Diagnosis of aortic diseases using multidetector computed tomography.
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Aortic Dissection↗
Biomedical subjects
Hideki Ota
Publications and source records attributed to Hideki Ota.
Surgical treatment of esophageal varices caused by an arteriovenous fistula between an artery of the thyroid gland and the submucosal venous network of the esophageal wall.
We report a case of esophageal varices caused by an arteriovenous fistula between an artery of the thyroid gland and the submucosal venous network of the esophageal wall. The fistula developed in a 51-year-old woman 24 years after she received subtotal thyroidectomy to treat Graves' disease. At the same time, gastrointestinal endoscopy revealed the presence of uncommon esophageal varices that were limited to the cervical and upper thoracic esophagus. Angiography confirmed the presence of both an arteriovenous fistula of the peripheral residual thyroid gland and the esophageal varices, after which we successfully treated the varices by surgical resection of the fistula.
Arteriovenous Fistula↗
MDCT compared with digital subtraction angiography for assessment of lower extremity arterial occlusive disease: importance of reviewing cross-sectional images.
OBJECTIVE: The aim of our study was to evaluate the efficacy of MDCT angiography in the assessment of lower limb peripheral arterial occlusive disease. MATERIALS AND METHODS: Twenty-four patients (representing 27 cases) with symptomatic lower extremity peripheral arterial occlusive disease underwent both MDCT angiography and digital subtraction angiography of the aortoiliac and lower extremity arteries. For data analysis, the arterial system was divided into 10 segments. Each segment was classified as normal, mildly stenotic, moderately stenotic, severely stenotic, or occluded. In evaluating MDCT angiographic findings, cross-sectional images were mainly observed by scrolling. The diagnostic accuracy of MDCT angiography was determined, using digital subtraction angiography as the standard reference. The extent of calcification in each segment was also assessed on MDCT angiography and was classified as absent, mildly calcified, or severely calcified. RESULTS: Of the 480 segments studied, 470 were assessable on both digital subtraction angiography and MDCT angiography. On digital subtraction angiography, 142 stenoocclusive segments (20 mildly stenotic, 14 moderately stenotic, 25 severely stenotic, and 83 occluded) were detected. With regard to the detection of segments that had more than mild stenosis, the sensitivity, specificity, and accuracy of MDCT angiography were 99.2%, 99.1%, and 99.1%, respectively. In the 421 noncalcified and mildly calcified segments, the sensitivity, specificity, and accuracy of MDCT angiography for the detection of more-than-mild stenosis were 100%, 100%, and 100%, respectively. CONCLUSION: MDCT angiography is a reliable method for evaluating the aortoiliac and lower extremity arteries.
Adolescent↗
Preoperative MDCT evaluation of the artery of Adamkiewicz and its origin.
OBJECTIVE: To assess the usefulness of MDCT in the preoperative evaluation of the artery of Adamkiewicz (ARM) and its parent artery. METHODS: Ten patients with thoracoabdominal vascular diseases underwent MDCT of the entire aorta and iliac arteries. The visualization of the ARM, and its branching level and site of origin, and the continuity of the intercostal/lumbar arteries with the ARM were investigated. RESULTS: In 9 of the 10 patients, the ARM was clearly visualized. The entire length from the intercostal/lumbar arteries to the ARM could be traced in 8 of the 10 patients. Surgical treatment or stentgraft insertion was based on a consideration of the vascular supply to the ARM. No postoperative ischemic spinal complications occurred. CONCLUSIONS: MDCT permits the evaluation of the ARM for its entire length and provides information on the intercostal and lumbar arteries and entire aorta.
Adult↗
Quantitative vascular measurements in arterial occlusive disease.
Accuracy in quantifying arterial occlusive disease requires an understanding of the relevant technical considerations and familiarity with the strengths and weaknesses of various imaging modalities in this setting. The degree of stenosis is evaluated in terms of diameter stenosis, which can be measured on either projection images or cross-sectional images, or area stenosis, which can be measured only on cross-sectional images. With projection images, the minimum luminal diameter should be sought on multiple images obtained at different angles. The reference site used for measurement should be noted and may be located at the level of the lesion or in a normal-looking portion of the stenotic vessel near the lesion. Multi-detector row computed tomographic (CT) angiography and magnetic resonance (MR) angiography are starting to replace digital subtraction angiography in quantifying arterial occlusive disease. CT angiography allows accurate evaluation without reducing in-plane resolution, although beam-hardening artifacts from high-attenuation structures can degrade image quality. MR angiography is useful even in cases of severe calcification but has a lower spatial resolution. Ultrasonography (US) may also be helpful in quantifying arterial occlusive disease; US analysis is almost always based on blood flow velocity measurement. Precise measurements of stenotic occlusion will help determine optimal therapy for affected patients.
Aged↗
Clinical presentation of pulmonary edema following esophagectomy on chest radiograph.
BACKGROUND/AIMS: To determine whether the clinical presentation of pulmonary edema following esophagectomy can be objectively determined by changes in X-ray density in the lung field on chest radiography. METHODOLOGY: Sixteen patients who underwent esophagectomy for thoracic esophageal cancer and five patients who underwent less radical surgery at Akita University Hospital between July 2000 and March 2001 were recruited to the thoracic esophageal cancer and control groups, respectively. Chest radiography was carried out using five aluminum disks (15, 20, 25, 30 and 35 mm thickness) placed in upper right corner of the film and X-ray density for the disks and chest lung field was measured using a densitometer until POD 7. RESULTS: In the thoracic esophageal cancer group, X-ray density in the lung field, body weight, and respiratory index increased significantly in the immediate postoperative period. The X-ray density in the lung field peaked on POD 2, and remained constant to POD 6. Correlations were found among changes in X-ray density in the lung field, body weight, and respiratory index. CONCLUSIONS: The measurement of X-ray density on a chest radiograph is useful for prediction as well as early management of patients with pulmonary edema following esophagectomy for thoracic esophageal cancer.
Aged↗