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1.
Medicine (Baltimore) ; 98(21): e15520, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124932

RESUMO

Diffusion-weighted imaging (DWI) is a functional imaging technique sensitive to microstructure in tissues. It is widely acknowledged to reflect cellularity in tumors. A small part of DWI is also sensitive to perfusion-related information and might therefore be also be able to reflect microvessel density in tumor tissues. Aim of the present study was to elucidate possible correlations between microvessel density and apparent diffusion coefficient (ADC) values in head and neck squamous cell carcinoma (HNSCC).Thirty-four patients with histologically proven primary HNSCC were included in the study. DWI was performed with a 3 T magnetic resonance imaging (MRI) (b-values 0 and 800 s/mm) and histogram analysis was calculated with a whole lesion measurement. In every case, microvessel density was estimated with CD105-stained specimens.There were no statistically significant correlations between ADC histogram parameters and microvessel density. The calculated correlation coefficients ranged from r = -0.27, P = .13 for entropy and vessel area to r = 0.16, P = .40 for ADCmin and vessel count.Whole-lesion histogram analysis of ADC values cannot reflect microvessel density in HNSCC.


Assuntos
Imagem de Difusão por Ressonância Magnética/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Microvasos/diagnóstico por imagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Adulto , Idoso , Imagem de Difusão por Ressonância Magnética/métodos , Endoglina , Entropia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Microvasos/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Coloração e Rotulagem , Carga Tumoral
2.
Int J Mol Sci ; 20(10)2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31091708

RESUMO

We performed a three-dimensional (3D) analysis of the microvascular network of the cerebral cortex of twitcher mice (an authentic model of Krabbe disease) using a restricted set of indexes that are able to describe the arrangement of the microvascular tree in CD31-stained sections. We obtained a near-linear graphical "fingerprint" of the microangioarchitecture of wild-type and twitcher animals that describes the amounts, spatial dispersion, and spatial relationships of adjacent classes of caliber-filtered microvessels. We observed significant alterations of the microangioarchitecture of the cerebral cortex of twitcher mice, whereas no alterations occur in renal microvessels, which is keeping with the observation that kidney is an organ that is not affected by the disease. This approach may represent an important starting point for the study of the microvascular changes that occur in the central nervous system (CNS) under different physiopathological conditions.


Assuntos
Córtex Cerebral/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Imagem Tridimensional/métodos , Leucodistrofia de Células Globoides/diagnóstico por imagem , Microvasos/diagnóstico por imagem , Animais , Córtex Cerebral/irrigação sanguínea , Camundongos , Microscopia Confocal/métodos
3.
Br J Radiol ; 92(1099): 20181038, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31067075

RESUMO

OBJECTIVE: Bosniak classification system provides a fine imaging evaluation for the malignant cystic renal masses. Superb microvascular imaging (SMI) is a new ultrasonic technique which apply advanced clutter suppression to reflect microflow information. The aim of this study was to evaluate the performance of ultrasound Bosniak classification aided by SMI in diagnosis of cystic renal masses. METHODS: By comparing with contrast-enhanced ultrasound (CEUS) and pathology, we evaluated the sensitivity, specificity and accuracy of conventional ultrasound and SMI combination in the diagnosis of renal cystic masses. RESULTS: Color Doppler Flow image (CDFI) and SMI had significant difference in evaluation the blood flow and Bosniak classification for cystic renal mass of IIf, III and IV (p = 0.020). SMI was consistent with CEUS for cystic renal mass Bosniak classification of IIf, III and IV. Although, CEUS had highest sensitivity of 97.4%, SMI had the highest area under curve in differential diagnosis malignance from benign masses [area under curve = 0.869 (0.743 - 0.995), p < 0.001]. CONCLUSION: SMI can display better in observing blood flow in septa and solid structures of renal cystic lesions compared with CDFI, thus, it can perform more accurate Bosniak classification for renal cystic mass. SMI and CEUS are consistent in Bosniak classification. Bosniak classification aided by SMI maybe an accurate non-invasive ultrasonic examination in distinguishing benign and malignant renal cystic lesions. ADVANCES IN KNOWLEDGE: Conventional ultrasound had limited ability to distinguish malignance in Bosniak classifications IIf and III. SMI can display better in observing blood flow in septa and solid structures of renal cystic lesions compared with CDFI.


Assuntos
Interpretação de Imagem Assistida por Computador/métodos , Doenças Renais Císticas/diagnóstico por imagem , Microvasos/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Rim/irrigação sanguínea , Rim/patologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
4.
Zhonghua Yan Ke Za Zhi ; 55(5): 392-396, 2019 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-31137152

RESUMO

Optical coherence tomography angiography (OCTA) can reflect the vascular morphological changes of various types of uveitis, including flow void, hypoperfusion, capillary abnormalities, capillary network disorders and choroidal neovascularization. Moreover, OCTA is featured of particular quantification functions, such as measurement of the areas of foveal avascular zone, choroidal neovascularization, vascular density and flow index. Despite certain limitations, its characteristics of non-invasiveness and capabilities of depicting vascular details are helpful to the observation and follow-up of uveitis. As current interpretation of the OCTA images for uveitis is not thorough enough, hence further analysis of the images is needed to improve its application on uveitis. (Chin J Ophthalmol, 2019, 55: 392-396).


Assuntos
Angiografia , Angiofluoresceinografia , Tomografia de Coerência Óptica , Uveíte/diagnóstico por imagem , Neovascularização de Coroide/diagnóstico por imagem , Humanos , Microvasos/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem
5.
Eur Arch Otorhinolaryngol ; 276(4): 1117-1125, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30840126

RESUMO

OBJECTIVE: The promotion of neovascularisation is a crucial aspect of carcinogenesis. The study evaluates the microvascular density (MVD) and expression of hypoxia-induced factor (HIF-1α) in hypertrophic vocal fold (VF) lesions of different histopathological states including non-dysplastic, low-grade, high-grade dysplasia and invasive glottic cancer. MATERIALS AND METHODS: Histological specimens collected from patients diagnosed and treated in a single centre with different histological grades were immunohistochemically stained with CD31, CD34 and HIF-1α. Of the total number of 77 analysed VF specimens, 20 were non-dysplastic, 20 had low-grade dysplasia, 17 high-grade dysplasia and 20 were invasive cancers. RESULTS: The highest mean value for MVD evaluated with expression of CD31 (MVD CD31) was 21.23 ± 14.46 and identified in the low-grade dysplasia group. The average MVD CD31 was 13.74 ± 5.56 and 20.11 ± 9.28 in the high-grade dysplasia and invasive cancer group, respectively. The highest MVD evaluated with CD34 (MVD CD34) was revealed for invasive cancer 35.64 ± 17.21. The MVD CD34 was higher for low-grade than in high-grade dysplasia (25.87 ± 12.30 vs 24.65 ± 15.92, respectively). The expression of HIF-1α was strong or very strong in 60% of non-dysplastic lesions, 100% of low-grade dysplasia cases, 53% of high-grade dysplasia cases and 50% of invasive cancer cases. The comparison of MVD CD31 with MVD CD34 revealed a strong positive correlation (ρ value 0.727). The comparison of both MVD CD31 and MVD CD34 with HIF-1α resulted in no linear relationship (ρ value of 0.143 and 0.165, respectively). CONCLUSION: The stage of low-grade dysplasia in intraepithelial vocal fold lesions is related to significant advancement of angiogenesis together with the highest hypoxia level.


Assuntos
Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Hipóxia , Neoplasias Laríngeas/patologia , Microvasos , Neovascularização Patológica , Prega Vocal , Adulto , Idoso , Carcinogênese/metabolismo , Carcinogênese/patologia , Correlação de Dados , Feminino , Humanos , Hipertrofia , Hipóxia/diagnóstico , Hipóxia/etiologia , Hipóxia/metabolismo , Masculino , Microvasos/diagnóstico por imagem , Microvasos/patologia , Microvasos/fisiopatologia , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Neovascularização Patológica/diagnóstico por imagem , Neovascularização Patológica/patologia , Prega Vocal/irrigação sanguínea , Prega Vocal/diagnóstico por imagem , Prega Vocal/patologia
6.
Cardiovasc Diabetol ; 18(1): 22, 2019 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-30819191

RESUMO

BACKGROUND: Patients with type 2 diabetes mellitus are at an increased risk of adverse cardiovascular events compared to those without diabetes. The timing, relative to disease onset, and degree of glycemic control that reduces the risk of adverse cardiovascular events remains uncertain. Coronary microvascular dysfunction is prevalent in patients with type 2 diabetes mellitus and is linked to adverse cardiovascular events. We assessed the association between endothelial-dependent and endothelial-independent coronary microvascular dysfunction and glycemic control in patients presenting with chest pain and nonobstructive coronary disease at angiography. METHODS: Patients presenting with chest pain and found to have non-obstructive CAD (stenosis < 40%) at angiography underwent an invasive assessment of endothelial-independent and endothelial -dependent microvascular function. Endothelial-independent microvascular function was assessed by comparing the coronary flow velocity, measured using a Doppler guidewire, in response to intracoronary infusion of adenosine to calculate the coronary flow reserve ratio in response to adenosine (CFRAdn Ratio). A CFRAdn Ratio ≤ 2.5 was considered abnormal. Endothelial-dependent microvascular function was assessed by measuring the percent change in coronary blood flow in response to intracoronary infusions of acetylcholine (%ΔCBFAch), and microvascular endothelial dysfunction defined as a %ΔCBFAch of ≤ 50%. Patients were classified by normal versus abnormal CFRAdn Ratio and %ΔCBFAch. Measurements of HbA1c and fasting serum glucose were obtained prior to catheterization and compared between groups. RESULTS: Between 1993 and 2012, 1469 patients (mean age 50.4 years, 35% male) underwent coronary angiography and invasive testing for coronary microvascular dysfunction, of which 129 (8.8%) had type 2 diabetes. Fifty-one (39.5%) had an abnormal %ΔCBFAch and 49 (38.0%) had an abnormal CFRAdn Ratio. Conventional cardiovascular risk factors and cardiovascular or diabetic medication use did not vary significantly between groups. Females with an abnormal CFRAdn Ratio or abnormal %ΔCBFAch had a significantly higher HbA1c compared to patients with a normal CFRAdn Ratio or %ΔCBFAch respectively: HbA1c % (standard deviation) 7.4 (2.1) vs. 6.5 (1.1), p = 0.035 and 7.3 (1.9) vs. 6.4 (1.2), p = 0.022, respectively. Female patients with an abnormal CFRAdn Ratio had significantly higher fasting serum glucose concentrations compared to those with a normal CFRAdn Ratio: fasting serum glucose mg/dL (standard deviation) 144.4 (55.6) vs. 121.9 (28.1), p = 0.035. This was not observed in men. Amongst female diabetics, a higher HbA1c was significantly associated with any coronary microvascular dysfunction both in a univariate and multivariate analysis: odds ratio (95% confidence interval) 1.69 (1.01-2.86) p = 0.049; and a fasting serum glucose > 140 mg/dL was significantly associated with an abnormal CFRAdn Ratio, 4.28 (1.43-12.81). CONCLUSION: Poor glycemic control is associated with coronary microvascular dysfunction amongst female diabetics presenting with chest pain and non-obstructive CAD. These findings highlight the importance of sex specific risk stratification models and treatment strategies when managing cardiovascular risk amongst diabetics. Further studies are required to identify additional risk prevention tools and therapies targeting microvascular dysfunction as an integrated index of cardiovascular risk.


Assuntos
Angina Pectoris/fisiopatologia , Glicemia/metabolismo , Doença da Artéria Coronariana/fisiopatologia , Estenose Coronária/fisiopatologia , Vasos Coronários/fisiopatologia , Diabetes Mellitus Tipo 2/sangue , Microvasos/fisiopatologia , Acetilcolina/administração & dosagem , Adenosina/administração & dosagem , Adulto , Idoso , Angina Pectoris/diagnóstico por imagem , Angina Pectoris/epidemiologia , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/epidemiologia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/efeitos dos fármacos , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Ecocardiografia Doppler , Feminino , Reserva Fracionada de Fluxo Miocárdico , Hemoglobina A Glicada/metabolismo , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Microcirculação , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Minnesota/epidemiologia , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Vasoconstritores/administração & dosagem , Vasodilatadores/administração & dosagem
7.
Invest Ophthalmol Vis Sci ; 60(2): 823-829, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30807638

RESUMO

Purpose: To evaluate changes in peripapillary microvascular parameters in the fellow eyes of patients with unilateral retinal vein occlusion (RVO) using optical coherence tomography angiography (OCTA) and to determine the relationships between peripapillary microvasculature and retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness. Methods: Eighty-three patients with unilateral RVO (50 patients with branch RVO and 33 with central RVO) and 83 normal controls were enrolled. OCTA (Cirrus HD-OCT 5000 with AngioPlex) 6 × 6-mm scans centered on the optic disc were acquired. Peripapillary vessel density (VD) and perfusion density (PD) were automatically calculated. Results: The average RNFL and GC-IPL thicknesses in the fellow eyes of RVO patients were significantly thinner than in normal controls (93.5 vs. 96.6 µm, P = 0.013 and 81.3 vs. 84.1 µm, P = 0.003, respectively). In the fellow eyes of patients with unilateral RVO, the peripapillary VD of the inner ring, outer ring, and full area (17.47, 18.50, and 17.89, respectively) were significantly lower than those of controls (17.87, 18.87, and 18.27, respectively). The peripapillary PD of the inner ring, outer ring, and full area (0.456, 0.467, and 0.456, respectively) were also significantly lower than those of controls (0.468, 0.476, and 0.466, respectively). RNFL and GC-IPL thicknesses were correlated with both peripapillary VD and PD. Conclusions: OCTA revealed that peripapillary microvascular parameters in the fellow eyes of patients with unilateral RVO were decreased, and GC-IPL and RNFL thinning were also observed. The RNFL and GC-IPL thicknesses were positively correlated with both peripapillary VD and PD.


Assuntos
Disco Óptico/irrigação sanguínea , Retina/patologia , Oclusão da Veia Retiniana/patologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Idoso , Feminino , Angiofluoresceinografia , Humanos , Masculino , Microvasos/diagnóstico por imagem , Microvasos/patologia , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Tamanho do Órgão , Retina/diagnóstico por imagem , Células Ganglionares da Retina/patologia , Oclusão da Veia Retiniana/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem
8.
Surg Technol Int ; 34: 93-100, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30716160

RESUMO

BACKGROUND: Leakage of the anastomosis after colorectal surgery is a severe complication, and one of the most important causes is poor vascular supply. However, a microvascular deficit is often not detectable during surgery under white light. Near-infrared indocyanine green (ICG)-enhanced fluorescence may be useful for assessing microvascular deficits and conceivably preventing anastomotic leakage. OBJECTIVES: This paper presents a preliminary retrospective case series on robotic colorectal surgery. The aim is to evaluate the feasibility, safety and role of near-infrared ICG-enhanced ?uorescence for the intraoperative assessment of peri-anastomotic tissue vascular perfusion. MATERIALS AND METHODS: From among more than 164 robotic colorectal cases performed, we retrospectively analyzed 28 that were all performed by the same surgeon (PCG) using near-infrared ICG-enhanced fluorescence technology: 16 left colectomies (57.1%), 8 rectal resections (28.6%), 3 right colectomies (10.8%) and 1 pancolectomy (3.6%). RESULTS: The rates of conversion, intraoperative complications, dye allergic reaction and mortality were all 0%. In two cases (7.1%)-1 left and 1 right colectomy-the level of the anastomosis was changed intraoperatively after ICG showed ischemic tissues. Despite the application of ICG, one anastomotic leak (after left colectomy for a chronic recurrent sigmoid diverticulitis with pericolic abscess) was observed. CONCLUSIONS: ICG technology may help to determine when to intraoperatively change the anastomotic level to a safer location. In our case series, ICG results led to a change in the level of the anastomosis in 7.1% of the cases. Despite the use of ICG, we observed one leak. This may have been related to vascularization-independent causes (e.g., infection in this case) or may reflect a need for better standardization of this ICG technology. In particular, we need a way to objectively assess the ICG signal and the related risk of leakage. More randomized, prospective, well-powered trials are needed to unveil the full potential of this innovative surgical technology.


Assuntos
Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica/diagnóstico , Cirurgia Colorretal/efeitos adversos , Corantes , Verde de Indocianina , Raios Infravermelhos , Fístula Anastomótica/etiologia , Fístula Anastomótica/prevenção & controle , Cirurgia Colorretal/métodos , Fluorescência , Intestino Grosso/irrigação sanguínea , Intestino Grosso/cirurgia , Cuidados Intraoperatórios , Microvasos/diagnóstico por imagem , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos
9.
Turk J Med Sci ; 49(1): 20-26, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30761837

RESUMO

Background/aim: We aimed to assess the association between retinal vascular caliber (RVC) scores and disease activity in rheumatoid arthritis (RA) patients. Materials and methods: Forty-seven RA patients, 32 systemic lupus erythematosus (SLE) patients, and 45 healthy people were enrolled. RA and SLE patients were subdivided into groups according to C-reactive protein (CRP) levels. RA patients were also grouped according to Disease Activity Score-28 (DAS-28). Fundus photography was performed for all patients. RVC was summarized as the central retinal artery and vein equivalents (CRAE and CRVE). Results: Mean CRVE for RA patients was 213.3 ± 17.8 µm compared with 209.2 ± 14.1 µm for SLE and 217.5 ± 26.2 µm for the control group (P = 0.17). RVC scores did not differ between the CRP-high and CRP-low groups. As the RA disease activity increased, the widening of CRVE became more prominent and statistically significant. When the DAS-28 > 5.1 (CRVE, 220.4 (211.8­246.5) µm) group and DAS-28 ≤ 3.2 (CRVE, 214.4 (172.4­242.3) µm) group were compared, statistical significance was more pronounced (P = 0.03) than when comparing the DAS-28 > 3.2 and DAS-28 ≤ 3.2 groups (P = 0.05). Conclusions: CRVE, which reflects systemic inflammation and possibly increased cardiovascular risk, was significantly increased in active RA patients. The association between retinal venular widening and disease activity, regardless of CRP, may be a sign that RA-related inflammation may have systemic vascular effects even with normal levels of CRP.


Assuntos
Artrite Reumatoide/epidemiologia , Microvasos/patologia , Veia Retiniana/patologia , Adulto , Artrite Reumatoide/patologia , Proteína C-Reativa/análise , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/patologia , Masculino , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Fotografação , Estudos Prospectivos , Veia Retiniana/diagnóstico por imagem
10.
PLoS One ; 14(1): e0211152, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30682202

RESUMO

In healthy arteries, blood flow is regulated by microvascular tone assessed by changes in blood flow volume and vascular resistance to endothelium-dependent and -independent vasodilators. We developed a novel method of using intravascular ultrasound (IVUS) and a Doppler flow wire to measure changes in blood flow volume and vascular resistance of the profunda arterial bed. We assessed the variability over 6 months in measuring microvascular endothelium-dependent dilation to acetylcholine and endothelium-independent dilation to adenosine in 20 subjects who were part of a larger study of Gulf War Illness without obstructive peripheral artery disease. Vasomotor function was assessed by Infusions of control (dextrose), acetylcholine (10-6M), adenosine (50µg), and nitroglycerin (25µg/ml). 400 IVUS and 240 flow velocity images were measured a mean 6 (SD = 2) months apart blind to measurement and infusion stage. The mean (SD) baseline profunda flow was 227 (172) ml/min and vascular resistance 4.6 x 104 (2.4 x 104) dynes-s/cm5. The intraclass correlation coefficients for 6-month variability for vascular function were excellent (range 0.827-0.995). Bland-Altman analyses showed mean differences of less than 2% for microvascular endothelium-dependent function (flow volume and resistance) and less than 1% for macrovascular endothelium-dependent function with acceptable limits of agreement. In 49 subjects assessing concurrent validity of the technique against atherosclerosis risk factors, we observed greater impairment in microvascular endothelium-dependent function per year of age (flow volume = -1.4% (p = 0.018), vascular resistance = 1.5% (p = 0.015)) and current smoking (flow volume = -36.7% (p = .006), vascular resistance = 50.0% (p<0.001)). This novel method of assessing microvascular vasomotor function had acceptable measurement reproducibility and validity.


Assuntos
Microvasos , Síndrome do Golfo Pérsico , Ultrassonografia de Intervenção , Resistência Vascular , Vasodilatação , Adulto , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Masculino , Microvasos/diagnóstico por imagem , Microvasos/fisiopatologia , Pessoa de Meia-Idade , Síndrome do Golfo Pérsico/diagnóstico por imagem , Síndrome do Golfo Pérsico/fisiopatologia , Reprodutibilidade dos Testes
11.
Acta Otolaryngol ; 139(1): 94-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30676845

RESUMO

BACKGROUND: In sentinel lymph node (SLN) biopsy for head and neck cancers, the radioisotope method has been the gold standard. However, this method has several problems, such as unavoidable radiation exposure and requirements of expensive equipment. AIMS/OBJECTIVES: To overcome these problems, we evaluated the contrast-enhanced ultrasonography (CEUS)-guided SLN-detection method, and predicted the SLN metastatic status using novel ultrasound technology, superb microvascular imaging (SMI). METHODS: Ten patients (6 with oral and 4 with oropharyngeal cancers) without neck lymph node metastasis were enrolled in this study. Ultrasound contrast agent, Sonazoid™, was infiltrated into the mucosa at the primary site to observe the lymphatic ducts and SLNs in the neck field. The detected SLNs were examined for blood flow using SMI to categorize the SLNs metastases-positive or negative. RESULTS: SLNs were successfully detected in 8 out of 10 cases. In 7 out of the 8 cases, in whom SLNs were successfully detected, the metastatic status of SLNs was correctly diagnosed with SMI. CONCLUSIONS AND SIGNIFICANCE: Although more clinical data are needed based on a larger cohort, establishing the CEUS-guided SLN-detection and criteria for the accurate diagnosis of SLN-metastases using SMI would be valuable as an alternative to radioisotope method, in oral and oropharyngeal cancers.


Assuntos
Meios de Contraste , Compostos Férricos , Ferro , Neoplasias Orofaríngeas/diagnóstico por imagem , Óxidos , Linfonodo Sentinela/diagnóstico por imagem , Ultrassonografia , Adulto , Idoso , Feminino , Humanos , Metástase Linfática , Masculino , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/irrigação sanguínea , Projetos Piloto
12.
Sensors (Basel) ; 19(2)2019 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-30634614

RESUMO

Vascular networks can provide invaluable information about tumor angiogenesis. Ultrafast Doppler imaging enables ultrasound to image microvessels by applying tissue clutter filtering methods on the spatio-temporal data obtained from plane-wave imaging. However, the resultant vessel images suffer from background noise that degrades image quality and restricts vessel visibilities. In this paper, we addressed microvessel visualization and the associated noise problem in the power Doppler images with the goal of achieving enhanced vessel-background separation. We proposed a combination of patch-based non-local mean filtering and top-hat morphological filtering to improve vessel outline and background noise suppression. We tested the proposed method on a flow phantom, as well as in vivo breast lesions, thyroid nodules, and pathologic liver from human subjects. The proposed non-local-based framework provided a remarkable gain of more than 15 dB, on average, in terms of contrast-to-noise and signal-to-noise ratios. In addition to improving visualization of microvessels, the proposed method provided high quality images suitable for microvessel morphology quantification that may be used for diagnostic applications.


Assuntos
Microvasos/diagnóstico por imagem , Imagens de Fantasmas , Ultrassonografia/métodos , Mama/diagnóstico por imagem , Mama/patologia , Feminino , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Masculino , Razão Sinal-Ruído , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia
13.
Microvasc Res ; 123: 68-73, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30611746

RESUMO

BACKGROUND: The impairment of endothelial function in type 1 diabetes mellitus (DM1) is considered as the basis of microvascular complications. In DM1 patients autoimmune thyroiditis is a frequent comorbidity which may be responsible for further deterioration of microcirculation function. In studies investigating the relationship between cardiovascular risk factors and microvascular function, skin microcirculation is widely used. The aim of our study was to evaluate the impact of coexisting autoimmune thyroiditis on skin microcirculation in children with type I diabetes mellitus. SUBJECTS: The study group consisted of 25 pediatric DM1 patients, 25 pediatric patients with type 1 diabetes and autoimmune thyroiditis (DM1 + AIT) and 29 control subjects matched for age and gender. The DM1 and DM1 + AIT patients were also matched for age at onset of DM and diabetes duration. METHODS: Performed capillaroscopy studies employed non-selective stimuli such as post-occlusive reactive hyperemia (PORH) and venous occlusion (VO) tests. The relative area covered by capillaries (coverage) and the distance between capillaries were assessed. These measurements were performed before tests as well as after PORH and VO. RESULTS: Coverage at baseline, after PORH and VO and distance after VO differ significantly between control subjects and the group DM1 + AIT. The coverage at baseline, after PORH and VO were significantly smaller in DM1 + AIT compared with the control group. Post-hoc analysis after controlling for lipids levels showed that differences between the DM1 + AIT and control group were remained only for coverage at baseline and after VO. Significant differences between DM1 + AIT and DM1 and control group for coverage after VO were also presented. CONCLUSIONS: Coexisting autoimmune thyroiditis significantly deteriorates skin microcirculation function in pediatric non-complicated type 1 diabetic patients. This process is independent of patient age, diabetes duration and age of diabetes onset.


Assuntos
Diabetes Mellitus Tipo 1/fisiopatologia , Angiopatias Diabéticas/fisiopatologia , Microcirculação , Microvasos/fisiopatologia , Pele/irrigação sanguínea , Tireoidite Autoimune/fisiopatologia , Adolescente , Fatores Etários , Estudos de Casos e Controles , Criança , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico por imagem , Angiopatias Diabéticas/diagnóstico por imagem , Angiopatias Diabéticas/etiologia , Feminino , Humanos , Hiperemia/fisiopatologia , Masculino , Angioscopia Microscópica , Microvasos/diagnóstico por imagem , Oclusão Terapêutica , Tireoidite Autoimune/complicações , Tireoidite Autoimune/diagnóstico por imagem
14.
J Stroke Cerebrovasc Dis ; 28(4): 1113-1125, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30679013

RESUMO

BACKGROUND AND PURPOSE: Chronic ischemia may induce brain microstructural damage and lead to neurocognitive dysfunction in patients with Moyamoya disease (MMD). We applied neurite orientation dispersion and density imaging (NODDI) and 15O-gas positron emission tomography (PET) to elucidate the specific ischemic brain microstructural damage of MMD in the cortex and the white matter. MATERIALS AND METHODS: Thirty-one patients (16-63years old, 9 males) and 20 age- and sex-matched normal controls were enrolled in this study. NODDI evaluates quantitative parameters reflecting neurite and axonal density, network complexity and the interstitial fluid in all participants. Of 31 patients, 12 newly diagnosed patients were evaluated with PET, also. We evaluated correlations between the microstructural parameters of NODDI and the hemodynamic and metabolic parameters of PET, the relationship between NODDI and clinical severity of each hemisphere (Normal, Asymtpomatic, Symptomatic, and Infarcted) as well as neurocognitive performance. RESULTS: All NODDI parameters significantly correlated with PET parameters (absolute r = 0.46-0.83, P ≤ .048) and clinical severity (P < .001), suggesting that neurite and axonal density and network complexity decreased, and the interstitial fluid increased, as the ischemic burden became severe. NODDI parameters reflecting neurite and axonal density and network complexity significantly correlated with neurocognitive profiles (r = 0.36-0.64, P ≤ .048), but the interstitial fluid component did not. CONCLUSIONS: Chronic ischemia in patients with MMD may induce decreased neurite and axonal density, simplified network complexity, and may lead to neurocognitive dysfunction. The increased interstitial fluid accompanying hemodynamic impairment may not be identical to the decreased neurite density and might be driven by another mechanism.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Encéfalo/irrigação sanguínea , Imagem de Difusão por Ressonância Magnética , Microvasos/diagnóstico por imagem , Doença de Moyamoya/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Adolescente , Adulto , Axônios/patologia , Isquemia Encefálica/patologia , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/psicologia , Estudos de Casos e Controles , Angiografia Cerebral/métodos , Circulação Cerebrovascular , Cognição , Feminino , Hemodinâmica , Humanos , Angiografia por Ressonância Magnética , Masculino , Microcirculação , Microvasos/fisiopatologia , Pessoa de Meia-Idade , Doença de Moyamoya/patologia , Doença de Moyamoya/fisiopatologia , Doença de Moyamoya/psicologia , Neuritos/patologia , Testes Neuropsicológicos , Valor Preditivo dos Testes , Índice de Gravidade de Doença , Adulto Jovem
15.
Med Phys ; 46(2): 738-745, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30585642

RESUMO

PURPOSE: This study aimed to develop a fast scheme of multiparametric perfusion functional imaging (PFI) based on dynamic contrast-enhanced ultrasound (DCEUS) for assessing renal microvascular hemodynamics. METHOD: The flow process in the DCEUS-based PFI was modified step-by-step to improve its operational efficiency, which was validated through in vivo renal perfusion experiments. A multiparametric model with a comprehensive coefficient of imaging quality (CIQ) was then built on four terms of the average information entropy, contrast, gray, and noise coefficient of PFIs to evaluate the sacrifice of imaging quality during modifications of DCEUS-based PFI. RESULTS: The multiparametric model successfully evaluated modifications of DCEUS-based PFI from multiple perspectives (R2  = 0.73, P < 0.01). Compared with the raw scheme in the renal sagittal and coronal planes, the fast PFI scheme significantly improved its operational efficiency by 62.82 ± 1.07% (P < 0.01) and the nine PFIs simultaneously maintained a similar CIQ of 0.26 ± 0.06. CONCLUSIONS: The inhomogeneous hemodynamic distributions with a ring-like feature in the renal microvasculature were accurately and efficiently characterized by the fast PFI scheme. The fast PFI scheme can be applied for early diagnosis, follow-up evaluation and monitoring treatment of chronic kidney disease.


Assuntos
Rim/irrigação sanguínea , Microvasos/diagnóstico por imagem , Microvasos/fisiologia , Imagem de Perfusão/métodos , Animais , Meios de Contraste , Controle de Qualidade , Coelhos , Fatores de Tempo , Ultrassonografia
16.
Microvasc Res ; 121: 71-81, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30321536

RESUMO

OBJECTIVES: Laser speckle contrast imaging (LSCI) has seen limited use in the study of perfusion dynamics such as vasomotion. The aim of this study was to investigate the effects of a prolonged seated position on perfusion dynamics in the nail bed using LSCI. METHODS: Perfusion was recorded in digits II to IV bilaterally for 20 min during two separate sessions in ten healthy volunteers. The acclimatization period was 5 min for the 1st session and 20 min for the 2nd. Perfusion variability and the presence of recurring perfusion dips were analyzed. A digital nerve block was done to verify suspected nervous origin of phenomenon. RESULTS: Synchronized phases of vasoconstriction were observed in all subjects with perfusion dips in all digits bilaterally and simultaneously. Application of a digital nerve block abolished perfusion dips. The frequency of this phenomenon increased by 25.0% (95% CI: 1.6 to 49.2%) in the left-hand digits after a prolonged seated position. Perfusion variability increased by 11.6% (95% CI: 2.6 to 20.3%) in the digits of the left hand. Perfusion changes in right-hand digits did not significantly increase. During the 1st session, temperature increased by 2.7 °C (1.1 to 4.2) while it decreased by 1.3 °C (0.2 to 2.4) during the 2nd session. CONCLUSION: The observed perfusion dips are of a centrally mediated nervous origin but are also affected by local factors. They are affected by seating duration and differ between left and right hands, likely because of local micro perfusion dips. This phenomenon seems related to digital thermoregulation.


Assuntos
Microcirculação , Microvasos/fisiologia , Unhas/irrigação sanguínea , Vasoconstrição , Adulto , Velocidade do Fluxo Sanguíneo , Regulação da Temperatura Corporal , Feminino , Lateralidade Funcional , Humanos , Fluxometria por Laser-Doppler , Masculino , Microvasos/diagnóstico por imagem , Imagem de Perfusão/métodos , Postura , Fluxo Sanguíneo Regional , Temperatura Cutânea , Fatores de Tempo , Adulto Jovem
17.
Sci Rep ; 8(1): 17949, 2018 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-30560881

RESUMO

Hypoxia is a common feature of the tumor microenvironment. Accumulating evidence has demonstrated hypoxia to be an important trigger of tumor cell invasion or metastasizes via hypoxia-signaling cascades, including hypoxia-inducible factors (HIFs). Microfluidic model can be a reliable in vitro tool for systematically interrogating individual factors and their accompanying downstream effects, which may otherwise be difficult to study in complex tumor tissues. Here, we used an in vitro model of microvascular networks in a microfluidic chip to measure the extravasation potential of breast cell lines subjected to different oxygen conditions. Through the use of HIF-1α knock-down cell lines, we also validated the importance of HIF-1α in the transmigration ability of human breast cell lines. Three human breast cell lines derived from human breast tissues (MCF10A, MCF-7 and MDA-MB-231) were used in this study to evaluate the role of hypoxia in promoting metastasis at different stages of cancer progression. Under hypoxic conditions, HIF-1α protein level was increased, and coincided with changes in cell morphology, viability and an elevated metastatic potential. These changes were accompanied by an increase in the rate of extravasation compared to normoxia (21% O2). siRNA knockdown of HIF-1α in hypoxic tumors significantly decreased the extravasation rates of all the cell lines tested and may have an effect on the function of metastatic and apoptotic-related cellular processes.


Assuntos
Angiografia , Hipóxia/patologia , Imagem Tridimensional , Microvasos/diagnóstico por imagem , Microvasos/patologia , Angiografia/métodos , Biomarcadores Tumorais , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Hipóxia Celular , Linhagem Celular Tumoral , Sobrevivência Celular , Feminino , Expressão Gênica , Humanos , Hipóxia/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Microvasos/metabolismo , Invasividade Neoplásica , Fenótipo , Microambiente Tumoral
18.
Med Sci Monit ; 24: 9223-9231, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30563959

RESUMO

BACKGROUND This study aimed to compare superb microvascular imaging (SMI) with grayscale ultrasound (US) and color Doppler flow imaging (CDFI) to evaluate vascular distribution and morphology to distinguish between benign and malignant thyroid nodules. MATERIAL AND METHODS Seventy-one patients with 76 thyroid nodules underwent grayscale US, CDFI, and SMI thyroid imaging. CDFI and SMI assessed vascular quantity, morphology, and distribution, and was graded according to Adler's method, as absent (grade 0), minimal (grade 1), moderate (grade 2), or marked (grade 3). The detection of malignancy was compared between the following imaging groups, grayscale US alone, US combined with CDFI, and US combined with SMI. RESULTS SMI was significantly more accurate in identifying malignant thyroid nodules (79.3%) compared with CDFI (55.2%) (P<0.001). In malignant thyroid nodules, penetrating blood vessels were identified by SMI in 62.1% and by CDFI in 41.4%; there was no significant difference in vascular distribution between SMI (P=0.835) and CDFI (P=0.806). Grayscale US with SMI resulted in the greatest diagnostic sensitivity, accuracy, and specificity (86.21%, 85.53%, and 85.11%) compared with grayscale US with CDFI (75.86%, 82.89%, and 87.23%). Receiver operating characteristic (ROC) area under the curve (AUC) values of US with SMI, US with CDFI, and US alone were 0.918 (95% CI, 0.856-0.979), 0.911 (95% CI, 0.849-0.973), and 0.847 (95% CI, 0.762-0.932), respectively (P<0.001). CONCLUSIONS SMI as an adjunct to grayscale US provided significantly more information on vascularity associated with malignancy in thyroid nodules, when compared with grayscale US or with US and CDFI.


Assuntos
Microvasos/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Adulto , Idoso , Área Sob a Curva , China , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Nódulo da Glândula Tireoide/irrigação sanguínea
19.
BMC Ophthalmol ; 18(1): 341, 2018 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-30594154

RESUMO

BACKGROUND: This study aimes to characterize the fundus structural changes in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and the correlation between macular vessel density, retinal nerve fibre layer (RNFL) parameters and visual field sensitivity (VFS) in NAION patients. METHODS: A retrospective case control study was performed using 37 eyes with NAION, 30 uninvolved contralateral eyes, and 27 eyes of healthy age-matched subjects. Data on the retinas and choroidal vessel densities and VFS were compared among the three groups. RESULTS: The NAION group exhibited significantly lower RNFL thicknesses, lower ganglion cell complexes (GCC), larger global loss volume (GLV) values and focal loss volume (FLV) values when compared with both uninvolved eyes and healthy eyes (p < 0.01 for all comparisons). The superficial vessel density (SVD) valus (whole, parafovea, superior-hemi and inferior-hemi) were significantly lower in NAION eyes, followed by uninvolved eyes and healthy eyes (p < 0.01; LSD, p < 0.05 for all comparisons). The deep vessel density (DVD) values (parafovea, superior-hemi and inferior-hemi) were the lowest by a significant value in NAION eyes, followed by uninvolved eyes and healthy eyes (p < 0.01; LSD, p < 0.05 for all comparisons). However, DVD value measurements (whole and fovea) of healthy and uninvolved eyes were not significantly different. The average threshold deviation (TD) was - 11.02 ± 3.75 dB for the overall field region, - 6.01 ± 2.21 dB for the affected superior field region and - 9.98 ± 3.34 dB for the affected inferior field region in NAION eyes. A statistically significant correlation was found between the RNFL thickness and visual field(VF) loss (r = - 0.788, p < 0.001). CONCLUSION: In addition to peripapillary vascular changes occurring in NAION eyes, macular vessel density is also involved. Furthermore, NAION-uninvolved eyes exhibited abnormalities compared with healthy eyes. This indicates that vascular changes may occur before changes in retinal thickness at the early stages of NAION.


Assuntos
Corioide/irrigação sanguínea , Macula Lutea/irrigação sanguínea , Neuropatia Óptica Isquêmica/fisiopatologia , Vasos Retinianos/patologia , Adulto , Idoso , Análise de Variância , Estudos de Casos e Controles , Feminino , Humanos , Macula Lutea/diagnóstico por imagem , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Neuropatia Óptica Isquêmica/diagnóstico por imagem , Estudos Retrospectivos , Acuidade Visual/fisiologia , Campos Visuais/fisiologia
20.
Medicine (Baltimore) ; 97(46): e12955, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30431569

RESUMO

Inadequate ablation lesion formation may be responsible for post-ablation ventricular tachycardia (VT) recurrences.We aimed to evaluate whether visualisation of radiofrequency (RF) lesion size by cardiac magnetic resonance imaging (CMR) has any role in predicting adequacy of lesion and in estimating outcome.Retrospective pilot studyNine consecutive patients (8 male, age 60 ±â€Š13 years) underwent ablation for sustained VT because of ischemic scar were evaluated for pre- and post-procedure scar tissue by CMR to characterize ablation lesions. Microvascular obstruction (MVO) surrounded by late gadolinium enhancement was defined as irreversible RF lesion. All patients were followed for at least 6 months for recurrences.Five of the patients had previous inferior myocardial infarction (MI), whereas remaining 4 had anterior MI. Acute procedural success, as defined by termination of the arrhythmia without recurrence in 30 minutes, was attained in all patients. Contrast enhancement and wall motion abnormality in presumed infarction area were confirmed by pre-ablation CMR images. MVO was detected at the reported ablation site in 6/9 patients, all arrhythmia- and symptom-free at median 24 months (range 8-38 months) follow-up. In remaining 3 patients who had VT recurrence (clinical VT in 2, sustain VT with a new morphology in 1), MVO was not detected despite achievement of acute procedural success. There was no correlation with pre-ablation scar size and clinical arrhythmia recurrence.CMR is a useful imaging modality to guide ablation procedures by detecting scar tissue. Additionally MVO seen by post-procedural imaging may be related to adequacy of RF ablation lesions and may correlate with clinical outcome.


Assuntos
Ablação por Cateter/efeitos adversos , Cicatriz/diagnóstico por imagem , Angiografia por Ressonância Magnética/estatística & dados numéricos , Isquemia Miocárdica/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Taquicardia Ventricular/diagnóstico por imagem , Idoso , Arritmias Cardíacas/diagnóstico por imagem , Arritmias Cardíacas/etiologia , Ablação por Cateter/métodos , Cicatriz/etiologia , Meios de Contraste , Feminino , Gadolínio , Humanos , Masculino , Microvasos/diagnóstico por imagem , Pessoa de Meia-Idade , Isquemia Miocárdica/etiologia , Projetos Piloto , Complicações Pós-Operatórias/etiologia , Prognóstico , Recidiva , Estudos Retrospectivos , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/cirurgia
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