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  1 / 15029 MEDLINE  
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[PMID]:29505526
[Au] Autor:Li X; Zhao Z; Liu X; Ma G; Zhu MJ
[Ad] Endereço:Department of Critical Care Medicine.
[Ti] Título:Encephalopathy associated with propofol infusion syndrome: A case report.
[So] Source:Medicine (Baltimore);97(1):e9521, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Propofol infusion syndrome (PRIS) is a rare but potentially fatal complication of propofol infusion. It is clinically characterized by metabolic acidosis, refractory bradycardia, rhabdomyolysis, renal failure, hyperlipidemia, and hepatomegaly. Brain lesion was only reported once in a pediatric patient. We present the 1st adult case with colon polyp and cancer who was diagnosed with PRIS. Her brain magnetic resonance imaging (MRI) and computed tomography (CT) scans reveal prominent bilateral brain lesions, matching with the proposed pathophysiologic mechanism of the syndrome. The patient received prompt acidosis correction and cardiorespiratory support. At last, she died from refractory circulatory failure. CONCLUSION: It may be necessary to order a prompt neuroimaging examination in patients suspected with PRIS to judge whether brain lesions exist or not.
[Mh] Termos MeSH primário: Encefalopatias/etiologia
Síndrome da Infusão de Propofol/complicações
[Mh] Termos MeSH secundário: Adulto
Encefalopatias/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética
Evolução Fatal
Feminino
Seres Humanos
Neuroimagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009521


  2 / 15029 MEDLINE  
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[PMID]:29237520
[Au] Autor:Mao J
[Ad] Endereço:Neonatologist Society, Chinese Medical Doctor Association.
[Ti] Título:[Patterns of brain injury in neonatal hypoxic-ischemic encephalopathy on magnetic resonance imaging: recommendations on classification].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1225-1233, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Although there are unified criteria for the clinical diagnosis and grading of neonatal hypoxic-ischemic encephalopathy (HIE), clinical features and neuropathological patterns vary considerably among the neonates with HIE due to birth asphyxia in the same classification. The patterns and progression of brain injury in HIE, which is closely associated with long-term neurodevelopment outcomes, can be well shown on magnetic resonance imaging (MRI), but different sequences may lead to different MRI findings at the same time. It is suggested that diffusion-weighted imaging sequence be selected at 2-4 days after birth, and the conventional MRI sequence at 4-8 days. The major patterns of brain injury in HIE on MRI are as follows: injury of the thalamus and basal ganglia and posterior limbs of the internal capsules; watershed injury involving the cortical and subcortical white matter; focal or multifocal minimal white matter injury; extensive whole brain injury. Severe acute birth asphyxia often leads to deep grey matter injury (thalamus and basal ganglia), and the brain stem may also be involved; the pyramidal tract is the most susceptible white matter fiber tract; repetitive or intermittent hypoxic-ischemic insults, with inflammation or hypoglycemia, usually cause injuries in the watershed area and deep white matter. It is worth noting that sometimes the pattern of brain injury among those described above cannot be determined exactly, but rather a predominant one is identified; not all cases of HIE have characteristic MRI findings.
[Mh] Termos MeSH primário: Lesões Encefálicas/classificação
Encéfalo/diagnóstico por imagem
Hipóxia-Isquemia Encefálica/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Lesões Encefálicas/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética/métodos
Seres Humanos
Recém-Nascido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  3 / 15029 MEDLINE  
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[PMID]:29489657
[Au] Autor:Liang K; Ou X; Huang X; Lan Q
[Ti] Título:Agenesis of the dorsal pancreas: a rare cause of insulin-dependent diabetes without abdominal pain: Case report.
[So] Source:Medicine (Baltimore);97(9):e0046, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Agenesis of the dorsal pancreas is a very rare condition with an unknown pathology and etiology, although it may be associated with autosomal dominant or X-linked dominant inheritance or retinoic acid and hedgehog signaling pathway alterations. This condition usually manifests with abdominal pain or pancreatitis, although some cases are asymptomatic. Approximately 50% of affected patients with this disorder present with hyperglycemia or various other anomalies. PATIENT CONCERNS: We report the case of a 23-year-old Chinese woman who visited the Department of Endocrinology and Metabolism with insulin-dependent diabetes but no specific symptoms, signs, or other deformities. Severe diabetic retinopathy indicated a long period of hyperglycemia. DIAGNOSIS: Agenesis of the dorsal pancreas was observed incidentally during the common diagnosis of diabetes, and the diagnosis was established using magnetic resonance imaging, diffusion-weighted imaging, and magnetic resonance cholangiopancreatography. INTERVENTIONS: Following the diagnosis of diabetes, insulin replacement therapy was initiated at a dosage of up to 45 U per day. The patient's blood glucose level was monitored, and the insulin dosage was adjusted accordingly. OUTCOMES: The patient's blood glucose levels gradually normalized after insulin treatment and were subsequently maintained with intensive insulin therapy. Treatment for diabetic retinopathy was provided by the Ophthalmology Department. LESSONS: Agenesis of the dorsal pancreas should be considered in a young patient diagnosed with diabetes who presents with obvious diabetes-related complications (e.g., renal, retinal, or neurological) inconsistent with the course of the disease or a history of other congenital anomalies. We recommend the routine use of computed tomography or magnetic resonance imaging when examining young patients with diabetes.
[Mh] Termos MeSH primário: Anormalidades Congênitas
Diabetes Mellitus Tipo 1/etiologia
Pâncreas/anormalidades
[Mh] Termos MeSH secundário: Dor Abdominal
Doenças Assintomáticas
Colangiopancreatografia por Ressonância Magnética
Anormalidades Congênitas/diagnóstico por imagem
Diabetes Mellitus Tipo 1/tratamento farmacológico
Imagem de Difusão por Ressonância Magnética
Feminino
Seres Humanos
Hiperglicemia/etiologia
Hipoglicemiantes/uso terapêutico
Insulina/uso terapêutico
Angiografia por Ressonância Magnética
Pâncreas/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010046


  4 / 15029 MEDLINE  
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[PMID]:28465460
[Au] Autor:Menjot de Champfleur N; Saver JL; Goyal M; Jahan R; Diener HC; Bonafe A; Levy EI; Pereira VM; Cognard C; Yavagal DR; Albers GW
[Ad] Endereço:From the Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, CA (G.W.A.); Department of Radiology (M.G.) and Department of Clinical Neurosciences (M.G.), University of Calgary, Alberta, Canada; Division of Interventional Neuroradiology (
[Ti] Título:Efficacy of Stent-Retriever Thrombectomy in Magnetic Resonance Imaging Versus Computed Tomographic Perfusion-Selected Patients in SWIFT PRIME Trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke).
[So] Source:Stroke;48(6):1560-1566, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The majority of patients enrolled in SWIFT PRIME trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke) had computed tomographic perfusion (CTP) imaging before randomization; 34 patients were randomized after magnetic resonance imaging (MRI). METHODS: Patients with middle cerebral artery and distal carotid occlusions were randomized to treatment with tPA (tissue-type plasminogen activator) alone or tPA+stentriever thrombectomy. The primary outcome was the distribution of the modified Rankin Scale score at 90 days. Patients with the target mismatch profile for enrollment were identified on MRI and CTP. RESULTS: MRI selection was performed in 34 patients; CTP in 139 patients. Baseline National Institutes of Health Stroke Scale score was 17 in both groups. Target mismatch profile was present in 95% (MRI) versus 83% (CTP). A higher percentage of the MRI group was transferred from an outside hospital ( =0.02), and therefore, the time from stroke onset to randomization was longer in the MRI group ( =0.003). Time from emergency room arrival to randomization did not differ in CTP versus MRI-selected patients. Baseline ischemic core volumes were similar in both groups. Reperfusion rates (>90%/TICI [Thrombolysis in Cerebral Infarction] score 3) did not differ in the stentriever-treated patients in the MRI versus CTP groups. The primary efficacy analysis (90-day mRS score) demonstrated a statistically significant benefit in both subgroups (MRI, =0.02; CTP, =0.01). Infarct growth was reduced in the stentriever-treated group in both MRI and CTP groups. CONCLUSIONS: Time to randomization was significantly longer in MRI-selected patients; however, site arrival to randomization times were not prolonged, and the benefits of endovascular therapy were similar. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01657461.
[Mh] Termos MeSH primário: Isquemia Encefálica/diagnóstico por imagem
Isquemia Encefálica/terapia
Circulação Cerebrovascular
Imagem de Difusão por Ressonância Magnética/métodos
Fibrinolíticos/uso terapêutico
Avaliação de Processos e Resultados (Cuidados de Saúde)
Stents
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/etiologia
Doenças das Artérias Carótidas/complicações
Terapia Combinada
Feminino
Seres Humanos
Infarto da Artéria Cerebral Média/complicações
Masculino
Meia-Idade
Método Simples-Cego
Acidente Vascular Cerebral/etiologia
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.016669


  5 / 15029 MEDLINE  
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[PMID]:29390388
[Au] Autor:Li H; Liu L; Shi Q; Stemmer A; Zeng H; Li Y; Zhang M
[Ad] Endereço:Department of Radiology, China-Japan Union Hospital of Jilin University, Xiantai Changchun, Jilin, China.
[Ti] Título:Bladder cancer: detection and image quality compared among iShim, RESOLVE, and ss-EPI diffusion-weighted MR imaging with high b value at 3.0 T MRI.
[So] Source:Medicine (Baltimore);96(50):e9292, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To compare the detection of bladder neoplasms and image quality among the diffusion-weighted imaging (DWI) acquired by the prototype single-shot echo-planar-imaging (ss-EPI) sequence for integrated slice-specific dynamic shimming (iShim), readout segmentation of long variable echo trains (RESOLVE) and conventional ss-EPI sequences.Around 63 patients with 77 bladder lesions were enrolled. The MR protocol included T1WI, T2WI and 3 types of DWI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each DWI for the detection of bladder tumor were computed. The subjective scores of imaging quality, diagnostic confidence, and detection of tumors of stage T2 or greater were recorded. The contrast-to-noise ratio (CNR), signal intensity ratios, and apparent diffusion coefficient (ADC) values were measured. The univariate analysis of variance technique, the Friedman test, and Bland-Altman plots were used in the statistical analysis. Observer performance of tumor T stage was tested using receiver operating characteristic (ROC) curve analysis.The sensitivity, NPV, and accuracy of iShim (92.75%; 61.54%; 93.51%) for detection of bladder tumor were superior to those of RESOLVE (84.06%; 42.11%; 85.71%) and ss-EPI (86.96%; 47.06%; 88.31%). All qualitative scores of iShim were higher than RESOLVE (all P < .05) and ss-EPI (all P < .05). The CNR, signal intensity ratios between bladder lesion and urine, lesion, and submucosal stalk (or nearby normal bladder wall), and between distal normal bladder wall and urine of iShim (39.84 ±â€Š12.11, 2.40 ±â€Š0.60, 1.98 ±â€Š0.43, 1.28 ±â€Š0.16) were higher than RESOLVE (16.97 ±â€Š7.08, 1.62 ±â€Š0.41, 1.52 ±â€Š0.42, 1.15 ±â€Š0.29, all P < .05) and ss-EPI (27.89 ±â€Š9.65, 1.66 ±â€Š0.46, 1.57 ±â€Š0.50, 0.99 ±â€Š0.22, all P < .05). No significant difference of ADC values were found for iShim and RESOLVE (P=0.46), iShim, and ss-EPI (P = 0.97), RESOLVE and ss-EPI (P = .48). The Az value for the detection of tumors of stage T2 or greater was slightly higher with the iShim DWI sequence (0.89) than with the RESOLVE (0.87, P = 0.72) or ss-EPI (0.85, P = .38) sequence.The iShim DWI has relatively better detection of bladder tumor and image quality without significant ADC value difference.
[Mh] Termos MeSH primário: Imagem de Difusão por Ressonância Magnética/métodos
Imagem Ecoplanar/métodos
Neoplasias da Bexiga Urinária/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Seres Humanos
Meia-Idade
Estadiamento de Neoplasias
Valor Preditivo dos Testes
Sensibilidade e Especificidade
Neoplasias da Bexiga Urinária/patologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009292


  6 / 15029 MEDLINE  
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[PMID]:28468744
[Au] Autor:Özgen B; Bulut E; Dolgun A; Bajin MD; Sennaroglu L
[Ad] Endereço:Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey. burce@hacettepe.edu.tr.
[Ti] Título:Accuracy of turbo spin-echo diffusion-weighted imaging signal intensity measurements for the diagnosis of cholesteatoma.
[So] Source:Diagn Interv Radiol;23(4):300-306, 2017 Jul-Aug.
[Is] ISSN:1305-3612
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We aimed to evaluate the diagnostic accuracy of turbo spin-echo diffusion-weighted imaging (TSE-DWI) at 3 T, for cholesteatoma (CS) diagnosis, using qualitative and quantitative methods with numerical assessment of signal intensity (SI), signal intensity ratios (SIR), and apparent diffusion coefficient (ADC) values. METHODS: In this retrospective study, two blinded observers independently evaluated the preoperative TSE-DWI images of 57 patients who were imaged with a presumed diagnosis of CS. Qualitative assessment with respect to the SI of the adjacent cortex and quantitative measurements of SI, SIR, and ADC values were performed. RESULTS: Surgery with histopathologic examination revealed 30 CS patients and 27 patients with non-cholesteatoma (NCS) lesions including chronic inflammation and cholesterol granuloma. On TSE-DWI, 96.7% of the CS lesions and none of the NCS lesions appeared hyperintense compared with the cortex. The mean SI and SIR indices of the CS group were significantly higher and the mean ADC values significantly lower compared with those of the NCS group (P < 0.001). Using specific cutoff values for SI (92.5) and SIR (0.9), CS could be diagnosed with 100% sensitivity and specificity. The use of quantitative imaging further increased the sensitivity of the TSE-DWI technique. CONCLUSION: The quantitative indices of SI, SIR, and ADC of TSE-DWI appear to be highly accurate parameters that can be used to confirm the diagnosis of CS.
[Mh] Termos MeSH primário: Colesteatoma da Orelha Média/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Diagnóstico Diferencial
Orelha Média/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Variações Dependentes do Observador
Estudos Retrospectivos
Sensibilidade e Especificidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.5152/dir.2017.16024


  7 / 15029 MEDLINE  
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[PMID]:29342201
[Au] Autor:Neska-Matuszewska M; Bladowska J; Sasiadek M; Zimny A
[Ad] Endereço:Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland.
[Ti] Título:Differentiation of glioblastoma multiforme, metastases and primary central nervous system lymphomas using multiparametric perfusion and diffusion MR imaging of a tumor core and a peritumoral zone-Searching for a practical approach.
[So] Source:PLoS One;13(1):e0191341, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In conventional MR examinations glioblastomas multiforme (GBMs), metastases and primary CNS lymphomas (PCNSLs) may show very similar appearance. The aim of the study was to evaluate usefulness of multiparametric T2*DSC perfusion and diffusion MR imaging in the preoperative differentiation of these tumors. MATERIAL AND METHODS: Seventy four solitary enhancing tumors (27 GBMs, 30 metastases, 17 PCNSLs) were enrolled in the study. Parameters of cerebral blood volume (rCBV), peak height (rPH), percentage of signal recovery (rPSR) and apparent diffusion coefficient (ADC) were assessed from the tumor core and the peritumoral non-enhancing T2-hyperintense zone. RESULTS: Within the tumor core there were no differences in perfusion and diffusion parameters between GBMs and metastases. Compared to GBMs and metastases, PCNSLs showed significantly lower rCBV and rPH, ADC as well as higher rPSR values. Max rCBV with a cut-off value of 2.18 demonstrated the highest accuracy of 0.98 in differentiating PCNSLs from other tumors. To distinguish GBMs from metastases analysis of the peritumoral zone was performed showing significantly higher rCBV, rPH and lower ADC values in GBMs with the highest accuracy of 0.94 found for max rCBV at a cut-off value of 0.98. CONCLUSIONS: Max rCBV seems to be the most important parameter to differentiate GBMs, metastases and PCNSLs. Analysis of max rCBV within the tumor core enables to distinguish hypoperfused PCNSLs from hyperperfused GBMs and metastases while evaluation of max rCBV within the peritumoral zone is helpful to distinguish GBMs showing peritumoral infiltration from metastases surrounded by pure edema.
[Mh] Termos MeSH primário: Glioblastoma/diagnóstico por imagem
Angiografia por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Idoso
Volume Sanguíneo/fisiologia
Neoplasias Encefálicas/patologia
Diferenciação Celular/genética
Neoplasias do Sistema Nervoso Central
Circulação Cerebrovascular/fisiologia
Diagnóstico Diferencial
Imagem de Difusão por Ressonância Magnética/métodos
Feminino
Glioblastoma/diagnóstico
Glioblastoma/genética
Seres Humanos
Linfoma/diagnóstico por imagem
Linfoma/metabolismo
Masculino
Meia-Idade
Metástase Neoplásica
Sistema Nervoso/patologia
Perfusão
Curva ROC
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191341


  8 / 15029 MEDLINE  
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[PMID]:29279564
[Au] Autor:Okabe K; Hoashi T; Asahara M; Esaki E; Ito M; Otsuka R; Funasaka Y; Saeki H
[Ad] Endereço:Department of Dermatology, Nippon Medical School.
[Ti] Título:A Case of a Giant Cell Tumor of the Tendon Sheath of the Middle Phalanx of the Fourth Toe.
[So] Source:J Nippon Med Sch;84(6):308-310, 2017.
[Is] ISSN:1347-3409
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Giant cell tumors of the tendon sheath (GCT-TS) are one of the most common tumors of the hand, along with ganglions. However, occurrence in the toes is far less common. Here we present a rare case of GCT-TS at the middle phalanx level of the flexor digitorum longus tendon sheath. Magnetic resonance imaging showed low intensity both on T1 and T2 weighted images. To the best of our knowledge, our case is the first report of a GCT-TS arising at the middle phalanx level of the flexor digitorum longus tendon sheath of the fourth toe. Although GCT-TS are rare in the toe, they must be included in the differential diagnoses of soft tissue tumors arising in the toes.
[Mh] Termos MeSH primário: Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico por imagem
Falanges dos Dedos do Pé
[Mh] Termos MeSH secundário: Adulto
Diagnóstico Diferencial
Imagem de Difusão por Ressonância Magnética
Feminino
Tumor de Células Gigantes de Bainha Tendinosa/patologia
Tumor de Células Gigantes de Bainha Tendinosa/cirurgia
Seres Humanos
Falanges dos Dedos do Pé/patologia
Falanges dos Dedos do Pé/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1272/jnms.84.308


  9 / 15029 MEDLINE  
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[PMID]:28464745
[Au] Autor:Bakke KM; Hole KH; Dueland S; Grøholt KK; Flatmark K; Ree AH; Seierstad T; Redalen KR
[Ad] Endereço:a Department of Oncology , Akershus University Hospital , Lørenskog , Norway.
[Ti] Título:Diffusion-weighted magnetic resonance imaging of rectal cancer: tumour volume and perfusion fraction predict chemoradiotherapy response and survival.
[So] Source:Acta Oncol;56(6):813-818, 2017 Jun.
[Is] ISSN:1651-226X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In locally advanced rectal cancer (LARC), responses to preoperative treatment are highly heterogeneous and more accurate diagnostics are likely to enable more individualised treatment approaches with improved responses. We investigated the potential of diffusion-weighted magnetic resonance imaging (DW MRI), with quantification of the apparent diffusion coefficient (ADC) and perfusion fraction (F), as well as volumetry from T2-weighted (T2W) MRI, for prediction of therapeutic outcome. MATERIAL AND METHODS: In 27 LARC patients receiving neoadjuvant chemotherapy (NACT) before chemoradiotherapy (CRT), T2W- and DW MRI were obtained before and after NACT. Tumour volumes were delineated in T2W MRI and ADCs and Fs were estimated from DW MRI using a simplified approach to the intravoxel incoherent motion (IVIM) model. Mean tumour values and histogram analysis of whole-tumour heterogeneity were correlated with histopathologic tumour regression grade (TRG) and 5-year progression-free survival (PFS). RESULTS: At baseline, high tumour F predicted good tumour response (TRG1-2) (AUC = 0.79, p = 0.01), with a sensitivity of 69% and a specificity of 100%. The combination of F and tumour volume (F /V ) gave the highest prediction of poor tumour response (AUC = 0.93, p < 0.001) with a sensitivity of 88% and a specificity of 91%, and also predicted PFS (p < 0.01). Baseline tumour ADC was not significantly related to therapeutic outcome, whereas a positive change in ADC from baseline to after NACT, ΔADC, significantly predicted good tumour response (AUC = 0.83, p < 0.01, 83% sensitivity, 73% specificity), but not PFS. CONCLUSIONS: The MRI parameter F/V at baseline was a remarkably strong predictor of both histopathologic tumour response and 5-year PFS in patients with LARC.
[Mh] Termos MeSH primário: Quimiorradioterapia Adjuvante/mortalidade
Imagem de Difusão por Ressonância Magnética/métodos
Terapia Neoadjuvante/mortalidade
Neoplasias Retais/patologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Processamento de Imagem Assistida por Computador/métodos
Gradação de Tumores
Perfusão
Estudos Prospectivos
Curva ROC
Neoplasias Retais/mortalidade
Neoplasias Retais/terapia
Taxa de Sobrevida
Resultado do Tratamento
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1080/0284186X.2017.1287951


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[PMID]:29365417
[Au] Autor:Zhang CD; Zhang HM; Meng YK; Ye F; Jiang J; Ouyang H; Zhao XM; Zhou CW
[Ad] Endereço:Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
[Ti] Título:[Combined T2-weighted and diffusion-weighted MR imaging for staging of rectal cancers].
[So] Source:Zhonghua Zhong Liu Za Zhi;40(1):46-51, 2018 Jan 23.
[Is] ISSN:0253-3766
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To compare the diagnostic value of T2 weighted imaging (T2WI), diffusion-weighted imaging (DWI), and T2WI+ DWI magnetic resonance imaging (MRI) for staging of rectal cancers for improving the accuracy of tumor staging. From January 2011 to December 2013, 120 cases of rectal cancers proved by colonoscopy without receiving any anti-tumor treatment were enrolled retrospectively. The MRI data for these patients were divided into three groups, ie., T2WI, DWI and T2WI+ DWI, for evaluating the tumor stages. The results were compared with histopathologic findings. The sensitivity and specificity were calculated and compared with chi-square test. The nodal staging was predicted by using T2WI+ DWI. The accuracy for prediction of tumor staging was 83.3%, 65.0% and 92.5% for T2WI, DWI, and T2WI+ DWI respectively. The specificity for evaluating T1 and T2 stage, and the sensitivity for evaluating T3 by DWI was significantly lower than those using T2WI and T2WI+ DWI in rectal cancers. The sensitivity for evaluation of T2 by DWI was lower than that using T2WI+ DWI (63.0% vs. 88.9%). The sensitivity for evaluation T2 and specificity for T3 by T2WI+ DWI was higher than thouse using T2WI only (88.9% vs. 51.9%, 94.0% vs. 72.0%). The accuracy for prediction of nodal staging by using T2WI+ DWI was 62.1% (72/116). T2WI is the key sequence for staging of rectal cancers. Although the diagnostic accuracy was not good by using DWI alone, the combination of T2WI and DWI can improve the accuracy significantly for tumor staging in rectal cancers, whereas the nodal staging was still a hard task for radiologists.
[Mh] Termos MeSH primário: Imagem de Difusão por Ressonância Magnética/métodos
Estadiamento de Neoplasias/métodos
Neoplasias Retais/diagnóstico por imagem
Neoplasias Retais/patologia
[Mh] Termos MeSH secundário: Distribuição de Qui-Quadrado
Seres Humanos
Imagem por Ressonância Magnética
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3766.2018.01.008



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