ABSTRACT
Background: Cavernous angiomas (CAs) are abnormal, congenital, vascular malformations, which often grow in size over the course of life. Conservative treatment, microsurgical resection, and stereotactic radiosurgery are the three main options for treatment of CA. Radiological studies play a key role in diagnosis, with magnetic resonance (MR) being the method of choice. Objective: The aim of this study was to establish the prevalence of cavernous angiomas, the size, appearance, that is, the type of CAs and to determine visualization of cavernous angiomas by magnetic resonance. Methods: The study included all patients who underwent an MR of the brain in the period from January 2011 to the end of December 2017 at the Radiology Clinic of Tuzla University Clinical Centre, and in whom MR examination verified one or more CAs. Results: The prevalence of cavernous angioma in the study was 0.57%, and men and women were equally represented. The number of cavernous angiomas per patient was between 1 and 79 ; the average diameter was 11mm, and the most common type at ≥ 3mm was equivalent to Type II, whilst the largest number of cavernous angiomas, regardless of the size and visualization on individual sequences, were equivalent to Type IV. No significant difference was found in sensitivity between spin echo sequence and T2W gradient echo sequence in the group comprised of cavernous angiomas ≥ 3mm, whilst in the group comprised of punctiform cavernomas < 3mm, T2W* was a significantly more sensitive sequence than spin echo, that is, spin echo sequence had significantly lower sensitivity in the detection of punctiform CAs. Conclusion: The prevalence of CAs was in line with the results of other studies. T2W* sequence is significantly more sensitive in comparison with spin echo only in the detection of punctiform CAs, and is important in the detection of multiple familiar CAs.
ABSTRACT
Although it is possible to find a number of comparative studies in the world literature discussing the results of coronary artery bypass surgery (CABG) with and without cardiopulmonary bypass (CPB), until now such analysis has not been made in Bosnia and Herzegovina. The main aim of this scientific work was to compare morbidity and mortality, need for blood transfusions, length of stay in the intensive care unit, total length of hospitalisation and number of complication in two groups of patients operated with these methods. Patients with EuroScore > or =5 with CABG operated in Cardiovascular Clinic Tuzla, from May 2000 to May 2005 divided in two groups, were included in this study. There were 100 patients in the first group operated with CPB and 100 patients in the second group operated without CPB. The average time spent on respirators was shorter in patients operated without CPB (3.7 vs.9.74 hours, p = 0.023) and the time spent in Intensive care shorter too (19 vs. 23 days, p = 0.008). Volume of postoperative bleeding was less in patients operated without CPB (574.9 vs. 988.9 ml, p = 0.038), as volume after blood transfusion (168.8 vs. 350.3 mi, p = 0.001). Intraoperative inotrope support was less in patients operated without CPB (8.0 vs. 19.0%, p = 0.038) as postoperative inotrope support (6.0 vs. 17.0%, p = 0.027). The most usual postoperative complication was atrial fibrillation and there was no difference between patients operated with CPB and without CPB (24% vs. 17%, p = 0.293). Mortality was not different in patients operated with or without CPB (2.0% vs. 6.0%, p = 0.140). The average time of total hospitalisation was also shorter in patients operated without CPB (8.0 vs. 9.5 days, p = 0.039. In conclusion CABG without CPB has many advantages compared to the conventional method. Mortality and morbidity are reduced and there is less need for transfusion. The time spent on mechanical ventilation is reduced and less time is spent in intensive care. The total hospitalisation time is also reduced.
