Indirect Lymphoscintigraphy in Patients with Limb Oedema

1986 ◽  
Vol 1 (3) ◽  
pp. 211-215 ◽  
Author(s):  
A. Pecking ◽  
R. Cluzan ◽  
J.P. Desprez-Curely ◽  
P. Guerin
Keyword(s):  
Lower Limb ◽  
Lymphatic System ◽  
Invasive Procedures ◽  
Non Invasive ◽  
Morphological Findings ◽  
Invasive Method ◽  
Varicose Disease ◽  
Post Traumatic ◽  
Web Space ◽  
Clinical Problems

One thousand four hundred and fifty-five lymphoscintigraphies using a radio-labelled colloid were performed as an objective test for the diagnosis and the survey of lower limb oedemas. It is a non-invasive method involving only a subdermic bipedal injection into the first web space of each foot. Our results demonstrate that in chronic swollen legs due to venous causes occuring from post-thrombotic syndrome or varicose disease the lymphatic system can be insufficient (14.9% and 19.8% of these cases). Abnormal results are found in 91.3% of clinically primary lymphoedemas. In unilateral primary lymphoedemas the clinically healthy controlateral limb can be insufficient (25%). In post-traumatic lower limb oedemas the lymphatic flow remains normal while perilymphatic extravasation and dermal filling are always to be found at the trauma site. The lymphoscintigraphy is a simple, physiological and reliable test. The morphological findings based upon 1455 examinations allow us to think that this method may resolve the clinical problems without recourse to more invasive procedures. We can expect that in a few years this morphological study will be completed with a functional lymphatic test.

Our Experience on Light Reflection Rheography (LRR): A New Non-Invasive Method for Lower Limbs Venous Examination

1986 ◽  
Vol 1 (3) ◽  
pp. 231-241 ◽  
Author(s):  
Giuseppe Nuzzaci ◽  
Nicola Mangoni ◽  
Argene Patrizia Tonarelli ◽  
Eleonora Lucente ◽  
Daniele Righi ◽  
...  
Keyword(s):  
Venous Pressure ◽  
High Specificity ◽  
Lower Limbs ◽  
Light Reflection ◽  
Pump Efficiency ◽  
Average Value ◽  
Non Invasive ◽  
Invasive Method ◽  
Varicose Disease ◽  
Pressure Changes

By means of a light reflection rheograph (LRR 100), the authors studied 353 lower limbs: 128 with primary varices, 41 with a post-phlebitic syndrome and 81 controls. The parameters that were selected were: VRT (venous refill time) and ΔLR (as expression of the venous emptying rate). In order to assess the accuracy of LRR measurements, simultaneous recordings of both LRR and venous pressure changes in 97 limbs (58 with primary varicose disease, 21 with post-phlebitic syndrome and 18 normals) were compared with each other. The correlation rate for VRT in the two methods revealed very high agreement, (r = 0.96). A fairly good correlation also occurred between changes in venous pressure and ΔLR (r = 0.74). The reproducibility rates ranged between ± 15.9% s.d. (VRT) and ± 7.7% s.d. (ΔLR), using 100 as the average value obtained from each subject. The authors conclude that LRR appears to offer high specificity, sensitivity and reproducibility rates for non-invasive assessment of valvular incompetence. It appears also potentially reliable for the evaluation of calf musculo-venous pump efficiency.

Malfunctional Reorganization in the Developing Limbo-Prefrontal System in Animals: Implications for Human Psychoses?

2001 ◽  
Vol 12 (1) ◽  
pp. 8-14
Author(s):  
Gertraud Teuchert-Noodt ◽  
Ralf R. Dawirs
Keyword(s):  
Prefrontal Cortex ◽  
Mental Disorders ◽  
Dentate Gyrus ◽  
Cognitive Functions ◽  
Experimental Approach ◽  
Regulatory Mechanisms ◽  
Hippocampal Dentate Gyrus ◽  
Non Invasive ◽  
Invasive Method ◽  
Activity Dependent

Abstract: Neuroplasticity research in connection with mental disorders has recently bridged the gap between basic neurobiology and applied neuropsychology. A non-invasive method in the gerbil (Meriones unguiculus) - the restricted versus enriched breading and the systemically applied single methamphetamine dose - offers an experimental approach to investigate psychoses. Acts of intervening affirm an activity dependent malfunctional reorganization in the prefrontal cortex and in the hippocampal dentate gyrus and reveal the dopamine position as being critical for the disruption of interactions between the areas concerned. From the extent of plasticity effects the probability and risk of psycho-cognitive development may be derived. Advance may be expected from insights into regulatory mechanisms of neurogenesis in the hippocampal dentate gyrus which is obviously to meet the necessary requirements to promote psycho-cognitive functions/malfunctions via the limbo-prefrontal circuit.

Investigations into the Clinical Utility of Latex D-Dimer in the Diagnosis of Deep Venous Thrombosis

1993 ◽  
Vol 69 (01) ◽  
pp. 008-011 ◽  
Author(s):  
Cedric J Carter ◽  
D Lynn Doyle ◽  
Nigel Dawson ◽  
Shauna Fowler ◽  
Dana V Devine
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Lower Limb ◽  
Clinical Utility ◽  
Rapid Test ◽  
Fibrin Degradation Product ◽  
Current Form ◽  
Non Invasive ◽  
Clinically Significant ◽  
D Dimer

SummaryThe serial use of non-invasive tests has been shown to be a safe method of managing outpatients who are suspected of having lower limb deep venous thrombosis (DVT). Objective testing has shown that the majority of these outpatients do not have venous thrombosis. A rapid test to exclude DVT in these patients, without the need for expensive and inconvenient serial non-invasive vascular testing, would have practical and economic advantages.Studies measuring the fibrin degradation product D-dimer using enzyme-linked immunoassays (EIA) in patients with veno-graphically proven DVT suggest that it should be possible to exclude this condition by the use of one of the rapid latex bead D-dimer tests.We have examined 190 patients with suspected DVT using both a latex and an EIA D-dimer assay. The latex D-dimer test used in this study was negative in 7 of the 36 proven cases of DVT. This sensitivity of only 80% is not sufficient to allow this type of assay, in its current form, to be used as an exclusion test for DVT. The same plasma samples were tested with an EIA assay. This information was used to mathematically model the effects of selecting a range of D-dimer discriminant cut off points for the diagnosis of DVT. These results indicate that 62% of suspected clinically significant DVT could have this diagnosis excluded, with a 98% sensitivity, if the rapid latex or equivalent D-dimer test could be reformulated to measure less than 185 ng/ml of D-dimer.

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

Non-invasive brain stimulation to assess neurophysiologic underpinnings of lower limb motor impairment in multiple sclerosis

2021 ◽  
Vol 356 ◽  
pp. 109143
Author(s):  
Clayton W. Swanson ◽  
Felix Proessl ◽  
Jaclyn A. Stephens ◽  
Augusto A. Miravalle ◽  
Brett W. Fling
Keyword(s):  
Multiple Sclerosis ◽  
Brain Stimulation ◽  
Lower Limb ◽  
Motor Impairment ◽  
Non Invasive

scholarly journals Asymmetric TCD Findings in Malignant MCA Infarction, Resolution after Decompressive Hemicraniectomy: A Case Report

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 127-136
Author(s):  
Hazel Gaile  Barrozo ◽  
Maria Anna De Guzman ◽  
Jose  Navarro ◽  
Narayanaswamy Venketasubramanian
Keyword(s):  
Pressure Effects ◽  
Mean Flow ◽  
Brain Swelling ◽  
Decompressive Hemicraniectomy ◽  
Non Invasive ◽  
Invasive Method ◽  
Malignant Mca Infarction ◽  
Subsequent Rise ◽  
Very High ◽  
Hemispheric Infarct

Transcranial Doppler (TCD) is a non-invasive method for assessing cerebral hemodynamics in the acute phase of stroke. We report a case of a 33-year-old man who presented with a massive left hemispheric infarct developing into “malignant” MCA infarction. TCD was utilized to monitor intracranial hemodynamics while the clinical and neuroimaging findings were used to help us in the decision to proceed with decompressive craniectomy (DC). Pre-operatively, there was reduced mean flow velocities (MFV) of the middle cerebral artery (MCA) with increasing pulsatility index (PI) ipsilateral to the infarct. The subsequent but smaller rise in the PI in the contralateral MCA was suggestive of very high intracranial pressure (ICP) from massive brain swelling. Serial TCD examinations post-operatively showed normalization of the PI, and subsequent rise in the left MCA MFV. Clinical improvement was also noted as the TCD findings improved. The asymmetry in TCD findings can be attributed to occlusion of the MCA with subsequent spontaneous recanalisation, occlusion of the MCA with subsequent recanalisation due to the DC, or initial occlusion and subsequent pressure effects on the arterioles of the MCA due to the “malignant” edema of that hemisphere that was relieved by DC. This case illustrates the value of TCD as a useful modality in monitoring intracranial hemodynamics in acute stroke.

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