scholarly journals LIVE RENAL DONORS

2010 ◽  
Vol 17 (02) ◽  
pp. 241-245
Author(s):  
HAFIZ SHAHZAD ASHRAF ◽  
Shafique Ahmed ◽  
IMRAN HYDER ◽  
Mubashir Ijaz ◽  
MOHAMMAD USMAN KHAN
Keyword(s):  
Ct Angiography ◽  
Kidney Diseases ◽  
Imaging Modality ◽  
Helical Computed Tomography ◽  
Medical Institute ◽  
Renal Vasculature ◽  
Conventional Angiography ◽  
Ct Angiogram ◽  
Operative Findings ◽  
Collecting System

Objectives: To compare the findings of helical computed tomographic angiography and intra-operative findings in live related donors. To evaluate the accuracy of helical computed tomography with advanced 3D techniques in depicting the renal vasculature, parenchymal and anatomy of collecting system. Setting: Sheikh Zayed Post Graduate Medical Institute and National Institute of kidney diseases Lahore. Material and Method: Between June 2006 to May 2009 eighty potential donors underwent CT angiogram as a part of theirpreoperative workup. We retrospectively studied the CT angiogram and compared the finding with the surgical findings. The results were reviewed with radiologists to determine the discrepancy in discordant cases. Results: The accuracy of CT angiography was 93.40% to predict number of vessels. Five arteries and one vein was missed, this disconcordant comprised 7.59% during initial CT interpretation. The overallconcordance between CT angiography and operative findings in delineating the arterial anatomy was found in 74(93.67%) and venous in 78 (98.73%) donors. All CT scans demonstrated normal collecting system except one, which showed a dilated right pelvicalical system and ureter. Simple renal cysts about the size of 2-4 cm were found in the four left kidneys. CT scan supplied additional important anatomical informationincluding kidney size and the presence of nephrolithiasis. Conclusion: Helical CT angiography is very specific for arterial and venous anatomy as well as other anatomical and functional details. It provides all the information required by a surgeon. It can become the single imaging modality for preoperative assessment of potential donors in place of conventional angiography and intravenous urography. CT angiography isminimally invasive and cost effective.

Abstract W P37: Accuracy Of CT Angiography In The Localization Of Carotid Occlusion Sites In Acute Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Marcelo Rocha ◽  
William T Delfyett ◽  
Amin Aghaebrahim ◽  
Ashutosh Jadhav ◽  
Tudor Jovin
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Target Lesion ◽  
Carotid Occlusion ◽  
Conventional Angiography ◽  
Vessel Occlusion ◽  
Cerebral Vessel ◽  
Ct Angiogram ◽  
Comprehensive Stroke Center

Background and Purpose: CT angiography yields rapid detection of a major cerebral vessel occlusion during the evaluation of patients with acute ischemic stroke leading to its widespread use in rapidly triaging for IA trial enrollment. In such trials, patients who have an extracranial carotid occlusion in tandem to the intracranial target lesion are typically excluded. However, ICA terminus occlusions may be misidentified as cervical carotid occlusions on CTA. The goal of this study is to determine the accuracy of CTA in identifying ICA terminus occlusions from tandem carotid occlusions (cervical and intracranial segments). Methods: Retrospective review of a prospectively maintained database containing patients treated at our comprehensive stroke center between 1996 and 2014 in whom catheter angiogram and CT angiogram were available on PACS. A Neuroradiologist, blinded to catheter angiographic results reviewed the CT angiography identifying the presence of intracranial stenoses and concomitant cervical carotid occlusions. Results: Of 196 patients presenting with intracranial carotid occlusions on catheter based angiogram, 101 patients were identified with good quality CT angiography and subsequent catheter angiograms. Mean ages for identified patients was 65 +/- 14, of which 52% women and 48% men. Forty-four percent of patients had an ASPECT score of 9-10. The overall rate of agreement between retrospective CTA and conventional angiography readings was 77%. Of 72 isolated intracranial occlusions on conventional angiography, CT angiography misidentified 23 cervical carotid occlusions. The sensitivity of CTA for detecting isolated carotid terminus occlusion was 68% in this cohort. Specific factors associated with CT and catheter based angiographic discrepancy are reviewed. Conclusions: The study raises systematic considerations for maximizing inclusion of patients with target arterial occlusions who are most likely to benefit from intra-arterial therapy in future clinical trials. Future steps will include determination of specificity, predictive value of CTA for localization of specific carotid occlusion sites. Clinical variables associated with lower CTA accuracy will also be examined.

Abstract 177: Absent Collateral Flow on CT Angiogram Predicts Acute Hemorrhagic Transformation in Ischemic Stroke

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Richard Burgess ◽  
Esteban Cheng Ching ◽  
Delora Wisco ◽  
Shumei Man ◽  
Ken Uchino ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Hemorrhagic Transformation ◽  
Collateral Flow ◽  
Stroke Patients ◽  
Conventional Angiography ◽  
Vessel Occlusion ◽  
Post Procedure ◽  
Ct Angiogram

Background: In patients with a large vessel occlusion, the degree of collateral vascular supply to an ischemic territory has been shown to be a predictor of stroke outcome. Prior studies have focused on the correlation between collateral flow measured on conventional digital subtraction angiography and outcome measures, including the presence of hemorrhagic conversion. CT/CTA is more widely available and more quickly accomplished than MR or conventional angiography. In this work we demonstrate that the absence of CT angiographic collaterals predicts hemorrhage transformation in acute ischemic stroke patients that have persistent vessel occlusion. Methods: Retrospective review of patient data from a prospectively acquired database identified acute ischemic stroke patients who underwent CT angiography followed by cerebral angiography, and post procedure non-contrast CT scans. Blinded evaluators independently assessed CT angiogram collaterals, angiographic TICI scores, and the presence and severity of post procedure hemorrhagic transformation. Fishers exact test was used to compare proportions between groups. Results: 146 patients were included. The mean age was 67. The median NIHSS was 15.5 (range 0-32). 34% of patients had any type of hemorrhagic conversion. Of patients with no collaterals on CT angiography, 63% had hemorrhagic conversion versus 23%, 33%, and 38% for patients with grades 1, 2, and 3 collaterals (p<0.05 for comparisons). Patients with TICI scores of 0 or 1 and no CTA collaterals all had hemorrhagic transformation. Conclusion: The absence of collateral flow on CT angiography in patients without recanalization strongly predicts the acute development of hemorrhagic conversion.

High-Resolution CT Angiogram for Lower Extremity Vein Mapping

2017 ◽  
Vol 83 (3) ◽  
pp. 257-259
Author(s):  
Mark P. Wright ◽  
Matthew R. Smeds ◽  
Lonnie Wright ◽  
Ahsan T. Ali
Keyword(s):  
High Resolution ◽  
Lower Extremity ◽  
Imaging Modality ◽  
Duplex Ultrasound ◽  
Preoperative Imaging ◽  
Venous Anatomy ◽  
Region Duplication ◽  
Ct Angiogram ◽  
Diagnostic Angiography ◽  
Operative Findings

High-resolution CTangiogram (CTA) has replaced traditional diagnostic angiography as the main preoperative imaging modality for vascular surgery patients. Although the use of CTA is increasing for arterial imaging, it has not been used routinely for vein mapping. The goal of this study was to evaluate the accuracy of CTA for venous anatomy and compare it to a standard venous duplex ultrasound (DUS). When the vein was used for bypass, the quality and size of the vein were evaluated in the operating room. As part of a preoperative workup before lower extremity revascularization, 16 patients underwent a CTA followed by a DUS. Although the CTA provided useful arterial anatomy, the greater saphenous vein (GSV) was also evaluated. In total, 22 GSV were evaluated in 11 patients. The vein diameter was measured by CTA at four locations: saphenofemoral junction, midthigh, knee joint, and midcalf region. Duplication or other anomalies were also noted, when present. These measurements were taken by an interventional radiologist independently and before the DUS. Routine vein mapping with diameter measurements were then performed with DUS in a vascular laboratory by registered vascular technicians. Measurements for each limb were then compared between CTA and DUS using linear regression (mean ± SD). There was no statistical difference in the diameter of the GSV when measured using a CT or a DUS at the standard points of measurements. Furthermore, the operative findings confirmed the CTA to be very accurate. There were four duplications in the GSV which were all seen on the CTA, whereas only two of these were identified by DUS. There was one vein found to be sclerotic and unusable by DUS that was not identified by CTA. CTA is as accurate as DUS for evaluation of superficial venous anatomy in the lower extremities. CTA can provide global anatomy and can be used as a one-stop imaging modality for both arterial and venous anatomy. However, sclerosis is not detected by CTA.

Detection and characterization of intracranial aneurysms: a 10-year multidetector CT angiography experience in a large center

2015 ◽  
Vol 8 (11) ◽  
pp. 1168-1172 ◽  
Author(s):  
Jeremy J Heit ◽  
R Gilberto Gonzalez ◽  
David Sabbag ◽  
H Bart Brouwers ◽  
Edgar Gerardo Ordonez Rubiano ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Intracranial Aneurysms ◽  
Multidetector Ct ◽  
Aneurysm Rupture ◽  
Posterior Circulation ◽  
Posterior Communicating Artery ◽  
Anterior Communicating Artery ◽  
Conventional Angiography ◽  
Ct Angiogram ◽  
Male Sex

BackgroundCT angiography (CTA) is increasingly used for the detection, characterization, and follow-up of intracranial aneurysms. A lower threshold to request a CT angiogram may render a patient population that differs from previous studies primarily evaluated with conventional angiography. Our objective was to broaden our knowledge of the factors associated with aneurysm rupture and patient mortality in this population.MethodsAll CTA studies performed over a 10-year period at a large neurovascular referral center were reviewed for the presence of an intracranial aneurysm. Patient demographics, mortality, CTA indication, aneurysm location, size, and rupture status were recorded.Results2927 patients with aneurysms were identified among 29 003 CTAs. 17% of the aneurysms were ruptured at the time of imaging, 24% of aneurysms were incidentally identified, and multiple aneurysms were identified in 34% of patients. Aneurysms most commonly arose from the supraclinoid internal carotid artery (22%), the middle cerebral artery (18%), and the anterior communicating artery (13%). Male sex, age <50 years, aneurysms >6 mm, and aneurysms arising from the anterior communicating artery, posterior communicating artery, or the posterior circulation were independent predictors of aneurysm rupture. Independent mortality predictors included male sex, posterior circulation aneurysms, intraventricular hemorrhage, and intraparenchymal hemorrhage.ConclusionsThese results indicate that aneurysms detected on CTA that arise from the anterior communicating artery, posterior communicating artery, or the posterior circulation, measure >6 mm in size, occur in men, and in patients aged <50 years are associated with rupture.

Comparative study of ultrasonographic findings with the operative findings of biliary surgery

2020 ◽  
Vol 22 (1) ◽  
pp. 25-29
Author(s):  
Zubayer Ahmad ◽  
Mohammad Ali ◽  
Kazi lsrat Jahan ◽  
ABM Khurshid Alam ◽  
G M Morshed
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Imaging Modality ◽  
False Positive Rate ◽  
Gallstone Disease ◽  
False Negative ◽  
False Negative Rate ◽  
Biliary Disease ◽  
Biliary Surgery ◽  
Operative Findings

Background: Biliary disease is one of the most common surgical problems encountered all over the world. Ultrasound is widely accepted for the diagnosis of biliary system disease. However, it is a highly operator dependent imaging modality and its diagnostic success is also influenced by the situation, such as non-fasting, obesity, intestinal gas. Objective: To compare the ultrasonographic findings with the peroperative findings in biliary surgery. Methods: This prospective study was conducted in General Hospital, comilla between the periods of July 2006 to June 2008 among 300 patients with biliary diseases for which operative treatment is planned. Comparison between sonographic findings with operative findings was performed. Results: Right hypochondriac pain and jaundice were two significant symptoms (93% and 15%). Right hypochondriac tenderness, jaundice and palpable gallbladder were most valuable physical findings (respectively, 40%, 15% and 5%). Out of 252 ultrasonically positive gallbladder, stone were confirmed in 249 cases preoperatively. Sensitivity of USG in diagnosis of gallstone disease was 100%. There was, however, 25% false positive rate detection. Specificity was, however, 75% in this case. USG could demonstrate stone in common bile duct in only 12 out of 30 cases. Sensitivity of the test in diagnosing common bile duct stone was 40%, false negative rate 60%. In the series, ultrasonography sensitivity was 100% in diagnosing stone in cystic duct. USG could detect with relatively good but less sensitivity the presence of chronic cholecystitis (92.3%) and worm inside gallbladder (50%). Conclusion: Ultrasonography is the most important investigation in the diagnosis of biliary disease and a useful test for patients undergoing operative management for planning and anticipating technical difficulties. Journal of Surgical Sciences (2018) Vol. 22 (1): 25-29

Circle of Willis: evaluation with spiral CT angiography, MR angiography, and conventional angiography.

Radiology ◽  
1995 ◽  
Vol 195 (2) ◽  
pp. 445-449 ◽  
Author(s):  
D A Katz ◽  
M P Marks ◽  
S A Napel ◽  
P M Bracci ◽  
S L Roberts
Keyword(s):  
Ct Angiography ◽  
Mr Angiography ◽  
Spiral Ct ◽  
Circle Of Willis ◽  
Conventional Angiography ◽  
Spiral Ct Angiography

scholarly journals Unresectable Carcinoma Pancreas : Efficacy of Imaging in Diagnosing and Labeling them as ‘Unresectable’

2013 ◽  
Vol 12 (3) ◽  
pp. 23-26 ◽  
Author(s):  
Md Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tania Tajreen ◽  
Eqramur Rahman ◽  
Md Minhajuddin Sajid ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pancreatic Carcinoma ◽  
Imaging Modality ◽  
Preoperative Imaging ◽  
Mri Imaging ◽  
Medical College ◽  
Magnetic Resonance Imaging Mri ◽  
Carcinoma Pancreas ◽  
Operative Findings ◽  
Better Than

Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imaging like ultrasonography (USG), computerized tomography (CT) scan and magnetic resonance imaging (MRI).Imaging also gives the opportunity to assess resectability. In our country MRI and CT scan are not widely available and most of the pancreatic carcinoma is too advanced for curative surgical resection when diagnosed. These are unresectable carcinoma pancreas (UCP). Objectives: To evaluate the efficacy of imaging in diagnosing carcinoma pancreas and to assess resectability after comparing them with peroperative findings. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in Bangladesh Institute for Research and Rehabilitation in Diabetic Endocrine and Metabolic disorders (BIRDEM) hospital, Dhaka, Bangladesh from July 2004 to June 2006 (2 years). After laparotomy findings and histopathological confirmation 50 patients were labeled as UCP. Among 50 patients male were 28 & female patients were 22. Imaging modalities used before surgery was assessed and compared with per operative findings. USG were done in all patients and CTscan in 45 patients. MRI was done in 08 patients suspected clinically as pancreatic carcinoma where USG /CT scan had failed to reach a conclusion. Findings of the various imaging studies regarding diagnosis and unresectability were compared with per operative findings. Results: USG was able to diagnose 42 (84%) pancreatic carcinoma patients with unresectibility in 29 (69%). Forty five patients (90%) were diagnosed by CT scan and could label 38 (84.44%) as unresectable. MRI was 100% accurate to diagnose and label the entire 08 patient as unresectable carcinoma pancreas. Cumulative multimodal preoperative imaging was 91.33% accurate in diagnosing carcinoma pancreas and could tell the features of unresectibility in 73.59% patients. Conclusion: CT scan should be the primary imaging modality for diagnosing pancreatic carcinoma and its resectability. MRI is very promising for diagnosing and assessing UCP. Multimodal imaging is better than single imaging. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 23-26

scholarly journals Assessing the Relative Value of CT Perfusion Compared to Non-contrast CT and CT Angiography in Prognosticating Reperfusion-Eligible Acute Ischemic Stroke Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Andrew Bivard ◽  
Christopher Levi ◽  
Longting Lin ◽  
Xin Cheng ◽  
Richard Aviv ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ct Angiography ◽  
Predictive Accuracy ◽  
Ct Perfusion ◽  
Imaging Modality ◽  
Characteristic Curve ◽  
Treatment Decision ◽  
Receiver Operator Characteristic Curve ◽  
Stroke Patients

In the present study we sought to measure the relative statistical value of various multimodal CT protocols at identifying treatment responsiveness in patients being considered for thrombolysis. We used a prospectively collected cohort of acute ischemic stroke patients being assessed for IV-alteplase, who had CT-perfusion (CTP) and CT-angiography (CTA) before a treatment decision. Linear regression and receiver operator characteristic curve analysis were performed to measure the prognostic value of models incorporating each imaging modality. One thousand five hundred and sixty-two sub-4.5 h ischemic stroke patients were included in this study. A model including clinical variables, alteplase treatment, and NCCT ASPECTS was weak (R2 0.067, P &lt; 0.001, AUC 0.605) at predicting 90 day mRS. A second model, including dynamic CTA variables (collateral grade, occlusion severity) showed better predictive accuracy for patient outcome (R2 0.381, P &lt; 0.001, AUC 0.781). A third model incorporating CTP variables showed very high predictive accuracy (R2 0.488, P &lt; 0.001, AUC 0.899). Combining all three imaging modalities variables also showed good predictive accuracy for outcome but did not improve on the CTP model (R2 0.439, P &lt; 0.001, AUC 0.825). CT perfusion predicts patient outcomes from alteplase therapy more accurately than models incorporating NCCT and/or CT angiography. This data has implications for artificial intelligence or machine learning models.

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