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Exertional heat stroke with pronounced presentation of microangiopathic hemolytic anemia: A case report. 劳累性中暑伴有明显的微血管病性溶血性贫血:病例报告。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-28 DOI: 10.4329/wjr.v16.i10.545
Chu-Han Xiang, Xi-Mu Zhang, Jie Liu, Jun Xiang, Lei Li, Qing Song

Background: Exertional heat stroke (EHS) is a critical condition arising from prolonged physical exertion in high temperatures that typically presents with normal hemoglobin levels. However, atypical presentations can also occur, leading to significant complications such as hemolytic anemia and organ dysfunction.

Case summary: This case report describes a male patient who experienced moderate-to-severe anemia that was difficult to correct, with a confirmed diagnosis of microangiopathic hemolytic anemia accompanying multiple organ dysfunction syndrome, indicative of critical EHS. Despite intensive resuscitation efforts, the patient's condition deteriorated, necessitating admission to the intensive care unit for advanced management.

Conclusion: This case highlights the importance of recognizing atypical presentations of EHS, particularly that with significant hemolytic anemia and concurrent organ failure. Clinicians should maintain a high level of suspicion for these complications in patients displaying symptoms of heat-related illness, especially when caused by strenuous activity, as early diagnosis and intervention are crucial to improve patient outcomes.

背景:劳累性中暑(EHS)是一种因在高温下长时间体力消耗而引起的危重症,通常表现为血红蛋白水平正常。病例摘要:本病例报告描述了一名男性患者出现难以纠正的中重度贫血,经确诊为微血管病性溶血性贫血,并伴有多器官功能障碍综合征,提示为危重的 EHS。尽管进行了全力抢救,但患者的病情仍不断恶化,不得不入住重症监护室接受进一步治疗:本病例强调了识别 EHS 非典型表现的重要性,尤其是伴有严重溶血性贫血和并发器官衰竭的病例。临床医生应高度怀疑有热相关疾病症状的患者会出现这些并发症,尤其是在剧烈运动的情况下,因为早期诊断和干预对改善患者预后至关重要。
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引用次数: 0
Portal venous gas complication following coronary angiography: A case report. 冠状动脉造影术后的门静脉气体并发症:病例报告。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-28 DOI: 10.4329/wjr.v16.i10.586
Zhang-Xiang Yu, Zhang Bin, Zhu-Kai Lun, Xu-Jian Jiang

Background: Portal vein gas (PVG) is an abnormal accumulation of gas within the portal and intrahepatic portal veins. It is associated with various abdominal diseases, ranging from benign conditions to life-threatening ones that require immediate surgical intervention. Coronary angiography is the standard diagnostic procedure for coronary artery disease. There were no prior reports are available of PVG as a complication of coronary angiography.

Case summary: In the specific case described here, the patient did not show signs of peritoneal irritation; however, computed tomography scans findings revealed pneumatosis in the wall of the small intestine, hepatic portal vein, and mesenteric vein, along with acute enteritis (etiology pending classification). A cesarean section was not performed, and the patient received treatment with fasting, rehydration, and anti-infection therapy. Subsequently, the patient's symptoms of abdominal distension and pain improved, and follow-up computed tomography scans indicated resolution of the portal system pneumatosis and intestinal wall edema, resulting in a favorable clinical outcome.

Conclusion: Portal venous gas complication following coronary angiography was a complication of coronary angiography.

背景:门静脉积气(PVG)是指门静脉和肝内门静脉内气体的异常积聚。它与各种腹部疾病有关,既有良性疾病,也有危及生命、需要立即手术治疗的疾病。冠状动脉造影是冠状动脉疾病的标准诊断程序。病例摘要:在本病例中,患者没有腹膜刺激症状,但计算机断层扫描结果显示小肠壁、肝门静脉和肠系膜静脉充气,并伴有急性肠炎(病因有待分类)。没有进行剖腹产手术,患者接受了禁食、补液和抗感染治疗。随后,患者的腹胀和腹痛症状有所改善,随访的计算机断层扫描显示,门静脉系统积气和肠壁水肿均已消除,临床疗效良好:结论:冠状动脉造影术后门静脉积气并发症是冠状动脉造影术的并发症之一。
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引用次数: 0
Ectopic recurrence following treatment of arteriovenous malformations in an adult: A case report and review of literature. 成人动静脉畸形治疗后的异位复发:病例报告和文献综述。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-28 DOI: 10.4329/wjr.v16.i10.537
Wen-Yu Cao, Jin-Ping Li, Peng Guo, Ling-Xie Song

Background: Digital subtraction angiography (DSA), the gold standard for the diagnosis of intracranial arteriovenous malformations (AVMs), can show clean nidus resection, leading to a perceived cure. Most cases of intracranial AVM recurrence have been reported in pediatric patients. The conventional understanding indicates that AVMs arise when abnormal blood vessels develop between the fourth and eighth weeks of embryonic development, which coincides with the typical period of blood vessel formation in the brain. As such, recurrent ectopic AVM are rare in adults.

Case summary: Herein, we present the case of a 31-year-old adult with a history of an intracranial AVM originally diagnosed with a symptomatic de novo cerebellar AVM formation. Recurrence was observed five years following angiographically-confirmed excision of the initial AVM. DSA performed prior to initial AVM resection indicated no cerebellar abnormalities. Moreover, the recurrent arteries exhibited differences in arteries and draining veins. In addition to reporting this case, we analyzed six previously-reported adult patients with similar ectopic recurrent AVMs. These cases are summarized to review and explore the potential causes of ectopic AVM recurrence in adults, which increase the likelihood of acquired AVM.

Conclusion: The clinical course of the reported patients demonstrated the possibility of ectopic AVM recurrence in adults. The median time between the diagnosis of the initial AVM and the occurrence of ectopic recurrent AVM in adults was 11 years (range: 5-20 years). Magnetic resonance imaging follow-up for more than 10 years may be required in adult AVM-treated patients.

背景:数字减影血管造影术(DSA)是诊断颅内动静脉畸形(AVM)的金标准,可显示干净的瘤巢切除,从而达到治愈的目的。大多数颅内动静脉畸形复发病例都发生在儿童患者身上。传统观点认为,动静脉畸形是在胚胎发育的第 4 至第 8 周出现异常血管时产生的,而胚胎发育的第 4 至第 8 周恰好是脑血管形成的典型时期。因此,复发性异位 AVM 在成人中非常罕见。病例摘要:本病例是一名 31 岁的成人,曾有颅内 AVM 病史,最初被诊断为无症状的新发小脑 AVM 形成。经血管造影证实切除初始 AVM 五年后发现复发。在切除最初的动静脉畸形之前进行的 DSA 显示小脑没有异常。此外,复发动脉在动脉和引流静脉方面存在差异。除报告本病例外,我们还分析了之前报告过的六名患有类似异位复发性 AVM 的成人患者。总结这些病例是为了回顾和探讨成人异位 AVM 复发的潜在原因,这些原因增加了获得性 AVM 的可能性:结论:所报告患者的临床病程证明了成人异位 AVM 复发的可能性。成人从诊断出最初的 AVM 到发生异位复发 AVM 的中位时间为 11 年(范围:5-20 年)。接受过 AVM 治疗的成人患者可能需要磁共振成像随访 10 年以上。
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引用次数: 0
Epstein-Barr virus positive post-transplant lymphoproliferative disorder with significantly decreased T-cell chimerism early after transplantation: A case report. Epstein-Barr病毒阳性的移植后淋巴组织增生性疾病,移植后早期T细胞嵌合率显著下降:病例报告。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-28 DOI: 10.4329/wjr.v16.i10.600
Qing-Na Guo, Hai-Sheng Liu, Lin Li, Dian-Ge Jin, Ji-Min Shi, Xiao-Yu Lai, Li-Zhen Liu, Yan-Min Zhao, Jian Yu, Yan-Yuan Li, Fang-Quan Yu, Zhe Gao, Jiao Yan, He Huang, Yi Luo, Yi-Shan Ye

Background: Post-transplant lymphoproliferative disorder (PTLD) is a rare but highly fatal complication occurring after allogeneic hematopoietic cell transplantation (allo-HCT) or solid organ transplantation (SOT). Unlike SOT, PTLD after allo-HCT usually originates from the donor and is rarely accompanied by a loss of donor chimerism.

Case summary: We report a case of Epstein-Barr virus positive PTLD manifesting as diffuse large B-cell lymphoma (DLBCL) with significantly decreased T-cell chimerism early after allo-HCT. A 30-year-old patient with acute myeloid leukemia underwent unrelated allo-HCT after first complete remission. Nearly 3 mo after transplantation, the patient developed cervical lymph node enlargement and gastric lesions, both of which were pathologically suggestive of DLBCL. Meanwhile, the patient experienced a significant and persistent decrease in T-cell chimerism. A partial remission was achieved after chemotherapy with single agent rituximab and subsequent R-CHOP combined chemotherapy.

Conclusion: The loss of T-cell chimerism and the concomitant T-cell insufficiency may be the cause of PTLD in this patient.

背景:移植后淋巴组织增生性疾病(PTLD)是异基因造血细胞移植(allo-HCT)或实体器官移植(SOT)后发生的一种罕见但高度致命的并发症。病例摘要:我们报告了一例Epstein-Barr病毒阳性的PTLD,表现为弥漫性大B细胞淋巴瘤(DLBCL),异基因造血干细胞移植后早期T细胞嵌合率明显下降。一名30岁的急性髓性白血病患者在首次完全缓解后接受了无关的异种器官移植。移植后近3个月,患者出现颈淋巴结肿大和胃部病变,病理结果均提示为DLBCL。与此同时,患者的T细胞嵌合率持续显著下降。在接受单药利妥昔单抗化疗和随后的R-CHOP联合化疗后,患者病情得到部分缓解:结论:T细胞嵌合体的丧失和伴随的T细胞功能不全可能是该患者PTLD的病因。
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引用次数: 0
Quantitative magnetic resonance imaging in prostate cancer: A review of current technology. 前列腺癌的定量磁共振成像:当前技术回顾。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-28 DOI: 10.4329/wjr.v16.i10.497
Ankita Dhiman, Virendra Kumar, Chandan Jyoti Das

Prostate cancer (PCa) imaging forms an important part of PCa clinical management. Magnetic resonance imaging is the modality of choice for prostate imaging. Most of the current imaging assessment is qualitative i.e., based on visual inspection and thus subjected to inter-observer disagreement. Quantitative imaging is better than qualitative assessment as it is more objective, and standardized, thus improving interobserver agreement. Apart from detecting PCa, few quantitative parameters may have potential to predict disease aggressiveness, and thus can be used for prognosis and deciding the course of management. There are various magnetic resonance imaging-based quantitative parameters and few of them are already part of PIRADS v.2.1. However, there are many other parameters that are under study and need further validation by rigorous multicenter studies before recommending them for routine clinical practice. This review intends to discuss the existing quantitative methods, recent developments, and novel techniques in detail.

前列腺癌(PCa)成像是 PCa 临床治疗的重要组成部分。磁共振成像是前列腺成像的首选方式。目前的大多数成像评估都是定性的,即基于肉眼观察,因此观察者之间会产生分歧。定量成像优于定性评估,因为它更加客观和标准化,从而提高了观察者之间的一致性。除了检测 PCa 外,一些定量参数可能具有预测疾病侵袭性的潜力,因此可用于预后和决定治疗方案。目前有多种基于磁共振成像的定量参数,其中少数已经纳入 PIRADS 2.1 版。然而,还有许多其他参数正在研究中,需要通过严格的多中心研究进一步验证,才能推荐用于常规临床实践。本综述旨在详细讨论现有的定量方法、最新进展和新型技术。
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引用次数: 0
Innovative approaches beyond periprocedural hydration for preventing contrast-induced acute kidney injury. 预防造影剂诱发急性肾损伤的创新方法,不局限于围术期水化。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-28 DOI: 10.4329/wjr.v16.i9.375
Chun-Han Cheng, Wen-Rui Hao, Tzu-Hurng Cheng

Contrast-induced acute kidney injury (CI-AKI) is a major concern in clinical practice, particularly among high-risk patients with preexisting renal and cardiovascular conditions. Although periprocedural hydration has long been the primary approach for CI-AKI prevention, recent advancements have led to the development of novel approaches such as RenalGuard and contrast removal systems. This editorial explores these emerging approaches and highlights their potential for enhancing CI-AKI prevention. By incorporating the latest evidence into clinical practice, health-care professionals can more effectively maintain renal function and improve outcomes for patients undergoing contrast-enhanced procedures.

造影剂诱发的急性肾损伤(CI-AKI)是临床实践中的一个主要问题,尤其是在已有肾脏和心血管疾病的高危患者中。虽然围术期水化一直是预防 CI-AKI 的主要方法,但最近的进步促使人们开发出了 RenalGuard 和造影剂清除系统等新方法。这篇社论探讨了这些新兴方法,并强调了它们在加强 CI-AKI 预防方面的潜力。通过将最新证据融入临床实践,医护人员可以更有效地维持肾功能,改善接受造影剂增强手术患者的预后。
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引用次数: 0
Behcet's disease-related panuveitis following COVID-19 vaccination: A case report. 接种 COVID-19 疫苗后引发的与白塞氏病相关的泛葡萄膜炎:病例报告。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-28 DOI: 10.4329/wjr.v16.i9.460
Rou-Ting Lin, Pei-Kang Liu, Chia-Wei Chang, Kai-Chun Cheng, Kuo-Jen Chen, Yo-Chen Chang

Background: Behcet's disease (BD) is an inflammatory disorder known for various symptoms, including oral and genital ulcers and ocular inflammation. Panuveitis, a severe eye condition, is rare as the first sign of BD.

Case summary: We present an unusual case of a 30-year-old man who developed panuveitis after receiving the mRNA-based coronavirus disease 2019 (COVID-19) vaccine (Moderna). Laboratory tests ruled out infections, but he had a positive HLA-B51 result and a history of genital ulcer and oral ulcers, leading to a BD diagnosis. Treatment with corticosteroids improved his condition. Interestingly, he had another episode of panuveitis after the second mRNA vaccine dose, which also responded to corticosteroids.

Conclusion: This case highlights the rare onset of BD following mRNA COVID-19 vaccination, suggesting a potential link between these vaccines and BD's eye symptoms, emphasizing the importance of quick treatment in similar cases.

背景:白塞氏病(BD)是一种炎症性疾病,有多种症状,包括口腔和生殖器溃疡以及眼部炎症。病例摘要:我们报告了一例不寻常的病例,一名 30 岁的男子在接种了基于 mRNA 的冠状病毒病 2019(COVID-19)疫苗(Moderna)后出现了泛发性葡萄膜炎。实验室检查排除了感染的可能性,但他的 HLA-B51 结果呈阳性,且有生殖器溃疡和口腔溃疡病史,因此被诊断为 BD。皮质类固醇治疗改善了他的病情。有趣的是,他在接种第二剂 mRNA 疫苗后再次发生泛葡萄膜炎,皮质类固醇治疗也起效:本病例突显了接种mRNA COVID-19疫苗后出现BD的罕见情况,表明这些疫苗与BD的眼部症状之间存在潜在联系,并强调了在类似病例中快速治疗的重要性。
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引用次数: 0
Extralobar pulmonary sequestration in children with abdominal pain: Four case reports. 腹痛患儿的肺外栓塞:四份病例报告。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-28 DOI: 10.4329/wjr.v16.i9.453
Meng-Yuan Jiang, Yuan-Xiang Wang, Zhi-Wei Lu, Yue-Jie Zheng

Background: Extralobar pulmonary sequestration (ELS) with torsion is extremely rare, consequently, the diagnosis of ELS with torsion in children presents a challenge for clinicians. Herein, we report four cases of ELS with torsion that presented with abdominal pain, and further review the relevant literature to summarize the clinical features.

Case summary: Four children presented to our department with abdominal pain. All underwent chest computed tomography, which revealed an intrathoracic soft tissue mass with pleural effusion. All four children underwent thoracoscopic resection of the identified pulmonary sequestration, and the vascular pedicle was clipped and excised. None of the patients experienced any postoperative complications.

Conclusion: Clinicians should consider the possibility of ELS with torsion in children presenting with abdominal pain as the chief complaint.

背景:小叶外肺动脉栓塞(ELS)伴扭转极为罕见,因此,诊断儿童 ELS 伴扭转给临床医生带来了挑战。在此,我们报告了四例伴有腹痛的 ELS 扭转病例,并进一步回顾了相关文献,总结了其临床特征:四名儿童因腹痛到我科就诊。所有患儿均接受了胸部计算机断层扫描,结果显示胸腔内软组织肿块伴胸腔积液。所有四名患儿均接受了胸腔镜下肺包块切除术,并剪除和切除了血管蒂。所有患者均未出现术后并发症:结论:对于以腹痛为主诉的儿童,临床医生应考虑ELS扭转的可能性。
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引用次数: 0
Cerebral perfusion in patients with unilateral internal carotid artery occlusion by dual post-labeling delays arterial spin labeling imaging. 通过双标记后延迟动脉自旋标记成像观察单侧颈内动脉闭塞患者的脑灌注情况。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-28 DOI: 10.4329/wjr.v16.i9.429
Gui-Rong Zhang, Yan-Yan Zhang, Wen-Bin Liang, Dun Ding

Background: Global and regional cerebral blood flow (CBF) changes in patients with unilateral internal carotid artery occlusion (ICAO) are unclear when the dual post-labeling delays (PLD) arterial spin labeling (ASL) magnetic resonance imaging (MRI) technique is used. Manual delineation of regions of interest for CBF measurement is time-consuming and laborious.

Aim: To assess global and regional CBF changes in patients with unilateral ICAO with the ASL-MRI perfusion technique.

Methods: Twenty hospitalized patients with ICAO and sex- and age-matched controls were included in the study. Regional CBF was measured by Dr. Brain's ASL software. The present study evaluated differences in global, middle cerebral artery (MCA) territory, anterior cerebral artery territory, and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) regions (including the caudate nucleus, lentiform nucleus, insula ribbon, internal capsule, and M1-M6) and brain lobes (including frontal, parietal, temporal, and insular lobes) between ICAO patients and controls at PLD 1.5 s and PLD 2.5 s.

Results: When comparing CBF between ICAO patients and controls, the global CBF in ICAO patients was lower at both PLD 1.5 s and PLD 2.5 s; the CBF on the occluded side was lower in 15 brain regions at PLD 1.5 s, and it was lower in 9 brain regions at PLD 2.5 s; the CBF in the contralateral hemisphere was lower in the caudate nucleus and internal capsule at PLD 1.5 s and in M6 at PLD 2.5 s. The global CBF in ICAO patients was lower at PLD 1.5 s than at PLD 2.5 s. The ipsilateral CBF at PLD 1.5 s was lower than that at PLD 2.5 s in 15 regions, whereas the contralateral CBF was lower at PLD 1.5 s than at PLD 2.5 s in 12 regions. The ipsilateral CBF was lower than the contralateral CBF in 15 regions at PLD 1.5 s, and in M6 at PLD 2.5 s.

Conclusion: Unilateral ICAO results in hypoperfusion in the global and MCA territories, especially in the ASPECTS area. Dual PLD settings prove more suitable for accurate CBF quantification in ICAO.

背景:使用双标记后延迟(PLD)动脉自旋标记(ASL)磁共振成像(MRI)技术时,单侧颈内动脉闭塞(ICAO)患者的整体和区域脑血流(CBF)变化尚不明确。目的:使用 ASL-MRI 灌注技术评估单侧 ICAO 患者的整体和区域 CBF 变化:研究纳入了 20 名住院的 ICAO 患者以及性别和年龄匹配的对照组。使用 Dr. Brain 的 ASL 软件测量区域 CBF。本研究评估了在 PLD 1.5 秒和 PLD 2.5 秒时,ICAO 患者和对照组之间在全球、大脑中动脉(MCA)区域、大脑前动脉区域和阿尔伯塔省卒中项目早期计算机断层扫描评分(ASPECTS)区域(包括尾状核、扁桃体核、岛叶带、内囊和 M1-M6)和脑叶(包括额叶、顶叶、颞叶和岛叶)的差异:在比较 ICAO 患者和对照组的 CBF 时,ICAO 患者在 PLD 1.5 秒和 PLD 2.5 秒时的整体 CBF 均较低;在 PLD 1.5 秒时,闭塞侧 15 个脑区的 CBF 较低,在 PLD 2.5 秒时,闭塞侧 9 个脑区的 CBF 较低;在 PLD 1.5 秒时,对侧半球尾状核和内囊的 CBF 较低,在 PLD 2.5 秒时,尾状核和内囊的 CBF 较低。15 个区域的同侧 CBF 在 PLD 1.5 秒时低于 PLD 2.5 秒时,而 12 个区域的对侧 CBF 在 PLD 1.5 秒时低于 PLD 2.5 秒时。15 个区域在 PLD 1.5 秒时同侧 CBF 低于对侧 CBF,M6 区域在 PLD 2.5 秒时同侧 CBF 低于对侧 CBF:结论:单侧 ICAO 会导致全球和 MCA 区域灌注不足,尤其是在 ASPECTS 区域。双 PLD 设置证明更适合在 ICAO 中准确量化 CBF。
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引用次数: 0
Intentionally unilateral prostatic artery embolization: Patient selection, technique and potential benefits. 有意单侧前列腺动脉栓塞术:患者选择、技术和潜在益处。
IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-28 DOI: 10.4329/wjr.v16.i9.380
Hippocrates Moschouris, Konstantinos Stamatiou

Background: Prostatic artery embolization (PAE) is a promising but also technically demanding interventional radiologic treatment for symptomatic benign prostatic hyperplasia. Many technical challenges in PAE are associated with the complex anatomy of prostatic arteries (PAs) and with the systematic attempts to catheterize the PAs of both pelvic sides. Long procedure times and high radiation doses are often the result of these attempts and are considered significant disadvantages of PAE. The authors hypothesized that, in selected patients, these disadvantages could be mitigated by intentionally embolizing PAs of only one pelvic side.

Aim: To describe the authors' approach for intentionally unilateral PAE (IU-PAE) and its potential benefits.

Methods: This was a single-center retrospective study of patients treated with IU-PAE during a period of 2 years. IU-PAE was applied in patients with opacification of more than half of the contralateral prostatic lobe after angiography of the ipsilateral PA (subgroup A), or with markedly asymmetric prostatic enlargement, with the dominant prostatic lobe occupying at least two thirds of the entire gland (subgroup B). All patients treated with IU-PAE also fulfilled at least one of the following criteria: Severe tortuosity or severe atheromatosis of the pelvic arteries, non-visualization, or visualization of a tiny (< 1 mm) contralateral PA on preprocedural computed tomographic angiography. Intraprocedural contrast-enhanced ultrasonography (iCEUS) was applied to monitor prostatic infarction. IU-PAE patients were compared to a control group treated with bilateral PAE.

Results: IU-PAE was performed in a total 13 patients (subgroup A, n = 7; subgroup B, n = 6). Dose-area product, fluoroscopy time and operation time in the IU-PAE group (9767.8 μGy∙m2, 30.3 minutes, 64.0 minutes, respectively) were significantly shorter (45.4%, 35.9%, 45.8% respectively, P < 0.01) compared to the control group. Clinical and imaging outcomes did not differ significantly between the IU-PAE group and the control group. In the 2 clinical failures of IU-PAE (both in subgroup A), the extent of prostatic infarction (demonstrated by iCEUS) was significantly smaller compared to the rest of the IU-PAE group.

Conclusion: In selected patients, IU-PAE is associated with comparable outcomes, but with lower radiation exposure and a shorter procedure compared to bilateral PAE. iCEUS could facilitate patient selection for IU-PAE.

背景:前列腺动脉栓塞术(PAE)是治疗无症状良性前列腺增生的一种前景广阔但技术要求较高的介入放射疗法。前列腺动脉栓塞术的许多技术难题与前列腺动脉(PA)的复杂解剖结构以及对骨盆两侧前列腺动脉进行导管插入的系统性尝试有关。这些尝试往往导致手术时间长和辐射剂量大,被认为是 PAE 的重大缺点。作者假设,在选定的患者中,通过有意栓塞仅一侧骨盆的 PA,可以减轻这些缺点。目的:描述作者有意单侧 PAE(IU-PAE)的方法及其潜在优势:这是一项单中心回顾性研究,研究对象是两年内接受过 IU-PAE 治疗的患者。IU-PAE适用于同侧PA血管造影后对侧前列腺叶一半以上不透明的患者(A亚组),或前列腺明显不对称增大,优势前列腺叶至少占整个腺体三分之二的患者(B亚组)。所有接受 IU-PAE 治疗的患者还至少符合以下一项标准:盆腔动脉严重迂曲或严重粥样化,术前计算机断层扫描血管造影未显示或显示对侧微小(< 1 毫米)PA。术中造影剂增强超声检查(iCEUS)用于监测前列腺梗塞。将IU-PAE患者与接受双侧PAE治疗的对照组进行比较:共有 13 名患者接受了 IU-PAE 治疗(A 子组,n = 7;B 子组,n = 6)。与对照组相比,IU-PAE组的剂量-面积乘积、透视时间和手术时间(分别为9767.8 μGy∙m2、30.3分钟、64.0分钟)显著缩短(分别为45.4%、35.9%、45.8%,P < 0.01)。IU-PAE 组与对照组的临床和影像学结果无明显差异。在2例临床失败的IU-PAE患者(均为A亚组)中,前列腺梗死的范围(iCEUS显示)明显小于其他IU-PAE组患者:结论:在经过选择的患者中,IU-PAE 与双侧 PAE 相比,结果相当,但辐射量更低,手术时间更短。
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引用次数: 0
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World journal of radiology
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