【Abstract】Objective To investigate the appropriate reconstruction techniques of multidetectorrow spiral CT angiography (MDCTA) to depict the collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor thrombosis of hepatocellular carcinoma (HCC). Methods MDCTA scanning was performed during the portal venous phase after intravenous contrast materials in 18 HCC patients with CTPV induced by tumor thrombosis. Raw data were reconstructed with thin slice thickness followed by 2D and 3D angiographic reconstruction methods, including maximum intensity projection(MIP), shade surface display （SSD） and volume rendering technique(VRT). Results MDCTA with MIP reconstruction accurately depicted both the tumor thrombus within the portal vein and the collateral vessels of CTPV including the biliary (cystic vein and pericholedochal veinous plexus) and the gastric (left and right gastric veins) branches. However, VRT and SSD methods did poorly in showing the tumor thrombus and the collateral vessels. Conclusion MDCTA with MIP reconstruction is the method of choice to evaluate the collateral vessels of CTPV.
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.
Objective To investigate the feasibility of establishing the visualization models of intraneural microvessels of sciatic nerves in Sprague Dawley (SD) rats by systemic infusion of Evan’s blue (EB) or lead oxide and to compare the advantages and disadvantages. Methods Fifteen healthy adult SD rats of either gender, weighing 200-250 g, were randomly divided into traditional group (group A, n=5), fluorescence group (group B, n=5), and radiography group (group C, n=5). Ink, EB, and lead oxide, all mixed with gelatin solution, were injected in groups A, B, and C, respectively. After 2 hours of cryopreservation under 4°C, all sciatic nerves were harvested and observed through stereomicroscope to make sure the filling condition. The two-dimentional (2D) images were then collected via reflexion fluorescent microscope in group B and via micro-CT scan in group C. All images were imported into computer to establish three-dimentional (3D) reconstruction models by Mimics 15.0. Results All groups could show the outline of intraneural microvessels of sciatic nerves under stereomicroscope. Diameters of them were measured under fluorescent microscope, ranging from 10 µm to 30 µm. Both groups B and C could establish 3D reconstruction models from 2D images. These models could clearly reproduce the structure of microvessels. Conclusion Both EB and lead oxide can be used to establish 3D reconstruction models to observe structure of the intraneural vessels. However, EB has some disadvantages, such as predisposition to infiltration, grainy 2D images and time-consuming procedure; it is not suitable for researches of large specimen. Though 2D pictures from lead oxide have lower resolution than EB, it is easier to be manipulated and appropriate for experiments of large specimen.
【Abstract】 Objective To study the image of the muscular and cutaneous branches of supratrochlear artery by internal and external carotid angiography and to design the frontal flap for nasal reconstruction. Methods The muscular and cutaneous branches of supratrochlear artery of 30 adults were investigated through internal and external carotid angiography and three-dimensional reconstruction of vessels to explore the courses of branches of supratrochlear artery and their communication with supraorbital artery. According to image observation, the frontal flap was designed and used to perform nasal reconstruction in 11 cases of nasal defects, including 7 males and 4 females with an average age of 23 years (range, 15-48 years). The nasal defect ranged from 3.0 cm × 2.5 cm to 5.0 cm × 3.5 cm. Results Internal carotid angiography and three-dimensional imaging of the vessels showed that supratrochlear artery was found in 30 patients, with a diameter of (0.9 ± 0.6) mm. The superficial cutaneous branch appeared constantly with a diameter of (0.7 ± 0.3) mm. Deep muscular branch traveled among frontal muscle, with a diameter of (0.5 ± 0.5) mm and a length of (32.0 ± 6.2) mm, and it was missing in 4 patients, the branches communicated with each other and with supraorbital artery. All flaps survived with good appearance and without cartilage exposure. After 4 months to 3 years of follow-up, the postoperative aesthetic appearance and function of nasal tip, alar, and columella were satisfactory; the height and slope length of the external nose were moderate; and the reconstructed nose had good texture and normal ventilation function without constriction of naris. Conclusion Imaging studies support the fact that supratrochlear artery has constant cutaneous branch. The application of frontal flap pedicled with cutaneous branch can improve the effectiveness of nasal reconstruction.
Objective To present a method for quantifying the anastomosis between two vessels based on angiograpy and provide a theoretical basis for vascular study in skin flap. Methods Ten bilateral skin flaps of 20 cm×20 cmbased on deep iliac circumflex vessels were elevated fromthe abdominal wall including musculus rectus abdominis and deep superior epigastric vessels in 5 minipigs which were 100-115 cm in length and 25-35 kg in weight. One side was inserted an expander under the panniculus carnosus and was expanded regularly with 30-40 ml isotonic Na chloride injection (expanded group) and the other was unexpanded group which were without any treatment. A X-ray image of the flap vessles was obtained after a gelatinlead oxide mixture was carotid arterially injected and 24 hours of cryopreservation of the body. Three parallel lines with equal interval perpendicular to long axis of the two vessels were designed at the communication area. Vessel anastomosis quantifying was determined by counting the number of marks derived from the intersections of the lines and the vessels and statistical analysis was carried out. Results The mark of intersectionin expanded group (81.20±10.33) was more than that in unexpanded group (22.40±5.41), showing significant difference(Plt;0.01). Conclusion The method for quantifying vessel anastomosis in skin flap is simple, reliable, and easytoperform. The principles of this procedure may also be applied to other experimental and clinical studies.
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.
Objective To observe and analyze the configuration and distribution of vortex veins by indocyanine green angiography (ICGA) combining with widefield contact lens system. Methods A total of 28 patients (32 eyes), including 16 females (19 eyes) and 12 males (13 eyes) with the age of 28-84 (average 71), were examined by ICGA combing with widefield contact lens. The patients were divided into high myopia group (15 eyes with diopter ge;-6.0 D) and non high myopia group (17 eyes with diopter lt;-6.0 D or normal sight). Results A total of 166 vortex veins were detected, including 118 circinate veins (71.1%), 34 thick-stripe-like veins (20.5%), and 14 irregular vein (8.4%). There are 71 vortex veins in the right eyes with average 5.07 vortex veins in each eye; and 95 veins in the left eyes with average 5.28 vortex veins in each eye. The number of vortex veins at in the inferior temporal, inferior-nasal, over-temporal and over-nasal retina was 47, 42, 39, and 38, respectively, with average 1.34 vortex veins in each quadrant (the inferiortemporal was the most: average 1.53). A total of 160 vortex veins came out from the scleral around the equator area 46 disc diameter (DD) away from the optic disc (964%); the other 6 vortex veins came out at the point 3-4 DD away from the optic disc (3.6%). A total of 123 (74.1%) vortex veins had ampullae with different directions. Horizontal and vertical ampullae were most common. There was no difference in numbers and configuration of vortex veins beween the two groups. Conclusion The vortex veins has circinate, thick-stripe-like, and irregular configurations; the distribution of vortex veins in eyes with high myopia or non high myopia is almost accordant. ICGA combining with the wide-field contact lens examination can observe all of the vortex veins within a single visual field.
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)
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)