Point of Care Thyroid Ultrasound (POCUS) in Endocrine Outpatients: A Pilot Study.

Background: Thyroid ultrasound is used for the assessment and characterisation of thyroid nodules/goitres and to guide diagnostic biopsy, it is normally performed by radiologists. Point of care ultrasound (POCUS) by trained non-radiologists, has the potential to reduce cost, expedite diagnosis and enhance patient satisfaction if embedded in an outpatient clinic setting.

Aim: To perform a pilot of the use of point of care thyroid ultrasound in an endocrine outpatient setting for the assessment of thyroid nodules and goitres.

Kommerell's diverticulum, risk factor for aortic dissection.

A 54-year-old man presented with sharp chest pain and hypertension. He was treated with intravenous antihypertensive with good control of the blood pressure. Chest X-ray showed widened mediastinum, and subsequent computed tomography scan of the chest demonstrated dissection of the descending thoracic aorta.

Full-length radiographs of the femur in patients with a femoral neck fracture and co-existent malignancy--are they of benefit?

It is recommended that full-length femoral radiographs should be obtained in patients presenting with a femoral neck fracture and a co-existent history of malignancy. Over a two-year period, we identified 133 (47 males, 86 females) patients admitted with a femoral neck fracture and a co-existent history of malignant disease, representing 6.5% of all femoral neck fractures admitted within this time frame.

Effect of suprarenal fixation of aortic stent-grafts on the renal artery ostia: assessment of morphological changes by virtual intravascular endoscopy.

Purpose: To investigate the morphological effects of suprarenal fixation of aortic stent-grafts on the renal artery ostia (RaO) by analysis of suprarenal stent wire distribution and vascular calcification across the RaO using virtual intravascular endoscopy (VIE).

Methods: Fourteen consecutive patients (11 men; mean age 75 years) from a single institution were studied following endovascular aortic aneurysm repair (EVAR) using the Zenith endograft system from September 1999 to March 2002. Imaging assessment included computed tomographic (CT) measurement of renal artery intraluminal ostial diameter and quantification and analysis of uncovered stent struts across the RaO and radiological determination of RaO calcification.

Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair.

Objective: The purpose of this report is to discuss the incidence, diagnosis, and management of stent graft infections after endovascular aneurysm repair (EVAR).

Methods: Data were collected from the hospital database and medical case notes for all patients with infected endografts after elective or emergency EVAR for abdominal aortic aneurysm (AAA) during the last 8 years in two university teaching hospitals in Northern Ireland. The data included the patient's age, gender, presentation of sepsis, treatment offered, and the ultimate outcome.

Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.

Objective: The effect of suprarenal stent fixation during endovascular aortic aneurysm repair (EVAR) on renal function remains unclear. A unique validated three-dimensional intraluminal imaging technique was used to analyze the effect of suprarenal stent position relative to renal artery orifices. Also analyzed was its medium-term to long-term effects on renal function.

Sustained improvement in vision in a recurrent growth hormone secreting macroadenoma during treatment with octreotide in the absence of marked tumour shrinkage.

Visual improvement following octreotide for growth hormone secreting pituitary macroadenomas is uncommon without tumour shrinkage. A 45-year old lady presented with blurred vision for 12 months. Visual assessment revealed a bitemporal hemianopia and CT scan demonstrated a large pituitary tumour with lateral and suprasellar extension.

Assessment of VIE image quality using helical CT angiography: in vitro phantom study.

The aim of this study is to quantify the effects of helical CT acquisitions parameters on the magnitude of three-dimensional stair-step artefacts, visualization of renal ostium and morphologies of suprarenal stents observed using virtual intravascular endoscopy. This was performed in a phantom of the human abdominal aorta with a stent graft in situ. Stair-step artefacts were quantified by measuring the standard deviation of signal intensity on surface shaded images and the influence of these artefacts on the visualization of arterial ostia and stent morphologies were assessed by three radiologists.

The use of direct thrombin injection to treat a type II endoleak following endovascular repair of abdominal aortic aneurysm.

This report describes the use of thrombin to treat a type II endoleak which was causing continued abdominal aortic aneurysm expansion in a patient who had undergone endovascular repair. A small quantity of thrombin was injected into the leak by a percutaneous approach directly into the aneurysm sac using color doppler ultrasound. The procedure was successful and required only a few minutes to perform.

Diagnostic value of CT virtual intravascular endoscopy in aortic stent-grafting.

Purpose: To investigate the diagnostic value of postprocessing techniques for 3-dimensional (3D) computed tomography (CT), with emphasis on CT virtual intravascular endoscopy (VIE), in patients with abdominal aortic aneurysms (AAA) treated with suprarenal stent-grafts.

Methods: The preprocedural and postprocedural CT datasets from 47 AAA patients (40 men; mean age 75 years, range 61-87) undergoing aortic stent-grafting with suprarenal fixation were examined. The CT datasets were processed to create various 3D reconstructions: shaded surface display (SSD), maximum intensity projection (MIP), and VIE.

Successful exclusion of a high internal carotid pseudoaneurysm using the Wallgraft endoprosthesis.

A 43-year-old woman presented with a several-month history of transient ischemic attacks 7 years following surgery for a malignant carotid body tumor. Angiography revealed a pseudoaneurysm at the distal vein graft anastomosis and a stenosis related to the proximal anastomosis. Due to the extensive previous surgery an endovascular approach was advocated and the pseudoaneurysm was successfully excluded using a covered stent (Wallgraft).