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1.
Int J Sports Med ; 41(1): 3-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31791089

RESUMO

This study evaluated the morphological changes of the lower limb and associated hemodynamic responses to different lower-body compression pressures (COMPs) in physically active, healthy individuals at rest. Each of the 32 participants underwent three trials with three different degrees of lower-body compression applied: "Low" (2.2±1.4 mmHg), "Medium" (12.9±3.9 mmHg), and "High" (28.8±8.3 mmHg). In each COMP, a cross-sectional area of leg muscles (CSAmuscle), subcutaneous fat (CSAfat), superficial vessels (SupV), deep arteries (DA), and deep veins (DV) at the calf, knee, and thigh levels were measured using magnetic resonance imaging (MRI). Additionally, blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) were measured using Doppler ultrasound (USCOM®). With High COMP, calf CSAmuscle and SupV were smaller (p<0.01), whereas DA and DV were larger (p<0.05). Calf CSAfat, however, was similar among all COMPs. There were no major changes in CSAmuscle and CSAfat at knee and thigh levels. CO (3.2±0.9 L/min) and SV (51.9±16.4 mL) were higher (p<0.05) only with High COMP, but other hemodynamic variables showed no significant changes across different COMPs. The High COMP at the lower limb induces leg morphological changes and increases associated hemodynamic responses of physically active healthy individuals at rest.


Assuntos
Hemodinâmica/fisiologia , Extremidade Inferior/fisiologia , Meias de Compressão , Artérias/diagnóstico por imagem , Artérias/fisiologia , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Feminino , Frequência Cardíaca/fisiologia , Humanos , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Volume Sistólico/fisiologia , Gordura Subcutânea/irrigação sanguínea , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/fisiologia , Ultrassonografia Doppler , Resistência Vascular/fisiologia , Veias/diagnóstico por imagem , Veias/fisiologia , Adulto Jovem
2.
J Vasc Access ; 21(1): 105-109, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31328635

RESUMO

Non-maturation of arteriovenous fistulas is a frequent problem after dialysis access creation, especially in the forearm. The presence of accessory veins may play an important role in the non-maturing fistula. Several surgical and endovascular techniques are described to deal with this problem. We describe a new surgical technique in which we perform a rejoining of the arm veins to create a single large run-off vessel with greater diameter and flow for haemodialysis.


Assuntos
Braço/irrigação sanguínea , Derivação Arteriovenosa Cirúrgica/métodos , Diálise Renal , Veias/cirurgia , Adulto , Idoso de 80 Anos ou mais , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem
3.
Tech Vasc Interv Radiol ; 22(4): 100630, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864535

RESUMO

Venous malformations are very commonly encountered in interventional radiologic practice. Indications for therapy are clearly defined based on the lesion's impact on patient's quality of life. Screening laboratory coagulation studies in patients with historical or lesion morphologic risk factors often reveal abnormal coagulation parameters consistent with localized intravascular coagulation or more severe coagulopathic states. These may require chronic or periprocedural medical management to avoid potentially life-threatening disseminated intravascular coagulation or other thromboembolic phenomena. Once a multidisciplinary decision to treat a venous malformation is made, one must decide between percutaneous and/or surgical techniques. Sclerotherapy with adjunctive stasis of efflux (STASE) techniques have become the mainstay of therapy for most venous malformations as they are well-tolerated and effective. STASE techniques work primarily by (i) the administration of sclerosant(s) exerting an inhibitory and/or endotheliocidal effect on venous malformation endothelium leading to thrombosis, involution, and fibrosis, and secondarily via adjunctive outflow occlusion using any combination of local compression, balloons, gelatin, coils, laser, radiofrequency, or adhesives to improve sclerosant penetration and dwell-time in the lesion. Adhesives alone can fill the lesion to facilitate surgical resection in some cases. Common sclerosants in modern practice include sodium tetradecyl sulfate, bleomycin, polidocanol, ethanol, and hypertonic saline. Most agents can be given directly in unmodified or "neat" form or can be mixed with a gas to form a sclerofoam or embolic such as gelatin to form a sclerogel. Choice and method of sclerosant delivery in each patient is based on the intraluminal lesion volume, architecture, vital structure proximity, agent toxicity, viscosity, and level of experience of the interventional radiologist with that particular agent. Multi-session STASE therapy usually reduces symptoms of chronic pain or mass with low risk of known complications of skin or nerve impairment, compartment syndrome, hemoglobinuria, deep venous thrombosis, or pulmonary phenomena.


Assuntos
Procedimentos Endovasculares , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Malformações Vasculares/terapia , Veias/anormalidades , Tomada de Decisão Clínica , Terapia Combinada , Procedimentos Endovasculares/efeitos adversos , Humanos , Seleção de Pacientes , Fatores de Risco , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Veias/diagnóstico por imagem , Veias/fisiopatologia
4.
West J Emerg Med ; 20(5): 719-725, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31539328

RESUMO

INTRODUCTION: Peripheral, ultrasound-guided intravenous (IV) access occurs frequently in the emergency department, but certain populations present unique challenges for successfully completing this procedure. Prior research has demonstrated decreased compressibility under double tourniquet technique (DT) compared with single tourniquet (ST). We hypothesized that catheters inserted under DT method would have a higher first-stick success rate compared with those inserted under ST method. METHODS: We randomized 100 patients with a history of difficult IV access, as defined by past ultrasound IV, prior emergency visit with two or more attempts required for vascular access, history of IV drug abuse, history of end stage renal disease on hemodialysis or obesity, to ultrasound-guided IV placement under either DT or ST method. We measured the vein characteristics measured under ultrasound, and recorded the number of attempts and location of attempts at vascular access. RESULTS: Of an initial 100 patients enrolled, we analyzed a total of 99 with 48 placed under ST and 51 placed under DT. Attending physicians inserted 41.7% of ST and 41.2% of DT, with non-attending inserters (including residents, nurses, and technicians) inserted the remainder. First-stick success rate was observed at 64.3% in ST and 66.7% in DT (p=0.93). Attendings had an overall higher first-stick success rate (95.1%) compared to non-attending inserters (65.5%) (p=<0.001). The average vein depth measured in ST was 0.73 centimeters (cm) compared with 0.87 cm in DT (p=0.02). CONCLUSION: DT technique did not produce a measureable increase in first-stick success rate compared to ST, including after adjusting for level of training of inserter. However, a significant difference in average vein depth between the study arms may have limited the reliability of our overall results. Future studies controlling for this variable may be required to more accurately compare these two techniques.


Assuntos
Cateterismo Periférico/métodos , Estado Terminal/terapia , Serviço Hospitalar de Emergência , Torniquetes , Ultrassonografia/métodos , Veias/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Infusões Intravenosas/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
5.
Molecules ; 24(18)2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31547271

RESUMO

Diosmin is a natural compound with a wide range of biological activity, e.g., it improves lymphatic drainage, supports microcirculation, and increases venous tone, and venous elasticity, hence, it is applied in the pharmacotherapy of chronic venous disorders (CVD). The aim of this study was to assess the correlation between diosmin administration (2 × 600 mg daily) in patients suffering from CVD and the levels of selected factors influencing angiogenesis, which are involved in CVD pathophysiology. Thirty-five CVD patients were examined. Levels of plasma tumor necrosis factor alpha (TNF alpha), vascular endothelial growth factor (VEGF-A and VEGF-C); angiostatin, interleukin 6 (IL-6), fibroblast growth factor 2 (FGF2); and plasminogen (PLG) were measured with an Elisa assay before and after three months of diosmin administration. The clinical symptoms of CVD were monitored using ultrasound images, echo Doppler assay, visual analogue scale (VAS), and measurement of the leg circumference. The average content of TNF alpha, VEGF-C, VEGF-A IL-6, and FGF2 decreased after the therapy with diosmin in a significant manner; with p < 0.001, p < 0.05, p < 0.05, p < 0.01, and p < 0.01, respectively, and a significant (p < 0.05) increase in the plasma angiostatin level after the three-month treatment was found. A significant (p < 0.05) decrease in edema and the average leg circumference of the patients was observed after the therapy. Diosmin influences the angiogenic and inflammatory mechanisms involved in the pathophysiology of edema presented in patients with a different class of CVD.


Assuntos
Diosmina/farmacologia , Neovascularização Fisiológica/efeitos dos fármacos , Doenças Vasculares/tratamento farmacológico , Adulto , Angiostatinas/sangue , Doença Crônica , Feminino , Fator 2 de Crescimento de Fibroblastos/sangue , Humanos , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Neovascularização Fisiológica/fisiologia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangue , Ultrassonografia Doppler , Varizes/diagnóstico por imagem , Varizes/tratamento farmacológico , Varizes/fisiopatologia , Doenças Vasculares/sangue , Doenças Vasculares/diagnóstico por imagem , Fator A de Crescimento do Endotélio Vascular/sangue , Fator C de Crescimento do Endotélio Vascular/sangue , Veias/diagnóstico por imagem , Veias/fisiopatologia
6.
Artigo em Chinês | MEDLINE | ID: mdl-31434372

RESUMO

Objective: To analyze the clinical characteristics of two groups(vascular classification declines or not in narrow band imaging (NBI) of patients with advanced hypopharyngeal carcinoma after induced chemotherapy, to follow-up and compare the survival differences between the two groups, and to explore the effect of vascular changes on clinical prognosis after induced chemotherapy in patients with advanced hypopharyngeal carcinoma. Methods: Clinical data of 56 patients with advanced hypopharyngeal carcinoma from August 2014 to September 2016 in Beijing Tongren Hospital, Capital Medical University were collected. The patients were divided into two groups according to NBI vascular classification declines or not after induced chemotherapy. The survival of patients and the impact of different factors on the prognosis were retrospectively analyzed. SPSS 24.0 statistical software was used for analysis. Frequency data were compared between the two groups using χ(2) test. Kaplan-Meier method and Cox regression analysis were employed for survival analysis and Log-Rank test was used for inter-group comparison, P<0.05 was statistically significant. Results: There was significant difference in overall survival rate(OS) between two groups of patients with advanced hypopharyngeal carcinoma after induced chemotherapy (P<0.05). Multivariate analysis showed that NBI vascular classification changes after induced chemotherapy was the impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Conclusion: In addition to recurrence and metastasis, NBI vascular classification changes is the important impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Patients with NBI vascular classification declines have significant survival benefit. The patients with advanced hypopharyngeal carcinoma should be checked with NBI examination before and after induced chemotherapy. NBI should be included in the routine screening indicators for prognosis of advanced hypopharyngeal carcinoma.


Assuntos
Antineoplásicos/farmacologia , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias Hipofaríngeas/tratamento farmacológico , Imagem de Banda Estreita , Veias/efeitos dos fármacos , Veias/diagnóstico por imagem , Antineoplásicos/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Humanos , Neoplasias Hipofaríngeas/diagnóstico por imagem , Neoplasias Hipofaríngeas/patologia , Quimioterapia de Indução , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
7.
Sensors (Basel) ; 19(17)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466235

RESUMO

The dorsal hand vein images captured by cross-device may have great differences in brightness, displacement, rotation angle and size. These deviations must influence greatly the results of dorsal hand vein recognition. To solve these problems, the method of dorsal hand vein recognition was put forward based on bit plane and block mutual information in this paper. Firstly, the input gray image of dorsal hand vein was converted to eight-bit planes to overcome the interference of brightness inside the higher bit planes and the interference of noise inside the lower bit planes. Secondly, the texture of each bit plane of dorsal hand vein was described by a block method and the mutual information between blocks was calculated as texture features by three kinds of modes to solve the problem of rotation and size. Finally, the experiments cross-device were carried out. One device was used to be registered, the other was used to recognize. Compared with the SIFT (Scale-invariant feature transform, SIFT) algorithm, the new algorithm can increase the recognition rate of dorsal hand vein from 86.60% to 93.33%.


Assuntos
Mãos/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Reconhecimento Automatizado de Padrão/métodos , Veias/diagnóstico por imagem , Algoritmos , Humanos
8.
Arch. Soc. Esp. Oftalmol ; 94(8): 400-404, ago. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185627

RESUMO

Mujer de 73 años que acude a consulta con diagnóstico de hipertiroidismo de 8 meses de evolución. Desde entonces comenzó con hiperemia y proptosis ocular. En la exploración se observa exoftalmos bilateral de predominio derecho, ligera hiperemia conjuntival en ojo derecho asociada a vasos epiesclerales aumentados en su calibre con forma de cabeza de medusa. Tomografía computada con recto inferior aumentado de calibre sin datos de compresión de nervio óptico. En el estudio doppler de órbita se encuentra un flujo arteriorizado sobre la vena oftálmica superior con un posible diagnóstico de fístula carótido-cavernosa. La orbitopatía tiroidea relacionada a una fístula carótido-cavernosa es una asociación infrecuente, ya que los datos clínicos de una de las patologías pueden enmascarar a la otra, por lo que es importante el conocimiento de ambas enfermedades para su correcto diagnóstico y tratamiento multidisciplinario


The case concerns a 73 year-old female with a diagnosis of hyperthyroidism of 8 months onset. Since then, she has suffered hyperaemia and ocular proptosis. Bilateral exophthalmos was observed in the physical examination, along with mild conjunctival hyperaemia in the right eye associated with dilated episcleral vessels. Computed tomography showed enlarged inferior rectus with no signs of ocular nerve or ophthalmic superior vein compression. In the orbital Doppler ultrasound scan, there was an arterialised flow over the superior ophthalmic vein, giving a possible diagnosis of cavernous carotid. Thyroid orbitopathy with a cavernous carotid fistula is an unusual combination in which the clinical signs of both pathologies can mask the complete diagnosis; thus it is important to be acquainted with both pathologies for their correct management and multidisciplinary treatment


Assuntos
Humanos , Feminino , Idoso , Fístula Carotidocavernosa/complicações , Oftalmopatia de Graves/complicações , Fístula Carotidocavernosa/diagnóstico por imagem , Olho/irrigação sanguínea , Oftalmopatia de Graves/diagnóstico , Hiperemia/diagnóstico , Hipertireoidismo/complicações , Músculos Oculomotores/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Veias/diagnóstico por imagem
9.
Khirurgiia (Mosk) ; (6): 111-116, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31317950

RESUMO

We present a case report of atypical hand ischemia probably caused by a combination of venous insufficiency and steal syndrome in patient with arteriovenous fistula for hemodialysis. Unclear clinical symptoms may be due to severe trophic disorders (delayed treatment) or combination of two complications (steal syndrome and venous insufficiency). At the same time, we did not get any diagnostic data confirming organic injury of the upper limb veins or central veins. AVF closure did not result positive changes. Angiography made it possible to assess veins patency, to detect additional patent AVF and to close it. It was previously assumed that this previously created AVF was completely occluded. Therefore, positive changes were observed: rapid healing of trophic ulcers, complete disappearance of pain and gradual restoration of function.


Assuntos
Fístula Arteriovenosa/cirurgia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Embolização Terapêutica/métodos , Mãos/irrigação sanguínea , Isquemia/cirurgia , Insuficiência Venosa/cirurgia , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Procedimentos Endovasculares/métodos , Mãos/cirurgia , Humanos , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Diálise Renal/instrumentação , Veias/diagnóstico por imagem , Insuficiência Venosa/etiologia
10.
Arch Soc Esp Oftalmol ; 94(8): 400-404, 2019 Aug.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31176495

RESUMO

The case concerns a 73 year-old female with a diagnosis of hyperthyroidism of 8 months onset. Since then, she has suffered hyperaemia and ocular proptosis. Bilateral exophthalmos was observed in the physical examination, along with mild conjunctival hyperaemia in the right eye associated with dilated episcleral vessels. Computed tomography showed enlarged inferior rectus with no signs of ocular nerve or ophthalmic superior vein compression. In the orbital Doppler ultrasound scan, there was an arterialised flow over the superior ophthalmic vein, giving a possible diagnosis of cavernous carotid. Thyroid orbitopathy with a cavernous carotid fistula is an unusual combination in which the clinical signs of both pathologies can mask the complete diagnosis; thus it is important to be acquainted with both pathologies for their correct management and multidisciplinary treatment.


Assuntos
Fístula Carotidocavernosa/complicações , Oftalmopatia de Graves/complicações , Idoso , Fístula Carotidocavernosa/diagnóstico por imagem , Olho/irrigação sanguínea , Feminino , Oftalmopatia de Graves/diagnóstico , Humanos , Hiperemia/diagnóstico , Hipertireoidismo/complicações , Músculos Oculomotores/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Veias/diagnóstico por imagem
11.
Ann Vasc Surg ; 60: 364-370, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31200031

RESUMO

BACKGROUND: Vein graft stenosis is a critical complication of lower-limb bypass surgery. For vein graft stenosis, balloon angioplasty has been performed instead of surgical revision in recent years. We therefore investigated the effectiveness of the balloon angioplasty for vein graft stenosis. METHODS AND RESULT: We conducted a retrospective analysis of prospectively collected data for 115 vein graft stenoses performed via balloon angioplasty from August 2011 to January 2018. The rate of freedom from reintervention after balloon angioplasty was 54.3%, 44.4%, and 38.0% at 1, 2, and 3 years, respectively. The rate of freedom from graft occlusion after balloon angioplasty was 79.9%, 71.9%, and 61.3% at 1, 2, and 3 years, respectively. Predictors of freedom from graft occlusion after balloon angioplasty by a multivariate analysis were a single treated lesion (hazard ratio [HR]: 0.38; 95% confidence interval [CI]: 0.17-0.85; P = 0.0189), balloon angioplasty within 90 days after bypass surgery (HR: 3.59; 95% CI: 1.56-8.07; P = 0.0033), and using a cutting balloon (HR: 0.42; 95% CI: 0.17-0.97; P = 0.0426). CONCLUSIONS: The freedom from graft occlusion rate after balloon angioplasty remained relatively high. Furthermore, better results can be expected in single treated lesions and cases of balloon angioplasty occurring 90 days after bypass surgery or in which a cutting balloon was used. Balloon angioplasty for lower-limb bypass graft stenosis was shown to be a useful treatment.


Assuntos
Angioplastia com Balão , Oclusão de Enxerto Vascular/terapia , Doenças Vasculares Periféricas/cirurgia , Enxerto Vascular/efeitos adversos , Veias/transplante , Idoso , Idoso de 80 Anos ou mais , Angioplastia com Balão/efeitos adversos , Feminino , Oclusão de Enxerto Vascular/diagnóstico por imagem , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/diagnóstico por imagem , Doenças Vasculares Periféricas/fisiopatologia , Intervalo Livre de Progressão , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem , Veias/fisiopatologia
12.
Ann Vasc Surg ; 60: 211-220, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31200038

RESUMO

BACKGROUND: The purpose of the study was to compare the access patency rates of forearm loop arteriovenous grafts (AVGs) using deep veins and superficial veins for venous outflow. METHODS: The medical records of patients on dialysis were retrospectively reviewed to identify the individual risk factors and the outcomes of forearm loop AVGs according to their outflow types. RESULTS: Overall, 170 cases were enrolled in this study. Of these, 103 cases (60.6%) used deep veins for outflow. Most patients using deep vein outflow had their venous anastomosis above the elbow (P = 0.000). Patients with venous anastomosis above the elbow were more likely to be female (P = 0.049) and have a lower albumin level (P = 0.025). The primary patency rates for superficial vein outflow and deep view outflow were 35.5% and 29.4% at 12 months and 18.9% and 4.9% at 24 months, respectively. There was a statistically significant difference between the two groups (P = 0.013). The assisted primary patency rates for superficial venous outflow and deep vein outflow were 85.5% and 79.5% at 12 months and 73.2% and 59.6% at 24 months, respectively (P = 0.139). Primary and assisted primary patency rates did not differ according to the crossing of the elbow. CONCLUSIONS: The primary patency rate of AVGs using deep veins for outflow was inferior to AVGs using superficial veins. But the assisted primary patency rate showed no difference. The use of a deep vein for outflow in the forearm loop AVG is a safe strategy for patients with exhausted superficial veins.


Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Antebraço/irrigação sanguínea , Veias/cirurgia , Idoso , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Feminino , Oclusão de Enxerto Vascular/diagnóstico por imagem , Oclusão de Enxerto Vascular/fisiopatologia , Oclusão de Enxerto Vascular/terapia , Humanos , Masculino , Diálise Renal , Retratamento , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Grau de Desobstrução Vascular , Veias/diagnóstico por imagem , Veias/fisiopatologia
13.
Magn Reson Imaging ; 61: 187-195, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31163188

RESUMO

This study reports on the development and evaluation of a novel segmentation method for extracting the internal jugular vein and the adjacent carotid artery from magnetic resonance (MR) images of patients with pulsatile tinnitus. A narrow band level set method with combined shape and appearance constraints was developed and applied to high-resolution MR images from 17 pulsatile tinnitus patients (age 52 ±â€¯23 years, 10 females). The proposed method was validated by comparing with the manual segmentation as well as by identifying the jugular vein and carotid artery based on 4D flow MRI in which the two types of vessels have opposing flow. Our study showed that the vein and artery are in contact with each other on 30.2% of all the slices. Dice value, Peak signal-to-noise ratio (PSNR), Hausdorff distance and mean sum of square distance (MSSD) between automatic and manual segmentation were 89.13 ±â€¯2.84%, 27.36 ±â€¯2.39%, 17.2 ±â€¯6.9 mm, 7.4 ±â€¯5.5 mm, demonstrating good segmentation accuracy. The average Dice similarity coefficient and the coefficient of variation compared with 4D flow MRI was 91.42 ±â€¯1.63% and 89.28 ±â€¯4.54% for the internal jugular vein and the carotid artery. The present pipeline for automatic internal jugular vein quantification holds promise for efficient image interpretation in large-scale cohort studies.


Assuntos
Artéria Carótida Primitiva/diagnóstico por imagem , Angiografia por Ressonância Magnética , Zumbido/diagnóstico por imagem , Veias/diagnóstico por imagem , Adulto , Idoso , Algoritmos , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagem Tridimensional , Veias Jugulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pacientes , Reprodutibilidade dos Testes , Razão Sinal-Ruído
14.
Cardiol Young ; 29(6): 833-834, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31159905

RESUMO

We present the case of a 17-year-old boy with a cardiac venous malformation. This case highlights the diagnostic challenges of such tumours and demonstrates the potential efficacy of a watch-and-wait management approach.


Assuntos
Cardiopatias Congênitas/diagnóstico , Malformações Vasculares/diagnóstico , Veias/anormalidades , Adolescente , Diagnóstico Diferencial , Ecocardiografia Transesofagiana/métodos , Ventrículos do Coração , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Veias/diagnóstico por imagem
15.
Magn Reson Imaging ; 62: 78-86, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31247250

RESUMO

PURPOSE: To identify quantitative dynamic contrast-enhanced (DCE)-MRI perfusion parameters indicating tumor response of hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE). MATERIALS AND METHODS: This prospective pilot study was approved by our institutional review board; written and informed consent was obtained for each participant. Patients underwent DCE-MRI examinations before and after TACE. A variable flip-angle unenhanced 3D mDixon sequence was performed for T1 mapping. A dynamic 4D mDixon sequence was performed after contrast injection for assessing dynamic signal enhancement. Nonparametric analysis was conducted on the time-intensity curves. Parametric analysis was performed on the time-concentration curves using a dual-input single-compartment model. Treatment response according to Liver Reporting and Data System (LI-RADS) v2018 was used as the reference standard. The comparisons within groups (before vs. after treatment) and between groups (nonviable vs. equivocal or viable tumor) were performed using nonparametric bootstrap taking into account the clustering effect of lesions in patients. RESULTS: Twenty-eight patients with 52 HCCs (size: 10-104 mm) were evaluated. For nonviable tumors (n = 27), time to peak increased from 62.5 ±â€¯18.2 s before to 83.3 ±â€¯12.8 s after treatment (P< 0.01). For equivocal or viable tumors (n = 25), time to peak and mean transit time significantly increased (from 54.4 ±â€¯24.1 s to 69.5 ±â€¯18.9 s, P < 0.01 and from 14.2 ±â€¯11.8 s to 33.9 ±â€¯36.8 s, P= 0.01, respectively) and the transfer constant from the extracellular and extravascular space to the central vein significantly decreased from 14.8 ±â€¯14.1 to 8.1 ±â€¯9.1 s-1 after treatment (P= 0.01). CONCLUSION: This prospective pilot DCE-MRI study showed that time to peak significantly changed after TACE treatment for both groups (nonviable tumors and equivocal or viable tumors). In our cohort, several perfusion parameters may provide an objective marker for differentiation of treatment response after TACE in HCC patients.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Quimioembolização Terapêutica , Meios de Contraste/farmacologia , Neoplasias Hepáticas/diagnóstico por imagem , Imagem por Ressonância Magnética , Idoso , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Projetos Piloto , Estudos Prospectivos , Reprodutibilidade dos Testes , Veias/diagnóstico por imagem
18.
J Vasc Interv Radiol ; 30(6): 813-821, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31060770

RESUMO

PURPOSE: The purpose of this study was to evaluate the management, outcomes, and technical and clinical safety of coil-assisted dominant outflow vein (DOV) occlusion for the ethanol embolization of high-flow arteriovenous malformations (AVMs) in the hands. MATERIALS AND METHODS: Between March 2013 and October 2016, 12 consecutive patients with AVMs with DOVs underwent ethanol embolization combined with detachable and pushable coil-assisted DOV occlusion. All patients completed the course of clinical follow-up (range: 14-57 months; mean: 36.7 months), and imaging follow-up (range: 8-25 months; mean: 16.6 months) results from the final treatment session were available for 8 patients. The therapeutic effects, degree of devascularization, and complications at the time of follow-up arteriography were evaluated as the clinical outcomes. RESULTS: The patients underwent 23 ethanol embolization procedures (range: 1-3; mean, 1.9) with 24 detachable coils and 223 pushable coils. The average stretched length of the total coils per patient was 320.17 cm. Seven of 12 patients (58.3%) exhibited complete responses, and 5 patients (41.7%) exhibited partial responses. Minor complications, including blistering and focal swelling, occurred in all 12 patients (100%) but showed spontaneous and complete recovery. No major complications occurred. CONCLUSIONS: Ethanol embolization has the potential to control high-flow hand AVMs by using coil-assisted DOV occlusion with an acceptable risk of minor and major complications.


Assuntos
Malformações Arteriovenosas/terapia , Embolização Terapêutica/instrumentação , Etanol/administração & dosagem , Mãos/irrigação sanguínea , Veias/fisiopatologia , Adolescente , Adulto , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/fisiopatologia , Velocidade do Fluxo Sanguíneo , Criança , Embolização Terapêutica/efeitos adversos , Desenho de Equipamento , Etanol/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Veias/anormalidades , Veias/diagnóstico por imagem , Adulto Jovem
19.
AJR Am J Roentgenol ; 213(3): 575-585, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31063424

RESUMO

OBJECTIVE. The purpose of this article is to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of MRI for detecting extramural venous invasion (EMVI) in patients with colorectal cancer. MATERIALS AND METHODS. PubMed and EMBASE were searched up to November 9, 2018. We included diagnostic accuracy studies that used MRI for EMVI detection in patients with colorectal cancer, using pathologic analysis as the reference standard. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and plotted in a hierarchic summary ROC plot. Metaregression analysis using several clinically relevant covariates was performed. RESULTS. Fourteen studies (n = 1751 patients) were included. Study quality was moderate in general. Pooled sensitivity was 0.61 (95% CI, 0.49-0.71), and pooled specificity was 0.87 (95% CI, 0.79-0.92). There was substantial heterogeneity according to the Cochran Q test (p < 0.01) and Higgins I2 heterogeneity index (98% and 95% for sensitivity and specificity, respectively). Publication bias was present (p = 0.01). Higher rates of advanced T category, use of high-resolution MRI, and use of antispasmodic drugs were shown to significantly affect heterogeneity (p < 0.01). Location of primary tumor, preoperative treatment status, study design, definition of reference standard, magnetic field strength, and use of functional MRI were not statistically significant (p = 0.17-0.92). CONCLUSION. MRI shows moderate sensitivity and good specificity for the detection of EMVI in colorectal cancer. The use of high-resolution MRI may improve diagnostic performance.


Assuntos
Neoplasias Colorretais/patologia , Imagem por Ressonância Magnética/métodos , Neoplasias Vasculares/diagnóstico por imagem , Neoplasias Vasculares/patologia , Veias/diagnóstico por imagem , Veias/patologia , Humanos
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