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1.
Int Immunopharmacol ; 129: 111661, 2024 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-38359662

RESUMEN

Low back pain (LBP) is most commonly caused by intervertebral disc degeneration (IVDD). Pyroptosis, apoptosis, and necroptosis are crucial in IVDD pathogenesis; however, possible simultaneous occurrence in IVDD and co-regulation between the pathways and the regulatory mechanisms have not been investigated. PANoptosis is a regulated cell death (RCD) pathway with the key characteristics of pyroptosis, apoptosis, and necroptosis. This study revealed that tert-butyl hydroperoxide (TBHP) altered the expression of key proteins involved in PANoptosis in nucleus pulposus cells (NPCs). Furthermore, the natural product Kongensin A (KA), which has potential anti-necrotic and anti-inflammatory properties, inhibited PANoptosis. TAK1, often referred to as mitogen-activated protein kinase kinase kinase 7 (Map3k7), is a key regulator of innate immunity, cell death, inflammation, and cellular homeostasis; however, the physiological roles and regulatory mechanisms underlying IVDD remain unclear. In this study, we discovered that KA can upregulate TAK1 expression in NPCs, -which inhibits PANoptosis by suppressing oxidative stress. In conclusion, our results suggest that KA inhibits PANoptosis and delays IVDD progression in NPCs by upregulating TAK1 expression to maintain mitochondrial redox balance. Consequently, targeting TAK1 may be a promising therapeutic approach for IVDD therapy.


Asunto(s)
Diterpenos , Degeneración del Disco Intervertebral , Disco Intervertebral , Núcleo Pulposo , Humanos , Degeneración del Disco Intervertebral/tratamiento farmacológico , Apoptosis , Estrés Oxidativo , Disco Intervertebral/patología
2.
Eur J Radiol ; 158: 110639, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36463703

RESUMEN

BACKGROUND: The histological sub-classes of brain tumors and the Ki-67 labeling index (LI) of tumor cells are major factors in the diagnosis, prognosis, and treatment management of patients. Many existing studies primarily focused on the classification of two classes of brain tumors and the Ki-67LI of gliomas. This study aimed to develop a preoperative non-invasive radiomics pipeline based on multiparametric-MRI to classify-three types of brain tumors, glioblastoma (GBM), metastasis (MET) and primary central nervous system lymphoma (PCNSL), and to predict their corresponding Ki-67LI. METHODS: In this retrospective study, 153 patients with malignant brain tumors were involved. The radiomics features were extracted from three types of MRI (T1-weighted imaging (T1WI), fluid-attenuated inversion recovery (FLAIR), and contrast-enhanced T1-weighted imaging (CE-T1WI)) with three masks (tumor core, edema, and whole tumor masks) and selected by a combination of Pearson correlation coefficient (CORR), LASSO, and Max-Relevance and Min-Redundancy (mRMR) filters. The performance of six classifiers was compared and the top three performing classifiers were used to construct the ensemble learning model (ELM). The proposed ELM was evaluated in the training dataset (108 patients) by 5-fold cross-validation and in the test dataset (45 patients) by hold-out. The accuracy (ACC), sensitivity (SEN), specificity (SPE), F1-Score, and the area under the receiver operating characteristic curve (AUC) indicators evaluated the performance of the models. RESULTS: The best feature sets and ELM with the optimal performance were selected to construct the tri-categorized brain tumor aided diagnosis model (training dataset AUC: 0.96 (95% CI: 0.93, 0.99); test dataset AUC: 0.93) and Ki-67LI prediction model (training dataset AUC: 0.96 (95% CI: 0.94, 0.98); test dataset AUC: 0.91). The CE-T1WI was the best single modality for all classifiers. Meanwhile, the whole tumor was the most vital mask for the tumor classification and the tumor core was the most vital mask for the Ki-67LI prediction. CONCLUSION: The developed radiomics models led to the precise preoperative classification of GBM, MET, and PCNSL and the prediction of Ki-67LI, which could be utilized in clinical practice for the treatment planning for brain tumors.


Asunto(s)
Neoplasias Encefálicas , Glioblastoma , Glioma , Humanos , Antígeno Ki-67 , Estudios Retrospectivos , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Imagen por Resonancia Magnética/métodos , Glioblastoma/diagnóstico por imagen , Glioblastoma/patología
3.
Echocardiography ; 39(5): 735-738, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35466419

RESUMEN

We report a rare case of multiple giant coronary artery aneurysms combined with anomalous aortic origin of left coronary artery in a 30-years old man precisely diagnosed by multimodality imaging, including echocardiography, coronary computed tomographic angiography (CCTA), cardiac magnetic resonance imaging (CMR), and selective coronary angiography. The imaging results were finally confirmed by surgery. We present the clinical value of multimodality imaging in diagnosing coronary artery aneurysm and anomalous origin.


Asunto(s)
Aneurisma Coronario , Anomalías de los Vasos Coronarios , Adulto , Aorta , Angiografía por Tomografía Computarizada/métodos , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/diagnóstico por imagen , Angiografía Coronaria , Anomalías de los Vasos Coronarios/complicaciones , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/diagnóstico por imagen , Humanos , Masculino , Imagen Multimodal
4.
J Cardiovasc Magn Reson ; 24(1): 19, 2022 03 21.
Artículo en Inglés | MEDLINE | ID: mdl-35307027

RESUMEN

BACKGROUND: Both stenosis rate and intraplaque hemorrhage (IPH) are important predictors of stroke risk. Simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) cardiovascular magnetic resonance (CMR) imaging can detect both stenosis rate and IPH. We aimed to evaluate consistency between SNAP and digital subtraction angiography (DSA) to assess symptomatic patients with stroke and explore the performance of SNAP to identify IPH and the clinical factors associated with IPH. METHODS: Eighty-one symptomatic patients with stroke, admitted to Wuhan Union Hospital who underwent CMR high-resolution vessel wall imaging (HR-VWI) and SNAP, were retrospectively identified. For patients who received interventional therapy, the imaging functions of SNAP and HR-VWI were compared with DSA. The diameters of the intracranial and carotid vessels were measured, and stenotic vessels were identified. The consistency of SNAP and HR-VWI in identifying IPH was also examined, and the correlations between IPH and clinical factors were analyzed. RESULTS: SNAP was more consistent with DSA than HR-VWI in measuring vascular stenosis (intraclass correlation coefficient [ICC]SNAP-DSA = 0.917, ICC HR-VWI-DSA = 0.878). Regarding the diameter measurements of each intracranial and carotid vessel segment, SNAP was superior or similar to HR-VWI, and both were consistent with DSA in the measurement of major intracranial vascular segments. HR-VWI and SNAP exhibited acceptable agreement in identifying IPH (Kappa = 0.839, 95% confidence interval [CI]: 0.704-0.974). Patients who underwent interventional therapy had a higher plaque burden (P < 0.001). Patients with IPH had lower levels of high-density lipoprotein cholesterol (HDL) (P = 0.038) and higher levels of blood glucose (P = 0.007) and cystatin C (P = 0.040). CONCLUSIONS: CMR SNAP is consistent with DSA in measuring vessel diameters and identifying atherosclerosis stenosis in each intracranial and carotid vessel segment. SNAP is also a potential alternative to HR-VWI in identifying stenosis and IPH.


Asunto(s)
Estenosis Carotídea , Placa Aterosclerótica , Accidente Cerebrovascular , Angiografía de Substracción Digital , Arterias Carótidas/diagnóstico por imagen , Arterias Carótidas/patología , Estenosis Carotídea/complicaciones , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/terapia , Constricción Patológica/patología , Hemorragia/diagnóstico por imagen , Hemorragia/etiología , Hemorragia/patología , Humanos , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética/métodos , Placa Aterosclerótica/patología , Valor Predictivo de las Pruebas , Estudios Retrospectivos
5.
Interact Cardiovasc Thorac Surg ; 34(2): 336-338, 2022 01 18.
Artículo en Inglés | MEDLINE | ID: mdl-34557912

RESUMEN

We report a case of a 58-year-old female with Stanford type A aortic dissection sparring the donor aorta 2 years after heart transplantation. Lumbar spine magnetic resonance examination for low back pain discovered the aortic dissection which was confirmed by following computed tomography angiography. The patient received surgical treatment including total arc replacement and thoracic aortic endovascular repair and recovered well.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Trasplante de Corazón , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/etiología , Disección Aórtica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/etiología , Aneurisma de la Aorta Torácica/cirugía , Implantación de Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/métodos , Procedimientos Endovasculares/métodos , Femenino , Trasplante de Corazón/efectos adversos , Humanos , Persona de Mediana Edad , Stents , Resultado del Tratamiento
6.
Br J Radiol ; 94(1127): 20210259, 2021 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-34464552

RESUMEN

OBJECTIVE: Patients with dilated cardiomyopathy (DCM) and severely reduced left ventricular ejection fractions (LVEFs) are at very high risks of experiencing adverse cardiac events. A machine learning (ML) method could enable more effective risk stratification for these high-risk patients by incorporating various types of data. The aim of this study was to build an ML model to predict adverse events including all-cause deaths and heart transplantation in DCM patients with severely impaired LV systolic function. METHODS: One hundred and eighteen patients with DCM and severely reduced LVEFs (<35%) were included. The baseline clinical characteristics, laboratory data, electrocardiographic, and cardiac magnetic resonance (CMR) features were collected. Various feature selection processes and classifiers were performed to select an ML model with the best performance. The predictive performance of tested ML models was evaluated using the area under the curve (AUC) of the receiver operating characteristic curve using 10-fold cross-validation. RESULTS: Twelve patients died, and 17 patients underwent heart transplantation during the median follow-up of 508 days. The ML model included systolic blood pressure, left ventricular end-systolic and end-diastolic volume indices, and late gadolinium enhancement (LGE) extents on CMR imaging, and a support vector machine was selected as a classifier. The model showed excellent performance in predicting adverse events in DCM patients with severely reduced LVEF (the AUC and accuracy values were 0.873 and 0.763, respectively). CONCLUSIONS: This ML technique could effectively predict adverse events in DCM patients with severely reduced LVEF. ADVANCES IN KNOWLEDGE: The ML method has superior ability in risk stratification in severe DCM patients.


Asunto(s)
Cardiomiopatía Dilatada/complicaciones , Cardiomiopatía Dilatada/mortalidad , Aprendizaje Automático , Imagen por Resonancia Magnética/métodos , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/mortalidad , Adulto , Cardiomiopatía Dilatada/diagnóstico por imagen , Electrocardiografía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Medición de Riesgo , Volumen Sistólico , Disfunción Ventricular Izquierda/diagnóstico por imagen
7.
Front Oncol ; 11: 576232, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33796448

RESUMEN

BACKGROUND: Drug-eluting embolic transarterial chemoembolization (DEE-TACE) is an advance in TACE technique. However, at present there is insufficient evidence to support that DEE-TACE is superior to conventional TACE (cTACE) for hepatocellular carcinoma (HCC). The aim of this meta-analysis is to evaluate the efficacy and safety of TACE with CalliSpheres® microspheres (CSM-TACE) compared with cTACE in patients with HCC. DATA SOURCES: PubMed, Embase, Web of Science, CNKI and Wanfang Databases were searched to identify relevant articles published before March 26, 2020. The data regarding treatment response, survival profile, adverse events and liver function indexes were retrieved. RESULTS: A total of 16 studies with 1454 HCC patients (722 treated with CSM-TACE and 732 with cTACE) were included. Patients receiving CSM-TACE had higher 1-month complete response (CR), objective response rate (ORR), disease control rate (DCR) (odds ratio (OR): 2.00, 95% confidence interval (95% CI): 1.29-3.09; OR: 2.87, 95% CI: 2.15-3.83; OR: 2.01, 95% CI: 1.37-2.95, respectively), 3-month CR, ORR, DCR (OR: 4.04, 95%CI: 2.46-6.64; OR: 3.39, 95%CI: 2.45-4.70; OR: 1.71, 95%CI: 1.14-2.55 respectively), and 6-month CR, ORR, DCR (OR: 4.02, 95%CI: 2.26-7.16; OR: 3.00, 95%CI: 2.05-4.38; OR: 2.66, 95%CI: 1.70-4.16 respectively) than those treated with cTACE. Furthermore, CSM-TACE exhibited a trend toward improved progression free survival (hazard ratio (HR): 0.86, 95%CI: 0.67-1.11) and overall survival (HR: 0.79, 95%CI: 0.59-1.07) over cTACE although these differences did not reach statistical significance. In terms of safety, the two TACE treatments showed similar post-treatment pain (OR: 0.84, 95%CI: 0.55-1.28), fever (OR: 0.99, 95%CI: 0.60-1.63), nausea/vomiting (OR: 0.84, 95% CI: 0.60-1.17), as well as 1-month follow-up alanine aminotransferase (Mean difference (MD): -3.66, 95%CI: -10.38-3.07), aspartate aminotransferase (MD: -2.30, 95%CI: -8.91-4.31) and total bilirubin (MD: -0.15, 95%CI: -2.26-1.96). CONCLUSION: CSM-TACE displays superior treatment response, non-inferior survival profile and safety over cTACE in HCC patients.

8.
BMC Med Imaging ; 21(1): 71, 2021 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-33858367

RESUMEN

BACKGROUND: Cardiac lipoma is a rare primary tumor in the heart and pericardium. Multimodality imaging methods, especially magnetic resonance imaging (MRI), are crucial in detecting and diagnosing cardiac lipomas. Besides, they are of significant importance in management of cardiac lipomas. The aim of this study was to evaluate the value of multimodality imaging methods in diagnosing and treatment of cardiac lipoma by describing a series of cases of cardiac lipoma. MATERIALS AND METHODS: Data of patients with cardiac lipoma at a local institution were retrospectively collected. Their imaging findings on echocardiography, computed tomography (CT), and cardiac MRI and clinical management were described in detail. RESULTS: 12 patients with cardiac lipoma were retrospectively included with thirteen lipomas found within heart and pericardium. Two patients' lipoma were symptomatic, while lipomas in other 10 patients were found incidentally. Most lipomas were sensitively detected with echocardiography. Accurate diagnoses were achieved with CT and MRI in all cases. Surgical resection was performed in one symptomatic patient due to the obstruction of the left ventricular outflow tract, while the removal of pericardial lipoma in another symptomatic patient was not possible due to diffuse myocardial infiltration observed in MRI. Based on MRI findings, two patients without clinical symptoms also underwent surgery to prevent the risk of detachment of ventricular lipoma with a narrow pedicle in one patient and potential further thinning of the myocardium by pericardial lipoma growth in another patient. CONCLUSIONS: Cardiac lipoma could be sensitively detected and accurately diagnosed with multiple noninvasive imaging tools. Comprehensive evaluation with multimodality imaging methods should also be conducted for better management planning and follow-up in all patients.


Asunto(s)
Neoplasias Cardíacas/diagnóstico por imagen , Lipoma/diagnóstico por imagen , Imagen Multimodal/métodos , Adulto , Anciano , Anciano de 80 o más Años , Ecocardiografía , Femenino , Humanos , Hallazgos Incidentales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pericardio/diagnóstico por imagen , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
10.
Curr Med Sci ; 41(1): 158-166, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33582921

RESUMEN

Myocardial fiber deformation measurements have been reported to be associated with adverse outcomes in patients with acute heart failure and those with myocardial infarction. However, few studies have addressed the prognostic value of global circumferential strain (GCS) in dilated cardiomyopathy (DCM) patients with severely impaired systolic function. This study aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived GCS in DCM patients with severely reduced ejection. Consecutive DCM patients with severely reduced ejection fraction (EF <35%) who underwent CMR were included. GCS was calculated from CMR cine images. The clinical endpoint was a composite of all-cause mortality, heart transplantation, implantable cardioverter defibrillator (ICD) implantation and aborted sudden cardiac death (SCD). A total of 129 patients with a mean EF of 15.33% (11.36%-22.27%) were included. During a median follow-up of 518 days, endpoint events occurred in 50 patients. Patients with GCS ≥ the median (-5.17%) had significantly reduced event-free survival as compared with those with GCS < the median (P<0.01). GCS was independently associated with adverse events after adjusting for clinical and imaging risk factors including extent of late gadolinium enhancement (LGE) (P<0.05). Adding GCS into the model including the extent of LGE resulted in significant improvements in the C-statistic (from 0.706 to 0.742; P<0.05) with a continuous net reclassification improvement (NRI) of 29.71%. It was concluded that GCS derived from CMR could be useful for risk stratification in DCM patients with severely reduced EF, which may increase common imaging risk factors including LGE.


Asunto(s)
Cardiomiopatía Dilatada/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Adulto , Cardiomiopatía Dilatada/epidemiología , Cardiomiopatía Dilatada/fisiopatología , Procedimientos Quirúrgicos Cardiovasculares/estadística & datos numéricos , Medios de Contraste/administración & dosificación , Medios de Contraste/normas , Imagen de Difusión por Resonancia Magnética/normas , Femenino , Gadolinio/administración & dosificación , Gadolinio/normas , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Volumen Sistólico , Análisis de Supervivencia
11.
J Cardiothorac Surg ; 16(1): 1, 2021 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-33407682

RESUMEN

Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement of diagnostic methods and treatment techniques, more cases of cardiac lipomas have been reported and suggest that the entity previously widely thought to display classic features may also show atypical findings. A systemic review of the rare cardiac tumor was done by searching the literature of cardiac lipoma. We endeavor to summarize the clinical features of the rare disease from pathogenesis to treatment. Literature of cardiac lipoma was retrospectively searched through PubMed and 255 cases of cardiac lipoma were included into this analysis. Cardiac lipomas can occur anywhere within the heart, 53.1% were located within the cardiac chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7% involved multiple structures. More than half of the reported cardiac lipomas (66%) may be clinically symptomatic, presenting with symptoms ranging from chest discomfort to syncope depending on their size and location as well as extent of myocardial involvement. Noninvasive cardiac imaging has replaced the role of autopsy and cardiothoracic surgery in detection and diagnosis of cardiac lipomas. Most symptomatic patients (83.7%) were treated by resection of cardiac lipomas and 68.3% of asymptomatic patients also underwentprophylactic resection. Overgrowth and myocardial infiltration of lipomas may result in unsuccessful resection. Recurrence of cardiac lipomas was rare but reported in a few cases. The early detection and accurate diagnosis of cardiac lipoma is of great significance in clinical management, to avoid an unfavourable outcome due to overgrowth.


Asunto(s)
Neoplasias Cardíacas , Lipoma , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/etiología , Neoplasias Cardíacas/cirugía , Humanos , Lipoma/diagnóstico , Lipoma/etiología , Lipoma/cirugía , Pericardio , Enfermedades Raras
12.
Clin Imaging ; 69: 266-268, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33010733

RESUMEN

Pregnant women with 2019 novel coronavirus disease (COVID-19) pneumonia are a special group of patients in the pandemic. We report a case of pregnant woman with COVID-19 pneumonia in the second trimester. Clinical and imaging features of the patient were similar to that reported in the literatures for both perinatal patients and non-pregnant patients.


Asunto(s)
Betacoronavirus , COVID-19 , Coronavirus , Neumonía Viral , Complicaciones Infecciosas del Embarazo , COVID-19/diagnóstico por imagen , Femenino , Humanos , Pandemias , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Complicaciones Infecciosas del Embarazo/epidemiología , Segundo Trimestre del Embarazo , Mujeres Embarazadas , SARS-CoV-2 , Tórax , Tomografía Computarizada por Rayos X
13.
Front Cardiovasc Med ; 8: 766423, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34977183

RESUMEN

Background: Late enhanced cardiac magnetic resonance (CMR) images of the left ventricular myocardium contain an enormous amount of information that could provide prognostic value beyond that of late gadolinium enhancements (LGEs). With computational postprocessing and analysis, the heterogeneities and variations of myocardial signal intensities can be interpreted and measured as texture features. This study aimed to evaluate the value of texture features extracted from late enhanced CMR images of the myocardium to predict adverse outcomes in patients with dilated cardiomyopathy (DCM) and severe systolic dysfunction. Methods: This single-center study retrospectively enrolled patients with DCM with severely reduced left ventricular ejection fractions (LVEFs < 35%). Texture features were extracted from enhanced late scanning images, and the presence and extent of LGEs were also measured. Patients were followed-up for clinical endpoints composed of all-cause deaths and cardiac transplantation. Cox proportional hazard regression and Kaplan-Meier analyses were used to evaluate the prognostic value of texture features and conventional CMR parameters with event-free survival. Results: A total of 114 patients (37 women, median age 47.5 years old) with severely impaired systolic function (median LVEF, 14.0%) were followed-up for a median of 504.5 days. Twenty-nine patients experienced endpoint events, 12 died, and 17 underwent cardiac transplantations. Three texture features from a gray-level co-occurrence matrix (GLCM) (GLCM_contrast, GLCM_difference average, and GLCM_difference entropy) showed good prognostic value for adverse events when analyzed using univariable Cox hazard ratio regression (p = 0.007, p = 0.011, and p = 0.007, retrospectively). When each of the three features was analyzed using a multivariable Cox regression model that included the clinical parameter (systolic blood pressure) and LGE extent, they were found to be independently associated with adverse outcomes. Conclusion: Texture features related LGE heterogeneities and variations (GLCM_contrast, GLCM_difference average, and GLCM_difference entropy) are novel markers for risk stratification toward adverse events in DCM patients with severe systolic dysfunction.

14.
Eur J Radiol ; 132: 109137, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33022550

RESUMEN

PURPOSE: To assess the feasibility and advantages of high-resolution high-contrast magnetic resonance neurography (HRHC-MRN) for visualizing the morphology and pathology of the peripheral branches of cranial nerves. MATERIALS: cMRN (3D SPACE STIR sequence) and HRHC-MRN (contrast enhanced 3D SPACE STIR sequence) were performed at 3 T MR unit on 16 volunteers and 12 patients with head and neck tumors. Quantitative measurements such as SNR, CNR and CR were calculated. Three readers evaluated the continuity of the 10 major peripheral branches of cranial nerves using a 5-score scale (scores 0-4). Interobserver variability was tested. Quantitative measurements and scores were compared between cMRN and HRHC-MRN. The imaging features of the nerve pathology were analyzed. RESULTS: The CRs of nerve to bone marrow, nerve to muscle, and nerve to gland were significantly higher with HRHC-MRN than with cMRN (P = 0.014, P = 0.02, P <0.001, respectively). The scores of all nerve trunks were significantly higher with HRHC-MRN than with cMRN (all, P < 0.001). For all nerves on HRHC-MRN, the interobserver consistency was excellent across the three readers (all κ > 0.8). The scores of the inferior alveolar nerve, hypoglossal nerve, lingual nerve, facial nerve, infraorbital nerve, masseteric nerve, glossopharyngeal/vagus nerve, supraorbital nerve, auriculotemporal nerve and buccal nerve were 3.95, 3.77, 3.63, 3.25, 3.15, 3.04, 3.04, 2.87, 2.79, 1.88, respectively. CONCLUSION: HRHC-MRN provides improved visualization of the peripheral branches of cranial nerves and is a promising nerve-selective imaging method for evaluating cranial nerve morphology and pathology.


Asunto(s)
Nervios Craneales , Imagen por Resonancia Magnética , Nervios Craneales/diagnóstico por imagen , Humanos , Imagenología Tridimensional , Espectroscopía de Resonancia Magnética , Variaciones Dependientes del Observador , Nervios Periféricos
15.
Eur J Radiol ; 117: 41-48, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31307651

RESUMEN

PURPOSE: This study aims to provide normal reference values for quantitative parameters for brachial and lumbosacral plexi on multimodal MRI. In addition, the parameter variations between the left and right sides, the individual nerve groups, genders and age groups were also evaluated. MATERIALS AND METHODS: Multimodal MRI was evaluated in 163 healthy subjects, who were randomly divided into three groups: brachial plexus, lumbosacral plexus and diffusion tensor imaging groups. Nerve diameters, contrast ratios, T2 nerve-muscle signal ratios (nT2), fractional anisotropy (FA) values and apparent diffusion coefficients (ADC) were measured in both plexi. Parametric tests and Pearson correlation for normally distributed data, and non-parametric tests and Spearman correlation for non-normally distributed data were used. RESULTS: There were no significant differences in parameters between the left and right sides. The diameters of the C7, L4-S1, sciatic, and femoral nerve roots were larger in men than in women (P < 0.05). The nT2 in the brachial and lumbosacral plexi and the contrast ratio in the lumbosacral plexus were significantly higher in the elderly. The diameter of the S1 nerve root was smaller in the elderly. There were no significant differences between the individual nerve groups in contrast ratios and in brachial plexus nT2. A gradual increase in the nT2 from the top to the bottom was observed in the L4-S1 nerve roots (P < 0.05). CONCLUSION: This study provides multi-parameter normative data for the brachial and lumbosacral plexi while considering differences between the two sides, the individual nerves, genders, and the ages.


Asunto(s)
Plexo Braquial/diagnóstico por imagen , Plexo Lumbosacro/diagnóstico por imagen , Imagen por Resonancia Magnética , Imagen Multimodal , Polineuropatías/diagnóstico por imagen , Adulto , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven
16.
Medicine (Baltimore) ; 97(20): e10799, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29768375

RESUMEN

RATIONALE: Spinal Giant Cell Tumors (SGCTs) are rare, aggressive, and benign tumors. Their presence in the cervical spine is even more exceptional. There are few reports of cervical GCT in the literature, especially recurrent cases. The treatment are challenging to clinically because radical resection is extremely difficult. PATIENT CONCERNS: In this study, we present the cases of a 25-year-old man and a 41-year-old woman who suffered from recurrent cervical GCT. INTERVENTIONS: They underwent extensive total spondylectomy of C3-5 and C2-4, respectively, by a combined anterior and posterior approach. OUTCOMES: Both patients had a satisfactory prognosis after 2 years followe-up, and extensive total spondylectomy provided good disease-free survival rates. Extensive total spondylectomy of cervical recurrent giant cell tumor was successfully achieved combined anterior and posterior approach. LESSONS: This surgical technique can be an effective option for this pathological condition, which is difficult to manage using other conventional treatment options including repeated curettage and radiotherapy. However, there are insufficient data on long-term subjective outcomes in this type of patient, and larger series studies are needed to determine the efficacy of this approach, especially compared with piecemeal resection techniques.


Asunto(s)
Vértebras Cervicales/cirugía , Tumores de Células Gigantes/cirugía , Recurrencia Local de Neoplasia/cirugía , Neoplasias de la Columna Vertebral/cirugía , Adulto , Femenino , Humanos , Masculino , Resultado del Tratamiento
17.
Br J Radiol ; 91(1083): 20170414, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29166135

RESUMEN

OBJECTIVE: To investigate the potential of diffusion tensor imaging (DTI) in quantitatively monitoring chronic constriction injuri (CCI) of sciatic nerves and to analyse the association of DTI parameters with nerve histology and limb function. METHODS: CCI was created on sciatic nerves in the right hind legs of 20 rabbits with the left as control. DTI parameters-fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD) and radial diffusivity (RD)-and limb function were longitudinally evaluated. Pathology analysis was performed on day 3 (d3), week 1 (w1), 2, 4, 6, 8 and 10. RESULTS: FA of the constricted nerves decreased on d3 (0.316 ± 0.044) and increased from w1 to w10 (0.331 ± 0.018, 0.354 ± 0.044, 0.375 ± 0.015, 0.394 ± 0.020, 0.42 ± 0.03 and 0.464 ± 0.039). ADC increased on d3 until w2 (1.502 ± 0.126, 1.462 ± 0.058 and 1.473 ± 0.124 × 10-3 mm2 s-1) and decreased to normal from w4 to w10 (1.356 ± 0.129, 1.375 ± 0.107, 1.290 ± 0.064 and 1.298 ± 0.026 × 10-3 mm2 s-1). AD decreased and stayed low from d3 to w10 (2.042 ± 0.160, 2.005 ± 0.095, 2.057 ± 0.124, 1.952 ± 0.213, 1.988 ± 0.180, 1.947 ± 0.106 and 2.097 ± 0.114). RD increased on d3 (1.233 ± 0.152) and declined from w1 to w10 (1.19 ± 0.06, 1.181 ± 0.14, 1.071 ± 0.102, 1.068 ± 0.084, 0.961 ± 0.063 and 0.923 ± 0.058). FA, ADC and RD correlated significantly with limb functional scores (all Ps < 0.0001) and their changes were associated with histological changes. CONCLUSION: FA, ADC and RD are promising to monitor CCI. AD may be a stable indicator for injury. Histological changes, oedema, axon loss and demyelination, and fibrosis, accompanied the changes of these parameters. Advances in knowledge: DTI parameters can detect and monitor acute and chronic changes after nerve compression.


Asunto(s)
Imagen de Difusión Tensora/métodos , Traumatismos de los Nervios Periféricos/diagnóstico por imagen , Traumatismos de los Nervios Periféricos/patología , Nervio Ciático/lesiones , Animales , Anisotropía , Constricción Patológica , Modelos Animales de Enfermedad , Procesamiento de Imagen Asistido por Computador , Conejos
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