Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
1.
Cancers (Basel) ; 14(2)2022 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-35053434

RESUMEN

Prostate-specific membrane antigen (PSMA)-directed positron emission tomography/computed tomography (PET/CT) is increasingly utilized for staging of men with prostate cancer (PC). To increase interpretive certainty, the standardized PSMA reporting and data system (RADS) has been proposed. Using PSMA-RADS, we characterized lesions in 18 patients imaged with 18F-PSMA-1007 PET/CT for primary staging and determined the stability of semi-quantitative parameters. Six hundred twenty-three lesions were categorized according to PSMA-RADS and manually segmented. In this context, PSMA-RADS-3A (soft-tissue) or -3B (bone) lesions are defined as being indeterminate for the presence of PC. For PMSA-RADS-4 and -5 lesions; however, PC is highly likely or almost certainly present [with further distinction based on absence (PSMA-RADS-4) or presence (PSMA-RADS-5) of correlative findings on CT]. Standardized uptake values (SUVmax, SUVpeak, SUVmean) were recorded, and volumetric parameters [PSMA-derived tumor volume (PSMA-TV); total lesion PSMA (TL-PSMA)] were determined using different maximum intensity thresholds (MIT) (40 vs. 45 vs. 50%). SUVmax was significantly higher in PSMA-RADS-5 lesions compared to all other PSMA-RADS categories (p ≤ 0.0322). In particular, the clinically challenging PSMA-RADS-3A lesions showed significantly lower SUVmax and SUVpeak compared to the entire PSMA-RADS-4 or -5 cohort (p < 0.0001), while for PSMA-RADS-3B this only applies when compared to the entire PSMA-RADS-5 cohort (p < 0.0001), but not to the PSMA-RADS-4 cohort (SUVmax, p = 0.07; SUVpeak, p = 0.08). SUVmean (p = 0.30) and TL-PSMA (p = 0.16) in PSMA-RADS-5 lesions were not influenced by changing the MIT, while PSMA-TV showed significant differences when comparing 40 vs. 50% MIT (p = 0.0066), which was driven by lymph nodes (p = 0.0239), but not bone lesions (p = 0.15). SUVmax was significantly higher in PSMA-RADS-5 lesions compared to all other PSMA-RADS categories in 18F-PSMA-1007 PET/CT. As such, the latter parameter may assist the interpreting molecular imaging specialist in assigning the correct PSMA-RADS score to sites of disease, thereby increasing diagnostic certainty. In addition, changes of the MIT in PSMA-RADS-5 lesions had no significant impact on SUVmean and TL-PSMA in contrast to PSMA-TV.

4.
Radiology ; 265(1): 70-7, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22771886

RESUMEN

PURPOSE: To investigate whether coronary artery calcium (CAC) scoring performed on three different workstations generates comparable and thus vendor-independent results. MATERIALS AND METHODS: Institutional review board and Federal Office for Radiation Protection approval were received, as was each patient's written informed consent. Fifty-nine patients (37 men, 22 women; mean age, 57 years±3 [standard deviation]) underwent CAC scoring with use of 64-section multidetector computed tomography (CT) with retrospective electrocardiographic gating (one examination per patient). Data sets were created at 10% increments of the R-R interval from 40%-80%. Two experienced observers in consensus calculated Agatston and volume scores for all data sets by using the calcium scoring software of three different workstations. Comparative analysis of CAC scores between the workstations was performed by using regression analysis, Spearman rank correlation (rs), and the Kruskal-Wallis test. RESULTS: Each workstation produced different absolute numeric results for Agatston and volume scores. However, statistical analysis revealed excellent correlation between the workstations, with highest correlation at 60% of the R-R interval (minimal rs=0.998; maximal rs=0.999) for both scoring methods. No significant differences were detected for Agatston and volume score results between the software platforms. At analysis of individual reconstruction intervals, each workstation demonstrated the same score variability, with the consequence that 12 of 59 patients were assigned to divergent cardiac risk groups by using at least one of the workstations. CONCLUSION: While mere numeric values might be different, commercially available software platforms produce comparable CAC scoring results, which suggests a vendor-independence of the method; however, none of the analyzed software platforms appears to provide a distinct advantage for risk stratification, as the variability of CAC scores depending on the reconstruction interval persists across platforms.


Asunto(s)
Calcinosis/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Programas Informáticos , Tomografía Computarizada por Rayos X/normas , Técnicas de Imagen Sincronizada Cardíacas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo , Estadísticas no Paramétricas
5.
Invest Radiol ; 46(1): 1-10, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21102347

RESUMEN

PURPOSE: Direct magnetic resonance imaging (MRI) planimetry of the maximal systolic aortic valve area does not consider temporal variations of the opening area during the ejection period. We evaluated an MRI-based methodology for the assessment of valvular dynamics in patients with severe aortic stenosis by measuring the systolic variability of the valvular blood stream, that is, the "vena contracta." MATERIALS AND METHODS: With institutional review board approval, we examined 22 patients (13 male, 9 female; mean age, 68 ±10 years) with severe aortic stenosis using 1.5 T MRI and a standardized scanning protocol consisting of gradient-echo phase-contrast velocity imaging and steady-state free precession-cine MRI before and after valve replacement therapy. Temporal changes of the aortic valve area, represented by systolic variations of the area of poststenotic turbulent flow at its smallest convergence, that is, the proximal vena contracta, were determined by MRI and quantified by a calculated parameter of temporal valve dynamics (T). T was defined as the period which the aortic valve spent over its maximal opening area (>85%) during systole. MRI was also used to determine left ventricular hypertrophy before (LVMI) and its regression (LVMR) after valve replacement. Findings were compared with transthoracic echocardiography and cardiac catheterization. RESULTS: All patients had an echocardiographic effective orifice area, EOATTE, of <1.0 cm2. The comparison of T to LVMI and LVMR revealed significant correlations (LVMI: r = -0.62; P = 0.002; LVMR: r = 0.62; P = 0.002). Further significant correlations with aortic stenosis severity were observed in the comparison with manual planimetry, invasive measurements, and echocardiographic valve areas, as well as with pressure gradients. CONCLUSIONS: MRI can measure systolic variations of the aortic valve area. Quantitative parameters of the hemodynamic relevance of valve dynamics obtained by this method correlate with established parameters of aortic stenosis severity and LVMR.


Asunto(s)
Estenosis de la Válvula Aórtica/diagnóstico , Válvula Aórtica/patología , Hemodinámica , Imagen por Resonancia Magnética/métodos , Adulto , Anciano , Anciano de 80 o más Años , Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/patología , Estenosis de la Válvula Aórtica/cirugía , Bioprótesis , Cateterismo Cardíaco , Progresión de la Enfermedad , Ecocardiografía , Femenino , Humanos , Imagen por Resonancia Magnética/instrumentación , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Factores de Tiempo
7.
Urol Int ; 84(1): 113-5, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20173381

RESUMEN

Ten years after his brother had been treated for seminoma, a 36-year-old male presented with a giant exulcerating mass involving the right testis and both inguinal regions. Subsequent biopsy revealed pure seminoma. Staging computed tomography (CT) showed bulky retroperitoneal and pelvic lymph node metastases. After seven courses of cisplatin-based chemotherapy, positron emission tomography suggested residual tumor in the right groin. The suspicious lesion and the right testis were resected showing no vital tumor tissue. Eight months after surgery there were no signs of disease progression at follow-up CT.


Asunto(s)
Seminoma/diagnóstico , Seminoma/terapia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Adulto , Antineoplásicos/uso terapéutico , Cisplatino/uso terapéutico , Progresión de la Enfermedad , Humanos , Metástasis Linfática , Masculino , Tomografía de Emisión de Positrones/métodos , Seminoma/patología , Neoplasias Testiculares/patología , Testículo/patología , Tomografía Computarizada por Rayos X/métodos
8.
J Card Surg ; 25(1): 116-9, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-19549043

RESUMEN

A 49-year-old male patient suffering from end-stage ischemic cardiomyopathy with a left ventricular ejection fraction below 15% was presented to redo coronary artery bypass grafting (CABG). Coronary angiogram demonstrated an occluded left anterior descending artery and occluded right coronary artery, perfused retrogradely from the circumflex artery. Since positron emission tomography did not demonstrate viable left ventricular myocardium except for the basis of the left ventricle, CABG was considered futile. Cardiac transplantation was contra-indicated due to pharmacologically unresponsive pulmonary artery hypertension. The patient successfully underwent left ventricular assist device implantation in combination with right coronary artery revascularization. The article reflects the regimen of right ventricular preservation in this patient.


Asunto(s)
Cardiomiopatía Dilatada/terapia , Puente de Arteria Coronaria , Corazón Auxiliar , Hipertensión Pulmonar/terapia , Función Ventricular Derecha , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/cirugía , Enfermedad de la Arteria Coronaria/terapia , Humanos , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones , Volumen Sistólico , Función Ventricular Izquierda
10.
Thyroid ; 19(9): 1009-11, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19731981

RESUMEN

BACKGROUND: Intratracheal goiter manifestations caused by ectopic thyroid tissue have occasionally been reported. We report a 42-year-old female who had undergone thyroid surgery twice, which had caused unilateral recurrent laryngeal nerve palsy. SUMMARY: The patient presented with progressive dyspnea. Magnetic resonance imaging showed a recurrent goiter growing through the tracheal wall. She was treated in a multidisciplinary approach; at first she underwent transtracheal laser surgical removal of the intratracheal mass followed by conventional completion thyroidectomy and radioiodine remnant ablation. Thorough histological analysis did not find any signs of malignancy. Currently the patient is disease- and complaint free. As far as we could ascertain, no patient with a recurrent benign goiter growing through the tracheal wall has been reported before. CONCLUSION: Recurrent benign goiter with intratracheal growth is extremely rare and requires a multidisciplinary approach.


Asunto(s)
Coristoma/cirugía , Bocio , Glándula Tiroides , Enfermedades de la Tráquea/cirugía , Adulto , Femenino , Bocio/diagnóstico , Humanos , Imagen por Resonancia Magnética , Complicaciones Posoperatorias/cirugía , Recurrencia , Tiroidectomía/efectos adversos , Enfermedades de la Tráquea/diagnóstico , Parálisis de los Pliegues Vocales/etiología
11.
J Magn Reson Imaging ; 30(1): 104-11, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19557852

RESUMEN

PURPOSE: To investigate dynamic contrast-enhanced MRI (DCE-MRI) for quantification of pulmonary blood flow (PBF) and blood volume (PBV) using the prebolus approach and to compare the results to the global lung perfusion (GLP). MATERIALS AND METHODS: Eleven volunteers were examined by applying different contrast agent doses (0.5, 1.0, 2.0, and 3.0 mL gadolinium diethylene triamine pentaacetic acid [Gd-DTPA]), using a saturation-recovery (SR) true fast imaging with steady precession (TrueFISP) sequence. PBF and PBV were determined for single bolus and prebolus. Region of interest (ROI) evaluation was performed and parameter maps were calculated. Additionally, cardiac output (CO) and lung volume were determined and GLP was calculated as a contrast agent-independent reference value. RESULTS: The prebolus results showed good agreement with low-dose single-bolus and GLP: PBF (mean +/- SD in units of mL/minute/100 mL) = single bolus 190 +/- 73 (0.5-mL dose) and 193 +/- 63 (1.0-mL dose); prebolus 192 +/- 70 (1.0-2.0-mL dose) and 165 +/- 52 (1.0-3.0-mL dose); GLP (mL/minute/100 mL) = 187 +/- 34. Higher single-bolus resulted in overestimated values due to arterial input function (AIF) saturation. CONCLUSION: The prebolus approach enables independent determination of appropriate doses for AIF and tissue signal. Using this technique, the signal-to-noise ratio (SNR) from lung parenchyma can be increased, resulting in improved PBF and PBV quantification, which is especially useful for the generation of parameter maps.


Asunto(s)
Medios de Contraste/administración & dosificación , Gadolinio DTPA/administración & dosificación , Aumento de la Imagen/métodos , Pulmón/irrigación sanguínea , Pulmón/fisiología , Imagen por Resonancia Magnética/métodos , Adulto , Velocidad del Flujo Sanguíneo/fisiología , Volumen Sanguíneo/fisiología , Gasto Cardíaco/fisiología , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Pulmón/anatomía & histología , Mediciones del Volumen Pulmonar/métodos , Masculino , Circulación Pulmonar/fisiología
12.
Eur J Radiol ; 69(2): 339-45, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18096344

RESUMEN

PURPOSE: To determine sensitivity, specificity and inter-observer variability of different whole-body MRI (WB-MRI) sequences in patients with multiple myeloma (MM). METHODS AND MATERIALS: WB-MRI using a 1.5T MRI scanner was performed in 23 consecutive patients (13 males, 10 females; mean age 63+/-12 years) with histologically proven MM. All patients were clinically classified according to infiltration (low-grade, n=7; intermediate-grade, n=7; high-grade, n=9) and to the staging system of Durie and Salmon PLUS (stage I, n=12; stage II, n=4; stage III, n=7). The control group consisted of 36 individuals without malignancy (25 males, 11 females; mean age 57+/-13 years). Two observers independently evaluated the following WB-MRI sequences: T1w-TSE (T1), T2w-TIRM (T2), and the combination of both sequences, including a contrast-enhanced T1w-TSE with fat-saturation (T1+/-CE/T2). They had to determine growth patterns (focal and/or diffuse) and the MRI sequence that provided the highest confidence level in depicting the MM lesions. Results were calculated on a per-patient basis. RESULTS: Visual detection of MM was as follows: T1, 65% (sensitivity)/85% (specificity); T2, 76%/81%; T1+/-CE/T2, 67%/88%. Inter-observer variability was as follows: T1, 0.3; T2, 0.55; T1+/-CE/T2, 0.55. Sensitivity improved depending on infiltration grade (T1: 1=60%; 2=36%; 3=83%; T2: 1=70%; 2=71%; 3=89%; T1+/-CE/T2: 1=50%; 2=50%; 3=89%) and clinical stage (T1: 1=58%; 2=63%; 3=79%; T2: 1=58%; 2=88%; 3=100%; T1+/-CE/T2: 1=50%; 2=63%; 3=100%). T2w-TIRM sequences achieved the best reliability in depicting the MM lesions (65% in the mean of both readers). CONCLUSIONS: T2w-TIRM sequences achieved the highest level of sensitivity and best reliability, and thus might be valuable for initial assessment of MM. For an exact staging and grading the examination protocol should encompass unenhanced and enhanced T1w-MRI sequences, in addition to T2w-TIRM.


Asunto(s)
Algoritmos , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Mieloma Múltiple/patología , Técnica de Sustracción , Imagen de Cuerpo Entero/métodos , Adulto , Anciano , Femenino , Humanos , Aumento de la Imagen/métodos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
14.
Int J Cardiol ; 119(3): e77-8, 2007 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-17537531

RESUMEN

We report a case of a 72-year-old man whose multi-slice cardiac computed tomography revealed an anomalous origin of the right coronary artery between the great arteries.


Asunto(s)
Anomalías de los Vasos Coronarios/diagnóstico por imagen , Anciano , Angina de Pecho/etiología , Anomalías de los Vasos Coronarios/complicaciones , Disnea/etiología , Humanos , Masculino , Tomografía Computarizada por Rayos X
17.
Eur Radiol ; 13(5): 1050-5, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12695827

RESUMEN

Pyomyositis (PM) is an infectious disease of the skeletal muscle with a wide range of symptoms such as pain, fever or swelling, and is predominantly found in the tropics. In recent years PM has increasingly been diagnosed in Europe and in the U.S. Our objective is to describe the ultrasound and MRI features of PM in children. A retrospective analysis of 12 children with PM (2 girls and 10 boys; age range 1-13 years) admitted to our hospital between 1998 and 2002 was carried out. All children had a US exam and 8 children underwent MRI. Children with osteomyelitis and accompanying myositis were excluded from this study. In all patients who had MRI ( n=8) the infected muscles were found to have the following features: hyperintensity on the T2-weighted images, diffuse borders and contrast enhancement. In the pelvis ( n=4), only one PM could be detected with US, in the other 3 cases only US of the hip joint was performed based on the clinical symptoms. In the extremities ( n=8) US always revealed an altered echogenicity of the affected muscles as well as fluid collection in 5 cases. Both US and MRI reveal characteristic changes of the PM. Ultrasound should be the first imaging modality in the extremities. In the pelvis MRI is the imaging modality of choice. The MRI is needed to differentiate pyomyositis from osteomyelitis.


Asunto(s)
Imagen por Resonancia Magnética , Miositis/diagnóstico , Ultrasonografía , Adolescente , Niño , Protección a la Infancia , Preescolar , Femenino , Estudios de Seguimiento , Alemania , Humanos , Lactante , Bienestar del Lactante , Articulaciones/diagnóstico por imagen , Articulaciones/patología , Pierna/diagnóstico por imagen , Pierna/patología , Masculino , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/patología , Miositis/microbiología , Miositis/patología , Pelvis/diagnóstico por imagen , Pelvis/patología , Radiografía , Estudios Retrospectivos , Hombro/diagnóstico por imagen , Hombro/patología , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/patología , Muslo/diagnóstico por imagen , Muslo/patología , Extremidad Superior/diagnóstico por imagen , Extremidad Superior/patología
18.
Pediatr Radiol ; 33(7): 485-8, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12712269

RESUMEN

We present a 2-year-old girl with an unusual presentation of Langerhans' cell histiocytosis (LCH). Five months prior to admission to our hospital, she received IV steroids for bronchial obstruction. On admission, clinical signs of SVC obstruction were evident and a mediastinal mass was evident on the chest radiograph and MRI. Biopsy revealed fibrosing mediastinitis. Five months later, osteolysis was present on a skull radiograph. Surgical biopsy of the skull lesion revealed LCH. This case is unique because it demonstrates a rare initial manifestation of LCH that has not been previously reported. Furthermore, the primary, solitary mediastinal manifestation without calcifications was histologically interpreted as fibrosing mediastinitis, and the final diagnosis of LCH was only made after identifying the skull lesion.


Asunto(s)
Histiocitosis de Células de Langerhans/complicaciones , Mediastinitis/etiología , Síndrome de la Vena Cava Superior/etiología , Preescolar , Femenino , Fibrosis , Histiocitosis de Células de Langerhans/diagnóstico , Humanos , Imagen por Resonancia Magnética , Mediastinitis/diagnóstico , Mediastinitis/diagnóstico por imagen , Radiografía , Cráneo/diagnóstico por imagen , Síndrome de la Vena Cava Superior/diagnóstico por imagen
19.
Pediatr Radiol ; 33(3): 168-72, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12612814

RESUMEN

BACKGROUND: Saethre-Chotzen syndrome (SCS) and Muenke-type mutation (MTM) are complex syndromes with craniosynostosis and skeletal anomalies including syndactyly, carpal and tarsal fusions, and cervical spine abnormalities. OBJECTIVE: In this study, we analysed radiographs of the cervical spine, hands and feet of a large patient population with genetically proven SCS and MTM. The aim was to describe the pattern of skeletal anomalies and to determine whether specific features are present that could help differentiate between the two entities. MATERIALS AND METHODS: Radiographs of 43 patients (23 males, 20 females) with SCS (n=35) or MTM (n=8) were evaluated. The median age was 8 years (range 1 month-36 years). All radiographs were reviewed by two radiologists. RESULTS: In the hands and feet, a variety of anomalies such as brachyphalangy, clinodactyly, partial syndactyly, partial carpal or tarsal fusion, and cone-shaped epiphyses were noted. Duplicated distal phalanx of the hallux (n=12/35) and triangular deformity of the epiphysis of the distal phalanx of the hallux (n=10/35) were detected in SCS only; calcaneo-cuboid fusion (n=2/35) was detected in MTM only. In the cervical spine, fusion of vertebral bodies and/or the posterior elements occurred only in patients with SCS. CONCLUSIONS: Pathognomonic signs for SCS are the triangular shape of the epiphysis and duplicated distal phalanx of the hallux. Calcaneo-cuboid fusion was detected in MTM only. These signs may be helpful in the differentiation of SCS from MTM.


Asunto(s)
Acrocefalosindactilia/diagnóstico por imagen , Acrocefalosindactilia/genética , Vértebras Cervicales/anomalías , Vértebras Cervicales/diagnóstico por imagen , Deformidades Congénitas del Pie/diagnóstico por imagen , Deformidades Congénitas de la Mano/diagnóstico por imagen , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , Anomalías Congénitas/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Mutación , Radiografía , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Columna Vertebral/anomalías , Columna Vertebral/diagnóstico por imagen
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...