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1
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Adhikari P. Radiological diagnosis and emergency endovascular management, and follow-up of a unruptured right subclavian artery aneurysm in an elderly patient: A case report. Radiol Case Rep 2024; 19:5336-5341. [PMID: 39280755 PMCID: PMC11399569 DOI: 10.1016/j.radcr.2024.07.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 09/18/2024] Open
Abstract
Right subclavian artery aneurysms are rare vascular anomalies that can present significant diagnostic and management challenges, especially in elderly patients. We present a case of a 72-year-old female who presented with sudden onset chest pain and was diagnosed with an unruptured right subclavian artery aneurysm with partial thrombus formation. Advanced imaging, including chest X-ray and contrast-enhanced CT scan, confirmed the diagnosis and guided a successful endovascular repair, stabilizing the patient. Follow-up care included regular clinical assessments and imaging studies to monitor the aneurysm's status and detect potential complications. This case underscores the critical role of early radiological diagnosis and prompt intervention in managing subclavian artery aneurysms, highlighting the effectiveness of endovascular techniques in such cases.
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Affiliation(s)
- Pratik Adhikari
- Department of Radiology, B.P. Koirala Institute of Health Sciences, Dharan, 56700, Nepal
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Yin Q, Chen Z, Wang H, Rong L. To Draw a Detailed Map for Maxillofacial Fast-Flow Vascular Diseases With the Combination of Color Doppler Ultrasound and Three-Dimensional Computed Tomography Angiography. J Craniofac Surg 2024:00001665-990000000-01385. [PMID: 38411176 DOI: 10.1097/scs.0000000000010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 02/28/2024] Open
Abstract
Vascular diseases, such as vascular malformations and hemangiomas, are often classified into "fast-flow" and "slow-flow" based on their internal blood velocity. Fast-flow vascular diseases of maxillofacial regions are a kind of complicated and dangerous pathological changes originating from or containing arteries, their treatment is often complex and different from disease to disease, and large amounts of intraoperative blood loss and poor operation field may cause side injury or other problems without a detailed map of the lesion. The authors use the combination of color Doppler ultrasound and three-dimensional computed tomography angiography to diagnose and classify 36 cases of maxillofacial fast-flow vascular diseases, from January 2018 to December 2022 presented in the authors' department. Three-dimensional computed tomography angiography can display the location, type, and blood supply of lesions, whereas color Doppler ultrasound has unique advantages in identifying some special lesions (such as the colorful images of orificium fistulaes and the "Yin-yang sign" of pseudoaneurysms), then projecting and marking them on the body surface, which greatly facilitate the surgical procedure. This cost-effective and noninvasive combination shows significant clinical application value.
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Affiliation(s)
- Qiang Yin
- Department of Plastic and Reconstructive Surgery
| | - Zhongping Chen
- Department of Radiology, First Hospital of Jilin University
| | - Haodong Wang
- Department of Vascular Surgery, First Hospital of Jilin University, Changchun, China
| | - Li Rong
- Department of Plastic and Reconstructive Surgery
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3
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Corvino F, Giurazza F, Ierardi AM, Lucatelli P, Basile A, Corvino A, Niola R. Splenic Artery Pseudoaneurysms: The Role of ce-CT for Diagnosis and Treatment Planning. Diagnostics (Basel) 2022; 12:1012. [PMID: 35454060 PMCID: PMC9024490 DOI: 10.3390/diagnostics12041012] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 01/19/2023] Open
Abstract
Splenic artery pseudoaneurysm (PSA) is a contained vascular wall lesion associated with a high mortality rate, generally related to pancreatitis, trauma, malignancy, iatrogenic injury, and segmental arterial mediolysis. Computed tomography angiography allows us to visualize the vascular anatomy, differentiate a PSA from an aneurysm, and provide adequate information for endovascular/surgical treatment. The present review reports on the main state-of-the-art splenic artery PSA diagnosis, differentiating between the pros and cons of the imaging methods and about the endovascular treatment.
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Affiliation(s)
- Fabio Corvino
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, 80131 Naples, Italy; (F.G.); (R.N.)
| | - Francesco Giurazza
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, 80131 Naples, Italy; (F.G.); (R.N.)
| | - Anna Maria Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Antonello Basile
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”, University Hospital “Policlinico-San Marco”, University of Catania, 95124 Catania, Italy;
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Raffaella Niola
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, 80131 Naples, Italy; (F.G.); (R.N.)
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4
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Successful endovascular embolization of a giant splenic artery pseudoaneurysm secondary to a huge pancreatic pseudocyst with concomitant spleen invasion. Pol J Radiol 2021; 86:e489-e495. [PMID: 34567295 PMCID: PMC8449560 DOI: 10.5114/pjr.2021.108876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/06/2020] [Indexed: 12/11/2022] Open
Abstract
Pseudoaneurysms of the pancreatic and peripancreatic arteries is a well-known complication of chronic or necrotizing pancreatitis due to proteolytic enzymatic digestion of the arterial wall. A major part of peripancreatic pseudoaneurysms involve the splenic artery, but any peripancreatic artery may be involved and bleed. They are potentially life threatening for patients, due to spontaneous intraperitoneal rupture, rupture and fistulization into the surrounding organs, or fistulization into the pancreatic duct. Small ones are usually asymptomatic and are often diagnosed incidentally, while giant (> 5 cm) aneurysms and pseudoaneurysms are symptomatic and may be detected as a pulsatile mass in the upper-left quadrant or epigastrium. Imaging plays a key role in the identification of splenic artery aneurysms and pseudoaneurysms, while angiography still represents the gold standard for the diagnosis, although nowadays it plays a prominent role in treatment. Treatment of splenic artery pseudoaneurysms is mandatory because of the high probability of rupture, with a mortality rate of up to 90%. The gold standard treatment is represented by surgery, with a mortality rate between 16% and 50%. In recent years the endovascular approach has proven to be an effective alternative treatment for splenic artery pseudoaneurysms, and it is currently the method of choice. In this article, we present the case of a ant pseudoaneurysm of the splenic artery due to huge pseudocysts in a young alcoholic patient with recurrent and chronic pancreatitis, complicated by fistulization and invasion of spleen parenchyma and arteriovenous fistula.
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Corvino A, Caruso M, Varelli C, Di Gennaro F, Pignata S, Corvino F, Vallone G, Catalano O. Diagnostic imaging of parotid gland oncocytoma: a pictorial review with emphasis on ultrasound assessment. J Ultrasound 2021; 24:241-247. [PMID: 32710434 PMCID: PMC8363736 DOI: 10.1007/s40477-020-00511-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022] Open
Abstract
Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless, slow-growing, non-tender, lobulated, and mobile mass. Histologically, it is composed of monotonous sheets of epithelial cells (oncocytes) with a central scar. The cross-sectional appearance is not specific, and it overlaps with other parotid lesions. On ultrasound (US), oncocytoma appears as an ovoid, well-defined, homogeneous, and hypoechoic lesion. Cystic and hemorrhagic areas as well as intralesional fat may be observed. Doppler analysis shows intratumoral vessels, sometimes with a spoke-wheel pattern. The peak systolic flow is high (up to 100 cm/sec). Furthermore, oncocytoma is avid of FDG on a PET scan, as well as a malignant tumor. Thus, a combined clinical, imaging, and pathologic assessment is essential to establish the most accurate diagnosis and plan the best treatment. US, combined with Doppler techniques, can play an important role in suggesting the diagnosis and confirming it through percutaneous sampling. The purpose of this review is to show the imaging findings in PGO, with special emphasis on the US appearance.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133, Naples, Italy.
- , Casal di Principe, Italy.
| | - Martina Caruso
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Francesca Di Gennaro
- Nuclear Medicine Division, Radiology and Radiotherapy Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, 80131, Naples, Italy
| | - Saverio Pignata
- Ultrasound Unit, Ninetta Rosano Institute, via Capo Tirone 14, 87021, Belvedere Marittimo (CS), Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
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Zheng HX, Lee YL, Chen GY, Hung YC. Iatrogenic pseudoaneurysm of the superficial temporal artery following craniectomy from a scalp hook retractor penetrating injury: Case report and literature review. Int J Surg Case Rep 2021; 84:106076. [PMID: 34157547 PMCID: PMC8220550 DOI: 10.1016/j.ijscr.2021.106076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/30/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Iatrogenic pseudoaneurysms in scalp vessels are an uncommon complication after cranial surgery. This paper reports a case of scalp pseudoaneurysm in the superficial temporal artery (STA) after forceful hook retraction in craniectomy and reviews the relevant literature. Case description A 36-year-old man with history of hypertension and depression presented to the emergency department with head injury after using sedation medication. Brain computed tomography (CT) revealed a 2-cm-thick right parietal extradural hematoma (EDH) with parietal skull fracture, a bilateral lower frontotemporal contusional intracerebral hematoma, diffuse subarachnoid hemorrhage, and a right frontotemporoparietal subdural hematoma. To prevent EDH progression, frontotemporal emergency craniectomy to remove the EDH was performed. The next day, a firm, painful mass measuring 3 × 3.5 cm2 was discovered over the right frontal scalp. The mass was close to the site where the scalp hook retractor had been placed during surgery. Sonography revealed pulsatile blood flow with an arterial feeder inside the mass. CT angiography revealed a 1 × 1.2 × 0.7 cm3 pseudoaneurysm in the right frontal scalp from the frontal branch of the STA. We scheduled a resection of the pseudoaneurysm and combined cranioplasty on the 29th postoperative day. The pseudoaneurysm was resected en bloc. The patient was discharged with clear consciousness and intact muscle power. Conclusion The complications of STA pseudoaneurysms caused by scalp hook retractors are rare and not yet well reported. Surgeons must avoid injuring the STA when using a scalp hook retractor.
A scalp pseudoaneurysm should be suspected when a postoperative mass is noted along the STA after scalp hook retractor use. Preoperative use of a Doppler vascular detector can help surgeons mark the course of the STA and its branches. Surgeons must avoid injury to the STA when using a scalp hook retractor.
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Affiliation(s)
- Hong-Xiang Zheng
- Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan
| | - Yao-Lin Lee
- Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan
| | - Guan-Yu Chen
- Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan
| | - Yi-Chieh Hung
- Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan; Department of Recreation and Healthcare Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
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Superficial Temporal Artery Pseudoaneurysm following Midface Thread-lift. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3524. [PMID: 33868876 PMCID: PMC8049386 DOI: 10.1097/gox.0000000000003524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/14/2021] [Indexed: 11/26/2022]
Abstract
Facial thread-lifting has been popular because of its ease and safety with short down time. However, many physicians perform the procedure in cosmetic clinics, which can result in several complications. This report describes the surgical treatment of iatrogenic superficial temporal artery pseudoaneurysm (STAP) following thread-lifting. A 27-year-old man developed a painless, pulsating soft mass in the pre-auricular region after undergoing a thread-lift in a private cosmetic clinic 3 months before being referred to the authors’ hospital. The mass was diagnosed as a STAP, using magnetic resonance imaging. The pseudoaneurysm was resected completely, and the superficial temporal artery was microsurgically reconstructed. Although there are some surgical procedures for treating STAP, such as surgical resection and embolization, the former is considered the first choice. Physicians should be trained before performing thread-lifting and must know the possibility of an iatrogenic STAP appearing after the procedure and the face and neck anatomy to prevent complications.
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Chen F, Li Y, Zhou H, Sun C, Li S, Wang L, Li X, Liu X. Analysis of Development Mechanism of Giant Cell Arteritis in Nude Mouse Model through Color Duplex Sonography and Computerized Tomography Nanocontrast Agent. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6627925. [PMID: 33928153 PMCID: PMC8053047 DOI: 10.1155/2021/6627925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/01/2021] [Accepted: 03/26/2021] [Indexed: 11/18/2022]
Abstract
To explore the application value of color duplex sonography and enhanced computerized tomography (CT) inspection based on a nanocontrast agent in diagnosis and pathogenesis in giant cell arteritis (GCA), the GCA nude mouse model was constructed. In this study, 40 healthy male BalB/c nude mice aged 6-8 weeks were randomly divided into a control group (no model) and an experimental group (model), with 20 mice in each group, and the temporal artery tissue of GCA patients diagnosed as positive by temporal artery biopsy was implanted into nude mice to construct a GCA nude mouse model. Abdominal aortic biopsy and immunohistochemistry were used to verify the success of the GCA nude mouse model. All nude mice were subjected to color duplex sonography and enhanced CT examination based on a nanocontrast agent. At the same time, the basic indicators such as body weight, temperature, white blood cell (WBC), lymphocytes (LYM), hemoglobin (HGB), and platelet (PLT) were measured, and the protein expression levels of interleukin-6 (IL-6) and signal transducer and activator of transcription 3 (STAT3) were detected by immunohistochemistry. The results showed that the temporal artery wall of the nude mice in the experimental group thickened and the lumen was significantly narrowed, indicating that the cell arteritis model of nude mice was successfully constructed; ultrasound examination showed that the right superficial temporal artery vascular cavity narrowed, the blood flow signal changed like a filling defect around the periphery, and there was a low echo halo. CT examination showed that the left superficial temporal artery narrowed, and the inner diameter of the narrow segment of blood vessels changed like a bead. The body weight of nude mice in the experimental group decreased significantly after the modeling was completed (P < 0.05); after modeling, the body temperature of the nude mice in the experimental group increased significantly (P < 0.05); LYM and HGB values of nude mice in the experimental group were significantly lower than those in the control group (P < 0.05); the content of IL-6, STAT3, IL-6, and STAT3 proteins in the arterial tissue of nude mice in the experimental group was lower than that of the control group (P < 0.05), indicating that color duplex sonography and CT contrast agent technology can be used in the diagnosis and development mechanism research of GC.
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Affiliation(s)
- Fugang Chen
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Yang Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Hongyan Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Chuang Sun
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Sun Li
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Lu Wang
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Xin Li
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
| | - Xiaoqiang Liu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian 116031, China
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ATIQUE GABRIEL S, BAUMANN BETELI C, VASCONCELOS SANTOS JA, JACINTHO de MELLO MA, EROLES CASSILLAS J, ROSSONI L, FERREIRA VOSS D, PACHECO de ARRUDA RIBEIRO I. Surgical management of traumatic superficial temporal artery pseudoaneurysm. Chirurgia (Bucur) 2021. [DOI: 10.23736/s0394-9508.19.04998-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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10
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Xie TH, Ren XX, Fu Y, Ha SN, Liu LT, Jin XS. Multiple well-differentiated retroperitoneal liposarcomas with different patterns of appearance on computed tomography: A case report. World J Clin Cases 2021; 9:1661-1667. [PMID: 33728310 PMCID: PMC7942046 DOI: 10.12998/wjcc.v9.i7.1661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/18/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary retroperitoneal liposarcoma (PRPLS) is a rare soft tissue tumor with nonspecific clinical symptoms; it has different computed tomography (CT) image features according to pathological types. Some patients with a single tumor have been previously reported in the literature. We present an exceptional case of a PRPLS patient with multiple large tumors exhibiting different patterns of appearance on CT and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology.
CASE SUMMARY A 64-year-old man presented with abdominal distension for 1 year. The patient was diagnosed with PRPLS based on physical examination, laparotomy, ultrasonography, CT scan, and surgery. Both of the tumors were completely resected through surgery and confirmed as atypical lipomatous tumor/well-differentiated liposarcoma by postoperative pathology. The postoperative course was uneventful without recurrence or metastasis, as demonstrated by abdominal-pelvic CT during an 18 mo follow-up.
CONCLUSION Multiple large Well-differentiated liposarcomas with different patterns of appearance on CT image can occur simultaneously in the same patient, to which more attention should be paid to make an effective differential diagnosis.
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Affiliation(s)
- Tian-Hao Xie
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Xiang-Xiang Ren
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Yan Fu
- Department of Ophthalmology, Baoding First Central Hospital, Baoding 071000, Hebei Province, China
| | - Si-Ning Ha
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Li-Tao Liu
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
| | - Xiao-Shi Jin
- Department of General Surgery, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
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Burns E, Chau A, Dunn C, Metry D. Skin-colored lateral forehead nodule. Pediatr Dermatol 2021; 38:485-486. [PMID: 33870560 DOI: 10.1111/pde.14527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Emily Burns
- Baylor College of Medicine, Houston, TX, USA
| | - Alex Chau
- Department of Interventional Radiology, Texas Children's Hospital, Houston, TX, USA
| | - Carly Dunn
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA
| | - Denise Metry
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA.,Department of Dermatology, Texas Children's Hospital, Houston, TX, USA
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Basha MAA, Eldib DB, Aly SA, Azmy TM, Mahmoud NEM, Ghandour TM, Aly T, Mostafa S, Elaidy AM, Algazzar HY. Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain. Insights Imaging 2020; 11:107. [DOI: https:/doi.org/10.1186/s13244-020-00914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/16/2020] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP.
Methods and results
A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66).
Conclusion
Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.
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Corvino A, Catalano O, de Magistris G, Corvino F, Giurazza F, Raffaella N, Vallone G. Usefulness of doppler techniques in the diagnosis of peripheral iatrogenic pseudoaneurysms secondary to minimally invasive interventional and surgical procedures: imaging findings and diagnostic performance study. J Ultrasound 2020; 23:563-573. [PMID: 32436181 PMCID: PMC7588580 DOI: 10.1007/s40477-020-00475-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022] Open
Abstract
The pseudoaneurysm (PA) is a perfused sac directly connecting with the arterial lumen by an interruption of the vessel wall continuity, more commonly secondary to trauma or iatrogenic causes. Aim of our study was to determine the accuracy and usefulness of Doppler techniques in the diagnosis of peripheral iatrogenic PAs secondary to minimally invasive procedures. From a three year prospective research, 20 Duplex Ultrasound (DUS) studies in as many patients presenting with periarterial pulsating mass clinically suspected for PA secondary to minimally invasive procedures were selected. The PA final diagnosis was confirmed by angiography in 12 patients (60% cases), by computed tomography angiography in 5 patients (25%), by surgery in 2 patients (10%), and by magnetic resonance angiography in 1 patient (5%). The vessels involved by PA formation were: common femoral artery in 8 cases (40%); superficial femoral artery in 4 cases (20%); brachial artery in 3 cases (15%); popliteal artery in 2 cases (10%); superficial temporal artery (STA) in 2 cases (10%); dorsal medial digital artery of the foot in 1 case (5%). Our study confirmed the usefulness of doppler techniques in the diagnosis of peripheral iatrogenic PAs. Specifically, a sensitivity of 90-95%, a specificity of 100% and predictive values of 100% (VPP) and 83-90% (VPN) were reported. The radiologist must always suspect a PA in the differential diagnosis of lesions contiguous to an artery vessel. This is to prevent potential complications such as e.g. massive haemorrhage. In this order, DUS allows a careful selection of patients who require to undergo in-depth imaging methods or surgical therapy, thus contributing to a significant reduction of contrast medium and exposure to ionizing radiation.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Via F. Acton 38, 80133, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Giuseppe de Magistris
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
| | - Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Niola Raffaella
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131, Naples, Italy
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14
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Chen L, Gao YH, Chen J, Yao YJ, Wang R, Yu Q, Hu B, Jiang LX. Diagnosis of Subungual Glomus Tumors with 18 MHz Ultrasound and CDFI. Sci Rep 2020; 10:17848. [PMID: 33082509 PMCID: PMC7575557 DOI: 10.1038/s41598-020-74774-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023] Open
Abstract
To evaluate the imaging features of subungual glomus tumors using 18 MHz high-frequency ultrasound with CDFI (Color Doppler Flow Imaging). 20 patients treated by surgical resection and examined by ultrasound between January 2008 and December 2019. All eligible cases are divided into two groups: Group A used the probe frequency of 9–14 MHz from January 2008 to December 2014, and Group B used the probe frequency of 18 MHz from January 2015 to December 2019. Patient demographics, clinical records, pathologic specimens and sonography features were reviewed. 50% of tumors in Group A and 100% of tumors in Group B showed clear boundary and regular shape. Blood flow signals were identified inside 50% tumors in Group A (3 in 6), all 14 cases with blood flow signals detected in Group B (14 in 14,100%). 2 cases were misdiagnosed and 1 case escaped diagnosis in Group A, no case was misdiagnosed in Group B. The accuracy of diagnosis rate of Group B is significantly higher than that of Group A. 18-MHz ultrasound combined with CDFI may be a practical useful tool for detecting subungual glomus tumors. More importantly 18-MHz ultrasound can obviously improve the diagnostic accuracy.
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Affiliation(s)
- Li Chen
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Yi-Hui Gao
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Jie Chen
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Yi-Jing Yao
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Rui Wang
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Qian Yu
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Bing Hu
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
| | - Li-Xin Jiang
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
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15
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Basha MAA, Eldib DB, Aly SA, Azmy TM, Mahmoud NEM, Ghandour TM, Aly T, Mostafa S, Elaidy AM, Algazzar HY. Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain. Insights Imaging 2020; 11:107. [PMID: 33000350 PMCID: PMC7527384 DOI: 10.1186/s13244-020-00914-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Anterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP. Methods and results A prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66). Conclusion Ultrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.
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Affiliation(s)
| | - Diaa Bakry Eldib
- Department of Radiodiagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt
| | - Sameh Abdelaziz Aly
- Department of Radiodiagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt
| | - Taghreed M Azmy
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Nader E M Mahmoud
- Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Tarek Mohamed Ghandour
- Department of Orthopaedic Surgery, Faculty of Human Medicine, Ain Shams University, Cairo, Egypt
| | - Tarek Aly
- Department of Orthopaedic Surgery, Faculty of Human Medicine, Tanta University, Tanta, Egypt
| | - Shimaa Mostafa
- Department of Rheumatology and Rehabilitation, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Asmaa M Elaidy
- Department of Psychiatry, Faculty of Human Medicine for Girls, Al-Azhar University, Zagazig, Egypt
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16
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Ma JJ, Zhang B. Diagnosis of an actively bleeding brachial artery hematoma by contrast-enhanced ultrasound: A case report. World J Clin Cases 2020; 8:3835-3840. [PMID: 32953861 PMCID: PMC7479570 DOI: 10.12998/wjcc.v8.i17.3835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Active bleeding due to arterial injury following the acupuncture can sometimes represent a life-threatening complication. Only few reports of an actively bleeding hematoma diagnosed by contrast-enhanced ultrasound, which enables the depiction of vascular, have been reported.
CASE SUMMARY Here, we report the case of a 75-year-old woman, who presented with sudden swelling, ecchymosis, and pain in the upper left limb. She underwent an acupuncture treatment of traditional Chinese medicine followed by a deep shoulder massage 2 d before admission to hospital. A few hours after the massage, her left upper arm was red, swollen and progressively aggravated. Ultrasonography showed a large hematoma (11.2 cm × 3.5 cm × 3.4 cm) beside the left brachial artery. Color Doppler ultrasound revealed that blood flow signals of the arteries branched into the hematoma. The contrast-enhanced ultrasound showed microbubbles from the brachial artery passing into the hematoma, diffused within the hematoma with the local surge of red blood cells, and disappearing after approximately 17 s. The microbubbles were likely due to bleeding from the arteries. After pressure bandaging treatment, the hematoma became smaller (3.1 cm × 1.7 cm) and organized according to ultrasonography performed 20 d later.
CONCLUSION This case highlights the ultimate importance of contrast-enhanced ultrasound for the diagnosis of an actively bleeding hematoma.
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Affiliation(s)
- Jiao-Jiao Ma
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
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17
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Catalano O, Varelli C, Sbordone C, Corvino A, De Rosa D, Vallone G, Wortsman X. A bump: what to do next? Ultrasound imaging of superficial soft-tissue palpable lesions. J Ultrasound 2020; 23:287-300. [PMID: 31786796 PMCID: PMC7441113 DOI: 10.1007/s40477-019-00415-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023] Open
Abstract
Soft-tissue palpable lesions are common in clinical practice, and ultrasound (US) represents the first imaging option in the evaluation of a patient with a soft-tissue swelling. A full and systematic US assessment is necessary, however. This includes grayscale, color- and power-Doppler, spectral-Doppler, and possibly elastography facilities, as well as a trained operator. Several lesions showing characteristic US features can be diagnosed confidently, without any further work-up, and the high spatial resolution of ultrasound in the superficial layers can be a powerful tool to discriminate their etiologies. Second-level options, to be reserved for indeterminate cases or those suspected malignant at initial ultrasound, include magnetic resonance imaging, percutaneous fine-needle aspiration or biopsy, and surgical-excision biopsy. In this article, we discuss the proper US approach for addressing superficial soft-tissue lesions.
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Affiliation(s)
- Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy.
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Carolina Sbordone
- Department of Medicine and Health Science "Vincenzo Tiberio", Molise University, Campobasso, Italy
| | - Antonio Corvino
- Department of Movement and Wellness Sciences, University of Naples Parthenope, Naples, Italy
| | - Dario De Rosa
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Gianfranco Vallone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Clinic, University of Chile and Pontifical Catholic University of Chile, Santiago, Chile
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18
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Corvino A, Pignata S, Campanino MR, Corvino F, Giurazza F, Tafuri D, Pinto F, Catalano O. Thyroglossal duct cysts and site-specific differential diagnoses: imaging findings with emphasis on ultrasound assessment. J Ultrasound 2020; 23:139-149. [PMID: 32052384 PMCID: PMC7242578 DOI: 10.1007/s40477-020-00433-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Thyroglossal duct cysts (TGDCs) are the most common congenital abnormality of the neck, accounting for approximately 70% of congenital neck lesions. Two-thirds of thyroglossal duct anomalies are diagnosed within the first three decades of life, with more than half being identified before 10 years of age. The age of presentation, clinical examination and imaging are essential for an accurate diagnosis. This review aims to summarize the imaging findings of TGDCs and their main differential diagnoses with emphasis on ultrasound assessment. A focus on site-specific key differentiating between them is also addressed.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Via F. Acton 38, 80133, Naples, Italy.
- , Casal di Principe, Italy.
| | - Saverio Pignata
- Ultrasound Unit, Ninetta Rosano Institute, Via Capo Tirone 14, 87021, Belvedere Marittimo (CS), Italy
| | - Maria Raffaela Campanino
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131, Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Domenico Tafuri
- Motor Science and Wellness Department, University of Naples "Parthenope", Via F. Acton 38, 80133, Naples, Italy
| | - Fabio Pinto
- Radiology Department, Marcianise Hospital, Via Santella, 81025, Marcianise, (CE), Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126, Naples, Italy
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19
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Lahlou N, Zahdi O, Hormat-Allah M, Bakkali T, El Bhali H, Sefiani Y, El Mesnaoui A, Lekehal B. False aneurysm of the superficial temporal artery. JOURNAL DE MÉDECINE VASCULAIRE 2020; 45:88-89. [PMID: 32265021 DOI: 10.1016/j.jdmv.2020.01.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/18/2020] [Indexed: 11/19/2022]
Affiliation(s)
- N Lahlou
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
| | - O Zahdi
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco.
| | - M Hormat-Allah
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
| | - T Bakkali
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
| | - H El Bhali
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
| | - Y Sefiani
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
| | - A El Mesnaoui
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
| | - B Lekehal
- Mohammed V University, Rabat, Morocco; Department of Vascular Surgery, CHU Ibn Sina, Souissi, 10104 Rabat, Morocco
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20
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Corvino A, Sandomenico F, Setola SV, Corvino F, Tafuri D, Catalano O. Lesioni cistiche complex di fegato: reperti ecocontrastografici diagnostico-differenziali. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020; 179. [DOI: 10.23736/s0393-3660.19.04120-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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21
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Sandomenico F, Corvino A, Setola SV, Simonetti I, Porcaro M, Trovato P, Catalano O, Petrillo A. Post-amputation neuroma of radial nerve in a patient with ephitelioid sarcoma: case report and literature review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:122-127. [PMID: 32191665 PMCID: PMC7569598 DOI: 10.23750/abm.v91i1.8510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/13/2019] [Indexed: 12/22/2022]
Abstract
Neuroma, also known as traumatic neuroma or amputation neuroma or stump neuroma, is a focal non neoplastic area of proliferative hyperplastic reaction secondary to peripheral nerve damage that commonly occurs after a focal trauma (acute or chronic) or surgery, such as amputation or partial transection. Neuromas are more commonly located in the lower limbs, followed by head and neck; other extremely rare sites include the ulnar nerve followed by the radial nerve and the brachial plexus. A radiologic plan is necessary to recognize soft tissue lesions with a neural origin and whether they are a true tumor or a pseudotumor such as a neuroma, fibrolipoma, or peripheral nerve sheath ganglion. In oncologic patients the appearance of post-surgical neuromas can produce problems in differential diagnosis with local recurrences. Therefore, with a combination of different imaging techniques, mainly ultrasound (US) and magnetic resonance imaging (MRI), it is possible to characterize neurogenic tumours safely, with a great impact on patient management and to plan an appropriate treatment. Here, we report the first case of post-amputation neuroma of radial nerve in a patient with clinical history of ephitelioid sarcoma with a short literature review.
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Affiliation(s)
- Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.
| | - Antonio Corvino
- 1Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133 Naples, Italy 2Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131 Naples Italy.
| | - Sergio Venanzio Setola
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.
| | - Igino Simonetti
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131Naples Italy.
| | - Mauro Porcaro
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131Naples Italy.
| | - Piero Trovato
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, I-80131Naples Italy.
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, via Cornelia dei Gracchi 65, I-80126 Naples Italy.
| | - Antonella Petrillo
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.
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22
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Al-Sibassi AN, Ethunandan M. Superficial Temporal Artery Aneurysm: Case Report and Review of Literature. J Oral Maxillofac Surg 2020; 78:1147-1150. [PMID: 32119828 DOI: 10.1016/j.joms.2020.01.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 01/26/2020] [Accepted: 01/28/2020] [Indexed: 10/25/2022]
Abstract
Superficial temporal artery (STA) aneurysms are painless, pulsatile masses that infrequently result from blunt trauma to the side of the head. Only a small number of them have been reported in the literature. We describe the diagnosis and management of a 22-year-old man who had fallen from his bicycle, resulting in an STA pseudoaneurysm, and review the pertinent literature.
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Affiliation(s)
- Ayman Nassib Al-Sibassi
- Dental Core Trainee, Department of Oral and Maxillofacial Surgery, University Hospital Southampton, Southampton, UK.
| | - Madan Ethunandan
- Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Hospital Southampton, Southampton, UK
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23
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Corvino A, Sandomenico F, Corvino F, Campanino MR, Verde F, Giurazza F, Tafuri D, Catalano O. Utility of a gel stand-off pad in the detection of Doppler signal on focal nodular lesions of the skin. J Ultrasound 2020; 23:45-53. [PMID: 30927249 PMCID: PMC7010871 DOI: 10.1007/s40477-019-00376-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/21/2019] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Gel pad is an aqueous, flexible, easy available, disposable spacer used for the ultrasound (US) scan of superficial or difficult-to-visualize areas. In clinical practice, it is widely used in B-mode US approach of superficial lesions but, to date, no data have been provided as to its efficacy in the Doppler detection of superficial flows. The aim of our study was to demonstrate the role of stand-off gel pad in the detection of the otherwise-missed peri- or intra-lesional flow signals on Doppler imaging. MATERIALS AND METHODS A total of 100 superficial lesions undergone to an US evaluation using a 7.5-12-MHz linear probe were evaluated prospectively with and without interposition of a gel stand-off pad to detect the presence or absence of vascularization and to classify the vascular pattern. RESULTS Peri- or intra-lesional flow was demonstrated in 56% of cases without and in 84% of cases with interposition of a gel stand-off pad; moreover, a statistically significant difference (p value < 0.001) was observed at Chi-square test in the identification of the flow pattern between the use and no use of the pad. CONCLUSIONS The use of a gel stand-off pad allows the detection of otherwise-missed peri- or intra-lesional flow signals on Doppler imaging, increasing the diagnostic role of this technique in differential diagnosis of superficial lesions.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, Via F. Acton 38, 80133 Naples, Italy
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131 Naples, Italy
- Via B. Croce n. 82, 81033 Casal di Principe, CE Italy
| | - Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131 Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Maria Raffaela Campanino
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131 Naples, Italy
| | - Francesco Verde
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131 Naples, Italy
| | - Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Domenico Tafuri
- Motor Science and Wellness Department, University of Naples “Parthenope”, Via F. Acton 38, 80133 Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126 Naples, Italy
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24
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Sandomenico F, Corvino A, Ronza FM, Catalano O, Fazioli F, De Chiara A, Campanino MR, Porcaro M, Tafuri D, Petrillo A. Recurrence of tumoral calcinosis: a case report. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:587-594. [PMID: 31910191 PMCID: PMC7233760 DOI: 10.23750/abm.v90i4.8251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/21/2019] [Indexed: 11/23/2022]
Abstract
We describe radiographic, contrast-enhanced MDCT and MRI findings with pathologic correlations of an unusual recurrence of tumoral calcinosis, also called Teutschlander disease. The disease was silent in the first decade of life, when it appeared with elbows recurring lesions, until the seventh decade of life, when a left hip active growth lesion developed. A review about tumoral calcinosis pathogenesis, clinical course and imaging differential diagnosis is reported. (www.actabiomedica.it).
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Affiliation(s)
- Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131 Naples Italy.
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25
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Corvino A, Rosa DD, Sbordone C, Nunziata A, Corvino F, Varelli C, Catalano O. Diastasis of rectus abdominis muscles: patterns of anatomical variation as demonstrated by ultrasound. Pol J Radiol 2019; 84:e542-e548. [PMID: 32082453 PMCID: PMC7016498 DOI: 10.5114/pjr.2019.91303] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aim of our study was to categorise the anatomical variations of rectus abdominis muscle diastasis (diastasis recti) by using ultrasound (US). MATERIAL AND METHODS In a one-year period 92 women were evaluated with US because of suspected diastasis of rectus muscles. Patients were examined in a supine position, with head extended, upper limbs aligned to the trunk, and knees flexed. US was performed with high-frequency, broad-band transducers. Trapezoid field-of-view and extended field-of-view were employed to measure diastasis exceeding 5 cm. Diastasis was defined as a margin-to-margin distance > 20 mm at rest and classified according to the following anatomical patterns: open only above the navel, open only below the navel, open at the navel level, open completely but wider above the navel, and open completely but wider below the navel. RESULTS Diastasis was found in 82 patients (30-61 years old, mean age 35 years). The width was 21-97 mm, mean 39 mm. The prevalence and severity of the anatomical patterns was as follows: open only above the navel in 48 patients (21-88 mm, mean 40 mm), open only below the navel in one patient (33 mm), open at the navel level in seven patients (23-39 mm, mean 34 mm), open completely but wider above the navel in 24 patients (21-97 mm, mean 41 mm), open completely but wider below the navel in two patients (21-29 mm, mean 25 mm). CONCLUSIONS The above-navel patterns of recti muscle diastasis are the most common. Even when open completely, diastasis is usually wider above the navel. Knowledge of the anatomical type of rectus muscle diastasis could be of value to the patient (exercises to do and to avoid) and to the surgeon (abdominoplasty planning).
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Affiliation(s)
- Antonio Corvino
- Department of Motor Science and Wellness, University of Naples “Parthenope”, Naples, Italy
| | - Dario De Rosa
- Radiology Unit, Istituto Diagnostico Varelli, Naples, Italy
| | - Carolina Sbordone
- Department of Medicine and Health Science, “Vincenzo Tiberio” Molise University, Campobasso, Italy
| | | | - Fabio Corvino
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Istituto Diagnostico Varelli, Naples, Italy
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26
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He FJ, Zhang P, Wang MJ, Chen Y, Zhuang W. Left armpit subcutaneous metastasis of gastric cancer: A case report. World J Clin Cases 2019; 7:4137-4143. [PMID: 31832419 PMCID: PMC6906569 DOI: 10.12998/wjcc.v7.i23.4137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/01/2019] [Accepted: 11/13/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide. Metastasis has always been a major cause of poor prognosis. Epidemiological evidence shows that the most common sites for metastasis of gastric carcinoma are the liver (48%), peritoneum (32%), lung (15%), and bone (12%); however, subcutaneous metastasis is are and occurs in approximately 0.8% of cases. We report a rare case of armpit subcutaneous metastasis of gastric cancer. The best surgical window was missed, as a result of lacking attention of the mass.
CASE SUMMARY A 69-year-old man who had previously undergone radical gastrectomy and received eight cycles of oral chemotherapy for gastric cancer showed a rapidly growing mass in his the left armpit; within just 3 mo, the mass grew to a size of 6.9 cm × 4.4 cm × 5.7 cm. Color Doppler ultrasonography and Positron emission tomography/computed tomography prompted the possibility of metastasis of the malignancy. Fine needle aspiration biopsy guided by color Doppler ultrasound showed the presence of cancer cells in the mass. Immunohistochemical examination showed CDX-2 (+), PCK (+), CK20 (+), CK7 (-), and TTF (-), which supported the metastasis of gastric cancer. Considering the risk of resection, the patient did not undergo surgical treatment.
CONCLUSION The case indicates that unidentified subcutaneous masses in patients with a history of gastric cancer should be carefully evaluated.
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Affiliation(s)
- Feng-Jun He
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Peng Zhang
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Mo-Jin Wang
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Chen
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wen Zhuang
- Department of Gastrointestinal Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China
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Corvino A, Sandomenico F, Setola SV, Corvino F, Pinto F, Catalano O. Added value of contrast-enhanced ultrasound (CEUS) with Sonovue ® in the diagnosis of inferior epigastric artery pseudoaneurysm: report of a case and review of literature. J Ultrasound 2019; 22:485-489. [PMID: 31327113 PMCID: PMC6838239 DOI: 10.1007/s40477-019-00398-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/11/2019] [Indexed: 12/13/2022] Open
Abstract
The anatomical position of the inferior epigastric artery (IEA), within the rectus sheath, subjects patients to possible IEA injury during abdominal wall surgical and interventional procedures. Pseudoaneurysm arising from IEA is very uncommon with only 16 cases reported in the literature. We present a case of an IEA false aneurysm resulting from therapeutic paracentesis for ascites in a 71-year-old patient who came to our department for abdominal pain and signs of anemization. To our knowledge, no published reports are currently available describing an IAE pseudoaneurysm successfully diagnosed with contrast-enhanced ultrasound.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, Via F. Acton 38, 80133 Naples, Italy
- Casal di Principe, Italy
| | - Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131 Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131 Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Fabio Pinto
- Radiology Department, Marcianise Hospital, Via Santella, 81025 Marcianise, CE Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia dei Gracchi 65, 80126 Naples, Italy
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Abstract
This case describes a 3-year-old boy who was brought to the pediatric emergency department for evaluation of facial swelling. The patient's history was remarkable for a deep facial laceration 5 days prior that required surgical repair in the operating room. On the day of presentation, he was noted to have mild swelling and tenderness to palpation of the left jaw below the mandible, in the same location as his recent laceration repair. Point-of-care ultrasound (POCUS) revealed a pseudoaneurysm with an arterial feeding vessel. This was confirmed by radiology-performed ultrasound, and the patient underwent a coil embolization procedure. To our knowledge, this is the first reported case of a pseudoaneurysm being diagnosed by POCUS in a pediatric patient. This case demonstrates the utility of POCUS in facilitating the timely recognition of vascular mass lesions and guiding management in the emergency department to avoid complications.
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29
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Corvino A, Sandomenico F, Setola SV, Corvino F, Tafuri D, Catalano O. Morphological and dynamic evaluation of complex cystic focal liver lesions by contrast-enhanced ultrasound: current state of the art. J Ultrasound 2019; 22:251-259. [PMID: 31087277 PMCID: PMC6704192 DOI: 10.1007/s40477-019-00385-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022] Open
Abstract
Complex cystic and cystic-like focal liver lesions (FLLs) encompass a spectrum of disorders ranging from non-neoplastic conditions to benign and malignant tumors. In this prospective, the possibility of non-invasive differentiation of these lesions is extremely important, because the clinical implications and therapeutic strategies vary considerably. Because of its advantageous cost/benefit ratio, widespread availability and easy execution, ultrasound (US) is the first-line imaging modality in most countries for the initial liver survey and represents the imaging technique that usually detects a complex liver cyst. However, US showed poor efficacy in the differential diagnosis of complex cystic FLLs. Thus, for years, computed tomography (CT) and magnetic resonance (MR) imaging have been used for further assessment of these lesions. Recently, the development of low mechanical index real-time contrast-enhanced ultrasound (CEUS) technique performed with the second generation of US contrast agents has led to an accurate depiction of macrovasculature and microvasculature. The technique yields information about contrast enhancement of the liver and FLLs almost as CT and MRI do, but in real time and without the use of ionizing radiation. To date, there is only a small amount of evidence about the role of CEUS in the less common setting of complex liver cysts. The aim of this review is to offer an up-to-date overview on the state of the art of CEUS in the study of the most common complex cystic focal liver lesions. To our knowledge, there are no literature comprehensive reviews on this topic.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples “Parthenope”, VIA F. Acton 38, 80133 Naples, Italy
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Via S. Pansini 5, 80131 Naples, Italy
- via Croce no. 82, 81033 Casal di Principe, CE Italy
| | - Fabio Sandomenico
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131 Naples, Italy
| | - Sergio Venanzio Setola
- Radiology Department, National Cancer Institute Pascale Foundation, Via M. Semmola 53, 80131 Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Domenico Tafuri
- Motor Science and Wellness Department, University of Naples “Parthenope”, VIA F. Acton 38, 80133 Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, Via Cornelia Dei Gracchi 65, 80126 Naples, Italy
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30
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Derbel B, Koubaa MA, Ben Abdellatif B, Miri R, Denguir R. [Post-traumatic pseudoaneurysm of the superficial temporal artery]. Ann Dermatol Venereol 2019; 146:685-686. [PMID: 31371037 DOI: 10.1016/j.annder.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/08/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Affiliation(s)
- B Derbel
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de chirurgie cardio-vasculaire, hôpital La Rabta, 1007 Tunis, Tunisie.
| | - M-A Koubaa
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie
| | - B Ben Abdellatif
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie
| | - R Miri
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de chirurgie cardio-vasculaire, hôpital La Rabta, 1007 Tunis, Tunisie
| | - R Denguir
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de chirurgie cardio-vasculaire, hôpital La Rabta, 1007 Tunis, Tunisie
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Pane F, Cavaglià E, Silvestre M, Coppola M, Corvino F, Borzelli A, Paladini A, Giurazza F, Corvino A, Zobel DB, Amodio F, Capasso F, Niola R. Successful endovascular treatment of a spontaneous bleeding accessory spleen: A case report. Radiol Case Rep 2019; 14:787-790. [PMID: 31011380 PMCID: PMC6462800 DOI: 10.1016/j.radcr.2019.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 03/30/2019] [Accepted: 03/31/2019] [Indexed: 11/23/2022] Open
Abstract
Accessory spleens are often encountered in radiologic studies and they are not usually associated with symptoms. They could arise from autotransplantation of splenic tissue after splenic trauma or splenectomy (splenosis) [1]. In this case we describe a woman treated for splenectomy 20 years before and subsequently for adhesions, that suffered sudden left upper abdominal quadrant pain, weakness, and pale color. Contrast-enhanced computed tomography revealed free spilling in the abdomen and venous bleeding of a big accessory spleen; thus the patient underwent transcatheter arterial embolization with coils. Due to the 2 previous surgical operations in the splenic loggia, endovascular treatment compared to "open surgery" was the best choice in this case because of determined less complications, a shorter period of hospitalization, and a reduction of health cost.
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Affiliation(s)
- Francesco Pane
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - Enrico Cavaglià
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Mattia Silvestre
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Milena Coppola
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - Fabio Corvino
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Antonio Borzelli
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Andrea Paladini
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont – UPO University, Corso G. Mazzini 18, 28100 Novara, Italy
| | - Francesco Giurazza
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Antonio Corvino
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - Daniela Beomonte Zobel
- Division of Interventional Radiology, IFO Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy
| | - Francesco Amodio
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
| | - Francesco Capasso
- Dipartimento di scienze biomediche avanzate, Università degli studi di Napoli “Federico II”, Via S.Pansini, 80131 Naples, Italy
| | - Raffaella Niola
- Interventional Radiology Department, AORN “A. Cardarelli”, Via A. Cardarelli 9, 80131 Naples, Italy
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Vidoni A, McLoughlin E, James SL, Botchu R. Intra-neural ganglion cyst of the lateral dorsal cutaneous nerve: an uncommon cause of lateral ankle pain. J Ultrasound 2019; 23:81-86. [PMID: 31161399 DOI: 10.1007/s40477-019-00387-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/22/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION An intra-neural ganglion cyst of the lateral dorsal cutaneous branch of the sural nerve is rare, with only a few cases reported in the literature. MATERIALS AND METHODS We carried out a retrospective investigation of patients with an intraneural ganglion cyst of the lateral dorsal cutaneous nerve. RESULTS We present a case series of four patients with intra-neural ganglion cysts of the lateral dorsal cutaneous nerve, the distal continuation of the sural nerve at the lateral aspect of the foot. CONCLUSION Intra-neural ganglion cysts of the lateral dorsal cutaneous nerve are rare. They represent a relatively uncommon source of lateral ankle pain, which can easily be diagnosed with ultrasound (US) and magnetic resonance imaging and managed effectively with US-guided aspiration or surgical excision.
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Affiliation(s)
- A Vidoni
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.,Royal National Orthopedic Hospital, Stanmore, UK
| | - E McLoughlin
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - S L James
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Corvino F, Giurazza F, Cangiano G, Cavaglià E, Amodio F, De Magistris G, Corvino A, Niola R. Safety and effectiveness of transcatheter embolization in the treatment of internal mammary artery injuries. LA RADIOLOGIA MEDICA 2018; 123:369-377. [PMID: 29256083 DOI: 10.1007/s11547-017-0844-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/11/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Demonstrate the role of endovascular management in the treatment of internal mammary artery (IMA) injuries using transcatheter embolization reviewing our 7-year experience. MATERIALS AND METHODS Our retrospective analysis of cases consists of a total of 12 patients (8 M and 4 F; mean age 52 years) who underwent angiographic studies and transcatheter embolization for IMA injuries. Causes of vascular injury were divided in high-energy trauma (n = 6), iatrogenic (n = 3) and penetrating injuries (n = 3). Type of trauma, associated injury, imaging findings, treatments and complications were assessed. Imaging findings included active haemorrhage, pseudoaneurysm and focal dissection. RESULTS Embolization was performed with microcoils in all patients; complete thrombosis was obtained in four patients by additional injection of Spongostan pledgets and in two patients with 300-500 μm particles. The technical success rate was 100%. No patient died as a direct result of vascular injury; one died of myocardial contusion and one for severe multiorgan failure related to high-energy trauma. No major and minor complications were registered. No patient required emergency surgery or subsequent surgical treatment. CONCLUSION Transcatheter embolization offers an effective, efficient and safe alternative to conventional surgical management of IMA injuries.
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Affiliation(s)
- Fabio Corvino
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy.
| | - Francesco Giurazza
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianluca Cangiano
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy
| | - Enrico Cavaglià
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy
| | - Francesco Amodio
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy
| | - Giuseppe De Magistris
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy
| | - Antonio Corvino
- Department of Radiology, University of Naples Parthenope, Naples, Italy
| | - Raffaella Niola
- Interventional Radiology Department, AORN "A. Cardarelli", Via A. Cardarelli 9, 80131, Naples, Italy
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Johnston J, Sullivan CM. Superficial temporal artery pseudoaneurysm following facial trauma. BMJ Case Rep 2018; 2018:bcr-2018-224303. [PMID: 29574436 DOI: 10.1136/bcr-2018-224303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 68-year-old man presented with rapid swelling of the right forehead 11 days after sustaining a laceration secondary to a fall. Presumed to be an abscess due to retained foreign body, needle aspiration was performed and arterial blood obtained. Doppler ultrasound revealed a 3 cm mixed echogenicity lesion with 'see-sawing' internal Doppler flow arising from the superficial temporal artery (STA), in keeping with a pseudoaneurysm. Treatment options including interventional radiology and open surgery were considered. Open operative intervention with direct surgical ligation provided an excellent outcome. Delayed pseudoaneurysm of the STA is a rare complication of trauma but should be considered in the differential of a traumatic lateral forehead swelling to prevent complications and inappropriate investigations and management.
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Affiliation(s)
- James Johnston
- Interventional Radiology Department, Morriston Hospital, Swansea, UK
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[Superficial temporal artery pseudoaneurysm: 2 cases]. Ann Dermatol Venereol 2017; 145:257-260. [PMID: 28918953 DOI: 10.1016/j.annder.2017.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/24/2017] [Accepted: 07/21/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pseudoaneurysm of the superficial temporal artery causes tumefaction in the temporal region. Herein, we report two cases. PATIENTS AND METHODS Case 1 : a 32-year-old man presented with a slightly pulsatile nodular formation measuring 2 cm in the right temporal region that had appeared nine months after traumatic injury. A diagnosis of superficial temporal artery pseudoaneurysm was considered. Excision was performed with ligation of the afferent and efferent artery. The clinical diagnosis was confirmed by histopathology. Case 2 : a 24-year-old man presented with a nonpulsatile subcutaneous tumefaction on his left temple. Surgery was proposed based on a supposed epidermal cyst. However, the perioperative aspect suggested a lesion of arterial origin and excision was performed following ligation of the afferent and efferent artery. CONCLUSION Pseudoaneurysm of the superficial temporal artery must be considered for all temporal cutaneous formations, particularly when there is a history of trauma. The clinical diagnosis may be confirmed by Doppler ultrasound. Surgery is the treatment of reference.
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