The purpose of this study was to establish normal left ventricular acoustic quantification (AQ) reference values for children from infancy to adolescence and to compare AQ-derived parameters with traditional M-mode and Doppler indices. We studied 150 normal, healthy children aged 2 days to 14 1/2 years. Left ventricular parasternal end diastolic area and left ventricular end diastolic volume calculated by AQ were linearly related to the body surface area to the 1.1 and 1.4 powers. AQ parasternal peak filling rate and atrial fractional area change in the neonatal period were 140% and 142% of the adolescent's values, respectively, and decreased to 110% and 112% by 36 months of age. The duration of the rapid filling phase and the rapid filling contribution, as identified by AQ, was shorter or lower than that measured by the Doppler method. Interobserver variability of AQ parameters ranged from 8.1% for the ejection fraction to 18.2% for the peak filling rate. Manual biplane determinations of volumes were slightly higher than AQ calculations with highly significant correlations (p <0.001). Our data permit the determination of normal ranges of AQ parameters in relation to body surface area or age.
Objective
To report the clinical and MRI-based volumetric mid-term outcome after image guided percutaneous sclerotherapy (PS) of venous malformations (VM) of the head and neck.
Methods
A retrospective analysis of a prospectively maintained database was performed, including patients with VM of the head and neck who were treated with PS. Only patients with available pre- and post-interventional MRI were included into this study. Clinical outcome, which was subjectively assessed by the patients, their parents (for paediatric patients) and/or the physicians, was categorized as worse, unchanged, minor or major improvement. Radiological outcome, determined by MRI-based volumetric measurements, was categorized as worse (>10% increase), unchanged (≤10% increase to <10% decrease), minor (≥10% to <25% decrease), intermediate (≥25% to <50% decrease) or major improvement (≥50% decrease).
Results
Twenty-seven patients were treated in 51 treatment sessions. After a mean follow-up of 31 months, clinical outcome was worse for 7.4%, unchanged for 3.7% of the patients, while there was minor and major improvement for 7.4% and 81.5%, respectively. In the volumetric imaging analysis 7.4% of the VMs were worse and 14.8% were unchanged. Minor improvement was observed in 22.2%, intermediate improvement in 44.4% and major improvement in 11.1%. The rate of permanent complications was 3.7%.
Conclusion
PS can be an effective therapy to treat the symptoms of patients with VMs of the head and neck and to downsize the VMs. MRI-based volumetry can be used to objectively follow the change in size of the VMs after PS. Relief of symptoms frequently does not require substantial volume reduction.
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