MR venography using time-resolved imaging in interventional management of pelvic venous insufficiency

Purpose of Review

To evaluate the utility of magnetic resonance venography with time-resolved imaging (MRV TRI) in the diagnosis of pelvic vein insufficiency (PVI).

Recent Findings

A retrospective single-center review of N = 17 consecutive patients who underwent pelvic MRI for the assessment of PVI was performed. N = 8/17 (47%) studies were positive for PVI. TRI imaging demonstrated N = 6/8 patients with Grade 0–3 PVI and N = 2/8 patients with May–Thurner Syndrome. N = 4/8 patients underwent elective endovascular management, all of which were technically successful.

Summary

In the assessment of PVI, MRV TRI provides a dynamic assessment of venous insufficiency, serving as an adjunct to the imaging diagnosis of this pathology.

     

Drink more, and eat less: advice in obstructive hypertrophic cardiomyopathy

This report describes a series of symptomatic patients with obstructive hypertrophic cardiomyopathy with significant postprandial hemodynamic changes. This finding was identified by history, clinical examination, and echocardiography in 6 consecutive symptomatic patients referred for the evaluation of ventricular septal reduction therapy. Counseling these patients with dietary changes to include small frequent meals and to increase noncaffeinated fluid intake resulted in reductions in symptoms. In conclusion, severe symptoms in obstructive hypertrophic cardiomyopathy unresponsive to pharmacologic treatment frequently result in referral for definitive septal reduction therapy through surgery or, less frequently, alcohol septal ablation therapy. However, recognition of postprandial exacerbation in symptomatic patients may allow for nonpharmacologic dietary interventions that may obviate the need for more invasive therapies and their associated complications.     

Mathematical analysis of DICOM CT datasets: Can endograft sizing be automated for complex anatomy?

OBJECTIVES: To validate the use of a novel mathematical algorithm applied to digital imaging and communication in medicine (DICOM) computed tomography (CT) data to automate the generation of complex endovascular graft planning. METHODS: An algorithm was developed enabling the creation of patient-specific mathematical model based upon DICOM CT data to allow for detailed efficient geometric analysis with repeatable results. This algorithm was applied to high resolution DICOM CT datasets of 15 patients, selected at random from 350 patients with aneurysms involving the visceral arteries. The longitudinal and rotational relationships of the visceral vessels were determined by the algorithm. For comparison purposes, the same measurements were acquired manually using centerline of flow software by a blinded investigator. The distance between the renal arteries, and location of the renal origins calculated with each method were then compared. RESULTS: Automated results were readily created for all 15 randomly selected patients. The measured versus calculated mean inter-renal artery distances were exceptionally close, differing by a mean of only 1.3 mm with a maximal range of 3.0 mm. The rotational position of the renal origins differed by only 10.5 degrees of arc (21 clock-face minutes) on average and by 32.5 degrees in the worst case. CONCLUSIONS: The generation of an automated mathematical model to represent complex aortic geometry is feasible and reproducible in the context of high-resolution CT data. This process has been validated in 15 patients, where results corresponded with manual measurements that were used to successfully implant customized devices that accommodate the imaged vessels. Additional attributes include the expression of the 3D aorta in a compact form (on the order of kilobytes) for purposes of data storage, transfer, and other manipulations. CLINICAL RELEVANCE: The construct of mathematical representation of patient specific anatomy from CT data is both feasible and applicable, allowing for automated endograft device design even in the setting of markedly tortuous anatomy where the repair must incorporate major aortic branches. The process has been validated in 15 patients, where results corresponded with manual measurements that were used to successfully implant customized devices that accommodate the imaged vessels. The application of this technology must now be studied in a prospective manner and incorporated into a system users may readily apply to patients undergoing evaluation. Additional attributes of a mathematical representation of the arterial tree include the 3D expression from a very compact set of parameters (on the order of kilobytes) for purposes of data storage, transfer, and other manipulations.     

Chemopreventive effect of different ratios of fish oil and corn oil on prognostic markers, DNA damage and cell cycle in colon carcinogenesis

Fish oil (FO) rich in n-3 polyunsaturated fatty acids (PUFAs) have a protective role in autoimmune disorders, type 2 diabetes, rheumatoid arthritis, and cancer, whereas corn oil (CO) rich in n-6 PUFAs has a proinflammatory and procarcinogenic effect. A balanced n-3/n-6 PUFA ratio in diet rather than absolute intake of either may be responsible for decreasing cancer incidence. This study was designed to evaluate the chemopreventive effect of different ratios of FO and CO on prognostic markers, DNA damage, and cell cycle distribution in colon carcinogenesis. Male Wistar rats were divided into control, N,N'-dimethylhydrazine dihydrochloride (DMH) treated, FO+CO(1 : 1)+DMH, and FO+CO(2.5 : 1)+DMH. All the groups, except control, received a weekly injection of DMH for 4 weeks. The animals were given modified AIN-76A diets and killed either 48 h later (initiation phase) or kept for 16 weeks (postinitiation phase). The animals treated with DMH in both the phases showed an increase in multiple plaque lesions, total sialic acid, lipid associated sialic acid, DNA damage and cell proliferation. However, levels of p53 in the postinitiation and cyclin D1 in both the phases were significantly elevated. FO+CO(2.5 : 1)+DMH treatment in both the phases led to a decrease in multiple plaque lesions, DNA damage, total sialic acid, lipid associated sialic acid as compared with the DMH treated group. There was a G1 arrest with a decrease in p53 and cyclin D1 levels in FO+CO(2.5 : 1) in both the phases whereas treatment with FO+CO(1 : 1)+DMH led to same results in the postinitiation phase only. This study suggests that FO+CO(2.5 : 1) is more effective in chemoprevention of experimental colon carcinogenesis.     

Complete recovery of visual loss following surgical treatment of mucopyocele of the anterior clinoid process

A mucocele is a collection of mucus, which is lined by the mucus-secreting epithelium of a paranasal sinus. Paranasal sinus mucoceles occur as a result of inflammation, tumor, trauma or surgical manipulation. The anterior clinoid process may be pneumatized by an extension of the sphenoid paranasal sinus air space during normal development. Mucocele of the anterior clinoid process is rare. We report a patient with mucopyocele of the anterior clinoid process that resulted in rapid monocular visual loss. The left optic canal was exposed extradurally via a supraorbital craniotomy and the mucopyocele was totally excised. The optic canal was decompressed by drilling the superior, lateral and medial rims, to achieve circumferential decompression of the optic nerve. The patient’s vision improved postoperatively.     

Right thyrocervical trunk bronchial artery collateral: source of type II Endoleak after endovascular repair of thoracic aortic aneurysm

A patient with an enlarging thoracic aortic aneurysm (TAA) after endovascular repair showed a persistent endoleak on follow-up imaging at three and six months. He subsequently underwent angiography and transcatheter embolization of a right thyrocervical trunk bronchial collateral. Examination of potential anomalous or collateral thoracic pathways is mandatory when considering treatment of a Type II endoleak following endovascular TAA repair.     

Open surface water index: a novel approach for surface water mapping and extraction using multispectral and multisensory data

ABSTRACT

In the present study, a novel water index has been proposed for mapping of open surface water in multispectral images and named as open surface water index (OSWI). The proposed index has been applied on Landsat-8 data to delineate the water area and the results are compared with those of existing water indices. The index is also applied on Sentinel-2A data and corresponding water pixels are extracted. The results have been validated with the help of classification as well as density slicing based methods on multisensory data. The preliminary results show that the proposed index is capable of identifying smaller water regions which remain unidentified by other indices.     

Digital skin: The impact of modern-day photograph filtering applications on children with skin diseases

Photograph editing has been present for centuries, but the past decade has seen an unprecedented rise in the practice, particularly on social media platforms. Common filters are able to soften complexion, remove blemishes, and even reshape facial features. Children and adolescents with skin conditions may find solace in using these applications to mask their disease online, but there is increasing concern about negative overall body image among those who filter their photographs. Pediatric dermatologists should remain aware of the practice of photograph editing among young people and consider asking patients about their social media presence.