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1.
Rev Med Chil ; 149(3): 472-475, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479328

RESUMO

We report a 51-year-old asymptomatic male, with type II diabetes, referred to our outpatient clinic due to ST and T alterations on the precordial leads on the electrocardiogram. The echocardiogram showed apical akinesia and left ventricular hypertrophy. There were no angiographic lesions in the coronary angiography. In the left ventriculography, a hyperdynamic left ventricle with suspected left ventricular hypertrophy and an apical aneurysm were found. The cardiac magnetic resonance confirmed those findings, without late gadolinium enhancement. According to the European Cardiology Society Risk Score, the patient had a low sudden death risk. However, this score does not consider the presence of an aneurysm as risk factor for sudden death, but it is considered in the 2017 ACC/AHA Heart Rhythm Society Guidelines, as a major risk factor. Therefore a defibrillator was implanted, and he was discharged on permanent oral anticoagulation.


Assuntos
Cardiomiopatia Hipertrófica , Diabetes Mellitus Tipo 2 , Aneurisma Cardíaco , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Meios de Contraste , Angiografia Coronária , Eletrocardiografia , Gadolínio , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(4): 663-668, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34494542

RESUMO

Pituitary metastasis,a rare kind of intracranial malignant tumor,is characterized by metastasis from all parts of the body to the pituitary.The common tumors metastatic to pituitary are abundant with blood supply,located in the posterior pituitary lobe and/or the pituitary stalk.The lesion shows infiltrative growth,and mainly demonstrates low signal on T1 weighted imaging and high signal on T2 weighted imaging.It is usually enhanced significantly after iodinated contrast administration.The metastatic tumor with poor blood supply is similar to pituitary macroadenoma on magnetic resonance image,which makes it difficult to be differentiated.We reported two cases of pathologically diagnosed pituitary metastasis with poor blood supply and reviewed related papers,aiming to provide the imaging differentiation points of hypovascular pituitary metastasis.


Assuntos
Doenças da Hipófise , Neoplasias Hipofisárias , Meios de Contraste , Humanos , Imageamento por Ressonância Magnética , Hipófise , Neoplasias Hipofisárias/diagnóstico por imagem
3.
Nanoscale ; 13(34): 14552-14571, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473175

RESUMO

Iron oxide nanoparticles (IONPs) are well-known contrast agents for MRI for a wide range of sizes and shapes. Their use as theranostic agents requires a better understanding of their magnetic hyperthermia properties and also the design of a biocompatible coating ensuring their stealth and a good biodistribution to allow targeting of specific diseases. Here, biocompatible IONPs of two different shapes (spherical and octopod) were designed and tested in vitro and in vivo to evaluate their abilities as high-end theranostic agents. IONPs featured a dendron coating that was shown to provide anti-fouling properties and a small hydrodynamic size favoring an in vivo circulation of the dendronized IONPs. While dendronized nanospheres of about 22 nm size revealed good combined theranostic properties (r2 = 303 mM s-1, SAR = 395 W gFe-1), octopods with a mean size of 18 nm displayed unprecedented characteristics to simultaneously act as MRI contrast agents and magnetic hyperthermia agents (r2 = 405 mM s-1, SAR = 950 W gFe-1). The extensive structural and magnetic characterization of the two dendronized IONPs reveals clear shape, surface and defect effects explaining their high performance. The octopods seem to induce unusual surface effects evidenced by different characterization techniques while the nanospheres show high internal defects favoring Néel relaxation for magnetic hyperthermia. The study of octopods with different sizes showed that Néel relaxation dominates at sizes below 20 nm while the Brownian one occurs at higher sizes. In vitro experiments demonstrated that the magnetic heating capability of octopods occurs especially at low frequencies. The coupling of a small amount of glucose on dendronized octopods succeeded in internalizing them and showing an effect of MH on tumor growth. All measurements evidenced a particular signature of octopods, which is attributed to higher anisotropy, surface effects and/or magnetic field inhomogeneity induced by tips. This approach aiming at an analysis of the structure-property relationships is important to design efficient theranostic nanoparticles.


Assuntos
Nanopartículas de Magnetita , Medicina de Precisão , Meios de Contraste , Compostos Férricos , Nanopartículas Magnéticas de Óxido de Ferro , Imageamento por Ressonância Magnética , Magnetismo , Nanomedicina Teranóstica , Distribuição Tecidual
4.
Mater Sci Eng C Mater Biol Appl ; 128: 112282, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34474835

RESUMO

Imaging of immune cells has wide implications in understanding disease progression and staging. While optical imaging is limited in penetration depth due to light properties, magnetic resonance (MR) imaging provides a more powerful tool for the imaging of deep tissues where immune cells reside. Due to poor MR signal to noise ratio, tracking of such cells typically requires contrast agents. This report presents an in-depth physical characterization and application of archaeal magnetoferritin for MR imaging of macrophages - an important component of the innate immune system that is the first line of defense and first responder in acute inflammation. Magnetoferritin is synthesized by loading iron in apoferritin in anaerobic condition at 65 °C. The loading method results in one order of magnitude enhancement of r1 and r2 relaxivities compared to standard ferritin synthesized by aerobic loading of iron at room temperature. Detailed characterizations of the magnetoferritin revealed a crystalline core structure that is distinct from previously reported ones indicating magnetite form. The magnetite core is more stable in the presence of reducing agents and has higher peroxidase-like activities compared to the core in standard loading. Co-incubation of macrophage cells with magnetoferritin in-vitro shows significantly higher enhancement in T2-MRI contrast of the immune cells compared to standard ferritin.


Assuntos
Apoferritinas , Nanopartículas de Magnetita , Meios de Contraste , Ferro/metabolismo , Macrófagos/metabolismo , Imageamento por Ressonância Magnética , Óxidos
5.
BMC Nephrol ; 22(1): 297, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465289

RESUMO

BACKGROUND: Kidney disease and renal failure are associated with hospital deaths in patients with COVID - 19. We aimed to test if contrast enhancement affects short-term renal function in hospitalized COVID - 19 patients. METHODS: Plasma creatinine (P-creatinine) was measured on the day of computed tomography (CT) and 24 h, 48 h, and 4-10 days after CT. Contrast-enhanced (n = 142) and unenhanced (n = 24) groups were subdivided, based on estimated glomerular filtration rates (eGFR), > 60 and ≤ 60 ml/min/1.73 m2. Contrast-induced acute renal failure (CI-AKI) was defined as ≥27 µmol/L increase or a > 50% rise in P-creatinine from CT or initiation of renal replacement therapy during follow-up. Patients with renal replacement therapy were studied separately. We evaluated factors associated with a > 50% rise in P-creatinine at 48 h and at 4-10 days after contrast-enhanced CT. RESULTS: Median P-creatinine at 24-48 h and days 4-10 post-CT in patients with eGFR> 60 and eGFR≥30-60 in contrast-enhanced and unenhanced groups did not differ from basal values. CI-AKI was observed at 48 h and at 4-10 days post contrast administration in 24 and 36% (n = 5/14) of patients with eGFR≥30-60. Corresponding figures in the eGFR> 60 contrast-enhanced CT group were 5 and 5% respectively, (p < 0.037 and p < 0.001, Pearson χ2 test). In the former group, four of the five patients died within 30 days. Odds ratio analysis showed that an eGFR≥30-60 and 30-day mortality were associated with CK-AKI both at 48 h and 4-10 days after contrast-enhanced CT. CONCLUSION: Patients with COVID - 19 and eGFR≥30-60 had a high frequency of CK-AKI at 48 h and at 4-10 days after contrast administration, which was associated with increased 30-day mortality. For patients with eGFR≥30-60, we recommend strict indications are practiced for contrast-enhanced CT. Contrast-enhanced CT had a modest effect in patients with eGFR> 60.


Assuntos
Injúria Renal Aguda/induzido quimicamente , COVID-19/complicações , Meios de Contraste/efeitos adversos , Creatinina/sangue , Iodo/efeitos adversos , Rim/efeitos dos fármacos , Injúria Renal Aguda/sangue , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/terapia , Idoso , COVID-19/sangue , COVID-19/mortalidade , COVID-19/fisiopatologia , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/diagnóstico por imagem , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Análise de Regressão , Terapia de Substituição Renal , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X
7.
World J Surg Oncol ; 19(1): 284, 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34537053

RESUMO

BACKGROUND: To determine the potential of the combination of DCE-MRI imaging method with DWI and serum CA125 and CA199 levels in the evaluation of the efficacy of neoadjuvant chemotherapy in breast cancer patients. METHODS: Sixty-five breast cancer patients who received neoadjuvant chemotherapy in our hospital from April 2016 to April 2017 were selected as research subjects. The patients received 4 courses of neoadjuvant chemotherapy. Lesions were monitored using DCE-MRI and DWI, while ELISA was used to measure the serum expression levels of the tumour markers CA125 and CA199. The patients were divided into the remission group and ineffective group based on pathological diagnosis. RESULTS: There were significant differences in Kep, Ktrans, ADCmin, ADCmean, tumour volume, and serum levels of CA125 and CA199 in patients in the remission group, before and after neoadjuvant chemotherapy, and there were significant differences in post-chemotherapy values of these indexes between the remission group and the ineffective group (p < 0.01). CONCLUSION: Combination of DCE-MRI diagnostic imaging with DWI can directly reflect the lesions in breast cancer patients after neoadjuvant chemotherapy. Serum levels of CA125 and CA199 levels are useful for evaluation of the impact of neoadjuvant chemotherapy on breast cancer patients, including risk of cancer cell metastasis and changes in some small lesions.


Assuntos
Neoplasias da Mama , Terapia Neoadjuvante , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Meios de Contraste , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Imageamento por Ressonância Magnética , Prognóstico , Resultado do Tratamento
8.
World J Gastroenterol ; 27(32): 5438-5447, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34539143

RESUMO

BACKGROUND: Intestinal lymphoma is a rare tumor. Contrast-enhanced ultrasound (CEUS) findings of intestinal lymphoma have not been reported previously, and the relationship between CEUS and clinicopathological features and prognostic factors is still unknown. AIM: To describe the B-mode US and CEUS features of intestinal lymphoma and investigate the correlation of CEUS and histopathological features. METHODS: This was a single-center retrospective study. Eighteen patients with histologically confirmed intestinal lymphoma underwent B-mode US and CEUS examinations between October 2016 and November 2019. We summarized the features of B-mode US and CUES imaging of intestinal lymphoma and compared the frequency of tumor necrosis in intestinal lymphomas with reference to different pathological subtypes (aggressive or indolent) and clinical stage (early or advanced). The time-intensity curve parameters of CEUS were also compared between patients with normal and elevated serum lactate dehydrogenase. RESULTS: In B-mode imaging, four patterns were observed in intestinal lymphoma: Mass type (12/18, 66.7%), infiltration type (1/18, 5.6%), mesentery type (4/18, 22.2%) and mixed type (1/18, 5.6%). All cases were hypoechoic and no cystic areas were detected. On CEUS, most cases (17/18, 94.4%) showed arterial hyperechoic enhancement. All cases showed arterial enhancement followed by venous wash out. A relatively high rate of tumor necrosis (11/18, 61.1%) was observed in this study. Tumor necrosis on CEUS was more frequent in aggressive subtypes (10/13, 76.9%) than in indolent subtypes (1/5, 20.0%) (P = 0.047). There were no correlations between tumor necrosis and lesion size and Ann Arbor stage. There was no significant difference in time-intensity curve parameters between normal and elevated lactate dehydrogenase groups. CONCLUSION: B-mode US and CEUS findings of intestinal lymphoma are characteristic. We observed a high rate of tumor necrosis, which appeared more frequently in aggressive pathological subtypes of intestinal lymphoma.


Assuntos
Neoplasias Intestinais , Linfoma , Meios de Contraste , Humanos , Neoplasias Intestinais/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Estudos Retrospectivos , Ultrassonografia
10.
Zhonghua Zhong Liu Za Zhi ; 43(8): 872-877, 2021 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-34407594

RESUMO

Objective: To explore the diagnostic value of synthetic magnetic resonance imaging (syMRI) quantitative parameters for benign and malignant breast lesions. Methods: From September 2018 to March 2019, a total of 43 cases of breast lesions which were confirmed by surgery and pathology in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled in this study. All patients underwent syMRI sequence scans before and after enhancement except for conventional T2WI, DWI, and enhancement scans. GE AW4.7 workstation was used to generate syMRI parameter maps (T1, T2, proton density mappings), and ITK-SNAP software was used to delineate the volume of interest. The T1, T2, PD values before and after dynamic contrast enhanced (DCE) were obtained, and the change values of each parameter were calculated. Meanwhile, the apparent diffusion coefficient (ADC) and time intensity curve (TIC) of the lesions were measured. The differences of each parameter value were compared between benign and malignant breast lesions, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic performance of each parameter. Results: Among the 43 enrolled cases, 13 were benign and 30 were malignant. Among the syMRI parameters, the pre-enhancement parameters including T1pre (median 1 663.07 ms), T2pre (median 103.33 ms), post-enhancement parameters ΔT1 (median 1 022.68 ms) and ΔT2 (median 27.67 ms) of benign group, significantly higher than those of the malignant group (the medians were 1 141.74, 92.53, 664.95, and 16.19 ms, respectively, P<0.05). The ADC value of the benign group (median 1.66×10(-3)mm(2)/s) was significantly higher than that of the malignant group (median 1.00×10(-3)mm(2)/s, P<0.05). The benign group included 6 cases of TIC curve type Ⅰ, 5 cases of type Ⅱ, and 2 cases of type Ⅲ. The malignant group included 2 cases of TIC curve type Ⅰ, 17 cases of type Ⅱ, and 11 cases of type Ⅲ. The difference between the two groups was statistically significant (P<0.05). The area under the ROC curve (AUC) of T1pre before DCE was 0.869, higher than 0.806 of ADC and 0.697 of TIC. When the best cut-off value of 1 282.94 ms was chosen, the sensitivity and specificity of diagnosis were 76.9% and 93.3%, respectively. The combination of T1pre and T2pre can further improve the diagnostic performance (AUC=0.908). Conclusions: Among the syMRI quantitative parameters, T1pre, T2pre, ΔT1 and ΔT2 have good value for the differential diagnosis of benign and malignant breast lesions. T1pre has the best diagnostic performance, and the combination of T1pre and T2pre can further improve the diagnostic performance.


Assuntos
Neoplasias da Mama , Meios de Contraste , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Imageamento por Ressonância Magnética , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
11.
Bratisl Lek Listy ; 122(9): 643-646, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34463110

RESUMO

METHODS: Forty-two COVID-19 patients who underwent emergency PCI due to the diagnosis of acute coronary syndrome were included in the study. Mean age was 63±14.76 and males accounted for 81 % (34/42). Contrast-induced acute kidney injury (CI-AKI) was defined as absolute increase in serum creatinine level by 0.3 mg/dL above baseline within 48 hours of contrast exposure. Patients were divided into two groups according to CI-AKI development following coronary angiography. RESULTS: CI-AKI developed in 33.3 % (14/42) of the patients. Pre-procedure e-GFR (p=0.028), serum albumin levels (p=0.021), and ejection fraction (p=0.039) were lower in the CI-AKI group. Whereas the platelet/lymphocyte ratio was significantly lower in the non-CI-AKI group (p=0.010). CONCLUSIONS: Our study results demonstrated that patients suffering from COVID-19 had a high risk of CI-AKI development following coronary angiography (Tab. 1, Ref. 36).


Assuntos
Injúria Renal Aguda , COVID-19 , Meios de Contraste , Intervenção Coronária Percutânea , Injúria Renal Aguda/induzido quimicamente , COVID-19/complicações , Meios de Contraste/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
12.
Anal Chem ; 93(33): 11398-11405, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34387072

RESUMO

A species-dependent and total gadolinium quantification strategy for the analysis of bone and bone marrow samples was developed and applied to femurs of rats previously treated with different gadolinium-based contrast agents (GBCAs). A combined mild dissolution/recomplexation strategy allows the quantification of total Gd as well as the quantification of intact GBCA in bones within one analysis for the first time. Samples of rat bones and bone marrow were dissolved in low concentrations of hydrochloric acid and diethylenetriamine pentaacetate (DTPA). This is followed by the addition of excess In(III) to recomplex all free ligands, previously added DTPA as well as the ligands of GBCAs that were not stable during the dissolution step. Separation and quantification were carried out by means of high-performance liquid chromatography (HPLC) on a hydrophilic interaction liquid chromatography (HILIC) column with subsequent inductively coupled plasma-mass spectrometry (ICP-MS). The results show that the investigated GBCA with a macrocyclic ligand shows a higher tendency to stay intact in the bone tissues over time, while a GBCA with a linear ligand is decomplexed more rapidly four weeks after GBCA administration. Additionally, for all macrocyclic GBCAs, a similar limited gadolinium accumulation was observed in the bone and bone marrow. Whereas linear GBCAs showed a higher gadolinium accumulation, a difference was observed between bone and bone marrow, indicating a different biodistribution behavior.


Assuntos
Gadolínio , Compostos Organometálicos , Animais , Osso e Ossos , Cromatografia Líquida de Alta Pressão , Meios de Contraste , Gadolínio DTPA , Espectrometria de Massas , Ratos , Solubilidade , Distribuição Tecidual
14.
Methods Enzymol ; 657: 331-347, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34353493

RESUMO

In this chapter, we introduce the photoacoustic imaging probe in detecting the infection of bacterial in host cells. We give detailed protocols for the synthesis and confirmation of a PA probe which response to caspase-1 and then self-assembly to enhance the signal. With this PA contrast agent, we may provide a new approach for an intracellular bacterial infection with the selective and sensitive diagnosis.


Assuntos
Técnicas Fotoacústicas , Infecções Estafilocócicas , Meios de Contraste , Humanos , Análise Espectral , Staphylococcus aureus
15.
Methods Enzymol ; 657: 443-480, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34353498

RESUMO

Near-infrared (NIR) targeting contrast agents have been investigated as great photoabsorbers to improve photoacoustic microscopy (PAM), OCT, and fluorescence imaging contrast for visualization of various diseases. In ophthalmology, a limited number of NIR contrast agents have been approved for clinical use. Recently, gold nanoparticles with different size and shapes have been developed for molecular imaging. This chapter provides the principles of multimodality PAM, OCT, and fluorescence imaging as well as a brief overview of contrast agents for optical imaging. A detailed protocol for the fabrication of discrete colloidal gold nanoparticles (GNPs), synthesis of functionalized RGD-conjugated chain-like GNP (CGNP) clusters labeled with indocyanine green (ICG) fluorescence dye (ICG@CGNP clusters-RGD), and validation of the synthesized nanoparticles to evaluate newly developed blood vessels in the retina, named choroidal neovascularization (CNV), is described. Using RGD peptide, ICG@CGNPs clusters-RGD can bind integrin which is expressed on activated endothelial cells and newly developed CNV. The targeting efficiency of nanoparticles is monitored by multimodality PAM, OCT, and fluorescence imaging longitudinally.


Assuntos
Nanopartículas Metálicas , Tomografia de Coerência Óptica , Meios de Contraste , Células Endoteliais , Ouro , Microscopia de Fluorescência , Retina
16.
Methods Enzymol ; 657: 89-109, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34353500

RESUMO

Matrix metalloproteinase-2 (MMP-2), which is one of MMPs family, is known as an extracellular gelatinase controlling cancer cell adhesion, growth, and metastasis. Because of the great interest in MMP-2 activity, the detailed protocols for evaluating MMP-2-responsive contrast agents, especially photoacoustic probes for in vivo use, are helpful for researchers in the field. We here describe the detailed synthetic procedure of MMP-2-activatable photoacoustic probe AlNc-pep-PEG consisting of aluminum naphthalocyanine, MMP-2-responsive peptide sequence, and poly(ethylene glycol), which has recently been developed in our research group. The detailed measurement protocol of photoacoustic signal intensity in vitro and in vivo by using in-house built photoacoustic signal measurement system and photoacoustic imaging apparatus are also summarized.


Assuntos
Metaloproteinase 2 da Matriz , Neoplasias , Alumínio , Meios de Contraste , Humanos , Imagem Molecular , Neoplasias/diagnóstico por imagem
17.
Br J Radiol ; 94(1125): 20210520, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415197

RESUMO

OBJECTIVE: Axillary lymph node status assessment has always been an important issue in clinical treatment of breast cancer. However, there has been no effective method to accurately predict the pathological complete response (pCR) of axillary lymph node after neoadjuvant chemotherapy (NAC). The objective of our study was to investigate whether conventional ultrasonography combined with contrast-enhanced ultrasonography (CEUS) can be used to evaluate axillary lymph node status of breast cancer patients after NAC. METHODS: A total of 74 patients who underwent NAC were recruited for the present study. Prior to and after NAC, examinations of conventional ultrasonography and CEUS were performed. After evaluating the images of conventional ultrasonography, four characteristics were recorded: lymph node medulla boundary, cortex of lymph node, lymph node hilus, and lymph node aspect ratio. Two additional imaging characteristics of CEUS were analyzed: CEUS way and CEUS pattern. Receiver operating characteristiccurve analysis was applied to evaluate their diagnostic performance. RESULTS: After 6~8 cycles of NAC, 46 (71.9%) patients had negative axillary lymph node, and 18 (28.1%) patients turned out non-pCR. According to statistical analysis, lymph node medulla, lymph node aspect ratio and CEUS way were independently associated with pCR of axillary lymph node after NAC. The area under the curve of the prediction model with three imaging characteristics was 0.882 (95% confidence interval: 0.608-0.958), and the accuracy to predict the patients' lymph node status was 78.1% (p < 0.01). CONCLUSIONS: Conventional ultrasonography combined with CEUS technology can accurately predict axillary lymph nodes status of breast cancer patients after NAC. ADVANCES IN KNOWLEDGE: The usefulness of CEUS technology in predicting pCR after neoadjuvant chemotherapy is highlighted.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante/métodos , Meios de Contraste , Aumento da Imagem/métodos , Linfonodos/diagnóstico por imagem , Terapia Neoadjuvante/métodos , Ultrassonografia/métodos , Axila , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
18.
Br J Radiol ; 94(1125): 20210430, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415199

RESUMO

OBJECTIVES: To assess the feasibility of a rapid, focused ferumoxytol-enhanced MR angiography (f-FEMRA) protocol in patients with claustrophobia. METHODS: In this retrospective study, 13 patients with claustrophobia expressed reluctance to undergo conventional MR angiography, but agreed to a trial of up to 10 min in the scanner bore and underwent f-FEMRA. Thirteen matched control patients who underwent gadolinium-enhanced MR angiography (GEMRA) were identified for comparison of diagnostic image quality. For f-FEMRA, the time from localizer image acquisition to completion of the angiographic acquisition was measured. Two radiologists independently scored images on both f-FEMRA and GEMRA for arterial and venous image quality, motion artefact and diagnostic confidence using a 5-point scale, five being best. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aorta and IVC were measured. The Wilcoxon rank-sum test, one-way ANOVA with Tukey correction and two-tailed t tests were utilized for statistical analyses. RESULTS: All scans were diagnostic and assessed with high confidence (scores ≥ 4). Average scan time for f-FEMRA was 6.27 min (range 3.56 to 10.12 min), with no significant difference between f-FEMRA and GEMRA in diagnostic confidence (4.86 ± 0.24 vs 4.69 ± 0.25, p = 0.13), arterial image quality (4.62 ± 0.57 vs 4.65 ± 0.49, p = 0.78) and motion artefact score (4.58 ± 0.49 vs 4.58 ± 0.28, p > 0.99). f-FEMRA scored significantly better for venous image quality than GEMRA (4.62 ± 0.42 vs 4.19 ± 0.56, p = 0.04). CNR in the IVC was significantly higher for steady-state f-FEMRA than GEMRA regardless of the enhancement phase (p < 0.05). CONCLUSIONS: Comprehensive vascular MR imaging of the thorax, abdomen and pelvis can be completed in as little as 5 min within the magnet bore using f-FEMRA, facilitating acceptance by patients with claustrophobia and streamlining workflow. ADVANCES IN KNOWLEDGE: A focused approach to vascular imaging with ferumoxytol can be performed in patients with claustrophobia, limiting time in the magnet bore to 10 min or less, while acquiring fully diagnostic images of the thorax, abdomen and pelvis.


Assuntos
Meios de Contraste , Óxido Ferroso-Férrico , Aumento da Imagem/métodos , Angiografia por Ressonância Magnética/métodos , Angiografia por Ressonância Magnética/psicologia , Transtornos Fóbicos/psicologia , Estudos de Coortes , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tempo
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