Advantages of 3D High-Resolution Vessel Wall Imaging in a Patient With Blood Blister-Like Aneurysm: A Case Report and Literature Review.

Blood blister-like aneurysms (BBAs) are rare and challenging intracranial aneurysms. They pose significant diagnostic and surgical risks due to their delicate walls. Accounting for a small percentage of intracranial aneurysms, BBAs are pathologically pseudoaneurysms, often resulting from arterial dissection, with a high tendency to rupture. This report underscores the critical nature of BBAs by reviewing a case in which subarachnoid hemorrhage caused by a BBA rupture was difficult to diagnose with conventional imaging. We highlight the efficacy of three-dimensional (3D) high-resolution vessel wall imaging (VWI) in discerning the subtle vascular abnormality of BBAs. The integration of the black-blood imaging technique within VWI provides superior contrast between the aneurysm and surrounding tissues, facilitating clearer visualization of the aneurysmal wall. The use of 3D T1-weighted imaging provides intricate details of the vessel wall including its contrast enhancement, which is crucial for a comprehensive assessment of a ruptured aneurysm. This case is consistent with the existing literature, supporting the role of VWI in the identification of ruptured BBAs, an area with limited but growing information on its diagnostic value. VWI is precise and accurate in the preoperative diagnosis of BBAs, emphasizing its potential to improve patient management and outcomes, especially in conditions with high risks of morbidity and mortality.

Characterization of the circulating serum amyloid A in bottlenose dolphins.

Several isoforms of serum amyloid A (SAA) have been identified so far and because the plasma concentration of it increases dramatically, it is used as an indicator of inflammation in animals. In many terrestrial mammals, the circulating isoforms are SAA1 and SAA2, which are synthesized in the liver. Extra-hepatically synthesized SAA3, however, is a predominantly local SAA isoform with a characteristic N-terminal TFLK motif and a highly alkaline isoelectric point (pI). The aim of this study was to characterize the circulating SAA isoforms in bottlenose dolphins (dSAA) by determining the deduced amino acid sequence isolated from liver and the pI of plasma from healthy dolphins and those with inflammation. The deduced amino acid sequences of dSAA showed characteristics of SAA3 with an N-terminal TFLK motif, a predicted alkaline pI and were phylogenetically clustered with the SAA3 group rather than the SAA1 and SAA2 groups. Various tissues contained dSAA mRNA with the highest levels being detected in the liver. Isoelectric focusing and western blot analysis showed that one highly alkaline SAA was markedly detected in plasma obtained from dolphins affected by inflammation. These results suggest that, unlike other mammals, the circulating SAA in dolphins exhibits SAA3 properties, as is the case in pigs.

[Assessment of the effects of administering a saline solution flush after contrast medium injection using different injection durations and flush methods].

The purpose of administering a saline solution flush after contrast medium injection is to more effectively utilize the contrast medium remaining in the vessels from the subclavian vein to the superior vena cava. In order to investigate the effects of administering a saline solution flush after a contrast medium injection, we evaluated the effects of various contrast medium injection durations and injection methods on the time-density curve (TDC) using a custom-made TDC measurement phantom. The TDC was found to have a biphasic appearance, showing a rapid increase after the arrival of contrast medium in the target region followed by a slower increase from an inflection point at 25 s after the start of contrast medium injection, reflecting the differences in circulatory dynamics for each duration. The results showed that the effect of saline solution flush was allowed the differences by contrast medium duration at the inflection point. Specifically, when the saline solution flush was administered before the inflection point, the CT number was increased, and when it was administered after the inflection point, contrast enhancement was prolonged. With regard to the method in which the saline solution flush is administered before the inflection point, it was found that injecting a mixture of contrast medium and saline solution before the saline solution flush reduced the degree of inflection of the TDC, resulting in a more stable TDC.