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Transjugular intrahepatic portosystemic shunt vs conservative treatment for recurrent ascites:A propensity score matched comparison

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World Journal of Gastroenterology 2022年第41期28卷 5944-5956页

作者： Martin Philipp Theresia Blattmann Jörn Bienert Kristian Fischer Luisa Hausberg Jens-Christian Kröger Thomas Heller Marc-AndréWeber Georg Lamprecht Department of Medicine Division of Gastroenterology and EndocrinologyRostock University Medical CenterRostock 18057Germany Institute of Diagnostic and Interventional Radiology Pediatric Radiology and NeuroradiologyRostock University Medical CentreRostock 18057Germany

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) placement is an effective intervention for recurrent tense ascites. Some studies show an increased risk of acute on chronic liver failure(ACLF) associated with TIPS placement. It is not clear whether ACLF in this context is a consequence of TIPS or of the pre-existing liver *** To better understand the risks of TIPS in this challenging setting and to compare them with those of conservative *** Two hundred and fourteen patients undergoing their first TIPS placement for recurrent tense ascites at our tertiary-care center between 2007 and 2017 were identified(TIPS group). Three hundred and ninety-eight patients of the same time interval with liver cirrhosis and recurrent tense ascites not undergoing TIPS placement(No TIPS group) were analyzed as a control group. TIPS indication,diagnosis of recurrent ascites, further diagnoses and clinical findings were obtained from a database search and patient records. The in-hospital mortality and ACLF incidence of both groups were compared using 1:1 propensity score matching and multivariate logistic *** After propensity score matching, the TIPS and No TIPS groups were comparable in terms of laboratory values and ACLF incidence at hospital admission. There was no detectable difference in mortality(TIPS: 11/214, No TIPS 13/214). During the hospital stay, ACLF occurred more frequently in the TIPS group than in the No TIPS group(TIPS: 70/214, No TIPS: 57/214, P = 0.04). This effect was confined to patients with severely impaired liver function at hospital admission as indicated by a significant interaction term of Child score and TIPS placement in multivariate logistic regression. The TIPS group had a lower ACLF incidence at Child scores < 8 points and a higher ACLF incidence at ≥ 11 points. No significant difference was found between groups in patients with Child scores of 8 to 10 *** TIPS placement for recurrent tense as

关键词： Liver cirrhosis Ascites Transjugular intrahepatic portosystemic shunt Acute on chronic liver failure Mortality Propensity score

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<i>De novo</i>cavernous aneurysms development after contralateral parent artery occlusion—Two cases report

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Open Journal of Clinical Diagnostics 2013年第4期3卷 173-177页

作者： Tangming Peng Zenghui Qian Aihua Liu Department of Interventional neuroradiology Beijing Neurosurgical Institute Beijing China Department of Interventional neuroradiology Beijing Tiantan Hospital Capital Medical University Beijing China

A 53-year-old woman developed a de novo aneurysm after contralateral internal carotid artery occlusion, and another 42-year-old woman developed a de novo aneurysm after contralateral vertebral artery occlusion. Both patients experienced a rapid development of de novo aneurysm formation, 6 and 9 months, respectively. The development of de novo aneurysm on the contralateral artery after parent artery occlusion showed that female and medium age may be contributory factors. In addition, the hemodynamic changes may be associated with the development of de novo aneurysm after contralateral parent artery occlusion.

关键词： De novo Aneurysm Parent Artery Occlusion Endovascular Treatment Hemodynamic Risk Factors

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Susceptibility weighted imaging: Clinical applications and future directions

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World Journal of Radiology 2018年第4期10卷 30-45页

作者： Ahmet Mesrur Halefoglu David Mark Yousem Department of Radiology Sisli Hamidiye Etfal Training and Research Hospital University of Health Sciences Division of neuroradiology Department of Radiology Johns Hopkins Medical Institution

Susceptibility weighted imaging(SWI) is a recently developed magnetic resonance imaging(MRI) technique that is increasingly being used to narrow the differential diagnosis of many neurologic disorders. It exploits the magnetic susceptibility differences of various compounds including deoxygenated blood, blood products, iron and calcium, thus enabling a new source of contrast in MR. In this review, we illustrate its basic clinical applications in neuroimaging. SWI is based on a fully velocity-compensated, high-resolution, three dimensional gradientecho sequence using magnitude and phase images either separately or in combination with each other, in order to characterize brain tissue. SWI is particularly useful in the setting of trauma and acute neurologic presentations suggestive of stroke, but can also characterize occult low-flow vascular malformations, cerebral microbleeds, intracranial calcifications, neurodegenerative diseases and brain tumors. Furthermore, advanced MRI post-processing technique with quantitative susceptibility mapping, enables detailed anatomical differentiation based on quantification of brain iron from SWI raw data.

关键词： Quantitative susceptibility mapping Brain Ischemia Magnetic resonance imaging Susceptibility weighted imaging

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Endovascular treatment of extracranial vertebral artery stenosis

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World Journal of Radiology 2012年第9期4卷 391-400页

作者： Burak Kocak Bora Korkmazer Civan Islak Naci Kocer Osman Kizilkilic Department of Radiology Division of NeuroradiologyCerrahpasa School of MedicineIstanbul University

Percutaneous angioplasty and stenting for the treatment of extracranial vertebral artery(VA) stenosis seems a safe,effective and useful technique for resolving symptoms and improving blood flow to the posterior circulation,with a low complication rate and good long-term *** patients with severe tortuosity of the vessel,stent placement is a real *** new coronary balloon-expandable stents may be preferred.A large variability of restenosis rates has been ***-eluting stents may be the *** a comprehensive review of the literature,it can be concluded that percutaneous angioplasty and stenting of extracranial VA stenosis is technically feasible,but there is insufficient evidence from randomized trials to demonstrate that endovascular management is superior to best medical management.

关键词： Vertebral artery stenosis Endovascular treatment Stent Angioplasty

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Rarity among benign gastric tumors: Plexiform fibromyxoma-Report of two cases

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World Journal of Gastroenterology 2017年第31期23卷 5817-5822页

作者： Kinga Szurian Holger Till Eva Amerstorfer Nicole Hinteregger Hans-Jorg Mischinger Bernadette Liegl-Atzwanger Iva Brcic Institute of Pathology Medical University of Graz Department of Paediatric and Adolescent Surgery Medical University of Graz Department of Radiology Division of NeuroradiologyVascular and Interventional RadiologyMedical University of Graz Department of Surgery Medical University of Graz

Plexiform fibromyxoma is a very rare mesenchymal tumor of the stomach, found almost exclusively in the antrum/pylorus region. The most common presenting symptoms are anemia, hematemesis, nausea and unintentional weight loss, without sex or age predilection. We describe here two cases of plexiform fibromyxoma, involving a 16-year-old female and a 34-year-old male. Both patients underwent complete resection(R0) by distal gastrectomy and retrocolic gastrojejunostomy(according to Billroth 2); for both, the postoperative course was uneventful. Histology showed multiple intramural and subserosal nodules with characteristic plexiform growth, featuring bland spindle cells situated in an abundant myxoid stroma with low mitotic activity. Immunohistochemistry showed α-smooth muscle actin-positive spindle cells, focal positivity for CD10, and negative staining for KIT, DOG1, CD34, S100, β-catenin, STAT-6 and anaplastic lymphoma kinase. One of the cases showed focal positivity for h-caldesmon and desmin. Upon followup, no sign of disease was found. In the differential diagnosis of plexiform fibromyxoma, it is important to exclude the more common gastrointestinal stromal tumors as they have greater potential for aggressivebehavior. Other lesions, like neuronal and vascular tumors, inflammatory fibroid polyps, abdominal desmoid-type fibromatosis, solitary fibrous tumors and smooth muscle tumors, must also be excluded.

关键词： Plexiform fibromyxoma Plexiform angiomyxoid myofibroblastic tumor Gastrointestinal stromal tumor Stomach Benign gastric tumor

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轻度升高的毛细血管通过时间异质性容积增加可以预测大血管闭塞急性缺血性卒中良好预后和除外颅内出血

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国际医学放射学杂志 2019年第5期 621-622页

作者： A.Potreck S.Loebel J.Pfaff L.?stergaard K.Mouridsen A.Radbruch 朱项阳 Department of neuroradiology University Hospital Heidelberg

摘要目的研究微血管变化[以毛细血管通过时间异质性(CTH)为指标]随时间推移是否使得急性缺血性卒中病人获得良好预后的机会下降,以及其是否是颅内出血(ICH)的

关键词：急性缺血性卒中预测因子大血管闭塞颅内出血时间异质性毛细血管

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Significant flow velocity reduction at the intracranial aneurysm neck after endovascular treatment leads to favourable angiographic outcome:a prospective study

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Stroke & Vascular Neurology 2021年第3期6卷 366-375页

作者： Zhongbin Tian Jian Liu Jay Kumar Wenqiang Li Yisen Zhang Ying Zhang Kun Wang Shengzhang Wang Zeguang Ren Xinjian Yang Department of Interventional neuroradiology Beijing Neurosurgical Institute and Beijing Tian Tan HospitalCapital Medical UniversityBeijingChina Department of Neurosurgery University of South FloridaTampaFloridaUSA Department of Mechanics and Engineering Science Fudan UniversityShanghaiChina

Background With widely usage of flow diverter in intracranial aneurysm treatment,some previously used predictors may not be effective in evaluating the recurrence *** aimed to comprehensively re-evaluate the predictors of intracranial aneurysm outcome with various endovascular treatment methods and *** This is a prospective registered *** analysed 6-month and 18-month follow-up angiographic data from the prospective *** on patient demographics,aneurysm morphology and type of treatment were ***-specific haemodynamic simulations were *** unfavourable angiographic outcome was defined as recurrence of aneurysm in cases with coiling or stent-assisted coiling,patency of aneurysm in cases with flow diverters or retreatment during *** In total,165 patients(177 intracranial aneurysms)with at least one angiographic follow-up data were *** the short-term(6-month)results,after univariate analysis,the demographic,morphological and treatment-related factors did not achieve significantly statistical *** reduction ratio(RR)of velocity at aneurysm neck after embolisation was significantly lower in the unfavourable angiographic group than the favourable angiographic outcome group(p=0.002).After the Cox regression analysis,the RR of velocity at aneurysm neck was the only independent factor associated with favourable angiographic outcome(OR 0.028;p=0.001)and had an acceptable area under the curve(0.714)with a clear cut-off value(46.14%).Similarly,for the analysis of midterm(18-month)results,the RR of velocity at the aneurysm neck was the only independent significant factor for the unfavourable angiographic outcome(OR 0.050;p=0.017).The area under the curve was 0.754 and the cut-off value was 48.20%.Conclusions The haemodynamics showed an independent effect on angiographic follow-up results and may provide helpful suggestions for clinical practice in the future.

关键词： aneurysm prospective intracranial

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1型或2型糖尿病疼痛性与无痛性多神经病在3 T MR神经成像上结构性神经重塑的异同

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国际医学放射学杂志 2020年第2期 240-241页

作者： J.M.E.Jende J.B.Groener Z.Kender C.Rother A.Hahn T.Hilgenfeld 李璐 Department of neuroradiology Heidelberg University Hospital

对糖尿病性多神经病(DPN)疼痛症状的病理生理机制缺乏足够的认识。它们可能与MRI特征有关,而目前尚未有相关研究。目的探讨DPN病人的神经结构、负荷、神经

关键词：痛性糖尿病神经病变多神经病型糖尿病神经重塑神经成像疼痛性无痛性结构性

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Staged endovascular reconstruction of complex traumatic intracranial carotid artery dissection

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Stroke & Vascular Neurology 2020年第3期5卷 308-310页

作者： Karan K Topiwala Mohammed Hussain Janhavi Modak Inam Kureshi Amre Nouh Mubashir Pervez Brendan Killory Daniel Lee Neurology University of Connecticut School of MedicineFarmingtonConnecticutUSA Interventional neuroradiology Hartford HospitalHartfordConnecticutUSA Neurosurgery Hartford HospitalHartfordConnecticutUSA Neurology Hartford HospitalHartfordConnecticutUSA

Case presenTaTion A 32-year old woman presented with traumatic facial injuries from a horseback riding *** was found to have a Glasgow Coma Score of 3T,left eyelid ptosis with a fixed-dilated pupil and a flaccid right upper *** angiogram of the head showed complex craniofacial injuries,including a transverse fracture transecting the clivus and the left petrous temporal bone,with SAH in the suprasellar *** was a bilateral engorgement of the superior ophthalmic veins,suggestive of bilateral CCF *** subtraction angiography(DSA)showed a left petrocavernous internal carotid artery dissection(ICAD).MRI of the brain demonstrated multiple embolic infarcts in the left middle cerebral artery(MCA)territory,despite therapeutic anticoagulation with heparin.

关键词： injuries dissection traumatic

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Clinical imaging factors of excellent outcome after thrombolysis in large- vessel stroke: a THRACE subgroup analysis

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Stroke & Vascular Neurology 2021年第4期6卷 631-639页

作者： Nolwenn Riou-Comte Benjamin Gory Marc Soudant François Zhu Yu Xie Lisa Humbertjean Gioia Mione Catherine Oppenheim Francis Guillemin Serge Bracard Sébastien Richard on behalf of the THRACE investigators Department of Neurology-Stroke Unit CIC-P 1433INSERMU1116Universitéde LorraineNancy Regional University Hospital CenterNancyFrance Department of Diagnostic and Therapeutic neuroradiology INSERM U1254IADIUniversitéde LorraineNancy Regional University Hospital CenterNancyFrance Clinical Investigation Centre-Clinical Epidemiology 1433 INSERMUniversitéde LorraineNancy Regional University Hospital CenterNancyFrance Department of neuroradiology INSERM U894UniversitéParis-DescartesSainte-Anne HospitalParisFrance 不详

Background For patients with stroke with large-vessel occlusion(LVO),study of factors predicting response to intravenous thrombolysis(IVT)would allow identifying subgroups with high expected gain,and those for whom it could be considered as futile,and even *** patients included in the Mechanical Thrombectomy After Intravenous Alteplase vs Alteplase Alone After Stroke trial,we investigated clinical-imaging factors associated with optimal response to *** We included patients receiving IVT *** outcome was defined by a 3-month modified Rankin Scale(mRS)score≤***-imaging predictors were assessed on multivariate analysis after multiple *** predictive performance of the model was assessed with the *** Among 247 patients with LVO treated with IVT alone,77(31%)showed 3-month mRS≤*** of 3-month mRS≤1 were no medical history of hypertension(OR 2.43;95%CI 1.74 to 3.38;p=0.007);no current smoking(OR 2.76;95%CI 1.79 to 4.26;p=0.02);onset-to IVT time(OR 0.47 per hour increase;95%CI 0.23 to 0.78;p=0.003);diffusion-weighted imaging(DWI)volume(OR 0.78 per 10 mL increase;95%CI 0.68 to 0.89;p=0.0004);presence of susceptibility vessel sign(SVS)(OR 7.89;95%CI 1.65 to 37.78;p=0.01)and SVS length(OR 0.87 per mm increase;95%CI 0.80 to 0.94;p=0.001).The prediction models showed a C-statistic=0.79(95%CI 0.79 to 0.80).Conclusions In patients with stroke with anterior-circulation LVO treated with IVT alone,predictors of excellent outcome at 3 months were no medical history of hypertension or current smoking,reduced onset-to IVT time,small DWI volume,presence of SVS and short SVS *** predictive factors could help practitioners in decision-making for IVT implementation in reperfusion strategies,all the more for the drip and ship *** registration number NCT01062698.

关键词： thrombolysis Clinical assessed

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