Defining the Role of Duplex Ultrasound Assessment to Determine Severity of Arterial Calcification: An Analysis of the Superficial Femoral Artery

2020 ◽  
Vol 44 (2) ◽  
pp. 74-78
Author(s):  
Charlotte Taylor ◽  
Lukasz P. Zielinski ◽  
Mohammed M. Chowdhury ◽  
Patrick A. Coughlin
Keyword(s):  
Computed Tomography ◽  
Correlation Coefficient ◽  
Lower Limb ◽  
Imaging Modality ◽  
Objective Assessment ◽  
Duplex Ultrasound ◽  
Arterial Calcification ◽  
Gold Standard Method ◽  
Calcification Score

Lower limb arterial calcification associates with poor cardiovascular outcomes. The gold standard method of assessment is via computed tomography, yet duplex is our primary imaging modality. Currently, there is no standardized objective assessment of lower limb arterial calcification using duplex. We aimed to define the role of duplex in the assessment of lower limb arterial calcification. Initial consensus was achieved between a cohort of vascular scientists on objective imaging specific markers of lower limb arterial calcification severity using duplex. This resulted in objective descriptions to grade calcification from 0 to 3 (no calcification through to severe calcification) which formed the duplex lower limb arterial calcification score. Reproducibility of the duplex lower limb arterial calcification score was assessed and further validation was undertaken by comparing the duplex lower limb arterial calcification with computed tomography–based assessment in a separate cohort of 44 patients investigated with both modalities. The intra- and inter-class correlation coefficient were > 0.87 . The Spearman rank correlation coefficient between the duplex and CT based arterial calcium measurements was (ρ = 0.644, P < .001). The duplex lower limb arterial calcification score provides a standardized and reproducible modality for assessment of lower limb arterial calcification and may aid with risk stratification in patients with peripheral arterial disease.

scholarly journals Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2350
Author(s):  
Puran . ◽  
Narendra Kumar Kardam
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Abdominal Trauma ◽  
Imaging Modality ◽  
Abdominal Injury ◽  
Male Predominance ◽  
Ct Findings ◽  
Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed   tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

scholarly journals Circulating Receptor Activator of Nuclear Factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in type 2 diabetes: a prospective, observational cohort study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Olivier Bourron ◽  
Franck Phan ◽  
Mamadou Hassimiou Diallo ◽  
David Hajage ◽  
Carole-Elodie Aubert ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Lower Limb ◽  
Arterial Calcification ◽  
Nuclear Factor ◽  
Calcification Score ◽  
Receptor Activator ◽  
Nuclear Factor Kb

Abstract Background Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods Lower limb arterial calcification scores were determined by computed tomography at baseline and after a mean follow up of 31.20 ± 3.86 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and metabolic parameters were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model. Results At baseline, mean ± SD and median lower limb arterial calcification scores were, 2364 ± 5613 and 527 respectively and at the end of the study, 3739 ± 6886 and 1355 respectively. Using multivariate analysis, the progression of lower limb arterial log calcification score was found to be associated with (β coefficient [slope], 95% CI, p-value) baseline log(calcification score) (1.02, 1.00–1.04, p < 0.001), triglycerides (0.11, 0.03–0.20, p = 0.007), log(RANKL) (0.07, 0.02–0.11, p = 0.016), previous ischemic cardiomyopathy (0.36, 0.15–0.57, p = 0.001), statin use (0.39, 0.06–0.72, p = 0.023) and duration of follow up (0.04, 0.01–0.06, p = 0.004). Conclusion In patients with type 2 diabetes, lower limb arterial calcification is frequent and can progress rapidly. Circulating RANKL and triglycerides are independently associated with this progression. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy. Trial registration NCT02431234

Arteries masquerading as varicose veins: A trap for phlebologists

2014 ◽  
Vol 30 (10) ◽  
pp. 729-735 ◽  
Author(s):  
L Jones ◽  
K Parsi
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Tissue Loss ◽  
Injection Sclerotherapy ◽  
Ultrasound Guided ◽  
History Of ◽  
The Right

Ultrasound guided sclerotherapy may be complicated by intra-arterial injections resulting in significant tissue necrosis. Here, we present a 69-year-old man with a history of right small saphenous vein “stripping”, presenting for the treatment of symptomatic lower limb varicose veins. Duplex ultrasound of the right lower limb outlined the pathway of venous incompetence. Despite the history of “stripping”, the small saphenous vein was present but the sapheno-popliteal junction was ligated at the level of the knee crease. No other unusual findings were reported at the time. During ultrasound guided sclerotherapy, subcutaneous vessels of the right posterior calf were noted to be pulsatile on B-mode ultrasound. Treatment was interrupted. Subsequent angiography and sonography showed absence of the right distal popliteal artery. A cluster of subcutaneous vessels of the right medial and posterior calf were found to be arterial collaterals masquerading as varicose veins. Injection sclerotherapy of these vessels would have resulted in significant tissue loss. This case highlights the importance of vigilance at the time of treatment and the invaluable role of ultrasound in guiding endovenous interventions.

scholarly journals The Emerging Clinical Utility of Neurosonology During COVID-19 Pandemic

2021 ◽  
Vol 13 (2) ◽  
pp. 27-36
Author(s):  
Eleni Bakola ◽  
Odysseas Kargiotis ◽  
Klearchos Psychogios ◽  
Apostolos Safouris ◽  
Lina Palaiodimou ◽  
...  
Keyword(s):  
Clinical Utility ◽  
Imaging Modality ◽  
Upper Airway ◽  
Duplex Ultrasound ◽  
Cerebrovascular Diseases ◽  
Cerebrovascular Complications ◽  
Ultrasound Evaluation ◽  
Hemodynamic Assessment ◽  
Virus Spreading

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 infection. Over the last 2 years the virus has spread worldwide with enormous implications on the healthcare systems. COVID-19 patients suffer from mild upper-airway manifestations to pneumonia and severe acute respiratory distress syndrome and their hospitalizations are often prolonged. Neurological manifestations of the disease are common. Neurosonology (transcranial Doppler & cervical duplex ultrasound) is an easily repeatable diagnostic imaging modality that can be simply applied at the bedside of COVID-19 patients with cerebrovascular diseases or in critically ill patients in the intensive care unit. Neurosonology may provide hemodynamic assessment of cerebral circulation, quantitative evaluation of increased intracranial pressure and detection of micro-embolic signals in real-time. Consequently, it may assist substantially in the diagnosis, risk stratification and therapeutic approach of COVID-19 patients with or without cerebrovascular complications. In the present narrative review, we discuss the emerging clinical utility of neurosonology during COVID-19 pandemic and highlight the upgraded role of neurosonology resulting from the combination of the established applications coupled with the reduced risk of virus spreading during ultrasound evaluation compared to other imaging modalities including computed tomography and magnetic resonance imaging.

scholarly journals ROLE OF MULTI-SLICE SPIRAL CT IN EVALUATION OF NECK MASS WITH CYTOLOGICAL CORRELATION

2020 ◽  
pp. 11-13
Author(s):  
Das Runa ◽  
Aniruddha Ghosh
Keyword(s):  
Computed Tomography ◽  
Imaging Modality ◽  
Spiral Ct ◽  
Neck Mass ◽  
Display Time ◽  
Neck Masses ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Anatomical Localization

Abstract: The swellings in the neck can be caused by innumerable pathological lesions arising from the various anatomical structures lying therein. Multi-Detector CT (MDCT) has now become the new standard in a radiological imaging modality. The utilization of MDCT has resulted in improved resolution and considerable reductions in scan acquisition and display time. Aim and Objective: This study is an effort to assess the role of MDCT in detection, characterization and diagnosing neck pathologies that correlate cytologically. Material and Methods: A study of 50 cases in a clinically suspected neck mass was studied for 1 year. Contrast-enhanced Ct neck was done and Specific CT criteria were used to characterize the mass so that a probable diagnosis could be made. MDCT diagnoses then compared with cytological results to conclude the efficiency of MDCT analysis of neck mass. Conclusion: Multi-detector computed tomography helps in precise anatomical localization and characterization of neck masses. Hence, it will be a method of choice for initial evaluation, preoperative planning, and biopsy targeting and postoperative follow-up. Key Words: Neck mass; Cervical lymph node; Computed tomography; Carcinoma.

scholarly journals The Role of Cardiac Computed Tomography in Tetralogy of Fallot and Pulmonary Atresia

2015 ◽  
pp. 52-61
Author(s):  
Oktavia Lilyasari
Keyword(s):  
Computed Tomography ◽  
Cardiac Catheterization ◽  
Imaging Modality ◽  
Cardiac Computed Tomography ◽  
Pulmonary Atresia ◽  
Cost Effective ◽  
Anatomy And Physiology ◽  
Great Vessels

Congenital heart disease (CHD) occurs in about 6 to 8 of 1000 live births with the increasing prevalence can be attributed to major improvements in diagnosis and treatment. Imaging has an important role in diagnosis of CHD. It outlines anatomy and physiology, helps to refine management, evaluates the consequences of interventions and helps guide prognosis. However, no single available imaging modality fulfills these roles for all patients and diseases. Therefore, assessment for CHD must involve multimodalities that can be used in a complementary fashion, and that together are sensitive, accurate, reproducible, and cost effective, whilst minimizing harm.In previous years, the diagnosis and the treatment of congenital malformations have often depended on cardiac catheterization. In many institutions, cardiac catheterization still remains the gold standard against which other modalities are measured. In the past decade, however, imaging methodologies have increasingly shifted toward the use of less invasive and noninvasive techniques. Although echocardiography is the most commonly used imaging modality for diagnosis and follow-up of subjects with CHD, the evolution of cardiovascular magnetic resonance (MR) imaging and increasingly computed tomography (CT) does offer new ways to visualize the heart and the great vessels.

scholarly journals Role of Computed Tomography in the Evaluation of Pediatric Retroperitoneal Masses: A Retrospective Study

2021 ◽  
Vol 6 (3) ◽  
pp. 237-241
Author(s):  
Gupta Vikrant ◽  
Abrol Deepak
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Imaging Modality ◽  
Clinical History ◽  
The Body ◽  
Age Group ◽  
Laboratory Findings ◽  
Renal Masses ◽  
Contrast Enhanced Ct

Objective: Retroperitoneum is one of the largest spaces in the body. Retroperitoneal (RP) masses are common in paediatric age group and present with vague clinical features. Computed Tomography (CT) is an excellent imaging modality in the evaluation of RP masses. The aim of this study was to evaluate the role of CT in the detection and characterization of RP masses. Materials and Methods: 28 clinically suspected or sonographically detected RP masses formed the material of the study. Detailed clinical history was elicited from the patients/attendants and findings of general physical examination recorded. Non-contrast and Contrast Enhanced CT was performed and masses were evaluated with respect to site of origin, consistency, components and pattern of enhancement. Probable CT diagnosis was made and findings correlated with pathological/laboratory findings wherever possible. The results were subjected to statistical analysis and expressed as percentages and proportions.Results: Majority of patients were seen in 1-5 years age group with M:F ratio of 1.8:1. Lump abdomen was the commonest presenting feature followed by pain abdomen. Lymph nodal masses were the commonest primary RP space mass while renal masses accounted for the majority of secondary RP masses in our study. Pathological/Laboratory correlation was available in 21 cases and CT was able to differentiate benign and malignant lesions in 95.2% cases. Overall diagnostic accuracy of CT in the evaluation of RP masses was 85.7%. Conclusions: CT is a simple and reliable tool in diagnosing pediatric RP masses with a high diagnostic accuracy.

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