Silent embolism in diagnostic cerebral angiography: Detection with diffusion‐weighted imaging

Chuah, Kenneth; Stuckey, Stephen; Berman, Ivor G

doi:10.1111/j.1440-1673.2004.01273.x

Cited by 38 publications

(31 citation statements)

References 12 publications

(13 reference statements)

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“…The annual rate of RCC diagnosis is increasing as a result of incidental detection by crosssectional abdominal imaging of patients with suspected abdominal disorders. Increased detection rates carry a favourable prognosis; however, mortality from RCC has not decreased [2][3][4].Diffusion-weighted imaging (DWI) is frequently used in cranial MRI studies and has shown potential for the characterisation of lesions such as acute cerebral infarctions, intracranial tumours, various infectious diseases and metabolic disorders [5][6][7][8]. The role of DWI is limited outside the central nervous system, owing to its inherent extreme sensitivity to motion, such as that related to respiration, peristalsis and artefacts, thus resulting in a high signal to noise ratio.…”

mentioning

confidence: 99%

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

Paudyal

Paudyal²,

Tsushima³

et al. 2010

BJR

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ABSTRACT. The purpose of this study is to evaluate the role of diffusion-weighted imaging (DWI) in combination with T 1 and T 2 weighted MRI for the characterisation of renal carcinoma. The institutional review board approved the study protocols and waived informed consent from all of the patients. 47 patients (32 male and 15 female; age range, 21-85 years; median age, 65 years) who had suspected renal lesions on abdominal CT underwent MRI for further evaluation and characterisation of the lesions from April 2005 to August 2007 in our university hospital. A region of interest was drawn around the tumour area on apparent diffusion coefficient (ADC) maps. Final diagnosis was confirmed by histological examination of surgical specimens from all patients. The ADC value was significantly higher in renal cell carcinoma (RCC) ; p50.0004), whereas intensity on T 1 and T 2 weighted imaging did not reach statistical significance. In conclusion, DWI has clinical value in the characterisation of renal carcinomas and could be applied in clinical practice for their management. Renal cell carcinoma (RCC) is the most common primary malignant tumour of the kidney; it accounts for 2-3% of all adult cancers and is the sixth cause of death by tumour throughout the world. More than 80% of renal cancers that arise in the renal parenchyma are RCC, whereas the majority of renal pelvis cancers are transitional cell carcinomas (TCCs) [1][2][3]. The three most common subtypes of RCC are (i) clear cell carcinoma, one of the most common types, accounting for 70-80% of cases; (ii) papillary renal cell carcinoma, accounting for about 10-15% of cases; and (iii) chromophobe renal carcinoma, which is the least common, accounting for 5% of all RCCs. The annual rate of RCC diagnosis is increasing as a result of incidental detection by crosssectional abdominal imaging of patients with suspected abdominal disorders. Increased detection rates carry a favourable prognosis; however, mortality from RCC has not decreased [2][3][4].Diffusion-weighted imaging (DWI) is frequently used in cranial MRI studies and has shown potential for the characterisation of lesions such as acute cerebral infarctions, intracranial tumours, various infectious diseases and metabolic disorders [5][6][7][8]. The role of DWI is limited outside the central nervous system, owing to its inherent extreme sensitivity to motion, such as that related to respiration, peristalsis and artefacts, thus resulting in a high signal to noise ratio. With the development of advanced MR technology and the use of faster robust sequences, better quality has been obtained in abdominal imaging [9]. DWI with high b-values has been reported to have a high sensitivity for depicting malignant disease. Apparent diffusion coefficient (ADC) values of malignant hepatic, ovarian, breast, prostatic, colonic and uterine cervical tumours were lower than those of benign lesions or normal tissue [10][11][12][13][14][15][16][17][18].Previous studies have suggested that patients with chromophobe and papillary RCC ha...

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mentioning

confidence: 99%

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

Paudyal

Paudyal²,

Tsushima³

et al. 2010

BJR

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“…Previous reports have indicated that incidental embolism is not rare, and past history of vasculopathy, amount of contrast medium used, fluoroscopy time, use of additional catheters, procedures of the occlusion test, and performance of endovascular surgery for cerebrovascular disease are risk factors for embolism. 1,4,5,8,9,11,13,16,17,20,21) Angiography of the coronary arteries also carries a risk for cerebral embolism due to the duration of the procedure. 4,15) Diffusion-weighted MR imaging (DWI) allows for the most sensitive early detection of cerebral ischemia within minutes of onset.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Ischemic Lesions Related to Cerebral Angiography and Neuro-interventional Procedures

Sato

Nakai

Tsurushima

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Embolic stroke is not a rare complication of cerebral angiography. The risk factors for incidental embolism after cerebral angiography were retrospectively examined using diffusion-weighted magnetic resonance imaging (DWI) in 180 patients who underwent 247 angiography procedures, consisting of 174 diagnostic angiography and 73 interventional procedures, and magnetic resonance imaging including DWI within 72 hours after angiography. The two neuroradiologists in our hospital detected embolism after cerebral angiography as high-intensity lesions (HIL) on DWI. The relationships between HIL on DWI and procedural factors were evaluated. DWI after cerebral angiography revealed HIL related to the procedure in 72 of 247 angiographies. In all procedures, age (p º 0.01), past history of cerebral infarction (p º 0.05), anti-platelet therapy (p º 0.05), neuro-intervention (p º 0.01), and total amount of contrast medium (odds ratio [OR] 2.125, 95% confidence interval [CI] 1.045-4.321) were significantly correlated with HIL. In diagnostic angiography, the performance of the procedure by a resident operator (OR 2.526, 95% CI 1.214-5.254) was significantly correlated with HIL. Age, past history of cerebral infarction, and previous anti-platelet therapy determined the risk of atherosclerotic changes in patients. The neuro-intervention and total amount of contrast medium used could predict the risk of time limitations for angiography. Resident operator is also a risk factor. This study demonstrates the importance of improving the risk of time limitations for angiography and the risk due to operator inexperience. Further training of residents may be needed to reduce the occurrence of embolic complications.

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“…Our thrombi, after days 1 and 3, however, were hypointense on DWI. This discrepancy could be explained by the fact that clinical manifestations of CVT are variable and do not coincide with radiological demonstration of venous thrombi [30].…”

Section: Experimental Venous Thrombi: Mri With Histopathological Corrmentioning

confidence: 93%

Experimental venous thrombi: MRI characteristics with histopathological correlation

Ichiki¹,

Sakai²,

Nango³

et al. 2012

BJR

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Objectives: The purpose of this study was to evaluate the MRI characteristics of venous thrombus over set time thresholds with histopathological correlation in a porcine model. Methods: Inferior vena cava thrombi were induced in 12 pigs. MRI was performed in three pigs 2 h, 1 day, 3 days and 2 weeks after thrombus induction. Results: The MRI characteristics were analysed in correlation with histopathological findings. The thrombi after 2 hours, which consisted of red blood cells (RBCs), showed isointensity on T 1 weighted images (T 1 WIs) and hyperintensity on both T 2 weighted images (T 2 WIs) and diffusion-weighted images (DWIs . After 2 weeks, the thrombi, which revealed RBC lysis surrounded by granulation tissues, showed isointensity on T 1 WIs and hyperintensity on T 2 WIs and DWIs. The mean ADC value was 2.48610 23 mm 2 s 21. Conclusion:The temporal MRI characteristics seemed to be related to chemical and physical changes in RBC and organisation of granulation tissues. Free radicals generated by macrophages might also be related to some extent.

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Silent embolism in diagnostic cerebral angiography: Detection with diffusion‐weighted imaging

Cited by 38 publications

References 12 publications

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

The role of the ADC value in the characterisation of renal carcinoma by diffusion-weighted MRI

Risk Factors of Ischemic Lesions Related to Cerebral Angiography and Neuro-interventional Procedures

Experimental venous thrombi: MRI characteristics with histopathological correlation

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