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1.
Medicine (Baltimore) ; 99(10): e19411, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150091

RESUMO

The effects of the intercondylar notch morphology on predicting anterior crucaite ligament (ACL) injury in males were unknown. We aimed to determine the risk factors of the intercondylar notch on ACL injury, and evaluate the predictive effects of the morphological parameters on ACL injury in males. Sixty-one patients with ACL injury and seventy-eight patients with intact ACLs were assigned to the case group and control group respectively. The notch width (NW), bicondylar width, notch width index (NWI), notch height (NH), notch cross-sectional area (CSA), notch angle (NA) and notch shape were obtained from the magnetic resonance images of male patients. Comparisons were performed between the case and control groups. Logistic regression model and the receiver operating characteristic curve were used to assess the predictive effects of these parameters on ACL injury. The NW, NWI, NH, CSA and NA in the case group were significantly smaller than those in the control group on the coronal magnetic resonance images. The NW and NWI were significantly smaller, while no significant differences of the NH and CSA were found between the 2 groups on the axial images. There was no significant difference in the notch shape between the 2 groups. The maximum value of area under the curve calculated by combining all relevant morphological parameters was 0.966. The ACL injury in males was associated with NW, NH, NWI, CSA, and NA. These were good indicators for predicting ACL injury in males.


Assuntos
Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Adolescente , Adulto , Osso e Ossos/diagnóstico por imagem , Estudos de Casos e Controles , Humanos , Escala de Gravidade do Ferimento , Articulação do Joelho/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Valor Preditivo dos Testes , Fatores de Risco , Sensibilidade e Especificidade , Adulto Jovem
2.
Int J Oral Sci ; 12(1): 5, 2020 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-32024813

RESUMO

Rheumatoid arthritis (RA) is an autoimmune disease affecting 1% of the world population and is characterized by chronic inflammation of the joints sometimes accompanied by extra-articular manifestations. K/BxN mice, originally described in 1996 as a model of polyarthritis, exhibit knee joint alterations. The aim of this study was to describe temporomandibular joint (TMJ) inflammation and damage in these mice. We used relevant imaging modalities, such as micro-magnetic resonance imaging (µMRI) and micro-computed tomography (µCT), as well as histology and immunofluorescence techniques to detect TMJ alterations in this mouse model. Histology and immunofluorescence for Col-I, Col-II, and aggrecan showed cartilage damage in the TMJ of K/BxN animals, which was also evidenced by µCT but was less pronounced than that seen in the knee joints. µMRI observations suggested an increased volume of the upper articular cavity, an indicator of an inflammatory process. Fibroblast-like synoviocytes (FLSs) isolated from the TMJ of K/BxN mice secreted inflammatory cytokines (IL-6 and IL-1ß) and expressed degradative mediators such as matrix metalloproteinases (MMPs). K/BxN mice represent an attractive model for describing and investigating spontaneous damage to the TMJ, a painful disorder in humans with an etiology that is still poorly understood.


Assuntos
Artrite Experimental/patologia , Artrite Reumatoide/patologia , Osso e Ossos/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/lesões , Microtomografia por Raio-X/métodos , Animais , Artrite Experimental/imunologia , Artrite Reumatoide/imunologia , Osso e Ossos/metabolismo , Osso e Ossos/patologia , Modelos Animais de Doenças , Humanos , Imagem por Ressonância Magnética , Metaloproteinase 8 da Matriz/imunologia , Camundongos , Camundongos Transgênicos , Articulação Temporomandibular/metabolismo , Tomografia Computadorizada por Raios X
3.
Adv Exp Med Biol ; 1213: 165-176, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030670

RESUMO

Advancements in musculoskeletal analysis have been achieved by adopting deep learning technology in image recognition and analysis. Unlike musculoskeletal modeling based on computational anatomy, deep learning-based methods can obtain muscle information automatically. Through analysis of image features, both approaches can obtain muscle characteristics such as shape, volume, and area, and derive additional information by analyzing other image textures. In this chapter, we first discuss the necessity of musculoskeletal analysis and the required image processing technology. Then, the limitations of skeletal muscle recognition based on conventional handcrafted features are discussed, and developments in skeletal muscle recognition using machine learning and deep learning technology are described. Next, a technique for analyzing musculoskeletal systems using whole-body computed tomography (CT) images is shown. This study aims to achieve automatic recognition of skeletal muscles throughout the body and automatic classification of atrophic muscular disease using only image features, to demonstrate an application of whole-body musculoskeletal analysis driven by deep learning. Finally, we discuss future development of musculoskeletal analysis that effectively combines deep learning with handcrafted feature-based modeling techniques.


Assuntos
Osso e Ossos/diagnóstico por imagem , Aprendizado Profundo , Interpretação de Imagem Assistida por Computador , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Humanos
5.
Medicine (Baltimore) ; 99(2): e18069, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914012

RESUMO

This study aims to find and locate foramens exactly in maxilla and mandible in case of complications during surgeries.Computer topographic angiography (CTA) images of 120 cases were reviewed. The measurements were performed on coronal, sagittal and axial planes after the 3 dimension volume reconstruction. The distances among foramens, bony landmarks, teeth, and facial artery were all measured with the angles as adjustments.The incisive foramen (IF) was measured 20.55 ±â€Š2.81 mm to margo inferior of incisor, and 45.27 ±â€Š5.27 degree from the axial midline. The greater palatine foramen located 43.17 ±â€Š2.55 mm from the IF, while 21.08 ±â€Š3.75 degree from the midline in axial plane. The lesser palatine foramina located 44.56 ±â€Š5.74 mm from the IF and 20.05 ±â€Š3.59 degree to the midline. The Mandibular foramen (MBF) was 91.15 ±â€Š1.86 mm horizontally to the margo inferior of incisor. The angle that the MBF-margo inferior of incisor line made with the axial midline was 31.25 ±â€Š2.89 degree. The shortest horizontal distance from the mental foramen (MF) to the facial artery in sagittal plane was 21.90 ±â€Š1.86 mm, while it became 13.00 ±â€Š2.05 mm in coronary section. The horizontal distance from the MF to the margo inferior of incisor in sagittal plane was 22.04 ±â€Š3.22 mm. It turned out to be 25.78 ±â€Š5.23 mm between MF and mid-sagittal line in coronary section. The vertical distance was 25.20 ±â€Š3.06 mm from the upper margin of the second premolar to the MF.The foramens were clearly seen through CTA. Moreover, linear and angular measurements were presented, which makes it safer and wiser for surgeons to consider the biometric data before operations.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Mandíbula/anatomia & histologia , /diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/cirurgia , Criança , Face/irrigação sanguínea , Face/diagnóstico por imagem , Feminino , Humanos , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
6.
Int Braz J Urol ; 46(1): 42-52, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31851457

RESUMO

INTRODUCTION: Tables predicting the probability of a positive bone scan in men with non-metastatic, castrate-resistant prostate cancer have recently been reported. We performed an external validation study of these bone scan positivity tables. MATERIALS AND METHODS: We performed a retrospective cohort study of patients seen at a tertiary care medical center (1996-2012) to select patients with non-metastatic, castrate-resistant prostate cancer. Abstracted data included demographic, anthropometric, and disease-specific data such as patient race, BMI, PSA kinetics, and primary treatment. Primary outcome was metastasis on bone scan. Multivariable logistic regression was performed using generalized estimating equations to adjust for repeated measures. Risk table performance was assessed using ROC curves. RESULTS: We identified 6.509 patients with prostate cancer who had received hormonal therapy with a post-hormonal therapy PSA ≥2ng/mL, 363 of whom had non-metastatic, castrate-resistant prostate cancer. Of these, 187 patients (356 bone scans) had calculable PSA kinetics and ≥1 bone scan. Median follow-up after castrate-resistant prostate cancer diagnosis was 32 months (IQR: 19-48). There were 227 (64%) negative and 129 (36%) positive bone scans. On multivariable analysis, higher PSA at castrate-resistant prostate cancer (4.67 vs. 4.4ng/mL, OR=0.57, P=0.02), shorter time from castrate-resistant prostate cancer to scan (7.9 vs. 14.6 months, OR=0.97, P=0.006) and higher PSA at scan (OR=2.91, P<0.0001) were significantly predictive of bone scan positivity. The AUC of the previously published risk tables for predicting scan positivity was 0.72. CONCLUSION: Previously published risk tables predicted bone scan positivity in men with non-metastatic, castrate-resistant prostate cancer with reasonable accuracy.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Neoplasias de Próstata Resistentes à Castração/diagnóstico por imagem , Neoplasias de Próstata Resistentes à Castração/patologia , Idoso , Osso e Ossos/diagnóstico por imagem , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Valor Preditivo dos Testes , Antígeno Prostático Específico/sangue , Curva ROC , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo
7.
Chem Biol Interact ; 316: 108931, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-31874163

RESUMO

Bone defects caused by cancer surgery or trauma have a strong negative impact on human health. Treatment with cell and material-based complexes provides an alternative strategy for the regeneration of damaged bone tissue. The good physical properties and suitable biodegradability of a thermosensitive hydrogel has been shown to act as a valuable scaffold. Platelet derived growth factor BB (PDGFBB) is mainly secreted by platelets and promotes the migration and angiogenesis of mesenchymal stem cells (MSCs). Although PDGFBB is known to indirectly enhance bone repair in vivo, the effects of PDGFBB on stem cells from apical papilla (SCAPs) require further investigation. In our study, the proliferation of cells was investigated by the cell counting kit-8 and live/dead staining methods. The results indicated that PDGFBB promoted the proliferation of SCAPs. Real-time polymerase chain reaction and Western blot experiments were used to detect osteogenic genes and proteins. Moreover, calvarial defects were created in Sprague-Dawley rats and different complexes implanted. The results shown by micro-CT and hematoxylin and eosin analysis demonstrated that the hydrogel combined with lentiviral supernatant-green fluorescent protein-PDGFBB significantly improved new bone formation and mineralization compared with the other three groups. In summary, our research showed that a thermosensitive hydrogel can be used as a scaffold for 3D cell culture, and PDGFBB gene-modified SCAPs can improve bone formation in calvarial defects.


Assuntos
Becaplermina/metabolismo , Regeneração Óssea/fisiologia , Hidrogéis/química , Células-Tronco/metabolismo , Tecidos Suporte/química , Animais , Becaplermina/genética , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Diferenciação Celular , Proliferação de Células , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Papila Dentária/citologia , Hidrogéis/farmacologia , Masculino , Osteogênese , Polietilenoglicóis/química , Poliglactina 910/química , Ratos , Ratos Sprague-Dawley , Células-Tronco/citologia , Células-Tronco/efeitos dos fármacos , Microtomografia por Raio-X
8.
Radiol Med ; 125(3): 313-318, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31883053

RESUMO

OBJECTIVES: Bone strain index (BSI) is a dual-energy X-ray absorptiometry (DXA)-derived index of bone strength obtained from lumbar densitometric scan. We estimated the reproducibility of BSI in healthy women with different body mass index. METHODS: We enrolled postmenopausal women (mean age ± SD: 66 ± 10 years) divided into three groups (A, B and C) according to body mass index (BMI: < 25; 25-29.9; ≥ 30 kg/m2) and two groups (D and E) according to waist circumference (WC: ≤ 88; > 88 cm), each of 30 subjects. They underwent two DXA examinations with in-between repositioning, according to the International Society for Clinical Densitometry guidelines for precision estimation. Bone mineral density (BMD) and BSI were expressed as g/cm2 and absolute value, respectively. The coefficient of variation (CoV) was calculated as the ratio between root-mean-square standard deviation and mean; least significant change percentage (LSC%) as 2.77 × CoV; reproducibility as the complement to 100% LSC. RESULTS: BSI increased proportionally to BMI and WC and significantly in group C compared to B and A (p = 0.032 and 0.006, respectively). BSI was significantly higher in E compared to D (p = 0.017), whereas no differences were observed in BMD. Although BSI reproducibility was slightly lower in group C (89%), the differences were not significant between all groups. BMD reproducibility did not significantly differ between all groups. CONCLUSIONS: BSI reproducibility was significantly lower than that of BMD and decreased proportionally to BMI and WC increase. This reduction of BSI reproducibility was more pronounced in patients with BMI ≥ 30 and WC > 88, as expected, being BSI a parameter sensible to weight.


Assuntos
Absorciometria de Fóton/métodos , Índice de Massa Corporal , Osso e Ossos/diagnóstico por imagem , Circunferência da Cintura , Idoso , Densidade Óssea , Osso e Ossos/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Posicionamento do Paciente , Estudos Prospectivos , Reprodutibilidade dos Testes , Coluna Vertebral/diagnóstico por imagem
9.
J Sports Sci Med ; 18(4): 596-603, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31827343

RESUMO

This study aimed to investigate the expression of PGC-1α/FNDC5/irisin induced by attenuation of high-fat diet (HFD)-induced bone accrual and determine whether swimming exercise could improve attenuating bone accrual through this mechanism. Eight-week-old Sprague-Dawley rats were divided into two groups for the first 8 weeks: CD, control diet (n = 10); and HFD, high-fat diet (n = 20). HFD-fed rats were again divided into two groups for further 8 weeks treatment: HFD (n = 10) and HFD with swimming exercise (HEx, n = 10). During this time, the CD group continuously fed the normal diet. Throughout the 16 weeks study period, the rats were weighed once every week. Samples were collected for analysis after last 8 weeks of treatment in the 16 weeks. Morphological and structural changes of the femur and tibial bone were observed using micro-CT, and Osteocalcin, CTX-1 and irisin levels in the blood were measured by enzyme-linked immunosorbent assay. The expression of IL-1, ß-catenin, FNDC5 and PGC-1α, in the femur were evaluated by immunohistochemistry. Eight weeks of HFD increased body weight and epididymal fat mass and decreased bone mineral density (BMD). Subsequent 8 weeks of swimming exercise improved obesity, BMD, bone microstructure, and bone metabolic factors in the HEx group. The irisin levels in the blood and the expressions of FNDC5 and PGC-1α in the bone were significantly lower in the HFD group than in the CD group, but elevated in the HEx group than in the HFD group. Swimming exercise is effective in improving obesity-worsened bone health and increases blood irisin and bone PGC-1α and FNDC5 levels.


Assuntos
Osso e Ossos/metabolismo , Dieta Hiperlipídica , Fibronectinas/metabolismo , Osteoporose/metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Natação/fisiologia , Animais , Distribuição da Gordura Corporal , Osso e Ossos/anatomia & histologia , Osso e Ossos/diagnóstico por imagem , Ciguatoxinas/sangue , Modelos Animais de Doenças , Fêmur/anatomia & histologia , Fêmur/metabolismo , Fibronectinas/sangue , Humanos , Interleucina-1/metabolismo , Masculino , Osteocalcina/sangue , Osteoporose/sangue , Osteoporose/etiologia , Distribuição Aleatória , Ratos Sprague-Dawley , Tíbia/anatomia & histologia , Tíbia/metabolismo , Microtomografia por Raio-X , beta Catenina/metabolismo
10.
Clin Nucl Med ; 44(12): 966-968, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31689278

RESUMO

Our patient was a 72-year-old man with absent activity of the right femoral artery and mildly decreased Tc-DPD activity on the right leg as indicated on the blood pool and delayed images, respectively. Subsequent peripheral angiography revealed a total occlusion of the right external iliac artery with good collateral flow. Careful review of blood flow and blood pool images of 3-phase bone scintigraphy could provide additional information about peripheral vascular disease.


Assuntos
Arteriopatias Oclusivas/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Artéria Ilíaca/diagnóstico por imagem , Idoso , Angiografia , Arteriopatias Oclusivas/patologia , Humanos , Artéria Ilíaca/patologia , Masculino , Cintilografia
11.
Medicine (Baltimore) ; 98(48): e18161, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770261

RESUMO

RATIONALE: Epithelioid hemangioma (EH) of bone is an intermediate vascular tumor that can be locally aggressive. The optimum management of multifocal EH of bone is not well delineated. We described our experience treating one patient with multifocal EH of bone in an effort to document the effect of bisphosphonates in bone EH. PATIENT CONCERNS: In this report, a 53-year old male patient presented with back pain which was initially been diagnosed of multiple bone metastatic carcinoma by 18F-FDG PET/CT scan and bone scintigraphy. DIAGNOSIS: CT-guided bone biopsy of ilium indicated that puncture tissue had irregular hyperplasia of thick and thin-walled blood vessels, immunohistochemistry revealed positive staining for CD31 and CD34, negative for CAMTA-1, PCK and EMA, which confirmed the diagnosis of multiple EH. INTERVENTIONS: The patient was treated with 4 times of intravenous Zometa (zoledronate, 4 mg each time) with average three-month interval. Bone metabolic markers including serum bone specific alkaline phosphatase (BALP) and type I collagen cross-linked C-terminal telopeptide (CTX) levels were closely monitored before and after use of bisphosphonates each time. OUTCOME: BALP and CTX were significantly lowered following intravenous Zometa and the back pain improved with integrated therapy including bone graft fusion internal fixation surgery and vertebroplasty. CONCLUSIONS: EH of multiple bones responded favorably to intravenous Zometa with improvement of bone metabolic markers. After 1 year on follow-up, the patient was doing well with no significant pain. We suggest that bisphosphonates should be considered in the treatment of multifocal osteolytic EH of bone.


Assuntos
Neoplasias Ósseas , Osso e Ossos , Hemangioendotelioma Epitelioide , Imuno-Histoquímica/métodos , Metástase Neoplásica/diagnóstico , Procedimentos Ortopédicos/métodos , Ácido Zoledrônico/administração & dosagem , Biópsia/métodos , Conservadores da Densidade Óssea/administração & dosagem , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Neoplasias Ósseas/terapia , Remodelação Óssea/efeitos dos fármacos , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Osso e Ossos/patologia , Terapia Combinada , Diagnóstico Diferencial , Difosfonatos/administração & dosagem , Monitoramento de Medicamentos/métodos , Hemangioendotelioma Epitelioide/diagnóstico , Hemangioendotelioma Epitelioide/metabolismo , Hemangioendotelioma Epitelioide/patologia , Hemangioendotelioma Epitelioide/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
12.
Ann Clin Lab Sci ; 49(5): 661-665, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31611211

RESUMO

OBJECTIVE: Gout is a type of inflammatory arthritis that can be complicated with bone erosion through several inflammatory factors. Mean platelet volume (MPV) is regarded as a marker in many inflammatory disorders, but despite this, the metric has not been used for gout. MATERIAL AND METHODS: This study evaluates the relationship between MPV and bone erosion in patients with gout. In total, 299 patients were evaluated retrospectively, and 120 patients were ultimately included based on inclusion criteria. RESULTS: Both the duration of this disease and mean platelet volume were related to bone erosion in gout and may be regarded as independent predictors of bone erosion. CONCLUSION: These results suggest that mean platelet volume can be a predictor of bone erosion in gout.


Assuntos
Artrite/sangue , Osso e Ossos/patologia , Gota/sangue , Volume Plaquetário Médio , Artrite/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Feminino , Gota/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão
13.
J Korean Med Sci ; 34(38): e250, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31583870

RESUMO

BACKGROUND: Chest radiographs (CXR) are the most commonly used imaging techniques by various clinicians and radiologists. However, detecting lung lesions on CXR depends largely on the reader's experience level, so there have been several trials to overcome this problem using post-processing of CXR. We investigated the added value of bone suppression image (BSI) in detecting various subtle lung lesions on CXR with regard to reader's expertise. METHODS: We applied a software program to generate BSI in 1,600 patients in the emergency department. Of them, 80 patients with subtle lung lesions and 80 patients with negative finding on CXR were retrospectively selected based on the subtlety scores on CXR and CT findings. Ten readers independently rated their confidence in deciding the presence or absence of a lung lesion at each of 960 lung regions on the two separated imaging sessions: CXR alone vs. CXR with BSI. RESULTS: The additional use of BSI for all readers significantly increased the mean area under the curve (AUC) in detecting subtle lung lesions (0.663 vs. 0.706; P < 0.001). The less experienced readers were, the more AUC differences increased: 0.067 (P < 0.001) for junior radiology residents; 0.064 (P < 0.001) for non-radiology clinicians; 0.044 (P < 0.001) for senior radiology residents; and 0.019 (P = 0.041) for chest radiologists. The additional use of BSI significantly increased the mean confidence regarding the presence or absence of lung lesions for 213 positive lung regions (2.083 vs. 2.357; P < 0.001) and for 747 negative regions (1.217 vs. 1.195; P = 0.008). CONCLUSION: The use of BSI increases diagnostic performance and confidence, regardless of reader's expertise, reduces the impact of reader's expertise and can be helpful for less experienced clinicians and residents in the detection of subtle lung lesions.


Assuntos
Osso e Ossos/diagnóstico por imagem , Pneumopatias/diagnóstico , Radiografia Torácica/métodos , Radiologistas/psicologia , Idoso , Área Sob a Curva , Estudos de Casos e Controles , Análise por Conglomerados , Feminino , Humanos , Pneumopatias/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pneumonia/diagnóstico , Pneumonia/diagnóstico por imagem , Curva ROC , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/diagnóstico por imagem
14.
Clin Nucl Med ; 44(11): 873-875, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31584488

RESUMO

Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a rare nonneoplastic histiocytic disorder that often involves the lymph nodes and occasionally the central nervous system or skeleton. However, the presence of extranodal Rosai-Dorfman lesions without lymphadenopathy is extremely rare. Here we present a case of a pathological confirmed Rosai-Dorfman disease with pituitary and skeletal involvement without lymph nodes involvement.


Assuntos
Osso e Ossos/patologia , Fluordesoxiglucose F18 , Histiocitose Sinusal/diagnóstico por imagem , Hipófise/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Osso e Ossos/diagnóstico por imagem , Criança , Histiocitose Sinusal/patologia , Humanos , Masculino , Hipófise/diagnóstico por imagem
15.
Int J Mol Sci ; 20(19)2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31575077

RESUMO

Long-term exposure to a diabetic environment leads to changes in bone metabolism and impaired bone micro-architecture through a variety of mechanisms on molecular and structural levels. These changes predispose the bone to an increased fracture risk and impaired osseus healing. In a clinical practice, adequate control of diabetes mellitus is essential for preventing detrimental effects on bone health. Alternative fracture risk assessment tools may be needed to accurately determine fracture risk in patients living with diabetes mellitus. Currently, there is no conclusive model explaining the mechanism of action of diabetes mellitus on bone health, particularly in view of progenitor cells. In this review, the best available literature on the impact of diabetes mellitus on bone health in vitro and in vivo is summarised with an emphasis on future translational research opportunities in this field.


Assuntos
Osso e Ossos/metabolismo , Complicações do Diabetes/metabolismo , Diabetes Mellitus/metabolismo , Diástase Óssea/etiologia , Diástase Óssea/metabolismo , Animais , Biomarcadores , Densidade Óssea , Remodelação Óssea , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Epigênese Genética , Humanos , Células-Tronco Mesenquimais/metabolismo , Transdução de Sinais
17.
Phys Med ; 64: 109-113, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31515009

RESUMO

PURPOSE: This paper aims to review the dosimetry and utility of currently implemented imaging modalities for assessment of multiple myeloma and consider the role of tin filtration computed tomography (CT) as a potential replacement to current standard practice. METHODS: Radiation output of tin CT was measured experimentally and used for software-based dose calculation. Resultant effective dose was then compared to calculated planar radiography doses and published doses of other imaging modalities. RESULTS: Based on example patient parameters used for modalities and 14 projection planar radiography site protocols, doses are comparable between planar radiography and tin filtration CT (approximately 0.9 and 1.0 mSv respectively). Both studies carried a reduced radiation burden compared to Expected Pathologically Increased Contrast-CT (EPIC-CT), FDG-PET and MIBI SPECT/CT (5.7, 11.1-20.0 and 13.0 mSv respectively). CONCLUSION: Tin filtered CT provided visualisation of multiple myeloma at doses comparable to planar radiography and where available may be a suitable alternative, following due consideration of patient specific justification and optimisation in line with best practice.


Assuntos
Osso e Ossos/diagnóstico por imagem , Mieloma Múltiplo/diagnóstico por imagem , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Humanos , Processamento de Imagem Assistida por Computador , Tomografia por Emissão de Pósitrons , Doses de Radiação , Radiometria , Software
18.
Br J Radiol ; 92(1104): 20190513, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31529977

RESUMO

MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.


Assuntos
Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias da Base do Crânio/diagnóstico por imagem , Artefatos , Osso e Ossos/diagnóstico por imagem , Tecido Conjuntivo/diagnóstico por imagem , Meios de Contraste , Imagem de Difusão por Ressonância Magnética , Hidropisia Endolinfática/diagnóstico por imagem , Gadolínio , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Súbita/diagnóstico por imagem , Humanos , Angiografia por Ressonância Magnética , Imagem por Ressonância Magnética/tendências
19.
J Pediatr Orthop ; 39(9): e718-e721, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31503233

RESUMO

BACKGROUND: Accessory ossicles off the talus (os trigonum) are a common radiographic finding seen within the foot with variable symptomatology in adult and pediatric patients. Although most studies have examined the incidence of these anatomic variants in a retrospective manner, few have longitudinally followed the behavior of os trigonum over time. The aim of this study was to investigate the incidence, mean age of appearance and fusion, and fusion rate of os trigonum in a large cohort of asymptomatic pediatric patients. METHODS: A total of 2620 serial digitized unilateral foot and ankle radiographs from 261 healthy white children (age range, 0.25 to 7 y at enrollment) were retrospectively reviewed. Radiographs were examined to determine the incidence of os trigonum, noting age of appearance and if present, the age of fusion. Skeletal maturity was graded based on ossification pattern of the calcaneal apophysis. RESULTS: Radiographic evidence of os trigonum was present in 18% of patients (n=16 females, n=15 males) with radiographs extending 1 SD beyond the average age of os trigonum appearance. There was no difference in incidence between females and males (P=0.27), and os trigonum was found to appear at a significantly younger age in females (9.1±1.8 y) than males (10.4±2.0 y, P=0.04). Overall, 70% (n=26) of subjects with os trigonum achieved fusion by age 17 (mean, 9.5±1.6 y in females, 11.2±1.6 in males) with no significant difference between sexes (P=0.61). Grading of skeletal maturity at the time of fusion showed that both male and female subjects underwent fusion on average between calcaneal stages 2 and 3 (P=0.5). CONCLUSIONS: This study confirms a relatively large prevalence of os trigonum in a random pediatric population, and clarifies both the average age of onset and high rate of fusion at a relatively narrow range of skeletal maturity. LEVEL OF EVIDENCE: Prognostic level II-retrospective study.


Assuntos
Osso e Ossos/anormalidades , Anormalidades Congênitas/epidemiologia , Tálus/anormalidades , Adolescente , Fatores Etários , Osso e Ossos/diagnóstico por imagem , Criança , Pré-Escolar , Anormalidades Congênitas/diagnóstico por imagem , Feminino , Humanos , Incidência , Lactente , Masculino , Prevalência , Radiografia , Estudos Retrospectivos , Fatores Sexuais
20.
Korean J Gastroenterol ; 74(3): 175-182, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31554034

RESUMO

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare but critical disease with a high mortality rate. The diagnostic dilemma of PPP syndrome is the fact that symptoms occur unexpectedly. A 48-year-old man presented with fever and painful swelling of the left foot that was initially mistaken for cellulitis and gouty arthritis. The diagnosis of PPP syndrome was made based on the abdominal CT findings and elevated pancreatic enzyme levels, lobular panniculitis with ghost cells on a skin biopsy, and polyarthritis on a bone scan. The pancreatitis and panniculitis disappeared spontaneously over time, but the polyarthritis followed its own course despite the use of anti-inflammatory agents. In addition to this case, 30 cases of PPP syndrome in the English literature were reviewed. Most of the patients had initial symptoms other than abdominal pain, leading to misdiagnosis. About one-third of them were finally diagnosed with a pancreatic tumor, of which pancreatic acinar cell carcinoma was the most dominant. They showed a mortality rate of 32.3%, associated mainly with the pancreatic malignancy. Therefore, PPP syndrome should be considered when cutaneous or osteoarticular manifestations occur in patients with pancreatitis. Active investigation and continued observations are needed for patients suspected of PPP syndrome.


Assuntos
Artrite/diagnóstico , Pancreatite/diagnóstico , Paniculite/diagnóstico , Artrite/tratamento farmacológico , Artrite/patologia , Artrite Gotosa/diagnóstico , Osso e Ossos/diagnóstico por imagem , Celulite (Flegmão)/diagnóstico , Diagnóstico Diferencial , Eritema/diagnóstico , Eritema/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Octreotida/uso terapêutico , Pancreatite/tratamento farmacológico , Pancreatite/patologia , Paniculite/tratamento farmacológico , Paniculite/patologia , Tomografia Computadorizada por Raios X
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