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4.
Circ Cardiovasc Imaging ; 15(11): e014804, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36378776

RESUMO

Multi-modality imaging plays critical roles during and after procedures associated with atrial fibrillation. Transesophageal echocardiography is an invaluable tool for left atrial appendage occlusion during the procedure and at follow-up. Both cardiac computed tomography and cardiac magnetic resonance contribute to postprocedural evaluation of pulmonary vein isolation ablation. The present review is the second of a 2-part series where we discuss the roles of cardiac imaging in the evaluation and management of patients with atrial fibrillation, focusing on intraprocedural and postprocedural assessment, including the clinical evidence and outcomes data supporting this future applications.


Assuntos
Apêndice Atrial , Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Humanos , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/cirurgia , Apêndice Atrial/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/cirurgia , Imagem Multimodal , Ecocardiografia Transesofagiana , Ablação por Cateter/efeitos adversos , Resultado do Tratamento
5.
J Fr Ophtalmol ; 45(10): 1184-1191, 2022 Dec.
Artigo em Francês | MEDLINE | ID: mdl-36319527

RESUMO

PURPOSE: To characterize the magnitude and consequences for interpretation of macular elevations associated with short posterior ciliary arteries (SPCA) extending to the fovea. METHODS: Retrospective study of 96 eyes of 138 patients who underwent multimodal imaging (color photographs, SD-OCT with OCT-angiography analysis, fluorescein angiography [FA] and indocyanine green angiography [ICG]) over a two-year period. The authors selected patients with a focal choroidal elevation (FCE) associated with a SPCA extending to the fovea. FCEs were classified according to their magnitude as "Low" (<50µm), "Medium" (50µm to 100µm) and "High" (>100µm). RESULTS: Ten patients aged 80.10±11.82 years had a FCE associated with a macular SPCA. The patients were followed for advanced AMD with neovascularization (2 cases), advanced AMD with geographic atrophy (3 cases), intermediate AMD (1 case) ; one patient was followed for diabetes ; three patients had no identified retinal pathology. The FCE associated with the SPCAs was Low (3 cases), Medium (2 cases), High (3 cases). In 2 cases, the FCE was limited to an unmeasurable choroidal fold. The interpretation associated with these FCEs was not always related to the magnitude of the elevation. CONCLUSION: Our observations show the value of multimodal imaging in the identification of SPCA extending to the fovea, sometimes associated with a macular FCE. In some cases, the signs associated with FCE interfered with the monitoring of the condition for which the patient was being followed. Identifying these FCEs and grading their amplitude is relevant, as they should not be confused with pathological structures.


Assuntos
Neovascularização de Coroide , Humanos , Estudos Retrospectivos , Neovascularização de Coroide/diagnóstico por imagem , Artérias Ciliares/diagnóstico por imagem , Acuidade Visual , Angiofluoresceinografia/métodos , Imagem Multimodal
7.
Retina ; 42(12): 2326-2335, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36394887

RESUMO

PURPOSE: To investigate features of central serous chorioretinopathy with choroidal neovascularization (CNV) on multimodal imaging and analyze their association with treatment response. METHODS: A total of 37 patients with chronic central serous chorioretinopathy complicated by CNV were divided into bevacizumab and photodynamic therapy groups, and each group was subdivided into responders and nonresponders according to subretinal fluid status at 3 months. We assessed multimodal imaging parameters (subfoveal choroidal thickness; vortex vein engorgement; choroidal vascular hyperpermeability; and CNV morphologic pattern, area, and vessel density) and analyzed their association with treatment responses. RESULTS: Responders in the bevacizumab group showed thinner subfoveal choroidal thickness (384.0 ± 103.2 vs. 398.3 ± 87.1 µm, P = 0.042), smaller CNV area (0.512 ± 0.267 vs. 1.323 ± 0.481 mm2, P = 0.007), open-circuit pattern (84.6% vs. 12.5%, P < 0.001), and capillary fringe (69.2% vs. 37.5%, P = 0.001) than nonresponders. Responders in the photodynamic therapy group had thicker subfoveal choroidal thickness (420.1 ± 93.5 vs. 395.7 ± 6.5 µm, P = 0.021), more quadrants with engorged vortex veins extending to the macula (P = 0.012), and intense choroidal vascular hyperpermeability (57.1% vs. 50.0%, P = 0.026) than nonresponders. Choroidal neovascularization showing closed-circuit pattern (85.7% vs. 0%, P = 0.001) and peripheral loop (64.3% vs. 0%, P = 0.001) demonstrated a good response to photodynamic therapy. CONCLUSION: Heterogeneous features of choroidal hyperpermeability, thickness, and CNV morphology in CNV accompanying central serous chorioretinopathy are associated with different therapeutic responses to bevacizumab and photodynamic therapy treatments.


Assuntos
Coriorretinopatia Serosa Central , Neovascularização de Coroide , Humanos , Coriorretinopatia Serosa Central/complicações , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/tratamento farmacológico , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/etiologia , Bevacizumab/uso terapêutico , Tomografia de Coerência Óptica , Imagem Multimodal
8.
Retin Cases Brief Rep ; 16(6): 747-753, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36288621

RESUMO

PURPOSE: To describe longitudinal, anatomical, and functional alterations caused by inflammatory and neovascular lesions of idiopathic multifocal choroiditis/punctate inner choroidopathy using adaptive optics imaging and microperimetry. METHODS: Longitudinal case study using multiple imaging modalities, including spectral-domain optical coherence tomography, fluorescein angiography, indocyanine green angiography, optical coherence tomography angiography, flood illumination adaptive optics, and microperimetry. RESULTS: A 21-year-old myopic Asian man presented with blurred vision in the right eye. Clinical examination was notable for an isolated hypopigmented, perifoveal lesion in each eye. Multimodal imaging showed inflammatory lesions in the outer retina, retina pigment epithelium, and inner choroid lesions of both eyes. The right eye additionally exhibited active Type-2 macular neovascularization with loss of cone mosaic regularity that was associated with reduced sensitivity on microperimetry. The clinical picture was consistent with multifocal choroiditis/punctate inner choroidopathy. The patient was treated with oral steroids and three injections of intravitreal bevacizumab in the right eye. After therapy, imaging showed reestablishment of the cone mosaic on flood illumination adaptive optics and improvement in sensitivity on microperimetry. CONCLUSION: Adaptive optics imaging and microperimetry may detect biomarkers that help to characterize the nature and activity of multifocal choroiditis lesions and to help monitor response to therapy. With timely intervention, structural abnormalities in the outer retina and choroid can be treated, and anatomical improvements precede improvements in visual function.


Assuntos
Corioidite , Verde de Indocianina , Masculino , Humanos , Adulto Jovem , Adulto , Coroidite Multifocal , Bevacizumab/uso terapêutico , Corioidite/patologia , Angiofluoresceinografia/métodos , Oftalmoscopia , Tomografia de Coerência Óptica/métodos , Imagem Multimodal/métodos
9.
J Phys Chem A ; 126(42): 7650-7659, 2022 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-36240504

RESUMO

Tyrosinase is crucial to regulate the metabolism of phenol derivatives, playing an important role in the biosynthesis of melanin pigments, whereas an abnormal level of tyrosinase would lead to severe diseases. It is rather necessary to develop a sensitive and selective imaging tool to assess the level of tyrosinase in vivo. We thoroughly researched the luminous mechanism of the existing TPTYR probe and provided design strategies to improve its two-photon excited fluorescence properties. The designed probes benza2-TPTYR and product benza2-TPTYR-coumarin have large two-photon absorption cross sections at the NIR spectral region (41 GM/706 nm, 71 GM/852 nm), while benza2-TPTYR-coumarin possesses easily distinguishable spectrum in the visible region and a high fluorescence efficiency (ΦF = 0.27). What is more, novel two-photon excited multimodal imaging based on the pure organic small molecule benza1-TPTYR-coumarin (61 GM/936 nm) is proposed first, simultaneously possessing strong instantaneous fluorescent (563.79 nm) and persistent room-temperature phosphorescent emissions (767.68 nm, 0.54 ms).


Assuntos
Corantes Fluorescentes , Monofenol Mono-Oxigenase , Melaninas , Temperatura , Cumarínicos , Fenóis , Medições Luminescentes , Imagem Multimodal
10.
Circ Cardiovasc Imaging ; 15(10): e014386, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36256725

RESUMO

Atrial fibrillation (AF) is the most common arrhythmia worldwide and is associated with increased risk of heart failure, stroke, and death. In current medical practice, multimodality imaging is routinely used in the management of AF. Twenty-one years ago, the ACUTE trial (Assessment of Cardioversion Using Transesophageal Echocardiography) results were published, and the management of AF changed forever by incorporating transesophageal echocardiography guided cardioversion of patients in AF for the first time. Current applications of multimodality imaging in AF in 2022 include the use of transesophageal echocardiography and computed tomography before cardioversion to exclude left atrial thrombus and in left atrial appendage occlusion device implantation. Transesophageal echocardiography, cardiac computed tomography, and cardiac magnetic resonance are clinically used for AF ablation planning. The decision to use a particular imaging modality in AF is based on patient's characteristics, guideline recommendation, institutional preferences, expertise, and cost. In this first of 2-part review series, we discuss the preprocedural role of echocardiography, computed tomography, and cardiac magnetic resonance in the AF, with regard to their clinical applications, relevant outcomes data and unmet needs, and highlights future directions in this rapidly evolving field.


Assuntos
Fibrilação Atrial , Imagem Multimodal , Humanos , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/terapia , Ecocardiografia Transesofagiana , Cardioversão Elétrica , Ensaios Clínicos como Assunto
11.
Tomography ; 8(5): 2522-2532, 2022 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-36287809

RESUMO

(1) Background: To determine the importance of diffusion-weighted whole-body MRI with background body signal suppression (DWIBS) in the staging process of patients with suspected head and neck carcinomas. (2) Methods: A total of 30 patients (24 male, 6 female) with a median age of 67 years with clinically suspected head and neck carcinoma with pathologic cervical nodal swelling in ultrasound underwent the staging procedure with computed tomography (CT) and whole-body MRI including DWIBS. (3) Results: In a total of 9 patients, abnormalities in the routine work-up of pretherapeutic staging were found. Five cases of either secondary cancer or distant metastases were only visible in DWIBS, while being missed on CT. One diagnosis was only detectable in CT and not in DWIBS, whereas three diagnoses were recognizable in both modalities. (4) Conclusions: DWIBS in addition to a standard neck MRI in cervical lymphadenopathy suspicious for head and neck cancer yielded additional clinically relevant diagnoses in 17% of cases that would have been missed by current staging routine procedures. DWIBS offered a negative predictive value of 98.78% for ruling out distant metastases or secondary malignancies.


Assuntos
Neoplasias de Cabeça e Pescoço , Imagem Corporal Total , Humanos , Masculino , Feminino , Idoso , Imagem Corporal Total/métodos , Fluordesoxiglucose F18 , Imagem Multimodal/métodos , Sensibilidade e Especificidade , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem
13.
J Clin Ultrasound ; 50(8): 1084-1096, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36218201

RESUMO

Amyloidosis is a systemic disease, characterized by deposition of amyloid fibrils in various organs, including the heart. For the diagnosis of cardiac amyloidosis (CA) it is required a high level of clinical suspicion and in the presence of clinical, laboratorial, and electrocardiographic red flags, a comprehensive multimodality imaging evaluation is warranted, including echocardiography, magnetic resonance, scintigraphy, and computed tomography, that will confirm diagnosis and define the CA subtype, which is of the utmost importance to plan a treatment strategy. We will review the use of multimodality imaging in the evaluation of CA, including the latest applications, and a practical flow-chart will sum-up this evidence.


Assuntos
Amiloide , Amiloidose , Amiloidose/diagnóstico por imagem , Amiloidose/patologia , Ecocardiografia , Humanos , Imagem Multimodal/métodos , Cintilografia
14.
J Clin Ultrasound ; 50(8): 1051-1059, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36218209

RESUMO

Advanced cardiac imaging (ACI), including myocardial deformation imaging, 3D echocardiography and cardiac magnetic resonance, overcomes the limitations of conventional echocardiography in the assessment of patients with primary mitral regurgitation (MR). They enable a more precise MR quantification and reveal early changes before advanced and irreversible remodeling with depressed heart function occurs. ACI permits a thorough analysis of mitral valvular anatomy and MR mechanisms (important for planning and guiding percutaneous and surgical procedures) and helps to identify structural and functional changes coupled with a high arrhythmogenic potential, especially the occurrence of atrial fibrillation and heart failure development. The key question is how the data provided by ACI can improve the current management of primary MR.


Assuntos
Ecocardiografia Tridimensional , Insuficiência da Valva Mitral , Ecocardiografia/métodos , Ecocardiografia Tridimensional/métodos , Humanos , Valva Mitral/diagnóstico por imagem , Imagem Multimodal
15.
J Clin Ultrasound ; 50(8): 1041-1050, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36218214

RESUMO

Aortic regurgitation (AR) is a common valvular pathology. Multimodality noninvasive cardiovascular imaging is routinely used to assess the mechanism of AR, degree, and its hemodynamic impact on the cardiovascular system. Collecting this information is crucial in establishing the prognosis and in guiding patient management and follow-up. While echocardiography remains the primary test to assess AR, a comprehensive assessment of this valvulopathy can be obtained by combining the information from different techniques. This state-of-the-art review is intended to provide an update ed overview of the applications, strengths, and limits of transthoracic echocardiography, cardiac magnetic resonance, and cardiac computed tomography in patients with AR.


Assuntos
Insuficiência da Valva Aórtica , Doenças das Valvas Cardíacas , Insuficiência da Valva Aórtica/diagnóstico por imagem , Ecocardiografia , Humanos , Imageamento por Ressonância Magnética , Imagem Multimodal/métodos
16.
BMC Ophthalmol ; 22(1): 400, 2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36207677

RESUMO

BACKGROUND: To report a rare case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with a combination of serous retinal detachment, papilledema, and retinal vasculitis. CASE PRESENTATION: A 19-year-old male complained of floaters in both eyes with decreased vision for 4 days. The best corrected visual acuity of the right eye and the left eye were 1.1 and 0.9 (logMAR), respectively. In both eyes, inflammatory cells can be seen suspended within the vitreous, multiple yellow/white lesions can be seen near the macula, and retinal neuroepithelial detachment. Swelling of the optic disc with blurring of the disc margins, in the left eye. Optical coherence tomography (OCT): showed retinal detachment in both eyes. The patient received oral prednisone treatment. 1 week later, OCT showed absorption of subretinal fluid in the macula of both eyes his binocular vision improved to 0.1 (logMAR). During the subsequent 28-month follow-up, fundus fluorescein angiography and OCT revealed extensive and progressive pigment epithelial atrophy in both eyes, and abnormal retinal vascular perfusion in the right eye due to persistent retinal vasculitis. Although the patient's binocular visual acuity remained at 0.1 (logMAR). CONCLUSIONS: In the present case of APMPPE with a combination of serous retinal detachment, papilledema, and retinal vasculitis, through the multimodal imaging, further confirming that the lesions were located in the choroid, while the pigment epithelial lesions were secondary changes.


Assuntos
Papiledema , Descolamento Retiniano , Doenças Retinianas , Vasculite Retiniana , Síndrome dos Pontos Brancos , Doença Aguda , Adulto , Atrofia , Angiofluoresceinografia/métodos , Humanos , Masculino , Imagem Multimodal , Prednisona/uso terapêutico , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico , Doenças Retinianas/complicações , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica/métodos , Adulto Jovem
17.
Int J Nanomedicine ; 17: 4525-4546, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36193213

RESUMO

Background: MRSA with high morbidity and mortality is prone to cause serious infection, SDT has become a new antibiotic-free modality for bacterial infection treatment. Switching from proinflammatory M1 macrophages to anti-inflammatory M2 macrophages dominant could activate the immune system to generate an anti-infection immune response. Methods: Herein, we developed M2 macrophages derived cell membranes coated PLGA nanoparticles with IR780 encapsulation (M2/IR780@PLGA) for antibacterial SDT and subsequent M2 macrophage polarization to enhance the therapeutic efficacy of MRSA myositis. For in situ visualization of antibacterial SDT, both diagnostic high-frequency US and magnetic resonance imaging (MRI) were introduced to monitor the sono-therapeutic progression of M2/IR780@PLGA nanoparticles in mice with bacterial myositis. Results: Our developed M2/IR780@PLGA nanoparticles exhibited excellent antibacterial effects due to the IR780 under low-frequency US irradiation in vitro. In an MRSA-infected mice model, a great deal of M2/IR780@PLGA nanoparticles accumulated at the site of inflammation due to M2 macrophage coating. The infected legs in the M2/IR780@PLGA nanoparticles-based SDT group were significantly smaller, fewer blood flow signals, a slight muscular edema without obvious intermuscular abscesses under high-frequency US and MR images guidance. Histopathology proved the infected legs in the M2/IR780@PLGA nanoparticles-mediated SDT group had less clumped bacteria infiltration, more M2 macrophage expression and less M1 macrophage expression. The percentage of mature dendritic cells in spleens was much higher in the group of mice with M2/IR780@PLGA nanoparticles-based SDT. Conclusion: This study provides a promising nanoparticles-based SDT anti-bacterial strategy, which could effectively enhance the antibacterial SDT and subsequent promote M2 macrophage polarization to boost the therapeutic efficacy of MRSA myositis.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Miosite , Nanopartículas , Animais , Antibacterianos/farmacologia , Linhagem Celular Tumoral , Macrófagos , Camundongos , Imagem Multimodal
18.
Clin Imaging ; 92: 101-108, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36270153

RESUMO

Canal of Nuck abnormalities are common in pediatric population but may rarely present in adults. Hydrocele of the Canal of Nuck is the most common presentation in adult population. These may be symptomatic or found incidentally on imaging. We review the embryology and present imaging features of Canal of Nuck hydroceles in this case-based review article, and highlight the features on various imaging modalities, such as ultrasound, CT (Computed Tomography), MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography). Radiologists should be aware of these findings in their practice and be able to recognize these congenital abnormalities.


Assuntos
Canal Inguinal , Imagem Multimodal , Adulto , Masculino , Humanos , Criança , Canal Inguinal/diagnóstico por imagem , Peritônio , Ultrassonografia/métodos , Tomografia Computadorizada por Raios X
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