Atypical Abnormal Pulmonary Vein Drainage with Atrial Septal Defect: Surgical Treatment

Sinus venosus atrial septal defect (SV‐ASD) usually coexists with partial anomalous pulmonary vein connection (PAPVC). It is a difficult diagnosis in transthoracic echocardiography (TTE) due to eccentric position of defects. We present a rare case of atypical anatomical variation in PAPVC, which was never described before. Two right pulmonary veins drained into superior vena cava, which overrode SV‐ASD and interatrial septum, a third pulmonary vein into the right atrium. Complete diagnosis could not be set after TTE, nor transesophageal echocardiography, whereas angio‐CT was finally conclusive. This diagnostic approach allowed the surgical planning.     

Pediatric cardiac computed tomography angiography: Expert consensus from the Filiale de Cardiologie Pédiatrique et Congénitale (FCPC) and the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV)

This article was designed to provide a pediatric cardiac computed tomography angiography (CCTA) expert panel consensus based on opinions of experts of the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV) and of the Filiale de Cardiologie Pédiatrique Congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, CTA radiation dose reduction techniques, and post-processing techniques. The consensus was based on data from available literature (original papers, reviews and guidelines) and on opinions of a group of specialists with extensive experience in the use of CT imaging in congenital heart disease. In order to reach high potential and avoid pitfalls, CCTA in children with congenital heart disease requires training and experience. Moreover, pediatric cardiac CCTA protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible to prevent unnecessary radiation exposure. We also provided a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.     

血管内支架成形术治疗症状性椎动脉起始部狭窄的疗效分析

目的研究血管内支架成形术治疗症状性椎动脉起始部狭窄的安全性及有效性。方法对16例症状性椎动脉起始部狭窄的患者行支架成形术治疗。16例患者均成功植入球囊扩张支架。结果术后11例患者恢复正常管径;5例患者狭窄程度明显改善,残余狭窄均小于20%。无1例发生严重并发症。在6个月的临床随访中,16例患者均无脑缺血发作及再狭窄发生。结论血管内支架成形术是治疗症状性椎动脉起始部狭窄的安全、有效方法,其长期疗效还需进一步随访研究。     

多层螺旋CT血管成像在支气管动脉灌注化疗前的定位价值

目的探讨多层螺旋CT血管成像(MSCTA)在支气管动脉(BA)灌注化疗前的定位价值。方法分析15例经支气管动脉介入治疗前的的肺癌病例,中央型13例,周围型2例。15例均行螺旋CT增强扫描,后传至工作站利用多平面重组(MPR)、最大密度投影(MIP)和容积再现(VR)等后处理技术观察支气管动脉。结果13例中央型肺癌均由肿瘤性支气管动脉供血,重建图像清晰显示肿瘤性支气管动脉的起点、分支情况及走行特点;其中2例右侧肿瘤性支气管动脉与肋间动脉共干。2例周围型肺癌中有1例由肿瘤性支气管动脉供血,1例找不到明确发自支气管动脉的供血血管。结论多层螺旋CT血管成像能够显示肺癌特别是中央型肺癌的肿瘤性支气管动脉并能为经支气管动脉灌注化疗提供准确定位。     

Vascular Centerline Extraction in 3D MR Angiograms for Phase Contrast MRI Blood Flow Measurement

The accuracy of 2D phase contrast (PC) magnetic resonance angiography (MRA) depends on the alignment between the vessels and the imaging plane. PC MRA imaging of blood flow is challenging when the flow in several vessels is to be evaluated with one acquisition. For this purpose, semi-automatic determination of the plane most perpendicular to several vessels is proposed based on centerlines extracted from 3D MRA. Arterial centerlines are extracted from 3D MRA based on iterative estimation-prediction, multi-scale analysis of image moments, and a second-order shape model. The optimal plane is determined by minimizing misalignment between its normal vector and the centerlines’ tangent vectors. The method was evaluated on a phantom and on 35 patients, by seeking the optimal plane for cerebral blood flow quantification simultaneously in internal carotids and vertebral arteries. In the phantom, difference of orientation and of height between known and calculated planes was 1.2° and 2.5 mm, respectively. In the patients, all but one centerline were correctly extracted and the misalignment of the plane was within 12° per artery. Semi-automatic centerline extraction simplifies and automates determination of the plane orthogonal to one vessel, thereby permitting automatic simultaneous minimization of the misalignment with several vessels in PC MRA.     

Cat-301 immunoreactivity in the lateral geniculate nucleus and visual cortex of the strabismic amblyopic cat

Purpose: It was investigated whether alterations in neuronal structure and function occasioned by strabismic amblyopia also may be reflected in alterations in the expression on Y type neurons of a Cat-301 antibody sensitive antigen in the lateral geniculate nucleus (LGN) and cortex of our cat model of strabismic amblyopia. Methods/Results: The percentage of positively labelled cells was reduced in LGN laminae that received input from the deviated eye in strabismic amblyopic cats compared with normal cats. In the strabismic cortex, the density of immunopositive neurons was significantly reduced compared with normal, the effect being most pronounced in layer IV Conclusions: Despite previous physiological recordings indicating a decrease in X-cell associated acuity in strabismic amblyopia, the present findings imply that the changes in the early visual experience occasioned by strabismus also produce specific molecular changes in theY neuronal class.     

Differences in the temporal dynamics of the visual ON and OFF pathways

The temporal structure of spike trains recorded from optic fibers and single units of the lateral geniculate nucleus (LGN) and primary visual cortex of the cat was studied with a novel method of inter-spike interval analysis. ON type relay cells of the LGN exhibited a multimodal interval distribution preferring a distinct interval (fundamental interval) and its multiples during the sustained light response, whereas most OFF cells showed a broad, unimodal distribution. The general pattern of the interval distribution was relatively independent of stimulus size and contrast and the degree of light adaptation. Simultaneously recorded S-potentials originating from the retinal input generally produced only a single peak at the fundamental interval length. Therefore, the multimodal interval distribution of LGN cells seems to be a result of intra-geniculate inhibition. Cortical cells also showed a weak tendency to fire with spike intervals similar to LGN cells. Therefore, the regular firing pattern observed at peripheral stages of the visual pathway can persist at higher levels and might promote the occurrence of oscillatory activity.     

带血管蒂舟骨瓣移位术的应用解剖

目的:为治疗距骨骨折提供新术式的解剖学基础.方法:在30侧灌注红色乳胶的成人下肢标本上,对舟骨背侧面形态、血供来源进行观测.结果:舟骨背侧面动脉主要来自内踝前动脉、跗内侧动脉以及足底内侧动脉浅支,分别发3～5支、1～3支和1～2支外径在0.2～1.0mm之间的骨膜支,形成骨膜动脉网.结论:以内踝前血管为蒂,可切取舟骨背侧2.0cm×1.0cm×0.5cm大小的骨瓣,用于距骨颈骨折修复.术式经临床应用证实,手术简便,效果可靠.