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https://www.readbyqxmd.com/read/27918576/respect-ed-rates-of-pulmonary-emboli-pe-and-sub-segmental-pe-with-modern-computed-tomographic-pulmonary-angiograms-in-emergency-departments-a-multi-center-observational-study-finds-significant-yield-variation-uncorrelated-with-use-or-small-pe-rates
#1
David Mountain, Gerben Keijzers, Kevin Chu, Anthony Joseph, Catherine Read, Gabriel Blecher, Jeremy Furyk, Chrianna Bharat, Karthik Velusamy, Andrew Munro, Kylie Baker, Frances Kinnear, Ahses Mukherjee, Gina Watkins, Paul Buntine, Georgia Livesay, Daniel Fatovich
INTRODUCTION: Overuse of CT Pulmonary Angiograms (CTPA) for diagnosing pulmonary embolism (PE), particularly in Emergency Departments (ED), is considered problematic. Marked variations in positive CTPA rates are reported, with American 4-10% yields driving most concerns. Higher resolution CTPA may increase sub-segmental PE (SSPE) diagnoses, which may be up to 40% false positive. Excessive use and false positives could increase harm vs. benefit. These issues have not been systematically examined outside America...
2016: PloS One
https://www.readbyqxmd.com/read/27911228/erratum-screening-via-ct-angiogram-after-traumatic-cervical-spine-fractures-narrowing-imaging-to-improve-cost-effectiveness-experience-of-a-level-i-trauma-center
#2
Gabriel A Smith
No abstract text is available yet for this article.
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27911224/letter-to-the-editor-screening-via-ct-angiogram-and-cervical-spine-fractures
#3
Xiao Wu, David Durand, Vivek B Kalra, Sowmya Mahalingam, Ajay Malhotra
No abstract text is available yet for this article.
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27908793/why-are-nearly-all-ct-pulmonary-angiograms-for-suspected-pulmonary-embolism-negative
#4
EDITORIAL
James E Dalen, Anna L Waterbrook
No abstract text is available yet for this article.
November 28, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27906915/the-value-of-ct-cardiac-angiography-and-ct-calcium-score-testing-in-a-modern-cardiology-service-in-new-zealand-a-report-of-a-single-centre-eight-year-experience-from-5-237-outpatient-procedures
#5
Chris Ellis, Greg Gamble, Colin Edwards, Niels van Pelt, Ruvin Gabriel, Boris Lowe, Jonathan Christiansen, Andrew To, Helen Winch, Mark Osborne, John Ormiston, Malcolm Legget
BACKGROUND: Computed tomographic (CT) cardiac angiography is of increasing value in several areas of patient management in cardiology. We assessed the ability of CT cardiac angiography to effectively 'rule out' severe coronary stenoses in patients presenting with 'atypical' symptoms and/or an equivocal stress test, which offers a new approach to the management of coronary artery disease. We also examined the use of the CT calcium score test in cardiovascular (CVS) risk assessment. METHODS: From a large single centre (Mercy Hospital) in Auckland, using a prospectively acquired, comprehensive database, we audited the entire eight-year experience of 5,169 patients (7/8/06 to 31/1/14) who underwent 5,237 64-slice computed tomographic (CT) cardiac angiogram or CT calcium score tests (GE Lightspeed scanner)...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27900349/symptomatic-bilateral-coronary-artery-fistula-to-pulmonary-artery-in-elderly-patient
#6
Francisco Pereira da Silva, Paulo Donato, Henrique Donato, Elisabete Jorge, Maria Joao Ferreira, Filipe Caseiro-Alves
We report the imaging findings of an uncommon coronary vascular termination anomaly, with fistula to the pulmonary artery. This 70 year old female patient presented unstable angina, showing a coronary artery fistula depicted in coronary angiogram from the left coronary to the pulmonary artery, with no significant atherosclerotic pathology. Due to development of ventricular tachycardia in stress echocardiogram examination, she was proposed for coronary fistula closure. Coronary CT was performed for procedure planning and allowed the identification of a second unsuspected fistula from the right coronary to the right pulmonary artery...
2016: European Journal of Radiology Open
https://www.readbyqxmd.com/read/27893633/the-study-of-medial-superficial-perforator-of-the-superficial-circumflex-iliac-artery-perforator-flap-using-ct-angiography-and-surgical-anatomy-in-142-patients
#7
Hyun Suk Suh, Hyung Hwa Jeong, Joon Pio Hong
BACKGROUND: The two major perforators supplying the superficial circumflex iliac artery perforator (SCIP) flap are the medial (superficial) and lateral (deep) perforators but lacks detailed description. The purpose of this study was to clarify the anatomy. MATERIAL AND METHOD: In a prospective analysis of 142 patients, CT angiograms of 284 SCIP regions were evaluated and 142 SCIP flaps were surgically correlated. The origin of the SCIA, the origin of the medial perforator, the location where it penetrates the deep fascia, and its pattern of pathway after penetration of the superficial fascia were evaluated...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27885318/multiscale-opening-of-conjoined-fuzzy-objects-theory-and-applications
#8
Punam K Saha, Subhadip Basu, Eric A Hoffman
Theoretical properties of a multi-scale opening (MSO) algorithm for two conjoined fuzzy objects are established, and its extension to separating two conjoined fuzzy objects with different intensity properties is introduced. Also, its applications to artery/vein (A/V) separation in pulmonary CT imaging and carotid vessel segmentation in CT angiograms (CTAs) of patients with intracranial aneurysms are presented. The new algorithm accounts for distinct intensity properties of individual conjoined objects by combining fuzzy distance transform (FDT), a morphologic feature, with fuzzy connectivity, a topologic feature...
October 2016: IEEE Transactions on Fuzzy Systems: a Publication of the IEEE Neural Networks Council
https://www.readbyqxmd.com/read/27876658/stenting-for-carotid-web-a-case-report
#9
R Martínez-Pérez, S P Lownie, S Pandey, M R Boulton
BACKGROUND: The carotid web is an intraluminal shelf-like projection arising from the posterior wall of the carotid bifurcation, and is an uncommon etiology of ischemic strokes. Our objective is to describe the feasibility of endovascular stenting to treat this condition CASE REPORT: In a 47-year-old female with a sudden occlusion of her right middle cerebral artery. CT angiogram and digital subtraction angiography showed the presence of a carotid web in the ipsilateral carotid bifurcation...
November 19, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27866279/high-risk-carotid-plaques-identified-by-ct-angiogram-can-predict-acute-myocardial-infarction
#10
Wassim Mosleh, Keenan Adib, Punnanithinont Natdanai, Andres Carmona-Rubio, Roshan Karki, Jacienta Paily, Mohamed Abdel-Aal Ahmed, Sujit Vakkalanka, Narasa Madam, Gregory D Gudleski, Charles Chung, Umesh C Sharma
Prior studies identified the incremental value of non-invasive imaging by CT-angiogram (CTA) to detect high-risk coronary atherosclerotic plaques. Due to their superficial locations, larger calibers and motion-free imaging, the carotid arteries provide the best anatomic access for the non-invasive characterization of atherosclerotic plaques. We aim to assess the ability of predicting obstructive coronary artery disease (CAD) or acute myocardial infarction (MI) based on high-risk carotid plaque features identified by CTA...
November 19, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27863899/ct-angiography-post-processed-contrast-enhancement-for-improved-detection-of-pulmonary-embolism
#11
Daniela Muenzel, Alexander A Fingerle, Tina Zahel, Andreas Sauter, Alain Vlassenbroek, Martin Dobritz, Ernst J Rummeny, Peter B Noël
RATIONALE AND OBJECTIVES: The study aimed to improve the detection of pulmonary embolism via an iodine contrast enhancement tool in patients who underwent suboptimal enhanced computed tomography angiography (CTA). MATERIALS AND METHODS: We evaluated the CT examinations of 41 patients who underwent CTA for evaluation of the pulmonary arteries which suffered from suboptimal contrast enhancement. The contrast enhancement of the reconstructed images was increased via a post-processing tool (vContrast)...
November 15, 2016: Academic Radiology
https://www.readbyqxmd.com/read/27847770/delayed-rebleeding-of-cerebral-aneurysm-misdiagnosed-as-traumatic-subarachnoid-hemorrhage
#12
Seung-Yoon Song, Dae-Won Kim, Jong-Tae Park, Sung-Don Kang
An intracranial saccular aneurysm is uncommonly diagnosed in a patient with closed head trauma. We herein present a patient with delayed rebleeding of a cerebral aneurysm misdiagnosed as traumatic subarachnoid hemorrhage (SAH). A 26-year-old female visited our emergency department because of headache after a motorcycle accident. Brain computed tomography (CT) showed a right-side dominant SAH in Sylvian fissure. Although traumatic SAH was strongly suggested because of the history of head trauma, we performed a CT angiogram to exclude any vascular abnormalities...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27843762/dangers-of-flying-high-and-diving-low-an-unusual-case-of-dyspnea
#13
Poornima Ramadas, Rumon Chakravarty, Prathik Krishnan, Anupa Nadkarni
Giant bullae are bullae that occupy at least 30 percent of a hemi thorax. This condition can rarely be idiopathic and not usually suspected in young patients with no risk factors. We describe a case of a giant solitary pulmonary bulla in a healthy young female with no known risk factors. 23-year-old female presented to the Emergency department with dyspnea and pleuritic right sided chest pain. She started experiencing these symptoms when she was on a 7-h flight and later experienced similar symptoms when she went scuba diving...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27833712/partially-thrombosed-internal-maxillary-pseudoaneurysm-after-gunshot-wound
#14
Menachem Gold
A 29-year-old man arrived in our emergency department after being shot on the face. Computed tomography (CT) revealed multiple facial bone fractures along the bullet trajectory. On day 10 of admission, CT angiogram of the neck revealed a partially thrombosed pseudoaneurysm in the parapharyngeal fat pad. The pseudoaneurysm was successfully treated with coil embolization. This report discusses diagnosis and treatment of a partially thrombosed internal maxillary artery pseudoaneurysm. Although digital subtraction angiography is the gold standard for pseudoaneurysm diagnosis, CT angiography may provide complimentary information, as seen in this case...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27831844/dual-energy-ct-in-emergency-neuroimaging-added-value-and-novel-applications
#15
Christopher A Potter, Aaron D Sodickson
Dual-energy computed tomography (CT) is a powerful diagnostic tool that is becoming more widely clinically available. Dual-energy CT has the potential to aid in the detection or add diagnostic confidence in the evaluation of a variety of emergent neurologic conditions with use of postprocessing techniques that allow one to take advantage of the different x-ray energy-dependent absorption behaviors of different materials. Differentiating iodine from hemorrhage may help in delineating CT angiographic spot signs, which are small foci of intracranial hemorrhage seen on CT angiograms in cases of acute hemorrhage...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27797837/phaeochromocytoma-presenting-as-an-acute-coronary-syndrome
#16
Towhid Imam, Philip Finny, Alan Choo-Kang, Rehman Khan
A 44-year-old Caucasian man presented to the emergency department in acute cardiogenic shock, with pulmonary oedema, secondary to an acute myocardial infarction and in a hyperosmolar hyperglycaemic state. The previous day he had undergone a colonoscopy, which revealed features of colitis, and was started on prednisolone. He had been previously diagnosed with type 2 diabetes, migraine and anxiety attacks. While awaiting a coronary angiogram he developed abdominal pain and a CT scan was performed and found a large right adrenal mass...
October 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27795862/malignant-hypertensive-retinopathy-in-an-infant-with-mid-aortic-occlusion
#17
Lawrence J Oh, Gaurav Bhardwaj, David S Winlaw, Craig E Donaldson
Purpose. Case report describing an eight-month-old infant presenting with intermittent esotropia and irritability who was found to have malignant (grade 4) hypertensive retinopathy and mid-aortic syndrome. Methods. Visual acuity was 6/140 in the right eye and not recordable in the left eye. Blood pressure was as high as 230/120 mmHg. Fundoscopy revealed bilateral optic disc swelling, macular stars, and serous retinal detachment in the left eye, findings that are consistent with malignant (grade 4) hypertensive retinopathy...
2016: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/27793158/clinical-and-echocardiographic-predictors-of-mortality-in-acute-pulmonary-embolism
#18
Talal Dahhan, Irfan Siddiqui, Victor F Tapson, Eric J Velazquez, Stephanie Sun, Clemontina A Davenport, Zainab Samad, Sudarshan Rajagopal
PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a diagnosis of acute PE, based on a positive ventilation perfusion scan or computed tomography (CT) chest angiogram, were identified using the Duke University Hospital Database. Of these, 69 had echocardiograms within 24-48 h of the diagnosis that were suitable for offline analysis...
October 28, 2016: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27789550/obscure-upper-gastrointestinal-haemorrhage-haemosuccus-pancreaticus
#19
Prateush Singh, Asim Khan, Manuel Jasper, Javaid Subhani
A Caucasian man aged 28 years with a history of pancreatitis presented with fatigue, intermittent melaena and severe anaemia. Symptomatic treatment for anaemia was coupled with thorough investigation to localise the source of gastrointestinal haemorrhage. Two oesophagogastroduodenoscopies and colonoscopies failed to identify a cause. CT abdomen revealed splenomegaly secondary to splenic vein thrombosis with evidence of portal hypertension and small collateral vessels. A CT mesenteric angiogram revealed a splenic artery pseudoaneurysm as the likely source of bleeding...
October 27, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27783043/progressive-vascular-functional-and-structural-damage-in-a-bronchopulmonary-dysplasia-model-in-preterm-rabbits-exposed-to-hyperoxia
#20
Julio Jiménez, Jute Richter, Taro Nagatomo, Thomas Salaets, Rozenn Quarck, Allard Wagennar, Hongmei Wang, Jeroen Vanoirbeek, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) is caused by preterm neonatal lung injury and results in oxygen dependency and pulmonary hypertension. Current clinical management fails to reduce the incidence of BPD, which calls for novel therapies. Fetal rabbits have a lung development that mimics humans and can be used as a translational model to test novel treatment options. In preterm rabbits, exposure to hyperoxia leads to parenchymal changes, yet vascular damage has not been studied in this model. In this study we document the early functional and structural changes of the lung vasculature in preterm rabbits that are induced by hyperoxia after birth...
October 24, 2016: International Journal of Molecular Sciences
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