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1.
Radiol Clin North Am ; 57(6): 1117-1131, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582039

RESUMO

Various imaging techniques play a role in the diagnosis of CNS vasculopathies, which comprise a heterogeneous group of disorders, including various noninflammatory and inflammatory etiologies. Noninflammatory vasculopathies include entities such as CADASIL, Susac, moyamoya, fibromuscular dysplasia, vasculopathy of connective tissue disorders, and reversible vasoconstriction syndrome. Inflammatory vasculopathies include vasculitides of different vessel sizes, primary angiitis of the CNS, vasculitis of systemic disease, and vasculitis secondary to specific causes. Miscellaneous etiology includes cerebral amyloid angiopathy, which has noninflammatory and inflammatory subtypes. This article discusses important clinical and imaging findings used to distinguish these disorders.


Assuntos
Diagnóstico por Imagem/métodos , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Ultrassonografia
2.
Radiol Clin North Am ; 57(6): 1163-1175, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582042

RESUMO

Primary brain tumors are the most common solid malignancy of childhood and constitute the most common cause of cancer-related death in children. It is important for the radiologist to understand the differences between pediatric and adult brain tumors. For instance, tumor type varies significantly with age; many histologic subtypes occur exclusively in childhood. An anatomic approach to pediatric brain tumors helps narrow the differential diagnosis; however, information from this approach must be considered in conjunction with recent advances in molecular subtyping of these tumors. This article emphasizes relevant clinical, molecular, and imaging features that are unique to pediatric brain tumors.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Neuroimagem/métodos , Tomografia Computadorizada por Raios X
3.
Radiol Clin North Am ; 57(6): 1199-1216, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582045

RESUMO

Radiographic monitoring of posttreatment glioblastoma is important for clinical trials and determining next steps in management. Evaluation for tumor progression is confounded by the presence of treatment-related radiographic changes, making a definitive determination less straight-forward. The purpose of this article was to describe imaging tools available for assessing treatment response in glioblastoma, as well as to highlight the definitions, pathophysiology, and imaging features typical of true progression, pseudoprogression, pseudoresponse, and radiation necrosis.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/radioterapia , Diagnóstico por Imagem/métodos , Glioblastoma/diagnóstico por imagem , Glioblastoma/radioterapia , Lesões por Radiação/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Neoplasias Encefálicas/patologia , Progressão da Doença , Glioblastoma/patologia , Humanos , Imagem por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Imagem Multimodal , Necrose , Tomografia por Emissão de Pósitrons , Lesões por Radiação/patologia
4.
Radiol Clin North Am ; 57(6): 1217-1231, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582046

RESUMO

Immunodeficiency can affect different components of the immune system and predispose to different types of opportunistic infections. For example, a defect in neutrophil or humoral immunity increases risk from disseminated infection by extracellular pathogens, whereas a defect in cytotoxic activity by natural killer cells or CD8+ T lymphocytes increases risk from intracellular pathogens. The latter also increases risk from malignancies, due to impairment of normal immunosurveillance against abnormal neoplastic cells. The purpose of this article is to discuss central nervous system lesions that may be seen in the immunocompromised patient, organized into 5 categories: bacterial, fungal, parasitic, viral, and neoplastic.


Assuntos
Neoplasias do Sistema Nervoso Central/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Hospedeiro Imunocomprometido , Encéfalo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios X
6.
ABC., imagem cardiovasc ; 32(4): 309-317, out.-dez. 2019. ilus, graf
Artigo em Português | LILACS | ID: biblio-1023941

RESUMO

As neoplasias cardíacas são divididas em primárias e secundárias. As secundárias são 20 a 40 vezes mais comuns do que as primárias. Embora raras, as neoplasias cardíacas primárias podem ser benignas e malignas, sendo as benignas responsáveis por 75% dos casos. Os principais objetivos da imagem cardiovascular são definir a morfologia e etiologia do tumor, identificar potenciais complicações e auxiliar na definição de tratamento. Para o diagnóstico de neoplasias cardíacas, a tomografia por emissão de pósitrons acoplada à tomografia computadorizada (PET-TC) com a fluordesoxiglicose-F18 (18F-FDG) é uma técnica ainda pouco utilizada, principalmente nos tumores cardíacos primários. Entretanto, ela pode ajudar na diferenciação entre tumores malignos e benignos e, assim, evitar biópsias cardíacas e tratamentos invasivos desnecessários. Para esta revisão, realizamos pesquisa na base de dados PubMed, considerando as publicações sobre o tema nos últimos 10 anos. A PET-TC 18F-FDG é um exame útil para diferenciar massas cardíacas benignas das malignas, de acordo com o maior grau de metabolismo glicolítico encontrado nas neoplasias malignas. Além do mais, nos tumores malignos, a PET-TC 18F-FDG tem papel central no estadiamento da doença e pode ajudar na avaliação de resposta ao tratamento


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Diagnóstico por Imagem/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias Cardíacas/diagnóstico , Sarcoma , Glicemia , Ecocardiografia/métodos , Espectroscopia de Ressonância Magnética/métodos , Doenças Cardiovasculares/diagnóstico , Compostos Radiofarmacêuticos , Fluordesoxiglucose F18 , Linfoma
10.
Cancer Treat Rev ; 79: 101890, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31470314

RESUMO

As a consequence of the current excellent loco-regional control rates attained using the generally accepted treatment paradigms involving intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC), only 10-20% of patients will suffer from local and/or nodal recurrence after primary treatment. Early detection of recurrence is important as localized recurrent disease is still potentially salvageable, but this treatment often incurs a high risk of major toxicities. Due to the possibility of radio-resistance of tumors which persist or recur despite adequate prior irradiation and the limited tolerance of adjacent normal tissues to sustain further additional treatment, the management of local failures remains one of the greatest challenges in this disease. Both surgical approaches for radical resection and specialized re-irradiation modalities have been explored. Unfortunately, available data are based on retrospective studies, and the majority of them are based on a small number of patients or relatively short follow-up. In this article, we will review the different salvage treatment options and associated prognostic factors for each of them. We will also propose a treatment algorithm based on the latest available evidence and discuss the future directions of treatment for locally recurrent NPC.


Assuntos
Carcinoma Nasofaríngeo/patologia , Carcinoma Nasofaríngeo/terapia , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/terapia , Terapia Combinada , Diagnóstico por Imagem/métodos , Gerenciamento Clínico , Humanos , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/mortalidade , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/mortalidade , Estadiamento de Neoplasias , Prognóstico , Recidiva , Retratamento , Resultado do Tratamento
11.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(4): 684-690, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31441272

RESUMO

Thermoacoustic imaging (TAI) is a new non-invasive, non-ionization and nondestructive modality capable of high microwave contrast and high ultrasound resolution, and it has attracted extensive attention in recent years. This review introduces the technical principle, imaging system and imaging characteristics of TAI, and then introduces the application of TAI for breast cancer detection as an example. This review introduces the advantages of TAI in solving corresponding clinical problems in view of its high resolution and high contrast. In addition, it also explains the roles of TAI in medical diagnosis and treatment. Finally, the potential applications of TAI in medical diagnosis is introduced from many aspects and multiple perspectives. The future development of TAI in the challenges of current medical diagnosis is also prospected.


Assuntos
Acústica , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Humanos , Micro-Ondas
12.
Medicine (Baltimore) ; 98(34): e16787, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441850

RESUMO

BACKGROUND: To determine the diagnostic accuracy of techniques with chronic thromboembolic pulmonary hypertension (CTEPH) patients via a protocol for systemic review and network meta-analysis. METHODS: We will search PubMed, EMBASE, Web of Science, and Google Scholar from inception to October 1, 2018. The reference lists of the retrieved articles are also consulted. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) will be used to assess the risk of bias in each study. The direct meta-analyses, network meta-analyses, and ranking of competing diagnostic tests will be used by STATA 12.0 and WINBUGS 1.4. Heterogeneity and inconsistency are assessed. RESULTS: This study is ongoing, will be submitted to a peer-reviewed journal publication once completed. CONCLUSION: This study will provide a comprehensive evidence summary of diagnostic test accuracy in detecting the CTEPH, and can help patients and clinicians to select appropriate or best diagnostic test. ETHICS AND COMMUNICATION: No ethical approval and patient consent are required, because it is based on published researches. PROSPERO REGISTRATION NUMBER: CRD42019121279.


Assuntos
Diagnóstico por Imagem/métodos , Hipertensão Pulmonar/diagnóstico , Doença Crônica , Humanos , Imagem por Ressonância Magnética/métodos , Meta-Análise em Rede , Projetos de Pesquisa , Sensibilidade e Especificidade , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Cintilografia de Ventilação/Perfusão/métodos
13.
Br J Radiol ; 92(1101): 20180925, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31287716

RESUMO

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder that is of epidemic proportions in contact sports athletes and is linked to subconcussive and concussive repetitive head impacts (RHI). Although postmortem analysis is currently the only confirmatory method to diagnose CTE, there has been progress in early detection techniques of fluid biomarkers as well as in advanced neuroimaging techniques. Specifically, promising new methods of diffusion MRI and radionucleotide PET scans could aid in the early detection of CTE.The authors examine early detection methods focusing on various neuroimaging techniques. Advances in structural and diffusion MRI have demonstrated the ability to measure volumetric and white matter abnormalities associated with CTE. Recent studies using radionucleotides such as flortaucipir and 18F-FDDNP have shown binding patterns that are consistent with the four stages of neurofibrillary tangle (NFT) distribution postmortem. Additional research undertakings focusing on fMRI, MR spectroscopy, susceptibility-weighted imaging, and singlephoton emission CT are also discussed as are advanced MRI methods such as diffusiontensor imaging and arterial spin labeled. Neuroimaging is fast becoming a key instrument in early detection and could prove essential for CTE quantification. This review explores a global approach to in vivo early detection.Limited data of in vivo CTE biomarkers with postmortem confirmation are available. While some data exist, they are limited by selection bias. It is unlikely that a single test will be sufficient to properly diagnosis and distinguish CTE from other neurodegenerative diseases such as Alzheimer disease or Frontotemporal Dementia. However, with a combination of fluid biomarkers, neuroimaging, and genetic testing, early detection may become possible.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encefalopatia Traumática Crônica/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Neuroimagem/métodos , Encéfalo/patologia , Lesões Encefálicas Traumáticas/patologia , Encefalopatia Traumática Crônica/patologia , Humanos
14.
Crit Rev Oncol Hematol ; 141: 153-162, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31302407

RESUMO

Failure of systemic cancer treatment can be, at least in part, due to the drug not being delivered to the tumour at sufficiently high concentration and/or sufficiently homogeneous distribution; this is termed as "pharmacokinetic drug resistance". To understand whether a drug is being adequately delivered to the tumour, "precision pharmacology" techniques are needed. Mass spectrometry imaging (MSI) is a relatively new and complex technique that allows imaging of drug distribution within tissues. In this review we address the applicability of MSI to the study of cancer drug distribution from the bench to the bedside. We address: (i) the role of MSI in pre-clinical studies to characterize anti-cancer drug distribution within the body and the tumour, (ii) the application of MSI in pre-clinical studies to define optimal drug dose or schedule, combinations or new drug delivery systems, and finally (iii) the emerging role of MSI in clinical research.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/farmacocinética , Resistencia a Medicamentos Antineoplásicos , Espectrometria de Massas/métodos , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Disponibilidade Biológica , Diagnóstico por Imagem/métodos , Relação Dose-Resposta a Droga , Esquema de Medicação , Sistemas de Liberação de Medicamentos , Monitoramento de Medicamentos/métodos , Humanos , Neoplasias/metabolismo , Medicina de Precisão/métodos , Distribuição Tecidual
15.
Br J Radiol ; 92(1101): 20190093, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31294609

RESUMO

What is the future of neuroradiology in the era of precision medicine? As with any big change, this transformation in medicine presents both challenges and opportunities, and to flourish in this new environment we will have to adapt. It is difficult to predict exactly how neuroradiology will evolve in this shifting landscape, but there will be changes in both what we image and what we do. In terms of imaging, we will need to move beyond simply imaging brain anatomy and toward imaging function, both at the molecular and circuit level. In terms of what we do, we will need to move from the periphery of the clinical enterprise toward its center, with a new emphasis on integrating imaging with genetic and clinical data to form a comprehensive picture of the patient that can be used to direct further testing and care.The payoff is that these changes will align neuroradiology with the emerging field of precision psychiatry, which promises to replace symptom-based diagnosis and trial-and-error treatment of psychiatric disorders with diagnoses based on quantifiable genetic, imaging, physiologic, and behavioural criteria and therapies targeted to the particular pathophysiology of individual patients. Here we review some of the recent developments in behavioural genetics and neuroscience that are laying the foundation for precision psychiatry. By no means comprehensive, our goal is to introduce some of the perspectives and techniques that are likely to be relevant to the precision neuroradiologist of the future.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Diagnóstico por Imagem/métodos , Transtornos Mentais/diagnóstico , Transtornos Mentais/patologia , Medicina de Precisão/métodos , Humanos
16.
ABC., imagem cardiovasc ; 32(3): 157-197, jul.-set. 2019. ilus, tab
Artigo em Português | LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1006549
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