Angiomyolipoma arising in the thigh

A 41-year-old man presented with an asymptomatic mass in the right medial thigh. Magnetic resonance imaging (MRI) revealed a well-demarcated, 10-cm mass in the right adductor muscles. The margins of the mass exhibited high signal intensity and the rest showed low or iso signal intensity on T1-weighted MR images. However, the high signal intensity was decreased on T2-weighted images with fat suppression. The central part of the tumor was of inhomogeneous high signal intensity on T2-weighted images; after Gd-DTPA injection it enhanced inhomogeneously on T1-weighted images with fat suppression. On dynamic computed tomography (CT) in the arterial phase, there were strongly enhancing spotty areas in the tumor. At surgery, a yellow-whitish tumor was resected and a pathological diagnosis of angiomyolipoma (AML) in the thigh was made. Received: 21 June 1999 Revision requested: 28 July 1999 Revision received: 13 December 1999 Accepted: 15 December 1999     

Steno-Occlusive Changes in the External Carotid System in Moyamoya Disease

To evaluate the steno-occlusive changes in the external carotid system in moyamoya disease, cerebral angiograms of 39 moyamoya patients were retrospectively reviewed. There were 26 females and 13 males, age ranged from 4 to 62 years with a mean of 26 years. Initial symptoms were ischaemia in 27 patients, haemorrhage in 9, and none in 3. Stenosis, occlusion, and dilatation in the external carotid system were analysed angiographically. No stenosis or occlusion of the superficial temporal artery, middle meningeal artery, or occipital artery was observed in either preoperative or postoperative follow-up angiograms in any patients. Steno-occlusive changes do not occur in the external carotid system, but are confined in the internal carotid system in moyamoya disease.     

RDSA在颅内动脉瘤成像中的技术探讨

目的:探讨旋转数字减影血管造影(RDSA)在颅内动脉瘤成像中的应用。方法:对疑有颅内动脉瘤的43例患者首先进行常规DSA检查,对其中27例进行RDSA检查,研究RDSA的技术参数及应用价值。结果:43例中,16例常规DSA能清楚显示,其余27例在常规DSA基础上加RDSA,动脉瘤的形态、位置及毗邻关系得到清楚显示。结论:常规DSA是诊断颅内动脉瘤的必要检查方法,RDSA是常规DSA的重要补充,对颅内动脉瘤的成像、治疗及复查有重要的价值。     

Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing carotid stenosis

We compared three angiographic methods for grading of carotid stenosis and examined the correlation between angiographic and ultrasound findings. Two observers independently measured 111 carotid stenoses on arteriographic films of 84 patients. The stenoses were graded according to the European Carotid Surgery Trial (ECST), North American Symptomatic Carotid Endarterectomy Trial (NASCET), and Common Carotid (CC) methods. The results obtained by these methods were compared, and the interobserver reproducibility of the measurements was calculated. In addition, all angiographic results were compared to ultrasound findings obtained before angiography. Measurements using the CC method were the most reproducible and those using the NASCET method the least. The NASCET method underestimated the degree of stenosis compared to the other methods. The ECST and CC methods yielded almost identical results (97% agreement). Ultrasound provided an accuracy of 94% compared to ECST and CC methods and 84% compared to the NASCET method. Interobserver reproducibility of angiographic quantification of carotid stenoses was best for the CC and ECST methods and least for the NASCET method. Ultrasound demonstrated better accuracy than the ECST and CC methods. Received: 7 April 1999/Received in revised form: 5 October 1999/Accepted: 11 April 2000     

MSCTA在静脉窦旁脑膜瘤手术中的应用价值

目的探讨多排螺旋CT血管造影(MSCTA)在颅内静脉窦旁脑膜瘤手术中的应用价值。方法对两所医院60例窦旁脑膜瘤患者术前行MSCTA检查,利用三维重建图像技术进行模拟手术入路及肿块与血窦之间的关系研判。结果通过三维后处理后60例患者皆合理的设计和选择了手术入路和术式,有效地避免了颅内静脉窦的损伤,其中5例改变了常规手术入路,7例改变了常规手术方式,6例术前早期制定了次全切手术方案及放疗计划。结论 MSCTA在颅内静脉窦旁脑膜瘤术前制定手术入路及手术方式方面具有重要参考价值。     

Massive organ embolization from primary aortic thrombosis

A 49-year-old woman was hospitalized for acute left foot arterial ischemia. Arterial Doppler revealed occlusion of the dorsalis pedis and posterior tibial arteries. A computed tomography angiography performed to assess abdominal pain showed hepatic, splenic, renal and pancreatic infarctions. A splenic artery embolism and a small aortic wall thrombus at the celiac trunk were identified. No radiological signs of aortic atherosclerosis were found. No predisposing conditions for secondary aortic thrombosis or intracardiac embolic sources were detected. It was determined that primary aortic thrombosis, a rare though potentially serious condition, was to blame. Isolated aortic mural thrombosis therapy is not well established, although systemic anticoagulation, thrombolysis, thromboaspiration, endovascular stent grafting and surgical thrombectomy have been attempted with varying success. In our patient, systemic anticoagulation therapy was initiated and resulted in aortic thrombus resolution. Close clinical follow-up is crucial, as the aortic thrombus can recur despite anticoagulation and aggressive control of the atherosclerotic risk factors.     

Evaluation of serum cathepsin D concentrations in coronary artery disease

BackgroundCoronary artery disease (CAD) cannot be sufficiently explained by the presence of traditional risk factors. Cathepsin D has been proposed to serve as a surrogate marker of atherosclerosis but its alterations in CAD patients have not been studied.ObjectiveTo evaluate serum cathepsin D concentrations in relation to the presence and severity of CAD.Materials and methodsA total of 104 subjects were recruited; 71 patients with suspected CAD and 33 healthy subjects. Thirty-four patients had >50% coronary stenosis of at least one artery (CAD+); the remaining 37 patients had <50% stenosis (CAD−) based on angiography. CAD+ patients were sub-divided into three sub-groups with single (SVD; n = 15), double (2VD; n = 9), and triple vessel (3VD; n = 10) disease. Serum soluble cathepsin D concentrations were determined using an enzyme-linked immunosorbent assay (ELISA).ResultsSerum cathepsin D concentrations were significantly higher in the CAD+ compared with healthy control (p = 0.016) but not CAD− group (p = 0.098). Within the CAD+ group, patients with 3VD had significantly higher serum cathepsin D concentrations compared with the SVD group (p = 0.025), and also compared with the CAD− (p = 0.011) and SVD (p = 0.001) groups. No significant associations were found between serum cathepsin D concentrations and potential confounders including age, sex, blood pressure, smoking history and dyslipidemia.ConclusionSerum cathepsin D concentrations may be associated with the presence of CAD.