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1.
J Vasc Interv Radiol ; 2024 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-39389228

RESUMO

PURPOSE: To compare the efficacies of percutaneous transhepatic obliteration (PTO) with initial afferent vein embolization (PTO-A) and with initial efferent vein embolization (PTO-E) for gastric varices (GVs). MATERIALS AND METHODS: Consecutive patients undergoing PTO-A or PTO-E for type 1 isolated gastric varices or type 2 gastroesophageal varices between June 2007 and February 2023 were included. PTO-A or PTO-E was indicated when balloon-occluded retrograde transvenous obliteration failed, or there was no portosystemic shunt for the retrograde transvenous approach. PTO-A was performed for patients before March 2009 and for patients with multiple efferent channels from the GVs. PTO-E was attempted for patients after April 2009. Twenty-six patients were included, of whom 18 underwent PTO-A, and 8 underwent PTO-E. In 12 patients, PTO-E was attempted without success, and they underwent PTO-A instead. The primary outcome was successful complete eradication of GVs within 1 week after the procedure. Secondary outcomes were the GV recurrence-free period and overall survival after the procedure. RESULTS: Technical success was achieved in all 26 patients, with a complete GV eradication rate of 33.3% in PTO-A and 100% in PTO-E, significantly higher in PTO-E (p = 0.002). The median recurrence-free period was 8.7 months with PTO-A and 75.1 months with PTO-E; PTO-E had a significantly longer recurrence-free period (p = 0.042). Median overall survival was 37.2 months with PTO-A and 49.9 months with PTO-E, with no significant difference (p = 0.955). CONCLUSION: PTO-E had a better complete eradication rate and longer recurrence-free period than PTO-A for GVs.

2.
Radiol Case Rep ; 19(7): 2669-2673, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38645961

RESUMO

Left-sided portal hypertension (LSPH) causes varices and splenomegaly due to splenic vein issues. Colonic varices are rare and lack standardized treatment. We report the successful treatment of colonic varices caused by LSPH, by addressing both the afferent and efferent veins. A 70-year-old man with distal cholangiocarcinoma had surgery without splenic vein resection, leading to proximal splenic vein stenosis and varices at multiple locations. Percutaneous transhepatic splenic venography revealed that collateral veins flowed into the ascending colonic varices and returned to the portal vein. Complete thrombosis of the varices was achieved by injecting sclerosants and placing coils in both the afferent and efferent veins. The procedure was safe and effective, with no variceal recurrence. This approach provides a minimally invasive option for treating colonic varices associated with LSPH.

3.
Intern Med ; 63(6): 803-807, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-37495529

RESUMO

A 55-year-old patient was admitted for variceal treatment, a complication of chronic portal hypertension and liver cirrhosis. Imaging studies revealed prominent duodenal varices, the pancreaticoduodenal vein as its afferent pathway, a drainer vessel into the inferior vena cava, and a paraumbilical vein. We successfully performed complete obliteration of the varix, including its afferent and efferent vessels, via the paraumbilical vein approach.


Assuntos
Duodeno/anormalidades , Embolização Terapêutica , Varizes Esofágicas e Gástricas , Doenças Fetais , Bexiga Urinária/anormalidades , Varizes , Humanos , Pessoa de Meia-Idade , Escleroterapia , Varizes/complicações , Varizes/terapia , Embolização Terapêutica/métodos , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/etiologia
4.
Radiol Case Rep ; 18(12): 4327-4330, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37789920

RESUMO

The standard treatment for ruptured duodenal varices remains to be established. Emergency balloon-occluded retrograde transvenous obliteration is challenging in patients with bleeding because re-rupture of varices can occur due to increased pressure when using the retrograde approach. Herein, we describe a case in which a catheter was retrogradely advanced to the afferent vein beyond bleeding duodenal varices; however, the varices re-ruptured during coil embolization, and a part of the catheter was deviated into the intestinal tract. The rupture site was embolized by liquid embolic materials from the microcatheter. Embolization via retrograde approach needs to be carefully performed.

6.
Radiol Case Rep ; 18(1): 200-204, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36340230

RESUMO

A 70-year-old woman with liver cirrhosis was admitted to our hospital for treatment of growing gastric varices in the fundus. Computed tomography showed gastric varices continuously draining the pericardiophrenic vein via the inferior phrenic vein. Balloon-occluded retrograde transvenous obliteration by a transjugular approach was planned. However, a conventional balloon catheter or microballoon catheter could not be inserted into the efferent vein near the varices because of the narrowness and tortuosity of the vein. Hence, coil-assisted retrograde transvenous obliteration was performed by an inverted catheter tip technique using a single conventional microcatheter. This technique might be useful for cases in which it is difficult to insert a balloon catheter into the efferent vein.

7.
Radiol Case Rep ; 16(4): 801-806, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33552329

RESUMO

Stomal varices are rare and ectopic varices defined as dilated portosystemic collateral veins located in sites other than the gastro-esophageal region. These sometimes cause recurrent bleedings and can be life-threatening. Optimal treatments have yet to be established. We report 3 cases of repetitive bleeding stomal varices in which resolution of bleeding was obtained over the medium term with minimally invasive approaches including balloon-occluded retrograde transvenous obliteration and variceal embolization by ultrasound-guided direct puncture. Rebleeding did not occur in any patients within 2-15 months of follow-up. Serious complications over Clavien-Dindo grade I were not found.

8.
Cardiovasc Intervent Radiol ; 44(6): 921-930, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33474605

RESUMO

PURPOSE: Portal venous system thrombosis is a complication of partial splenic artery embolization, and pre-treatment risk assessment is thus important. The purpose of this study was to identify the risk factors for portal venous system thrombosis after partial splenic artery embolization. MATERIALS AND METHODS: We retrospectively analyzed 67 consecutive patients who underwent contrast-enhanced computed tomography before and after first partial splenic artery embolization between July 2007 and October 2018. As risk factors, we investigated age, sex, hematological data, liver function, steroid use, heparin use, and findings from pre- and post-treatment computed tomography. Uni- and multivariate analyses were performed to evaluate the relationship between thrombus appearance or growth and these factors. Values of p < 0.05 were considered significant. RESULTS: Partial splenic artery embolization was technically successful in all 67 patients. Nine patients showed appearance or growth of thrombus. Univariate analysis showed maximum diameter of the splenic vein before treatment (p = 0.0076), percentage of infarcted spleen (p = 0.017), and volume of infarcted spleen (p = 0.022) as significant risk factors. Multivariate analysis showed significant differences in maximum diameter of the splenic vein before treatment (p = 0.041) and percentage of infarcted spleen (p = 0.023). According to receiver operating characteristic analysis, cutoffs for maximum diameter of the splenic vein and percentage of infarcted spleen for distinguishing the appearance or growth of thrombus were 17 mm and 58.2%. CONCLUSION: Large maximum diameter of the splenic vein before partial splenic artery embolization and high percentage of infarcted spleen after partial splenic artery embolization were identified as risk factors for portal venous system thrombosis. LEVEL OF EVIDENCE: Level 4, Case Series.


Assuntos
Embolização Terapêutica/efeitos adversos , Veia Porta/fisiopatologia , Artéria Esplênica/fisiopatologia , Veia Esplênica/anatomia & histologia , Tomografia Computadorizada por Raios X/métodos , Trombose Venosa/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Embolização Terapêutica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Trombose Venosa/fisiopatologia , Adulto Jovem
9.
BJR Case Rep ; 7(5): 20210011, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-35136621

RESUMO

A 66-year-old man presented with liver cirrhosis due to non-alcoholic steatohepatitis and hyperammonemia. Contrast-enhanced CT showed a dilated and tortuous splenorenal shunt and a large venous aneurysm in the shunt. The venous aneurysm showed gradual enlargement over 10 years and worsening hyperammonemia, so balloon-occluded retrograde transvenous obliteration was performed. Under balloon occlusion, 5% ethanolamine oleate was injected from a microcatheter into the venous aneurysm, which was subsequently embolized with microcoils. Contrast-enhanced CT after the procedure showed complete thrombosis of the venous aneurysm. 10 months later, the venous aneurysm reduced in size, and hyperammonemia had improved.

10.
Intern Med ; 58(20): 2923-2929, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31243212

RESUMO

Objective Therapeutic predictors derived from the venous pressure before therapy have not been identified for Budd-Chiari syndrome (BCS). The aim of this study was to determine whether or not measuring the distal pressure or pressure gradient was useful for predicting treatment efficacy in BCS. Methods We retrospectively analyzed seven consecutive patients diagnosed with symptomatic BCS at our hospital between 2008 and 2017. Distal and proximal venous pressures at occlusion sites of BCS were measured before treatment in all cases. The pressure gradient was defined as the difference between distal and proximal venous pressures. A receiver operating characteristics (ROC) analysis was performed for venous pressures. Results Percutaneous old balloon angioplasty (POBA) was performed in seven cases, with technical success achieved in all cases (100%). No complications were encountered. The median primary patency was 574 (interquartile range, 439.5-1,056.5) days. The 1-year primary patency rate was 71.73%. Six cases (85.7%) showed resolution of symptoms, representing clinical success. The ROC analysis revealed a high distal pressure (area under the ROC curve = 0.83, cut-off=12 mmHg) as a predictor of treatment efficacy of POBA for symptomatic BCS. In addition, the pressure gradient was considered significant from a clinical perspective, because the 6 successful cases with resolution of symptoms showed a large pressure gradient (range, 8-21 mmHg) before treatment, whereas the failed case showed a relatively small pressure gradient (7 mmHg). Conclusion High distal pressure and a large pressure gradient might predict the treatment efficacy of balloon angioplasty for symptomatic BCS.


Assuntos
Angioplastia com Balão/métodos , Síndrome de Budd-Chiari/fisiopatologia , Síndrome de Budd-Chiari/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome de Budd-Chiari/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Flebografia , Prognóstico , Curva ROC , Estudos Retrospectivos , Resultado do Tratamento , Grau de Desobstrução Vascular/fisiologia , Pressão Venosa/fisiologia
11.
Intern Med ; 58(14): 2095-2099, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-30996176

RESUMO

A 66-year-old woman with symptoms of fatigue and headache was diagnosed with giant cell arteritis (GCA). Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed the strong accumulation of FDG in the descending aorta, abdominal aorta, bilateral subclavian artery, and total iliac artery. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) showed signal enhancement at the descending aorta and abdominal aorta. We repeated FDG-PET and DWIBS 2 months after the initiation of therapy with prednisolone. In line with the FDG-PET findings, the signal enhancement of the aortic wall completely vanished on DWIBS. DWIBS may be a novel useful tool for the diagnosis and follow-up of GCA treatment.


Assuntos
Anti-Inflamatórios/uso terapêutico , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/fisiopatologia , Arterite de Células Gigantes/diagnóstico por imagem , Arterite de Células Gigantes/tratamento farmacológico , Arterite de Células Gigantes/fisiopatologia , Prednisolona/uso terapêutico , Administração Oral , Idoso , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Seguimentos , Humanos , Imagem Multimodal/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Resultado do Tratamento , Imagem Corporal Total/métodos
12.
Yonago Acta Med ; 62(1): 24-29, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30962741

RESUMO

BACKGROUND: Left subclavian artery (LSA) embolization is occasionally required to prevent type II endoleak in the thoracic endovascular aortic repair (TEVAR) procedure. This is a retrospective study comparing compressed Amplatzer Vascular Plug II embolization (CAE) and conventional coil embolization (CCE) in preventing retrograde flow into the aneurysmal sac through the LSA after TEVAR. METHODS: We retrospectively reviewed the records of patients who underwent CAE or CCE of the LSA during TEVAR from June 2013 to March 2016 in our hospital. The efficacy, safety and cost of each method were compared between two groups. RESULTS: Thirty patients underwent LSA embolization during TEVAR. Six CCEs in 6 patients were performed from June 2013 to November 2013, while twenty-four CAEs in 24 patients were performed from December 2013 to March 2016. Technical success was achieved in all patients in both groups. No embolization-related complications or type II endoleaks from LSA were recorded during the follow-up period in all patients. In both groups, all embolic materials were detected in the proximal portion of the LSA from the LSA orifice to the vertebral artery origin and no vertebral artery occlusions were detected. The mean compression ratio of AVP II was 58 ± 5.9% of predicted length of standard procedure. In the CAE group, one AVP II was sufficient to achieve complete LSA occlusion in all patients. On the other hand, multiple coils (10.2 ± 2.7) were used in the CCE group (P < .01), resulting in a significantly lower cost incurred in the CAE group (CAE: 129,000 JPY vs. CCE: 639,600 ± 140,060 JPY; P < .01). CONCLUSION: The CAE is a useful and cost-effective procedure for TEVAR-related LSA embolization.

13.
Intern Med ; 58(9): 1355-1360, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30626815

RESUMO

A 26-year-old woman with Takayasu's arteritis (TAK) experienced back and neck pain during tocilizumab (TCZ) treatment. The levels of C-reactive protein were normal, and ultrasonography revealed no significant changes. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) showed signal enhancement in the walls of several arteries. Contrast computed tomography showed arterial inflammation in the same lesion. After increasing the dose of prednisolone and TCZ, all signal enhancements decreased and continued to decrease, as observed on days 76 and 132. Thus, DWIBS may be a novel imaging modality for assessing the disease activity of TAK, particularly during follow-up.


Assuntos
Anti-Inflamatórios/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Prednisolona/administração & dosagem , Arterite de Takayasu/patologia , Adulto , Dor nas Costas/etiologia , Proteína C-Reativa/metabolismo , Artéria Carótida Primitiva , Estenose das Carótidas/etiologia , Estenose das Carótidas/patologia , Angiografia por Tomografia Computadorizada , Relação Dose-Resposta a Droga , Feminino , Humanos , Infusões Intravenosas , Imageamento por Ressonância Magnética/métodos , Imagem Multimodal , Cervicalgia/etiologia , Recidiva , Síndrome do Roubo Subclávio/etiologia , Síndrome do Roubo Subclávio/patologia , Arterite de Takayasu/tratamento farmacológico , Ultrassonografia , Imagem Corporal Total/métodos
15.
Jpn J Radiol ; 34(8): 564-71, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27262856

RESUMO

PURPOSE: To investigate the current status of interventional radiology (IR) procedures for a type II endoleak (T2EL) in Japan, and to identify the technical aspects that affect treatment results. MATERIALS AND METHODS: A retrospective survey was conducted by distributing questionnaires to 25 institutions. The eligibility criteria were endovascular aortic repair (EVAR) performed using commercial stent grafts and IR performed for T2EL between January 2007 and December 2013. Technical success was defined as disappearance of the EL on digital subtraction angiography immediately after embolization, and imaging success was defined as no EL on contrast-enhanced computed tomography within 6 months. Statistical comparisons of the number of involved branches, embolization level, embolic material, and changes in aneurysm size were made between the imaging success and imaging failure groups. The technical and imaging success rates were also compared between the initial therapy and repeat groups. RESULTS: A total of 166 cases were investigated. Initial therapy was performed in 147 cases (88.6 %), with repeat therapy in 19 cases (11.4 %). Transcatheter arterial embolization (TAE) was used most frequently, in 161 cases (97 %), with direct puncture (DP) used in 5 cases (3 %). Both coil embolization for the branches and NBCA embolization for the sac were frequently chosen. The technical success rate was 83.2 % (TAE group), and the imaging success rate was 46.5 % (TAE + DP groups). Branch + sac embolization was performed more frequently in the imaging success group. There was no significant difference in the number of involved branches or embolic material between the imaging success and imaging failure groups. Enlargement of the aneurysm was more frequently seen in the imaging failure group. There were no significant differences in the technical success and imaging success rates between the initial therapy and repeat groups. CONCLUSION: This is the first report of a multi-institutional questionnaire survey of IR procedures for T2EL after EVAR in Japan that was conducted to determine the current status. Enlargement of aneurysm size after embolization was more frequently seen in the imaging failure group. It is important to embolize both branch and sac to achieve imaging success, regardless of embolic material. Long-term outcomes need to be investigated.


Assuntos
Aneurisma da Aorta Abdominal/terapia , Embolização Terapêutica/métodos , Endoleak/diagnóstico por imagem , Radiologia Intervencionista/métodos , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Angiografia Digital , Aortografia , Meios de Contraste , Procedimentos Endovasculares/métodos , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Intensificação de Imagem Radiográfica , Estudos Retrospectivos , Sociedades Médicas , Stents , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
J Vasc Interv Radiol ; 27(6): 824-30, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27056283

RESUMO

PURPOSE: To retrospectively evaluate the safety and risk of transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for urgent acute arterial bleeding control in the lower gastrointestinal tract by angiography and colonoscopy. MATERIALS AND METHODS: NBCA TAE was performed in 16 patients (mean age, 63.7 y) with lower gastrointestinal bleeding (diverticular hemorrhage, tumor bleeding, and intestinal tuberculosis). Angiographic evaluation was performed by counting the vasa recta filled with casts of NBCA and ethiodized oil (Lipiodol) after TAE. Patients were classified as follows: group Ia, with a single vas rectum with embolization of 1 branch (n = 6); group Ib, with a single vas rectum with embolization of ≥ 2 branches (n = 8); group II, with embolization of multiple vasa recta (n = 2). All patients underwent colonoscopy within 1 month, and ischemic complications (ulcer, scar, mucosal swelling, fibrinopurulent debris, and necrosis) were evaluated. RESULTS: The procedure was successful in all patients. No ischemic change was observed in any patients in group Ia and in two patients in group Ib. Ischemic changes were observed in six group Ib patients and both group II patients. Group Ib patients experienced ischemic complications that improved without treatment. One patient in group II underwent resection for intestinal perforation after embolization of three vasa recta. One patient in group II with sigmoid stricture with embolization of six vasa recta required prolonged hospitalization. CONCLUSIONS: NBCA embolization of ≥ 3 vasa recta can induce ischemic bowel damage requiring treatment. NBCA TAE of one vas rectum with ≥ 2 branches could also induce ischemic complications. However, these were silent and self-limited.


Assuntos
Angiografia Digital , Colonoscopia , Embolização Terapêutica/métodos , Embucrilato/administração & dosagem , Hemorragia Gastrointestinal/terapia , Enteropatias/terapia , Adulto , Idoso , Embolização Terapêutica/efeitos adversos , Embucrilato/efeitos adversos , Óleo Etiodado/administração & dosagem , Feminino , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/patologia , Humanos , Enteropatias/diagnóstico por imagem , Enteropatias/patologia , Masculino , Isquemia Mesentérica/diagnóstico por imagem , Isquemia Mesentérica/etiologia , Isquemia Mesentérica/patologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
17.
Acta Radiol ; 57(6): 742-9, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26253930

RESUMO

BACKGROUND: Multiple system atrophy, cerebellar type (MSA-C) sometimes shows asymmetrical findings on magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). PURPOSE: To assess the frequency and clinical significance of asymmetrical MRI and (99m)Tc-ethyl cysteinate dimer perfusion (ECD) SPECT findings of the cerebellum, middle cerebellar peduncle (MCP), and pons in MSA-C patients. MATERIAL AND METHODS: We retrospectively reviewed 28 patients with MSA-C who underwent MRI and (99m)Tc-ECD SPECT and evaluated laterality of atrophy and signal changes on MRI, and laterality of perfusion on (99m)Tc-ECD SPECT transversely and longitudinally. RESULTS: Laterality was identified for 64%, 61%, and 21% of atrophy in the cerebellum, MCP, and pons, respectively, on MRI and for 71% of atrophy in the cerebellum on perfusion SPECT. Concerning comparisons between the latest MRI and SPECT findings, laterality of cerebellar/MCP atrophy on MRI and decreased cerebellar perfusion on SPECT was matched in 57%, mismatched in 11%, and absent in 25% of patients. On past images, MRI and SPECT showed matched laterality in 33%, mismatched laterality in 27%, no laterality in 13%, and SPECT precedent laterality in 27% of patients. Including the latest and past images, asymmetrical changes were observed in 75% of patients. We could not identify any correlation between laterality of image findings and cerebellar symptoms in most patients. CONCLUSION: Asymmetrical changes on MRI and perfusion SPECT are common in MSA-C patients. Perfusion SPECT is useful for diagnosing MSA-C in the early stages from a functional perspective.


Assuntos
Imageamento por Ressonância Magnética/métodos , Atrofia de Múltiplos Sistemas/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Idoso , Cisteína/análogos & derivados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Estudos Retrospectivos
18.
Acta Radiol ; 57(5): 538-46, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26133194

RESUMO

BACKGROUND: Although pericardial effusion is often identified using non-gated chest computed tomography (CT), findings predictive of cardiac tamponade have not been adequately established. PURPOSE: To determine the findings predictive of clinical cardiac tamponade in patients with moderate to large pericardial effusion using non-gated chest CT. MATERIAL AND METHODS: We performed a retrospective analysis of 134 patients with moderate to large pericardial effusion who were identified from among 4581 patients who underwent non-gated chest CT. Cardiac structural changes, including right ventricular outflow tract (RVOT), were qualitatively evaluated. The inferior vena cava ratio with hepatic (IVCupp) and renal portions (IVClow) and effusion size were measured. The diagnostic performance of each structural change was calculated, and multivariate analysis was used to determine the predictors of cardiac tamponade. RESULTS: Of the 134 patients (mean age, 70.3 years; 64 men), 37 (28%) had cardiac tamponade. The sensitivity and specificity were 76% and 74% for RVOT compression; 87% and 84% for an IVClow ratio ≥0.77; and 60% and 77% for an effusion size ≥25.5 mm, respectively. Multivariate logistic regression analysis demonstrated that RVOT compression, an IVClow ratio ≥0.77, and an effusion size ≥25.5 mm were independent predictors of cardiac tamponade. The combination of these three CT findings had a sensitivity, specificity, and accuracy of 81%, 95%, and 91%, respectively. CONCLUSION: In patients with moderate to large pericardial effusion, non-gated chest CT provides additional information for predicting cardiac tamponade.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Tamponamento Cardíaco/etiologia , Feminino , Humanos , Masculino , Derrame Pericárdico/complicações , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
19.
J Magn Reson Imaging ; 41(6): 1662-8, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25136971

RESUMO

PURPOSE: To investigate type II endometrial carcinoma characterization using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and evaluate the diagnostic accuracy of semiquantitative DCE-MRI in differentiating type II from type I tumors. MATERIALS AND METHODS: Seventy-seven patients with endometrial carcinoma were retrospectively evaluated using 3T DCE-MRI. The maximum absolute enhancement of signal intensity (SImax), maximum relative enhancement (SIrel), wash-in rate (WIR), and the SImax/SI (piriformis) ratio were analyzed. To differentiate type I from type II tumors, optimal threshold criteria were established. The Mann-Whitney U-test was used for statistical comparison and receiver operating characteristic curve analysis was used to determine optimal cutoff values. RESULTS: The SIrel (P < 0.001), WIR (P < 0.0001), and SImax/SI (piriformis) ratio (P < 0.0001), but not SImax, differed significantly between type I and type II carcinomas. Cutoff values of SIrel ≥58.8, WIR ≥37.0, and SImax/SI (piriformis) ratio ≥1.55 had sensitivities of 93%, 93%, and 67%, specificities of 60%, 60%, and 79%, accuracies of 66%, 66%, and 67%, respectively, for predicting type II endometrial carcinoma. CONCLUSION: Endometrial carcinoma with strong (high level) enhancement on DCE-MRI is suggestive of type II endometrial carcinoma. Semiquantitative evaluation of DCE-MRI may be useful for differentiating type II from type I tumors.


Assuntos
Neoplasias do Endométrio/patologia , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Estudos Retrospectivos
20.
Acta Radiol ; 56(3): 329-38, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24558166

RESUMO

BACKGROUND: Moyamoya disease is a relatively rare cerebrovascular occlusive disorder. Several studies have reported cerebral microbleeds (CMBs) in moyamoya disease patients using T2*-weighted imaging (T2*WI) and/or susceptibility-weighted imaging (SWI). PURPOSE: To investigate the incidence, distribution patterns, and influencing factors of asymptomatic CMBs in patients with moyamoya disease. MATERIAL AND METHODS: Phase-sensitive imaging (PSI) was used to investigate 27 consecutive moyamoya disease patients with a 3-T magnetic resonance imaging system, then a meta-analysis of 245 patients (asymptomatic moyamoya disease, n = 23; ischemic moyamoya disease, n = 161; hemorrhagic moyamoya disease, n = 61) from four previous individual studies and our PSI study was performed. The meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Based on the clinical and radiological data, we divided the studies into different model groups to calculate the incidence of CMBs and discuss the distribution patterns of CMBs. RESULTS: Thirty-five asymptomatic CMBs were demonstrated in 14 moyamoya disease patients (51.9%) in our PSI study. Of these, 45.7% were located in the periventricular white matter. In the meta-analysis, the pooled incidence of asymptomatic CMBs in moyamoya disease was 46% (95% confidence interval [CI], 28.2-63.8%) on SWI or PSI and 29.6% (95% CI, 17.4-41.7%) on T2*WI. Statistical analysis showed that PSI or SWI offered better detection of CMBs in moyamoya disease than T2*WI, and 3-T T2*WI offered better detection than 1.5-T T2*WI. Furthermore, hemorrhagic onset-type moyamoya disease correlated with a high incidence of asymptomatic CMBs. CONCLUSION: PSI or SWI can detect CMBs better than T2*WI, and 3-T T2*WI. Hemorrhagic onset-type moyamoya disease seems to correlate with a high incidence of asymptomatic CMBs. The meta-analysis indicates that asymptomatic CMBs may be an important factor for hemorrhagic stroke risk. Long-term evaluation of CMBs using PSI or SWI may contribute to the management of moyamoya disease.


Assuntos
Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/patologia , Imageamento por Ressonância Magnética/métodos , Doença de Moyamoya/epidemiologia , Doença de Moyamoya/patologia , Adolescente , Adulto , Idoso , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Criança , Comorbidade , Feminino , Humanos , Incidência , Masculino , Microcirculação , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
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