Carotid Body Detection on CT Angiography

Nguyen, Rosa; Shah, Lubdha M.; Quigley, Edward P.; Harnsberger, H R; Wiggins, Richard H.

doi:10.3174/ajnr.a2429

Cited by 24 publications

(16 citation statements)

References 18 publications

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“…The first study to characterize the normal CB using CTA was published in 2011. 11 In that study, CB size was not found to correlate with smoking, living at high altitude, age, or sex. Correlation with chronic diseases characterized by sympathetic hyperactivity was not performed in that study.…”

Section: Introductionmentioning

confidence: 74%

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Carotid body size on CTA: Correlation with comorbidities

et al. 2014

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Section: Introductionmentioning

confidence: 74%

“…11 A 20e25% statistically significant enlargement of the CB at CTA in patients with DM, HTN, and CHF was demonstrated relative to control patients. This enlargement is concordant with the low end of enlargement reported in the pathology literature for HTN.…”

Section: Discussionmentioning

confidence: 91%

Carotid body size on CTA: Correlation with comorbidities

et al. 2014

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“…The left carotid body was seen on 86.0% of scans (154 of 179 studies). However, in that study no assessment of the quality of CB imaging was carried out [2].…”

Section: Discussionmentioning

confidence: 97%

“…Nyugen et al evaluated 180 CTAs and they reported that the normal carotid body could be seen on most scans [2]. The right carotid body was seen on 82.6% of CTAs (148 of 179 studies).…”

Section: Discussionmentioning

confidence: 99%

“…The examinations were performed with a double-source scanner (SOMATOM Definition Dual-Source CT, Siemens Healthcare, Germany) in accordance with the standard CTA protocol for assessment of the carotid arteries, which was similar to the protocol applied by Nguyen et al in their paper about CB imaging [2]. The differences in the applied CTA protocol concerned the velocity of administering the intravenous contrast medium, the type of contrast medium applied and the thickness of the layers used in the reconstructions of the images: Iomeprol contrast medium (Iomeron 400, Bracco U.K. Ltd, UK) was injected at a rate of 4.5 mL/s; the following image reconstructions were used: axial images in 0.6 mm thick layer and multiplanar reconstructions in 1.0 mm thick layers in the coronal and sagittal sections.…”

Section: Methodsmentioning

confidence: 99%

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The Quality of Imaging of the Carotid Body by the Standard Protocol for Computed Tomography Angiography of the Carotid Arteries

Jaźwiec¹,

Gać²,

Niewiński³

et al. 2015

Adv Clin Exp Med

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In the late 20 th century, it was found that the basic function of the CB is chemical control of the regulation of respiratory action by means of a reflex from chemoreceptors, but it was not until the last 15 years that research has revealed another important function: the chemoreceptors present in the CB play an essential role in regulating the functions of the circulatory system [3][4][5]. Research connected with the carotid body is currently focused on establishing the significance of chronically increased CB activity in the progression of heart failure and in the genesis of hypertension [6][7][8][9]. Patients with heart failure display (for example)The carotid body (CB) is an anatomically minor structure located on both sides of the bifurcation of the external and internal carotid artery, slightly towards the back. It does not normally exceed the dimensions of 7 × 4 × 2 mm [1].Recently, the clinical significance of the carotid body has been increasing. A group of tumors known as paragangliomas originates from the carotid body, and it has recently been suggested that a CB diameter exceeding 6 mm may be related to a heightened risk of developing paragangliomas, especially in persons with a known family occurrence AbstractBackground. The clinical significance of the carotid body (CB) has been increasing. Currently, research connected with the CB is focused on establishing the significance of chronically increased activity of the CB in the progression of heart failure and in the genesis of hypertension. Moreover, it has been suggested that cardiac hypertrophy may be associated with an increase in CB volume.Objectives. The aim of study was to assess the quality of imaging the CB by following the standard protocol for computed tomography angiography (CTA) of the carotid arteries. Material and Methods. The analysis includes 50 consecutive CTA examinations of the carotid arteries. A retrospective assessment of the quality of imaging both the right and left CB (rCB and lCB) was carried out for all the CTA examinations of the carotid arteries. Results. The rCB was exposed in 62% and the lCB in 56% of the CTA examinations. None of the CTA examinations analyzed resulted in good or very good quality visualization of the CB. Only 22% of the CTA examinations provided a medium quality rCB image. An even lower ratio of medium-quality visualizations of the lCB was noted: only 14% of the analyzed examinations. In the male sample group, the CB was exposed significantly more often than in the female group. Conclusions. The standard protocol for CTA examinations of the carotid arteries appears to be insufficient for use in assessing the CB (Adv Clin Exp Med 2015, 24, 6, 1037-1043).

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Carotid body resection for sympathetic modulation in systolic heart failure: results from first‐in‐man study

Niewiński¹,

Janczak²,

Ruciński³

et al. 2016

European J of Heart Fail

109

145

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(2017). Carotid body resection for sympathetic modulation in systolic heart failure -results from first-in-man study. ABSTRACT AimsAugmented reflex responses from peripheral chemoreceptors, which are mainly localized in the carotid bodies (CB), characterize patients with systolic heart failure (HF) and contribute to adrenergic hyperactivation. We investigated whether surgical resection of CB in these patients can be performed safely to decrease sympathetic tone. Methods and resultsWe studied 10 male patients with systolic HF (age: 59±3 years, left ventricular ejection fraction: 27±7%) who underwent unilateral right-sided CB resection (4 patients) or bilateral CB resection (6 patients).Primary endpoints of the study were changes in muscle sympathetic nerve activity (MSNA) and peripheral chemosensitivity measured as ventilatory response to hypoxia from baseline to 1 month post-CB resection. Safety analysis included analysis of arterial blood gas and oxygenation at night through 2 months post-procedure and adverse events assessed up to 12-months.At 1-month visit, CB resection was associated with a significant decrease in both MSNA (86.6±3.1 vs.79.7±4.2 bursts/100 beats, p=0.03) and in peripheral chemosensitivity (1.35±0.19 vs. 0.41±0.17 L/min/SpO2, p=0.005). It also resulted in improved exercise tolerance. Amongst some patients with bilateral CB resection there was a trend towards worsening of oxygen saturation at night, which in one case required therapy with non-invasive ventilation. ConclusionWe present first-in-man evidence that CB resection in patients with systolic HF is associated with decrease in sympathetic activity. Bilateral procedure may carry a risk of worsening oxygenation at night.CB modulation constitutes an interesting research avenue, but careful consideration of the balance between safety and efficacy is necessary before further clinical trials.

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Carotid Body Detection on CT Angiography

Cited by 24 publications

References 18 publications

Carotid body size on CTA: Correlation with comorbidities

Carotid body size on CTA: Correlation with comorbidities

The Quality of Imaging of the Carotid Body by the Standard Protocol for Computed Tomography Angiography of the Carotid Arteries

Carotid body resection for sympathetic modulation in systolic heart failure: results from first‐in‐man study

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