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PubMed2001

Expression of nm23-H1 gene product in esophageal squamous cell carcinoma and its association with vessel invasion and survival.

BACKGROUND: We assessed the nm23-H1 gene product expression and its relationship with lymphatic and blood vessel invasion in patients with esophageal squamous cell carcinoma. METHODS: Formalin-fixed and paraffin-embedded tissue sections from 45 patients who were treated surgically were used in this study. Pathologists graded lymphatic and blood vessel invasion in each of the tissue samples. Expression of nm23-Hl gene product was determined using a specific monoclonal antibody. RESULTS: Expression of nm23-H1 gene product was present in 17 (37.8%) cases. We found an inverse correlation between nm23-H1 gene product expression and lymphatic vessel invasion, whereas no correlation between nm23-H1 gene product expression and blood vessel invasion. Overall survival rate was not different between nm23-H1 gene product positive and negative patients (p = 0.21). However, reduced expression of nm23-H1 gene product was associated with shorter overall survival in patients with involved lymph nodes (p < 0.05), but not in patients without involved lymph nodes (p = 0.87). CONCLUSIONS: In patients with esophageal squamous cell carcinoma, there appears to be an inverse relationship between nm23-H1 gene product expression and lymphatic vessel invasion. Furthermore, nm23-H1 gene product expression might be a prognostic marker in patients with involved lymph nodes. Our data does not demonstrate any correlation between nm23-H1 gene product expression and blood vessel invasion.

Biomarkers, Tumor↗
PubMed1990

Prognostic significance of peritumoral lymphatic and blood vessel invasion in node-negative carcinoma of the breast.

The prognostic significance of intramammary lymphatic and blood vessel invasion was evaluated in a retrospective series of 221 patients with node-negative carcinoma of the breast treated with modified radical mastectomy. To facilitate identification of lymphatic and blood vessel invasion, the tumors were studied with an immunohistochemical technique using antibodies to endothelial markers. Peritumoral lymphatic and blood vessel invasion (PLBI) (encompassing both lymphatic and blood vessel invasion) was an adverse prognostic indicator independent of menopausal status, tumor size, and other histologic variables. Recurrence of disease and death resulting from carcinoma were significantly higher for patients with PLBI-present (+) tumors compared with patients with PLBI-absent (-) tumors (P less than .0001). The risk of recurrence for patients with PLBI+ tumors was 4.7 times that for their PLBI- counterparts. The presence of intratumoral lymphatic and blood vessel invasion (ILBI) is less important because few examples were found without concomitant PLBI. When PLBI was separated into lymphatic invasion and blood vessel invasion individually, the prognostic significance was retained in both groups. The immunohistochemical approach reduced both false-negative and false-positive observations and identified about 40% of PLBI that would have been missed by routine histologic examination alone. The presence of PLBI appears to be a potentially useful discriminant in predicting the outcome of patients with node-negative carcinoma of the breast.

Breast Neoplasms↗
PubMed2000

Significance of hyperintense vessels on FLAIR MRI in acute stroke.

OBJECTIVE: To describe hyperintense vessels sign (HVS) in patients with acute stroke on fluid-attenuated inversion recovery (FLAIR) MRI and determine its clinical significance and utility. BACKGROUND: Enhancement of vessels on postcontrast MRI in patients with acute stroke is considered an indicator of early brain ischemia. Recently, the FLAIR technique has shown promise in earlier and better detection of ischemic brain parenchymal lesions. METHODS: Two observers retrospectively reviewed 304 MRI of patients with stroke and identified 30 patients with acute middle cerebral artery stroke and HVS on FLAIR obtained within 24 hours of symptom onset. These patients were evaluated with contrast-enhanced MRI (n = 9), MR angiography of carotid and intracranial circulation (n = 30), cerebral angiography (n = 8), transcranial Doppler (n = 17), and SPECT (n = 16). The extent of HVS was compared with final infarct size and NIH Stroke Scale score. RESULTS: HVS on FLAIR was seen in 10% of the patients with acute stroke. HVS was associated with large vessel occlusion or severe stenosis (>90%). Intravascular enhancement on contrast MRI was observed in vessels that were hyperintense on FLAIR. Both cortical and subcortical infarcts demonstrated HVS. MR angiographic and cerebral angiographic findings of large vessel occlusion or severe stenosis (>90%), slow flow, low velocities by transcranial Doppler, and hypoperfusion on SPECT correlated with HVS. HVS was the earliest ischemic change in three patients scanned within 3 hours of ictus. Final infarct size was smaller than the area showing HVS in all patients. CONCLUSION: HVS on FLAIR MRI is an indicator of slow flow and early ischemia as a result of large vessel occlusion or stenosis and inadequacy of collateral circulation. HVS does not mean that infarction has occurred but indicates brain tissue at risk of infarction. It should prompt consideration of revascularization and flow augmentation strategies.

Acute Disease↗
PubMed2005

The role of pericytes in blood-vessel formation and maintenance.

Blood vessels are composed of two interacting cell types. Endothelial cells form the inner lining of the vessel wall, and perivascular cells--referred to as pericytes, vascular smooth muscle cells or mural cells--envelop the surface of the vascular tube. Over the last decades, studies of blood vessels have concentrated mainly on the endothelial cell component, especially when the first angiogenic factors were discovered, while the interest in pericytes has lagged behind. Pericytes are, however, functionally significant; when vessels lose pericytes, they become hemorrhagic and hyperdilated, which leads to conditions such as edema, diabetic retinopathy, and even embryonic lethality. Recently, pericytes have gained new attention as functional and critical contributors to tumor angiogenesis and therefore as potential new targets for antiangiogenic therapies. Pericytes are complex. Their ontogeny is not completely understood, and they perform various functions throughout the body. This review article describes the current knowledge about the nature of pericytes and their functions during vessel growth, vessel maintenance, and pathological angiogenesis.

Animals↗
PubMed2006

Use of the Amplatzer vascular plug as an anchoring scaffold for coil-mediated parent vessel occlusion: technical case report.

OBJECTIVE: Parent vessel sacrifice is a useful treatment strategy for fusiform intracranial aneurysms. Originally performed using the detachable silicone balloon, endovascular arterial occlusion is currently achieved using coils, a process which can be limited by coil mass migration. METHODS: We demonstrate the use of the Amplatzer vascular plug as a fixed anchor within the target parent vessel to facilitate coil-mediated occlusion, especially in vascular segments not encased by a bony canal. The technique was used successfully in two patients: a 90-year-old woman presenting with IIIrd and VIth cranial nerve palsy from a fusiform left cavernous internal carotid aneurysm and a 44-year-old man with distal thromboemboli from a fusiform dissecting-type right vertebral artery involving the origin of the posterior inferior cerebellar artery. RESULTS: Both patients were treated successfully with proximal parent vessel occlusion using coils after deployment of an Amplatzer vascular plug proximal to the target lesion. With the Amplatzer device acting as a fixed anchor in the parent vessel, coils were deployed proximally in a compact configuration. After deployment of the vascular plugs and coils, hermetic occlusion of the parent vessel was documented angiographically. CONCLUSION: The Amplatzer vascular plug can facilitate coil occlusion of large cervical vessels by acting as a focal coil and embolic material immobilizer, which can prevent coil mass migration and lead to improved packing density.

Adult↗
PubMed1984

The role of alpha and beta adrenergic receptors in constriction and dilation of the systemic capacitance vessels: a study with measurements of the mean circulatory pressure in dogs.

The response of the mean circulatory pressure (MCP), an index of the tone of the systemic capacitance vessels, to the infusion of an alpha-adrenergic receptor stimulant (phenylephrine) and a beta-adrenergic receptor stimulant (isoproterenol) was studied in anesthetized, open-chest dogs. Provided that the blood volume (particularly, extra volume) remains constant, an increase in the MCP indicates an increase in the tone of the capacitance vessels ("venoconstriction") and a decrease in the MCP indicates a decrease in the tone of the capacitance vessels ("venodilation"). It was almost definitely concluded that the stimulation of the alpha-adrenergic receptor led to the increased tone of the systemic capacitance vessels and the stimulation of the beta-adrenergic receptor did not decrease the tone of the systemic capacitance vessels in anesthetized, open-chest dogs, but the stimulation of the beta-adrenergic receptor decreased the tone of the systemic capacitance vessels, when the tone had been previously elevated by angiotensin-II.

Angiotensin II↗
PubMed1992

Differing actions of endothelin-1 on canine systemic resistance and capacitance vessels.

In anesthetized open-chest dogs, an intravenous bolus injection of endothelin-1 (ET-1, 400 pmol/kg) caused transient hypotension (initial hypotensive phase; phase 1), followed by a continuous elevation of blood pressure (late hypertensive phase; phase 2). The constriction and dilation of the systemic capacitance and resistance vessels were evaluated from the change in mean circulatory pressure (MCP) and in total peripheral resistance (TPR) in phases 1 and 2. To examine the modification of the action of ET-1 on the blood vessels by the baroceptor reflex or by the endothelium-derived relaxing factor (EDRF) released by ET-1 in phase 1, we performed experiments in dogs under total spinal anesthesia (TSA group), methylene blue-treated dogs (MB group) as well as in the untreated dogs (control group). ET-1 decreased the TPR significantly, and increased the MCP significantly in phase 1 in the control (n = 8) and TSA (n = 8) groups; there was no difference between the groups. ET-1 had no significant effect on TPR but increased the MCP significantly in MB group (n = 8) during phase 1. The percentage increase of MCP in the MB group significantly exceeded that of the control group. ET-1 increased both the TPR and MCP significantly in phase 2 in the control group (n = 8). This study indicated that the vasoconstrictor action of ET-1 on the systemic capacitance vessels in phase 1 did not result from a baroceptor reflex, and that the vasodilator action of ET-1 on the systemic resistance vessels may be at least in part mediated via EDRF released by ET-1. We suggest that the vasoconstrictor action of ET-1 on the systemic capacitance vessels is strong, but the vasodilator action of EDRF on the systemic capacitance vessels is weak.

Animals↗
PubMed1998

Coronary bypass grafting for single-vessel coronary artery disease: a 17-year review with short- and long-term follow-up.

STUDY OBJECTIVES: We reviewed our short- (30 days) and long-term (up to 17 years) experience with surgical revascularization for patients with angiographically documented isolated single-vessel coronary artery disease. DESIGN: Retrospective study of single-vessel coronary artery bypass procedures performed from January 1980 through June 1996. During this time, 100 consecutive patients underwent a single-vessel coronary artery bypass. All patients were men with a mean age of 59+/-9 years (range, 35 to 78 years) and a mean ejection fraction of 56+/-8% (range, 35 to 77%). The vessels bypassed included the left anterior descending in 66 (66%), right coronary artery in 31 (31%), and the obtuse marginal in 3 (3%). RESULTS: Short-term results reveal no deaths and six (6.0%) complications. Long-term follow-up by chart review and telephone survey was available in 87 (87%) patients at a mean of 46.9 months (range, 12 to 151 months). Cumulative freedom from angina and repeated revascularization was 93% and 98% at 1 year and 55% and 81% at 10 years, respectively (Kaplan-Meier). CONCLUSION: Single-vessel coronary artery bypass for isolated single-vessel disease can be performed with minimal morbidity and no mortality and provides excellent long-term relief of angina.

Adult↗
PubMed2003

Real-time detection of vessel diameters with ultrasound.

Transcutaneous vessel imaging is a frequently used ultrasound imaging modality in medicine. The measurement of vessel diameters can be done with conventional B-mode imaging systems, which work at frame rates up to 100 Hz. Furthermore, there are special systems available, which can track vessel walls very precisely using the phase of signals that are sent at frame rates up to several thousand Hz. Though, such systems are usually not able to provide the examiner with 2D images of the object. With respect to brachial artery flow-mediated vasodilatation (FMD), which is frequently used as a measure of endothelial function, it is necessary to observe diameter changes of small arterial vessels noninvasively for several minutes at a high resolution. In the past, the diameter had to be measured manually in tedious postprocessing of ECG-gated image sequences. We developed a system composed of a Siemens Omnia ultrasound system with a VF13-5 transducer (9 MHz center frequency) and a personal computer, that is capable of calculating vessel diameter changes with an accuracy below the wavelength of the ultrasound system in real-time at a frame rate of 27 Hz. We implemented a two-dimensional active contour model using the Viter-bi-algorithm and a phase-sensitive vessel wall tracking algorithm, in order to guarantee both, geometric information and accuracy. Results from carotid and brachial arteries show that arterial pulsations below 0.1 mm can be visualized reliably over several minutes. With this system we want to find out, if FMD is suitable for an individual assessment of the risk for cardiovascular diseases.

Algorithms↗
PubMed2005

Tumor vessel compression hinders perfusion of ultrasonographic contrast agents.

Contrast-enhanced ultrasound (CEUS) is an advanced approach to in vivo assessment of tumor vascularity and is being increasingly adopted in clinical oncology. It is based on 1- to 10 microm-sized gas microbubbles, which can cross the capillary beds of the lungs and are effective echo enhancers. It is known that high cell density, high transendothelial fluid exchange, and poorly functioning lymphatic circulation all provoke solid stress, which compresses vessels and drastically reduces tumor blood flow. Given their size, we supposed that the perfusion of microbubbles is affected by anatomic features of tumor vessels more than are contrast agents traditionally used in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Here, we compared dynamic information obtained from CEUS and DCE-MRI on two experimental tumor models exhibiting notable differences in vessel anatomy. We found that tumors with small, flattened vessels show a much higher resistance to microbubble perfusion than to MRI contrast agents, and appear scarcely vascularized at CEUS examination, despite vessel volume adequate for normal function. Thus, whereas CEUS alone could induce incorrect diagnosis when tumors have small or collapsed vessels, integrated analysis using CEUS and DCE-MRI allows in vivo identification of tumors with a vascular profile frequently associated with malignant phenotypes.

Albumins↗
PubMed1990

Topographical anatomy of the bronchomediastinal lymph vessels: their relationships and formation of the collecting trunks.

This article aims to clarify the topographical relationships of the bronchomediastinal collecting lymph vessels to other structures, in particular the great vessels, the trachea, the esophagus and the mediastinal pleura. Minute dissection was performed on eight cadavers with special reference to the converging collecting lymph vessels which form the bronchomediastinal trunks. On the right side, the trunks were consistently observed on both the right brachiocephalic vein and the subserous surface of the mediastinal pleura (anterior and posterior mediastinal trunks). The pathway from the right recurrent chain nodes ran laterally behind the carotid sheath and led either into the deep cervical nodes situated on the scalenus anterior or directly into the right venous angle. On the left side, the trunks showed varying courses. The nodes from which the trunks arose were constant, and classifiable into three groups: the uppermost paratracheal nodes near the recurrent chain nodes, the anterior mediastinal nodes (the left phrenic nodes) surrounding the phrenic nerve in front of and inferior to the aortic arch (the origin of the superior mediastinal trunk), and the left tracheobronchial nodes (the origin of the inferior mediastinal trunk). The large transverse superficial communicating vessel between the right and left sides was usually found in front of the trachea above the aortic arch; it was often connected to the nodes of the brachiocephalic angle. Deep communications were also found in front of the carina and behind the trachea. These findings allow the collecting vessels from the thoracic viscera to be divided into two pathways on each side: the anterior and posterior mediastinal trunks on the right side, and the superior and inferior mediastinal trunks on the left side. In addition to the four trunks, the superficial communicating vessel between the right and left sides is also drained from the superior mediastinum. The internal mammary lymph chain, which often emptied directly into the venous angle or into the deep cervical nodes, occasionally joined with the right anterior mediastinal trunk or the left superior mediastinal trunk.

Adult↗
PubMed1992

Structure and distribution of the lymphatic vessels in the parietal pleura of the monkey as studied by enzyme-histochemistry and by light and electron microscopy.

The entire distribution of lymphatics in whole mount preparations of the Japanese monkey was studied using the enzyme-histochemical technique reported by KATO et al. (1990, 1991). In this staining, the lymphatic endothelium was colored dark brown by its positive 5'-nucleotidase activity, while most blood vessels (especially arterioles) were colored blue due to their positive alkaline phosphatase reaction. The whole mount preparations of the pleura treated enzyme-histochemically clearly indicated the distribution, branching patterns and running courses of lymphatic vessels. They revealed numerous short blind-ending knobs which represented the initial portions of lymphatics. These knobs were seen near the surface of the parietal pleura along its entire extent. In the costal and diaphragmatic pleura, the lymphatics ran parallel to the intercostal muscle fibers, but perpendicular to the tendinous and muscular fibers of the diaphragm; they formed ladders, independent of the courses of blood vessels. In the mediastinal pleura, lymphatic vessels showed a tree-like branching accompanying blood vessels. Under the light microscope, toluidine-blue stained semithin sections revealed the initial part of lymphatics as a small irregularly outlined cavity (7-10 microns in diameter) surrounded by a dense connective tissue. This lymphatic dilation was sometimes located close to a thin mesothelial layer. Such a structure suggesting a "stoma" was seen near the attachment of the muscular diaphragm to the sternum and along the borders of the ribs. Transmission electron microscopy revealed an occasional interruption in the mesothelium. This stoma continued to a submesothelial cavity whose base comprised an attenuated endothelium of an extended lymphatic vessel.

5'-Nucleotidase↗
PubMed2003

Pathways for movement of fluid and cells from hepatic sinusoids to the portal lymphatic vessels and subcapsular region in rat livers.

It has long been a mystery how fluid and migrating cells in the hepatic sinusoids reach lymphatic vessels in the portal tract. Here we describe previously-unknown channels that connect the space of Disse with the portal tract in the rat liver. Transmission electron microscopy was performed on livers injected with either horseradish peroxidase (HRP) or lipopolysaccharide, and scanning electron microscopy was carried out on livers macerated with KOH. Transmission electron microscopy revealed the presence of channels with collagen fibers traversing the limiting plate. A tracer study showed that HRP was in the channels as well as along inlet venules. Dendritic cells in the hepatic sinusoids or between hepatocytes of the limiting plate were also observed extending their pseudopodia through the channels in the limiting plate to the interstitial space of the portal tract. Scanning electron microscopy further showed that many channels (1-3microm in diameter) penetrated through the limiting plate independently of blood vessels and connected the space of Disse with the interstitial space of the portal tract. In addition, the portal tract possessed prelymphatic vessels that were lined with fibroblast-like cells and frequently contained dendritic cells. The initial segment of the portal lymphatic vessels opened to the interstitial tissue space. These results indicate that fluid and dendritic cells in the hepatic sinusoids probably pass through both the space of Disse and the channels traversing the limiting plate, enter the interstitial space of the portal tracts, and finally move from the prelymphatic vessels to the portal lymphatic vessels.

Animals↗
PubMed2006

The protective effects of angiotensin II blockade with olmesartan medoxomil on resistance vessel remodeling (The VIOS study): rationale and baseline characteristics.

BACKGROUND: The VIOS (Vascular Improvement with Olmesartan medoxomil Study) study is a randomized, parallel study to determine the relative effects of suppressing the renin-angiotensin system (RAS) with the angiotensin receptor antagonist olmesartan medoxomil versus suppressing sympathetic drive with the beta-adrenoceptor antagonist atenolol on remodeling of the subcutaneous small resistance vessel. Remodeling of small resistance vessels may be the earliest pathologic finding associated with hypertension. It may predate the onset of clinically apparent hypertension. METHODS: In this study, 100 patients with stage I hypertension are characterized at baseline before being treated for 1 year to obtain a goal BP of less than 140/90 mm Hg as defined by Joint National Committee (JNC)-7. Resistance vessel remodeling is determined using the gluteal fat biopsy technique in the hypertensive patients and a group of normotensive healthy volunteers. Additionally, efforts will be made to define whether noninvasive hemodynamic parameters, retinal vessel measurement changes, or biologic markers may predict and track the underlying vascular morphologic and physiologic changes induced by either regimen during the 12-month treatment period. RESULTS: The primary endpoint will be the degree of vascular remodeling as obtained from percutaneous biopsy of gluteal subcutaneous resistance vessels in each of two treatment arms compared with the normal volunteers. The design of the study and the pertinent baseline characteristics of these patients with uncomplicated essential hypertension are presented. CONCLUSION: The suppression of the RAS by the blockade of angiotensin II type 1 (AT(1)) receptors may demonstrate remodeling effects on the ubiquitous small resistance vessels similar to that seen in the myocardium and renal glomeruli, thus affording more complete end-organ protection.

Adult↗
PubMed1987

Use of standard gradients with compound oblique angulation for optimal quantitative MR flow imaging in oblique vessels.

The earliest described phase-modulation techniques for flow quantification by MR imaging require a phase image obtained by modifying one of the imaging gradients and a reference phase image obtained without the modified gradient. However, by using the same gradients that are used for routine two-dimensional Fourier transform imaging, both anatomic and velocity-encoded images can be obtained in one scan. Although convenient, this technique is sensitive to flow both within and perpendicular to the imaging plane. Consequently, significant errors occur in the measurement of flow in vessels oblique to the image plane. To determine the relative accuracy and practicality of quantitatively measuring flow in oblique vessels, we used standard sequence gradients with routine orthogonal plane imaging and direct compound oblique plane imaging. Phantom studies of flow in a vessel aligned along the z axis showed a significant linear correlation (r = .999; p less than .05) between the spin phase and spin velocity. However, studies of flow at relatively low physiologic rates (12-17 cm/sec) in vessels angled 0-30 degrees off axis showed that obliquities of as little as 10 degrees result in significant quantification errors. This is due to a larger phase shift per unit velocity along the frequency-encoding direction vs along the slice-select direction and to a mixture of velocities within a voxel that is oblique to the flow direction. In most instances, resolution of these errors can be achieved satisfactorily only by electronic plane rotation with compound oblique angulation so that the image plane and vessel are perpendicular. When so used, this technique potentially might provide important adjunctive quantitative flow data in oblique vessels during routine clinical imaging.

Magnetic Resonance Spectroscopy↗
PubMed1990

CT anatomy of the internal mammary vessels: importance in planning percutaneous transthoracic procedures.

Knowledge of the anatomy of the internal mammary vessels is important to avoid hemorrhagic complications when an anterior parasternal approach is used for percutaneous transthoracic procedures such as biopsy and empyema drainage. We examined 100 consecutive CT scans of the thorax to assess both the number of internal mammary vessels and their relation to the sternum. The mean distance from the sternum to the most medial vessel, the internal mammary vein, was 1.03 +/- 0.25 cm on the right side and 0.98 +/- 0.23 cm on the left side. The mean distance from the sternum to the most lateral vessel, the internal mammary artery, was 1.57 +/- 0.30 cm on the right and 1.47 +/- 0.30 cm on the left. Three internal mammary vessels were present in 20% of cases on the right side and in 18% on the left side. In nine patients, the internal mammary artery was greater than 2.0 cm from the lateral border of the sternum. We recommend an approach that is greater than 2.5 cm from the sternal border when performing parasternal percutaneous transthoracic procedures in order to avoid hemorrhagic complications from injury to the internal mammary vessels. A "safe" window does exist medially between the sternal border and the internal mammary vein but should be used only in procedures performed under CT guidance.

Adolescent↗
PubMed1996

MR angiography of tibial runoff vessels: imaging with the head coil compared with conventional arteriography.

OBJECTIVE: We compared peripheral vascular MR angiography done with a standard transmit-receive head coil with conventional arteriography for identifying and evaluating runoff vessels below the knee. MATERIALS AND METHODS: We examined 55 legs in 31 symptomatic patients with both conventional contrast angiography and gradient-echo two-dimensional time-of-flight MR angiography. Both legs of patients were placed in a standard transmit-receive head coil for MR angiography and were imaged simultaneously. For evaluation of stenoses, images of vessels were divided into 10 segments, and each segment was graded on a four-point scale. RESULTS: In the 393 native vascular segments evaluated, the sensitivity of MR angiography in identifying normal vessels was 95% and the specificity was 98%. In detecting segmental occlusion, MR angiography was 98% sensitive and 97% specific. Sensitivity and specificity for stenoses greater than 75% were 98% and 96%, respectively, and for stenoses greater than 50%, they were 98% and 95%, respectively. Interpretative discrepancies were found in 35 vessel segments in 18 legs; none was of clinical relevance. Of all vessel segments shown as occluded by conventional angiography, 1% appeared patent on MR angiograms. No vessel segments shown as normal on MR angiograms were found to be occluded on conventional angiograms. CONCLUSION: When performed simultaneously on both legs of symptomatic patients, 2D time-of-flight MR angiography with a standard transmit-receive head coil provides a time-efficient and highly sensitive and specific means of evaluating below-knee runoff.

Adult↗
PubMed1996

Distal ileocolic intussusception: another cause of inversion of superior mesenteric vessels in infants.

OBJECTIVE: Inversion of the superior mesenteric vessels is associated with various conditions. The purpose of this study was to prospectively evaluate the position of these vessels in infants with idiopathic ileocolic intussusception. SUBJECTS AND METHODS: Abdominal sonography was performed before and after reduction of ileocolic intussusception in 16 infants. RESULTS: In 14 infants with ileocolic intussusception proximal to the splenic flexure, the relationship of the superior mesenteric vessels was normal (superior mesenteric vein to the right ventral side of superior mesenteric artery). Inversion of the superior mesenteric vessels (superior mesenteric vein to the left of the superior mesenteric artery) was found in two patients with distal ileocolic intussusception (head of the intussusceptum at the sigmoid colon or rectum). After reduction, the relationship of these vessels was normal in all 16 infants. CONCLUSION: Inversion of the superior mesenteric vessels is sometimes caused by distal ileocolic intussusception in infants.

Colon, Sigmoid↗