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AJNR. American Journal of Neuroradiology Oct 2021By means of artificial intelligence, 3D angiography is a novel postprocessing method for 3D imaging of cerebral vessels. Because 3D angiography does not require a mask...
BACKGROUND AND PURPOSE
By means of artificial intelligence, 3D angiography is a novel postprocessing method for 3D imaging of cerebral vessels. Because 3D angiography does not require a mask run like the current standard 3D-DSA, it potentially offers a considerable reduction of the patient radiation dose. Our aim was an assessment of the diagnostic value of 3D angiography for visualization of cerebrovascular pathologies.
MATERIALS AND METHODS
3D-DSA data sets of cerebral aneurysms ( = 10), AVMs ( = 10), and dural arteriovenous fistulas (dAVFs) ( = 10) were reconstructed using both conventional and prototype software. Corresponding reconstructions have been analyzed by 2 neuroradiologists in a consensus reading in terms of image quality, injection vessel diameters (vessel diameter [VD] 1/2), vessel geometry index (VGI = VD1/VD2), and specific qualitative/quantitative parameters of AVMs (eg, location, nidus size, feeder, associated aneurysms, drainage, Spetzler-Martin score), dAVFs (eg, fistulous point, main feeder, diameter of the main feeder, drainage), and cerebral aneurysms (location, neck, size).
RESULTS
In total, 60 volumes have been successfully reconstructed with equivalent image quality. The specific qualitative/quantitative assessment of 3D angiography revealed nearly complete accordance with 3D-DSA in AVMs (eg, mean nidus size= 19.9 [SD, 10.9]/20.2 [SD, 11.2] mm; = 0.9, = .001), dAVFs (eg, mean diameter of the main feeder= 2.04 [SD, 0.65]/2.05 [SD, 0.63] mm; = 0.9, = .001), and cerebral aneurysms (eg, mean size= 5.17 [SD, 3.4]/5.12 [SD, 3.3] mm; = 0.9, = .001). Assessment of the geometry of the injection vessel in 3D angiography data sets did not differ significantly from that of 3D-DSA (vessel geometry index: = 0.84, = .003; vessel geometry index: = 0.82, = .003; vessel geometry index: = 0.84, <.001).
CONCLUSIONS
In this study, the artificial intelligence-based 3D angiography was a reliable method for visualization of complex cerebrovascular pathologies and showed results comparable with those of 3D-DSA. Thus, 3D angiography is a promising postprocessing method that provides a significant reduction of the patient radiation dose.
Topics: Angiography, Digital Subtraction; Artificial Intelligence; Central Nervous System Vascular Malformations; Cerebral Angiography; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm; Intracranial Arteriovenous Malformations; Magnetic Resonance Angiography
PubMed: 34503946
DOI: 10.3174/ajnr.A7252 -
Sichuan Da Xue Xue Bao. Yi Xue Ban =... May 2022To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB),...
OBJECTIVE
To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB), and to guide clinical practice and continue to optimize diagnosis and treatment strategies.
METHODS
This retrospective study included 266 patients who underwent angiography due to ANVUGIB between March 2016 and March 2021. Data on the positive rate of angiography, the technical success rate and clinical success rate of TAE, and the rebleeding rate and the all-cause mortality within 30 days after TAE treatment were collected, and the influencing factors relevant to the above events were analyzed accordingly.
RESULTS
All 266 patients completed angiography--the positive rate of angiography was 54.1% (144/266), the total technical success rate was 97.3% (217/223), the clinical success rate was 73.1% (155/212), and the rebleeding rate and all-cause mortality within 30 days were 26.9% (57/212) and 16.1% (35/217), respectively. This study found that shock index>1 ( =5.950; 95% : 1.481-23.895; =0.012), computed tomography angiography (CTA) positive result ( =6.813; 95% : 1.643-28.252; =0.008) and interval<24 h ( =10.530; 95% : 2.845-38.976; <0.001) were independent predictors of positive angiography. Shock index>1 ( =2.544; 95% : 1.301-4.972; =0.006) and INR>1.5 ( =3.207; 95% : 1.381-7.451; =0.007) were independent risk factors for rebleeding. Patients with postoperative bleeding ( =3.174; 95% : 1.164-8.654; =0.024) and patients with rebleeding after embolization ( =34.665; 95% : 11.471-104.758; <0.001) had a higher risk of death within 30 days.
CONCLUSION
TAE is safe and effective in the treatment of ANVUGIB. Patients with shock index>1 and positive CTA are more likely to be angiographic positive, and should undergo angiography as early as possible after bleeding. In addition, rebleeding after embolization deserves high attention.
Topics: Acute Disease; Angiography; Embolization, Therapeutic; Gastrointestinal Hemorrhage; Humans; Retrospective Studies; Treatment Outcome
PubMed: 35642145
DOI: 10.12182/20220560203 -
International Journal of Surgery... Feb 2024Anastomotic leak (AL) remains a significant complication after esophagectomy. Indocyanine green fluorescent angiography (ICG-FA) is a promising and safe technique for... (Review)
Review
Anastomotic leak (AL) remains a significant complication after esophagectomy. Indocyanine green fluorescent angiography (ICG-FA) is a promising and safe technique for assessing gastric conduit (GC) perfusion intraoperatively. It provides detailed visualization of tissue perfusion and has demonstrated usefulness in oesophageal surgery. GC perfusion analysis by ICG-FA is crucial in constructing the conduit and selecting the anastomotic site and enables surgeons to make necessary adjustments during surgery to potentially reduce ALs. However, anastomotic integrity involves multiple factors, and ICG-FA must be combined with optimization of patient and procedural factors to decrease AL rates. This review summarizes ICG-FA's current applications in assessing esophago-gastric anastomosis perfusion, including qualitative and quantitative analysis and different imaging systems. It also explores how fluorescent imaging could decrease ALs and aid clinicians in utilizing ICG-FA to improve esophagectomy outcomes.
Topics: Humans; Indocyanine Green; Coloring Agents; Angiography; Anastomotic Leak; Anastomosis, Surgical; Esophagectomy; Perfusion
PubMed: 37988405
DOI: 10.1097/JS9.0000000000000913 -
Asia-Pacific Journal of Ophthalmology...
Topics: Fluorescein Angiography; Fovea Centralis; Hematocrit; Humans
PubMed: 33793443
DOI: 10.1097/APO.0000000000000385 -
Methodist DeBakey Cardiovascular Journal 2023The past decade has seen significant advances in dynamic imaging of the aorta. Today's vascular surgeons have the opportunity to choose from a wide array of imaging... (Review)
Review
The past decade has seen significant advances in dynamic imaging of the aorta. Today's vascular surgeons have the opportunity to choose from a wide array of imaging modalities to evaluate different aortic pathologies. While vascular ultrasound and aortography are considered to be the bread and butter imaging modalities, newer dynamic imaging techniques provide time-resolved information in various aortic pathologies. However, despite growing evidence of their advantages in the literature, they have not been routinely adopted. In order to understand the role of these emerging modalities, one must understand their principles, advantages, and limitations in the context of various clinical scenarios. In this review, we provide an overview of dynamic imaging techniques for aortic pathologies and describe various dynamic computed tomography and magnetic resonance imaging protocols, clinical applications, and potential future directions.
Topics: Humans; Magnetic Resonance Angiography; Aorta; Tomography, X-Ray Computed; Aortography; Magnetic Resonance Imaging
PubMed: 36910554
DOI: 10.14797/mdcvj.1172 -
Imaging the Choroid: From Indocyanine Green Angiography to Optical Coherence Tomography Angiography.Asia-Pacific Journal of Ophthalmology... 2020The choroid is the vascular structure nourishing the retinal pigment epithelium and the outer retina and it plays a key role in the homeostasis of the eye both under... (Review)
Review
The choroid is the vascular structure nourishing the retinal pigment epithelium and the outer retina and it plays a key role in the homeostasis of the eye both under physiological and pathological conditions. In the last 20 years we have moved from "guessing" what was happening beyond the retinal pigment epithelium to actually visualize structural and functional changes of the choroid in vivo noninvasively. In this review we describe the state of the art of choroidal imaging, focusing on the multiple techniques available in the clinical and research setting including indocyanine green angiography, labeled-cells angiographies, optical coherence tomography (OCT), enhanced depth imaging, swept source OCT, and OCT angiography. In the first section of the article, we describe their main applications and the basic principles to interpret the imaging results. Increasing evidence suggests that the choroid is much more involved than we used to think in many pathological conditions from uveitis to intraocular tumors, from vascular diseases to age-related macular degeneration. All clinicians should hence know which is the most appropriate imaging investigation to explore the choroid in the disease they are dealing with and how to interpret the results. For this reason the second section of this review summarizes the best imaging approach and the most common findings visible on choroidal imaging in different diseases of the eye.
Topics: Choroid; Coloring Agents; Fluorescein Angiography; Humans; Indocyanine Green; Tomography, Optical Coherence
PubMed: 32739938
DOI: 10.1097/APO.0000000000000307 -
PloS One 2021To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy.
PURPOSE
To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy.
DESIGN
Retrospective, cross-sectional study.
PARTICIPANTS
1099 eyes from 1099 diabetic patients with no clinical evidence of diabetic retinopathy (DR) were included in this study.
METHODS
Diabetic patients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed.
MAIN OUTCOME MEASURES
OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner).
RESULTS
The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected.
CONCLUSIONS
Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabetic patients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.
Topics: Aged; Angiography; Cigarette Smoking; Cross-Sectional Studies; Diabetic Retinopathy; Ex-Smokers; Female; Humans; Macula Lutea; Male; Middle Aged; Non-Smokers; Retinal Vessels; Retrospective Studies; Risk Factors; Smokers; Tomography, Optical Coherence
PubMed: 34242286
DOI: 10.1371/journal.pone.0253928 -
Balkan Medical Journal Sep 2022Pulmonary embolism is a clinical condition caused by the obstruction of the pulmonary artery and its branches with endogenous, exogenous embolism, or local thrombus...
BACKGROUND
Pulmonary embolism is a clinical condition caused by the obstruction of the pulmonary artery and its branches with endogenous, exogenous embolism, or local thrombus formation. It is a rare but potentially life-threatening event in the pediatric population. Pediatric pulmonary embolism has many unknown characteristics.
AIMS
To evaluate clinical features, genetic and acquired risk factors, diagnostic imaging, and treatment strategies with long-term results in children with pulmonary embolism.
STUDY DESIGN
A retrospective multicenter clinical trial.
METHODS
Patients aged 0-18 years who were diagnosed with pulmonary embolism with computed tomography pulmonary angiography (CTPA) findings (intraluminal filling defect in the lobar or main pulmonary artery) in 3 university hospitals between 2006 and 2021 were included in the study. A form was created for data standardization, and variables were collected retrospectively through medical record review. In addition to the features given above, we also evaluated in situ pulmonary artery thrombosis (ISPAT) and patients' Wells scores. Follow-up CTPA results were evaluated for patient response to treatment. Complete recovery means that there were no lesions, incomplete recovery if there was still embolism, and no response if there was no change.
RESULTS
Twenty-four patients (female:13, male:11) were included in the study. The mean age was 13.5 years. All patients but one had at least one or more genetic or acquired risk factors. Factor V Leiden mutation (16.6%) was the most common genetic risk factor. Six of 16 patients with Doppler ultrasonography were diagnosed with ISPAT because there was no sign of thromboembolic thrombosis. Nine (41.6%) patients had a Wells score of >4 (pulmonary embolism clinically strong), and 15 (58.4%) patients scored <4 (pulmonary embolism clinically likely weak), indicating that an alternative diagnosis was more likely than pulmonary embolism (sensitivity %37.5). The mean follow-up period was 23 (±17) months. Complete and incomplete recovery was observed in 15 (62.5%) and 7 (29.1%) patients, respectively, among the patients who underwent follow-up evaluation. No response was obtained in 2 patients (8.3%) who died.
CONCLUSION
The Wells scoring system seems insufficient to diagnose pulmonary embolism in children and should be improved by adding new parameters. ISPAT may be more common in children with congenital heart disease and systemic disease.
Topics: Adolescent; Angiography; Child; Computed Tomography Angiography; Female; Humans; Male; Pulmonary Embolism; Retrospective Studies; Turkey
PubMed: 36089832
DOI: 10.4274/balkanmedj.galenos.2022.2022-3-46 -
Magma (New York, N.Y.) Apr 2023
Topics: Magnetic Resonance Imaging; Magnetic Resonance Angiography; Magnetic Resonance Spectroscopy
PubMed: 37072540
DOI: 10.1007/s10334-023-01087-x -
Journal of the American College of... Nov 2021
Topics: Coronary Angiography; Coronary Artery Disease; Humans
PubMed: 34736564
DOI: 10.1016/j.jacc.2021.08.059