Department of Neurology, The Jikei University School of Medicine, Japan.
Department of Diagnostic Radiology, The Jikei University School of Medicine, Japan.
Intern Med. 2020 Aug 1;59(15):1883-1885. doi: 10.2169/internalmedicine.3788-19. Epub 2020 Apr 23.
An 81-year-old woman presented to our emergency room by ambulance with gait disturbance and pain in her left neck. Magnetic resonance imaging (MRI) showed acute left-sided dorsolateral medullary infarction and an occluded left vertebral artery. The temporal bone echo window was insufficient, but our pastable soft ultrasound probe attached to the cervix (PSUP) detected many microembolic signals caused by the contrast agent (cMES) in the common carotid artery. Chest CT revealed right pulmonary arteriovenous fistula (PAVF) and she underwent coil embolization for PAVF considering the possibility of paradoxical embolism via PAVF. After embolization, the cMES disappeared on PSUP. Therefore, PSUP was useful for diagnosing and confirming the interventional procedural success for performing PAVF.
一位 81 岁女性因行走障碍和左侧颈部疼痛，由救护车送往我院急诊。磁共振成像（MRI）显示左侧背外侧延髓急性梗死和左侧椎动脉闭塞。颞骨超声窗不足，但我们的颈旁软探头（PSUP）检测到颈总动脉内对比剂引起的许多微栓子信号（cMES）。胸部 CT 显示右侧肺动静脉瘘（PAVF），考虑到经 PAVF 发生矛盾栓塞的可能性，对患者进行了 coil 栓塞治疗 PAVF。栓塞后，PSUP 上的 cMES 消失。因此，PSUP 可用于诊断和确认 PAVF 介入治疗的成功。
