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Ischaemic MR

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https://www.readbyqxmd.com/read/29556767/three-dimensional-black-blood-contrast-enhanced-mri-improves-detection-of-intraluminal-thrombi-in-patients-with-acute-ischaemic-stroke
#1
Won Jang, Hyo Sung Kwak, Gyung Ho Chung, Seung Bae Hwang
OBJECTIVES: This study evaluated the utility of three-dimensional (3D), black-blood (BB), contrast-enhanced, magnetic resonance imaging (MRI) for the detection of intraluminal thrombi in acute stroke patients. METHODS: Forty-seven patients with acute stroke involving the anterior circulation underwent MRI examination within 6 h of clinical onset. Cerebral angiography was used as the reference standard. In a blinded manner, two neuroradiologists interpreted the following three data sets: (1) diffusion-weighted imaging (DWI) + 3D BB contrast-enhanced MRI; (2) DWI + susceptibility weighted imaging (SWI); (3) DWI + 3D BB contrast-enhanced MRI + SWI...
March 19, 2018: European Radiology
https://www.readbyqxmd.com/read/29556351/perfluorocarbon-enhanced-glasgow-oxygen-level-dependent-gold-magnetic-resonance-metabolic-imaging-identifies-the-penumbra-following-acute-ischemic-stroke
#2
Graeme A Deuchar, David Brennan, William M Holmes, Martin Shaw, I Mhairi Macrae, Celestine Santosh
The ability to identify metabolically active and potentially salvageable ischaemic penumbra is crucial for improving treatment decisions in acute stroke patients. Our solution involves two complementary novel MRI techniques (Glasgow Oxygen Level Dependant (GOLD) Metabolic Imaging), which when combined with a perfluorocarbon (PFC) based oxygen carrier and hyperoxia can identify penumbra due to dynamic changes related to continued metabolism within this tissue compartment. Our aims were (i) to investigate whether PFC offers similar enhancement of the second technique (Lactate Change) as previously demonstrated for the T2 *OC technique (ii) to demonstrate both GOLD metabolic imaging techniques working concurrently to identify penumbra, following administration of Oxycyte® (O-PFC) with hyperoxia...
2018: Theranostics
https://www.readbyqxmd.com/read/29529191/overview-of-mitral-regurgitation-in-europe-results-from-the-european-registry-of-mitral-regurgitation-eumiclip
#3
Juan Manuel Monteagudo Ruiz, Maurizio Galderisi, Agostino Buonauro, Luigi Badano, Patrizia Aruta, Martin J Swaans, Laura Sanchis, Antti Saraste, Mark Monaghan, Konstantinos C Theodoropoulos, Michael Papitsas, Noah Liel-Cohen, Sergio Kobal, Mojca Bervar, Boštjan Berlot, Gerasimos Filippatos, Ignatios Ikonomidis, Spyridon Katsanos, Felix C Tanner, Daniela Cassani, Francesco F Faletra, Laura A Leo, Amparo Martinez, Javier Matabuena, Antonio Grande-Trillo, David Alonso-Rodriguez, Dolores Mesa, Teresa Gonzalez-Alujas, Marta Sitges, Fernando Carrasco-Chinchilla, Chi Hion Li, Covadonga Fernandez-Golfin, José Luis Zamorano
Aims: To determine the prevalence of mitral regurgitation (MR) in a large cohort of consecutive patients undergoing clinically indicated echocardiography and to examine the distribution of primary and secondary MR. Methods and results: All patients undergoing an echocardiographic study in 19 European centres within a 3-month period were prospectively included. MR assessment was performed as recommended by the European Association of Cardiovascular Imaging (EACVI)...
February 23, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29523557/endovascular-treatment-for-acute-ischaemic-stroke-in-routine-clinical-practice-prospective-observational-cohort-study-mr-clean-registry
#4
MULTICENTER STUDY
Ivo G H Jansen, Maxim J H L Mulder, Robert-Jan B Goldhoorn
OBJECTIVE: To determine outcomes and safety of endovascular treatment for acute ischaemic stroke, due to proximal intracranial vessel occlusion in the anterior circulation, in routine clinical practice. DESIGN: Ongoing, prospective, observational cohort study. SETTING: 16 centres that perform endovascular treatment in the Netherlands. PARTICIPANTS: 1488 patients included in the Multicentre Randomised Controlled Trial of Endovascular Treatment for Acute Ischaemic Stroke in the Netherlands (MR CLEAN) Registry who had received endovascular treatment, including stent retriever thrombectomy, aspiration, and all alternative methods for acute ischaemic stroke within 6...
March 9, 2018: BMJ: British Medical Journal
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
#5
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
#6
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
#7
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...
April 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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