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carotid blowout syndrome caused by chronic infection:A case report

World Journal of Clinical Cases 2022年第15期10卷 5051-5056页

作者： Tian-Hao Xie Wen-Jun Zhao Xiao-Long Li Yan Hou Xiong Wang Jing Zhang Xiu-Hua An Li-Tao Liu Department of General Surgery Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina Department of Ophthalmology MEM Yinghua HospitalBaoding 071000Hebei ProvinceChina Department of Traumatology The First Hospital of Hebei Medical UniversityShijiazhuang 050000Hebei ProvinceChina Department of Imaging Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina Department of General Surgery Li County HospitalBaoding 071400Hebei ProvinceChina Department of Internal Medicine Wangdu County Chinese Medicine HospitalBaoding 072450Hebei ProvinceChina

BACKGROUND carotid blowout syndrome(CBS)refers to rupture of the extracranial carotid artery and its branches;as a severe complication,it usually occurs after surgery or radiotherapy for malignant tumours of the head and *** present a case of CBS caused by chronic infection of the external carotid artery(ECA).In this case,we did not find any evidence of head and neck *** SUMMARY A 42-year-old man was referred to the Emergency Department with a complaint of a lump found on the left side of his neck with pain and fever for 4 *** diagnosed the condition as neck infection with abscess formation based on physical examination,routine blood examination,ultrasound examination and plain computed tomography(CT)and decided to perform emergency *** the operation,30 mL of grey and smelly pus was drained from the deep surface of the sternocleidomastoid *** second day after the operation,the patient suddenly exhibited a large amount of haemoptysis and incision *** enhanced CT showed distal occlusion of the left ECA and irregular thickening of the broken ends of the artery encased in an uneven enhancement of soft tissue *** ECA occlusion and rupture were *** patient was transferred to a vascular unit for transcatheter ECA embolization and recovered *** Surgeons need to pay attention to vascular lesions caused by chronic infection that may develop into acute CBS.

关键词： carotid blowout syndrome carotid arteries Infection Surgery Case report

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Advantage in Bright-blood and Black-blood Magnetic Resonance Imaging with High-resolution for Analysis of carotid Atherosclerotic Plaques

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Chinese Medical Journal 2015年第18期128卷 2478-2484页

作者： Mei Li Wei-Jie Le Xiao-Feng Tao Ming-Hua Li Yue-Hua Li Nan Qu Department of Radiology Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University Shanghai 200233 China Department of Radiology Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China

Background： About 50% of the cerebral ischemia events are induced by intracranial and extracranial atheroscterosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging （MRI） techniques. Methods： Totally, 49 patients suspected ofextracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography （MRA） examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography （DSA） examination was carried out for 16 patients within I month. Results： Totally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T I -weighted image （T I WI） and hyperintensities in proton density weighted image （PDWI） and T2-weighted image （T2WI）, lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs 0.97, P 〈 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%. 100%, and 97.9%, respectively. Conclusions： High-resolu

关键词： Atherosclcrosis Black-blood Bright-blood carotid arteries Magnetic Resonance Image

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Short-term results of carotid stenting for the treatment of extracranial carotid occlusive disease

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Chinese Medical Journal 2006年第11期119卷 957-962页

作者： FU Wei-guo ZHU Ting CHEN Bin JIANG Jun-hao YANG Jue SHI Zhen-yu Institute of Vascular Surgery Zhongshan Hospital Fudan University Shanghai 200032 China

carotid artery angioplasty and stenting （CAS） has been performed with increasing frequency for the treatment of extracranial carotid occlusive diseases （ECOD） in recent years. Its feasibility and safety are supported by the Stenting and Angioplasty with Protection in Patient at High Risk for Endarterectomy （SAPPHIRE） trial,1 which revealed a lower incidence of death, stroke and myocardial infarction compared with carotid endarterectomy （CEA） in high-risk patients. However, it is a pity that up to now, initial results of this endovascular procedure have yet been infrequently documented in China. This retrospective study was to analyze the short-term results of CAS to treat ECOD in a single medical center.

关键词： carotid arteries angioplasty stenting complication

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Expression of recombinant adeno-associated virus in the brain of rats with a focal embolic stroke via carotid artery

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Chinese Medical Journal 2002年第8期115卷 1170-1174,149-150页

作者：韩宗超张苏明李宏伟阮旭中肖萧王涛汪道文华中科技大学同济医学院附属同济医院神经内科武汉430030 华中科技大学同济医学院附属同济医院内科.基因研究中心武汉430030 美国匹兹堡大学基因研究中心

OBJECTIVE: To study whether recombinant adeno-associated virus (rAAV)　mediated foreign gene, LacZ, could pass the blood　brain barrier by intra-carotid artery delivery and express in vivo in ischemic brain of the focal embolic stroke rats to investigate a possibility of delivering foreign gene through carotid artery to treat acute ischemic stroke. METHODS: The carotid artery territory in 41 rats was embolized with or without arterial-like fibrin rich clots to make a model of focal embolic stroke rat. rAAV containing LacZ gene (rAAV-LacZ) was constructed in 293 cells by calcium phosphate cotransfection. The rats were assigned to one of the following treatments: 1 control (without embolism) groups, including PBS treated (n = 6), pLacZ treated (n = 6 ) and rAAV-LacZ treated (n = 6): 2 embolic groups, including embolism + PBS (n =7),embolism + pLacZ (n = 8) and embolism + rAAV-LacZ (n = 8). Brains were cryosectioned and kappa-Gal stain was performed at 2, 4, and 8 weeks, respectively, after transfection, and then infarct volume was measured and the percentage of LacZ staining-positive cells was calculated. RESULTS: In all the control groups and embolism + PBS treated animal, no kappa-Gal staining-positive cells were found, but in embolism + pLacZ (n = 8) and embolism+rAAV-LacZ groups a lot of kappa-Gal staining-positive cells were found. The expression cells were in the tissues around the infarction. The gene expression persisted only nearly four weeks in embolic group with pLacZ. In the embolic group with rAAV-LacZ the expression was very stable during the experiment course (eight weeks) and the percentage of the expressed cells was significantly higher than that of its contralateral areas at the same time points, respectively. CONCLUSIONS: The plasmid vector and rAAV could enter the brain through the ischemia-damaged blood barrier and foreign gene can be expressed in brain. The positive gene expression is mainly in the peripheral areas of the infarction. rAAV as a perm

关键词： Gene Therapy Animals Blood-Brain Barrier Brain carotid arteries Cerebrovascular Accident Dependovirus Genetic Vectors Intracranial Embolism Male Rats Rats, Sprague-Dawley Research Support, Non-U.S. Gov't

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Association between fasting and postprandial triglyceride levels and carotid intima-media thickness in type 2 diabetes patients

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Chinese Medical Journal 2003年第12期116卷 1933-1935页

作者：陈香田浩明刘瑞 Department of Endocrinology West China Hospital Department of Endocrinology and Laboratory of Internal Medicine West China Hospital

OBJECTIVE: To investigate the association of fasting and postpiandial triglyceride with carotid intima-media thickness among type 2 diabetic patients in southeast China. METHODS: A total of 78 type 2 diabetic patients from southeast China were recruited. All the subjects underwent a standardized mixed-meal test (SMMT) and an oral glucose tolerance test. carotid intima-media thickness (IMT) was measured by color doppler ultrasound examination. RESULTS: Postprandial triglyceride (PTG) after SMMT increased significantly in type 2 diabetic patients. The carotid IMT in patients with postprandial hypertriglyceridemia was significantly greater than that in patients with postprandial normal-triglyceridemia (0.90 mm vs 0.81 mm, P 0.05). CONCLUSION: The results suggest that postprandial hypertriglyceridemia may be an independent risk factor of early atherosclerosis in type 2 diabetes.

关键词： Eating carotid arteries Diabetes Mellitus, Type 2 Female Humans Male Middle Aged Risk Factors Triglycerides Tunica Intima Tunica Media

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Ultrafast pulse wave velocity technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis patients with euthyroidism

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中国医学影像技术 2024年第8期40卷 1179-1182页

作者： JIANG Yanhui LIU Meiling XIE Jingwen ZHANG Jianxing Department of Ultrasound the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China

Objective To explore the value of ultrafast pulse wave velocity(UFPWV)technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis(HT)patients with *** Conventional ultrasound and UFPWV for carotid artery were prospectively performed in 91 HT patients with euthyroidism(HT group)and 81 healthy subjects(control group).Clinical data and ultrasonic parameters were compared between *** correlation analysis was performed to observe the correlations of carotid pulse wave velocity in end of systole(PWV-ES)with clinical indexes and other ultrasonic parameters in HT *** stepwise linear regression analysis was used to screen the independent impact factors of increased carotid PWV-ES in HT *** Significant differences of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),total cholesterol(TC),low density lipoprotein and neutrophil-lymphocyte ratio(NLR)were found between groups(all Pcarotid PWV-ES in HT group was significantly higher than that in control group(Pcarotid artery intima-media thickness(CIMT)nor carotid pulse wave velocity in beginning of systole(PWV-BS)was found between groups(both P>0.05).carotid PWV-ES in HT group was positively correlated with patients'age,body mass index,TPOAb,TC,triglyceride,NLR and CIMT(r=0.217—0.707,all Pcarotid PWV-ES in HT patients with euthyroidism(all Pcarotid artery elasticity in HT patients with euthyroidism,among which PWV-ES was relatively sensitive.

关键词： Hashimoto disease carotid arteries ultrasonography prospective studies

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Segmentation of carotid arterial walls using neural networks

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World Journal of Radiology 2020年第1期12卷 1-9页

作者： Daniel D Samber Sarayu RamachANDran Anoop Sahota Sonum Naidu Alison Pruzan Zahi A Fayad Venkatesh Mani Translational and Molecular Imaging Institute (TMII) Icahn School of Medicine at Mount SinaiNew York

BACKGROUND Automated,accurate,objective,and quantitative medical image segmentation has remained a challenging goal in computer science since its *** study applies the technique of convolutional neural networks(CNNs)to the task of segmenting carotid arteries to aid in the assessment of *** To investigate CNN’s utility as an ancillary tool for researchers who require accurate segmentation of carotid *** An expert reader delineated vessel wall boundaries on 4422 axial T2-weighted magnetic resonance images of bilateral carotid arteries from 189 subjects with clinically evident atherosclerotic disease.A portion of this dataset was used to train two CNNs(one to segment the vessel lumen and the other to segment the vessel wall)with the remaining portion used to test the algorithm’s efficacy by comparing CNN segmented images with those of an expert *** quantitative assessment between automated and manual segmentations was determined by computing the DICE coefficient for each pair of segmented images in the test dataset for each CNN *** average DICE coefficient for the test dataset(CNN segmentations compared to expert’s segmentations)was 0.96 for the lumen and 0.87 for the vessel *** correlation values and the intra-class correlation coefficient(ICC)were computed for the lumen(Pearson=0.98,ICC=0.98)and vessel wall(Pearson=0.88,ICC=0.86)***-Altman plots of area measurements for the CNN and expert readers indicate good agreement with a mean bias of 1%-8%.CONCLUSION Although the technique produces reasonable results that are on par with expert human assessments,our application requires human supervision and monitoring to ensure consistent *** intend to deploy this algorithm as part of a software platform to lessen researchers’workload to more quickly obtain reliable results.

关键词： carotid arteries Segmentation Convolutional neural network Magnetic resonance imaging Vessel wall

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Significance of ultrasound evaluation of carotid atherosclerotic plaque for diagnosing ischemic cerebrovascular disease

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Neural Regeneration Research 2007年第7期2卷 440-442页

作者： Li Gu Yaqin Feng Liwen Liu Liping Yang Lili He Department of Special Diagnosis Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA Lintong 710600 Shaanxi Province China Retiree Institute of Shaanxi Military Area Command of Chinese PLA Weinan 720060 Shaanxi Province China Xijing Hospital of Fourth Military Medical University Xi＇an 710032 Shaanxi Province China

BACKGROUND： carotid artery is the main source for craniocerebral blood supply. Its intimal plaque formation and arterial stenosis degree both are the risk factors for ischemic cerebrovascular ***, the close relationship of carotid atherosclerotic plaque and ischemic cerebrovascular disease, and ultrasound evaluation of carotid atherosclerotic plaque have become the hot spot in studying ischemic cerebrovascular disease.OBJECTIVE： This study was to detect the degree of carotid atherosclerosis of ischemic cerebrovascular disease patients by ultrasonography, and to analyze the situation of carotid atherosclerosis and its relationship with clinic.DESIGN： Clinical randomized concurrent control experiment.SETTING： Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS： Totally 60 outpatients and inpatients with ischemic cerebrovascular disease, 42 males and 18 females, admitted to Lintong Convalescent Hospital of Lanzhou Military Area Command of Chinese PLA between January 2006 and December 2006 were involved in the patient group. They met the diagnosis criteria of ischemic cerebrovascular disease constituted by the 4th Cerebrovascular Disease Conference in 1996, and were confirmed to suffer from ischemic cerebrovascular disease by skull CT and MRI. Another 20 subjects who received healthy examination concurrently in the same hospital, 12 males and 8 females, were involved in the control group. Informed consents of detected items were obtained from involved subjects.METHODS： The plaque thickness of mid portion, distal end and crotch of common carotid artery （CCA）,internal carotid artery （ICA）, external carotid artery （ECA） and vertebral artery （VA） of involved subjects,who received health examination was separately detected with color Doppler ultrasonograph （HDI-5000）.Then, total integral of plaque was calculated. The intima-media thickness （IMT） was measured with two-dimensional ultrasonography. The inner diamete

关键词： ischemic cerebrovascular disease arteriosclerosis ultrasonography carotid arteries

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Quality control of ultrasonic measurement of carotid artery intima-media thickness

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Journal of Geriatric Cardiology 2009年第4期6卷 222-226页

作者： Ying Yang Feng Zhao Li-Tong Qi Bao-Wei Zhang Feng Chen Sai-Nan Zhu Yong Huo Department of Cardiology Peking University First Hospital Beijing 100034 China Department of Statistics Peking University First Hospital Beijing 100034 China

Background To report quality control methods and baseline reproducibility data of the ultrasound measurements of carotid artery intima-media thickness in the project of Establishment of an Integrated System for Coronary Heart Disease Prevention and Treatment. Methods Standard ultrasound scanning and measuring protocols were established by the study group. All sonographers and readers were trained by the carotid ultrasound core lab and all digital ultrasound images were centrally read. Ten subjects were scanned twice （with 1 week interval） by 2 sonographers independently and images were read by a single reader to evaluate the sonographer variability. Twenty subjects＇ images were read twice （with 1 week interval） by a single reader to assess the reader variability and the reproducibility of IMT measured at different carotid segments. Results The intraclass correlation （ICC） of intra- and inter-sonographer and intra- reader for mean IMT measurements was 0.99, 0.98 and 0.97 respectively; while for max IMT, it was 0.97, 0.99 and 0.95 respectively. Among different carotid segments and sites, ICC for mean 1MT measurements of common carotid （CCA）, carotid artery bulb （Bulb）, internal carotid artery （ICA）, overall near wall and overall far wall was 0.97, 0.99, 0.89, 0.93 and 0.98 respectively. Conclusion The reproducibility of IMT measurements according to our protocol is acceptable, although better reproducibility is found when measuring the mean IMT than max IMT, CCA and Bulb IMT than ICA IMT, and far wall IMT than near wall IMT.

关键词： atherosclerosis carotid arteries ultrasound reproducibility intima-media thickness

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Study on the Prevalence and Corelation of carotid Atherosclerosis in Stroke Patients

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中国临床神经科学 2000年第Z1期8卷 66-页

作者： Wei Hua Wang Yongjun Yah Zhenying Department of Neurology Beijing Xuanwu Hospital Beijing100053 Department of Neurology Beijing Xuanwu Hospital Beijing100053 Department of Neurology Beijing Xuanwu Hospital Beijing100053

Objective To assess the prevalence and severity of carotid atherosclerosis in stroke patients and the risk factors of carotid atherosclerosis. Methods Two hundred fifty-one ischemic stroke patients,46 ccrcbral hemorrhagc patients and 96 control subjects were entercd into this study. Sonographic assessment of the extracranial carotid arteries was performed in all patients. Diametcr. IMT, plaques and percentage ratio of lumen stenosis were observcd. Results (1)The prevalence of carotid plaqucs was prominent in stroke patients than the control subjects(63.0%vs 36.5%). (2)The prevalencc of lumen stenosis＞50% in ischemic stroke patients was higher than the cerebral hemorrhage patients and control subjects (15.6% vs 4.3%. 2.1%).(3) The prevalence of severe carotid artery stcnosis(＞75%) was promincnt in aged 61～70 years old patients.(4)Our data revealed 30% of the cortical infarction subgroup, 17.5%of the subcortical infarction subgroup, 17% of the lacunar infarction subgroup,8% of the vcrtibral-basilar artery infarction subgroup.2.8% of thc CT normal subgroup possessed carotid stcnosis ＞50%. (5)Age, diabetes mellitus and ApoAl(inversely) were independent predictors of the extracranial carotid atherosclcrosis. Discusssion (Ⅰ)There is close relation between extracraniai carotid atherosclerosis and ischemic cerebrovascular disease.(2)The extent of serious carotid artery stcnosis in aged patients was lower.(3)Thc severity of extracranial carotid artery atherosclerosis was prominent in patients with conical infarction. Conclusion There is a high prevalence of extracranial carotid atherosclerosis in Chinese stroke patients.

关键词： carotid artery ischemic stroke cerebrovascular disease cerebral hemorrhage lacunar infarction carotid arteries normal subgroup risk factors

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