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Cardiovascular and Interventional... Mar 2021The presence of metal implants may reduce angiographic image quality due to automated beam adjustments. Digital variance angiography (DVA) is reported to be superior to... (Observational Study)
Observational Study
PURPOSE
The presence of metal implants may reduce angiographic image quality due to automated beam adjustments. Digital variance angiography (DVA) is reported to be superior to digital subtraction angiography (DSA) with increased contrast-to-noise ratio (CNR) and better image quality. The aim of the study was to evaluate whether DVA could counterbalance the image quality impairment of lower-limb angiographies with metal implants.
MATERIALS AND METHODS
From November 2019 to January 2020, 85 raw lower-limb iodine contrast angiograms of 12 patients with metal implants were processed retrospectively with DVA analyses. For objective comparison, CNR of DSA and DVA images was calculated and the ratio CNR/CNR was determined. Visual image quality was evaluated in a paired comparison and by a five-grade Likert scale by three experienced radiologists.
RESULTS
The CNR was calculated and compared in 1252 regions of interest in 37 image pairs containing metal implants. The median ratio of CNR/CNR was 1.84 with an interquartile range of 1.35-2.32. Paired comparison resulted in 84.5% in favour of DVA with an interrater agreement of 83.2% (Fleiss κ 0.454, p < 0.001). The overall image quality scores for DSA and DVA were 3.64 ± 0.08 and 4.43 ± 0.06, respectively (p < 0.001, Wilcoxon signed-rank test) with consistently higher individual ratings for DVA.
CONCLUSION
Our small-sample pilot study shows that DVA provides significantly improved image quality in lower-limb angiography with metal implants, compared to DSA imaging. The improved CNR suggest that this approach could reduce radiation exposure for lower-limb angiography with metal implants.
LEVEL OF EVIDENCE
Level 4, case studies.
Topics: Aged; Aged, 80 and over; Angiography, Digital Subtraction; Artifacts; Contrast Media; Female; Humans; Image Processing, Computer-Assisted; Leg; Male; Metals; Pilot Projects; Prostheses and Implants; Retrospective Studies
PubMed: 33145701
DOI: 10.1007/s00270-020-02697-x -
The British Journal of Radiology Feb 2021Deviations from the normal process of embryogenesis can result in various developmental anomalies of the superior vena cava (SVC). While these anomalies are often... (Review)
Review
Deviations from the normal process of embryogenesis can result in various developmental anomalies of the superior vena cava (SVC). While these anomalies are often asymptomatic, they assume clinical importance during interventions such as central venous catheterisations and pacemaker implantations and during cardiothoracic surgeries while instituting cardiopulmonary bypass and for creation of cavo-pulmonary connections. Role of imaging in identifying these anomalies is indispensable. Cross-sectional imaging techniques like CT venography and magnetic resonance (MR) venography allow direct visualisation and consequently increased detection of anomalies. CT venography plays an important role in detection of SVC anomalies as it is readily available, has excellent spatial resolution, short acquisition times and potential for reconstruction of images in multiple planes. This pictorial review focuses on the developmental anomalies of the SVC and its tributaries highlighting their embryological basis, imaging appearances on CT venography and potential clinical implications, where relevant.
Topics: Computed Tomography Angiography; Humans; Magnetic Resonance Angiography; Phlebography; Radiologists; Vena Cava, Superior
PubMed: 33197326
DOI: 10.1259/bjr.20200856 -
Journal of the American College of... Mar 2022
Topics: Coronary Angiography; Coronary Stenosis; Fractional Flow Reserve, Myocardial; Humans
PubMed: 35272802
DOI: 10.1016/j.jacc.2022.01.009 -
Indian Journal of Ophthalmology Oct 2020
Topics: Choroid; Fluorescein Angiography; Humans
PubMed: 32971679
DOI: 10.4103/ijo.IJO_186_20 -
Interventional Neuroradiology : Journal... Dec 2022The vascular anatomy of orbit is highly complex, and the main blood supply to the orbit is via the ophthalmic artery, which is a branch of the internal carotid artery....
BACKGROUND
The vascular anatomy of orbit is highly complex, and the main blood supply to the orbit is via the ophthalmic artery, which is a branch of the internal carotid artery. The purpose of this study was to determine the morphometry of the ophthalmic artery and its branches by superselective angiography in a large series of pediatric patients.
METHODS
We evaluated 134 angiographies performed on children with intraocular retinoblastoma undergoing intra-arterial chemotherapy. The origin, diameter, and angiographic visibility percentages of the ophthalmic artery and its branches were examined according to age group and sex.
RESULTS
The ophthalmic artery originated 97.8% from the internal carotid artery and 2.2% from the middle meningeal artery. The mean diameter of ophthalmic artery was measured 0.76 ± 0.14 mm in girls, 0.80 ± 0.15 mm in boys and 0.79 ± 0.15 mm in general. The posterior ciliary, lacrimal, inferior muscular, and anterior ethmoidal arteries had a higher angiographic visibility percentages (> 85%) than the other OA branches. Only the diameter of the dorsal nasal artery showed a significant correlation with age. The supratrochlear and posterior ciliary arteries showed statistically significant relationship with sex.
CONCLUSIONS
Present study will make a substantial contribution to the pediatric literature about the ophthalmic artery and its branches. A better understanding of ophthalmic artery morphology can help surgeons and neurointerventional radiologists to avoid possible severe complications during embolization, intra-arterial chemotherapy, cosmetic procedures, endonasal and orbital surgeries.
Topics: Male; Female; Humans; Child; Ophthalmic Artery; Angiography; Carotid Artery, Internal; Meningeal Arteries; Retinal Neoplasms
PubMed: 35317633
DOI: 10.1177/15910199221067664 -
The Journal of Invasive Cardiology Sep 2020Distal TRA is a novel access site in the interventional cardiology field, with current data demonstrating high success and infrequent complication rates - global...
Distal TRA is a novel access site in the interventional cardiology field, with current data demonstrating high success and infrequent complication rates - global procedural metrics that are comparable with historical proximal TRA. Distal TRA may conversely provide important advantages over proximal TRA, including patient comfort, shorter hemostasis time, and lower radial artery occlusion rates.
Topics: Arterial Occlusive Diseases; Coronary Angiography; Humans; Quality Improvement; Radial Artery
PubMed: 32865510
DOI: No ID Found -
Japanese Journal of Radiology Sep 2022Conventional time-of-flight (TOF) magnetic resonance angiography (MRA) failed to depict clear visualization of coiled cerebral aneurysms with PulseRider due to...
PURPOSE
Conventional time-of-flight (TOF) magnetic resonance angiography (MRA) failed to depict clear visualization of coiled cerebral aneurysms with PulseRider due to metal-induced susceptibility artifacts. Our aim was to overcome the metal artifact using a novel imaging technique of non-contrast-enhanced ultrashort echo-time magnetic resonance angiography (UTE-MRA).
MATERIALS AND METHODS
Five unruptured intracranial aneurysms were treated using PulseRider and the patients underwent silent MRA (UTE-MRA). The images were compared with TOF-MRA and digital subtraction angiography (DSA).
RESULTS
Silent MRA can visualize the residual cavity of the coiled aneurysms, which was not well visualized and rather defective when using TOF-MRA. While a segment of the proximal marker composed of stainless steel was poorly visualized, the other parts of the parent artery and the arteries of bifurcation, including the aneurysmal neck, were clearly visualized, equivalent to that of DSA.
CONCLUSIONS
UTE-MRA achieves better visualization of cerebral aneurysms after PulseRider treatment than TOF-MRA.
Topics: Angiography, Digital Subtraction; Cerebral Angiography; Embolization, Therapeutic; Follow-Up Studies; Humans; Intracranial Aneurysm; Magnetic Resonance Angiography
PubMed: 35430678
DOI: 10.1007/s11604-022-01276-z -
Surgical and Radiologic Anatomy : SRA Jun 2021The embryological development of the cerebral vasculature is very complex. Historical and also more recent studies based on human embryos, comparative anatomy and... (Review)
Review
The embryological development of the cerebral vasculature is very complex. Historical and also more recent studies based on human embryos, comparative anatomy and cerebral angiographies allowed us to better understand this vasculature development. The knowledge and understanding of such embryological development are important for physicians interested in neurovascular pathologies. Indeed, all vascular variants and almost all vascular pathologies, such as aneurysms, dolichoectasia, atherosclerosis, and neurovascular conflicts could be explained by an alteration during the embryological life. There are also many variants of these vascular structures present in normal developed adults, which are variably associated with pathological entities. Understanding the process which leads to the development of the normal cerebral arterial system in humans is, therefore, very important to have a better knowledge of the possible clinical and surgical implications of these anomalies. In this paper, we review the embryological development of the cranio-facial arterial vasculature from its beginning at approximately days 21-50 of intrauterine life, with pictures illustrating each developmental phase.
Topics: Anatomy, Comparative; Cerebral Angiography; Cerebral Arteries; Embryo, Mammalian; Embryonic Development; Face; Humans; Medical Illustration
PubMed: 33492439
DOI: 10.1007/s00276-021-02684-y -
AJNR. American Journal of Neuroradiology Nov 2022Patients with acute ischemic stroke are increasingly triaged with one-stop management approaches, resulting in baseline imaging with a flat detector CT scanner. This...
BACKGROUND AND PURPOSE
Patients with acute ischemic stroke are increasingly triaged with one-stop management approaches, resulting in baseline imaging with a flat detector CT scanner. This study aimed to estimate the effective dose to a patient of a novel cervical and intracranial flat detector CT angiography and a flat detector CT perfusion protocol and to compare it with the effective dose of analogous multidetector row CT protocols.
MATERIALS AND METHODS
We estimated the effective dose to the patient according to the International Commission on Radiological Protection 103 using an anthropomorphic phantom with metal oxide semiconductor field effect transistor dosimeters. Placement was according to the organ map provided by the phantom manufacturer. We used 100 measurement points within the phantom, and 18 metal oxide semiconductor field effect transistor dosimeters were placed on the surface of the phantom. All protocols followed the manufacturer's specifications, and patient positioning and collimation were performed as in routine clinical practice. Measurements were obtained on the latest-generation angiography and multidetector row CT systems with identical placement of the metal oxide semiconductor field effect transistor dosimeters.
RESULTS
The estimated effective doses of the investigated perfusion protocols were 4.52 mSv (flat detector CT perfusion without collimation), 2.88 mSv (flat detector CT perfusion with collimation), and 2.17 mSv (multidetector row CT perfusion). A novel protocol called portrait flat detector CT angiography that has a z-axis coverage area comparable with that of multidetector row CT angiography had an estimated effective dose of 0.91 mSv, while the dose from multidetector row CT was 1.35 mSv.
CONCLUSIONS
The estimated effective dose to the patient for flat detector CT perfusion and angiography on a modern biplane angiography system does not deviate substantially from that of analogous multidetector row CT protocols.
Topics: Humans; Radiation Dosage; Ischemic Stroke; Phantoms, Imaging; Angiography; Multidetector Computed Tomography; Stroke; Oxides
PubMed: 36202555
DOI: 10.3174/ajnr.A7658 -
Diabetes & Vascular Disease Research 2022Diabetes mellitus is significantly associated with posterior circulation ischemic stroke. We aimed to compare the characteristics of vertebrobasilar plaques in...
Comparison of symptomatic vertebrobasilar plaques between patients with and without Diabetes Mellitus using computed tomographic angiography and vessel wall magnetic resonance imaging.
OBJECTIVES
Diabetes mellitus is significantly associated with posterior circulation ischemic stroke. We aimed to compare the characteristics of vertebrobasilar plaques in symptomatic patients with and without diabetes using high-resolution vessel wall magnetic resonance imaging and computed tomographic angiography.
METHODS
From April 2017 to May 2021, cases from patients with transient ischemic attack or stroke in the posterior circulation territory who underwent high-resolution vessel wall magnetic resonance imaging and computed tomographic angiography were reviewed. Characteristics of culprit vertebrobasilar plaques were compared between patients with and without diabetes. Multivariate regression analysis was performed to assess the correlation between culprit plaque characteristics and diabetes.
RESULTS
A total of 148 patients were included and 75 patients were diagnosed with diabetes mellitus. Patients with diabetes had more intraplaque hemorrhage, calcification, spotty calcification presence, and higher calcification volume (all < 0.05) compared with those without diabetes. Multivariate analysis demonstrated differences in the presence of intraplaque hemorrhage ( = 0.045) and number of spotty calcifications ( = 0.047) were statistically significant after adjusting for baseline characteristics.
CONCLUSIONS
Symptomatic patients with diabetes have a higher incidence of intraplaque hemorrhage and larger calcification burden than those without diabetes, indicating the association of diabetes with more advanced plaque features in the posterior circulation.
Topics: Angiography; Calcinosis; Diabetes Mellitus; Hemorrhage; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Plaque, Atherosclerotic; Stroke
PubMed: 35199586
DOI: 10.1177/14791641211073944