Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.356
Filtrar
1.
Anticancer Res ; 40(2): 1015-1022, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014947

RESUMO

BACKGROUND/AIM: Systemic mastocytosis (SM) is a heterogeneous hematological entity, characterized by the proliferation of mast cells, commonly involving the skeleton. The present study sought to elucidate whether the computed tomographic (CT) number as Hounsfield units (HU) derived from whole-body CT is associated with bone marrow findings in SM. PATIENTS AND METHODS: Patient records of the local Oncology and Hematology Department from 2007 to 2018 were screened for patients with SM. Total 16 patients [five female (31.2%)] with a mean age of 55.7±10.3 years were included in the present retrospective study. KIT mutation; tryptase, alkaline phosphatase, and calcium level in serum; and the proportion of mast cells, and CD2, CD25- and CD117-positive cells in bone marrow biopsies were evaluated. RESULTS: HU correlated with serum calcium level (r=-0.51, p=0.04), mast cell proportion (r=0.66, p=0.01) and with the proportion of CD117-positive cells in bone marrow biopsy (r=0.56, p=0.04). In the group with aggressive SM, the mean HU value was statistically significantly higher than that of the indolent title:group [245±127 (range=100-451) vs. 121±16 (range=90-135), respectively, p=0.04]. CONCLUSION: The present study identified that the HU value derived from low-dose CT was associated with mast cell infiltration in bone marrow in SM and with the proportion of CD117-positive cells. Further studies are needed to determine whether the measurement of the HU value has prognostic implications in SM and can be used as a reliable biomarker in this disease.


Assuntos
Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Mastocitose Sistêmica/diagnóstico , Tomografia Computadorizada por Raios X , Imagem Corporal Total , Adulto , Idoso , Biomarcadores , Biópsia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Mastocitose Sistêmica/metabolismo , Pessoa de Meia-Idade
2.
Ann Hematol ; 99(3): 557-570, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31989249

RESUMO

In 27% of diffuse large B cell lymphoma (DLBCL) cases, bone marrow (BM), assessed by BM biopsy, is involved. BM involvement, an extranodal site involvement, affects the International Prognostic Index (IPI) score adversely. However, chromosomal abnormalities are neither included as a prognostic factor nor are they considered in the IPI risk classification category. We retrospectively analyzed 600 DLBCL patients at diagnosis for BM involvement (by both BM biopsy immunohistochemistry [BMI] with karyotyping and 18-fluorodeoxyglucose-positron emission tomography [FDG-PET] high uptake [BMP]). The BM-involved DLBCL patients identified by both BMI and BMP showed significantly inferior survival outcomes. Chromosomal abnormalities, especially complex karyotype (CK) of the involved BM, are related to much worse survival outcomes due to the inadequate treatment response including frontline auto-hematopoietic stem cell transplantation (HSCT). Therefore, CK population should either be considered for more aggressive treatment modalities, such as frontline allo-HSCT, or those further clinical trials are explored for alternative or novel treatment approaches. Furthermore, if the FDG-PET shows high possibility of marrow involvement, bilateral BM biopsy with cytogenetic evaluation should be incorporated into the routine workup for newly diagnosed DLBCL patients. This is to look for other markers of poor-risk factors, such as CK or further genetic mutations.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Medula Óssea/diagnóstico por imagem , Aberrações Cromossômicas , Transplante de Células-Tronco Hematopoéticas , Linfoma Difuso de Grandes Células B , Tomografia por Emissão de Pósitrons , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoenxertos , Ciclofosfamida/administração & dosagem , Intervalo Livre de Doença , Doxorrubicina/administração & dosagem , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma Difuso de Grandes Células B/terapia , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Rituximab/administração & dosagem , Taxa de Sobrevida , Vincristina/administração & dosagem
3.
Br J Radiol ; 93(1108): 20190817, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31899657

RESUMO

OBJECTIVE: To determine if MRI findings prior to intra-articular corticosteroid hip infiltration are related to treatment outcomes. METHODS: This prospective outcome study with retrospective MRI evaluation includes 100 consecutive patients with MRI within 6 months before a therapeutic intra-articular hip injection. Labrum, bone marrow, acetabular and femoral cartilage abnormalities were assessed by two radiologists blinded to patient outcomes: the proportion reporting "improvement" on the Patient's Global Impression of Change (PGIC) scale at 1 day, 1 week and 1 month follow-up were compared based on MRI findings using χ2. The t-test was used to compare pain change scores with MRI abnormalities. RESULTS: Patients with a normal labrum in the posterosuperior quadrant were more likely to report PGIC "improvement" at 1 week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral anteroinferior quadrant (p = 0.001, 1 day; p = 0.010, 1 week; p = 0.034, 1 month) with the highest reduction in patients with labral degeneration. Females were 2.80 times more likely to report clinically relevant "improvement" at 1 day (p = .049) and 2.90 times more likely to report clinically relevant "improvement" at 1 month (p = .045). CONCLUSION: Cartilage defects and marrow abnormalities were not associated with outcomes. Patients with a normal labrum in the posterosuperior quadrant had better outcomes at 1 week. Patients with labral degeneration of the anteroinferior quadrant had higher levels of pain reduction at all time points. Females were significantly more likely to report PGIC "improvement". ADVANCES IN KNOWLEDGE: A significant treatment outcome was observed amongst gender, although there were no significant differences in the MRI findings.


Assuntos
Articulação do Quadril/diagnóstico por imagem , Imagem por Ressonância Magnética Intervencionista , Osteoartrite do Quadril/diagnóstico por imagem , Peptídeos/administração & dosagem , Acetábulo/diagnóstico por imagem , Adulto , Idoso , Medula Óssea/diagnóstico por imagem , Cartilagem/diagnóstico por imagem , Distribuição de Qui-Quadrado , Feminino , Articulação do Quadril/efeitos dos fármacos , Humanos , Injeções Intra-Articulares/métodos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/tratamento farmacológico , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
4.
Radiol Med ; 125(1): 68-74, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31531809

RESUMO

OBJECTIVE: In this study, we prospectively investigated the diagnostic capability of diffusion-weighted magnetic resonance imaging (DWI) in assessing vertebral marrow changes in postmenopausal women with osteoporosis. MATERIALS AND METHODS: Sixty postmenopausal women (mean age 60.2 ± 6.11 years) underwent both dual-energy X-ray absorptiometry (DEXA) of the spine and MRI. Results were acquired from each patient's L2 to L4, for a total of 180 lumbar vertebrae. Based on bone mineral density (BMD) measurements obtained from DEXA, the vertebrae were divided into three groups as follows: normal (n = 52), osteopenic (n = 92), and osteoporotic (n = 36). DWI of the vertebral body was performed to assess the apparent diffusion coefficient (ADC). The ADC outcomes were compared among the three groups and correlated with BMD. RESULTS: ADC values (× 10-6 mm2/s) were significantly lower in the osteoporotic group (135.67 ± 44.10) in comparison to the normal group (561.85 ± 190.37) (P = 0.0001). The results showed a positive correlation between ADC and BMD values (r = 0.748, P = 0.0001). In receiver operating characteristic (ROC) analysis, the area under the curve for DWI was 0.912 (P = 0.001). A cut-off value of 400 mm2/s for the diagnosis of osteoporosis; had sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 90.90%, 83.34%, 88.89%, 93.75%, and 76.93%, respectively. CONCLUSION: ADC values correlated positively with BMD in women. DWI can allow quantitative evaluation of bone marrow changes and osteoporosis in postmenopausal women.


Assuntos
Densidade Óssea , Medula Óssea/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Vértebras Lombares/diagnóstico por imagem , Osteoporose Pós-Menopausa/diagnóstico por imagem , Pós-Menopausa , Absorciometria de Fóton , Área Sob a Curva , Doenças Ósseas Metabólicas/diagnóstico por imagem , Medula Óssea/fisiologia , Feminino , Humanos , Vértebras Lombares/fisiologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/classificação , Osteoporose Pós-Menopausa/fisiopatologia , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Estatísticas não Paramétricas
5.
Radiol Med ; 125(1): 1-6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31562581

RESUMO

PURPOSE: To evaluate the influence of fat deposition on T1 relaxation time of pancreatic parenchyma using dual-flip-angle T1 mapping with and without fat suppression. METHODS: Forty-five patients who underwent abdominal MR imaging including T1 mapping with dual-flip-angle method on 3T MRI were included. We measured T1 relaxation time of pancreatic parenchyma on the T1 map images with and without fat suppression. T1 relaxation time of bone marrow was also measured as a reference organ with abundant fat deposition. Fat signal fraction (FSF) was also measured at the same location as T1 map images. Then, the correlation between T1 relaxation time and FSF was assessed. RESULTS: T1 relaxation times of pancreatic parenchyma and bone marrow on the T1 map images without fat suppression showed significantly negative correlation with FSF (pancreas, r = - 0.394, P = 0.007; bone marrow, r = - 0.550, P < 0.001), while there were no significant correlations between them on the T1 map images with fat suppression. On the T1 map images without fat suppression, T1 relaxation times of pancreatic parenchyma as well as bone marrow in patients with FSF ≥ 10% were significantly shorter than those in patients with FSF < 10% (pancreas, P = 0.041; bone marrow, P = 0.005). Conversely, on the T1 map images with fat suppression, no significant differences in T1 relaxation times were found between two groups. CONCLUSION: T1 relaxation time of the pancreas on T1 mapping was influenced by the presence of fat deposition. Therefore, fat suppression technique in T1 mapping will be essential for evaluating T1 relaxation time of pancreatic parenchyma.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Pâncreas/diagnóstico por imagem , Pancreatopatias/diagnóstico por imagem , Técnica de Subtração , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico por imagem , Padrões de Referência , Estudos Retrospectivos , Fatores de Tempo
6.
Radiol Med ; 125(3): 280-287, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31823293

RESUMO

OBJECTIVE: To report our experience with the use of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and dynamic contrast-enhanced (DCE)-MRI in bone marrow before and after administration of granulocyte colony-stimulating factor (GCSF). Moreover, a small series of patients with bone metastases from breast cancer have been evaluated by IVIM DW-MRI and DCE-MRI before and after GCSF administration. MATERIALS AND METHODS: We studied with IVIM-MRI and DCE-MRI 14 patients with rectal or uterine cervix cancer studied before and 4-18 days after administration of GCSF; the second MR examination was obtained after three chemotherapy courses. IVIM perfusion fraction (f), pseudo-diffusion coefficient (D*), true diffusion coefficient (D) and apparent diffusion coefficient (ADC) as well area under the curve at 60 s (AUC60) were calculated for bone marrow before and after GCSF administration. Moreover, two different IVIM parametric maps (i.e., ADC and ADClow) were generated by selecting two different intervals of b values (0-1000 and 0-80, respectively). Furthermore, four patients affected by pelvic bone metastases from breast adenocarcinoma who received GCSF administration were also qualitatively evaluated for evidence of lesions on ADC maps, ADClow maps and DCE-MRI. RESULTS: ADC, D, D*, f and AUC60 values were significantly higher in hyperplastic bone marrow than in untreated bone marrow (p values < 0.0001, < 0.0001, < 0.001, < 0.001, < 0.0001, respectively). All bone metastases were clearly differentiable from hyperplastic bone marrow on ADClow maps, but not on ADC maps and DCE-MRI. CONCLUSION: MR functional imaging techniques, such as DW-, IVIM DW- and DCE-MRI are effective tools in assessing the response of bone marrow to the administration of growth factors. Although an overlap between signal of hyperplastic bone marrow and lytic bone metastases can occur on ADC maps and DCE-MRI, evaluation of ADClow maps by IVIM DW-MRI could permit to differentiate hyperplastic bone marrow from lytic bone metastases. Further studies are needed to confirm our data.


Assuntos
Medula Óssea/efeitos dos fármacos , Medula Óssea/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Imagem de Difusão por Ressonância Magnética/métodos , Fator Estimulador de Colônias de Granulócitos/farmacologia , Adulto , Idoso , Área Sob a Curva , Medula Óssea/patologia , Neoplasias da Mama/patologia , Meios de Contraste , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/patologia , Fatores de Tempo , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/patologia
7.
Ann Hematol ; 98(12): 2693-2701, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31686155

RESUMO

Systemic mastocytosis (SM) is broadly subcategorized according to mast cell (MC) burden and organ involvement into indolent (ISM), smoldering (SSM), and advanced SM (AdvSM). However, the pattern and extent of bone involvement remains controversial. In this institutional review board (IRB)-approved study, 115 patients with different forms of SM (ISM (n = 37, 32%), SSM (n = 9, 8%), and AdvSM (n = 69, 60%)) underwent a whole-body magnetic resonance imaging including sagittal and coronal T1 and turbo inversion recovery magnitude (TIRM) sequences of the spine. The evaluation included the pattern and extent of pathologic bone marrow (BM) signals in the spine and extremities, osteolytic lesions, and vertebral fractures. A pathologic BM pattern was observed in 4/37 (11%), 8/9 (89%), and 66/69 (96%); affection of the appendicular skeleton in 3/37 (8%), 8/9 (89%), and 67/69 (97%); and vertebral fractures in 7/37 (19%), 0/9, and 13/69 (19%) patients with ISM, SSM, and AdvSM, respectively. In AdvSM, pathologic BM pattern included activated (62%), diffuse sclerotic (25%), and small-spotted BM (9%), respectively. Only activated/sclerotic BM was associated with significantly higher MC burden, organ damage, and inferior median survival (2.9 years, p = 0.04). Vertebral fractures resembled classical multi-segmental osteoporotic fractures in ISM but not in AdvSM in which they were only found in activated/sclerotic BM. Only one patient with AdvSM had a focal osteolytic lesion in the femur. Activated/sclerotic BM changes of the spine and affection of the appendicular skeleton are indicative for SSM or AdvSM. Osteolytic lesions, which are very rare, and osteoporotic fractures are ineligible for the diagnosis of AdvSM.


Assuntos
Medula Óssea/diagnóstico por imagem , Imagem por Ressonância Magnética , Mastocitose Sistêmica , Imagem Corporal Total , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Mastocitose Sistêmica/diagnóstico por imagem , Mastocitose Sistêmica/mortalidade , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida
8.
Clin Nucl Med ; 44(11): e624-e626, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31584492

RESUMO

F-Fluorothymidine-positron emission tomography with CT fusion ([F]FLT-PET/CT) offers a unique and non-invasive method for three-dimensional localization and quantification of functional bone marrow. [F]FLT-PET/CT has potential application in radiotherapy planning when risk of marrow toxicity is a significant clinical concern. In this patient with chemo-refractory, transformed lymphoma and treatment-induced cytopenias, [F]FLT-PET/CT was a novel and useful adjunct to (1) image the distribution of functional bone marrow reserve, (2) guide "marrow-sparing" radiotherapy planning, and (3) quantify the effects of radiotherapy-induced bone marrow suppression both in-field and out-of-field.


Assuntos
Células Sanguíneas/efeitos da radiação , Medula Óssea/fisiopatologia , Medula Óssea/efeitos da radiação , Didesoxinucleosídeos , Tratamentos com Preservação do Órgão , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Células Sanguíneas/patologia , Medula Óssea/diagnóstico por imagem , Contagem de Células , Feminino , Humanos , Linfoma/radioterapia
9.
Molecules ; 24(20)2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31623098

RESUMO

Oleoyl serine (OS), an endogenous fatty acyl amide (FAA) found in bone, has been shown to have an anti-osteoporotic effect. OS, being an amide, can be hydrolyzed in the body by amidases. Hindering its amide bond by introducing adjacent substituents has been demonstrated as a successful method for prolonging its skeletal activity. Here, we tested the therapeutic efficacy of two methylated OS derivatives, oleoyl α-methyl serine (HU-671) and 2-methyl-oleoyl serine (HU-681), in an ovariectomized mouse model for osteoporosis by utilizing combined micro-computed tomography, histomorphometry, and cell culture analyses. Our findings indicate that daily treatment for 6 weeks with OS or HU-671 completely rescues bone loss, whereas HU-681 has only a partial effect. The increased bone density was primarily due to enhanced trabecular thickness and number. Moreover, the most effective dose of HU-671 was 0.5 mg/kg/day, an order of magnitude lower than with OS. The reversal of bone loss resulted from increased bone formation and decreased bone resorption, as well as reversal of bone marrow adiposity. These results were further confirmed by determining the serum levels of osteocalcin and type 1 collagen C-terminal crosslinks, as well as demonstrating the enhanced antiadipogenic effect of HU-671. Taken together, these data suggest that methylation interferes with OS's metabolism, thus enhancing its effects by extending its availability to its target cells.


Assuntos
Adiposidade/efeitos dos fármacos , Medula Óssea/efeitos dos fármacos , Medula Óssea/patologia , Ácidos Oleicos/química , Osteoporose/etiologia , Osteoporose/metabolismo , Serina/análogos & derivados , Serina/farmacologia , Adipócitos/efeitos dos fármacos , Adipócitos/metabolismo , Animais , Medula Óssea/diagnóstico por imagem , Modelos Animais de Doenças , Feminino , Camundongos , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteoporose/diagnóstico , Ovariectomia/efeitos adversos , Serina/química , Microtomografia por Raio-X
10.
Medicine (Baltimore) ; 98(37): e16936, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517814

RESUMO

The study aimed to investigate the effect of ratios of marrow cavity diameter to intramedullary nail diameter from different layers on hidden blood loss (HBL), overt blood loss (OBL) and total blood loss (TBL) during using proximal femoral nail antirotation-Asian version (PFNA)-II for femoral intertrochanteric fractures.We retrospectively studied 70 patients treated in our hospital recently. We recorded postoperative hematocrit (Hct) and OBL during operation. TBL and HBL were calculated using CROSS equation. The ratios of marrow cavity diameter to intramedullary nail diameter from different layers, including start of funnel, end of funnel and femoral isthmus, were measured. The mean of the ratio from frontal and lateral X-ray were designated as R. We classified all included participants into a high and a low matching group according to z-score of R within each layer. TBL, HBL, and OBL were compared between the 2 groups. We applied multiple linear regression analysis between the HBL as a dependent variable and gender, age, body mass index, fracture type, and R as independent variables.The present study indicated a significant reduction in the HBL and TBL in the high matching group compared to low matching group on three layers, whereas it showed no significant difference in OBL between the 2 groups on three layers. It showed that R values from start of funnel and end of funnel were significantly associated with HBL.Matching rate of PFNA II at the funnel might be an important factor for HBL and TBL postoperatively.


Assuntos
Perda Sanguínea Cirúrgica , Medula Óssea/diagnóstico por imagem , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/cirurgia , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica/prevenção & controle , Medula Óssea/patologia , Feminino , Fraturas do Fêmur/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Hemorragia Pós-Operatória/patologia , Hemorragia Pós-Operatória/terapia , Estudos Retrospectivos
11.
BMC Musculoskelet Disord ; 20(1): 392, 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31470834

RESUMO

BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic autoinflammatory bone disease that mostly affects children and adolescents. It is a diagnosis of exclusions since no clinical signs and symptoms are pathognomonic. Radiological tests are often essential, but bone biopsy may be needed in unclear cases. CASE PRESENTATION: A 9-year-old Caucasian girl with a history of bone pain. The data from the history and results of laboratory tests suggested osteomyelitis, but no adequate response to the treatment was observed. A number of imaging tests did not confirm the diagnosis, therefore a bone biopsy was necessary. CONCLUSIONS: Differential diagnosis of CRMO is challenging and it is based on exclusions. Since it might be misdiagnosed or mistreated, bone biopsy should be considered in patients reporting bone pain who are unresponsive to treatment.


Assuntos
Dor Musculoesquelética/etiologia , Osteomielite/diagnóstico , Doenças Raras/diagnóstico , Artrite Infecciosa/diagnóstico , Biópsia , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Osteomielite/complicações , Osteomielite/patologia , Cintilografia , Doenças Raras/complicações , Doenças Raras/patologia , Tíbia/diagnóstico por imagem , Tíbia/patologia , Tomografia Computadorizada por Raios X
12.
J Cancer Res Clin Oncol ; 145(10): 2529-2539, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31485768

RESUMO

PURPOSE: This study aimed to determine the potential of positron emission tomography/computed tomography (PET/CT) in replacing routine bone-marrow biopsies (BMB) in newly diagnosed extranodal natural killer/T-cell lymphoma (ENKTCL). METHODS: Newly diagnosed patients underwent PET/CT imaging and routine BMB to assess bone/bone marrow involvement (BMI). Clinical stage and treatment plan were determined, and survival was compared. RESULTS: In a total of 101 patients, 78 were diagnosed as stage I/II and 23 as stage III/IV without using the BMB results. No BMB-positive patients were identified in stages I/II, and therefore, the BMB results did not alter the stage and treatment choice in any patients. The sensitivity and specificity of focal skeletal PET/CT lesion(s) in assessing BMI was 100% and 92.8%, respectively, taking routine BMB as the reference standard. The overall survival (OS) and progression-free survival (PFS) of BMB-positive patients was significantly inferior (P = 0.0011 and 0.0465, respectively, in advanced-stage patients; both P < 0.0001 in all patients), and this was corroborated by the PET/CT findings (P = 0.0006 and 0.0116, respectively, in advanced-stage patients; both P < 0.0001 in all patients). CONCLUSIONS: Based on the results, PET/CT demonstrated satisfactory predictive performance in terms of staging and prognosis in ENKTCL. BMB did not influence staging and treatment in newly diagnosed ENKTCL, and routine non-targeted BMB is not obligatory for early stage patients undergoing PET/CT. Targeted BMB is recommended to confirm BMI in advanced-stage patients.


Assuntos
Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Linfoma Extranodal de Células T-NK/diagnóstico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adolescente , Adulto , Idoso , Biomarcadores , Biópsia , Feminino , Humanos , Linfoma Extranodal de Células T-NK/mortalidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Prognóstico , Modelos de Riscos Proporcionais , Sensibilidade e Especificidade , Análise de Sobrevida , Adulto Jovem
13.
Eur J Radiol ; 118: 207-214, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31439244

RESUMO

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


Assuntos
Medula Óssea/diagnóstico por imagem , Calcâneo/diagnóstico por imagem , Edema/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/patologia , Doenças da Medula Óssea/patologia , Calcâneo/patologia , Cor , Edema/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
14.
BMC Musculoskelet Disord ; 20(1): 312, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31272448

RESUMO

BACKGROUND: People who have had anterior cruciate ligament reconstruction (ACLR) are at a high risk of developing tibiofemoral joint (TFJ) osteoarthritis (OA), with concomitant meniscal injury elevating this risk. This study aimed to investigate OA-related morphological change over 2 years in the TFJ among individuals who have undergone ACLR with or without concomitant meniscal pathology and in healthy controls. A secondary aim was to examine associations of baseline TFJ cartilage defects and bone marrow lesions (BML) scores with tibial cartilage volume change in ACLR groups. METHODS: Fifty seven ACLR participants aged 18-40 years (32 isolated ACLR, 25 combined meniscal pathology) underwent knee magnetic resonance imaging (MRI) 2.5 and 4.5 years post-surgery. Nine healthy controls underwent knee MRI at the ~ 2-year intervals. Tibial cartilage volume, TFJ cartilage defects and BMLs were assessed from MRI. RESULTS: For both ACLR groups, medial and lateral tibial cartilage volume increased over 2 years (P <  0.05). Isolated ACLR group had greater annual percentage increase in lateral tibial cartilage volume compared with controls and with the combined group (P = 0.03). Cartilage defects remained unchanged across groups. Both ACLR groups showed more lateral tibia BML regression compared with controls (P = 0.04). Baseline cartilage defects score was positively associated with cartilage volume increase at lateral tibia (P = 0.002) while baseline BMLs score was inversely related to medial tibia cartilage volume increase (P = 0.001) in the pooled ACLR group. CONCLUSIONS: Tibial cartilage hypertrophy was apparent in ACLR knees from 2.5 to 4.5 years post-surgery and was partly dependent upon meniscal status together with the nature and location of the underlying pathology at baseline. Magnitude and direction of change in joint pathologies (i.e., cartilage defects, BMLs) were less predictable and either remained stable or improved over follow-up.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Artroscopia/efeitos adversos , Osteoartrite do Joelho/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Lesões do Menisco Tibial/cirurgia , Adulto , Lesões do Ligamento Cruzado Anterior/complicações , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/patologia , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Tíbia/diagnóstico por imagem , Tíbia/patologia , Lesões do Menisco Tibial/complicações , Fatores de Tempo , Adulto Jovem
15.
Int J Mol Sci ; 20(15)2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31349607

RESUMO

Molecular mechanisms governing cell fate decision events in bone marrow mesenchymal stromal cells (MSC) are still poorly understood. Herein, we investigated the homeobox gene Prep1 as a candidate regulatory molecule, by adopting Prep1 hypomorphic mice as a model to investigate the effects of Prep1 downregulation, using in vitro and in vivo assays, including the innovative single cell RNA sequencing technology. Taken together, our findings indicate that low levels of Prep1 are associated to enhanced adipogenesis and a concomitant reduced osteogenesis in the bone marrow, suggesting Prep1 as a potential regulator of the adipo-osteogenic differentiation of mesenchymal stromal cells. Furthermore, our data suggest that in vivo decreased Prep1 gene dosage favors a pro-adipogenic phenotype and induces a "browning" effect in all fat tissues.


Assuntos
Regulação da Expressão Gênica , Proteínas de Homeodomínio/genética , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Adipogenia/genética , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/metabolismo , Animais , Medula Óssea/diagnóstico por imagem , Medula Óssea/metabolismo , Diferenciação Celular/genética , Biologia Computacional/métodos , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Proteínas de Homeodomínio/metabolismo , Camundongos , Osteogênese/genética , Análise de Célula Única , Microtomografia por Raio-X
17.
Thromb Haemost ; 119(9): 1471-1480, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31226718

RESUMO

BACKGROUND: Inflammation plays a fundamental role in mediating all stages of atherosclerosis. Given the higher prevalence of inflammatory rheumatologic conditions in women and the female propensity towards worse cardiovascular outcomes, refined strategies are needed to better identify the high-risk female cardiovascular phenotype. OBJECTIVES: This article aims to assess sex-specific links between inflammatory processes and the development and progression of ischemic heart disease. PATIENTS AND METHODS: The relationship between vertebral bone marrow metabolism-a marker of inflammation-and myocardial injury was retrospectively assessed in 294 patients (28.6% women, mean age: 66.9 ± 10.0 years) who underwent 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and 99mTc-tetrofosmin single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI). RESULTS: A significant increase in 18F-FDG bone marrow uptake was observed in women with impaired myocardial perfusion (SPECT-MPI) as compared to women with normal myocardial perfusion (standardized uptake value [SUV]: 2.2 ± 1.2 vs. 1.7 ± 0.5, p = 0.013), while no such difference was observed in men (SUV: 1.6 ± 0.8 vs. 1.6 ± 0.4, p = 0.372). Furthermore, a significant inverse correlation between left ventricular ejection fraction (LVEF) and bone marrow metabolism was seen in women (r = -0.229, p = 0.037), but not in men (r = -0.075, p = 0.289). Accordingly, in women, but not in men, bone marrow activity was identified as an independent predictor of both, reduced LVEF (ß-coefficient, -4.537; p = 0.040) and impaired myocardial perfusion (ß-coefficient, 0.138; p = 0.014). CONCLUSION: A strong link between bone marrow metabolism and impaired myocardial function and perfusion was observed in women, but not in men. Our data suggest that novel biomarkers of inflammation might help to identify women at risk for ischemic cardiomyopathy and to tailor disease management to the female cardiovascular phenotype.


Assuntos
Biomarcadores/metabolismo , Medula Óssea/metabolismo , Inflamação/diagnóstico , Isquemia Miocárdica/diagnóstico , Miocárdio/metabolismo , Fatores Sexuais , Idoso , Medula Óssea/diagnóstico por imagem , Progressão da Doença , Feminino , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão do Miocárdio , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Caracteres Sexuais , Função Ventricular Esquerda
18.
PLoS One ; 14(5): e0216733, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150420

RESUMO

In archaeological assemblages the presence of percussion marks, on the surface of long bones, is an indicator of long bone marrow extraction. The form, quantity and distribution of percussion marks are analysed to gain a better understanding of the marrow extraction process. Patterns of bone percussion damage in archaeological assemblages may highlight standardized actions, possibly related to butchery traditions. However, additional factors could underlie these patterns and should also be considered. In this article we test intuitiveness as a factor in appearance of percussion mark patterns, to see if patterns can appear when bones are being fractured without prior experience with bone fracture properties. To test this hypothesis, for this study we selected a sample of 40 cattle (Bos taurus) long limb bones from a large bone breakage experiment (400 long limb bones), where participants had no previous experience in bone breakage and may thus have broken bones intuitively. We used Geographic Information System (GIS) software to analyse the distribution of percussion marks. Using ArcGIS Spatial Analysts tools, we identified and quantified significant concentrations of percussion marks. Results show that percussion mark patterns emerge for the same bone element, and that specific sides and zones were recurrently selected by experimenters. The distribution of patterns varies among the different long bone elements, and we attribute this variance to an adjustment to bone morphology. In addition, we calculated and identified bone damage patterns resulting from hammerstone percussion. Crossing bone survivorship with percussion mark patterns enabled us to recognise and evaluate the effects of fragmentation and surface visibility in controlled experimental conditions. The GIS method facilitates comparisons between different variables and provides a sophisticated visual representation of results. Enlarging the sample will allow to constitute a more substantial analogous model for fossil assemblages.


Assuntos
Medula Óssea , Fósseis/patologia , Fraturas Ósseas , Sistemas de Informação Geográfica , Matadouros , Animais , Arqueologia/métodos , Medula Óssea/anatomia & histologia , Medula Óssea/diagnóstico por imagem , Carnivoridade , Bovinos , Manipulação de Alimentos/história , Manipulação de Alimentos/métodos , Fósseis/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/história , Fraturas Ósseas/patologia , História Antiga , Humanos , Modelos Anatômicos
19.
Semin Musculoskelet Radiol ; 23(3): 276-288, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31163502

RESUMO

Bone marrow edema (BME) represents a frequent and easily detected MR imaging finding that is recognized as a common source of pain. It is considered a nonspecific finding that constitutes a central component of a wide spectrum of pathologies affecting the hip joint, showing high variability in terms of prognosis and treatment requirements. Solid knowledge of the various BME patterns and associated imaging findings indicative of these conditions can aid in differentiation. Additionally, correlation with clinical and laboratory data are essential for arriving at a final diagnosis in several cases. In this review, we describe the disease characteristics and imaging findings and also highlight the differential diagnostic clues regarding common hip disorders associated with BME including avascular necrosis, transient osteoporosis, stress injuries, and infectious/inflammatory disorders.


Assuntos
Artralgia/etiologia , Doenças da Medula Óssea/diagnóstico por imagem , Edema/complicações , Edema/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Artralgia/fisiopatologia , Medula Óssea/diagnóstico por imagem , Edema/fisiopatologia , Humanos
20.
Med Oncol ; 36(7): 58, 2019 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-31104192

RESUMO

Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PNET) is an aggressive bone tumor. Bone marrow aspiration and biopsy (BMAB) has been recognized as the gold standard for assessing bone marrow status. While the latest guideline suggests the need to omit bone marrow aspiration in patients with no findings on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) based on one retrospective report, there is no study using 18F-FDG PET/computed tomography (CT). We retrospectively reviewed 26 consecutive, previously untreated, ES/PNET patients. We compare the results of bone marrow aspiration and biopsy (BMAB) and those of 18F-FDG PET/CT in ES/PNET patients. All of the 21 patients without metastases on 18F-FDG PET/CT had negative BMAB. The sensitivity of bone marrow involvement in bone metastases positive patients on 18F-FDG PET/CT was 75% (3/4), and the specificity was 100% (22/22). In addition to the metastatic findings on 18F-FDG PET/CT, tumor diameter, lactate dehydrogenase level at diagnosis, and the presence or absence of bone metastasis were factors related to bone marrow involvement. It may be a reasonable option to omit BMAB in ES/PNET patients with no distant metastasis based on 18F-FDG PET/CT findings.


Assuntos
Medula Óssea/diagnóstico por imagem , Neoplasias Ósseas/secundário , Tumores Neuroectodérmicos Primitivos Periféricos/diagnóstico por imagem , Sarcoma de Ewing/diagnóstico por imagem , Adolescente , Adulto , Biópsia por Agulha , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Criança , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroectodérmicos Primitivos Periféricos/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Sarcoma de Ewing/patologia , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA