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Introduction: The arch of aorta is a curved structure between the ascending aorta and the descending aorta.Three branches arise from the superior aspect of the arch- Brachiocephalic trunk, Left common carotid artery and Left subclavian artery. The aortic arch and its branches are well known for their anomalies which are important causes of cardio-vascular morbidity and mortality. The present study contribute for awareness and alertness regarding their incidence and prevalence for radiologists, cardiologists and endo-thoracic surgeons and to prevent complications during therapeutic procedures. Subjects and Methods: 500 CTA images were studied retrospectively from the patients who underwent chest and neck CTA for different reasons. Results: Out of 500 patients 474 (94.8%) patients had the classical branching pattern with left sided aorta. Six types of anomalies of the aortic arch and its branches were found in 26 (5.2%) patients. The most common anatomical variant was a common trunk for Brachiocephalic trunk and Left Common Carotid artery (bovine arch) found in 9 (1.8%) patients. In five (1%) patients, Left Vertebral Artery arises directly from the arch of aorta between left common carotid artery and left subclavian artery. Five (1%) patients had Right sided arch of aorta. Aberrant Right subclavian artery was found in four (0.8%) patients. Double arch in 2 (0.4%) cases and in one (0.2%) patient, we observed five branches arising directly from the arch, they are Right Common Carotid artery, Left Common Carotid artery, Left Vertebral artery, Left Subclavian artery and Aberrant Right Subclavian artery. Conclusion: With the ever increasing day to day advancements in complex endovascular interventions for the aorta and other great vessels of head and neck regions, early identification of aortic arch variant anatomy is of clinical significance to the radiologists and endovascular surgeons.
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Objective To explore the clinical significance of the precision evaluation of computed tomography angiography and color Doppler image formation technology to the condition of the vascular system in the donor site.Methods From January,2014 to December,2014,CTA and color Doppler were used to examine conditions of the first dorsal metatarsal artery's courser and the size of original caliber in 25 patients with thumb or finger defected.Also the distance between skin and the first dorsal metatarsal artery.The accurate positions and adjacent relations of vessels in donor site were precisely marked and then the vessel original caliber was measured.Results All the first dorsal metatarsal arteries of 25 cases can be appeared clearly in CTA and color Doppler.Blood vessels line and filling results were completely consistent in intraoperative findings.The difference of the vessel original average caliber was statistically significant (P ＜ 0.05) (1.20 ± 0.25 mm,1.41 ± 0.15 mm and 1.3 ±0.2 mm in Doppler,CTA and operation,respectively) while the distance was not significant (P ＞ 0.05)(9.20 ±3.06 mm,10.32 ± 2.76 mm and 0.2 ± 2.6 mm in Doppler,CTA and operation,respectively) All the 25 transplanted toes were survived.Conclusion CTA combined color Doppler image formation technology in thumb or finger reconstruction can objectively reflect the real situation of the vessels in donor sites,and the structural characteristics and classification of anatomy for individualized,and has important clinical value in preoperative foot blood supply assessment.
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PURPOSE: We compared non-invasive imaging studies of CTA, TOF-MRA and CE-MRA to evaluate detecting internal carotid artery stenosis and occlusion. MATERIALS AND METHODS: We enrolled 20 patients with clinically suspected internal carotid artery stenosis and occlusion, or asymptomatic patient with more than 50% stenosis suspected on color Doppler ultrasonography for regular check-up. Prospectively, CTA, TOF-MRA and CE-MRA were performed, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TOF-MRA and CE-MRA using CTA as a reference standard for detecting more than 50% stenosis were evaluated, and correlations of measured percent stenosis between 3 imaging studies were also evaluated. RESULTS: No significant difference was found between 3 imaging studies in measuring stenosis(p>0.05). Correlation coefficient was 0.932 between CTA and TOF-MRA, and 0.971 between CTA and CE-MRA. TOF-MRA had 83.3% sensitivity, 87.5% specificity, 71.4% positive predictive value, 93.3% negative predictive value and 86.4% accuracy for detecting more than 50% stenosis and occlusion. CE-MRA had 83.3% sensitivity, 93.8% specificity, 83.3% positive predictive value, 93.8% negative predictive value and 90.9% accuracy. CONCLUSION: TOF-MRA and CE-MRA provided high correlations in the evaluation of internal carotid artery stenosis and occlusion.
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Humans , Angiography , Carotid Arteries , Carotid Stenosis , Constriction, Pathologic , Prospective Studies , Sensitivity and Specificity , Ultrasonography, Doppler, ColorABSTRACT
Objective To assess the effectiveness of Z-axis automatic tube current modulation ( ATCM) technique with respect to dose reduction and image noise in the thyroid regional tissues during neck computed tomography angiography (CTA). Methods A total of 140 patients underwent neck CTA with 64-slice spiral CT, and were randomized into fixed-tube current group and ATCM group. Objective noise, CTDIw, DLP and mA of each group were recorded. Results The image qualities of all the patients were diagnostically acceptable, though the objective noise of neck in the ATCM group was higher than that in the group of fixed-tube current (P＜ 0.05 ). The radiation doses in the ATCM group [ CTDIw (35.99±1.31 ) mGy, DLP (11 121.39 ±5.51) mGy·cm] were significantly inferior to those in the group of fixed tube current [ CTDIw (43.22±1.42) mGy, DLP (1514.45±5.56) mGy·cm]. Conclusions Compared with fixedtube current technique, ATCM technique could significantly reduce the radiation dose in neck CT with diagnostic acceptability of the image quality.
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Objective:To valuate the application of 64-slice spiral CT angiography in the arterial diseases of the lower extremities.Methods:Radiography data and treatment of 27 patients with arterial diseases of the lower extremities were reviewed,the scans cover renal artery to the artery of the lower extremity.We used workstation for 3D reconstruction Results:VR and MIP findings on 64-MSCT angiography were as follows:17 abdominal aortic and lower extremity arterial mural calcification,5 pseudoaneurysm aneursm,1 hemangioma racemosum,3 thromboangiitis obliterans,1 thrombopoiesis at anastomotic stoma.Conclusion:64-MSCT angiography has high clinical potential to be used in the diagnosis of lower extremity vascular lesions,which can help screen and define the type,size of the vascular diseases,and make programme.
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Objective:To evaluate the importance of 3D-CTA with volume rendering for the diagnosis of multiple intracranial aneurysms. Methods: Axial source images were obtained by helical CT scanning and reconstruction of 3D-CTA images was done by volume rendering technique in conjunction with multiplanar reformation. Results: In the past one year,there were 10 patients diagnosed as having multiple intracranial aneurysms by 3D-CTA and altogether 24 aneurysms were visualized,including 10 small aneurysms(≤5mm.Three dimensional CT angiography with volume rendering demonstrated aneurysms very well and provided useful information concerning the site,shape,size and spatial relationship with the surrounding vessels and bone anatomy. Conclusion: Three-dimensional CT angiography with volume rendering is a quick,reliable,and relatively noninvasive method for diagnosing multiple intracranial aneurysms.It delineates detailed aneurysmal morphology,and provides useful information for planning microsurgical approaches.
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Objective To investigate the image quality and diagnostic accuracy using 64-slice spiral computed tomography (64-CTA) scanner in patients with suspected coronary artery disease. Methods Sixty eight patients with chest pain or post PTCA underwent CT coronary angiography (CTA) and selected coronary angiography (SCA). The SCA results were served as "gold standard" to evaluate the diagnostic accuracy of CTA, while the sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated, respectively. Results 64-slice spiral CT could clearly demonstrate the coronary arterial trunk and branchs with stenosis, calcifications abnormal orifise origination and bridge vascular disease; especially with high accuracy in revealing calcification and even with quantification. The sensitivity, specificity, PPV and NPV of the degree of stenosis more than 75% for coronary artery segments evaluated by CTA were significantly higher than those of the degree of stenosis less than 50% for coronary artery segments(P