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Pesquisa : E01.370.388.100.370 [Categoria DeCS]
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  1 / 1797 MEDLINE  
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PMID:29489697
Autor:Huang JY; Lu Q; Liu JB
Endereço:Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China.
Título:Delayed hepatic rupture post ultrasound-guided percutaneous liver biopsy: A case report.
Fonte:Medicine (Baltimore); 97(9):e9955, 2018 Mar.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: Hemorrhage, one of complications after liver biopsy, is often identified immediately after the procedure while delayed liver rupture is relatively rare. PATIENT CONCERNS: A 45-year-old woman was diagnosed with undetermined liver cirrhosis and abnormal liver function. To determine the etiology and severity of liver cirrhosis, ultrasound-guided liver biopsy was arranged. The patients did not complain any pain during the procedure. Ultrasound examination on postoperative day1 (POD 1) and MRI on POD 3 showed no evidence of hematoma and ascites. On POD 7, however, the patient was taken to the hospital with a sudden onset of pain in the right upper quadrant of the abdomen. DIAGNOSES: Contrast-enhanced computed tomography revealed liver rupture of right inferior segment of the liver with subcapsular hematoma. INTERVENTIONS: Patient was treated with infusion of 2-unit red blood cell suspension, fluid and hemostatics. OUTCOMES: The vital signs of the patient were stabilized after the therapy. The follow-up ultrasound 1 month later showed a shrunken subcapsular hematoma measuring 4.2 × 2.1 cm at the right lobe. LESSONS: Whenever a liver biopsy procedure is performed, the care should be taken to avoid puncturing those areas that may have liver incisure. Moreover, the patient need to rest for several days and to avoid heavy activities, which is one of the major risk factors for post-procedure bleeding.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  2 / 1797 MEDLINE  
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PMID:29223276
Autor:Dhakal A; Chen H; Dexter EU
Endereço:Department of Medicine, Roswell Park Cancer Institute and Department of Medicine, University at Buffalo, Buffalo, NY. Electronic address: ajaydhakal@hotmail.com.
Título:A 51-Year-Old Woman With an Increasing Chest Wall Mass Years After Resection of an Early Stage Lung Cancer.
Fonte:Chest; 152(6):e151-e154, 2017 12.
ISSN:1931-3543
País de publicação:United States
Idioma:eng
Resumo:CASE PRESENTATION: A 51-year-old woman was found to have a new 14 × 6 mm soft tissue mass under the right serratus muscle on a CT scan of the chest performed for routine surveillance due to her history of stage I lung cancer. A follow-up CT scan performed 4 months later showed that the mass had increased in size to 22 × 8 mm. The patient presents to the oncology clinic to discuss the results of the CT scan. She has no pain or swelling on the right lateral chest and no cough, fever, or shortness of breath. She is at her baseline health with good appetite and functional status.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


  3 / 1797 MEDLINE  
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PMID:28749035
Autor:Yaxley AJ; Yaxley JW; Thangasamy IA; Ballard E; Pokorny MR
Endereço:Prince Charles Hospital, University of Queensland, Brisbane, Qld, Australia.
Título:Comparison between target magnetic resonance imaging (MRI) in-gantry and cognitively directed transperineal or transrectal-guided prostate biopsies for Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 MRI lesions.
Fonte:BJU Int; 120 Suppl 3:43-50, 2017 11.
ISSN:1464-410X
País de publicação:England
Idioma:eng
Resumo:OBJECTIVE: To compare the detection rates of prostate cancer (PCa) in men with Prostate Imaging-Reporting and Data System (PI-RADS) 3-5 abnormalities on 3-Tesla multiparametric (mp) magnetic resonance imaging (MRI) using in-bore MRI-guided biopsy compared with cognitively directed transperineal (cTP) biopsy and transrectal ultrasonography (cTRUS) biopsy. METHODS: This was a retrospective single-centre study of consecutive men attending the private practice clinic of an experienced urologist performing MRI-guided biopsy and an experienced urologist performing cTP and cTRUS biopsy techniques for PI-RADS 3-5 lesions identified on 3-Tesla mpMRI. RESULTS: There were 595 target mpMRI lesions from 482 men with PI-RADS 3-5 regions of interest during 483 episodes of biopsy. The abnormal mpMRI target lesion was biopsied using the MRI-guided method for 298 biopsies, the cTP method for 248 biopsies and the cTRUS method for 49 biopsies. There were no significant differences in PCa detection among the three biopsy methods in PI-RADS 3 (48.9%, 40.0% and 44.4%, respectively), PI-RADS 4 (73.2%, 81.0% and 85.0%, respectively) or PI-RADS 5 (95.2, 92.0% and 95.0%, respectively) lesions, and there was no significant difference in detection of significant PCa among the biopsy methods in PI-RADS 3 (42.2%, 30.0% and 33.3%, respectively), PI-RADS 4 (66.8%, 66.0% and 80.0%, respectively) or PI-RADS 5 (90.5%, 89.8% and 90.0%, respectively) lesions. There were also no differences in PCa or significant PCa detection based on lesion location or size among the methods. CONCLUSION: We found no significant difference in the ability to detect PCa or significant PCa using targeted MRI-guided, cTP or cTRUS biopsy methods. Identification of an abnormal area on mpMRI appears to be more important in increasing the detection of PCa than the technique used to biopsy an MRI abnormality.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE


  4 / 1797 MEDLINE  
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PMID:29357388
Autor:Han Y; Kim HJ; Kong KA; Kim SJ; Lee SH; Ryu YJ; Lee JH; Kim Y; Shim SS; Chang JH
Endereço:Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Título:Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis.
Fonte:PLoS One; 13(1):e0191590, 2018.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs. METHODS: A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis. The articles were limited to those published after 2000 that studied small PLs ≤ 3 cm in diameter. RESULTS: From 7345 records, 9 articles on the bronchoscopic (BR) approach and 15 articles on the percutaneous (PC) approach were selected. The pooled diagnostic yield was 75% (95% confidence interval [CI], 69-80) using the BR approach and 93% (95% CI, 90-96) using the PC approach. For PLs ≤ 2 cm, the PC approach (pooled diagnostic yield: 92%, 95% CI: 88-95) was superior to the BR approach (66%, 95% CI: 55-76). However, for PLs > 2 cm but ≤ 3 cm, the diagnostic yield using the BR approach was improved to 81% (95% CI, 75-85). Complications of pneumothorax and hemorrhage were rare with the BR approach but common with the PC approach. CONCLUSIONS: CT-TNB was superior to TBLB-rEBUS&VBN for the evaluation of small PLs. However, for lesions greater than 2 cm, the BR approach may be considered considering its diagnostic yield of over 80% and the low risk of procedure-related complications.
Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW


  5 / 1797 MEDLINE  
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PMID:29458952
Autor:Yen P; Dumas S; Albert A; Gordon P
Endereço:Department of Diagnostic Radiology, Nanaimo Regional General Hospital, Nanaimo, British Columbia, Canada. Electronic address: peggy_yen@live.com.
Título:Post-Vacuum-Assisted Stereotactic Core Biopsy Clip Displacement: A Comparison Between Commercially Available Clips and Surgical Clip.
Fonte:Can Assoc Radiol J; 69(1):10-15, 2018 Feb.
ISSN:1488-2361
País de publicação:Canada
Idioma:eng
Resumo:PURPOSE: The placement of localization clips following percutaneous biopsy is a standard practice for a variety of situations. Subsequent clip displacement creates challenges for imaging surveillance and surgical planning, and may cause confusion amongst radiologists and between surgeons and radiologists. Many causes have been attributed for this phenomenon including the commonly accepted "accordion effect." Herein, we investigate the performance of a low cost surgical clip system against 4 commercially available clips. METHODS: We retrospectively reviewed 2112 patients who underwent stereotactic vacuum-assisted core biopsy followed by clip placement between January 2013 and June 2016. The primary performance parameter compared was displacement >10 mm following vacuum-assisted stereotactic core biopsy. Within the group of clips that had displaced, the magnitude of displacement was compared. RESULTS: There was a significant difference in displacement among the clip types (P < .0001) with significant pairwise comparisons between pediatric surgical clips and SecureMark (38% vs 28%; P = .001) and SenoMark (38% vs 27%; P = .0001) in the proportion displaced. The surgical clips showed a significant magnitude of displacement of approximately 25% greater average distance displaced. CONCLUSIONS: As a whole, the commercial clips performed better than the surgical clip after stereotactic vacuum-assisted core biopsy suggesting the surrounding outer component acts to anchor the central clip and minimizes clip displacement. The same should apply to tomosynthesis-guided biopsy.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE


  6 / 1797 MEDLINE  
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PMID:29390333
Autor:Lin S; Zhang L; Li M; Cheng Q; Zhang L; Zheng S
Endereço:State Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University.
Título:Atypical hemangioma mimicking mixed hepatocellular cholangiocarcinoma: Case report.
Fonte:Medicine (Baltimore); 96(50):e9192, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:RATIONALE: Hemangioma of the liver is a benign hepatic tumor, more common in women than in men, which is typically asymptomatic, solitary, and incidentally discovered. Atypical hemangioma is a variant of hepatic hemangioma with atypical imaging finding features on CT and MRI that can be confused with hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and mixed hepatocellular cholangiocarcinoma (HCC-CC). PATIENT CONCERNS: We report a case of atypical hepatic hemangioma mimicking HCC-CC: A 59-year-old man was referred to our hospital for a hepatic lesion that was 4.7×3.6 cm in size and located in segments 2 and 3 of the liver. Serum alpha-fetoprotein (AFP) level increased from 17.03 ng/mL to 374.9 ng/mL. The patient was positive for hepatitis B. DIAGNOSES: Atypical hepatic hemangioma. INTERVENTIONS: US, CT, MRI and Tc-99m RBC liver scans were performed. Dynamic contrast-enhanced MRI showed no uptake in the corresponding area during the arterial phase, peripheral nodular enhancement during the portal phase and delayed phase, and hypo-intensity in the central area. An initial diagnosis of HCC-CC was offered based on the history and imaging findings. Finally, percutaneous liver biopsy (PLB) was offered to the patient. Histopathologic examination of the liver lesions revealed nodular cirrhosis and atypical hyperplasia of liver cells with cavernous hemangioma, where numerous old Schistosoma japonicum eggs were found. OUTCOMES: Accurate diagnosis of the patient obviated the need for surgery. The patient's recovery after liver puncture was uneventful, and he was discharged on the seventh post-operative day. LESSONS: In some cases, accurate preoperative imaging of focal hepatic lesions is essential but insufficient for diagnosis. PLB and histopathological examination are important, especially in patients with suspected malignancy.
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE
Nome de substância:0 (Biomarkers, Tumor)


  7 / 1797 MEDLINE  
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PMID:29206373
Autor:Matheus WE; Ferreira U
Endereço:Departamento de Cirurgia, Departamento de Uro-oncologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil.
Título:Focal therapy will be the next step on prostate cancer management? | Opinion: No.
Fonte:Int Braz J Urol; 43(6):1017-1020, 2017 Nov-Dec.
ISSN:1677-6119
País de publicação:Brazil
Idioma:eng
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:EC 3.4.21.77 (Prostate-Specific Antigen)


  8 / 1797 MEDLINE  
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PMID:29189042
Autor:Brizmohun Appayya M; Sidhu HS; Dikaios N; Johnston EW; Simmons LA; Freeman A; Kirkham AP; Ahmed HU; Punwani S
Endereço:1 Centre for Medical Imaging, University College London, Wolfson House , London , UK.
Título:Characterizing indeterminate (Likert-score 3/5) peripheral zone prostate lesions with PSA density, PI-RADS scoring and qualitative descriptors on multiparametric MRI.
Fonte:Br J Radiol; 91(1083):20170645, 2018 Feb.
ISSN:1748-880X
País de publicação:England
Idioma:eng
Resumo:OBJECTIVE: To determine whether indeterminate (Likert-score 3/5) peripheral zone (PZ) multiparametric MRI (mpMRI) studies are classifiable by prostate-specific antigen (PSA), PSA density (PSAD), Prostate Imaging Reporting And Data System version 2 (PI-RADS_v2) rescoring and morphological MRI features. METHODS: Men with maximum Likert-score 3/5 within their PZ were retrospectively selected from 330 patients who prospectively underwent prostate mpMRI (3 T) without an endorectal coil, followed by 20-zone transperineal template prostate mapping biopsies +/- focal lesion-targeted biopsy. PSAD was calculated using pre-biopsy PSA and MRI-derived volume. Two readers A and B independently assessed included men with both Likert-assessment and PI-RADS_v2. Both readers then classified mpMRI morphological features in consensus. Men were divided into two groups: significant cancer (≥ Gleason 3 + 4) or insignificant cancer (≤ Gleason 3 + 3)/no cancer. Comparisons between groups were made separately for PSA & PSAD using Mann-Whitney test and morphological descriptors with Fisher's exact test. PI-RADS_v2 and Likert-assessment were descriptively compared and percentage inter-reader agreement calculated. RESULTS: 76 males were eligible for PSA & PSAD analyses, 71 for PI-RADS scoring, and 67 for morphological assessment (excluding significant image artefacts). Unlike PSA (p = 0.915), PSAD was statistically different (p = 0.004) between the significant [median: 0.19 ng ml (interquartile range: 0.13-0.29)] and non-significant/no cancer [median: 0.13 ng ml (interquartile range: 0.10-0.17)] groups. Presence of mpMRI morphological features was not significantly different between groups. Subjective Likert-assessment discriminated patients with significant cancer better than PI-RADS_v2. Inter-reader percentage agreement was 83% for subjective Likert-assessment and 56% for PI-RADS_v2. CONCLUSION: PSAD may categorize presence of significant cancer in patients with Likert-scored 3/5 PZ mpMRI findings. Advances in knowledge: PSAD may be used in indeterminate PZ mpMRI to guide decisions between biopsy vs monitoring.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Biomarkers, Tumor); EC 3.4.21.77 (Prostate-Specific Antigen)


  9 / 1797 MEDLINE  
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PMID:29420984
Autor:Nour SG
Endereço:Division of Abdominal Imaging, Interventional MRI Program, Department of Radiology and Imaging Sciences, Emory University Hospitals and School of Medicine, Room BG-42, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA; Division of Interventional Radiology, Interventional MRI Program, Department of Radiology and Imaging Sciences, Emory University Hospitals and School of Medicine, Room BG-42, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA; Division of Image-Guided Medicine, Interventional MRI Program, Department of Radiology and Imaging Sciences, Emory University Hospitals and School of Medicine, Room BG-42, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA. Electronic address: sherif.nour@emoryhealthcare.org.
Título:MR Imaging-Guided Focal Treatment of Prostate Cancer: An Update.
Fonte:Radiol Clin North Am; 56(2):301-318, 2018 Mar.
ISSN:1557-8275
País de publicação:United States
Idioma:eng
Resumo:Focal treatment of prostate cancer has evolved from a concept to a practice in the recent few years and is projected to fill an existing need, bridging the gap between conservative and radical traditional treatment options. With its low morbidity and rapid recovery time compared with whole-gland treatment alternatives, focal therapy is poised to gain more acceptance among patients and health care providers. As our experience with focal treatment matures and evidence continues to accrue, the landscape of this practice might look quite different in the future.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  10 / 1797 MEDLINE  
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PMID:29420983
Autor:Sarkar S; Verma S
Endereço:Research and Development, Eigen, 13366 Grass Valley Avenue, Grass Valley, CA 95945, USA.
Título:MR Imaging-Targeted Prostate Biopsies.
Fonte:Radiol Clin North Am; 56(2):289-300, 2018 Mar.
ISSN:1557-8275
País de publicação:United States
Idioma:eng
Resumo:Conventional ultrasound-guided prostate biopsies have multiple limitations leading to underdetection of clinically significant prostate cancer (PCa) and overdetection of clinically insignificant PCa. Multiparametric MR imaging of the prostate offers better localization of prostatic tumors in comparison with ultrasound imaging and can help address these limitations. MR imaging-identified lesions can be targeted for biopsy directly in-gantry or indirectly using a fusion of MR imaging and ultrasound imaging. The fusion may be performed by the operator visually or using a software fusion device. In this article, we review the various techniques for MR imaging-targeted prostate biopsies and their clinical impact for PCa diagnosis.
Tipo de publicação: JOURNAL ARTICLE; REVIEW



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