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RoFo : Fortschritte Auf Dem Gebiete Der... Jan 2020Acute thrombotic pulmonary embolism (PE) is a common and potentially fatal event with imaging playing a pivotal role in the diagnosis and management of these patients. (Review)
Review
BACKGROUND
Acute thrombotic pulmonary embolism (PE) is a common and potentially fatal event with imaging playing a pivotal role in the diagnosis and management of these patients.
METHOD
This review discusses imaging techniques, diagnostic algorithms, imaging findings and endovascular treatment of acute thrombotic PE, and illustrates important differential diagnoses relating to the spectrum of acute non-thrombotic PE and non-embolic pulmonary artery disease. The review emphasizes information relevant for everyday radiological practice and highlights recent advances that can be readily applied in the clinical routine.
RESULTS/CONCLUSION
Computed tomography pulmonary angiography (CTPA) is the current reference standard for the diagnosis of acute PE. Ventilation and perfusion (VQ) scanning or - in centers with adequate expertise - magnetic resonance imaging (MRI) is indicated in pregnant or young patients and patients with contraindications to iodinated contrast. Invasive angiography is reserved for patients with intended endovascular treatment. Artifacts, acute non-thrombotic PE, chronic PE and non-embolic pulmonary artery diseases should always be considered as differential diagnoses.
KEY POINTS
· CTPA is the reference standard for the diagnosis of acute PE.. · MRI for acute PE should only be performed in centers with adequate expertise.. · Invasive angiography is reserved for patients with intended endovascular treatment.. · Artifacts and non-embolic pulmonary artery diseases can mimic acute pulmonary thromboembolism.. · Non-thrombotic and chronic PE are also differential diagnoses of acute pulmonary thromboembolism..
CITATION FORMAT
· Palm V, Rengier F, Rajiah P et al. Acute Pulmonary Embolism: Imaging Techniques, Findings, Endovascular Treatment and Differential Diagnoses. Fortschr Röntgenstr 2020; 192: 38 - 49.
Topics: Acute Disease; Adult; Aged; Angiography; Computed Tomography Angiography; Contrast Media; Diagnosis, Differential; Endovascular Procedures; Female; Humans; Lung; Magnetic Resonance Angiography; Male; Middle Aged; Pregnancy; Pulmonary Embolism; Ventilation-Perfusion Scan
PubMed: 31137046
DOI: 10.1055/a-0900-4200 -
American Family Physician Feb 2022Hemoptysis is the expectoration of blood from the lower respiratory tract, usually from bronchial arteries. The most common causes are acute respiratory infections,...
Hemoptysis is the expectoration of blood from the lower respiratory tract, usually from bronchial arteries. The most common causes are acute respiratory infections, cancer, bronchiectasis, and chronic obstructive pulmonary disease. No cause is identified in 20% to 50% of cases. Hemoptysis must be differentiated from pseudohemoptysis, which is blood that originates from nasopharyngeal or gastrointestinal sources. The initial evaluation includes determining the severity of bleeding and stability of the patient and may require bronchoscopy for airway protection. Mild hemoptysis comprises more than 90% of cases and has a good prognosis, whereas massive hemoptysis has a high mortality rate. A history and physical examination can assist in identifying an etiology, but diagnostic testing is often required. Chest radiography is a good initial test, but it has limited sensitivity for determining the site and etiology of the bleeding. Computed tomography and computed tomography angiography of the chest with intravenous contrast are the preferred modalities to determine the etiology of bleeding; however, bronchoscopy may also be needed. In addition to supportive medical treatment, management should include treatment of the underlying etiology because recurrence often takes place in the absence of treatment of the identified cause. Bronchial arterial embolization is used to treat massive hemoptysis, particularly when an involved artery is noted on computed tomography angiography. Surgery is reserved for patients whose medical treatment and embolization are not effective.
Topics: Angiography; Bronchial Arteries; Bronchoscopy; Embolization, Therapeutic; Hemoptysis; Humans
PubMed: 35166503
DOI: No ID Found -
Turk Kardiyoloji Dernegi Arsivi : Turk... Jun 2021
Topics: Arterial Occlusive Diseases; Coronary Angiography; Humans; Radial Artery; Ultrasonography, Interventional
PubMed: 34106057
DOI: 10.5543/tkda.2021.21114 -
Ugeskrift For Laeger Oct 2020
Topics: Chest Pain; Coronary Angiography; Electrocardiography; Humans
PubMed: 33118500
DOI: No ID Found -
NMR in Biomedicine Feb 2023Velocity-selective (VS) excitation is a relatively new type of excitation that can be useful for generating image contrast based on spin's motion. This review aims to... (Review)
Review
Velocity-selective (VS) excitation is a relatively new type of excitation that can be useful for generating image contrast based on spin's motion. This review aims to explain the principles of VS excitation and their utilization for clinical applications. We first review the generalized excitation k-space formalism, which reveals a Fourier relationship between sequence parameters and excitation profiles for spins with arbitrary spatial location, off-resonance, and velocity. Based on the k-space framework, we analyze practical VS excitation pulse sequences that yield sinusoidal or sinc-shaped velocity profiles. Then we demonstrate how these two types of VS excitation can be used as magnetization preparation for clinical applications, including saturation- or inversion-based arterial spin labeling and black- or bright-blood angiography. We also discuss practical considerations and issues for each application, including the determination of design parameters and the effects of MR system errors, such as magnetic field offsets and eddy currents.
Topics: Magnetic Resonance Angiography; Motion; Arteries; Spin Labels; Magnetic Resonance Imaging
PubMed: 35994473
DOI: 10.1002/nbm.4820 -
RoFo : Fortschritte Auf Dem Gebiete Der... Mar 2024
Topics: Coronary Angiography; Radiography; Radiology; Computed Tomography Angiography; Insurance, Health
PubMed: 38382507
DOI: 10.1055/a-2226-5089 -
Deutsches Arzteblatt International Jun 2019
Topics: Angiography; Computed Tomography Angiography; Tomography, X-Ray Computed
PubMed: 31431250
DOI: 10.3238/arztebl.2019.0460b -
JACC. Cardiovascular Imaging Oct 2019
Topics: Coronary Angiography; Coronary Artery Disease; Humans
PubMed: 31601385
DOI: 10.1016/j.jcmg.2019.09.001 -
Igaku Butsuri : Nihon Igaku Butsuri... 2021IVR-CT was developed at Aichi Cancer Center (Japan) in 1992 and is now in use worldwide. It was developed initially for the purpose of performing CT more easily during... (Review)
Review
IVR-CT was developed at Aichi Cancer Center (Japan) in 1992 and is now in use worldwide. It was developed initially for the purpose of performing CT more easily during arteriography, but also during non-vascular IR procedures such as biopsy and drainage. Four-detector-row IVR-MDCT was introduced to Shizuoka Cancer center in 2002, which was upgraded to 320-Row IVR-ADCT (320-IVR-CT) by 2013. Although we performed an initial investigation into the efficacy of 320 IVR-CT for vascular intervention, the direct MPR method using volume scanning is predominant in the field of non-vascular intervention. In this review, we describe the history of IVR-CT, report the efficacy of 320-IVR-CT for vascular and non-vascular intervention, and report our experiences.
Topics: Angiography; Humans; Japan
PubMed: 34744140
DOI: 10.11323/jjmp.41.3_92 -
Diagnostic and Interventional Imaging Sep 2022Diagnostic radiologists play an important role in the evaluation of patients presenting with signs and symptoms of lower extremity peripheral vascular disease, including... (Review)
Review
Diagnostic radiologists play an important role in the evaluation of patients presenting with signs and symptoms of lower extremity peripheral vascular disease, including critical limb ischemia in both acute and chronic settings, and intermittent claudication. The complications associated with tissue and/or limb loss related to acute limb ischemia and critical limb ischemia of the lower extremity make rapid diagnosis and early intervention critical in the management of these patients. Computed tomography angiography (CTA) is an effective, widely available, easily reproducible, non-invasive imaging modality that offers a rapid and accurate means to diagnose and grade the extent of vascular disease. However, CTA run-off reports are usually dictated in free text form, and referring and treating physicians may be unsure whether an anatomic structure has been evaluated if it has not been specifically mentioned in the report. In this article, the vascular anatomy and anatomic variants of the lower extremity, the most common lower extremity vascular pathologies are reviewed and clinically important CTA imaging findings are outlined. This provides a framework for radiologists to accurately evaluate lower extremity vascular pathologies and convey clinically relevant imaging findings for management by vascular surgeons or interventional radiologists.
Topics: Angiography; Computed Tomography Angiography; Humans; Ischemia; Lower Extremity; Peripheral Vascular Diseases
PubMed: 35843841
DOI: 10.1016/j.diii.2022.06.010