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Ischaemic MR

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https://www.readbyqxmd.com/read/29426989/magnetic-resonance-post-contrast-vascular-hyperintensities-at-3-t-a-new-highly-sensitive-sign-of-vascular-occlusion-in-acute-ischaemic-stroke
#1
Loïc Duron, Julien Savatovsky, Michael Obadia, Marie Astrid Metten, Pascal Roux, Raphael Blanc, Jean-Claude Sadik, Sarah Dhundass, Augustin Lecler
BACKGROUND: Magnetic resonance imaging (MRI) is the diagnostic cornerstone for precisely identifying acute ischaemic strokes and locating vascular occlusions, especially since mechanical thrombectomy has become a reference treatment. We observed that a post-contrast three-dimensional turbo-spin-echo T1-weighted sequence showed striking post-contrast vascular hyperintensities (PCVH) in ischaemic territories. We aimed to evaluate the prevalence and the meaning of this finding. METHODS: This retrospective single centre study included 130 consecutive patients admitted for acute ischaemic stroke with a 3-T MRI performed in the first 12 h of symptom onset from September 2014 through September 2016...
February 9, 2018: European Radiology
https://www.readbyqxmd.com/read/29392098/patient-specific-coronary-blood-supply-territories-for-quantitative-perfusion-analysis
#2
Constantine Zakkaroff, John D Biglands, John P Greenwood, Sven Plein, Roger D Boyle, Aleksandra Radjenovic, Derek R Magee
Myocardial perfusion imaging, coupled with quantitative perfusion analysis, provides an important diagnostic tool for the identification of ischaemic heart disease caused by coronary stenoses. The accurate mapping between coronary anatomy and under-perfused areas of the myocardium is important for diagnosis and treatment. However, in the absence of the actual coronary anatomy during the reporting of perfusion images, areas of ischaemia are allocated to a coronary territory based on a population-derived 17-segment (American Heart Association) AHA model of coronary blood supply...
2018: Computer Methods in Biomechanics and Biomedical Engineering. Imaging & Visualization
https://www.readbyqxmd.com/read/29330587/posterior-reversible-encephalopathy-syndrome-with-spinal-cord-involvement-pres-sci-as-a-rare-complication-of-severe-diabetic-ketoacidosis-a-case-report-and-review-of-the-literature
#3
Jianfei Nao, Han Zhang, Si Wu, Xiaotian Zhang, Dongming Zheng
INTRODUCTION: In addition to diffuse brain oedema, diabetic ketoacidosis (DKA) can lead to ischaemic or haemorrhagic stroke, extrapontine myelinolysis, and sinovenous thrombosis. However, posterior reversible encephalopathy syndrome (PRES) and spinal cord oedema are rarely reported in patients with DKA. METHODS: We present a case of a 17-year-old-girl who developed headache, blurred vision, and paraplegia after her DKA was controlled. Sequential magnetic resonance (MR) scans of the brain and spinal cord were performed...
January 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29328848/high-risk-endovascular-aneurysm-repair-a-case-report
#4
Samanthi De Silva
Mr AB is a 66-year old gentleman who presented for elective endovascular aneurysm repair (EVAR) following a routine screening scan identifying a 5.5cm abdominal aortic aneurysm (AAA). He had a past history of chronic obstructive pulmonary disease (COPD) with FEV1/FVC ratio of 48% on pre-assessment. He was hypertensive with a history of ischaemic heart disease (IHD), which has remained asymptomatic following coronary artery bypass grafting (CABG) eight years prior to this presentation.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29316375/selection-criteria-for-endovascular-therapy-for-acute-ischaemic-stroke-are-patients-missing-out
#5
Julian Maingard, Leonid Churilov, Peter Mitchell, Richard Dowling, Bernard Yan
INTRODUCTION: Endovascular clot retrieval (ECR) following intravenous thrombolysis is superior to intravenous thrombolysis alone for acute stroke with large vessel occlusion. However, trial selection criteria may exclude potentially salvageable patients. We investigated the impact of published selection criteria on the different proportions of patients excluded and clinical outcome. METHODS: We included patients with anterior circulation stroke treated with ECR from a single centre...
January 9, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29259787/renin-angiotensin-system-inhibitors-in-patients-with-or-without-ischaemic-mitral-regurgitation-after-acute-myocardial-infarction
#6
Kitae Kim, Shuichiro Kaji, Manabu Kasamoto, Ryosuke Murai, Yasuhiro Sasaki, Takeshi Kitai, Takafumi Yamane, Natsuhiko Ehara, Atsushi Kobori, Makoto Kinoshita, Yutaka Furukawa
Objective: Little is known about the long-term effects of renin-angiotensin system inhibitors (RASI) on cardiovascular events in patients after acute myocardial infarction (AMI) with ischaemic mitral regurgitation (IMR). The purpose of this study was to investigate the association of RASI with the incidence of adverse cardiac events in patients with or without IMR after AMI. Methods: We reviewed charts of 1208 consecutive patients admitted with AMI who underwent emergency coronary angiography between 2000 and 2012...
2017: Open Heart
https://www.readbyqxmd.com/read/29232365/monitoring-compliance-with-standards-of-care-for-chronic-diseases-using-healthcare-administrative-databases-in-italy-strengths-and-limitations
#7
Rosa Gini, Martijn J Schuemie, Alessandro Pasqua, Emanuele Carlini, Francesco Profili, Iacopo Cricelli, Patrizio Dazzi, Valentina Barletta, Paolo Francesconi, Francesco Lapi, Andrea Donatini, Giulia Dal Co, Modesta Visca, Mariadonata Bellentani, Miriam Sturkenboom, Niek Klazinga
BACKGROUND: A recent comprehensive report on healthcare quality in Italy published by the Organization of Economic Co-operation and Development (OECD) recommended that regular monitoring of quality of primary care by means of compliance with standards of care for chronic diseases is performed. A previous ecological study demonstrated that compliance with standards of care could be reliably estimated on regional level using administrative databases. This study compares estimates based on administrative data with estimates based on GP records for the same persons, to understand whether ecological fallacy played a role in the results of the previous study...
2017: PloS One
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#8
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28844055/what-is-mr-spectroscopy
#9
Karen Angela Manias, Andrew Peet
(1)H-Magnetic Resonance Spectroscopy (MRS) is a novel advanced imaging technique used as an adjunct to MRI to reveal complementary non-invasive information about the biochemical composition of imaged tissue. Clinical uses in paediatrics include aiding diagnosis of brain tumours, neonatal disorders such as hypoxic-ischaemic encephalopathy, inherited metabolic diseases, traumatic brain injury, demyelinating conditions and infectious brain lesions. MRS has potential to improve diagnosis and treatment monitoring of childhood brain tumours and other CNS diseases, facilitate biopsy and surgical planning, and provide prognostic biomarkers...
August 26, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/28835250/dark-blood-late-gadolinium-enhancement-without-additional-magnetization-preparation
#10
Robert J Holtackers, Amedeo Chiribiri, Torben Schneider, David M Higgins, René M Botnar
BACKGROUND: This study evaluates a novel dark-blood late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) method, without using additional magnetization preparation, and compares it to conventional bright-blood LGE, for the detection of ischaemic myocardial scar. LGE is able to clearly depict myocardial infarction and macroscopic scarring from viable myocardium. However, due to the bright signal of adjacent left ventricular blood, the apparent volume of scar tissue can be significantly reduced, or even completely obscured...
August 23, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28800758/validation-of-verbal-autopsy-determination-of-cause-of-deaths-in-malaysia-2013
#11
Shubash Shander Ganapathy, Khoo Yi Yi, Mohd Azahadi Omar, Mohamad Fuad Mohamad Anuar, Chandrika Jeevananthan, Chalapati Rao
BACKGROUND: Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities...
August 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28776469/relationship-between-haemodynamic-impairment-and-collateral-blood-flow-in-carotid-artery-disease
#12
Nolan S Hartkamp, Esben T Petersen, Michael A Chappell, Thomas W Okell, Maarten Uyttenboogaart, Clark J Zeebregts, Reinoud Ph Bokkers
Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial arterial spin labeling (ASL) imaging...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28708196/assessment-of-mitral-apparatus-in-patients-with-acute-inferoposterior-myocardial-infarction-and-ischaemic-mitral-regurgitation-with-two-dimensional-echocardiography-from-anatomically-correct-imaging-planes
#13
Karolina Mėlinytė, Živile Valuckiene, Renaldas Jurkevičius
BACKGROUND: Ischaemic mitral regurgitation (IMR) is associated with adverse prognosis after myocardial infarction (MI) as a result of left ventricular remodelling and geometric deformation of the mitral apparatus (MA). AIM: The aim of this study was to assess MA from anatomically correct imaging planes in acute inferoposterior MI and IMR. METHODS: Ninety-three patients with no structural cardiac valve abnormalities and the first acute inferoposterior MI were prospectively enrolled into the study...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28540481/impact-of-perfusion-lesion-in-corticospinal-tract-on-response-to-reperfusion
#14
Ying Zhou, Ruiting Zhang, Sheng Zhang, Shenqiang Yan, Ze Wang, Bruce C V Campbell, David S Liebeskind, Min Lou
OBJECTIVES: We aimed to examine the impact of corticospinal tract (CST) involvement in acute ischaemic stroke (AIS) patients on functional outcome and the interaction with reperfusion. METHODS: We retrospectively examined data in consecutive anterior circulation AIS patients undergoing thrombolysis. MR perfusion (time to maximum of tissue residue function, Tmax) and apparent diffusion coefficient (ADC) images were transformed into standard space and the volumes of CST involvement by Tmax > 6 s (CST-Tmax) and ADC < 620 × 10(-6) mm(2)/s (CST-ADC) lesions were calculated...
December 2017: European Radiology
https://www.readbyqxmd.com/read/28536224/impella-percutaneous-left-ventricular-assist-device-for-severe-acute-ischaemic-mitral-regurgitation-as-a-bridge-to-surgery
#15
Bilal Jalil, Karim El-Kersh, Jarrod Frizzell, Shozab Ahmed
Ischaemic papillary muscle rupture causing acute severe mitral regurgitation (MR) has a dramatic presentation and a very high mortality. Emergent surgical repair improves outcomes, which necessitates robust preoperative stabilisation. Here we discuss a patient with cardiogenic shock with an acute severe MR that was deemed very high risk for emergent valve replacement due to haemodynamic instability and respiratory failure. A percutaneous left ventricular assist device Impella 2.5 (Abiomed, Danvers, MA) drastically improved clinical status, and the patient underwent a successful surgical mitral valve replacement soon after placement of the temporary assist device...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28468840/selection-of-patients-for-intra-arterial-treatment-for-acute-ischaemic-stroke-development-and-validation-of-a-clinical-decision-tool-in-two-randomised-trials
#16
RANDOMIZED CONTROLLED TRIAL
Esmee Venema, Maxim J H L Mulder, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Bart J Emmer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
Objective To improve the selection of patients with acute ischaemic stroke for intra-arterial treatment using a clinical decision tool to predict individual treatment benefit.Design Multivariable regression modelling with data from two randomised controlled clinical trials.Setting 16 hospitals in the Netherlands (derivation cohort) and 58 hospitals in the United States, Canada, Australia, and Europe (validation cohort).Participants 500 patients from the Multicenter Randomised Clinical Trial of Endovascular Treatment for Acute Ischaemic Stroke in the Netherlands trial (derivation cohort) and 260 patients with intracranial occlusion from the Interventional Management of Stroke III trial (validation cohort)...
May 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#17
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28347575/validation-of-a-basic-neurosonology-laboratory-for-detecting-cervical-carotid-artery-stenosis
#18
C de la Cruz Cosme, M S Dawid Milner, G Ojeda Burgos, A Gallardo Tur, M Márquez Martínez, T Segura
INTRODUCTION: Most of the cases of ischaemic stroke in our setting are of atherothrombotic origin. Detecting intracranial and cervical carotid artery stenosis in patients with ischaemic stroke is therefore essential. Ultrasonography has become the tool of choice for diagnosing carotid artery stenosis because it is both readily accessibility and reliable. However, use of this technique must be validated in each laboratory. The purpose of this study is to validate Doppler ultrasound in our laboratory as a means of detecting severe carotid artery stenosis...
March 24, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28336740/towards-personalised-intra-arterial-treatment-of-patients-with-acute-ischaemic-stroke-a-study-protocol-for-development-and-validation-of-a-clinical-decision-aid
#19
Maxim J H L Mulder, Esmee Venema, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
INTRODUCTION: Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. METHODS AND ANALYSIS: We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and treatment effect...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28329173/mitral-valve-repair-for-secondary-mitral-regurgitation-in-non-ischaemic-dilated-cardiomyopathy-is-associated-with-left-ventricular-reverse-remodelling-and-increase-of-forward-flow
#20
Vasileios Kamperidis, Suzanne E van Wijngaarden, Philippe J van Rosendael, William Kok Fai Kong, Madelien V Regeer, Frank van der Kley, Georgios Sianos, Nina Ajmone Marsan, Jeroen J Bax, Victoria Delgado
Aims: It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischaemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. We hypothesized that mitral valve repair improves LV systolic function and forward flow and induces LV reverse remodelling in this group of patients. Methods and results: Seventy-six patients (65 ± 14 years old, 43% male) with non-ischaemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated...
February 23, 2017: European Heart Journal Cardiovascular Imaging
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