RESUMEN
Fifteen patients, aged between 9 and 21 years (mean, 15.1), with native coarctation of the aorta (CoA) or suspected recoarctation after surgical repair, underwent three different diagnostic procedures. Two-dimensional echocardiography (2D echo) and magnetic resonance imaging (MRI) of the thoracic aorta were performed in all patients; 14 patients underwent aortography, and digital subtraction angiography of the aorta was performed in one (after injection via a central venous catheter). Conventional electrocardiographic (ECG) gated MRI was performed, using the sagittal plane, a 256 x 256 acquisition matrix, multi-slice technique and a slice thickness of 10 mm. Diameters at the coarctation site were determined by all methods. Additional diameters of the descending aorta and the aortic arch were measured by MRI and echocardiography, respectively. All noninvasively obtained diameters were compared with angiographic data. Ultrasound imaging of the aortic isthmus was achieved in seven of 15 patients and of the aortic arch in nine of 15. The mean difference compared with angiographically determined diameters was 1.7 (0-7) mm, being greater for the coarctation site [mean, 2.2 (0-4)]. MRI images of the aortic isthmus were obtained in all patients, but the difference to angiographically determined diameters was slightly higher [mean, 3.2 mm (0-8)] than the ultrasound results. This deviation was presumably due to technical conditions, such as slice thickness and orthogonal imaging planes. Including all diameters, the correlation to invasive measurements was r = 0.82 (SEM = 3.1) for MRI and r = 0.89 (SEM = 2.3) for echo recordings.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Angiografía , Coartación Aórtica/diagnóstico por imagen , Ecocardiografía , Imagen por Resonancia Magnética , Adolescente , Adulto , Coartación Aórtica/diagnóstico , Niño , Femenino , Humanos , MasculinoRESUMEN
Computer assisted radionuclide angiography (CARNA) with 99mTc-DTPA was employed to study 143 patients with transient ischemic attacks (TIA) and 79 patients with prolonged reversible ischemic neurologic deficit (PRIND). The results of CARNA were compared with findings from radiographic angiography (RGA) in 173 patients and with findings in transmission computerized axial tomography (T-CAT) in 154 patients. In patients with TIA, CARNA showed a hemispherical perfusion deficit in 74.8%, and with PRIND 87.3%. This deficit, determined as the relative difference between the involved and the non-involved hemisphere, was significantly (p less than 0.0025) greater in PRIND (minus 23%) than in TIA (minus 17%). Sensitivity of CARNA was independent of the interval from ictus to examination for more than 4 months. RGA in TIA revealed true positives in 82.0%, in PRIND it was 89.5%. T-CAT was positive in TIA in only 16.8% but in PRIND it was 64.4%. Combined sensitivities in TIA (92.4%) and in PRIND (94.0%) were highest with the combination of CARNA and RGA. However, in PRIND the combination of non-invasive methods (CARNA and T-CAT) revealed 93.2% positive findings. Combinations of these evaluation methods may be used to detect cerebrovascular disease in patients with such dysfunction.
Asunto(s)
Isquemia Encefálica/diagnóstico , Angiografía Cerebral , Ataque Isquémico Transitorio/diagnóstico , Tomografía Computarizada de Emisión , Tomografía Computarizada por Rayos X , Enfermedades de las Arterias Carótidas/diagnóstico , Humanos , Ácido Pentético , Tecnecio , Pentetato de Tecnecio Tc 99mRESUMEN
Fifty-five peripheral pulmonary lesions in 46 patients were examined by computed tomography. The results were correlated with histologic diagnoses. The series comprised 26 bronchial carcinomas, 17 metastases, 4 chondromas, 5 tuberculomas and 3 echinacoccal cysts. The high resolution capacity of CT in the evaluation of macro pathologic pattern specially with the electronic image processing, with densitometry in regional interest is emphasised. Therefore cysts, fatty and other solid masses in the lung can be distinguished. Further more one can gain information of the underlying tissue on the basis of absorption profile.