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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
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Description
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
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Induction of Cerebral Arterial Gas Embolism in Rat
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Cerebral air embolism: acute imaging.

K L Weiss1, K J Macura, A Ahmed

  • 1Department of Radiology, The Medical College of Georgia, Augusta, GA, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 27, 2007
PubMed
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Computed tomography (CT) and magnetic resonance imaging (MRI) can detect iatrogenic cerebral air embolism. Diffusion-weighted MRI is particularly effective for identifying acute infarctions caused by air embolism, complementing CT findings.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Iatrogenic cerebral air embolism is a rare but serious complication.
  • Accurate and timely diagnosis is crucial for patient outcomes.
  • Conventional imaging techniques may have limitations in detecting early ischemic changes.

Purpose of the Study:

  • To evaluate the utility of computed tomography (CT) and magnetic resonance imaging (MRI) in the acute diagnosis of iatrogenic cerebral air embolism.
  • To compare the effectiveness of different MRI sequences, including diffusion-weighted imaging (DWI), in detecting cerebral infarction secondary to air embolism.

Main Methods:

  • A case of iatrogenic cerebral air embolism following right subclavian vein recatheterization was studied.
  • Acute imaging was performed using computed tomography (CT) and various magnetic resonance imaging (MRI) sequences.
  • Diffusion-weighted imaging (DWI), T2-weighted fluid-attenuated inversion recovery (FLAIR), and turbo gradient spin echo (TGSE) sequences were utilized.

Main Results:

  • CT demonstrated intravascular air but with potentially misleading attenuation values.
  • Diffusion-weighted MRI (DWI) clearly identified hyperintense acute infarctions in the affected vascular territories 8.5 hours postprocedure.
  • T2-weighted FLAIR and TGSE MRI sequences did not reveal these acute ischemic changes.

Conclusions:

  • The combination of CT and diffusion-weighted MRI (DWI) is considered ideal for the acute evaluation of suspected cerebral air embolism.
  • DWI is a sensitive technique for detecting early ischemic changes in cerebral air embolism, offering advantages over conventional T2-weighted sequences.