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Zhu Z, Li H, Wang M. Second trimester screening for the basilar artery: a new approach using slowflowHD. J Matern Fetal Neonatal Med 2024; 37:2326302. [PMID: 38442990 DOI: 10.1080/14767058.2024.2326302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Sonographic evaluation of the basilar artery is challenging, and a limited number of reports are available about the prenatal period, as manual positioning of probes is technically difficult. The objective of this study was to describe a sonographic transabdominal approach based on slowflow HD for screening of the basilar artery during the second trimester scan. METHODS A total of 49 women who were enrolled in a second trimester screening were included when the fetus was in the occipitoanterior position. Dopper screening of the cerebral artery was performed, which revealed the "Y" sign indicating the basilar trunk arising from two vertebral arteries in the axial oblique view when the probe was located around the junction of the vertebral processes and occipital bone and was superior to the first vertebral body, sloping slightly to the cephalic side. The Doppler ultrasound probe was placed perpendicular to the basilar artery. The flow direction was below the baseline, away from the probe in the basilar artery, consistent with a caudocephalic orientation. Peak systolic and diastolic velocities were measured. RESULTS The basilar artery was identified in all 49 fetuses, with a mean gestational age of 22 weeks (range 20 to 26 weeks). The mean peak systolic velocity of the basilar artery was 15.8 cm/second (range 9.12-26.44 cm/second). There was a slight increase in peak systolic velocity according to the gestational age of the fetus. CONCLUSIONS This study demonstrated that evaluation of the basilar artery can be performed during the second trimester via a new transabdominal approach involving slowflow HD.
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Affiliation(s)
- Zhengfeng Zhu
- Ultrasound Department, Zhengzhou University Third Hospital and Henan Province Women and Children's Hospital, Zhengzhou, China
| | - Hezhou Li
- Ultrasound Department, Zhengzhou University Third Hospital and Henan Province Women and Children's Hospital, Zhengzhou, China
| | - Ming Wang
- Ultrasound Department, Zhengzhou University Third Hospital and Henan Province Women and Children's Hospital, Zhengzhou, China
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Zhang Z, Mao J, Lao J, Deng X, Fang Y, Chen N, Liu C, Chen Y, Shen L. A classification of idiopathic epiretinal membrane based on foveal avascular zone area using optical coherence tomography angiography. Ann Med 2024; 56:2316008. [PMID: 38502921 PMCID: PMC10953779 DOI: 10.1080/07853890.2024.2316008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/04/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE To evaluate the characteristics and prognoses of idiopathic macular epiretinal membrane (iERM) using a classification based on the foveal avascular zone (FAZ) area. METHOD IERMs were classified into four stages based on the FAZ area. Baseline FAZ-related parameters, pre-and postoperative central macular thickness (CMT), and best corrected visual acuity (BCVA) were observed and compared between different stages. The correlations of structural parameters with pre-and postoperative logMAR BCVA were analyzed. RESULTS 162 iERM eyes were enrolled, including 105 eyes followed up for 12 months after surgery. The preoperative BCVA was better at the early stage. Postoperative BCVA at Stages 2 and 3 were better compared to Stage 4. The early stage was associated with thinner CMT pre-and postoperatively. However, there was no significant difference in CMT between postoperative Stages 1 and 2 or Stages 3 and 4. Preoperative logMAR BCVA was negatively correlated with FAZ area, perimeter, and FD-300 and was positively correlated with CMT and acircularity index (AI). CMT correlated positively with BCVA for each stage, except Stage 4; FAZ area, perimeter, and FD-300 had a negative correlation at Stage 1. Baseline BCVA and CMT positively correlated with BCVA at the last follow-up, while FAZ area and FD-300 were negatively correlated. Baseline BCVA had a positive correlation for each stage, except Stage 1; FD-300 had a negative correlation at Stages 2 and 3; CMT had a positive correlation at Stage 3. CONCLUSION A classification based on the FAZ area was established innovatively. This classification can reflect the progression of iERM and is helpful to the postoperative prognosis.
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Affiliation(s)
- Zhengxi Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jianbo Mao
- Department of Ophthalmology Center, Zhejiang Provincial People’s Hospital, Affiliated Hospital of Hangzhou Medical College, Hangzhou, China
| | - Jimeng Lao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Xinyi Deng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Department of Ophthalmology Center, Zhejiang Provincial People’s Hospital, Affiliated Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yuyan Fang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Yongkang Hospital, Yongkang, China
| | - Nuo Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Chenyi Liu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Chicago College of Optometry, Midwestern University, Downers Grove, IL, USA
| | - Yiqi Chen
- Department of Ophthalmology Center, Zhejiang Provincial People’s Hospital, Affiliated Hospital of Hangzhou Medical College, Hangzhou, China
| | - Lijun Shen
- Department of Ophthalmology Center, Zhejiang Provincial People’s Hospital, Affiliated Hospital of Hangzhou Medical College, Hangzhou, China
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Entelmann W, Lindner T, Nawka MT, Fiehler J, Jansen O, Huhndorf M. Hybrid dynamic bright and black blood angiography by non-contrast-enhanced vessel selective saturation angiography. Magn Reson Imaging 2024; 108:22-28. [PMID: 38309377 DOI: 10.1016/j.mri.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
The integrity of vessel walls and changes in blood flow are involved in many diseases, and information about these anatomical and physiological conditions is important for a diagnosis. There are several different angiography methods that can be used to generate images for diagnostic purposes, but often using different imaging techniques and MR sequences. The purpose of this study was to develop a method that allows time-resolved, vessel-selective simultaneous bright and black blood imaging by vesselselective blood saturation. Measurements in six volunteers were performed to evaluate the time-resolved bright blood angiography and the significance of the generated black blood contrast. It was shown that this method can be used to generate a black blood contrast with a sufficient signal difference to the surrounding gray matter in addition to the time-resolved and vessel-selective bright blood contrast. Using post-processing methods, whole brain angiograms can be calculated from the acquired data.
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Affiliation(s)
- Wiebke Entelmann
- University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Germany.
| | - Thomas Lindner
- University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Germany.
| | - Marie Teresa Nawka
- University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Germany.
| | - Jens Fiehler
- University Medical Center Hamburg-Eppendorf, Department of Neuroradiology, Germany.
| | - Olav Jansen
- University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Germany.
| | - Monika Huhndorf
- University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Germany.
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Revilla-González G, Varela LM, Ruiz de Azua-López Z, Amaya-Villar R, Pezzotti MR, Castro MJ, Ureña J, González-Montelongo MDC, Castellano A. Changes in Adhesion and the Expression of Adhesion Molecules in PBMCs after Aneurysmal Subarachnoid Hemorrhage: Relation to Cerebral Vasospasm. Transl Stroke Res 2024; 15:378-387. [PMID: 36814009 PMCID: PMC10891186 DOI: 10.1007/s12975-023-01136-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/24/2023]
Abstract
Aneurysmal subarachnoid hemorrhage (aSAH) is a neurovascular disease produced by extravasation of blood to the subarachnoid space after rupture of the cerebral vessels. After bleeding, the immune response is activated. The role of peripheral blood mononuclear cells (PBMCs) in this response is a current subject of research. We have analysed the changes in PBMCs of patients with aSAH and their interaction with the endothelium, focusing on their adhesion and the expression of adhesion molecules. Using an in vitro adhesion assay, we observed that the adhesion of PBMCs of patients with aSAH is increased. Flow cytometry analysis shows that monocytes increased significantly in patients, especially in those who developed vasospasm (VSP). In aSAH patients, the expression of CD162, CD49d, CD62L and CD11a in T lymphocytes and of CD62L in monocytes increased. However, the expression of CD162, CD43, and CD11a decreased in monocytes. Furthermore, monocytes from patients who developed arteriographic VSP had lower expression of CD62L. In conclusion, our results confirm that after aSAH, monocyte count and adhesion of PBMCs increase, especially in patients with VSP, and that the expression of several adhesion molecules is altered. These observations can help predict VSP and to improve the treatment of this pathology.
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Affiliation(s)
- Gonzalo Revilla-González
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Dpto. Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Lourdes María Varela
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Dpto. Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Zaida Ruiz de Azua-López
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- UGC de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Rosario Amaya-Villar
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- UGC de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - María Rosa Pezzotti
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Dpto. Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - María José Castro
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Juan Ureña
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Dpto. Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - María Del Carmen González-Montelongo
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
- Dpto. Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.
- Unidad de Investigación, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Hospital Universitario Puerta del Mar, Cádiz, Spain.
| | - Antonio Castellano
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
- Dpto. Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.
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Sandhya R, Nazia H, Angira P, Andrada P, Joseph C, Paul T. 3D Echocardiographic and Computed Tomographic Angiography Guidance for Percutaneous Closure of a Type II (Intermediate) Aortopulmonary Window. Pediatr Cardiol 2024; 45:934-938. [PMID: 37823902 DOI: 10.1007/s00246-023-03293-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023]
Abstract
A 4-year-old female was diagnosed with Type II Aortopulmonary window after being seen for a murmur. By utilizing multimodality advanced imaging, including 2D and 3D echo, computed tomography (CTA) with semi-transparent overlay as a road map, we were able to preoperatively plan camera angles and device selection as well as close the defect percutaneously under echocardiography guidance. This report highlights the importance of a multimodality imaging approach to interventional procedures.
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Affiliation(s)
- Ramlogan Sandhya
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA.
| | - Husain Nazia
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Patel Angira
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Popescu Andrada
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Camarda Joseph
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
| | - Tannous Paul
- Ann and Robert H. Lurie Children's Hospital, 225 E Chicago Av, Chicago, IL, 60611, USA
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Liao J, Zhang T, Zhang Y, Li C, Huang Z. VET: Vasculature Extraction Transformer for Single-Scan Optical Coherence Tomography Angiography. IEEE Trans Biomed Eng 2024; 71:1179-1190. [PMID: 37930903 DOI: 10.1109/tbme.2023.3330681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality for analyzing skin microvasculature, enabling non-invasive diagnosis and treatment monitoring. Traditional OCTA algorithms necessitate at least two-repeated scans to generate microvasculature images, while image quality is highly dependent on the repetitions of scans (e.g., 4-8). Nevertheless, a higher repetition count increases data acquisition time, causing patient discomfort and more unpredictable motion artifacts, which can result in potential misdiagnosis. To address these limitations, we proposed a vasculature extraction pipeline based on the novelty vasculature extraction transformer (VET) to generate OCTA images by using a single OCT scan. Distinct from the vision Transformer, VET utilizes convolutional projection to better learn the spatial relationships between image patches. This study recruited 15 healthy participants. The OCT scans were performed in five various skin sites, i.e., palm, arm, face, neck, and lip. Our results show that in comparison to OCTA images obtained by the speckle variance OCTA (peak-signal-to-noise ratio (PSNR): 16.13) and eigen-decomposition OCTA (PSNR: 17.08) using four repeated OCT scans, OCTA images extracted by the proposed pipeline exhibit a better PSNR (18.03) performance while reducing the data acquisition time by 75%. Visual comparisons show that the proposed pipeline outperformed traditional OCTA algorithms, particularly in the imaging of lip and face areas, where artifacts are commonly encountered. This study is the first to demonstrate that the VET can efficiently extract high-quality vasculature images from a single, rapid OCT scan. This capability significantly enhances diagnostic accuracy for patients and streamlines the imaging process.
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7
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Vernikouskaya I, Bertsche D, Metze P, Schneider LM, Rasche V. Multi-network approach for image segmentation in non-contrast enhanced cardiac 3D MRI of arrhythmic patients. Comput Med Imaging Graph 2024; 113:102340. [PMID: 38277768 DOI: 10.1016/j.compmedimag.2024.102340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 01/28/2024]
Abstract
Left atrial appendage (LAA) is the source of thrombi formation in more than 90% of strokes in patients with nonvalvular atrial fibrillation. Catheter-based LAA occlusion is being increasingly applied as a treatment strategy to prevent stroke. Anatomical complexity of LAA makes percutaneous occlusion commonly performed under transesophageal echocardiography (TEE) and X-ray (XR) guidance especially challenging. Image fusion techniques integrating 3D anatomical models derived from pre-procedural imaging into the live XR fluoroscopy can be applied to guide each step of the LAA closure. Cardiac magnetic resonance (CMR) imaging gains in importance for radiation-free evaluation of cardiac morphology as alternative to gold-standard TEE or computed tomography angiography (CTA). Manual delineation of cardiac structures from non-contrast enhanced CMR is, however, labor-intensive, tedious, and challenging due to the rather low contrast. Additionally, arrhythmia often impairs the image quality in ECG synchronized acquisitions causing blurring and motion artifacts. Thus, for cardiac segmentation in arrhythmic patients, there is a strong need for an automated image segmentation method. Deep learning-based methods have shown great promise in medical image analysis achieving superior performance in various imaging modalities and different clinical applications. Fully-convolutional neural networks (CNNs), especially U-Net, have become the method of choice for cardiac segmentation. In this paper, we propose an approach for automatic segmentation of cardiac structures from non-contrast enhanced CMR images of arrhythmic patients based on CNNs implemented in a multi-stage pipeline. Two-stage implementation allows subdividing the task into localization of the relevant cardiac structures and segmentation of these structures from the cropped sub-regions obtained from previous step leading to efficient and effective way of automated cardiac segmentation.
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Affiliation(s)
- Ina Vernikouskaya
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
| | - Dagmar Bertsche
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
| | - Patrick Metze
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
| | - Leonhard M Schneider
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
| | - Volker Rasche
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
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Noy R, Livneh I, Zohar Y, Abergel E, Vaisbuch Y. Intraoperative hybrid technique for excision of temporal bone paraganglioma: A case report. Head Neck 2024; 46:E44-E48. [PMID: 38334158 DOI: 10.1002/hed.27672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Temporal bone paragangliomas are vascularized neoplasms. Although preoperative angioembolization serves as a valuable approach to reduce intraoperative blood loss, it comes with an elevated risk of cranial neuropathies, offers no assurance of complete hemostasis, and precludes real-time adjustments during surgery. METHODS A 74-year-old patient presented with recurrent episodes of ear bleeding. On examination, a vascular lesion obstructed her external auditory canal. It had the clinical and radiological characteristics of a paraganglioma. Angiography revealed that it had three feeding vessels. RESULTS The patient was successfully scheduled for hybrid, intraoperative angiography and temporary balloon occlusion of the feeding vessels supplying the lesion instead of preoperative angioembolization. CONCLUSIONS Utilizing hybrid intraoperative angiography with temporary balloon occlusion during the surgical removal of temporal bone paragangliomas represents an innovative technique that reduces the risk of permanent cranial neuropathies while providing the capacity for real-time adjustments and improved hemostasis.
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Affiliation(s)
- Roee Noy
- Department of Otolaryngology - Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel
- The Rappaport Faculty of Medicine and Integrated Cancer Center, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ido Livneh
- The Rappaport Faculty of Medicine and Integrated Cancer Center, Technion-Israel Institute of Technology, Haifa, Israel
- Institute of Pathology, Rambam Health Care Campus, Haifa, Israel
| | - Yaniv Zohar
- The Rappaport Faculty of Medicine and Integrated Cancer Center, Technion-Israel Institute of Technology, Haifa, Israel
- Institute of Pathology, Rambam Health Care Campus, Haifa, Israel
| | - Eitan Abergel
- The Rappaport Faculty of Medicine and Integrated Cancer Center, Technion-Israel Institute of Technology, Haifa, Israel
- Endovascular Neuro-Intervention Unit, Rambam Health Care Campus, Haifa, Israel
| | - Yona Vaisbuch
- Department of Otolaryngology - Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel
- The Rappaport Faculty of Medicine and Integrated Cancer Center, Technion-Israel Institute of Technology, Haifa, Israel
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Li M, Huang K, Xu Q, Yang J, Zhang Y, Ji Z, Xie K, Yuan S, Liu Q, Chen Q. OCTA-500: A retinal dataset for optical coherence tomography angiography study. Med Image Anal 2024; 93:103092. [PMID: 38325155 DOI: 10.1016/j.media.2024.103092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 11/10/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
Optical coherence tomography angiography (OCTA) is a novel imaging modality that has been widely utilized in ophthalmology and neuroscience studies to observe retinal vessels and microvascular systems. However, publicly available OCTA datasets remain scarce. In this paper, we introduce the largest and most comprehensive OCTA dataset dubbed OCTA-500, which contains OCTA imaging under two fields of view (FOVs) from 500 subjects. The dataset provides rich images and annotations including two modalities (OCT/OCTA volumes), six types of projections, four types of text labels (age/gender/eye/disease) and seven types of segmentation labels (large vessel/capillary/artery/vein/2D FAZ/3D FAZ/retinal layers). Then, we propose a multi-object segmentation task called CAVF, which integrates capillary segmentation, artery segmentation, vein segmentation, and FAZ segmentation under a unified framework. In addition, we optimize the 3D-to-2D image projection network (IPN) to IPN-V2 to serve as one of the segmentation baselines. Experimental results demonstrate that IPN-V2 achieves an about 10% mIoU improvement over IPN on CAVF task. Finally, we further study the impact of several dataset characteristics: the training set size, the model input (OCT/OCTA, 3D volume/2D projection), the baseline networks, and the diseases. The dataset and code are publicly available at: https://ieee-dataport.org/open-access/octa-500.
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Affiliation(s)
- Mingchao Li
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Kun Huang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Qiuzhuo Xu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Jiadong Yang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Yuhan Zhang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Zexuan Ji
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
| | - Keren Xie
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, NanJing 210029, China.
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, NanJing 210029, China.
| | - Qinghuai Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, NanJing 210029, China.
| | - Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, NanJing 210094, China.
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Kuwata S, Izumo M, Okuno T, Shiokawa N, Sato Y, Koga M, Okuyama K, Tanabe Y, Harada T, Ishibashi Y, Akashi YJ. Impact of Renal Congestion in Patients With Secondary Mitral Regurgitation After Mitral Transcatheter Edge-to-Edge Repair. Circ J 2024; 88:510-516. [PMID: 37438144 DOI: 10.1253/circj.cj-23-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
BACKGROUND Renal congestion is a potential prognostic factor in patients with heart failure and recently, assessment has become possible with intrarenal Doppler ultrasonography (IRD). The association between renal congestion assessed by IRD and outcomes after mitral transcatheter edge-to-edge repair (TEER) is unknown, so we aimed to clarify renal congestion and its prognostic implications in patients with mitral regurgitation (MR) who underwent TEER using MitraClip system.Methods and Results: Patients with secondary MR who underwent TEER and were assessed for intrarenal venous flow (IRVF) by IRD were classified according to their IRVF pattern as continuous or discontinuous. Of the 105 patients included, 78 patients (74%) formed the continuous group and 27 (26%) were the discontinuous group. Kaplan-Meier analysis revealed significant prognostic power of the IRVF pattern for predicting the composite outcome of all-cause death and heart failure rehospitalization (log-rank P=0.0257). On multivariate Cox regression analysis, the composite endpoint was independently associated with the discontinuous IRVF pattern (hazard ratio, 3.240; 95% confidence interval, 1.300-8.076; P=0.012) adjusted using inverse probability of treatment weighting. CONCLUSIONS IRVF patterns strongly correlated with clinical outcomes without changes in renal function. Thus, they may be useful for risk stratification after mitral TEER for patients with secondary MR.
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Affiliation(s)
- Shingo Kuwata
- Department of Cardiology, St. Marianna University School of Medicine
| | - Masaki Izumo
- Department of Cardiology, St. Marianna University School of Medicine
| | - Taishi Okuno
- Department of Cardiology, St. Marianna University School of Medicine
| | - Noriko Shiokawa
- Diagnostic Medical Sonography, St. Marianna University Hospital
| | - Yukio Sato
- Department of Cardiology, St. Marianna University School of Medicine
| | - Masashi Koga
- Department of Cardiology, St. Marianna University School of Medicine
| | - Kazuaki Okuyama
- Department of Cardiology, St. Marianna University School of Medicine
| | - Yasuhiro Tanabe
- Department of Cardiology, St. Marianna University School of Medicine
| | - Tomoo Harada
- Department of Cardiology, St. Marianna University School of Medicine
| | - Yuki Ishibashi
- Department of Cardiology, St. Marianna University School of Medicine
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Camblor-Blasco A, Nuñez-Gil IJ, Duran Cambra A, Almendro-Delia M, Ródenas-Alesina E, Fernández-Cordon C, Vedia O, Corbí-Pascual M, Blanco-Ponce E, Raposeiras-Roubin S, Guillén Marzo M, Sanchez Grande Flecha A, Garcia Acuña JM, Salamanca J, Escudier-Villa JM, Martin-Garcia AC, Tomasino M, Vazirani R, Perez-Castellanos A, Uribarri A. Prognostic Utility of Society for Cardiovascular Angiography and Interventions Shock Stage Approach for Classifying Cardiogenic Shock Severity in Takotsubo Syndrome. J Am Heart Assoc 2024; 13:e032951. [PMID: 38471832 DOI: 10.1161/jaha.123.032951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/02/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Cardiogenic shock (CS) is a significant complication of Takotsubo syndrome (TTS), contributing to heightened mortality and morbidity. Despite this, the Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks validation in patients with TTS and CS. This study aimed to characterize a patient cohort with TTS using the SCAI staging system and assess its utility in cases of TTS complicated by CS. METHODS AND RESULTS From a TTS national registry, 1591 consecutive patients were initially enrolled and stratified into 5 SCAI stages (A through E). Primary outcome was all-cause in-hospital mortality; secondary end points were TTS-related in-hospital complications and 1-year all-cause mortality. After exclusions, the final cohort comprised 1163 patients, mean age 71.0±11.8 years, and 87% were female. Patients were categorized across SCAI shock stages as follows: A 72.1%, B 12.2%, C 11.2%, D 2.7%, and E 1.8%. Significant variations in baseline demographics, comorbidities, clinical presentations, and in-hospital courses were observed across SCAI shock stages. After multivariable adjustment, each higher SCAI shock stage showed a significant association with increased in-hospital mortality (adjusted odds ratio: 1.77-29.31) compared with SCAI shock stage A. Higher SCAI shock stages were also associated with increased 1-year mortality. CONCLUSIONS In a large multicenter patient cohort with TTS, the functional SCAI shock stage classification effectively stratified mortality risk, revealing a continuum of escalating shock severity with higher stages correlating with increased in-hospital mortality. This study highlights the applicability and prognostic value of the SCAI staging system in TTS-related CS.
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Affiliation(s)
| | - Ivan J Nuñez-Gil
- Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense Madrid Spain
- Universidad Europea Madrid Spain
| | | | | | - Eduard Ródenas-Alesina
- Cardiology Department Hospital Universitari Vall d'Hebron Barcelona Spain
- CIBERCV Madrid Spain
| | | | - Oscar Vedia
- Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense Madrid Spain
- Universidad Europea Madrid Spain
| | | | | | | | | | | | - Jose Maria Garcia Acuña
- Cardiology Department Hospital Clinico Universitario de Santiago de Compostela Santiago de Compostela Spain
| | - Jorge Salamanca
- Cardiology Department Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) Madrid Spain
| | | | | | - Marco Tomasino
- Cardiology Department Hospital Universitari Vall d'Hebron Barcelona Spain
| | - Ravi Vazirani
- Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense Madrid Spain
- Universidad Europea Madrid Spain
| | - Alberto Perez-Castellanos
- Servicio de Cardiología, Instituto de Investigación Sanitaria Islas Baleares (IdISBa) Hospital Universitario Son Espases Palma Spain
| | - Aitor Uribarri
- Cardiology Department Hospital Universitari Vall d'Hebron Barcelona Spain
- CIBERCV Madrid Spain
- Vall d'Hebron Institut de Recerca (VHIR) Barcelona Spain
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12
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Hallman C, Baumwart R, Hallman RM. 64-Slice ECG-gated computed tomographic angiography for assessment of coronary arteries in brachycephalic dogs with pulmonary stenosis. Vet Rec 2024; 194:e3857. [PMID: 38379246 DOI: 10.1002/vetr.3857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Brachycephalic dogs with pulmonary stenosis are known to have a higher incidence of concurrent coronary artery abnormalities than non-brachycephalic breeds, which increases risk when performing balloon valvuloplasty. The use of ECG-gated CT angiography has been reported for the evaluation of coronary arteries in normal dogs and dogs with pulmonary stenosis. The purpose of this study was to report findings of coronary artery origination and morphology of main branches using ECG-gated CT angiography in brachycephalic dogs with pulmonary stenosis. METHODS An ECG-gated CT angiographic protocol was used to image coronary artery anatomy in nine brachycephalic dogs with pulmonary stenosis. Images were assessed for quality as well as coronary artery morphology by one veterinary radiologist, one veterinary cardiologist and one veterinary radiology resident. RESULTS All nine dogs had good to excellent image quality. Coronary artery anomalies were identified in three of nine dogs: one R2A anomaly, one L2A anomaly and one L2C anomaly. Two dogs were assessed to be poor balloon valvuloplasty candidates based on CT angiographic images. LIMITATION Coronary artery morphology was not confirmed via postmortem examination in all patients. CONCLUSION ECG-gated CT angiography is a minimally invasive imaging modality capable of diagnosing various coronary artery anomalies in brachycephalic dogs with pulmonary stenosis and aiding in the determination of patient candidacy for balloon valvuloplasty.
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Affiliation(s)
- Clay Hallman
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Ryan Baumwart
- Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Ruth Mackenzie Hallman
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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Alexandrou M, Rempakos A, Mutlu D, Ogaili AA, Choi JW, Poommipanit P, Alaswad K, Basir MB, Davies R, Benton S, Jaffer FA, Chandwaney RH, Kearney KE, ElGuindy AM, Rafeh NA, Goktekin O, Gorgulu S, Khatri JJ, Krestyaninov O, Khelimskii D, Rangan BV, Mastrodemos OC, Burke MN, Sandoval Y, Lombardi WL, Brilakis ES, Azzalini L. Comparative Analysis of Polymer Versus Non-Polymer Jacketed Wires in Chronic Total Occlusion Percutaneous Coronary Intervention. Am J Cardiol 2024; 215:10-18. [PMID: 38224729 DOI: 10.1016/j.amjcard.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
There is significant variation in wire utilization patterns for chronic total occlusion (CTO) percutaneous coronary intervention. This study aimed to compare the outcomes of polymer-jacketed wires (PJWs) versus non-PJWs in anterograde procedures. We analyzed clinical and angiographic characteristics, and procedural outcomes of 7,575 anterograde CTO percutaneous coronary interventions that were performed at 47 centers between 2012 and 2023. Cases in which PJWs were exclusively used were classified in the PJW group, whereas cases where at least one non-PJW was employed were classified in the non-PJW group. Study end points were as follows: technical success, coronary perforation, major adverse cardiac event. PJWs were exclusively used in 3,481 cases (46.0%). These cases had lower prevalence of proximal cap ambiguity, blunt stump, and moderate/severe calcification. They also had lower Japanese CTO (J-CTO), Prospective Global Registry for the Study of Chronic Total Occlusion (PROGRESS-CTO), and PROGRESS-CTO complications scores, higher technical success (94.3% vs 85.7%, p <0.001), and lower perforation rates (2.2% vs 3.2%, p = 0.013). Major adverse cardiac event rates did not differ between groups (1.3% vs 1.5%, p = 0.53). Exclusive use of PJWs was independently associated with higher technical success in both the multivariable (odds ratio [OR] 2.66, 95% confidence interval [CI] 2.13 to 3.36, p <0.001) and inverse probability of treatment weight analysis (OR 2.43, 95% CI 2.04 to 2.89, p <0.001). Exclusive use of PJWs was associated with lower risk of perforation in the multivariable analysis (OR 0.69, 95% CI 0.49 to 0.95, p = 0.02), and showed a similar trend in the inverse probability of treatment weight analysis (OR 0.77, 95% CI 0.57 to 1.04, p = 0.09). Exclusive use of PJWs is associated with higher technical success and lower perforation risk in this non-randomized series of patients.
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Affiliation(s)
- Michaella Alexandrou
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Athanasios Rempakos
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Deniz Mutlu
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Ahmed Al Ogaili
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - James W Choi
- Department of Cardiology, Texas Health Presbyterian Hospital, Dallas, Texas
| | - Paul Poommipanit
- Section of Cardiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio
| | - Khaldoon Alaswad
- Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan
| | - Mir Babar Basir
- Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan
| | - Rhian Davies
- Department of Cardiology, WellSpan York Hospital, York, Pennsylvania
| | - Stewart Benton
- Department of Cardiology, WellSpan York Hospital, York, Pennsylvania
| | - Farouc A Jaffer
- Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts
| | - Raj H Chandwaney
- Department of Invasive Cardiology, Oklahoma Heart Institute, Tulsa, Oklahoma
| | - Kathleen E Kearney
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Ahmed M ElGuindy
- Department of Cardiology, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Nidal Abi Rafeh
- Department of Cardiology, North Oaks Health System, Hammond, Louisiana
| | - Omer Goktekin
- Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Sevket Gorgulu
- Department of Cardiology, Biruni University Medical School, Istanbul, Turkey
| | | | - Oleg Krestyaninov
- Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russian Federation
| | - Dmitrii Khelimskii
- Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russian Federation
| | - Bavana V Rangan
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Olga C Mastrodemos
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - M Nicholas Burke
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Yader Sandoval
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - William L Lombardi
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Emmanouil S Brilakis
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington.
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Pakdel A, Asgari F, Bahri RA, Aghamir SMK. Segmental artery angioembolization as an efficient treatment modality for delayed hematuria with normal angiography: two case reports. J Med Case Rep 2024; 18:101. [PMID: 38468299 DOI: 10.1186/s13256-024-04431-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/02/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Percutaneous nephrolithotomy is the most commonly used modality for the removal of kidney stones larger than 2 cm in size. Like other stone removal methods, percutaneous nephrolithotomy also has some complications, including bleeding and delayed hematuria. These complications are improved with conservative management and bed rest most of the time. However, it may require more invasive treatments. Angioembolization following an abnormal renal angiography is an efficient treatment modality for delayed hematuria. Furthermore, nephrectomy is suggested in uncontrolled cases of delayed hematuria when renal angiography is normal. CASE PRESENTATION We described two cases of uncontrolled delayed hematuria after percutaneous nephrolithotomy and angioembolization were carried out rather than potential nephrectomies. The first case was a 61-year-old Iranian man with left kidney stones, for whom percutaneous nephrolithotomy was planned. The patient was referred to the hospital after discharge with massive hematuria and had normal angiographic findings. An angioembolization was suggested for the patient and was carried out. His hematuria was dramatically improved within 30 minutes, and his hemoglobin level started to increase 2 days later. The second case was a 53-year-old Iranian man with kidney stones who was a candidate for right kidney percutaneous nephrolithotomy. The patient was referred to the hospital 4 days after discharge with a decreased hemoglobin level and massive hematuria. The patient had normal angiographic findings and was planned for angioembolization to control his hemorrhage, which dramatically decreased after the angioembolization within 60 minutes. CONCLUSION Embolization of the segmental arteries of the targeted calyx can eliminate hematuria of the patient and prevent further nephrectomy.
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Affiliation(s)
- Alireza Pakdel
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardin Asgari
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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15
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Kim JS, Kim ES, Hwang HS, Jeong KH, Yu SY, Kim K. Association between albuminuria and retinal microvascular parameters measured with swept-source optical coherence tomography angiography in patients with diabetic retinopathy. PLoS One 2024; 19:e0295768. [PMID: 38446750 PMCID: PMC10917288 DOI: 10.1371/journal.pone.0295768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/28/2023] [Indexed: 03/08/2024] Open
Abstract
PURPOSE To evaluate the relationship between urine albumin excretion (UAE) and retinal microvascular parameters assessed using swept-source optical coherence tomography angiography (SS-OCTA) in patients with diabetic retinopathy (DR). METHODS This retrospective cross-sectional study included 180 patients with diabetes and 50 age-matched controls. Patients with diabetes were grouped according to the five-stage DR severity, combined with the presence of albuminuria. All subjects underwent 12×12mm2 field SS-OCTA. The foveal avascular zone metrics, vessel density, and capillary nonperfusion area (NPA) were quantified using a semi-automatic software algorithm on three different rectangular fields (3×3 mm2, 6×6 mm2, and 10×10 mm2). The correlations between albuminuria and the four OCTA parameters were analyzed. RESULTS A total of 105 subjects had normal UAE, and 75 subjects had albuminuria. Of the 102 subjects whose DR severity was higher than mild non-proliferative DR (NPDR), capillary NPA on the 3×3 mm2, 6×6 mm2, and 10×10 mm2 fields was significantly larger in the albuminuria group. None of the OCTA parameters were significantly different between the two groups in subjects with mild NPDR or without DR. Multiple logistic regression analysis showed that an increase in NPA in the 6×6 mm2 and 10×10 mm2 fields was a significant risk factor for the presence of albuminuria (odds ratio = 1.92 and 1.35). CONCLUSION An increase in capillary NPA was independently associated with albuminuria in patients with clinically significant DR levels. SS-OCTA imaging can be a useful marker for the early detection of diabetic nephropathy.
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Affiliation(s)
- Jin Sug Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Hyeon Seok Hwang
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Kyung Hwan Jeong
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
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16
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Oh SE, Shin HJ, Park CK, Park HYL. Clinical Significance of Recurrent Disc Hemorrhage and Choroidal Microvasculature Dropout on Optical Coherence Tomography Angiography in Glaucoma. Invest Ophthalmol Vis Sci 2024; 65:5. [PMID: 38466280 PMCID: PMC10916887 DOI: 10.1167/iovs.65.3.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose The purpose of this study was to investigate the clinical significance of recurrent disc hemorrhage (DH) and choroidal microvasculature dropout (MvD). Methods A retrospective cohort study was conducted of 181 eyes with open-angle glaucoma. The clinical characteristics of patients with nonrecurrent and recurrent DH with and without MvD were investigated. Results Fifty-eight patients (32.0%) had a single, nonrecurrent DH, and 63 (34.8%) had more than one DH. Sixty eyes (33.1%) with no history of DH were presented as a control group. MvD was more frequent in the recurrent DH group (44.4%) than in the nonrecurrent DH group (27.6%, P = 0.041). The recurrent DH with MvD group experienced more frequent central visual field (VF) progression (71.4%) than the recurrent DH without MvD group (17.1 %, P < 0.001). The recurrent DH without MvD group had a higher frequency of DH recurrence at different locations (42.9%) and more vascular symptoms (37.1%) than the recurrent DH with MvD group (14.3% and 7.1%, P = 0.013 and P = 0.005, respectively). Presence of DH, presence of MvD, vascular symptoms, and DH recurrence at different locations were the factors associated with central VF progression in multivariate analysis. Conclusions DH occurrence and the presence of MvDs constitute critical parameters associated with central VF progression. In the presence of MvD, recurrent DH was more likely to recur at the same location as the MvD, whereas recurrent DH without MvD was related to vascular symptoms and recurred at other locations. When eyes present with recurrent DH and MvD, closer follow-up and more aggressive treatment are required to prevent the progression of central VF.
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Affiliation(s)
- Si Eun Oh
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Hee Jong Shin
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
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Yue JY, Ji K, Liu HP, Wu QW, Liang CH, Gao JB. Evaluating the consistency in different methods for measuring left atrium diameters. BMC Med Imaging 2024; 24:57. [PMID: 38443826 PMCID: PMC10916282 DOI: 10.1186/s12880-024-01231-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The morphological information of the pulmonary vein (PV) and left atrium (LA) is of immense clinical importance for effective atrial fibrillation ablation. The aim of this study is to examine the consistency in different LA diameter measurement techniques. METHODS Retrospective imaging data from 87 patients diagnosed with PV computed tomography angiography were included. The patients consisted of 50 males and 37 females, with an average age of (60.74 ± 8.70) years. Two physicians independently measured the anteroposterior diameter, long diameter, and transverse diameter of the LA using six different methods. Additionally, we recorded the post-processing time of the images. Physician 1 conducted measurements twice with a one-month interval between the measurements to assess intra-rater reliability. Using the intraclass correlation coefficient (ICC), the consistency of each LA diameter measurement by the two physicians was evaluated. We compared the differences in the LA diameter and the time consumed for measurements using different methods. This was done by employing the rank sum test of a randomized block design (Friedman M test) and the q test for pairwise comparisons among multiple relevant samples. RESULTS (1) The consistency of the measured LA diameter by the two physicians was strong or very strong. (2) There were statistical differences in the anteroposterior diameter, long diameter, and transverse diameter of LA assessed using different methods (χ2 = 222.28, 32.74, 293.83, P < 0.001). (3) Different methods for measuring the diameters of LA required different amounts of time (χ2 = 333.10, P < 0.001). CONCLUSION The results of left atrium (LA) diameter measurements conducted by different physicians were found to be reliable. However, the LA diameters obtained through various techniques exhibited variations. It was observed that measuring LA long diameters using only the VR (volume rendering) picture was the most clinically applicable method.
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Affiliation(s)
- Jun-Yan Yue
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui Henan Province, 453200, Xinxiang, China
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, 450000, Zhengzhou, Henan Province, China
- Heart Center, The First Affiliated Hospital of Xinxiang Medical University, 453200, Henan Pro vince, Weihui, China
| | - Kai Ji
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui Henan Province, 453200, Xinxiang, China
| | - Hai-Peng Liu
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui Henan Province, 453200, Xinxiang, China
| | - Qing-Wu Wu
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui Henan Province, 453200, Xinxiang, China
| | - Chang-Hua Liang
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui Henan Province, 453200, Xinxiang, China
| | - Jian-Bo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, 450000, Zhengzhou, Henan Province, China.
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Huang K, Li H, Tu S, Du J, Yao W, Liu R, Han Y, Ye R, Suo S, Zhu W, Liu X. Angiography‑based quantitative flow ratio for functional assessment of intracranial atherosclerotic disease. EUROINTERVENTION 2024; 20:e312-e321. [PMID: 38436369 PMCID: PMC10905197 DOI: 10.4244/eij-d-23-00611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/04/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Intracranial atherosclerotic stenosis (ICAS), an important cause of stroke, is associated with a considerable stroke recurrence rate despite optimal medical treatment. Further assessment of the functional significance of ICAS is urgently needed to enable individualised treatment and, thus, improve patient outcomes. AIMS We aimed to evaluate the haemodynamic significance of ICAS using the quantitative flow ratio (QFR) technique and to develop a risk stratification model for ICAS patients. METHODS Patients with moderate to severe stenosis of the middle cerebral artery, as shown on angiography, were retrospectively enrolled. For haemodynamic assessment, the Murray law-based QFR (μQFR) was performed on eligible patients. Multivariate logistic regression models composed of μQFR and other risk factors were developed and compared for the identification of symptomatic lesions. Based on the superior model, a nomogram was established and validated by calibration. RESULTS Among 412 eligible patients, symptomatic lesions were found in 313 (76.0%) patients. The μQFR outperformed the degree of stenosis in discriminating culprit lesions (area under the curve [AUC]: 0.726 vs 0.631; DeLong test p-value=0.001), and the model incorporating μQFR and conventional risk factors also performed better than that containing conventional risk factors only (AUC: 0.850 vs 0.827; DeLong test p-value=0.034; continuous net reclassification index=0.620, integrated discrimination improvement=0.057; both p<0.001). The final nomogram showed good calibration (p for Hosmer-Lemeshow test=0.102) and discrimination (C-statistic 0.850, 95% confidence interval: 0.812-0.883). CONCLUSIONS The μQFR was significantly associated with symptomatic ICAS and outperformed the angiographic stenosis severity. The final nomogram effectively discriminated symptomatic lesions and may provide a useful tool for risk stratification in ICAS patients.
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Affiliation(s)
- Kangmo Huang
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Haotao Li
- Department of Neurology, Changshu No.2 People's Hospital, Changshu, China
| | - Shengxian Tu
- Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Juan Du
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Weihe Yao
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Rui Liu
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yunfei Han
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ruidong Ye
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shiteng Suo
- Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wusheng Zhu
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xinfeng Liu
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Ghassemi F, Salari F, Hatami V, Mohebbi M, Sabour S. Papillary and peripapillary vascular densities and corresponding correlation with peripapillary retinal thicknesses using optical coherence tomography angiography in healthy children and adolescents. Sci Rep 2024; 14:5372. [PMID: 38438407 PMCID: PMC10912724 DOI: 10.1038/s41598-023-50934-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/28/2023] [Indexed: 03/06/2024] Open
Abstract
To evaluate the peripapillary retinal thickness (PPRT), vascular density (PPVD), and disc vascular density (PVD) and their correlations in normal healthy children using optical coherence tomography angiography (OCTA). This was a cross-sectional study of 70 eyes from 36 normal healthy children aged 6-18 years who performed optic nerve head scans using OCTA. The PPRT included the peripapillary nerve fiber layer (PP-RNFLT), inner retina (PP-IRT), middle retinal thickness, and outer retinal thicknesses. The PP-RNFLT and PP-IRT were not significantly different between males and females. Superior nasal peripapillary RNFLT and IRT were significantly affected by age (ANOVA, P > 0.05). The PP-IRT and PP-RNFLT were lower in the 7-11 years old group in comparison with the other 3 groups (Post hoc Tukey test, P value < 0.05). Age and sex-matched PVD were not correlated with PPVD (partial correlation, P > 0.05). PPRT was not correlated with PVD, PPVD, superficial and deep retinal vascular densities, and choroidal vascular density. This study demonstrated that PPRT appears to change during growth in childhood. Superior nasal PPRT was affected more in the groups, decreasing from less than 7 years old to 7-11 years old and then back to pre-reduction values after 11 years old.
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Affiliation(s)
- Fariba Ghassemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran.
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farhad Salari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
| | - Vahid Hatami
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
| | - Masoumeh Mohebbi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
- Cornea Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Sabour
- Safety Promotion and Injury Prevention Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Clinical Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Stone GW, Christiansen EH, Ali ZA, Andreasen LN, Maehara A, Ahmad Y, Landmesser U, Holm NR. Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis. Lancet 2024; 403:824-837. [PMID: 38401549 DOI: 10.1016/s0140-6736(23)02454-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND Previous meta-analyses have shown reduced risks of composite adverse events with intravascular imaging-guided percutaneous coronary intervention (PCI) compared with angiography guidance alone. However, these studies have been insufficiently powered to show whether all-cause death or all myocardial infarction are reduced with intravascular imaging guidance, and most previous intravascular imaging studies were done with intravascular ultrasound rather than optical coherence tomography (OCT), a newer imaging modality. We aimed to assess the comparative performance of intravascular imaging-guided PCI and angiography-guided PCI with drug-eluting stents. METHODS For this systematic review and updated meta-analysis, we searched the MEDLINE, Embase, and Cochrane databases from inception to Aug 30, 2023, for studies that randomly assigned patients undergoing PCI with drug-eluting stents either to intravascular ultrasound or OCT, or both, or to angiography alone to guide the intervention. The searches were done and study-level data were extracted independently by two investigators. The primary endpoint was target lesion failure, defined as the composite of cardiac death, target vessel-myocardial infarction (TV-MI), or target lesion revascularisation, assessed in patients randomly assigned to intravascular imaging guidance (intravascular ultrasound or OCT) versus angiography guidance. We did a standard frequentist meta-analysis to generate direct data, and a network meta-analysis to generate indirect data and overall treatment effects. Outcomes were expressed as relative risks (RRs) with 95% CIs at the longest reported follow-up duration. This study was registered with the international prospective register of systematic reviews (PROSPERO, number CRD42023455662). FINDINGS 22 trials were identified in which 15 964 patients were randomised and followed for a weighted mean duration of 24·7 months (longest duration of follow-up in each study ranging from 6 to 60 months). Compared with angiography-guided PCI, intravascular imaging-guided PCI resulted in a decreased risk of target lesion failure (RR 0·71 [95% CI 0·63-0·80]; p<0·0001), driven by reductions in the risks of cardiac death (RR 0·55 [95% CI 0·41-0·75]; p=0·0001), TV-MI (RR 0·82 [95% CI 0·68-0·98]; p=0·030), and target lesion revascularisation (RR 0·72 [95% CI 0·60-0·86]; p=0·0002). Intravascular imaging guidance also reduced the risks of stent thrombosis (RR 0·52 [95% CI 0·34-0·81]; p=0·0036), all myocardial infarction (RR 0·83 [95% CI 0·71-0·99]; p=0·033), and all-cause death (RR 0·75 [95% CI 0·60-0·93]; p=0·0091). Outcomes were similar for OCT-guided and intravascular ultrasound-guided PCI. INTERPRETATION Compared with angiography guidance, intravascular imaging guidance of coronary stent implantation with OCT or intravascular ultrasound enhances both the safety and effectiveness of PCI, reducing the risks of death, myocardial infarction, repeat revascularisation, and stent thrombosis. FUNDING Abbott.
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Affiliation(s)
- Gregg W Stone
- The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | | | | | - Akiko Maehara
- Cardiovascular Research Foundation, New York, NY, USA; Columbia University Medical Center, New York, NY, USA
| | - Yousif Ahmad
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Ulf Landmesser
- Deutsches Herzzentrum Charité, Charité Universitätsmedizin Berlin, Berlin, Germany; German Center for Cardiovascular Research (DZHK), Berlin, Germany
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Yoshiura T, Masuda T, Tahara M, Kobayashi Y, Kikuhara Y, Ishibashi T, Nonaka H, Oku T, Sato T, Funama Y. Cardiac computed tomography angiography with and without bolus tracking methods in infants with congenital heart disease. Radiat Prot Dosimetry 2024; 200:251-258. [PMID: 38088430 DOI: 10.1093/rpd/ncad295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 10/12/2023] [Accepted: 11/15/2023] [Indexed: 03/05/2024]
Abstract
The study investigated radiation dose, vascular computed tomography (CT) enhancement and image quality of cardiac computed tomography angiography (CCTA) with and without bolus tracking (BT) methods in infants with congenital heart disease (CHD). The volume CT dose index (CTDIvol) and dose length product (DLP) were recorded for all CT scans, and the effective dose was obtained using a conversion factors. The CT number for the ascending aorta (AO) and pulmonary artery (PA), image noise of muscle tissue and contrast-to-noise ratio (CNR) were measured and calculated. The median values in the groups with and without BT were 2.20 mGy versus 0.44 mGy for CTDIvol, 8.10 mGy·cm versus 6.20 mGy·cm for DLP, and 0.66 mSv versus 0.51 mSv for effective dose (p < 0.001). There were no statistical differences in vascular CT enhancement, image noise, and CNR. CCTA without BT methods can reduce the radiation dose while maintaining vascular CT enhancement and image quality compared to CCTA with BT methods.
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Affiliation(s)
- Takayuki Yoshiura
- Graduate School of Health Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto, 862-0976, Japan
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki-City, Okayama, 701-0193, Japan
| | - Masahiro Tahara
- Hiroshima Central Street Children's Clinic, 7-1 Mikawa-cho, Hiroshima, 730-0029, Japan
| | - Yukie Kobayashi
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Yukari Kikuhara
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Toru Ishibashi
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Haruki Nonaka
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Takayuki Oku
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Tomoyasu Sato
- Department of Medical Technology, Tsuchiya General Hospital, 3-30 Nakajima-cho, Hiroshima, 730-8655, Japan
| | - Yoshinori Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto, 862-0976, Japan
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22
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Sengupta N, Kastenberg DM, Bruining DH, Latorre M, Leighton JA, Brook OR, Wells ML, Guglielmo FF, Naringrekar HV, Gee MS, Soto JA, Park SH, Yoo DC, Ramalingam V, Huete A, Khandelwal A, Gupta A, Allen BC, Anderson MA, Dane BR, Sokhandon F, Grand DJ, Tse JR, Fidler JL. The Role of Imaging for GI Bleeding: ACG and SAR Consensus Recommendations. Radiology 2024; 310:e232298. [PMID: 38441091 DOI: 10.1148/radiol.232298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Gastrointestinal (GI) bleeding is the most common GI diagnosis leading to hospitalization within the United States. Prompt diagnosis and treatment of GI bleeding is critical to improving patient outcomes and reducing high health care utilization and costs. Radiologic techniques including CT angiography, catheter angiography, CT enterography, MR enterography, nuclear medicine red blood cell scan, and technetium-99m pertechnetate scintigraphy (Meckel scan) are frequently used to evaluate patients with GI bleeding and are complementary to GI endoscopy. However, multiple management guidelines exist, which differ in the recommended utilization of these radiologic examinations. This variability can lead to confusion as to how these tests should be used in the evaluation of GI bleeding. In this document, a panel of experts from the American College of Gastroenterology and Society of Abdominal Radiology provide a review of the radiologic examinations used to evaluate for GI bleeding including nomenclature, technique, performance, advantages, and limitations. A comparison of advantages and limitations relative to endoscopic examinations is also included. Finally, consensus statements and recommendations on technical parameters and utilization of radiologic techniques for GI bleeding are provided. © Radiological Society of North America and the American College of Gastroenterology, 2024. Supplemental material is available for this article. This article is being published concurrently in American Journal of Gastroenterology and Radiology. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Citations from either journal can be used when citing this article. See also the editorial by Lockhart in this issue.
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Affiliation(s)
- Neil Sengupta
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - David M Kastenberg
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - David H Bruining
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Melissa Latorre
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Jonathan A Leighton
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Olga R Brook
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Michael L Wells
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Flavius F Guglielmo
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Haresh V Naringrekar
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Michael S Gee
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Jorge A Soto
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Seong Ho Park
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Don C Yoo
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Vijay Ramalingam
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Alvaro Huete
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Ashish Khandelwal
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Avneesh Gupta
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Brian C Allen
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Mark A Anderson
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Bari R Dane
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Farnoosh Sokhandon
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - David J Grand
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Justin R Tse
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
| | - Jeff L Fidler
- From the Department of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, Ill (N.S.); Department of Gastroenterology and Hepatology (D.M.K.) and Department of Radiology (F.F.G., H.V.N.), Thomas Jefferson University Hospital, Philadelphia, Pa; Department of Gastroenterology and Hepatology (D.H.B.) and Department of Radiology (M.L.W., A.K., J.L.F.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; Department of Gastroenterology and Hepatology (M.L.) and Department of Radiology (B.R.D.), NYU Langone Medical Center, New York, NY; Department of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Ariz (J.A.L.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (O.R.B., V.R.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (M.S.G., M.A.A.); Department of Radiology, Boston University Medical Center, Boston, Mass (J.A.S., A.G.); Department of Radiology, Asan Medical Center, Seoul, South Korea (S.H.P.); Department of Radiology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI (D.C.Y., D.J.G.); Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (A.H.); Department of Radiology, Duke University Medical Center, Durham, NC (B.C.A.); Department of Radiology, William Beaumont University Hospital, Royal Oak, Mich (F.S.); and Department of Radiology, Stanford University School of Medicine, Stanford, Calif (J.R.T.)
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Torosyan N, Schwartz B, Chen B, Ebinger JE, Gransar H, Park R, Rozanski A, Bairey Merz CN, Berman DS. Changes in Preventive Therapies Following Coronary Computed Tomography Angiography vs Invasive Angiography in Nonobstructive CAD. JACC Cardiovasc Imaging 2024; 17:339-341. [PMID: 37921720 DOI: 10.1016/j.jcmg.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/11/2023] [Accepted: 09/29/2023] [Indexed: 11/04/2023]
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Fujimura S, Yamanaka Y, Takao H, Ishibashi T, Otani K, Karagiozov K, Fukudome K, Yamamoto M, Murayama Y. Hemodynamic and morphological differences in cerebral aneurysms between before and after rupture. J Neurosurg 2024; 140:774-782. [PMID: 37657114 DOI: 10.3171/2023.6.jns23289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Although it has been proposed that aneurysm morphology is different after rupture, detailed research of the morphological changes using 3D imaging acquired before and after rupture has not been conducted because of the difficulty of data collection. Similarly, hemodynamic changes due to morphological alterations after rupture have not been analyzed. The aim of this study was to investigate the changes in morphology and hemodynamics observed after aneurysm rupture. METHODS For 21 cerebral aneurysms (21 patients) that ruptured during observation, 3D geometry of the aneurysms and parent arteries were reconstructed based on the angiographic images before and after their rupture. In addition, using the reconstructed geometry, blood flow was simulated by computational fluid dynamics (CFD) analysis. Morphological and hemodynamic parameters were calculated both before and after rupture, and their changes from before to after were compared. RESULTS In the morphological parameters, statistically significantly higher values were observed after rupture in height (before: 5.5 ± 2.1 mm, after: 6.1 ± 2.0 mm; p < 0.0001), aspect ratio (p = 0.002), aneurysm volume (p = 0.04), and undulation index (p = 0.005). In terms of hemodynamic changes, the mean normalized wall shear stress (NWSS) decreased significantly (before: 5.4 × 10-1 ± 2.9 × 10-1, after: 4.4 × 10-1 ± 2.8 × 10-1; p < 0.001) as well as the other NWSS parameters, including maximum and minimum NWSS, which were associated with stagnant flow due to the morphological changes after rupture. CONCLUSIONS Aneurysm morphology was found to change after rupture into an elongated and irregular geometry, accompanied by an increase in aneurysm volume. These morphological changes were also associated with statistically significant hemodynamic alterations that produced low wall sheer stress by stagnant flow. The authors' results also provide the opportunity to explore and develop a risk evaluation method for aneurysm rupture based on prerupture morphology and hemodynamics by further exploration in this direction.
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Affiliation(s)
- Soichiro Fujimura
- 1Department of Mechanical Engineering, Tokyo University of Science, Katsushika-ku, Tokyo
- 2Division of Innovation for Medical Information Technology and
| | - Yuma Yamanaka
- 2Division of Innovation for Medical Information Technology and
- 3Graduate School of Mechanical Engineering, Tokyo University of Science, Katsushika-ku, Tokyo; and
| | - Hiroyuki Takao
- 2Division of Innovation for Medical Information Technology and
- 4Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo
| | - Toshihiro Ishibashi
- 4Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo
| | - Katharina Otani
- 4Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo
- 5Siemens Healthcare K.K., Gate City Osaki West Tower, Shinagawa-ku, Tokyo, Japan
| | - Kostadin Karagiozov
- 4Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo
| | - Koji Fukudome
- 1Department of Mechanical Engineering, Tokyo University of Science, Katsushika-ku, Tokyo
| | - Makoto Yamamoto
- 1Department of Mechanical Engineering, Tokyo University of Science, Katsushika-ku, Tokyo
| | - Yuichi Murayama
- 4Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo
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25
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Seto AH, Klein AJP. Editorial: Angiography is not enough! Cardiovasc Revasc Med 2024; 60:72-73. [PMID: 37867121 DOI: 10.1016/j.carrev.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Affiliation(s)
- Arnold H Seto
- VA Long Beach Healthcare System, Long Beach, CA 90803, United States of America.
| | - Andrew J P Klein
- Piedmont Heart Institute, Atlanta, GA 30309, United States of America
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Challoob M, Gao Y, Busch A. Distinctive Phase Interdependency Model for Retinal Vasculature Delineation in OCT- Angiography Images. IEEE Trans Med Imaging 2024; 43:1018-1032. [PMID: 37871100 DOI: 10.1109/tmi.2023.3326742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Automatic detection of retinal vasculature in optical coherence tomography angiography (OCTA) images faces several challenges such as the closely located capillaries, vessel discontinuity and high noise level. This paper introduces a new distinctive phase interdependency model to address these problems for delineating centerline patterns of the vascular network. We capture the inherent property of vascular centerlines by obtaining the inter-scale dependency information that exists between neighboring symmetrical wavelets in complex Poisson domain. In particular, the proposed phase interdependency model identifies vascular centerlines as the distinctive features that have high magnitudes over adjacent symmetrical coefficients whereas the coefficients caused by background noises are decayed rapidly along adjacent wavelet scales. The potential relationships between the neighboring Poisson coefficients are established based on the coherency of distinctive symmetrical wavelets. The proposed phase model is assessed on the OCTA-500 database (300 OCTA images + 200 OCT images), ROSE-1-SVC dataset (9 OCTA images), ROSE-1 (SVC+ DVC) dataset (9 OCTA images), and ROSE-2 dataset (22 OCTA images). The experiments on the clinically relevant OCTA images validate the effectiveness of the proposed method in achieving high-quality results. Our method produces average FScore of 0.822, 0.782, and 0.779 on ROSE-1-SVC, ROSE-1 (SVC+ DVC), and ROSE-2 datasets, respectively, and the FScore of 0.910 and 0.862 on OCTA_6mm and OCT_3mm datasets (OCTA-500 database), respectively, demonstrating its superior performance over the state-of-the-art benchmark methods.
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Rusu MC, Tudose RC, Vrapciu AD, Popescu ŞA. Lowered hyoid bone overlapping the thyroid cartilage in CT angiograms. Surg Radiol Anat 2024; 46:333-339. [PMID: 38315210 DOI: 10.1007/s00276-024-03300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND The ventral enclosure of the thyroid cartilage by a collapsed hyoid bone (CHB) is poorly encountered in previous research. It was aimed to observe whether or not these malformations could be found and detailed anatomically in a consistent lot of computed tomography (CT) files. METHODS Two hundred archived CT angiograms were explicitly observed for the CHB anatomical variant. RESULTS Different possibilities of CHB were found in 6/200 cases, five males and one female. The symmetrical overlap of the thyroid cartilage by the hyoid body was found in one male case. In three cases, two males and one female, there was asymmetrical overlapping due to tilted hyoid bones. In one male case with such asymmetrical CHD, an ossified anterior longitudinal ligament was noted: the tips of the superior horns of the thyroid cartilage reached lateral to it, thus being retropharyngeal. A different male case had a lowered hyoid with a greater horn fused to the superior horn of the thyroid cartilage, with an interposed ossified triticeal cartilage. In the last male case, the right greater horn collapsed laterally to an ossified triticeal cartilage fused with the thyroid cartilage's superior horn. CONCLUSIONS The CHB is an undeniable anatomical possibility of an atavism that alters conventional anatomical and surgical landmarks. Different anatomical components of the hyoid bone can descend uni- or bilaterally.
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Affiliation(s)
- Mugurel Constantin Rusu
- Division of Anatomy, Department 1, Faculty of Dentistry, "Carol Davila", University of Medicine and Pharmacy, 8 Eroilor Sanitari Blvd, 050474, Bucharest, Romania.
| | - Răzvan Costin Tudose
- Division of Anatomy, Department 1, Faculty of Dentistry, "Carol Davila", University of Medicine and Pharmacy, 8 Eroilor Sanitari Blvd, 050474, Bucharest, Romania
| | - Alexandra Diana Vrapciu
- Division of Anatomy, Department 1, Faculty of Dentistry, "Carol Davila", University of Medicine and Pharmacy, 8 Eroilor Sanitari Blvd, 050474, Bucharest, Romania
- University Emergency Hospital Bucharest, 050098, Bucharest, Romania
| | - Şerban Arghir Popescu
- Department 11 of Plastic and Reconstructive Surgery and Pediatric Surgery, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Alexander AY, Patel NP, Cloft HJ, Lanzino G, Brinjikji W. Clinical and radiological features of parasagittal dural arteriovenous fistulas: a report of 8 cases from a single institution. Neurosurg Focus 2024; 56:E16. [PMID: 38427987 DOI: 10.3171/2023.12.focus23792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/27/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Dural arteriovenous fistulas (dAVFs) of the superior sagittal sinus (SSS) are uncommon and represent 5%-12% of all intracranial dAVFs. SSS dAVFs can be divided into two main subtypes. The first type involves direct arterialization of the SSS, whereas the second type consists of a parasagittal arteriovenous shunt draining into a cortical vein directly lateral to the SSS and has retrograde cortical venous drainage with only secondary involvement of the SSS. Descriptions of the latter type of SSS dAVF are limited. As such, the authors present a consecutive case series of parasagittal SSS dAVFs from their institution. They detail clinical presentation, treatment strategies, and clinical and radiographic outcomes. METHODS The authors retrospectively reviewed a prospectively collected database of dAVFs that were treated between 2017 and 2023. All dAVFs characterized by an arterialized parasagittal vein directly lateral to the SSS were included in this study. Baseline demographic, clinical, radiological, treatment, and outcome-specific variables of interest were abstracted. RESULTS One hundred fifty-four dAVFs were seen at the authors' institution over the 6-year period of interest. Eight (5.2%) were parasagittal dAVFs. At initial diagnostic imaging, 7 were Cognard grade III and 1 was grade IV. All patients initially underwent embolization of their dAVF. Three patients did not have complete obliteration of their dAVF after the first embolization. One patient underwent further treatment with repeat embolization, and 1 underwent microsurgical disconnection-both resulted in complete occlusion of the dAVF. Seven dAVFs were obliterated at final follow-up and 1 remained patent as the patient refused further treatment despite angiographic progression of dAVF. All symptomatic patients had resolution of their symptoms, and the average length of follow-up was 16.8 months. CONCLUSIONS Treatment of parasagittal dAVFs consists of occluding the proximal portion of the parasagittal arterialized draining vein. Endovascular therapy with liquid embolic agents is usually the first line of treatment. Surgical ligation is a valid option if the fistula cannot be successfully obliterated with embolization. Symptoms related to the SSS dAVF resolve after their obliteration.
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Affiliation(s)
- A Yohan Alexander
- Departments of1Neurologic Surgery and
- 2Medical School, University of Minnesota, Minneapolis, Minnesota
| | | | - Harry J Cloft
- Departments of1Neurologic Surgery and
- 3Radiology, Mayo Clinic, Rochester; and
| | - Giuseppe Lanzino
- Departments of1Neurologic Surgery and
- 3Radiology, Mayo Clinic, Rochester; and
| | - Waleed Brinjikji
- Departments of1Neurologic Surgery and
- 3Radiology, Mayo Clinic, Rochester; and
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Hiramatsu M, Ozaki T, Tanoue S, Mizutani K, Nakamura H, Tokuyama K, Sakata H, Matsumaru Y, Nakahara I, Niimi Y, Fujinaka T, Kiyosue H. Detailed Anatomy of Bridging Veins Around the Foramen Magnum: a Multicenter Study Using Three-dimensional Angiography. Clin Neuroradiol 2024; 34:67-74. [PMID: 37552244 PMCID: PMC10881699 DOI: 10.1007/s00062-023-01327-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND AND PURPOSE There has been limited literature regarding the bridging veins (BVs) of the medulla oblongata around the foramen magnum (FM). The present study aims to analyze the normal angioarchitecture of the BVs around the FM using slab MIP images of three-dimensional (3D) angiography. METHODS We collected 3D angiography data of posterior fossa veins and analyzed the BVs around the FM using slab MIP images. We analyzed the course, outlet, and number of BVs around the FM. We also examined the detection rate and mean diameter of each BV. RESULTS Of 57 patients, 55 patients (96%) had any BV. The median number of BVs was two (range: 0-5). The BVs originate from the perimedullary veins and run anterolaterally to join the anterior condylar vein (ACV), inferior petrosal sinus, sigmoid sinus, or jugular bulb, inferolaterally to join the suboccipital cavernous sinus (SCS), laterally or posterolaterally to join the marginal sinus (MS), and posteriorly to join the MS or occipital sinus. We classified BVs into five subtypes according to the draining location: ACV, jugular foramen (JF), MS, SCS, and cerebellomedullary cistern (CMC). ACV, JF, MS, SCS, and CMC BVs were detected in 11 (19%), 18 (32%), 32 (56%), 20 (35%), and 16 (28%) patients, respectively. The mean diameter of the BVs other than CMC was 0.6 mm, and that of CMC BV was 0.8 mm. CONCLUSION Using venous data from 3D angiography, we detected FM BVs in most cases, and the BVs were connected in various directions.
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Affiliation(s)
- Masafumi Hiramatsu
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Tomohiko Ozaki
- Department of Neurosurgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan
| | - Shuichi Tanoue
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Katsuhiro Mizutani
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Nakamura
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kohei Tokuyama
- Department of Radiology, Oita University Faculty of Medicine, Yuhu, Japan
| | - Hiroyuki Sakata
- Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan
| | - Yuji Matsumaru
- Division of Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ichiro Nakahara
- Department of Comprehensive Strokology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St Luke's International Hospital, Tokyo, Japan
| | - Toshiyuki Fujinaka
- Department of Neurosurgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan
| | - Hiro Kiyosue
- Department of Diagnostic Radiology, Kumamoto University Faculty of Medicine, Kumamoto, Japan
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Ucar FA, Frenzel M, Kronfeld A, Altmann S, Sanner AP, Mercado MAA, Uphaus T, Brockmann MA, Othman AE. Improvement of Neurovascular Imaging Using Ultra-High-Resolution Computed Tomography Angiography. Clin Neuroradiol 2024; 34:189-199. [PMID: 37831106 PMCID: PMC10881789 DOI: 10.1007/s00062-023-01348-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To evaluate diagnostic image quality of ultra-high-resolution computed tomography angiography (UHR-CTA) in neurovascular imaging as compared to normal resolution CT-angiography (NR-CTA). MATERIAL AND METHODS In this retrospective single-center study brain and neck CT-angiography was performed using an ultra-high-resolution computed tomography scanner (n = 82) or a normal resolution CT scanner (NR-CTA; n = 73). Ultra-high-resolution images were reconstructed with a 1024 × 1024 matrix and a slice thickness of 0.25 mm, whereas NR-CT images were reconstructed with a 512 × 512 matrix and a slice thickness of 0.5 mm. Three blinded neuroradiologists assessed overall image quality, artifacts, image noise, overall contrast and diagnostic confidence using a 4-point Likert scale. Furthermore, the visualization and delineation of supra-aortic arteries with an emphasis on the visualization of small intracerebral vessels was assessed using a cerebral vascular score, also utilizing a 4-point Likert scale. Quantitative analyses included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), noise and the steepness of gray value transition. Radiation exposure was determined by comparison of computed tomography dose index (CTDIvol), dose length product (DLP) and mean effective dose. Interrater agreement was evaluated via determining Fleiss-Kappa. RESULTS Ultra-high-resolution CT-angiography (UHR-CTA) yielded excellent image quality with superior quantitative (SNR: p < 0.001, CNR: p < 0.001, steepness of gray value transition: p < 0.001) and qualitative results (overall image quality: 4 (Inter quartile range (IQR) = 4-4); p < 0.001, diagnostic confidence: 4 (IQR = 4-4); p < 0.001) compared to NR-CT (overall image quality: 3 (IQR = 3-3), diagnostic confidence: 3 (IQR = 3-4)). Furthermore, UHR-CT enabled significantly superior delineation and visualization of all vascular segments, from proximal extracranial vessels to the smallest peripheral cerebral branches (e.g. , UHR-CTA PICA 4 (3-4) vs. NR-CTA PICA: 3 (2-3); UHR-CTA P4: 4 (IQR = 3-4) vs. NR-CTA P4: 2 (IQR = 2-3); UHR-CTA M4: 4 (IQR = 4-4) vs. NR-CTA M4: 3 (IQR = 2-3); UHR-CTA A4: 4 (IQR = 3-4) vs. NR-CTA A4: 2 (IQR = 2-3); all p < 0.001). Noteworthy, a reduced mean effective dose was observed when applying UHR-CT (NR-CTA: 1.8 ± 0.3 mSv; UHR-CTA: 1.5 ± 0.5 mSv; p < 0.001). CONCLUSION Ultra-high-resolution CT-angiography improves image quality in neurovascular imaging allowing the depiction and evaluation of small peripheral cerebral arteries. It may thus improve the detection of pathologies in small cerebrovascular lesions and the resulting diagnosis.
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Affiliation(s)
- Felix A Ucar
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Marius Frenzel
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Andrea Kronfeld
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sebastian Altmann
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Antoine P Sanner
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
- Department of Computer Science, Fraunhofer IGD, Technical University Darmstadt, Fraunhoferstraße 5, 64283, Darmstadt, Germany
| | | | - Timo Uphaus
- Department of Neurology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Ahmed E Othman
- Department of Neuroradiology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
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Razavi P, Baldwin G, Vingopoulos F, Garg I, Tracy J, Wescott H, Choi H, Zeng R, Lains I, Husain D, Kim LA, Vavvas DG, Miller JB. Associations of quantitative contrast sensitivity with wide-field swept-source optical coherence tomography angiography in retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2024; 262:789-799. [PMID: 37955700 DOI: 10.1007/s00417-023-06288-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/20/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE To investigate associations between contrast sensitivity (CS) and vascular metrics on wide-field swept-source optical coherence tomography angiography (WF-SS-OCTA) in patients with retinal vein occlusion (RVO). METHODS This prospectively recruited, cross-sectional observational study included RVO patients who underwent quantitative CS function (qCSF) testing and WF-SS-OCTA using 3 × 3, 6 × 6, and 12 × 12 mm angiograms on the same day. The study measured several qCSF outcomes and WF-SS-OCTA vascular metrics, including vessel density (VD), vessel skeletonized density (VSD), and foveal avascular zone (FAZ). The data were analyzed using multivariable regression analysis controlling for age and central subfield thickness (CST). RESULTS A total of 43 RVO eyes of 43 patients and 30 fellow eyes were included. In RVO eyes, multiple vascular metrics were associated with CS outcomes but not visual acuity (VA). On 12 × 12 images, CS thresholds at 1 cpd, 1.5 cpd, and 3 cpd were significantly associated with VD and VSD, but VA was not. When comparing standardized regression coefficients, we found that vascular metrics had a larger effect size on CS than on VA. For instance, the standardized beta coefficient for FAZ area and CS at 6 cpd (β* = - 0.46, p = 0.007) was larger than logMAR VA (β* = 0.40, p = 0.011). CONCLUSION Microvascular changes on WF-SS-OCTA in RVO had a larger effect size on CS than VA. This suggests CS may better reflect the microvascular changes of RVO compared to VA. qCSF-measured CS might be a valuable adjunct functional metric in evaluating RVO patients.
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Affiliation(s)
| | | | | | - Itika Garg
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Jack Tracy
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | | | - Hanna Choi
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | | | - Ines Lains
- Harvard Retinal Imaging Lab, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA
| | - Leo A Kim
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA
| | | | - John B Miller
- Harvard Retinal Imaging Lab, Boston, MA, USA.
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA.
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Yaprak L, Çetinkaya Yaprak A, Sarigül F, Erkan Pota Ç, Ayan A. Comparison of retinochoroidal and optic nerve head microvascular circulation between HIV-positive patients and healthy subjects using optical coherence tomography angiography. J Fr Ophtalmol 2024; 47:104015. [PMID: 38129198 DOI: 10.1016/j.jfo.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/15/2023] [Accepted: 09/28/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To evaluate the retinal, choroidal, and optic disc head microvascular circulation in human immunodeficiency virus (HIV)-infected individuals without retinopathy receiving highly active antiretroviral therapy (HAART) using swept-source optical coherence tomography angiography (SS-OCTA). METHODS This cross-sectional study included 100 eyes of 100 patients with HIV infection but no HIV-related ocular disease and 108 eyes of 108 age- and sex-matched healthy subjects as the control group. SS-OCTA was used to assess foveal avascular zone (FAZ) area, retinal nerve fiber layer thickness (RNFL), choriocapillaris (CC) flow area, outer retinal (OR) thickness, radial peripapillary capillary (RPC) vessel density (VD), ONH VD, and choroidal thickness. RESULTS No statistically significant difference was found between the two groups except in the foveal VD of the deep capillary plexus (DCP). The foveal VD of the DCP was lower in the HIV-positive group (P=0.011). The mean FAZ area (mm2), perimeter (mm), and CC flow area (mm) values were higher in the HIV-positive group at statistically significant levels (P=0.021, P=0.02, and P=0.039, respectively). However, no statistically significant differences were found between the two groups concerning the OR flow area, subfoveal choroidal thickness, or the VDs of the RPC or ONH. CONCLUSIONS This is the first study in the literature to evaluate the microvascular circulation of the ONH in HIV-positive patients. Although retinal and choroidal microvascular circulation decreased in HIV-positive patients receiving HAART treatment, we found no effect on the microvascular circulation of the ONH or RPC microvascular circulation. Our findings suggest that retinochoroidal microvascular circulation is affected in HIV-positive patients over time.
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Affiliation(s)
- L Yaprak
- Department of Ophthalmology, Antalya and Research Hospital, Health Sciences University, Antalya, Turkey.
| | - A Çetinkaya Yaprak
- Department of Ophthalmology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - F Sarigül
- Department of Infectious Disease and Clinical Microbiology, Antalya Life Hospital, Antalya, Turkey
| | - Ç Erkan Pota
- Department of Ophthalmology, Manavgat State Hospital, Antalya, Turkey
| | - A Ayan
- Department of Rheumatologys, Antalya and Research Hospital, Health Sciences University, Antalya, Turkey
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Aslaner MA, Helvacı Ö, Cerit MN, Şendur HN. The value of venous system ultrasound in predicting the need for emergency haemodialysis in haemodialysis patients. J Ultrasound 2024; 27:67-71. [PMID: 37526835 PMCID: PMC10908672 DOI: 10.1007/s40477-023-00802-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Emergency haemodialysis (HD) is a therapeutic procedure performed in serious clinical situations. This study investigated venous Doppler ultrasound parameters for predicting emergency HD in patients on routine HD treatment for end-stage renal disease in the emergency department (ED). METHOD Adult patients on a routine HD program in a tertiary care ED between April and December 2022 were enrolled in the study. Inferior vena cava, hepatic, and portal vein flow parameters and the venous excess ultrasound (VExUS) score calculated from these parameters were noted in order to predict emergency HD indications. Hyperkalaemia, hypervolemia, missing more than one session, uremic findings, and metabolic acidosis were regarded as emergency HD indications. RESULTS One hundred twenty-nine venous ultrasound examinations were performed on 43 patients with routine HD during the study period. The rate of emergency HD was 30.2%. The most common indication of it was hypervolemia (76.9%), followed by missing more than one session (23.1%). Only the portal vein had an AUC value of 0.714, with a sensitivity of 61.5% and specificity of 83.3% for predicting emergency HD. Other parameters including the IVC, hepatic vein, and VExUS score were of no diagnostic value. CONCLUSION The findings of this study show that only the portal vein Doppler flow parameter has very limited diagnostic value for emergency HD in patients on a routine HD program in the ED. This study can serve as a guide to further research.
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Affiliation(s)
- Mehmet Ali Aslaner
- Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Özant Helvacı
- Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mahi Nur Cerit
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Halit Nahit Şendur
- Department of Radiology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Wu J, Liu W. Distinguishing Glial Tissue from Optic Disc in Bergmeister's Papilla Using OCT Angiography. Ophthalmology 2024; 131:332. [PMID: 37330715 DOI: 10.1016/j.ophtha.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/19/2023] Open
Affiliation(s)
- Jing Wu
- Department of Ophthalmology, Daping Hospital, Army Medical Center, Army Medical University, Daping, Yuzhong District, Chongqing, People's Republic of China
| | - Wei Liu
- Department of Ophthalmology, Daping Hospital, Army Medical Center, Army Medical University, Daping, Yuzhong District, Chongqing, People's Republic of China
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Zhang Y, Wang D, Lin F, Song Y, Chen Y, Peng Y, Chen M, Liu Y, Jiang J, Yang Z, Li F, Zhang X. Diagnostic performance of wide-field optical coherence tomography angiography in detecting open-angle glaucoma in high myopia. Acta Ophthalmol 2024; 102:e168-e177. [PMID: 38129974 DOI: 10.1111/aos.16603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/28/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To compare the diagnostic performance of the capillary density (CD) of the central 1-6 mm and peripheral 6-12 mm annular regions in detecting open-angle glaucoma in high myopia (HM) using 15 × 12 mm wide-field swept-source optical coherence tomography angiography (WF SS-OCTA). METHODS The study enrolled 206 and 103 eyes with HM and highly myopic open-angle glaucoma (HM-OAG), respectively. WF SS-OCTA images centred on the fovea were obtained to analyse the changes in the CD in the 1-3 mm, 3-6 mm, 6-9 mm, and 9-12 mm annular regions. CD of the superficial capillary plexus (SCP) was measured with the built-in software. The area under the receiver operating characteristic curve (AUROC) of each region was compared. RESULTS The diagnostic performance of the SCP CD in the central 1-6 mm annular region (AUROC = 0.849) was better than that in the peripheral 6-12 mm annular region (AUROC = 0.756, p = 0.001). The annular AUROCs of SCP CD peaked in the 3-6 mm annular region (AUROC = 0.858) and gradually decreased with increasing diameter and were lower than the corresponding AUROCs of the ganglion cell-inner plexiform layer thickness (p < 0.05 for all comparisons). SCP CD of the inferior quadrant in the 3-6 mm annular region had the best diagnostic performance (AUROC = 0.859). CONCLUSION The SCP CD in the central 1-6 mm annular region exhibited better diagnostic performance for the detection of HM-OAG in HM. The assessment of more peripheral regions has no added value in detecting glaucoma in HM.
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Affiliation(s)
- Yinhang Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Deming Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuying Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Meiling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuhong Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jiaxuan Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zefeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Yabalak A, Ögün MN, Önalan A, Yılmaz M, Tokmak H, Ersoy S, Bilgili F, Bakkal T. Evaluation of the relationship between computed tomography angiography collateral scores and clinical outcome. Arq Neuropsiquiatr 2024; 82:1-7. [PMID: 38438069 PMCID: PMC10911890 DOI: 10.1055/s-0044-1779268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/11/2023] [Indexed: 03/06/2024]
Abstract
BACKGROUND The relationship between collateral circulation and prognosis after endovascular treatment in anterior circulation strokes has been reported in many studies. OBJECTIVE In this study, we aimed to compare the predictive power of clinical outcome by comparing five different collateral scores that are frequently used. METHODS Among the patients who underwent endovascular treatment in our clinic between November 2019 and December 2021, patients with premorbid mRS < 3, intracranial ICA and/or MCA M1 occlusion, and a pre-procedural multiphase CTA examination were included in the study. Demographic, technical, and duration information about the procedure, major events after the procedure, and clinical outcomes at 3 months were recorded. The mCTA, Tan, Maas, Miteff, and rLMC collateral scores of the patients were evaluated. RESULTS Clinical outcome at 3 months were good in 37 of the 68 patients included in the study (mRS ≤ 2). Only the mCTA and rLMC collateral scores were statistically significantly higher in those with a good clinical outcome. Significant correlation with 3-month mRS was detected only in mCTA and rLMC scores. Although rLMC and mCTA collateral scores showed a statistically significant association with prognosis, they were not sufficient to be an independent predictor of prognosis. CONCLUSION mCTA and rLMC were found to have the highest predictive power of clinical outcome and the highest correlation with the 3-month clinical outcome. Our study suggests that it would be beneficial to develop a new scoring system over multiphase CTA, which combines regional and temporal evaluation, which are the strengths of both collateral scoring.
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Affiliation(s)
- Ahmet Yabalak
- Duzce University, Faculty of Medicine, Department of Neurology, Duzce, Türkiye.
| | - Muhammed Nur Ögün
- Bolu Abant Izzet Baysal University, Department of Neurology, Bolu, Türkiye.
| | - Ayşenur Önalan
- Kartal Lutfi Kırdar City Hospital, Department of Neurology, Istanbul, Türkiye.
| | - Murat Yılmaz
- Bolu Abant Izzet Baysal University, Department of Neurology, Bolu, Türkiye.
| | - Hilmiye Tokmak
- Bolu Abant Izzet Baysal University, Department of Neurology, Bolu, Türkiye.
| | - Sadettin Ersoy
- Bolu Abant Izzet Baysal University, Department of Neurology, Bolu, Türkiye.
| | - Fatma Bilgili
- Bolu Abant Izzet Baysal University, Department of Neurology, Bolu, Türkiye.
| | - Tahsin Bakkal
- Bolu Abant Izzet Baysal University, Department of Neurology, Bolu, Türkiye.
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Philip R, Vijaya L, Balekudaru S, Panda S, Khurana M, David RL, Asokan R, George R. Effect of beta blockers on optical coherence tomography angiography in normal, suspect, and glaucomatous eyes: A prospective study. Indian J Ophthalmol 2024; 72:432-438. [PMID: 38153967 DOI: 10.4103/ijo.ijo_1654_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/22/2023] [Indexed: 12/30/2023] Open
Abstract
PURPOSE The study aimed to assess the effect of hypertension, and use of systemic beta blockers (BB) and other antihypertensives on ocular perfusion by optical coherence tomography angiography (OCTA) in normal, suspect, and glaucomatous eyes. METHODS Cross-sectional study in tertiary eye care center. Prospectively recruited consenting subjects between 18 and 90 years with or without glaucoma. Measured the optic nerve peripapillary perfusion and flux and macular vessel density (MVD: 6 × 6 and 3 × 3 mm) in the superficial retinal layer using OCTA. RESULTS Included 200 eyes (112 patients). Compared to nonhypertensives or those on non-BB antihypertensives (NBB), hypertensives on BB had lower peripapillary perfusion (43.45,43.40, 42.05%, P = 0.003), and MVD (6 × 6 mm: 16.65, 16.70,15.75 mm/mm 2 , P = 0.002; 3 × 3 mm: 18.70, 18.50, 18.00 mm/mm 2 , P = 0.025). Those on systemic BB with vasodilatory properties had similar perfusion parameters as nonhypertensives and NBB. Those on systemic BB without vasodilating properties had significantly lower peripapillary perfusion (42.05 vs 43.30%, P = 0.011) and MVD (6 × 6 mm: 15.15 vs 16.60 mm/mm 2 , P < 0.001; 3 × 3 mm: 17.40 vs 18.70 mm/mm 2 , P = 0.005) compared to nonhypertensives. On multivariate analysis, peripapillary perfusion increased with increase in diastolic blood pressure (β:0.051, p: 0.04) and increasing age was the only factor found to be significantly associated with decreased peripapillary and macular perfusion parameters. CONCLUSION Systemic BB users have worse ocular perfusion parameters compared to those on other medications or nonhypertensives on univariate analysis but similar perfusion on multivariate analysis. Those on BB with vasodilation have better ocular perfusion parameters. All BB cannot be considered equally detrimental to ocular perfusion. Further well-controlled prospective studies are needed to reassess the effects of BB with or without vasodilation on ocular perfusion.
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Affiliation(s)
- Reni Philip
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Lingam Vijaya
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Shantha Balekudaru
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Smita Panda
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Mona Khurana
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rathini L David
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rashima Asokan
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
- Occupational Optometry Services, Elite School of Optometry, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Ronnie George
- Smt. Jadhavbai Nathamal Singhvee Glaucoma Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Campo G, Erriquez A, Biscaglia S. Perfect Wedding Between Patient With STEMI and Angiography-Derived Indexes of Coronary Physiology. Circ Cardiovasc Interv 2024; 17:e013944. [PMID: 38375668 DOI: 10.1161/circinterventions.124.013944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Affiliation(s)
- Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
| | - Andrea Erriquez
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
| | - Simone Biscaglia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy
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Cohen SL, Feizullayeva C, Wang JJ, Chan N, McCandlish JA, Cronin PP, Barish MA, O'Connell W, Sanelli PC. Maternal and Fetal Radiation-Induced Cancer Risk From Computed Tomography Pulmonary Angiography During Pregnancy: A Retrospective Cohort Study Across a Multihospital Integrated Health Care Network. J Comput Assist Tomogr 2024; 48:257-262. [PMID: 38271533 DOI: 10.1097/rct.0000000000001545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Computed tomography pulmonary angiogram (CTPA) is important to evaluate suspected pulmonary embolism in pregnancy but has maternal/fetal radiation risks. The objective of this study was to estimate maternal and fetal radiation-induced cancer risk from CTPA during pregnancy. METHODS Simulation modeling via the National Cancer Institute's Radiation Risk Assessment Tool was used to estimate excess cancer risks from 17 organ doses from CTPA during pregnancy, with doses determined by a radiation dose indexing monitoring system. Organ doses were obtained from a radiation dose indexing monitoring system. Maternal and fetal cancer risks per 100,000 were calculated for male and female fetuses and several maternal ages. RESULTS The 534 CTPA examinations had top 3 maternal organ doses to the breast, lung, and stomach of 17.34, 15.53, and 9.43 mSv, respectively, with a mean uterine dose of 0.21 mSv. The total maternal excess risks of developing cancer per 100,000 were 181, 151, 121, 107, 94.5, 84, and 74.4, respectively, for a 20-, 25-, 30-, 35-, 40-, 45-, and 50-year-old woman undergoing CTPA, compared with baseline cancer risks of 41,408 for 20-year-old patients. The total fetal excess risks of developing cancer per 100,000 were 12.3 and 7.3 for female and male fetuses, respectively, when compared with baseline cancer risks of 41,227 and 48,291. DISCUSSION Excess risk of developing cancer from CTPA was small relative to baseline cancer risk for pregnant patients and fetuses, decreased for pregnant patients with increasing maternal age, and was greater for female fetuses than male fetuses.
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Affiliation(s)
| | | | | | - Nicholas Chan
- Department of Medicine, Cleveland Clinic, Cleveland, OH
| | | | - Paul P Cronin
- Department of Radiology and Imaging Science, Emory University Hospital, Atlanta, GA
| | - Matthew A Barish
- Department of Diagnostic Radiology, North Shore University Hospital/Northwell Health, Manhasset, NY
| | - William O'Connell
- Department of Diagnostic Radiology, North Shore University Hospital/Northwell Health, Manhasset, NY
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Jalili J, Nadimi M, Jafari B, Esfandiari A, Mojarad M, Subramanian PS, Aghsaei Fard M. Vessel Density Features of Optical Coherence Tomography Angiography for Classification of Optic Neuropathies Using Machine Learning. J Neuroophthalmol 2024; 44:41-46. [PMID: 37440373 DOI: 10.1097/wno.0000000000001925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
BACKGROUND To evaluate the classification performance of machine learning based on the 4 vessel density features of peripapillary optical coherence tomography angiography (OCT-A) for classifying healthy, nonarteritic anterior ischemic optic neuropathy (NAION), and optic neuritis (ON) eyes. METHODS Forty-five eyes of 45 NAION patients, 32 eyes of 32 ON patients, and 76 eyes of 76 healthy individuals with optic nerve head OCT-A were included. Four vessel density features of OCT-A images were developed using a threshold-based segmentation method and were integrated in 3 models of machine learning classifiers. Classification performances of support vector machine (SVM), random forest, and Gaussian Naive Bayes (GNB) models were evaluated with the area under the receiver-operating-characteristic curve (AUC) and accuracy. RESULTS We divided 121 images into a 70% training set and 30% test set. For ON-NAION classification, best results were achieved with 50% threshold, in which 3 classifiers (SVM, RF, and GNB) discriminated ON from NAION with an AUC of 1 and accuracy of 1. For ON-Normal classification, with 100% threshold, SVM and RF classifiers were able to discriminate normal from ON with AUCs of 1 and accuracies of 1. For NAION-normal classification, with 50% threshold, the SVM and RF classified the NAION from normal with AUC and accuracy of 1. CONCLUSIONS ML based on the combined peripapillary vessel density features of total vessels and capillaries in the whole image and ring image could provide excellent performance for NAION and ON distinction.
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Affiliation(s)
- Jalil Jalili
- Biomedical Engineering Unit (JJ, MN), Cardiovascular Disease Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Farabi Eye Hospital (BJ, AE, MAF), Tehran University of Medical Sciences, Tehran, Iran; School of Medicine (MM), Guilan University of Medical Sciences, Rasht, Iran; and Department of Ophthalmology (PSS), University of Colorado, School of Medicine, Aurora, Colorado
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Wang X, Cai S, Wang H, Li J, Yang Y. Deep-learning-based renal artery stenosis diagnosis via multimodal fusion. J Appl Clin Med Phys 2024; 25:e14298. [PMID: 38373294 DOI: 10.1002/acm2.14298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/19/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
PURPOSE Diagnosing Renal artery stenosis (RAS) presents challenges. This research aimed to develop a deep learning model for the computer-aided diagnosis of RAS, utilizing multimodal fusion technology based on ultrasound scanning images, spectral waveforms, and clinical information. METHODS A total of 1485 patients received renal artery ultrasonography from Peking Union Medical College Hospital were included and their color doppler sonography (CDS) images were classified according to anatomical site and left-right orientation. The RAS diagnosis was modeled as a process involving feature extraction and multimodal fusion. Three deep learning (DL) models (ResNeSt, ResNet, and XCiT) were trained on a multimodal dataset consisted of CDS images, spectrum waveform images, and individual basic information. Predicted performance of different models were compared with senior physician and evaluated on a test dataset (N = 117 patients) with renal artery angiography results. RESULTS Sample sizes of training and validation datasets were 3292 and 169 respectively. On test data (N = 676 samples), predicted accuracies of three DL models were more than 80% and the ResNeSt achieved the accuracy 83.49% ± 0.45%, precision 81.89% ± 3.00%, and recall 76.97% ± 3.7%. There was no significant difference between the accuracy of ResNeSt and ResNet (82.84% ± 1.52%), and the ResNeSt was higher than the XCiT (80.71% ± 2.23%, p < 0.05). Compared to the gold standard, renal artery angiography, the accuracy of ResNest model was 78.25% ± 1.62%, which was inferior to the senior physician (90.09%). Besides, compared to the multimodal fusion model, the performance of single-modal model on spectrum waveform images was relatively lower. CONCLUSION The DL multimodal fusion model shows promising results in assisting RAS diagnosis.
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Affiliation(s)
- Xin Wang
- Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Sheng Cai
- Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Hongyan Wang
- Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jianchu Li
- Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuqing Yang
- State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, Beijing, China
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Sangha K, White T, Boltyenkov AT, Bastani M, Sanmartin MX, Katz JM, Malhotra A, Rula E, Naidich JJ, Sanelli PC. Time-driven activity-based costing (TDABC) of direct-to- angiography pathway for acute ischemic stroke patients with suspected large vessel occlusion. J Stroke Cerebrovasc Dis 2024; 33:107516. [PMID: 38183964 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Direct-to-angiography (DTA) is a novel care pathway for endovascular treatment (EVT) of acute ischemic stroke (AIS) that has been shown to reduce time-to-treatment and improve clinical outcomes for EVT-eligible patients. The institutional costs of adopting the DTA pathway and the many factors affecting costs have not been studied. In this study, we assess the costs and main cost drivers associated with the DTA pathway compared to the conventional CT pathway for patients presenting with AIS and suspected LVO in the anterior circulation. METHODS Time driven activity based costing (TDABC) model was used to compare costs of DTA and conventional pathways from the healthcare institution perspective. Process mapping was used to outline all activities and resources (personnel, equipment, materials) needed for each step in both pathways. The cost model was developed using our institutional patient database and average New York state wages for personnel costs. Total, incremental and proportional costs were calculated based on institutional and patient factors affecting the pathways. RESULTS DTA pathway accrued additional $82,583.61 (9%) in total costs compared to the conventional approach for all AIS patients. For EVT-ineligible patients, the DTA pathway incurred additional $82,964.37 (76%) in total costs compared to the CT pathway. For EVT eligible patients, the total and per-patient costs were greater in the CT pathway by $380.76 (0.04%) and $5.60 (0.04%) respectively. CONCLUSION As the DTA pathway incurred additional $82,964.37 for EVT-ineligible patients, appropriate patient selection criteria are needed to avoid transferring EVT-ineligible patients to the angiography suite.
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Affiliation(s)
| | - Timothy White
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset NY, United States
| | - Artem T Boltyenkov
- Siemens Medical Solutions USA Inc., Malvern, PA, United States; Imaging Clinical Effectiveness and Outcomes Research (iCEOR), Center for Health Innovations and Outcomes Research (CHIOR), Feinstein Institutes for Medical Research, United States
| | - Mehrad Bastani
- Imaging Clinical Effectiveness and Outcomes Research (iCEOR), Center for Health Innovations and Outcomes Research (CHIOR), Feinstein Institutes for Medical Research, United States
| | - Maria X Sanmartin
- Siemens Medical Solutions USA Inc., Malvern, PA, United States; Imaging Clinical Effectiveness and Outcomes Research (iCEOR), Center for Health Innovations and Outcomes Research (CHIOR), Feinstein Institutes for Medical Research, United States
| | - Jeffrey M Katz
- Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset NY, United States; Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset NY, United States
| | - Ajay Malhotra
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Heaven CT, United States
| | - Elizabeth Rula
- Harvey L. Neiman Health Policy Institute, Reston, VA, United States
| | - Jason J Naidich
- Imaging Clinical Effectiveness and Outcomes Research (iCEOR), Center for Health Innovations and Outcomes Research (CHIOR), Feinstein Institutes for Medical Research, United States; Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset NY, United States
| | - Pina C Sanelli
- Imaging Clinical Effectiveness and Outcomes Research (iCEOR), Center for Health Innovations and Outcomes Research (CHIOR), Feinstein Institutes for Medical Research, United States; Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset NY, United States
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Pahuja A, Dhiman R, Aggarwal V, Aalok SP, Saxena R. Evaluation of Peripapillary and Macular Optical Coherence Tomography Angiography Characteristics in Different Stages of Papilledema. J Neuroophthalmol 2024; 44:53-60. [PMID: 37364246 DOI: 10.1097/wno.0000000000001908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
BACKGROUND Prospective evaluation of optical coherence tomography (OCT) and OCT angiography (OCT-A) characteristics in different stages of papilledema in idiopathic intracranial hypertension (IIH). METHODS In this prospective, observational study patients of IIH with papilledema were recruited and divided into 3 groups-early/established (Group 1), chronic (Group 2), and atrophic papilledema (Group 3). Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell inner plexiform layer (GC-IPL) were recorded on OCT. Peripapillary and macular perfusion was documented at superficial retinal, deep retinal, and choriocapillary level using OCT-A. The investigations were repeated at 3 months. RESULTS RNFL showed significant thinning in all groups on follow-up with the atrophic group showing maximum thinning ( P = 0.01-Group 3). GC-IPL was significantly reduced in all stages of papilledema at baseline compared with the controls. Thinnest GC-IPL was noted in the atrophic group (52.75 ± 7.44 μm; P = 0.00 in Group 3 vs controls) that showed further deterioration on follow-up. On Image J analysis, significant decrease was noted at various levels in the peripapillary and macular perfusion at baseline especially in the atrophic group which showed further deterioration noted on follow-up. The final visual acuity showed a statistically significant weak negative correlation with baseline RNFL (r = -0.306) and GC-IPL (r = -0.384) and moderately negative correlation with baseline superficial peripapillary retinal perfusion (r = -0.553). A significant negative correlation was seen between increasing grade of papilledema and superficial peripapillary retinal perfusion with both Image J and automated indices (r = -0.46; r = -0.61), respectively. CONCLUSIONS GC-IPL may help identify early damage in papilledema even in the presence of thicker RNFL. Significant vascular changes can be observed on OCT-A that may help predict the final visual outcome in papilledema due to IIH.
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Affiliation(s)
- Akshra Pahuja
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Feyen L, Artzner C, Paprottka P, Haage P, Kröger K, Alhmid B, Katoh M. Endovascular treatment of renal artery stenosis in Germany: a retrospective analysis of the DEGIR registry 2018-2021. ROFO-FORTSCHR RONTG 2024; 196:283-291. [PMID: 37995733 DOI: 10.1055/a-2193-1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
PURPOSE To provide an overview of endovascular treatment of renal artery stenosis (RAS) using the data of the Deutsche Gesellschaft für interventionelle Radiologie (DeGIR) quality management system. MATERIALS AND METHODS A retrospective analysis was performed. Pre-, peri- and postprocedural data, technical success rates, complication rates, and clinical success rates at dismissal were examined. RESULTS Between 2018 and 2021, 2134 angiography examinations of the renal arteries were performed: diagnostic angiography in 70 patients (3 %), balloon angioplasty in 795 (37 %), stent implantation in 1166 (55 %) and miscellaneous procedures in 103 (5 %). The lesion length was less than or equal to 5 mm in 1837 patients (87 %), between 5 and 10 mm in 197 (9 %), and between 10 and 20 mm in 62 (3 %). The degree of stenosis was less than 50 % in 156 patients (7 %), greater than 50 % in 239 (11 %), and greater than 70 % in 1472 (70 %). Occlusion was treated in 235 patients (11 %). Symptoms at discharge resolved in 600 patients (29 %), improved in 1012 (49 %), were unchanged in 77 (4 %), and worsened in 5 (0.2 %). Complications were reported in 51 patients (2.5 %) and the mortality rate was 0.15 %. CONCLUSION A substantial number of patients with RAS and occlusions were treated by radiologists in Germany, with high technical success rates and low complication rates. The indication should be determined carefully as the current European guidelines for the treatment of RAS suggest that only carefully selected groups of patients will benefit from recanalizing treatment. KEY POINTS · Carefully selected patient groups may benefit from endovascular treatment of renal artery stenosis.. · Analysis of the DEGIR quality management database shows that treatment of renal artery stenosis was performed by radiologists in Germany with high technical success rates and low complication rates.. · Recanalization even led to symptom improvement in a large proportion of patients with occlusions..
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Affiliation(s)
- Ludger Feyen
- Department of Diagnostic and Interventional Radiology, HELIOS Hospital Krefeld, Germany
- School of Medicine, University Witten Herdecke Faculty of Health, Witten, Germany
- Department of Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, Germany
| | - Christoph Artzner
- Department of Diagnostic and Interventional Radiology, University Hospitals Tubingen, Tübingen, Germany
| | - Philipp Paprottka
- Department of Diagnostic and Interventional Radiology, Technical University of Munich Hospital Rechts der Isar, München, Germany
| | - Patrick Haage
- Department of Diagnostic and Interventional Radiology, HELIOS University Hospital Wuppertal, Germany
- School of Medicine, University Witten Herdecke Faculty of Health, Witten, Germany
| | - Knut Kröger
- Department of Angiology, HELIOS Hospital Krefeld, Germany
| | - Bachar Alhmid
- Department of Angiology, HELIOS Hospital Krefeld, Germany
| | - Marcus Katoh
- Department of Diagnostic and Interventional Radiology, HELIOS Hospital Krefeld, Germany
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Lo HY, Lee JK, Lin YH. The feasibility, efficacy, and safety of RDN procedure using CO 2 angiography through radial artery in severe chronic kidney disease patients. Hypertens Res 2024; 47:760-766. [PMID: 38177288 DOI: 10.1038/s41440-023-01540-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 01/06/2024]
Abstract
The recent evidence regarding the effectiveness of renal denervation (RDN) in blood pressure control is becoming increasingly substantial. However, many studies have excluded populations with severely impaired kidney function, even though these individuals have a higher prevalence of hypertension compared to the general population, and controlling their blood pressure is more challenging. The effectiveness and safety of RDN in patients with severe chronic kidney disease (CKD) lack strong evidence support. Concerns about worsening kidney function still exist, particularly in patients with CKD stage 5. We conducted an observational study involving 10 patients who were using at least 3 different antihypertensive medications and had an estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m2 but had not undergone dialysis. For these patients, we performed RDN via the radial artery approach, with the assistance of carbon dioxide (CO2) angiography. Utilizing this approach, the systolic 24-hour ambulatory blood pressure monitoring did not exhibit a significant decrease at 3 months; however, a significant reduction was observed at 6 months after RDN. We also minimized contrast agent usage, observed no kidney function decline 3 months post-RDN, and experienced no vascular-related complications. Using the radial artery approach and CO2 angiography assistance for RDN may be an effective and safe blood pressure control method for patients with severe kidney impairment.
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Affiliation(s)
- Hao-Yun Lo
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Jen-Kuang Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Yen-Hung Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University College of Medicine, Taipei, Taiwan
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Huang N, Hormel TT, Liang GB, Wei X, Guo Y, Chen S, Jia Y. Optimizing numerical k-sampling for swept-source optical coherence tomography angiography. Opt Lett 2024; 49:1201-1204. [PMID: 38426973 DOI: 10.1364/ol.518720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
High-quality swept-source optical coherence tomography (SS-OCT) requires accurate k-sampling, which is equally vital for optical coherence tomography angiography (OCTA). Most SS-OCT systems are equipped with hardware-driven k-sampling. However, this conventional approach raises concerns over system cost, optical alignment, imaging depth, and stability in the clocking circuit. This work introduces an optimized numerical k-sampling method to replace the additional k-clock hardware. Using this method, we can realize high axial resolution (4.9-µm full-width-half-maximum, in air) and low roll-off (2.3 dB loss) over a 4-mm imaging depth. The high axial resolution and sensitivity achieved by this simple numerical method can reveal anatomic and microvascular structures with structural OCT and OCTA in both macular and deeper tissues, including the lamina cribrosa, suggesting its usefulness in imaging retinopathy and optic neuropathy.
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Keser Z, Diehn FE, Lanzino G. Photon-Counting Detector CT Angiography in Cervical Artery Dissection. Stroke 2024; 55:e48-e49. [PMID: 38293798 DOI: 10.1161/strokeaha.123.046174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Zafer Keser
- Departments of Neurology (Z.K.), Mayo Clinic, Rochester, MN
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Ali H, Weinstein J, Sarwar A, Evenson A, Raven K, Curry MP, Ahmed M. Angiography with cone-beam CT versus contrast-enhanced MRI for living donor transplant imaging: Is MRI enough? Clin Anat 2024; 37:185-192. [PMID: 37638802 DOI: 10.1002/ca.24104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023]
Abstract
The purpose of this study is to compare the subjective and objective quality and confidence between conventional angiography with cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) for the preoperative evaluation of potential donors for living donor liver transplant. Seventeen patients undergoing preoperative donor evaluation for living donor liver transplantation that underwent angiography with CBCT and contrast-enhanced MRI for evaluation of hepatic vascular anatomy were included in the study. Four attending radiologists interpreted anonymized, randomized angiography with CBCT images and MRIs, rating the diagnostic quality and confidence of their interpretation (on a 3-point scale) for each element, as well as clinically relevant measurements. Overall, the readers rated the quality of angiography with CBCT to be higher than that of MRI (median [interquartile range] = 3 (2, 3) vs. 2 (1-3), p < 0.001) across all patients. Readers of angiography with CBCT had more confidence in their interpretations as an average of all elements evaluated than the MRI readers (3 (3) vs. 3 (2, 3), p < 0.001). When the same reader interpreted both MRI and CBCT, the right hepatic artery diameter (3.8 mm ± 0.72 mm vs. 4.5 mm ± 1.2 mm, p < 0.005) and proper hepatic artery diameter (4.43 mm ± 0.98 mm vs. 5.4 mm ± 1.05 mm, p < 0.003) were significantly different between MRI and CBCT. There was poor interrater reliability for determining segment IV arterial supply for both modalities (κ < 0.2). Angiography with CBCT provides higher subjective diagnostic quality and greater radiologist confidence than MRI. The difference in measurements between CBCT and MRI when the same reader reads both studies suggests CBCT adds additional information over MRI evaluation alone.
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Affiliation(s)
- Hamza Ali
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeffrey Weinstein
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ammar Sarwar
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy Evenson
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin Raven
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael P Curry
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Muneeb Ahmed
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Yoshida K, Omura M, Tamura K, Hirata S, Yamaguchi T. Detection of Individual Microbubbles by Burst-Wave-Aided Contrast-Enhanced Active Doppler Ultrasonography. IEEE Trans Ultrason Ferroelectr Freq Control 2024; 71:380-394. [PMID: 38261486 DOI: 10.1109/tuffc.2024.3357140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
We propose burst-wave-aided, contrast-enhanced, active Doppler ultrasonography for visualizing lymph vessels. This technique forces ultrasound contrast agents (UCAs) to move using the acoustic radiation force induced by burst waves with low amplitude while suppressing their destruction. Using a flow phantom, we measured the average, decrease rate of echo intensity [i.e., pulse intensity integral (PII)], and the velocity of individual contrast agents, which directly affects the performance of imaging and tracking contrast agents under stationary flow conditions. Comparison with pulse-inversion Doppler without exposure to the burst wave demonstrated that the velocity of the contrast agents could be enhanced up to several tens of millimeters per second by the effect of the burst wave, maximizing the echo intensity extracted by a clutter filter. The contrast ratio (CR), defined as the ratio of the contrast echo to the phantom echo outside the channel, did not change appreciably, even when the lower cut-off velocity of the clutter filter was increased up to 10 mm/s. This implies a better robustness against the motion of the tissue. In addition, the performance for detecting contrast agents (i.e., echo intensity) was superior or similar to that of pulse-inversion Doppler, even in undesirable conditions where the flow had a velocity component in the opposite direction to that of the acoustic radiation force. The echo intensity was lower or the same as that in pulse-inversion Doppler, demonstrating the potential for suppressing the destruction of contrast agents and enabling long-term observations. From these results, we expect that the proposed method will be beneficial for visualizing lymph vessels.
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Rossmann T, Veldeman M, Oulasvirta E, Nurminen V, Rauch PR, Gruber A, Lehecka M, Niemelä M, Numminen J, Raj R. Long-term treatment outcomes and natural course of low-grade intracranial dural arteriovenous fistulas. Neurosurg Focus 2024; 56:E2. [PMID: 38428004 DOI: 10.3171/2024.1.focus23767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/02/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE In contrast to high-grade dural arteriovenous fistula (dAVF), low-grade dAVF is mainly associated with tinnitus and carries a low risk of morbidity and mortality. It remains unclear whether the benefits of active interventions outweigh the associated risk of complications in low-grade dAVF. METHODS The authors conducted a retrospective single-center study that included all consecutive patients diagnosed with an intracranial low-grade dAVF (Cognard type I and IIa) during 2012-2022 with DSA. The authors analyzed symptom relief, symptomatic angiographic cure, treatment-related complications, risk for intracerebral hemorrhage (ICH), and mortality. All patients were followed up until the end of 2022. RESULTS A total of 81 patients were diagnosed with a low-grade dAVF. Of these, 48 patients (59%) underwent treatment (all primary endovascular treatments), and 33 patients (41%) did not undergo treatment. Nine patients (19%) underwent retreatments. Angiographic follow-up was performed after median (IQR) 7.7 (6.1-24.1) months by means of DSA (mean 15.0, median 6.4 months, range 4.5-83.4 months) or MRA (mean 29.3, median 24.7 months, range 5.9-62.1 months). Symptom control was achieved in 98% of treated patients after final treatment. On final angiographic follow-up, 73% of patients had a completely occluded dAVF. There were 2 treatment-related complications resulting in 1 transient (2%) and 1 permanent (2%) neurological complication. One patient showed recurrence and progression of a completely occluded low-grade dAVF to an asymptomatic high-grade dAVF. No cases of ICH- or dAVF-related mortality were found in either treated patients (median [IQR] follow-up 5.1 [2.0-6.8] years) or untreated patients (median [IQR] follow-up 5.7 [3.2-9.0] years). CONCLUSIONS Treatment of low-grade dAVF provides a high rate of symptom relief with small risks for complications with neurological sequela. The risks of ICH and mortality in patients with untreated low-grade dAVF are minimal. Symptoms may not reveal high-grade recurrence, and radiological follow-up may be warranted in selected patients with treated low-grade dAVF. An optimal radiographic follow-up regimen should be developed by a future prospective multicenter registry.
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Affiliation(s)
- Tobias Rossmann
- Departments of1Neurosurgery and
- 2Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Linz, Austria
- 3Johannes Kepler University, Linz, Austria; and
| | - Michael Veldeman
- Departments of1Neurosurgery and
- 4Department of Neurosurgery, RWTH Aachen University Hospital, Aachen, Germany
| | | | | | - Philip-Rudolf Rauch
- 2Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Linz, Austria
- 3Johannes Kepler University, Linz, Austria; and
| | - Andreas Gruber
- 2Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Linz, Austria
- 3Johannes Kepler University, Linz, Austria; and
| | | | | | - Jussi Numminen
- 5Radiology, Helsinki University Hospital, University of Helsinki, Finland
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