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1.
Eur Radiol Exp ; 5(1): 52, 2021 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-34873633

RESUMO

Over the past two decades, the epidemiology of chronic liver disease has changed with an increase in the prevalence of nonalcoholic fatty liver disease in parallel to the advent of curative treatments for hepatitis C. Recent developments provided new tools for diagnosis and monitoring of liver diseases based on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), as applied for assessing steatosis, fibrosis, and focal lesions. This narrative review aims to discuss the emerging approaches for qualitative and quantitative liver imaging, focusing on those expected to become adopted in clinical practice in the next 5 to 10 years. While radiomics is an emerging tool for many of these applications, dedicated techniques have been investigated for US (controlled attenuation parameter, backscatter coefficient, elastography methods such as point shear wave elastography [pSWE] and transient elastography [TE], novel Doppler techniques, and three-dimensional contrast-enhanced ultrasound [3D-CEUS]), CT (dual-energy, spectral photon counting, extracellular volume fraction, perfusion, and surface nodularity), and MRI (proton density fat fraction [PDFF], elastography [MRE], contrast enhancement index, relative enhancement, T1 mapping on the hepatobiliary phase, perfusion). Concurrently, the advent of abbreviated MRI protocols will help fulfill an increasing number of examination requests in an era of healthcare resource constraints.

2.
Int J Surg ; 96: 106170, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34775110

RESUMO

BACKGROUND: Inguinal hernia is a degenerative disease occurring in a high motile surround. Stopping degeneration and promoting tissue regeneration should be the treatment goal. Groin hernias are conventionally managed with static flat meshes, mostly fixated to the delicate inguinal environment. Far from a regenerative effect, the biologic response of conventional hernia meshes is characterized by a foreign body reaction leading to a stiff/shrunken scar plate, which is often the source of unpleasant complications. Recently, a newly engineered 3D device for inguinal hernia repair - ProFlor-has been developed to produce a regenerative biological response. Unlike conventional hernia meshes, this regenerative 3D hernia scaffold seems to demonstrate suitable features for a pathogenetical and physiological coherent treatment of the disease. The aim of this manuscript is to cross evidence these features through magnetic resonance imaging (MRI) and histology. STUDY DESIGN: The biological response of ProFlor at three defined post-implantation stages has been evaluated through MRI signal intensity and compared to neighbouring muscles and fat. As additional proof, histology of tissue specimens excised at the same post-implantation periods from porcine models during an experimental attempt were also evaluated. RESULTS: MRI of newly ingrown tissue in ProFlor demonstrated similar signal intensity of muscles while fat tissue showed remarkably higher values. These data matched with the histology of ProFlor biopsies excised from pigs. CONCLUSIONS: The motile compliance to groin movements of ProFlor appears to induce a probiotic biologic response comparable to a regenerative scaffold, allowing to physiologically resolve the degenerative source of inguinal hernia disease.

3.
Magn Reson Imaging ; 86: 55-60, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34808304

RESUMO

PURPOSE: A strong prognostic score that enables a stratification of newly diagnosed Hodgkin Lymphoma (HL) to identify patients at high risk of refractory/relapsed disease is still needed. Our aim was to investigate the potential value of a radiomics analysis pipeline from whole-body MRI (WB-MRI) exams for clinical outcome prediction in patients with HL. MATERIALS AND METHODS: Index lesions from baseline WB-MRIs of 40 patients (22 females; mean age 31.7 ± 11.4 years) with newly diagnosed HL treated by ABVD chemotherapy regimen were manually segmented on T1-weighted, STIR, and DWI images for texture analysis feature extraction. A machine learning approach based on the Extra Trees classifier and incorporating clinical variables, 18F-FDG-PET/CT-derived metabolic tumor volume, and WB-MRI radiomics features was tested using cross-validation to predict refractory/relapsed disease. RESULTS: Relapsed disease was observed in 10/40 patients (25%), two of whom died due to progression of disease and graft versus host disease, while eight reached the complete remission. In total, 1403 clinical and radiomics features were extracted, of which 11 clinical variables and 171 radiomics parameters from both original and filtered images were selected. The 3 best performing Extra Trees classifier models obtained an equivalent highest mean accuracy of 0.78 and standard deviation of 0.09, with a mean AUC of 0.82 and standard deviation of 0.08. CONCLUSIONS: Our preliminary results demonstrate that a combined machine learning and texture analysis model to predict refractory/relapsed HL on WB-MRI exams is feasible and may help in the clinical outcome prediction in HL patients.

4.
Clin Imaging ; 80: 304-314, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34482241

RESUMO

Due to the growing use of CT, there has been an increase in the frequency of detecting focal liver lesions. Intrinsically hyperattenuating hepatic lesions or pseudolesions are not uncommon at unenhanced CT. Hyperattenuating hepatic lesions can be divided into non-calcified and calcified. Causes of intrinsic hyperattenuation include hemorrhage, thrombosis, and calcifications. Focal liver lesions can show hyperattenuation on unenhanced CT in case of severe liver steatosis. Recognition of etiologies associated with hyperattenuation on unenhanced CT can help the radiologist in characterizing focal liver lesions and pseudolesions. In this paper, we describe the spectrum of intrinsically hyperattenuating focal liver lesions and pseudolesions at unenhanced CT.


Assuntos
Calcinose , Fígado Gorduroso , Neoplasias Hepáticas , Calcinose/diagnóstico por imagem , Diagnóstico Diferencial , Fígado Gorduroso/diagnóstico por imagem , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Tomografia Computadorizada por Raios X
5.
Diagnostics (Basel) ; 11(6)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34073062

RESUMO

Imaging of lymphoma is based on the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and/or contrast-enhanced CT, but concerns have been raised regarding radiation exposure related to imaging scans in patients with cancer, and its association with increased risk of secondary tumors in patients with lymphoma has been established. To date, lymphoproliferative disorders are among the most common indications to perform whole-body magnetic resonance imaging (MRI). Whole-body MRI is superior to contrast-enhanced CT for staging the disease, also being less dependent on histology if compared to 18F-FDG-PET/CT. As well, it does not require exposure to ionizing radiation and could be used for the surveillance of lymphoma. The current role of whole-body MRI in the diagnostic workup in lymphoma is examined in the present review along with the diagnostic performance in staging, response assessment and surveillance of different lymphoma subtypes.

6.
Pol J Radiol ; 86: e246-e254, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34093922

RESUMO

Ascending thoracic aorta disease is often a life-threatening condition. Aortic aneurysm and aortic dissection are the most frequent ascending aorta diseases requiring surgical intervention. Surgical repair techniques of the ascending aorta are various; they include reconstruction of the ascending aorta by using a graft with or without a prosthetic valve, reconstruction with a composite artificial graft or using a biological graft, and reconstruction of the ascending aorta with a composite graft preserving the native valve and arch repair. The radiologist plays a key role in the identification of post-operative complications; differentiation from normal postoperative findings is fundamental. Our aim is to discuss the main diseases affecting the ascending aorta requiring surgery and the different techniques used to treat them. We also discuss the normal computed tomography (CT) imaging findings and after-surgery complications.

7.
Crit Rev Oncol Hematol ; 163: 103390, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34090998

RESUMO

The introduction of checkpoint inhibitors (ICIs) in renal cell carcinoma (RCC) treatment landscape, resulted in improvements in overall survival (OS) in metastatic patients. Brain metastases (BMs) are a specific metastatic site of interest representing a predictive factor of poor prognosis. Patients with BMs were usually excluded from prospective clinical trials in the past. Despite recent evidence suggest the efficacy and safety of ICIs, the BMs treatment remains a challenge; the immunotherapy responsiveness seems to be multifactorial and dependent on several factors, such as the genetic intratumor heterogeneity and the immunosuppressive role of the brain tumor microenvironment. This review, starting from the immunological background in RCC BMs, provide an overview of the upcoming evidence from clinical trials, address the issues related to the neuroradiological immunotherapy response evaluation and, with a look to the future, describes how the epigenetic modulation of immune evasion could represent a background for new therapeutic strategies.


Assuntos
Neoplasias Encefálicas , Carcinoma de Células Renais , Neoplasias Renais , Neoplasias Encefálicas/tratamento farmacológico , Carcinoma de Células Renais/tratamento farmacológico , Humanos , Inibidores de Checkpoint Imunológico , Neoplasias Renais/tratamento farmacológico , Estudos Prospectivos , Microambiente Tumoral
8.
Artigo em Inglês | MEDLINE | ID: mdl-33794596

RESUMO

The Coronavirus Disease 2019 (COVID-19) represents the first medical catastrophe of the new millennium. Although imaging is not a screening test for COVID-19, it plays a crucial role in evaluation and follow-up of COVID-19 patients. In this paper, we will review typical and atypical imaging findings of COVID-19.

9.
Neuroradiol J ; 34(5): 470-475, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33872085

RESUMO

AIMS: To evaluate prospectively whether an intravenous gadolinium injection could improve the detection of the central vein sign on susceptibility-weighted imaging sequences obtained with a 1.5 T magnetic resonance scanner in patients with multiple sclerosis compared to unenhanced susceptibility-weighted images. MATERIALS AND METHODS: This prospective, institution review board-approved study included 19 patients affected by multiple sclerosis (six men; 13 women; mean age 40.8 years, range 20-74 years). Patients had the relapsing-remitting clinical subtype in 95% of cases, and only one (5%) patient had the primary progressive clinical subtype of multiple sclerosis. T2-weighted images, fluid-attenuated inversion recovery images, unenhanced and contrast-enhanced susceptibility-weighted images were evaluated in consensus by two neuroradiologists for the presence of the central vein sign. The readers were blinded to magnetic resonance imaging reports, clinical information, the presence and the localisation of focal hyperintense white matter lesions. Any discordance between readers was resolved through a joint review of the recorded images with an additional neuroradiologist. RESULTS: A total of 317 multiple sclerosis lesions were analysed. The central vein sign had a higher prevalence detection rate on gadolinium-enhanced susceptibility-weighted images (272 of 317 lesions, 86%) compared to unenhanced susceptibility-weighted images (172 of 317 lesions, 54%). CONCLUSION: Gadolinium-enhanced susceptibility-weighted imaging improves the detection rate of the central vein sign in multiple sclerosis lesions.

10.
Radiol Med ; 126(7): 963-970, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33881714

RESUMO

PURPOSE: No prior studies investigated the role of ultrasound in the assessment of response of patients undergoing treatment of metatarsalgia with custom-made orthoses. Our aim was to describe ultrasound findings of patients with plantar forefoot pain treated with custom-made foot orthoses. METHODS: Twenty patients (15 females; mean age: 62.6 ± 11 years) affected by metatarsalgia in 27/40 feet underwent clinical evaluation before, three months and six months after treatment with custom-made full foot insole with a support proximal and an excavation below the painful metatarsals. Ultrasound was performed before and three months after the use of orthoses to examine the presence of intermetatarsal/submetatarsal bursitis, metatarsophalangeal joints effusion, anterior plantar fat pad oedema, flexor tendinitis/tenosynovitis, and Morton's neuroma. Outcome measures were clinical response with Foot Function Index (FFI)/Visual Analogue Scale (VAS) and ultrasound features changes. RESULTS: Median VAS and FFI before treatment were 8[5-8.5] and 45.85[32.4-59.4], respectively. After 3 and 6 months of insoles use, both median VAS (2.5 [0-5] and 0 [0-2.75], respectively) and median FFI (7.9 [3.95-20] and 0 [0-3.95], respectively) showed a significant reduction in pain and disability (p < .001). Before treatment, ultrasound revealed 22 intermetatarsal bursitis, 16 submetatarsal bursitis, 10 joint effusions, 20 fat pad oedema, 3 flexor tendinitis/tenosynovitis and 3 Morton's neuromas. After 3 months of treatment, a significant decrease of intermetatarsal bursitis (7, p < .001) was observed. No significant changes were observed in any other ultrasound parameters. CONCLUSION: Ultrasound might be able to detect some imaging features associated with the response of forefoot pain to custom-made foot orthoses, especially intermetatarsal bursitis.


Assuntos
Órtoses do Pé , Antepé Humano/diagnóstico por imagem , Metatarsalgia/diagnóstico , Ultrassonografia/métodos , Adulto , Idoso , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Metatarsalgia/terapia , Pessoa de Meia-Idade , Estudos Retrospectivos
11.
Brain Sci ; 11(4)2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33918426

RESUMO

In the recent pandemic disease, called COVID-19, the role of neurologists and neurobiologists represents a chance to study key features of brain infection and deepen neurological manifestations of COVID-19 and other coronavirus infections. In fact, many studies suggest brain damage during infection and persistent neurological symptoms after COVID-19 infection. Reverse transcription PCR test, antibody tests, Computed Tomography (CT) of the lung, and Magnetic Resonance (MR) of the brain of the patient were periodically performed during this case report for eight months after infection. The aim of this article is to describe the prolonged neurological clinical consequences related to COVID-19. We believe it is clinically clear that we can define a post-acute COVID-19 neurological syndrome. Therefore, in patients after a severe clinical condition of COVID-19, a deepening of persistent neurological signs is necessary.

13.
Sci Rep ; 11(1): 2559, 2021 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-33510220

RESUMO

Laparoscopic cholecystectomy (LC) is the standard technique for treatment of gallbladder disease. In case of acute cholecystitis we can identify preoperative factors associated with an increased risk of conversion and intraoperative complications. The aim of our study was to detect preoperative laboratory and radiological findings predictive of difficult LC with potential advantages for both the surgeons and patients in terms of options for management. We designed a retrospective case-control study to compare preoperative predictive factors of difficult LC in patients treated in emergency setting between January 2015 and December 2019. We included in the difficult LC group the surgeries with operative time > 2 h, need for conversion to open, significant bleeding and/or use of synthetic hemostats, vascular and/or biliary injuries and additional operative procedures. We collected 86 patients with inclusion criteria and difficult LC. In the control group, we selected 86 patients with inclusion criteria, but with no operative signs of difficult LC. The analysis of the collected data showed that there was a statistically significant association between WBC count and fibrinogen level and difficult LC. No association were seen with ALP, ALT and bilirubin values. Regarding radiological findings significant differences were noted among the two groups for irregular or absent wall, pericholecystic fluid, fat hyperdensity, thickening of wall > 4 mm and hydrops. The preoperative identification of difficult laparoscopic cholecystectomy provides an important advantage not only for the surgeon who has to perform the surgery, but also for the organization of the operating block and technical resources. In patients with clinical and laboratory parameters of acute cholecystitis, therefore, it would be advisable to carry out a preoperative abdominal CT scan with evaluation of features that can be easily assessed also by the surgeon.


Assuntos
Colecistectomia Laparoscópica/métodos , Idoso , Doenças Biliares/cirurgia , Colecistite Aguda/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Curr Probl Diagn Radiol ; 50(2): 175-185, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31761413

RESUMO

PURPOSE: To determine the diagnostic performance of texture analysis of prostate MRI for the diagnosis of prostate cancer among Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. MATERIALS AND METHODS: Forty-three patients with at least 1 PI-RADS 3 lesion on prostate MRI performed between June 2016 and January 2019 were retrospectively included. Reference standard was pathological analysis of radical prostatectomy specimens or MRI-targeted biopsies. Texture analysis extraction of target lesions was performed on axial T2-weighted images and apparent diffusion coefficient (ADC) maps using a radiomic software. Lesions were categorized as prostate cancer (Gleason score [GS] ≥ 6), and no prostate cancer. Statistical analysis was performed using the generalized linear model (GLM) regression and the discriminant analysis (DA). AUROC with 95% confidence intervals were calculated to assess the diagnostic performance of standalone features and predictive models for the diagnosis of prostate cancer (GS ≥ 6) and clinically-significant prostate cancer (GS ≥ 7). RESULTS: The analysis of 46 PI-RADS 3 lesions (ie, 27 [58.7%] no prostate cancers; 19 [41.3%] prostate cancers) revealed 9 and 6 independent texture parameters significantly correlated with the final histopathological results on T2-weighted and ADC maps images, respectively. The resulting GLM and DA predictive models for the diagnosis of prostate cancer yielded an AUROC of 0.775 and 0.779 on T2-weighted images or 0.815 and 0.821 on ADC maps images. For the diagnosis of clinically-significant prostate cancer, the resulting GLM and DA predictive models for the diagnosis of prostate cancer yielded an AUROC of 0.769 and 0.817 on T2-weighted images or 0.749 and 0.744 on ADC maps images. CONCLUSION: Texture analysis of PI-RADS 3 lesions on T2-weighted and ADC maps images helps identifying prostate cancer. The good diagnostic performance of the combination of multiple radiomic features for the diagnosis of prostate cancer may help predicting lesions where aggressive management may be warranted.


Assuntos
Imageamento por Ressonância Magnética , Neoplasias da Próstata , Humanos , Masculino , Gradação de Tumores , Neoplasias da Próstata/diagnóstico por imagem , Estudos Retrospectivos
15.
Radiol Med ; 126(2): 299-305, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32572763

RESUMO

PURPOSE: To perform a survey among all members of the Italian Society of Medical and Interventional Radiology (SIRM) to assess how whole-body MRI (WB-MRI) is performed in oncologic patients in Italy. METHODS: On March 2019, we administered an online poll to all SIRM members about their use of WB-MRI in 2018 asking 15 questions regarding oncologic indications, imaging protocol, use of contrast media, experience in WB-MRI, duration of scan time and reporting time. RESULTS: Forty-eight members participated to the survey. WB-MRIs/total MRIs ratio was 1%. Lymphoma was the most common indication (17/48, 35%), followed by myeloma and prostate cancer, with these three tumors representing the most common indication in 39/48 of cases (81%). WB-MRI acquisition time and reporting time were 46-60 min in 22/48 centers (46%) and 20-30 min in 19/48 (40%), respectively. WB-MRIs were mostly performed in 1.5T scanners (43/48, 90%), with surface coils (22/48, 46%) being preferred to Q-body (15/48, 31%) and integrated coils (11/48, 23%). Contrast media were injected in 22/48 of the centers (46%), mainly used for breast cancer (13/22, 59%). DWI was the most used sequence (45/48, 94%), mostly with b800 (27/48, 56%), b0 (24/48, 50%) and b1000 (20/48, 42%) values. In about half of cases, radiologists started evaluating WB-MRI non-contrast morphologic sequences, then checking DWI and post-contrast images. CONCLUSION: WB-MRI was mainly performed at 1.5T unit, with lymphoma, myeloma and prostate cancer having been the most common indications. The extreme variability in the choice of imaging protocols and use of contrast agents demonstrates the need of a standardization of WB-MRI application in clinical practice.


Assuntos
Imageamento por Ressonância Magnética/métodos , Neoplasias/diagnóstico por imagem , Padrões de Prática Médica/estatística & dados numéricos , Imagem Corporal Total/métodos , Meios de Contraste , Humanos , Itália , Inquéritos e Questionários
16.
Ann Surg ; 274(1): 57-62, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33177355

RESUMO

OBJECTIVE: The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group). SUMMARY BACKGROUND DATA: Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use. METHODS: In this randomized controlled trial, several primary endpoints (operative time, intraoperative blood loss, other complications, conversion rate, and anastomotic leak) and secondary endpoints (overall postoperative complications) were evaluated. In addition, we evaluated histopathologic data, including specimen length and the number of lymph nodes harvested, as objective signs of the quality of CME, related to oncological outcomes. RESULTS: The CME group had a significantly longer mean operative time than the NCME group (216.3 minutes vs 191.5 minutes, P = 0.005). However, the CME group had a higher number of lymph nodes (23.8 vs 16.6; P < 0.001) and larger surgical specimens (34.3 cm vs 29.3 cm; P = 0.002). No differences were reported with respect to intraoperative blood loss, conversion rate, leakage, or other postoperative complications. CONCLUSIONS: In this study laparoscopic CME were a safe and feasible technique with improvement in lymph nodes harvesting and length of surgical specimens with no increase of surgical intraoperative and postoperative complications.


Assuntos
Colectomia/métodos , Neoplasias do Colo/cirurgia , Laparoscopia/métodos , Mesocolo/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Fístula Anastomótica , Perda Sanguínea Cirúrgica , Colectomia/efeitos adversos , Neoplasias do Colo/patologia , Conversão para Cirurgia Aberta , Estudos de Viabilidade , Feminino , Humanos , Laparoscopia/efeitos adversos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Duração da Cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos , Análise de Sobrevida , Resultado do Tratamento
17.
Front Cardiovasc Med ; 8: 787761, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34977193

RESUMO

Efforts in the fight against COVID-19 are achieving success in many parts of the world, although progress remains slow in other regions. We believe that a syndemic approach needs to be adopted to address this pandemic given the strong apparent interplay between COVID-19, its related complications, and the socio-structural environment. We have assembled an international, multidisciplinary group of researchers and clinical practitioners to promote a novel syndemic approach to COVID-19: the CArdiometabolic Panel of International experts on Syndemic COvid-19 (CAPISCO). This geographically diverse group aims to facilitate collaborative-networking and scientific exchanges between researchers and clinicians facing a multitude of challenges on different continents during the pandemic. In the present article we present our "manifesto", with the intent to provide evidence-based guidance to the global medical and scientific community for better management of patients both during and after the current pandemic.

18.
Cardiovasc Diagn Ther ; 10(6): 2018-2035, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33381441

RESUMO

Non-invasive depiction of coronary arteries has been a great challenge for imaging specialists since the introduction of computed tomography (CT). Technological development together with improvements in spatial, temporal, and contrast resolution, progressively allowed implementation of the current clinical role of the CT assessment of coronary arteries. Several technological evolutions including hardware and software solutions of CT scanners have been developed to improve spatial and temporal resolution. The main challenges of cardiac computed tomography (CCT) are currently plaque characterization, functional assessment of stenosis and radiation dose reduction. In this review, we will discuss current standards and future improvements in CCT.

19.
Eur J Radiol ; 131: 109246, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32911127

RESUMO

PURPOSE: To test whether T2 mapping of the sacro-iliac joints (SIJs) might help identifying patients with spondyloarthritis. METHOD: This study included 20 biologic-naive patients with axial spondyloarthritis (10 females; mean age: 38 ±â€¯9years; range, 19-47) and 27 controls (16 males; mean age = 39 ±â€¯13years; range = 28-71) who prospectively underwent SIJs MRI at 1.5 T, including a multislice multiecho spin-echo sequence. Standard MRIs were reviewed to assess the SIJs according to the Assessment of SpondyloArthritis International Society (ASAS) criteria and SPondyloArthritis Research Consortium of Canada (SPARCC) MRI index. T2 maps obtained from multiecho sequences were used to draw regions of interests in the cartilaginous part of the SIJs. Disease activity was assessed using BASDAI questionnaire. Bland-Altman method, ROC curve analysis, Chi square, Mann-Whitney U, Pearson's and Spearman's correlation coefficient were used for data analysis. RESULTS: According to ASAS criteria, MRI was positive for sacroiliitis in 5/20 patients (25 %). Inter-observer reproducibility of T2 values was 87 % (coefficient of repeatability = 7.0; bias = 0.49; p < .001). Mean T2 values of patients (58.5 ±â€¯4.4 ms, range: 52.6-68.2 ms) were significantly higher (p < .001) than those of controls (44.1 ±â€¯6.6 ms, range: 33.6-67.2 ms). A T2 value of 52.51 ms yielded 100 % sensitivity and 91.7 % specificity to differentiate patients from controls. No statistically significant association/correlation was found between T2 values and BASDAI (r=-.026, p = .827), disease duration (r = .024, p = .871), SPARCC (r=-.004, p = .981), ASAS criteria (p = .476), HLA-B27-positivity (p = .139), age (r=-.2.53, p = .891), and gender (p = .404). CONCLUSIONS: T2 relaxation times of the SIJs were significantly higher in patients than in healthy controls, making this tool potentially helpful to early identify patients with spondyloarthritis.


Assuntos
Imageamento por Ressonância Magnética/métodos , Articulação Sacroilíaca/diagnóstico por imagem , Sacroileíte/complicações , Sacroileíte/diagnóstico por imagem , Espondilartrite/complicações , Espondilartrite/diagnóstico por imagem , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Reprodutibilidade dos Testes , Adulto Jovem
20.
Radiol Med ; 125(11): 1148-1166, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32948928

RESUMO

Aortic valve stenosis (AS) is a common valvular heart disease. Recently, transcatheter aortic valve implantation (TAVI) has changed the treatment of severe AS in elderly patients with contraindications to traditional surgical replacement. Echocardiography is conventionally used as the first imaging modality to assess the presence and severity of AS and to provide anatomical and functional information. Nowadays, imaging techniques play a crucial role in the planning of TAVI to define suitable candidates. Computed tomography (CT) is essential to display the anatomy of the aortic valve complex (including aortic annulus, Valsalva sinuses, coronary arteries ostia, sinotubular junction), thoracoabdominal aorta, and vascular access. Cardiac CT may also provide the evaluation of coronary arteries in alternative to conventional coronary angiography. Magnetic resonance imaging may be alternative or supplementary in selected cases, providing detailed information of cardiac function and myocardial wall characteristics. More recently, advanced computer modeling image-based techniques can be used to support the evaluation of the feasibility and safety of TAVI procedures.


Assuntos
Estenose da Valva Aórtica/cirurgia , Tomografia Computadorizada por Raios X/métodos , Substituição da Valva Aórtica Transcateter/métodos , Idoso , Estenose da Valva Aórtica/diagnóstico por imagem , Angiografia Coronária , Ecocardiografia , Humanos , Achados Incidentais , Imageamento por Ressonância Magnética/tendências
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