Role of apparent diffusion map in the evaluation of retinoblastoma

ABSTRACT Purpose: This study aimed to analyze the association between magnetic resonance imaging apparent diffusion coefficient map value and histopathological differentiation in patients who underwent eye enucleation due to retinoblastomas. Methods: An observational chart review study of patients with retinoblastoma that had histopathology of the lesion and orbit magnetic resonance imaging with apparent diffusion coefficient analysis at Hospital de Clínicas de Porto Alegre between November 2013 and November 2016 was performed. The histopathology was reviewed after enucleation. To analyze the difference in apparent diffusion coefficient values between the two major histopathological prognostic groups, Student's t-test was used for the two groups. All statistical analyses were performed using SPSS version 19.0 for Microsoft Windows (SPSS, Inc., Chicago, IL, USA). Our institutional review board approved this retrospective study without obtaining informed consent. Results: Thirteen children were evaluated, and only eight underwent eye enucleation and were included in the analysis. The others were treated with photocoagulation, embolization, radiotherapy, and chemotherapy and were excluded due to the lack of histopathological results. When compared with histopathology, magnetic resonance imaging demonstrated 100% accuracy in retinoblastoma diagnosis. Optic nerve invasion detection on magnetic resonance imaging showed a 66.6% sensitivity and 80.0% specificity. Positive and negative predictive values were 66.6% and 80.0%, respectively, with an accuracy of 75%. In addition, the mean apparent diffusion coefficient of the eight eyes was 0.615 × 103 mm2/s. The mean apparent diffusion coefficient value of poorly or undifferentiated retinoblastoma and differentiated tumors were 0.520 × 103 mm2/s and 0.774 × 103 mm2/s, respectively. Conclusion: This study revealed that magnetic resonance imaging is useful in the diagnosis of retinoblastoma and detection of optic nerve infiltration, with a sensitivity of 66.6% and specificity of 80%. Our results also showed lower apparent diffusion coefficient values in poorly differentiated retinoblastomas with a mean of 0.520 × 103 mm2/s, whereas in well and moderately differentiated, the mean was 0.774 × 103 mm2/s.

Central nervous system infection: imaging findings suggestive of a fungus as the cause / Infecção do sistema nervoso central: os achados de imagem sugestivos de fungo como causa

Abstract Fungal infections of the central nervous system (CNS) are rare. However, because of the increase in the number of immunocompromised individuals, they have been gaining prominence in the differential diagnosis of CNS infections. Imaging techniques are sensitive for detecting and localizing an abnormality, in many cases allowing the origin of a lesion to be categorized as infectious, inflammatory, neoplastic, or vascular. This essay illustrates the magnetic resonance imaging and computed tomography findings of the most common fungal infections of the CNS, based on the experience of the Radiology Department of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, RS, Brazil.

Resumo As infecções fúngicas do sistema nervoso central (SNC) são raras, entretanto, com o aumento no número de indivíduos imunocomprometidos elas têm ganhado destaque no diagnóstico diferencial de infecções no SNC. As atuais técnicas de imagem são sensíveis para detectar uma anormalidade, localizá-la, e em muitos casos categorizar a lesão como de origem infecciosa e/ou inflamatória, neoplásica ou vascular. Este ensaio ilustra os achados de ressonância magnética e tomografia computadorizada mais comuns nas infecções fúngicas do SNC baseadas na experiência do Serviço de Radiologia do Hospital de Clínicas de Porto Alegre.

Relação dos níveis do hormônio estimulante da tireóide (TSH) com a maliginidade dos nódulos de tireóide / Association between elevated levels of TSH and higher prevalence of thyroid cancer has been reported

Introdução: associação entre os níveis elevados de TSH como fator trófico á célula tireoidiana e a maior prevalência de câncer tireoidiano tem sido discutida. Objetivos: Relacionar os Níveis de TSH em Valores de Corte, conforme a literatura, com a malignidade em nódulos de tireóide (NT). Material e métodos: Estudo tranversal de 159 prontuários ( 171NT) no HU/UFSC de agosto de 2010- 2012. Realizadas avaliações cito-patológicas e do TSH em ensaio de quimiluminescência( terceira geração) á época da punção aspirativa e categorizando os pontos de corte. Pacientes com disfunçaõ estabelecida foram excluídos. Análises estatistícas com teste do X2 e Fischer e significância em p< 0,05. Resultados: A média de idade dos pacientes foi de 48 anos com 92,4% de mulheres; 2,9% , 64,3% , 5,3%, 10,5%, 8,8% e 8,2% dos NT com Bethesda 1a VI respectivamente. O TSH variou de 0,08 a 10,5 ( média: 1,965 ± 1,69; mediana: 1,48) uUI/mL. Trinta e cindo NT foram operados, sendo 74,3% malignos e, deses, 80,8% carcinomas papilíferos. Análises dos grupamentos Bethesda e citopatológicos ( casos operados + não operados com citopatologias II, V, VI = 150 NT) em valores de corte de TSH< 1 e ≥ 1, TSH < 1,8 e ≥ 1,8 uUI/mL .Evidenciaram significância apenas em 1,8, com 32,7% dos NT Bethesda II e 71,4 % dos Bethesda VI ≥ 1,8 . Confirmando-se a Histopatologia onde 33,9%de 115 NT Benignos versus 60% de 35 NT Malignos apresentavam TSH≥ 1,8 uUI/mL(p<0,006).

Background: Association between elevated levels of TSH and higher prevalence of thyroid cancer has been reported. Objectives: To relate TSH levels with malignancy in thyroid nodules (TN). Methods: A transversal study of 159 medical records (171NT) in HU / UFSC August 2010-2012. Performed cyto-pathological and TSH reviews in chemiluminescence assay (third generation) will time of aspiration and categorizing the cutoffs. Patients with established dysfunction were excluded. Statistical analysis with X2 test or Fisher and significance was p <0.05. Results: Total 159 patients (171 TN). Average age: 48 years; women: 92.4%; TSH: 0.08 to 10.5 (mean: 1.965, median: 1.48) uUI / mL and 2.9%, 64.3%, 5.3%, 10.5%, 8.8% and 8.2% of the 171 TN with Bethesda I to VI, respectively. Thirty-five TN operated, being 74.3% malignant and, of these, 80.8% papillary carcinomas. Analyses in groups of Bethesda (171 TN) and cyto-pathological (150 TN) on TSH cutoffs of <1, ≥ 1, <1.8 and ≥ 1.8 uUI / mL showed significance on higher cutoffs (1.8) in the various groups of Bethesda, confirming the cyto-histopathology in 33.9% of 115 benign TN vs 60.0% of 35 malignant ≥ 1.8 uUI / mL (p = 0.006). Conclusion: Malignancy in NT was related to valro cutting TSH ≥ 1.8 UUI / mL.