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1.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(1): 47-52, 2021 Feb 28.
Artigo em Chinês | MEDLINE | ID: mdl-33663662

RESUMO

Objective To determine the appropriate averaging strategy for pancreatic perfusion datasets to create images for routine reading of insulinoma.Methods Thirty-nine patients undergoing pancreatic perfusion CT in Peking Union Medical College Hospital and diagnosed as insulinoma by pathology were enrolled in this retrospective study.The time-density curve of abdominal aorta calculated by software dynamic angio was used to decide the timings for averaging.Five strategies,by averaging 3,5,7,9 and 11 dynamic scans in perfusion,all including peak enhancement of the abdominal aorta,were investigated in the study.The image noise,pancreas signal-to-noise ratio(SNR),lesion contrast and lesion contrast-to-noise ratio(CNR)were recorded and compared.Besides,overall image quality and insulinoma depiction were also compared.ANOVA and Friedman's test were performed.Results The image noise decreased and the SNR of pancreas increased with the increase in averaging time points(all P<0.001).The lesion contrast(69.81±41.35)averaged from 5 scans showed no significant difference compared with that(72.77±45.25)averaged from 3 scans(P=0.103),both of which were higher than that in other groups(all P≤0.001).The lesion CNRs of the last four groups showed no significant difference(all P>0.99)and were higher than that of the first group(all P<0.05).There was no significant difference in overall image quality among the 5 groups(P=0.977).Conclusions Image averaged from 5 scans showed moderate image noise,pancreas SNR and relatively high lesion contrast and lesion CNR.Therefore,it is advised to be used in image averaging to detect insulinoma.

2.
Magn Reson Imaging ; 78: 18-24, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33556484

RESUMO

BACKGROUND: To evaluate 3-dimensional amide proton transfer weighted (APTw) imaging for type I endometrial carcinoma (EC), and investigate correlations of Ki-67 labelling index with APTw and intravoxel incoherent motion (IVIM) imaging. METHODS: 54 consecutive patients suspected of endometrial lesions underwent pelvic APTw and IVIM imaging on a 3 T MR scanner. APTw values and IVIM-derived parameters (Dt, D*, f) were independently measured by two radiologists on 22 postoperative pathological confirmed of type I EC lesions. Results were compared between histological grades and Ki-67 proliferation groups. ROC analysis was performed. Pearson's correlation analysis was performed for APTw values and IVIM-derived parameters with Ki-67 labeling index. RESULTS: APTw values and Dt, D*, f of all type I EC were 2.9 ± 0.1%, 0.677 ± 0.027 × 10-3 mm2/s, 31.801 ± 11.492 × 10-3 mm2/s, 0.179 ± 0.050 with inter-observer ICC 0.996, 0.850, 0.956, 0.995, respectively. APTw values of Ki-67 low-proliferation group (<30%, n = 8) were 2.5 ± 0.2%, significantly lower than the high-proliferation group (>30%, n = 14) with APTw values of 3.1 ± 0.1% (p = 0.016). Area under the curve was 0.768. APTw values of type I EC were moderately positively correlated with Ki-67 labelling index (r = 0.583, p = 0.004). There was no significant difference of Dt (p = 0.843), D* (p = 0.262), f (p = 0.553) between the two groups. No correlation was found between IVIM-derived parameters and Ki-67 labelling index (Dt, p = 0.717; D* p = 0.151; f, p = 0.153). CONCLUSION: 3D TSE APTw imaging is a feasible approach for detecting type I EC. Ki-67 labeling index positively moderately correlates with APTw not with IVIM.

3.
J Alzheimers Dis ; 80(2): 567-576, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33579854

RESUMO

BACKGROUND: Mechanisms through which arterial stiffness impacts cognitive function are crucial for devising better strategies to prevent cognitive decline. OBJECTIVE: To examine the associations of arterial stiffness with white matter integrity and cognition in community dwellings, and to investigate whether white matter injury was the intermediate of the associations between arterial stiffness and cognition. METHODS: This study was a cross-sectional analysis on 952 subjects (aged 55.5±9.1 years) who underwent diffusion tensor imaging and measurement of brachial-ankle pulse wave velocity (baPWV). Both linear regression and tract-based spatial statistics were used to investigate the association between baPWV and white matter integrity. The association between baPWV and global cognitive function, measured as the mini-mental state examination (MMSE) was evaluated. Mediation analysis was performed to assess the influence of white matter integrity on the association of baPWV with MMSE. RESULTS: Increased baPWV was significantly associated with lower mean global fractional anisotropy (ß= -0.118, p < 0.001), higher mean diffusivity (ß= 0.161, p < 0.001), axial diffusivity (ß= 0.160, p < 0.001), and radial diffusivity (ß= 0.147, p < 0.001) after adjustment of age, sex, and hypertension, which were measures having a direct effect on arterial stiffness and white matter integrity. After adjustment of age, sex, education, apolipoprotein E ɛ4, cardiovascular risk factors, and brain atrophy, we found an association of increased baPWV with worse performance on MMSE (ß= -0.093, p = 0.011). White matter disruption partially mediated the effect of baPWV on MMSE. CONCLUSION: Arterial stiffness is associated with white matter disruption and cognitive decline. Reduced white matter integrity partially explained the effect of arterial stiffness on cognition.

4.
J Thorac Imaging ; 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33560763

RESUMO

PURPOSE: The aim of the study was to evaluate the role of cardiac magnetic resonance (CMR) mapping and strain analysis in the identification of cardiac involvement in idiopathic inflammatory myopathy (IIM) patients with preserved left ventricular ejection fraction. MATERIALS AND METHODS: In all, 38 IIM patients who underwent CMR examination at our institution were retrospectively included. Twenty-three age-matched healthy individuals served as controls. Mapping parameters including native T1, extracellular volume (ECV), and T2 mapping and strain parameters including global radial strain, global circumferential strain, and global longitudinal strain were measured semiautomatically using a dedicated processing software. All the mapping and strain values were compared between patients and controls. RESULTS: Late gadolinium enhancement was only present in IIM patients (n=17, 44.7%). IIM patients showed higher native T1 (1346 vs. 1269 ms, P<0.001), ECV (31.1% vs. 27.4%, P<0.01), and higher T2 (44.4 vs. 39.2 ms, P<0.001) values compared with controls. The global radial strain (36.7% vs. 46.9%, P<0.001), global circumferential strain (-21.2% vs. -24.1%, P<0.01), and global longitudinal strain (-13.6% vs. -15.6%, P<0.05) values were significantly reduced compared with controls. CONCLUSIONS: Native T1, ECV, T2 values, and global strain values may hold promise for the detection of subclinical myocardial involvement in IIM patients with preserved left ventricular ejection fraction.

5.
Sci China Life Sci ; 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33439457

RESUMO

We aimed to assess the associations of large artery stenosis (LAS) and cerebral small vessel disease (CSVD) with the risk of ischemic stroke and to investigate their respective and combined contributions. In the prospective population-based Shunyi Study, 1,082 stroke-free participants aged 55.9±9.1 years were included. Participants were followed for incident stroke throughout the study period (2013-2019). Total small vessel disease score was used to measure CSVD burden. Cervico-cerebral large artery stenosis was evaluated via brain magnetic resonance angiography and carotid ultrasound. We estimated the risk of ischemic stroke in relation to LAS and CSVD with Cox regression models. During a mean follow-up of 4.2 years, 34 participants (3.1%) experienced at least one ischemic stroke. Severe LAS (≥50% stenosis versus no stenosis: HR=3.27 (95% CI: 1.31-8.18)) and high CSVD burden (total small vessel disease score 2-4 versus 0 point: HR=12.73 (4.83-33.53)) were associated with increased stroke risk independently. In multivariate models, CSVD burden (7.72%) explained a larger portion of the variation in stroke risk than severity of LAS (3.49%). Our findings identified that both LAS and CSVD were associated with future ischemic stroke in asymptomatic subjects, while those with high CSVD burden deserve more attention in primary prevention of stroke.

6.
Radiology ; : 204267, 2020 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-33289616

RESUMO

The COVID-19 pandemic has challenged and changed our healthcare systems around the world. There has been a heterogeneity of disease burden, healthcare resources, and non-imaging testing availability, both geographically and over time. In parallel, there has been a continued increase in understanding of how the disease affects patients, effectiveness of therapeutic options, and factors that modulate transmission risk. Here we detail experiences from radiology experts in representative countries from around the world, to share insights gained from local experience. These insights provide a guidepost to help address management challenges as cases continue to rise in many parts of the world and suggest modifications in workflow that are likely to continue after this pandemic subsides.

7.
Eur Radiol ; 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33146791

RESUMO

OBJECTIVES: To develop a nomogram to identify anaplastic lymphoma kinase (ALK) mutations in lung adenocarcinoma patients using clinical, CT, PET/CT, and histopathological features. METHODS: This retrospective study included 399 lung adenocarcinoma patients (129 ALK-rearranged patients and 270 ALK-negative patients) that were randomly divided into a training cohort and an internal validation cohort (4:1 ratio). Clinical factors, radiologist-defined CT features, maximum standard uptake values (SUVmax), and histopathological features were used to construct predictive models with stepwise backward-selection multivariate logistic regression (MLR). The models were then evaluated using the AUC. The integrated model was compared to the clinico-radiological model using the DeLong test to evaluate the role of histopathological features. An associated individualized nomogram was established. RESULTS: The integrated model reached an AUC of 0.918 (95% CI, 0.886-0.950), sensitivity of 0.774, and specificity of 0.934 in the training cohort and an AUC of 0.857 (95% CI, 0.777-0.937), sensitivity of 0.739, and specificity of 0.810 in the validation cohort. The MLR analysis showed that younger age, never smoker, lymph node enlargement, the presence of cavity, high SUVmax, solid or micropapillary predominant histology subtype, and local invasiveness were strong and independent predictors of ALK rearrangements. The nomogram calculated the risk of harboring ALK mutation for lung adenocarcinoma patients and exhibited a good generalization ability. CONCLUSION: Our study demonstrates that histopathological features added value to the imaging characteristics-based model. The nomogram with clinical, imaging, and histopathological features can serve as a supplementary non-invasive tool to evaluate the probability of ALK rearrangement in lung adenocarcinoma. KEY POINTS: • The developed nomogram can accurately predict the probability of lung adenocarcinoma harboring ALK-fused gene. • Pathological analysis is important to predict ALK rearrangement in lung adenocarcinoma. • Lung adenocarcinoma with lepidic predominant growth pattern and TTF-1 negativity is unlikely to have ALK rearrangement.

8.
Mol Imaging Biol ; 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33185840

RESUMO

PURPOSE: To evaluate the utility of three-dimensional (3D) amide proton transfer-weighted (APTw) imaging for differentiation of endometrial adenocarcinoma and uterine benign lesions. PROCEDURES: This prospective study enrolled 22 normal volunteers and 113 patients with suspicious uterine lesions, including endometrial adenocarcinoma, leiomyoma, and adenomyosis. Pelvic APTw MRI was performed on a 3-T MRI scanner with default APTw parameters. Two radiologists blindly evaluated uterine lesion APTw image quality by a 3-point Likert scale and independently measured APTw values on images with excellent to good image quality. Inter-reader agreement was evaluated. The Mann-Whitney U test with Bonferroni correction was used to compare the differences among different types of uterine lesions. A receiver operating characteristic analysis was performed. RESULTS: A total of 111 lesions (33 endometrial adenocarcinoma, 26 leiomyoma, and 52 adenomyosis lesions) from 99 patients revealing a majority of good quality with excellent inter-reader agreement were included for the image quality evaluation. APTw values of endometrial adenocarcinoma were 2.9 ± 0.1 %, significantly higher than those of leiomyoma (1.9 ± 0.1 %), adenomyosis (2.2 ± 0.1 %), and normal uterine myometrium (1.9 ± 0.1 %) (all p < 0.0001). The area under the receiver operating characteristic curve for differentiating endometrial adenocarcinoma from leiomyoma, adenomyosis, and myometrium was 0.87, 0.85, and 0.91, respectively. Feasible threshold APTw values of each group were determined as 2.4 %, 2.7 %, and 2.4 % with a sensitivity of 83.3 %, 76.7 %, and 83.3 % and a specificity of 83.3 %, 81.6 %, and 86.4 %, respectively. CONCLUSIONS: Malignant endometrial adenocarcinoma had significantly higher APTw values than leiomyoma, adenomyosis, and normal uterine myometrium. Our study adds to the growing body of validation on 3D APTw imaging and uterine lesions.

9.
Eur Radiol ; 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32975662

RESUMO

OBJECTIVES: To evaluate the diagnostic performance of 1.5-T non-contrast MR coronary angiography (MRCA) for detection of coronary artery disease (CAD) using whole-heart imaging combined with volume-targeted imaging. METHODS: Forty-five patients scheduled for conventional coronary angiography (CAG) underwent 1.5-T free-breathing non-contrast steady-state free-precession MRCA, including whole-heart and subsequent three-vessel volume-targeted imaging. Coronary stenosis was evaluated as follows: (1) by whole-heart MRCA alone; (2) by combined MRCA (whole-heart plus volume-targeted images). The diagnostic performance for significant stenosis (≥ 50% diameter reduction) was evaluated and compared using CAG as a reference standard. RESULTS: Combined MRCA was completed in all 45 patients with a total acquisition time of 16.6 ± 3.3 min. The sensitivity, specificity, and accuracy of combined MRCA per patient were 97% (95% confidence interval 84-100%), 83% (52-98%), and 93% (82-98%), respectively. The areas under the receiver operating characteristic curve of combined MRCA were significantly higher than those of whole-heart MRCA on a per patient (0.97 versus 0.85, p = 0.0078) and per vessel (0.96 versus 0.86, p < 0.0001) basis. Compared with whole-heart MRCA, combined MRCA showed equally high sensitivity but significantly improved specificity on a per patient (83% versus 25%, p = 0.016) and per vessel (85% versus 50%, p < 0.0001) basis. CONCLUSIONS: 1.5-T non-contrast MRCA combining whole-heart and volume-targeted imaging can detect significant CAD with high sensitivity and moderate specificity. Combined MRCA significantly improves specificity compared with whole-heart imaging alone. KEY POINTS: • 1.5-T non-contrast MRCA with combined whole-heart and volume-targeted imaging can detect CAD with high sensitivity and moderate specificity comparable with coronary CTA. • Compared with whole-heart imaging alone, combined imaging provides improved diagnostic accuracy, especially specificity.

10.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 491-496, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895101

RESUMO

Objective To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Methods Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. Results The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(P=0.019),the maximum diameter of tumours on axial images(P=0.003),the maximum upper and lower diameters(P=0.004),Shamblin classification(P=0.012),and number of blood supply arteries(P<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Conclusions Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.


Assuntos
Tumor do Corpo Carotídeo , Angiografia por Tomografia Computadorizada , Tumor do Corpo Carotídeo/diagnóstico por imagem , Cabeça , Humanos , Pescoço , Estudos Retrospectivos
11.
J Stroke Cerebrovasc Dis ; 29(9): 105062, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807467

RESUMO

BACKGROUND AND PURPOSE: To study the feasibility and clinical utility of head-neck joint high-resolution vessel wall imaging (HNJ-VWI) in the assessment of ischemic stroke. METHODS: We reviewed our institutional HNJ-VWI database. Patients with transient ischemic attack (TIA) or ischemic stroke were included. Abnormal findings of intracranial and/or extracranial artery were assessed on three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) and HNJ-VWI modified from high-resolution 3D T1 sequence and classified into three groups including intracranial, extracranial and coexisting based on the locations. Etiologies of stroke were recorded according to Trial of Org 10172 in Acute Stroke Treatment criteria. RESULTS: One hundred and ten consecutive patients were studied. 3D TOF MRA displayed 71.8% (79/110, based on patients) abnormal arteries (stenosis or occlusion) , while HNJ-VWI displayed 96.3% (106/110) abnormal arteries (plaque,wall thickness and occlusion) including four isolated extracranial lesions and ten coexisting lesions. The etiologies of TIA/ischemic stroke included large artery atherosclerosis (80 cases), cerebral small vessel disease (6 cases), cardiogenic (2 cases), dissection (6 cases), vasculitis (4 cases), moyamoya disease (6 cases), others (2 cases) and undetermined (4 cases). For patients with atherosclerosis stroke, re-infarctions were more common in coexisting group than intracranial group (extracranial vs. intracranial vs coexisting: 0% vs. 9.1% vs. 43.7%, p = 0.001). CONCLUSIONS: HNJ-VWI is a feasible and valuable technique in assessment of ischemic stroke by detecting extracranial and intracranial artery abnormalities with one-step scan.


Assuntos
Infarto Encefálico/diagnóstico por imagem , Angiografia Cerebral/métodos , Artérias Cerebrais/diagnóstico por imagem , Ataque Isquêmico Transitório/diagnóstico por imagem , Articulações/irrigação sanguínea , Angiografia por Ressonância Magnética , Adulto , Infarto Encefálico/etiologia , Estudos de Viabilidade , Feminino , Humanos , Ataque Isquêmico Transitório/etiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco
12.
Eur Radiol ; 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809164

RESUMO

OBJECTIVES: To investigate the diagnostic performance of 70-kVp stress dynamic myocardial CT perfusion (CTP) as a low-dose, one-stop cardiac CT examination in clinical application. MATERIALS AND METHODS: Consecutive symptomatic patients were prospectively recruited and scanned with stress dynamic myocardial CTP. The CTP phase with the best enhancement of the coronary arteries was selected and extracted as the CTP-derived single-phase coronary CT angiography (SP-CTA). The diagnostic performance of CTP and CTP+SP-CTA for functionally significant CAD was assessed. Invasive coronary angiography and fractional flow reserve were used as the reference standard for the myocardial ischemia evaluation. RESULTS: In total, 71 patients (43 men and 28 women; 63.6 ± 8.8 years old) underwent the stress dynamic myocardial CTP; 63 vessels (36.2%) from 42 of the patients (59.2%) were identified as causing ischemia. On a per-vessel basis, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy for CTP and CTP+SP-CTA were 77.8%, 93.7%, 87.5%, 88.1%, and 87.9% and 84.1%, 93.7%, 88.3%, 91.2%, and 90.2%, respectively. The area under the curve (AUC) of CTP+SP-CTA (AUC = 0.963; 95%CI, 0.938-0.989) was significantly superior to that of CTP (AUC = 0.922; 95%CI, 0.880-0.964) and that of SP-CTA (AUC = 0.833; 95%CI, 0.765-0.900) alone (all p < 0.01). The mean radiation dose of the CTP examination was 3.8 ± 1.4 mSv. CONCLUSION: CTP-derived SP-CTA improved the diagnostic value of CTP. With a promising performance of myocardial ischemia detection and low radiation dose, the innovative low-dose, one-stop CTP examination is clinically feasible for patients who need to receive a myocardial perfusion assessment. KEY POINTS: • Myocardial CTP performed well in the evaluation of hemodynamically significant CAD. • CTP-derived single-phase CCTA improved the diagnostic value of CTP. • The combined use of low-dose CTP and CTP-derived CCTA at 70 kVp is clinically feasible for CAD patients who need to receive a myocardial perfusion assessment.

13.
Invest Radiol ; 55(12): 769-774, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32796197

RESUMO

OBJECTIVES: Estimations of tumor volume and boundary in pancreatic ductal adenocarcinoma (PDAC) are crucial for surgery planning. The aim of the study is to evaluate tomoelastography for detection of PDAC and quantification of PDAC volume based on tissue stiffness. MATERIALS AND METHODS: From March 2018 to December 2019, a total of 102 participants (30 healthy participants and 72 patients with histologically proven PDAC) were prospectively enrolled in a multicenter study. Multifrequency magnetic resonance elastography was combined with tomoelastography postprocessing to generate maps of shear wave speed (SWS) depicting highly resolved anatomical details of tissue stiffness. Subregional analysis of pancreatic head, body, and tail and reproducibility tests were performed in healthy participants, whereas tumorous (PDAC-T) and nontumorous (PDAC-NT) pancreatic tissue analysis was conducted in patients. In all patients, tumor volumes measured by computed tomography (CT) were compared with SWS-derived volumes. In addition, in 32 patients, tumor sizes were evaluated by macroscopy after resection. RESULTS: Tumor volumes were quantified in 99% and 87% of all cases with tomoelastography and CT, respectively. Pancreatic SWS was highly reproducible (repeatability coefficient = 0.12) and did not vary regionally or with patient age, sex, or body mass index (all P > 0.08). Shear wave speed was higher in PDAC-T (2.08 ± 0.38 m/s) than in healthy (1.25 ± 0.09 m/s; P < 0.001) and PDAC-NT (1.28 ± 0.14 m/s; P < 0.001) participants. A threshold of 1.47 m/s separated PDAC-T from healthy volunteers (area under the curve = 1.0, sensitivity = 100%, specificity = 100%), while 1.49 m/s separated PDAC-T from PDAC-NT with high accuracy (area under the curve = 0.99, sensitivity = 90%, specificity = 100%). Tomoelastography-derived tumor volume correlated with CT volume (r = 0.91, P < 0.001) and ex vivo tumor volume (r = 0.66, P < 0.001). CONCLUSIONS: Tomoelastography provides a quantitative imaging marker for tissue stiffness depicting PDAC boundaries and separates PDAC from unaffected pancreatic tissue.

14.
Radiology ; : 203173, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32729811

RESUMO

The World Health Organization (WHO) undertook the development of a rapid guide on the use of chest imaging in the diagnosis and management of COVID-19. The rapid guide was developed over two months using standard WHO processes, except for the use of 'rapid reviews' and online meetings of the panel. The evidence review was supplemented by a survey of stakeholders regarding their views on the acceptability, feasibility, impact on equity and resource use of the relevant chest imaging modalities (chest radiography, chest CT and lung ultrasound). The guideline development group had broad expertise and country representation. The rapid guide includes three diagnosis recommendations and four management recommendations. The recommendations cover patients with suspected or confirmed COVID-19 with different levels of disease severity, throughout the care pathway from outpatient facility or hospital entry, to home discharge. All recommendations are conditional and are based on low certainty evidence (n=2), very low certainty evidence (n=2), or expert opinion (n=3). The remarks accompanying the recommendations suggest which patients are likely to benefit from chest imaging and what factors should be considered when choosing the specific imaging modality. The guidance also offers considerations about implementation, monitoring and evaluation, and identifies research needs.

15.
Cardiovasc Diagn Ther ; 10(3): 431-441, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32695623

RESUMO

Background: Cardiac magnetic resonance cine images are conventionally acquired in breath-hold with a segmented balanced steady-state free precession (bSSFP) sequence, which requires a relatively long acquisition time and high patient cooperation. The single-shot compressed sensing (ss CS) cine sequence is a real-time sequence that has reasonable spatial and temporal resolution and can be applied during free breathing. However, the contrast between the myocardium and surrounding soft tissue is relatively reduced, and the epicardial delineation results are not as accurate with the ss CS cine sequence compared with the bSSFP sequence. In this study, we evaluated the use of a 2-shot CS cine technique in quickly acquiring high-quality images and accurately assessing cardiac function in clinical practice. Methods: The patients enrolled in the study underwent cardiovascular magnetic resonance (CMR) on a 3T scanner from Jul. to Dec. 2018. Cine imaging was performed with 3 different methods: a standard segment cine sequence, a real-time ss CS cine sequence, and a 2-shot CS cine sequence prototype. Quantitative analysis of image quality was performed using a 0-4 scoring system, and also edge sharpness was measured, and cardiac function analysis was performed for all 3 types of cine images. Results: Thirty-eight patients underwent imaging with the three types of cine sequences. The average scan time of the standard cine sequence was 101±20 s, the average scan time of the ss CS cine sequence was 20±4 s, and the average scan time of the 2-shot CS cine sequence was 30±6 s. The standard cine sequence image score was 3.68±0.64 and edge sharpness was (2.47±0.18) mm, the ss CS cine sequence image score was 3.13±0.35 and edge sharpness was (4.69±0.02) mm, and the 2-shot cine sequence image score was 3.54±0.51 and the edge sharpness was (2.51±0.13) mm. In terms of the quantitative study of cardiac function, the differences between the standard cine sequence and the ss CS cine sequence were not statistically significant, except for those of the imaging score and LV mass. There were no significant differences in the cardiac function parameters between the standard cine sequence and the 2-shot cine sequence. There was a strong correlation between the standard cine and ss CS cine sequences and between the standard cine and 2-shot CS cine sequences (P<0.01) of all the cardiac function parameters. Conclusions: The 2-shot CS cine sequence can acquire images with a level of quality comparable to that of the standard cine sequence in a significantly shorter period of time. The functional parameters are similar between the 2-shot CS cine sequence and the standard cine sequence.

16.
J Atheroscler Thromb ; 2020 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-32536634

RESUMO

AIMS: The relationship between central arterial stiffness and aging-related intracranial arteriopathy is not well investigated in the general population. In a population-based study, we investigated arterial stiffness in relation to intracranial atherosclerotic stenosis and intracranial arterial dolichoectasia. METHODS: This study was a cross-sectional analysis on 1,123 subjects (aged 56.0±9.3 years, 37.9% men) of the population-based Shunyi study in China. Arterial stiffness was assessed by measuring brachial-ankle pulse wave velocity (baPWV). Intracranial atherosclerotic stenosis and intracranial arterial dolichoectasia were evaluated via brain magnetic resonance angiography. Multivariate regression models were constructed to investigate the association between baPWV and intracranial large artery diseases. RESULTS: Increased baPWV was significantly associated with higher prevalence of intracranial atherosclerotic stenosis (odds ratio for the highest quartile of baPWV compared with the lowest quartile, 3.66 [95% confidence interval, 1.57-8.54]), after adjustment for cardiovascular risk factors in multivariate analysis. BaPWV was not associated with the presence of basilar artery dolichoectasia and dilation of basilar artery and internal carotid artery. When the diameters of intracranial arteries were regarded as continuous variables, increased baPWV was inversely related to the internal carotid artery diameter in fully adjusted models (ß±SE, -0.083±0.042, p=0.047). CONCLUSIONS: This population-based study demonstrates that arterial stiffness was more likely associated with intracranial stenotic arteriopathy other than intracranial dilative arteriopathy.

17.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(2): 139-146, 2020 Apr 28.
Artigo em Chinês | MEDLINE | ID: mdl-32385018

RESUMO

Objective To prospectively evaluate the correlation between intravoxel incoherent motion (IVIM)-derived parameters and CT perfusion parameters as well as the pathological grade in insulinoma. Methods A total of 55 patients with suspected insulinoma undergoing IVIM and CT perfusion scans were prospectively enrolled. The images were post-processed to obtain IVIM parameters including apparent diffusion coefficient (ADC),diffusion (D),perfusion correlated diffusion (D*),and f,and CT perfusion parameters including blood flow (BF),blood volume (BV),and permeability (PM). The pathological specimens were stained to obtain pathological parameters including the grading,ki-67 index,and the mitotic count. The IVIM derived parameters of normal pancreas including head,body,and tail as well as that of the pancreatic insulinoma were compared. The correlation between IVIM parameters and CT perfusion parameters as well as the pathological parameters was analyzed. Results ADC and D values of pancreatic tail were significantly lower than those of the pancreatic head and neck (all P<0.001). There were significant differences in all IVIM parameters between insulinoma and normal pancreas (all P<0.001). The ADC and f value of the normal pancreas was positively correlated with BF (r=0.437,P=0.003;r=0.357,P=0.010). There is no correlation between the remaining IVIM parameters and the CT perfusion parameters as well as between IVIM parameters and pathological parameters (all P>0.05). Conclusions IVIM parameters differ at different anatomical parts of normal pancreas. IVIM parameters can distinguish normal pancreatic parenchyma from insulinoma. The ADC value is weakly correlated with BF.


Assuntos
Insulinoma/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Humanos , Movimento (Física) , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X
18.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(2): 202-208, 2020 Apr 28.
Artigo em Chinês | MEDLINE | ID: mdl-32385026

RESUMO

Objective To explore the chest high-resolution computed tomography (HRCT) features in patients with rheumatoid arthritis (RA) complicated with pulmonary involvement. Methods Totally 161 patients with RA with lung involvement were collected from June 2014 to May 2018. The chest HRCT findings were retrospectively analyzed. According to the imaging features as well as the results of history taking,pulmonary function test,pathology,and bronchoalveolar lavage fluid test,RA-related lung diseases (RA-LD) were classified and their clinical characteristics were compared. Results These 161 RA-LD patients (56 males and 105 females) whose mean age at diagnosis was (60.7±12.8) years (14-85 years) included 87 cases of usual interstitial pneumonia (UIP) (including 16 cases of possible UIP),44 cases of non-specific interstitial pneumonia (NSIP),10 cases of organizing pneumonia,7 cases of lymphocytic interstitial pneumonia,9 cases of small airway disease (SAD) (including 8 cases of bronchiolitis obliterans and 1 case of follicular bronchiolitis),and 4 other lung manifestations (including 3 cases of diffuse alveolar hemorrhage and 1 case of rheumatoid nodules). The UIP group had the oldest average age [(63.3±12.1) years old] and the highest smoking rate (41.4%). The SAD group had the youngest average age [(54.7±15.1) years old] and there was no smoking history. There were significant differences between these two groups (P=0.020,P<0.001). Seventy patients (43.5%) with RA-LD were complicated with pleural lesions. Conclusions RA involving the lung is common and has varied imaging manifestations,with interstitial lung diseases (mainly UIP and NSIP) being the most important manifestations. RA patients should undergo lung HRCT as early as possible to identify the lung involvement and related types.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/complicações , Feminino , Humanos , Pulmão , Doenças Pulmonares Intersticiais/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
19.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(2): 216-221, 2020 Apr 28.
Artigo em Chinês | MEDLINE | ID: mdl-32385028

RESUMO

Objective To evaluate the feasibility of non-contrast-enhanced magnetic resonance angiography (NCE-MRA) on a 3.0T scanner. Methods Totally 36 volunteers and 24 patients with clinically suspected coronary artery disease underwent NCE-MRA. The quality of the NCE-MRA images was graded for each segment on a four-point scale. The subjects were divided into two groups according to image quality. The age,body mass index (BMI),heart rate,end-expiratory diaphragm displacement,and respiratory diaphragm motion amplitude were evaluated and compared. Results The average image quality score of every segment was above 2 points. The proximal and middle segments of left anterior descending artery had significantly higher quality scores than the distal segments (P=0.000) and the proximal segment of left circumflex coronary artery had significantly higher quality scores than the distal segments (P=0.000),the proximal segment of right coronary artery also had a significant higher quality score than its distal segment (P=0.001). The image quality was good in 38 subjects (64.4%). The heart rate [(66.35±9.39) beat/min vs. (75.32±11.67) beat/min] (P=0.002) and the body mass index [(24.72±3.33) kg/m 2 vs. (27.82±3.61) kg/m 2] (P=0.002) were significantly different between the good image quality group and the poor image quality group. The end-expiratory diaphragm displacement in good image quality group was (4.43±2.07)mm,which was significantly lower than that in poor image quality group [(9.26±7.62)mm](P=0.013). The respiratory diaphragm motion amplitude [(21.35±6.02) mm] in good image quality group was significantly lower than that in poor image quality group [(30.68±14.20)mm](P=0.012). Conclusion NCE-MRA on 3.0T is a feasible tool for visualization of the proximal and middle segments of coronary arteries,and the image quality can be optimized by controlling heart rate and respiration in the future.


Assuntos
Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Angiografia por Ressonância Magnética , Meios de Contraste , Vasos Coronários/diagnóstico por imagem , Estudos de Viabilidade , Humanos
20.
Acad Radiol ; 2020 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-32434689

RESUMO

RATIONALE AND OBJECTIVES: To evaluate image quality, radiation dose and its diagnostic performance in clinical utility of CT colonography (CTC) applying spectral filtration and advanced modeled iterative reconstruction (ADMIRE) techniques in third-generation dual-source CT. MATERIALS AND METHODS: A total of 125 patients for screening or diagnostic purposes underwent CTC at 120kVp standard dose (120kVp-STD) with filtered-back projection reconstruction (FBP) in supine position, then at a tin-filtered 150 kVp low dose (Sn150kVp-LD) and a tin-filtered 100 kVp ultra-low dose (Sn100kVp-ULD) with ADMIRE reconstruction in prone position. Radiation metrics were recorded. Objective and subjective image qualities were compared, and the diagnostic performance was assessed for both colonic and extracolonic findings using CTC reporting and data system (C-RADS). RESULTS: The effective dose was significantly lower for Sn150kVp-LD and Sn100kVp-ULD than 120kVp-STD protocol, resulting in 22.5% and 87.5% reductions (1.55±0.30 and 0.25±0.07 mSv vs. 2.00±0.52 mSv; both p<0.01), respectively. Image noise and signal-to-noise ratio were improved significantly for Sn150kVp-LD with ADMIRE compared with 120kVp-STD, both of which had similar excellent 2D and 3D subjective image quality with equivalent diagnostic performance. Sn100kVp-ULD with ADMIRE had decreased subjective image quality and significant different C-RADS extracolonic-score (E-score) compared with 120kVp-STD, however, C-RADS colonic-score (C-score) of that showed no significantly difference. CONCLUSION: Sn150kVp and Sn100kVp with ADMIRE reconstruction provide an alternative low dose CTC strategy and could be feasible in clinical screening or diagnostic scenarios.

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