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21:39 CET
VoE 31 - Vascular
Vascular
Wednesday, February 28, 09:00 - 10:00
Moderator: S. Deftereos (Alexandroupolis/GR)


C-0312
09:00
Percutaneous trans-luminal managment of the vascular manifestations of neurofibromatosis type 1
J. Raborn, A. Gunn, K. Mahmoud, S. Moawad, M. Poundstone, A. M. K. Abdel Aal, S. Saddekni; Birmingham/US

Learning objectives:
1. Review the clinical manifestations of Neurofibromatosis type 1 (NF1). 2. Discuss the vascular pathology associated with NF1. 3. Review the clinical presentation, diagnosis, and percutaneous managment of NF1 related renal artery stenosis, middle aortic syndrome, and cerebral artery disease.
Background:
Neurofibromatosis 1 (NF1) is an autosomal dominant disorder found in approximately 1 out of every 3,000 individuals. The disorder results from a microdeletion in the NF1 gene on chromosome 17q11.2 that results in premature translation termination of the neurofibromin protein. The classic clinical pr[...]
Findings and procedure details:
Renal arterial involvement NF1 vasculopathy most commonly affects the renal artery. Renal artery stenosis (RAS) is a more common presentation than renal artery aneurysms. Patients with RAS typically present with hypertension and/or renal dysfunction. The initial diagnostic modality of choice is ultr[...]
Conclusion:
The management of NF1 vasculopathy involves a combination of medical therapy with either surgical or percutaneous interventions. Specific indications for intervention are poorly defined; however, the overall goal is symptom alleviation. Appropriate patient selection based on the degree of vascular i[...]
Personal information:
Ahmed Kamel Abdel Aal , MD, PhD, FSIR University of Alabama at Birmingham (UAB). Department of Radiology Division of Interventional Radiology. United States , Alabama. Address: 619 19th Street South, Birmingham, AL 35249. Tel: (205) 975-4850 Fax: (205) 975-5257. Email: akamel@uabmc.edu Twitter: ahm[...]
References:
1. Dillon, M. J. The diagnosis of renovascular disease. Pediatr. Nephrol. Berl. Ger. 11, 366–372 (1997). 2. Han, M. & Criado, E. Renal artery stenosis and aneurysms associated with neurofibromatosis. J. Vasc. Surg. 41, 539–543 (2005). 3. Neurofibromatosis: phenotype, natural history, and pathoge[...]

C-0829
09:07
Correlation between NIHSS score in patients with acute ischemic cerebral stroke and the site of occluded vessel.
M. Wiernik, T. J. Popiela; Krakow/PL

Aims and objectives:
Aims and objectives: Non enhanced CT is still an essential diagnostic tool for fast clinical decisions in treatment of ischemic cerebral stroke[1, 2][1]. Its’ leading role is excluding intracranial bleeding that is a contraindication for intravenous thrombolysis[3, 4]. Brain CT perfusion is a cr[...]
Methods and materials:
Methods and materials Population and imaging protocol After a retrospective analysis of 246 brain CT perfusion studies 53 patient cases were included into further analysis (27 males and 26 females). The age of the patients varied from 42 to 88 years. Exclusion criteria included TIA or pr[...]
Results:
RESULTS Population an imaging protocol: 27 males and 26 females were included. Mean age: 72,5 years. Incidence of acute cerebral stroke was examined in brain CT perfusion - if negative a consecutive brain MR with T2WI/DWI or NECT was performed in following 6-12h. Results of brain[...]
Conclusion:
Conclusions: Low NIHSS score may correlate with higher probability of posterior circulation than MCA cerebral stroke. In addition to positive clinical findings suggesting posterior circulation ischemia, low NIHSS score may lead in these patients to a protocol modification including moving the RO[...]
Personal information:
Maciej Wiernik MD - radiologist in training at Medical Imaging Center CUMRiK in Cracow.
References:
1. Latchaw, R.E., et al., Recommendations for Imaging of Acute Ischemic Stroke. Stroke, 2009. 40(11): p. 3646. 2. Lövblad, K.-O. and A.E. Baird, Computed tomography in acute ischemic stroke. Neuroradiology, 2010. 52(3): p. 175-187. 3. Leiva-Salinas, C. and M. Wintermark, Imaging of Acute Ische[...]

C-1117
09:14
A simplified method for evaluation of the duration of venous reflux of varicocele and clinical outcomes
V. Goren, C. YILMAZ, R. Goren, B. GULEK; Adana/TR

Aims and objectives:
A varicocele is an abnormal dilatation of the pampiniform venous plexus. The diagnosis of varicocele is made by clinical examination and should be confirmed by color Doppler ultrasonography (CDUS). Various parameters acquired from CDUS examination are very useful, such as the vein diameter and venou[...]
Methods and materials:
Men who were admitted for evaluation of their inability to have a child were evaluated from May 2009 to August 2014. Patients with bilateral varicoceles, prior varicocelectomy, azoospermia, or hormonal imbalances involving follicle-stimulating hormone, luteinizing hormone, or total testosterone were[...]
Results:
The patients’ preoperative and postoperative SA results were compared according to the preoperative DVR. The cutoff DVR value was calculated as 4.5 seconds according to patients who underwent successful treatment. The ROC curve yielded 81.8% sensitivity and 71.4% specificity when 4.5 seconds was cho[...]
Conclusion:
The new assessment method of DVR predicted varicocelectomy outcome. It has a good intra and interobserver variability. The use of DVR may help to predict the varicocelectomy outcome and prevent the unnecessary treatment of grade 1 and 2 varicoceles. Patients with grade 1 or 2 varicoceles, a DVR of ≥[...]
Personal information:
V.Goren, MD Adana City Hospital, Department of Radiology, Adana, Turkey Adana City Hospital Department of Radiology Yuregir, Adana Phone: + 905333131949 e-mail : vinilgoren@gmail.com
References:
Jungwirth A, Diemer T, Dohle RG, et al. Guidelines on Male Infertility. European Association of Urology Guidelines 2015 Edition. Edition presented at the EAU Annual Congress Madrid 2015 ed. Arnhem, The Netherlands: European Association of Urology; 2015. Donkol RH, Salem T. Paternity after varicocel[...]

C-1976
09:21
Shear wave elastography like noninvasive method for evaluating atherosclerotic stenosis and risk for stroke: practical experience.
I. BEKALO; Odessa/UA

Aims and objectives:
To explore the possibility of using shear wave elastography (SWE) for determination of the carotid plaque stiffness and define characteristics associated with vulnerable plaques for identifying high-risk patients.
Methods and materials:
Ultrasound and SWE images were obtained from 120 adults who underwent medical check-up in our hospital. Subjects consisted of 67 patients (aged 63.8±5.1) with clinical and radiological findings by the stroke physician and 53 patients (aged 56.5±5.7) without clinical and radiological findings of stro[...]
Results:
Plaques from patients with stroke anamnesis were generally less echogenic than plaques from asymptomatic patients and elasticity values were lower than plaques in asymptomatic patients and ranged from 43 kPa to 63 kPa with a mean value 53 kPa. Plaques from patients without stroke anamnesis were more[...]
Conclusion:
Elastography measurements may be used to differentiate between vulnerable and stable plaques. Share wave elastography is a noninvasive method, which can help in identifying vulnerable plaques and evaluate risk for stroke.
Personal information:
Bekalo, MD Private hospital INTO-SANA, Department of Radiology 65009 Odessa, Ukraine Phone : +380967528337 Fax : +380482307500 e-mail : irynabekalo@yandex.ru
References:
1. North American Symptomatic Carotid Endarterectomy Trial Collaborators Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–453. doi: 10.1056/NEJM199108153250701. [PubMed] [Cross Ref] 2. Bercoff J, Tanter M, Fink M. Supers[...]

C-2755
09:28
Aortitis: imaging findings and pathologic correlation
P. Hernandez Mateo, M. Domínguez Fraga, A. Vidal, I. de la Pedraja, A. Bustos; Madrid/ES

Learning objectives:
To review and describe clinical, pathological and radiological findings of aortitis showing representative cases of the most frequent conditions. To stand out the important role of cross sectional imaging (TC, PET/TC and MRI) in the management and follow-up of these patients.
Background:
Aortitis is a subtipe of vasculitis that involves histologically inflammation of the aortic wall. This is a specific condition of the wide spectrum of vasculitis that show different etiologies, pathophysiologies, clinical manifestations and prognoses. Aortic wall inflammation may be caused by an i[...]
Findings and procedure details:
We revised in our hospital files all aortic aneurysms that had been operated in our center in the last 5 years. In total 323 cases were found and only 19 of them had histological proven diagnosis of aortitis: 5 IgG4-Related Disease Aortitis, 5 Takaysus artertitis, 1 Giant Cell arteritis, 2 piogenic [...]
Conclusion:
CONCLUSIONS Aortitis is a complex disease caused by different etiologies. It is frequently misdiagnosed as patients manifest scarce clinical symptoms but its diagnosis is crucial as sometimes consequences can be fatal if left untreated. Differentiating non-infectious from infectious aortitis const[...]
Personal information:
e-mail: phmaula@gmail.com Radiology Department Hospital Clínico San Carlos, Madrid
References:
Restrepo C, Ocazionez D, Suri R, Vargas D. Aortitis: Imaging Spectrum of the Infectious and Inflammatory Conditions of the Aorta. RadioGraphics. 2011;31:435-451. Litmanovich D, Yıldırım A, Bankier A. Insights into imaging of aortitis. Insights into Imaging. 2012;3:545-560. Hartlage G, Palios J, Barr[...]

C-2827
09:35
Aortic flow measurement by phase-contrast MRI: what is the impact of temporal resolution?
J. LE MOAL1, S. Bejar1, V. Lefebvre1, A. Monnet2, F. doguet1, F. Bauer1, J.-N. Dacher1, B. Dubourg1; 1Rouen/FR 2Lille/FR

Aims and objectives:
If transthoracic echocardiography (TTE) remains the gold standard for the diagnosis and evaluation of valvular diseases [1–3], MRI with Phase-Contrast Imaging Sequences (PC-MRI) is a well-established technique with many advantages and applications [4,5]. The European Society of Cardiology and the Am[...]
Methods and materials:
Study population: Between January 2014 and July 2017, 126 patients were referred for CMR assessment of the thoracic aorta, i.e. the following indications (whether screening, assessment of a known pathology or follow-up): AR, aortic stenosis, aortic dilatation, Marfan’s syndrome, bicuspid aortic valv[...]
Results:
Study Population 126 CMR were analyzed. Of these, 9 low quality studies were excluded (respiratory artifacts, arrhythmia, velocity aliasing, mismatch between 2D contrast slices), hence 117 MRIs were considered. One of these displayed significant backfolding artifacts on 40f PC-MRI. It was therefor[...]
Conclusion:
Increase in PC-MRI temporal resolution is significantly associated with a minor increase in Rvol, RF and peak velocity at the expense of an increase in breath-holding length. It has also no impact on clinical AR grading. These findings emphasize that: (1) when assessing aortic regurgitation, the sam[...]
Personal information:
References:
1. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. Circulation. 2014;129:e521–643. 2. Zoghbi W. Recommendations for evaluation of the severity of native valvular regurgitation with two-dim[...]

C-3065
09:42
Doppler Spectral Waveforms 101
J. Vucetic, J. Rivera Mata, J. Cárdenas Herrán, R. Mirón Mombiela, C. Senís Syas; Valencia/ES

Learning objectives:
Review Doppler spectral waveform patterns of arterial system of the body Describe common features of pathological flows in different regions and organs.
Background:
Introduction: Recognizing of the origin of the normal spectral waveform is necessary to understand the deformation to which it is subjected by different pathologies. A spectral wave is a longitudinal wave composed of compressions and rarefactions that represent increase and decrease of pressures r[...]
Findings and procedure details:
A. Normal spectral waveforms Each major vessel in the body has a specific waveform pattern and resistance index (RI) depending on its position relative to the heart and physiological requirements of the organ it supplies and presents characteristic changes when the flow is compromised. Fig. 3 [...]
Conclusion:
It’s necessary to dominate Doppler US technique and be familiar with characteristic normal and pathological waveforms. Recognizing physiologic high and low resistance patterns is useful for understanding pathological flows. Changes in the normal spectral waveform translate local and distant patholog[...]
Personal information:
References:
Dhaliwal G, Mukherjee D. Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment. The International Journal of Angiology : Official Publication of the International College of Angiology, Inc. 2007;16(2):36-44. J Am Soc Echocardiogr 2006;19:955-972. 0894-7317 Hidek[...]

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