Echocardiography-guided percutaneous closure of patent ductus arteriosus without arterial access: Feasibility and safety for a new strategy / 中南大学学报(医学版)

Objective:To evaluate the feasibility and safety of device closure of patent ductus arteriosus (PDA)using only venous access under echocardiography guidance alone.Methods:A total of 102 consecutive pediatric patients underwent transcatheter PDA closure without arterial access,under the guidance of only echocardiography.The patients were followed up by clinical examination,electrocardiogram,and echocardiogram at 1,3,6 12,and 24 months.Results:Transvenous PDA closure under echocardiographic guidance was successful in 99 (97.1％)patients.There were no acute procedural complications or severe adverse events.The duration ranged from 10 to 65 minutes (median,21 minutes).Immediate complete closure of PDA was achieved in 87 patients (87.9％),and 100％ of the patients were completely closed after 24 h.There were no severe adverse events in the period of 1-24 months (median,12 months) follow up.Conclusion:Transvenous PDA closure without fluoroscopy avoids radiation exposure,contrast agent usage and potential arterial complications.It can be used as an alternative procedure,especially for children.

Imaging of Congenital Subclavian Artery to Subclavian Vein Fistula in a Newborn.

The purpose of this paper is to report a congenital subclavian artery to subclavian vein fistula in a three weeks old male infant who presented with congestive heart failure and pulmonary hypertension. He had been scanned by various imaging modalities including echocardiography, cardiac computed tomography, diagnostic cardiac catheterization, cardiac magnetic resonance angiocardiography and cranial computed tomoangiography. He had successful surgical ligation after failure of device occlusion trial at age of 9 months.

Ultrasound imaging versus conventional histopathology in diagnosis of periapical lesions of endodontic origin: A comparative evaluation.

Context: Accurate assessment of periapical status is critical in diagnosis, treatment planning, and evaluation of healing. Novel imaging modalities like sonography offer promising results with reduced radiation risks. Aims: To evaluate the potential of ultrasound imaging technique together with the application of color Doppler to differentiate between periapical lesions of endodontic origin. Materials and Methods: Twenty patients with periapical lesions of endodontic origin who were already scheduled for undergoing endodontic surgery were examined further using sonography. Color Doppler was performed to assess blood flow. Information on the size of the lesion, its content, and vascular supply was gained and recorded by means of ultrasound images. The sonographic images were analyzed and discussed with an expert sonologist, and a tentative diagnosis between a periapical cyst and periapical granuloma was made. Endodontic surgery and histopathological examination was done for each case and the results were compared. Results: The sonograms revealed the lesions within the bone in three dimensions and their contents, that is, fluids or tissues or blood vessels. Measurements of the periapical lesions in three dimensions were also obtained. Of the twenty cases studied, ultrasound could detect periapical granulomas in all 9 cases and radicular cysts in all 11 cases. Conclusion: Ultrasound imaging had the potential to be used for the evaluation of periapical lesions of endodontic origin. However, further studies are required to establish a definite correlation.

Graduating 4th year radiology residents' perception of optimal imaging modalities for neoplasm and trauma: a pilot study from four U.S. universities / Percepção de médicos residentes em radiologia de 4º ano sobre as melhores modalidades de imagem na investigação de neoplasias e trauma: um estudo piloto de quatro universidades americanas

OBJECTIVE: Our purpose was to assess 4th year radiology residents' perception of the optimal imaging modality to investigate neoplasm and trauma. MATERIALS AND METHODS: Twenty-seven 4th year radiology residents from four residency programs were surveyed. They were asked about the best imaging modality to evaluate the brain and spine, lungs, abdomen, and the musculoskeletal system. Imaging modalities available were MRI, CT, ultrasound, PET, and X-ray. All findings were compared to the ACR appropriateness criteria. RESULTS: MRI was chosen as the best imaging modality to evaluate brain, spine, abdominal, and musculoskeletal neoplasm in 96.3 percent, 100 percent, 70.4 percent, and 63 percent of residents, respectively. CT was chosen by 88.9 percent to evaluate neoplasm of the lung. Optimal imaging modality to evaluate trauma was CT for brain injuries (100 percent), spine (92.6 percent), lung (96.3 percent), abdomen (92.6 percent), and major musculoskeletal trauma (74.1 percent); MRI was chosen for sports injury (96.3 percent). There was agreement with ACR appropriateness criteria. CONCLUSION: Residents' perception of the best imaging modalities for neoplasm and trauma concurred with the appropriateness criteria by the ACR.

OBJETIVO: Avaliar a percepção de médicos residentes em radiologia de 4º ano sobre as melhores modalidades de imagem na investigação de neoplasias e trauma. MATERIAIS E MÉTODOS: Vinte e sete médicos residentes de 4º ano de quatro programas de residência em radiologia americanos participaram do estudo. Aos participantes foi perguntado sobre a melhor modalidade de imagem para se avaliar o cérebro e a coluna vertebral, pulmões, abdome e o sistema musculoesquelético. As modalidades de imagem disponíveis foram: RM, TC, ultrassonografia, PET e radiografia simples. Todos os achados foram comparados com os Critérios de Adequação de Exames de Imagem e Radioterapia do ACR. RESULTADOS: A RM foi escolhida como melhor modalidade de imagem para se avaliar neoplasias encefálicas, espinhais, abdominais e musculoesqueléticas por 96,3 por cento, 100 por cento, 70,4 por cento e 63 por cento dos residentes, respectivamente. A TC foi escolhida por 88,9 por cento dos residentes para avaliar neoplasias pulmonares. A modalidade de imagem ótima para se avaliar trauma foi a TC para lesões encefálicas (100 por cento), espinhais (92,6 por cento), pulmonares (96,3 por cento), abdominais (92,6 por cento) e grandes lesões traumáticas musculoesqueléticas (74,1 por cento); a RM foi escolhida para lesões esportivas (96,3 por cento). Observou-se concordância com os critérios de adequação do ACR. CONCLUSÃO: Houve concordância entre a percepção dos residentes sobre as melhores modalidades de imagem para avaliação de neoplasias e trauma e os critérios de adequação do ACR.

Risk factors for rupture and imaging advancement of abdominal aortic aneurysm / 中国介入影像与治疗学

Abdominal aortic aneurysm (AAA) is a common aortic disease causing death. Many factors are associated with AAA rupture, such as aneurysm diameter, shape, intraluminal thrombus, and hemodynamic changes. It has been shown that hemodynamic changes may be one of the main risk factors for AAA rupture. There are several imaging modalities to evaluate AAA, in which Doppler ultrasound and magnetic resonance blood flow imaging are capable of assessing the hemodynamic changes in AAA. This review will discuss the risk factors for rupture and imaging advancement of AAA.

Early Diagnosis of Hepatocellular Carcinoma Using lmaging Modalities

Hepatocellular carcinoma (HCC) is one of the most frequent primary malignancies in the world, and, particularly, it is common in the Far East. In the world, more than one million new cases of HCC are seen each year. The prognosis of patients with HCC is extremely poor with an average survival of about six months following the diagnosis. In order to improve the prognosis of HCC, early diagnosis should be attempted utilizing mass screening methods. Screening of a high-risk population with alpha-fetoprotein (AFP) along with non-invasive medical imaging modalities will lead to early diagnosis of HCC and subsequent improvement of survival. Indeed, recent advances in medical imaging techniques have increased the rate of detection of small HCCs, and such imaging modalities include ultrasonography(US), radionuclide imaging(RNI), computed tomography(CT), magnetic resonance imaging(MRI), and angiography. Each imaging method is reviewed with special emphasis on the early diagnosis of HCC.