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Publications (10 of 55) Show all publications
Johansson, E., Benhabib, H., Herod, W., Hopyan, J., Machnowska, M., Maggisano, R., . . . Fox, A. J. (2019). Carotid near-occlusion can be identified with ultrasound by low flow velocity distal to the stenosis. Acta Radiologica, 60(3), 396-404
Open this publication in new window or tab >>Carotid near-occlusion can be identified with ultrasound by low flow velocity distal to the stenosis
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2019 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 60, no 3, p. 396-404Article in journal (Refereed) Published
Abstract [en]

Background: Most carotid near-occlusions are indistinguishable from conventional >= 50% stenosis on ultrasound, demonstrating high peak systolic velocity (PSV) in the stenosis. Purpose To study whether the velocity distal to the stenosis can separate high PSV near-occlusion from conventional >= 50% stenosis.

Material and Methods: We included patients with >= 50% carotid stenosis with high PSV (>= 125 cm/s), examined with both computed tomography angiography (CTA) and ultrasound within 30 days, and a distal velocity measurement was performed. Based on CTA, cases were divided into three groups: conventional stenosis; near-occlusion without full collapse (NwoC; normal-appearing albeit small distal artery); and near-occlusion with full collapse (NwC; threadlike distal artery). Distal Doppler ultrasound flow velocities were compared between these groups.

Results: Sixty patients were included: 33 patients with conventional stenosis; 20 patients with NwoC; and seven patients with NwC. Mean distal PSV was 93, 63, and 21 cm/s (P < 0.001) and mean distal end-diastolic velocity was 30, 24, and 5 cm/s (P < 0.001), respectively. A distal PSV < 50 cm/s was 63% sensitive and 94% specific for separating both types of near-occlusion from conventional stenosis.

Conclusion: In high PSV carotid stenoses, the distal velocity was lower in near-occlusions than conventional carotid stenosis. Distal velocities warrant further investigation in diagnostic studies.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Stroke, carotid stenosis, near-occlusion, CT angiography, ultrasound, distal velocity
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-157204 (URN)10.1177/0284185118780900 (DOI)000458887800016 ()29896980 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-04-08Bibliographically approved
Visona, A., Pesavento, R., Mazzolai, L., Cimminiello, C., Pecsvarady, Z., Olinic, D. & Johansson, E. (2019). ESVM integrated care pathways - a call for action. VASA, 48(2), 113-114
Open this publication in new window or tab >>ESVM integrated care pathways - a call for action
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2019 (English)In: VASA, ISSN 0301-1526, E-ISSN 1664-2872, Vol. 48, no 2, p. 113-114Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Hogrefe & Huber Publishers, 2019
Identifiers
urn:nbn:se:umu:diva-158107 (URN)10.1024/0301-1526/a000755 (DOI)000462271600002 ()30821213 (PubMedID)
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-04-12Bibliographically approved
Westlund, A., Holmlund, P., Johansson, E., Malm, J. & Eklund, A. (2019). Semi-automatic method for segmentation of the internal jugular vein in ultrasound movies evaluated at different body postures. Biomedical Physics & Engineering Express, 5(4), Article ID 045034.
Open this publication in new window or tab >>Semi-automatic method for segmentation of the internal jugular vein in ultrasound movies evaluated at different body postures
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2019 (English)In: Biomedical Physics & Engineering Express, E-ISSN 2057-1976, Vol. 5, no 4, article id 045034Article in journal (Refereed) Published
Abstract [en]

Objective: The collapse of the internal jugular vein (IJV) regulates intracranial pressure (ICP) in upright body positions. The cross-section area (CSA) is therefore of interest when studying the effects of postural changes in various neurological diseases. We have developed a semi-automatic segmentation method, which tracks the CSA of the IJV in ultrasound movies, and evaluated its performance in three body positions (supine, 16°, 71°). Approach: The proposed method utilized post-processing image filtering combined with a modified snake active contour algorithm. The ultrasound movies were retrospectively analysed (n = 231, 3s, 28 fps) based on previously collected data from 17 healthy volunteers. The computed CSAs (CA) from the segmentation method were compared to manually segmented CSAs (MA) in two frames per movie. Tracking performance were evaluated by visual inspection. Main results: In the supine position, 100% of the ultrasound movies were tracked successfully, and the mean of CA-MA was −4.4 ± 6.9 mm2 (MA, 88.4 ± 50.5 mm2). The most challenging movies occurred in upright body posture where tracking success rate was 90% and mean of CA-MA was −1.4 ± 2.2 mm2 (MA, 12.0 ± 11.1 mm2). The semi-automatic segmentations took 55 s to perform on average (per movie) compared to manual segmentations which took 50 min. Significance: Segmentations made by the proposed method were comparable to manual segmentations in all tilt-angles, however much faster. Efficient and accurate tracking of the CSA of the IJV, with respect to postural changes, could help furthering our understanding of how IJV-biomechanics relates to regulation of intracranial pressure in different neurological diseases and physiological states.

Place, publisher, year, edition, pages
Institute of Physics Publishing (IOPP), 2019
Keywords
posture, intracranial pressure, ultrasound, jugular veins, computer-assisted image analysis
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-161912 (URN)10.1088/2057-1976/ab285e (DOI)000475798800001 ()
Available from: 2019-08-07 Created: 2019-08-07 Last updated: 2019-08-07Bibliographically approved
Jashari, F., Ibrahimi, P., Johansson, E., Grönlund, C., Wester, P. & Henein, M. Y. (2018). Carotid IM-GSM is better than IMT for identifying patients with multiple arterial disease. Scandinavian Cardiovascular Journal, 52(2), 93-99
Open this publication in new window or tab >>Carotid IM-GSM is better than IMT for identifying patients with multiple arterial disease
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2018 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 52, no 2, p. 93-99Article in journal (Refereed) Published
Abstract [en]

Objective. Atherosclerosis is a systemic inflammatory disease that can affect more than one arterial bed simultaneously. The aim of this study was to determine the relationship between ultrasound markers of atherosclerosis and multiple arterial disease. Design. We have included 87 currently asymptomatic carotid disease patients (mean age 69 +/- 6 year, 34% females) in this study. Intima media thickness (IMT) and intima media-grey scale median (IM-GSM) were measured in the common carotid artery (CCA), and correlated with previous and/or current atherosclerotic vascular disease in the coronary, carotid and lower extremities. Patients were divided into three groups: (1) asymptomatic, (2) previous symptoms in one arterial territory and (3) previous symptoms in multiple arterial territories. Results. Patients with previous disease in the coronary arteries had higher IMT (p=.034) and lower IM-GSM (p<.001), and those with prior stroke had lower IM-GSM (p=.007). Neither IMT nor IM-GSM was different between patients with and without previous lower extremity vascular disease. IM-GSM was significantly different between groups, it decreased significantly with increasing number of arterial territories affected (37.7 +/- 15.4 vs. 29.3 +/- 16.4 vs. 20.7 +/- 12.9) p<.001, for asymptomatic, symptoms in one and in multiple arterial systems, respectively. Conventional IMT was not significantly different between groups p=.49. Conclusion. Carotid IMT was higher and IM-GSM lower in patients with symptomatic nearby arterial territories but not in those with peripheral disease. In contrast to conventional IMT, IM-GSM can differentiate between numbers of arterial territories affected by atherosclerosis, suggesting that it is a better surrogate for monitoring multiple arterial territory disease.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keywords
Atherosclerosis, carotid artery, intimal-media complex, IMT, IM-GSM
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-146595 (URN)10.1080/14017431.2018.1435903 (DOI)000428305000006 ()29402147 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2019-05-20Bibliographically approved
Johansson, E. & Salzer, J. (2018). Interaction should guide management decisions [Letter to the editor]. American Journal of Neuroradiology, 39(5), E57-E57
Open this publication in new window or tab >>Interaction should guide management decisions
2018 (English)In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 39, no 5, p. E57-E57Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
American Society of Neuroradiology, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-149381 (URN)10.3174/ajnr.A5579 (DOI)000432175900003 ()29545244 (PubMedID)2-s2.0-85047092923 (Scopus ID)
Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-06-21Bibliographically approved
Johansson, E. (2018). Konferensrapport European Stroke Organization Conference (ESOC), Göteborg. Vaskulär medicin, 34(2), 27-27
Open this publication in new window or tab >>Konferensrapport European Stroke Organization Conference (ESOC), Göteborg
2018 (Swedish)In: Vaskulär medicin, ISSN 2000-3188, Vol. 34, no 2, p. 27-27Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Svensk förening för hypertoni, stroke och vaskulär medicin, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-149378 (URN)
Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-06-27Bibliographically approved
Lindén, C., Qvarlander, S., Jóhannesson, G., Johansson, E., Östlund, F., Malm, J. & Eklund, A. (2018). Normal-Tension Glaucoma Has Normal Intracranial Pressure: A Prospective Study of Intracranial Pressure and Intraocular Pressure in Different Body Positions. Ophthalmology (Rochester, Minn.), 125(3), 361-368
Open this publication in new window or tab >>Normal-Tension Glaucoma Has Normal Intracranial Pressure: A Prospective Study of Intracranial Pressure and Intraocular Pressure in Different Body Positions
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2018 (English)In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 125, no 3, p. 361-368Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To test the hypothesis that normal-tension glaucoma (NTG) is caused by an increased pressure difference across the lamina cribrosa (LC) related to a low intracranial pressure (ICP).

DESIGN: Prospective case-control study.

PARTICIPANTS: Thirteen NTG patients (9 women; median 71 [range: 56-83] years) were recruited for investigation with the same protocol as 11 healthy volunteers (8 women; 47 [30-59] years). A larger control group (n = 51; 30 women; 68 [30-81] years) was used only for ICP comparison in supine position.

METHODS: ICP and intraocular pressure (IOP) were simultaneously measured in supine, sitting, and 9° head-down tilt (HDT) positions. Trans-lamina cribrosa pressure difference (TLCPD) was calculated using ICP and IOP together with geometric distances estimated from magnetic resonance imaging to adjust for hydrostatic effects.

MAIN OUTCOME MEASURES: ICP, IOP, and TLCPD in different body positions.

RESULTS: Between NTG patients and healthy volunteers, there were no differences in ICP, IOP, or TLCPD in supine, sitting, or HDT (P ≥ 0.11), except for IOP in HDT (P = 0.04). There was no correlation between visual field defect and TLCPD, IOP, or ICP and in any body position (P ≥ 0.39). Mean ICP in supine was 10.3 mmHg (SD = 2.7) in the NTG group (n = 13) and 11.3 (2.2) mmHg in the larger control group (n = 51) (P = 0.24).

CONCLUSIONS: There was no evidence of reduced ICP in NTG patients as compared with healthy controls, either in supine or in upright position. Consequently, the hypothesis that NTG is caused by an elevated TLCPD from low ICP was not supported.

National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-142423 (URN)10.1016/j.ophtha.2017.09.022 (DOI)000425377300015 ()29096996 (PubMedID)
Funder
Swedish Research Council, 2015-05616
Available from: 2017-11-30 Created: 2017-11-30 Last updated: 2018-06-21Bibliographically approved
Lindén, C., Qvarlander, S., Jóhannesson, G., Johansson, E., Östlund, F., Malm, J. & Eklund, A. (2018). Re: Linden et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368) REPLY [Letter to the editor]. Ophthalmology (Rochester, Minn.), 125(6), e43-e44
Open this publication in new window or tab >>Re: Linden et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368) REPLY
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2018 (English)In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 125, no 6, p. e43-e44Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-148825 (URN)10.1016/j.ophtha.2018.01.006 (DOI)000432371600007 ()29784104 (PubMedID)
Note

Refers to: Baartman B, Sudhagoni R, Swan R, Greenwood M, Berdahl, J. Re: Linden et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368) DOI: 10.1016/j.ophtha.2017.09.022

Available from: 2018-06-21 Created: 2018-06-21 Last updated: 2018-11-06Bibliographically approved
Lindén, C., Qvarlander, S., Jóhannesson, G., Johansson, E., Östlund, F., Malm, J. & Eklund, A. (2018). Re: Linden et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368) REPLY [Letter to the editor]. Ophthalmology (Rochester, Minn.), 125(10), E74-E75
Open this publication in new window or tab >>Re: Linden et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368) REPLY
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2018 (English)In: Ophthalmology (Rochester, Minn.), ISSN 0161-6420, E-ISSN 1549-4713, Vol. 125, no 10, p. E74-E75Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Ophthalmology
Identifiers
urn:nbn:se:umu:diva-152382 (URN)10.1016/j.ophtha.2018.04.028 (DOI)000445012100008 ()30243346 (PubMedID)
Note

Refers to: Baartman B, Sudhagoni R, Swan R, Greenwood M, Berdahl, J. Re: Linden et al.: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361-368) DOI: 10.1016/j.ophtha.2017.09.022

Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2018-11-06Bibliographically approved
Johansson, E. (2018). Referat från 20:e Kardiovaskulära Vårmötet i Stockholm 25-27/4 2018. Vaskulär medicin, 34(2), 7-7
Open this publication in new window or tab >>Referat från 20:e Kardiovaskulära Vårmötet i Stockholm 25-27/4 2018
2018 (Swedish)In: Vaskulär medicin, ISSN 2000-3188, Vol. 34, no 2, p. 7-7Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Svensk förening för hypertoni, stroke och vaskulär medicin, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-149377 (URN)
Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-06-27Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5317-4563

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