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1.
BMJ Open ; 10(9): e040175, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32994259

RESUMO

INTRODUCTION: The course of the disease in SARS-CoV-2 infection in mechanically ventilated patients is unknown. To unravel the clinical heterogeneity of the SARS-CoV-2 infection in these patients, we designed the prospective observational Maastricht Intensive Care COVID cohort (MaastrICCht). We incorporated serial measurements that harbour aetiological, diagnostic and predictive information. The study aims to investigate the heterogeneity of the natural course of critically ill patients with a SARS-CoV-2 infection. METHODS AND ANALYSIS: Mechanically ventilated patients admitted to the intensive care with a SARS-CoV-2 infection will be included. We will collect clinical variables, vital parameters, laboratory variables, mechanical ventilator settings, chest electrical impedance tomography, ECGs, echocardiography as well as other imaging modalities to assess heterogeneity of the course of a SARS-CoV-2 infection in critically ill patients. The MaastrICCht is also designed to foster various other studies and registries and intends to create an open-source database for investigators. Therefore, a major part of the data collection is aligned with an existing national intensive care data registry and two international COVID-19 data collection initiatives. Additionally, we create a flexible design, so that additional measures can be added during the ongoing study based on new knowledge obtained from the rapidly growing body of evidence. The spread of the COVID-19 pandemic requires the swift implementation of observational research to unravel heterogeneity of the natural course of the disease of SARS-CoV-2 infection in mechanically ventilated patients. Our study design is expected to enhance aetiological, diagnostic and prognostic understanding of the disease. This paper describes the design of the MaastrICCht. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the medical ethics committee (Medisch Ethische Toetsingscommissie 2020-1565/3 00 523) of the Maastricht University Medical Centre+ (Maastricht UMC+), which will be performed based on the Declaration of Helsinki. During the pandemic, the board of directors of Maastricht UMC+ adopted a policy to inform patients and ask their consent to use the collected data and to store serum samples for COVID-19 research purposes. All study documentation will be stored securely for fifteen years after recruitment of the last patient. The results will be published in peer-reviewed academic journals, with a preference for open access journals, while particularly considering deposition of the manuscripts on a preprint server early. TRIAL REGISTRATION NUMBER: The Netherlands Trial Register (NL8613).


Assuntos
Infecções por Coronavirus , Cuidados Críticos/métodos , Estado Terminal , Imagem Multimodal/métodos , Pandemias , Pneumonia Viral , Respiração Artificial , Betacoronavirus/isolamento & purificação , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Estado Terminal/epidemiologia , Estado Terminal/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Prognóstico , Sistema de Registros/estatística & dados numéricos , Respiração Artificial/métodos , Respiração Artificial/estatística & dados numéricos , Índice de Gravidade de Doença
2.
Medicine (Baltimore) ; 99(35): e20932, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871859

RESUMO

BACKGROUND: Accurate clinical staging of patients with cholangiocarcinoma (CCA) has a significant impact on treatment decisions. In this study, we aimed to compare the diagnostic value of magnetic resonance imaging (MRI) and 18-fludeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for staging of CCA. METHODS: We performed comprehensive systematic search in Web of Science (including MEDLINE) and Excerpta Medica Database for relevant diagnostic studies in accordance with the preferred reporting items for systematic reviews and meta-analysis statement. Based on data extracted from patient-based analysis, we calculated the pooled sensitivity and specificity with the 95% confidence intervals (CIs). In addition, the publication bias was assessed by Deek funnel plot of the asymmetry test. The potential heterogeneity was explored by threshold effect analysis and subgroup analyses. RESULTS: Thirty-two studies with 1626 patients were included in present analysis. In T stage, the pooled sensitivity and specificity of MRI were 0.90 (95% CI 0.86-0.93), 0.84 (95% CI 0.73-0.91) respectively. The pooled sensitivity and specificity of F-FDG PET/CT were 0.91 (95% CI 0.83-0.95) and 0.85 (0.64-0.95) respectively. In N stage, the pooled sensitivity and specificity of MRI were 0.64 (95% CI 0.52-0.74) and 0.69 (95% CI 0.51-0.87) respectively. The pooled sensitivity and specificity of PET/CT were 0.52 (95% CI 0.37-0.66) and 0.92 (95% CI 0.79-0.97) respectively. In M stage, the pooled sensitivity and specificity of F-FDG PET/CT were 0.56 (95% CI, 0.42-0.69) and 0.95 (95% CI, 0.91-0.97) respectively. The Deek test revealed no significant publication bias. No threshold effect was identified. The subgroup analyses showed that pathological type (extrahepatic cholangiocarcinoma vs hilar cholangiocarcinoma/intrahepatic cholangiocarcinoma), country (Asia vs non-Asia) and type of MRI (1.5T vs. 3.0T) were potential causes for the heterogeneity of MRI studies and country (Asia vs non-Asia) was a potential source for F-FDG PET/CT studies. CONCLUSION: The analysis suggested that both modalities provide reasonable diagnostic accuracy in T stage without significant differences between them. We recommend that both modalities be considered based on local availability and practice for the diagnosis of primary CCA tumors. In N stage, the diagnosis of lymph node metastasis (N) of CCA is still limited by MRI and F-FDG PET/CT, due to unsatisfactory diagnostic accuracy of both. Nevertheless, F-FDG PET/CT can be used to confirm lymph node metastasis while a negative result may not rule out metastasis. Furthermore, F-FDG PET/CT have a low sensitivity and a high specificity for detection of distant metastasis.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Colangiocarcinoma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Idoso , Colangiocarcinoma/epidemiologia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos
3.
Clin Imaging ; 67: 255-263, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32890910

RESUMO

The purpose of this article is to describe the clinical and radiological features of presacral lesions. CT and MRI are the diagnostic modalities of choice and are complimentary in the assessment of presacral lesions. Imaging findings of presacral lesions on CT and MRI are described with the use of examples. Preoperative biopsy, surgical and non-surgical managements are outlined. While the general radiologist cannot be familiar with every rare presacral condition, characterisation of a presacral lesion based on anatomy, demographics and imaging features can guide us in making a sound differential.


Assuntos
Imagem Multimodal , Neoplasias Pélvicas/diagnóstico por imagem , Biópsia , Humanos , Imagem por Ressonância Magnética/métodos , Radiologia
4.
Middle East Afr J Ophthalmol ; 27(2): 128-130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874047

RESUMO

We report two cases with foveal congenital simple hamartoma of the retinal pigment epithelium (CSHRPE), as both patients presented to our retina services complaining of a unilateral decreased vision. Full ophthalmic examination and multimodal imaging were performed including fundus photography, fundus autofluorescence, optical coherence tomography, fluorescein angiography, and electrophysiological testing. Both patients presented with 20/80 vision in the affected eyes. Foveal CSHRPE was found in both eyes, along with parapapillary hyperpigmented rim, multiple pinpoint macular lesions, and few posterior pole hyperpigmented lesions. Multifocal electroretinogram showed diminished central amplitude in both eyes, with three-dimensional topography map showing blunted foveal peaks in one eye and the absence of a central peak in the other patient. Both patients had a stable vision and clinical examination of the CSHRPE during 5 and 6 years follow up, respectively. Foveal CSHRPE is usually symptomatic and results in a decline in visual acuity. Follow-up of these patients showed stable vision and clinical examination.


Assuntos
Hamartoma/congênito , Doenças Retinianas/congênito , Epitélio Pigmentado da Retina/anormalidades , Adulto , Técnicas de Diagnóstico Oftalmológico , Eletrorretinografia , Angiofluoresceinografia , Fóvea Central/patologia , Fundo de Olho , Hamartoma/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Doenças Retinianas/diagnóstico , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual/fisiologia
5.
Middle East Afr J Ophthalmol ; 27(2): 134-138, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874049

RESUMO

Nodular posterior scleritis represents a small percentage of all cases of posterior scleritis. Because of the scarcity of nodular posterior scleritis, it may be confused or even misdiagnosed as an intraocular tumor or posterior uveitis. Here, we are reporting a case of nodular posterior scleritis in a 25-year-old medically free male. Furthermore, we reviewed previously reported cases of nodular posterior scleritis. Our patient presented with a choroidal mass of about one disc diameter in size. In addition, the patient had exudative retinal detachment and chorioretinal folds. B scan ultrasonography showed subretinal fluid, macular nodular thickening and underlying echolucent area along with medium internal reflectivity on A scan. Fluorescein angiography revealed early pinpoint areas of hyperfluorescence and late pooling under the detached retina. Indocyanine green angiography demonstrated early diffuse hypofluorescence corresponding to the area of detachment and late multiple pinpoint spots of hyperfluorescence. After intravenous methylprednisolone 1 g for 3 days followed by a course of oral prednisolone along with mycophenolate mofetil, the patient experienced rapid recovery with improvement in vision and complete resolution of subretinal fluid. On further follow-up, the patient regained 20/20 vision. Nodular posterior scleritis is a rare unilateral disease with strong female predominance. Multimodal imaging should be employed to confirm the diagnosis. The disease must be diagnosed correctly to avoid any unnecessary diagnostic work-up and aggressive management. Most cases carry excellent prognosis with no recurrence.


Assuntos
Neoplasias da Coroide/diagnóstico , Melanoma Amelanótico/diagnóstico , Descolamento Retiniano/diagnóstico , Esclerite/diagnóstico , Administração Oral , Adulto , Antibióticos Antineoplásicos/uso terapêutico , Neoplasias da Coroide/tratamento farmacológico , Corantes/administração & dosagem , Quimioterapia Combinada , Angiofluoresceinografia , Glucocorticoides/uso terapêutico , Humanos , Verde de Indocianina/administração & dosagem , Infusões Intravenosas , Masculino , Melanoma Amelanótico/tratamento farmacológico , Metilprednisolona/uso terapêutico , Imagem Multimodal , Ácido Micofenólico/uso terapêutico , Prednisolona/uso terapêutico , Descolamento Retiniano/tratamento farmacológico , Esclerite/tratamento farmacológico , Tomografia de Coerência Óptica
6.
Middle East Afr J Ophthalmol ; 27(2): 139-141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874050

RESUMO

Paracentral acute middle maculopathy (PAMM) is an optical coherence tomography (OCT) finding seen in patients with retinal capillary ischemia. In this case report, we present a case of PAMM after a transient central retinal artery occlusion and the multifocal electroretinogram (mfERG) and other multimodal imaging findings. Clinical examination, OCT angiography, OCT en face, fluorescein angiography, and visual fields were performed at the baseline and follow-up examinations. As a result, we identified in this PAMM case evidence of hypoperfusion in both the choriocapillaris as well as the deep capillary plexus. To the best of our knowledge, the involvement of choriocapillaris has not been reported previously in the literature. Moreover, we concluded that mfERG constitutes a useful investigation in PAMM and this is the first mfERG findings to be presented for a PAMM case specifically.


Assuntos
Isquemia/diagnóstico , Oclusão da Artéria Retiniana/diagnóstico , Artéria Retiniana/patologia , Capilares/patologia , Corioide/irrigação sanguínea , Eletrorretinografia , Angiofluoresceinografia , Humanos , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Retina/fisiopatologia , Oclusão da Artéria Retiniana/fisiopatologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
7.
Medicine (Baltimore) ; 99(32): e21652, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769936

RESUMO

To investigate the diagnostic value of multimodal ultrasound imaging composed of conventional ultrasonography (US), contrast-enhanced ultrasonography (CEUS), and shear wave elastography (SWE) for liver tumors.Between October 2017 and October 2019, US, CEUS, and SWE examinations of a total of 158 liver tumors in 136 patients at The First Affiliated Hospital of Nanchang University were performed. The histopathological or imaging diagnostic results were used as controls to evaluate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of US, CEUS, SWE, and multimodal ultrasound imaging, which combines these 3 modes, in the differential diagnosis of benign and malignant liver tumors.Among the 158 tumors, there were 64 benign tumors, including 55 cases of hepatic hemangioma, 3 cases of focal nodular hyperplasia of the liver, 4 cases of hepatic cyst, and 2 cases of focal nonuniform distribution of fat in the liver. There were 94 malignant tumors, including 32 cases of hepatocellular carcinoma, 22 cases of intrahepatic cholangiocellular carcinoma, 29 cases of metastatic liver cancer, and 11 cases of dysplastic nodules in cirrhotic liver. In the diagnosis of benign and malignant liver tumors, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 82.56%, 68.06%, 75.96%, 75.53%, and 76.56% for US; 92.39%, 86.36%, 89.87%, 90.43%, and 89.06% for CEUS; 87.14%, 76.81%, 82.91%, 82.98%, and 82.81% for SWE; and 97.85%, 95.38%, 96.83%, 96.81%, and 96.88% for multimodal ultrasound imaging, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were all significantly higher for multimodal ultrasound imaging than those values for US, CEUS, and SWE (all P < .05). The areas under the receiver operating characteristic curve for US, CEUS, SWE, and multimodal ultrasound imaging in the diagnosis of benign and malignant liver tumors were 0.760, 0.897, 0.829, and 0.968, respectively.US, CEUS, and SWE all have diagnostic value in the diagnosis of benign and malignant liver tumors. Multimodal ultrasound imaging could significantly increase the accuracy of the diagnosis of benign and malignant liver tumors and has higher value for clinical application.


Assuntos
Neoplasias Hepáticas/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Meios de Contraste/uso terapêutico , Técnicas de Imagem por Elasticidade/métodos , Feminino , Humanos , Fígado/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/instrumentação , Imagem Multimodal/métodos , Ultrassonografia/instrumentação
8.
Radiol Clin North Am ; 58(5): 965-979, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32792127

RESUMO

Blunt trauma accounts for more than 95% of traumatic renal injury and results from shear forces from rapid acceleration or deceleration and/or collision against the spine or ribs. The use of multiphasic contrast-enhanced computed tomography (CT) has proven pivotal in the evaluation and management of traumatic kidney injury, and CT imaging features provide the basis for nonsurgical staging. This article describes the epidemiology and mechanisms of blunt and penetrating traumatic renal injury and reviews the range of findings from various imaging modalities, with a particular emphasis on contrast-enhanced CT.


Assuntos
Rim/lesões , Imagem Multimodal/métodos , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos Penetrantes/diagnóstico por imagem , Humanos , Rim/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Ultrassonografia
9.
JACC Cardiovasc Imaging ; 13(8): 1792-1808, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32762885

RESUMO

The severe acute respiratory syndrome-coronavirus-2 outbreak has rapidly reached pandemic proportions and has become a major threat to global health. Although the predominant clinical feature of coronavirus disease-2019 (COVID-19) is an acute respiratory syndrome of varying severity, ranging from mild symptomatic interstitial pneumonia to acute respiratory distress syndrome, the cardiovascular system can be involved in several ways. As many as 40% of patients hospitalized with COVID-19 have histories of cardiovascular disease, and current estimates report a proportion of myocardial injury in patients with COVID-19 of up to 12%. Multiple pathways have been suggested to explain this finding and the related clinical scenarios, encompassing local and systemic inflammatory responses and oxygen supply-demand imbalance. From a clinical point of view, cardiac involvement during COVID-19 may present a wide spectrum of severity, ranging from subclinical myocardial injury to well-defined clinical entities (myocarditis, myocardial infarction, pulmonary embolism, and heart failure), whose incidence and prognostic implications are currently largely unknown because of a significant lack of imaging data. Integrated heart and lung multimodality imaging plays a central role in different clinical settings and is essential in the diagnosis, risk stratification, and management of patients with COVID-19. The aims of this review are to summarize imaging-oriented pathophysiological mechanisms of lung and cardiac involvement in COVID-19 and to provide a guide for integrated imaging assessment in these patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Cardiopatias/diagnóstico , Coração/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Imagem Multimodal/métodos , Pneumonia Viral/diagnóstico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Saúde Global , Cardiopatias/epidemiologia , Cardiopatias/etiologia , Humanos , Incidência , Imagem Cinética por Ressonância Magnética/métodos , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Tomografia Computadorizada por Raios X/métodos
10.
Int J Nanomedicine ; 15: 5017-5026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764933

RESUMO

Background: Molecular imaging is of great benefit to early disease diagnosis and timely treatment. One of the most striking innovations is the development of multimodal molecular imaging technology, which integrates two or more imaging modalities, largely in view of making the best of the advantages of each modality while overcoming their respective shortcomings. Hence, engineering a versatile and easily prepared nanomaterial with integrating multimodal molecular imaging function holds great promise, but is still a great challenge. Materials and Methods: We firstly designed and synthesized a BDT-DPP conjugated polymer and then noncovalent self-assembly with phospholipid-polyethylene glycol endowed BDT-DPP with water solubility and biocompatibility. Followed by [Cu] labeling, the acquired multifunctional nanoparticles (NPs) were studied in detail for the photophysical property. The cytotoxicity and biocompatibility of DPP-BDT NPs were examined through MTT assay and H&E stained analysis. In addition, we investigated the accumulation of the NPs in HepG2 tumor models by positron emission tomography (PET) and photoacoustic (PA) dual-mode imaging. Results and Discussion: The DPP-BDT NPs exhibited excellent optical stability, strong near-infrared (NIR) light absorption as well as fine biocompatibility. After tail vein injection into the living mice, the PA signals in the neoplastic tissues were gradually increased and reached to the maximum at the 4-h post-injection, which was consistent with the PET analysis. Such strong PA and PET signals were attributed to the efficient NPs accumulation resulting from the enhanced permeability and retention (EPR) effect. Conclusion: The biocompatible DPP-BDT NPs demonstrated to be strong NIR absorption property and PAI sensitivity. Besides, these novel DPP-BDT NPs can act not only as a PA imaging contrast agent but also as an imaging agent for PET.


Assuntos
Cetonas/química , Nanopartículas/química , Neoplasias Experimentais/diagnóstico por imagem , Técnicas Fotoacústicas/métodos , Tomografia por Emissão de Pósitrons/métodos , Pirróis/química , Animais , Meios de Contraste/química , Radioisótopos de Cobre/administração & dosagem , Radioisótopos de Cobre/farmacocinética , Feminino , Células Hep G2 , Humanos , Injeções , Camundongos , Camundongos Nus , Imagem Multimodal/métodos , Células NIH 3T3 , Nanopartículas/administração & dosagem , Fosfatidiletanolaminas/química , Polietilenoglicóis/química , Polímeros/química , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/química , Ensaios Antitumorais Modelo de Xenoenxerto
11.
PLoS One ; 15(8): e0238080, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32834009

RESUMO

The purpose of this study was to evaluate potential insights into the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) using multimodal diagnostic imaging and laboratory evaluation in long-term follow-up. A retrospective, single-center case series was conducted on seven consecutive patients (14 eyes) who were given a diagnosis of APMPPE from March 1, 2011, through June 30, 2019 with at least three months of follow-up. Clinical characteristics (age, symptoms, visual acuity [VA]), laboratory testing including coxsackievirus titers, and multimodal imaging from fundus photography, spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICG) were analyzed for each patient. The initial median VA was 20/71 and final median VA was 20/22. Coxsackievirus B (CVB) titers were elevated (≥ 1:80) in six of seven patients, with a four-fold increase in convalescent titers seen in two patients suggestive of recent infection. All patients were treated with oral corticosteroids, and five patients underwent corticosteroid-sparing immunomodulatory therapy. Initially, multifocal deep choroidal lesions were observed in the posterior pole corresponding to patches of hypocyanescence on ICG. Overlying retinal pigment epithelium (RPE) disease was observed on FAF, although this finding was not universally observed, suggesting that RPE disease may occur as a sequelae to unchecked choroidal inflammation. SD-OCT architectural changes confirmed outer retina and ellipsoid zone disruption. FA of active lesions showed early hypofluorescence and late hyperfluorescence with surrounding leakage while inactive disease showed areas of staining. Long-term follow-up of multimodal diagnostic imaging in APMPPE revealed that choroidal inflammation likely precedes RPE change and photoreceptor damage. Elevation of coxsackievirus titers with seroconversion may be associated with an infectious trigger in concert with immune-mediated disease in this posterior uveitis syndrome.


Assuntos
Enterovirus/fisiologia , Exposição Ambiental/efeitos adversos , Coroidite Multifocal/diagnóstico por imagem , Coroidite Multifocal/virologia , Imagem Multimodal , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/virologia , Doença Aguda , Adolescente , Adulto , Idoso , Angiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Óptica , Estudos Retrospectivos , Tomografia de Coerência Óptica , Adulto Jovem
12.
Eur J Radiol ; 131: 109217, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32861174

RESUMO

Due to its pandemic diffusion, SARS- CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection represents a global threat. Despite a multiorgan involvement has been described, pneumonia is the most common manifestation of COVID-19 (Coronavirus disease 2019) and it is associated with a high morbidity and a considerable mortality. Especially in the areas with high disease burden, chest imaging plays a crucial role to speed up the diagnostic process and to aid the patient management. The purpose of this comprehensive review is to understand the diagnostic capabilities and limitations of chest X-ray (CXR) and high-resolution computed tomography (HRCT) in defining the common imaging features of COVID-19 pneumonia and correlating them with the underlying pathogenic mechanisms. The evolution of lung abnormalities over time, the uncommon findings, the possible complications, and the main differential diagnosis occurring in the pandemic phase of SARS-CoV-2 infection are also discussed.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Animais , Diagnóstico Diferencial , Seguimentos , Humanos , Imagem Multimodal , Pandemias , Tomografia Computadorizada por Raios X/métodos
13.
AJNR Am J Neuroradiol ; 41(10): 1797-1799, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32819902

RESUMO

Bilateral basal ganglia hemorrhage is exceedingly rare. To our knowledge, our patient is the first reported case of a confirmed coronavirus disease 2019 (COVID-19) patient who had bilateral basal ganglia hemorrhage. In the absence of other risk factors for bilateral deep cerebral involvement, we suspect that COVID-19 may be contributing to these rare pathologies. Most published data represent a correlation between COVID-19 and neurologic complications, and more research is still needed to prove causation.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico por imagem , Hemorragia dos Gânglios da Base/etiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Feminino , Humanos , Imagem por Ressonância Magnética , Imagem Multimodal , Pandemias , Tomografia Computadorizada por Raios X
14.
Cancer Radiother ; 24(5): 423-428, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32620459

RESUMO

Prostate cancer is the most common malignant tumour and represents the third cause of cancer-mortality in men. The management of prostate cancer has dramatically changed over the last decades, mainly due to improvement of diagnostic modalities and development of new therapeutic strategies. Imaging plays a key role in all the steps of prostate cancer management. In recent years, magnetic resonance imaging (MRI) and positron-emission tomography (PET) - computed tomography (CT) have emerged as two major tools for the detection of prostate cancer, tumour staging and treatment choice. Both MRI and PET-CT - using choline or prostate-specific membrane antigen (PSMA) as radiotracer - have become mandatory. This article presents the contribution of the latest advances in these two imaging techniques of prostate cancer and their future developments.


Assuntos
Antígenos de Superfície , Glutamato Carboxipeptidase II , Imagem por Ressonância Magnética/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Próstata/diagnóstico por imagem , Adenocarcinoma/química , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/radioterapia , Idoso , Radioisótopos de Carbono , Colina/análogos & derivados , Radioisótopos de Flúor , Humanos , Masculino , Imagem Multimodal/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Neoplasias da Próstata/química , Neoplasias da Próstata/radioterapia , Compostos Radiofarmacêuticos , Ultrassonografia/métodos
15.
JACC Cardiovasc Imaging ; 13(7): 1615-1626, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32646721
16.
Medicine (Baltimore) ; 99(27): e21063, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629735

RESUMO

BACKGROUND: Overflow breast disease (OBD), also known as breast nipple discharge, refers fluid or liquid that comes out of nipple. Many patients with breast cancer experience such condition. However, it is not easy to detect it at early stage, especially for pathological OBD. Previous study found low-dose CT combined mammography (LDCTMG) could help in diagnosis of OBD. However, there is no systematic review investigating this issue. Therefore, this study will examine the accuracy of LDCTMG in diagnosis of OBD. METHODS: This study protocol will search literature sources in electronic databases and other sources. The electronic databases will be retrieved in The Cochrane Library, the Cochrane Register of Diagnostic Test Accuracy Studies, PUBMED, EMBASE, Web of Science, CINAHL, CNKI, and WANGFANG from inception to the present. We will also search other sources. All literature sources will be sought without restrictions to the language and publication status. Two researchers will independently carry out study selection, data extraction, and study quality assessment. Statistical analysis will be performed using RevMan 5.3. RESULTS: This study will exert a high-quality synthesis of eligible studies on the analysis of LDCTMG in diagnosis of OBD. CONCLUSIONS: The results of this study may provide evidence to help judge whether LDCTMG is accurate in diagnosis of OBD. STUDY REGISTRATION: INPLASY202050116.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Mamografia/métodos , Derrame Papilar/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Doenças Mamárias/epidemiologia , Doenças Mamárias/patologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Imagem Multimodal/métodos
17.
Clin Imaging ; 67: 136-142, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32622334

RESUMO

We report a marked abnormality in myocardial attenuation on non-gated contrast-enhanced CT in a patient with multiorgan sarcoidosis and correlate our findings with CMR, PET and SPECT. The noteworthy observation of myocardial hypoattenuation, in correspondence with the multimodality cardiovascular imaging findings, suggests that standard contrast-enhanced CT may provide information regarding tissue characterization. This report also demonstrates the independent clinical utility of CMR and PET in the evaluation and management of cardiac sarcoidosis.


Assuntos
Cardiomiopatias/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Miocárdio , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos
18.
Methodist Debakey Cardiovasc J ; 16(2): 86-96, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670468

RESUMO

Of the 100,000-plus valve surgeries performed each year in the United States, up to 6% of those develop complications from prosthetic valve dysfunction. Prosthetic valve dysfunction (PVD) can be life threatening and often challenging to diagnose. In this review, we discuss the prevalence and incidence of PVD, explore its different etiologies, and assess the role of multimodality imaging with an emphasis on cardiac multidetector computed tomography (MDCT) for evaluating patients with PVD. We also investigate the utility of MDCT in preprocedural planning for transcatheter devices and redo surgical planning and discuss management strategies for patients with PVD.


Assuntos
Implante de Prótese de Valva Cardíaca/instrumentação , Próteses Valvulares Cardíacas , Valvas Cardíacas/cirurgia , Tomografia Computadorizada Multidetectores , Complicações Pós-Operatórias/diagnóstico por imagem , Falha de Prótese , Implante de Prótese de Valva Cardíaca/efeitos adversos , Valvas Cardíacas/diagnóstico por imagem , Valvas Cardíacas/fisiopatologia , Humanos , Incidência , Imagem Multimodal , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/cirurgia , Valor Preditivo dos Testes , Prevalência , Reoperação , Fatores de Risco , Resultado do Tratamento
19.
Methodist Debakey Cardiovasc J ; 16(2): 138-145, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32670474

RESUMO

The number of cardiovascular imaging studies is growing exponentially, and so is the need to improve clinical workflow efficiency and avoid missed diagnoses. With the availability and use of large datasets, artificial intelligence (AI) has the potential to improve patient care at every stage of the imaging chain. Current literature indicates that in the short-term, AI has the capacity to reduce human error and save time in the clinical workflow through automated segmentation of cardiac structures. In the future, AI may expand the informational value of diagnostic images based on images alone or a combination of images and clinical variables, thus facilitating disease detection, prognosis, and decision making. This review describes the role of AI, specifically machine learning, in multimodality imaging, including echocardiography, nuclear imaging, computed tomography, and cardiac magnetic resonance, and highlights current uses of AI as well as potential challenges to its widespread implementation.


Assuntos
Técnicas de Imagem Cardíaca , Doenças Cardiovasculares/diagnóstico por imagem , Diagnóstico por Computador , Interpretação de Imagem Assistida por Computador , Aprendizado de Máquina , Humanos , Imagem Multimodal , Valor Preditivo dos Testes
20.
J Am Coll Cardiol ; 76(11): 1345-1357, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32710927

RESUMO

Standard evaluation and management of the patient with suspected or proven cardiovascular complications of coronavirus disease-2019 (COVID-19), the disease caused by severe acute respiratory syndrome related-coronavirus-2 (SARS-CoV-2), is challenging. Routine history, physical examination, laboratory testing, electrocardiography, and plain x-ray imaging may often suffice for such patients, but given overlap between COVID-19 and typical cardiovascular diagnoses such as heart failure and acute myocardial infarction, need frequently arises for advanced imaging techniques to assist in differential diagnosis and management. This document provides guidance in several common scenarios among patients with confirmed or suspected COVID-19 infection and possible cardiovascular involvement, including chest discomfort with electrocardiographic changes, acute hemodynamic instability, newly recognized left ventricular dysfunction, as well as imaging during the subacute/chronic phase of COVID-19. For each, the authors consider the role of biomarker testing to guide imaging decision-making, provide differential diagnostic considerations, and offer general suggestions regarding application of various advanced imaging techniques.


Assuntos
Doenças Cardiovasculares , Infecções por Coronavirus , Imagem Multimodal/métodos , Pandemias , Pneumonia Viral , Betacoronavirus , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Gerenciamento Clínico , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia
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