-
Journal of Neuroinflammation Mar 2023Recent literature on multiple sclerosis (MS) demonstrates the growing implementation of optical coherence tomography-angiography (OCT-A) to discover potential... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND OBJECTIVES
Recent literature on multiple sclerosis (MS) demonstrates the growing implementation of optical coherence tomography-angiography (OCT-A) to discover potential qualitative and quantitative changes in the retina and optic nerve. In this review, we analyze OCT-A studies in patients with MS and examine its utility as a surrogate or precursor to changes in central nervous system tissue.
METHODS
PubMed and EMBASE were systematically searched to identify articles that applied OCT-A to evaluate the retinal microvasculature measurements in patients with MS. Quantitative data synthesis was performed on all measurements which were evaluated in at least two unique studies with the same OCT-A devices, software, and study population compared to controls. A fixed-effects or random-effects model was applied for the meta-analysis based on the heterogeneity level.
RESULTS
The study selection process yielded the inclusion of 18 studies with a total of 1552 evaluated eyes in 673 MS-associated optic neuritis (MSON) eyes, 741 MS without optic neuritis (MSNON eyes), and 138 eyes without specification for the presence of optic neuritis (ON) in addition to 1107 healthy control (HC) eyes. Results indicated that MS cases had significantly decreased whole image superficial capillary plexus (SCP) vessel density when compared to healthy control subjects in the analyses conducted on Optovue and Topcon studies (both P < 0.0001). Likewise, the whole image vessel densities of deep capillary plexus (DCP) and radial peripapillary capillary (RPC) were significantly lower in MS cases compared to HC (all P < 0.05). Regarding optic disc area quadrants, MSON eyes had significantly decreased mean RPC vessel density compared to MSNON eyes in all quadrants except for the inferior (all P < 0.05). Results of the analysis of studies that used prototype Axsun machine revealed that MSON and MSNON eyes both had significantly lower ONH flow index compared to HC (both P < 0.0001).
CONCLUSIONS
This systematic review and meta-analysis of the studies reporting OCT-A measurements of people with MS confirmed the tendency of MS eyes to exhibit reduced vessel density in the macular and optic disc areas, mainly in SCP, DCP, and RPC vessel densities.
Topics: Humans; Tomography, Optical Coherence; Multiple Sclerosis; Retina; Angiography; Retinal Vessels; Optic Neuritis; Fluorescein Angiography
PubMed: 36973708
DOI: 10.1186/s12974-023-02763-4 -
Clinical & Experimental Optometry May 2019Optical coherence tomography angiography (OCT-A) is an emerging technology that allows for the non-invasive imaging of the ocular microvasculature. Despite the wealth of... (Review)
Review
Optical coherence tomography angiography (OCT-A) is an emerging technology that allows for the non-invasive imaging of the ocular microvasculature. Despite the wealth of observations and numerous research studies illustrating the potential clinical uses of OCT-A, this technique is currently rarely used in routine clinical settings. In this review, technical and clinical aspects of OCT-A imaging are discussed, and the future clinical potential of OCT-A is considered. An understanding of the basic principles and limitations of OCT-A technology will better inform clinicians of its future potential in the diagnosis and management of ocular diseases.
Topics: Angiography; Diagnostic Techniques, Ophthalmological; Eye; Forecasting; Humans; Microvessels; Tomography, Optical Coherence
PubMed: 30537233
DOI: 10.1111/cxo.12854 -
The Journal of Thoracic and... Jul 2018
Topics: Coronary Angiography; Coronary Vessels; Heart
PubMed: 29754787
DOI: 10.1016/j.jtcvs.2018.03.132 -
Interactive Cardiovascular and Thoracic... Mar 2022The B3 downwards-shifting malformation was first proposed by Boyden in 1950. Here, we report 14 cases of this malformation in the right lung and the first case of...
OBJECTIVES
The B3 downwards-shifting malformation was first proposed by Boyden in 1950. Here, we report 14 cases of this malformation in the right lung and the first case of segmentectomy for this malformation.
METHODS
All patients with pulmonary lesions underwent three-dimensional computed tomography bronchography and angiography (3D-CTBA) between January 2019 and January 2020, prior to surgery. A consecutive 2356 patients were included, and 14 cases of this malformation were identified; bronchovascular patterns were analysed in each patient.
RESULTS
The incidence of this malformation was 0.6%. It was further divided into 3 types: over downwards-shift, partial downwards-shift and normal downwards-shift. The normal downwards-shift type was the most common (8/14), where B3 shifted downwards completely to merge with B4 + 5. In the partial downwards-shift (5/14), only part of the B3 shifted. In the over downwards-shift type (1/14), both B3 and B1b shifted downwards. A bifurcated right upper lobe (RUL) bronchus (B1 defective) was observed in 3 cases. The incidence of V1a, V1b, V2a, V2b, V2c, V3a, V3b and V3c was 100% (14/14). The incidence rates of A1, A3a and A3b were 100% (14/14). The incidence of A2 rec and A2 asc was 92.9% (13/14) and 71.4% (10/14), respectively.
CONCLUSIONS
The B3 downwards-shifting malformation or 'Boyden's triad' is a rare anomaly. Anatomical exploration of this malformation is important for surgery.
Topics: Angiography; Bronchi; Bronchography; Humans; Lung; Tomography, X-Ray Computed
PubMed: 34791266
DOI: 10.1093/icvts/ivab325 -
Cardiovascular Journal of Africa 2016Pregnant women with known or suspected cardiovascular disease (CVD) often require cardiovascular imaging during pregnancy. The accepted maximum limit of ionising... (Review)
Review
Pregnant women with known or suspected cardiovascular disease (CVD) often require cardiovascular imaging during pregnancy. The accepted maximum limit of ionising radiation exposure to the foetus during pregnancy is a cumulative dose of 5 rad. Concerns related to imaging modalities that involve ionising radiation include teratogenesis, mutagenesis and childhood malignancy. Importantly, no single imaging study approaches this cautionary dose of 5 rad (50 mSv or 50 mGy). Diagnostic imaging procedures that may be used in pregnancy include chest radiography, fluoroscopy, echocardiography, invasive angiography, cardiovascular computed tomography, computed tomographic pulmonary angiography, cardiovascular magnetic resonance (CMR) and nuclear techniques. Echocardiography and CMR appear to be completely safe in pregnancy and are not associated with any adverse foetal effects, provided there are no general contra-indications to MR imaging. Concerns related to safety of imaging tests must be balanced against the importance of accurate diagnosis and thorough assessment of the pathological condition. Decisions about imaging in pregnancy are premised on understanding the physiology of pregnancy, understanding basic concepts of ionising radiation, the clinical manifestations of existent CVD in pregnancy and features of new CVD. The cardiologist/physician must understand the indications for and limitations of, and the potential harmful effects of each test during pregnancy. Current evidence suggests that a single cardiovascular radiological study during pregnancy is safe and should be undertaken at all times when clinically justified. In this article, the different imaging modalities are reviewed in terms of how they work, how safe they are and what their clinical utility in pregnancy is. Furthermore, the safety of contrast agents in pregnancy is also reviewed.
Topics: Angiography; Echocardiography; Female; Fetus; Heart Diseases; Humans; Pregnancy; Radiography, Thoracic; Thorax
PubMed: 27213857
DOI: 10.5830/CVJA-2016-022 -
Magma (New York, N.Y.) Oct 2020Coronary magnetic resonance angiography (coronary MRA) is advantageous in its ability to assess coronary artery morphology and function without ionizing radiation or... (Review)
Review
Coronary magnetic resonance angiography (coronary MRA) is advantageous in its ability to assess coronary artery morphology and function without ionizing radiation or contrast media. However, technical limitations including reduced spatial resolution, long acquisition times, and low signal-to-noise ratios prevent it from clinical routine utilization. Nonetheless, each of these limitations can be specifically addressed by a combination of novel technologies including super-resolution imaging, compressed sensing, and deep-learning reconstruction. In this paper, we first review the current clinical use and motivations for non-contrast coronary MRA, discuss currently available coronary MRA techniques, and highlight current technical developments that hold unique potential to optimize coronary MRA image acquisition and post-processing. In the final section, we examine the various research-based coronary MRA methods and metrics that can be leveraged to assess coronary stenosis severity, physiological function, and atherosclerotic plaque characterization. We specifically discuss how such technologies may contribute to the clinical translation of coronary MRA into a robust modality for routine clinical use.
Topics: Contrast Media; Coronary Angiography; Coronary Vessels; Heart; Magnetic Resonance Angiography
PubMed: 32242282
DOI: 10.1007/s10334-020-00834-8 -
The Neuroradiology Journal Feb 2015Advances in imaging modalities have improved the assessment of intracranial hemodynamics using non-invasive techniques. This review examines new imaging modalities and... (Review)
Review
Advances in imaging modalities have improved the assessment of intracranial hemodynamics using non-invasive techniques. This review examines new imaging modalities and clinical applications of currently available techniques, describes pathophysiology and future directions in hemodynamic analysis of intracranial stenoses, aneurysms and arteriovenous malformations and explores how hemodynamic analysis may have prognostic value in predicting clinical outcomes and assist in risk stratification. The advent of new technologies such as pseudo-continuous arterial spin labeling, accelerated magnetic resonance angiography (MRA) techniques, 4D digital subtraction angiography, and improvements in clinically available techniques such as phase-contrast MRA may change the landscape of vascular imaging and modify current clinical practice guidelines.
Topics: Angiography, Digital Subtraction; Brain Ischemia; Central Nervous System Vascular Malformations; Cerebral Angiography; Cerebrovascular Circulation; Four-Dimensional Computed Tomography; Hemodynamics; Humans; Intracranial Aneurysm; Intracranial Hemorrhages; Magnetic Resonance Angiography; Stroke
PubMed: 25924168
DOI: 10.15274/NRJ-2014-10115 -
Clinical Neuroradiology Jun 2021Simulators are increasingly used in the training of endovascular procedures; however, for the use of the Mentice vascular interventional system trainer (VIST) simulator...
PURPOSE
Simulators are increasingly used in the training of endovascular procedures; however, for the use of the Mentice vascular interventional system trainer (VIST) simulator in neuroradiology, the validity of the method has not yet been proven. The study was carried out to test the construct validity of such a simulator by demonstrating differences between beginner and expert neurointerventionalists and to evaluate whether a training effect can be demonstrated in repeated cases for different levels of experience.
METHODS
In this study 4 experts and 6 beginners performed 10 diagnostic angiographies on the VIST simulator (Mentice AB, Gothenburg, Sweden). Of the cases four were non-recurring, whereas three were repeated once and ten subjects performed all tasks. Additionally, another expert performed only five non-recurring cases. The simulator recorded total time, fluoroscopy time, amount of contrast medium and number of material changes. Furthermore, gaze direction and heart rate were recorded, and subjects completed a questionnaire on workload.
RESULTS
Beginners and experts showed significant differences in total duration time, fluoroscopy time and amount of contrast agent (all p < 0.05). Gaze direction, dwell time and heart rate were similar between both groups. Only beginners improved during training with respect to total duration time, fluoroscopy time and amount of contrast agent. If a case was previously known to them, the total duration and fluoroscopy time were significantly shortened (p < 0.001).
CONCLUSION
This study demonstrated both the construct validity of a diagnostic neuroangiography simulator as well as a significant training effect for beginners. Therefore, in particular beginner neurointerventionalists should use such simulation tools more extensively in their initial training.
Topics: Angiography; Clinical Competence; Computer Simulation; Fluoroscopy; Humans; Simulation Training; User-Computer Interface
PubMed: 32303789
DOI: 10.1007/s00062-020-00902-5 -
Journal of Glaucoma Jun 2022Face mask wearing has no significant effects on artifacts or vessel density measurements in optic nerve head (ONH) and macular optical coherence tomography-angiography...
PRCIS
Face mask wearing has no significant effects on artifacts or vessel density measurements in optic nerve head (ONH) and macular optical coherence tomography-angiography (OCT-A) scans.
PURPOSE
The aim was to assess the difference in area of artifacts observed in optical OCT-A scans with and without face mask wear and to verify if mask wear interferes with OCT-A vessel density measurements.
SUBJECTS AND CONTROLS
A total of 64 eyes of 10 healthy subjects, 4 ocular hypertensive, 8 glaucoma suspects, and 17 glaucoma patients were included.
MATERIALS AND METHODS
High-density ONH and macula OCT-A scans were obtained in patients with and without surgical masks. Seven different artifacts (motion, decentration, defocus, shadow, segmentation failure, blink, and Z-offset) were quantitatively evaluated by 2 trained graders. The changes in the area (% of scan area) of artifacts, without and with mask wearing, and differences of vessel density were evaluated.
RESULTS
Trends of increasing motion artifact area for the ONH scans [4.23 (-0.52, 8.98) %, P=0.08] and defocus artifact area for the macular scans [1.06 (-0.14, 2.26) %, P=0.08] were found with face mask wear. However, there were no significant differences in the mean % area of any artifacts (P>0.05 for all). Further, the estimated mean difference in vessel density in images acquired without and with masks was not significant for any type of artifact.
CONCLUSION
Face mask wearing had no significant effect on area of artifacts or vessel density measurements. OCT-A vessel density measurements can be acquired reliably with face mask wear during the pandemic.
Topics: Angiography; Artifacts; COVID-19; Fluorescein Angiography; Glaucoma; Humans; Intraocular Pressure; Masks; Pandemics; Retinal Vessels; Tomography, Optical Coherence
PubMed: 35320142
DOI: 10.1097/IJG.0000000000002019 -
Survey of Ophthalmology 2023An array of retinochoroid imaging modalities aid in comprehensive evaluation of the immunopathological changes in the retina and choroid, forming the core component for... (Review)
Review
An array of retinochoroid imaging modalities aid in comprehensive evaluation of the immunopathological changes in the retina and choroid, forming the core component for the diagnosis and management of inflammatory disorders such as uveitis. The recent technological breakthroughs have led to the development of imaging platforms that can evaluate the layers of retina and choroid and the structural and functional alteration in these tissues. Ophthalmologists heavily rely on imaging modalities such as dye-based angiographies (fluorescein angiography and indocyanine green angiography), optical coherence tomography, fundus autofluorescence, as well as dye-less angiography such as optical coherence tomography angiograph,y for establishing a precise diagnosis and understanding the pathophysiology of the diseases. Furthermore, these tools are now being deployed with a 'multimodal' approach for swift and accurate diagnosis. In this comprehensive review, we outline the imaging platforms used for evaluation of posterior uveitis and discuss the organized, algorithmic approach for the assessment of the disorders. Additionally, we provide an insight into disease-specific characteristic pathological changes and the established strategies to rule out disorders with overlapping features on imaging.
Topics: Humans; Multimodal Imaging; Uveitis, Posterior; Uveitis; Fluorescein Angiography; Fundus Oculi; Tomography, Optical Coherence; Choroid
PubMed: 36724831
DOI: 10.1016/j.survophthal.2023.01.006