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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1477-1480, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018270

RESUMO

Physiological parameters can be estimated from dynamic contrast enhanced magnetic resonance imaging (DCEMRI) data using pharmacokinetic models. This work evaluates the performance of various pharmacokinetic models through a retrospective study on cervix cancer, including two generalized kinetic models and three 2-compartment exchange models (2CXMs). In the current clinical practice, region of interest (ROI) is treated as a whole and the models are assessed by their top pharmacokinetic parameters. We explore the intervoxel relationship in the pharmacokinetic parameter maps and demonstrate that, for those insignificant parameters, texture descriptors can largely improve their discriminative power. Multi-parametric classifiers are developed to fuse the information carried by physiological parameters and the descriptors. Assessed merely by the top parameter, the DP (distributed parameter) model is the best one with an area under the ROC (receiver operating characteristic) curve (AUC) of 0.80; by combining multiple pharmacokinetic parameters, the ExTofts model is the winner with an AUC of 0.837. Finally, the classifier of the AATH (adiabatic approximation to the tissue homogeneity) model build on combined features achieves an AUC of 0.92.Clinical Relevance - Using data from 36 cervical cancer patients and 17 normal subjects, this work quantitatively compared the various pharmacokinetic models and provided recommendations for model selection in cervical cancer diagnosis.


Assuntos
Neoplasias do Colo do Útero , Meios de Contraste , Feminino , Humanos , Imagem por Ressonância Magnética , Curva ROC , Estudos Retrospectivos
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1485-1488, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018272

RESUMO

The susceptibility-based positive contrast MR technique was applied to estimate arbitrary magnetic susceptibility distributions of the metallic devices using a kernel deconvolution algorithm with a regularized L-1 minimization. Previously, the first-order primal-dual (PD) algorithm could provide a faster reconstruction time to solve the L-1 minimization, compared with other methods. Here, we propose to accelerate the PD algorithm of the positive contrast image using the multi-core multi-thread feature of graphics processor units (GPUs). The some experimental results showed that the GPU-based PD algorithm could achieve comparable accuracy of the metallic interventional devices in positive contrast imaging with less computational time. And the GPU-based PD approach was 4~15 times faster than the previous CPU-based scheme.Clinical Relevance-This can estimate arbitrary magnetic susceptibility distributions of the metallic devices with the processing efficacy of 4~15 times faster than before.


Assuntos
Algoritmos , Meios de Contraste , Imagem por Ressonância Magnética , Software
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2121-2124, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018425

RESUMO

Super-resolution ultrasound imaging (SR-US) has enabled a tenfold improvement in resolution of the microvasculature with clinical application in many disease processes such as cancer, diabetes and cardiovascular disease. Plane wave ultrasound (US) platforms in turn are capable of the very high frame rates needed to track microbubble (MB) contrast agents used in SR-US. Both B-mode US imaging and contrast enhanced US imaging (CEUS) have been effectively used in SR-US, with B-mode US having higher signal-to-noise ratio (SNR) and CEUS providing higher contrast-to-tissue ratio (CTR). Lengthy imaging time needed for SR-US to allow perfusion and MB detection is an impediment to clinical adoption. Both SNR and CTR improvements can enhance SR-US imaging by enhancing the detection of MBs thus reducing imaging time. This study simultaneously evaluated nonlinear contrast pulse sequences (CPS) employing different amplitude modulation (AM) and pulse inversion (PI) nonlinear CEUS imaging techniques as well as combinations of the two, (AMPI) with B-mode US imaging. The objective was to improve the detection rate of MB during SR-US. Imaging was performed in vitro and in vivo in the rat hind limb using a Vantage 256 research scanner (Verasonics Inc.). Comparisons of four CPS compositions with B-mode US imaging was made based on the number of MB detected and localized in SR-US images. The use of a PI nonlinear CEUS imaging strategy improved SR-US imaging by increasing the number of MB detected in a sequence of frames by an average of 28.3% and up to 52.6% over a B-mode US imaging strategy, which would decrease imaging time accordingly.


Assuntos
Meios de Contraste , Microbolhas , Animais , Microvasos , Ratos , Razão Sinal-Ruído , Ultrassonografia
4.
Medicine (Baltimore) ; 99(41): e22318, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031270

RESUMO

INTRODUCTION: The market for dietary supplements in the sports sector has been growing rapidly for several years, though there is still lacking evidence regarding their claimed benefits. One group is that of nitric oxide increasing supplements, so-called "NO-boosters," which are claimed to improve the supply of oxygen and nutrients to the muscle by enhancing vasodilation.The aim of this study was to investigate 3 of these supplements in healthy male athletes for their muscle perfusion-enhancing potential using contrast-enhanced ultrasound (CEUS). METHODS: This placebo-controlled, double-blind, randomized cross-over trial will be carried out at the Center for Orthopedics, Trauma Surgery and Spinal Cord Injury of the University Hospital Heidelberg. Three commercial NO enhancing products including 300 mg of the specific green tea extract VASO6 and a combination of 8 g L-citrulline malate and 3 g L-arginine hydrochloride will be examined for their potential to increase muscular perfusion in 30-male athletes between 18 and 40 years and will be compared with a placebo. On each of the 3 appointments CEUS of the dominant biceps muscle will be performed at rest and after a standardized resistance training. Every athlete receives each of the 3 supplements once after a wash-out period of at least 1 week. Perfusion will be quantified via VueBox quantification software. The results of CEUS perfusion measurements will be compared intra- and interindividually and correlated with clinical parameters. DISCUSSION: The results of this study may help to establish CEUS as a suitable imaging modality for the evaluation of potentially vasodilatory drugs in the field of sports. Other supplements could also be evaluated in this way to verify the content of their advertising claims. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), ID: DRKS00016972, registered on 25.03.2019.


Assuntos
Arginina/administração & dosagem , Citrulina/administração & dosagem , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Chá , Ultrassonografia/métodos , Adolescente , Adulto , Meios de Contraste , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Vasodilatação
5.
Medicine (Baltimore) ; 99(41): e22580, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031307

RESUMO

RATIONALE: Mycobacterium tuberculosis (TB) remains a serious threat in developing countries. Primary isolated hepatic tuberculosis is extremely rare. Because of its non-specific imaging features, noninvasive preoperative imaging diagnosis of isolated hepatic tuberculoma remains challenging. PATIENT CONCERNS: A 48-year-old man was admitted to our hospital due for suspected liver neoplasm during health examination. DIAGNOSES: The tests for blood, liver function, and tumor markers were within normal range. Preoperative ultrasonography (US) showed a hypoechoic lesion with a longitudinal diameter of 2.5 cm in segment six of liver. It exhibited early arterial phase hyperenhancement and late arterial phase rapid washout in contrast-enhanced US. It demonstrated hyperintensity in T2-weighted magnetic resonance imaging and partly restricted diffusion in diffusion-weighted imaging. For this nodule, the preoperative diagnosis was small hepatocellular carcinoma (HCC). INTERVENTIONS: Laparoscopic hepatectomy was performed. Intraoperative extensive adhesion in the abdominal cavity and liver was found. The lesion had undergone expansive growth. OUTCOMES: Microscopically, a granuloma with some necrosis was detected. With both acid-fast staining and TB fragment polymerase chain reaction showing positive results, TB was the final histology diagnosis. After surgery, the patient declined any anti-TB medication. During the follow-up, he had no symptoms. In the sixth month after surgery, he underwent an upper abdominal US. It showed no lesions in the liver. LESSONS: Because of non-specific imaging findings and non-specific symptoms, a diagnosis of isolated hepatic TB is difficult to make, especially for small lesions. A diagnosis of HCC should be made cautiously when small isolated lesions in the liver are encountered, especially in patients without a history of hepatitis and with negative tumor markers.


Assuntos
Tuberculose Hepática/diagnóstico por imagem , Tuberculose Hepática/cirurgia , Carcinoma Hepatocelular/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Hepatectomia , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ultrassonografia
7.
Medicine (Baltimore) ; 99(35): e21907, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871924

RESUMO

BACKGROUND: Superb microvascular imaging (SMI) is a novel Doppler technique that depicts low velocity blood flow without the use of a contrast agent. Studies suggested that SMI may or may not detect neovascularization of carotid plaque with accuracy comparable to contrast-enhanced ultrasound. To gain clarity, a meta-analysis to systematically review and synthesize relevant data on the SMI for the detection of intraplaque neovascularization was undertaken. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the June 31, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software will be used for data analysis. RESULTS: This systematic review will investigate whether SMI is feasible on the detection of intraplaque neovascularization compared with contrast-enhanced ultrasound. CONCLUSION: Its findings will provide helpful evidence for the feasibility of SMI on the detection of intraplaque neovascularization. SYSTEMATIC REVIEW REGISTRATION: INPLASY202070097.


Assuntos
Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/patologia , Metanálise como Assunto , Neovascularização Patológica/diagnóstico por imagem , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/patologia , Revisões Sistemáticas como Assunto , Velocidade do Fluxo Sanguíneo , Meios de Contraste , Estudos de Viabilidade , Humanos , Aumento da Imagem/métodos , Microvasos/diagnóstico por imagem , Ultrassonografia/métodos
8.
S Afr Med J ; 110(7): 642-645, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32880340

RESUMO

We present an unusual case of syphilitic pancreatitis and ascending aortitis in a 41-year-old HIV-negative male patient presenting to a tertiary institution with obstructive jaundice. After a battery of investigations that included computed tomography (CT) and 18F-labelled fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) imaging, syphilis serology and histology, a diagnosis of tertiary syphilis was made. The patient responded favourably to antibiotics, with resolution of all lesions on FDG PET/CT 13 weeks after initiation of therapy. Even though tertiary syphilis is a rare entity, it should be earmarked as a mimicker of other pathological conditions, including, in this case, primary pancreatic malignancy.


Assuntos
Pancreatite/diagnóstico , Pancreatite/microbiologia , Sífilis/diagnóstico , Adulto , Aneurisma da Aorta Torácica/diagnóstico por imagem , Biópsia , Angiografia por Tomografia Computadorizada , Meios de Contraste , Diagnóstico Diferencial , Humanos , Icterícia Obstrutiva/microbiologia , Masculino , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico , Sífilis Cardiovascular/diagnóstico , Tomografia Computadorizada por Raios X
9.
Am J Case Rep ; 21: e926781, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32952147

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, SARS-CoV-2, and is associated with severe respiratory disease. There are extensive publications on the chest computed tomography (CT) findings of COVID-19 pneumonia, with ground-glass opacities (GGO) and mixed GGO and consolidation being the most common findings. Those with interstitial thickening manifesting as reticular opacities typically show superimposed ground-glass opacities, giving a crazy-paving pattern. CASE REPORT We report the case of a 77-year-old man with a background of asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) who presented with progressive cough and shortness of breath for 2 days. He was in close contact with a confirmed COVID-19 case. Reverse-transcription polymerase chain reaction analysis of a nasopharyngeal swab was positive for SARS-CoV-2. The initial chest radiograph was negative for lung consolidation and ground-glass opacities. During admission, he had worsening shortness of breath with desaturation, prompting a chest CT examination, which was performed on day 14 of illness. The chest CT revealed an atypical finding of predominant focal subpleural interstitial thickening in the right lower lobe. He was provided supportive treatment along with steroid and antibiotics. He recovered well and subsequently tested negative for 2 consecutive swabs. He was discharged after 34 days. CONCLUSIONS Interstitial thickening or reticular pattern on CT has been described in COVID-19 pneumonia, but largely in association with ground-glass opacity or consolidation. This case demonstrates an atypical predominance of interstitial thickening on chest CT in COVID-19 pneumonia on day 14 of illness, which is the expected time of greatest severity of the disease.


Assuntos
Infecções por Coronavirus/diagnóstico , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Pneumonia Viral/diagnóstico , Intensificação de Imagem Radiográfica , Síndrome Respiratória Aguda Grave/diagnóstico por imagem , Corticosteroides/administração & dosagem , Idoso , Antibacterianos/administração & dosagem , Técnicas de Laboratório Clínico , Meios de Contraste , Infecções por Coronavirus/complicações , Tosse/diagnóstico , Tosse/etiologia , Progressão da Doença , Dispneia/diagnóstico , Dispneia/etiologia , Seguimentos , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Doenças Pulmonares Intersticiais/complicações , Doenças Pulmonares Intersticiais/terapia , Masculino , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Medição de Risco , Síndrome Respiratória Aguda Grave/virologia , Resultado do Tratamento
10.
Bone Joint J ; 102-B(10): 1331-1340, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32993344

RESUMO

AIMS: Stiffness is a common complication after total knee arthroplasty (TKA). Pathogenesis is not understood, treatment options are limited, and diagnosis is challenging. The aim of this study was to investigate if MRI can be used to visualize intra-articular scarring in patients with stiff, painful knee arthroplasties. METHODS: Well-functioning primary TKAs (n = 11), failed non-fibrotic TKAs (n = 5), and patients with a clinical diagnosis of fibrosis1 (n = 8) underwent an MRI scan with advanced metal suppression (Slice Encoding for Metal Artefact Correction, SEMAC) with gadolinium contrast. Fibrotic tissue (low intensity on T1 and T2, low-moderate post-contrast enhancement) was quantified (presence and tissue thickness) in six compartments: supra/infrapatella, medial/lateral gutters, and posterior medial/lateral. RESULTS: Fibrotic tissue was identified in all patients studied. However, tissue was significantly thicker in fibrotic patients (4.4 mm ± 0.2 mm) versus non-fibrotic (2.5 mm ± 0.4 mm) and normal TKAs (1.9 mm ± 0.2 mm, p = < 0.05). Significant (> 4 mm thick) tissue was seen in 26/48 (54%) of compartments examined in the fibrotic group, compared with 17/30 (57%) non-fibrotic, and 10/66 (15%) normal TKAs. Although revision surgery did improve range of movement (ROM) in all fibrotic patients, clinically significant restriction remained post-surgery. CONCLUSION: Stiff TKAs contain intra-articular fibrotic tissue that is identifiable by MRI. Studies should evaluate whether MRI is useful for surgical planning of debridement, and as a non-invasive measurement tool following interventions for stiffness caused by fibrosis. Revision for stiffness can improve ROM, but outcomes are sub-optimal and new treatments are required. Cite this article: Bone Joint J 2020;102-B(10):1331-1340.


Assuntos
Artroplastia do Joelho , Artropatias/diagnóstico por imagem , Artropatias/etiologia , Imagem por Ressonância Magnética/métodos , Complicações Pós-Operatórias/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Fibrose , Humanos , Aumento da Imagem , Masculino , Metais , Pessoa de Meia-Idade
11.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 459-467, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895097

RESUMO

Objective To evaluate the correlation between the radiomics signature of hepatobiliary phase imaging of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)and Child-Pugh of liver cirrhosis,establish nomogram prediction model,and assess the predictive value of quantitative assessment of liver reserve function of patients with liver cirrhosis. Methods One hundred patients with liver cirrhosis who met the inclusion criteria were divided into 52 patients with Child-Pugh grade A and 48 patients with Child-Pugh grade B+C according to Child-Pugh classification criteria,and were randomly divided into training set and test set at a proportion of 7∶3.The AK software was used to extract the imaging features of the Gd-EOB-DTPA-enhanced MRI hepatobiliary images of the patients in the training set,and the least absolute shrinkage and selection operator feature selection algorithm was used to reduce the dimension of the data,select the features,and construct the radiomics tags.According to the radiomics label Rad-score,a line chart(nomogram)prediction model was established to predict the Child-Pugh B+C level of liver reserve function.The model was applied to the training set and test set respectively,and the diagnostic efficiency was quantitatively evaluated by receiver operating characteristic(ROC)curve. Results After dimension reduction and screening of 396 texture feature parameters extracted by AK software,7 image feature parameters were obtained.According to the above characteristics,the radiomics tag Rad-score was constructed and the nomogram prediction model was created.The differences of Rad-score scores between Child-Pugh A and Child-Pugh B+C groups in training set and test set were statistically analyzed by Wilcoxon rank sum test(P=0.000, P=0.001).The diagnostic efficacy of nomogram prediction model for predicting Child-Pugh B+C grade of liver reserve function in the ROC curve of training set and test set was 0.88 and 0.86 respectively. Conclusions The nomogram prediction model created according to the radiomics tag Rad-score of patients with liver cirrhosis with different liver reserve functions can be used as a more accurate and reliable auxiliary detection tool for liver reserve function.It provides a new means for clinicians to evaluate liver reserve function more accurately.


Assuntos
Imagem por Ressonância Magnética , Meios de Contraste , Gadolínio DTPA , Humanos , Cirrose Hepática
12.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 540-545, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895108

RESUMO

Ultrasound contrast agent microbubbles combined with low frequency ultrasound named as low-frequency ultrasound-targeted microbubble destruction technology has become an effective and non-invasive anti-tumor therapy for deep tumors.It can enhance the efficacies of chemotherapy,gene therapy,immunotherapy,and anti-angiogenic therapy by improving cell membrane permeability and destroying tumor neovasculature.It can be applied to sonodynamic therapy and realize multimodal synergistic therapy on the basis of nanoparticles,which increases the anti-tumor efficiency and offers a promising target therapy for tumors.


Assuntos
Microbolhas , Neoplasias , Meios de Contraste , Terapia Genética , Humanos , Ultrassonografia
14.
Artigo em Japonês | MEDLINE | ID: mdl-32963135

RESUMO

The purpose of this study was to calculate statistically significant patient data and test bolus (TB) parameters in order to predict the contrast enhancement of main bolus (eMB) in coronary computed tomography (CT) angiography, and to create a predictive model of eMB with the calculated parameters by machine learning. A total of 126 patients underwent coronary CT angiography. Contrast material was administered at a fixed injection rate and volume. The peak enhancement (PE) and the time needed to reach peak (TP) of the TB were calculated for each patient. The dependency of MB contrast attenuation on these parameters was evaluated. Significant correlations were obtained among PE, TP, and the patient body surface area (BSA) with the eMB. The coefficient of determination of the linear regression model to estimate eMB by machine learning using the above three variables was 0.70 for the training data and 0.55 for the test data. For comparison, the coefficient of determination of the model using only BSA was 0.55 for the training data and 0.36 for the test data; the accuracy of the model created during this time was confirmed.


Assuntos
Angiografia por Tomografia Computadorizada , Meios de Contraste , Angiografia Coronária , Humanos , Aprendizado de Máquina , Tomografia Computadorizada por Raios X
15.
Artigo em Japonês | MEDLINE | ID: mdl-32963136

RESUMO

Although the test bolus tracking method is available as a predicting method of scan timing in the coronary computed tomography (CT) angiography, it is known that there is a problem of scan timing due to the use of a part of test bolus method. The diluted test bolus method was adopted for test bolus, and as a result of using in combination with the test bolus tracking method, it showed a higher contrast enhancement compared with the test bolus tracking method; a stable contrast enhancement with less variation in CT number was obtained. The CT number at the peak in the test scan and the CT number of the main scan showed a high correlation. The contrast injection technique using the diluted test bolus method and the test bolus tracking method is a useful method in the coronary CT angiography. We named this contrast injection technique diluted test bolus tracking method.


Assuntos
Angiografia por Tomografia Computadorizada , Meios de Contraste , Angiografia , Angiografia Coronária , Injeções , Tomografia Computadorizada por Raios X
16.
Artigo em Japonês | MEDLINE | ID: mdl-32963137

RESUMO

PURPOSE: Dynamic C-arm computed tomography perfusion (C-arm CTP) is a newly developed application that can provide cerebral perfusion images in the angio suite, similar to conventional multi-detector CTP in a diagnostic room. We introduce the workflow of C-arm CTP acquisition and our initial experience in a clinical setting. METHOD: C-arm CTP was acquired with 40 ml of non-diluted contrast medium injected at 4 ml/s in the median cubital vein followed by 30 ml of saline injected at the same rate. The injection began 5 seconds after the acquisition was started. Two mask runs were followed with eight successive fill runs. Arterial input function was automatically calculated to deliver perfusion maps. Incidence of acquisition errors was evaluated in two phases. RESULT: C-arm CTP images were successfully acquired in all cases, and the images provided useful information under a stable examination protocol. However, we experienced some operational and systematic artifacts that degraded image quality of perfusion maps in Phase 1. The incident rate of errors was significantly improved in Phase 2. CONCLUSION: C-arm CTP acquisitions were feasible during acute stroke treatment in the angio suite. It is expected that the image quality will be further improved through process improvement and reconstruction setting optimization to minimize unexpected artifacts in individual cases.


Assuntos
Acidente Vascular Cerebral , Tomografia Computadorizada por Raios X , Algoritmos , Artefatos , Meios de Contraste , Humanos
17.
Z Gastroenterol ; 58(9): 847-854, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32947630

RESUMO

BACKGROUND: The aim of our study is to analyze viscosity characteristics of focal liver lesions (FLLs) and the diagnostic performance of shear wave dispersion (SWD) in differentiating benign and malignant FLLs. METHODS: Between January 2018 and April 2018, 58 consecutive patients (median age 57, age range 21-74 years, 37 males) with 58 FLLs located on the right lobe of liver were prospectively studied. The Aplio i900 series diagnostic ultrasound system (Canon Medical systems) equipped with a curvilinear PV1-475BX transducer (1-8 MHz) was used. SWD slope and viscosity measurements were expressed as mean ± standard deviation for both liver tumors and background liver parenchyma. Histopathological results after surgery were regarded as the gold standard for diagnosis. RESULTS: Final diagnosis included 40 cases of malignant and 18 cases of benign FLLs. The mean viscosity value were 14.78 ±â€Š1.86 m/s/kHz for hepatocellular carcinoma (n = 30), 14.81 ±â€Š2.35 m/s/kHz for liver metastasis lesions (n = 10), 13.23 ±â€Š1.31 m/s/kHz for hemangioma (n = 13), and 13.67 ± 2.72 m/s/kHz for focal nodular hyperplasia (n = 5). Malignant FLLs showed higher mean viscosity values (14.79 ±â€Š3.15 m/s/KHz) than benign FLLs (13.36 ±â€Š2.76 m/s/KHz) (p < 0.05). The best performing cut-off value of lesion viscosity was 13.15 m/s/kHz (sensitivity 83.3 %; specificity 56.5 %; area under the curve (AUC) 0.71) for malignancy) (p < 0.05). CONCLUSIONS: The analysis of SWD slope and liver viscosity parameters provide additional viscoelastic information about FLLs before operation.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Fígado/diagnóstico por imagem , Adulto , Idoso , Meios de Contraste , Diagnóstico Diferencial , Humanos , Fígado/patologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Ultrassonografia , Viscosidade , Adulto Jovem
18.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(9): 772-776, 2020 Sep 24.
Artigo em Chinês | MEDLINE | ID: mdl-32957761

RESUMO

Objective: To analysis the clinical characteristics and to summarize therapy experience of pediatric patients with cardiac syncope caused by anomalous origin of the left coronary artery from the right sinus (ALCA-R). Methods: We retrospectively analyzed the clinical data including clinical manifestations, myocardial injury biomarkers, radiological features, treatments and prognoses of pediatric patients with ALCA-R who were admitted to Beijing Children's Hospital from November 2015 to June 2018. Results: Four female patients were included in this analysis, age of onset was 7 to 14 years. All the patients presented with exercise-induced syncope and acute myocardial infarction. During the course, three patients presented with acute left heart failure, and one patient had history of sudden cardiac arrest. Laboratory data showed significant elevation of both the creatine kinase and troponin levels in four patients. All electrocardiogram (ECG) showed left main coronary artery occlusion, echocardiography suggested the possible anomalous origin of the left coronary artery in one child. Coronary CT angiography (CTA) revealed there was no coronary ostium in the left coronary sinus, and the left coronary artery had an anomalous origin from the right sinus. The left main coronary artery passed between the ascending artery and the root of the main pulmonary artery, which was compressed by these two large vessels. Two patients underwent cardiac magnetic resonance examination, which detected late gadolinium enhancement in ALCA-R with an interarterial course. Unroofing of the left coronary ostium (cut-back procedure) was performed in two patients, and the other two patients who were not operated were recommended to restrict their physical activities. During a regular follow-up period of 12-43 months, all the children survived without recurrent cardiovascular event. Conclusion: If an adolescent presents with exercise-induced syncope, acute myocardial infarction and even sudden death, and ECG shows left main coronary artery occlusion characteristics, we should consider the possibility of developmental abnormality of coronary artery, particularly the ALCA-R. Once diagnosed as ALCA-R, patients should be recommended to avoid strenuous activities,early recognition and surgical treatment are imperative for these patients.


Assuntos
Anomalias dos Vasos Coronários , Adolescente , Criança , Meios de Contraste , Angiografia Coronária , Feminino , Gadolínio , Humanos , Estudos Retrospectivos , Síncope
19.
J Cardiovasc Magn Reson ; 22(1): 62, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32878630

RESUMO

BACKGROUND: Intensive endurance exercise may induce a broad spectrum of right ventricular (RV) adaptation/remodelling patterns. Late gadolinium enhancement (LGE) has also been described in cardiovascular magnetic resonance (CMR) of some endurance athletes and its clinical meaning remains controversial. Our aim was to characterize the features of contrast CMR and the observed patterns of the LGE distribution in a cohort of highly trained endurance athletes. METHODS: Ninety-three highly trained endurance athletes (> 12 h training/week at least during the last 5 years; 36 ± 6 years old; 53% male) and 72 age and gender-matched controls underwent a resting contrast CMR. In a subgroup of 28 athletes, T1 mapping was also performed. RESULTS: High endurance training load was associated with larger bi-ventricular and bi-atrial sizes and a slight reduction of biventricular ejection fraction, as compared to controls in both genders (p < 0.05). Focal LGE was significantly more prevalent in athletes than in healthy subjects (37.6% vs 2.8%; p < 0.001), with a typical pattern in the RV insertion points. In T1 mapping, those athletes who had focal LGE had higher extracellular volume (ECV) at the remote myocardium than those without (27 ± 2.2% vs 25.2 ± 2.1%; p < 0.05). CONCLUSIONS: Highly trained endurance athletes showed a ten-fold increase in the prevalence of focal LGE as compared to control subjects, always confined to the hinge points. Additionally, those athletes with focal LGE demonstrated globally higher myocardial ECV values. This matrix remodelling and potential presence of myocardial fibrosis may be another feature of the athlete's heart, of which the clinical and prognostic significance remains to be determined.


Assuntos
Atletas , Cardiomegalia Induzida por Exercícios , Meios de Contraste/administração & dosagem , Coração/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Compostos Organometálicos/administração & dosagem , Resistência Física , Função Ventricular Direita , Remodelação Ventricular , Adaptação Fisiológica , Adulto , Estudos de Casos e Controles , Feminino , Fibrose , Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Valor Preditivo dos Testes , Volume Sistólico , Função Ventricular Esquerda , Adulto Jovem
20.
J Cardiovasc Magn Reson ; 22(1): 66, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32921308

RESUMO

BACKGROUND: Cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) is a valuable technique for detecting myocardial disorders and fibrosis. However, we sometimes observe a linear, mid-wall high intensity signal in the basal septum in the short axis view, which often presents diagnostic difficulties in the clinical setting. The purpose of this study was to compare the linear, mid-wall high intensity in the basal septum identified by LGE with the anterior septal perforator arteries identified by coronary computed tomography angiography (CorCTA). METHODS: We retrospectively selected 148 patients who underwent both CorCTA and CMR LGE within 1 year. In the interpretation of LGE, we defined a positive linear high intensity (LHI+) as follows: ① LHI in the basal septum and ② observable for 1.5 cm or more. All other patients were defined as a negative LHI (LHI-). In LHI+ patients, we assessed the correlation between the LHI length and the septal perforator artery length on CorCTA. We also compared the length of the septal perforator artery on CorCTA between LHI+ patients and LHI- patients. RESULTS: A population of 111 patients were used for further analysis. Among these , there were 55 LHI+ patients and 56 LHI- patients. In LHI+ patients, linear regression analysis revealed that there was a good agreement between LGE LHI and septal perforator arteries by CorCTA in terms of length measurements. The measured length of the anterior septal perforator arteries was significantly shorter in LHI- patients than in LHI+ patients (10 ± 8 mm vs. 21 ± 8 mm; P < 0.05). CONCLUSIONS: The LHI observed in the basal septum on short axis LGE may reflect contrast enhancement of the anterior septal perforator arteries. It is important to interpret this septal LHI against knowledge of anatomic structure, to avoid misinterpretations of LGE and prevent misdiagnosis.


Assuntos
Cardiomiopatias/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Meios de Contraste/administração & dosagem , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Gadolínio DTPA/administração & dosagem , Septos Cardíacos/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Isquemia Miocárdica/diagnóstico por imagem , Idoso , Artefatos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos
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