scholarly journals Spatial Distribution of Intracranial Vessel Wall Enhancement in Hypertension and Primary Angiitis of the CNS

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jae W. Song ◽  
Haochang Shou ◽  
Emmanuel C. Obusez ◽  
Scott B. Raymond ◽  
Samuel D. Rafla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spatial Distribution ◽  
Vessel Wall ◽  
Image Interpretation ◽  
Laboratory Data ◽  
Intracranial Vessel ◽  
Intracranial Atherosclerotic Disease ◽  
Primary Angiitis ◽  
Intracranial Arteries ◽  
Diagnosis Of Hypertension

AbstractWe hypothesized a difference in the spatial distribution of intracranial vessel wall enhancement between CNS vasculitis and risk factors for intracranial atherosclerotic disease (ICAD). Fifty-five vessel wall MR imaging (VWI) exams were included in this retrospective observational study. Intracranial arteries were evaluated for vessel wall enhancement by branching pattern (e.g., primary, secondary, and tertiary segments). Demographic and laboratory data as well as ICAD risk factors, including a diagnosis of hypertension, were collected. A diagnosis of primary angiitis of the CNS (PACNS) was confirmed by biopsy or clinical assessment by a stroke neurologist. Univariate and multivariate Poisson regression models were fit for the outcomes. In multivariate analyses, hypertension showed significant associations with primary (β = 1.31, 95% CI 0.78–1.88, p < 0.0001) and secondary (β = 1.15, 95% CI 0.29–2.18, p = 0.05) segments, contrasting with PACNS which showed a distal spatial distribution with significant associations with secondary (β = 0.77, 95% CI 0.14–1.39, p = 0.05) and tertiary (β = 1.34, 95% CI 0.68–2.01, p < 0.0001) segments. Our results suggest the spatial distribution of vessel wall enhancement is an important consideration when interpreting VWI exams, particularly in patients with a comorbid diagnosis of hypertension. Given the global prevalence of hypertension, these results are impactful and may improve image interpretation of VWI in stroke patients.

Intracranial Vessel Wall MRI in a Rabbit Elastase Aneurysm Model

2019 ◽  
Author(s):  
James Ho ◽  
Nakisa Sadeghi ◽  
Ilana Galex ◽  
Nathan Davis ◽  
Sofia Cabello ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Vessel ◽  
Aneurysm Model

Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available

2020 ◽  
Vol 78 (10) ◽  
pp. 642-650
Author(s):  
Felipe Torres PACHECO ◽  
Luiz Celso Hygino da CRUZ JUNIOR ◽  
Igor Gomes PADILHA ◽  
Renato Hoffmann NUNES ◽  
Antônio Carlos Martins MAIA JUNIOR ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Vessel Wall ◽  
Vascular Diseases ◽  
Vascular Wall ◽  
Vessel Wall Imaging ◽  
Clinical Settings ◽  
Direct Evaluation ◽  
Intracranial Vessel ◽  
Indirect Evaluation ◽  
Wall Imaging

ABSTRACT Intracranial vessel wall imaging plays an increasing role in diagnosing intracranial vascular diseases. With the growing demand and subsequent increased use of this technique in clinical practice, radiologists and neurologists should be aware of the choices in imaging parameters and how they affect image quality, clinical indications, methods of assessment, and limitations in the interpretation of these images. Due to the improvement of the MRI techniques, the possibility of accurate and direct evaluation of the abnormalities in the arterial vascular wall (vessel wall imaging) has evolved, adding substantial data to diagnosis when compared to the indirect evaluation based on conventional flow analyses. Herein, the authors proposed a comprehensive approach of this technique reinforcing appropriated clinical settings to better use intracranial vessel wall imaging.

scholarly journals Complex wall modeling for hemodynamic simulations of intracranial aneurysms based on histologic images

2021 ◽  
Vol 16 (4) ◽  
pp. 597-607
Author(s):  
Annika Niemann ◽  
Samuel Voß ◽  
Riikka Tulamo ◽  
Simon Weigand ◽  
Bernhard Preim ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Geometric Model ◽  
Image Data ◽  
Outer Wall ◽  
3D Models ◽  
Patient Specific ◽  
Intracranial Vessel ◽  
Hemodynamic Simulations

Abstract Purpose For the evaluation and rupture risk assessment of intracranial aneurysms, clinical, morphological and hemodynamic parameters are analyzed. The reliability of intracranial hemodynamic simulations strongly depends on the underlying models. Due to the missing information about the intracranial vessel wall, the patient-specific wall thickness is often neglected as well as the specific physiological and pathological properties of the vessel wall. Methods In this work, we present a model for structural simulations with patient-specific wall thickness including different tissue types based on postmortem histologic image data. Images of histologic 2D slices from intracranial aneurysms were manually segmented in nine tissue classes. After virtual inflation, they were combined into 3D models. This approach yields multiple 3D models of the inner and outer wall and different tissue parts as a prerequisite for subsequent simulations. Result We presented a pipeline to generate 3D models of aneurysms with respect to the different tissue textures occurring in the wall. First experiments show that including the variance of the tissue in the structural simulation affect the simulation result. Especially at the interfaces between neighboring tissue classes, the larger influence of stiffer components on the stability equilibrium became obvious. Conclusion The presented approach enables the creation of a geometric model with differentiated wall tissue. This information can be used for different applications, like hemodynamic simulations, to increase the modeling accuracy.

scholarly journals High-Resolution Vessel Wall Magnetic Resonance Imaging of Small Unruptured Intracranial Aneurysms

2021 ◽  
Vol 10 (2) ◽  
pp. 225
Author(s):  
Łukasz Zwarzany ◽  
Ernest Tyburski ◽  
Wojciech Poncyljusz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Resonance Imaging ◽  
Aneurysm Wall ◽  
Conventional Risk Factors

Background: We decided to investigate whether aneurysm wall enhancement (AWE) on high-resolution vessel wall magnetic resonance imaging (HR VW-MRI) coexists with the conventional risk factors for aneurysm rupture. Methods: We performed HR VW-MRI in 46 patients with 64 unruptured small intracranial aneurysms. Patient demographics and clinical characteristics were recorded. The PHASES score was calculated for each aneurysm. Results: Of the 64 aneurysms, 15 (23.4%) showed wall enhancement on post-contrast HR VW-MRI. Aneurysms with wall enhancement had significantly larger size (p = 0.001), higher dome-to-neck ratio (p = 0.024), and a more irregular shape (p = 0.003) than aneurysms without wall enhancement. The proportion of aneurysms with wall enhancement was significantly higher in older patients (p = 0.011), and those with a history of prior aneurysmal SAH. The mean PHASES score was significantly higher in aneurysms with wall enhancement (p < 0.000). The multivariate logistic regression analysis revealed that aneurysm irregularity and the PHASES score are independently associated with the presence of AWE. Conclusions: Aneurysm wall enhancement on HR VW-MRI coexists with the conventional risk factors for aneurysm rupture.

scholarly journals Spatial and Temporal Variability of Soil Salinity in the Yangtze River Estuary Using Electromagnetic Induction

2021 ◽  
Vol 13 (10) ◽  
pp. 1875
Author(s):  
Wenping Xie ◽  
Jingsong Yang ◽  
Rongjiang Yao ◽  
Xiangping Wang
Keyword(s):  
Electrical Conductivity ◽  
Spatial Distribution ◽  
Soil Salinity ◽  
Yangtze River ◽  
Laboratory Data ◽  
River Estuary ◽  
Yangtze River Estuary ◽  
Soil Electrical Conductivity ◽  
The Yangtze River ◽  
The Yangtze River Estuary

Soil salt-water dynamics in the Yangtze River Estuary (YRE) is complex and soil salinity is an obstacle to regional agricultural production and the ecological environment in the YRE. Runoff into the sea is reduced during the impoundment period as the result of the water-storing process of the Three Gorges Reservoir (TGR) in the upper reaches of the Yangtze River, which causes serious seawater intrusion. Soil salinity is a problem due to shallow and saline groundwater under serious seawater intrusion in the YRE. In this research, we focused on the temporal variation and spatial distribution characteristics of soil salinity in the YRE using geostatistics combined with proximally sensed information obtained by an electromagnetic induction (EM) survey method in typical years under the impoundment of the TGR. The EM survey with proximal sensing method was applied to perform soil salinity survey in field in the Yangtze River Estuary, allowing quick determination and quantitative assessment of spatial and temporal variation of soil salinity from 2006 to 2017. We developed regional soil salinity survey and mapping by coupling limited laboratory data with proximal sensed data obtained from EM. We interpreted the soil electrical conductivity by constructing a linear model between the apparent electrical conductivity data measured by an EM 38 device and the soil electrical conductivity (EC) of soil samples measured in laboratory. Then, soil electrical conductivity was converted to soil salt content (soil salinity g kg−1) through established linear regression model based on the laboratory data of soil salinity and soil EC. Semivariograms of regional soil salinity in the survey years were fitted and ordinary kriging interpolation was applied in interpolation and mapping of regional soil salinity. The cross-validation results showed that the prediction results were acceptable. The soil salinity distribution under different survey years was presented and the area of salt affected soil was calculated using geostatistics method. The results of spatial distribution of soil salinity showed that soil salinity near the riverbanks and coastlines was higher than that of inland. The spatial distribution of groundwater depth and salinity revealed that shallow groundwater and high groundwater salinity influenced the spatial distribution characteristics of soil salinity. Under long-term impoundment of the Three Gorges Reservoir, the variation of soil salinity in different hydrological years was analyzed. Results showed that the area affected by soil salinity gradually increased in different hydrological year types under the impoundment of the TGR.

scholarly journals AB0533 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) IN GENERAL POPULATION WITHOUT ANCA ASSOCIATED VASCULITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1563.3-1563
Author(s):  
H. Tamaki ◽  
S. Fukui ◽  
T. Nakai ◽  
G. Kidoguchi ◽  
S. Kawaai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Autoimmune Disease ◽  
General Population ◽  
Granulomatosis With Polyangiitis ◽  
Dietary Habits ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Anca Associated Vasculitis ◽  
The Mean

Background:Currently it is hypothesized that many systemic autoimmune diseases occur due to environmental risk factors in addition to genetic risk factors. Anti-Neutrophil Cytoplasmic Antibody (ANCA) is mainly associated with three systemic autoimmune disease including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA). It is known that ANCA can be positive before clinical symptoms in patients with known diagnosis of GPA and ANCA titers rise before clinical manifestations appear. However, prevalence of ANCA among general population is not well known. It has not been described as well how many of people with positive ANCA eventually develop clinical manifestations of ANCA associated Vasculitis.Objectives:This study aims to estimate prevalence of ANCA in general population without ANCA associated Vasculitis. It also describes natural disease course of people with positive ANCA without ANCA associated Vasculitis. Risk factors for positive ANCA are also analyzed.Methods:This is a single center retrospective study at Center for Preventive Medicine of St. Luke’s International Hospital in Tokyo. ANCA was checked among the patients who wished to between 2018 and 2019. St. Luke’s Health Check-up Database (SLHCD) was utilized to collect the data. The patients whose serum was measured for ANCA were identified. The data for basic demographics, social habits, dietary habits and laboratory data were extracted. The charts of the patients with positive ANCA were reviewed.Results:Sera of total 1204 people were checked for ANCA. Of these 1204 people, 587 (48.8%) are male and the mean age was 55.8 years (32.6 to 79). There were total 11 patients with positive ANCA. Myeloperoxidase ANCA (MPO-ANCA) was positive for 3 patients and proteinase 3 ANCA (PR3-ANCA) was positive for 8 patients. Of these 11 patients, 5 were male (45.5%) and the mean age was 54.6 years. Two patients had history of autoimmune disease (primary biliary cirrhosis and ulcerative colitis). Five patients were evaluated by rheumatologists with the median follow-up period of 274 days. None of them developed clinical signs and symptoms of ANCA associated Vasculitis. Four out of five patients had ANCA checked later, two of which turned negative. The prevalence of ANCA in this cohort was 0.9% (95% confidence interval [95% CI]: 0.5% to 1.6%). Univariate analysis was performed to identify risk factors of positive ANCA. The variables analyzed include age, gender, body mass index (BMI), smoking habits, alcohol intake, dietary habits (fruits, fish, red meat), hypertension, dyslipidemia, and laboratory data. None of these variables demonstrated statistically significant differences except for positive rheumatoid factor (ANCA positive group: 33 % vs ANCA negative group: 9.1%, p value = 0.044).Conclusion:The prevalence of ANCA in this cohort was 0.9% (95% CI: 0.5% to 1.6%). None of them who had a follow-up developed ANCA associated Vasculitis during the follow-up period. Longer follow-up and more patients are necessary to determine natural course of people with positive ANCA.Disclosure of Interests:None declared

scholarly journals Hypoalbuminemia on Admission as an Independent Risk Factor for Acute Functional Decline after Infection

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 26
Author(s):  
Hidehiko Nakano ◽  
Hideki Hashimoto ◽  
Masaki Mochizuki ◽  
Hiromu Naraba ◽  
Yuji Takahashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Barthel Index ◽  
Nutritional Assessment ◽  
Functional Decline ◽  
Laboratory Data ◽  
Severity Of Illness ◽  
Multivariable Logistic Regression Analysis ◽  
Need For Care ◽  
Assessment Indicator ◽  
Basic Characteristics

The risk of acute functional decline increases with age, and concepts including frailty and post-acute care syndrome have been proposed; however, the effects of the nutritional status currently remain unclear. Patients admitted to the emergency department of Hitachi General Hospital for infectious diseases between April 2018 and May 2019 were included. To identify risk factors for functional decline at discharge, defined as Barthel Index <60, we investigated basic characteristics, such as age, sex, disease severity, the pre-morbid care status, and cognitive impairment, as well as laboratory data on admission, including albumin as a nutritional assessment indicator. In total, 460 surviving patients out of 610 hospitalized for infection were analyzed. In a multivariable logistic regression analysis, factors independently associated with Barthel Index <60 at discharge were age (adjusted OR 1.03, 95%CI 1.01–1.06, p = 0.022), serum albumin (adjusted OR: 0.63, 95%CI: 0.41–0.99, p = 0.043), and the need for care prior to admission (adjusted OR: 5.92, 95%CI: 3.15–11.15, p < 0.001). Hypoalbuminemia on admission in addition to age and the need for care prior to admission were identified as risk factors for functional decline in patients hospitalized for infection. Functional decline did not correlate with the severity of illness.

Spironolactone-Induced Agranulocytosis

1997 ◽  
Vol 31 (5) ◽  
pp. 582-585 ◽  
Author(s):  
Anna M Whitling ◽  
Pablo E Pérgola ◽  
John Lee Sang ◽  
Robert L Talbert
Keyword(s):  
Risk Factors ◽  
Adverse Effect ◽  
Bone Marrow ◽  
Leukocyte Count ◽  
Laboratory Data ◽  
University Hospital ◽  
Drug Induced ◽  
Bone Marrow Biopsies ◽  
Case Summary ◽  
Before And After

OBJECTIVE: TO report a case of agranulocytosis secondary to spironolactone in a patient with cryptogenic liver disease. CASE SUMMARY: A 58-year-old Hispanic woman with cryptogenic cirrhosis was admitted to University Hospital on October 31, 1995. Laboratory data revealed a leukocyte count of 1.0 × 103/mm3 and an absolute neutrophil count (ANC) of 10 cells/mm3. Prior to treatment with spironolactone, the leukocyte count was 10.2 × 103/mm3 and ANC 8400 cells/mm3. Agranulocytosis resolved 5 days following the discontinuation of spironolactone. Results from the bone marrow biopsies before and after treatment with spironolactone suggested that agranulocytosis was caused by the drug's toxic effect on the bone marrow. DISCUSSION: Drug-induced agranulocytosis is a serious adverse effect, occurring at a rate of approximately 6.2 cases per million persons each year. In addition to the case reported here, three other reports of agranulocytosis secondary to spironolactone have been published in the literature. Several factors have been identified that may increase a patient's risk for developing agranulocytosis, including increased age, hepatic or renal impairment, drag dosage and duration, and concurrent medications. CONCLUSIONS: Agranulocytosis secondary to spironolactone is a serious potential adverse effect. Patients with risk factors for developing this adverse effect should be closely monitored since early detection and discontinuation of spironolactone can improve prognosis.

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