著者

Hideo Ishikawa Yu Yamaguchi Takashi Nishihara Naoki Omachi Misaki Ryuge Kazushi Kitaguchi Tomoaki Hattori

出版者

The Japan Society for Respiratory Endoscopy

雑誌

Respiratory Endoscopy (ISSN:27583813)

巻号頁・発行日

vol.1, no.2, pp.28-41, 2023-11-29 (Released:2023-11-29)

参考文献数

44

被引用文献数

2

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Hemoptysis is a symptom with a high mortality rate. The in-hospital mortality rate of hospitalized patients with hemoptysis is 5%-9%. Bronchial artery embolization was formerly positioned as an emergency treatment for massive hemoptysis. Nowadays, it has become a standard treatment for elective treatment for chronic recurrent hemoptysis. Despite the high mortality rate, only 2%-8% of hospitalized patients with hemoptysis underwent Bronchial Artery Embolization (BAE). One possible reason is the concern about spinal cord infarction, followed by the shortage of operators specializing in BAE.The incidence rate of spinal cord infarction was 0.18%, 0.71%, and 0.06% for gelatin sponge, n-butyl-2-cyanoacrylate (NBCA), and coil, respectively, in a nationwide observational study in JAPAN. CIRSE (Cardiovascular and Interventional Radiological Society of Europe) guideline states that BAE by the coil is relatively safe and spinal-protective based on this study.BAE is primarily performed by radiologists and is a unique intervention targeting various arteries throughout the thorax, often smaller than 2 mm and, in some cases, less than 1 mm. The authors believe that it is essential to increase the number of pulmonologists subspecializing in BAE, like cardiologists and neurosurgeons who perform catheter treatment in their field.This paper aims to provide a technical and practical Expert Review of BAE by coil for pulmonologists based on our experience at a high-volume center managed by pulmonologists. The authors will also discuss a general narrative review on classifications of hemoptysis and BAE because we are concerned about the extreme international inconsistency in classifying and defining hemoptysis-related matters and will propose some challenging suggestions depending on our experience to rectify this situation.

著者

Shota Kondo Yuko Nakamura Toru Higaki Takashi Nishihara Masahiro Takizawa Toru Shirai Motoshi Fujimori Yoshitaka Bito Keigo Narita Takahiro Sueoka Yukiko Honda Chihiro Tani Kazuo Awai

出版者

Japanese Society for Magnetic Resonance in Medicine

雑誌

Magnetic Resonance in Medical Sciences (ISSN:13473182)

巻号頁・発行日

pp.mp.2022-0041, (Released:2022-06-01)

参考文献数

26

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Purpose: The wavelet denoising with geometry factor weighting (g-denoising) method can reduce the image noise by adapting to spatially varying noise levels induced by parallel imaging. The aim of this study was to investigate the clinical applicability of g-denoising on hepatobiliary-phase (HBP) images with gadoxetic acid.Methods: We subjected 53 patients suspected of harboring hepatic neoplastic lesions to gadoxetic acid-enhanced HBP imaging with and without g-denoising (g+HBP and g–HBP). The matrix size was reduced for g+HBP images to avoid prolonging the scanning time. Two radiologists calculated the SNR, the portal vein-, and paraspinal muscle contrast-to-noise ratio (CNR) relative to the hepatic parenchyma (liver-to-portal vein- and liver-to-muscle CNR). Two other radiologists independently graded the sharpness of the liver edge, the visibility of intrahepatic vessels, the image noise, the homogeneity of liver parenchyma, and the overall image quality using a 5-point scale. Differences between g–HBP and g+HBP images were determined with the two-sided Wilcoxon signed-rank test.Results: The liver-to-portal- and liver-to-muscle CNR and the SNR were significantly higher on g+HBP- than g–HBP images (P < 0.01), as was the qualitative score for the image noise, homogeneity of liver parenchyma, and overall image quality (P < 0.01). Although there were no significant differences in the scores for the sharpness of the liver edge or the score assigned for the visibility of intrahepatic vessels (P = 0.05, 0.43), with g+HBP the score was lower in three patients for the sharpness of the liver edge and in six patients for the visibility of intrahepatic vessels.Conclusion: At gadoxetic acid-enhanced HBP imaging, g-denoising yielded a better image quality than conventional HBP imaging although the anatomic details may be degraded.