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1.
J Healthc Eng ; 2021: 2961697, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34956565

RESUMO

This paper aims to explore the application value of SonoVue contrast-enhanced ultrasonography based on deep unsupervised learning (DNS) in the diagnosis of nipple discharge. In this paper, a new model (ODNS) is proposed based on the unsupervised learning model and stack self-coding network. The ultrasonic images of 1,725 patients with breast lesions in the shared database are used as the test data of the model. The differences in accuracy (Acc), recall (RE), sensitivity (Sen), and running time between the two models before and after optimization and other algorithms are compared. A total of 48 female patients with nipple discharge are enrolled. The differences in SE, specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of conventional ultrasound and contrast-enhanced ultrasonography are analyzed based on pathological examination results. The results showed that when the number of network layers is 5, the classification accuracies of DNS and ODNS model data reached the highest values, which were 91.45% and 98.64%, respectively.


Assuntos
Inteligência Artificial , Derrame Papilar , Feminino , Humanos , Derrame Papilar/diagnóstico por imagem , Fosfolipídeos , Sensibilidade e Especificidade , Hexafluoreto de Enxofre , Ultrassonografia
4.
Am J Vet Res ; 82(9): 712-721, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34432515

RESUMO

OBJECTIVE: To investigate the efficacy of a phospholipid-stabilized sulfur hexafluoride microsphere (SHM) contrast agent and water for hydrosonography of the upper portion of the gastrointestinal tract of dogs. ANIMALS: 12 healthy adult Beagles. PROCEDURES: In a crossover study, each dog was anesthetized and underwent noncontrast ultrasonography then hydrosonography following administration of tap water (30 mL/kg) without (water method) or with SHM (0.1 mL; SHM method) via an orogastric tube. There were at least 3 days between hydrosonographic procedures. Wall thickness, wall layer definition, conspicuity of the mucosal-luminal interface, and image quality were evaluated separately in the near and far fields for the gastric cardia, body, and pylorus and descending duodenum and compared among the 3 scanning methods. RESULTS: Mean wall thickness measurements did not differ significantly between the water and SHM methods at any location except the far-field gastric cardia where the mean wall thickness for the SHM method was less than that for the water method. In general, the SHM method improved wall layer definition and conspicuity of the mucosal-luminal interface of structures in the near field, compared with noncontrast method. The water and SHM methods both resulted in superior image quality relative to the noncontrast method for the near-field gastric cardia, far-field gastric cardia, and far-field duodenum. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that, for dogs, gastrointestinal hydrosonography by use of the SHM method improved wall layer definition and mucosal conspicuity, particularly in near-field images of the upper portion of the gastrointestinal tract.


Assuntos
Meios de Contraste , Hexafluoreto de Enxofre , Animais , Estudos Cross-Over , Cães , Trato Gastrointestinal/diagnóstico por imagem , Microesferas , Fosfolipídeos , Água
5.
Comput Math Methods Med ; 2021: 9962970, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34194540

RESUMO

Objective: To discuss the clinical application value of contrast-enhanced ultrasound (CEUS) in testicular occupied lesions. Methods: Nine conventional-ultrasound-found testicular occupied lesions which underwent CEUS meantime were analyzed retrospectively. The CEUS perfusion pattern was compared with the surgical pathological result or follow-up findings. Results: Among all the 9 testicular occupied lesions, there were 5 testicular malignant tumors, 1 testicular benign tumor, 1 testicular tuberculosis, and 2 testicular hematomas. CEUS diagnosed 6 testicular malignant tumors, 1 testicular benign tumor, and 2 testicular hematomas, and its diagnostic accuracy was about 88.9%. Conclusion: CEUS has high clinical application value in the differential diagnoses of benign and malignant testicular occupied lesions.


Assuntos
Doenças Testiculares/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Adulto , Biologia Computacional , Meios de Contraste , Diagnóstico Diferencial , Erros de Diagnóstico , Hematoma/diagnóstico por imagem , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/irrigação sanguínea , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Fosfolipídeos , Estudos Retrospectivos , Hexafluoreto de Enxofre , Neoplasias Testiculares/irrigação sanguínea , Tuberculose dos Genitais Masculinos/diagnóstico por imagem , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricos
6.
Abdom Radiol (NY) ; 46(10): 4647-4659, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34136936

RESUMO

OBJECTIVES: To assess the respective diagnostic value of Sonazoid™ and SonoVue® for characterizing FLLs as benign or malignant and the corresponding safety. METHODS: This prospective Phase 3 study was conducted at 17 centres in China and Korea (May 2014 to April 2015); 424 patients (20 to 80 years) with at least 1 untreated focal liver lesion (FLL) (< 10 cm in diameter) underwent a contrast-enhanced ultrasound (CEUS) examination (218 received Sonazoid of 0.12 µL microbubbles/kg; 206 received SonoVue of 2.4 mL). Three independent blinded readers evaluated pre- and post-contrast images characterising the FLLs as benign or malignant. RESULTS: Sonazoid-enhanced and SonoVue-enhanced ultrasound provided a statistically significant improvement in specificity for all 3 readers comparing to unenhanced ultrasound (for Sonazoid: p = 0.0093, < 0.0001, 0.0011; for SonoVue: p = 0.002, 0.03, 0.12, respectively). Difference in accuracy improvement between the 2 groups was within the pre-specified non-inferiority margin of 20% for all 3 readers (6.1%, 95% CI: - 5.0 to 17.2; - 7.5%, 95% CI: - 18.4 to 3.5; - 0.3%, 95% CI: - 11.3 to 10.7). The diagnostic confidence level for all 3 readers increased with post-contrast images relative to pre-contrast images. Both contrast agents were well tolerated. CONCLUSION: Results showed a similar efficacy for Sonazoid™ and SonoVue® in diagnosing FLLs as benign or malignant, and underlined the benefit of CEUS imaging over unenhanced ultrasound imaging in reaching a confident diagnosis without having to refer patients for additional imaging exams.


Assuntos
Meios de Contraste , Neoplasias Hepáticas , Compostos Férricos , Humanos , Ferro , Fígado/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Óxidos , Fosfolipídeos , Estudos Prospectivos , Sensibilidade e Especificidade , Hexafluoreto de Enxofre , Ultrassonografia
8.
Am J Vet Res ; 82(7): 538-545, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34166085

RESUMO

OBJECTIVE: To compare qualitative features and quantitative parameters of 2 contrast agents (sulfur hexafluoride microbubbles [SHM; SonoVue] and perfluorobutane [PFB; Sonazoid]) for performance of contrast-enhanced ultrasonography (CEUS) of the pancreas in dogs. ANIMALS: 8 healthy Beagles. PROCEDURES: In a crossover study design, CEUS of the pancreas was performed twice in each dog, once with SHM and once with PFB, in random order with at least 3 days between examinations. The recorded cine images were qualitatively assessed for homogeneity of pancreatic enhancement and conspicuity of the pancreatic signal relative to the background. For the quantitative assessment, circular regions of interest were placed over the pancreatic body, and a time-intensity curve was obtained. For each region of interest, CEUS parameters including peak intensity (PI), time to peak pancreatic enhancement, area under the curve (AUC), and wash-in rate were obtained. RESULTS: The homogeneity of the pancreatic parenchyma was not significantly different between contrast agents. The signal conspicuity relative to background noise was significantly higher with PFB than with SHM. Mean values of PI, wash-in rate, and AUC were significantly higher with PFB than with SHM. Time to peak enhancement was not significantly different between contrast agents. CONCLUSIONS AND CLINICAL RELEVANCE: Pancreatic CEUS with SHM and PFB produced similar homogeneity scores, but only PFB provided excellent signal conspicuity. Perfluorobutane produced higher values of PI, wash-in rate, and AUC. Findings indicated that PFB can provide homogeneous and strong enhancement of the pancreas during CEUS in healthy dogs and that pancreatic CEUS parameter values differ with the contrast agent used.


Assuntos
Microbolhas , Hexafluoreto de Enxofre , Animais , Meios de Contraste , Estudos Cross-Over , Cães , Fluorcarbonetos , Pâncreas/diagnóstico por imagem , Fosfolipídeos , Ultrassonografia/veterinária
9.
Radiology ; 299(3): 730-735, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34029167

RESUMO

History A 26-year-old man presented with a 1-month history of chest pain, a palpable and painful right inguinal mass, and edema in the right lower extremity. One month earlier, he started to experience left chest pain with no cough. Pulmonary CT angiography (CTA) revealed a left lower lobe segmental pulmonary embolus. The local hospital made a diagnosis of pulmonary embolism. He received anticoagulants, and his chest pain was gradually relieved. At the time of current presentation, the patient was experiencing right lower extremity swelling and pain. Physical examination revealed a 4 × 3 cm palpable right inguinal mass with no redness. His medical history and family history were negative. The results of laboratory work-up were normal, with a d-dimer level of 0.16 mg/L fibrinogen equivalent units (reference range, <0.46 mg/L) and an international normalized ratio of 2.45 (therapeutic range, 2.0-3.0 for a patient taking warfarin), except the prothrombin time was 28.2 seconds (reference range, 9.6-12.8 seconds) and the activated partial thromboplastin time was 52.2 seconds (reference range, 24.8-33.8 seconds). Echocardiography, chest radiography, chest CT, and contrast-enhanced (CE) CT revealed no abnormalities. The patient underwent right lower extremity vascular conventional US (Philips IU22; Philips) with an L9-3 probe (3-9 MHz, venous condition) and contrast-enhanced US (1.5-2.0 mL, SonoVue; Bracco) with an intravenous bolus injection at the initial evaluation. Two days later, noncontrast and contrast-enhanced CT images of the lower abdomen (1.5 mL per kilogram of body weight, 300 mg/mL iomeprol, Iomeron; Bracco) were acquired for further evaluation.


Assuntos
Sarcoma Sinovial/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Adulto , Meios de Contraste , Diagnóstico Diferencial , Veia Femoral/diagnóstico por imagem , Humanos , Veia Ilíaca/diagnóstico por imagem , Iopamidol/análogos & derivados , Masculino , Fosfolipídeos , Embolia Pulmonar/diagnóstico , Sarcoma Sinovial/cirurgia , Hexafluoreto de Enxofre , Neoplasias Vasculares/cirurgia
10.
J Hazard Mater ; 417: 126107, 2021 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-34020356

RESUMO

Sulfur hexafluoride (SF6) is the most potent greenhouse gas contributed by the power and semiconductor industries. The global emissions of gas in the past 10 years have increased tremendously due to lack of disposal routes. This was brought to 190 nations' attention in the Kyoto Protocol for the need of emission control measures to reduce its impacts of climate change and global warming. Various novel techniques have surfaced to tackle this issue, such as non-thermal plasma (NTP) which includes radio frequency plasma, microwave plasma, dielectric barrier discharge, and electron beam. The main by-products resulting from the decomposition of SF6 by these techniques are sulfur oxyfluorides, sulfur dioxide, hydrofluoric acid, and fluorine gas. This environmental and health effects as well as global emission of SF6 gas are considered a threat to humans and the climate, where modern disposal methods of contaminated SF6 gas and its by-products should replace the conventional approaches. Relevant government policies on the safety and disposal concern of SF6 gas are reviewed and challenges and further research directions for the disposal of SF6 gas are highlighted in this review article.


Assuntos
Semicondutores , Hexafluoreto de Enxofre , Fluoretos , Humanos , Micro-Ondas
11.
J Appl Physiol (1985) ; 131(1): 107-118, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34043468

RESUMO

Recent studies indicate limited utility of nitrogen multiple-breath washout (N2MBW) in infancy and advocate for using sulfur hexafluoride (SF6) MBW in this age-group. Modern N2MBW systems, such as EXHALYZER D (ECO MEDICS AG, Duernten, Switzerland), use O2 and CO2 sensors to calculate N2 concentrations (in principle, N2% = 100 - CO2% - O2%). High O2 and CO2 concentrations have now been shown to significantly suppress signal output from the other sensor, raising apparent N2 concentrations. We examined whether improved EXHALYZER D N2 signal, accomplished after thorough examination of this CO2 and O2 interaction on gas sensors and its correction, leads to better agreement between N2MBW and SF6MBW in healthy infants and toddlers. Within the same session, 52 healthy children aged 1-36 mo [mean = 1.30 (SD = 0.72) yr] completed SF6MBW and N2MBW recordings (EXHALYZER D, SPIROWARE version 3.2.1) during supine quiet sleep. SF6 and N2 SPIROWARE files were reanalyzed offline with in-house software using identical algorithms as in SPIROWARE with or without application of the new correction factors for N2MBW provided by ECO MEDICS AG. Applying the improved N2 signal significantly reduced mean [95% confidence interval (CI)] differences between N2MBW and SF6MBW recorded functional residual capacity (FRC) and lung clearance index (LCI): for FRC, from 26.1 (21.0, 31.2) mL, P < 0.0001, to 1.18 (-2.3, 4.5) mL, P = 0.5, and for LCI, from 1.86 (1.68, 2.02), P < 0.001, to 0.44 (0.33, 0.55), P < 0.001. Correction of N2 signal for CO2 and O2 interactions on gas sensors resulted in markedly closer agreement between N2MBW and SF6MBW outcomes in healthy infants and toddlers.NEW & NOTEWORTHY Modern nitrogen multiple-breath washout (N2MBW) systems such as EXHALYZER D use O2 and CO2 sensors to calculate N2 concentrations. New corrections for interactions between high O2 and CO2 concentrations on the gas sensors now provide accurate N2 signals. The correct N2 signal led to much improved agreement between N2MBW and sulfur hexafluoride (SF6) MBW functional residual capacity (FRC) and lung clearance index (LCI) in 52 sleeping healthy infants and toddlers, suggesting a role for N2MBW in this age-group.


Assuntos
Pulmão , Nitrogênio , Testes Respiratórios , Pré-Escolar , Capacidade Residual Funcional , Humanos , Lactente , Testes de Função Respiratória , Hexafluoreto de Enxofre
12.
Ultrasound Med Biol ; 47(7): 1857-1867, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33810887

RESUMO

Collateral damage to healthy surrounding tissue during conventional radiotherapy increases when deviations from the treatment plan occur. Ultrasound contrast agents (UCAs) are a possible candidate for radiation dose monitoring. This study investigated the size distribution and acoustic response of two commercial formulations, SonoVue/Lumason and Definity/Luminity, as a function of dose on clinical megavoltage photon beam exposure (24 Gy). SonoVue samples exhibited a decrease in concentration of bubbles smaller than 7 µm, together with an increase in acoustic attenuation and a decrease in acoustic scattering. Definity samples did not exhibit a significant response to radiation, suggesting that the effect of megavoltage photons depends on the UCA formulation. For SonoVue, the influence of the megavoltage photon beam was especially apparent at the second harmonic frequency, and can be captured using pulse inversion and amplitude modulation (3.5-dB decrease for the maximum dose), which could eventually be used for dosimetry in a well-controlled environment.


Assuntos
Meios de Contraste/efeitos da radiação , Fluorcarbonetos/efeitos da radiação , Fosfolipídeos/efeitos da radiação , Radioterapia/métodos , Hexafluoreto de Enxofre/efeitos da radiação , Acústica , Dosagem Radioterapêutica
13.
Korean J Radiol ; 22(5): 801-810, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33660455

RESUMO

OBJECTIVE: To investigate imaging biomarkers of microperfusion in contrast-induced nephropathy (CIN) using contrast-enhanced ultrasound (CEUS). MATERIALS AND METHODS: The CIN model was fabricated by administering indomethacin (10 mg/kg), L-NAME (15 mg/kg), and iopamidol (10 mL/kg) to Sprague-Dawley rats. After 24 hours, CEUS was performed on CIN (n = 6) and control (n = 6) rats with sulphur hexafluoride microbubbles (SonoVue). From time-intensity curves obtained from the kidney arriving time (AT), acceleration time (AC), time to peak (TTP), and peak enhancement (PE) were measured and compared between the groups. After CEUS, the rats were sacrificed, and cell apoptosis markers were evaluated to confirm the development of CIN. RESULTS: Among CEUS parameters, AT (7.8 ± 1.6 vs. 4.2 ± 0.5 s, p = 0.002), AC (4.7 ± 1.4 vs. 2.0 ± 0.4 s, p = 0.002), and TTP (12.5 ± 2.9 vs. 6.2 ± 0.6 s, p = 0.002) were significantly prolonged in the CIN group compared to controls. PE was significantly higher in the control group than in the CIN group (17.1 ± 1.9 vs. 12.2 ± 2.0 dB, p = 0.004). In kidney tissue, mRNA and protein levels of the apoptotic makers were significantly higher in the CIN group than in the control group (p = 0.003 and p = 0.002). CONCLUSION: CEUS parameters can be used as imaging biomarkers for microperfusion in CIN. In rats with CIN, AT, AC, and TTP were significantly prolonged, while PE was significantly lower compared to controls.


Assuntos
Injúria Renal Aguda/etiologia , Fosfolipídeos/efeitos adversos , Hexafluoreto de Enxofre/efeitos adversos , Ultrassonografia , Injúria Renal Aguda/diagnóstico , Animais , Modelos Animais de Doenças , Interleucina-18/genética , Interleucina-18/metabolismo , Rim/metabolismo , Rim/patologia , Testes de Função Renal , Lipocalina-2/genética , Lipocalina-2/metabolismo , Masculino , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos , Ratos Sprague-Dawley , Regulação para Cima , Proteína X Associada a bcl-2/genética , Proteína X Associada a bcl-2/metabolismo
14.
Medicine (Baltimore) ; 100(3): e24243, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546044

RESUMO

RATIONALE: Hepatic splenosis or heterotopic auto-transplantation of spleen in the liver usually occurs after either spleen trauma or surgery. It is of great importance for the differential diagnosis of hepatic splenosis and other liver tumors because surgery is usually not needed if a diagnosis of splenosis is confirmed. PATIENT CONCERNS: Multiple hepatic masses were revealed by grayscale ultrasound in a 55-year-old man complaining of persistent colic in the upper abdomen after greasy food. DIAGNOSIS: Benign neoplasm with enlarged lymph node in the gastro-hepatic ligament was suspected by contrast enhanced US. The nature of the hepatic mass was undetermined by CECT. INTERVENTIONS: The lesions were surgically removed. OUTCOMES: Multiple splenic tissue implants in the liver and peritoneum were confirmed by pathology after surgery. The patient recovered well and was followed up for more than 1 year without recurrence. LESSONS: Splenosis should be included in the differential diagnosis of focal liver lesion in patients with a history of spleen trauma or surgery. In spite of nonspecific findings on pre-contrast ultrasound, splenosis shows characteristic homogeneous hyperenhancement in arterial and portal phases, as well as prolonged hyperenhancement in the late phase for more than 5 minutes. Furthermore, the confidence of the diagnosis of splenosis may be enhanced by identifying multiple masses with similar enhancing patterns in other regions of the abdominal cavity.


Assuntos
Coristoma/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Baço , Humanos , Masculino , Pessoa de Meia-Idade , Fosfolipídeos , Hexafluoreto de Enxofre , Ultrassonografia
15.
Thorax ; 76(4): 380-386, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33593931

RESUMO

BACKGROUND: Multiple breath washout (MBW) using sulfur hexafluoride (SF6) has the potential to reveal ventilation heterogeneity which is frequent in patients with obstructive lung disease and associated small airway dysfunction. However, reference data are scarce for this technique and mostly restricted to younger cohorts. We therefore set out to evaluate the influence of anthropometric parameters on SF6-MBW reference values in pulmonary healthy adults. METHODS: We evaluated cross-sectional data from 100 pulmonary healthy never-smokers and smokers (mean 51 (SD 20), range 20-88 years). Lung clearance index (LCI), acinar (Sacin) and conductive (Scond) ventilation heterogeneity were derived from triplicate SF6-MBW measurements. Global ventilation heterogeneity was calculated for the 2.5% (LCI2.5) and 5% (LCI5) stopping points. Upper limit of normal (ULN) was defined as the 95th percentile. RESULTS: Age was the only meaningful parameter influencing SF6-MBW parameters, explaining 47% (CI 33% to 59%) of the variance in LCI, 32% (CI 18% to 47%) in Sacin and 10% (CI 2% to 22%) in Scond. Mean LCI increases from 6.3 (ULN 7.4) to 8.8 (ULN 9.9) in subjects between 20 and 90 years. Smoking accounted for 2% (CI 0% to 8%) of the variability in LCI, 4% (CI 0% to 13%) in Sacin and 3% (CI 0% to 13%) in Scond. CONCLUSION: SF6-MBW outcome parameters showed an age-dependent increase from early adulthood to old age. The effect was most pronounced for global and acinar ventilation heterogeneity and smaller for conductive ventilation heterogeneity. No influence of height, weight and sex was seen. Reference values can now be provided for all important SF6-MBW outcome parameters over the whole age range. TRIAL REGISTRATION NUMBER: NCT04099225.


Assuntos
Antropometria , Testes Respiratórios , Pneumopatias Obstrutivas/fisiopatologia , Hexafluoreto de Enxofre/análise , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Testes de Função Respiratória , Fumantes
16.
BMC Cardiovasc Disord ; 21(1): 21, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413110

RESUMO

BACKGROUND: Microvascular insufficiency plays an important role in the development of diabetic cardiomyopathy (DCM), therapeutic angiogenesis has been mainly used for the treatment of ischemic diseases. This study sought to verify the preclinical performance of SonoVue microbubbles (MB) combined ultrasound (US) treatment on myocardial angiogenesis in the rat model of DCM and investigate the optimal ultrasonic parameters. METHODS: The male Sprague-Dawley (SD) rats were induced DCM by streptozotocin through intraperitoneal injecting and fed with high-fat diet. After the DCM model was established, the rats were divided into the normal group, DCM model group, and US + MB group, while the US + MB group was divided into four subsets according to different pulse lengths (PL) (8 cycles;18 cycle;26 cycle; 36 cycle). After all interventions, all rats underwent conventional echocardiography to examine the cardiac function. The rats were sacrificed and myocardial tissue was examined by histology and morphometry evaluations to detect the myocardial protective effect of SonoVue MBs using US techniques. RESULTS: From morphologic observation and echocardiography, the DCM rats had a series of structural abnormalities of cardiac myocardium compared to the normal rats. The US-MB groups exerted cardioprotective effect in DCM rats, improved reparative neovascularization and increased cardiac perfusion, while the 26 cycle group showed significant therapeutic effects on the cardiac functions in DCM rats. CONCLUSION: This strategy using SonoVue MB and US can improve the efficacy of angiogenesis, even reverse the progress of cardiac dysfunction and pathological abnormalities, especially using the 26 cycle parameters. Under further study, this combined strategy might provide a novel approach for early intervention of DCM in diabetic patients.


Assuntos
Meios de Contraste/administração & dosagem , Vasos Coronários/fisiopatologia , Cardiomiopatias Diabéticas/terapia , Miocárdio/patologia , Neovascularização Fisiológica , Fosfolipídeos/administração & dosagem , Hexafluoreto de Enxofre/administração & dosagem , Terapia por Ultrassom , Animais , Circulação Coronária , Vasos Coronários/diagnóstico por imagem , Cardiomiopatias Diabéticas/diagnóstico por imagem , Cardiomiopatias Diabéticas/patologia , Cardiomiopatias Diabéticas/fisiopatologia , Ecocardiografia Doppler em Cores , Frequência Cardíaca , Masculino , Microbolhas , Microcirculação , Densidade Microvascular , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Volume Sistólico , Função Ventricular Esquerda
17.
BMC Cardiovasc Disord ; 21(1): 42, 2021 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472596

RESUMO

BACKGROUND: To compare the diagnostic accuracy of Doppler ultrasound (DUS) with contrast-enhanced ultrasound (CEUS) for detection of iliac vein stent stenosis using multidetector computed tomography venography (MDCTV) as the reference method. METHODS: Patients with iliac vein obstructive disease treated with nitinol stents (Smart Control, Cordis, USA) between January 2016 and December 2017 were consecutively included in this study. DUS, CEUS, and MDCTV were carried out in all patients within one week of each other at 1 year post stenting to investigate the presence of stent compression and in-stent restenosis (ISR). RESULTS: The study included 139 patients (87 females; mean age 58 ± 15 years). For detecting stent compression, the kappa coefficient between the ultrasound modality of gray-scale imaging and MDCTV was 0.901, indicating very good agreement between these two modalities. ISR was detected in 50, 61, and 65 patients by DUS, CEUS, and MDCTV, respectively. DUS and CEUS (kappa = 0.449) and DUS and MDCTV (kappa = 0.516) had moderate agreement for ISR diagnosis, while for which CEUS and MDCTV (kappa 0.884) had very good agreement. The sensitivity and specificity of DUS and CEUS for diagnosing ISR were 63.1% and 90.8%, 87.8% and 97.3%, respectively. CONCLUSIONS: CEUS is probably superior to DUS in terms of diagnostic accuracy for the follow-up of patients with iliac vein stent stenosis.


Assuntos
Meios de Contraste , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Veia Ilíaca , Síndrome de May-Thurner/terapia , Fosfolipídeos , Síndrome Pós-Trombótica/terapia , Stents , Hexafluoreto de Enxofre , Ultrassonografia Doppler em Cores , Insuficiência Venosa/terapia , Adulto , Idoso , Constrição Patológica , Feminino , Humanos , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/fisiopatologia , Masculino , Síndrome de May-Thurner/diagnóstico por imagem , Síndrome de May-Thurner/fisiopatologia , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Flebografia , Síndrome Pós-Trombótica/diagnóstico por imagem , Síndrome Pós-Trombótica/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Resultado do Tratamento , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/fisiopatologia
18.
Medicina (Kaunas) ; 57(1)2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33435420

RESUMO

Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1-2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.


Assuntos
Meios de Contraste , Técnicas de Diagnóstico Urológico , Ultrassonografia/métodos , Refluxo Vesicoureteral/diagnóstico por imagem , Adolescente , Adulto , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Cistografia , Feminino , Humanos , Lactente , Injeções , Laparoscopia , Masculino , Pessoa de Meia-Idade , Fosfolipídeos , Politetrafluoretileno , Exposição à Radiação , Recidiva , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Hexafluoreto de Enxofre , Ureteroscopia , Uretra/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Infecções Urinárias/etiologia , Infecções Urinárias/prevenção & controle , Urografia , Refluxo Vesicoureteral/classificação , Refluxo Vesicoureteral/complicações , Refluxo Vesicoureteral/terapia , Adulto Jovem
19.
Vet Radiol Ultrasound ; 62(3): 342-349, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33476091

RESUMO

Sono-urethrography is a technique used to evaluate the integrity of the urethra utilizing fluid dilation of the urethral lumen. The purpose of this prospective, method comparison, pilot study was to investigate the feasibility of sono-urethrography in male dogs and to compare the quality of the images obtained using three different contrast solutions. The prostatic, membranous, and penile urethra was evaluated using saline, agitated saline, and ultrasound contrast agent (Sonovue) in 10 adult, male Beagles. Visibility of the urethral wall was better with sono-urethrography than with conventional ultrasonography, and the conspicuity of urethra could be assessed using all solutions. Hyperechoic lines created by agitated saline and Sonovue were more useful than anechoic saline in allowing identification of the urethra. Visibility scores for the internal margin of the urethral wall using sono-urethrography were significantly higher with saline and one-minute post agitated saline injection. However, the individual layers of the urethral wall could not be observed, regardless of the contrast solution used. Shadowing created by the pelvic bone deteriorated the window through which the urethra could be visualized, and this could not be overcome using sono-urethrography. The results of this study indicated that sono-urethrography is a feasible option for the visualization of the male urethra in dogs. The authors recommend sono-urethrography using saline or agitated saline infusion to evaluate the urethral wall and lumen. Sono-urethrography using ultrasound contrast agent can be applied to assess the integrity of the urethra by improving its conspicuity.


Assuntos
Cães/anatomia & histologia , Fosfolipídeos/farmacologia , Hexafluoreto de Enxofre/farmacologia , Uretra/diagnóstico por imagem , Animais , Meios de Contraste/farmacologia , Masculino , Projetos Piloto , Estudos Prospectivos , Radiografia/métodos , Radiografia/veterinária , Ultrassonografia/métodos , Ultrassonografia/veterinária
20.
Retina ; 41(4): 735-743, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32697444

RESUMO

BACKGROUND/PURPOSE: To determinate the efficacy of the human amniotic membrane plugs with sulfur hexafluoride versus human amniotic membrane plug with air as endotamponade to treat macular holes that failed to close after vitrectomy plus internal limiting membrane peeling. Multimodal imaging was focused to evaluate preoperative features and postoperative changes. METHODS: Prospective interventional comparative study. Twenty eyes of 20 patients affected with macular hole that failed to close were divided into 2 groups: 10 eyes received an amniotic membrane plug with 20% sulfur hexafluoride tamponade and 10 eyes received an amniotic membrane plug with air tamponade. All eyes were studied using multimodal advanced diagnostic tools, such as spectral-domain optical coherence tomography, optical coherence tomography angiography, microperimetry, and adaptive optics to investigate the postoperative results. RESULTS: In both groups, all macular holes were found successfully closed after 12 months. Mean preoperative best-corrected visual acuity was 20/400 in the SF6 group and 20/250 in air group. Final mean best-corrected visual acuity was 20/63 in both groups. The superficial capillary plexus, studied using optical coherence tomography angiography, showed a statistically significant difference between the treated and the fellow eyes. Adaptive optics images revealed the presence of a photoreceptor cell mosaic in the area of the amniotic membrane plug. CONCLUSION: The human amniotic membrane combined with air endotamponade demonstrated its effectiveness to seal macular holes that failed to close after vitrectomy plus internal limiting membrane peeling. Advanced multimodal diagnostic imaging helped us to better understand the modifications associated with the use of the amniotic membrane in these cases.


Assuntos
Ar , Âmnio/transplante , Tamponamento Interno/métodos , Perfurações Retinianas/terapia , Hexafluoreto de Enxofre/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Decúbito Ventral , Estudos Prospectivos , Perfurações Retinianas/fisiopatologia , Perfurações Retinianas/cirurgia , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual/fisiologia , Vitrectomia
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