scholarly journals MDCT angiography of emergent, non-traumatic, upper extremity vascular lesions

2020 ◽  
Vol 93 (1116) ◽  
pp. 20190731
Author(s):  
Sameer Ahmed ◽  
Megan H Lee ◽  
Hannah Ahn ◽  
Elliot K. Fishman
Keyword(s):  
Upper Extremity ◽  
Multidetector Ct ◽  
Vascular Malformations ◽  
Maximum Intensity Projection ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Emergency Setting ◽  
Mdct Angiography ◽  
Non Invasive

Timely, accurate diagnosis of upper extremity vascular pathology is critical for successful clinical and surgical management. Although the vast majority of upper extremity vascular injury is due to trauma, physicians in the emergency setting, including radiologists, must be familiar with vascular lesions from iatrogenic injury, thromboembolic disease, vascular malformations, and vasculitis. Non-invasive diagnostic imaging with multidetector CT (MDCT) angiography is often employed in the emergency department to evaluate patients with suspected vascular pathology of the upper extremity. Maximum intensity projection and volume rendering technique are two methods that are useful for evaluating vasculature. In addition, dual-energy MDCT is useful in that it allows for the generation of iodine-selective images and bone subtracted images. These techniques can be used to create images that simulate catheter angiograms. In this article, we will discuss the role of MDCT angiography in the diagnosis and management of emergent non-traumatic vascular lesions of the upper extremity.

scholarly journals Developmental timing of CCM2 loss influences cerebral cavernous malformations in mice

2011 ◽  
Vol 208 (9) ◽  
pp. 1835-1847 ◽  
Author(s):  
Gwénola Boulday ◽  
Noemi Rudini ◽  
Luigi Maddaluno ◽  
Anne Blécon ◽  
Minh Arnould ◽  
...  
Keyword(s):  
Autosomal Dominant ◽  
Vascular Malformations ◽  
Vascular Lesions ◽  
Developmental Timing ◽  
Cerebral Cavernous Malformations ◽  
Loss Of Function ◽  
Cavernous Malformations ◽  
The Central Nervous System ◽  
Dominant Condition

Cerebral cavernous malformations (CCM) are vascular malformations of the central nervous system (CNS) that lead to cerebral hemorrhages. Familial CCM occurs as an autosomal dominant condition caused by loss-of-function mutations in one of the three CCM genes. Constitutive or tissue-specific ablation of any of the Ccm genes in mice previously established the crucial role of Ccm gene expression in endothelial cells for proper angiogenesis. However, embryonic lethality precluded the development of relevant CCM mouse models. Here, we show that endothelial-specific Ccm2 deletion at postnatal day 1 (P1) in mice results in vascular lesions mimicking human CCM lesions. Consistent with CCM1/3 involvement in the same human disease, deletion of Ccm1/3 at P1 in mice results in similar CCM lesions. The lesions are located in the cerebellum and the retina, two organs undergoing intense postnatal angiogenesis. Despite a pan-endothelial Ccm2 deletion, CCM lesions are restricted to the venous bed. Notably, the consequences of Ccm2 loss depend on the developmental timing of Ccm2 ablation. This work provides a highly penetrant and relevant CCM mouse model.

scholarly journals Role of sclerotherapy in management of low flow vascular malformations

2021 ◽  
Vol 8 (4) ◽  
pp. 1234
Author(s):  
Manpreet Kaur ◽  
Parul Sachdeva ◽  
Rajan Syal ◽  
Savijot Singh
Keyword(s):  
Head And Neck ◽  
Vascular Malformations ◽  
Neck Region ◽  
Low Flow ◽  
Vascular Lesions ◽  
Surgical Removal ◽  
Complete Regression ◽  
Head And Neck Region ◽  
Life Threatening

Background: Low flow vascular malformations are most common in the head and neck region. Only symptomatic malformations require treatment. Sclerotherapy followed by surgery was considered the gold standard treatment but in the head and neck region, it may produce cosmetic and physiological defects. In the present study, multiple injections of sclerotherapy with 3% sodium tetradecyl sulphate was used for the treatment of low flow vascular malformations.Methods: Twenty cases of low flow vascular malformations of the oral cavity who presented in the outpatient department of ESIC Model Hospital, Ludhiana from 2014-2016 were selected for the study. Only significantly sized (>4 cm) and easily accessible lesions were included. Staged sequential sclerotherapy with 3% STS under strict fluoroscopy control was used as the sole treatment.Results: A total of 20 patients were taken of which, 25% required three sessions, 65% five to six sessions each and 10% required eight sessions each. All patients showed good results with complete regression and no mucosal ulceration.Conclusions: Staged sequential sclerotherapy with 3% STS should be the treatment of choice in low flow vascular lesions involving mucosal and cutaneous structures of head and neck region especially anterior two-thirds of tongue, palate, gingiva, buccal mucosa and lips. Surgical removal may affect critical neurovascular structures and cause cosmetic deformity. So the removal is advisable in life-threatening conditions, lesions requiring general anaesthesia and single sitting removal.

Rotational angiography for diagnosis and surgical planning in the management of spinal vascular lesions

2012 ◽  
Vol 32 (5) ◽  
pp. E6 ◽  
Author(s):  
Alexander E. Ropper ◽  
Ning Lin ◽  
Bradley A. Gross ◽  
Hekmat K. Zarzour ◽  
Ruth Thiex ◽  
...  
Keyword(s):  
Vascular Malformations ◽  
Three Dimensional ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Spinal Angiography ◽  
Rotational Angiography ◽  
Spinal Vascular Malformations ◽  
Significant Difference ◽  
Surgical Treatment Planning

Object The management of spinal vascular malformations has undergone significant evolution with the advent of advanced endovascular and angiographic technology. Three-dimensional rotational spinal angiography is an advanced tool that allows the surgeon to gain a better appreciation of the anatomy of these spinal vascular lesions and their relation to surrounding structures. This article describes the use of rotational angiography and 3D reconstructions in the diagnosis and management of spinal vascular malformations. Methods The authors present representative cases involving surgical treatment planning for spinal vascular malformations with focus on the utility and technique of rotational spinal angiography. They report the use of rotational spinal angiography for a heterogeneous collection of vascular pathological conditions. Results Eight patients underwent rotational spinal angiography in addition to digital subtraction angiography (DSA) for the diagnosis and characterization of various spinal vascular lesions. Postprocessed images were used to characterize the lesion in relation to surrounding bone and to enhance the surgeon's ability to precisely localize and obliterate the abnormality. The reconstructions provided superior anatomical detail compared with traditional DSA. No associated complications from the rotational angiography were noted, and there was no statistically significant difference in the amount of radiation exposure to patients undergoing rotational angiography relative to traditional angiography. Conclusions The use of rotational spinal angiography provides a rapid and powerful diagnostic tool, superior to conventional DSA in the diagnosis and preoperative planning of a variety of spinal vascular pathology. A more detailed understanding of the anatomy of such lesions provided by this technique may improve the safety of the surgical approach.

scholarly journals Overview of the current role of endovascular and surgical treatment in spinal dural arteriovenous fistulas

2009 ◽  
Vol 26 (1) ◽  
pp. E8 ◽  
Author(s):  
Amir R. Dehdashti ◽  
Leodante B. Da Costa ◽  
Karel G. terBrugge ◽  
Robert A. Willinsky ◽  
Michael Tymianski ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Vascular Malformations ◽  
Endovascular Embolization ◽  
Vascular Lesions ◽  
Current Role ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Complete Obliteration ◽  
Spinal Dural Arteriovenous Fistulas

Dural arteriovenous fistulas are the most common vascular malformations of the spinal cord. These benign vascular lesions are considered straightforward targets of surgical treatment and possibly endovascular embolization, but the outcome in these cases depends mainly on the extent of clinical dysfunction at the time of the diagnosis. A timely diagnosis is an equally important factor, with early treatment regardless of the type more likely to yield significant improvements in neurological functioning. The outcomes after surgical and endovascular treatment are similar if complete obliteration of the fistulous site is obtained. In the present study, the authors evaluated the current role of each modality in the management of these interesting lesions.

320-Row Multidetector CT Angiography in the Detection of Critical Cerebrovascular Anomalies

2016 ◽  
Vol 43 (4) ◽  
pp. 543-548
Author(s):  
Julien Hébert ◽  
Federico Roncarolo ◽  
Donatella Tampieri ◽  
Maria delPilar Cortes
Keyword(s):  
Digital Subtraction Angiography ◽  
Cerebral Angiography ◽  
Multidetector Ct ◽  
Unruptured Aneurysm ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Montreal Neurological Institute ◽  
Cerebrovascular Lesions ◽  
Quality Imaging

AbstractBackground: The acquisition of a new 320-row multidetector computed tomography angiography (CTA) scanner at the Montreal Neurological Institute and Hospital has provided higher quality imaging with less radiation exposure and shorter time of acquisition. However, its reliability has not been fully proven in critical vascular lesions when it comes to replacing a more invasive examination such as cerebral angiography. We wished to validate the accuracy of this equipment to investigate four common indications for patients to undergo conventional digital subtraction angiography: subarachnoid hemorrhage, vasospasm, unusual intracerebral hemorrhage, and unruptured aneurysm. Methods: Radiological reports and relevant imaging from 82 consecutive subjects who underwent a 320-row multidetector CTA followed by cerebral angiography from February 2010 to February 2014 were retrospectively analysed. A total of 102 cerebrovascular anomalies were found. Reports from both imaging modalities were compared to determine the diagnostic accuracy of CTA. Results: The overall sensitivity and specificity of 320-row multidetector CTA for detecting cerebrovascular abnormalities were, respectively, 97.60% and 63.20%. Similar results were obtained for all four categories of clinical indications. Conclusion: Results obtained from CTA were consistent with those obtained on digital subtraction angiography regardless of the vascular pathology. To our knowledge, this study is the first validating the accuracy of 320-row CTA in diagnosing critical cerebrovascular lesions.

Role of Doppler Ultrasound in Comparison With MDCT Angiography in the Assessment of Lower Limb PAD

2021 ◽  
Vol 15 (11) ◽  
pp. 2936-2937
Author(s):  
Mehwish Tahir ◽  
Sadaf Iqbal ◽  
Maimoona Gulshan
Keyword(s):  
Doppler Ultrasound ◽  
Lower Limb ◽  
Multidetector Ct ◽  
Duplex Ultrasound ◽  
Arterial Disease ◽  
Radiology Department ◽  
Atherosclerotic Plaques ◽  
Mdct Angiography ◽  
Peripheral Arterial

Aim: Role of Doppler ultrasound in comparison with MDCT angiography in the assessment of lower limb Peripheral arterial disease. Methodology: This study was conducted in Radiology department of Shalamar Hospital Lahore. A total of 42 patients (31 males and 11 females) diagnosed with PAD by using both Doppler ultrasound and MDCTA were included. The data collected was entered, tabulated and statistically analyzed on IBM-SPSS 25.0 version. Results: A total of 336 arterial segments were assessed on both modalities. Duplex ultrasound detected 278 (83%) positive patent segments, 124(37%) segments showing atherosclerosis and 63(19%) segments with stenosis/thrombus, in comparison to MDCTA which was able to detect 221 (66%) patent vessels,153(46%) segments showing atherosclerosis and 114 (34%) segments showing thrombus/ stenosis. The results showed that the MDCTA was able to detect 15% more arterial segments with stenosis/ thrombus and 9% more segments with atherosclerotic plaques as compared to Doppler. Conclusion: Doppler ultrasound is the modality of choice in detecting grade 0 and 1 PAD while. MDCTA is more accurate in assessing patients with grade 2 and 3 PAD who need surgical intervention. Key Words: PAD, Duplex ultrasound, Multidetector CT Angiography

scholarly journals MDCT angiography in evaluation of pediatric hemangiomas and peripheral vascular malformations

2018 ◽  
Vol 6 (12) ◽  
pp. 4087
Author(s):  
Rohini Gupta Ghasi ◽  
Varun Narayan ◽  
Brij Bhushan Thukral
Keyword(s):  
Soft Tissue Mass ◽  
Vascular Malformations ◽  
Maximum Intensity Projection ◽  
Arterial Phase ◽  
Venous Malformations ◽  
Mdct Angiography ◽  
Tissue Mass ◽  
Peak Enhancement ◽  
Venous Phase ◽  
Delayed Phase

Background: To evaluate the role of MDCT angiography in peripheral hemangiomas and vascular malformations in pediatric patients.Methods: Total of 36 consecutive pediatric patients with clinically suspected peripheral hemangiomas and peripheral malformations were included in the study. MDCT angiography and doppler sonography was done for all patients. Final diagnosis was made by response to treatment and follow up. The statistical significance of various MDCT findings and post processing techniques was calculated. p value of <0.05 was considered significant.Results: Venous malformations were the most common. The MDCTA features which were significant in diagnosing venous malformations were phleboliths (p=0.039), peak enhancement in venous or delayed phase, absence of soft tissue mass, lacy tangle of vessels on maximum intensity projection and volume rendered images. Features significant in diagnosing arteriovenous malformations were tortuous arterial feeders, peak enhancement in arterial phase (0.0001), early draining vein (p=0.0001), venous phase wash out (p=0.0001), tense tangle of vessels on maximum intensity projection and volume rendered images (p=0.0003). Phleboliths (p=0.43) and venous or delayed phase peak enhancement (p=0.69) were overlapping features in congenital hemangiomas and venous malformations. Arterial phase enhancement (p=0.10) and early draining veins (p=0.39) were overlapping features in infantile proliferating hemangiomas and arteriovenous malformations. However, presence of soft tissue mass (p=0.0001) and lack of venous phase wash out (p=0.0003) were differentiating features for hemangiomas.Conclusions: MDCT angiography can be used as a highly accurate modality to diagnose hemangiomas and vascular malformations. It has an advantage over color Doppler in depicting entire extent of deep lesions.

Role of Cardiac MRI in Detecting Familial Hypertrophic Cardiomyopathy: Review

2016 ◽  
Vol 1 (1) ◽  
pp. 4
Author(s):  
Marymol Koshy ◽  
Bushra Johari ◽  
Mohd Farhan Hamdan ◽  
Mohammad Hanafiah
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Genetic Disorder ◽  
Familial Hypertrophic Cardiomyopathy ◽  
Non Invasive ◽  
Wide Range ◽  
Proper Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
Potential Use

Hypertrophic cardiomyopathy (HCM) is a global disease affecting people of various ethnic origins and both genders. HCM is a genetic disorder with a wide range of symptoms, including the catastrophic presentation of sudden cardiac death. Proper diagnosis and treatment of this disorder can relieve symptoms and prolong life. Non-invasive imaging is essential in diagnosing HCM. We present a review to deliberate the potential use of cardiac magnetic resonance (CMR) imaging in HCM assessment and also identify the risk factors entailed with risk stratification of HCM based on Magnetic Resonance Imaging (MRI).

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