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BMC Pulmonary Medicine Nov 2022Massive hemoptysis is a rare but potentially life-threatening condition of patients with cystic fibrosis (CF) and advanced pulmonary disease. Hypertrophied bronchial...
BACKGROUND
Massive hemoptysis is a rare but potentially life-threatening condition of patients with cystic fibrosis (CF) and advanced pulmonary disease. Hypertrophied bronchial arteries are understood to cause massive hemoptysis when rupturing. Risk factors to predict massive hemoptysis are scarce and bronchial artery diameters are not part of any scoring system in follow-up of patients with CF. Aim of this study was to correlate bronchial artery diameter with massive hemoptysis in CF.
METHODS
Bronchial artery and non-bronchial systemic artery diameters were measured in contrast enhanced computed tomography (CT) scans in patients with massive hemoptysis and compared to patients with end-stage CF and no history of hemoptysis. Demographic and clinical data and side of bronchial artery/non-bronchial systemic artery hypertrophy and coil embolization were documented.
RESULTS
In this retrospective multicenter study 33 patients with massive hemoptysis were included for bronchial artery/non-bronchial systemic artery diameter measurements, (13 female, 20 male, median age 30 years (18-55)). Bronchial artery diameters were significantly larger in the case group than in the control group with median 4 mm (2.2-8.2 mm), and median 3 mm (1-7 mm), respectively (p = 0.002). Sensitivity of bronchial arteries ≥ 3.5 mm to be associated with hemoptysis was 0.76 and specificity 0.71 with ROC creating an area under the curve of 0.719. If non-bronchial systemic arteries were present, they were considered culprit and embolized in 92% of cases.
CONCLUSION
Bronchial arteries ≥ 3.5 mm and presence of hypertrophied non-bronchial systemic arteries correlate with massive hemoptysis in patients with CF and might serve as risk predictor for massive hemoptysis. Therefore, in patients with advanced CF we propose CT scans to be carried out as CT angiography to search for bronchial arteries ≥ 3.5 mm and for hypertrophied non-bronchial systemic arteries as possible risk factors for massive hemoptysis.
Topics: Humans; Male; Female; Adult; Bronchial Arteries; Cystic Fibrosis; Embolization, Therapeutic; Hemoptysis; Angiography
PubMed: 36397043
DOI: 10.1186/s12890-022-02233-2 -
International Ophthalmology Dec 2021To quantitatively evaluate the possible effects of phacoemulsification cataract surgery on macular hemodynamics using optical coherence tomography angiography (OCTA). (Observational Study)
Observational Study
PURPOSE
To quantitatively evaluate the possible effects of phacoemulsification cataract surgery on macular hemodynamics using optical coherence tomography angiography (OCTA).
METHODS
This was a prospective observational study. Superficial and deep macular vascular densities, as well as parameters of foveal avascular zone (FAZ), were measured preoperatively (baseline) and at 1 day, 1 week, and 4 weeks postoperatively in normal eyes (≥ 22 mm and ≤ 24 mm) of patients scheduled for phacoemulsification cataract surgery with intraocular lens implantation. The correlations between the rate of change of pre- and postoperative vascular densities and surgical parameters were analyzed.
RESULTS
A total of 107 eyes of 107 patients were included in this study. Compared to the baseline measurements, no statistically significant variation was found in macular vascular densities at 1 day after the surgery (P > 0.05). Both superficial and deep macular vascular densities were significantly increased postoperatively at weeks 1 and week 4 (P < 0.05; P < 0.05); however, no statistically significant differences were detected in any of the FAZ parameters between the baseline measurements and the entire follow-up period (P > 0.05 for all). Also, no statistically significant correlations were established between main surgical parameters and macular vascular densities changes.
CONCLUSIONS
In normal eyes, macular blood perfusion gradually increased after phacoemulsification cataract surgery and was stabilized in one week. The foveal avascular zone was stabilized before and after the surgery. The main parameters and intraoperative perfusion of phacoemulsification surgery may not be the key factors affecting macular hemodynamics.
Topics: Angiography; Cataract; China; Fluorescein Angiography; Hemodynamics; Humans; Phacoemulsification; Tomography, Optical Coherence; Visual Acuity
PubMed: 34350527
DOI: 10.1007/s10792-021-01987-8 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2021A 42-year-old male was admitted for paroxysmal syncope for 10 months, chest tightness for 20 days and chest pain for 10 days. The patient was diagnosed with... (Review)
Review
A 42-year-old male was admitted for paroxysmal syncope for 10 months, chest tightness for 20 days and chest pain for 10 days. The patient was diagnosed with hypertrophic cardiomyopathy. The patient did not have a history of hypertension or diabetes. Coronary angiography and left ventricular cardiac catheterization were done in order to examine the coronary artery and the pressure gradient of the left ventricular outflow tract. The cardiac catheterization was performed via a right radial artery approach and a total of 200 mL of 370 mg I/mL iopromide was injected. The patient developed contrast-induced encephalopathy following the cardiac catheterization procedure, displaying severe headache, cortical blindness and neuropsychiatric symptom as the main clinical manifestations. The patient was then given symptomatic and supportive treatment, including decreasing intracranial pressure, analgesics and sedatives, and the patient recovered.
Topics: Adult; Brain Diseases; Cardiomyopathy, Hypertrophic; Coronary Angiography; Humans; Iohexol; Male
PubMed: 34018376
DOI: 10.12182/20210560508 -
Radiological Physics and Technology Mar 2022In this article, we review automatic brightness control (ABC) for fluoroscopy imaging systems. Starting from the simple manual control, the discussion is extended to the... (Review)
Review
In this article, we review automatic brightness control (ABC) for fluoroscopy imaging systems. Starting from the simple manual control, the discussion is extended to the kV-primary ABC system, and then to the most recent contrast-to-noise ratio optimized (CNR Optimized) automatic dose rate control system (ADRC). The nature of this review article is trifold. First, it describes the ABC/ADRC and associated circuits governing the operation of the fluoroscopy imaging chain. Second, we show the characteristics of a control logic from a radiation physics point of view. Third, we introduce the most recent activities in the evaluation of CNR-optimized fluoroscopy systems and the phantom design that would be compatible with the design concept of the ADRC. Because of these three subject items in the discussion process, this article is also educational in nature written for medical physicists and radiological technologists who might be less familiar with the design concept of fluoroscopy operation, specifically on the ABC and ADRC. We insert a few related matters associated with fluoroscopy automatic control circuits where they seem applicable and appropriate to enhance the understanding of fluoroscopy operation logic.
Topics: Angiography; Fluoroscopy; Logic; Phantoms, Imaging; Radiation Dosage
PubMed: 35050444
DOI: 10.1007/s12194-022-00649-3 -
Clinical Imaging Sep 2023The objective is to show that TR-MRA is a useful non-invasive technique without ionizing radiation of traditional angiography in evaluating VMs. (Review)
Review
PURPOSE
The objective is to show that TR-MRA is a useful non-invasive technique without ionizing radiation of traditional angiography in evaluating VMs.
MATERIALS AND METHODS
Retrospective search utilizing M-Power for MRA studies done at 3 T (Trio, Siemens) with both 3D contrast enhanced TR-MRA and 3D CE-MRA sequences from 2009 to 2018 were obtained after IRB approval. The images were blindly reviewed by two experienced cardiovascular radiologists for informations regarding vascular malformations with the ability to separate arteries and veins without any overlay or contamination in real time. Both TR-MRA and 3D CE-MRA images were carefully evaluated. The following characteristics: flow rate, size, type, feeding vessels, draining vessels and clots were evaluated. The findings were then compared to the Catheter Angiography for the patients that had catheter angiography study.
RESULTS
The M-Power search resulted a total of 69 patients (24 males, 45 females, age range 11 days to 74 years). Of those 69, there were 25 patients with confirmatory Catheter Angiography study. The radiologists characterized VMs as 19 high flow VMs, 47 slow flow VMs, 2 lymphatic malformations and 1 no flow VM. Of those with Cath, there was 100% concordance with the TR-MRA.
CONCLUSION
TR-MRA provides functional characterization of a VM that cannot be determined with CE-MRA alone. This is critical in treatment planning with high-flow VMs.
Topics: Male; Female; Humans; Infant, Newborn; Magnetic Resonance Angiography; Retrospective Studies; Angiography, Digital Subtraction; Vascular Malformations; Veins; Contrast Media
PubMed: 37364365
DOI: 10.1016/j.clinimag.2023.06.010 -
Pediatric Cardiology Jan 2023The aim of the study was to determine the variables associated with high-quality (HQ) versus low-quality (LQ) three-dimensional rotational angiography (3DRA) and create...
The aim of the study was to determine the variables associated with high-quality (HQ) versus low-quality (LQ) three-dimensional rotational angiography (3DRA) and create guides for optimization of approach to 3DRA in congenital cardiac catheterization (CCC). CCC has adopted 3DRA as a mainstay, but there has not been systematic analysis of approach to and factors associated with HQ 3DRA. This was a single-center, retrospective study of 3DRAs using Canon Infinix-I platform. Reconstructions were graded by 3 interventionalists. Quality was dichotomized into HQ and LQ. Univariable analyses and multivariable logistic regression models were performed. From 8/2016 to 12/2018, 208 3DRAs were performed in 195 CCCs; median age 7 years (2, 16), weight 23 kg (12, 57). The majority of 3DRAs were performed in patients with biventricular physiology (N = 137, 66%) and in pulsatile sites (N = 144, 69%). HQ 3DRA (N = 182, 88%) was associated with greater total injection volume [2.20 mL/kg (1.44, 3.29) vs. 1.62 mL/kg (1.10, 1.98), p = 0.005] and more dilute contrast solution [60% (50, 100) vs. 100% (60, 100), p = 0.007], but not with contrast volume administered (p = 0.2) on univariable analysis. On multivariable logistic regression, HQ 3DRA was significantly associated with patient weight [OR 0.97 (95% CI (0.94, 0.99), p = 0.018], total injection volume [OR 1.04 (95% CI 1.01, 1.07) p = 0.011], and percent contrast solution [OR 0.97 (95% CI 0.95, 1.00), p = 0.022]. These data resulted in creation of scatter plots and a novel 3DRA Nomogram for estimating the probability of HQ 3DRA. This is the first study to create evidence-based contrast dose guides and nomogram for 3DRA in CCC. HQ 3DRA was associated with lower weight, higher total injection volumes, and more dilute contrast solution.
Topics: Humans; Child; Retrospective Studies; Imaging, Three-Dimensional; Angiography; Cardiac Catheterization; Plastic Surgery Procedures
PubMed: 36029321
DOI: 10.1007/s00246-022-02994-x -
Journal of Nuclear Cardiology :... Feb 2022
Topics: Angiography; Coronary Angiography; Coronary Artery Disease; Humans; Myocardial Ischemia
PubMed: 32910417
DOI: 10.1007/s12350-020-02313-y -
The Artery of Adamkiewicz: Anatomy and Considerations in Spine Surgery - A Review of the Literature.Journal of Long-term Effects of Medical... 2022The artery of Adamkiewicz (AKA) provides blood supply to the thoracolumbar spinal cord. Any disruption of the AKA can lead to the anterior spinal artery (ASA) syndrome,... (Review)
Review
The artery of Adamkiewicz (AKA) provides blood supply to the thoracolumbar spinal cord. Any disruption of the AKA can lead to the anterior spinal artery (ASA) syndrome, with devastating systematic and neurologic complications for the patient. This is a narrative review of the anatomy of AKA, the characteristics of ASA syndrome and the role of radiologic techniques in diagnosis and treatment. A detailed search of the PubMed database was conducted from January 2000 until April 2020, to locate articles relevant to our study. The references of the included studies were also retrieved in order not to miss any information. The ASA syndrome can present as a possible post-operative complication after minimally invasive or open surgeries of multiple specialties that involve the field of spine. Risk factors associated with ASA syndrome include; kyphosis of the patient, corresponding spinal surgical approach, intraoperative hypotension, multiple ligations of the AKA, a left side approach and a 360-combined or revision surgery. The incidence varies among different operations. Many different imaging modalities have been used in preoperative plan, including but not limited to computed tomography angiography, magnetic resonance angiography, and subtraction angiography. The use of computed tomography angiography or magnetic resonance angiography preoperatively can play a major role in the prevention of the ASA syndrome. However, more research needs to be done before making any final assumptions.
Topics: Angiography; Arteries; Humans; Spinal Cord; Spine; Tomography, X-Ray Computed
PubMed: 35695630
DOI: 10.1615/JLongTermEffMedImplants.2022038879 -
Clinical Neuroradiology Jun 2022Unruptured intracranial aneurysms (UIAs) at the distal internal carotid artery (ICA) (segments C5-C7) are difficult to accurately display on computed tomography...
PURPOSE
Unruptured intracranial aneurysms (UIAs) at the distal internal carotid artery (ICA) (segments C5-C7) are difficult to accurately display on computed tomography angiography (CTA) due to the influences of bone structures and vessel curvature. We investigated the utility of three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) at 3.0‑T for the detection of morphologic features compared to digital subtraction angiography (DSA).
METHODS
This retrospective study included 2398 patients between January 2015 and May 2020 who underwent 3D-TOF-MRA and DSA within 3 months. Morphologic features including aneurysm size, neck width, shape and relation to adjacent arteries and other diagnostic parameters were recorded. Three observers blinded to the clinical and DSA results independently analyzed MRA data sets. The statistical difference of each aneurysm-specific variable was performed using χ-tests and multivariate logistic regression analysis.
RESULTS
A total of 551 aneurysms in 514 patients were confirmed at the distal ICA by DSA. Patient-based, aneurysm-based and location-based evaluations with 3D-TOF-MRA yielded high diagnostic accuracy in the detection of target UIAs. The accuracy of displayed morphologic features was 94.9% for size, 97.2% for neck width, 92.6% for shape, and 96.4% for relationship to adjacent vessels. Multivariate logistic regression showed that tiny (P < 0.001) or giant (P = 0.039) size and a lobulated shape (P = 0.006) significantly affected the morphologic assessment on 3D-TOF-MRA.
CONCLUSION
Three-dimensional TOF-MRA can accurately depict and display morphologic features of distal ICA UIAs. Tiny or giant-sized distal ICA aneurysms and with lobulation tend to carry a great risk of misdiagnosis in morphologic assessments.
Topics: Angiography, Digital Subtraction; Cerebral Angiography; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm; Magnetic Resonance Angiography; Retrospective Studies; Sensitivity and Specificity
PubMed: 35072753
DOI: 10.1007/s00062-021-01076-4 -
Indian Journal of Ophthalmology Jul 2022
Topics: Fluorescein Angiography; Humans; Retinal Diseases; Retinal Vessels
PubMed: 35791225
DOI: 10.4103/ijo.IJO_161_22