Objective To investigate the iconographic characteristics and clinical significances of synchronic examination of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) for high myopia.Methods Thirty patients (57 eyes) with high myopia（gt;-6.00D）, selected randomly and consecutively, were examined by ICGA and FFA synchronically.Results The result of early phase of FFA showed hypofluorescence of the background in 25 eyes，while of late phase showed subretinal neovascularization (SRNV) in 10 eyes and streak formation in 40 eyes. The result of ICGA showed choroidal retrobulbar arteries in 8 eyes, hypofluorescence of the background in 35 eyes, SRNV in 8 eyes, and streak formation in 52 eyes.Conclusion The iconographic characteristics of ICGA and FFA of high myopia include hypofluorescence of the background, SRNV and streak formation. ICGA can givemore exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.(Chin J Ocul Fundus Dis，2003，19：87-89)
Purpose To analyse the maculopathy in 597 eyes of 317 cases with diabetic retinopathy,and to explore the classification and visual prognosis. Methods Using fluorescein angiography to examine the extend of capillary leakage and foveal avascular zone as well as the extent of the capillary closure in macular area. Results ①Diabetic maculopathy was divided into 5 types,among 597 eyes,no leakage type 154 eyes (25.8%),focal edema type 188 eyes(31.5%),diffuse edema type (including cystoid edema)231 eyes(40.0%),ischemic type 12 eyes(2.0%) and proli ferative type was 4 eyes(0.7%).② There is close relationship between the classification and visual prognosis.such as when visual acuity was ge;0.5,no leakage type was 99.4%, focal edema type was 83.0%,diffuse edema type was 28.4%,ischemic type was 8.4%,and proliferative type was 0.5%.the visual acuity of cystoid edema was worse than diffuse edema only 20.3%.③The stage and visual prognosis:The higher the stage the worse the visual prognosis.if visual acuityge;0.5, 1 stage in 96.2% eyes,2 stage in 84.8%,3 stage in 53.2%,4 stage in 37.2%,5 stage in 12.5%. Conclusion Diabetic maculopathy is the main cause of visual impairment in diabetic retinopathy. Different type has different visual prognosis.macular edema and cystoid edema are the main factors to decrease visual acuity and could be treated by focal and grid laser photocoagulation to prevent visual loss. (Chin J Ocul Fundus Dis,2000,16:144-146)
ObjectiveTo explore the clinical value of low-dose contrast agnet in CT angiography (CTA) for head and neck by SOMATOM Definition Flash CT.MethodsSixty consecutive patients with head and neck vessel diseases examined by CTA in the head and neck were chosen from West China Hospital of Sichuan University from March to July 2015, and then were randomly divided into two groups (the experimental group: n=30, 30 mL contrast medium; the control group: n=30, 50 mL contrast medium). Imaging post processing techniques included curved plannar reconstruction, volume rendering, and maximal intensity projection. CT values of the different level of carotid arteries (aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery) were measured. The artifact of the remaining contract in the jugular vein and overall quality of the image were observed by two senior doctors using double blind method.ResultsAll the patients in the two groups completed CTA for head and neck successfully. The image qualities of the two groups satisfid clinical diagnostic requirements, and there was no difference in the image qualities between the two groups (P>0.05). The evaluation of venous pollution in the experimental group was lighter than that in the control group (P<0.05). The CT values of aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery in the experimental group [(341.3±89.5), (391.0±103.7), (305.0±62.0) HU] were slightly lower than those in the control group [(437.3±83.7), (532.5±113.3), (396.6±93.1) HU], which were statistically significant (P<0.05).ConclusionLow-dose contrast in CTA for head and neck by SOMATOM Definition Flash CT can satisfy the clinical diagnostic requirements, and reduce the dose of contrast agent and venous pollution, with a good clinical value.
Objective To evaluate the application value of scanning laser angiography with a wide-field contact lens system in the diagnosis of choroidal melanoma. Methods Twenty-four patients with choroidal melanoma were randomly divided into two groups, who underwent fundus fluorescein angiography and indocyanine green angiography scanning with the wide-field contact and non-contact lens system respectively in order to acquire the 150deg;wide-field and 30deg;view image data. The quality of the images was comprehensively evaluated. Results Satisfying images were acquired from all of the 24 patients. Widefield contact lens system indicated the accurate adjacent relation between the lesion position and the other dissection mechanisms, and also provided the general information about the size of the tumor and the perfusion of fluorescien or indocyanine green in the blood vessels. At the same time, it enlarged the view scope 3-5 times, which make for the screening of the peripheral lesions. Conclusions Scanning laser angiography with a wide-field contact lens system has important application value in the diagnosis of choroidal melanoma. (Chin J Ocul Fundus Dis, 2006, 22: 166-169)
ObjectiveTo explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. MethodsThirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. ResultsIn the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). ConclusionCTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.
The ability of quickscan(QS)to assess haemodynamically significant lesions in the iliac and femoro-popliteal arteries was studied.Quickscan was prospectively and independently compared to intra-arterial digital subtraction angiography(IADSA)of the iliac and femoro-popliteal arteries.In 176 patients 757 arterial segments were evaluated.A QS frequency ratio of 1:3 or greater had a sensitivity of 88%,a specificity of 94% and accuracy of 92% in detecting stenosisgt;5O% diameter(67% area)reduction as shown on IADSA.In the detection of occlusion,QS had a sensitivity of 91%,specificity of 95% and accuracy of 94%.There was significant correlation between area reduction found by QS and the calf/brachial pressure index(CBI)(r=-0.77,Plt;0.01).Thirty-seven patients underwent an angioplasty based on QS finding alone.All 37 were successful.The authors conclude that quickscan can provide an inexpensive,quick and non-invasive screening technique for the routine initial assessment of peripheral vascular disease.The results indicate that an agreement with angiography which is as good as duplex scanning.It has potential to replace angiography for workup prior to surgical or catheter intervention,in the assessment of the success of the procedure and its continuing follow-up.
ObjectiveTo observe the clinical effect of the ophthalmic artery branch retrograde interventional therapy for central retinal artery occlusion (CRAO). MethodsFourteen CRAO patients (14 eyes) were enrolled in this study, including 8 males and 6 females. The age was ranged from 35 to 80 years old,with an average of (56.7±20.3) years. The duration of occurrence after the onset was 9 to 72 hours, with a mean of 22 hours. There were 4 eyes with vision of no light perception, 5 eyes with light perception and 5 eyes with hand movement. The intraocular pressure was ranged from 14-20 mmHg (1 mmHg=0.133 kPa), with an average of 19 mmHg. All the patients received the treatment of ophthalmic artery branch retrograde interventional therapy according to the indications and contraindications of thrombolytic therapy in acute cerebral infraction patients. Micro catheters was inserted into the exposed arteries from a skin incision below the eyebrow under guidance of digital subtraction angiography (DSA), urokinase (total 0.4 million U) and papaverine 30 mg were injected into the arteries. After artery thrombolysis, the changes of DSA, filling time of retinal artery and its branches on fluorescence fundus angiography (FFA) within 48 hours and the visual acuity were observed. According to the visual acuity of post-treatment and pre-treatment, the therapeutic effects on vision were defined as effective markedly (improving 3 lines or more), effective (improving 2 lines) and no effect (change within 1 line or a decline). According to the arm-retinal circulation time (A-Rct) and filling time of retinal artery and its branches (FT) on fluorescence fundus angiography (FFA), the therapeutic effects on retinal circulation were defined as effective markedly (A-Rct 15 s, FT 2 s), effective (A-Rct was improved but in the range of 16-20 s, FT was in 3-8 s) and no effect (A-Rct was improved but 21 s, FT 9 s). The follow up ranged from 5 to 21days, with a mean of 6 days. The related local or systemic complications were recorded. ResultsOphthalmic arterial catheterization under DSA was successful in all 14 eyes. After intermittent injection of drugs, ophthalmic artery and internal carotid artery displayed good images in DSA. The results showed enlargement of ophthalmic artery and its branches after injection of thrombolytic drugs by micro catheters. The circulation time in ophthalmic artery is speed up for 2 s before thrombolysis in 5 eyes, 3 s in 6 eyes, and 4 s in 3 eyes. Within 48 hours after thrombolysis treatment, the filling time of retinal artery and its branches on FFA was significantly increased than that of before interventional therapy. The retinal circulation was effective markedly in 8 eyes (57.1%), effective in 4 eyes (28.6%) and no effect in 2 eyes (14.3%). The vision changes showed effective markedly in 6 eyes (42.9%), effective in 6 eyes (42.9%), no effect in 2 eyes (14.2%). There was no abnormal eye movements, vitreous hemorrhage and incision hematoma, intracranial hemorrhage, cerebral embolism, and other local and systemic adverse effectives during the follow-up. ConclusionsThe ophthalmic artery branch retrograde interventional therapy in the treatment for CRAO can improve retinal circulation and vision. And there is no related local or systemic complications.
ObjectiveTo investigate the value and clinical significance of multi-slice spiral computed tomography angiography (MSCTA) in diagnosing true splenic artery aneurysm. MethodsSeven patients with splenic artery aneurysm diagnosed by MSCTA between October 2010 and July 2014 were included in this study. Image post-processing technologies such as multi-planar reformation, curved planar reformation, maximum intensity projection and volume rendering technology were introduced. ResultsAll the artery aneurysms were found through image post-processing technologies. There were 9 tumors in the 7 patients with splenic artery aneurysm, among which 1 was at the upper segment of pancreas, 2 at the segment of pancreas, 3 at the anterior segment of pancreas, and 1 (multiple) at the anterior segment of pancreas and anterior of hilus of spleen. The maximum volume of tumor was 60 mm×57 mm×54 mm. One tumor wall had calcification and other 6 cases only displayed tumor wall had varying degrees of "egg-shell" calcification, and mural thrombosis was detected in 3 cases. ConclusionsMSCTA is a reliable method to display splenic artery aneurysm. The combination of multiple image post-processing technologies is more helpful in observing the features of tumor body and the internal and external conditions of tumor cavity, which has guiding significance for further clinical treatment.
ObjectiveTo explore the status,reasons and precautions of misdiagnosis of pulmonary sequestration. MethodsSeventy-seven articles about pulmonary sequestration published in Wanfang and CNKI databases between January 2005 and December 2013 were retrospectively analyzed,of which 41 articles referring to misdiagnosis rate.The misdiagnosis rate,time,status,consequence,reason and main means of definite diagnosis were analyzed. ResultsThe total number of cases of pulmonary sequestration in the 41 articles was 689,in whom 399 cases were misdiagnosed.Misdiagnosis rate was 57.91%.The minimum misdiagnosis time was 14 days and the maximum was 40 years.Pulmonary sequestration was most often misdiagnosed as pulmonary cyst(23.16%),bronchiectasis(22.73%),lung cancer(20.08%),lung abscess(6.93%)and pneumonia(6.28%).Most misdiagnosed patients did not suffer adverse consequences,except 4 patients were dead and 1 patient undertook unnecessary extended operation.Lack of specificity in clinical manifestations,lack of awareness of the disease,diversity of imaging performance and complications covering the original disease were the most common reasons of misdiagnosis.Postoperative pathological examination(83.77%),intraoperative findings(13.42%)and computed tomography angiography(2.16%)were the main means of definite diagnosis in misdiagnosed cases. ConclusionPulmonary sequestration is lack of specificity in clinical manifestations and easy to be misdiagnosed.Imaging showing the abnormal blood supply vessels is the key to the diagnosis.Improving the awareness of it can reduce misdiagnosis and incorrect treatment.
Objective To observe the digital subtraction angiography (DSA) characteristics of ophthalmic artery and its main branches in ischemic cerebrovascular disease (ICVD). Methods The internal carotid arteries, external carotid arteries and ophthalmic arteries of 32 ICVD patients were examined for DSA. The characteristics of ophthalmic artery origin, trail and main branches were observed. Results Among 64 carotid arteries of 32 patients, there was one carotid artery with internal occlusion, there was no severe stenosis in the other 63 carotid arteries. The 63 ophthalmic arteries originated all from supraclinoidal and ophthalmic segments of internal carotid arteries. 58 ophthalmic arteries were single branch from the internal carotid artery. 5 ophthalmic arteries had 2 branches, one come from the internal carotid artery, the other come from the middle meningeal artery (external carotid artery branch ) in 4 cases or from the anterior cerebral artery (carotid artery branch) in 1 case. The main branches of ophthalmic artery included central retinal artery, posterior ciliary artery, lacrimal gland artery, ocular muscular artery; anterior ethmoid artery, posterior ethmoid artery, supraorbital artery, dorsal nasal artery, supratrochlear artery and eyelid artery. The beginning point of each branches were variable. Conclusions Ophthalmic arteries of ICVD patients primary arise from the internal carotid artery. It most often appears as single branch and occasionally as double branches. The beginning points of major branches of ophthalmic artery are variable.