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1.
Rev. clín. esp. (Ed. impr.) ; 220(2): 126-134, mar. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-186426

RESUMEN

La ecografía clínica se ha desarrollado exponencialmente en la última década en distintos ámbitos de la medicina. De igual manera que ha ocurrido en otros campos de actuación de la medicina interna, su uso se ha implantado en la enfermedad tromboembólica venosa, tanto en la trombosis venosa profunda como en la embolia pulmonar. En esta revisión se repasan las técnicas para el diagnóstico, tanto de la trombosis venosa profunda a través de la ultrasonografía por compresión, como de la ecografía multiórgano que incluye la ultrasonografía por compresión, la ecografía pulmonar en busca de infartos pulmonares y la ecocardioscopia para la detección de dilatación y/o disfunción del ventrículo derecho, para el diagnóstico de la embolia pulmonar. Además, se plantean los escenarios clínicos más frecuentes en los que puede ser de ayuda la ecografía clínica en la vida real, así como sus limitaciones y la evidencia existente


The use of clinical ultrasonography has grown exponentially in the past decade in various medical settings. As with other areas of activity in the field of internal medicine, clinical ultrasonography has been implemented in venous thromboembolism disease, both in deep vein thrombosis and pulmonary embolism. In this review, we cover the diagnostic techniques, both for deep vein thrombosis through compression ultrasonography and for multiorgan ultrasonography, which include compression ultrasonography, pulmonary ultrasonography in the search for pulmonary infarctions and echocardiography for detecting dilation and right ventricular dysfunction for the diagnosis of pulmonary embolism. We also establish the most common clinical scenarios in which clinical ultrasonography can be of assistance in actual clinical practice, as well as its limitations and current evidence


Asunto(s)
Humanos , Ultrasonografía/métodos , Tromboembolia Venosa/diagnóstico por imagen , Trombosis de la Vena/diagnóstico por imagen , Embolia Pulmonar/diagnóstico por imagen , Endosonografía/métodos , Tratamiento de Urgencia/métodos , Sensibilidad y Especificidad , Ultrasonografía Doppler en Color/métodos
2.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(1): 18-21, ene.-mar. 2020. ilus
Artículo en Español | IBECS | ID: ibc-187068

RESUMEN

Vasa previa ocurre cuando los vasos umbilicales no protegidos por el tejido placentario o cordón umbilical se sitúan en el segmento uterino inferior, delante de la presentación fetal a menos de 2 cm del orificio cervical interno. Los factores de riesgo son inserción velamentosa de cordón, placenta previa, placenta succenturiata y técnicas de reproducción asistida. El diagnóstico mediante ecografía transvaginal y Doppler color permite objetivar la presencia de vasos fetales por delante de la presentación fetal. El manejo incluye la maduración fetal con corticoides y cesárea electiva antes del parto. Describimos un caso clínico ocurrido en nuestro hospital


Vasa praevia is a condition in which the umbilical vessels, not supported by either the umbilical cord or placental tissue, cross the foetal membranes of the lower segment within 2 cm of the internal cervical os. The risk factors are velamentous insertion of the cord, placenta praevia, a bilobed and succenturiate placenta, and the use of assisted human reproductive techniques. The antenatal diagnosis by transvaginal ultrasound and colour Doppler can be used during the routine second trimester ultrasound in women with high risk. When the diagnosis is made in the antenatal period, the safest form of delivery is an elective caesarean with administration of corticosteroids prior to the onset of labour. A case diagnosed in our hospital is presented


Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Vasa Previa/diagnóstico por imagen , Diagnóstico Prenatal , Cesárea/métodos , Complicaciones del Embarazo/diagnóstico , Factores de Riesgo , Ultrasonografía Doppler en Color , Diagnóstico Precoz , Presentación en Trabajo de Parto , Diagnóstico Diferencial , Complicaciones del Embarazo/fisiopatología , Vasa Previa/fisiopatología , Corticoesteroides/uso terapéutico
3.
Ultrasonics ; 104: 106093, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32151876

RESUMEN

Color Doppler (CD) ultrasound has been commonly employed in biomedical field to get hemodynamic information. However, reliable diagnostic evaluation and criteria for vascular diseases may not be provided due to technical limitations of CD, including single-directional measurement, aliasing, and limited imaging conditions. In this study, adaptive hybrid (AH) scheme is proposed to enhance measurement accuracy of conventional CD. It can improve the accuracy of velocity field measurement by replacing erroneous vectors in the measured CD results with the correct vectors obtained from a speckle image velocimetry (SIV) technique. The performance of the proposed AH technique was validated through in vitro experiments for various flow rates and insonation angle conditions, comparing conventional velocimetry techniques. The in vitro experiments demonstrated that the AH technique could measure flow velocity with better accuracy than the CD with bias errors of below 0.7 mm/s. The clinical applicability of the AH was also validated by measuring venous flows at human lower extremity, checking constant volumetric flow rates. Flow rates measured by the AH were maintained along the vein, while the CD and SIV results varied. As a result, the AH can provide improved measurement accuracy without installing a new supplementary equipment. It would be effectively utilized for analyzing flow dynamics and diagnosing valve-related disease.


Asunto(s)
Velocidad del Flujo Sanguíneo/fisiología , Extremidad Inferior/irrigación sanguínea , Ultrasonografía Doppler en Color/métodos , Enfermedades Vasculares/diagnóstico por imagen , Adulto , Algoritmos , Femenino , Humanos , Aumento de la Imagen , Masculino , Fantasmas de Imagen , Transductores
4.
Rev Assoc Med Bras (1992) ; 66(1): 31-35, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32130378

RESUMEN

Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient's symptoms.


Asunto(s)
Estenosis Carotídea/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Hiperlipoproteinemia Tipo II/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Placa Aterosclerótica/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Adulto , Arteria Carótida Externa/diagnóstico por imagen , Arteria Carótida Externa/patología , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/patología , Grosor Intima-Media Carotídeo , Angiografía por Tomografía Computarizada/métodos , Femenino , Humanos , Placa Aterosclerótica/patología , Ultrasonografía Doppler en Color/métodos
5.
Radiol Med ; 125(5): 481-490, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32020529

RESUMEN

OBJECTIVES: To systematically review the current literature concerning the role of superb microvascular imaging (SMI), a novel Doppler technique that enables detection of fine vessels and slow blood flow, in the evaluation of musculoskeletal disorders. METHODS: An online search of the literature was conducted for the period 2013 to April 2019 and included original articles written in English language. A data analysis was performed at the end of the literature search. RESULTS: Eight original articles with prospective design and one with retrospective design were included in this review: 4 studies focused on rheumatoid arthritis, 2 on rheumatoid and other arthritides, 1 on lateral epicondylosis and 2 on carpal tunnel syndrome. Sample size ranged from 26 to 83 patients. Despite some methodological differences, all studies compared the performance of SMI with that of a conventional Doppler technique such as power and color Doppler and found an improvement in vascularity detection with SMI. The main variations were in sample size, evaluated parameters and vascularity interpretation methods. Inter-observer agreement for SMI ranged from moderate to excellent. CONCLUSIONS: SMI is a promising tool for the diagnosis and treatment planning of different musculoskeletal disorders. Future investigations should include larger samples of patients with long-term follow-up.


Asunto(s)
Microvasos/diagnóstico por imagen , Enfermedades Musculoesqueléticas/diagnóstico por imagen , Ultrasonografía Doppler/métodos , Artritis/diagnóstico por imagen , Artritis/fisiopatología , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/fisiopatología , Velocidad del Flujo Sanguíneo , Síndrome del Túnel Carpiano/diagnóstico por imagen , Síndrome del Túnel Carpiano/fisiopatología , Humanos , Microvasos/fisiopatología , Enfermedades Musculoesqueléticas/fisiopatología , Síndromes de Compresión Nerviosa/diagnóstico por imagen , Síndromes de Compresión Nerviosa/fisiopatología , Estudios Prospectivos , Estudios Retrospectivos , Tendinopatía/diagnóstico por imagen , Tendinopatía/fisiopatología , Codo de Tenista/diagnóstico por imagen , Codo de Tenista/fisiopatología , Ultrasonografía Doppler en Color/métodos
6.
Urologe A ; 59(3): 266-270, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-32060579

RESUMEN

Considering that Quist et al. first described the acute idiopathic scrotal edema (AISE) already in 1956, there are not many studies published in literature concerning the etiology, the development, and the progress of the disease since then. According to the literature the incidence of AISE is about 20%. Although it is an important differential diagnosis for acute scrotum, it remains extensively unknown. Therefore, AISE should be kept in mind by urologists, pediatric surgeons and pediatricians to avoid needless surgery or antibiotic therapy.


Asunto(s)
Edema/diagnóstico , Escroto/patología , Torsión del Cordón Espermático/diagnóstico por imagen , Ultrasonografía Doppler en Color , Enfermedad Aguda , Niño , Diagnóstico Diferencial , Edema/etiología , Humanos , Masculino , Escroto/diagnóstico por imagen , Torsión del Cordón Espermático/diagnóstico
7.
Medicine (Baltimore) ; 99(3): e18847, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011502

RESUMEN

BACKGROUND: Acupuncture has been widely used to treat primary dysmenorrhea (PD) with satisfactory outcomes. Sanyinjiao (SP6) is the most commonly used acupoint for PD. Different needling techniques may influence the effect of SP6, and its underlying mechanism needs to be explored. This randomized controlled parallel trial is designed to evaluate the immediate analgesic effect and hemodynamic responses in uterine arterial blood flow of perpendicular needling and transverse needling at SP6 in patients with PD of cold-dampness stagnation pattern using color doppler ultrasonography. METHODS: Forty-eight patients who meet inclusion criteria will be randomized in a ratio of 1:1 to either perpendicular needling or transverse needling groups. Every participant will receive 1 session of acupuncture treatment for 10 minutes at bilateral SP6. In the perpendicular needling group, needles will be inserted vertically 1 to 1.2 cun and will be manipulated to achieve needling sensation. In transverse needling group, the needles will be inserted transversely 1 to 1.2 cun toward the abdomen without any manipulation to avoid needling sensation. Color doppler ultrasonography will be performed before, during, and after needling. The primary outcome measure is visual analog scale for pain. The secondary outcome measures include the uterine artery blood flow changes by measuring pulsatility index, resistance index values, and ratio of systolic peak and diastolic peak, the Hamilton anxiety scale, blood pressure, and heart rate. Adverse events in both groups also will be recorded. DISCUSSION: This trial will be the first study protocol designed to explore the influence of needling techniques on the analgesia effect of solo acupoint and its hemodynamic responses for PD. It will promote more widespread awareness of the benefits of using suitable needling techniques in acupuncture clinical setting and provide a further explanation of the underlying hemodynamic mechanism. TRIAL REGISTRATION: This study protocol was registered at the Chinese clinical trial registry (ChiCTR1900026051).


Asunto(s)
Terapia por Acupuntura/métodos , Dismenorrea/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Femenino , Humanos , Proyectos de Investigación , Ultrasonografía Doppler en Color , Útero/irrigación sanguínea , Útero/diagnóstico por imagen
8.
Ann Otol Rhinol Laryngol ; 129(6): 548-555, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31910645

RESUMEN

OBJECTIVE: To describe results of image guided sclerotherapy of venous malformations (VM) localized in the masseter muscle. METHODS: Retrospective review of prospectively maintained data was done to include consecutive cases treated over 5-year period, with minimum 6 months follow-up. Sclerotherapy was done using ultrasound (US) guided needle puncture(s) of the lesions percutaneously, and 3% polidocanol foam injected under image guidance. RESULTS: Seventeen cases (10 male, 7 female) with mean age 15.6 years (range 6-28 years) were identified. Clinical presentation was with facial asymmetry, becoming pronounced on jaw clenching, and three cases had mild local pain. On US, the lesions appeared as partially compressible masses with anechoic spaces, showing color filling on releasing probe pressure. Fourteen had phleboliths. Eight patients had undergone magnetic resonance imaging, lesions appearing as oval, homogenous, lobulated, T2 hyperintense masses, with heterogeneous contrast enhancement. Number of sclerotherapy sessions were-single in four cases, two in eight cases and three in five cases, for total of 35 sessions (average 2.05 session per patient). The mean dose of drug injected per session was 1.85 mL and total mean dose per patient was 2.79 mL. Post-procedure vomiting occurred in one patient while all had local swelling and mild pain, lasting between 3 to 7 days. No facial nerve palsy or sloughing/ulceration/skin necrosis was noted. On US follow-up (6-26 months, mean 15.9 months), 12 patients had small echogenic masses without any vascularity, and five had small anechoic areas <25%. All patients had complete resolution of swelling and pain. CONCLUSIONS: For VMs localized to the masseter muscle, image guided sclerotherapy is highly effective and safe, and recommended as first line treatment.


Asunto(s)
Músculo Masetero/irrigación sanguínea , Polidocanol/uso terapéutico , Soluciones Esclerosantes/uso terapéutico , Escleroterapia/métodos , Malformaciones Vasculares/terapia , Venas/diagnóstico por imagen , Adolescente , Adulto , Niño , Estudios de Cohortes , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Flebografía , Punciones/métodos , Estudios Retrospectivos , Ultrasonografía/métodos , Ultrasonografía Doppler en Color , Malformaciones Vasculares/diagnóstico por imagen , Adulto Joven
10.
Ultraschall Med ; 41(1): 29-35, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31362328

RESUMEN

BACKGROUND: Ultrasound is an essential imaging tool for evaluating physiological and pathological fetal or maternal conditions during pregnancy. Published data is limited with respect to the application of CEUS during pregnancy. CEUS has already been safely applied for assessing uteroplacental blood flow, cesarean scar pregnancy and invasive placenta percreta. CT and MRI scans during pregnancy must be thoroughly evaluated due to harmful ionizing radiation and cerebral gadolinium deposition, respectively. PURPOSE: The aim of the present retrospective single-center study is to assess the diagnostic performance and safety of CEUS during pregnancy to evaluate hepatic lesions of unknown entity. METHODS: 6 pregnant patients who underwent CEUS between 2005 and 2014 (mean age: 32 years; mean weeks of pregnancy: 28 weeks) were included in this study. The applied contrast agent was a second-generation blood-pool agent (SonoVue®, Bracco, Milan, Italy). CEUS examinations were performed and interpreted by a single radiologist with experience since 2000 (EFSUMB Level 3). RESULTS: CEUS was safely performed on all included pregnant women without the occurrence of adverse fetal or maternal events. In the context of the present study, CEUS helped to safely differentiate hepatic metastases, focal nodular hyperplasia, atypical hemangioma, hepatic arteriovenous malformation and cystic echinococcosis. In two patients CEUS determined immediate therapy. CONCLUSION: Although not clinically approved in obstetrics so far, CEUS is a safe imaging modality which, in addition to B-mode and color Doppler ultrasonography, may be applied during pregnancy for further medical indications and to provide helpful information.


Asunto(s)
Medios de Contraste , Neoplasias Hepáticas , Complicaciones Neoplásicas del Embarazo , Ultrasonografía Doppler en Color , Adulto , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/secundario , Embarazo , Complicaciones Neoplásicas del Embarazo/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía Doppler en Color/efectos adversos
13.
Urology ; 135: 66-70, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31541647

RESUMEN

OBJECTIVE: To define age-specific normal Color Doppler Duplex Ultrasound (CDDU) parameters based on a large institutional database of men referred for vascular erectile testing, but found to have normal and sustained rigidity following penile injection of alprostadil. METHODS: A retrospective review of patients who underwent CDDU from January 1, 2005 to December 31, 2014 was conducted. The indications for CDDU assessments included complaint of erectile dysfunction refractory to PDE-5 inhibitors, new-onset penile curvature, or secondary consultation for erectile dysfunction. Pearson correlation test was used to evaluate the association between ordinal age groups with peak systolic velocity (PSV) and resistive index (RI) measurements to determine the effect of age on erectile response. RESULTS: A total of 2043 patients underwent CDDU from January 1, 2005 to December 31, 2014. 259 patients (12.7%) with a mean age 53.7 and a mean BMI of 27.2 were noted to have normal erectile rigidity and normal Doppler parameters (PSV >35 cm/s, RI >0.90). Prolonged erection, defined by need to inject phenylephrine reversal agent at 1-2 hours, occurred in 93% of patients. When age was categorized by decade, a negative correlation coefficient was obtained for previsual sexual stimulation PSV (-0.09, P = .164) and postvisual sexual stimulation PSV (-0.23, P = .005). CONCLUSION: In men with normal vascular erections there appears to be a significant, age-related decline in postvisual sexual stimulation PSV without compromise to cavernous venous occlusion as measured by RI. We have used Doppler parameters in patients without vascular ED to define age-specific normalcy.


Asunto(s)
Envejecimiento/fisiología , Disfunción Eréctil/diagnóstico , Erección Peniana/fisiología , Pene/diagnóstico por imagen , Ultrasonografía Doppler en Color , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Erección Peniana/efectos de los fármacos , Pene/irrigación sanguínea , Pene/fisiología , Fenilefrina/administración & dosificación , Fenilefrina/antagonistas & inhibidores , Inhibidores de Fosfodiesterasa 5/farmacología , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Estudios Retrospectivos , Insuficiencia del Tratamiento , Agentes Urológicos/uso terapéutico , Adulto Joven
14.
J Stroke Cerebrovasc Dis ; 29(2): 104563, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31831329

RESUMEN

OBJECTIVE: Juvenile-onset mixed connective tissue disease (JMCTD) is a chronic inflammatory disease. We have previously demonstrated preclinical atherosclerosis in these patients, now exploring this further by assessing markers of endothelial dysfunction. METHODS: Thirty-three patients with JMCTD and 33 age-and sex-matched controls were included. Soluble intercellular adhesion molecule-1 (sICAM-1), Il-6 and, von Willenbrand factor (vWF) were assayed from blood taken at the time of carotid ultrasound. RESULTS: Our major findings were: (1) Levels of sICAM-1 (P < .001), IL-6 (P = .004), and vWF (P = .001) were higher, whereas (2) high density lipoprotein cholesterol (<.01) and apolipoprotein A1 (P < .01) were lower in the patient group compared to controls. CONCLUSIONS: Patients with JMCTD had significantly increased levels of markers of endothelial dysfunction.


Asunto(s)
Biomarcadores/sangre , Enfermedades de las Arterias Carótidas/sangre , Endotelio Vascular/metabolismo , Molécula 1 de Adhesión Intercelular/sangre , Interleucina-6/sangre , Enfermedad Mixta del Tejido Conjuntivo/sangre , Factor de von Willebrand/análisis , Adulto , Factores de Edad , Apolipoproteína A-I/sangre , Enfermedades de las Arterias Carótidas/diagnóstico , Grosor Intima-Media Carotídeo , Estudios de Casos y Controles , HDL-Colesterol/sangre , Femenino , Humanos , Masculino , Enfermedad Mixta del Tejido Conjuntivo/diagnóstico por imagen , Enfermedad Mixta del Tejido Conjuntivo/tratamiento farmacológico , Ultrasonografía Doppler en Color , Regulación hacia Arriba , Adulto Joven
15.
Radiol Med ; 125(3): 288-295, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31823294

RESUMEN

PURPOSE: High-flow priapism is an incomplete and painless persistent erection caused by trauma. Its diagnosis is performed thanks to clinic and imaging evaluation with detection of fistula/pseudoaneurysm in the cavernous tissue. This paper aims to retrospectively assess the efficacy and safety of superselective arterial embolization in patients with high-flow priapism. MATERIALS AND METHODS: From January 2008 to March 2017, nine patients with high-flow priapism have been treated in a single center with embolization. The main etiology was trauma in eight subjects. The patients were evaluated with laboratory examinations and clinical and imaging findings (color Doppler ultrasonography and angiography). The mean follow-up time after embolization was 24 months. RESULTS: Eleven procedures were performed in nine patients: two of them required a second treatment session because of recurrence after 1-2 weeks. Embolic agents were microcoils, microparticles (300-500 µm) and Spongostan. Restoration of erectile function was monitored by clinical and color Doppler evaluation during follow-up. CONCLUSIONS: Superselective embolization should be the procedure of choice in patients affected by high-flow priapism; this technique appears to be successful in preserving erectile function. The choice of the embolic agent is crucial, and it should be tailored for each patient.


Asunto(s)
Embolización Terapéutica/métodos , Pene/irrigación sanguínea , Priapismo/terapia , Adolescente , Adulto , Angiografía , Niño , Embolización Terapéutica/instrumentación , Procedimientos Endovasculares/métodos , Humanos , Masculino , Persona de Mediana Edad , Erección Peniana , Pene/lesiones , Priapismo/diagnóstico por imagen , Priapismo/etiología , Recurrencia , Flujo Sanguíneo Regional , Retratamiento , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Doppler en Color , Adulto Joven
16.
Angiology ; 71(1): 56-61, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31416325

RESUMEN

The SYNTAX score (SS) and SS II, which include additional clinical parameters, are widely used today for deciding revascularization following coronary angiography. We investigated the association between the presence and severity of carotid artery disease (CrAD) using the SS and SS II in 287 patients who underwent coronary artery bypass grafting. We based this investigation on the known association between coronary artery disease and CrAD. A significant association was observed between the groups with and without CrAD in terms of SS II values (28.4 ± 9.6 vs 21.4 ± 7.7, respectively; P < .001). A significant difference was also observed when stenosis was classified according to severity as <50%, 50% to 70%, and >70% (P < .001). The results indicated a positive correlation between the presence and severity of CrAD as SS II increased (r = 0.187, P = .005). According to the results of multivariate logistic regression analysis, the SS II was an independent predictor of CrAD.


Asunto(s)
Estenosis Carotídea/diagnóstico por imagen , Angiografía Coronaria , Puente de Arteria Coronaria , Enfermedad de la Arteria Coronaria/cirugía , Ultrasonografía Doppler en Color , Anciano , Estenosis Carotídea/complicaciones , Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
17.
Arterioscler Thromb Vasc Biol ; 40(2): 323-334, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31852218

RESUMEN

OBJECTIVE: Deep venous thrombosis (DVT), one of the most common venous thromboembolic disorders, is closely linked with pulmonary embolism and post-thrombotic syndrome, both of which have a high mortality. However, the factors that trigger DVT formation are still largely unknown. Elevated expression of IL (interleukin)-6-an important inflammatory cytokine-has been linked with DVT formation. However, the molecular mechanisms leading to the elevated IL-6 in DVT remain unclear. Here, we proposed that epigenetic modification of IL-6 at the post-transcriptional level may be a crucial trigger for IL-6 upregulation in DVT. Approach and Results: To explore the association between microRNAs and IL-6 in DVT, we performed microRNA microarray analysis and experiments both in vitro and in vivo. Microarray and quantitative real-time polymerase chain reaction results showed that IL-6 expression was increased while miR-338-5p level was decreased substantially in peripheral blood mononuclear cells of patients with DVT, and there was significant negative correlation between miR-338-5p and IL-6. Experiments in vitro showed that overexpressed miR-338-5p reduced IL-6 expression, while miR-338-5p knockdown increased IL-6 expression. Moreover, our in vivo study found that mice with anti-IL-6 antibody or agomiR-338-5p delivery resulted in decreased IL-6 expression and alleviated DVT formation, whereas antagomiR-338-5p acted inversely. Most of miR-338-5p was found located in cytoplasm by fluorescence in situ hybridization. Dual-luciferase reporter assay identified direct binding between miR-338-5p and IL-6. CONCLUSIONS: Our results suggest that decreased miR-338-5p promotes DVT formation by increasing IL-6 expression.


Asunto(s)
Regulación de la Expresión Génica , Interleucina-6/genética , Extremidad Inferior/irrigación sanguínea , MicroARNs/genética , Trombosis de la Vena/genética , Angiografía , Animales , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Interleucina-6/biosíntesis , Masculino , Ratones , Ratones Endogámicos C57BL , MicroARNs/biosíntesis , Persona de Mediana Edad , ARN/genética , Estudios Retrospectivos , Ultrasonografía Doppler en Color , Trombosis de la Vena/diagnóstico , Trombosis de la Vena/metabolismo
18.
Ann Vasc Surg ; 62: 499.e5-499.e8, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31536792

RESUMEN

PURPOSE: This case aimed to explore the clinical, histological, and immunohistochemical features of intravascular fasciitis (IVF) that involve a large blood vessel. CASE REPORT: A 27-year-old man presented with swelling and pain of the left lower limb for 5 days. The report of Doppler ultrasonography confirmed deep venous thrombosis (DVT) in the lower left limb (acute phase). However, laboratory value for the presence of D-dimer was negative. Thus, we performed an ascending venography and identified a mass in the common femoral vein. At operation, an incision of the left common femoral vein was made, and the mass was completely resected. CONCLUSIONS: The situation of IVF that grew in a large vein is extremely rare and can easily be misdiagnosed as DVT. The presence of D-dimer is important for a differential diagnosis. Ascending venography can be applied in making an accurate diagnosis.


Asunto(s)
Errores Diagnósticos , Fascitis/diagnóstico por imagen , Vena Femoral/diagnóstico por imagen , Extremidad Inferior/irrigación sanguínea , Flebografía , Ultrasonografía Doppler en Color , Trombosis de la Vena/diagnóstico por imagen , Adulto , Biomarcadores/sangre , Fascitis/sangre , Fascitis/cirugía , Vena Femoral/cirugía , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Masculino , Valor Predictivo de las Pruebas , Trombosis de la Vena/sangre
19.
Ann Vasc Surg ; 62: 500.e1-500.e3, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31560940

RESUMEN

Internal jugular vein (IJV) thrombosis is a rare vascular event. The most common causes of internal jugular vein thrombosis are prolonged central venous catheterization, infection, malignancy and ovarian hyperstimulation syndrome. We have presented here a case of an 82-year-old male with chronic kidney disease who presented with left neck swelling and pain who was found to have a thrombus in the left IJV. He was successfully treated with conservative treatment without any complications.


Asunto(s)
Venas Yugulares , Insuficiencia Renal Crónica/complicaciones , Trombosis de la Vena/etiología , Anciano de 80 o más Años , Analgésicos/uso terapéutico , Antibacterianos/uso terapéutico , Anticoagulantes/uso terapéutico , Tratamiento Conservador , Humanos , Venas Yugulares/diagnóstico por imagen , Masculino , Insuficiencia Renal Crónica/diagnóstico , Resultado del Tratamiento , Ultrasonografía Doppler en Color , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/terapia
20.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(10): 1149-1154, 2019 Oct 30.
Artículo en Chino | MEDLINE | ID: mdl-31801719

RESUMEN

OBJECTIVE: To analyze the incidence and risk factors of benign liver space-occupying mass in patients with chronic hepatitis B (CHB) and the ultrasound features that differentiate these masses from small hepatocellular carcinoma. METHODS: We retrospectively analyzed the color Doppler and clinical data of 17 721 patients with CHB treated in the Hepatology Unit of Nanfang Hospital between January, 2016 and December, 2017. The data were compared with those of 21629 healthy control subjects undergoing routine physical examination in the Center of Heath Management of Nanfang Hospital during the same period. RESULTS: Compared with the control subjects, the patients with CHB had significantly higher incidences of hepatic cysts (11.8% vs 8.7%, P < 0.05), hepatic hemangioma (8.2% vs 1.6%, P < 0.05) and hepatic cirrhosis nodules (20.6% vs 2.4%, P < 0.05). The incidences of hepatic cysts and cirrhosis nodules increased with age and was significantly higher in male than in female patients (P < 0.001). The highest incidence of hepatic hemangioma was found in CHB patients aged 30-49 years without a gender difference (P>0.05). Sonographically, the benign liver masses commonly showed homogeneous echo within the lesion with clear boundaries and regular shape. Hepatic hemangioma was distinctively hyperechoic in 83.32% (1579/1895) of the patients, while small hepatocellular carcinoma presented with weaker peripheral and internal blood flow signals with a lower flow velocity in the arteries and a higher flow velocity in the portal vein. Liver cirrhosis nodules mostly showed a mixture of strong and weak echoes (79.60%; 7637/9595) without blood flow signal within or around the nodule; an increased volume of the nodule accompanied by heterogeneous echoes within the nodule indicated an increased probability of malignant lesion. Hepatic cysts often displayed no echo within the lesion, but the echo could be enhanced posteriorly. CONCLUSIONS: The patients with CHB are at a significantly higher risk of developing hepatic cysts, hepatic hemangiomas and hepatic cirrhosis nodules than the control population, and an older age and the male gender are associated with a higher incidence of hepatic cysts or cirrhosis. The differences in the sonographic and hemodynamic features can help to differentiate hepatic benign mass from malignant lesions, and kinetic changes in sonography can be used to monitor potential malignant transformation of the cirrhotic lesions.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Hepatitis B Crónica/diagnóstico por imagen , Cirrosis Hepática/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Ultrasonografía Doppler en Color , Adulto , Estudios de Casos y Controles , Diagnóstico Diferencial , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pacientes , Estudios Retrospectivos
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