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1.
J Comput Assist Tomogr ; 44(1): 7-12, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939875

RESUMO

OBJECTIVE: The aim of the study was to investigate the feasibility of coronary computed tomography (CT) angiography with a low kilovoltage peak scan and a refined scan timing prediction using a small contrast medium (CM) dose. METHODS: In protocol A, 120-kVp scanning and a standard CM dose were used. The scan timing was fixed. In protocol B, 80 kVp and a 60% CM dose were used. The scan timing was determined according to the interval from the CM arrival to the peak time in the ascending aorta. We measured the CT number and recorded the radiation dose. RESULTS: Higher CT numbers were observed in the left circumflex (proximal, P = 0.0235; middle, P = 0.0007; distal, P < 0.0001) in protocol B compared with protocol A. The radiation dose in protocol B was significantly lower than in protocol A (2.2 ± 0.9 vs 4.3 ± 1.7 mSv). CONCLUSIONS: Low-contrast, low-radiation dose, high-image quality coronary CT angiography can be performed with low kilovoltage peak scanning and a refined scan timing prediction.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Meios de Contraste/administração & dosagem , Doença da Artéria Coronariana/diagnóstico por imagem , Intensificação de Imagem Radiográfica/métodos , Idoso , Cálculos da Dosagem de Medicamento , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Estudos Retrospectivos
2.
J Comput Assist Tomogr ; 44(1): 13-19, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939876

RESUMO

OBJECTIVE: To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol. METHODS: Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups. RESULTS: In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P < 0.0001). CONCLUSION: Low-kV and low-CM volume CTA, combined with IMR, allows to correctly performing TAVI planning with high-quality images and significant radiation dose reduction compared with standard CTA protocol.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Meios de Contraste/administração & dosagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Estenose da Valva Aórtica/cirurgia , Feminino , Humanos , Bases de Conhecimento , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Período Pré-Operatório , Doses de Radiação , Substituição da Valva Aórtica Transcateter
3.
J Comput Assist Tomogr ; 44(1): 20-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939877

RESUMO

OBJECTIVES: The purpose of this study was to evaluate whether quantitative analysis of lower leg muscle enhancement measured from dynamic computed tomographic angiography (dyn-CTA) could be used for diagnosis of peripheral arterial occlusive disease. METHODS: Patients (N = 35) with known peripheral arterial occlusive disease underwent the dyn-CTA of calves first. Five minutes later, standard CTA of the peripheral runoff from the diaphragm to the toes was performed. A runoff score was assigned by radiologists as a reference standard for each of 4 lower leg artery segments. The lower leg muscle enhancement measured from the dyn-CTA was analyzed by using quantitative kinetic parameters, including initial enhancement (E1), peak enhancement (Epeak), and enhancement ratio (ER) calculated from average time attenuation curves. In addition, histogram of lower leg muscle enhancement was evaluated by using the first enhanced phase images. RESULTS: Lower extremities were diagnosed as a normal group (n = 22) with each vessel segment score equals to 1 or lower and runoff score, 7 or lower, and otherwise as an ischemia group (n = 48). Average ± SD E1 is 91.4% ± 8.5% and 82.3% ± 10.7%, Epeak is 122.7% ± 10.4% and 115.6% ± 11.1%, and ER is 0.75 ± 0.05 and 0.72 ± 0.09 for normal and ischemia group, respectively. Statistical analysis showed that average E1 and Epeak for the ischemia group were significantly lower (P < 0.05) than the normal group. The histogram analysis demonstrated that mean and median of muscle enhancement in the ischemia group were significantly smaller (P < 0.05), and coefficient of variation (CV) was significantly larger (P < 0.05) than the normal group. There were weak negative correlations (r = -0.42, P < 0.05) between runoff scores and E1 and Epeak, and weak positive correlation (r = 0.40, P < 0.05) between runoff scores and CV. The receiver operating characteristics analysis between the 2 groups had area under the curve of 0.77 and 0.76 for E1 and CV, respectively. CONCLUSIONS: Lower leg muscle enhancement measured from the dyn-CTA could be assessed quantitatively to assist diagnosis of ischemia in clinical practice.


Assuntos
Arteriopatias Oclusivas/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Extremidade Inferior/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Doença Arterial Periférica/diagnóstico por imagem , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação
4.
J Comput Assist Tomogr ; 44(1): 32-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939879

RESUMO

OBJECTIVE: To evaluate the effect of ultra high-resolution computed tomography (UHRCT) and model-based iterative reconstruction (MBIR) on the detectability of simulated submillimeter artery. METHODS: A small vessel phantom ranging from 0.4 to 2.0 mm in diameter and edge phantoms of low to high attenuation values were scanned by UHRCT (super-high-resolution mode and normal-resolution-mode) and conventional CT, and data were reconstructed by MBIR and filtered back projection (FBP). Vessel detectability was assessed subjectively and the effective size at which 50% of response was achieved (ES50 [mm]) was calculated. Modulation transfer function (MTF) was calculated by an edge spread function method. RESULTS: ES50 of super high-resolution mode (0.36 mm for MBIR and 0.50 mm for FBP) was significantly smaller than those of normal-resolution mode (P < 0.01). In the MTF analysis, the MTF of MBIR improved as the edge phantom attenuation increased, whereas that of FBP was stable. CONCLUSIONS: Both UHRCT and MBIR are effective for the detectability of simulated submillimeter artery.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Vasos Coronários/diagnóstico por imagem , Algoritmos , Humanos , Imagens de Fantasmas , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador
5.
J Comput Assist Tomogr ; 44(1): 37-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939880

RESUMO

OBJECTIVE: The purpose of this study was to determine whether computed tomography (CT) angiography with machine learning (ML) can be used to predict the rapid growth of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: This retrospective study was approved by our institutional review board. Fifty consecutive patients (45 men, 5 women, 73.5 years) with small AAA (38.5 ± 6.2 mm) had undergone CT angiography. To be included, patients required at least 2 CT scans a minimum of 6 months apart. Abdominal aortic aneurysm growth, estimated by change per year, was compared between patients with baseline infrarenal aortic minor axis. For each axial image, major axis of AAA, minor axis of AAA, major axis of lumen without intraluminal thrombi (ILT), minor axis of lumen without ILT, AAA area, lumen area without ILT, ILT area, maximum ILT area, and maximum ILT thickness were measured. We developed a prediction model using an ML method (to predict expansion >4 mm/y) and calculated the area under the receiver operating characteristic curve of this model via 10-fold cross-validation. RESULTS: The median aneurysm expansion was 3.0 mm/y. Major axis of AAA and AAA area correlated significantly with future AAA expansion (r = 0.472, 0.416 all P < 0.01). Machine learning and major axis of AAA were a strong predictor of significant AAA expansion (>4 mm/y) (area under the receiver operating characteristic curve were 0.86 and 0.78). CONCLUSIONS: Machine learning is an effective method for the prediction of expansion risk of AAA. Abdominal aortic aneurysm area and major axis of AAA are the important factors to reflect AAA expansion.


Assuntos
Aneurisma da Aorta Abdominal/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Aprendizado de Máquina , Masculino , Estudos Retrospectivos
6.
J Comput Assist Tomogr ; 44(1): 153-159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939897

RESUMO

OBJECTIVE: The aim of this study was to assess the utility of 70-kilovoltage-peak (kVp) contrast-enhanced computed tomography (CECT) for visualization and identification of the right adrenal vein (RAV) in comparison with that of conventional 120-kVp CECT. METHODS: This retrospective study included patients who underwent adrenal venous sampling with concurrent biphasic 120-kVp (120-kVp group, n = 43) or 70-kVp (70-kVp group, n = 47) CECT. Signal-to-noise ratios, contrast-to-noise ratios, longitudinal lengths, conspicuity scores, RAV detection rates, and size-specific dose estimates were compared between the 2 groups. RESULTS: In comparison with the 120-kVp group, the 70-kVp group had significantly higher signal-to-noise and contrast-to-noise ratios (P < 0.001-P = 0.033), greater longitudinal lengths (P < 0.001-P = 0.002), superior conspicuity scores for the RAV (P < 0.001), higher RAV detection rates (P = 0.015-P = 0.033), and lower size-specific dose estimates (P < 0.001). CONCLUSIONS: Seventy-kilovoltage-peak CECT has advantages over conventional 120-kVp CECT and is potentially useful for noninvasive assessment of the precise anatomy of the RAV.


Assuntos
Glândulas Suprarrenais/irrigação sanguínea , Angiografia por Tomografia Computadorizada/métodos , Hiperaldosteronismo/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Estudos Retrospectivos , Sensibilidade e Especificidade , Razão Sinal-Ruído
7.
Medicine (Baltimore) ; 99(4): e18881, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977894

RESUMO

INTRODUCTION: Nexplanon is a 4 cm rod-shaped barium sulphate coated contraceptive implant with a usual subdermal insertion in the inner non-dominant upper arm. Complications proper to subdermal contraceptive implants are unusual and principally localized and minor, comprising infection at the site of implantation, hematoma, abnormal scar development, or local nerve and blood vessel injuries. Infrequently, contraceptive implant migration can happen, though habitually not far from the site of insertion. Pulmonary embolization of the device is remarkably rare and can present with symptoms such as chest pain or dyspnea. PATIENT CONCERNS AND DIAGNOSIS: We report one of the rare cases of asymptomatic Nexplanon pulmonary embolism in a 26-year-old female. INTERVENTIONS AND OUTCOMES: An endovascular intervention successfully retrieved the device from the lateral segment right middle lobe pulmonary artery without any complications. CONCLUSION: Several cases of contraceptive implant migration into the pulmonary artery have been reported to this day. Preventing this life-threatening complication is challenging, and yet, no clear guidelines have been established.


Assuntos
/administração & dosagem , Desogestrel/administração & dosagem , Implantes de Medicamento/efeitos adversos , Migração de Corpo Estranho/cirurgia , Artéria Pulmonar/diagnóstico por imagem , Adulto , Angiografia por Tomografia Computadorizada/métodos , Feminino , Migração de Corpo Estranho/diagnóstico por imagem , Humanos , Ultrassonografia
8.
Medicine (Baltimore) ; 99(2): e18069, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914012

RESUMO

This study aims to find and locate foramens exactly in maxilla and mandible in case of complications during surgeries.Computer topographic angiography (CTA) images of 120 cases were reviewed. The measurements were performed on coronal, sagittal and axial planes after the 3 dimension volume reconstruction. The distances among foramens, bony landmarks, teeth, and facial artery were all measured with the angles as adjustments.The incisive foramen (IF) was measured 20.55 ±â€Š2.81 mm to margo inferior of incisor, and 45.27 ±â€Š5.27 degree from the axial midline. The greater palatine foramen located 43.17 ±â€Š2.55 mm from the IF, while 21.08 ±â€Š3.75 degree from the midline in axial plane. The lesser palatine foramina located 44.56 ±â€Š5.74 mm from the IF and 20.05 ±â€Š3.59 degree to the midline. The Mandibular foramen (MBF) was 91.15 ±â€Š1.86 mm horizontally to the margo inferior of incisor. The angle that the MBF-margo inferior of incisor line made with the axial midline was 31.25 ±â€Š2.89 degree. The shortest horizontal distance from the mental foramen (MF) to the facial artery in sagittal plane was 21.90 ±â€Š1.86 mm, while it became 13.00 ±â€Š2.05 mm in coronary section. The horizontal distance from the MF to the margo inferior of incisor in sagittal plane was 22.04 ±â€Š3.22 mm. It turned out to be 25.78 ±â€Š5.23 mm between MF and mid-sagittal line in coronary section. The vertical distance was 25.20 ±â€Š3.06 mm from the upper margin of the second premolar to the MF.The foramens were clearly seen through CTA. Moreover, linear and angular measurements were presented, which makes it safer and wiser for surgeons to consider the biometric data before operations.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Mandíbula/anatomia & histologia , /diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/cirurgia , Criança , Face/irrigação sanguínea , Face/diagnóstico por imagem , Feminino , Humanos , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
9.
Medicine (Baltimore) ; 99(2): e18742, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914093

RESUMO

To investigate the feasibility of histogram analysis with computed tomography angiography (CTA) in distinguishing between soft tissue sarcomas and benign soft tissue tumors. Fourty nine patients (23 men, mean age = 44.3 years, age range = 25-64) with pathologically-confirmed soft tissue sarcoma (n = 24) or benign soft tissue tumors (n = 25) in the lower extremities undergoing CTA for tumor evaluation were retrospectively analyzed. Two radiologists separately performed histogram analyses of CT density with CTA images by drawing a region of interest (ROI). The 10th (P10), 25th (P25), 50th (P50), 75th (P75), 90th percentiles (P90), mean, and standard deviations (SD) of measured tumor density were obtained along with measurements of the absolute value of kurtosis (AVK), absolute value of skewness (AVS), and inhomogeneity for each tumor. Intra-class correlation coefficients (ICC) were calculated to determine inter- and intra-reader variability in parameter measurements. The Mann-Whitney U test was used to compare histogram parameters between soft tissue sarcomas and benign soft tissue tumors. Receiver operator characteristic (ROC) curves were constructed to evaluate the accuracy of tumor discrimination. ICC was greater than 0.7 for AVS, AVK, and inhomogeneity, and >0.9 for mean, SD, and all percentile measures. There was no significant difference in P10, P25, P50, P75, P90, mean, or SD between soft tissue sarcomas and benign tumors (P > .05). AVS, AVK, and inhomogeneity were significantly higher in soft tissue sarcomas (P < .05). Areas under the curve (AUC) were 0.81, 0.83, and 0.84 for AVS, AVK, and inhomogeneity respectively. AUC were below 0.6 for mean, SD, and all percentiles.Skewness, kurtosis, and inhomogeneity measurements derived from histogram analysis from CTA distinguish between soft tissue sarcomas and benign soft tissue tumors.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Br J Radiol ; 93(1105): 20190003, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31738082

RESUMO

OBJECTIVE: This study aimed to assess and compare the diagnostic performance of the coronary artery to aortic luminal attenuation ratio (CAR), transluminal attenuation gradient (TAG), and corrected coronary opacification (CCO) difference on coronary CT angiography (cCTA) for detecting haemodynamically significant coronary artery stenosis. METHODS: 33 patients who underwent cCTA, gated SPECT myocardial perfusion imaging (MPI), and invasive coronary angiography within 3 months were included in this retrospective study. The degree of coronary stenosis on cCTA was visually assessed in all patients. Additionally, CAR, TAG, and CCO difference were analyzed and calculated in all patients. Haemodynamically significant coronary stenosis was defined as a vessel with ≥50% luminal stenosis on invasive coronary angiography and an associated abnormal perfusion defect on MPI in the same territory. Diagnostic performance was assessed on a per-vessel basis by the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS: Among 99 vessels, 12 were excluded and the remaining 87 were analyzed. 17 (19.5%) vessels were determined as haemodynamically significant coronary artery stenosis. On ROC analysis, the AUC was 0.71 for cCTA, 0.80 for CAR, 0.61 for TAG, 0.74 for CCO, 0.87 for combined CAR and cCTA, 0.77 for combined TAG and cCTA, and 0.75 for combined CCO and cCTA. The AUC for combined CAR and cCTA was significantly greater compared with cCTA alone (p < 0.01). CONCLUSION: Non-invasive CAR derived from 64-detector row CT was feasible and might be helpful for the detection of haemodynamically significant coronary artery stenosis. Still, further investigations such as intra- and inter-reader correlation, evaluation of larger numbers in different settings, and time efficiency are required for applying CAR in various situations. ADVANCES IN KNOWLEDGE: CAR could be used as novel noninvasive technique to detect haemodynamically significant coronary artery stenosis.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Estenose Coronária/diagnóstico por imagem , Idoso , Aorta Torácica/diagnóstico por imagem , Estenose Coronária/fisiopatologia , Feminino , Hemodinâmica , Humanos , Masculino , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Tomografia Computadorizada de Emissão de Fóton Único
13.
J Comput Assist Tomogr ; 44(1): 1-6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31855880

RESUMO

OBJECTIVES: To investigate the coronary venous system (CVS) and its spatial relationship with coronary arteries by using 256-slice computed tomography (CT). METHODS: One hundred one patients underwent coronary CT angiography by using a 256-slice CT. In each patient, the CVS and its spatial relationship with coronary arteries were analyzed. We measured the diameters and angulations of the coronary sinus (CS), great cardiac vein, anterior interventricular vein (AIV), left marginal vein, posterior vein of the left ventricle (PVLV), and posterior interventricular vein (PIV), and the distances, respectively, from the CS ostium and from the crossing point to the ostium of corresponding tributaries. RESULTS: The following 5 pairs of veins and arteries had a higher frequency of intersecting compared with others: the CS/great cardiac vein and the left circumflex coronary artery (97.1%), the AIV and the diagonal or ramus branch (92.1%), the PIV and the posterior branch of left ventricle artery (88.1%), the left marginal vein and the circumflex or circumflex marginal (73.9%), and the PVLV and the circumflex or circumflex marginal (31.6%). The other 2 pairs had a higher frequency of running parallel to each other: the AIV and the left anterior descending artery (76.2%) and the PIV and the posterior descending artery (54.4%). Most tributaries were lateral to their corresponding arteries at the crossing point except for the AIV. For the PVLV and PIV, the distances from the crossing point to the ostium of corresponding veins when the veins were lateral to the arteries were smaller than those when the veins were medial to the arteries (P < 0.05). CONCLUSIONS: The CVS and its anatomical relationship with the coronary arterial system can be examined with details by using a 256-slice CT, which has important clinical implications.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/instrumentação , Vasos Coronários/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada/métodos , Doença da Artéria Coronariana , Vasos Coronários/anatomia & histologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Ideggyogy Sz ; 72(11-12): 407-412, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31834684

RESUMO

Background and purpose: Acute mortality rate of stroke in Hungary is significantly higher than in Western Europe, which is likely to be partially attributable to suboptimal treatment. Methods: We examined the use of acute vascular imaging and mechanical thrombectomy for acute ischaemic stroke patients. We collected data on 20 consecutive patients from Hungarian stroke centers before 31st August 2016. Results: Out of the reported 410 patients, 166 (40.4%) underwent CT angiography and 44 (10.7%) had mechanical thrombectomy. Conclusion: Only about 1/3 of acute ischaemic stroke patients eligible for thrombectomy actually had it. The underlying reasons include long onset-to-door time, low utilization of acute vessel imaging and a limited neuro-intervention capacity needing improvement.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/cirurgia , Trombectomia/métodos , Humanos , Hungria , Resultado do Tratamento
15.
Rev. cuba. angiol. cir. vasc ; 20(2): e391, jul.-dic. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1003861

RESUMO

Introducción: Los aneurismas arteriales son poco frecuentes en edad pediátrica, sin embargo; se observa un incremento en la incidencia de pseudoaneurismas a partir de traumatismos vasculares, sobre todo, por la aplicación de procederes invasivos. También se observan en procesos infecciosos y tumorales adyacentes, que acaban por lesionar la pared arterial. La mayoría suelen ser asintomáticos, o se presentan como una masa pulsátil que se asientan sobre la zona de la arteria afectada. Objetivo: Demostrar la importancia del diagnóstico temprano de los pseudoaneurismas para el tratamiento quirúrgico oportuno y evitar complicaciones posteriores. Presentación del caso: se discute un caso de una paciente de dos años de edad con un trauma vascular iatrogénico en la extremidad inferior derecha, que se manifestó como una tumoración pulsátil. Se realizó eco-doppler y angiografía, con lo que se diagnosticó un aneurisma de la arteria femoral derecha. Se realizó una exéresis y reconstrucción vascular con buena evolución. Conclusiones: El diagnóstico rápido de estas entidades vasculares evita que se presenten complicaciones posteriores y aseguran una evolución rápida y satisfactoria de los pacientes que las padecen(AU)


Introduction: Arterial aneurysms are rare in the pediatric ages. However, it is observed an increasement of the incidence of pseudoaneurysms caused by vascular traumas, mainly due to the use of invasive procedures. It is also present in infectious and tumour processes that end up injuring the arterial wall. Most of them are asymptomatic or are presented as a pulsatile mass that sets up over the affected artery's zone. Objective: To show the importance of early diagnosis of pseudo-aneurysms. Case presentation: It is presented the case of a two years old patient with a iatrogenic vascular trauma in the right lower limb that manifested in the way of a pulsatile tumor. Through an eco-Doppler and an angiography, an aneurysm of the right femoral artery was diagnosed, which led to an excision and a vascular reconstruction with good evolution. Conclusions: Early diagnosis of these vascular entities allows its timely surgical treatment, avoids the appearance of further complications and assures a prompt and satisfactorily evolution of the patients(AU)


Assuntos
Humanos , Feminino , Pré-Escolar , Falso Aneurisma/cirurgia , Falso Aneurisma/diagnóstico , Artéria Femoral , Angiografia por Tomografia Computadorizada/métodos
16.
Pan Afr Med J ; 33: 312, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692927

RESUMO

Congenital malformations of the aortic arches are a heterogeneous group of diseases associated with developmental disorders of the primitive branchial arches during fetal life. The coarctation of the aorta is a common congenital vascular malformation which is a congenital narrowing of the aortic isthmus, a segment of the aorta between the left subclavian artery and the ductus arteriosus. The interruption of the aortic arch is considered by some authors as an extreme coarctation of the aorta, characterized by discontinuity between ascending and descending aorta. These abnormalities are integrated, in most cases, in the context of cardiac malformations from which they are indivisible. CT angiogram plays an essential role in the examination of these abnormalities, their preoperative assessment and their follow-up in the long term. We conducted a retrospective study of 42 patients undergoing CT angiogram following the detection of heart disease on echocardiography. CT angiogram was performed in 6 cases. The average age of patients was 2 years, ranging from 6 days to 14 years; a male predominance was reported with a sex ratio of 1,6. The main diseases were: coarctation of the aorta: 18 cases; hypoplasies of the aortic arch: 8 cases; interruptions of the aortic arch: 7 cases; abnormalities of the aortic arches: 9 cases. Some of these abnormalities were associated. Extracardiac abnormalities associated with congenital heart diseases are relatively frequent; multislice scanner allows for good analysis of the cardiac afferent and efferent pathways. CT complements echocardiogram for pre-treatment assessment of the main malformative diseases, especially for the detection of the associated extra-cardiac vascular abnormalities, thanks to its satisfactory tridimensional multiplanar exploration. It tends to supplant angiography in many pathological malformations for several reasons: it is less invasive; it provides high-resolution 3D images useful to surgeons; it established the anatomical diagnosis, assesses tracheal compression and any associated malformation; it guides surgical treatment.


Assuntos
Aorta Torácica/diagnóstico por imagem , Coartação Aórtica/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Cardiopatias Congênitas/diagnóstico por imagem , Adolescente , Aorta Torácica/anormalidades , Criança , Pré-Escolar , Ecocardiografia/métodos , Feminino , Humanos , Imagem Tridimensional/métodos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 98(46): e17474, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725604

RESUMO

BACKGROUND: The objective of this study aims to assess the clinic impact of low-radiation computed tomography coronary angiography (LR-CTCA) diagnosis for coronary artery stenosis (CAS). METHODS: This study will comprehensively search the following electronic databases from inception to the present: PUBMED, EMBASE, Cochrane Library, PsycINFO, Web of Science, Google, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, VIP database, WANGFANG, and China National Knowledge Infrastructure. All these electronic databases will be searched without language restrictions. All case-controlled studies on assessing the clinical impact of LR-CTCA diagnosis for patients with CAS will be included. Quality Assessment of Diagnostic Accuracy Studies tool will be utilized to evaluate the methodological quality for each qualified studies. RESULTS: We will assess the clinic impact of LR-CTCA diagnosis for CAS by measuring sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. CONCLUSION: The results of this study will summarize the latest evidence of LR-CTCA diagnosis for CAS. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019139336.


Assuntos
Angiografia por Tomografia Computadorizada/estatística & dados numéricos , Estenose Coronária/diagnóstico por imagem , Estudos de Casos e Controles , Angiografia por Tomografia Computadorizada/métodos , Humanos , Funções Verossimilhança , Metanálise como Assunto , Razão de Chances , Doses de Radiação , Projetos de Pesquisa , Sensibilidade e Especificidade , Revisão Sistemática como Assunto
18.
Medicine (Baltimore) ; 98(48): e18169, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770266

RESUMO

INTRODUCTION: Sinus of Valsalva aneurysm (SVA) protruding into the mitral anterior leaflet is an extremely rare clinical condition; herein, we present a case of unruptured noncoronary SVA protruding into the mitral anterior leaflet. PATIENT'S CONCERNS: A 46-year-old male was referred to hospital for exertional dyspnea. DIAGNOSIS: Transthoracic echocardiography (TTE) and coronary computed tomography angiography (CTA) suggested a noncoronary SVA protruding into the mitral anterior leaflet, causing mitral regurgitation and aortic insufficiency. INTERVENTIONS: The aneurysm was resected and the aortic and mitral valves were replaced with mechanical valves via a transaortic approach. OUTCOMES: Postoperative recovery was uneventful. CONCLUSIONS: A rare noncoronary SVA protruding into the mitral anterior leaflet can be diagnosed via TTE and CTA. Transaortic mitral surgery is feasible in patients with a dilated aortic annulus ring and mitral valve diseases.


Assuntos
Aneurisma Aórtico , Insuficiência da Valva Aórtica , Dispneia , Implante de Prótese de Valva Cardíaca/métodos , Insuficiência da Valva Mitral , Valva Mitral , Procedimentos Cirúrgicos Vasculares/métodos , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/fisiopatologia , Aneurisma Aórtico/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Dispneia/diagnóstico , Dispneia/etiologia , Dispneia/fisiopatologia , Ecocardiografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/fisiopatologia , Insuficiência da Valva Mitral/cirurgia , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/fisiopatologia , Resultado do Tratamento
19.
Radiol Clin North Am ; 57(6): 1083-1091, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582036

RESUMO

This article reviews the current state of imaging for acute ischemic stroke. Protocolized imaging acquisition using computed tomography in conjunction with coordinated stroke care allows for rapid diagnosis and prompt revascularization. Following the initial evidence to support endovascular therapy for large-vessel occlusion, published between 2014 and 2015, there are now guidelines supporting treatment up to 24 hours after time of onset of symptoms. Neuroimaging remains a central component in diagnosing acute stroke and potentially excluding patients from stroke treatment, as outlined in this article.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia por Ressonância Magnética/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Humanos , Neuroimagem/métodos
20.
Radiol Clin North Am ; 57(6): 1093-1108, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582037

RESUMO

Acute stroke is a leading cause of morbidity and mortality in the United States. Acute ischemic strokes have been classified according to The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification system, and this system aids in proper management. Nearly every patient who presents to a hospital with acute stroke symptoms has some form of emergent imaging. As such, imaging plays an important role in early diagnosis and management. This article reviews the imaging patterns of acute strokes, and how the infarct pattern and imaging characteristics can suggest an underlying cause.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Angiografia por Ressonância Magnética/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Humanos , Fatores de Risco , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico por imagem
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