| 1. |
- Ericson, K, et al.
(författare)
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Volume Determination of Intracranial Arteriovenous Malformations prior to Stereotactic Radiosurgical Treatment
- 1996
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 2:4, s. 271-5
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Tidskriftsartikel (refereegranskat)abstract
- Exact dose planning for stereotactic radiosurgery was enabled in connection with diagnostic angiography or at the end of an endovascular procedure by simply placing a stereotactic localizing box onto the head of the patient while acquiring PA and lateral angiographic views. The fiducials engraved on the localizing box enabled the appropriate images to be scaled to the stereotactic space. Regular dose planning was then performed after estimating the size of the patient's head. A prediction of the chances of obliteration and the risks of complication could then be made immediately after the endovascular or diagnostic procedure, and further therapy could be selected much more confidently. This technique may also be used at centres without facilities for radiosurgical treatment if only the localizing box is available. The images may then be sent for evaluation to a unit with dose planning equipment. The technique is simple and involves little risk, significantly improving patient management. Digital subtraction angiography was used in this study. A correction algorithm was used to minimize the geometric distortion inherent to the digital technique.
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| 2. |
- Soderman, M, et al.
(författare)
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Radiation dose and image quality in neuroangiography: effects of increased tube voltage, added x-ray filtration and antiscatter grid removal
- 1998
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 4:3, s. 199-207
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Tidskriftsartikel (refereegranskat)abstract
- During endovascular treatment the patient may be subject to fluoroscopy for long periods as well as multiple x-ray exposures. The radiation dose to the patient can be considerable, and cause local deterministic effects such as alopecia or even skin burn. The potential carcinogenic effects should also be noted, being especially important in the paediatric population. We measured radiation doses to patients and personnel during neuroendovascular procedures and diagnostic neuroangiography. We also tried to reduce the radiation dose to the patient utilising increased tube voltage, additional primary X-ray filtration and by removing the antiscatter grid in front of the image intensifier, employing air gap technique. We investigated radiation doses to patient and personnel during neuroangiographic procedures and optimized the examination technique with regard to radiation dose with maintained image quality. Radiation exposure to patients and personnel was measured with thermoluminescent dosimeters and permanently mounted KermaDose-Area-Product meters in front of the X-ray tubes during 13 cerebral angiographies and six neuroendovascular procedures. We performed experiments with radiation dose measurements and evaluation of image quality with 80 and 90 kV tube voltage during image acquisition and 75 and 85 kV during fluoroscopy, as well as with different primary X-ray filtration. Images from patient studies acquired with the original grid in front of the image intensifier were compared with images from patient studies acquired with the grid removed and air gap technique (30 cm). Images from patient studies acquired with the original examination technique were compared to images from patient studies acquired with increased x-ray tube voltage, increased x-ray filtering and with the antiscatter grid removed using an airgap as scatter reduction method. Radiation exposure to personnel was very low using standard protective devices. Measurable doses were recorded only on the hands and forehead of the neuroradiologist. Maximum entrance skin dose was about 1 Gy on the side of the patientspatient's forehead during an endovascular procedure. Increasing the tube voltage from 75 to 85 – 85 and 90 kV, exchanging the original 0.5 mm aluminium primary filtration for 0.2 mm copper and removing the antiscatter grid allowed us to reduce entrance skin dose to the patient by 70% with unchanged or slightly improved image quality.
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| 3. |
- Söderman, M, et al.
(författare)
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Acute-Sinus Thrombosis in a Child with Antibodies against Cardiolipins. Report of a Case Treated with Local Fibrinolysis
- 1996
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 2:2, s. 143-8
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Tidskriftsartikel (refereegranskat)abstract
- A case of thrombosis of the straight sinus and the left transverse sinus in an 11 year old boy is described. The patient had a history of slight trauma followed by infection of the upper airways and presented with severe impressive and expressive dysphasia and stupor.He was treated with in situ fibrinolysis. Despite successful local fibrinolysis and thrombectomy with a balloon catheter the patient rethrombosed his left transverse sinus several times and had a late thrombosis of his jugular vein.Nevertheless, flow in the left sigmoid sinus was facilitated and focal brain oedema was significantly reduced.Serum levels of antibodies against cardiolipins, associated with venous thrombosis, were elevated and interfered with reagents used for measuring the activated partial tromboplastin time, causing it to be falsely prolonged with subsequent underdosage of heparin. He was treated with oral anticoagulants for one year after the episode and recovered completely.
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| 4. |
- Söderman, M, et al.
(författare)
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Otorrhagia from the "aberrant internal carotid" artery in the middle ear. Surgical and endovascular aspects
- 1997
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Ingår i: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. - : SAGE Publications. - 1591-0199. ; 3:3, s. 231-8
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Tidskriftsartikel (refereegranskat)abstract
- Agenesis of the cervical portion of the internal carotid artery (ICA) may result in blood supply to the ipsilateral cerebral hemisphere being provided by an enlarged inferior tympanic branch of the ascending pharyngeal artery. This enlarged vessel, passing through Jacobson's canal and anastomosing with the likewise enlarged caroticotympanic branch of the ICA in front of the promontorium, may simulate a middle ear mass. We present five patients with this unusual anatomical variant, three of which underwent biopsy of what was believed to be a middle ear tumour. One patient experienced rupture of an arterial aneurysm in the middle ear successfully treated with endovascular application of detachable platinum coils. It is mandatory for ENT-surgeons and radiologists who perform head-and-neck examinations to recognize this anatomical variant, not mistaking it for a tumour, since biopsy of a large artery supplying the brain may have disastrous consequences. In patients with otorrhagia, an arterial aneurysm must be considered as a possible source of bleeding, in some cases amenable for treatment with an endovascular technique. The diagnosis of “aberrant internal carotid artery” is usually made with CT of the temporal bone or MR of the skull base. Cerebral angiography is in most cases not necessary, unless an endovascular procedure is planned.
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