Language：English   Publishing type：Research paper (scientific journal)  

Pelvic fractures are common in cases of blunt trauma, which is strongly associated with mortality. Transcatheter arterial embolization is a fundamental treatment strategy for fatal arterial injuries caused by blunt pelvic trauma. However, vascular injuries due to blunt pelvic trauma can show various imaging findings other than arterial hemorrhage. We present a pictorial review of common and uncommon vascular injuries, including active arterial bleeding, pseudoaneurysm, arteriovenous fistula, arterial occlusion, vasospasm, and active venous bleeding. Knowledge of these vascular injuries can help clinicians select the appropriate therapeutic strategy and thus save lives.

DOI： 10.1007/s11604-022-01355-1

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The objective of this study was to determine the association between arterial embolisation (AE) for pelvic fractures and death. METHODS: The study had a retrospective design, using data from a nationwide population based prospective registry of trauma patients in Japan. This propensity score matched study included all adult patients from the registry with pelvic fractures between January 2004 and December 2018. The primary outcome was hospital death. Secondary outcomes included 28 day survival and length of hospital stay (LOS) in days. Multivariable logistic regression analyses were performed to control confounding variables, including patient, clinical, and hospital related variables; concomitant trauma; severe trauma; and haemodynamic instability. A conditional logistic regression analysis was performed to assess the association between treatment of pelvic fracture with AE and hospital mortality rate. RESULTS: Among 17 670 eligible patients with pelvic fractures, 2 379 (13.5%) underwent AE (AE group) and 1 512 (8.6%) died in the hospital. After one to one propensity matching with 2 138 patients from each group (AE and non-AE), the hospital mortality rate was significantly lower in the AE group than in the non-AE group (15.0% vs. 18.1%; p = .007). The AE group had significantly lower mortality (odds ratio; 95% confidence interval [CI] 0.60; 0.43 - 0.84; p = .003) and a significantly higher 28 day mean survival rate than the non-AE group (0.89; 95% CI 0.87 - 0.90 vs. 0.86; 0.85 - 0.88; p = .003), although there was no significant difference in the LOS (48 days vs. 46 days; p = .11). CONCLUSION: This propensity score matched analysis showed an association between AE for pelvic fractures and lower hospital mortality rates. The findings in this large nationwide cohort study provide strong evidence for the benefit of embolisation for patients with pelvic fractures.

DOI： 10.1016/j.ejvs.2022.05.048

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Endoscopic ultrasonography has become a routine procedure in clinical practice and is widely accepted as a safe procedure. Previous studies have reported that severe bleeding rarely occurs even when performing fine-needle aspiration biopsy. Severe hemorrhage following non-interventional endoscopic ultrasonography has never been reported. We herein report a case of hemorrhagic shock due to hemoperitoneum caused by a ruptured right gastroepiploic artery consequent to a diagnostic endoscopic ultrasonography. The patient was administered two antithrombotic agents. An extensive diagnostic workup contributed to the correct diagnosis, which led to a successful treatment by transcatheter arterial embolization. Endoscopists should be aware of this rare, but potentially fatal, adverse event of endoscopic ultrasonography.

DOI： 10.1007/s12328-021-01466-8

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Language：English   Publishing type：Research paper (scientific journal)  

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in patients with hemorrhagic shock who develop massive subdiaphragmatic bleeding. This procedure enables rapid and less invasive aortic blockade compared to resuscitative thoracotomy and aortic cross-clamp procedures. However, the REBOA procedure is often blindly performed in the emergency department without fluoroscopy, and the appropriateness of the procedure may be evaluated on computed tomography (CT) after REBOA. Therefore, radiologists should be familiar with the imaging features of REBOA. We present a pictorial review of the radiological findings of REBOA along with a description of the procedure, its complications, and pitfalls.

DOI： 10.1007/s11604-021-01166-w

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Language：English   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

症例は50歳代女性。交通事故により全身多発外傷を受傷し、骨盤骨折に伴う大量出血に対して経カテーテル的動脈塞栓術(TAE)を行う方針となった。造影CTでは、不安定型骨盤骨折が認められ、骨盤骨折の骨片が右内腸骨動脈側へ転位していた。右内腸骨動脈造影では、外側仙骨動脈と子宮動脈が描出されていたが、それより遠位で内腸骨動脈は完全に閉塞していた。術中所見は、塞栓物質としてNBCAを用いて塞栓し、左内腸骨動脈造影で認められた広範な動脈における血管径の不整や狭小化に対し、左内腸骨動脈本幹からゼラチンスポンジ細片を用いて塞栓した。術後、骨盤骨折に対して創外固定術を施行し、術翌日には観血的整復固定術を施行した。固定後は経過良好で、再出血や合併症は認めず、受傷12日後にリハビリ目的に他院転院となった。

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Language：Japanese  

DOI： 10.15015/00002119

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Language：Japanese   Publisher：(一社)日本インターベンショナルラジオロジー学会  

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Language：Japanese   Publisher：神奈川県医師会  

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Language：English  

DOI： 10.1016/j.jvir.2018.05.025

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Language：Japanese   Publisher：神奈川県医師会  

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Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

This retrospective study included 65 patients who underwent multidetector computed tomography (MDCT) carotid angiography; 28 patients were <70 years old (group 1), and 37 were ≥70 years old (group 2). Each low-attenuation (<30 Hounsfield units [HU]) plaque volume (LPV) and total uncalcified plaque volume ([TUPV] ≤150 HU) were semiautomatically measured on each aortic arch and internal carotid artery (ICA) curved planar reformations (CPR), using MDCT angiographic data. Correlation coefficients were employed to assess the impact of each plaque volume on various factors including ICA stenosis. The correlations (r > 0.5) were observed between aortic LPV and each ICA stenosis ratio and >30% stenosis in group 1, between aortic TUPV and male gender in group 1, and between ICA-TUPV and each aortic TUPV or the largest plaque thickness in group 2. Marginal correlations were observed between hyperlipidemia and aortic LPV and ICA-TUPV in group 1. There was no association between cerebral infarction and the aortic and ICA plaques. Both the aortic arch and ICA plaque volumes can be measured clinically. The increasing aortic LPV may be a significant factor associated with the development of ICA stenosis in patients younger than 70 years old.

DOI： 10.1155/2019/5817534

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Other Link： http://downloads.hindawi.com/journals/bmri/2019/5817534.xml

Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

To evaluate the relationship of aortic low attenuation plaque volume (LAPV) on multidetector computed tomography (MDCT) with the abdominal aortic aneurysm (AAA), the coronary arterial disease (CAD, ≥50% stenosis), severe (≥90% stenosis) CAD, hypertension, and long-term (≥10 years) hypertension. Curved planar reformations (CPR) of three segments (the ascending, the arch, and the upper descending aorta) of the thoracic aorta were generated with attenuation-dependent color codes to measure LAPV with 029 HU and total noncalcified plaque volume (TNPV) with 0150 HU in 95 patients. Correlation coefficients were employed to assess the impact of each LAPV and TNPV on AAA, CAD, severe CAD, hypertension, and long-term hypertension. Each Mean LAPV/cm and TNPV/cm was statistically greater in the aortic arch than the ascending (p&lt
0.001 on each) or the proximal descending segment (p&lt
0.001 on each). LAPV in the aortic arch has moderate correlations with AAA, severe CAD, and long-term hypertension (r=0.643, 0.639, 0.662, resp.). Plaque volumes in each aortic segment can be measured clinically and the increasing LAPV in the arch may be a significant factor associated with the development of severe atherosclerosis underlying AAA, severe CAD, and long-term hypertension.

DOI： 10.1155/2018/3563817

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：HINDAWI LTD  

Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared. There were 28 patients treated with UAE using NBCA. Complete hemostasis was achieved by UAE in 19 of 28 patients. In eight of nine patients with unsuccessful hemostasis, surgical hemostatic interventions were performed after UAE, and hemostasis was achieved in seven patients. UAE using NBCA showed no significant intergroup differences in complete hemostasis according to the presence or absence of DIC based on obstetrical DIC score (70% versus 62.5%, P = 1.000) or ISTH DIC score (54.5% versus 76.5%, P = 0.409). UAE using NBCA may be a useful first-choice treatment for PPH with DIC.

DOI： 10.1155/2017/1562432

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J-GLOBAL

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Language：Japanese   Publisher：(一社)日本救急医学会  

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Language：Japanese   Publisher：(一社)日本救急医学会  

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Language：English   Publisher：AMER ROENTGEN RAY SOC  

OBJECTIVE. The purpose of this study was to evaluate the usefulness of renal perfusional cortex volume for arterial input function.
MATERIALS AND METHODS. This retrospective study included 45 potential kidney donors-33 patients with aortic dissection and 12 patients with renovascular hypertension- who underwent both MDCT angiography with 0.5-mm collimation and renal Tc-99m-diethylenetriamine pentaacetic acid (DTPA) scanning using the modified Gates method. Each perfusional cortex volume for the arterial input function and parenchymal volume was measured by semiautomatic segmentation using the region-growing technique. Linear regression analysis and correlation coefficients were used to assess the impact of the cortical volume, parenchymal volume, and renal scanning glomerular filtration rate (GFR) on estimated GFR (eGFR) using a modified Modification of Diet in Renal Disease (MDRD) equation.
RESULTS. The correlation coefficient was higher for the total renal DTPA GFR adjusted for body surface area, weight-adjusted perfusion cortex volume, and adjusted total parenchyma volume in rank (r = 0.712, 0.642, 0.510, respectively, p < 0.0001 for each). The coefficient of the right renal perfusional cortex volume percent with a mean value of 52.1% +/- 10.1% was 0.826 (p < 0.0001) for the right renal DTPA GFR percent with a mean value of 51.0% +/- 12.1% (range, 22.0-89.5%), although the value for the right renal parenchymal volume percent with a mean value of 49.5% +/- 5.5% was 0.764 (p < 0.0001).
CONCLUSION. Weight-adjusted perfusional cortex volume for arterial input function can be measured clinically and may replace renal DTPA scanning using the modified Gates method.

DOI： 10.2214/AJR.14.12778

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Language：Japanese   Publisher：金原出版  

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Language：English   Publisher：SPRINGER INTERNATIONAL PUBLISHING AG  

Purpose: To clarify the postmortem multi-detector computed tomography (MDCT) vascular signs that occur shortly after death.
Materials and methods: The vascular signs in MDCT images were evaluated quantitatively in 96 early postmortem cardiac arrest patients, 47 cardiac arrest patients who survived due to resuscitation and 47 control patients without cardiac arrest.
Results: Elliptical (40 cases) or collapsed deformity (2 cases, in only the abdominal aorta) and high-attenuated sedimentation (19 cases in the aorta and 10 cases in superior or inferior vena cava) were limited to the postmortem patients. The incidence of elliptical deformity was higher for the abdominal aorta, descending thoracic aorta and ascending thoracic aorta in rank. The sedimentation was observed in the ascending thoracic aorta with a higher frequency than in the descending thoracic and abdominal aorta. A high-attenuating wall in any portion of the aorta was observed in 34 of the postmortem patients, 11 of the surviving patients and 10 of the control group, with a predominance of the ascending thoracic aorta.
Conclusion: Elliptical deformity in the abdominal and descending thoracic aorta and high-attenuated sedimentation in the ascending thoracic aorta were shown to be signs of postmortem MDCT shortly after death.

DOI： 10.1186/2193-1801-3-169

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Language：Japanese  

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J-GLOBAL

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J-GLOBAL

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Language：English  

We report a case of systemic arterial supply to normal segment of the lung without sequestration in a 27-year-old man with intermittent and massive hemoptysis. Multidetector-row CT scan demonstrated that dilated basal pulmonary venous branches and an aberrant artery connecting lower thoracic aorta and running toward the medial basal segment of right lung. Angiography showed a dilated aberrant artery with mild shunts to basal pulmonary venous branches connecting an anomalous pulmonary vein. Transarterial embolization of the aberrant artery was occluded by multiple 0.035-in. coils under balloon occlusion technique. Hemoptysis has been ceased after transarterial coil embolization which is useful and safe in the treatment of this rare congenital anomaly and may be alternative to surgical intervention. © 2010 Elsevier Ireland Ltd.

DOI： 10.1016/j.ejrex.2010.12.010

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：金原出版  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2003251698

Publishing type：Book review, literature introduction, etc.  

Transeatheter arterial embolization (TAE) has been commonly performed for bleeding control after blunt abdominal injuries. We reviewed the medical records of 55 consecutive patients performed TAE after abdominal trauma. We assessed the outcome of TAE with respect to injury grade and complications. There was no difference among injury grade in relation to the success rate of TAE. But concomitant pelvic and brain injuries associated with failure of TAE.

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