Bronchial circulation angiogenesis in the rat quantified with SPECT and micro-CT

INTRODUCTION: As pulmonary artery obstruction results in proliferation of the bronchial circulation in a variety of species, we investigated this angiogenic response using single photon emission computed tomography (SPECT) and micro-CT. MATERIALS AND METHODS: After surgical ligation of the left pulmonary artery of rats, they were imaged at 10, 20, or 40 days post-ligation. Before imaging, technetium-labeled macroaggregated albumin ((99m)Tc MAA) was injected into the aortic arch (IA) labeling the systemic circulation. SPECT/micro-CT imaging was performed, the image volumes were registered, and activity in the left lung via the bronchial circulation was used as a marker of bronchial blood flow. To calibrate and to verify successful ligation, (99m)Tc MAA was subsequently injected into the left femoral vein (IV), resulting in accumulation within the pulmonary circulation. The rats were reimaged, and the ratio of the IA to the IV measurements reflected the fraction of cardiac output (CO) to the left lung via the bronchial circulation. Control and sham-operated rats were studied similarly. RESULTS: The left lung bronchial circulation of the control group was 2.5% of CO. The sham-operated rats showed no significant difference from the control. However, 20 and 40 days post-ligation, the bronchial circulation blood flow had increased to 7.9 and 13.9%, respectively, of CO. Excised lungs examined after barium filling of the systemic vasculature confirmed neovascularization as evidenced by tortuous vessels arising from the mediastinum and bronchial circulation. CONCLUSION: Thus, we conclude that SPECT/micro-CT imaging is a valuable methodology for monitoring angiogenesis in the lung and, potentially, for evaluating the effects of pro- or anti-angiogenic treatments using a similar approach.     

The periprostatic venous plexus: an unusual source of fatal pulmonary embolism during corporoplasty

International Journal of Legal Medicine - When a sudden death occurs during a minor surgical intervention, it may require a careful and extensive postmortem investigation. One such case concerns a...     

Systemic to pulmonary venous communication in the superior vena caval syndrome.

A case of superior vena caval obstruction due to bronchogenic carcinoma is presented. Upper extremity venography demonstrated shunting of contrast media from systemic veins to the right pulmonary veins. This collateral pathway has been previously described in the superior vena caval syndrome. A proposed mechanism for this flow pattern is discussed.     

腰椎静脉丛三维增强MR静脉成像初步研究

目的 探讨正常人腰椎静脉系统在三维增强MR静脉造影(MRV)的显示率,初步确定正常人腰椎椎管内前静脉(AIVV)的宽度范围。观察腰椎静脉系统在各种疾病情况下的表现。方法89例MR增强扫描受检者行MRV检查,其中62例为正常志愿者。分别观察不同年龄组各个腰椎节段的椎管内、外静脉显示情况。测量AIVV的宽度。观察各种疾病时椎管内、外静脉的表现。结果除L1和L2水平的左右吻合静脉外,其他各个节段41岁以上组的静脉显示率均低于40岁以下组(P<0.05)。AIVV平均宽度从L1-5逐渐增粗;年龄、性别、左右侧差异无统计学意义。AIVV全部显示的42例正常志愿者中,AIVV的平均宽度L1-L5逐渐增粗,范围在(3.9±0.6)mm-(7.9±1.2)mm;各种疾病时,AIVV可表现为正常、受压、移位或扩张。结论 三维增强MR静脉造影能满意地显示AIVV各分支及椎管外静脉的全貌,能够显示各种病变时椎静脉相应改变,对于指导临床治疗、研究椎静脉的临床意义具有潜在价值。     

Bronchial migration of pulmonary arterial coil

Transcatheter embolization was performed with stainless steel coils in a patient with bilateral pulmonary arterial aneurysms of unknown etiology. After a successful initial procedure, endobronchial migration of one of the coils was found which required surgical treatment. Indications of embolization and different types of materials are discussed.     

肺纤维化相关的细胞间通讯网络研究

目的 建立肺纤维化相关的细胞间通讯网络,并探究细胞间通讯网络在肺纤维化中的作用.方法 基于公开的肺纤维化单细胞测序数据和配体-受体相互作用数据库,并基于自助抽样的新算法建立肺纤维化相关的细胞间相互作用网络;使用Circos和Cytoscape软件对细胞间通讯网络进行可视化,并进一步分析其对细胞功能通路的影响.结果 首先,建立了肺纤维化相关的肌成纤维细胞、成纤维细胞、脂成纤维细胞、间充质祖细胞、间皮细胞、内皮细胞和高表达Pdgfrb的间充质细胞之间的通讯网络模型.然后,筛选出各种细胞类群中与肺纤维化显著相关的配体-受体关系对,并重点研究了几个与肺纤维化有关的配体或受体.最后,分析了与细胞间通讯网络相关的细胞功能通路.结论 该研究基于单细胞转录组测序数据利用自助抽样算法,建立了肺纤维化相关的细胞间通讯网络,并初步揭示了与肺纤维化相关的显著高表达的配体、受体及其影响的功能通路.     

肺动脉闭锁伴室间隔缺损的肺血管解剖类型探讨

目的:分析肺动脉闭锁合并室间隔缺损的肺动脉解剖形态与肺循环血供来源,探讨其适宜的肺血管造影方法.方法:回顾研究了38例肺动脉闭锁合并室间隔缺损的心血管造影结果,重点分析了肺动脉的起源、分布与解剖形态.所有病例均常规予以右室或左室造影和降主动脉上部造影,其中11例行选择性动脉导管造影,6例行选择性侧支血管造影.结果:全部38例患者中,肺循环血供主要来自于由动脉导管24例(63%),大型体-肺侧支7例(18%),动脉导管与大型体-肺侧支共存3例(8%),细小侧支4例(11%);其中8例显示肺动脉总干,27例显示中心肺动脉及共汇(71%).结论:合并室间隔缺损的肺动脉闭锁可发生在不同部位,肺动脉的血供来源及解剖形态复杂多样化,心血管造影仍是定义其解剖分型的重要手段.     

Bronchial compression by a patent ductus arteriosus associated with pulmonary atresia

Two infants with pulmonary atresia are presented, wherein a large, vertically oriented patent ductus arteriosus, acting as the only source of pulmonary blood supply, compressed the left bronchus, causing significant respiratory distress. Hyperinflation of the left lung was the clue to this circumstance. After bronchographic confirmation, surgical repair was accomplished by placement of aortopulmonary shunts and division of the patent ductus. Other causes of airway compression in congenital heart disease are briefly reviewed. The embryology of the ductus arteriosus is discussed, emphasizing its anatomic configuration and physiologic role in pulmonary atresia.     

双侧颈深浅丛均阻滞对循环呼吸功能的影响

目的探讨应用浓度为0.67%利多卡因和0.25%左布比卡因合剂在双侧颈深浅丛均阻滞时,对呼吸及循环功能的影响。方法麻醉穿刺方法同传统的改良的一点深丛阻滞法。实验组为两侧深浅丛均阻滞,深丛注药4 ml;浅丛于胸锁乳突肌后缘,于皮肤与颈阔肌间向头、向足、向对侧各注药3ml,胸锁乳突肌中点处注药2 ml,共计30 ml;对照组为传统的改良阻滞法。分别记录阻滞前,阻滞后15、30、45、60 min和手术毕6个时间点的呼吸频率(RR)、血氧饱和度(SpO2),心率(HR)、收缩压(SBP)及舒张压(DBP)。结果两组患者呼吸循环功能在阻滞后的30min内,RR、SpO2,HR、SBP、DBP变化都较明显,两组比较差异有统计学意义(P<0.05或P<0.01)。结论小剂量、低浓度的利多卡因和左布比卡因合剂应用于双侧颈深浅丛均阻滞对呼吸循环影响更小,相对更安全。     

Symptomatic enlarged cervical anterior epidural venous plexus in a patient with Marfan syndrome

A 38-year-old man with Marfan syndrome presented with headache and neck pain. MR imaging revealed a large enhancing mass in the cervical anterior epidural space. Cervical laminectomy with biopsy of the lesion revealed a large engorged anterior epidural venous plexus (AEVP). Marfan syndrome may predispose the patient to enlargement of AEVP secondary to a vessel wall abnormality.     

Deep venous thrombosis with suspected pulmonary embolism: detection with combined CT venography and pulmonary angiography

PURPOSE: To determine the frequency and location of deep venous thrombosis at computed tomographic (CT) venography after CT pulmonary angiography in a large series of patients clinically suspected of having pulmonary embolism and to compare the accuracy of CT venography with lower-extremity venous sonography. MATERIALS AND METHODS: Venous phase images were acquired from the diaphragm to the upper calves after completion of CT pulmonary angiography in 650 patients (373 women, 277 men; age range, 18-99 years; mean age, 63 years) to determine the presence and location of deep venous thrombosis. Results of CT venography were compared with those of bilateral lower-extremity venous sonography in 308 patients. RESULTS: A total of 116 patients had pulmonary embolism and/or deep venous thrombosis, including 27 patients with pulmonary embolism alone, 31 patients with deep venous thrombosis alone, and 58 patients with both. Among 89 patients with deep venous thrombosis, thrombosis was bilateral in 26, involved the abdominal or pelvic veins in 11, and was isolated to the abdominal or pelvic veins in four. In patients in whom sonographic correlation was available, CT venography had a sensitivity of 97% and a specificity of 100% for femoropopliteal deep venous thrombosis. CONCLUSION: Combined CT venography and pulmonary angiography can accurately depict the femoropopliteal deep veins, permitting concurrent testing for venous thrombosis and pulmonary embolism. CT venography also defines pelvic or abdominal thrombus, which was seen in 17% of patients with deep venous thrombosis.     

Identification of the periprostatic venous plexus by MR imaging

T2-weighted images (spin echo 2,000/60) show a high signal intensity rim around the prostate. Our investigations show that this rim is not part of the pelvic fat; it has T1 and T2 relaxation times similar to heparinized blood; it demonstrates little inflow effect; and after an intravenous injection of Gd-diethylenetriamine pentaacetic acid, its signal intensity increases. We conclude that this rim is the periprostatic venous plexus.