Intravascular Ultrasound for Evaluation of Left Gonadal Vein Anatomic Variations During Coil Embolization

We illustrate the intravascular ultrasound (US) findings in the evaluation of left gonadal vein anatomic variations. During a 2-year period, 4 consecutive patients (mean age, 37 years; range, 28–45 years) with left-sided varicocele underwent embolization. Intravascular US examinations and retrograde venography were performed to assess varicocele anatomy. Anatomic variants were recorded and categorized. A comparison between intravascular US and fluoroscopic findings was performed. The Fisher exact test was used for statistical analysis (P <.05). Technical success was achieved in all cases. There was a statistically significant difference in the maximum gonadal vein diameter between venography and intravascular US (P =.0087). Intravascular US showed left gonadal vein anatomic variations and better ability in the evaluation of the vein diameter. © 2018 by the American Institute of Ultrasound in Medicin

Varicocele embolization: Anatomical variations of the left internal spermatic vein and endovascular treatment with different types of coils

Purpose: To present anatomical variations of left internal spermatic vein and a comparison between treatments with hydrogel-coated and non-coated platinum coils in patients with varicocele. Materials and methods: A total of 153 men (mean age, 27.5 ± 6.7 [SD] years; range: 18–45 years) with left sided varicocele underwent coil embolization. Anatomic variants of gonadal vein were categorized into five subtypes (I–V). Additional venous collaterals were also recorded. Three types of coils were used (hydrogel coated platinum coils, fibered coils and non-coated platinum coils). Technical success, tolerance, efficacy and safety of hydrogel coated platinum coils were recorded. Comparison between different types of coils used was made. Fisher's exact test was used for statistical analysis. Results: Varicoceles were classified as type I (26.1%), type II (13.7%), type III (32.1%), type IV (18.3%) and type V (9.8%). The internal spermatic vein – renal vein angle ranged from 32°–128° (mean angle, 93.5°). Technical success was achieved in 145 patients (94.8%) without complications. The mean number of coils used was 3 (range: 1–6 coils). A total of 260 hydrogel coated platinum coils in 95 patients and 135 non-coated coils in 50 patients were deployed with no complications. No differences were noted between the different types of coils used regarding embolic efficacy and safety. A 6.2% (9/145) recurrence rate and a 33.3% (14/42) fertility rate were observed. Clinical success regarding symptom relief after painful varicocele embolization was 100% (36/36) for technically successful cases. Conclusion: Varicocele embolization with the use of hydrogel coated or non-coated platinum coils is technically feasible and safe without complications. No superiority of one type of coil over the other was found. © 2018 Soci showét showé françaises de radiologi

THE ROOTS OF RADIOLOGY IN GREECE

This article presents as reliably as possible the roots of the Radiology specialty in Greece, from the time of the discovery of X-rays by WC Roentgen It mentions the most Important dates relevant to the foundation of the specialty of Radiology in Greec

Contrast-enhanced sonographic detection of vesicoureteral reflux in children: Comparison with voiding cystourethrography

Purpose: Prospective evaluation of contrast-enhanced sonography (CES) as an alternative to radiographic voiding cystourethrography (VCUG) in the detection of vesicoureteral reflux (VUR). Materials and Methods: Seventy-six children (age range: 0-9 years, mean age 1.4 years) with suspicion of VUR due to various indications were examined by contrast-enhanced sonography (CES) and VCUG. CES examination was performed after instillation of Levovist into the catheterized urinary bladder, which had been prefilled with normal saline. Reflux was diagnosed when hyperechogenic microbubbles were observed in the renal units. Thereafter, VCUG was performed in all patients through the same catheter. CES findings were compared to the results of VCUG. Results: CES showed VUR in 24 renal units whereas VCUG showed reflux in 18 renal units. With regard to the presence of VUR, the findings obtained by both methods were concordant in 17 renal units. Taking VCUG as the reference standard, the sensitivity of CES was 96%, the specificity was 94.8%, the positive predictive value 77.4% and the negative predictive value 99.2%. Additionally, McNemar test showed that CES detected a statistically significant higher number of renal units with VUR (p < 0.05). Conclusion: It is suggested that CES is an accurate and reliable imaging modality for the detection of VUR, although it cannot replace VCUG in some cases. In addition, CES can be recommended in the follow-up of VUR, reducing the number of radiographic investigations

Echo-Doppler measurements of portal vein and hepatic artery in asymptomatic patients with hepatitis B virus and healthy adults

Background and aim. The aim of this prospective study was to determine the range of various hemodynamic parameters of portal vein and hepatic artery with echo-Doppler imaging in asymptomatic carriers of hepatitis B virus (HBV) and healthy adults. Methods. One hundred and twenty two healthy adults and fifty-three asymptomatic patients with chronic HBV formed two groups. All participants underwent color Doppler imaging of the portal vein and hepatic artery. A single operator performed all echo-Doppler measurements. The examination protocol included measurements of portal vein and hepatic artery diameter (d), blood flow (BF), time averaged velocity (TAV) and calculation of Doppler Perfusion Index (DPI) of liver. Results. Asymptomatic HBV carriers showed a statistically significant decrease in portal vein TAV(12.8±6.1 vs 17.5±8.8), an increase in portal vein BF (411.38±211.31 vs 327.55±188.77) and decrease in DPI (0.18±0.14 vs 0.28±0.15). Conclusions. Echo-Doppler measurements of portal vein and hepatic artery can detect significant hemodynamic changes in asymptomatic HBV carriers

Long-term prognostic value of heart-rate recovery after treadmill testing in patients with diabetes mellitus

Background: Heart-rate recovery (HRR) is considered to be an independent predictor of cardiac and all-cause mortality. We examined the long-term prognostic value of HRR in patients suffering from diabetes mellitus. Methods: In this study, we included 258 consecutive patients. Patients whose HRR value or myocardial perfusion imaging could have been influenced by factors other than myocardial ischaemia, were excluded. The value of HRR was defined as the decrease in the heart-rate from peak exercise to 1 min after the termination of the exercise. All patients underwent SPECT myocardial perfusion imaging combined with exercise testing. Cardiovascular death and non-fatal myocardial infarction were considered as hard cardiac events, while late revascularization procedures as soft events. Cox proportional-hazard models were applied to evaluate the association between HRR and the investigated outcome. Results: During the follow-up period (30.8 +/- 6.9 months), hard cardiac events occurred in 21 (8%) patients (15 with abnormal HRR value, p<0.001), while 35 (14%) patients underwent revascularization (31 with abnormal HRR value, p<0.001). Considering it as a continuous variable, HRR was a strong predictor for both hard cardiac (coefficient=-0.41, SE=0.052, p<0.001) and soft cardiac events (coefficient=-0.63, SE=0.058, p<0.001). After adjustments were made for potential confounders, including scintigraphic variables, abnormal HRR remained an independent predictor for hard and soft cardiac events (p<0.001). Conclusion: Our results suggest that among patients with diabetes, a decreased HRR is a significant independent predictor of hard and soft cardiac events. (C) 2008 Elsevier Ireland Ltd. All rights reserved

Association of Bone Mineral Density, Parameters of Bone Turnover, and Body Composition in Patients With Chronic Obstructive Pulmonary Disease

Patients with chronic obstructive pulmonary disease (COPD) often develop osteoporosis. Many hormones regulate bone metabolism and body composition, and some of them are affected in COPD patients vs controls. In 46 COPD patients, we measured hip neck, total hip, lumbar spine, and whole-body T-score with dual-energy X-ray absorptiometry, parameters of body composition (body mass index [BMI], fat mass index [FMI] and fat-free mass index [FFMI]), and adiponectin, leptin, parathormone, osteocalcin, calcitonin, and insulin-like growth factor I (IGF-I) serum levels and correlated them with COPD stage. Our results suggest that total hip bone mineral density (BMD) is affected by FFMI and COPD stage; lumbar spine BMD is affected by FM! and COPD stage; and whole-body BMD is affected by BMI, COPD stage, and leptin. Adiponectin, parathormone, osteocalcin, calcitonin, and IGF-I levels were not significantly correlated to BMD at any of the measured sites. Our findings are in agreement with the current literature in that a decline in lung function is correlated to a decline in BMD