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Papers by vaiva dabravolskaite

PLOS ONE, Jul 6, 2016

To prospectively compare the diagnostic performance and the visualization of the upper urinary tr... more To prospectively compare the diagnostic performance and the visualization of the upper urinary tract (UUT) using a comprehensive 3.0T-magnetic resonance urography (MRU) protocol versus triple-phase computed tomography urography (CTU). During the study period (January-2014 through December-2015), all consecutive patients in our tertiary university hospital scheduled by a urologist for CTU to exclude UUT malignancy were invited to participate. Diagnostic performance and visualization scores of 3.0T-MRU were compared to CTU using Wilcoxon matched-pairs test. Twenty patients (39 UUT excreting units) were evaluated. 3.0T-MRU and CTU achieved equal diagnostic performances. The benign etiology of seven UUT obstructions was clarified equally with both methods. Another two urinary tract malignant tumors and one benign extraurinary tumor were detected and confirmed. Diagnostic visualization was slightly better in the intrarenal cavity areas with CTU but worsened towards distal ureter. MRU showed consistently slightly better visualization of the ureter. In the comparison, full 100% visualizations were detected in all areas in 93.6% (with 3.0T-MRU) and 87.2% (with CTU) and >75% visualization in 100% (3.0T-MRU) and 93.6% (CTU). Mean CTU effective radiation dose was 9.2 mSv.

The hydration protocol incorporated into the computed tomography resulted in better dila... more The hydration protocol incorporated into the computed tomography resulted in better dilatation of the renal cavities as seen in image A (axial CT) compared to magnetic resonance excretory urography (MRU, image B), but occasionally at the expense of a contrast layering effect (Area between arrows). A susceptibility artefact due to the presence of a metallic sterilization clip in the MRU (image C, arrow) results in a void signal area. The clip produced no artefacts at CT (image D, thick arrow) and thin arrows show the position of distal ureters. The artefact at MRU impaired the visibility of a short ureteral segment as seen in the volume reconstruction MRU image E (arrow).</p

Diameter measurement of the renal pelvis and ureter.</p

Percentage visualization of the upper urinary tract.</p

Visualization scores.</p

Three-dimensional Volume Rendering reconstruction of the urinary tract against a faded b... more Three-dimensional Volume Rendering reconstruction of the urinary tract against a faded background from the images obtained with CT urography (A) and MR urography (B) excretory phases.MR urography achieved a comparable diagnostic performance.</p

Flow chart of study patients, indications for imaging and results as determined by clini... more Flow chart of study patients, indications for imaging and results as determined by clinical evaluation, the results of imaging studies and the final histopathological diagnosis. (UC = Urothelial carcinoma; RCC = Renal Cell Carcinoma).</p

A 78 year old female patient presented with macroscopic hematuria. Axial contrast enhanc... more A 78 year old female patient presented with macroscopic hematuria. Axial contrast enhanced MRI (A) and CT (B) images at the level of the right renal pelvis showed an enhancing intraluminal mass (arrows) with no tumor extension outside the renal pelvis wall. A tumorous filling defect was also well visualized in the excretory phase MRU (C) and CTU (D) images and the presence of a small synchronous tumor on the opposite wall (arrowheads) was better recognized in the excretory phase images. The tumor filled the renal pelvic cavity (E, Arrow) resulting in subtotal occlusion with associated intrarenal-cavity dilatation as visualized on a postero-anterior three-dimensional volume rendering MRU. The tumor area showed restricted diffusion as estimated via the diffusion weighted imaging (F; b = 800; Arrow) with ADC values of 0.78 × 10−3 mm2/s (not shown). Final histopathology revealed a grade 2 pT1 urothelial carcinoma.</p

Magnetic Resonance (MR) and Computed Tomography (CT) Urography Imaging protocols.</p

MR urography maximum intensity projections at 5 min (A), 10 min (B) and 15 min intervals... more MR urography maximum intensity projections at 5 min (A), 10 min (B) and 15 min intervals after the administration of contrast show no difference in visualization of the upper urinary tract (UUT) at MR-combined different time intervals. Different segments can be better visualized at different time intervals therefore improving the overall UUT visibility and provided comparable performance with CT urography (D, volume rendering reconstruction).</p

BMC cancer, Nov 2, 2016

To investigate whether very low mammographic breast density (VLD), HER2, and hormone receptor sta... more To investigate whether very low mammographic breast density (VLD), HER2, and hormone receptor status holds any prognostic significance within the different prognostic categories of the widely used Nottingham Prognostic Index (NPI). We also aimed to see whether these factors could be incorporated into the NPI in an effort to enhance its performance. This study included 270 patients with newly diagnosed invasive breast cancer. Patients with mammographic breast density of <10 % were considered as VLD. In this study, we compared the performance of NPI with and without VLD, HER2, ER and PR. Cox multivariate analysis, time-dependent receiver operating characteristic curve (tdROC), concordance index (c-index) and prediction error (0.632+ bootstrap estimator) were used to derive an updated version of NPI. Both mammographic breast density (VLD) (p < 0.001) and HER2 status (p = 0.049) had a clinically significant effect on the disease free survival of patients in the intermediate and hi...

PLOS ONE, 2016

European Heart Journal - Case Reports, Dec 27, 2022

Journal of clinical medicine, Feb 29, 2024

European Heart Journal - Case Reports

Background Coronary subclavian steal syndrome (CSSS) is an often easily overlooked cause of angin... more Background Coronary subclavian steal syndrome (CSSS) is an often easily overlooked cause of angina that may occur after a coronary artery bypass graft (CABG) procedure. The onset of CSSS several years after coronary revascularization has been described in case reports, and in the few retrospective reviews that compare the endovascular approach with surgical treatment. Subclavian stenosis can naturally coincide with coronary artery disease and may already be present during the initial CABG. Case summary A 59-year-old male with a history of three-vessel disease who had a left internal mammary artery (LIMA) bypass graft, exhibited a gradual worsening of angina that coincided with numbness and impaired function of the left fingers, hand, and arm. Myocardial perfusion imaging showed reversible ischaemia, and coronary angiography suggested a thrombotic lesion proximal to the LIMA ostium. Calcified and partially thrombosed proximal left subclavian artery (LSA) aneurysm was visualized using...

Clinical Interventions in Aging

The aim of the present study was to describe and analyze changes in the incidences of lower extre... more The aim of the present study was to describe and analyze changes in the incidences of lower extremity amputations (LEAs), patient characteristics, vascular history of amputees and survival in Southwest Finland. Patients and Methods: This is a retrospective patient study in the Hospital District of Southwest Finland. All consecutive patients with atherosclerosis and diabetes-caused LEA, between 1st January 2007 and 31st December 2017, were included. The annual incidences of major LEA patients were statistically standardized. Patients' diagnoses, functional status, previous revascularizations and minor amputations were recorded, and survival was analyzed. Results: During the 11-year-period major LEAs were performed on 891 patients, 118 (13.2%) were urgent operations. The overall incidence of major LEA was 17.2/100 000 and was age-dependent (3.1 for ≤64 years, 34.3 for 65-74 years, 81.5 for 75-84 years, 216 for ≥85 years). A decrease in incidence was detected in the <65 year-age-group (incidence 4.98 in 2007 and 1.88 in 2017; p = 0.0018). Among older age groups, there was no significant change. Half (50.6%) of all amputees were diabetics. Altogether, 472 patients (53.0%) had a history of revascularization before LEA. 80.1% of index amputations were transfemoral and 19.9% transtibial. Resurgery was performed on 94 (10.5%) patients. The 1-, 3-and 5-year overall survival were 56%, 30%, and 18%, respectively. Conclusion: Our results suggest that in an aging population, despite good availability of vascular services, a significant number of patients are not fit for active revascularization, and LEA is the only feasible treatment for critical limb ischemia.