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1.
Radiol Med ; 124(12): 1229-1237, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31773458

RESUMO

The aim of our study was to assess the performance of contrast-enhanced digital mammography (CEDM) in the preoperative loco-regional staging of invasive lobular carcinoma (ILC) patients, about the valuation of the extension of disease and in measurement of lesions. Then, we selected retrospectively, among the 1500 patients underwent to CEDM at the Breast Diagnostics Department of the Careggi University Hospital of Florence and the National Cancer Institute of Milan from September 2016 to November 2018, 31 women (mean age 57.1 aa; range 41-78 aa) with a definitive histological diagnosis of ILC. CEDM has proved to be a promising imaging technique, being characterized by a sensitivity of 100% in the detection of the index lesion, and of 84.2% in identifying any adjunctive lesions: It was the presence of a non-mass enhancement (NME) to lower the sensitivity of the technique (25% vs. 100% for mass-like enhancements or a mass closely associated with a NME). Specificity in the characterization of additional lesions was 66.7%, and the diagnosis of the extension of disease was correct in 77.4% of cases: NME also led to a decrease in diagnostic accuracy in the evaluation of disease extension up to 40% versus 85% for masses and 80% for masses associated with NME (M/NME). Moreover, in 12/31 (38.7%), CEDM allowed to correctly identify lesions not shown by mammography + ultrasonography + tomosynthesis: In the half of these (6/12), there was a multicentricity, thus allowing an adequate surgical planning change. CEDM was also very accurate in analyzing the maximum diameter of the masses, while it was much less reliable in the case of the M/NME and pure NME. In conclusion, CEDM is a new promising imaging technique in the loco-regional preoperative staging and in the evaluation of disease extension for ILC, especially in case of mass enhancement lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma Lobular/diagnóstico por imagem , Meios de Contraste , Iohexol/análogos & derivados , Mamografia/métodos , Adulto , Idoso , Neoplasias da Mama/química , Neoplasias da Mama/patologia , Carcinoma Lobular/química , Carcinoma Lobular/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Cuidados Pré-Operatórios , Intensificação de Imagem Radiográfica/métodos , Padrões de Referência , Estudos Retrospectivos , Sensibilidade e Especificidade , Carga Tumoral , Ultrassonografia Mamária
2.
Nanoscale ; 11(32): 15326-15338, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31386732

RESUMO

All-in-one nanoagents with a single-component and all-required functions have attracted increasing attention for the imaging-guided therapy of tumors, but the design and preparation of such nanoagents remain a challenge. Herein, we report the introduction of oxygen vacancies to traditional semiconductors with heavy-metal elements for tuning photoabsorption in the near infrared (NIR) region, by using Bi2WO6 (band-gap: ∼2.7 eV) as a model. Bi2WO6-x nanodots with sizes of ∼3 or ∼8 nm have been prepared by a facile coprecipitation-solvothermal method assisted by citric acid (CA, 0.1-1.5 g) as the reduction agent. CA confers the removal of O atoms from the [Bi2O2]2+ layer during the solvothermal process, resulting in the formation of plenty of oxygen vacancies in the Bi2WO6-x crystal. As a result, NIR photoabsorption of Bi2WO6-x nanodots can be remarkably enhanced with the increase of the CA amount from 0 to 1.0 g. Under irradiation of a single-wavelength (808 nm, 1.0 W cm-2) NIR laser, black Bi2WO6-x-CA1.0 nanodots can not only efficiently produce a sufficient amount of heat with a photothermal conversion efficiency of 45.1% for photothermal therapy, but also generate singlet oxygen (1O2) for photodynamic therapy. Furthermore, due to the presence of heavy-metal (Bi and W) elements, Bi2WO6-x-CA1.0 nanodots have high X-ray attenuation ability for CT imaging. After the Bi2WO6-x-CA1.0 nanodot dispersion is injected into the tumor-bearing mice, the tumor can be imaged by using CT and an IR thermal camera. After irradiation with a single-wavelength (808 nm, 1.0 W cm-2, 10 min) NIR laser, the tumor can be completely suppressed by the synergic photothermal and photodynamic effects of Bi2WO6-x-CA1.0 nanodots, without recurrence and treatment-induced toxicity. Therefore, Bi2WO6-x nanodots have great potential as a novel all-in-one nanoagent for the imaging and phototherapy of tumors.


Assuntos
Bismuto/química , Nanoestruturas/química , Oxigênio/química , Compostos de Tungstênio/química , Animais , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos da radiação , Raios Infravermelhos , Iohexol/análogos & derivados , Iohexol/química , Iohexol/farmacologia , Camundongos , Nanoestruturas/uso terapêutico , Nanoestruturas/toxicidade , Neoplasias/diagnóstico , Neoplasias/patologia , Neoplasias/terapia , Fotoquimioterapia , Fototerapia , Oxigênio Singlete/química , Oxigênio Singlete/metabolismo , Temperatura Ambiente , Distribuição Tecidual , Tomografia Computadorizada por Raios X
3.
Eur J Radiol ; 119: 108626, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31430661

RESUMO

PURPOSE: To investigate the image quality, diagnostic accuracy, and dose reduction potential of a split-bolus protocol(SBP) compared with a multiphasic protocol(MPP) in the detection of recurrent or progressive pancreatic ductal adenocarcinoma(PDAC) or cholangiocarcinoma(CC) using contrast- enhanced computed tomography(CECT). MATERIALS AND METHODS: This prospective study included 56 patients who underwent CECT, 28 with our institutional standard MPP(100 ml contrast bolus) and 28 with a novel SBP(110 ml). Radiation exposure was determined in terms of total dose- length product(DLP) and computed tomography dose index(CTDI). Image quality was measured objectively by analysis of attenuation in Hounsfield units(HU) in regions of interest(ROIs) and subjectively by two blinded readers using a Likert scale. Diagnostic accuracy and interreader variability were tested. RESULTS: The total DLP of the SBP group(498.1 ± 43.7 mGy*cm) was significantly lower than in the MPP group(1,092.5 ± 106.9 mGy*cm; p < 0.001). The SBP showed higher contrast enhancement of all critical anatomical structures including portal vein, liver, and pancreas compared with the MPP, except for the aorta(SBP: 326.9 ± 15.7 HU vs. MPP: 246.7 ± 12.2 HU; p < 0.001). Subjective analysis revealed poorer image quality ratings for important landmarks with the MPP (resection surface: p = 0.624, portal vein: p = 0.395, liver p = 0.361). The two blinded readers correlated significantly. Sensitivity, specificity, positive and negative predictive values (PPV/NPV), and overall interreader variabilities correlated significantly. Furthermore, significantly fewer slices per exam were required for the SBP(1,823 vs. 3,235; p < 0.001). CONCLUSION: The SBP provides the same image quality and diagnostic accuracy as an MPP while significantly lowering radiation exposure in CT follow-up of PDAC or CC.


Assuntos
Neoplasias dos Ductos Biliares/diagnóstico por imagem , Carcinoma Ductal Pancreático/diagnóstico por imagem , Colangiocarcinoma/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Neoplasias Pancreáticas/diagnóstico por imagem , Idoso , Ductos Biliares/diagnóstico por imagem , Ductos Biliares/efeitos da radiação , Protocolos Clínicos , Feminino , Humanos , Iohexol/administração & dosagem , Iohexol/análogos & derivados , Iopamidol/administração & dosagem , Iopamidol/análogos & derivados , Fígado/diagnóstico por imagem , Fígado/efeitos da radiação , Masculino , Tomografia Computadorizada Multidetectores/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Pâncreas/efeitos da radiação , Veia Porta/diagnóstico por imagem , Veia Porta/efeitos da radiação , Estudos Prospectivos , Doses de Radiação , Exposição à Radiação , Sensibilidade e Especificidade
4.
Int J Cardiovasc Imaging ; 35(12): 2239-2248, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31363878

RESUMO

This prospective study evaluated the image quality and accuracy of coronary computed tomography angiography (CCTA) for diagnosing coronary artery disease (CAD) in patients with atrial fibrillation (AF), in which CCTA used adaptive iterative dose reduction (AIDR) with a low tube voltage and low concentration of isotonic contrast agent. Sixty-eight consecutive patients with AF and suspected CAD were equally and randomly apportioned to two groups and underwent CCTA. In the experimental group, the contrast agent was iodixanol (270 mg I/mL), patients were scanned with 100 kV, and reconstruction was by AIDR. In the conventional scanning (control) group, the contrast agent was iopromide (370 mg I/mL), patients were scanned with 120 kV, and reconstruction was by filtered back projection. The image quality, effective radiation dose (E), and total iodine intake of the groups were compared. Thirty-nine patients with coronary artery stenosis later were given invasive coronary angiography (ICA). The groups were similar with regard to mean CT value, noise, and signal-to-noise and contrast-to-noise ratios. The figure of merit of the experimental group was significantly higher than that of the control group, while the E and total iodine were significantly lower. Using ICA as the diagnostic reference, the groups shared similar sensitivity, specificity, and false positive and false negative rates for diagnosing coronary artery stenosis. For determining CAD in patients with AF, CCTA with isotonic low-concentration contrast agent and low-voltage scanning is a feasible alternative that improves accuracy and reduces radiation dose and iodine intake.


Assuntos
Fibrilação Atrial/complicações , Angiografia por Tomografia Computadorizada , Meios de Contraste/administração & dosagem , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Iohexol/análogos & derivados , Ácidos Tri-Iodobenzoicos/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/diagnóstico , Doença da Artéria Coronariana/complicações , Estenose Coronária/complicações , Estudos de Viabilidade , Feminino , Humanos , Iohexol/administração & dosagem , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos
5.
J Comput Assist Tomogr ; 43(5): 721-728, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356519

RESUMO

OBJECTIVE: This study aimed to investigate the predictive and prognostic values of repeated spectral computed tomographic (CT) parameter changes for the prediction of treatment responses to the angiogenesis inhibitor AL3818 in hepatic tumors. METHODS: A total of 30 rabbits with VX2 hepatic tumors that underwent spectral contrast-enhanced abdominal CT before and during treatment were included in the study. The percent change (Δ, %) of the normalized iodine concentration (nIC) during the arterial phase (AP) and venous phase (VP) was used to predict the tumor response and to calculate the overall survival (OS). The threshold of the nIC for tumor response prediction and prognostic significance was determined by a receiver operating characteristic curve and Kaplan-Meier analysis. RESULTS: After treatment, there were 43% (13/30) responders and 57% (17/30) nonresponders. When ΔnICAP ≥ -13.10% was used as the threshold, the sensitivity and specificity for the prediction of tumor response were 82.41% and 92.31%, respectively. ΔnICVP resulted in 88.20% sensitivity and 76.92% specificity for cutoff values ≥10.78%. Kaplan-Meier analyses showed that high ΔnICAP and ΔnICVP were associated with improved OS. CONCLUSIONS: The current study shows the capability of the changes (Δ) in repeated spectral CT parameters to predict the tumor response during antiangiogenesis therapy in small hepatic tumors. ΔnICAP and ΔnICVP were predictors for treatment response and were associated with OS.


Assuntos
Inibidores da Angiogênese/farmacologia , Indóis/farmacologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Quinolinas/farmacologia , Tomografia Computadorizada por Raios X , Animais , Meios de Contraste , Modelos Animais de Doenças , Iohexol/análogos & derivados , Valor Preditivo dos Testes , Prognóstico , Coelhos , Interpretação de Imagem Radiográfica Assistida por Computador
6.
Radiol Med ; 124(10): 1006-1017, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31250270

RESUMO

OBJECTIVE: To evaluate the diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM) in comparison with that of full-field digital mammography (FFDM), either alone or accompanied with breast ultrasound (BUS) in a large series of patients/breast lesions (n = 644). PATIENTS AND METHODS: In this retrospective study, five radiologists evaluated the lesions by three imaging modalities: FFDM, FFDM + BUS, and CESM and compared the imaging to the gold standard (histopathology or clinical follow-up). Diagnostic performance parameters and receiver operating characteristic (ROC) curves of CESM were calculated and compared to those of FFDM or FFDM + BUS (McNemar's test). Additionally, the reliability of tumor size measurement by CESM was compared with the histopathological measurement. RESULTS: The study included 218 benign and 426 malignant lesions. 85% of benign and 93% of malignant lesions were adequately identified using CESM. With respect to FFDM and FFDM + BUS, CESM significantly increased sensitivity to 93.2% (+ 10.7% and + 3.4%, respectively); specificity to 84.4% (+ 15.8% and + 1.7%, respectively); PPV to 92.3% (+ 26.8% and + 3.6%, respectively); NPV to 86.0% (+ 1.6% and + 1.8%, respectively); and accuracy to 90.2% (+ 15.8% and + 3.2%, respectively). In the ROC curves analyses, the comparison among the three AUC values was also statistically significant (p < 0.001). Good agreement between tumor diameters measured using CESM and histopathology was observed (Spearman's rank correlation, r = 0.891, p < 0.0001), although this technique tended to produce an overestimation of the size (+ 7 mm). CONCLUSIONS: CESM has high diagnostic accuracy and can be considered as a useful technique for the assessment of breast lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Iohexol/análogos & derivados , Mamografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Humanos , Iohexol/administração & dosagem , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia Mamária
7.
Eur Radiol ; 29(11): 6109-6118, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31016447

RESUMO

OBJECTIVE: To compare the effect of contrast medium iodine concentration on contrast enhancement, heart rate, and injection pressure when injected at a constant iodine delivery rate in coronary CT angiography (CTA). METHODS: One thousand twenty-four patients scheduled for coronary CTA were prospectively randomized to receive one of four contrast media: iopromide 300 mg I/ml, iohexol 350 mg I/ml, iopromide 370 mg I/ml, or iomeprol 400 mg I/ml. Contrast media were delivered at an equivalent iodine delivery rate of 2.0 g I/s. Intracoronary attenuation was measured and compared (per vessel and per segment). Heart rate before and after contrast media injection was documented. Injection pressure was recorded (n = 403) during contrast medium injection and compared between groups. RESULTS: Intracoronary attenuation values were similar for the different contrast groups. The mean attenuation over all segments ranged between 384 HU for 350 mg I/ml and 395 HU for 400 mg I/ml (p = 0.079). Dose-length product (p = 0.8424), signal-to-noise ratio (all p > 0.05), time to peak (p = 0.324), and changes in heart rate (p = 0.974) were comparable between groups. The peak pressures differed: 197.4 psi for 300 mg I/ml (viscosity 4.6 mPa s), 229.8 psi for 350 mg I/ml (10.4 mPa s), 216.1 psi for 370 mg I/ml (9.5 mPa s), and 243.7 psi for 400 mg I/ml (12.6 mPa s) (p < 0.0001). CONCLUSION: Intravascular attenuation and changes in heart rate are independent of iodine concentration when contrast media are injected at the same iodine delivery rate. Differences in injection pressures are associated with the viscosity of the contrast media. KEY POINTS: • The contrast enhancement in coronary CT angiography is independent of the iodine concentration when contrast media are injected at body temperature (37 °C) with the same iodine delivery rate. • Iodine concentration does not influence the change in heart rate when contrast media are injected at identical iodine delivery rates. • For a fixed iodine delivery rate and contrast temperature, the viscosity of the contrast medium affects the injection pressure.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Meios de Contraste/farmacocinética , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Vasos Coronários/diagnóstico por imagem , Iodo/metabolismo , Iohexol/farmacocinética , Meios de Contraste/administração & dosagem , Doença da Artéria Coronariana/metabolismo , Feminino , Humanos , Injeções Intravenosas , Iohexol/administração & dosagem , Iohexol/análogos & derivados , Iopamidol/administração & dosagem , Iopamidol/análogos & derivados , Iopamidol/farmacocinética , Masculino , Pessoa de Meia-Idade
8.
Biol Pharm Bull ; 42(6): 915-922, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30918133

RESUMO

The goal of the present study focused on the adverse reaction of contrast medium (CM) via the induction of inflammatory molecules in human umbilical vein endothelial cells (HUVECs). Ultravist-induced monocyte chemoattractant protein-1 (MCP-1) and vascular cell adhesion molecule-1 (VCAM-1) gene expression was markedly increased in interleukin-4 (IL-4)-pretreated HUVECs in a time- and dose-dependent manner and was paralleled by concomitant production of MCP-1 and VCAM-1 proteins. MCP-1 and VCAM-1 gene expression by Ultravist in combination with IL-4 was mediated by the c-Jun N-terminal kinases (JNK1/2) signaling pathway. IL-4-pretreated Ultravist-stimulated HUVECs showed greatly increased migration and adhesion of THP-1 cells. Cell migration was decreased by treatment of CCR2 antagonist, and cell adhesion was also decreased by VCAM-1 blocking antibody. Furthermore, when tested in vivo under similar conditions, MCP-1 protein was significantly increased in Ultravist combined with IL-4-injected mice. Taken together, our findings suggest that MCP-1 blocking may be crucial in preventing the endothelial dysfunction induced by contrast medium in patients with inflammatory disease and atherosclerosis.


Assuntos
Quimiocina CCL2/biossíntese , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Interleucina-4/farmacologia , Iohexol/análogos & derivados , Molécula 1 de Adesão de Célula Vascular/biossíntese , Animais , Adesão Celular/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Células Cultivadas , Quimiocina CCL2/metabolismo , Meios de Contraste , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Feminino , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Iohexol/farmacologia , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Proto-Oncogênicas c-akt/metabolismo , Fator de Transcrição STAT1/metabolismo , Transdução de Sinais , Células THP-1 , Molécula 1 de Adesão de Célula Vascular/metabolismo
9.
AJR Am J Roentgenol ; 212(4): 748-754, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30900916

RESUMO

OBJECTIVE: Although CT has been used as a complementary diagnostic method for the preoperative diagnosis of thyroid cancer, it has the shortcomings of substantial radiation exposure and the use of contrast material (CM). The purpose of this article is to evaluate the image quality and diagnostic performance of 70-kVp thyroid CT with low volumes of CM versus conventional 120-kVp thyroid CT protocol. MATERIALS AND METHODS: Eighty patients referred for preoperative thyroid CT were randomly divided into two groups (group A: 40 patients, 70 kVp, 60 mL of CM; group B: 40 patients, 120 kVp, 100 mL of CM). Quantitative and qualitative image quality and radiation doses for the two groups were compared using the Mann-Whitney U and chi-square tests. Degrees of agreement between preoperative CT staging and pathologic results were evaluated and compared using the Wald statistic. RESULTS: Calculated signal-to-noise ratios of different anatomic structures, calculated contrast-to-noise ratios, overall image quality, subjective noise, and streak artifacts were not significantly different between the two groups (all p > 0.05), and neither were the accuracies of preoperative CT staging (all p > 0.05). The estimated effective doses were significantly lower in group A (mean [± SD], 0.52 ± 0.14 mSv in group A and 2.28 ± 0.29 mSv in group B; p < 0.001). CONCLUSION: Ultra-low-dose 70-kVp CT with a low volume of CM provides sufficient image quality for preoperative staging of thyroid cancer and substantially reduces the radiation dose compared with standard 120-kVp CT.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Razão Sinal-Ruído , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
10.
Cell Biochem Biophys ; 77(2): 157-163, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30924055

RESUMO

Iodinated radiographic contrast media is used in cancer radiography for cancer diagnosis. The aim of this present study was to examine five iodinated radiographic contrast media (IRCM) (i.e., iohexol, iopamidol, iobitridol, ioxaglate, and iodixanol) in terms of their cytotoxicity, mitochondria membrane potential (ΔΨm), and P-glycoprotein function in multidrug resistant K562/Dox cancer cells and corresponding sensitive cancer cells. The cytotoxicity was determined by colorimetric resazurin reduction assay. The ΔΨm and P-glycoprotein function was measured using a noninvasive functional spectrofluorometry. Rhodamine B, fluorescence probe, was used to estimate ΔΨm. The kinetic of P-glycoprotein-mediated efflux pirarubicin was used to monitor P-glycoprotein function in multidrug resistant (MDR) cancer cells. The results showed that ioxaglate and iodixanol show similar efficacy in MDR cancer cells and for their corresponding sensitive cancer cells. Iopamidol, iohexol, and iobitridol showed higher efficacy in MDR cancer cells than for the corresponding sensitive cancer cells by approximately 2 fold. The results also showed no significant change in the |ΔΨm| values in treated K562 and K562/Dox cancer cells when compared to the non-treated K562 and K562/Dox cancer cells. However, there were notable changes detected for iobitridol and iodixanol at 50 mgI/mL. Similarly, the results showed significant differences in P-glycoprotein function of K562/Dox cancer cells after treatment with IRCM when compared to the non-treated K562/Dox cancer cells, with iohexol and iodixanol being the notable exceptions once again. In this present study, IRCM exhibited cytotoxicity on MDR cancer cells and their corresponding sensitive cancer cells. IRCM also showed potential as an anticancer agent in the future.


Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Meios de Contraste/química , Resistencia a Medicamentos Antineoplásicos , Mitocôndrias/metabolismo , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores , Meios de Contraste/farmacologia , Doxorrubicina/farmacologia , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Humanos , Iodo/química , Iohexol/análogos & derivados , Iohexol/química , Iohexol/farmacologia , Células K562 , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Rodaminas/química , Ácidos Tri-Iodobenzoicos/química , Ácidos Tri-Iodobenzoicos/farmacologia
11.
BMC Cardiovasc Disord ; 19(1): 74, 2019 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-30922230

RESUMO

BACKGROUND: The usefulness of the CHA2DS2-VASC risk score (CVRS) in predicting the occurrence of contrast-induced nephropathy (CIN) among patients with chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI) remains unclear. METHOD: A total of 239 patients with CTO who underwent PCI were included in this study. They were divided into 3 groups according to the CVRS: low-risk group (1 point, n = 64), intermediate-risk group (2 points, n = 135), and high-risk group (≥3 points, n = 40). Baseline serum creatinine was determined upon admission before the procedure. The serum creatinine level was monitored for 72 h post-procedure to determine the occurrence of CIN. RESULTS: The total incidence of CIN in patients with CTO who underwent PCI was 16.3%. The average CVRS in the CIN group was significantly higher than that in the non-CIN group (3.1 ± 1.2 VS 2.1 ± 1.1, P < 0.001). The incidence of CIN in the high-risk group was 5.6 times higher than that in the low-risk group (37.5% VS 6.3%, P < 0.001). Similar to the Mehran risk score (AUC, 0.754; 95% CI, 0.698-0.810; P < 0.001), the receiver operating characteristic curve analysis showed a good diagnostic value of the CVRS in predicting CIN among patients with CTO who underwent interventional therapy for having CVRS≥3 (sensitivity, 69.2%; specificity, 78.0%; AUC, 0.742; 95% CI, 0.682-0.797; P < 0.001). The multivariate analysis showed that the higher pulse pressure and contrast volume, lower baseline glomerular filtration rate, and CVRS ≥3 were independent predictors of CIN. CONCLUSIONS: The CVRS can be used as a simple pre-procedural predictor of CIN among patients with CTO undergoing PCI.


Assuntos
Meios de Contraste/efeitos adversos , Oclusão Coronária/terapia , Técnicas de Apoio para a Decisão , Iohexol/análogos & derivados , Nefropatias/induzido quimicamente , Rim/efeitos dos fármacos , Intervenção Coronária Percutânea/efeitos adversos , Ácidos Tri-Iodobenzoicos/efeitos adversos , Idoso , Biomarcadores/sangue , Pressão Sanguínea , China , Doença Crônica , Meios de Contraste/administração & dosagem , Angiografia Coronária/efeitos adversos , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/fisiopatologia , Creatinina/sangue , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Iohexol/administração & dosagem , Iohexol/efeitos adversos , Rim/fisiopatologia , Nefropatias/diagnóstico , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Radiografia Intervencionista/efeitos adversos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Ácidos Tri-Iodobenzoicos/administração & dosagem
12.
Radiology ; 291(2): 531-538, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30835189

RESUMO

Background Optimal timing of the CT scan relative to the contrast media bolus remains a challenging task given the shorter scan durations of modern CT scanners, as well as interpatient variability. Purpose To compare contrast opacification in CT angiography of the aorta between a cohort with fixed trigger delay and a cohort with patient-specific individualized trigger delay for contrast media timing with bolus tracking. Materials and Methods In this prospective study (January-August 2018), CT angiography of the thoracoabdominal aorta with bolus tracking was performed in two different study cohorts: one with a fixed trigger delay of 4 seconds (fixed cohort) and one with a patient-specific trigger delay (individualized cohort). All CT and contrast media protocol parameters were kept identical among cohorts. Objective image quality was evaluated by one reader; two readers assessed subjective image quality. Student t test was used to test for differences in mean attenuation; the Wilcoxon-Mann-Whitney test was used to test for differences in noise, contrast-to-noise ratio, and subjective image quality. Results The fixed cohort had 108 study participants (16 women; mean age ± standard deviation, 72 years ± 10); the individualized cohort had 108 participants (16 women; mean age, 72 years ± 12). The trigger delay in the individualized cohort ranged from 6.4-11.3 seconds (mean, 9.2 seconds). There was higher overall attenuation in the individualized cohort than in the fixed cohort (486 HU ± 92 for individualized vs 438 HU ± 99 for fixed; P < .001), with increasing differences from the aortic arch (8 HU) to the iliac arteries (95 HU). The regression model indicated uniform attenuation in the individualized cohort and decreasing attenuation in the fixed cohort (decrease of 87 HU by the iliac arteries; P < .001). There was no difference between cohorts for image noise (20 vs 19; P = .41), but contrast-to-noise ratio (21 vs 19; P = .04) and subjective image quality were higher in the individualized cohort than in the fixed cohort (excellent or good image quality, 100% vs 67%; P < .001). Conclusion Compared with a fixed delay time after bolus tracking, a patient-specific individualized trigger delay improves image quality and provides uniform contrast attenuation for CT angiography of the aorta. ©RSNA, 2019.


Assuntos
Aorta/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Meios de Contraste/administração & dosagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Aortografia/métodos , Feminino , Humanos , Iohexol/administração & dosagem , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo
14.
Neuroradiol J ; 32(3): 179-188, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30777482

RESUMO

BACKGROUND: Computed tomography (CT) perfusion has been studied as a tool to predict delayed cerebral ischemia (DCI) and clinical outcome in spontaneous subarachnoid hemorrhage (SAH). The purpose of the study was to determine whether quantitative CT perfusion performed within 72 hours after admission can predict the occurrence of DCI and clinical outcome as measured with a modified Rankin scale (mRS) at 3 months after ictus. METHODS: Cerebral perfusion was assessed in a prospective cohort of patients with acute SAH. CT perfusion parameters at <72 h post SAH were quantitatively measured in the main vascular territories and represented as whole-brain means. Spearman rank correlation coefficient and generalized additive regression models for binary outcome were used. RESULTS: A total of 66 patients underwent CT perfusion at <72 h. Poor clinical grade on admission was correlated with worse cerebral perfusion in all parameters. Multivariable analysis yielded an association of time to peak (TTP; odds ratio (OR) = 0.89; 95% confidence interval (CI): 0.77, 1.02; p = 0.083) with the occurrence of DCI. We also found an association of TTP values with poor outcome, with an 8% increase in the odds of mRS > 3 for each one second increase in TTP at admission (OR = 1.08; 95% CI: 1.00, 1.17; p = 0.061). CONCLUSIONS: We identified an association of early TTP changes with DCI and poor clinical outcome. However, there were no associations with cerebral blood flow or mean transit time and DCI/clinical outcome. CT perfusion still remains to be validated as a tool in predicting outcome in SAH.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Angiografia Cerebral/métodos , Angiografia por Tomografia Computadorizada/métodos , Hemorragia Subaracnóidea/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Digital , Isquemia Encefálica/fisiopatologia , Meios de Contraste , Feminino , Humanos , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Interpretação de Imagem Radiográfica Assistida por Computador , Recuperação de Função Fisiológica , Hemorragia Subaracnóidea/fisiopatologia , Fatores de Tempo
16.
Water Res ; 152: 274-284, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30682571

RESUMO

The biological degradation of many trace organic compounds has been reported to be strongly redox dependent. The traditional characterization of redox conditions using the succession of inorganic electron acceptors such as dissolved oxygen and nitrate falls short in accurately describing the critical transition state between oxic and suboxic conditions. Novel monitoring strategies using intrinsic redox tracers might be suitable to close that gap. This study investigated the potential use of the successive biological transformation of the iodinated contrast medium iopromide as an intrinsic tracer of prevailing redox conditions in biofiltration systems. Iopromide degradation in biofiltration systems was monitored by quantifying twelve known biological transformation products formed under oxic conditions. A novel dimensionless parameter (TIOP) was introduced as a measure for the successive transformation of iopromide. A strong correlation between the consumption of dissolved oxygen and iopromide transformation emphasized the importance of general microbial activity on iopromide degradation. However, results disproved a direct correlation between oxic (>1 mg/L O2) and suboxic (<1 mg/L O2) conditions and the degree of iopromide transformation. Results indicated that besides redox conditions also the availability of biodegradable organic substrate affects the degree of iopromide transformation. Similar behavior was found for the compounds gabapentin and benzotriazole, while the oxic degradation of metoprolol remained stable under varying substrate conditions.


Assuntos
Poluentes Químicos da Água , Iohexol/análogos & derivados , Compostos Orgânicos , Oxirredução
17.
Chemosphere ; 221: 212-218, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30640003

RESUMO

Iodinated X-ray contrast media are known for their stability concerning deiodination in the aquatic environment under aerobic conditions. In this study, we demonstrate the abiotic reductive deiodination of the iodinated contrast media iopromide, iopamidol and diatrizoate in the presence of corrinoids. In addition, triiodinated benzoic acid derivatives with iodine atoms bound at different positions were investigated. Corrinoids like cyanocobalamin (vitamin B12) and dicyanocobinamide served as electron shuttles and as catalysts between the reducing agent (e.g., titanium (III) citrate) and the electron accepting iodinated compound. The concentration decrease of the iodinated compounds followed first-order kinetics with rate constant kobs depending on the iodinated compound. A linear correlation between the rate of iodide release and the corrinoid concentration was observed, with deiodination rates for dicyanocobinamide twice as high as for vitamin B12. Reducing agents with a less negative standard redox potential like dithiothreitol or cysteine caused slower deiodination as the cobalt center was only reduced to its CoII oxidation state. With a temperature increase from 11 to 23 °C, the concentrations of released iodide doubled. A complete deiodination was only observed for the iodinated contrast media but not for structurally similar iodinated benzoic acid derivatives.


Assuntos
Meios de Contraste/química , Corrinoides/química , Halogenação , Raios X , Catálise , Diatrizoato/química , Iodo/química , Iohexol/análogos & derivados , Iohexol/química , Iopamidol/química , Cinética , Oxirredução
18.
Radiol Med ; 124(5): 350-359, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30539411

RESUMO

PURPOSE: To evaluate the image quality and radiation dose exposure of low-dose coronary CTA (cCTA) study, reconstructed with the new model-based iterative reconstruction algorithm (IMR), compared with standard hybrid-iterative reconstruction (iDose4) cCTA in patients with suspected coronary artery disease. MATERIALS AND METHODS: Ninety-eight patients with an indication for coronary CT study were prospectively enrolled. Fifty-two patients (study group) underwent 256-MDCT low-dose cCTA (80 kV; automated-mAs; 60 mL of CM, 350 mgL/mL) with prospective ECG-triggering acquisition and IMR. A control group of 46 patients underwent 256-MDCT standard prospective ECG-gated protocol (100 kV; automated-mAs; 70 mL of CM, 400 mgL/mL; iDose4). Subjective and objective image quality (attenuation value, SD, SNR and CNR) were evaluated by two radiologists subjectively. Radiation dose exposure was quantified as DLP, CTDIvol and ED. RESULTS: Mean values of mAs were significantly lower for IMR-cCTA (167 ± 62 mAs) compared to iDose-cCTA (278 ± 55 mAs), p < 0.001. With a significant reduction of 38% in radiation dose exposure (DLP: IMR-cCTA 91.7 ± 26 mGy cm vs. iDose-cCTA 148.6 ± 35 mGy cm; p value < 0.001), despite the use of different CM, we found higher mean attenuation values of the coronary arteries in IMR group compared to iDose4 (mean density in LAD: 491HU IMR-cCTA vs. 443HU iDose-cCTA; p = 0.03). We observed a significant higher value of SNR and CNR in study group due to a lower noise level. Qualitative analysis did not reveal any significant differences between the two groups (p = 0.23). CONCLUSIONS: Low-dose cCTA study combined with IMR reconstruction allows to correctly evaluate coronary arteries disease, offering high-quality images and significant radiation dose exposure reduction (38%), as compared to standard cCTA protocol.


Assuntos
Algoritmos , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Idoso , Idoso de 80 Anos ou mais , Técnicas de Imagem de Sincronização Cardíaca , Meios de Contraste , Feminino , Humanos , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doses de Radiação , Razão Sinal-Ruído
19.
Surg Radiol Anat ; 41(2): 231-234, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30483866

RESUMO

The external carotid artery (ECA) normally bifurcates terminally with the superficial temporal artery (STA) and the maxillary artery (MA). From the horizontally coursing, mandibular segment of the MA leaves the middle meningeal artery (MMA). We hereby report a previously unknown anatomic possibility, incidentally found during an angio-CT scan in an adult female patient. Unilaterally, the ECA was terminally trifurcated, sending off the MA, STA, and MMA. On that side, the mandibular segment of the MA had a gamma-loop and the contralateral one had a U-loop; both these loops were inferior to the lateral pterygoid muscle, closely approaching the respective lingula of the mandible. These findings are relevant during surgery of the parotid gland and infratemporal fossa, approaches of the MMA, and inferior alveolar nerve blocks. The modified origin of the MMA could be explained by an altered development of the primitive stapedial artery.


Assuntos
Variação Anatômica , Artéria Carótida Externa/anatomia & histologia , Artéria Carótida Externa/diagnóstico por imagem , Idoso , Angiografia Cerebral , Angiografia por Tomografia Computadorizada , Meios de Contraste , Feminino , Humanos , Imagem Tridimensional , Aneurisma Intracraniano/diagnóstico por imagem , Iohexol/análogos & derivados , Mandíbula/irrigação sanguínea , Artéria Maxilar/anatomia & histologia , Artérias Meníngeas/anatomia & histologia , Músculos Pterigoides/irrigação sanguínea , Interpretação de Imagem Radiográfica Assistida por Computador , Artérias Temporais/anatomia & histologia
20.
Chemosphere ; 218: 189-196, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30471499

RESUMO

The detection of wastewater impact on stream chemistry is often hindered by high background concentrations of ubiquitous solutes. In the present study we tested the applicability of artificial sweeteners (AS) and iodinated X-ray contrast media (ICM) as tracers to detect this impact by examining wastewater treatment plant (WWTP) effluents and surface water samples. The developed direct injection LC-MS/MS method enabled the detection of these anthropogenic micropollutants in aqueous samples down to trace level concentrations. The 2-h-composite sampling of WWTP effluent revealed fluctuating ICM concentrations between and within days with highest concentrations at the end of the week. Diatrizoic acid (DTZ) and iopromide (IOP) were the predominant ICM with concentrations up to 7 µg/L. Concentrations of the AS acesulfame (ACE) fluctuated between 0.5 µg/L and 1 µg/L. Concentrations of AS and ICM in surface water were both associated with wastewater impact. DTZ contamination was more widespread whereas some sampling points exhibited a more pronounced contamination with non-ionic ICM. Surface water was frequently contaminated with AS. Particularly ACE was detected in every surface water sample indicating that it is chemically stable and that inputs to the aquatic environment via WWTP effluents are widespread. The broad application of ACE as food additive enables its application as a tracer throughout Germany. Furthermore, the developed LC-MS/MS method enables rapid detection of ACE down to the low ng/L-range. Nonetheless, DTZ or IOP could be used in addition to ACE to verify anthropogenic influences on natural waters.


Assuntos
Meios de Contraste/análise , Monitoramento Ambiental , Rios/química , Edulcorantes/análise , Águas Residuárias/química , Cromatografia Líquida , Diatrizoato/análise , Alemanha , Compostos de Iodo , Iohexol/análogos & derivados , Iohexol/análise , Espectrometria de Massas em Tandem/métodos , Tiazinas/análise , Poluentes Químicos da Água/análise
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