scholarly journals The filling defect of pulmonary artery, an imaging finding what we should know

2020 ◽  
Vol 10 (1) ◽  
pp. 204589402091068
Author(s):  
Min Liu ◽  
Xin Cao Tao ◽  
Zhenguo Zhai ◽  
Zhanhong Ma ◽  
Li Zhu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Pulmonary Thromboembolism ◽  
Clinical Manifestations ◽  
Pulmonary Angiography ◽  
Resonance Imaging ◽  
Computed Tomography Pulmonary Angiography ◽  
Pulmonary Arterial

The most common cause of pulmonary artery filling defects on computed tomography pulmonary angiography or magnetic resonance imaging is pulmonary thromboembolism, but not infrequently, the presentation of this finding lacks specificity. Given that the morbidity and mortality associated with pulmonary thromboembolism is high, proper diagnosis of the condition is essential. Unusual or more rarely encountered etiologies must be considered when clinical manifestations and imaging findings are inconsistent. With this review, our purpose is to describe possible causes of pulmonary arterial filling defects. We aim to provide clinicians with a comprehensive list of differential diagnoses to facilitate a measured approach to the assessment of pulmonary arterial filling defects on computed tomography pulmonary angiography or magnetic resonance imaging.

Comparison of the Diagnostic Utility of Cardiac Magnetic Resonance Imaging, Computed Tomography, and Echocardiography in Assessment of Suspected Pulmonary Arterial Hypertension in Patients with Connective Tissue Disease

2012 ◽  
Vol 39 (6) ◽  
pp. 1265-1274 ◽  
Author(s):  
SMITHA RAJARAM ◽  
ANDREW JAMES SWIFT ◽  
DAVID CAPENER ◽  
CHARLES A. ELLIOT ◽  
ROBIN CONDLIFFE ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Pulmonary Arterial Hypertension ◽  
Magnetic Resonance ◽  
Connective Tissue ◽  
Pulmonary Artery ◽  
Cardiac Mri ◽  
Diagnostic Utility ◽  
Resonance Imaging ◽  
Pulmonary Arterial

Objective.Pulmonary arterial hypertension (PAH) is a life-threatening complication of connective tissue diseases (CTD). Our aim was to compare the diagnostic utility of noninvasive imaging modalities, i.e., magnetic resonance imaging (MRI), computed tomography (CT), and echocardiography, in evaluation of these patients.Methods.In total, 81 consecutive patients with CTD and suspected PH underwent cardiac MRI, CT, and right heart catheterization (RHC) within 48 hours. Functional cardiac MRI variables [ventricle areas and ratios, delayed myocardial enhancement, position of the interventricular septum, right ventricular mass, ventricular mass index (VMI), and pulmonary artery distensibility] were all evaluated. The pulmonary artery size, pulmonary artery/aortic ratio (PA/Ao), left and right ventricular (RV) diameter ratio, RV wall thickness, and grade of tricuspid regurgitation were measured on CT. Tricuspid gradient (TG) and size of the RV were assessed using echocardiography.Results.In our study of 81 patients with CTD, 55 had PAH, 22 had no PH, and 4 had PH owing to left heart disease. There was good correlation between mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) measured by RHC and VMI derived from MRI (mPAP, r = 0.69, p < 0.001; PVR, r = 0.78, p < 0.001) and systolic area ratio (mPAP, r = 0.69, p < 0.001; PVR, r = 0.68, p < 0.001) and TG derived from echocardiography (mPAP, r = 0.84, p < 0.001; PVR, r = 0.76, p < 0.001). In contrast, CT measures showed only moderate correlation. MRI and echocardiography each performed better as a diagnostic test for PAH than CT-derived measures: VMI ≥ 0.45 had a sensitivity of 85% and specificity 82%; and TG ≥ 40 mm Hg had a sensitivity of 86% and specificity 82%. Univariate Cox regression analysis showed the MRI measurements were better at predicting mortality. Patients with RV end diastolic volume < 135 ml had a better prognosis than those with a value > 135 ml, with a 1-year survival of 95% versus 66%, respectively.Conclusion.In patients with CTD and suspected PAH, cardiac MRI and echocardiography have greater diagnostic utility than CT in the assessment of patients with suspected PAH, and MRI has prognostic value.

scholarly journals Tactics of managing patients with primarily detected nasopharyngeal neoplasm. Case reports

2021 ◽  
Vol 23 (3) ◽  
pp. 231-235
Author(s):  
Olga E. Vereshchagina ◽  
◽  
Sergey A. Karpishchenko ◽  
Diana A. Alekseeva ◽  
Olga A. Stancheva ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Pathological Process ◽  
Resonance Imaging ◽  
Nasopharyngeal Neoplasm ◽  
Postnasal Drip ◽  
Chemoradiation Treatment

In 5% of cases in the nasopharynx of an adult can be found a neoplasm with benign or malignant nature. Clinical manifestations of such pathology are next: persistent dysfunction of the auditory tubes, nasalness and postnasal drip syndrome. Endoscopy of the nasopharynx, computed tomography of the sinuses and magnetic resonance imaging of the head are the main diagnostic criteria for detecting neoplasms in this area. The tactics of treatment depends on the dysplasia type of the pathological process and varies from endoscopic one-stage resection to chemoradiation treatment. Using the example of two clinical cases, we will consider an algorithm for diagnosis and treatment the patients.

scholarly journals Investigation of the Need for Computed Tomography Pulmonary Angiography in the Decision to Discontinue Treatment for Pulmonary Thromboembolism

2021 ◽  
Author(s):  
Eda Çelik ◽  
Ömer Araz ◽  
Buğra Kerget ◽  
Elif Yılmazel Uçar ◽  
Metin Akgün ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Artery ◽  
Sensitivity And Specificity ◽  
Outpatient Clinic ◽  
Pulmonary Thromboembolism ◽  
Pulmonary Angiography ◽  
Treatment Discontinuation ◽  
Computed Tomography Pulmonary Angiography ◽  
Pulmonary Artery Obstruction ◽  
D Dimer

Abstract Purpose: Acute pulmonary thromboembolism (PTE) is an important cause of morbidity and mortality that can reduce quality of life due to long-term complications during and after treatment discontinuation. The aim of this study was to evaluate patients for these complications before discontinuing treatment and determine the necessity of computed tomography pulmonary angiography (CTPA) imaging.Methods: This retrospective study included 116 patients over the age of 18 who received anticoagulant treatment for at least 3 months and presented for treatment discontinuation to the Atatürk University Research Hospital Chest Diseases Outpatient Clinic between January 2015 and September 2019. Results: CTPA performed at treatment discontinuation showed complete thrombus resolution with treatment in 73 patients (62.9%). High pulmonary artery obstruction index (PAOI) at diagnosis was statistically associated with findings of residual or chronic thrombus on CTPA at treatment discontinuation (p=0.001). In the differentiation of patients with residual/chronic thrombus and those with thrombus resolution, D-dimer at a cut-off value of 474 µg/L had 60% sensitivity and 70% specificity. At a cut-off value of 35.5 mmHg, mean pulmonary artery pressure on echocardiography had sensitivity and specificity of 72% and 77%, respectively. At a cut-off of 23.75, PAOI had sensitivity and specificity of 93% and 69%, respectively.Discussion: In addition to physical examination findings, D-dimer and echocardiography were guiding parameters in the evaluation of treatment discontinuation and thrombus resolution in patients presenting to the outpatient clinic for discontinuation of treatment for acute PTE. PAOI at diagnosis may be another important guiding parameter in addition to these examinations.

Cesarean scar defects: diagnosis and treatment in non-pregnant women

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 6-10
Author(s):  
Sergey A. Martynov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Genital Tract ◽  
Conservative Therapy ◽  
Clinical Manifestations ◽  
Subsequent Pregnancy ◽  
Resonance Imaging ◽  
Diagnostic Features ◽  
Pregnancy And Childbirth

The aim of the review was to summarize information on clinical manifestations, diagnostic features, as well as methods for correction of scar defects after cesarean section (CS) outside pregnancy. Lack of the scar after CS, niche, isthmocele are a myometrium defect in the area of scar after CS, which is most often detected by ultrasound, sonohysterography or magnetic resonance imaging and is manifested by postmenstrual bleeding from the genital tract. In some cases, it can cause menorrhagia, dyspareunia, pelvic pain, infertility, uterine rupture during subsequent pregnancy and childbirth. Conservative therapy or surgical treatment with laparoscopy, laparotomy or vaginal approach is carried out depending on the symptoms, size of the defect, the thickness of the residual myometrium, as well as the womans reproductive plans.

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