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2.
Stroke ; 44(12): 3324-30, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23929748

RESUMO

BACKGROUND AND PURPOSE: Intra-arterial therapy (IAT) promotes recanalization of large artery occlusions in acute ischemic stroke. Despite high recanalization rates, poor clinical outcomes are common. We attempted to optimize a score that combines clinical and imaging variables to more accurately predict poor outcome after IAT in anterior circulation occlusions. METHODS: Patients with acute ischemic stroke undergoing IAT at University of Texas (UT) Houston for large artery occlusions (middle cerebral artery or internal carotid artery) were reviewed. Independent predictors of poor outcome (modified Rankin Scale, 4-6) were studied. External validation was performed on IAT-treated patients at Emory University. RESULTS: A total of 163 patients were identified at UT Houston. Independent predictors of poor outcome (P≤0.2) were identified as score variables using sensitivity analysis and logistic regression. Houston Intra-Arterial Therapy 2 (HIAT2) score ranges 0 to 10: age (≤59=0, 60-79=2, ≥80 years=4), glucose (<150=0, ≥150=1), National Institute Health Stroke Scale (≤10=0, 11-20=1, ≥21=2), the Alberta Stroke Program Early CT Score (8-10=0, ≤7=3). Patients with HIAT2≥5 were more likely to have poor outcomes at discharge (odds ratio, 6.43; 95% confidence interval, 2.75-15.02; P<0.001). After adjusting for reperfusion (Thrombolysis in Cerebral Infarction score≥2b) and time from symptom onset to recanalization, HIAT2≥5 remained an independent predictor of poor outcome (odds ratio, 5.88; 95% confidence interval, 1.96-17.64; P=0.02). Results from the cohort of Emory (198 patients) were consistent; patients with HIAT2 score≥5 had 6× greater odds of poor outcome at discharge and at 90 days. HIAT2 outperformed other previously published predictive scores. CONCLUSIONS: The HIAT2 score, which combines clinical and imaging variables, performed better than all previous scores in predicting poor outcome after IAT for anterior circulation large artery occlusions.


Assuntos
Isquemia Encefálica/terapia , Acidente Vascular Cerebral/terapia , Terapia Trombolítica/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/tratamento farmacológico , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Injeções Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Radiografia , Reperfusão , Estudos Retrospectivos , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/tratamento farmacológico , Ativador de Plasminogênio Tecidual/uso terapêutico , Resultado do Tratamento
3.
Oral Maxillofac Surg Clin North Am ; 35(3): 311-325, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37032182

RESUMO

There is a broad spectrum of pathology that occurs in the oral cavity. Knowledge of the different anatomic subsites and contents of each is important for accurate diagnosis and treatment. Oral cavity tumors are predominantly malignant in nature, but there are many nonmalignant lesions of which the practicing clinician should be aware. This article will discuss the anatomy, imaging approaches, and imaging characteristics of nonmalignant and malignant pathology in the oral cavity.


Assuntos
Neoplasias Bucais , Humanos , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Diagnóstico Diferencial
4.
Neuroimaging Clin N Am ; 31(3): 265-284, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34243863

RESUMO

Imaging evaluation of the thyroid gland spans a plethora of modalities, including ultrasound imaging, cross-sectional studies, and nuclear medicine techniques. The overlapping of clinical and imaging findings of benign and malignant thyroid disease can make interpretation a complex undertaking. We aim to review and simplify the vast current literature and provide a practical approach to the imaging of thyroid disease for application in daily practice. Our approach highlights the keys to differentiating and diagnosing common benign and malignant disease affecting the thyroid gland.


Assuntos
Diagnóstico por Imagem , Glândula Tireoide , Estudos Transversais , Humanos , Glândula Tireoide/diagnóstico por imagem , Ultrassonografia
5.
BJR Case Rep ; 6(3): 20200013, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32922843

RESUMO

We report a case of a 77-year-old female with purulent chondritis of the thyroid cartilage who was initially referred for laryngeal neoplasm. Purulent chondritis of the laryngeal cartilage is a rare entity with three reports in the literature. The unique CT imaging features of expansile laryngeal cartilage with peripheral rim enhancement and central fluid-attenuation correlate to the abscess formation between the inner and outer perichondria. The correct imaging assessment prompts surgical management and avoid misdiagnosis.

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