Evaluation of Collateral Circulation in Cirrhosis by Computed Tomography Portal Venography

2019 ◽  
Vol 9 (2) ◽  
pp. 390-394
Author(s):  
Jing Wen ◽  
Yingzhan Zhang

Objective: Cirrhotic portal hypertension can lead to extensive collateral circulation in the portal vein system, and the esophagogastric variceal bleeding (EVB) can easily lead to death. Computed tomography portal venography (CTPV) can display the composition of portal vein noninvasively. The purpose of this study was to investigate the diagnostic value of CTPV in collateral circulation of cirrhosis and to predict the risk of EVB. Methods: A total of 37 patients with cirrhosis in our hospital were analyzed retrospectively. All patients underwent CTPV and gastroscope to observe and classify varicose veins. The consistency of the two methods was analyzed. The diameters of patients with major tributaries of portal vein were compared between the hemorrhagic and non-hemorrhagic patients. The receiver operation characteristic (ROC) curves were used to evaluate the predictive value for EBV. Patients with varicose veins underwent endoscopic esophagogastric variceal ligation. Results: The tributaries of portal vein and the collateral circulation was showed clearly in CTPV. The esophagogastric varices was found in 30 patients, and the Kim grades I, II and III were 8, 10 and 12 respectively. The varicose was found in 28 patients under gastroscope. The CTPV and endoscopy were highly consistent in grading of esophagogastric varices (kappa 0.674). Compared with the non-hemorrhagic patients, the diameter of SMV, LGV and SV in hemorrhagic patients increased significantly. The ROC curves of predicted EBU by these diameters were 0.64, 0.76, and 0.83, respectively. There was no statistical difference between the diameter of portal vein and its tributaries before and after endoscopic variceal ligation. Conclusion: The CTPV can show the collateral vessels of portal vein in patients with cirrhosis, evaluate the degree of varicosity, and determine the risk of varicose rupture.

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Krohn ◽  
Gebauer ◽  
Hübler ◽  
Beck

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.


2019 ◽  
Vol 1 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Norafida Bahari ◽  
Nik Azuan Nik Ismail ◽  
Jegan Thanabalan ◽  
Ahmad Sobri Muda

In this article, we evaluate the effectiveness of Cone Beam Computed Tomography, through a case study, in assessing the complication of intracranial bleeding during an endovascular treatment of brain arteriovenous malformation when compared to Multislice-Detector Computed Tomography performed immediately after the procedure. The image quality of Cone Beam Computed Tomography has enough diagnostic value in differentiating between haemorrhage, embolic materials and the arteriovenous malformation nidus to facilitate physicians to decide for further management of the patient.


Author(s):  
Norafida Bahari ◽  
NikAzuan Nik Ismail ◽  
Jegan Thanabalan ◽  
Ahmad Sobri Muda

In this article, we evaluate the effectiveness of Cone Beam Computed Tomography, through a case study, in assessing the complication of intracranial bleeding during an endovascular treatment of brain arteriovenous malformation when compared to Multislice-Detector Computed Tomography performed immediately after the procedure. The image quality of Cone Beam Computed Tomography has enough diagnostic value in differentiating between haemorrhage, embolic materials and the arteriovenous malformation nidus to facilitate physicians to decide for further management of the patient.


1989 ◽  
Vol 25 (1) ◽  
pp. 52
Author(s):  
J M Lee ◽  
J H Moon ◽  
D J Lee ◽  
C S Choi ◽  
I W Kang ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liang-Yuan Li ◽  
Tian-Sheng Yan ◽  
Jing Yang ◽  
Yu-Qi Li ◽  
Lin-Xi Fu ◽  
...  

Abstract Background Subjects with chronic respiratory symptoms and preserved pulmonary function (PPF) may have small airway dysfunction (SAD). As the most common means to detect SAD, spirometry needs good cooperation and its reliability is controversial. Impulse oscillometry (IOS) may complete the deficiency of spirometry and have higher sensitivity. We aimed to explore the diagnostic value of IOS to detect SAD in symptomatic subjects with PPF. Methods The evaluation of symptoms, spirometry and IOS results in 209 subjects with chronic respiratory symptoms and PPF were assessed. ROC curves of IOS to detect SAD were analyzed. Results 209 subjects with chronic respiratory symptoms and PPF were included. Subjects who reported sputum had higher R5–R20 and Fres than those who didn’t. Subjects with dyspnea had higher R5, R5–R20 and AX than those without. CAT and mMRC scores correlated better with IOS parameters than with spirometry. R5, R5–R20, AX and Fres in subjects with SAD (n = 42) significantly increased compared to those without. Cutoff values for IOS parameters to detect SAD were 0.30 kPa/L s for R5, 0.015 kPa/L s for R5–R20, 0.30 kPa/L for AX and 11.23 Hz for Fres. Fres has the largest AUC (0.665, P = 0.001) among these parameters. Compared with spirometry, prevalence of SAD was higher when measured with IOS. R5 could detect the most SAD subjects with a prevalence of 60.77% and a sensitivity of 81% (AUC = 0.659, P = 0.002). Conclusion IOS is more sensitive to detect SAD than spirometry in subjects with chronic respiratory symptoms and PPF, and it correlates better with symptoms. IOS could be an additional method for SAD detection in the early stage of diseases.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.


Author(s):  
U.C.M. Kafka ◽  
A. Carstens ◽  
G. Steenkamp ◽  
H. Symington

The purpose of this study was to determine the diagnostic value of magnetic resonance imaging (MRI) and computed tomography (CT) in oral masses of dogs. Nineteen dogs underwent clinical, MR and CT examinations. Eleven malignant and ten non-malignant masses were evaluated. Osteosarcoma was the most commonly found malignant oral mass and gingival hyperplasia was the most commonly found benign mass. The results showed that MRI provided more accurate information regarding the size of the masses and invasion of adjacent structures although MRI and CT show similar accuracy in assessment of bone invasion. Calcification and cortical bone erosion was better seen on CT images. Whereas contrast-MRI provided useful additional information, contrast-CT had no added benefit. In general, oral masses located in the caudal mandible, oropharynx and maxilla are better evaluated using MRI, once the histological type has been verified.


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