Introduction: Stenoses in the path of arteriovenous fistulas (AVF) for hemodialysis are a very prevalent problem and there is long experience in their treatment by percutaneous angioplasty (PTA). These procedures, however, involve non-negligible equipment requirements, exposure to radiation and intravenous contrast that are not beneficial for the patient and make their performance more complex. This study reviews our initial experience with Doppler ultrasound-guided angioplasty. Methods: Prospective cohort of patients with native AVF dysfunction due to significant venous stenosis treated by Doppler echo-guided PTA. AVF puncture, lesion catheterization, balloon localization and inflation, and outcome verification were performed under ultrasound guidance. Only one fistulography was performed before and another one after dilatation. As a control, the cases performed during the same period by the usual angiographic method were also collected. Results: Between February 2015 and September 2018, 51 PTAs were performed on native AVF, of which 27 were echogenic (mean age, 65.3 years; 63% male). The technical success rate was 96%. In 26% of cases, PTA was repeated due to residual stenosis after angiographic imaging. There were 7.3% periprocedural complications. 92% of the AVFs were punctured at 24 hours. Primary patency at 1 month, 6 months and 1 year was 100%, 64.8% and 43.6%, and assisted patency was 100%, 87.2% and 74.8%. There were no significant differences in immediate or late results with respect to angiographically guided AVF angioplasty. Conclusions: AVF-PTA can be performed safely and effectively guided by Doppler ultrasound, which simplifies the logistics required for its performance, although we still need to improve the capacity for early verification of the result with this imaging technique.

Imaging technology plays a key role in guiding endovascular treatment of aortic aneurysm, especially in the complex thoracoabdominal aorta. The combination of high quality images with a sterile and functional environment in the surgical suite can reduce contrast and radiation exposure for both patient and operator, in addition to better outcomes. This presentation aims to describe the current use of this technique, combining angiotomography and intraoperative cone beam computed tomography, image “fusion” and intravascular ultrasound, to guide procedures and thus improve the intraoperative success rate and reduce the need for reoperation. On the other hand, a procedure is described to create customized 3D templates with the high-definition images of the patient’s arterial anatomy, which serve as specific guides for making fenestrated stents in the operating room. These customized fenestration templates could expand the number of patients with complex aneurysms treated minimally invasively.

Based on the characteristics of liquid lens sparse aperture imaging, a radiative multiplet array structure is proposed; a simplified model of sparse aperture imaging is given, and the analytical expression of the modulation transfer function is derived from the optical pupil function of the multiplet array structure; the specific distribution form of this multiplet array structure is given, and the structure parameters are approximated by the dimensionless method; the two types of radiative multiplet array structures are discussed, and the filling factor, redundancy, modulation transfer function and other characteristic parameters are calculated. The physical phenomena exhibited by the parametric scan are discussed, and the structural features and imaging characteristics of these two arrays are compared. The results show that the type-II structure with larger actual equivalent aperture and actual cutoff frequency and lower redundancy is selected when the average modulation transfer function and the IF characteristics of the modulation transfer function of the two structures are close to each other; the type-II structure has certain advantages in imaging; the conclusion is suitable for arbitrary enclosing circle size because the liquid lens-based multiplet array structure adopts dimensionless approximation parameters; compared with the composite toroidal structure, the radiative multiplet mirror structure has a larger actual cut-off frequency and actual equivalent aperture when the filling factor is the same.

Objective: to determine the diagnostic performance of magnetic resonance hysterosalpingography (HSG-MRI), using laparoscopy as the reference method. Materials and methods: 22 patients were included. All underwent HSG-MRI with a 1.5 Tesla resonator and then laparoscopy with chromotubation. Two radiologists examined the MRIs, determining tubal patency by consensus. Descriptive and diagnostic performance analyses were performed. Results: HSG-MRI had a success rate of 91%. Study duration was 49 ± 15 minutes, volume injected 26 ± 16 cm³ and pain scale 30 ± 19 out of 100. Sensitivity and specificity of HSG-MRI were 100% for global and left Cotte test, and 25% and 93.3% for right Cotte test, respectively. There were 2 minor complications and no major complications. Discussion: our initial results demonstrated high sensitivity and specificity. Although other studies analyzed the ability of HSG-MRI to assess tubal patency with good results, the use of a flawed reference standard left room for reasonable doubt, preventing a recommendation based on solid evidence. However, when comparing our results with those published, we observed a high degree of concordance insofar as the positive effusion is correctly diagnosed with a specificity of 100% or with a percentage close to this figure.

The possibility of preoperative prediction of pathologic complete response in rectal cancer has been studied in order to identify patients who would respond to neoadjuvant therapy and to individualize therapeutic strategies. Endoscopic ultrasound of the rectum is an accurate method for the evaluation of local tumor and lymph node invasion. Objective: To evaluate the potential of endoscopic ultrasound as a predictor of complete pathological response to neoadjuvant treatment in patients with locally advanced rectal cancer. Material and methods: Retrospective study of patients with rectal cancer from January 2014 to December 2016. Results: We obtained a statistical association between T stage by endoscopic ultrasound and complete pathological response (p = 0.015). It is not so for N, sphincter involvement, circumferential involvement and maximum tumor thickness (p = 0.723, p = 0.510, p = 0.233 and p = 0.114, respectively). When multivariate logistic regression analysis was applied to assess the degree of influence of the predictor variables on pathologic response, none of these variables was associated with complete pathologic response. Conclusion: Prediction of pathologic complete response in rectal cancer has been considered as the crucial point upon which treatments for rectal cancer could be individualized. So far, no imaging method has been able to demonstrate efficacy in predicting complete pathologic response, and in turn there is no direct association between any endosonographic finding that can accurately predict it.

Introduction: It is universally accepted that the posteroanterior skull radiograph shows a lower degree of distortion than other radiographic images, so that measurements on it are considered reliable. Objective: To determine the percentage of distortion in the different facial regions of the postero-anterior skull radiograph. Methods: Thirty human skulls with their jaws were divided by three horizontal and four vertical planes into fifteen quadrants; there were ten in the skull and five in the jaw. On each of them a steel wire was placed in vertical and horizontal positions and their length (actual measurement) was measured. Each set was X-rayed in posteroanterior projection and the length of the wires was measured in the image (radiographic measurement). Results: It was not possible to measure in the lateral quadrants of the skull. The horizontal measurement in the right and left lower intermediate quadrants of the skull and in the intermediate and lateral quadrants of both sides of the mandible is not reliable; in the median quadrant of the mandible it is minimized; in the right and left upper intermediate and median quadrants of the skull and in the median of the mandible it is magnified. Vertical measurements in all quadrants are reliable; in the right and left upper intermediate and left upper and middle quadrants of the skull and in the right and left middle and lateral quadrants of the mandible it is magnified; in the lower intermediate and upper and lower middle quadrants of the skull and median of the mandible it is minimized. The least distortion for both measurements occurs in the upper median quadrant of the skull. Percentages of distortion are reported for each quadrant. Conclusions: Distortion is present in the posteroanterior skull radiograph and varies from one region of the face to another.