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1.
J Rheumatol ; 51(3): 263-269, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37914219

RESUMO

OBJECTIVE: To assess the construct validity of the novel Outcome Measures in Rheumatology (OMERACT) ultrasound (US) semiquantitative scoring system for morphological lesions in major salivary glands by comparing it with magnetic resonance imaging (MRI) and unstimulated whole salivary flow rates (U-WSFRs) in patients with primary Sjögren syndrome (pSS). METHODS: Nine sonographers applied the OMERACT 0-3 grayscale scoring system for parotid (PGs) and submandibular glands (SMGs) in 11 patients with pSS who also had MRIs performed. These were evaluated by 2 radiologists using a semiquantitative 0-3 scoring system for morphological lesions. The agreement between US and MRI and the association between U-WSFRs and imaging structural lesions was determined. A score ≥ 2 for both US and MRI was defined as gland pathology. RESULTS: The prevalence of US morphological lesions in 11 patients with a score ≥ 2 was 58% for PGs and 76% for SMGs, and 46% and 41% for PGs and SMGs, respectively, for MRI. The agreement between OMERACT US scores and MRI scores was 73-91% (median 82%) in the right PG and 73-91% (median 91%) in the left PG, 55-91% (median 55%) in the right SMG and 55-82% (median 55%) in the left SMG. When relations between the presence of hyposalivation and an US score ≥ 2 were examined, agreement was 91-100% (median 83%) in both PGs and 55-91% (median 67%) in both SMGs. CONCLUSION: There is moderate to strong agreement between the OMERACT US and MRI scores for major salivary glands in patients with pSS. Similar agreement ratios were observed between the higher OMERACT US scores and presence of hyposalivation.


Assuntos
Síndrome de Sjogren , Xerostomia , Humanos , Síndrome de Sjogren/diagnóstico por imagem , Glândulas Salivares/diagnóstico por imagem , Ultrassonografia , Xerostomia/diagnóstico por imagem , Imageamento por Ressonância Magnética
2.
Tuberk Toraks ; 66(3): 185-196, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30479225

RESUMO

INTRODUCTION: Pulmonary embolism (PE) is known as one of the major causes of cardiovascular morbidity and mortality. Identification of high risk patients for short term and long-term mortality is crucial. The purpose of this study is to demonstrate the prognostic importance of simplified pulmonary embolism severity index (sPESI), radiological investigations and comorbidities in terms of short-term mortality by simultaneous assessment of sPESI score, pulmonary computed tomography (CT) angiography findings and underlying comorbidities in patients diagnosed with acute pulmonary embolism. MATERIALS AND METHODS: We retrospectively evaluated 570 patients diagnosed with acute PE confirmed by computer tomography pulmonary angiography (CTPA). Comorbidities were recorded, pulmonary embolism severity index scores were calculated and CTPA data were evaluated as predictors for short-term mortality. RESULT: The study population consisted of 570 patients, 292 (51.2%) patients were female and 74 patients (12.9%) died within 30 days due to PE diagnosis. In univariate analysis male gender (p= 0.031), congestive heart failure (CHF)(p< 0.029), main pulmonary artery involvement (p= 0.045), presence of pleural effusion (p= 0.001) and pericardial effusion (p= 0.004) at time of diagnosis and high risk sPESI group (p< 0.001) had a significant influence on mortality. In the multivariate analysis, pleural effusions (HR, 1.67; CI, 1.05-2.66; p< 0.030) and sPESI high risk group (HR, 9.56; CI, 4.71-19.43; p< 0.001) were remained significant and independent prognostic factors for survival. CONCLUSIONS: The present study underlined that presence of pleural effusion at the time of diagnosis in patients with massive pulmonary embolism and a high sPESI score in other patients were significant predictors of short-term mortality.


Assuntos
Embolia Pulmonar/mortalidade , Índice de Gravidade de Doença , Idoso , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/mortalidade , Prognóstico , Embolia Pulmonar/diagnóstico , Estudos Retrospectivos , Medição de Risco , Turquia
3.
Acta Radiol ; 58(7): 849-855, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27799571

RESUMO

Background Pelvic congestion syndrome (PCS) is a commonly overlooked condition which is a potential cause of chronic pelvic pain. Magnetic resonance imaging (MRI) of the sacroiliac joint (SIJ) may demonstrate unexpected conditions that can mimic sacroiliitis (SI). Awareness of MRI-defined pelvic venous congestion (PVC) may help in identifying PCS, where vascular abnormality may be the sole manifestation of SIJ pain. Purpose To detect incidental MRI-defined PVC in patients who underwent SIJ-MRI for presumed SI and define the variance of its incidence. Material and Methods A total of 870 women who underwent SIJ-MRI were retrospectively evaluated. Incidental findings of PVC and other genitourinary and musculoskeletal system disorders were documented. Results Of the 774 included patients, 37% demonstrated incidentally detected imaging findings related to the genitourinary system, musculoskeletal system, and PVC. The prevalence of MRI-defined PVC signs was higher in patients without SI than with SI. The prevalence of musculoskeletal disorders was higher in patients with SI whereas prevalence for genitourinary disorders was similar. Binary logistic regression analysis revealed a statistically significant correlation between SI-PVC and SI-genitourinary disorders but not between SI-musculoskeletal disorders pairs ( P = 0.001, 0.001, and 0.057 > 0.05). The probability of observing SI in SIJ-MRI is positively correlated with the absence of PVC or genitourinary disorders. Conclusion Patients who underwent MRI for presumed SI demonstrated incidental PVC as well as other genitourinary and musculoskeletal findings. An awareness of these imaging findings can help identify PVC and may draw clinicians' attention to the possibility of PCS.


Assuntos
Hiperemia/complicações , Hiperemia/diagnóstico por imagem , Imageamento por Ressonância Magnética , Articulação Sacroilíaca/diagnóstico por imagem , Sacroileíte/complicações , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Pelve , Estudos Retrospectivos , Adulto Jovem
4.
Acta Radiol ; 57(7): 878-85, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26315838

RESUMO

BACKGROUND: Knowledge of the precise sites of deep infiltrating endometriosis (DIE) lesions is essential for preoperative workup and treatment. Susceptibility-weighted imaging (SWI) has high sensitivity for blood products and have recently been applied in abdominal imaging. PURPOSE: To determine the value of SWI in the diagnosis of DIE. MATERIAL AND METHODS: Forty-three clinically suspected DIE patients with sonographically diagnosed ovarian endometriomas who had tenderness or palpable nodule(s) on rectovaginal examination were referred to pelvic magnetic resonance imaging (MRI) including SWI. Two patients were excluded from the study because of low quality of SWI series. Twenty-eight patients who were offered laparoscopic endometriosis surgery (LES) preferred medical treatment over surgical approach. Thirteen out of 41 participants had LES. Lesions were evaluated for their locations, signal intensities on T1-weighted (T1W) and T2-weighted (T2W) images, and presence of signal voids on SWI using 3T MRI and correlated with LES findings. RESULTS: A total of 18 endometriosis foci were laparoscopically removed from 13 patients. DIE lesions removed at laparoscopy were located at the uterosacral ligament (9/18), rectovaginal region (4/18), retrocervical region (2/18), and fallopian tubes (3/18). Eleven out of 18 (61%) DIE foci were detected by their high-signal intensities on T1W images whereas 16 out of 18 (89%) DIE foci were detected by signal voids on SWI. CONCLUSION: SWI imaging with its high sensitivity to blood products, contributes to the diagnosis of DIE by depicting different phases of hemorrhage not seen by conventional MRI sequences.


Assuntos
Endometriose/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Endometriose/patologia , Endometriose/cirurgia , Feminino , Humanos , Laparoscopia , Estudos Prospectivos , Sensibilidade e Especificidade
5.
Acta Radiol ; 57(11): 1418-1424, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26041768

RESUMO

Background Dynamic magnetic resonance imaging (dMRI) is an imaging tool that can be used to evaluate and stage pelvic organ prolapse (POP). Greater understanding of the incidental detection of POP in asymptomatic patients is needed. Purpose To evaluate the prevalence of dMRI-detected POP in pre-and postmenopausal women who were imaged for reasons unrelated to pelvic floor dysfunction. Material and Methods A total of 227 women who had diagnoses that did not include POP underwent abdominal/pelvic dMRI. Patients with a positive gynecological examination for or a clinical history of POP ( n = 11), hysterectomy ( n = 4), or gynecologic-oncology surgery ( n = 2) were excluded, as well as patients who were unable to strain during MRI ( n = 11). A total of 199 patients without visible prolapse were enrolled in the study. An H-line, M-line, pubococcygeal line (PCL), and mid-pubic line (MPL) were used to detect and grade prolapse. Results The prevalence of dMRI-identified POP was higher in postmenopausal subjects. The PCL led to a greater frequency of prolapse detection than the MPL. The frequency of middle compartment descent was similar regardless of whether the PCL or MPL was used as a reference line. There was a higher incidence of prolapse in the posterior compartment. Using an H-line and PCL as references, the anterior and posterior compartments were found to significantly differ between pre- and postmenopausal subjects. The MRI parameters that were used to define POP were not correlated with parity, vaginal birth, BMI, or fetal birth weight. With respect to the MPL, age was correlated with both the presence of an elongated H-line and with descent. Conclusion Dynamic MRI identified incidental pelvic organ prolapse in asymptomatic patients. The prevalence of dMRI-detected POP was higher in postmenopausal women without visible prolapse. These findings suggest the need for further studies to identify how to modify the currently used dMRI thresholds for postmenopausal women.


Assuntos
Doenças Assintomáticas/epidemiologia , Imageamento por Ressonância Magnética/estatística & dados numéricos , Prolapso de Órgão Pélvico/diagnóstico por imagem , Prolapso de Órgão Pélvico/epidemiologia , Pós-Menopausa , Pré-Menopausa , Adulto , Feminino , Humanos , Achados Incidentais , Pessoa de Meia-Idade , Prevalência , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Turquia/epidemiologia
6.
J Obstet Gynaecol Res ; 42(7): 890-894, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27078713

RESUMO

Catamenial sciatic radiculopathy resulting from endometriosis is a rare presentation of a common disease in which the pathogenesis of pain is still under debate. A 32-year-old woman presented complaining of infertility, catamenial sciatica, and pelvic and gluteal pain. Magnetic resonance imaging showed endometriotic infiltration of the left proximal lumbosacral plexus, sacral nerve track, sciatic nerve at the sciatic notch and pudendal nerve along the iliococcygeus muscle, together with left endometrioma and deep infiltrating endometriosis lesions. Laparoscopic endometriosis surgery was performed after all of the complications and possible outcomes of the surgery were discussed with the patient. Our case report highlights the importance of magnetic resonance imaging evidence of perineural spread, outlining the pathophysiology of the pelvic pain associated with neuroendometriosis.

7.
J Ultrasound Med ; 34(1): 151-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25542951

RESUMO

OBJECTIVES: The aim of this study was to determine whether shear wave elastography of the placenta differs between normal pregnancies and pregnancies complicated by preeclampsia between 20 and 23 weeks' gestation. METHODS: A prospective study was performed with 204 consecutive singleton pregnancies that had routine anomaly scanning between 20 and 23 weeks' gestation. One hundred twenty-nine of these patients were examined with shear wave elastography; 101 women who had clinically normal pregnancies with normal fetal biometric measurements and normal deliveries without any perinatal complications formed group A, and 28 women who had a clinical diagnosis of early-onset preeclampsia before anomaly scanning formed group B. Women with either posterior placentations (n = 63) or other obstetric disorders (n = 12) were excluded from the study. RESULTS: Shear wave elastographic values for group B were significantly higher than those for group A (P < .05). No statistically significant difference was found between the elasticity values measured at the center or edge of the placenta (P > .05). CONCLUSIONS: Shear wave elastography differentiates between the placental elasticity of normal pregnancies and pregnancies complicated by preeclampsia when performed during the second trimester. As a new method for tissue characterization, shear wave elastography is useful for evaluation of placental function and can be used as a supplement to existing methods for prediction of preeclampsia.


Assuntos
Técnicas de Imagem por Elasticidade , Doenças Placentárias/diagnóstico por imagem , Placenta/diagnóstico por imagem , Pré-Eclâmpsia/diagnóstico por imagem , Segundo Trimestre da Gravidez , Adolescente , Adulto , Elasticidade , Feminino , Humanos , Gravidez , Estudos Prospectivos , Adulto Jovem
8.
Arch Gynecol Obstet ; 291(4): 811-7, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25241273

RESUMO

PURPOSE: The aim of this study is to determine if the Strain elastography (SE) of the placenta measured in the second trimester differs between normal pregnancies and pregnancies complicated by preeclampsia (PE). METHODS: 219 singleton pregnancies who had routine anomaly scanning between the 20th and 23rd weeks of gestation were included in this observational study. Women with either posterior placentations (n = 63) or other obstetric pathologies (n = 12) were excluded from the study, leaving 144 pregnant women for the evaluation of strain ratio with SE. One hundred and one women with normal pregnancies and normal deliveries without any perinatal complications formed Group A. Twenty-eight patients who were clinically diagnosed with early onset PE before anomaly scanning formed Group B. Fifteen normotensive pregnant women with either mild proteinuria, and past history of preeclampsia during their previous pregnancies formed Group C. The strain ratios were compared between the groups. RESULTS: The strain ratio of Group B was significantly higher than those of Group A and Group C (p < 0.05). CONCLUSIONS: The placental elasticity ratios measured by SE imaging during the second trimester differ between the normal pregnancies and the pregnancies complicated by PE. SE might be used as a supplement tool in addition to the existing methods for the prediction of PE.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Placenta/diagnóstico por imagem , Placenta/fisiopatologia , Pré-Eclâmpsia/diagnóstico por imagem , Útero/diagnóstico por imagem , Adolescente , Adulto , Estudos de Casos e Controles , Parto Obstétrico , Elasticidade , Feminino , Humanos , Análise Multivariada , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez
9.
Exp Clin Transplant ; 22(3): 214-222, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38695590

RESUMO

OBJECTIVES: Sarcopenia is common in chronic kidney disease and associated with increased mortality. We investigated the prevalence of sarcopenia, defined as low muscle mass by the psoas muscle index, in endstage renal disease patients on waiting lists for kidney transplant and determined its association with prognostic nutritional index, C-reactive protein-toalbumin ratio, cardiovascular events, and mortality. MATERIALS AND METHODS: Our study included 162 patients with end-stage renal disease and 87 agematched healthy controls. We calculated nutritional status as follows: prognostic nutritional index = (10 × albumin [g/dL]) + (0.005 × total lymphocyte count (×103/µL]) and C-reactive protein-to-albumin ratio. We gathered demographic and laboratory data from medical records. RESULTS: Patients with end-stage renal disease had a mean age of 44.7 ± 14.2 years; follow-up time was 3.37 years (range, 0.35-9.60 y). Although patients with endstage renal disease versus controls had higher prevalence of sarcopenia (16.7% vs 3.4%; P = .002) and C-reactive protein-to-albumin ratio (1.47 [range, 0.12-37.10] vs 0.74 [range, 0.21-10.20]; P < .001), prognostic nutritional index was lower (40 [range, 20.4-52.2] vs 44 [range, 36.1-53.0]; P < .001). In patients with end-stage renal disease with and without sarcopenia, prognostic nutritional index (P = .005) was lower and C-reactive protein-to-albumin ratio (P = .041) was higher in those with versus those without sarcopenia. Among 67 patients on waiting lists who received kidney transplants, those without sarcopenia had better 5-year patient survival posttransplant than those with sarcopenia (P = .001). Multivariate regression analysis showed sarcopenia and low prognostic nutritional index were independentrisk factors for mortality among patients with end-stage renal disease. CONCLUSIONS: Sarcopenia was ~5 times more frequent in patients with end-stage renal disease than in healthy controls and was positively correlated with the prognostic nutritional index. Sarcopenia was an independent risk factor for mortality in patients on transplant waiting lists.


Assuntos
Biomarcadores , Proteína C-Reativa , Falência Renal Crônica , Transplante de Rim , Avaliação Nutricional , Estado Nutricional , Valor Preditivo dos Testes , Sarcopenia , Listas de Espera , Humanos , Sarcopenia/diagnóstico por imagem , Sarcopenia/mortalidade , Sarcopenia/epidemiologia , Sarcopenia/diagnóstico , Transplante de Rim/efeitos adversos , Transplante de Rim/mortalidade , Masculino , Feminino , Pessoa de Meia-Idade , Falência Renal Crônica/mortalidade , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/cirurgia , Fatores de Risco , Adulto , Fatores de Tempo , Prevalência , Listas de Espera/mortalidade , Proteína C-Reativa/análise , Medição de Risco , Biomarcadores/sangue , Albumina Sérica Humana/análise , Albumina Sérica Humana/metabolismo , Estudos de Casos e Controles , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Músculos Psoas/diagnóstico por imagem , Estudos Retrospectivos
10.
Turkiye Parazitol Derg ; 47(2): 83-87, 2023 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-37249110

RESUMO

OBJECTIVE: Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus sensu latu, is one of the neglected zoonotic infectious diseases and Türkiye is among the endemic countries. This study was designed to analyze serology results for patients who were diagnosed as CE by clinical symptoms and radiological methods over a three-year period. METHODS: Sera were analyzed for Anti-E. granulosus IgG by a chemiluminescence immunoassay (CLIA) (HYDATIDOSIS VIRCLIA® IgG MONOTEST, Vircell) using the VIRCLIA® (CLIA; Vircell, Granada, Spain) and results processed by the dedicated software. Cut-off for a positive test was ≥1.1 index value. Echinococcal cysts were detected based on ultrasonography, computed tomography, and magnetic resonance imaging. RESULTS: A total of 244 sera were analyzed from 109 patients, during three-year-period from January 2018 to December 2020. Anti-E. granulosus IgG was ordered twice in 89 patients, three times in 15 patients, four times in four patients, and five times in one patient. CLIA test was positive among 41 of 109 (37.6%) patients in whom 32 (76%) had only hepatic involvement, whereas in 5 (12%) hepatic and pulmonary involvement were coexisted. The mean age of seropositive patients was 39.8 (6-75±2.72) and 61.9% of them (n=26) were female. Time intervals between sequential test orders varied from 1 day to 33 months. Eight seropositive patients turned out to be negative, and one of 66 seronegative patients became seropositive. Positive test results were converted to negative in the case of therapy or cyst inactivity. CONCLUSION: We may conclude that CLIA could be used as a complementary tool for CE patient follow-up.


Assuntos
Equinococose , Echinococcus granulosus , Radiologia , Animais , Humanos , Feminino , Masculino , Estudos Retrospectivos , Equinococose/diagnóstico , Imunoglobulina G
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