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1.
J Comput Assist Tomogr ; 44(1): 118-123, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939892

RESUMO

AIM: This study aimed to assess the interobserver agreement of magnetic resonance (MR) imaging of Liver Imaging Reporting and Data System version 2018 (LI-RADS v2018). SUBJECTS AND METHODS: Retrospective analysis was done for 119 consecutive patients (77 male and 42 female) at risk of hepatocellular carcinoma who underwent dynamic contrast MR imaging. Image analysis was done by 2 independent and blinded readers for arterial phase hyperenhancement, washout appearance, enhancing capsule appearance, and size. Hepatic lesions were classified into 7 groups according to LI-RADS v2018. RESULTS: There was excellent interobserver agreement of both reviewers for LR version 4 (κ = 0.887, P = 0.001) with 90.76% agreement. There was excellent interobserver agreement for nonrim arterial phase hyperenhancement (κ = 0.948; 95% confidence interval [CI], 0.89-0.99; P = 0.001), washout appearance (κ = 0.949; 95% CI, 0.89-1.0; P = 0.001); and enhancing capsule (κ = 0.848; 95% CI, 0.73-0.97; P = 0.001) and excellent reliability of size (interclass correlation, 0.99; P = 0.001). There was excellent interobserver agreement for LR-1 (κ = 1.00, P = 0.001), LR-2 (κ = 0.94, P = 0.001), LR-5 (κ = 0.839, P = 0.001), LR-M (κ = 1.00, P = 0.001), and LR-TIV (κ = 1.00; 95% CI, 1.0-1.0; P = 0.001), and good agreement for LR-3 (κ = 0.61, P = 0.001) and LR-4 (κ = 0.61, P = 0.001). CONCLUSION: MR imaging of LI-RADS v2018 is a reliable imaging modality and reporting system that may be used for standard interpretation of hepatic focal lesions.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Retrospectivos
2.
Artigo em Inglês | MEDLINE | ID: mdl-31777049

RESUMO

AIM: To assess with diffusion tensor tractography (DTT) the interobserver agreement of white matter tract involvement in patients with gliomas. PATIENT AND METHODS: A prospective study was conducted on 35 patients (21 male, 14 female; age: 2-71 years) with gliomas that underwent DTT. Two independent readers assessed the patterns of involvement of the corticospinal tract, corpus callosum, optic radiation, and fasciculi as normal, edematous, displaced, infiltrated, or disrupted. RESULTS: Overall interobserver agreement of involvement of the white matter tracts was excellent (κ = 0.93; 95% confidence interval [CI], 0.91-0.95; p = 0.001). Interobserver agreement was excellent for involvement of corticospinal tracts (κ = 0.81; 95% CI, 0.57-1.00; p = 0.001), corpus callosum (κ = 0.91; 95% CI, 0.75-1.00; p = 0.001), optic radiation (κ = 0.77; 95% CI, 0.53-0.98; p = 0.001), and fasciculi (κ = 0.912; 95% CI, 0.81-0.99; p = 0.001. The interobserver agreement was excellent for tract edema (κ = 0.81; 95% CI, 0.57-1.00; p = 0.001), tract displacement (κ = 0.91; 95% CI, 0.75-1.00; p = 0.001), tract disruption (κ = 0.81; 95% CI, 0.57-1.00; p = 0.001), and good for tract infiltration (κ = 0.77; 95% CI, 0.53-0.98; p = 0.001). The interobserver agreement was excellent for white matter tract involvement in patients with low-grade gliomas (κ = 0.81; 95% CI, 0.57-1.00; p = 0.001) and high-grade gliomas (κ = 0.91; 95% CI, 0.75-1.00; p = 0.001). CONCLUSION: DTT is a reliable and reproducible method for assessment of white matter tract involvement in patients with low- and high-grade gliomas.

3.
Eur J Radiol Open ; 6: 330-335, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31768408

RESUMO

Aim: To assess the reliability of a standardized reporting system of acute appendicitis at low-dose 320-rows CT. Subjects and Methods: Retrospective analysis CT of 78 patients with pathologically proven acute appendicitis. The study was performed at a low-dose 320-rows CT. The image analysis was performed by 2 radiologists according to a standardized reporting system of acute appendicitis. Results: There was an excellent overall of the inter-observer agreement of both observers for the standardized reporting system of acute appendicitis (K = 0.89, 95 % CI = 0.87-0.92, P = 0.001). There was good inter-observer agreement for visualization of the appendix (K = 0.78, P = 0.001), the tip diameter (K = 0.75, P = 0.001), and a single wall thickness of appendix (K = 0.77, P = 0.001). There was excellent inter-observer agreement for outer to outer wall diameter (K = 0.82, P = 0.001), mucosal hyper-enhancement (K = 0.80, P = 0.001), appendicolith (K = 0.86, P = 0.001), gas in the appendix (K = 0.82, P = 0.001), surrounding fat stranding (K = 0.81, P = 0.001), focal cecal thickening (K = 0.85, P = 0.001), peri-appendiceal air (K = 0.87, P = 0.001), peri-appendicular fluid collection, phlegmon, or abscess (K = 0.82, P = 0.001), and right ovary cyst (K = 0.83, P = 0.001). Conclusion: we concluded that excellent reliability of a standardized reporting system of acute appendicitis in the adults using low-dose 320-rows CT.

4.
J Comput Assist Tomogr ; 43(6): 906-911, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31738213

RESUMO

The aim of this article was to review computed tomography angiography and magnetic resonance angiography of pulmonary atresia with ventricular septal defect. This disorder is a rare complex congenital heart disease. Preoperative imaging of pulmonary atresia with ventricular septal defect with computed tomography angiography and magnetic resonance angiography is important for complete anatomical delineation and planning for treatment. Preoperative imaging used for assessment of the main pulmonary artery (its size, valve, and confluence), aortopulmonary collaterals (its origin, insertion, course, and size), presence of patent ductus arteriosus, other sources of collaterals as bronchial and coronary arteries, and pattern of pulmonary arborization. Imaging can detect associated aortic, pulmonary venous and coronary anomalies, and other congenital heart disease. Postoperative imaging after unifocalization and stent is for assessment of patency, stenosis, and occlusion of stent or perivascular lesions as seroma.


Assuntos
Defeitos dos Septos Cardíacos/diagnóstico por imagem , Defeitos dos Septos Cardíacos/cirurgia , Atresia Pulmonar/diagnóstico por imagem , Atresia Pulmonar/cirurgia , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Cateterismo Cardíaco , Procedimentos Cirúrgicos Cardíacos , Angiografia por Tomografia Computadorizada , Humanos , Angiografia por Ressonância Magnética , Período Pós-Operatório , Período Pré-Operatório , Procedimentos Cirúrgicos Pulmonares
5.
J Comput Assist Tomogr ; 43(5): 786-792, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31609295

RESUMO

We aim to review the imaging findings of Klippel-Trenaunay syndrome. This disorder characterized clinically by a triad of capillary malformations manifesting as a port-wine stain, venous varicosities typically along the lateral aspect of the lower extremities, and bone and/or soft tissue hypertrophy. Imaging of extremities shows unilateral venous varicosities, persistent embryonic veins, anomalous of the superficial and deep venous system, low-flow venolymphatic malformations, and bony and soft tissue hypertrophy. Other findings include neurospinal as cavernoma, aneurysm, and hemimegalencephaly, pulmonary as pulmonary thromboembolism and pulmonary hypertension and visceral as gastrointestinal and genitourinary vascular anomalies. Imaging may detect associated lesions and differentiate from simulating lesions.


Assuntos
Síndrome de Klippel-Trenaunay-Weber/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Fenótipo
6.
Int J Pediatr Otorhinolaryngol ; 126: 109623, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31400658

RESUMO

PURPOSE: to differentiate sublingual thyroglossal duct cyst (TGDC) from midline dermoid cyst (DC) with diffusion weighted imaging (DWI). MATERIALS AND METHODS: Retrospective analysis of 22 consecutive patients (11 male and 11 female aged 5-15 years) with midline cystic lesion at floor of mouth. They underwent DWI of floor of mouth. Apparent diffusion coefficient (ADC) of the cystic lesions was calculated and correlated with surgical findings. RESULTS: The mean ADC value of TGDC of 1st observer was (2.20 ±â€¯0.28 × 10-3 mm2/s) and of 2nd observer was (2.28 ±â€¯0.27 × 10-3 mm2/s) was significantly higher than that of DC (P = 0.001) whose ADC of 1st observer was (1.55 ±â€¯0.15 × 10-3 mm2/s) and of 2nd observer was (1.53 ±â€¯0.11 × 10-3 mm2/s). There was excellent inter-observer agreement of both readings (r = 92%, P = 0.001). When ADC of 1.76 and 1.62 × 10-3 mm2/s was used as a threshold value for differentiating TGDC from DC, the best results were obtained with area under the curve of 0.94 and 0.96, accuracy of 90% and 86%, sensitivity of 91% and 91%%, specificity of 90% and 80%, negative predictive value of 90% and 88% and positive predictive value of 92% and 84% of both reviewers respectively. CONCLUSION: DWI is reliable and reproducible imaging modality for differentiation sublingual TGDC from DC.

7.
J Comput Assist Tomogr ; 43(5): 671-678, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356518

RESUMO

The fourth edition of World Health Organization (2017) classified odontogenic tumors according to the tissue of origin. Epithelial odontogenic tumors include ameloblastomas, calcifying epithelial odontogenic tumors, adenomatoid odontogenic tumors, and squamous odontogenic tumors. Mixed epithelial and mesenchymal odontogenic tumors include odontomas, ameloblastic fibromas, dentigenic ghost cell odontogenic tumors, and primordial odontogenic tumors. Mesenchymal odontogenic tumors include cementoblastomas, cement-ossifying fibromas, odontogenic fibromas, and odontogenic myxomas. Malignant odontogenic tumors are either carcinomas or sarcomas. The imaging appearance of odontogenic tumors varies according to its category. Computed tomography and magnetic resonance imaging play an important role in localization, characterization, and extension of odontogenic tumors to the teeth and surrounding tissue.


Assuntos
Tumores Odontogênicos/classificação , Tumores Odontogênicos/diagnóstico por imagem , Humanos , Terminologia como Assunto , Organização Mundial da Saúde
8.
J Comput Assist Tomogr ; 43(4): 525-532, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31162240

RESUMO

The aim of this review was to review the basic background, technique, and clinical applications of arterial spin labeling in brain tumors. Arterial spin labeling is used for differentiation of brain tumors from nonneoplastic lesions such as infarction and infection. It has a role in the grading of gliomas and in the differentiation of gliomas from lymphomas and metastasis. It is used for detection of the best biopsy site and prediction of treatment response. Arterial spin labeling is used for the assessment of extra-axial tumors and pediatric tumors. Last, it has a role in the differentiation of tumor recurrence from postradiation changes and in monitoring patients after therapy.


Assuntos
Neoplasias Encefálicas , Encéfalo , Glioma , Imagem por Ressonância Magnética , Marcadores de Spin , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Neoplasias Encefálicas/irrigação sanguínea , Neoplasias Encefálicas/diagnóstico por imagem , Circulação Cerebrovascular/fisiologia , Glioma/irrigação sanguínea , Glioma/diagnóstico por imagem , Humanos , Interpretação de Imagem Assistida por Computador
9.
J Comput Assist Tomogr ; 43(3): 399-405, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31082945

RESUMO

We aimed to review computed tomography and magnetic resonance angiography of congenital anomalies of pulmonary veins. Total anomalous pulmonary venous return shows all pulmonary veins drain abnormally in another site rather than left atrium. Imaging can detect anomalous veins either supracardiac, infracardiac, or mixed. Partial anomalous pulmonary venous return shows some pulmonary vein have abnormal drainage that well delineated with computed tomography angiography. Scimitar syndrome is a type of partial anomalous pulmonary venous return where the pulmonary veins of the right lung drain infracardiac and is associated with right lung hypoplasia and dextrocardia. Pseudoscimitar show anomalous vein that takes a tortuous course and drains into the left atrium producing a false-positive scimitar sign. Cor triatriatum shows septum divide left atrium with proximal chamber receives blood flow from the pulmonary veins. Levoatriocardinal vein is an anomalous connection between the left atrium and anomalous vein from systemic venous system that is embryo logically derived from the cardinal veins. Computed tomography angiography can detect pulmonary vein stenosis, atresia, hypoplasia, and varix. Imaging is important for intimal diagnosis and detects the anomalous vessels and its connection, presence of stenosis, and associated other congenital cardiac anomalies. Also, it is a great role in assessment of patients after surgery.


Assuntos
Veias Pulmonares/anormalidades , Veias Pulmonares/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Humanos , Angiografia por Ressonância Magnética , Sensibilidade e Especificidade
10.
J Comput Assist Tomogr ; 43(3): 467-471, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31082953

RESUMO

AIM: This study aimed to assess metrics of diffusion tensor imaging in evaluating microstructural abnormalities of the lateral rectus muscle in Duane retraction syndrome (DRS). PATIENT AND METHODS: A prospective study was conducted on 27 patients with DRS and 16 age- and sex-matched controls who underwent diffusion tensor imaging of orbit and forced duction test (FDT). Fractional anisotropy (FA) and mean diffusivity (MD) of the lateral rectus were calculated by 2 observers. RESULTS: Fractional anisotropy of the lateral rectus in patients (0.62 ± 0.07 and 0.59 ± 0.06) was significantly higher (P = 0.001) than that in controls (0.49 ± 0.06 and 0.51 ± 0.06). Selection values of 0.53 and 0.52 as cutoff points of FA of the lateral rectus to differentiate patients from controls revealed areas under the curve of 0.92 and 0.86 and accuracy values of 84.8% and 80.4% by both observers, respectively. Mean diffusivity of the lateral rectus by both observers in patients (1.19 ± 0.13 and 1.23 ± 0.19 × 10 mm/s) was significantly lower (P = 0.001) than that in controls (1.54 ± 0.18 and 1.49 ± 0.16 × 10 mm/s). Selection values of 1.35 and 1.40 × 10 mm/s as cutoff points of MD of the lateral rectus to differentiate patients from the control groups revealed areas under the curve of 0.93 and 0.85 and accuracy values of 91.3% and 80.4% by both observers, respectively. Interobserver agreement for MD and FA of the lateral rectus by both observers were excellent (r = 0.870 and, 0.959). Diffusion tensor imaging metrics of the lateral rectus muscle did not differ significantly between patients with unilateral and bilateral disease (P = 0.05) and patients with DRS type I and type III (P = 0.05). Diffusion tensor imaging metrics of the lateral rectus muscle differed significantly between FDT grades I and II versus grades III and IV, and these metrics were well correlated with the degree of FDT. CONCLUSION: Diffusion tensor imaging metrics are valuable noninvasive tools in evaluating the microstructural abnormalities of the lateral rectus in DRS and are well correlated with degree of FDT.


Assuntos
Imagem de Tensor de Difusão/métodos , Síndrome da Retração Ocular/diagnóstico por imagem , Músculos Oculomotores/diagnóstico por imagem , Estudos de Casos e Controles , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Estudos Prospectivos
11.
Artigo em Inglês | MEDLINE | ID: mdl-31082973

RESUMO

AIM: This study aimed to assess metrics of diffusion tensor imaging in evaluating microstructural abnormalities of the lateral rectus muscle in Duane retraction syndrome (DRS). PATIENT AND METHODS: A prospective study was conducted on 27 patients with DRS and 16 age- and sex-matched controls who underwent diffusion tensor imaging of orbit and forced duction test (FDT). Fractional anisotropy (FA) and mean diffusivity (MD) of the lateral rectus were calculated by 2 observers. RESULTS: Fractional anisotropy of the lateral rectus in patients (0.62 ± 0.07 and 0.59 ± 0.06) was significantly higher (P = 0.001) than that in controls (0.49 ± 0.06 and 0.51 ± 0.06). Selection values of 0.53 and 0.52 as cutoff points of FA of the lateral rectus to differentiate patients from controls revealed areas under the curve of 0.92 and 0.86 and accuracy values of 84.8% and 80.4% by both observers, respectively. Mean diffusivity of the lateral rectus by both observers in patients (1.19 ± 0.13 and 1.23 ± 0.19 × 10 mm/s) was significantly lower (P = 0.001) than that in controls (1.54 ± 0.18 and 1.49 ± 0.16 × 10 mm/s). Selection values of 1.35 and 1.40 × 10 mm/s as cutoff points of MD of the lateral rectus to differentiate patients from the control groups revealed areas under the curve of 0.93 and 0.85 and accuracy values of 91.3% and 80.4% by both observers, respectively. Interobserver agreement for MD and FA of the lateral rectus by both observers were excellent (r = 0.870 and, 0.959). Diffusion tensor imaging metrics of the lateral rectus muscle did not differ significantly between patients with unilateral and bilateral disease (P = 0.05) and patients with DRS type I and type III (P = 0.05). Diffusion tensor imaging metrics of the lateral rectus muscle differed significantly between FDT grades I and II versus grades III and IV, and these metrics were well correlated with the degree of FDT. CONCLUSION: Diffusion tensor imaging metrics are valuable noninvasive tools in evaluating the microstructural abnormalities of the lateral rectus in DRS and are well correlated with degree of FDT.

12.
Artigo em Inglês | MEDLINE | ID: mdl-31082974

RESUMO

We aimed to review computed tomography and magnetic resonance angiography of congenital anomalies of pulmonary veins. Total anomalous pulmonary venous return shows all pulmonary veins drain abnormally in another site rather than left atrium. Imaging can detect anomalous veins either supracardiac, infracardiac, or mixed. Partial anomalous pulmonary venous return shows some pulmonary vein have abnormal drainage that well delineated with computed tomography angiography. Scimitar syndrome is a type of partial anomalous pulmonary venous return where the pulmonary veins of the right lung drain infracardiac and is associated with right lung hypoplasia and dextrocardia. Pseudoscimitar show anomalous vein that takes a tortuous course and drains into the left atrium producing a false-positive scimitar sign. Cor triatriatum shows septum divide left atrium with proximal chamber receives blood flow from the pulmonary veins. Levoatriocardinal vein is an anomalous connection between the left atrium and anomalous vein from systemic venous system that is embryo logically derived from the cardinal veins. Computed tomography angiography can detect pulmonary vein stenosis, atresia, hypoplasia, and varix. Imaging is important for intimal diagnosis and detects the anomalous vessels and its connection, presence of stenosis, and associated other congenital cardiac anomalies. Also, it is a great role in assessment of patients after surgery.

13.
World Neurosurg ; 127: e593-e598, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30928596

RESUMO

OBJECTIVE: We sought to differentiate glioblastomas from solitary brain metastasis using arterial spin labeling perfusion (ASL)- and diffusion tensor imaging (DTI)-derived metrics. METHODS: A prospective study was done on 36 patients with provisional diagnosis of glioblastomas versus brain metastasis who underwent ASL and DTI of the brain. The tumor blood flow (TBF) and DTI metrics (fractional anisotropy [FA] and mean diffusivity [MD]) of the enhancing tumoral and peritumoral parts were measured. RESULTS: There was a significant difference of TBF (P = 0.001) and MD (P = 0.001) of the tumoral and peritumoral parts of glioblastoma and metastasis (P = 0.001). There was a significant difference of FA of peritumoral part (P = 0.001) and insignificant difference of tumoral part (P = 0.06) between glioblastomas and metastasis. The cutoff of TBF of tumoral and peritumoral parts used for differentiation were 29.7 and 17.8 (mL/100 g/minute) revealed an area under the curve (AUC) of 0.943 and 0.937 with accuracy of 91.7% and 88.9%. The cutoff of MD of tumoral and peritumoral parts were 1.27 and 1.33 (10-3 mm2/second) revealed AUC of 0.840 and 0.987 and accuracy of 83.3% and 91.7%, respectively. Combined TBF, MD, and FA of the peritumoral part revealed AUC of 0.984 and accuracy of 91.7%. CONCLUSIONS: A combination of ASL- and DTI-derived metrics of the peritumoral part can be used for differentiation of glioblastomas from solitary brain metastasis.


Assuntos
Neoplasias Encefálicas/patologia , Encéfalo/patologia , Imagem de Tensor de Difusão , Glioblastoma/patologia , Metástase Neoplásica/patologia , Benchmarking , Neoplasias Encefálicas/diagnóstico , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão/métodos , Feminino , Glioblastoma/diagnóstico , Humanos , Masculino , Metástase Neoplásica/diagnóstico , Estudos Prospectivos
14.
J Comput Assist Tomogr ; 43(3): 507-512, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30762655

RESUMO

PURPOSE: This study aimed to assess apparent diffusion coefficient (ADC) of the placenta and fetal organs in intrauterine growth restriction (IUGR). MATERIALS AND METHODS: A prospective study of 30 consecutive pregnant women (aged 21-38 years with mean age of 31.5 years and a mean gestational week of 35 ± 2.3) with IUGR and 15 age-matched pregnant women was conducted. All patients and controls underwent diffusion-weighted magnetic resonance imaging. The ADCs of the placenta and fetal brain, kidney, and lung were calculated and correlated with neonates needing intensive care unit (ICU) admission. RESULTS: There was a significant difference in ADC of the placenta and fetal brain, lung, and kidney (P = 0.001, 0.001, 0.04, and 0.04, respectively) between the patients and the controls. The cutoff ADCs of the placenta and fetal brain, lung, and kidney used to detect IUGR were 1.45, 1.15, 1.80, and 1.40 × 10 mm/s, respectively, with areas under the curve (AUCs) of 0.865, 0.858, 0.812, and 0.650, respectively, and accuracy values of 75%, 72.5%, 72.5%, and 70%, respectively. Combined ADC of the placenta and fetal organs used to detect IUGR revealed an AUC of 1.00 and an accuracy of 100%. There was a significant difference in ADC of the placenta and fetal brain, lung, and kidney between neonates needing admission and those not needing ICU admission (P = 0.001, 0.001, 0.002, and 0.002, respectively). The cutoff ADCs of the placenta and fetal brain, lung, and kidney used to define neonates needing ICU were 1.35, 1.25, 1.95, and 1.15 × 10 mm/s with AUCs of 0.955, 0.880, 0.884, and 0.793, respectively, and accuracy values of 86.7%, 46.7%, 76.7%, and 70%, respectively. Combined placental and fetal brain ADC used to define neonates needing ICU revealed an AUC of 0.968 and an accuracy of 93.3%. CONCLUSION: Combined ADC of the placenta and fetal organs can detect IUGR, and combined ADC of the placenta and fetal brain can define fetuses needing ICU.


Assuntos
Encéfalo/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Retardo do Crescimento Fetal/diagnóstico por imagem , Rim/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Placenta/diagnóstico por imagem , Encéfalo/embriologia , Feminino , Idade Gestacional , Humanos , Rim/embriologia , Pulmão/embriologia , Masculino , Idade Materna , Gravidez , Diagnóstico Pré-Natal , Estudos Prospectivos , Adulto Jovem
15.
Eur J Radiol ; 111: 76-80, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30691669

RESUMO

AIM OF THE WORK: To investigate mean diffusivity (MD) and fractional anisotropy (FA) measured by diffusion tensor imaging (DTI) as complementary tools to differentiate recurrent breast cancer from post-operative changes in patients with breast-conserving surgery (BCS). PATIENTS AND METHODS: Prospective study was conducted upon 30 patients with BCS that underwent DTI and dynamic contrast MR imaging. DTI was performed using an axial two-dimensional spin-echo echo-planar imaging sequence. The MD and FA of the lesions were calculated by 2 observers. A single pixel seed isotropic region of interest was placed in the solid part of the tumor on the axial color FA map guided by an enhanced part of the tumor. The final diagnosis was done by biopsy for all patients. RESULTS: The pathological examination proved to be recurrent breast cancer (n = 13) and post-operative changes (n = 17). Recurrent breast cancer had significantly lower MD (P = 0.001, 0.001) and higher FA (P = 0.003, 0.02) than in post-operative changes for both observers respectively. At ROC curve analysis of MD, the AUC was 0.86 and 0.85 by both observers. The threshed MD was (0.86, 0.85 × 10-3 mm2/s) used for differentiation between entities revealed sensitivity (76.9%, 92.3%), specificity (82.4%, 64.7%) and accuracy (80%, 76.7%) of both observers respectively. At ROC curve analysis of FA, the AUC was 0.82 and 0.75 by both observers. The threshold FA (0.82, 0.75) was used for differentiation between entities revealed sensitivity (92.3%, 76.9%), specificity (70.6%, 70.6%) and accuracy of (80.0%, 73.3%) of both observers respectively. There was a strong positive correlation of MD (r = 0.86) and FA (r = 0.73) of both observers. Combined analysis of FA and MD used for differentiation between entities had AUC (0.90, 0.88) revealed sensitivity (92.3%, 92.3%), specificity (82.4%, 70.6%) and accuracy of (86.7%, 80.0%) for both observers respectively. CONCLUSIONS: Combined analysis of MD and FA of DTI may play an important role as a non-invasive method for differentiation recurrent breast cancer from post-operative changes in patients with BCS.


Assuntos
Neoplasias da Mama/patologia , Imagem de Tensor de Difusão , Mastectomia Segmentar , Recidiva Local de Neoplasia/patologia , Adulto , Anisotropia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Imagem de Tensor de Difusão/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Período Pós-Operatório , Estudos Prospectivos , Curva ROC
16.
World Neurosurg ; 123: e303-e309, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30502475

RESUMO

OBJECTIVE: Differentiation of primary central nervous system lymphoma (PCNSL) from glioblastoma using arterial spin labeling perfusion and diffusion tensor imaging (DTI). METHODS: We performed a prospective study of 31 patients with a provisional diagnosis of PCNSL and glioblastoma who underwent conventional magnetic resonance imaging, DTI, and arterial spin labeling of the brain. The tumor blood flow (TBF), mean diffusivity (MD) plus fractional anisotropy (FA) of the mass were measured. The final diagnosis was confirmed by pathological examination. RESULTS: The TBF of PCNSL (26.41 ± 4.03 mL/100 g/minute) was significantly lower than that of glioblastoma (51.08 ± 3.9 mL/100 g/minute; P = 0.001). The TBF cutoff (35.73 mL/100 g/minute) used for differentiation showed area under the curve (AUC) of 0.93, accuracy of 95.2%, sensitivity of 91.7%, and specificity of 100%. The MD of PCNSL (0.87 ± 0.2X 10-3 mm2/second) was significantly lower than that of glioblastoma (0.87 ± 0.2 × 10-3 mm2/second; P = 0.01). The MD cutoff (0.935 × 10-3 mm2/second) used for differentiation showed an AUC of 0.73 and accuracy of 66.7% and a sensitivity of 75% and specificity of 55.6%. The FA of PCNSL (0.253 ± 0.05) was significantly greater than that of glioblastoma (0.135 ± 0.06; P = 0.001). The FA cutoff (0.185) used for differentiation revealed an AUC of 0.944 and accuracy of 85.7% and a sensitivity of 83.3% and specificity of 88.9%. The combined TBF, MD, and FA cutoffs revealed an AUC of 0.96 and accuracy of 95.5% and a sensitivity of 83.3% and specificity of 100%. CONCLUSION: The noninvasive imaging parameters using TBF and DTI might help in differentiating PCNSL from glioblastoma.


Assuntos
Neoplasias do Sistema Nervoso Central/diagnóstico por imagem , Glioblastoma/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Imagem de Perfusão , Adulto , Idoso , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Neoplasias do Sistema Nervoso Central/fisiopatologia , Diagnóstico Diferencial , Feminino , Glioblastoma/fisiopatologia , Humanos , Linfoma/fisiopatologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional , Sensibilidade e Especificidade
17.
J Comput Assist Tomogr ; 43(2): 288-293, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30407242

RESUMO

OBJECTIVE: The aim of this study was to assess the accuracy of mass effect sign in the diagnosis of cholesteatoma at high-resolution computed tomography (HRCT). METHODS: This prospective study included 32 ears in 24 patients with chronic otitis media who underwent HRCT of the temporal bone. Otoscopic and operative notes were recorded. Image analysis was done both qualitatively and quantitatively. In the qualitative analysis, mass effect was evaluated visually by comparing both ears together in 4 certain anatomical sites. Ossicular erosions, erosion of tegmen tympani, erosion of tympanic segment of facial nerve canal, and the presence of lobulated nondependent opacity were also evaluated. In the quantitative analysis, we calculated the difference between the distances of the described anatomical sites in both ears. RESULTS: Qualitative analysis of mass effect sign showed 97.1% accuracy in detecting cholesteatoma. Ossicular erosions showed 69.2% accuracy in the diagnosis of cholesteatoma. In the quantitative analysis, we found that the cutoff point of 0.45 mm in the difference of aditus measure between both ears showed 85.3% accuracy in differentiating cholesteatoma from otitis media. The cutoff point of 0.75 mm in the differences in supratubal measure showed 86.1% accuracy. The cutoff point of 0.45 mm in the medial to incus measure showed 100% accuracy. CONCLUSION: High-resolution computed tomography is highly valuable for the detection of mass effect sign, which has great importance in diagnosing cholesteatoma.


Assuntos
Colesteatoma da Orelha Média/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Criança , Orelha Média/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Adulto Jovem
18.
J Comput Assist Tomogr ; 43(2): 183-186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30407244

RESUMO

PURPOSE: The aim of this study was to assess of liver and spleen in children with Gaucher disease type 1 with chemical shift imaging. METHODS: Retrospective analysis was conducted on 36 untreated children with Gaucher disease type 1 and 15 age- and sex-matched control children who underwent chemical shift imaging of the abdomen. The hepatic and splenic fat fraction was calculated. The Pediatric Gaucher Severity Scoring System, hematologic parameters, and enzyme assay of the disease were calculated and correlated with hepatic and splenic fat fraction. RESULTS: The mean hepatic fat fraction in Gaucher disease was 14.1 ± 3.1 (95% confidence interval [CI], 12.9-15.2) was significantly higher (P = 0.001) than that of control subjects 5.2 ± 0.9 (95% CI, 4.7-5.7). The mean splenic fat fraction in Gaucher disease was 11.2 ± 2.9 (95% CI, 11.2 ± 2.9), and that of control was 4.5 ± 0.9 (95% CI, 4.02-5.2). The thresholds of hepatic and splenic fat fraction used to differentiate patients from control subjects were 0.47 and 0.39 with areas under the curve of 0.947 and 0.999, respectively. The hepatic and splenic fat fraction is correlated with the Pediatric Gaucher Severity Scoring System (r = -0.523, -0.602), hemoglobin concentration (r = -0.491, -0.505), platelet count (r = -0.593, -0.24), ß-glucosidase (r = 0.519, 0.549), and chitotriosidase (r = -0.03, 0.267), respectively. CONCLUSIONS: Hepatic and splenic fat fraction is a promising quantitative imaging parameter for detection and quantification of hepatic and splenic infiltration in children with Gaucher disease and correlated with clinical scoring, hematologic parameters, and enzyme assay of the disease.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Doença de Gaucher/diagnóstico por imagem , Fígado/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Baço/diagnóstico por imagem , Tecido Adiposo/metabolismo , Adolescente , Criança , Pré-Escolar , Feminino , Doença de Gaucher/metabolismo , Humanos , Fígado/metabolismo , Masculino , Estudos Retrospectivos , Baço/metabolismo
19.
Magn Reson Imaging ; 54: 84-89, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30142392

RESUMO

BACKGROUND: Differentiation between residual head and neck squamous cell carcinoma and post-radiation changes is difficult with routine computed tomography and magnetic resonance imaging. PURPOSE: To assess the reliability and reproducibility of mean diffusivity (MD) and fractional anisotropy (FA) parameters of diffusion tensor imaging in differentiation residual head and neck squamous cell carcinoma from post-radiation changes. MATERIAL AND METHODS: A retrospective analysis of diffusion tensor imaging of 43 patients with head and neck squamous cell carcinoma cancer after radiotherapy. The MD and FA of the lesion were calculated by the same reader at two-time points. RESULTS: There was a significantly lower difference (P = 0.001) in MD of both readings between residual head and neck squamous cell carcinoma (1.48 ±â€¯0.06 and 1.47 ±â€¯0.07 × 10-3 mm2/s) and post-radiation changes (1.72 ±â€¯0.08 and 1.71 ±â€¯0.11 × 10-3 mm2/s). The FA of residual head and neck squamous cell carcinoma of both readings (0.41 ±â€¯0.09 and 0.42 ±â€¯0.09) shows a significantly higher difference (P = 0.001) than post-radiation changes (0.17 ±â€¯0.04 and 0.16 ±â€¯0.03). There was excellent intra-reader agreement between both readings using MD (K = 0.958) and FA (K = 0.987). The threshold MD and FA used for differentiating the residual from post-radiation changes of both readings was 1.61, 1.65 × 10-3 mm2/s and 0.27, 0.25 with an area under the curve of 0.991, 0.934, 0.993 and 0.990 respectively. CONCLUSION: MD and FA of diffusion tensor imaging are non-invasive reliable and reproducible parameters that can help in differentiation residual head and neck squamous cell carcinoma from post-radiation changes.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão/métodos , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Idoso , Anisotropia , Diagnóstico Diferencial , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasia Residual/diagnóstico por imagem , Reprodutibilidade dos Testes , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Resultado do Tratamento
20.
Pol J Radiol ; 83: e151-e159, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30038693

RESUMO

Purpose: To assess inter-observer variability of the Coronary Artery Disease - Reporting and Data System (CAD-RADS) for classifying the degree of coronary artery stenosis in patients with stable chest pain. Material and methods: A prospective study was conducted upon 96 patients with coronary artery disease, who underwent coronary computed tomography angiography (CTA). The images were classified using the CAD-RAD system according to the degree of stenosis, the presence of a modifier: graft (G), stent (S), vulnerable plaque (V), or non-diagnostic (n) and the associated coronary anomalies, and non-coronary cardiac and extra-cardiac findings. Image analysis was performed by two reviewers. Inter-observer agreement was assessed. Results: There was excellent inter-observer agreement for CAD-RADS (k = 0.862), at 88.5%. There was excellent agreement for CAD-RADS 0 (k = 1.0), CAD-RADS 1 (k = 0.92), CAD-RADS 3 (k = 0.808), CAD-RADS 4 (k = 0.826), and CAD-RADS 5 (k = 0.833) and good agreement for CAD-RADS 2 (k = 0.76). There was excellent agreement for modifier G (k = 1.0) and modifier S (k = 1.0), good agreement for modifier N (k = 0.79), and moderate agreement for modifier V (k = 0.59). There was excellent agreement for associated coronary artery anomalies (k = 0.845), non-coronary cardiac findings (k = 0.857), and extra-cardiac findings (k = 0.81). Conclusions: There is inter-observer agreement of CAD-RADS in categorising the degree of coronary arteries stenosis, and the modifier of the system and associated cardiac and extra-cardiac findings.

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