian-Zhi; Zheng, Tao; Lv, Wen-Hai; Zhao, Lan-Fu; Chen, Long; Sterling, Cole; Qu, Yan; Gao, Guo-Dong

    2016-06-01

    Symptomatic cavernous malformations involving the brainstem are difficult to access by conventional approaches, which often require dramatic brain retraction to gain adequate operative corridor. Here, we present a successful endoscopic endonasal transclival approach for resection of a hemorrhagic, symptomatic mesencephalic cavernous malformation. A 20-year-old woman presented with acute onset of headache, nausea, and vomiting. Computed tomography scan revealed a ventral midbrain hemorrhage. On day 3 of admission, the patient developed left-sided hemiparesis, restriction of medial and lateral left-eye movements, and loss of left pupillary light reflex. Subsequent magnetic resonance imaging demonstrated an increase of the midbrain lesion to 1.2 cm × 1.7 cm. Diffusion tensor imaging showed compression and lateral displacement of the right corticospinal tract near the thalamus and cerebral peduncle. Given the patient's clinical presentation and the findings on imaging, we suspected a mesencephalic cavernous malformation. The patient underwent an endoscopic endonasal transclival resection of a ventral midline mesencephalon cavernous malformation. A dark red lesion was directly visualized under the endoscope. After a small cortiectomy, the pial and perforator vessels were dissected, and dark-brown blood was drained from the cavernoma cavity. Using a biopsy forceps and with careful attention to the cavernoma borders, the lesion was removed and hemostasis was achieved. Pathologic examination confirmed cavernous malformation. One week after the operation, magnetic resonance imaging demonstrated total resection of the lesion. A 3-month follow-up revealed improved neurologic symptoms with minimal surgical morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Breast vascular mapping obtained with contrast-enhanced MR imaging: implications for cancer diagnosis, treatment, and risk stratification.

    Science.gov (United States)

    Sardanelli, Francesco; Fausto, Alfonso; Menicagli, Laura; Esseridou, Anastassia

    2007-12-01

    The value of breast vascular maps obtained using contrast-enhanced MR imaging has recently been explored. Additional information is obtained only by evaluating maximum intensity projections of the first dynamic subtraction to achieve a form of MR angiography of the breast. No increase in acquisition time and no dedicated contrast injections are needed. Four studies have been performed to evaluate the one-sided (asymmetric) increase in vascularity associated with ipsilateral cancer in a total of 404 patients with a cancer prevalence ranging from 38% to 80%. Sensitivity ranged from 72% to 88%, specificity from 57% to 100%, positive predictive value from 85% to 100%, negative predictive value from 38% to 88%, and overall accuracy from 73% to 87%. An asymmetric increase in breast vascularity ipsilateral to a cancer may be due to reduced flow resistance in the tumour, to a high metabolic rate (more likely in large tumours) or to angiogenic stimulation of the whole breast harbouring the lesion (more likely in small tumours). Tumour size could play a specific role in determining the ipsilaterally increased vascularity, and invasive cancers might be more frequently associated with ipsilaterally increased vascularity than in situ cancers. Moreover, while a reduction in breast vasculature has anecdotically been observed in breasts with locally advanced cancers treated with neoadjuvant chemotherapy, especially when taxanes are used, the higher incidence of breast cancer in patients with size asymmetry between the breasts as determined on screening mammography suggests that a role for breast MR vascular mapping in breast cancer risk stratification should be explored. Finally, arteries and veins might be differentiated with dedicated techniques. High-relaxivity agents may be used with advantage in these future investigations.

  2. Quantitative Susceptibility Mapping in Cerebral Cavernous Malformations: Clinical Correlations.

    Science.gov (United States)

    Tan, H; Zhang, L; Mikati, A G; Girard, R; Khanna, O; Fam, M D; Liu, T; Wang, Y; Edelman, R R; Christoforidis, G; Awad, I A

    2016-07-01

    Quantitative susceptibility mapping has been shown to assess iron content in cerebral cavernous malformations. In this study, our aim was to correlate lesional iron deposition assessed by quantitative susceptibility mapping with clinical and disease features in patients with cerebral cavernous malformations. Patients underwent routine clinical scans in addition to quantitative susceptibility mapping on 3T systems. Data from 105 patients met the inclusion criteria. Cerebral cavernous malformation lesions identified on susceptibility maps were cross-verified by T2-weighted images and differentiated on the basis of prior overt hemorrhage. Mean susceptibility per cerebral cavernous malformation lesion (χ̄lesion) was measured to correlate with lesion volume, age at scanning, and hemorrhagic history. Temporal rates of change in χ̄lesion were evaluated in 33 patients. Average χ̄lesion per patient was positively correlated with patient age at scanning (P cavernous malformation lesions with prior overt hemorrhages exhibited higher χ̄lesion than those without (P cavernous malformation lesions, higher mean quantitative susceptibility mapping signal in hemorrhagic lesions, and minimum longitudinal quantitative susceptibility mapping signal change in clinically stable lesions. Quantitative susceptibility mapping has the potential to be a novel imaging biomarker supplementing conventional imaging in cerebral cavernous malformations. The clinical significance of such measures merits further study. © 2016 by American Journal of Neuroradiology.

  3. Transcatheter embolization of a congenital intrahepatic arterioportal venous malformation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sing, T.M.Y.S.; Wong, K.P.; Young, N. [Westmead Hospital, Westmead, NSW, (Australia). Department of Radiaology; Le, S.D.V. [Bankstown-Lidcombe Hospital, Bankstown, NSW, (Australia). Department of Nuclear Medicine and Ultrasound

    1997-08-01

    Congenital intrahepatic arterioportal venous malformations (APVM) are uncommon lesions. A congenital intrahepatic APVM found incidentally in a 51 -year-old man during pre-operative aortography for an abdominal aortic aneurysm is reported here. This was successfully treated by transcatheter embolization of the involved hepatic artery prior to surgical repair of the aortic aneurysm. A 51-year-old smoker was admitted for pre-operative aortography of an abdominal aortic aneurysm (AAA). Liver function tests showed a mildly elevated alkaline phosphatase. There was no previous history of liver disease or trauma. Aortography demonstrated a large infra-renal AAA measuring 10 cm in diameter and 20 cm in length. The coeliac axis was noted to be grossly dilated with tortuous veins seen to the right side of the lower thoracic spine on delayed images. Coeliac angiography revealed a dilated intrahepatic vascular abnormality in the left lobe of the liver with late opacification of the portal vein. Contrast abdominal CT demonstrated the AAA and the dilated coeliac axis feeding a large vascular malformation in the lateral aspect of the left lobe of the liver. The arterial inflow was via the left hepatic artery and a large vein was seen leading into the left portal vein. Endoscopy showed no oesophageal varices. (authors). 11 refs., 7 figs.

  4. Venous Thromboembolism in Pediatric Vascular Anomalies

    Directory of Open Access Journals (Sweden)

    Taizo A. Nakano

    2017-07-01

    Full Text Available The presence of a vascular anomaly suggests that capillaries, veins, arteries, and/or lymphatic vessels have demonstrated abnormal development and growth. Often dilated and misshaped, these vessels augment normal flow of blood and lymphatic fluids that increases the overall risk to develop intralesional thrombosis. Abnormal endothelial and lymphoendothelial cells activate hemostasis and hyperfibrinolytic pathways through poorly understood mechanisms, which contribute to the development of localized intravascular coagulopathy. Vascular malformations, tumors, and complex combined syndromes demonstrate varying degrees of prothrombotic activity and consumptive coagulopathy depending on the vessels involved and the pattern and extent of abnormal growth. The clinical impact of venous thromboembolism in pediatric vascular anomalies varies from painful syndromes that disrupt quality of life to life-threatening embolic disease. There remains little literature on the study, evaluation, and treatment of thrombosis in pediatric vascular anomalies. However, there have been great advances in our ability to image complex lesions, to surgically and interventionally augment disease, and to provide enhanced supportive care including patient education, compression therapy, and strategic use of anticoagulation.

  5. Dual-Modality Activity-Based Probes as Molecular Imaging Agents for Vascular Inflammation

    NARCIS (Netherlands)

    Withana, N.P.; Saito, T.; Ma, X.; Garland, M.; Liu, C.; Kosuge, H.; Amsallem, M.; Verdoes, M.; Ofori, L.O.; Fischbein, M.; Arakawa, M.; Cheng, Z.; McConnell, M.V.; Bogyo, M.

    2016-01-01

    Macrophages are cellular mediators of vascular inflammation and are involved in the formation of atherosclerotic plaques. These immune cells secrete proteases such as matrix metalloproteinases and cathepsins that contribute to disease formation and progression. Here, we demonstrate that

  6. Subfascial involvement in glomuvenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, Raja; Alomari, Ahmad I.; Chaudry, Gulraiz [Boston Children' s Hospital, Division of Interventional Radiology, Boston, MA (United States); Mulliken, John B. [Boston Children' s Hospital, Division of Plastic Surgery, Boston, MA (United States); Fishman, Steven J. [Boston Children' s Hospital, Department of Surgery, Boston, MA (United States); Kozakewich, Harry P.W. [Boston Children' s Hospital, Department of Pathology, Boston, MA (United States)

    2014-07-15

    Glomuvenous malformation (GVM) is an inherited autosomal dominant trait. The lesions, which appear as bluish nodules or plaque-like cutaneous elevations, are usually tender and more firm than sporadic venous malformations. Conventionally, the lesions are thought to be limited to the cutaneous and subcutaneous tissue planes. The objective was to characterize the depth of involvement of GVM lesions. Magnetic resonance imaging (MRI) findings in GVM were retrospectively evaluated by two radiologists. The signal characteristics, tissue distribution, pattern of contrast enhancement of the lesions in GVM were documented. Thirty patients (19 female) aged 1-35 years (mean 18 years) were diagnosed with GVM based on clinical features (n = 20) and/or histopathological findings (n = 10). The lesions were present in the lower extremity (n = 15), upper extremity (n = 6), cervico-facial region (n = 6), pelvis (n = 2), and chest wall (n = 1). All patients had skin and subcutaneous lesions. Fifty percent of the patients (n = 15) demonstrated subfascial intramuscular (n = 15), intra-osseous (n = 1), and intra-articular involvement (n = 1). Contrary to the conventional belief that GVMs are generally limited to the skin and subcutaneous tissue, deep subfascial extension of the lesions is common. (orig.)

  7. Dandy-Walker Malformation

    African Journals Online (AJOL)

    rme

    Dandy-Walker variant consist of vermian hypoplasia and cystic dilttion of the fourth ventricle without enlargement of the posterior fossa. (Figure 1). Fig. 1: Dandy-Walker malformation. Dandy-. Walker variant in a 13-year-old girl with thoracal scoliosis. Sagittal T1-weighted MRI shows agenesis of the corpus callosum and a.

  8. Anorectal malformations in Africa

    African Journals Online (AJOL)

    Anorectal malformations (ARMs) remain a significant birth defect with an accepted incidence of approximately 0.2 -. 1.2%.1,2 Although major advances have occurred in the man- agement of these children during the last 15 years, ARMs remain a clinical challenge largely because of the significant reconstructive and ...

  9. A novel CCM1 mutation associated with multiple cerebral and vertebral cavernous malformations.

    Science.gov (United States)

    Lanfranconi, Silvia; Ronchi, Dario; Ahmed, Naghia; Civelli, Vittorio; Basilico, Paola; Bresolin, Nereo; Comi, Giacomo Pietro; Corti, Stefania

    2014-08-03

    Cerebral cavernous malformations are relatively rare vascular disorders that may affect any part of the central nervous system. This presentation has been associated with heterozygous mutations in CCM1/KRIT1, CCM2/malcavernin and CCM3/PDCD10. We aimed to investigate the genetic defect underlying multiple cerebral and vertebral cavernous malformations in a multigenerational Italian family. The proband is a 49-year-old man who underwent cerebral MRI in his thirties for persistent haeadache and tingling in his left arm and leg and was diagnosed with multiple supratentorial cavernous angiomas. A right frontal angioma with radiological evidence of a recent bleeding was surgically removed when he was 39 years old and he was thereafter asymptomatic. Magnetic resonance imaging revealed multiple cerebral cavernous malformations in seven members of his familily. Four subjects were asymptomatic. Other family mambers displayed heterogeneous clinical features including seizures and recurrent brain haemorrhages. Sequence analysis in the proband disclosed a novel heterozygous nucleotide substitution (c.263-10A > G) in intron 5 of CCM1. This variant is predicted to create an abnormal acceptor splice site and segregated in affected relatives available for molecular screening. The analysis of CCM1 transcript in proband's lymphocytes confirmed the partial retention of intron 3 resulting in a premature termination codon. Our findings demonstrate that c.263-10A > G mutation is associated with cerebral cavernous malformations. A better knowledge of the disease-associated phenotype may lead to an early diagnosis and to an appropriate clinical surveillance in affected patients.

  10. Paravertebral and Retroperitoneal Vascular Tumour Presenting with Kasabach-Merritt Phenomenon in Childhood, Diagnosed with Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Gonca Keskindemirci

    2015-01-01

    Full Text Available Kasabach-Merritt phenomenon (KMP is characterized by vascular tumour and consumptive coagulopathy with life-threatening thrombocytopenia, prolonged prothrombin time and partial thromboplastin time, hypofibrinogenemia, and the presence of high fibrin split products. We report a case of 3-year-old boy with local aggressive vascular lesions associated with KMP. Magnetic resonance imaging revealed an extensive lesion at paravertebral and retroperitoneal regions that was infiltrating vertebrae. Although we did not get any response to steroid or propranolol treatment, partial response was observed radiologically with interferon-alpha treatment. Unfortunately, the patient died because of the uncontrolled consumptive coagulopathy that led to intracranial hemorrhage which was caused by huge knee hematoma after minor trauma.

  11. Evaluation of magnetic resonance imaging for the differentiation of inflammatory, neoplastic, and vascular intradural spinal cord diseases in the dog.

    Science.gov (United States)

    Masciarelli, Amanda E; Griffin, John F; Fosgate, Geoffrey T; Hecht, Silke; Mankin, Joseph M; Holmes, Shannon P; Platt, Simon R; Kent, Marc; Pancotto, Theresa E; Chen, Annie V; Levine, Jonathan M

    2017-07-01

    Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi-institutional, retrospective, case-control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7-year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7-72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (ĸ = 0.882-0.833), and good (ĸ = 0.726-0.671) for diagnosing dogs with neoplasia. © 2017 American College of Veterinary Radiology.

  12. A case of lymphatic malformation/lymphangioma of the scrotum

    Directory of Open Access Journals (Sweden)

    Gensuke Akaike

    2012-04-01

    Full Text Available Lymphatic malformation/lymphangioma of the scrotum is rare. It is caused by lymphatic abnormalities and the most common sites are the neck and axilla. The scrotum is one of the most uncommon sites. We report the case of a 12-year-old boy with pathologically confirmed cystic lymphangioma/lymphatic malformation in the scrotum. The diagnosis was suspected from ultrasonography and magnetic resonance imaging. The most common cause of a cystic mass in the scrotum is scrotal hydrocele, but cystic lymphangioma/lymphatic malformation should be considered as a differential diagnosis for multicystic scrotal mass.

  13. A case of lymphatic malformation/lymphangioma of the scrotum.

    Science.gov (United States)

    Akaike, Gensuke; Nozaki, Taiki; Makidono, Akari; Saida, Yukihisa; Hirabayashi, Takeshi; Suzuki, Koyu

    2012-01-01

    Lymphatic malformation/lymphangioma of the scrotum is rare. It is caused by lymphatic abnormalities and the most common sites are the neck and axilla. The scrotum is one of the most uncommon sites. We report the case of a 12-year-old boy with pathologically confirmed cystic lymphangioma/lymphatic malformation in the scrotum. The diagnosis was suspected from ultrasonography and magnetic resonance imaging. The most common cause of a cystic mass in the scrotum is scrotal hydrocele, but cystic lymphangioma/lymphatic malformation should be considered as a differential diagnosis for multicystic scrotal mass.

  14. Update on neuroimaging phenotypes of mid-hindbrain malformations

    Energy Technology Data Exchange (ETDEWEB)

    Jissendi-Tchofo, Patrice [University Hospital of Lille (CHRU), Department of Neuroradiology, MRI 3T Research, Plateforme Imagerie du vivant, IMPRT-IFR 114, Lille-Cedex (France); CHU Saint-Pierre, Radiology Department, Pediatric Neuroradiology Section, Brussels (Belgium); Severino, Mariasavina [Istituto Giannina Gaslini, Neuroradiology Unit, Genoa (Italy); Nguema-Edzang, Beatrice; Toure, Cisse; Soto Ares, Gustavo [University Hospital of Lille (CHRU), Department of Neuroradiology, MRI 3T Research, Plateforme Imagerie du vivant, IMPRT-IFR 114, Lille-Cedex (France); Barkovich, Anthony James [University of California, Neuroradiology Section, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

    2014-10-23

    Neuroimaging techniques including structural magnetic resonance imaging (MRI) and functional positron emission tomography (PET) are useful in categorizing various midbrain-hindbrain (MHB) malformations, both in allowing diagnosis and in helping to understand the developmental processes that were disturbed. Brain imaging phenotypes of numerous malformations are characteristic features that help in guiding the genetic testing in case of direct neuroimaging-genotype correlation or, at least, to differentiate among MHB malformations entities. The present review aims to provide the reader with an update of the use of neuroimaging applications in the fine analysis of MHB malformations, using a comprehensive, recently proposed developmental and genetic classification. We have performed an extensive systematic review of the literature, from the embryology main steps of MHB development through the malformations entities, with regard to their molecular and genetic basis, conventional MRI features, and other neuroimaging characteristics. We discuss disorders in which imaging features are distinctive and how these features reflect the structural and functional impairment of the brain. Recognition of specific MRI phenotypes, including advanced imaging features, is useful to recognize the MHB malformation entities, to suggest genetic investigations, and, eventually, to monitor the disease outcome after supportive therapies. (orig.)

  15. Propranolol as an alternative treatment option for pediatric lymphatic malformation.

    Science.gov (United States)

    Ozeki, Michio; Kanda, Kaori; Kawamoto, Norio; Ohnishi, Hidenori; Fujino, Akihiro; Hirayama, Masahiro; Kato, Zenichiro; Azuma, Eiichi; Fukao, Toshiyuki; Kondo, Naomi

    2013-01-01

    Lymphatic malformation (LM), which was previously termed lymphangioma, is a rare congenital malformation of the lymphatic system and its treatment is still challenging. Propranolol (beta blocker) has been recently developed as a first-line treatment of infantile hemangioma. Our study aimed to assess the effect of propranolol on pediatric LM and the relationship between its effectiveness and vascular endothelial growth factor (VEGF) family members (VEGF-A, C and D). Six Japanese patients with LM (age range: 10 months-19 years old; 2 macrocystic, 2 microcystic and 2 combined type) were enrolled. Oral propranolol was administered at 2 mg/kg/day. The efficacy of propranolol for LM was evaluated by the rate of volume change as calculated from MRI imaging and by symptomatic improvement. In all patients, there were no significant side effects. Patients 3 and 5 were classified as objective responders with tumor volume reduction of 30.6% and 22.9%, respectively, at 24 weeks. Patient 1 showed 8% tumor volume reduction and patient 6 showed symptomatic improvement, hence, both were classified as minimal responders. The other two patients were classified as non-responders. Plasma VEGF-A, C, and D levels were significantly higher in the LM group than in the controls (all P < 0.01 by Mann-Whitney test). VEGF-A and D levels at 24 weeks were significantly lower than those at pre-treatment (P = 0.031, 0.047 by Wilcoxon matched pairs test). Though further trials with this treatment must be carried out, we propose that propranolol may be an alternative therapy option for intractable LM.

  16. Computed Tomography Angiography is the Definitive Vascular Imaging Modality for Penetrating Neck Injury: A South African Experience.

    Science.gov (United States)

    Madsen, A S; Kong, V Y; Oosthuizen, G V; Bruce, J L; Laing, G L; Clarke, D L

    2017-09-01

    Computed tomography angiography has become central to the diagnostic algorithm for penetrating neck injury, but despite its widespread use the literature to support this adoption is limited. We reviewed our experience with computed tomography angiography for the identification of vascular trauma in hemodynamically stable patients with penetrating neck injury at a major trauma center in South Africa. A prospectively kept trauma registry capturing data in real time was retrospectively reviewed. All patients with penetrating neck injury investigated with computed tomography angiography as the initial vascular investigation during a 47-month period were included. A total of 380 patients were included. Indications for computed tomography angiography were as follows: hard signs (13), soft signs (201), no signs but proximity/zone I or III wounds (141), and undefined signs of vascular injury (25). Of the 380 scans, 7 (1.8%) were indeterminate, 299 (78.7%) negative, and 74 (19.5%) positive for a vascular injury (54 arterial and 20 isolated venous injury). Eight were false positive and 4 false negative. The sensitivity, specificity, positive, and negative predictive values for detecting arterial injury were 93.9%, 97.5%, 85.2%, and 99.1%, respectively. Overall, the yield for demonstrating "true arterial injury" was 12.1% (46/380); hard signs: 76.9% (10/13), soft signs: 16.4% (33/201), and no signs: 2.1% (3/141) which all were secondary to gunshot wounds). Only 8.4% (32/380) required intervention for arterial injury and none for isolated venous injury (hard signs: 62.0%, soft signs: 11.4%, and no signs: 0.7%). No serious complications resulted from computed tomography angiography. Computed tomography angiography is a safe and effective imaging modality for the investigation of vascular trauma post penetrating neck injury. Asymptomatic patients with stab wounds do not need to be imaged regardless of proximity concerns. Symptomatic stable patients including a subgroup with hard

  17. Molecular imaging of the human pulmonary vascular endothelium in pulmonary hypertension: a phase II safety and proof of principle trial

    Energy Technology Data Exchange (ETDEWEB)

    Harel, Francois [Montreal Heart Institute, Research Center, Montreal, QC (Canada); Universite de Montreal, Department of Nuclear Medicine, Montreal, Quebec (Canada); Langleben, David; Abikhzer, Gad [McGill University, Lady Davis Institute and Jewish General Hospital, Montreal, Quebec (Canada); Provencher, Steve; Guimond, Jean [Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec (Canada); Fournier, Alain; Letourneau, Myriam [INRS-Institut Armand-Frappier, Laval, Quebec (Canada); Finnerty, Vincent; Nguyen, Quang T.; Levac, Xavier [Montreal Heart Institute, Research Center, Montreal, QC (Canada); Mansour, Asmaa; Guertin, Marie-Claude [Montreal Health Innovation Coordination Center, Montreal, QC (Canada); Dupuis, Jocelyn [Montreal Heart Institute, Research Center, Montreal, QC (Canada); Universite de Montreal, Department of Medicine, Montreal, Quebec (Canada)

    2017-07-15

    The adrenomedullin receptor is densely expressed in the pulmonary vascular endothelium. PulmoBind, an adrenomedullin receptor ligand, was developed for molecular diagnosis of pulmonary vascular disease. We evaluated the safety of PulmoBind SPECT imaging and its capacity to detect pulmonary vascular disease associated with pulmonary hypertension (PH) in a human phase II study. Thirty patients with pulmonary arterial hypertension (PAH, n = 23) or chronic thromboembolic PH (CTEPH, n = 7) in WHO functional class II (n = 26) or III (n = 4) were compared to 15 healthy controls. Lung SPECT was performed after injection of 15 mCi {sup 99m}Tc-PulmoBind in supine position. Qualitative and semi-quantitative analyses of lung uptake were performed. Reproducibility of repeated testing was evaluated in controls after 1 month. PulmoBind injection was well tolerated without any serious adverse event. Imaging was markedly abnormal in PH with ∝50% of subjects showing moderate to severe heterogeneity of moderate to severe extent. The abnormalities were unevenly distributed between the right and left lungs as well as within each lung. Segmental defects compatible with pulmonary embolism were present in 7/7 subjects with CTEPH and in 2/23 subjects with PAH. There were no segmental defects in controls. The PulmoBind activity distribution index, a parameter indicative of heterogeneity, was elevated in PH (65% ± 28%) vs. controls (41% ± 13%, p = 0.0003). In the only subject with vasodilator-responsive idiopathic PAH, PulmoBind lung SPECT was completely normal. Repeated testing 1 month later in healthy controls was well tolerated and showed no significant variability of PulmoBind distribution. In this phase II study, molecular SPECT imaging of the pulmonary vascular endothelium using {sup 99m}Tc-PulmoBind was safe. PulmoBind showed potential to detect both pulmonary embolism and abnormalities indicative of pulmonary vascular disease in PAH. Phase III studies with this novel tracer and

  18. Thin-slice T2 MRI imaging predicts vascular pathology in hemifacial spasm: a case-control study.

    Science.gov (United States)

    Sekula, Raymond F; Frederickson, Andrew M; Branstetter, Barton F; Oskin, James E; Stevens, Dale R; Zwagerman, Nathan T; Grandhi, Ramesh; Hughes, Marion A

    2014-09-01

    Hemifacial spasm (HFS) is a condition that may severely reduce patients' quality of life. We sought to determine the sensitivity and specificity of thin-slice T2 magnetic resonance imaging (MRI) for detecting vascular compression in HFS patients. Prospective information was collected on 28 patients with HFS who presented to our center between March 2011 and March 2012 with thin-slice T2 MR imaging. The sensitivity and specificity for differentiating patients from controls were calculated. Sensitivities were 78.6% and 92.9% for the blinded radiologists and 75% for the partially blinded neurosurgeon. Specificities were 42.9% and 28.6% for the blinded radiologists and 75% for the partially blinded neurosurgeon. Magnetic resonance imaging of the facial nerve can guide clinicians in selecting patients who are good surgical candidates. Thin-slice T2 MRI should be viewed as supportive rather than diagnostic. © 2014 International Parkinson and Movement Disorder Society.

  19. Simultaneous submicrometric 3D imaging of the micro-vascular network and the neuronal system in a mouse spinal cord

    CERN Document Server

    Fratini, Michela; Campi, Gaetano; Brun, Francesco; Tromba, Giuliana; Modregger, Peter; Bucci, Domenico; Battaglia, Giuseppe; Spadon, Raffaele; Mastrogiacomo, Maddalena; Requardt, Herwig; Giove, Federico; Bravin, Alberto; Cedola, Alessia

    2014-01-01

    Defaults in vascular (VN) and neuronal networks of spinal cord are responsible for serious neurodegenerative pathologies. Because of inadequate investigation tools, the lacking knowledge of the complete fine structure of VN and neuronal systems is a crucial problem. Conventional 2D imaging yields incomplete spatial coverage leading to possible data misinterpretation, whereas standard 3D computed tomography imaging achieves insufficient resolution and contrast. We show that X-ray high-resolution phase-contrast tomography allows the simultaneous visualization of three-dimensional VN and neuronal systems of mouse spinal cord at scales spanning from millimeters to hundreds of nanometers, with neither contrast agent nor a destructive sample-preparation. We image both the 3D distribution of micro-capillary network and the micrometric nerve fibers, axon-bundles and neuron soma. Our approach is a crucial tool for pre-clinical investigation of neurodegenerative pathologies and spinal-cord-injuries. In particular, it s...

  20. Cerebral cavernous malformations: From molecular pathogenesis to genetic counselling and clinical management

    NARCIS (Netherlands)

    R.A. Haasdijk (Remco Anton); C. Cheng (Caroline); A.A. Maat-Kievit (Anneke); H.J. Duckers (Henricus)

    2012-01-01

    textabstractCerebral cavernous (or capillary-venous) malformations (CCM) have a prevalence of about 0.1-0.5% in the general population. Genes mutated in CCM encode proteins that modulate junction formation between vascular endothelial cells. Mutations lead to the development of abnormal vascular

  1. Fetal MRI clues to diagnose cloacal malformations

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Patel, Manish N.; Kraus, Steven [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Levitt, Marc A.; Pena, Alberto [Cincinnati Children' s Hospital Medical Center, Colorectal Center for Children, Pediatric Surgery, Cincinnati, OH (United States); Lim, Foong-Yen; Crombleholme, Timothy M. [Cincinnati Children' s Hospital Medical Center, Fetal Care Center of Cincinnati, Pediatric Surgery, Cincinnati, OH (United States); Linam, Leann E. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States)

    2011-09-15

    Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis. To define the prenatal MRI findings in cloacal malformations. We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses. The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5-6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos. Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified. (orig.)

  2. Hydrocephalus in Dandy-Walker malformation.

    Science.gov (United States)

    Spennato, Pietro; Mirone, Giuseppe; Nastro, Anna; Buonocore, Maria Consiglio; Ruggiero, Claudio; Trischitta, Vincenzo; Aliberti, Ferdinando; Cinalli, Giuseppe

    2011-10-01

    Even if the first description of Dandy-Walker dates back 1887, difficulty in the establishment of correct diagnosis, especially concerning differential diagnosis with other types of posterior fossa CSF collection, still persists. Further confusion is added by the inclusion, in some classification, of different malformations with different prognosis and therapeutic strategy under the same label of "Dandy-Walker". An extensive literature review concerning embryologic, etiologic, pathogenetic, clinical and neuroradiological aspects has been performed. Therapeutic options, prognosis and intellectual outcome are also reviewed. The correct interpretation of the modern neuroradiologic techniques, including CSF flow MR imaging, may help in identifying a "real" Dandy-Walker malformation. Among therapeutical strategies, single shunting (ventriculo-peritoneal or cyst-peritoneal shunts) appears effective in the control of both ventricle and cyst size. Endoscopic third ventriculostomy may be considered an acceptable alternative, especially in older children, with the aim to reduce the shunt-related problems. Prognosis and intellectual outcome mostly depend on the presence of associated malformations, the degree of vermian malformation and the adequate control of hydrocephalus.

  3. Management of cerebral cavernous malformations in the pediatric population: a literature review and case illustrations.

    Science.gov (United States)

    Kosnik-Infinger, L; Carroll, C; Greiner, H; Leach, J; Mangano, F T

    2015-09-01

    Cavernous malformations (CM) are vascular malformations of the central nervous system that may occur in the brain and spinal cord. They are one of the four major types of vascular malformations that also includes developmental venous anomalies (DVA)s, arteriovenous malformations (AVMs), and capillary telangiectasias. CMs are a common vascular malformation, and 25% of them occur in the pediatric age group. They can present with acute or chronic symptoms including headache, neurologic deficits secondary to hemorrhage, mass effect, or epilepsy. This review will focus on the neurosurgical management of intracranial cavernous malformations in children. Pediatric CMs have special considerations different from CM that occur in the adult population which are highlighted throughout this review. Characteristics specific to pediatric CM epidemiology, genetics, presentation, pathology, location, size, epilepsy, and management will be discussed. Specific considerations must be entertained with the diagnosis of pediatric CM in that management needs to include consideration of the lifetime risk of hemorrhage, as well as the possibility of development of epilepsy. If in an accessible location, most cavernomas should be surgically removed in a timely fashion to provide lifelong cure for pediatric patients. The review closes with the discussion of two interesting cavernous malformation cases occurring in a 12-year old male and a 12-year old female that exhibit many of the important aspects specific to the management of a pediatric patient with CM, highlighting the importance of a multidisciplinary approach to treatment.

  4. A case of lymphatic malformation/lymphangioma of the scrotum

    OpenAIRE

    Gensuke Akaike; Taiki Nozaki; Akari Makidono; Yukihisa Saida; Takeshi Hirabayashi; Koyu Suzuki

    2012-01-01

    Lymphatic malformation/lymphangioma of the scrotum is rare. It is caused by lymphatic abnormalities and the most common sites are the neck and axilla. The scrotum is one of the most uncommon sites. We report the case of a 12-year-old boy with pathologically confirmed cystic lymphangioma/lymphatic malformation in the scrotum. The diagnosis was suspected from ultrasonography and magnetic resonance imaging. The most common cause of a cystic mass in the scrotum is scrotal hydrocele, but cystic ly...

  5. Embolization of a Traumatic Uterine Arteriovenous Malformation

    OpenAIRE

    Castillo, Monette S.; Borge, Marc A.; Pierce, Kenneth L.

    2007-01-01

    Uterine arteriovenous malformation (AVM) is a rare but potentially life-threatening source of bleeding. A high index of suspicion and accurate diagnosis of the condition in a timely manor are essential because instrumentation that is often used for other sources of uterine bleeding can lead to massive hemorrhage. Although angiography remains the gold standard for diagnosis, ultrasound (US) and magnetic resonance imaging (MRI) are the modalities of choice for the evaluation of a suspected AVM....

  6. SimVascular 2.0: an Integrated Open Source Pipeline for Image-Based Cardiovascular Modeling and Simulation

    Science.gov (United States)

    Lan, Hongzhi; Merkow, Jameson; Updegrove, Adam; Schiavazzi, Daniele; Wilson, Nathan; Shadden, Shawn; Marsden, Alison

    2015-11-01

    SimVascular (www.simvascular.org) is currently the only fully open source software package that provides a complete pipeline from medical image based modeling to patient specific blood flow simulation and analysis. It was initially released in 2007 and has contributed to numerous advances in fundamental hemodynamics research, surgical planning, and medical device design. However, early versions had several major barriers preventing wider adoption by new users, large-scale application in clinical and research studies, and educational access. In the past years, SimVascular 2.0 has made significant progress by integrating open source alternatives for the expensive commercial libraries previously required for anatomic modeling, mesh generation and the linear solver. In addition, it simplified the across-platform compilation process, improved the graphical user interface and launched a comprehensive documentation website. Many enhancements and new features have been incorporated for the whole pipeline, such as 3-D segmentation, Boolean operation for discrete triangulated surfaces, and multi-scale coupling for closed loop boundary conditions. In this presentation we will briefly overview the modeling/simulation pipeline and advances of the new SimVascular 2.0.

  7. ccm1 cell autonomously regulates endothelial cellular morphogenesis and vascular tubulogenesis in zebrafish.

    NARCIS (Netherlands)

    Hogan, B.M.; Bussmann, J.; Wolburg, H.; Schulte-Merker, S.

    2008-01-01

    Cerebral cavernous malformations (CCMs) are a prevalent class of vascular anomalies characterized by thin-walled clusters of malformed blood vessels in the brain. Heritable forms are caused by mutations in CCM1, CCM2 and CCM3, but despite the importance of these factors in vascular biology, an

  8. [Vascular "tumors" and the rules of their surgical management].

    Science.gov (United States)

    Enjolras, O; Deffrennes, D; Borsik, M; Diner, P; Laurian, C

    1998-08-01

    After defining vascular tumors and malformations, formerly called angiomas, the authors adopt the classification of the International Society for the Study of vascular Anomalies. The various groups of malformations, after definition of the subject and the problems raised, are illustrated by a number of clinical cases and the rules of surgical management are discussed. Capillary malformations, formerly called portwine stains, can be treated by dye laser, but sometimes tissue and orthognathic reconstructive surgery in the presence of a skeletal malformation. Lymphatic malformations (lymphangiomas), optimally assessed by CT or MRI, can be treated by a variety of approaches: sclerotherapy, surgery. Venous malformations raise very different problems in the cervicocephalic region and on the limbs and trunk, but always require a multidisciplinary approach with, according to the site, size and repercussions, Ethibloc percutaneous sclerotherapy, embolization, surgery. Arteriovenous malformations require complete surgical treatment, usually preceded by embolization; reconstruction consists of local flaps or skin expansion in simple cases, and revascularized free flaps in difficult cases. If the malformation is cosmetically and functionally acceptable, the authors propose conservative management. The first-line treatment of haemangiomas is pharmacological (corticosteroids, interferon), but surgery may be indicated in two situations: early and late. There is a renewed interest in early surgery, subtended by several factors including cosmetic concerns and the development of new technologies, including the Cavitron. Late surgery retains its classical cosmetic and functional indications. Two key-words dominate the rules of therapeutic management of all types of vascular malformations: a multidisciplinary approach and modesty.

  9. Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study.

    Science.gov (United States)

    Dolati, Parviz; Gokoglu, Abdulkerim; Eichberg, Daniel; Zamani, Amir; Golby, Alexandra; Al-Mefty, Ossama

    2015-01-01

    Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured. Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases. Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients.

  10. Microultrasound Molecular Imaging of Vascular Endothelial Growth Factor Receptor 2 in a Mouse Model of Tumor Angiogenesis

    Directory of Open Access Journals (Sweden)

    Joshua J. Rychak

    2007-09-01

    Full Text Available High-frequency microultrasound imaging of tumor progression in mice enables noninvasive anatomic and functional imaging at excellent spatial and temporal resolution, although microultrasonography alone does not offer molecular scale data. In the current study, we investigated the use of microbubble ultrasound contrast agents bearing targeting ligands specific for molecular markers of tumor angiogenesis using high-frequency microultrasound imaging. A xenograft tumor model in the mouse was used to image vascular endothelial growth factor receptor 2 (VEGFR-2 expression with microbubbles conjugated to an anti-VEGFR-2 monoclonal antibody or an isotype control. Microultrasound imaging was accomplished at a center frequency of 40 MHz, which provided lateral and axial resolutions of 40 and 90 μm, respectively. The B-mode (two-dimensional mode acoustic signal from microbubbles bound to the molecular target was determined by an ultrasound-based destruction-subtraction scheme. Quantification of the adherent microbubble fraction in nine tumor-bearing mice revealed significant retention of VEGFR-2-targeted microbubbles relative to control-targeted microbubbles. These data demonstrate that contrast-enhanced microultrasound imaging is a useful method for assessing molecular expression of tumor angiogenesis in mice at high resolution.

  11. Neurotology findings in patients with diagnosis of vascular loop of cranial nerves VIII in magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Grocoske, Francisco Luiz Busato

    Full Text Available Introduction: The vascular compression by redundant vessels under the VIII cranial nerves has been studied since the 80's, and many authors proposed correlations between the compression and the otoneurological findings (vertigo, tinnitus, hypoacusis, audiometry and electrophysiological findings. Objective: Analyze and correlate the different signs and otoneurological symptoms, the audiological findings and its incidence over individuals with Vascular Loop (VL diagnosis of VIII cranial nerves by magnetic resonance imaging (MRI. Method: Retrospective study through the analysis of medical records of 47 patients attended in the otoneurology clinic of Clinical Hospital of UFPR. All the patients have MRI exams with compatible pictures of VL of the VIII cranial nerves. Results: The tinnitus was the most frequent symptom, in 83% of the patients, followed by hypoacusis (60% and vertigo (36%. The audiometry presented alterations in 89%, the brainstem evoked auditory potential in 33% and the vecto-electronystagmography in 17% of the patients. Was not found statistically significant relation between the buzz or hypoacusis, and the presence of VL in MRI. Only 36% of patients had complaints of vertigo, the main symptom described in theory of vascular compression of the VIII pair of nerve. As in the audiometry and in brainstem evoked auditory potential was not found a statistically significant relation between the exam and the presence of the VL in the RMI. Conclusion: The results show independence between the findings of the RMI, clinical picture and audiological results (p>0,05 suggesting that there are no exclusive and direct relation between the diagnosis of vascular loop in the MRI and the clinical picture matching.

  12. Management of bleeding uterine arteriovenous malformation with bilateral uterine artery embolization.

    Science.gov (United States)

    Kim, Taehwan; Shin, Ji Hoon; Kim, Jinoo; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong-Il; Yang, Heechul; Sung, Kyu-Bo

    2014-03-01

    To evaluate the technical feasibility and clinical outcome of bilateral uterine artery embolization (UAE) as a first-line therapeutic option for bleeding uterine arteriovenous malformation (AVM). Between 2002 and 2012, 19 patients were diagnosed with acquired uterine AVM clinically and through imaging studies. The clinical characteristics, angiographic features, technical success rate of embolization, procedure-related complications, imaging, and clinical follow-up data were assessed. Clinical success was defined as immediate symptomatic resolution with disappearance of vascular abnormality on subsequent imaging studies. A total of 20 bilateral UAE, with or without embolization of extra-uterine feeders, were performed as the first-line treatment. Technical and clinical success rate was 90.0% (18/20) and 89.5% (17/19), respectively. Embolization was incomplete in two patients who had residual extra-uterine fine feeders to the AVM or a procedure- related complication (ruptured uterine artery); the former showed slow regression of the vascular malformation during the observation period, while the latter underwent a successful second bilateral UAE. Immediate clinical success was achieved in the remaining 17 patients after a single session and no recurrence of bleeding was found. Recovery to normal menstrual cycle was seen in all 17 patients with clinical success within one or two months, two of whom subsequently had uneventful intrauterine pregnancies carried to term. Bilateral UAE is a safe and effective first-line therapeutic option for the management of bleeding uterine AVMs. However, incomplete embolization due to unembolizable feeders or difficult access into the uterine artery may lead to suboptimal treatment.

  13. MR imaging quantitative analysis of fetal Chiari II malformations and associated open neural tube defects: balanced SSFP versus half-Fourier RARE and interobserver reliability.

    Science.gov (United States)

    Abele, Travis A; Lee, Stacy L; Twickler, Diane M

    2013-10-01

    To evaluate bSSFP (balanced steady state free precession) and half-Fourier RARE (rapid acceleration with relaxation enhancement) MRI sequences in their ability to demonstrate fetal anatomic landmarks, quantify the degree of cerebellar herniation in Chiari II malformations and level and length of the associated open neural tube defects, as well as evaluate interobserver reliability of these measurements. Two independent observers retrospectively reviewed MRIs of 37 fetuses with Chiari II malformations and associated open neural tube defects (mean gestational age: 27 weeks 2 days). Comparison of bSSFP and RARE included: (i) Ability to confidently identify anatomic landmarks of the posterior fossa and spine; (ii) Measurements of the foramen magnum, cerebellar tonsillar herniation length, intervertebral disc space level of tonsillar herniation, open neural tube defect length, and disc space start and end level of the open neural tube defect; (iii) Observed conspicuity of anatomic landmarks. There was no significant difference in assessment of cerebellar tonsillar herniation or open neural tube defect level between bSSFP and RARE for either observer. Intervertebral discs were more conspicuous on bSSFP while cerebellar tonsils were more conspicuous on RARE (P neural tube defect length (r = 0.97, 0.96). Despite improved conspicuity of the intervertebral discs with bSSFP and cerebellar tonsils with RARE, there is no significant difference in measurement of hindbrain herniation or open neural tube defect level; interobserver reliability is excellent for both sequences. Copyright © 2013 Wiley Periodicals, Inc.

  14. Cerebral Cavernous Malformation and Hemorrhage

    Science.gov (United States)

    ... or neurosurgeon that is familiar with your neurological history and who is knowledgeable about cavernous malformations and about epilepsy in pregnancy. Preventative Measures and Other Considerations So ...

  15. Multimodal magnetic resonance diagnostics of arteriovenous malformations; Multimodale MR-Diagnostik arteriovenoeser Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Essig, M. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie, Heidelberg (Germany)

    2007-10-15

    Arteriovenous malformations (AVM) are complex inborn malformations of the vascular system. In the brain they can lead to severe complications, such as parenchymal haemorrhaging, epileptic seizures or neurologic failure, which necessitates a safe diagnosis and therapy. In addition to conventional angiography, magnetic resonance imaging (MRI) and MR angiography (MRA) have now been established as the gold standard diagnostic procedures. Using MRA the angioarchitecture of malformations can be captured and with a parallel imaging of the parenchyme the method is very well suited for therapy planning and monitoring. This review summarizes the present day possibilities of multimodal MRT diagnosis of AVM and describes the purely morphologic as well as the physiologic and pathophysiologic characteristics. The various MR angiographic techniques will be firstly described with respect to the basic technical principles and the results obtained so far will be summarized. The principle of functional MRT will be described and the diagnostic possibilities with respect to AVM will be discussed. (orig.) [German] Arteriovenoese Malformationen sind komplexe, angeborene Fehlbildungen des Gefaesssystems. Im Gehirn koennen sie zu schwerwiegenden Komplikationen wie Parenchymblutungen, Anfallsleiden oder neurologischen Ausfaellen fuehren, was eine sichere Diagnostik und Therapie bedingt. Neben der konventionellen Angiographie als Goldstandard haben sich Magnetresonanztomographie (MRT) und MR-Angiographie (MRA) als diagnostische Verfahren etabliert. Die MRA erlaubt es, die Angioarchitektur der Malformationen zu erfassen, und durch die parallele Abbildung des Parenchyms ist die Methode sehr gut fuer Therapieplanung und Verlaufsbeurteilung geeignet. Diese Uebersichtsarbeit fasst die heutigen Moeglichkeiten einer multimodalen MRT-Diagnostik arteriovenoeser Malformationen zusammen, und zwar mit einem besonderen Schwerpunkt auf moderne, so genannte funktionelle MR-Techniken, die neben der reinen

  16. Delayed presentation of an arteriovenous malformation after cerebellar hemangioblastoma resection-Case report.

    Science.gov (United States)

    Bennett, E Emily; Otvos, Balint; Kshettry, Varun R; Gonzalez-Martinez, Jorge

    2016-01-01

    Haemangioblastoma has been uncommonly reported to occur in coexistence either temporally or spatially with the development of an arteriovenous malformations (AVM). We present a case of a delayed AVM following haemangioblastoma resection. 44 year old female initially presented with a several week history of headaches, vertigo and nausea and emesis and was found to have a cystic lesion with a solid enhancing component on Magnetic Resonance Imaging (MRI) in the superior aspect of the vermis. She underwent gross total resection and final pathology was consistent with WHO grade I haemangioblastoma. One year later, patient re-presented with headaches, dizziness and left trochlear nerve palsy with rotary nystagmus. Imaging revealed a left posterior tentorial paramedian cerebellar vascular nidus with venous drainage into the left transverses sinus suspicious for arteriovenous malformation. She underwent gross total resection of the lesion. Final pathology confirmed the diagnosis of an arteriovenous malformation. Recent research supports both haemangioblastoma and AVM are of embryologic origin but require later genetic alterations to develop into symptomatic lesions. It is unclear in our case if the AVM was present at the time of the initial haemangioblastoma resection or developed de novo after tumor resection. However, given the short time between tumor resection and presentation of AVM, de novo AVM although possible, appears less likely. AVM and haemangioblastoma rarely presents together either temporally or spatially. We present a case of a delayed AVM following haemangioblastoma resection. More research is needed to elucidate the rare intermixture of these lesions. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.