Publications by authors named "Catharina S P van Rijswijk"

4 Publications

  • Page 1 of 1

Assessing the value of volume navigation during ultrasound-guided radiofrequency- and microwave-ablations of liver lesions.

Eur J Radiol Open 2021 8;8:100367. Epub 2021 Jul 8.

Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands.

Purpose: The goal of our study was to determine the influence of ultrasound (US)-coupled volume navigation on the use of computed tomography (CT) during minimally-invasive radiofrequency and microwave ablation procedures of liver lesions.

Method: Twenty-five patients with 40 liver lesions of different histological origin were retrospectively analysed. Lesions were ablated following standard protocol, using 1) conventional US-guidance, 2) manual registered volume navigation (VNav), 3) automatic registered (VNav) or 4) CT-guidance. In case of ultrasonographically inconspicuous lesions, conventional US-guidance was abandoned and VNav was used. If VNav was also unsuccessful, the procedure was either continued with VNav or CT-guidance. The number, size and location of the lesions targeted using the different approaches were documented.

Results: Of the 40 lesions, sixteen (40.0 %) could be targeted with conventional US-guidance only, sixteen (40.0 %) with VNav, three (7.5 %) with VNav and five (12.5 %) only through the use of CT-guidance. Of the three alternatives (VNav, VNav and CT only) the mean size of the lesions targeted using VNav (9.1 ± 4.6 mm) was significantly smaller from those targeted using US-guidance only (20.4 ± 9.4 mm; p < 0.001). The location of the lesions did not influence the selection of the modality used to guide the ablation.

Conclusions: In our cohort, VNav allowed the ablation procedure to become less dependent on the use of CT. VNav supported the ablation of lesions smaller than those that could be ablated with US only and doubled the application of minimally-invasive US-guided ablations.
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July 2021

Measuring CMAPs in addition to MEPs can distinguish peripheral ischemia from spinal cord ischemia during endovascular aortic repair.

Clin Neurophysiol Pract 2021 11;6:16-21. Epub 2020 Dec 11.

Department of Neurology, Leiden University Medical Center, the Netherlands.

Objective: Spinal cord injury is a devastating complication after endovascular thoracic and thoracoabdominal aneurysm repair (EVAR). Motor evoked potentials (MEPs) can be monitored to detect spinal cord injury, but may also be affected by peripheral ischemia caused by femoral artery sheaths. We aimed to determine the incidence of peripheral ischemia during EVAR, and whether central and peripheral ischemia can be distinguished using compound muscle action potentials (CMAPs).

Methods: We retrospectively analyzed all EVAR procedures between March 1st 2015 and January 1st 2020 during which MEPs were monitored. Peripheral ischemia was defined as both a reduction in MEP amplitudes reversed by removing the femoral sheaths and no clinical signs of immediate post-procedural paraparesis. All other MEP decreases were defined as central ischemia.

Results: A significant MEP decrease occurred in 14/27 (52%) of all procedures. Simultaneous CMAP amplitude reduction was observed in 7/8 (88%) of procedures where peripheral ischemia occurred, and never in procedures with central ischemia.

Conclusions: MEP reductions due to peripheral ischemia are common during EVAR. A MEP-reduction without a CMAP decrease indicates central ischemia.

Significance: CMAP measurements can help to distinguish central from peripheral ischemia, potentially reducing the chance of misinterpreting of MEP amplitude declines as centrally mediated, without affecting sensitivity.
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December 2020

Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection.

Case Rep Med 2017 6;2017:8140641. Epub 2017 Mar 6.

Department of Nephrology, Leiden University Medical Center, Leiden, Netherlands.

The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy. Considering AAT deficiency in these cases might lead to a more timely diagnosis.
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March 2017

Soft-tissue tumors: value of static and dynamic gadopentetate dimeglumine-enhanced MR imaging in prediction of malignancy.

Radiology 2004 Nov 30;233(2):493-502. Epub 2004 Sep 30.

Department of Radiology, Leiden University Medical Center, Bldg C3-Q, 2300 RC Leiden, the Netherlands.

Purpose: To prospectively evaluate static and dynamic gadopentetate dimeglumine-enhanced magnetic resonance (MR) imaging relative to nonenhanced MR imaging in differentiation of benign from malignant soft-tissue lesions and to evaluate which MR imaging parameters are most predictive of malignancy, with associated interobserver variability.

Materials And Methods: One hundred forty consecutive patients (78 male patients [median age, 51 years], 62 female patients [median age, 53 years]) with a soft-tissue mass underwent nonenhanced static and dynamic contrast material-enhanced MR imaging. Diagnosis was based on histologic findings in surgical specimens (86 of 140), findings at core-needle biopsy (43 of 140), or results of all imaging procedures with clinical follow-up (11 of 140). Multivariate logistic regression analysis was used to identify the best combination of MR imaging parameters that might be predictive of malignancy. Subjective overall performance of two observers was evaluated with receiver operating characteristic analysis.

Results: For subjective overall diagnosis, area under the receiver operating characteristic curve, a measure for diagnostic accuracy, was significantly larger for combined nonenhanced and contrast-enhanced MR imaging than it was for nonenhanced MR imaging alone, with no significant difference between observers. Multivariate analysis of all lesions revealed that combined nonenhanced static and dynamic contrast-enhanced MR imaging parameters were significantly superior to nonenhanced MR imaging parameters alone and to nonenhanced MR imaging parameters combined with static contrast-enhanced MR imaging parameters in prediction of malignancy. The most discriminating parameters were presence of liquefaction, start of dynamic enhancement (time interval between start of arterial and tumor enhancement), and lesion size (diameter). Results for extremity lesions were the same, with one exception: With dynamic contrast-enhanced MR imaging parameters, diagnostic performance of one observer did not improve.

Conclusion: Static and dynamic contrast-enhanced MR imaging, when added to nonenhanced MR imaging, improved differentiation between benign and malignant soft-tissue lesions.
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November 2004