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      Diagnostic Value of Low-Dose 256-Slice Spiral CT Angiography, MR Angiography, and 3D-DSA in Cerebral Aneurysms

      research-article
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      Disease Markers
      Hindawi

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          Abstract

          Objective

          To evaluate the diagnostic value of low-dose 256-slice CT angiography (CTA), MR angiography (MRA), and three dimensional-digital subtraction angiography (3D-DSA) in cerebral aneurysms.

          Methods

          CTA, MRA, and 3D-DSA were performed in all enrolled patients to explore the diagnostic significance of the three different examinations.

          Results

          There were 92 aneurysms confirmed during DSA and surgery in 79 patients. The diagnostic coincidence rates of DSA, CTA, and MRA were 96.7%, 89.1%, and 86%, respectively. The diagnostic coincidence rates of CTA and MRA were lower than those of DSA. The detection rate of CTA for aneurysms less than 3 mm in diameter was higher than that of MRA.

          Conclusion

          CTA, DSA, and MRA have their own advantages and disadvantages in the diagnosis of cerebral aneurysms. They all have the diagnostic value for aneurysms.

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          Most cited references21

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          Biomarkers of Inflammation in Left Ventricular Diastolic Dysfunction

          Left ventricular diastolic dysfunction (LVDD) is an important precursor to many different cardiovascular diseases. Diastolic abnormalities have been studied extensively in the past decade, and it has been confirmed that one of the mechanisms leading to heart failure is a chronic, low-grade inflammatory reaction. The triggers are classical cardiovascular risk factors, grouped under the name of metabolic syndrome (MetS), or other systemic diseases that have an inflammatory substrate such as chronic obstructive pulmonary disease. The triggers could induce myocardial apoptosis and reduce ventricular wall compliance through the release of cytokines by multiple pathways such as (1) immune reaction, (2) prolonged cell hypoxemia, or (3) excessive activation of neuroendocrine and autonomic nerve function disorder. The systemic proinflammatory state causes coronary microvascular endothelial inflammation which reduces nitric oxide bioavailability, cyclic guanosine monophosphate content, and protein kinase G (PKG) activity in adjacent cardiomyocytes favoring hypertrophy development and increases resting tension. So far, it has been found that inflammatory cytokines associated with the heart failure mechanism include TNF-α, IL-6, IL-8, IL-10, IL-1α, IL-1β, IL-2, TGF-β, and IFN-γ. Some of them could be used as diagnosis biomarkers. The present review aims at discussing the inflammatory mechanisms behind diastolic dysfunction and their triggering conditions, cytokines, and possible future inflammatory biomarkers useful for diagnosis.
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            Time-Resolved 3D Contrast-Enhanced MRA on 3.0T: a Non-Invasive Follow-Up Technique after Stent-Assisted Coil Embolization of the Intracranial Aneurysm

            Objective To evaluate the usefulness of time-resolved contrast enhanced magnetic resonance angiography (4D MRA) after stent-assisted coil embolization by comparing it with time of flight (TOF)-MRA. Materials and Methods TOF-MRA and 4D MRA were obtained by 3T MRI in 26 patients treated with stent-assisted coil embolization (Enterprise:Neuroform = 7:19). The qualities of the MRA were rated on a graded scale of 0 to 4. We classified completeness of endovascular treatment into three categories. The degree of quality of visualization of the stented artery was compared between TOF and 4D MRA by the Wilcoxon signed rank test. We used the Mann-Whitney U test for comparing the quality of the visualization of the stented artery according to the stent type in each MRA method. Results The quality in terms of the visualization of the stented arteries in 4D MRA was significantly superior to that in 3D TOF-MRA, regardless of type of the stent (p < 0.001). The quality of the arteries which were stented with Neuroform was superior to that of the arteries stented with Enterprise in 3D TOF (p < 0.001) and 4D MRA (p = 0.008), respectively. Conclusion 4D MRA provides a higher quality view of the stented parent arteries when compared with TOF.
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              Outcomes analysis of ruptured distal anterior cerebral artery aneurysms treated by endosaccular embolization and surgical clipping.

              Although endovascular surgery is now widely used to treat intracranial aneurysms, no comparative studies of clipping versus endovascular surgery to address distal ACA aneurysms at the same institution are available. We compared the results of these treatment modalities to address distal ACA aneurysms at our institution. We treated 68 patients with ruptured distal ACA aneurysms (endovascular surgery, n=13; clipping surgery, n=55). We performed a retrospective comparison of the treatment outcomes. To study the efficacy of endovascular surgery we classified all our cases into three types: type A were small-necked aneurysms, type B were wide-necked aneurysms on the parent artery, and type C were aneurysms in which the A3 portion of the ACA arose from the aneurysmal dome near the neck. Intraoperative hemorrhage occurred in 7.7% of aneurysms treated by endovascular surgery and in 34.5% treated by clipping surgery. In 7.7% of the endovascularly-treated aneurysms we noted coil migration during embolization surgery; venous infarction due to cortical vein injury occurred in 7.3% of clipped aneurysms. Of the endovascularly-treated aneurysms, 7.7% manifested post-embolization hemorrhage; 23.1% manifested coil compaction. In clipping surgery, postoperative rerupture occurred in 1.8% of the aneurysms; one patient presented with postoperative acute epidural hematoma. Clip dislocation was noted in 1.8% of aneurysms. Angiography was indicative of post-treatment vasospasm in 7.7% of aneurysms treated endovascularly and in 50.9% of the clipped aneurysms. The clinical outcome showed no significant difference between endovascular surgery and clipping surgery.
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                Author and article information

                Contributors
                Journal
                Dis Markers
                Dis. Markers
                DM
                Disease Markers
                Hindawi
                0278-0240
                1875-8630
                2020
                13 January 2020
                : 2020
                : 8536471
                Affiliations
                Second Affiliated Hospital of Harbin Medical University, China
                Author notes

                Guest Editor: Zhongjie Shi

                Author information
                https://orcid.org/0000-0002-6443-9317
                Article
                10.1155/2020/8536471
                7201482
                32399089
                c65da07f-9b28-4198-b6ba-b2f6103d6ae5
                Copyright © 2020 Yan Feng and Sheng Jie Shu.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 July 2019
                : 23 October 2019
                Funding
                Funded by: National Natural Fund of China
                Award ID: 61307023
                Categories
                Research Article

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