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1.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 33(5): 254-257, sept.-oct. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-ADZ-859

RESUMO

La arteria ciática persistente es una entidad poco frecuente, considerada como una malformación vascular congénita de tipo axial por falta de involución de la arteria ciática durante el desarrollo embrionario. Puede, o no, asociarse con alteraciones en el desarrollo de las arterias iliaca, femoral común y/o femoral superficial. Clínicamente los pacientes pueden ser asintomáticos, o pueden manifestar un dolor crónico tipo neuralgia ciática, por irritación nerviosa, al estar en contigüidad con el vaso anómalamente persistente, o por dolor isquémico, al sufrir trombosis de un aneurisma que con relativa frecuencia suele desarrollarse en este vaso anómalamente persistente, o por embolia arterial distal, pudiendo llegar a comprometer la viabilidad de la extremidad (AU)


The persistent sciatic artery is an uncommon disease, considered an axial congenital vascular malformation due to the lack of involution of the sciatic artery during embryonic development. It may be associated with abnormalities in the development of the iliac, common femoral and superficial femoral arteries. Patients may be asymptomatic, or they could present chronic pain, such as sciatic neuralgia, caused by nerve damage, since it is close to the abnormal persistent vessel, or due to ischemic pain, as a result of a thrombosis or embolism of an aneurysm, which could compromise the viability of the limb (AU)


Assuntos
Humanos , Masculino , Adulto Jovem , Neuropatia Ciática/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Angiografia por Tomografia Computadorizada , Ecocardiografia Doppler
2.
Zhonghua Yi Xue Za Zhi ; 102(33): 2563-2566, 2022 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-36058677

RESUMO

CT angiography derived fractional flow reserve (CT-FFR) has been an important tool for evaluating functional significance of coronary stenosis since 2011, promoting coronary CT angiography (CCTA) from the era of traditional anatomical evaluation to a new era of functional evaluation,playing a key role in guiding clinical decisions and prognostic evaluation of coronary artery disease. This review focuses on the innovative research and contributions of Chinese scholars' in CT-FFR filed, including homemade techniques, extending clinical applications and generalization of CT-FFR.


Assuntos
Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Estenose Coronária/diagnóstico por imagem , Humanos , Curva ROC
3.
Zhonghua Yi Xue Za Zhi ; 102(33): 2571-2574, 2022 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-36058679

RESUMO

The diagnosis of coronary artery disease depends on a comprehensive assessment including morphological and functional information. Coronary CT angiography derived fractional flow reserve (CT-FFR) could obtain morphological and functional information from a single coronary CT angiography (CCTA) scan, achieving a "one-stop" assessment of coronary artery disease. CT-FFR is a non-invasive imaging examination to assess the hemodynamic changes of focal coronary lesions and suitable for patients with moderate to severe coronary artery stenosis or mild coronary artery stenosis combined with other high-risk characteristics, to assist in determining whether the lesions cause myocardial ischemia, and to guide clinical decisions and predict the risk of cardiovascular events. The application of CT-FFR relies on satisfied image quality of CCTA, and requires the cooperation of radiologists, clinicians and patients. This paper describes from the aspects of the measurement and analysis of CT-FFR, the diagnostic value of CT-FFR, the value of CT-FFR in assisting clinical decision making and prognosis, the comparison of CT-FFR with other functional cardiovascular imaging techniques and the future perspectives.


Assuntos
Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Angiografia por Tomografia Computadorizada/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Humanos , Radiologistas , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
4.
Zhonghua Yi Xue Za Zhi ; 102(33): 2575-2577, 2022 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-36058680

RESUMO

The advent of coronary CT angiography derived fractional flow reserve (CT-FFR) calculation technology has brought great improvements to the clinical diagnostic process and treatment decision-making towards coronary artery disease. In recent years, CT-FFR technology has gradually begun to be taken into clinical practice in China, however, currently, the popularization is not widespread, and it is imperative to further standardize the clinical application of CT-FFR technology. This paper focused on the opportunities, significance and challenges of CT-FFR application in China from the advantages and disadvantages perspectives of this new technology based on three international studies. Combined with specific national conditions and the latest evidence-based clinical medical results, this paper proposes a win-win cooperation initiative between cardiologists and radiologists for the reference and caution of both clinical practitioners and medical affairs bureaus.


Assuntos
Cardiologistas , Reserva Fracionada de Fluxo Miocárdico , Angiografia por Tomografia Computadorizada/métodos , Humanos , Radiologistas , Tomografia Computadorizada por Raios X
5.
Zhonghua Yi Xue Za Zhi ; 102(33): 2578-2582, 2022 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-36058681

RESUMO

Cerebrovascular disease is a significant global public health concern, despite the diagnosis and treatment of stroke has made great progress in recent years, however, its mainly guided by anatomical indicators, which still needs to be further improved, and there is an urgent need to explore a more accurate and comprehensive functional imaging assessment method. Rapid development of coronary CT angiography derived fractional flow reserve (CT-FFR) has become an important technique for noninvasive evaluation of coronary artery disease, and these successful application experiences inspiried neurologists to explore the functional evaluation technique of cerebral arteries and demonstrated broad application prospects. In this paper, by analyzing and comparing the coronary CT-FFR technology, the progress, existing problems and possible solutions of the functional evaluation for cerebral arterial stenosis are discussed from the aspects of coronary CT-FFR study, cerebral artery functional evaluation study, and the comparison and consideration of cerebral arterial and coronary CT-FFR.


Assuntos
Doenças Arteriais Cerebrais , Reserva Fracionada de Fluxo Miocárdico , Angiografia por Tomografia Computadorizada , Angiografia Coronária/métodos , Humanos , Tomografia Computadorizada por Raios X
6.
Zhonghua Yi Xue Za Zhi ; 102(33): 2634-2637, 2022 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-36058691

RESUMO

A retrospective study was performed on 8 patients, including 7 males and 1 female, aged 47 to 77 (59±3) years, with intracranial artery stenosis in General Hospital of Eastern Theater Command from November 2018 to May 2019, who underwent CT angiography (CTA), digital subtraction angiography (DSA) and invasive fractional flow reserve (FFR) assessment. Three-dimensional (3D) prototyping models of intracranial artery based on image data of CTA was constructed and the hemodynamic parameters were obtained using computational fluid dynamics methods. The results showed that CT-FFR value was 0.59±0.18, and invasive FFR value was 0.60±0.22, from which we propased that noninvasive hemodynamic analyses can be used to evaluate the physiological significance of intracranial arterial stenosis.


Assuntos
Angiografia por Tomografia Computadorizada , Reserva Fracionada de Fluxo Miocárdico , Artérias , Constrição Patológica , Angiografia Coronária/métodos , Estudos de Viabilidade , Feminino , Humanos , Hidrodinâmica , Masculino , Estudos Retrospectivos
7.
J Mech Behav Biomed Mater ; 134: 105403, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36049368

RESUMO

BACKGROUND: Rupture of unstable atherosclerotic plaques with a large lipid-rich necrotic core and a thin fibrous cap cause myocardial infarction and stroke. Yet it has not been possible to assess this for individual patients. Clinical guidelines still rely on use of luminal narrowing, a poor indicator but one that persists for lack of effective means to do better. We present a case study demonstrating the assessment of biomechanical indices pertaining to plaque rupture risk non-invasively for individual patients enabled by histologically validated tissue characterization. METHODS: Routinely acquired clinical images of plaques were analyzed to characterize vascular wall tissues using software validated by histology (ElucidVivo, Elucid Bioimaging Inc.). Based on the tissue distribution, wall stress and strain were then calculated at spatial locations with varied fibrous cap thicknesses at diastolic, mean and systolic blood pressures. RESULTS: The von Mises stress of 152 [131, 172] kPa and the equivalent strain of 0.10 [0.08, 0.12] were calculated where the fibrous cap thickness was smallest (560 µm) (95% CI in brackets). The stress at this location was at a level predictive of plaque failure. Stress and strain at locations with larger cap thicknesses were calculated to be lower, demonstrating a clinically relevant range of risk levels. CONCLUSION: Patient specific tissue characterization can identify distributions of stress and strain in a clinically relevant range. This capability may be used to identify high-risk lesions and personalize treatment decisions for individual patients with cardiovascular disease and improve prevention of myocardial infarction and stroke.


Assuntos
Infarto do Miocárdio , Placa Aterosclerótica , Acidente Vascular Cerebral , Angiografia por Tomografia Computadorizada , Fibrose , Humanos , Infarto do Miocárdio/diagnóstico por imagem , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/patologia , Acidente Vascular Cerebral/diagnóstico por imagem
8.
JACC Cardiovasc Imaging ; 15(9): 1591-1601, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36075619

RESUMO

BACKGROUND: Combined computed tomography-derived myocardial blood flow (CTP-MBF) and computed tomography angiography (CTA) has shown good diagnostic performance for detection of coronary artery disease (CAD). However, fractal analysis might provide additional insight into ischemia pathophysiology by characterizing multiscale perfusion patterns and, therefore, may be useful in diagnosing hemodynamically significant CAD. OBJECTIVES: The purpose of this study was to investigate, in a multicenter setting, whether fractal analysis of perfusion improves detection of hemodynamically relevant CAD over myocardial blood flow quantification (CTP-MBF) using dynamic, 4-dimensional, dynamic stress myocardial computed tomography perfusion (CTP) imaging. METHODS: In total, 7 centers participating in the prospective AMPLIFiED (Assessment of Myocardial Perfusion Linked to Infarction and Fibrosis Explored with Dual-source CT) study acquired CTP and CTA data in patients with suspected or known CAD. Hemodynamically relevant CAD was defined as ≥90% stenosis on invasive coronary angiography or fractional flow reserve <0.80. Both fractal analysis and CTP-MBF quantification were performed on CTP images and were combined with CTA results. RESULTS: This study population included 127 participants, among them 61 patients, or 79 vessels, with CAD as per invasive reference standard. Compared with the combination of CTP-MBF and CTA, combined fractal analysis and CTA improved sensitivity on the per-patient level from 84% (95% CI: 72%-92%) to 95% (95% CI: 86%-99%; P = 0.01) and specificity from 70% (95% CI: 57%-82%) to 89% (95% CI: 78%-96%; P = 0.02). The area under the receiver-operating characteristic curve improved from 0.83 (95% CI: 0.75-0.90) to 0.92 (95% CI: 0.86-0.98; P = 0.01). CONCLUSIONS: Fractal analysis constitutes a quantitative and pathophysiologically meaningful approach to myocardial perfusion analysis using dynamic stress CTP, which improved diagnostic performance over CTP-MBF when combined with anatomical information from CTA.


Assuntos
Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Imagem de Perfusão do Miocárdio , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Citidina Trifosfato , Fractais , Humanos , Imagem de Perfusão do Miocárdio/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes
11.
Comput Math Methods Med ; 2022: 1768208, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36092791

RESUMO

The aim of this study was to investigate the relationship between multislice computed tomography (CT) angiography (MSCTA) imaging and high-sensitivity C-reactive protein (hs-CRP) in patients with hypertension and lower extremity arteriosclerosis. 68 hypertensive patients with lower extremity arteriosclerosis were selected as the observation group, and 68 healthy volunteers were selected as the control group to compare the differences in hs-CRP. According to the degree of stenosis, the patients were further divided into five grades: no obvious stenosis, mild stenosis, moderate stenosis, severe stenosis, and occlusion. The correlation between the degree of stenosis and the content of hs-CRP was compared. The changes of hs-CRP content before and after treatment were compared, and the difference of images before and after surgical treatment and the difference of hs-CRP expression in patients with occlusion were compared. Compared with the control group, the content of hs-CRP in the observation group was significantly higher (P < 0.05), and the degree of stenosis was positively correlated with the content of hs-CRP. After two weeks of treatment, the hs-CRP levels of patients with severe stenosis and occlusion were significantly lower than those before treatment (P < 0.01). The level of hs-CRP in patients with occlusion after arterial stent intervention was significantly lower than before, and the images also showed that the blood vessels were significantly expanded. The degree of stenosis in patients with lower extremity arteriosclerosis diagnosed by MSCTA imaging was closely related to the expression of hs-CRP in the patient, and a sustained high concentration of hs-CRP corresponded to a more severe degree of vascular occlusion. In conclusion, the hs-CRP can be used as one of the factors to predict and evaluate the occurrence of cardiovascular and cerebrovascular diseases.


Assuntos
Doença da Artéria Coronariana , Hipertensão , Proteína C-Reativa/metabolismo , Angiografia por Tomografia Computadorizada , Constrição Patológica/diagnóstico por imagem , Angiografia Coronária , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Extremidade Inferior/diagnóstico por imagem , Tomografia Computadorizada Multidetectores
12.
BMC Cardiovasc Disord ; 22(1): 398, 2022 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068548

RESUMO

OBJECTIVE: We sought to investigate the correlation of pericoronary adipose tissue with coronary artery disease and left ventricular (LV) function. METHODS: Participants with clinically suspected coronary artery disease were enrolled. All participants underwent coronary computed tomography angiography (CCTA) and echocardiography followed by invasive coronary angiography (ICA) within 6 months. Pericoronary adipose tissue (PCAT) was extracted to analyze the correlation with the Gensini score and LV function parameters, including IVS, LVPW, LVEDD, LVESD, LVEDV, LVESV, FS, LVEF, LVM, and LVMI. The correlation between PCAT and the Gensini score was assessed using Spearman's correlation analysis, and that between the PCAT volume or FAI and LV function parameters was determined using partial correlation analysis. RESULTS: One hundred and fifty-nine participants (mean age, 64.55 ± 10.64 years; men, 65.4% [104/159]) were included in the final analysis. Risk factors for coronary artery disease, such as hypertension, diabetes, dyslipidemia, and a history of smoking or drinking, had no significant association with PCAT (P > 0.05), and there was also no correlation between PCAT and the Gensini score. However, the LAD-FAI was positively correlated with the IVS (r = 0.203, P = 0.013), LVPW (r = 0.218, P = 0.008), LVEDD (r = 0.317, P < 0.001), LVESD (r = 0.298, P < 0.001), LVEDV (r = 0.317, P < 0.001), LVESV (r = 0.301, P < 0.001), LVM (r = 0.371, P < 0.001), and LVMI (r = 0.304, P < 0.001). Also, the LCX-FAI was positively correlated with the LVEDD (r = 0.199, P = 0.015), LVESD (r = 0.190, P = 0.021), LVEDV (r = 0.203, P = 0.013), LVESV (r = 0.197, P = 0.016), LVM (r = 0.220, P = 0.007), and LVMI (r = 0.172, P = 0.036), and the RCA-FAI was positively correlated with the LVEDD (r = 0.258, P = 0.002), LVESD (r = 0.238, P = 0.004), LVEDV (r = 0.266, P = 0.001), LVESV (r = 0.249, P = 0.002), LVM (r = 0.237, P = 0.004), and LVMI (r = 0.218, P = 0.008), respectively. Finally, the total volume was positively correlated with FS (r = 0.167, P = 0.042). CONCLUSION: The FAI was positively correlated with the LV function but was not associated with the severity of coronary artery disease.


Assuntos
Doença da Artéria Coronariana , Tecido Adiposo/diagnóstico por imagem , Idoso , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Função Ventricular Esquerda
13.
Balkan Med J ; 39(5): 366-373, 2022 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-36089832

RESUMO

Background: Pulmonary embolism is a clinical condition caused by the obstruction of the pulmonary artery and its branches with endogenous, exogenous embolism, or local thrombus formation. It is a rare but potentially life-threatening event in the pediatric population. Pediatric pulmonary embolism has many unknown characteristics. Aims: To evaluate clinical features, genetic and acquired risk factors, diagnostic imaging, and treatment strategies with long-term results in children with pulmonary embolism. Study Design: A retrospective multicenter clinical trial. Methods: Patients aged 0-18 years who were diagnosed with pulmonary embolism with computed tomography pulmonary angiography (CTPA) findings (intraluminal filling defect in the lobar or main pulmonary artery) in 3 university hospitals between 2006 and 2021 were included in the study. A form was created for data standardization, and variables were collected retrospectively through medical record review. In addition to the features given above, we also evaluated in situ pulmonary artery thrombosis (ISPAT) and patients' Wells scores. Follow-up CTPA results were evaluated for patient response to treatment. Complete recovery means that there were no lesions, incomplete recovery if there was still embolism, and no response if there was no change. Results: Twenty-four patients (female:13, male:11) were included in the study. The mean age was 13.5 years. All patients but one had at least one or more genetic or acquired risk factors. Factor V Leiden mutation (16.6%) was the most common genetic risk factor. Six of 16 patients with Doppler ultrasonography were diagnosed with ISPAT because there was no sign of thromboembolic thrombosis. Nine (41.6%) patients had a Wells score of >4 (pulmonary embolism clinically strong), and 15 (58.4%) patients scored <4 (pulmonary embolism clinically likely weak), indicating that an alternative diagnosis was more likely than pulmonary embolism (sensitivity %37.5). The mean follow-up period was 23 (±17) months. Complete and incomplete recovery was observed in 15 (62.5%) and 7 (29.1%) patients, respectively, among the patients who underwent follow-up evaluation. No response was obtained in 2 patients (8.3%) who died. Conclusion: The Wells scoring system seems insufficient to diagnose pulmonary embolism in children and should be improved by adding new parameters. ISPAT may be more common in children with congenital heart disease and systemic disease.


Assuntos
Embolia Pulmonar , Adolescente , Angiografia/métodos , Criança , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Masculino , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Estudos Retrospectivos , Turquia/epidemiologia
14.
Aging Male ; 25(1): 257-265, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36102620

RESUMO

OBJECTIVES: To explore the value of dual-energy computed tomography (DE-CT) angiography in diagnosis of arteriogenic erectile dysfunction (ED) patients and feasibility of new scanning area that excludes the testis. MATERIALS AND METHODS: Ninety-three patients suspected of suffering arterial ED and 40 health volunteers underwent penile duplex Doppler ultrasound and DE-CT angiography (DE-CTA). The scanning range of DE-CTA covered whole arterial system of pelvis and testis was excluded. Two blinded investigators independently evaluated the arterial system that supplies the penis. RESULTS: Finally, 1596 segments were evaluated and 470 segments were judged to be abnormal. The distribution was: 2 (0.4%) in common iliac artery, 7 (1.5%) in internal iliac artery, 82 (17.5%) in internal pudendal artery, 89 (18.9%) in penile artery, 120 (25.5%) in dorsal artery, and 170 (36.2%) in cavernosal artery. The specificity, sensitivity, positive predictive value, and negative predictive value of DE-CTA in diagnostic were 86.02%, 87.50%, 94.12%, and 72.92%. Besides, the new scan area allowed for effective evaluation of the arteries while excluding the testis. CONCLUSION: DE-CTA can provide unbiased, safe evaluation of the vascular status of the penile bed in patients with ED.


Assuntos
Disfunção Erétil , Impotência Vasculogênica , Artérias/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Disfunção Erétil/diagnóstico por imagem , Humanos , Impotência Vasculogênica/diagnóstico por imagem , Masculino , Tecnologia
15.
Sci Rep ; 12(1): 15274, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-36088490

RESUMO

To investigated morphological variability of vertebral artery (VA) origin and its entrance level into cervical transverse foramina by computed tomography angiography (CTA). To retrospectively investigated CTA of 223 subjects (446 VA courses). Investigated were origin of the VA and its level of entrance into vertebral transverse foramen with notification of the sex and side of variation. The VA entered the C6 transverse process in 91.70% of specimens (409 out of 446 VA courses). Abnormal entrance of VA was observed in 8.30% of specimens (37 VA courses), with the level of entrance into the C3, C4, C5, or C7 transverse foramen at 0.22%, 2.47%, 4.71% and 0.90% respectively. Comparably, the overall variability of abnormal origin of VA was 1.57% (7 out of 466 VA courses), in which the left vertebral arteries all arose from aortic arch. The variation rate of vertebral entrance rose up to 50% in abnormal origin subgroup. When comparing subgroups of subjects with normal and abnormal origin, there was significance difference in the frequency of entrance variation in the level of transverse foramen (p < 0.001). Abnormal entrance and origin of VA were observed in 8.30% and 1.57% of VA courses, which can be accurately appeared by CTA. Regarding to the subgroups of abnormal origin, the frequency of entrance variation was significantly increased in the level of transverse foramen compared to that of normal origin.


Assuntos
Angiografia por Tomografia Computadorizada , Artéria Vertebral , Angiografia , Vértebras Cervicais , Humanos , Estudos Retrospectivos , Artéria Vertebral/anatomia & histologia , Artéria Vertebral/diagnóstico por imagem
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1626-1629, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36085693

RESUMO

Accessing aortic remodeling status through regular follow-ups is essential for acute type A aortic dissection patients undergone surgical treatment. Aortic remodeling status was usually determined using diameter or area measurements of the true and false lumen in specific anatomical slices of medical images. However, these indicators only represent partial information about the aorta and can hardly characterize the overall aorta situation. In this study, we included two types of morphology features collected from computed tomography angiography images to predict the aortic remodeling. One type is the volumetric measurements of the true and false lumen, which provide a better overall description of the aorta, and the other type is the volumetric measurements of the thrombus in false lumen and the patent false lumen, which present more detailed information of the dissection. Through progressively incorporating these measurements into the construction of the remodeling prediction model, we investigated the importance of the features that describe the overall situation and that characterize aortic internal details in remodeling prediction, especially the effect of quantitative thrombosis features. The results showed that with the inclusion of the two types of volume features, the prediction accuracy of the model increased, which proves that volumetric measurements of aortic dissection, especially the volume of thrombus, are of significant value in aortic remodeling prediction, and should be paid more attention on in clinical practice and research areas. Clinical Relevance-Demonstrating the importance of volumetric measurements of true and false lumen thrombus in false lumen and patent false lumen in the prediction of aortic remodeling.


Assuntos
Aneurisma Dissecante , Aneurisma Dissecante/diagnóstico por imagem , Angiografia , Aorta/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Humanos , Tomografia Computadorizada por Raios X
17.
Medicine (Baltimore) ; 101(36): e30454, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086746

RESUMO

The degree of blood vessel stenosis significantly influences diabetic foot treatment. This study aimed to investigate the association between computed tomography angiography (CTA) stenosis and skin perfusion pressure (SPP), which are noninvasive vascular assessments used to evaluate diabetic foot wounds. Forty patients who reported diabetic foot wounds between November 2016 and December 2017 were included in the study. SPPand CTA were performed to evaluate the blood flow, and the rate of decrease in wound size was measured for the wounds corresponding to Meggitt-Wagner grade 1 at the first evaluation and 4-week intervals. The P value of the association between the degree of CTA stenosis and the SPP value was 0.915, and the P value of the association between CTA stenosis and decreasing rate of wound size was .235. There was no statistically significant association between SPP and the decreasing rate of wound size according to the degree of CTA stenosis. The association between SPP value and the decreasing rate of wound size was statistically significant (P < .05). The decreasing rate in diabetic foot wound size was significantly associated with SPP but not with CTA stenosis.


Assuntos
Diabetes Mellitus , Pé Diabético , Angiografia por Tomografia Computadorizada , Constrição Patológica , Pé Diabético/terapia , Humanos , Perfusão , Pele/diagnóstico por imagem
18.
Medicine (Baltimore) ; 101(36): e30360, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086770

RESUMO

Thoracic outlet syndrome (TOS) presents with a variety of neurovascular symptoms, and its diagnosis cannot be established purely on the basis of clinical assessments. Computed tomography angiography (CTA) is currently the most useful investigative modality for patients with suspected vascular TOS. However, CTA facilities are limited, and CTA itself is an expensive and a resource-intensive technique associated with risks such as radiation exposure and contrast toxicity. Therefore, a screening test to identify the need for CTA may facilitate clinical management of patients with suspected TOS. Data for patients with suspected arterial TOS who underwent duplex ultrasound with arterial hemodynamic assessment (HDA) (pulse-volume recording and Doppler arterial pressure measurement) at King Saud University Medical City Vascular Lab between 2009 and 2018 were collected. The sensitivity, specificity, positive and negative predictive values (NPV), and area under the curve for duplex ultrasound and arm arterial HDA with CTA were reviewed. The data for 49 patients (mean age, 31 ± 14 years) were reviewed, of which 71% were female. The sensitivity, specificity, positive predictive value, and NPV of duplex ultrasound were 86.7%, 49.3%, 26.5%, and 94.6%, respectively. For arm arterial HDA, these values were 73.3%, 78.9%, 42.3%, and 93.3%, respectively. The combination of arm arterial HDA with duplex ultrasound scores yielded sensitivity, specificity, positive predictive value, and NPV of 93.3%, 42.3%, 25.5%, and 96.8%, respectively. The combination of duplex ultrasound with arm arterial HDA showed higher sensitivity and NPV than either test alone. The specificity of arm arterial HDA was significantly higher than that of the other measurements. When suspected, arterial TOS could be ruled out using duplex ultrasound and arm arterial HDA. These 2 investigations may help determine the need for CTA.


Assuntos
Angiografia por Tomografia Computadorizada , Síndrome do Desfiladeiro Torácico , Adolescente , Adulto , Angiografia/métodos , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Síndrome do Desfiladeiro Torácico/diagnóstico por imagem , Adulto Jovem
19.
Khirurgiia (Mosk) ; (9): 105-114, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36073591

RESUMO

We report surgical treatment of 4 patients with superior mesenteric artery aneurysm. A comprehensive examination including Doppler ultrasound and CT angiography of visceral arteries made it possible to assess the features of vascular anatomy. In accordance with the peculiarities of upper mesenteric artery angioarchitectonics, open and endovascular methods were used. A differentiated approach made it possible to treat patients without any complications.


Assuntos
Aneurisma , Procedimentos Endovasculares , Gastroenteropatias , Aneurisma/complicações , Aneurisma/diagnóstico , Aneurisma/cirurgia , Angiografia por Tomografia Computadorizada , Gastroenteropatias/complicações , Humanos , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/cirurgia
20.
Radiat Prot Dosimetry ; 198(9-11): 547-553, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-36005971

RESUMO

The effective dose is a quantity used in clinical practice for statistical evaluation of the radiation dose of patients undergoing different types of examinations. Coronary computed tomography angiography (CCTA) is a specific examination whose calculated effective dose may be subject to several biases. For this reason, it is important to consider factors (different examination techniques, heart rate and patient habitus) that may influence its resulting value. Another critical factor is the methodological procedure for calculating the effective dose and cardiac-specific coefficient used to estimate effective dose from the dose-length product in computed tomography. Because CCTA is increasingly used in cardiology, it is recommended that the chest coefficient be replaced with a new cardiac coefficient when calculating the effective dose.


Assuntos
Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Coração , Humanos , Doses de Radiação , Tomografia Computadorizada por Raios X
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