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1.
Int J Cardiovasc Imaging ; 36(6): 1167-1175, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32166507

RESUMO

Direct stenting (DS) without pre-dilatation of the culprit lesion might improve myocardial perfusion and prognosis in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI); however, some studies report conflicting results. We investigated whether DS provides incremental myocardial benefits over conventional stenting (CS) in STEMI patients based on cardiac magnetic resonance imaging (CMR) measures. Reperfused patients who underwent CMR examinations within 1 week of STEMI onset were selected from a multicenter CMR registry of STEMI (NCT: 03768453). Patients were stratified into either a DS or CS group. Each group comprised 137 patients after 1:1 propensity score matching. Major adverse events (MACEs), including death, myocardial re-infarction, re-admission for heart failure, and stroke were noted during a median period of 44 months (interquartile range 32-58 months). DS was associated with larger (p = 0.007) and shorter (p = 0.005) stent sizes than CS. DS and CS achieved comparable angiographic TIMI-3 flow grades (p = 0.86) and myocardial blush grades (p = 0.70). There were no group differences regarding the incidence of CMR manifestations of microvascular dysfunction, including microvascular obstruction (MVO) (p = 0.89) and intramyocardial hemorrhage (p = 0.47), the extent of MVO (p = 0.21), infarction size (p = 0.83), or left ventricular ejection fraction (p = 0.57). Kaplan-Meier analysis revealed similar risks of MACEs (log rank p = 0.909), which occurred in 23.4% of DS and 26.3% of CS patients (p = 0.576). DS did not show any incremental benefits over CS on myocardial impairments as evaluated using CMR.Clinical Trial Registration: Clinicaltrials.gov, NCT: 03768453.

2.
Acad Radiol ; 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32111466

RESUMO

RATIONALE AND OBJECTIVES: The purpose of this study was to define the CT spectral imaging characteristics of pancreatic neuroendocrine neoplasms (PNENs) and evaluate their potential for differential diagnosis of nonlow grade (non-LG) PNENs from low grade (LG) PNENs. MATERIALS AND METHODS: CT spectral imaging data of 54 pathologically proven PNENs were retrospectively reviewed. Patients were divided into two groups: 40 cases with grade 1 in LG PNENs group and 14 cases with grade 2 and grade 3 in non-LG PNENs group. RESULTS: Gender, calcification, inhomogeneity, invasiveness, PD dilatation, lymph node enlargement, size, normalized iodine (water) concentration in arterial phase (AP) (Iodine (ap)), normalized effective-Z (Zap), slope of normalized CT spectral curves in both AP, and portal venous phase were found to be significant variables for differentiating non-LG PNENs from LG PNENs (p < 0.05). Non-LG PNENs had larger size and lower Zap and Iodine (ap) than LG PNENs. The tumor size, Zap and Iodine (ap) had fair to good diagnostic performance with the area under receiver-operating-characteristic curve (AUC) 0.843, 0.733, and 0.728, respectively. Multivariate analysis with logistic regression had higher AUC (p<0.05) than all the single parameters except for size. CONCLUSION: There were significant differences in CT spectral imaging parameters between non-LG and LG PNENs. Tumor size was the most promising independent parameter and the combination of quantitative parameters with qualitative parameters is the best predictor in differentiating of non-LG PNENs from LG PNENs. CT spectral imaging can help determine the malignancy of PNENs, which can better assist in surgical planning.

3.
J Neurol Sci ; 413: 116769, 2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32169741

RESUMO

PURPOSE: Glucocorticoid (GC) is probably related to biological aging, but the exact mechanism remains unknown. Cushing's disease (CD) could represent a unique human model for examining the effects of prolonged exposure to hypercortisolism and its relationship with aging. Thus, we studied the alterations of neurites in CD patients with Neurite orientation dispersion and density imaging (NODDI). METHODS: CD patients (n = 15) and healthy control subjects (n = 15) were included in this study. Orientation dispersion index (Odi), neurite density index (Ndi), partial fraction of free water (fiso), partial fraction of extracellular water (fec) were examined in a cross-sectional analysis. RESULTS: Significant altered NODDI parameters were found in CD patients. Some of these alterations were correlated with current age. Additionally, increased dendritic density was found in cerebellar of CD patients. CONCLUSION: Hypercortisolism relative reductions of the dendritic density were correlated with current age in several regions of CD patients. Our study enhances the understanding of the link between the aging and GC.

4.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(6): 602-607, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31875437

RESUMO

OBJECTIVE: To assess the accuracy of paralleling technique in measuring the depth of approximal infrabony pocket after periodontal flap surgery by comparing the measured and actual depths. METHODS: The study population included 26 patients with infrabony defects who had undergone periodontal flap surgery, bone graft surgery, and guided tissue regene-ration. The measured and actual depths of approximal infrabony pocket after periodontal flap surgery were compared. The 26 infrabony defects were categorized into the following groups according to tooth position: anterior teeth, premolar, and molar groups, and according to type of infrabony pocket: one-walled, two-walled, and three-walled infrabony pocket groups. Paired t-test was used to detect the difference between the two values. RESULTS: Depth measurements of the approximal infrabony pocket depth of the anterior teeth and premolar were not significantly different (P>0.05), whereas those of the molar group were significantly different (P<0.05). In addition, depth measurements in one-walled and two-walled infrabony pocket groups showed no significant differences (P>0.05), whereas those in the three-walled infrabony pocket group were significantly different (P<0.05). CONCLUSIONS: Paral-leling technique can accurately measure the depth of approximal infrabony pockets of anterior teeth and premolar teeth that are one- or two-walled. However, this method cannot accurately measure the approximal infrabony pockets of molar teeth and three-walled infrabony pockets as indicated by significant differences in their depth measurements.


Assuntos
Perda do Osso Alveolar , Procedimentos Cirúrgicos Bucais , Transplante Ósseo , Humanos , Dente Molar , Bolsa Periodontal
5.
Steroids ; 151: 108457, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31326450

RESUMO

The adverse effects of hypercortisolism on the human brain have been highlighted in previous studies of Cushing's disease (CD). However, the reversibility of brain damage after the resolution of hypercortisolism remains unclear. Thus, we studied the potential volumetric reversibility in biochemically remitted CD patients. Cross-sectional analysis demonstrated the active CD patients (n = 61) had the smallest gray matter (GM) volumes (553.33 ±â€¯45.90 CM3) among four groups. While the GM volumes of short-term remitted CD patients (586.62 ±â€¯46.89 CM3, n = 28) and long-term remitted CD patients (596.58 ±â€¯45.95 CM3, n = 35) were between those of the active CD patients and healthy control subjects (628.14 ±â€¯46.88 CM3, n = 74). Moreover, significant positive correlations between remitted time and GM volumes were only found in short-term remitted CD patients. On the contrary, the alterations of white matter (WM) in CD patients seem to be independent of concomitant hypercortisolism, persisting after remission. A preliminary longitude analysis also demonstrated similar results. Volumetric reversibility of GM, but not WM is highly prevalent in short-term after resolution of hypercortisolism in Cushing disease. Our study enhances our understanding of the reversible and the irreversible structural alterations in the human brain due to hypercortisolism.

6.
Lung Cancer ; 132: 39-44, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31097092

RESUMO

BACKGROUND: Pulmonary lymphoma arises primarily from the lung, which is extremely rare, or be secondarily involved by lymphoma. The clinical features, management, and prognostic factors have not been clearly identified. METHODS: Sixty-three patients with primary pulmonary lymphoma (PPL) and 117 patients with secondary pulmonary lymphoma (SPL) treated in our institution between June 2003 and December 2017 were retrospectively reviewed. RESULTS: MALT (67%) was the most common pathological subtype of PPL, while DLBCL (48%) was the most common subtype of SPL. Compared to the patients with PPL, the presence of B symptoms, advanced disease stage, intermediate-high or high risks of IPI and NCCN-IPI, elevated inflammatory parameters, and elevated cytokine levels were all observed in patients with SPL. Consolidation was the most frequent radiological finding in PPL cases, while nodules were the most frequent finding in SPL. With a median follow-up of 35 months (range 2-176), the estimated 3-year OS rates were 95%, 100%, 70% and 50% in indolent PPL, indolent SPL, aggressive PPL, and aggressive SPL, respectively. In indolent pulmonary lymphoma, none of the prognostic factors we studied significantly influenced survival of the patients. In aggressive pulmonary lymphoma, univariate analysis showed that NCCN-IPI was related to OS in PPL. Multivariate analysis showed that ß2-MG was an independent prognostic factor for OS in SPL. CONCLUSIONS: Primary and secondary pulmonary lymphoma differ in their clinical features and outcome. Furthermore, ß2-MG is the independent prognostic factor for OS in patients with aggressive SPL.

7.
Acta Diabetol ; 56(9): 1061-1071, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31028529

RESUMO

AIMS: To quantify epicardial adipose tissue (EAT) and visceral adipose tissue (VAT) in Chinese adults with impaired glucose regulation (IGR) or diabetes and compare the contributions of EAT and VAT to the occurrence of IGR and diabetes with those of traditional obesity indices. METHODS: Cardiac and abdominopelvic noncontrast computed tomographic images of 668 individuals were used to measure EAT and VAT volume. Multivariable logistic regression and area under the receiver operating characteristic (ROC) curve were used to illustrate the contributions of these tissues. RESULTS: Patients with IGR or diabetes had larger EAT and VAT volumes than did the controls, and the VAT volume was significantly different between the IGR and diabetic groups. In multivariable models, higher EAT or VAT volume was positively associated with the presence of IGR and diabetes. After adjusting further for body mass index (BMI) and waist-to-hip ratio (WHR), a higher EAT volume was still positively associated with IGR (odds ratio (OR) = 1.46; 95% confidence interval (CI), 1.04-2.03), and a higher VAT volume was positively associated with IGR (OR = 1.86; 95% CI, 1.15-3.02) and diabetes (OR = 1.86; 95% CI, 1.16-2.99). The areas under the curve (AUCs) of the association of EAT (AUC = 0.751; 95% CI, 0.712-0.789) and VAT (AUC = 0.752; 95% CI, 0.713-0.792) with dysglycemia (IGR + diabetes) were significantly larger than those of the traditional obesity indices (all P < 0.05). CONCLUSIONS: High EAT or VAT volume is positively associated with IGR and diabetes in Chinese adults. With a given WHR and BMI, such an association still exists to some extent. The correlation may be stronger than those of the traditional obesity indices.


Assuntos
Tecido Adiposo/metabolismo , Diabetes Mellitus/metabolismo , Intolerância à Glucose/metabolismo , Gordura Intra-Abdominal/metabolismo , Pericárdio , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/patologia , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais/legislação & jurisprudência , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/patologia , Feminino , Intolerância à Glucose/diagnóstico , Intolerância à Glucose/epidemiologia , Intolerância à Glucose/patologia , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/patologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/metabolismo , Obesidade/patologia , Pericárdio/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Relação Cintura-Quadril , Adulto Jovem
8.
Endocr Pract ; 25(6): 534-544, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30865546

RESUMO

Objective: To summarize the characteristics of patients with pituitary stalk thickening, analyze the association between pituitary stalk width and hypopituitarism, and develop a diagnostic model to differentiate neoplastic and inflammatory origins. Methods: A total of 325 patients with pituitary stalk thickening in a tertiary teaching hospital between January 2012 and February 2018 were enrolled. Basic characteristics and hormonal status were evaluated. Indicators to predict etiology in patients with histologic diagnoses were analyzed. Results: Of the 325 patients, 62.5% were female. Deficiency in gonadotropin was most common, followed by corticotropin, growth hormone, and thyrotropin. The increase in pituitary stalk width was associated with a risk of central diabetes insipidus (odds ratio [OR], 3.57; P<.001) and with a combination of central diabetes insipidus and anterior pituitary deficiency (OR, 2.28; P = .029). The cut-off pituitary stalk width of 4.75 mm had a sensitivity of 69.2% and a specificity of 71.4% for the presence of central diabetes insipidus together with anterior pituitary deficiency. Six indicators (central diabetes insipidus, pattern of pituitary stalk thickening, pituitary stalk width, neutrophilic granulocyte percentage, serum sodium level, and gender) were used to develop a model having an accuracy of 95.7% to differentiate neoplastic from inflammatory causes. Conclusion: Pituitary stalk width could indicate the presence of anterior pituitary dysfunction, especially in central diabetes insipidus patients. With the use of a diagnostic model, the neoplastic and inflammatory causes of pituitary stalk thickening could be preliminarily differentiated. Abbreviations: APD = anterior pituitary dysfunction; AUC = area under the curve; CDI = central diabetes insipidus; GH = growth hormone; MRI = magnetic resonance imaging; OR = odd ratio; PHBS = posterior hypophyseal bright spots; PST = pituitary stalk thickening; PSW = pituitary stalk width.


Assuntos
Diabetes Insípido Neurogênico , Hipopituitarismo , Doenças da Hipófise , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Hipófise
9.
Neuroimage Clin ; 22: 101691, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30708349

RESUMO

BACKGROUND: Computerized multi-model training has been widely studied for its effect on delaying cognitive decline. In this study, we designed the first Chinese-version computer-based multi-model cognitive training for mild cognitive impairment (MCI) patients. Neuropsychological effects and neural activity changes assessed by functional MRI were both evaluated. METHOD: MCI patients in the training group were asked to take training 3-4 times per week for 6 months. Neuropsychological and resting-state fMRI assessment were performed at baseline and at 6 months. Patients in both groups were continuously followed up for another 12 months and assessed by neuropsychological tests again. RESULTS: 78 patients in the training group and 63 patients in the control group accomplished 6-month follow-up. Training group improved 0.23 standard deviation (SD) of mini-mental state examination, while control group had 0.5 SD decline. Addenbrooke's cognitive examination-revised scores in attention (p = 0.002) and memory (p = 0.006), as well as stroop color-word test interference index (p = 0.038) and complex figure test-copy score (p = 0.035) were also in favor of the training effect. Difference between the changes of two groups after training was not statistically significant. The fMRI showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus. However, difference between the changes of two groups after another 12 months was not statistically significant. CONCLUSIONS: Multi-model cognitive training help MCI patients to gained cognition benefit, especially in memory, attention and executive function. Functional neuroimaging provided consistent neural activation evidence. Nevertheless, after one-year follow up after last training, training effects were not significant. The study provided new evidence of beneficial effect of multi-model cognitive training.


Assuntos
Córtex Cerebral/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/reabilitação , Remediação Cognitiva/métodos , Terapia Assistida por Computador/métodos , Idoso , Córtex Cerebral/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Resultado do Tratamento
10.
Eur Radiol ; 29(8): 4239-4248, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30666447

RESUMO

OBJECTIVES: This study aimed to investigate the feasibility of coronary stent image subtraction using spectral tools derived from dual-layer spectral computed tomography (CT). METHODS: Forty-three patients (65 stents) who underwent coronary CT angiography using dual-layer spectral CT were included. Conventional, 50-keV (kilo electron-volt), 100-keV, and virtual non-contrast (VNC) images were reconstructed from the same cardiac phase. Stents were subtracted on VNC images from conventional (convsub), 100-keV (100-keVsub), and 50-keV (50-keVsub) images. The in-stent lumen diameters were measured on subtraction, conventional, and 100-keV images. Subjective evaluation of reader confidence and subtractive quality was evaluated. Friedman tests were performed to compare in-stent lumen diameters and subjective evaluation among different images. Correlation between stent diameter and subjective evaluation was expressed as Spearman's rank correlation coefficient (rs). The diagnostic accuracy was assessed according to invasive coronary angiography (ICA) performed in 11 patients (20 stents). RESULTS: In-stent lumen diameters were significantly larger on subtraction images than those on conventional and 100-keV images (p < 0.05). Higher reader confidence was found on 100-keV, convsub, 100-keVsub, and 50-keVsub images compared with conventional images (p < 0.05). Subtractive quality of 100-keVsub images was better than that of convsub images (p = 0.037). A moderate-to-strong correlation between stent diameter and subjective evaluation was found (rs = 0.527~0.790, p < 0.05). Higher specificity, positive predictive value, and negative predictive value of subtraction images were shown by ICA results. CONCLUSIONS: Subtraction images derived from dual-layer spectral CT enhanced in-stent lumen visibility and could potentially improve diagnostic performance for evaluating coronary stents. KEY POINTS: • Dual-layer spectral CT enabled good subtractive quality of coronary stents without misregistration artifacts. • Subtraction images could improve in-stent lumen visibility. • Reader confidence and diagnostic performance were enhanced with subtraction images.


Assuntos
Angiografia Digital/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/diagnóstico por imagem , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Stents , Idoso , Idoso de 80 Anos ou mais , Artefatos , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos
11.
Liver Cancer ; 7(3): 235-260, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30319983

RESUMO

Background: Hepatocellular carcinoma (HCC) (about 85-90% of primary liver cancer) is particularly prevalent in China because of the high prevalence of chronic hepatitis B infection. HCC is the fourth most common malignancy and the third leading cause of tumor-related deaths in China. It poses a significant threat to the life and health of Chinese people. Summary: This guideline presents official recommendations of the National Health and Family Planning Commission of the People's Republic of China on the surveillance, diagnosis, staging, and treatment of HCC occurring in China. The guideline was written by more than 50 experts in the field of HCC in China (including liver surgeons, medical oncologists, hepatologists, interventional radiologists, and diagnostic radiologists) on the basis of recent evidence and expert opinions, balance of benefits and harms, cost-benefit strategies, and other clinical considerations. Key Messages: The guideline presents the Chinese staging system, and recommendations regarding patients with HCC in China to ensure optimum patient outcomes.

12.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 36(2): 167-173, 2018 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-29779278

RESUMO

OBJECTIVE: This study aims to evaluate the time lapse between the endodontic and periodontal treatments of the combined periodontal-endodontic lesion to guide the clinical treatment. METHODS: A systemic literature search was performed in articles published from 1980 to March 2017 using the electronic databases, including PubMed, EMbase, Cochrane, Web of Science, CNKI, CBM, and Wanfang Databases. RESULTS: After screening, two randomized controlled trials, two prospective case series studies, and eight case reports were ultimately included. All clinical studies and case reports were treated with root canal therapy and periodontal nonsurgical or periodontal surgical treatment, with root canal therapy as the initial treatment step. Changes in the periodontal probing depth and attachment loss were reported in all clinical studies and case reports. CONCLUSIONS: An observational period between the endodontic and periodontal nonsurgical treatments may not be required. However, given that the quality of several included studies was limited, and the number of randomized controlled trials was small, a large number of randomized controlled trials are needed to verify this result.


Assuntos
Doenças Periodontais , Tratamento do Canal Radicular , Doenças Periodontais/terapia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Abdom Radiol (NY) ; 43(7): 1713-1722, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29198003

RESUMO

PURPOSE: To compare the results of T1ρ MR imaging and 2D real-time shear-wave elastography (SWE) for liver fibrosis detection and staging. METHODS: Twenty-nine rabbit models of CCl4-induced liver fibrosis were established and six untreated rabbits served as controls. T1ρ MR imaging and 2D real-time SWE examination were performed at 2, 4, 6, 8, 10, and 12 weeks. T1ρ values and liver stiffness (LS) values were measured. Fibrosis was staged according to the METAVIR scoring system. Correlation test was performed among T1ρ values, LS values, and fibrosis stage. Receiver operating characteristic (ROC) analysis was performed for assessing diagnostic performance of T1ρ and SWE in detection of no fibrosis (F0), substantial fibrosis (≥ F2), severe fibrosis (≥ F3), and cirrhosis (F4). RESULTS: There was moderate positive correlation between fibrosis stage and T1ρ values (r = 0.566; 95% CI 0.291-0.754; P < 0.0001), and LS value (r = 0.726; 95% CI 0.521-0.851; P = 0.003). T1ρ values showed moderate positive correlations with LS values [r = 0.693; 95% confidence interval (CI) 0.472-0.832; P < 0.0001]. Areas Under ROC (AUROCs) were 0.861 (95% CI 0.705-0.953) for SWE and 0.856 (95% CI 0.698-0.950) for T1ρ (P = 0.940), 0.906 (95% CI 0.762-0.978) for SWE and 0.849 (95% CI 0.691-0.946) for T1ρ (P = 0.414), 0.870 (95% CI 0.716-0.958) for SWE and 0.799 (95% CI 0.632-0.913) for T1ρ (P = 0.422), and 0.846 (95% CI 0.687-0.944) for SWE and 0.692 (95% CI 0.517-0.835) for T1ρ (P = 0.137), when diagnosing liver fibrosis with ≥ F1, ≥ F2, ≥ F3, and F4, respectively. There was moderate positive correlation between inflammatory activity and T1ρ values (r = 0.520; 95% CI 0.158-0.807; P = 0.013). CONCLUSION: T1ρ imaging has potential for liver fibrosis detection and staging with good diagnostic capability similar to that of ultrasonography elastography.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Cirrose Hepática/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Animais , Modelos Animais de Doenças , Fígado/diagnóstico por imagem , Masculino , Coelhos , Índice de Gravidade de Doença
14.
Radiol Med ; 123(2): 83-90, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29058232

RESUMO

PURPOSE: To investigate the image quality (IQ) of reduced radiation dose (RRD) renal artery CT angiography (CTA) using iterative model reconstruction (IMR) algorithm at different tube voltage. METHODS: Renal artery CTA scans were acquired with a 256-MDCT scanner on 84 patients assigned into four groups. Group 4 was scanned as standard radiation dose (SRD) group: 120 kVp, automatic tube current modulation (ATCM) technique with an Image Quality Index of 20, and filtered back projection (FBP) algorithm. Tube voltage for three RRD groups was 80 kVp in group 1, 100 kVp in group 2, and 120 kVp in group 3, and all three groups were with image quality index of 18 and IMR algorithm. Image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured. Subjective evaluation including diagnostic confidence, vessel artifact and intravascular contrast were performed. The effective radiation dose was recorded. RESULTS: Effective radiation dose was reduced in three RRD groups compared to group 4. Intravascular contrast was significantly better in group 1 and 2 than in group 3, and artifacts decreased in group 2 than in group 3 (P < 0.05). Vascular SNR, CNR and image noise improved in three IMR groups than those in FBP group (P < 0.05). Furthermore, among three IMR groups, group 1 and 2 achieved better objective evaluation than group 3 (P < 0.05). CONCLUSIONS: IMR along with RRD for renal artery CTA improved image quality compared to SRD protocol using FBP. On top of that, lower tube voltage tended to be more optimal.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Artéria Renal/diagnóstico por imagem , Adulto , Algoritmos , Índice de Massa Corporal , Angiografia por Tomografia Computadorizada/instrumentação , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação
15.
Clin Endocrinol (Oxf) ; 87(4): 367-374, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28543178

RESUMO

OBJECTIVE: The data on patients with short-term remission of Cushing's disease (CD) might provide information that is not available from previous long-term remission studies. We aimed to investigate structural changes in the brain in these patients and to examine whether these changes were associated with clinical characteristics. DESIGN: A cross-sectional study was performed. METHODS: Thirty-four patients with CD (14 with CD in short-term remission and 20 with active CD) and 34 controls matched for age, sex and education underwent clinical evaluation and magnetic resonance imaging brain scans. Biometric measurements, disease duration and remission duration data were collected. Grey matter volumes in the whole brain were examined using voxel-based morphometry (VBM). RESULTS: No differences were observed in the grey matter volumes of the medial frontal gyrus (MFG) and cerebellum between the patients with remitted CD and healthy controls, whereas patients with active CD had smaller grey matter volumes in these two regions compared with controls and patients with remitted CD. Furthermore, significant correlations were found between remission time and grey matter values in these regions in short-term remission patients with CD. Additionally, greater grey matter volumes in the bilateral caudate of short-term remission patients with CD were observed. CONCLUSIONS: Trends for structural restoration were found in CD patients with short-term remission. This finding was associated with the number of days elapsed since curative surgery and the current age of the patients. This study enhances our understanding of potential reversibility after the resolution of hypercortisolism in CD patients.


Assuntos
Imagem por Ressonância Magnética/métodos , Hipersecreção Hipofisária de ACTH/diagnóstico por imagem , Hipersecreção Hipofisária de ACTH/patologia , Adulto , Estudos Transversais , Síndrome de Cushing/diagnóstico por imagem , Síndrome de Cushing/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/patologia , Adulto Jovem
16.
Brain Res ; 1665: 80-87, 2017 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-28438531

RESUMO

Exposure to chronic hypercortisolism has multiple adverse effects on brain biology in humans. Cushing's disease (CD) represents a unique and natural human model for examining the effects of hypercortisolism on the brain. This cross-sectional study used Diffusional Kurtosis Imaging (DKI) to investigate the microstructure alterations in both white matter (WM) and gray matter (GM) of CD patients and to determine the relationship of these changes with clinical characteristics. DKI images were obtained from 15 active CD patients. DKI parametric maps were estimated through voxel-based analyses (VBA) and compared with 15 healthy controls matched for age, sex and education. In addition, correlations were analyzed between the altered DKI parameters and clinical characteristics. Compared with healthy controls, CD patients mainly exhibited significantly altered diffuse parameters in the GM and WM of the left medial temporal lobe (MTL). The mean values of increased radial diffusivity (RD) of CD patients in GM of the left hippocampus/parahippocampal gyrus correlated positively with the clinical severity of CD. Additionally, we also found altered kurtosis parameters in the cerebellum and frontal lobe. DKI imaging of CD patients could represent complementary information in both white matter and gray matter. The impairment of the left MTL might explain some part of the memory and cognition impairments in CD patients.


Assuntos
Substância Cinzenta/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adulto , Algoritmos , Disfunção Cognitiva/diagnóstico , Estudos Transversais , Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão/métodos , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade
17.
Clin Endocrinol (Oxf) ; 86(3): 367-376, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27859451

RESUMO

CONTEXT AND OBJECTIVE: Cushing's disease (CD) provides a unique and naturalist model for studying the influence of hypercortisolism on the human brain and the reversibility of these effects after resolution of the condition. This cross-sectional study used resting-state fMRI (rs-fMRI) to investigate the altered spontaneous brain activity in CD patients and the trends for potential reversibility after the resolution of the hypercortisolism. We also aim to determine the relationship of these changes with clinical characteristics and cortisol levels. SUBJECTS AND METHODS: Active CD patients (n = 18), remitted CD patients (n = 14) and healthy control subjects (n = 22) were included in this study. Amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values were calculated to represent spontaneous brain activity. RESULTS: Our study resulted in three major findings: (i) active CD patients showed significantly altered spontaneous brain activity in the posterior cingulate cortex (PCC)/precuneus (PCu), occipital lobe (OC)/cerebellum, thalamus, right postcentral gyrus (PoCG) and left prefrontal cortex (PFC); (ii) trends for partial restoration of altered spontaneous brain activity after the resolution hypercortisolism were found in several brain regions; and (iii) active CD patients showed a significant correlation between cortisol levels and ALFF/ReHo values in the PCC/PCu, a small cluster in the OC and the right IPL. CONCLUSIONS: This study provides a new approach to investigating brain function abnormalities in patients with CD and enhances our understanding of the effect of hypercortisolism on the human brain. Furthermore, our explorative potential reversibility study of patients with CD may facilitate the development of future longitudinal studies.


Assuntos
Encéfalo/fisiopatologia , Hipersecreção Hipofisária de ACTH/fisiopatologia , Adulto , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Estudos Transversais , Síndrome de Cushing/fisiopatologia , Humanos , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Hipersecreção Hipofisária de ACTH/diagnóstico por imagem , Adulto Jovem
18.
Sci Rep ; 6: 36995, 2016 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-27841342

RESUMO

To evaluate the efficacy of magnetic resonance imaging (MRI) parameter optimizations for the diagnosis of periprosthetic infection and tumor recurrence in joint replacement patients. We compared the quality of images for 16 joint replacement patients that were recorded using the optimized MRI parameters with and without view angle tilting (VAT) correction at 1.5 T in coronal fast-spin-echo T2-weighted MRI. The optimized MRI data of 86 patients with pain after hip replacement and 67 patients who received tumor resection and joint replacement for bone cancer were retrospectively analyzed to identify MRI features that were useful for the diagnosis of periprosthetic infection and tumor recurrence. Increasing receiver bandwidth and decreasing slice thickness combined with VAT significantly reduced the area of metal-induced artifacts. Irregular soft tissue mass, soft tissue edema, bone destruction, and fistula were significant features of periprosthetic infection, with sensitivities of 47.4-100% and specificities of 73.1-100.0%, which were confirmed based on surgical and pathological findings. Soft tissue mass was a significant feature of tumor recurrence, with 100% sensitivity, 96.0% specificity, and 97.0% consistency. The optimized VAT MRI method demonstrated a high level of diagnostic accuracy for the detection of periprosthetic infection and tumor recurrence in joint replacement patients.


Assuntos
Neoplasias Ósseas/patologia , Imagem por Ressonância Magnética , Infecções Relacionadas à Prótese/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Ligas/química , Artroplastia de Quadril , Artefatos , Neoplasias Ósseas/cirurgia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Próteses e Implantes , Estudos Retrospectivos , Sensibilidade e Especificidade
19.
Int J Oral Sci ; 8(4): 213-222, 2016 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-27811845

RESUMO

Postnatal mesenchymal stem cells have the capacity to differentiate into multiple cell lineages. This study explored the possibility of dental pulp stem cells (DPSCs) for potential application in tendon tissue engineering. The expression of tendon-related markers such as scleraxis, tenascin-C, tenomodulin, eye absent homologue 2, collagens I and VI was detected in dental pulp tissue. Interestingly, under mechanical stimulation, these tendon-related markers were significantly enhanced when DPSCs were seeded in aligned polyglycolic acid (PGA) fibre scaffolds. Furthermore, mature tendon-like tissue was formed after transplantation of DPSC-PGA constructs under mechanical loading conditions in a mouse model. This study demonstrates that DPSCs could be a potential stem cell source for tissue engineering of tendon-like tissue.


Assuntos
Polpa Dentária , Células-Tronco Mesenquimais , Tendões , Engenharia Tecidual , Animais , Diferenciação Celular , Células Cultivadas , Camundongos , Células-Tronco , Tecidos Suporte
20.
Shanghai Kou Qiang Yi Xue ; 25(6): 641-646, 2016 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-28275782

RESUMO

PURPOSE: To evaluate the feasibility of constructing tissue engineered composites in vitro by combining human leptin (hLEP) gene modified rat bone marrow stromal cells (BMSCs) and guided tissue regeneration collagen membrane (Bio-Gide). METHODS: BMSCs of SD rats were isolated and cultured by whole bone marrow adherent method. BMSCS were transfected with adenovirus carrying hLEP gene (Ad-hLEP-EGFP) and observed under inverted fluorescence microscope. Enzyme linked immunosorbent assay (ELISA) was used to detect the expression of hLEP. The proliferation activity of transfected cells was assessed by MTT assay. Ad-hLEP-EGFP transfected BMSCs were cultured for 24 h in combination with Bio-Gide collagen membrane, hLEP modified tissue engineered composite was observed under laser scanning confocal microscope (LSCM) and scanning electron microscope (SEM). RESULTS: Through Ad-hLEP-EGFP transfection, hLEP was overexpressed in BMSCs, which didn't affect the proliferation of cells. SEM showed hLEP modified BMSCs grew well on Bio-Gide collagen membrane and secreted extracellular matrix. LSCM suggested BMSCs could migrate to different scales of Bio-Gide collagen membrane. CONCLUSIONS: hLEP modified BMSCs can be combined with Bio-Gide collagen membrane and grow well, suggesting that hLEP modified tissue engineered composite can be successfully constructed. The composite might be suitable for periodontal tissue engineering.


Assuntos
Resinas Acrílicas , Células da Medula Óssea , Resinas Compostas , Leptina/genética , Poliuretanos , Engenharia Tecidual , Adenoviridae , Animais , Diferenciação Celular , Células Cultivadas , Colágeno , Humanos , Células-Tronco Mesenquimais , Ratos , Ratos Sprague-Dawley , Transfecção
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