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INTRODUCTION: The aim of this study was to investigate the success of a deep learning model in detecting kidney stones in different planes according to stone size on unenhanced computed tomography (CT) images. MATERIALS AND METHODS: This retrospective study included 455 patients who underwent CT scanning for kidney stones between January 2016 and January 2020; of them, 405 were diagnosed with kidney stones and 50 were not. Patients with renal stones of 0-1 cm, 1-2 cm, and >2 cm in size were classified into groups 1, 2, and 3, respectively. Two radiologists reviewed 2,959 CT images of 455 patients in three planes. Subsequently, these CT images were evaluated using a deep learning model. The accuracy rate, sensitivity, specificity, and positive and negative predictive values of the deep learning model were determined. RESULTS: The training group accuracy rates of the deep learning model were 98.2%, 99.1%, and 97.3% in the axial plane; 99.1%, 98.2%, and 97.3% in the coronal plane; and 98.2%, 98.2%, and 98.2% in the sagittal plane, respectively. The testing group accuracy rates of the deep learning model were 78%, 68% and 70% in the axial plane; 63%, 72%, and 64% in the coronal plane; and 85%, 89%, and 93% in the sagittal plane, respectively. CONCLUSIONS: The use of deep learning algorithms for the detection of kidney stones is reliable and effective. Additionally, these algorithms can reduce the reporting time and cost of CT-dependent urolithiasis detection, leading to early diagnosis and management.
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Aprendizado Profundo , Cálculos Renais , Urolitíase , Humanos , Cálculos Renais/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodosRESUMO
PURPOSE: To investigate the correlation between magnetic resonance imaging (MRI)-derived prostate parameters and benign prostatic hyperplasia (BPH) type with the International Prostate Symptom Score (IPSS). MATERIALS AND METHODS: In all, 61 patients (median age, 60; range, 41-81 years) who underwent preoperative MRI and prostatectomy were included in this retrospective study. The MRI-based parameters including total prostate volume (TPV), transition zone (TZ) volume (TZV), TZ index, intravesical prostatic protrusion (IPP), the anterior fibromuscular stroma (AFMS) distance, prostatic urethral angle, bladder wall thickness, urethral wall thickness, urethral compression, urethral wall changes, and BPH type were correlated with total IPSS, IPSS-storage symptom (IPSS-ss), IPSS-voiding symptom (IPSS-vs), and responses to the individual IPSS questions using Spearman (ρ) or Pearson (r) correlation coefficients, one-way analysis of variance (ANOVA), and multiple linear regression. RESULTS: TPV (r = 0.414, P = 0.001), TZV (r = 0.405, P = 0.001), IPP (r = 0.270, P = 0.04), and AFMS distance (r = 0.363, P = 0.004) correlated with total IPSS. In multiple linear regression analysis, TZV was the only predictor for total IPSS (P = 0.001), IPSS-ss (P < 0.001), IPSS-vs (P = 0.03), and the scores for the IPSS questions 1 (P = 0.03) and 4 (P = 0.001). TPV was a predictor of the scores for questions 2 (P = 0.003), 3 (P = 0.009), and 7 (P < 0.001). CONCLUSION: Several MRI-derived prostate measurements (TPV, TZV, IPP, AFMS distance) correlated with total IPSS. TZV was the only predictor for total IPSS based on multiple regression analysis. LEVEL OF EVIDENCE: 3 J. Magn. Reson. Imaging 2017;45:917-925.
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Imageamento por Ressonância Magnética/métodos , Hiperplasia Prostática/diagnóstico por imagem , Hiperplasia Prostática/patologia , Avaliação de Sintomas/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Internacionalidade , Masculino , Pessoa de Meia-Idade , Estatística como Assunto , Avaliação de Sintomas/normasRESUMO
BACKGROUND: The most common etiology of shoulder pain in adults is rotator cuff tear. Elastography is an imaging method that can report the strain and elastic modulus of the biological tissue. We think acoustic radiation force impulse (ARFI) elastography can effectively assess rotator cuff tendinopathy. PURPOSE: This study aimed to investigate the usefulness of ARFI elastography in evaluating supraspinatus tendinopathy. MATERIALS AND METHODS: We included 44 patients (22 men, 22 women, median age, 47 years; range, 20-69 years) with unilateral supraspinatus tendinopathy diagnosed with magnetic resonance imaging (MRI) in this prospective study. The normal tendons and tendinopathies, including supraspinatus tendinosis, partial-thickness, and full-thickness supraspinatus tears, were evaluated with ultrasound and ARFI elastography. The ARFI elastography values were compared between healthy and tendinopathy groups, and the gender was compared between elastography values of the normal tendons and tendinopathies using the Mann-Whitney U test. RESULTS: The values of ARFI elastography correlated with tendinopathy. (P = 0.001). The gender differed between the elastography values of the normal tendons (P = 0.002) and tendinopathies (P = 0.001). CONCLUSION: ARFI elastography is a non-invasive and feasible method for quantitatively assessing supraspinatus tendinopathy. It can be an alternative method to MRI in diagnosing supraspinatus tendinopathy.
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Técnicas de Imagem por Elasticidade , Lesões do Manguito Rotador , Tendinopatia , Adulto , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/patologia , Técnicas de Imagem por Elasticidade/métodos , Estudos Prospectivos , Lesões do Manguito Rotador/diagnóstico por imagem , Lesões do Manguito Rotador/patologia , Tendinopatia/diagnóstico por imagem , Tendinopatia/patologia , AcústicaRESUMO
PURPOSE: To investigate the relationship between hepatic steatosis (HS), pancreatic steatosis (PS), and coexisting HS and PS and the Coronavirus disease-2019 (COVID-19) pneumonia total severity score (TSS) and prognosis, assessed through computed tomography (CT), and to evaluate the degree of effectiveness of the three steatosis conditions on TSS and prognosis. METHODS: This retrospective study involved 461 patients (255 male and 206 female, median age of 53 years) with COVID-19 who underwent unenhanced chest CT. HS, PS, and coexisting HS and PS, assessed through CT, were compared with patient demographics, comorbidities, TSS, hospitalization and intubation requirements, and mortality rates. The parameters were compared using Mann-Whitney U and chi-square tests. The parameters of three groups of patients with only HS, only PS, and both HS and PS were compared using the Kruskal-Wallis test. RESULTS: Results revealed that TSS (P < 0.001 for all) and hospitalization rates (P < 0.001 for all except for HS [P = 0.004]) were higher in patients with HS, PS, and both than in those without. Intubation (P = 0.003) and mortality rates (P = 0.018) were significantly higher solely in patients with PS. However, TSS, hospitalization, and diabetes mellitus were significantly higher than in age-standardized analyses for PS. In a comparison between only HS, only PS, and coexisting HS and PS in 210 patients, the highest TSS was in the coexistence group (P < 0.001). CONCLUSION: The TSS and hospitalization rates correlate with HS, PS, and coexisting HS and PS, whereas intubation and mortality rates only correlate with PS. However, TSS correlates with coexisting HS and PS at the highest rate.
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COVID-19 , Fígado Gorduroso , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , COVID-19/complicações , Prognóstico , Estudos RetrospectivosRESUMO
Aim: To investigate the relationship between pancreatic steatosis (PS) assessed on computed tomography (CT) and COVID-19 prognosis. Materials & methods: This retrospective study covers 396 patients with COVID-19 (mean age: 52.50 ± 16.86 years), who underwent unenhanced chest CT. PS was compared with clinical findings, comorbidities, requirements for hospitalization, intubation and intensive care unit (ICU), length of hospitalization and death. Results: PS was found to be strongly correlated with the severity of clinical findings and hospitalization rates (p < 0.001). In hospitalized patients, length of hospitalization (p = 0.002) and rates of ICU requirement (p = 0.003) were higher in patients with PS. Conclusion: PS, correlated with clinical severity and hospitalization requirement, is an independent risk factor for COVID-19.
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Kidney cysts are quite common in adults. Though small simple renal cysts in an adult over 30-40 years of age are not too unusual, however, if the same cysts are seen in a child, and especially if there are additional findings, then several diagnostic possibilities may come to mind. The role of ultrasound, together with the help of intravenous contrast agents and Doppler mode, are very critical in describing the morphologic features and follow-up of the complex or multiple and bilateral renal cysts. These sonographic signs are occasionally specific for diagnosis, but in many cases sonographic clues should be evaluated together with the other genetic and clinical data to reach diagnosis.The first part of this pictorial essay included the introduction into the subject and the classification of non-genetic cystic renal diseases. The key features for the non-genetic cystic renal diseases are illustrated. In the second part, eye-catching features of genetic cystic renal diseases are demonstrated.
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Cistos , Doenças Renais Císticas , Neoplasias Renais , Adulto , Criança , Meios de Contraste , Humanos , Doenças Renais Císticas/diagnóstico por imagem , Doenças Renais Císticas/genética , UltrassonografiaRESUMO
A 53-year-old woman with fatigue lasting for 6 weeks and increased parathormone level underwent a neck ultrasound. It revealed a large, lobulated, solid intrathyroidal nodule consisting of hypoechoic component with microcalcifications and hy-perechoic component with vascularity on Doppler mode. There were also subcentimetric intrathyroidal hypo- and hyperechoic nodules. Upon the diagnosis of papillary thyroid cancer on fine-needle aspiration biopsy, a total thyroidectomy procedure was performed. In the histopathologic evaluation, the hypoechoic component was diagnosed as papillary thyroid cancer, while the hyperechoic component was diagnosed as ectopic parathyroid adenoma. Subcentimetric nodules were demonstrated as multi-foci of papillary thyroid cancer.
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Neoplasias das Paratireoides , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Biópsia por Agulha Fina , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/cirurgia , UltrassonografiaRESUMO
BACKGROUND: Intrathyroidal ectopic thymus (IET) can be misdiagnosed as thyroid nodules. PURPOSE: The purpose of this study is to evaluate the sonoelastographic findings of IET in pediatric population. METHODS: Twelve children who had been examined with ultrasound (US) and strain elastography between December 2012 and December 2019 were included in this retrospective study. The patients' demographics and ultrasonographic findings, including the location, margin, shape, diameters, volume, structure, vascularity, and elastography values of the lesions were evaluated. RESULTS: Twelve lesions were detected in 12 asymptomatic patients (3 females and 9 males) with a mean age of 4.67 ± 2.27 years. The most common location of the IET was in posterior part and middle third of thyroid, and the most common appearance on US was a well-defined, ovoid-shaped, and predominantly hypoechoic solid lesion with punctate/linear branching hyperechogenities. The lesions were mostly hypovascular on Doppler US. The mean strain ratio on elastography was found to be 1.10 ± 0.04. In the follow-up of 7 patients with available information, there was no significant change in size or appearance of IET on US. CONCLUSION: IET should be considered in the differential diagnosis of the lesions within the thyroid. The first step to accurately diagnose an IET is to consider it in the differential diagnosis. In addition to US, strain elastography findings can be used to distinguish IETs from papillary thyroid cancers which can have similar US appearance, and help avoid unnecessary biopsies.
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Coristoma , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Criança , Pré-Escolar , Coristoma/diagnóstico por imagem , Feminino , Humanos , Masculino , Estudos Retrospectivos , Nódulo da Glândula Tireoide/diagnóstico por imagem , UltrassonografiaRESUMO
Kidney cysts are quite common in adults. Though small simple renal cysts in an adult over 30-40 years of age are not too unusual, however, if the same cysts are seen in a child, and especially if there are additional findings, then several diagnostic possibilities may come to mind. The role of ultrasound, together with the help of intravenous contrast agents and Doppler mode, is very critical in describing the morphologic features and follow-up of the complex or multiple and bilateral renal cysts. Sonographic signs are occasionally specific for diagnosis, but in many cases they should be evaluated together with the other genetic and clinical data to reach a diagnosis.The first part of this pictorial essay includes "non-genetic cystic renal diseases" and the second part will include "genetic cystic renal diseases".
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Cistos , Doenças Renais Císticas , Neoplasias Renais , Adulto , Criança , Humanos , Doenças Renais Císticas/diagnóstico por imagem , Doenças Renais Císticas/genética , UltrassonografiaRESUMO
PURPOSE: We aimed to investigate the value of magnetic resonance imaging (MRI)-based parameters in differentiating between progressive massive fibrosis (PMF) and lung cancer. METHODS: This retrospective study included 60 male patients (mean age, 67.0±9.0 years) with a history of more than 10 years working in underground coal mines who underwent 1.5 T MRI of thorax due to a lung nodule/mass suspicious for lung cancer on computed tomography. Thirty patients had PMF, and the remaining ones had lung cancer diagnosed histopathologically. The sequences were as follows: coronal single-shot turbo spin echo (SSH-TSE), axial T1- and T2-weighted spin-echo (SE), balanced turbo field echo, T1-weighted high-resolution isotropic volume excitation, free-breathing and respiratory triggered diffusion-weighted imaging (DWI). The patients' demographics, lesion sizes, and MRI-derived parameters were compared between the patients with PMF and lung cancer. RESULTS: Apparent diffusion coefficient (ADC) values of DWI and respiratory triggered DWI, signal intensities on T1-weighted SE, T2-weighted SE, and SSH-TSE imaging were found to be significantly different between the groups (p < 0.001, for all comparisons). Median ADC values of free-breathing DWI in patients with PMF and cancer were 1.25 (0.93-2.60) and 0.76 (0.53-1.00) (× 10-3 mm2/s), respectively. Most PMF lesions were predominantly iso- or hypointense on T1-weighted SE, T2-weighted SE, and SSH-TSE, while most malignant ones predominantly showed high signal intensity on these sequences. CONCLUSION: MRI study including SE imaging, specially T1-weighted SE imaging and ADC values of DWI can help to distinguish PMF from lung cancer.
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Imagem de Difusão por Ressonância Magnética , Neoplasias Pulmonares , Idoso , Fibrose , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Estudos RetrospectivosRESUMO
BACKGROUND Metabolic syndrome affects 35% of the adult population in developed countries associated with non-alcoholic steatohepatitis, insulin resistance, and cardiovascular events. Fatty infiltration of the pancreas, or pancreatic steatosis, is a risk factor for acute pancreatitis, pancreatic malignancies, and diabetes mellitus, yet its relationship with metabolic syndrome is not well defined. METHODS We performed a single-centered retrospective observational study of 322 healthy subjects (subjects volunteering to be kidney transplant donors, mean age=46.3±13.5, 163 men and 159 women) in the last 2 years (July 2018-February 2020) from our institution. Pancreatic steatosis and hepatosteatosis were confirmed by computed tomography. RESULTS Pancreatic steatosis was present in 26.3% (85/322) of the subjects, and this finding correlated with age, body mass index (BMI), male sex, a family history of diabetes, creatinine, cystatin C, uric acid, low-density lipoprotein (LDL) cholesterol, triglycerides, glycemia, hemoglobin, transverse body diameter, and subcutaneous fat thickness levels by univariable logistic regression. On multiple linear regression only age (95% CI 1.01, 1.06), BMI (95% CI 1.01, 1.19), male sex (95% CI 1.49-5.99), uric acid (95% CI 1.01, 1.76), and subcutaneous fat thickness levels (95% CI 1.21-2.36) remained independently associated with pancreatic steatosis. CONCLUSION Pancreatic steatosis is common and associated with obesity, elevated serum uric acid, subcutaneous fat thickness, and male sex. Future studies are needed to evaluate if there are specific clinical consequences to the presence of pancreatic steatosis.
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Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease.
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Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Radiologia/normas , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Algoritmos , Inteligência Artificial , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Diagnóstico Diferencial , Surtos de Doenças , Reações Falso-Negativas , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Radiografia/normas , Radiologia/tendências , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , SARS-CoV-2 , Sensibilidade e Especificidade , Manejo de Espécimes/estatística & dados numéricosRESUMO
BACKGROUND: Developmental venous anomalies (DVAs) can be determined on magnetic resonance imaging (MRI), and they may be associated with multiple sclerosis (MS) lesions. PURPOSE: The objective was to evaluate the MRI findings of DVAs in the brain, to compare the prevalence of them between MS patients and control subjects, and to investigate the correlation of DVA-associated fluid-attenuated inversion recovery (FLAIR) hyperintensities and MRI-derived parameters between MS patients and control subjects having DVA. METHODS: Total 160 patients with a mean age of 45 ± 16 years who underwent multiparametric MRI including susceptibility-weighted imaging (SWI), diffusion-weighted imaging, 3D FLAIR, and contrast-enhanced imaging were included in this retrospective study. First, the presence of DVA was compared between the MS and control groups using the Chi-square test. Then, among the subjects having DVA, age, gender, and MRI-derived parameters such as the signal increase of DVA on FLAIR, location, and drainage of DVA were compared between the MS and control groups using Chi-square test. RESULTS: The presence of DVA did not differ between the MS and control groups (P = 0.828). Signal increase around DVA on FLAIR (P = 0.03) and the age of less than 45 years demonstrated a significant correlation with MS group (P = 0.022). CONCLUSION: In our study, DVAs were effectively detected using SWI and 3D contrast-enhanced T1-weighted imaging on MRI. The signal increase of DVA was better revealed on 3D FLAIR on MRI, and it was the only significant MRI-derived parameter in patients with MS.
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Imageamento por Ressonância Magnética Multiparamétrica , Esclerose Múltipla/diagnóstico por imagem , Adulto , Encéfalo , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Veias Cerebrais , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
PURPOSE: Prostate cancer is the most common noncutaneous cancer among men in the USA. Focal laser thermal ablation (FLA) has the potential to control small tumors while preserving urinary and erectile function by leaving the neurovascular bundles and urethral sphincters intact. Accurate needle guidance is critical to the success of FLA. Multiparametric magnetic resonance images (mpMRI) can be used to identify targets, guide needles, and assess treatment outcomes. In this study, we evaluated the location of ablation zones relative to targeted lesions in 23 patients who underwent FLA therapy in a phase II trial. The ablation zone margins and unablated tumor volume were measured to determine whether complete coverage of each tumor was achieved, which would be considered a clinically successful ablation. METHODS: Preoperative mpMRI was acquired for each patient 2-3 months preceding the procedure and the prostate and lesion(s) were manually contoured on 3 T T2-weighted axial images. The prostate and ablation zone(s) were also manually contoured on postablation 1.5 T T1-weighted contrast-enhanced axial images acquired immediately after the procedure intraoperatively. The lesion surface was nonrigidly registered to the postablation image using an initial affine registration followed by nonrigid thin-plate spline registration of the prostate surfaces. The margins between the registered lesion and ablation zone were calculated using a uniform spherical distribution of rays, and the volume of intersection was also calculated. Each prostate was contoured five times to determine the segmentation variability and its effect on intersection of the lesion and ablation zone. RESULTS: Our study showed that the boundaries of the segmented tumor and ablation zone were close. Of the 23 lesions that were analyzed, 11 were completely covered by the ablation zone and 12 were partially covered. A shift of 1.0, 2.0, and 2.6 mm would result in 19, 21, and all tumors completely covered by the ablation zone, respectively. The median unablated tumor volume across all tumors was 0.1 mm 3 with an IQR of 3.7 mm 3 , which was 0.2% of the median tumor volume (46.5 mm 3 with an IQR of 46.3 mm 3 ). The median extension of the tumors beyond the ablation zone, in cases which were partially ablated, was 0.9 mm (IQR of 1.3 mm), with the furthest tumor extending 2.6 mm. CONCLUSION: In all cases, the boundary of the tumor was close to the boundary of the ablation zone, and in some cases, the boundary of the ablation zone did not completely enclose the tumor. Our results suggest that some of the ablations were not clinically successful and that there is a need for more accurate needle tracking and guidance methods. Limitations of the study include errors in the registration and segmentation methods used as well as different voxel sizes and contrast between the registered T2 and T1 MRI sequences and asymmetric swelling of the prostate postprocedurally.
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Terapia a Laser/métodos , Imageamento por Ressonância Magnética , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Cirurgia Assistida por Computador/métodos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: To evaluate the magnetic resonance imaging (MRI)-derived parameters in differentiation of patients with progressive supranuclear palsy (PSP) from patients with Parkinson's disease (PD), multiple system atrophy (MSA), and control subjects was aimed. METHODS: Thirty-three patients [mean age, 65.21 ± 4.75 years; PSP (n = 9), MSA (n = 8), PD (n = 6), and control subjects (n = 10)] who have undergone cranial MRI were included in this retrospective study. MRI-derived parameters including areas of midbrain and pons, midbrain area-to-pons area (M/P) ratio, widths of middle cerebellar peduncle (MCP) and superior cerebellar peduncle (SCP), MCP/SCP ratio, magnetic resonance parkinsonism index (MRPI), cerebral interpeduncular angle, and length of midbrain tegmentum were compared in patients with PSP, PD, MSA, and control subjects through the analysis of variance and Kruskal-Wallis tests with Bonferroni correction and Mann-Whitney U test. RESULTS: The length of midbrain tegmentum, midbrain area, SCP, and M/P ratio were found to be lower, while cerebral interpeduncular angle and MRPI were higher in patients with PSP. Pons area, MCP width, and MCP/SCP ratio were found to be lower in patients with MSA. For PSP, cerebral interpeduncular angle has a sensitivity of 100% and specifity of 90%, and MRPI had a sensitivity of 88.9% and specifity of 100% for PSP. DISCUSSION: Several MRI-derived parameters can be used in differentiation of patients with PSP from patients with PD, MSA and control subjects. The cerebral interpeduncular angle and MRPI, which demonstrated higher values in patients with PSP, were more significant for PSP than the other parameters.
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Imageamento por Ressonância Magnética/métodos , Mesencéfalo/diagnóstico por imagem , Atrofia de Múltiplos Sistemas/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Ponte/diagnóstico por imagem , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
PURPOSE: To evaluate the sonoelastographic changes in the Achilles tendon in patients with chronic renal failure (CRF) using virtual touch imaging quantification (VTIQ) elastography. METHODS: Twenty-six patients undergoing three hemodialysis sessions per week and 26 subjects admitted to our institution between January 2016 and April 2016 were included in this prospective study. The characteristics and body mass index of the patients were noted. Ultrasonography was performed parallel to the long axis of the bilateral Achilles tendons during relaxation of the legs using the Siemens Acuson S3000™ ultrasound device (Siemens HealthCare, Erlangen, Germany). Tendon thickness was reviewed, and tissue stiffness was quantitatively assessed using VTIQ elastography. Independent samples t test and Mann-Whitney U test were used for statistical analyses. RESULTS: The median values of shear wave velocities of the Achilles tendon in patients with CRF were 7.19 m/s (4.23-9.77 m/s) on the right and 6.98 m/s (4.00-9.82 m/s) on the left, while they were 5.11 m/s (4.09-8.82 m/s) on the right and 5.36 m/s (4.05-8.80 m/s) on the left in controls. The stiffness of the Achilles tendons in patients with CRF was found to be higher than that in controls (right: P < 0.001, left: P = 0.004). There was no statistically significant difference in tendon thickness between the CRF and control groups (P > 0.05). CONCLUSION: The thickness and stiffness of tendon can be effectively evaluated with sonoelastography. The thickness of the Achilles tendon did not significantly differ between the patients with CRF and healthy subjects. However, the stiffness of the Achilles tendon measured with VTIQ elastography was demonstrated to be increased in the patients with CRF.
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Tendão do Calcâneo/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Falência Renal Crônica/complicações , Tendinopatia/diagnóstico por imagem , Tendão do Calcâneo/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Voluntários Saudáveis , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Diálise Renal , Ruptura Espontânea/diagnóstico por imagem , Ruptura Espontânea/etiologia , Tendinopatia/etiologiaRESUMO
PURPOSE: The aim of this study was to evaluate the correlations between laboratory findings and ultrasonographic measurements of renal length and cortical thickness in patients receiving follow-up for chronic kidney disease (CKD). METHODS: A total of 41 CKD patients (18 males and 23 females; mean age, 65.2 years; range, 42 to 85 years) with a low glomerular filtration rate who did not require renal replacement therapy were included in this prospective study. Patients were followed up with laboratory assays at bimonthly intervals and with ultrasonography performed twice a year. Renal cortical thickness, renal length, and estimated glomerular filtration rate (eGFR) values were compared using the paired-samples t test. Additionally, Pearson correlation analysis was conducted between renal length and cortical thickness measurements and eGFR values to assess kidney function. RESULTS: At the beginning of the study and after 24 months, mean eGFR values of the 41 patients were 35.92 mL/min and 28.38 mL/min, respectively. The mean renal length was 91.29 mm at the beginning of the study and 90.24 mm at the end of the study. The mean cortical thickness was 5.76±2.05 mm at the beginning of the study and 5.28±1.99 mm at the end of the study. A statistically significant positive association was found between eGFR and mean renal length (r=0.66, P<0.01) and between eGFR and mean cortical thickness (r=0.85, P<0.01), with the latter being more prominent. CONCLUSION: Our study suggests that ultrasonographic cortical thickness measurements may be an important imaging technique in the follow-up care of patients with CKD.
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AIM: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Surgical management of these injuries is challenging with high morbidity rates. In this study we aim to present the results of endovascular management of iatrogenic vascular injuries due to spinal surgeries. MATERIAL AND METHODS: We retrospectively reviewed 11 patients (5 male, 6 female) who had vascular injuries due to cervical and lumbar spinal surgeries. Clinical findings were bleeding (n=5), leg edema (n=6) and right heart failure with severe dyspnea (n=1). The age range of the patients were between 42-67 (mean: 57.1). Six patients were reviewed with imaging before the procedures and the rest of the patients (n=5) were directly referred to the angiography unit for diagnosis and possible endovascular treatment. RESULTS: The types of surgeries were; cervical surgery (n=5) and lumbar disc operation (n=6). The type of vascular injuries were; vertebral artery stenosis (n=1), vertebral artery pseudoaneurysm (n=3), vertebral artery occlusion (n=1) and iliac arteriovenous fistula (n=6). The type of endovascular treatments were; parent artery occlusion (PAO) (n=2), covered stent graft implantation (n=6) and intrasaccular coil embolization of pseudoaneurysm (n=1). The remaining 2 patients were managed conservatively. No major complications or mortality occured during endovascular interventions. No bleeding or ischemia occured in the follow-up period. CONCLUSION: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Endovascular interventions are safe and effective in the diagnosis and treatment of such vascular injuries.
Assuntos
Procedimentos Endovasculares/métodos , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/cirurgia , Adulto , Idoso , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Feminino , Humanos , Doença Iatrogênica , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/efeitos adversos , Resultado do Tratamento , Lesões do Sistema Vascular/etiologiaRESUMO
ABSTRACT Introduction: The aim of this study was to investigate the success of a deep learning model in detecting kidney stones in different planes according to stone size on unenhanced computed tomography (CT) images. Materials and Methods: This retrospective study included 455 patients who underwent CT scanning for kidney stones between January 2016 and January 2020; of them, 405 were diagnosed with kidney stones and 50 were not. Patients with renal stones of 0-1 cm, 1-2 cm, and >2 cm in size were classified into groups 1, 2, and 3, respectively. Two radiologists reviewed 2,959 CT images of 455 patients in three planes. Subsequently, these CT images were evaluated using a deep learning model. The accuracy rate, sensitivity, specificity, and positive and negative predictive values of the deep learning model were determined. Results: The training group accuracy rates of the deep learning model were 98.2%, 99.1%, and 97.3% in the axial plane; 99.1%, 98.2%, and 97.3% in the coronal plane; and 98.2%, 98.2%, and 98.2% in the sagittal plane, respectively. The testing group accuracy rates of the deep learning model were 78%, 68% and 70% in the axial plane; 63%, 72%, and 64% in the coronal plane; and 85%, 89%, and 93% in the sagittal plane, respectively. Conclusions: The use of deep learning algorithms for the detection of kidney stones is reliable and effective. Additionally, these algorithms can reduce the reporting time and cost of CT-dependent urolithiasis detection, leading to early diagnosis and management.