SPONTANEOUS DISSECTION OF THE INTERNAL CAROTID ARTERY: COMBINED USE OF ULTRASOUND AND CT ANGIOGRAPHY

 

Grigoreva E.V., Nosova A.G., Dalibaldyan V.A., Krylov V.V.

Purpose. To demonstrate the capabilities of MSCT in the diagnosis of recurrent osteosarcoma of the lower jaw after surgical treatment – resection of the lower jaw and the installation of a reconstructive plate; to show the value of MSCT in the choice of the further surgical treatment.

Materials and methods. A clinical observation of a 65-year-old female patient with complaints of prolonged pain and swelling in the left side of the face and neck is presented. In order to detect changes in the lower jaw, the oncologist sent the patient to MSCT examination of the facial skeleton with intravenous contrast.

Results. During MSCT of the facial skeleton, the patient was diagnosed with CT-signs of soft tissues mass of the middle and lower zones of the face, neck on the left, bone-destructive changes in the lateral wall of the left maxillary sinus, and the alveolar process of the upper jaw on the left.

Conclusion. MSCT allows to get basic diagnostic information about the state of the maxillofacial region in a patient with a recurrence of osteosarcoma and choose the most optimal management and surgical treatment in the future.

 

A.I. Evdokimov University Clinic of Moscow State University of Medicine and Dentistry.

 

Moscow, Russia.

Keywords: dissection, CT angiography, duplex scanning, brachiocephalic arteries, neuroradiology.


Corresponding author: Grigoreva E.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript .

For citation: Grigoreva E.V., Nosova A.G., Dalibaldyan V.A., Krylov V.V. Spontaneous dissection of the internal carotid artery: combined use of ultrasound and СТ angiography. REJR 2020; 10(2):244-251. DOI:10.21569/2222-7415-2020-10-2-244-251.

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Received:       13.04.20 Accepted:     19.06.20

Exploring the possibilities of Ultrasonic Shear Wave Elastography (SWE) in controlling the formation of bone calluses at different stages of its development.

Material and methods. A study of 51 patients (29 men, 22 women from 17 to 65 years) with fractures of long tubular bones of the upper and lower limbs was conducted. Ultrasound tests were performed on the SuperSonic Aixplorer (France) device with an assessment of tissue stiffness in the kPa and the use of multifrequency probes 2-15 MHz. In the area of the fracture scanned bone corn, surrounding soft tissues and vessels, excluded interposition. The formation of bone calluses was studied at different stages of its development, from 0-7 days to 6 months.

Results. According to the SWE, the most intensive increase in bone calluses is in the first 1.5 months after the fracture, followed by the build-up of bone calluses. For each stage of bone callos formation determined sensitivity, specificity of the method of SWE.

Discussion. The use of the SWE method to control the formation of bone calluses is possible from the first days after bone fracture. The stiffness of bone calluses at SWE is determined in the kPa. Ultrasound also allows you to study the condition of bone fragments, surrounding tissues and vessels. Conducting ultrasound with the use of SWE, dopplerography allows in dynamics to trace the formation of bone calluses in all three stages of its development.

Conclusion. SWE wave allows to determine the stiffness of the bone calluses in the dynamics, starting from the first days after the fracture and to its complete formation. SWE implements a new approach to assess the stiffness of bone calluses, which allows to get accurate quantitative results in real time. The sensitivity and specificity of the SWE in determining the stiffness of bone calluses is highest in the first – connective tissue stage of its formation (94% and 90% respectively).