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Hashikata H, Maki Y, Ishibashi R, Toda H. Interactive spinal computed tomography angiography-guided spinal digital subtraction angiography and embolization for thoracolumbar epidural arteriovenous fistulas: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 4:CASE22275. [PMID: 36593676 PMCID: PMC9514287 DOI: 10.3171/case22275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/12/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Spinal digital subtraction angiography (sDSA) is the gold standard for examining spinal arteriovenous fistulas; however, thorough sDSA evaluations of spinal arteriovenous fistulas require a long procedure, which may increase the radiation exposure time. OBSERVATIONS A 72-year-old man presented with progressive myelopathy due to a spinal epidural arteriovenous fistula. Spinal computed tomography angiography (sCTA) showed an epidural arteriovenous fistula fed by the left L3 segmental artery. To prepare for sDSA, the sCTA images were modified to mark the segmental artery bifurcations from T5 to L5 with multicolored markers. These modified sCTA images were loaded onto the multiwindow DSA display. The sCTA images were interactively modulated during sDSA. This sCTA-guided sDSA identified 18 segmental arteries within 47 minutes. The total radiation exposure was 1,292 mGy. Subsequently, transarterial embolization resolved the epidural arteriovenous fistula with clinical improvement. LESSONS Three-dimensional sCTA can provide detailed anatomical information before sDSA. Modified sCTA images with segmental artery bifurcation marking can provide interactive guidance on multipanel DSA displays. sCTA-guided sDSA is useful for accurate catheterization and reduction of procedure time.
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Affiliation(s)
- Hirokuni Hashikata
- Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Yoshinori Maki
- Department of Neurosurgery, Hikone Chuo Hospital, Hikone City, Japan; and ,Department of Rehabilitation, Hikari Hospital, Saikawa Otsu City, Japan
| | - Ryota Ishibashi
- Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Hiroki Toda
- Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
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Evangelista L, Giuliani L, Pagliei V, Varrassi M, Bruno F, Palumbo P, Arrigoni F, Splendiani A, Di Cesare E, Masciocchi C, Barile A. When to perform vertebroplasty? A retrospective analysis from a single center and a review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021402. [PMID: 34505841 PMCID: PMC8477064 DOI: 10.23750/abm.v92is5.11955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM To establish an optimal timing for vertebroplasty in order to obtain a clinically important pain reduction and improving quality of live in patients with osteoporotic or traumatic vertebral fractures. METHODS This study includes 22 vertebroplasty procedures performed from October 2018 to July 2020 in 21 patients with traumatic or osteoporotic vertebral fractures (19 female, two men; age between 53 and 89 years). All treatments were executed under fluoroscopic guidance using 11 or 13 G needle through transpedicular or costovertebral unilateral approach. Each patient underwent conscious sedation, continuously monitored by an anesthesiologist. Preoperative MRI images, obtained by 3T or 1.5T MRI scanner, always showed bone marrow edema. The VAS scale and Roland Morris disability questionnaire (RMdq) were administered to patients before and after the treatment to evaluate pain and life quality. RESULTS 7 patients were treated in the first month after the injury, one was treated twice; 8 patients in the second month, 6 in the third. We observed a reduction of: 5.5 points in the vas scale, 10.3 in the RMdq in the first month; 5.6 points vas, 11.6 points RMdq in the second month; 4 points vas and 9.75 points RMdq in the third month. CONCLUSIONS This study demostrated that, in our preliminary experience, vertebroplasty has the best outcome if performed at 2 months from injury.
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Affiliation(s)
- Laura Evangelista
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Luca Giuliani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Valeria Pagliei
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Marco Varrassi
- Neuroradiology and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM) - SIRM Foundation, via della Signora 2, Milan, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM) - SIRM Foundation, via della Signora 2, Milan, Italy.
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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Pagliei V, Bruno F, Battista G, Iacopino A, Riva C, Arrigoni F, Palumbo P, Bardi L, Carbone M, Di Cesare E, Masciocchi C, Splendiani A, Barile A. Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021404. [PMID: 34505843 PMCID: PMC8477063 DOI: 10.23750/abm.v92is5.11877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022]
Abstract
Background and aim: Considering the high rate of mortality and permanent disability related to vertebral traumas, an early and detailed diagnosis of the trauma and subsequently an immediate and effective intervention are crucial. Cervical vertebral injury classifications guide treatment choice through a severity grade based on radiological information. The purpose of the present study was to define which imaging classification system could provide the best morphological and clinical-surgical correlations for cervical spine traumas. Methods: We retrospectively analyzed patients evaluated for cervical spine trauma at our Institution in the period 2015-2020. Information regarding the morphological examination (using CT and MRI), the neurological evaluation, and the therapeutic management were collected. C3-C7 fractures were classified according to the SLIC and AOSpine criteria; axial lesions were classified according to the modified AOSpine for the C1-C2 compartment and through the Roy-Camille and the Anderson D’Alonzo system for the odontoid process of the axis. Results: 29 patients were included in the final study population. Nine patients with axial spine trauma and 21 with subaxial cervical spine trauma. A conservative approach was applied in 16 patients while nine patients underwent neurosurgery. Considering the therapeutical indications provided by the SLIC system, a 76.9% accordance was found for patients with a <4 score, while a 100% concordance was calculated for patients with a >4 score undergoing neurosurgery. Regarding the AOSspine classification, a 28.6% concordance was observed for patients classified group B being treated with a posterior neurosurgical approach, while for patients belonging to subgroup C, considered for anterior neurosurgical approach, a 66.7% accordance was calculated. Conclusions: The study demonstrated a better morphological correlation for the AOSpine classification in subaxial trauma and the AOSpine and Anderson D’Alonzo in axial trauma. The therapeutic indication found a better correlation in the SLIC classification for subaxial trauma and the Anderson D’Alonzo for axial ones. (www.actabiomedica.it)
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Affiliation(s)
- Valeria Pagliei
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Giuseppe Battista
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Iacopino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Camilla Riva
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Luca Bardi
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli.
| | - Mattia Carbone
- A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Department of Radiology, Italy.
| | - Ernesto Di Cesare
- Department of Clinical Medicine, Public Health, Life and Environmental Science, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of d Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
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Palumbo P, Daffinà J, Bruno F, Arrigoni F, Splendiani A, Di Cesare E, Barile A, Masciocchi C. Basics in Magnetic Resonance guided Focused Ultrasound: technical basis and clinical application. A brief overview. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021403. [PMID: 34505842 PMCID: PMC8477067 DOI: 10.23750/abm.v92is5.11881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
First applications of high focused ultrasound as intracranial ablative therapy were firstly described in early 50’. Since then, the technological innovations have shown an increasingly safe and effective face of this technique. And in the last few years, Magnetic Resonance (MR) guided Focused Ultrasound (gFUS) has become a valid minimally invasive technique in the treatment of several diseases, from bone tumors to symptomatic uterine fibroids or essential tremors. MR guidance, through the tomographic view, offers the advantage of an accurate target detection and treatment planning. Moreover, real-time monitoring sequences allow to avoid non-target ablation. An adequate knowledge of FUS is essential to understand its clinical effectiveness. Therefore, this brief review aims to debate the physical characteristics of US and the main fields of clinical application.
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Affiliation(s)
- Pierpaolo Palumbo
- Department of Diagnostic Imaging, area of Cardiovascular and Interventional Imaging, Abruzzo Health Unit 1, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Julia Daffinà
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Clinical Medicine, Public Health, Life and Environmental Science, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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Cobianchi Bellisari F, Bruno F, Monti R, Cicerone C, Palumbo P, Arrigoni F, Mariani S, Gianneramo C, Mangoni di S Stefano ML, Carbone M, Gentili F, Mazzei MA, Masciocchi C, Barile A. Diagnostic performance of DIXON sequences on low-field scanner for the evaluation of knee joint pathology. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021403. [PMID: 34505845 PMCID: PMC8477066 DOI: 10.23750/abm.v92is5.11870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Recently, there has been a growing interest in the use of Dixon sequence for knee MRI in order to save time spent on the scanner, and improving diagnostic utility. Our purpose was to compare the diagnostic performance of Dixon sequence on low-field MRI with the proton-density sequence on high-field MRI. METHODS This prospective study included 40 patients who underwent 0.25T knee MRI, using the routine protocol with the addition of a sagittal 4-point Dixon sequence (SPED), and an additional sequence on 1.5T scanner, consisting in a fat-suppressed proton-density fast-spin-echo (FS PD-FSE). Two radiologists independently examined the images, evaluating the anatomic identification score and diagnostic performances of the two sequences. Interreader agreement was evaluated using an intraclass correlation coefficient (ICC). RESULTS Final population counted 34 patients (36 knee MR images) with a mean age of 52.9 years (range, 18-75 years). Interreader agreement was very high except for cartilage injuries at medial femoral condyle and medial tibial plateau (ICC SPED: 0.757, ICC FS PD-FSE: 0.746), even if not statistically significant. There were no significant differences in mean signal-to-noise ratio (SNR), artifacts presence and diagnostic confidence between SPED and PD-FS sequence. CONCLUSIONS Dixon sequences on low-field scanner have a comparable diagnostic accuracy to PD-FS sequence obtained on a high field scanner for knee MR imaging. (www.actabiomedica.it).
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Affiliation(s)
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy .
| | - Riccardo Monti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy .
| | - Claudia Cicerone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy .
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy .
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Silvia Mariani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Camilla Gianneramo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - Mattia Carbone
- Department of Radiology, San Giovanni E Ruggi D'Aragona Hospital, Ospedale, Via San Leonardo, Salerno, Italy.
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, University of Parma, Parma, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, University of Siena, Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy .
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy .
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Sgalambro F, Giordano AV, Carducci S, Varrassi M, Perri M, Arrigoni F, Palumbo P, Bruno F, Bardi L, Mangoni di S Stefano ML, Danti G, Gentili F, Mazzei MA, Di Cesare E, Splendiani A, Masciocchi C, Barile A. The role of interventional radiology in hepatic and renal hemorrhage embolization: single center experience and literature review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021405. [PMID: 34505844 PMCID: PMC8477065 DOI: 10.23750/abm.v92is5.11876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022]
Abstract
Background and aim: Intraabdominal hemorrhage secondary to liver and kidney injury is a major cause of morbidity and mortality. Endovascular arterial embolization is an established interventional radiology technique used to treat active bleeding, and its role in managing abdominal hemorrhages is growing, given the increasing trend for conservative treatment. Our study aims to retrospectively evaluate the technical and clinical results and the possible complications of arterial embolization procedures performed in emergency, in post-traumatic, iatrogenic, and pathological hepatic and renal bleedings. Methods: We performed a ten-year, single-center retrospective survey (from January 2010 to December 2019) of all patients treated in emergency by intra-arterial embolization of liver and kidney bleeding. Preliminary CT angiography studies were evaluated, as well as the angiographic findings. Materials used, procedural data, and clinical outcomes, including complications, were recorded. Results: The diagnostic angiography showed a single source of bleeding in 20 cases (66.7%), two bleeding vessels in 4 cases (13.3%), and multiple hemorrhagic sources in 6 cases (20%). All bleeding sources were successfully embolized; in 12 patients (40%), complete embolization was achieved with coils and 18 patients (60%) with hemostatic sponges. In one case, a second embolization procedure was performed for the persistence of hemodynamic instability. No major post-procedural complications were recorded. The mean procedure duration was 65.1 minutes. Conclusions: Based on our experience and literature data, the treatment of endovascular embolization in acute abdominal bleeding of hepatic and renal origin represents the treatment of choice, as it can provide complete therapeutic success in hemodynamically stable patients. (www.actabiomedica.it)
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Affiliation(s)
- Ferruccio Sgalambro
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Aldo Victor Giordano
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Sergio Carducci
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marco Varrassi
- Interventional Radiology and Neuroradiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marco Perri
- Diagnostic and Interventional Radiology, SS. Filippo e Nicola Hospital, Avezzano (AQ), Italy.
| | - Francesco Arrigoni
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy .
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Milan, Italy.
| | - Luca Bardi
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli .
| | | | - Ginevra Danti
- Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, University of Parma, Parma, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, University of Siena, Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy .
| | - Ernesto Di Cesare
- Department of Life, Health and Enviromental Sciences, University of L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy.
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Metachronous spinal dural arteriovenous fistula: Case report and review of literature on implications for pathophysiology and management. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Shimohira M, Kiyosue H, Osuga K, Gobara H, Kondo H, Nakazawa T, Matsui Y, Hamamoto K, Ishiguro T, Maruno M, Sugimoto K, Koganemaru M, Kitagawa A, Yamakado K. Location of embolization affects patency after coil embolization for pulmonary arteriovenous malformations: importance of time-resolved magnetic resonance angiography for diagnosis of patency. Eur Radiol 2021; 31:5409-5420. [PMID: 33449178 DOI: 10.1007/s00330-020-07669-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess the diagnostic accuracy of computed tomography (CT) and time-resolved magnetic resonance angiography (TR-MRA) for patency after coil embolization of pulmonary arteriovenous malformations (PAVMs) and identify factors affecting patency. METHODS Data from the records of 205 patients with 378 untreated PAVMs were retrospectively analyzed. Differences in proportional reduction of the sac or draining vein on CT between occluded and patent PAVMs were examined, and receiver operating characteristic analysis was performed to assess the accuracy of CT using digital subtraction angiography (DSA) as the definitive diagnostic modality. The accuracy of TR-MRA was also assessed in comparison to DSA. Potential factors affecting patency, including sex, age, number of PAVMs, location of PAVMs, type of PAVM, and location of embolization, were evaluated. RESULTS The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CT were 82%, 81%, 77%, 85%, and 82%, respectively, when the reduction rate threshold was set to 55%, which led to the highest diagnostic accuracy. The sensitivity, specificity, PPV, NPV, and accuracy of TR-MRA were 89%, 95%, 89%, 95%, and 93%, respectively. On both univariable and multivariable analyses, embolization of the distal position to the last normal branch of the pulmonary artery was a factor that significantly affected the prevention of patency. CONCLUSIONS TR-MRA appears to be an appropriate method for follow-up examinations due to its high accuracy for the diagnosis of patency after coil embolization of PAVMs. The location of embolization is a factor affecting patency. KEY POINTS • Diagnosis of patency after coil embolization for pulmonary arteriovenous malformations (PAVMs) is important because a patent PAVM can lead to neurologic complications. • The diagnostic accuracies of CT with a cutoff value of 55% and TR-MRA were 82% and 93%, respectively. • The positioning of the coils relative to the sac and the last normal branch of the artery was significant for preventing PAVM patency.
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Affiliation(s)
- Masashi Shimohira
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan.
| | - Hiro Kiyosue
- Department of Radiology, Oita University, Yufu, Japan
| | - Keigo Osuga
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Diagnostic Radiology, Osaka Medical College, Takatsuki, Japan
| | - Hideo Gobara
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Hiroshi Kondo
- Department of Radiology, Teikyo University School of Medicine, Itabashi, Tokyo, Japan
| | - Tetsuro Nakazawa
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Diagnostic Imaging, Osaka General Medical Center, Osaka, Japan
| | - Yusuke Matsui
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Kohei Hamamoto
- Department of Radiology, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Tomoya Ishiguro
- Department of Neuro-Intervention, Osaka City General Hospital, Osaka, Japan
| | - Miyuki Maruno
- Department of Radiology, Oita University, Yufu, Japan
| | - Koji Sugimoto
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Akira Kitagawa
- Department of Radiology, Aichi Medical University, Nagakute, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
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Spinal dural fistula evaluation using 4-Dimensional intra-aortic spinal CTAngiography in a hybrid angiography suite. J Neuroradiol 2021; 48:492-494. [PMID: 33418055 DOI: 10.1016/j.neurad.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/23/2022]
Abstract
Intra-aortic CT Angiography (IA-CTA) is a relatively new technique that shows promise in efficient diagnosis and evaluation of the angioarchitecture of spinal dural arteriovenous fistulae(sdAVF). The authors document the first reported use of a 4D-CT and C-arm fluoroscope in a hybrid interventional suite to evaluate a sdAVF. Time resolved IA-CTA is clinically feasible in the evaluation of sdAVF, has higher temporal resolution as compared to standard IA-CTA and reduced contrast load, radiation dose and potential for procedural complications as compared to standard spinal angiography.
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Guerrini S, Bagnacci G, Barile A, La Paglia E, Gentili F, Luzzi L, Giordano N, Fioravanti A, Bellisai F, Cantarini L, Volterrani L, Frediani B, Mazzei MA. Anterior chest wall non-traumatic diseases: a road map for the radiologist. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:43-50. [PMID: 32945278 PMCID: PMC7944680 DOI: 10.23750/abm.v91i8-s.9972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 12/17/2022]
Abstract
The anterior chest wall (AWC) non-traumatic pathologies are largely underestimated, and early detection through imaging is becoming increasingly important. This paper aims to review the major non-traumatic ACW pathologies, with a particular interest in imaging features and differential diagnosis. (www.actabiomedica.it)
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Affiliation(s)
- Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
| | - Giulio Bagnacci
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
| | | | - Francesco Gentili
- Section of Radiology, Department of Medicine and Surgery, Azienda Ospedaliera Universitaria di Parma, Parma, Italy.
| | - Luca Luzzi
- Thoracic Surgery Unit, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
| | - Nicola Giordano
- Scleroderma Unit, Internal Medicine, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
| | - Antonella Fioravanti
- Unit of Rheumatology, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Tuscany, Italy.
| | - Francesca Bellisai
- Unit of Rheumatology, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Tuscany, Italy.
| | - Luca Cantarini
- Unit of Rheumatology, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Tuscany, Italy.
| | - Luca Volterrani
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
| | - Bruno Frediani
- Unit of Rheumatology, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Tuscany, Italy.
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
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11
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Ierardi AM, Piacentino F, Pesapane F, Carnevale A, Curti M, Fontana F, Venturini M, Pinto A, Gentili F, Guerrini S, De Filippo M, Giganti M, Carrafiello G. Basic embolization techniques: tips and tricks. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:71-80. [PMID: 32945281 PMCID: PMC7944672 DOI: 10.23750/abm.v91i8-s.9974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
Good knowledge of the various approaches of embolization of peripheral bleedings and different embolic materials available is of paramount importance for successful and safe embolization. We review and illustrate the main endovascular and percutaneous techniques used for embolization, along with the characteristics of the different embolic materials, and the potential complications.
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Affiliation(s)
- Anna Maria Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Filippo Piacentino
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
| | - Filippo Pesapane
- Breast Imaging Unit, IEO European Institute of Oncology IRCCS, Milan, Italy.
| | - Aldo Carnevale
- University Radiology Unit, Radiology Department, Arcispedale Sant'Anna, Via A. Moro 8, Ferrara, 44123, Italy.
| | - Marco Curti
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
| | - Federico Fontana
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
| | - Massimo Venturini
- Department of Diagnostic and Interventional Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
| | - Antonio Pinto
- Department of Radiology, CTO Hospital, Azienda dei Colli, Naples, Italy.
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, University of Parma, Parma, Italy.
| | - Susanna Guerrini
- Department of Radiological Sciences, Diagnostic Imaging Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
| | - Massimo De Filippo
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, University of Parma, Parma, Italy.
| | - Melchiore Giganti
- Department of Morphology, Surgery and Experimental Medicine, Radiology Section, University of Ferrara, Via L. Ariosto 35, Ferrara, 44121, Italy.
| | - Gianpaolo Carrafiello
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan and Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
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12
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Palumbo P, Bruno F, Arrigoni F, Zappia M, Ierardi AM, Guglielmi G, Zugaro L, Carotti M, Di Cesare E, Splendiani A, Brunese L, Masciocchi C, Barile A. Diagnostic and interventional management of infective spine diseases. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:125-135. [PMID: 32945287 PMCID: PMC7944670 DOI: 10.23750/abm.v91i8-s.9994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 01/10/2023]
Abstract
Spondylodiscitis (SD) is one of the main causes of back pain. Although the low mortality, high morbidity is related to spondilodiscitys, leading spine instability, chronic pain or neurological deficit. Diagnostic imaging plays a primary role in diagnosing spondylodiscitis. However different accuracy is highlighted by different diagnostic tool, depending also on timing of disease which represents a cardinal element for the phenotypic manifestation of the disease, beyond spatial resolution and tissue characterization proper of specific modality imaging. Conventional Radiology (CR), Computed Tomography (CT) and MRI (Magnetic Resonance Imaging) all have proven to be of primary importance in the approach to spondylodiscitis, although magnetic resonance imaging has demonstrated the greatest advantage in identifying the disease from its earliest stages, demonstrating high sensitivity and specificity (92% and 96%, respectively). This review focus on the role of different imaging modality in the approach to the spondylodiscitis, also addressing the role of interventional radiology that is pivotal not only for a diagnosis of certainty through biopsy, but also for a minimally-invasive treatment of paravertebral abscesses spondylodiscitis-related. (www.actabiomedica.it)
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Affiliation(s)
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Marcello Zappia
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | - Anna Maria Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
| | - Luigi Zugaro
- Department of Emergency Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Marina Carotti
- University Department of Radiology - Division of Special and Pediatric Radiology Hospital "Umberto I - Lancisi - Salesi", Ancona, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Luca Brunese
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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13
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Giovagnoni A, De Filippo M, Barile A. Diagnostic and interventional radiology: an update. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:5-8. [PMID: 32945273 PMCID: PMC7944668 DOI: 10.23750/abm.v91i8-s.9995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/23/2022]
Abstract
NOT PRESENT.
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Affiliation(s)
- Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, AN, Italy.
| | - Massimo De Filippo
- Department of Medicine and Surgery (DiMec), Section of Radiology, University of Parma, Maggiore Hospital, Parma, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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14
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Di Lullo AM, Paolucci A, Motta S, Cantone E, Barbieri E, Cicala D, Grassi R, Bruno F, Splendiani A, Tortora F, Cavaliere M, Brunese L. Diagnosis and management of intralabyrinthine schwannoma: case series and review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:136-144. [PMID: 32945288 PMCID: PMC7944674 DOI: 10.23750/abm.v91i8-s.9976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
Intralabyrinthine schwannoma (ILS) is a rare benign tumor affecting cochlear and vestibular nerves, whose symptoms are generally unspecific and frequently responsible for a late diagnosis. Radiological examinations, with particular reference to magnetic resonance imaging (MRI), represent the only diagnostic technique to identify ILS. On computed tomography ILS can only be indirectly suspected by the presence of surrounding bone remodeling, whereas MRI provides direct visualization of the neoplasm as a filling defect within the labyrinth with vivid contrast enhancement. At the same time, MRI is also helpful in defining ILS anatomical extension into adjacent structures and in planning therapeutic management. Here we report three representative cases of ILS with new pictorial imaging features to improve ILS early detection and optimize subsequent therapeutic management.
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Affiliation(s)
- Antonella Miriam Di Lullo
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy, CEINGE- Advanced Biotechnology, Naples, Italy
| | | | - Sergio Motta
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Emiliano Barbieri
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Domenico Cicala
- Department of Neurosciences, “Santobono-Pausilipon” Pediatric Hospital, Naples, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila,Italy
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila,Italy
| | - Fabio Tortora
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
| | - Michele Cavaliere
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - Luca Brunese
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
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15
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Mizutani K, Arai N, Toda M, Akiyama T, Fujiwara H, Jinzaki M, Yoshida K. A Novel Flow Dynamics Study of the Intracranial Veins Using Whole Brain Four-Dimensional Computed Tomography Angiography. World Neurosurg 2019; 131:e176-e185. [DOI: 10.1016/j.wneu.2019.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
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16
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Abstract
BACKGROUND Radiological imaging is important in the preoperative diagnosis of many forms of spinal pathology and plays a fundamental role in the assessment of p.o. effects, which can be verified on the spinal column as well as on the surrounding soft tissues, depending on the imaging method used. AIM The article provides an overview of the current status and possibilities of radiological diagnostic methods for the verification of possibly recommended spine surgery in the context of degenerative, inflammatory-infectious, post-traumatic or p.o. pathologies and changes in the spine: X‑rays, computed tomography (CT), magnetic resonance imaging (MRI). The supplementary nuclear medicine procedures (scintigraphy, PET[-CT], SPECT, etc.) which may be required for special questions are not discussed. MATERIAL AND METHODS The merits and limitations of the techniques used in the investigation of advanced degenerative spinal pathologies and post-traumatic conditions are discussed, with multidetector CT being the focus of attention in spinal clearance for traumatic injuries. In most cases of spinal infection, MRI images, as a central diagnostic tool, show typical findings such as destruction of adjacent endplates, bone marrow and intervertebral disc abnormalities, and paravertebral or epidural abscesses. However, it is not always easy to diagnose a spinal infection, especially if atypical MR patterns of infectious spondylitis are present. Knowledge of them means misdiagnosis and improper treatment can be avoided. RESULTS It is shown that high-quality modern radiological examinations are essential for diagnosis and p.o. management, as these provide answers to the main questions in the treatment: Is the entity/injury stable or unstable, acute or old, benign or malign; is there a myelopathy or p.o. complication? DISCUSSION The main indications for p.o. diagnostic imaging, difficulties such as metal artefact formation, and potential pitfalls are analyzed. Entity-specific radiological image patterns, imaging algorithms and differential diagnostic peculiarities are presented and discussed based on current literature and selected case studies.
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Affiliation(s)
- Uwe H W Schütz
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. .,Orthopädie und Schmerzmedizin am Grünen Turm, Grüner-Turm-Str. 4-10, 88212, Ravensburg, Deutschland.
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17
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Cifarelli CP, Vargo JA, Tenenholz T, Hack JD, Guthrie G, Carpenter JS. Gamma Knife Radiosurgery for Arteriovenous Malformations Using a Four-Dimensional Dynamic Volume Computed Tomography Angiography Planning System as an Alternative to Traditional Catheter Angiogram. Cureus 2018; 10:e2788. [PMID: 30112264 PMCID: PMC6089481 DOI: 10.7759/cureus.2788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Gamma knife radiosurgery (GKRS) remains a critical intervention in the long-term management of arteriovenous malformations (AVMs). For planning a treatment, identification of the nidus is essential, and it is dependent on high-resolution blood flow imaging, usually in the form of a traditional angiogram. The development of dynamic 320-slice computed tomography (CT) angiography has offered a noninvasive alternative to intra-arterial fluoroscopic imaging, and it is capable of providing equivalent temporal resolution. In this study, we describe the feasibility of using four-dimensional CT angiography (4D-CTA) in GKRS planning for AVM treatment and a comparative analysis with a traditional angiogram. Methods A retrospective review was performed on AVM patients treated via GKRS with a 4D-CTA prior to the day of treatment, on the day of treatment, or with a day-of-treatment angiogram. Treatment times, along with total times in the Leksell® coordinate frame G, were obtained from the medical records. The frame-on time was calculated by subtracting the treatment time from the total time starting from application to removal, and the statistical analysis was performed across groups using analysis of variance (ANOVA). All treatments were performed on the Perfexion™ model with a dynamic flow imaging procured via a 320-slice CT scanner or traditional angiography platform. Results Some 27 patients underwent a total of 29 GKRS procedures for AVM treatment at our institution between September 2011 and January 2017. Mean age at the time of treatment was 35.5 (6-65) years, and male:female ratio was 5:4. Some 12 patients had 4D-CTA performed prior to the day of treatment, eight patients had the same CTA completed after frame placement on the day of treatment, while seven patients underwent traditional angiography. The mean frame-on times of each group were 190, 336, and 426 minutes, respectively (p < 0.0001). No procedures were aborted based on the image quality. Conclusions 4D-CTA is an effective tool in identifying the AVM nidus for GKRS planning. These studies can be performed prior to the day of treatment, allowing for a significant reduction in frame-on time and eliminating the risk of angiogram complication on the day of GKRS.
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Affiliation(s)
- Christopher P Cifarelli
- Neurological Surgery, West Virginia University School of Medicine/Ruby Memorial Hospital, Morgantown, USA
| | - John A Vargo
- Department of Radiation Oncology, West Virginia University School of Medicine, Morgantown, USA
| | - Todd Tenenholz
- Department of Radiation Oncology, West Virginia University, Ruby Memorial Hospital, Morgantown, USA
| | - Joshua D Hack
- Department of Radiation Oncology, West Virginia University School of Medicine, Morgantown, USA
| | - Grenaville Guthrie
- Radiology, West Virginia University School of Medicine/Ruby Memorial Hospital, Morgantown, USA
| | - Jeffrey S Carpenter
- Radiology, West Virginia University School of Medicine/Ruby Memorial Hospital, Morgantown , USA
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18
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Clinical applications of dynamic CT angiography for intracranial lesions. Acta Neurochir (Wien) 2018; 160:675-680. [PMID: 29353408 DOI: 10.1007/s00701-018-3465-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Dynamic CT angiography (dCTA) augments traditional CTA with temporal resolution and has been demonstrated to influence operative planning in skull base surgery. METHODS Three hundred twenty-five dynamic CTA cases from a single institution were reviewed for indication of study, findings, and comparison to other modalities of imaging. RESULTS The most frequent application of dCTA was pre-operative surgical planning (59.4%); resection of skull base tumors represented the majority of these pre-operative studies (93.3%). It was also used to evaluate new neurological symptoms (20.9%). Of these, the most common symptoms prompting a dCTA study included headache (22.1%) and visual field deficit (11.8%). The most commonly visualized vascular lesions were partial (22.9%) and complete vascular occlusions (9.0%). Dynamic CTA has also been useful in post-operative imaging for vascular malformations (9.5%) and tumors (2.5%). Finally, dCTA was employed to evaluate ambiguous abnormal findings observed on other imaging modalities (7.7%). Cerebral dCTA ruled out inconclusive abnormal vascular findings visualized on other imaging modalities (64.0%) more frequently than it confirmed them (32.0%), and was inconclusive in a singular case (4.0%). CONCLUSIONS Cerebral dCTA is an evolving new technology with a diverse spectrum of potential applications. In addition to its role in guiding pre-operative planning for skull base surgical cases, dynamic CTA offers excellent spatial and temporal resolution for assessment of vascular lesions.
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19
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Dynamic Four-Dimensional Computed Tomography Angiography for Neurovascular Pathologies. World Neurosurg 2017; 105:1034.e11-1034.e18. [DOI: 10.1016/j.wneu.2017.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/01/2017] [Accepted: 06/02/2017] [Indexed: 11/22/2022]
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20
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Mizutani K, Miwa T, Akiyama T, Kanazawa T, Nagashima H, Miyakoshi K, Niimi Y, Yoshida K. Postnatal delayed exacerbation of dural sinus malformation associated with brainstem cavernous malformations: A case report. Interv Neuroradiol 2017; 23:510-515. [PMID: 28728536 DOI: 10.1177/1591019917720806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Dural sinus malformation (DSM) is a rare paediatric vascular malformation characterised by abnormal dilation of the posterior dural sinus. Owing to its rarity, the pathophysiology of DSM has not been fully elucidated. We report a case of prenatally diagnosed DSM with an unusual clinical course. We detected DSM in a male foetus in the 26th week of gestation by using foetal ultrasonography. Although the DSM regressed during the foetal stage and the arteriovenous shunt was insignificant in the neonate, the shunt rapidly developed four months after birth. The neonate also had postnatal de novo brainstem cavernous malformation (CM), which also developed rapidly, supposedly due to the aggravated venous hypertension resulting from the DSM. We successfully treated the aggravated shunts by endovascular transarterial and transvenous embolisation six times over two years and, subsequently, the clinical condition and the size of the brainstem CM became stable. The DSM and CM seemed to have a metameric origin. Such aberrant cases could help to further the understanding of DSM.
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Affiliation(s)
- Katsuhiro Mizutani
- 1 Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Tomoru Miwa
- 1 Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Takenori Akiyama
- 1 Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Tokunori Kanazawa
- 1 Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Hideaki Nagashima
- 1 Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Kei Miyakoshi
- 2 Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yasunari Niimi
- 3 Department of Neuroendovascular Therapy, St Luka's International Hospital, Tokyo, Japan
| | - Kazunari Yoshida
- 1 Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
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Yamaguchi S, Takemoto K, Takeda M, Kajihara Y, Mitsuhara T, Kolakshyapati M, Mukada K, Kurisu K. The Position and Role of Four-Dimensional Computed Tomography Angiography in the Diagnosis and Treatment of Spinal Arteriovenous Fistulas. World Neurosurg 2017; 103:611-619. [DOI: 10.1016/j.wneu.2017.03.100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 11/24/2022]
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22
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Splendiani A, D'Orazio F, Patriarca L, Arrigoni F, Caranci F, Fonio P, Brunese L, Barile A, Di Cesare E, Masciocchi C. Imaging of post-operative spine in intervertebral disc pathology. Musculoskelet Surg 2017; 101:75-84. [PMID: 28168634 DOI: 10.1007/s12306-017-0453-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/15/2017] [Indexed: 12/17/2022]
Abstract
This work is an imaging review of spine after surgery with special regard to imaging modality in intervertebral disc pathology. Advances in imaging technology can be evaluated. Depending on the clinical question is asked to the radiologist, it is possible to evaluate post-operative patients with conventional radiology (X-ray), computed tomography and magnetic resonance. Main indications for each technique are analysed. Imaging is important in the diagnosis of many forms of spine pathology and plays a fundamental role in evaluating post-surgical effects of treatments, according to the imaging method which is used, both on spine and on its surrounding tissues (intervertebral discs, spinal cord, muscles and vessels).
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Affiliation(s)
- A Splendiani
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - F D'Orazio
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - L Patriarca
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Arrigoni
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Caranci
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - P Fonio
- Radiology Unit, Department of Surgical Sciences, University of Torino, Turin, Italy
| | - L Brunese
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - A Barile
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - E Di Cesare
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - C Masciocchi
- Department of Biotechnologies and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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23
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La Marra A, Quarchioni S, Ferrari F, Gravina GL, Barile A, Gregori LM, Di Cesare E, Splendiani A. 640-Slice CT Measurement of Superior Orbital Fissure as Gateway for Light into the Brain: Statistical Evaluation of Area and Distance. PLoS One 2016; 11:e0162940. [PMID: 27661082 PMCID: PMC5035002 DOI: 10.1371/journal.pone.0162940] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 08/31/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Our aim was to provide normative data concerning superior orbital fissure area (SOFA), ocular skin and the substantia nigra (D-SS) and orbital fissure and the substantia nigra (D-SOF-S) distances by CT scan in adult Caucasian population. METHODS The area of the superior orbital fissure (SOF), the distance between the ocular skin and the substantia nigra and the distance between the superior orbital fissure and the substantia nigra using CT and 3D-CT images. RESULTS Normative data stratified for age and gender were obtained. The data here reported show that some degree of variability in SOFA, D-SS and D-SOF-S measurements can be observed healthy Caucasian subjects. Gender stratified prediction intervals (mean +/- 2 Standard Deviations) for SOFA and D-SOF-S were 69.2 (+/-15.8) and 38.4 (+/-7.6) for male and 56.8 (+/-11.9) and 36.5 (+/-6.1) for female, respectively. Age and gender significantly impacted on D-SS values and normative data were constructed generating data stratified for these two variables. D-SS was 89.4 (+/-10.3) and 86.4 (+/-9.7) for male and female, respectively. CONCLUSIONS Here we provide adjunctive anatomical information on specific anatomical cerebral zones. Our data may have implications for surgeons actively committed to treat pathological conditions involving these cerebral areas. Additionally, the anatomical variability found with respect to SOF and the potential different exposure of the substanzia nigra to the bright light could play a role in Parkinson's disease as already speculated in literature.
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Affiliation(s)
- Alice La Marra
- Department of Applied Clinical Sciences and Biotechnology, Radiology Unit, University of L'Aquila, L’Aquila, Italy
| | - Simone Quarchioni
- Department of Applied Clinical Sciences and Biotechnology, Radiology Unit, University of L'Aquila, L’Aquila, Italy
| | - Fabiana Ferrari
- Department of Applied Clinical Sciences and Biotechnology, Radiology Unit, University of L'Aquila, L’Aquila, Italy
| | - Giovanni Luca Gravina
- Department of Applied Clinical Sciences and Biotechnology, Radiotherapy and Cardiac Unit, University of L'Aquila, L’Aquila, Italy
| | - Antonio Barile
- Department of Applied Clinical Sciences and Biotechnology, Radiology Unit, University of L'Aquila, L’Aquila, Italy
| | - Lorenzo Maria Gregori
- Department of Applied Clinical Sciences and Biotechnology, Radiology Unit, University of L'Aquila, L’Aquila, Italy
| | - Ernesto Di Cesare
- Department of Applied Clinical Sciences and Biotechnology, Radiotherapy and Cardiac Unit, University of L'Aquila, L’Aquila, Italy
| | - Alessandra Splendiani
- Department of Applied Clinical Sciences and Biotechnology, Neuroradiology Unit, University of L'Aquila, L’Aquila, Italy
- * E-mail:
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Mizonobe K, Shiraishi Y, Nakano S, Fukuda C, Asanuma O, Harada K, Date H. Evaluation of Size Correction Factor for Size-specific Dose Estimates (SSDE) Calculation. Nihon Hoshasen Gijutsu Gakkai Zasshi 2016; 72:727-34. [PMID: 27647595 DOI: 10.6009/jjrt.2016_jsrt_72.9.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
American Association of Physicists in Medicine (AAPM) Report No.204 recommends the size-specific dose estimates (SSDE), wherein SSDE=computed tomography dose index-volume (CTDIvol )×size correction factor (SCF), as an index of the CT dose to consider patient thickness. However, the study on SSDE has not been made yet for area detector CT (ADCT) device such as a 320-row CT scanner. The purpose of this study was to evaluate the SCF values for ADCT by means of a simulation technique to look into the differences in SCF values due to beam width. In the simulation, to construct the geometry of the Aquilion ONE X-ray CT system (120 kV), the dose ratio and the effective energies were measured in the cone angle and fan angle directions, and these were incorporated into the simulation code, Electron Gamma Shower Ver.5 (EGS5). By changing the thickness of a PMMA phantom from 8 cm to 40 cm, CTDIvol and SCF were determined. The SCF values for the beam widths in conventional and volume scans were calculated. The differences among the SCF values of conventional, volume scans, and AAPM were up to 23.0%. However, when SCF values were normalized in a phantom of 16 cm diameter, the error tended to decrease for the cases of thin body thickness, such as those of children. It was concluded that even if beam width and device are different, the SCF values recommended by AAPM are useful in clinical situations.
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Affiliation(s)
- Kazufusa Mizonobe
- Department of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
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Radon MR, Chandran A, Bhojak M, Das KV. Radiation Dose Reduction in 4D Cerebral CT Angiography by Individualized Estimation of Cerebral Circulation Time. AJNR Am J Neuroradiol 2016; 37:2189-2194. [PMID: 27561832 DOI: 10.3174/ajnr.a4911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/05/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The novel technique of 4D CTA for dynamic assessment of the intracranial vessels has a greater radiation burden than conventional CTA. Previous descriptions of the technique used a fixed-duration exposure protocol. This study examines the potential for dose reduction by individualizing exposure time to patient physiology by the use of time-enhancement curve techniques as previously applied in CT angiography and venography. MATERIALS AND METHODS 4D-CTA examinations performed at our institution were retrospectively reviewed. Scan protocols used a test-bolus scan with either a subjective estimate of the main acquisition timing (estimated-duration method) or a quantitative measure (measured-duration method). The estimated-duration method used peak arterial enhancement to determine the start of exposure, with the duration chosen at the radiologist's discretion. The measured-duration method used arterial and venous time-enhancement curves to determine exposure start and duration. Exposure duration, study adequacy, quality score, and maximum venous enhancement were compared among groups. RESULTS One hundred fifty-one examinations used the estimated-duration method, and 53 used measured-duration. The measured-duration method used a shorter exposure time (10 versus 15.8 seconds; P < .001). There was no statistically significant difference in the study adequacy rate, subjective quality score, or maximum venous enhancement. The radiation dose was reduced by 51% in the measured-duration method (3021 mGy × cm, 6.9 mSv, versus 1473 mGy × cm, 3.4 mSv). Both methods showed good agreement with DSA (κ = 0.88 for estimated-duration, κ = 1.0 for measured duration). CONCLUSIONS Exposure time in 4D-CTA can be reduced with dual time-enhancement curves to match exposure to physiology without degrading study adequacy or quality.
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Affiliation(s)
- M R Radon
- From the Department of Neuroradiology, The Walton Centre, Liverpool, United Kingdom.
| | - A Chandran
- From the Department of Neuroradiology, The Walton Centre, Liverpool, United Kingdom
| | - M Bhojak
- From the Department of Neuroradiology, The Walton Centre, Liverpool, United Kingdom
| | - K V Das
- From the Department of Neuroradiology, The Walton Centre, Liverpool, United Kingdom
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Turner RC, Lucke-Wold BP, Josiah D, Gonzalez J, Schmidt M, Tarabishy AR, Bhatia S. Stereotactic radiosurgery planning based on time-resolved CTA for arteriovenous malformation: a case report and review of the literature. Acta Neurochir (Wien) 2016; 158:1555-62. [PMID: 27334738 PMCID: PMC4944162 DOI: 10.1007/s00701-016-2874-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 06/02/2016] [Indexed: 02/05/2023]
Abstract
Stereotactic radiosurgery has long been recognized as the optimal form of management for high-grade arteriovenous malformations not amenable to surgical resection. Radiosurgical plans have generally relied upon the integration of stereotactic magnetic resonance angiography (MRA), standard contrast-enhanced magnetic resonance imaging (MRI), or computed tomography angiography (CTA) with biplane digital subtraction angiography (DSA). Current options are disadvantageous in that catheter-based biplane DSA is an invasive test associated with a small risk of complications and perhaps more importantly, the two-dimensional nature of DSA is an inherent limitation in creating radiosurgical contours. The necessity of multiple scans to create DSA contours for radiosurgical planning puts patients at increased risk. Furthermore, the inability to import two-dimensional plans into some radiosurgery programs, such as Cyberknife TPS, limits treatment options for patients. Defining the nidus itself is sometimes difficult in any of the traditional modalities as all draining veins and feeding arteries are included in the images. This sometimes necessitates targeting a larger volume, than strictly necessary, with stereotactic radiosurgery for treatment of the AVM. In this case report, we show the ability to use a less-invasive and three-dimensional form of angiography based on time-lapsed CTA (4D-CTA) rather than traditional DSA for radiosurgical planning. 4D-CTA may allow generation of a series of images, which can show the flow of contrast through the AVM. A review of these series may allow the surgeon to pick and use a volume set that best outlines the nidus with least interference from feeding arteries or draining veins. In addition, 4D-CTA scans can be uploaded into radiosurgery programs and allow three-dimensional targeting. This is the first reported case demonstrating the use of a 4D CTA and an MRI to delineate the AVM nidus for Gamma Knife radiosurgery, with complete obliteration of the nidus over time and subsequent management of associated radiation necrosis with bevacizumab.
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Affiliation(s)
- Ryan C Turner
- Department of Neurosurgery, West Virginia University School of Medicine, One Medical Center Drive, Suite 9183, Morgantown, WV, 26506, USA
- Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV, 26506, USA
| | - Brandon P Lucke-Wold
- Department of Neurosurgery, West Virginia University School of Medicine, One Medical Center Drive, Suite 9183, Morgantown, WV, 26506, USA
- Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV, 26506, USA
| | - Darnell Josiah
- Department of Neurosurgery, West Virginia University School of Medicine, One Medical Center Drive, Suite 9183, Morgantown, WV, 26506, USA
- Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV, 26506, USA
| | - Javier Gonzalez
- Department of Neurology, West Virginia University School of Medicine, Morgantown, WV, 26506, USA
| | - Matthew Schmidt
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, 26506, USA
| | - Abdul Rahman Tarabishy
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, 26506, USA
| | - Sanjay Bhatia
- Department of Neurosurgery, West Virginia University School of Medicine, One Medical Center Drive, Suite 9183, Morgantown, WV, 26506, USA.
- Center for Neuroscience, West Virginia University School of Medicine, Morgantown, WV, 26506, USA.
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Di Cesare E, Splendiani A, Barile A, Squillaci E, Di Cesare A, Brunese L, Masciocchi C. CT and MR imaging of the thoracic aorta. Open Med (Wars) 2016; 11:143-151. [PMID: 28352783 PMCID: PMC5329815 DOI: 10.1515/med-2016-0028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 03/07/2016] [Indexed: 12/25/2022] Open
Abstract
At present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels, mandatory for the ineludible longitudinal reconstruction. The main limits are related to the X-ray dose expoure and the use of iodinated contrast media. MRI has great potential in the study of the thoracic aorta. Nevertheless, if compared to CT, acquisition times remain longer and movement artifact susceptibility higher. The main MRI disadvantages are claustrophobia, presence of ferromagnetic implants, pacemakers, longer acquisition times with respect to CT, inability to use contrast media in cases of renal insufficiency, lower spatial resolution and less availability than CT. CT is preferred in the acute aortic disease. Nevertheless, since it requires iodinated contrast media and X-ray exposure, it may be adequately replaced by MRI in the follow up of aortic diseases. The main limitation of MRI, however, is related to the scarce visibility of stents and calcifications.
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Affiliation(s)
- Ernesto Di Cesare
- Dipartimento di Scienze Cliniche Applicate e biotecnologiche, Università degli studi di L'Aquila, Via Vetoio 1, 67100 L'Aquila, Italy , Tel 00390862368306, Fax 00390862368797
| | - Alessandra Splendiani
- Dipartimento di Scienze Cliniche Applicate e biotecno-logiche Università degli studi di L'Aquila, Italy
| | - Antonio Barile
- Dipartimento di Scienze Cliniche Applicate e biotecno-logiche Università degli studi di L'Aquila, Italy
| | - Ettore Squillaci
- Dipartimento di Diagnostica per Immagini Universi-tà Tor Vergata Roma, Italy
| | - Annamaria Di Cesare
- Dipartimento di Scienze Cliniche Applicate e biotecno-logiche Università degli studi di L'Aquila, Italy
| | - Luca Brunese
- Dipartimento di medicina e Scienza della salute, Universita del Molise, Campobasso, Italy
| | - Carlo Masciocchi
- Dipartimento di Scienze Cliniche Applicate e biotecno-logiche Università degli studi di L'Aquila, Italy
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Thoracic spine trauma: advanced imaging modality. Radiol Med 2016; 121:780-92. [PMID: 27307000 DOI: 10.1007/s11547-016-0657-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/29/2016] [Indexed: 01/02/2023]
Abstract
Technological advances in diagnostic imaging make the diagnosis of spinal trauma more accurate both in the acute and in the chronic settings. Improvements in medical care and in diagnostic imaging lead to an increasing prevalence of patients' surviving injuries. The management of these patients depends on early and appropriate radiological evaluation in the acute phase. The aim of this work was to review advanced imaging modalities employed to study thoracic spine and spinal cord in injured patients.
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Splendiani A, Bruno F, Mariani S, La Marra A, Capretti I, Di Cesare E, Masciocchi C. A rare localization of pure dermoid cyst in the frontal bone. Neuroradiol J 2016; 29:130-3. [PMID: 26915898 DOI: 10.1177/1971400916631993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report the case of an 84-year-old woman who came to our attention with right palpebral edema associated with pain in the omolateral fronto-orbital region. The patient underwent an MRI scan that revealed a rounded, extracerebral intradiploic cystic lesion with dyshomogeneous signal intensity. Computed tomography (CT) imaging was also performed with reformatted 3D reconstruction. Post-surgical histologic analysis confirmed the diagnosis of intradiploic dermoid cyst. We here report the case and discuss epidemiology, imaging features and work-up of this pathological entity.
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Affiliation(s)
- Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
| | - Silvia Mariani
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
| | - Alice La Marra
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
| | - Ilaria Capretti
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, Radiology Unit, University of L'Aquila, Italy
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Clarençon F, Maizeroi-Eugène F, Maingreaud F, Bresson D, Ayoub D, Sourour NA, Menjot de Champfleur N, Chiras J, Yardin C, Mounayer C. Interest of convex spherical anamorphosis in better understanding of brain AVMs' angioarchitecture. J Neurointerv Surg 2015; 8:959-64. [PMID: 26362085 DOI: 10.1136/neurintsurg-2015-011888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/15/2015] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Convex spherical anamorphosis is a barrel distortion that consists of the application of a plane surface on a convex hemisphere. Applied in vascular imaging of brain arteriovenous malformations (bAVMs), this deformation may help to 'spread' the nidus and surrounding vessels (arteries/veins) and thus to differentiate the different components of bAVMs more accurately. METHODS The imaging data from 15 patients (8 male, 7 female; 14 supratentorial bAVMs, 1 infratentorial) were used to test the algorithm. The algorithm was applied to three-dimensional rotational angiography (3D-RA) volume rendering reconstructions in anteroposterior, lateral and oblique views and compared with regular 3D-RA and DSA. Arterial feeder and draining vein count and quality visualization of the main draining vein and intranidal aneurysms were compared between the three imaging techniques. RESULTS Anamorphosis was able to depict more arterial feeders than 3D-RA alone (p=0.027). There was no statistically significant difference between 6 f/s DSA and anamorphosis for arterial feeder count. No difference was observed in draining vein count between the three imaging modalities. Visualization of the precise origin of the main draining vein was considered to be good in 67% of the cases with anamorphosis versus 47% and 33% for 6 f/s DSA and 3D-RA alone, respectively. Intranidal aneurysms were accurately depicted by anamorphosis (2 cases), whereas 6 f/s DSA and 3D-RA showed doubtful images in one and two additional cases, respectively, which were finally confirmed as focal venous ectasias on supraselective injection. CONCLUSIONS Anamorphosis can help to visualize more precisely the main draining vein origin of the bAVM and depict more accurately intranidal aneurysms.
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Affiliation(s)
- Frédéric Clarençon
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - Damien Bresson
- Department of Neurosurgery, Lariboisière University Hospital, Paris, France
| | - David Ayoub
- Department of Neurosurgery, Saint-Joseph University Hospital, Beyrouth, Lebanon Department of Neuroradiology, Limoges University Hospital, Limoges, France
| | - Nader-Antoine Sourour
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Jacques Chiras
- Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Catherine Yardin
- Department of Histology, Cytology, Cellular Biology and Cytogenetics, Limoges University Hospital, Limoges, France
| | - Charbel Mounayer
- Department of Neuroradiology, Limoges University Hospital, Limoges, France
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