Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.290
Filtrar
1.
No Shinkei Geka ; 48(1): 47-54, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-31983688

RESUMO

We report a rare case of perianeurysmal edema(PAE)around the dome of a usual intracranial aneurysm. A 79-year-old woman who presented with a dull headache that had become stronger from a month before was referred to our hospital for further examination of an aneurysm. MR angiogram had detected the aneurysm, having a dumbbell shape and arising from the M2 bifurcation of the right middle cerebral artery. Initial fluid attenuated inversion recovery and T2 weighed images revealed a slightly high intensity area in the brain around the dome of the aneurysm buried in the right temporal lobe, suggesting the presence of PAE possibly due to a preceding minor leak or partial thrombosis or impending rupture of the aneurysm. A CT angiogram revealed bleb formation of the aneurysm(size:10×6 to 4mm)without definite intraluminal thrombosis. The patient and her family consented to emergency craniotomy. During the microsurgical approach, thickening of the arachnoid membrane on the right sylvian fissure was observed. The subarachnoid space between the right frontal and temporal lobes was turbid/adhesive, and deposition of hemosiderin was observed around the aneurysm, indicating a preceding minor bleeding. The aneurysm was successfully clipped, and the postoperative course was uneventful. The present case showed that PAE could be observed even in a usual aneurysm. This finding might be an indirect sign of a preceding minor leak from the aneurysm, particularly when the dome is buried in brain parenchyma or is in close contact with the surrounding brain surface.


Assuntos
Edema , Aneurisma Intracraniano , Idoso , Craniotomia , Edema/diagnóstico por imagem , Edema/etiologia , Feminino , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Imagem por Ressonância Magnética , Artéria Cerebral Média
2.
Wien Klin Wochenschr ; 132(1-2): 27-34, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31773271

RESUMO

BACKGROUND: On magnetic resonance imaging (MRI), posterior lumbar subcutaneous edema (PLSE) is a frequent incidental, yet unclear finding within the deep subcutaneous perifascial tissue. This study aimed to investigate PLSE in various pathological lumbar conditions. METHODS: This retrospective study included the MR images of the lumbar spine of 279 patients (age range 18-82 years) without cardiovascular, renal or hepatic diseases, 79 of whom had low-grade disc degeneration, 101 combined endplate and facet joint degeneration, 53 axial spondyloarthritis and 46 infectious spondylodiscitis. There were 232 patients with a body mass index (BMI) <30, and 47 with a BMI ≥30 (obese). For each group, the relationship between PLSE and BMI was analyzed using multiple logistic regression, and between PLSE extension and BMI using ordinal regression. RESULTS: A PLSE was found in 11/79 (13.9%) patients with disc degeneration, 37/101 (36.6%) with endplate and facet joint degeneration, 7/53 (13.2%) with spondyloarthritis, and 28/46 (60.9%) with spondylodiscitis. For each group, a statistically significant relationship was demonstrated between PLSE and BMI (P = 0.000-P = 0.031), except for spondylodiscitis (P = 0.054), as well as between PLSE extension and BMI (P = 0.000-P = 0.049). A PLSE was found in 21.1% of nonobese and 72.3% of obese patients (P = 0.000). CONCLUSION: The presence of PLSE seems to be associated with various lumbar conditions, particularly in obese patients. Its perifascial location may suggest a potential fascial origin; however, PLSE should not to be confused with posttraumatic, postsurgical or infectious edema or edema associated with internal diseases.


Assuntos
Edema , Degeneração do Disco Intervertebral , Vértebras Lombares , Imagem por Ressonância Magnética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Edema/complicações , Edema/diagnóstico por imagem , Feminino , Humanos , Achados Incidentais , Degeneração do Disco Intervertebral/complicações , Degeneração do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
3.
Br J Radiol ; 93(1106): 20190620, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31573325

RESUMO

CT is a readily available imaging modality for cross-sectional characterization of acute musculoskeletal injuries in trauma. Dual-energy CT provides several additional benefits over conventional CT, namely assessment for bone marrow edema, metal artifact reduction, and enhanced assessment of ligamentous injuries. Winter sports such as skiing, snowboarding, and skating can result in high speed and high energy injury mechanisms; dual-energy CT is well suited for the characterization of those injuries.


Assuntos
Esportes na Neve/lesões , Tomografia Computadorizada por Raios X/métodos , Adulto , Traumatismos do Tornozelo/diagnóstico por imagem , Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/lesões , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Lesões do Quadril/diagnóstico por imagem , Humanos , Imagem Tridimensional , Traumatismos do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Fraturas do Rádio/diagnóstico por imagem , Fraturas da Tíbia/diagnóstico por imagem , Traumatismos do Punho/diagnóstico por imagem , Adulto Jovem
4.
Clin Nucl Med ; 45(2): 139-140, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31876814

RESUMO

A 66-year-old woman with a known history of diffuse large B-cell lymphoma presented with left lower limb swelling following recent long-distance air travel. Ultrasound Doppler showed no evidence of deep vein thrombosis. In view of her medical history, an F-FDG PET/CT was ordered that found a soft tissue mass following the course of the femoral neurovascular bundle along the anteromedial aspect of the left thigh down to the popliteal fossa and the lateral calf muscle. This was confirmed to be tumor recurrence.


Assuntos
Edema/diagnóstico por imagem , Vasos Linfáticos/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Diagnóstico Diferencial , Feminino , Fluordesoxiglucose F18 , Humanos , Compostos Radiofarmacêuticos , Coxa da Perna/diagnóstico por imagem
5.
BMC Bioinformatics ; 20(Suppl 6): 532, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31822264

RESUMO

BACKGROUND: Myocarditis is defined as the inflammation of the myocardium, i.e. the cardiac muscle. Among the reasons that lead to this disease, we may include infections caused by a virus, bacteria, protozoa, fungus, and others. One of the signs of the inflammation is the formation of edema, which may be a consequence of the interaction between interstitial fluid dynamics and immune response. This complex physiological process was mathematically modeled using a nonlinear system of partial differential equations (PDE) based on porous media approach. By combing a model based on Biot's poroelasticity theory with a model for the immune response we developed a new hydro-mechanical model for inflammatory edema. To verify this new computational model, T2 parametric mapping obtained by Magnetic Resonance (MR) imaging was used to identify the region of edema in a patient diagnosed with unspecific myocarditis. RESULTS: A patient-specific geometrical model was created using MRI images from the patient with myocarditis. With this model, edema formation was simulated using the proposed hydro-mechanical mathematical model in a two-dimensional domain. The computer simulations allowed us to correlate spatiotemporal dynamics of representative cells of the immune systems, such as leucocytes and the pathogen, with fluid accumulation and cardiac tissue deformation. CONCLUSIONS: This study demonstrates that the proposed mathematical model is a very promising tool to better understand edema formation in myocarditis. Simulations obtained from a patient-specific model reproduced important aspects related to the formation of cardiac edema, its area, position, and shape, and how these features are related to immune response.


Assuntos
Simulação por Computador , Edema , Imagem por Ressonância Magnética/métodos , Miocardite , Medicina de Precisão/métodos , Biologia Computacional , Edema/diagnóstico por imagem , Edema/etiologia , Humanos , Interpretação de Imagem Assistida por Computador , Miocardite/complicações , Miocardite/diagnóstico por imagem
6.
Int Heart J ; 60(6): 1407-1414, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31735778

RESUMO

Radiofrequency (RF) ablation results in creation of acute edema which can lead to temporary disruption of electrical propagation.The goal of this study was to find the effective contact force (CF) to minimize edema formation in comparison to the lesion size.Ventricular RF lesions (n = 49) were created by a CF-sensing catheter in a canine model (n = 10) with varying force for 30 seconds. Animals underwent T2-weighted (T2w) and late gadolinium enhancement MRI (LGE-MRI) immediately after ablation and at 12 weeks. Acute LGE lesion volume, acute edema, and chronic LGE lesion volume were measured. Acute edema/acute LGE lesion volume ratio was used to divide the lesions into two groups.Mean edema/lesion volume ratio was 5.0 ± 2.8. The lesions were divided into greater edema group (n = 8) and smaller edema group (n = 41) based on a cutoff edema/lesion volume ratio. When comparing the two groups, the CF and force time integral (FTI) were significantly lower in the greater edema group. There was no difference in catheter power setting, tip temperature change, impedance drop, and bipolar electrogram voltage change. Acute LGE volume and chronic lesion depth were significantly smaller in the greater edema group. Moreover, receiver-operator characteristic curve for the smaller edema lesion group showed that the most discriminant cutoff values for CF and FTI were 12.4 g and 584 gs, respectively.To minimize edema size while still forming permanent lesions, ablation should be performed with FTI > 584 gs or CF > 12.4 g.


Assuntos
Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Edema/etiologia , Edema/prevenção & controle , Ventrículos do Coração/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Animais , Modelos Animais de Doenças , Cães , Edema/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Imagem por Ressonância Magnética , Complicações Pós-Operatórias/diagnóstico por imagem
7.
J Dtsch Dermatol Ges ; 17(9): 913-921, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31538737

RESUMO

OBJECTIVE: Comparison of fluorescence optical imaging (FOI) with grayscale (GS) and power Doppler ultrasound (PDUS) to detect joint inflammation in patients with confirmed or suspected psoriatic arthritis (PsA). METHODS: Patients (n = 60) with psoriasis and tenderness and/or swelling of joints were separated into two groups: diagnosis confirmed by the treating dermatologist before the start of the study (n = 26), and suspected PsA (n = 34). GS/PDUS of the hand most clinically affected was performed with a dorsal/palmar view (wrist, MCP, PIP, DIP2-5). FOI examination was carried out in a standardized manner by analyzing the predefined Phases 1-3. RESULTS: FOI was found to be more sensitive than ultrasound (US) for detection of inflammation in PIP/DIP joints (p = 0.035). Confirmed PsA patients showed more findings in FOI P2 and P3, while suspected PsA patients showed more findings in P1. In the confirmed PsA group, most involved joints were MCP joints, while in the suspected PsA group, more involved wrist joints and DIP joints (p = 0.006) were detected with FOI. CONCLUSIONS: The differences between the confirmed and suspected groups indicate that FOI is helpful in the detection of early PsA since P1 may correspond to acute inflammation, whereas P2 and P3 enhancement reflect chronic inflammation. Fluorescence optical imaging might therefore be a novel diagnostic tool for early PsA diagnosis.


Assuntos
Artrite Psoriásica/diagnóstico por imagem , Adulto , Idoso , Diagnóstico Precoce , Edema/diagnóstico por imagem , Feminino , Articulações dos Dedos/diagnóstico por imagem , Dermatoses da Mão/diagnóstico por imagem , Humanos , Masculino , Microscopia de Fluorescência/métodos , Pessoa de Meia-Idade , Dor Musculoesquelética/diagnóstico por imagem , Imagem Óptica/métodos , Ultrassonografia , Articulação do Punho/diagnóstico por imagem
8.
World Neurosurg ; 132: e862-e868, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31394363

RESUMO

OBJECTIVE: Preoperative tumor-related edema of the optic tract (EOT) is often found along the white matter tract of the visual system. However, the relationship of EOT with visual function and outcome remains unclear. Therefore we aimed to elucidate whether the presence of EOT is associated with visual outcome in patients with sellar and suprasellar tumors. METHODS: A total of 212 eyes of 106 patients who underwent endoscopic endonasal surgery for sellar and suprasellar tumors at our institution between March 2016 and August 2018 were included in this retrospective study. Data on patient characteristics, preoperative magnetic resonance imaging findings, and ophthalmologic evaluations were collected. Patients were assigned to 2 groups depending on preoperative magnetic resonance imaging findings (EOT group = 19 [17.9%], non-EOT group = 87 [82.1%]). Visual acuity, visual field (VF), global visual function score, VF index, VF mean deviation, and retinal nerve fiber layer thickness as determined by optical coherence tomography were compared between the groups before and after treatment. RESULTS: In the EOT group, 4 patients had pituitary adenoma, 8 had craniopharyngioma, and 7 had other pathologies. There was no significant difference of pathologies between the groups. Preoperatively, EOT group showed significantly lower values of global visual function score, VF index, mean deviation, and retinal nerve fiber layer thickness than did the non-EOT group (P < 0.001). Postoperatively, the EOT group showed worse visual outcomes than did the non-EOT group. CONCLUSIONS: This study reveals that EOT caused by sellar and suprasellar tumors is associated with worse visual function and poor improvement postoperatively.


Assuntos
Adenoma/cirurgia , Craniofaringioma/cirurgia , Edema/diagnóstico por imagem , Trato Óptico/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Transtornos da Visão/fisiopatologia , Adenoma/complicações , Adolescente , Adulto , Idoso , Criança , Craniofaringioma/complicações , Edema/etiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cavidade Nasal , Cirurgia Endoscópica por Orifício Natural , Neuroendoscopia , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Tamanho do Órgão , Neoplasias Hipofisárias/complicações , Prognóstico , Retina/diagnóstico por imagem , Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Transtornos da Visão/etiologia , Acuidade Visual , Campos Visuais , Adulto Jovem
9.
Muscle Nerve ; 60(5): 549-557, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31397909

RESUMO

INTRODUCTION: This study assesses the burden, distribution, and evolution of muscle inflammation and damage on MRI among subtypes of idiopathic inflammatory myopathy (IIM). METHODS: Musculoskeletal MRIs performed in 66 patients with IIM and 10 patients with non-IIM between 2009 and 2016 were retrospectively graded for muscle edema, fatty replacement (FR), and atrophy. RESULTS: Immune-mediated necrotizing myopathy (IMNM) patients had severe and extensive lower limb muscle edema, FR, and atrophy. The pelvic muscles and adductors were significantly more affected than in patients with dermatomyositis and polymyositis. Inclusion body myositis (IBM) was characterized by marked anterior thigh involvement, which stabilized or progressed at follow-up imaging. Atrophy and FR grades improved over time in some non-IBM IIM patients. DISCUSSION: Patients with IMNM and IBM have characteristic patterns of muscle MRI abnormalities that may allow them to be differentiated radiologically from other IIM subtypes. Muscle damage in non-IBM IIM may be reversible.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Edema/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/diagnóstico por imagem , Miosite/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Dermatomiosite/diagnóstico por imagem , Feminino , Humanos , Inflamação/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Miosite de Corpos de Inclusão/diagnóstico por imagem , Polimiosite/diagnóstico por imagem
10.
Eur J Radiol ; 118: 207-214, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31439244

RESUMO

PURPOSE: To investigate the diagnostic accuracy of dual-energy computed tomography (CT) virtual non-calcium (VNCa) reconstructions for the depiction of traumatic bone marrow edema of the calcaneus. METHOD: Data from 62 patients (33 women, 29 men; mean age: 41 years, range: 19-84 years) with acute tarsal trauma who had undergone third-generation dual-source dual-energy CT and 3-T magnetic resonance imaging (MRI) within seven days between January 2017 and July 2018 were retrospectively analyzed. Five radiologists, blinded to clinical and MRI information, independently assessed conventional grayscale dual-energy CT series for the presence of fractures; after at least eight weeks, readers re-evaluated all cases using color-coded VNCa reconstructions for the presence of bone marrow edema. Quantitative analysis of CT numbers on VNCa reconstructions was performed by a sixth radiologist. Two additional experienced radiologists, blinded to clinical and CT information, assessed MRI series in consensus to define the reference standard. Sensitivity, specificity and the area under the curve (AUC) were the primary indices for diagnostic accuracy. RESULTS: MRI revealed 62 areas with bone marrow edema in 39 patients. In the qualitative analysis, VNCa showed high overall sensitivity (286/310 [92%]) and specificity (899/930 [97%]) for the depiction of bone marrow edema. A cut-off value of -53 Hounsfield units (HU) provided a sensitivity of 82% (51/62) and specificity of 95% (176/186]) for differentiating bone marrow edema. The overall AUC was 0.98. CONCLUSIONS: In both quantitative and qualitative analyses, dual-energy CT VNCa reconstructions show excellent diagnostic accuracy for the visualization of traumatic calcaneal bone marrow edema compared to MRI.


Assuntos
Medula Óssea/diagnóstico por imagem , Calcâneo/diagnóstico por imagem , Edema/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/patologia , Doenças da Medula Óssea/patologia , Calcâneo/patologia , Cor , Edema/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
11.
Br J Radiol ; 92(1102): 20190109, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287733

RESUMO

OBJECTIVE: Dermatomyositis (DM) and polymyositis (PM) make up the largest group of potentially treatable myopathies and require early diagnosis. This study investigates whether the edema of thigh muscles in DM/PM can be quantitatively assessed by a novel accelerated T2 mapping technique-GRAPPATINI. METHODS: Three conventional MR sequences and GRAPPATINI accelerated T2 mapping of bilateral thighs from 20 patients (7 DM and 13 PM) and 10 healthy volunteers were prospectively carried out on a 3 T MR scanner. Afterwards, T2 values of 477 thigh muscles from the patients and the healthy controls were manually measured. In addition, the correlations between T2 values and serum muscle enzymes in patients were also analyzed. RESULTS: The new GRAPPATINI technique made quantitative T2 mapping of bilateral thighs feasible with a scanning time of only 2 min 18 s. Moreover, GRAPPATINI-generated T2 values of muscles from patients were markedly higher than those from healthy subjects (p < 0.001). GRAPPATINI accelerated T2 mapping appeared a more sensitive technique in that some DM/PM muscles appearing normal per conventional MRI had increased T2 relaxation time. Furthermore, GRAPPATINI-generated T2 values of DM/PM thigh muscles positively correlated with serum enzyme levels (p < 0.001), which reflected the severity of myopathy. CONCLUSION: GRAPPATINI can significantly shorten acquisition time of T2 mapping and may potentially be applied clinically in DM and PM. ADVANCES IN KNOWLEDGE: GRAPPATINI acceleration makes T2 mapping feasible in clinical practice in providing quantitative information regarding thigh muscle inflammation in DM and PM.


Assuntos
Dermatomiosite/diagnóstico por imagem , Edema/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Músculo Esquelético/diagnóstico por imagem , Polimiosite/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Coxa da Perna/diagnóstico por imagem , Fatores de Tempo
12.
Radiol Med ; 124(10): 1028-1036, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31273545

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) to identify bone marrow edema (BME) of the ankle. METHODS: This prospective institutional review board approved study included 40 consecutive patients (29 males and 11 females; mean age of 32.3 years) studied with DECT (80 kV and tin filter 150 kV) and MRI within 10 days. DECT data were post-processed for generating non-calcium images of the ankle. Two radiologists evaluated the presence of BME on color-coded maps. Diagnostic accuracy values for diagnosing BME were calculated for DECT maps (qualitative assessment) and for CT numbers (quantitative assessment) by using receiver operator curves and area under the curve (AUC), using MRI as the gold standard. Interobserver and intraobserver agreements were calculated with k-statistics. A p < 0.05 was considered statistically significant. RESULTS: DECT depicted BME in 23/25 patients (92.0%). The sensitivity, specificity, PPV and NPV, and accuracy achieved by evaluating the DECT images were 92.0, 86.6, 92.0, 84.6, and 90.0%, for reader 1 and 88.0, 86.6, 91.6, 78.6, and 87.5, for reader 2, respectively. The interobserver and intraobsever agreements were near perfect (k = 0.87 and k = 0.83, respectively). DECT numbers were significantly different between positive (mean - 12.6 ± 29.6 HU) and negative cases (mean - 64.2 ± 34.5 HU) with a p value < 0.001. By using - 20HU cutoff to identify BME (AUC of 0.896.), the sensitivity, specificity, PPV and NPV, and accuracy of the quantitative analysis were 88.0, 92.6, 95.7, 92.6, and 87.5%, respectively. CONCLUSION: DECT represents an accurate imaging tool for demonstration of BME of the ankle when compared to MRI.


Assuntos
Articulação do Tornozelo/diagnóstico por imagem , Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade
13.
Clin Nucl Med ; 44(8): 680-682, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274623

RESUMO

A 46-year-old woman presented with a complaint of fever. CRP was 2.1 mL/L in blood, white blood cell count was 20-29/hpf, and bacterial count was 3418/µL in a urinalysis. Ga scan revealed accumulation of Ga in the left distal femur, although she had no symptoms around the site. MRI demonstrated diffuse high signal intensity on T2-weighted STIR images. Osteomyelitis was suspected, and biopsy was performed. Bacterial culture of the bone marrow was negative, and histological examination showed no infiltration of inflammatory cells. Two months after the biopsy, disappearance of altered signal intensity of MRI was observed.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Cintilografia , Radioisótopos de Gálio , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos
15.
BMC Musculoskelet Disord ; 20(1): 330, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307450

RESUMO

BACKGROUND: The aetiology of bone marrow oedema-like abnormalities (BMOA) seen on magnetic resonance imaging (MRI) is as yet not fully understood. The current study aimed to investigate the potential of projection radiography and Raman microspectroscopy to provide information regarding the underlying physiological changes associated with BMOA in equine bone samples. METHODS: MRI was used to assess 65 limbs from 43 horses. A subset of 13 limbs provided 25 samples, 8 with BMOA present and 17 as controls; these were examined with projection radiography to assess bone mineral density and Raman spectroscopy to assess bone composition. Statistical analysis was conducted using SPSS, the relationship between BMOA and age was tested using binary logistic regression, other outcome measures via unpaired t-tests. RESULTS: Overall BMOA was found to be associated with locally increased bone density (p = 0.011), suggesting increased bone formation; however, no measurable changes relating to bone remodelling were found, and there were no detectable changes in the chemical composition of bone. CONCLUSIONS: BMOA is associated with locally increased bone density, without an associated change in the chemical composition of bone, suggesting this is not linked to BMOA. The presence of increased bone density associated with BMOA does appear to suggest that an increased amount of bone formation is occurring in these regions, but as Raman microspectroscopy data do not demonstrate any significant changes in bone chemical composition associated with BMOA, it would appear that the increased bone volume is due to a greater amount of bone being formed rather than an imbalance in relation to bone remodelling. The study provides a proof of principle for the use of Raman microspectroscopy and projection radiography in in vitro studies of BMOA.


Assuntos
Densidade Óssea , Doenças Ósseas/veterinária , Doenças da Medula Óssea/veterinária , Osso e Ossos/química , Edema/veterinária , Animais , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/patologia , Doenças da Medula Óssea/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Edema/diagnóstico por imagem , Edema/patologia , Membro Anterior , Cavalos , Imagem por Ressonância Magnética , Espectroscopia de Ressonância Magnética/métodos , Estudo de Prova de Conceito , Análise Espectral Raman/métodos
17.
J Shoulder Elbow Surg ; 28(12): 2334-2342, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31300369

RESUMO

BACKGROUND: Rapidly destructive arthropathy (RDA) of the shoulder is rare. Consequently, there are very few studies that have reported the characteristic findings of this disease. This study aimed to analyze the clinical, radiographic, and histologic features of patients with RDA of the shoulder. METHODS: In total, 9 cases (8 patients) were enrolled in this study. All patients were elderly women, with a mean age of 72.7 years (range, 57-78 years). The mean duration of symptoms was 4.1 months (range, 1.2-5.9 months). Reverse total shoulder arthroplasty and total shoulder arthroplasty were performed in 5 cases with massive rotator cuff tears and 4 without them, respectively. RESULTS: The mean duration of radiologically evident joint destruction after negative results on radiography was 3.1 months (range, 1.0-5.9 months). On plain radiography, humeral head flattening and collapse that appeared like cut grass were observed (100%). Relatively good preservation of the glenoid with a normal joint space was observed in 7 cases, whereas glenoid erosion was observed in 2 (22.2%). T1-weighted magnetic resonance imaging showed a subchondral fracture (100%) of low signal intensity with associated bone marrow edema. Histologically, chronic inflammation of the synovium and osteocytes in the lacunae, as well as callus formation, were observed along the subchondral fracture. CONCLUSION: Flattening and collapse of the humeral head within an average of 4 months of symptom onset are characteristic of RDA of the shoulder. Bone marrow edema, joint effusion, and subchondral fracture on magnetic resonance imaging and fracture fragments and callus formation on histopathologic analysis were observed. Glenoid erosion was observed in 2 cases with arthrosis progression.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Artropatias/diagnóstico por imagem , Artropatias/patologia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/patologia , Idoso , Artroplastia do Ombro , Doenças da Medula Óssea/complicações , Edema/complicações , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/patologia , Cavidade Glenoide/diagnóstico por imagem , Humanos , Cabeça do Úmero/diagnóstico por imagem , Artropatias/complicações , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Radiografia
18.
J Craniofac Surg ; 30(8): e768-e771, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31348204

RESUMO

To evaluate the edema area around basal ganglia hemorrhage by the application of computerized tomography (CT)-based radiomics as a prognostic factor and improve the diagnosis efficacy, a total of 120 patients with basal ganglia hemorrhage were analyzed retrospectively. The texture analysis software Mazda 3.3 was used to preprocess the CT images and manually sketch the region of interest to extract the texture features. The extracted texture features were selected by Fisher coefficient, POE+ACC and mutual information. The texture discriminant analysis uses the B11 module in the Mazda 3.3 software. The data were randomly divided into a training dataset (67%) and test dataset (33%). To further study the texture features, the training dataset can be divided into groups according to the median of GCS score, NIHSS score, and maximum diameter of hematoma. Random forest model, support vector machine model, and neural network model were built. AUC of the receiver operating characteristics curve was used to assess the performance of models with test dataset. Among all texture post-processing methods, the lowest error rate was 2.22% for the POE+ACC/nonlinear discriminant. For the maximum diameter of hematoma, GCS score, and NIHSS score group, the lowest error rate were 26.66%, 23.33%, and 30.00%, respectively. The values of AUCs were 0.87, 0.81, and 0.76, for random forest model, support vector machine model, and neural network model in the test dataset, respectively. Radiomic method with proper model may have a potential role in predicting the edema area around basal ganglia hemorrhage. It can be used as a secondary group in the diagnosis of edema area around basal ganglia hemorrhage.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico por imagem , Edema/diagnóstico por imagem , Idoso , Hemorragia dos Gânglios da Base/complicações , Edema/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
19.
BMJ Case Rep ; 12(7)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31296627

RESUMO

We present a case of transient osteoporosis of the hip in a 38-year-old recreational trail runner. Shortly after a trail running competition, he developed acute hip pain, functional disability and an antalgic gait. Diagnosis was made with MRI showing bone marrow oedema, plain radiographs demonstrating osseous demineralisation and bone scintigraphy showing uniform radioactive uptake. Treatment included off-loading of the anatomical site for 6 months until symptom resolution, analgaesia, Vitamin D, bisphosphonates and pulsed electromagnetic field therapy. He recovered fully and returned to running activities 8 months after initial presentation. Transient osteoporosis of the hip is rare but benign, self-limiting condition; however, awareness and exact diagnosis are important as runners often present with hip pain and other more serious pathologies such as avascular necrosis or stress fractures need to be excluded.


Assuntos
Dor Aguda/complicações , Artralgia/complicações , Osteoporose/complicações , Osteoporose/diagnóstico por imagem , Corrida , Dor Aguda/terapia , Adulto , Analgesia , Artralgia/terapia , Conservadores da Densidade Óssea/uso terapêutico , Doenças da Medula Óssea/complicações , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/terapia , Ácido Clodrônico/uso terapêutico , Edema/complicações , Edema/diagnóstico por imagem , Edema/terapia , Radiação Eletromagnética , Articulação do Quadril/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Osteoporose/terapia , Radiografia , Cintilografia , Vitamina D/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA