Multimodality Imaging of the Peripheral Venous System

The purpose of this article is to review the spectrum of image-based diagnostic tools used in the investigation of suspected deep vein thrombosis (DVT). Summary of the experience gained by the author as well as relevant publications, regarding vein imaging modalities taken from a computerized database, was reviewed. The imaging modalities reviewed include phlebography, color Doppler duplex ultrasonography (CDDUS), computerized tomography angiography (CTA) and venography (CTV), magnetic resonance venography (MRV), and radionuclide venography (RNV). CDDUS is recommended as the modality of choice for the diagnosis of DVT. A strategy combining clinical score and D-dimer test refines the selection of patients. Phlebography is reserved for discrepant noninvasive studies

Antiatherosclerotic effects of licorice extract supplementation on hypercholesterolemic patients: decreased CIMT, reduced plasma lipid levels, and decreased blood pressure

Background: Ethanolic extract of licorice root has been shown to reduce low-density lipoprotein (LDL) oxidation in atherosclerotic mice and in both hypercholesterolemic and normal lipidemic humans. Objective: This study examined the effect of licorice-root extract on carotid intima-media thickness (CIMT) in individuals with hypercholesterolemia. Design: Individuals with hypercholesterolemia (total cholesterol ≥6.18 mmol/L [240 mg/dL]) and without significant stenosis were randomly allocated to two groups: an experimental group that consumed 0.2 g/day of ethanolic extract of licorice root for 12 months, and a control group that received a placebo. Results: Of 110 eligible participants, 94 (41–80 years old) completed the study. A significant CIMT decrease from 0.92±0.25 mm to 0.84±0.21 mm was observed in the experimental group compared with an increase from 0.85±0.17 mm to 0.88±0.19 mm in the control group. Mean plasma total cholesterol levels and LDL cholesterol decreased, at the range baseline to 1 year, from 284±32 mg/dl to 262±25 mg/dl and from 183±8.5 mg/dl to 174±9.1 mg/dl, respectively, for the experimental group (p<0.001) and from 291±35 to 289±31 mg/dl and from 177.6±10.7 to 179.3±9.6 (p=0.08), respectively, for the control group. Mean high-density lipoprotein (HDL) did not change significantly in either group. In the experimental group, systolic blood pressure decreased from 138±12 mmHg to 125±13 mmHg after 1 year (p=0.01) and increased from 136±15 mmHg to 137±13 mmHg in the control group. Diastolic blood pressure decreased from 92±9 mmHg to 84±10 mmHg (p=0.01) in the experimental group and increased from 89±11 mmHg to 90±8 mmHg in the control group. Conclusion: Following 1 year of licorice consumption, mean CIMT, total cholesterol, LDL levels, and blood pressure were decreased. This suggests that licorice may attenuate the development of atherosclerosis and of related cardiovascular diseases

Sonographic evaluation of vascular injuries

The purpose of this presentation is to highlight the color Doppler duplex sonographic features of procedure-related and blunt or penetrating trauma-related vascular injuries. Different kinds of vascular complications such as pseudoaneurysms, arteriovenous fistulas, dissection, and thrombosis are discussed. Cases of vascular injuries in the extremities, neck, and abdomen are presented to illustrate the spectrum of sonographic appearances. Color Doppler duplex sonography is valuable in the diagnosis and monitoring of most vessel injuries and in the treatment of pseudoaneurysms. It is useful for flow analysis and for follow-up after treatment. However, because of limitations inherent to sonography, such as bones, air, casts, skin burns, and relatively slow performance of the test, magnetic resonance imaging, computed tomography, and angiography are necessary for further evaluation in selected cases. Color Doppler duplex sonography is a widely available, noninvasive, and accurate technique for evaluating vascular injuries and should be the first-line imaging modality in most patients