Luminal Abnormalities Research Articles

Gallbladder Abnormalities in Acute Viral Hepatitis

We carried out a prospective case controlled study to evaluate the temporal sequence of sonographic abnormalities in acute viral hepatitis (AVH) and their resolution patterns. Correlations were established between the sonographic abnormalities and the clinical and biochemical profiles. Fifty-six patients within 2 weeks of onset of illness (37 within 1 week and 19 between 1 and 2 weeks) underwent real-time ultrasound at weekly intervals until clinical and biochemical resolution. Abnormal sonographic patterns were found in 55 of 56 (98.2%) patients. The wall thickness was abnormal (6.1 +/- 4.3 mm) in 55 (98.2%) cases, luminal abnormalities observed in 33 (58.9%) cases, and alterations in volume in 14 (25%) cases. Complete resolution took place in 53 (96.4%) cases by 12 weeks. A wall thickness of greater than 7 mm and abnormal luminal contents were more frequent in patients studied within 1 week of illness than later (p less than 0.05). No other correlations could be established between the different sonographic patterns and the clinical and biochemical profiles at any stage of the illness. We conclude that sonographic abnormalities are common in patients with AVH, with resolution as the rule with clinical recovery.

Effect of Transfusion Therapy on Arteriographic Abnormalities and on Recurrence of Stroke in Sickle Cell Disease

Abstract Stroke is a relatively frequent and severe complication of sickle cell disease. We performed cerebral arteriograms in 30 patients with sickle cell disease to evaluate the cause of acute neurologic deficits and to assess the effects of transfusion therapy given for a year or more after the acute episode. Twenty-three patients with motor and speech deficits had multiple abnormalities of major cerebral arteries. The internal carotid and anterior and middle cerebral arteries showed stenosis and/or occlusion at their common junction. Irregular luminal surfaces suggested that endothelial damage and intimal hyperplasia were the basis of stroke. Prolonged transfusion therapy nearly stopped progression of stenosis and markedly decreased the irregularity of the luminal surfaces; in 4 untransfused patients, the degree of stenosis doubled and the luminal abnormalities persisted. Prior to transfusion, 90% of patients had recurrence of stroke. With transfusion therapy, only 10% of patients had recurrence despite persistent arterial abnormalities. Clinical recurrences per patient-month decreased 75- fold. The patients tolerated prolonged transfusion therapy well, despite progressive iron accumulation. Seven patients with smooth abnormalities of a single artery, nonocclusive changes, or with normal arteriograms did not receive transfusions. Only one of this group had recurrence of symptoms.

Effect of transfusion therapy on arteriographic abnormalities and on recurrence of stroke in sickle cell disease

Stroke is a relatively frequent and severe complication of sickle cell disease. We performed cerebral arteriograms in 30 patients with sickle cell disease to evaluate the cause of acute neurologic deficits and to assess the effects of transfusion therapy given for a year or more after the acute episode. Twenty-three patients with motor and speech deficits had multiple abnormalities of major cerebral arteries. The internal carotid and anterior and middle cerebral arteries showed stenosis and/or occlusion at their common junction. Irregular luminal surfaces suggested that endothelial damage and intimal hyperplasia were the basis of stroke. Prolonged transfusion therapy nearly stopped progression of stenosis and markedly decreased the irregularity of the luminal surfaces; in 4 untransfused patients, the degree of stenosis doubled and the luminal abnormalities persisted. Prior to transfusion, 90% of patients had recurrence of stroke. With transfusion therapy, only 10% of patients had recurrence despite persistent arterial abnormalities. Clinical recurrences per patient-month decreased 75-fold. The patients tolerated prolonged transfusion therapy well, despite progressive iron accumulation. Seven patients with smooth abnormalities of a single artery, nonocclusive changes, or with normal arteriograms did not receive transfusions. Only one of this group had recurrence of symptoms.

IMAGE ENHANCEMENT WITH MAGNIFICATION AND SUBTRACTION

The techniques of direct serial magnification cerebral angiography and subtraction techniques have resulted in improvement of the roentgen image and increased diagnostic accuracy. Detail, particularly of the minute penetrating arteries that are barely perceptible on conventional angiography is enhanced. These vessels are readily identified and luminal abnormalities and vascular displacements are easily detectable. Normal anatomy is vividly displayed and the features of neoplastic and degenerative lesions are better appreciated.