Diagnostic and interventional radiology最新文献

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Staged angioplasty using a full-length balloon catheter to achieve maturation of arteriovenous fistulas. 使用全长球囊导管进行分阶段血管成形术,使动静脉瘘成熟。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2025-01-01 Epub Date: 2024-05-13 DOI: 10.4274/dir.2024.232607
Miju Bae, Chang Ho Jeon, Sung Woon Chung, Chung Won Lee, Up Huh, Jongwon Kim, Hyuncheol Jeong
{"title":"Staged angioplasty using a full-length balloon catheter to achieve maturation of arteriovenous fistulas.","authors":"Miju Bae, Chang Ho Jeon, Sung Woon Chung, Chung Won Lee, Up Huh, Jongwon Kim, Hyuncheol Jeong","doi":"10.4274/dir.2024.232607","DOIUrl":"10.4274/dir.2024.232607","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of staged full-length balloon-assisted maturation (BAM) for the maturation of arteriovenous fistulas (AVFs) on entire segmental veins, including stenosis, causing primary AVF failure.</p><p><strong>Methods: </strong>This study included patients who underwent AVF surgery using an autogenous vein between February 2020 and June 2021 and received staged angioplasty with a full-length balloon catheter. To minimize balloon overlap and the risk of barotrauma to the immature vein, serial-staged upsizing balloon angioplasty with a long balloon catheter covering the entire vein segment was employed approximately 2 weeks apart.</p><p><strong>Results: </strong>Twenty-three patients (mean age, 69.50 years; mean follow-up, 620.62 days) with average diameters of the radial artery and cephalic vein at 2.14 ± 0.5 mm and 2.43 ± 0.5 mm, respectively, were enrolled. In the first procedure, the average AVF diameter and flow were 4.03 ± 0.57 mm and 438.08 ± 220.95 mL/min, respectively, with juxta-anastomotic stenosis (JAS) present in 61.5% of cases. After staged full-length BAM, the average fistula diameter and flow improved to 5.95 ± 0.86 mm and 717.52 ± 305.95 mL/min, respectively. Maturation was achieved in 87% of the cases. No hematomas or ruptures occurred around the arterialized veins. Despite successful maturation and cannulation, 65.2% of the patients required additional percutaneous transluminal angioplasty (PTA) during the follow-up period. The necessity for PTA was determined by the presence of JAS prior to the first staged full-length BAM, with an odds ratio of 11.74 (95% confidence interval: 1.31-104.96, <i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>Staged full-length BAM can be safely used in patients with small veins requiring further maturation. Most patients achieved successful cannulation following maturation without post-procedural complications.</p><p><strong>Clinical significance: </strong>Staged full-length BAM is a safe and effective method for enhancing maturation in patients with underdeveloped small veins.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"45-51"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reporting checklists as compulsory supplements to artificial intelligence manuscript submissions. 将报告清单作为人工智能投稿的强制性补充。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2025-01-01 Epub Date: 2024-06-24 DOI: 10.4274/dir.2024.242849
Michail E Klontzas
{"title":"Reporting checklists as compulsory supplements to artificial intelligence manuscript submissions.","authors":"Michail E Klontzas","doi":"10.4274/dir.2024.242849","DOIUrl":"10.4274/dir.2024.242849","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"17-18"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of guided reporting: quality and reading time of automatically generated radiology report in breast magnetic resonance imaging using a dedicated software solution. 评估引导式报告:使用专用软件解决方案自动生成乳腺磁共振成像放射学报告的质量和阅读时间。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2025-01-01 Epub Date: 2024-09-02 DOI: 10.4274/dir.2024.242702
Martin H Maurer, Daniel Lorenz, Maximilian Clemens Otterbach, Igor Toker, Alexander Huppertz
{"title":"Evaluation of guided reporting: quality and reading time of automatically generated radiology report in breast magnetic resonance imaging using a dedicated software solution.","authors":"Martin H Maurer, Daniel Lorenz, Maximilian Clemens Otterbach, Igor Toker, Alexander Huppertz","doi":"10.4274/dir.2024.242702","DOIUrl":"10.4274/dir.2024.242702","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Unstructured, free-text dictation (FT), the current standard in breast magnetic resonance imaging (MRI) reporting, is considered time-consuming and prone to error. The purpose of this study is to assess the usability and performance of a novel, software-based guided reporting (GR) strategy in breast MRI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eighty examinations previously evaluated for a clinical indication (e.g., mass and focus/non-mass enhancement) with FT were reevaluated by three specialized radiologists using GR. Each radiologist had a different number of cases (R1, n = 24; R2, n = 20; R3, n = 36). Usability was assessed by subjective feedback, and quality was assessed by comparing the completeness of automatically generated GR reports with that of their FT counterparts. Errors in GR were categorized and analyzed for debugging with a final software version. Combined reading and reporting times and learning curves were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Usability was rated high by all readers. No non-sense, omission/commission, or translational errors were detected with the GR method. Spelling and grammar errors were observed in 3/80 patient reports (3.8%) with GR (exclusively in the discussion section) and in 36/80 patient reports (45%) with FT. Between FT and GR, 41 patient reports revealed no content differences, 33 revealed minor differences, and 6 revealed major differences that resulted in changes in treatment. The errors in all patient reports with major content differences were categorized as content omission errors caused by improper software operation (n = 2) or by missing content in software v. 0.8 displayable with v. 1.7 (n = 4). The mean combined reading and reporting time was 576 s (standard deviation: 327 s; min: 155 s; max: 1,517 s). The mean times for each reader were 485, 557, and 754 s, and the respective learning curves evaluated by regression models revealed statistically significant slopes (&lt;i&gt;P&lt;/i&gt; = 0.002; &lt;i&gt;P&lt;/i&gt; = 0.0002; &lt;i&gt;P&lt;/i&gt; &lt; 0.0001). Overall times were shorter compared with external references that used FT. The mean combined reading and reporting time of MRI examinations using FT was 1,043 s and decreased by 44.8% with GR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;GR allows for complete reporting with minimized error rates and reduced combined reading and reporting times. The streamlining of the process (evidenced by lower reading times) for the readers in this study proves that GR can be learned quickly. Reducing reporting errors leads to fewer therapeutic faults and lawsuits against radiologists. It is known that delays in radiology reporting hinder early treatment and lead to poorer patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;While the number of scans and images per examination is continuously rising, staff shortages create a bottleneck in radiology departments. The IT-based GR method can be a major boon, improving radiologist efficiency, report quality, and the ","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":"19-28"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Flow-diverting stents in the management of extracranial carotid artery aneurysms. 血流分流支架在颅内外颈动脉动脉瘤治疗中的应用。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-12-30 DOI: 10.4274/dir.2024.242946
Celal Cinar, Erol Akgul, Alperen Elek, Mahmut Kusbeci, Egemen Ozturk, Hasan Bilen Onan, Irem Islek, Mohammad Naim Forogh, Mohammad Nawas Nasiri, Ismail Oran
{"title":"Flow-diverting stents in the management of extracranial carotid artery aneurysms.","authors":"Celal Cinar, Erol Akgul, Alperen Elek, Mahmut Kusbeci, Egemen Ozturk, Hasan Bilen Onan, Irem Islek, Mohammad Naim Forogh, Mohammad Nawas Nasiri, Ismail Oran","doi":"10.4274/dir.2024.242946","DOIUrl":"https://doi.org/10.4274/dir.2024.242946","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records. Procedures were performed under general anesthesia using standard endovascular techniques. Patients received preoperative and postoperative antiplatelet therapy and were fully anticoagulated during the procedure. Follow- up assessments included digital subtraction angiography or computed tomography angiography at 6-12 months and clinical evaluations to monitor symptom resolution and complications.</p><p><strong>Results: </strong>Eighteen patients, with an average age of 46.44 ± 17.54 years, underwent 19 endovascular interventions. Technical success was achieved in all cases. Single stent deployment was used in 15 aneurysms, and telescopic stent deployment in 7. Total occlusion of the aneurysm was achieved in 94.4% of cases. One patient required retreatment due to the separation of two overlapped telescopic stents. All patients were discharged within 2 days post-procedure, with symptomatic patients experiencing the complete resolution of symptoms. No complications or adverse events were reported during the follow-up period.</p><p><strong>Conclusion: </strong>The endovascular treatment of ECAAs with FDSs appears to be a safe and effective alternative, achieving high technical success and positive clinical outcomes.</p><p><strong>Clinical significance: </strong>The use of FDSs for treating ECAAs significantly improves patient outcomes with minimal complications.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The value of dual-energy computed tomography angiography-based virtual monoenergetic imaging for evaluations after cerebral aneurysm clipping. 基于双能量计算机断层扫描血管成像的虚拟单能量成像对脑动脉瘤夹闭术后评估的价值。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-12-16 DOI: 10.4274/dir.2024.242975
Zhihua Lu, Suying Wu, Feijian Wu, Qingdong Jin, Qingjing Huang, Baoteng Zhang
{"title":"The value of dual-energy computed tomography angiography-based virtual monoenergetic imaging for evaluations after cerebral aneurysm clipping.","authors":"Zhihua Lu, Suying Wu, Feijian Wu, Qingdong Jin, Qingjing Huang, Baoteng Zhang","doi":"10.4274/dir.2024.242975","DOIUrl":"https://doi.org/10.4274/dir.2024.242975","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to research the optimal energy range of dual-energy computed tomography angiography (DECTA)-based virtual monoenergetic imaging (VMI) for evaluations after cerebral aneurysm clipping.</p><p><strong>Methods: </strong>Sixty patients who underwent DECTA after cerebral aneurysm clipping were analyzed retrospectively. Conventional computed tomography angiography (CTA) was compared with VMIs at 60, 70, 80, 90, and 100 keV. The mean attenuation and standard deviation values within the regions of interest placed in the brain parenchyma and arteries with the worst artifact were measured, respectively. The ΔCT and artifact index (AI) values were calculated to assess the artifact severity. The contrast-to-noise ratio (CNR) was calculated to assess vascular contrast. Two radiologists assessed brain parenchyma and cerebrovascular scores qualitatively using a five-point Likert scale.</p><p><strong>Results: </strong>Quantitative analysis showed that the artifacts of VMIs were significantly reduced compared with conventional CTA (<i>P</i> ≤ 0.014), except for the ΔCT and AI of 60 keV and the ΔCT of 70 keV. However, there was no significant difference in the vascular contrast on VMIs compared with conventional CTA, except for the CNR of 60 keV (<i>P</i> = 0.008). In qualitative analysis, the proportions of brain parenchyma scores and cerebrovascular scores ≥4 on the VMIs of 70 and 80 keV were higher than those of conventional CTA and other VMIs.</p><p><strong>Conclusion: </strong>For the patients who underwent DECTA after cerebral aneurysm clipping, the 70-80 keV VMIs are expected to be the optimal energy range for balancing clip artifacts and visibility of adjacent vessels.</p><p><strong>Clinical significance: </strong>Studying the optimal energy range of DECTA-based VMI for post-operative assessment of aneurysm clipping can reduce metal artifacts in images and increase vascular contrast. This facilitates the follow-up of patients after aneurysm clipping, offers timely and accurate detection of postoperative complications, provides assistance to clinicians in diagnosis and treatment, and improves patient prognosis.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breast cancer detection and classification with digital breast tomosynthesis: a two-stage deep learning approach. 数字乳腺断层合成的乳腺癌检测和分类:两阶段深度学习方法。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-12-09 DOI: 10.4274/dir.2024.242923
Yazeed Alashban
{"title":"Breast cancer detection and classification with digital breast tomosynthesis: a two-stage deep learning approach.","authors":"Yazeed Alashban","doi":"10.4274/dir.2024.242923","DOIUrl":"https://doi.org/10.4274/dir.2024.242923","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to propose a new computer-assisted two-staged diagnosis system that combines a modified deep learning (DL) architecture (VGG19) for the classification of digital breast tomosynthesis (DBT) images with the detection of tumors as benign or cancerous using the You Only Look Once version 5 (YOLOv5) model combined with the convolutional block attention module (CBAM) (known as YOLOv5-CBAM).</p><p><strong>Methods: </strong>In the modified version of VGG19, eight additional layers were integrated, comprising four batch normalization layers and four additional pooling layers (two max pooling and two average pooling). The CBAM was incorporated into the YOLOv5 model structure after each feature fusion. The experiment was carried out using a sizable benchmark dataset of breast tomography images. A total of 22,032 DBT examinations from 5,060 patients were included in the data.</p><p><strong>Results: </strong>Test accuracy, training loss, and training accuracy showed better performance with our proposed architecture than with previous models. Hence, the modified VGG19 classified DBT images more accurately than previously possible using pre-trained model-based architectures. Furthermore, a YOLOv5-based CBAM precisely discriminated between benign lesions and those that were malignant.</p><p><strong>Conclusion: </strong>DBT images can be classified using modified VGG19 with accuracy greater than the previously available pre-trained models-based architectures. Furthermore, a YOLOv5-based CBAM can precisely distinguish between benign and cancerous lesions.</p><p><strong>Clinical significance: </strong>The proposed two-tier DL algorithm, combining a modified VGG19 model for image classification and YOLOv5-CBAM for lesion detection, can improve the accuracy, efficiency, and reliability of breast cancer screening and diagnosis through innovative artificial intelligence-driven methodologies.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open- and closed-type congenital cholesteatomas of the middle ear: computed tomography differentiation and correlation with surgical staging. 开放式和闭合型先天性中耳胆脂瘤:计算机断层鉴别及与手术分期的关系。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-12-09 DOI: 10.4274/dir.2024.242913
Minjung Seong, Hyung-Jin Kim, Yikyung Kim, Sung Tae Kim
{"title":"Open- and closed-type congenital cholesteatomas of the middle ear: computed tomography differentiation and correlation with surgical staging.","authors":"Minjung Seong, Hyung-Jin Kim, Yikyung Kim, Sung Tae Kim","doi":"10.4274/dir.2024.242913","DOIUrl":"https://doi.org/10.4274/dir.2024.242913","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the differences in computed tomography (CT) features between closed-type congenital cholesteatoma (CCC) and open-type congenital cholesteatoma (OCC) of the middle ear and to evaluate the usefulness of preoperative CT examination for staging workup of congenital cholesteatoma (CC) in correlation with the surgical findings.</p><p><strong>Methods: </strong>We retrospectively reviewed the preoperative CT scans of the temporal bone obtained from 80 patients with surgically confirmed CC of the middle ear. All patients had a solitary lesion, except for one patient with two lesions, resulting in 81 CCs, which formed the basis of this study. We compared the CT features between CCCs and OCCs, focusing on their morphological characteristics, such as size, shape, location, and bone change. Based on the Potsic classification, the stage of CCs was determined at CT and surgery, and the results were compared between CCCs and OCCs.</p><p><strong>Results: </strong>Of the 81 CCs, surgery revealed 43 CCCs and 38 OCCs. On CT scans, CCC was frequently seen as a small (median: 3.15 mm), round to oval (65.1%) mass, most commonly located in the anterosuperior quadrant (74.4%) of the middle ear with less frequent ossicular erosion (14.0%). In contrast, OCC was frequently seen as a large (median: 6.70 mm), irregular (94.7%) mass, most commonly located in the posterosuperior quadrant (68.4%) of the middle ear with frequent ossicular erosion (55.3%). The size, shape, location, and presence of ossicular erosion were significantly different between the two types. Overall, the CT and surgical stages of CCs demonstrated good agreement (kappa value: 0.77) and the CT and surgical stages of OCCs were statistically significantly higher than those of CCCs (<i>P</i> < 0.001 in both).</p><p><strong>Conclusion: </strong>CT is useful for preoperative determination of the types and staging of CC of the middle ear.</p><p><strong>Clinical significance: </strong>Preoperative differentiation between CCC and OCC is important to avoid reoperation and prevent an extensive surgery. By providing valuable information on the morphology and extent of the lesions, CT is useful for not only the accurate preoperative determination of the type of CCs but also the accurate prediction of staging of the lesion, which should be important to preparing optimal treatment plans.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proposal for training: the educational value of a musculoskeletal embolization patellar tendinopathy model. 训练建议:肌肉骨骼栓塞髌骨肌腱病变模型的教育价值。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-12-09 DOI: 10.4274/dir.2024.243005
Emeric Gremen, Julien Ghelfi, Marylène Bacle, Julien Frandon
{"title":"Proposal for training: the educational value of a musculoskeletal embolization patellar tendinopathy model.","authors":"Emeric Gremen, Julien Ghelfi, Marylène Bacle, Julien Frandon","doi":"10.4274/dir.2024.243005","DOIUrl":"https://doi.org/10.4274/dir.2024.243005","url":null,"abstract":"","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of balloon angioplasty under intravascular ultrasound guidance in calcified below-the-knee tibial arteries. 超声引导下球囊血管成形术治疗膝下胫动脉钙化的疗效。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-12-09 DOI: 10.4274/dir.2024.243022
Muhammed Said Beşler, Asiye Sözeri, Murat Canyiğit
{"title":"Effectiveness of balloon angioplasty under intravascular ultrasound guidance in calcified below-the-knee tibial arteries.","authors":"Muhammed Said Beşler, Asiye Sözeri, Murat Canyiğit","doi":"10.4274/dir.2024.243022","DOIUrl":"https://doi.org/10.4274/dir.2024.243022","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the optimal balloon diameter for intravascular ultrasound (IVUS)-guided balloon angioplasty in calcified below-the-knee (BTK) tibial artery lesions.</p><p><strong>Methods: </strong>Between February 2024 and April 2024, a retrospective review was conducted on 17 patients with Rutherford category 4-6 severely calcified tibial arteries with >70% stenosis, treated with IVUS-guided balloon angioplasty. Sequentially, 3 mm and then 3.5 mm diameter balloons were inflated. The minimum lumen diameter and area were measured before and after the procedure in the proximal, mid, and distal segments of the tibial arteries. One- and three-month follow-ups were conducted using Doppler ultrasound.</p><p><strong>Results: </strong>Significant increases in lumen diameter (<i>P</i> < 0.001 for all) and lumen area (<i>P</i> < 0.001, <i>P</i> = 0.003, <i>P</i> = 0.002, respectively) were observed in the proximal, mid, and distal segments of the BTK arteries following IVUS-guided 3.5 mm balloon angioplasty. Ultra-low iodinated contrast media was used [median 2 mL (range, 1-4 mL)]. Lumen area increase ratios were similar among the proximal, mid, and distal segments (<i>P</i> = 0.905). No target vessel revascularization, major amputation, or mortality was observed during follow-up. Wound healing was seen in 62.5% of the cases with foot ulcers.</p><p><strong>Conclusion: </strong>In the treatment of calcified BTK tibial arteries, a gradual balloon diameter increase up to 3.5 mm in IVUS-guided balloon angioplasty is safe and effective.</p><p><strong>Clinical significance: </strong>Gradual balloon diameter increase up to 3.5 mm under IVUS guidance in calcified BTK lesions demonstrates significant potential. It enables ultra-low contrast usage, provides low complication rates, and achieves high patency and limb salvage, along with satisfactory wound healing in the short term.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing ultrasound-guided intra-articular injection and medial branch block for lumbar facet joint pain: a clinical study. 比较超声引导下关节内注射和内侧支阻滞治疗腰椎面关节疼痛:一项临床研究。
IF 1.4 4区 医学
Diagnostic and interventional radiology Pub Date : 2024-11-27 DOI: 10.4274/dir.2024.242765
Hui Zhao, Yun-Long Hou, Le-Hang Guo, Qiao Wang, Tian He, Guang-Fei Gu, Li-Ping Sun, Feng-Shan Jin
{"title":"Comparing ultrasound-guided intra-articular injection and medial branch block for lumbar facet joint pain: a clinical study.","authors":"Hui Zhao, Yun-Long Hou, Le-Hang Guo, Qiao Wang, Tian He, Guang-Fei Gu, Li-Ping Sun, Feng-Shan Jin","doi":"10.4274/dir.2024.242765","DOIUrl":"https://doi.org/10.4274/dir.2024.242765","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the effectiveness of ultrasound-guided intra-articular (IA) injections with medial branch nerve blocks in treating lumbar facet joint pain.</p><p><strong>Methods: </strong>This retrospective study enrolled 94 patients clinically diagnosed with lumbar facet joint pain. Diagnostic blocks confirmed the diagnosis in 82 patients, evidenced by a pain visual analog score (VAS) reduction of at least 50% immediately following the injection. Of these, 42 were treated with ultrasound-guided IA injections (group 1), and 40 received ultrasound-guided medial branch blocks (group 2). Effective pain relief was defined as a VAS reduction of at least 50%.</p><p><strong>Results: </strong>Group 1 showed significantly higher pain relief rates compared with group 2 at both 1-month (54.76% versus 2.5%, <i>P</i> < 0.001) and 3-month (26.19% versus 5%, <i>P</i> = 0.014) follow-ups. Within group 1, patients aged 21-50 years experienced higher relief rates (81.25% at 1-month and 56.25% at 3-month follow-ups) compared with those over 50 (38.46% at 1-month and 7.69% at 3-month follow-ups), which was statistically significant (<i>P</i> = 0.007 at 1-month and <i>P</i> = 0.001 at 3-month follow-ups). Furthermore, in group 1, patients with sedentary jobs reported significantly greater pain relief (90.91% at 1-month and 81.82% at 3-month follow-ups) compared with those with non-sedentary jobs (41.94% at 1-month and 6.45% at 3-month follow-ups) (<i>P</i> = 0.005 at 1-month and <i>P</i> < 0.001 at 3-month follow-ups).</p><p><strong>Conclusion: </strong>Ultrasound-guided IA injection provides better pain relief compared with medial branch nerve blocks. This method serves as a viable alternative for patients, especially younger and middle-aged patients with lumbar facet pain due to sedentary lifestyles.</p><p><strong>Clinical significance: </strong>This study compared and analyzed the therapeutic effects of two different ultrasound intervention blockade methods on patients with lumbar facet joint pain, demonstrating that IA injection has a better pain relief effect and can be used as a pain relief method for patients who refuse radiofrequency therapy.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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