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Should We Be Concerned? Comparison of Catheter and CT Angiogram for Arterial distensibility at the Site of Carotid Stenosis during Catheter Angiography

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Open Journal of Medical Imaging 2017年第4期7卷 237-247页

作者： Aly Abayazeed Juan Diego Lozano Gabriela Santos-Nunez Srinivasan Vendantham Ajit Puri Ajay Wakhloo Deepak Takhtani Department of Radiology University of Massachusetts Medical School Worcester MA USA

Purpose: During catheter angiogram (CA) there is momentary increase in intravascular volume and pressure due to intra-arterial injection that can potentially cause vascular distention at the stenotic site, whereas on CT angiogram (CTA) is unlikely due to intravenous administration. Methods: CA and CTA of the carotid artery from 29 patients were retrospectively studied. CA and CTA were obtained for each patient. Curved sagittal MPRs mirroring the carotid artery on CA were used to measure the diameter at stenosis and at the distal lumen. Mural plaque calcium content was graded on axial CTAs. Results: Accounting for repeated measurements, the likelihood that the lumen diameter from CA will be larger than CTA was higher at stenosis than distal to it but the difference in lumen diameters at stenosis was similar to CTA. There is insufficient evidence that intra-arterial hand-injection during CA leads to underestimation of the degree of stenosis. Percentage stenosis using the NASCET criteria differed between the 3 measurements, post hoc analysis showed significant difference between CA and axial CTA (p p > 0.99). The difference in lumen diameter did not depend on our calcium grading (p = 0.484). Conclusions: There is insufficient evidence to suggest that intra-arterial hand-injection contributes to vessel distention and underestimation of percent stenosis during CA in this study. Mural plaque calcium does not affect the degree of stenosis on CTA.

关键词： Arterial distensibility Carotid Stenosis Catheter Angiogram

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Do we really understand the role of the oesophagogastric junction in disease?

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World Journal of Gastroenterology 2009年第2期15卷 144-150页

作者： Barry P McMahon Blair A Jobe John E Pandolfino Hans Gregersen Department of Medical Physics & Clinical Engineering Adelaide & Meath Hospital Tallaght Dublin 24 Ireland Associate Professor of Surgery Director of Esophageal Diagnostics & Therapeutic Endoscopy Heart Lung and Esophageal Surgery Institute University of Pittsburgh Medical Centre Shadyside Medical Building Suite 715 Pittsburgh PA 15232 United States Division of Gastroenterology Northwestern Memorial University Hospital 676 N. St. Clair St. Suite 1400 Chicago IL 60611 United States Professor of Biomechanics Director of Research Mech-Sense Aalborg Hospital Science and Innovation Centre Sφndre Skovvej 15 9000 Aalborg Denmark

The role of the oesophago-gastric junction (OGJ) in gastro-oesophageal reflux disease is still not completely understood, and there is no clinically used method to assess the OGJ function in patients. Only indirect methods such as pH studies are carried out. The OGJ acts a valve controlling the flow of solids, liquids and gases between the oesophagus and the stomach. Manometry can determine if a sphincter is toned or relaxed; but, it cannot confirm that the sphincter region is actually open. Distension is a new technique for measuring function in the OGJ. By measuring the cross-sectional area through the narrow region in the junction during distension of a catheter mounted bag, much more information on the opening and closing patterns of the junction can be determined. This technique has already been demonstrated to show changes in the OGJ after surgical treatments for reflux disease. New measurement ideas around the concept of distending the OGJ offer new hope that a clinically useable test for compliance at the junction can be developed and could potentially help in determining appropriate therapy.

关键词： Achalasia distensibility Impedance Planimetry Intraluminal impedance manometry Oesophago-gastric junction

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Functional oesophago-gastric junction imaging

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World Journal of Gastroenterology 2006年第18期12卷 2818-2824页

作者： Barry P McMahon Asbjφrn M Drewes Hans Gregersen Department of Medical Physics and Clinical Engineering Adelaide and Meath Hospital DublinIncorporating the National Children's HospitalTallaghtDublin 24Ireland Centre for Visceral Biomechanics & Pain Aalborg HospitalAalborgDenmark

Despite its role in disease there is still no definitive method to assess oesophago-gastric junction competence （OGJ）. Traditionally the OGJ has been assessed using manometry with lower oesophageal sphincter pressure as the indicator. More recently this has been shown not to be a very reliable marker of sphincter function and competence against reflux. Disorders such as gastro-oesophageal reflux disease and to a lesser extend achalasia still effects a significant number of patients. This review looks at using a new technique known as impedance planimetry to profile the geometry and pressure in the OGJ during distension of a bag. The data gathered can be reconstructed into a dynamic representation of OGJ action. This has been shown to provide a useful representation of the OGJ and to show changes to the competence of the OGJ in terms of compliance and distensibility as a result of endoluminal therapy.

关键词： Oesophagogastric junction Lower oesophageal sphincter Competence distensibility Functional imaging

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