RESUMO
BACKGROUND: Previous studies have suggested the role of microcalcifications in plaque vulnerability. This exploratory study sought to assess the potential of hybrid positron-emission tomography (PET)/magnetic resonance imaging (MRI) using 18F-sodium fluoride (18F-NaF) to check simultaneously 18F-NaF uptake, a marker of microcalcifications, and morphological criteria of vulnerability. METHODS AND RESULTS: We included 12 patients with either recently symptomatic or asymptomatic carotid stenosis. All patients underwent 18F-NaF PET/MRI. 18F-NaF target-to-background ratio (TBR) was measured in culprit and nonculprit (including contralateral plaques of symptomatic patients) plaques as well as in other arterial walls. Morphological criteria of vulnerability were assessed on MRI. Mineral metabolism markers were also collected. 18F-NaF uptake was higher in culprit compared to nonculprit plaques (median TBR 2.6 [2.2-2.8] vs 1.7 [1.3-2.2]; P = 0.03) but was not associated with morphological criteria of vulnerability on MRI. We found a positive correlation between 18F-NaF uptake and calcium plaque volume and ratio but not with circulating tissue-nonspecific alkaline phosphatase (TNAP) activity and inorganic pyrophosphate (PPi) levels. 18F-NaF uptake in the other arterial walls did not differ between symptomatic and asymptomatic patients. CONCLUSIONS: 18F-NaF PET/MRI may be a promising tool for providing additional insights into the plaque vulnerability.
Assuntos
Calcinose , Estenose das Carótidas , Placa Aterosclerótica , Calcinose/diagnóstico por imagem , Estenose das Carótidas/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Placa Aterosclerótica/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Fluoreto de SódioRESUMO
OBJECTIVE: Carotid atherosclerotic plaques are a source of emboli for stroke. 'Unstable' carotid atherosclerotic plaques may have intraplaque haemorrhages, neovessels, prevalent macrophages, excessive calcium deposits, a large lipid core and a thin fibrous cap. Regular physical activity (PA) may lower the risk of plaques becoming unstable. We evaluated the association of both PA and sedentary behaviour (SB) with carotid plaque histopathology. METHODS: 90 asymptomatic patients who were undergoing carotid endarterectomy for carotid artery narrowing identified on ultrasound reported their PA and SB by questionnaires. We calculated PA intensity in MET (metabolic equivalent of task)-min/week. For analysis, the population was divided into tertiles according to PA (T1PA: the less PA patients; T2PA: the intermediate PA patients; T3PA: the most physically active patients) (T1PA
Assuntos
Artérias Carótidas/patologia , Exercício Físico , Placa Aterosclerótica/patologia , Comportamento Sedentário , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Doenças Cardiovasculares/prevenção & controle , Artérias Carótidas/cirurgia , Estudos Transversais , Endarterectomia das Carótidas , Feminino , Hemorragia/etiologia , Hemorragia/prevenção & controle , Humanos , Masculino , Placa Aterosclerótica/complicações , Placa Aterosclerótica/cirurgia , Fatores de RiscoRESUMO
Necrotizing Infundibular Crystalline Folliculitis (NICF) is rare entity of unknown pathogenesis presenting as follicular crystalline papules arising in seborrheic areas. We report 2 cases of NICF in patients under targeted therapy for metastatic adenocarcinoma. In one case, the lesions reappeared cyclically every 3 weeks after each injection and in the other case, lesions persisted until disruption of the continuous oral therapy. Punch-biopsies demonstrated folliculitis with a plugging crystalline material associated with either bacteria or yeast. These are the first descriptions of drug-induced NICF.
Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/efeitos adversos , Toxidermias/etiologia , Foliculite/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Camptotecina/administração & dosagem , Camptotecina/efeitos adversos , Camptotecina/análogos & derivados , Neoplasias Colorretais/tratamento farmacológico , Toxidermias/patologia , Cloridrato de Erlotinib/efeitos adversos , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Humanos , Irinotecano , Neoplasias Pulmonares/tratamento farmacológico , MasculinoAssuntos
Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Transplante de Rim , Complicações Pós-Operatórias/patologia , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Adulto , Atrofia , Biomarcadores Tumorais/análise , Carcinoma de Células Renais/química , Carcinoma de Células Renais/classificação , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/etiologia , Glomerulonefrite Membranosa/cirurgia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Rim/química , Rim/patologia , Doenças Renais Císticas/etiologia , Doenças Renais Císticas/patologia , Neoplasias Renais/química , Neoplasias Renais/diagnóstico , Neoplasias Renais/etiologia , Masculino , Mucina-1/análise , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/uso terapêutico , Nefrectomia , Complicações Pós-Operatórias/diagnóstico , Reoperação , Tacrolimo/efeitos adversos , Tacrolimo/uso terapêuticoRESUMO
X-ray computer assisted tomography scanner is an imaging method based on the use of X-ray attenuation in tissue. This attenuation is proportional to the density of the tissue (without or after contrast media injection) in each pixel image of the image. Spiral scanner, the electron beam computed tomography (EBCT) scanner and multidetector computed tomography scanner allow renal anatomical measurements, such as cortical and medullary volume, but also the measurement of renal functional parameters, such as regional renal perfusion, renal blood flow and glomerular filtration rate. These functional parameters are extracted from the modeling of the kinetics of the contrast media concentration in the vascular space and the renal tissue, using two main mathematical models (the gamma variate model and the Patlak model). Renal functional imaging allows measuring quantitative parameters on each kidney separately, in a non-invasive manner, providing significant opportunities in nephrology, both for experimental and clinical studies. However, this method uses contrast media that may alter renal function, thus limiting its use in patients with chronic renal failure. Moreover, the increase irradiation delivered to the patient with multi detector computed tomography (MDCT) should be considered.