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Systemic Veins of the Thorax.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
As well as demonstrating thrombus within the SVC and/or great veins, extraluminal masses pressing upon them need also to be demonstrated, and for this CT is invaluable. When accompanied by a contrast infusion from an arm, intraluminal defects may usually be demonstrated as well. The 'scout view' may also give a useful 'venogram'. The contrast medium will help to show other vessels, tumour enhancement, etc.
Trauma
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Danielle M. Prentice, Lauren A. Plante
Iodinated contrast medium is not known to be harmful to fetuses: it is not teratogenic and does not suppress fetal thyroid function. The American College of Radiology states, “We do not recommend withholding the use of iodinated contrast agents in pregnant or potentially pregnant patients when it is needed for diagnostic purposes” [80].
Cardiac Diagnostic Testing in Pregnancy
Published in Afshan B. Hameed, Diana S. Wolfe, Cardio-Obstetrics, 2020
Pulmonary CTA is the imaging of choice in the diagnoses of PE due to its high sensitivity and specificity. Disadvantages include maternal breast radiation exposure of up to 10–70 mGy, fetal radiation exposure, and risks related to iodinated contrast material [32,34]. The most common side effects associated with iodinated contrast media include nausea, vomiting, flushing, and anaphylactoid reaction. Iodine contrast media can readily cross the placenta; however, animal studies have not shown any teratogenic or mutagenic effects with its use [8]. The current recommendation is that contrast may be used when needed and when benefits outweigh the risks.
Subtraction coronary CT angiography in patients with high heart rate
Published in Acta Cardiologica, 2023
Bi Zhou, Zhuoyue Tang, Xianlong Huang, Hongzhang Zhu, Xiaojiao Li, Hua Xiong, Jiayi Yu, Ruikun Liao, Dan Zhang
From January 2018 to February 2019, 61 patients who were referred for CCTA because of suspected CAD or previously placed at least one stent agreed to undergo the new subtraction CCTA protocol. The exclusion criteria were allergy to iodinated contrast media, arrhythmia and kidney dysfunction. Of these 61 patients, 12 patients with negative CCTA reports, 1 patient with severe blooming artefacts in proximal coronary arteries which influenced CT attenuation measurement and 2 patients whose examination failed because of severe body motion artefacts were excluded from this study. Finally, 46 patients (26 men and 20 women; mean age 61.6 ± 11.7 years) were enrolled for further analysis, of which 41% (19/46) patients took beta-blocker in clinical departments previously. The target segments were defined as coronary segments with severe calcification (cross-sectional calcification >1/2 circumference [14]) or stent. Of all enrolled patients, 39% (18/46) patients with 15 severe calcification segments and 25 stent segments further received ICA in half a month as the gold standard for detection of significant stenosis. A cardiologist with more than 20 years of clinical ICA experience was blinded to the CT findings and defined obstructive CAD as luminal reduction >50% visually by ICA (Artis zee III ceiling; Siemens Healthcare).
Coronary artery lesion distribution in patients with chronic kidney disease undergoing percutaneous coronary intervention
Published in Renal Failure, 2022
Naofumi Ikeda, Toshihide Hayashi, Shikou Gen, Nobuhiko Joki, Kazuhiko Aramaki
Although the sample size of this study was not very small, the retrospective, cross-sectional design does not permit a discussion of the causal effect of the uremic milieu on coronary atherosclerosis in the RCA. Due to the retrospective nature of our study, we were unable to extract data regarding specific branches of the RCA, which limits detailed analysis. Unfortunately, it was impossible to examine risk factors for coronary disease or CKD, such as serum phosphate, on RCA lesions because the results for such markers were not included in the database. Deterioration of renal function in advanced stages of CKD can lead to fears of contrast-enhanced nephropathy. Except for urgent cases, those with advanced stages of CKD, especially CKD5, have a low risk of affecting renal function from the use of contrast-enhanced coronary angiography, but it seems that the number of cases was small. It is possible that contrast medium was used in patients included in this study. As a result, it is possible that the number of cases is biased. Furthermore, as a cross-sectional study, we present real-world prevalence data for the studied institution and included time range. However, the lack of equal numbers across groups limits our statistical analysis of potential morphological and physiological variance between groups. Future studies should include longitudinal studies of demographically matched patients to validate observed differences across stages.
Risk factors for post-endoscopic retrograde cholangiopancreatography cholangitis in patients with hepatic alveolar echinococcosis—an observational study
Published in Annals of Medicine, 2022
Fei Du, Wenhao Yu, Zhixin Wang, Zhi Xie, Li Ren
Univariate analysis showed that hilar bile duct stricture and endoscopic retrograde biliary drainage were risk factors for the development of post-ERCP cholangitis. The hilar bile duct strictures in our patients were divided mainly into two types either caused by AE invasion or as a post-hepatectomy complication. In the AE invasion group of patients, the anatomical complexity and significant anatomical deformities of the hilar bile duct [29] may have led to longer ERCP times, with the growth of the lesion tending to cause stent occlusion [29], and a higher risk of post-ERCP cholangitis. AE has aggressive growth characteristics similar to tumours, resulting in cholangitis similar to malignant hilar biliary obstruction after ERCP. In t post-hepatectomy complication group of patients, post-surgical hilar bile duct strictures were a more difficult technical procedure, resulting in inadequate drainage. In this regard, contrast media has been reported to cause post-ERCP cholangitis [30].