Purpose:To investigate wall shear rates in vivo in the common carotid, brachial, and superficial femoral arteries using very high resolution magnetic resonance imaging (MRI) phase contrast measurements.
Materials and Methods:Mean, maximum, and minimum wall shear rate and an oscillatory shear index were measured for 20 volunteers, aged 23.3 Ϯ 1.9 years, in the three arteries, using phase contrast imaging with 0.0625 mm 2 resolution and three-dimensional paraboloid fitting.
Results:The superficial femoral artery had the lowest mean (130.3 Ϯ 13.1 second Ϫ1 ), maximum (735.8 Ϯ 32.4 second Ϫ1 ), and minimum (-224.5 Ϯ 17.0 second Ϫ1 ) wall shear rate, as well as the highest oscillatory shear index (0.21 Ϯ 0.02). All values were significantly different (P Ͻ 0.05) from both the brachial artery and the common carotid artery values. The highest mean (333.3 Ϯ 13.6 second Ϫ1 ) and minimum (117.9 Ϯ 24.5 second Ϫ1 ) wall shear rates and the lowest oscillatory shear index (0 Ϯ 0) were found in the common carotid artery.
Conclusion:It is possible to measure wall shear rate in vivo in different arteries using MRI with very high resolution. The findings exhibit the in vivo environment of wall shear rates and suggest a nonuniform distribution of wall shear rates throughout the arterial system.
Rationale:
Castleman disease (CD) is a rare lymphoproliferative disease with a poorly understood etiology. The occurrence of CD in the abdominal cavity is very rare, especially in the retroperitoneal peripancreatic region.
Patient concerns:
A 33-year-old woman was referred to our department on March 1, 2018 for a detailed physical examination due to retroperitoneal peripancreatic lymph node enlargement over 15 days.
Diagnosis:
Enhanced magnetic resonance imaging of the epigastrium showed the mass with abundant blood supply is located between the liver and the stomach in the upper margin of the pancreas. Postoperative pathological examination revealed CD, type of unicentric Castleman disease.
Interventions:
We performed an open surgery on this patient and completely removed the mass. There was no postoperative radiochemotherapy.
Outcomes:
The patient was followed-up for more than 12 months after the operation and showed good recovery.
Lessons:
CD is a rare disorder that is hard to diagnose early and complete resection of the tumor is still the most effective treatment.
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