ABSTRACT
ABSTRACT Objective: To compare enhancement patterns of typical adrenal adenomas, lipid-poor adenomas, and non-adenomas on magnetic resonance imaging (MRI). Materials and Methods: Evaluation of adrenal nodules larger than 1.0 cm, with at least 2-year follow-up, evaluated on MRI in January 2007 and December 2016. Two different protocols were included - upper abdomen MRI (delayed phase after 3 minutes) and abdomen and pelvis MRI (delayed phase after 7 minutes) - and nodules were divided in typical adenomas (characterized on out-of-phase MRI sequence), lipid-poor adenomas (based on follow-up imaging stability) and non-adenomas (based on pathological finding or follow-up imaging). T2-weighted and enhancement features were analyzed (absolute and relative washout and enhancement curve pattern), similarly to classic computed tomography equations. Results: Final cohort was composed of 123 nodules in 116 patients (mean diameter of 1.8 cm and mean follow up time of 4 years and 3 months). Of them, 98 (79%) nodules had features of typical adenomas by quantitative chemical shift imaging, and demonstrated type 3 curve pattern in 77%, mean absolute and relative washout of 29% and 16%, respectively. Size, oncologic history and T2-weighted features showed statistically significant differences among groups. Also, a threshold greater than 11.75% for absolute washout on MRI achieved sensitivity of 71.4% and specificity of 70.0%, in differentiating typical adenomas from non-adenomas. Conclusion: Calculating absolute washout of adrenal nodules on MRI may help identifying proportion of non-adenomas.
Subject(s)
Humans , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/diagnostic imaging , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Retrospective Studies , Sensitivity and Specificity , Contrast Media , Diagnosis, DifferentialABSTRACT
Resumo Fundamento A cardiomiopatia hipertrófica (CMH) e a hipertrofia ventricular esquerda (HVE) secundária à hipertensão arterial sistêmica (HAS) podem estar associadas a anormalidades funcionais do átrio esquerdo (AE). Objetivos Caracterizar a mecânica do AE na CMH e na HAS e avaliar qualquer correlação com a extensão da fibrose ventricular esquerda medida por ressonância magnética cardíaca (RMC) em pacientes com CMH. Métodos A função longitudinal do AE derivada do ecocardiograma bidimensional com speckle tracking foi adquirida a partir de cortes apicais de 60 pacientes com CMH e 34 indivíduos controles, pareados por idade. Pacientes com CMH também foram submetidos à RMC, com medida da extensão do realce tardio por gadolínio. A associação com parâmetros de strain do AE foi analisada. Valores p < 0,05 foram definidos como estatisticamente significativos. Resultados A média da fração de ejeção do ventrículo esquerdo não foi diferente entre os grupos. A razão E/e' estava comprometida no grupo CMH e preservada no grupo controle. A mecânica do AE estava significativamente reduzida na CMH em comparação aos pacientes com HAS. O strain rate do AE nas fases de reservatório (SRrAE) e na fase contrátil (SRctAE) foram os melhores parâmetros de discriminação de CMH com uma área sob a curva (AUC) de 0,8, seguido do strain do AE na fase de reservatório (SrAE) (AUC 0,76). O SRrAE e o SRctAE apresentaram elevada especificidade (89% e 91%, respectivamente), e o SrAE apresentou sensibilidade de 80%. Um decréscimo de 2,79% no strain rate do AE na fase de condução (SRcdAE) foi preditor de um aumento de 1 cm na extensão do RT pelo gadolínio (r2=0,42, β 2,79, p=0,027). Conclusões O SRrAE e o SRctAE foram os melhores fatores de discriminação de HVE secundária à CMH. O SRcdAE foi preditor do grau de fibrose ventricular esquerda avaliada por RMC. Esses achados sugerem que a mecânica do AE pode ser um potencial preditor de gravidade de doença na CMH.
Abstract Background Hypertrophic cardiomyopathy (HCM) and left ventricular hypertrophy (LVH) secondary to systemic hypertension (HTN) may be associated with left atrial (LA) functional abnormalities. Objectives We aimed to characterize LA mechanics in HCM and HTN and determine any correlation with the extent of left ventricular (LV) fibrosis measured by cardiac magnetic resonance (CMR) in HCM patients. Methods Two-dimensional speckle tracking-derived longitudinal LA function was acquired from apical views in 60 HCM patients, 60 HTN patients, and 34 age-matched controls. HCM patients also underwent CMR, with measurement of late gadolinium enhancement (LGE) extension. Association with LA strain parameters was analyzed. Statistical significance was set at p<0.05. Results Mean LV ejection fraction was not different between the groups. The E/e' ratio was impaired in the HCM group and preserved in the control group. LA mechanics was significantly reduced in HCM, compared to the HTN group. LA strain rate in reservoir (LASRr) and in contractile (LASRct) phases were the best discriminators of HCM, with an area under the curve (AUC) of 0.8, followed by LA strain in reservoir phase (LASr) (AUC 0.76). LASRr and LASR-ct had high specificity (89% and 91%, respectively) and LASr had sensitivity of 80%. A decrease in 2.79% of LA strain rate in conduit phase (LASRcd) predicted an increase of 1cm in LGE extension (r2=0.42, β 2.79, p=0.027). Conclusions LASRr and LASRct were the best discriminators for LVH secondary to HCM. LASRcd predicted the degree of LV fibrosis assessed by CMR. These findings suggest that LA mechanics is a potential predictor of disease severity in HCM.
Subject(s)
Humans , Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/diagnostic imaging , Contrast Media , Fibrosis , Hypertrophy, Left Ventricular/complications , Hypertrophy, Left Ventricular/diagnostic imaging , GadoliniumABSTRACT
ABSTRACT Objective: To analyze the incidence, risk factors, and associations of clinical outcomes for contrast-induced acute kidney injury (CI-AKI) in patients with acute coronary syndrome (ACS) after coronary angioplasty. Method: Prospective cohort of 182 patients followed for three months after undergoing angioplasty, from July 2020 to June 2021. The analyzed variables were sociodemographic, clinical, and those related to the procedure. Results: The incidence of CI-AKI was 35.7% (n = 65) and was associated with old age, diabetes mellitus, and chronic kidney disease (p = 0.004, p < 0.001, and p = 0.009, respectively). Out of the 17 patients who died within 90 days, 76.5% had CI-AKI (n = 13), the odds ratio between death and CI-AKI was approximately 7.2 times (95% confidence interval (CI), [2.41;26.36]; p = 0.001). The decrease of one unit in the patient's baseline hemoglobin showed a 6.5% increase for CI-AKI (95% CI, [−0.089; −0.040]; p < 0.0001). Conclusion: CI-AKI is prevalent in patients with ACS after angioplasty and is related to diabetes mellitus and chronic kidney disease, showing high mortality rates.
RESUMEN Objetivo: Analizar la incidencia, los factores de riesgo y las asociaciones de resultados clínicos para Lesión Renal Aguda Inducida por Contraste (LRA-IC) en pacientes con Síndrome Coronario Agudo (SCA) después de angioplastia coronaria. Método: Cohorte prospectiva de 182 pacientes monitorizados durante tres meses tras realizada la angioplastia, en el periodo entre julio de 2020 y junio de 2021. Se evaluaron las variables sociodemográficas, clínicas y relacionadas con el procedimiento. Resultados: La incidencia de LRA-IC fue del 35,7% (n = 65) y se asoció con la edad avanzada, la diabetes mellitus y la enfermedad renal crónica (p = 0,004, p < 0,001 y p = 0,009, respectivamente). De los 17 pacientes que fallecieron dentro de los 90 días, el 76,5% tenía LRA-IC (n = 13), la razón de probabilidad entre muerte y LRA-IC fue aproximadamente 7,2 veces (intervalo de confianza, IC del 95%, [2,41;26,36]; p = 0,001). La disminución de una unidad en la hemoglobina basal del paciente demostró un aumento del 6,5% para LRA-IC (IC del 95%, [-0,089; -0,040]; p < 0,0001). Conclusión: En los pacientes con SCA después de angioplastia, la LRA-IC tiene una alta incidencia y está relacionada con la diabetes mellitus y la enfermedad renal crónica, presentando altas tasas de mortalidad.
RESUMO Objetivo: Analisar a incidência, os fatores de risco e as associações dos desfechos clínicos para Lesão Renal Aguda Induzida Por Contraste (LRA-IC) em pacientes com Síndrome Coronariana Aguda (SCA) após angioplastia coronariana. Método: Coorte prospectivo de 182 pacientes seguidos por três meses após angioplastia, entre julho de 2020 e junho de 2021. As variáveis foram sociodemográficas, clínicas e relacionadas ao procedimento. Resultados: A incidência de LRA-IC foi de 35,7% (n = 65) e esteve associada à idade avançada, diabetes mellitus e doença renal crônica (respectivamente p = 0,004, p < 0,001 e p = 0,009). Dos 17 pacientes que faleceram em até 90 dias, 76,5% tiveram LRA-IC (n = 13), a razão de chances entre óbito e LRA-IC foi de aproximadamente 7,2 vezes (intervalo de confiança (IC) 95%, [2,41;26,36]; p = 0.001). A diminuição de uma unidade na hemoglobina basal do paciente demonstrou um aumento de 6,5% para LRA-IC (IC 95%, [-0,089; -0,040]; p < 0,0001). Conclusão: Em pacientes com SCA após angioplastia, a LRA-IC tem alta incidência e está relacionada com diabetes mellitus e doença renal crônica, apresentando altos índices de mortalidade.
Subject(s)
Percutaneous Coronary Intervention , Kidney Diseases , Contrast Media , Acute Coronary Syndrome , Acute Kidney InjuryABSTRACT
Objective: This study aimed to evaluate the radiopacity, compressive strength, setting time and bioactivity of Biodentine after modification with Ytterbium Tri-Fluoride (YbF3) in three different concentrations. Material and Methods: Radiopacity was determined using the equivalence in millimeters of aluminum (mm Al) from digital radiographs. Compressive strength was evaluated using a universal testing machine. The initial and final setting times were evaluated using Gillmore needle. The bioactive potential was evaluated using the environmental scanning electron microscope (ESEM) connected with Energy Dispersive X-ray analysis (EDX) and X-ray Diffractometer (XRD) at three different time intervals. pH was measured using a pH-meter. Data were analyzed using one-way ANOVA followed by Tukey's post hoc tests (P≤ 0.05). Results: Radiopacity of Biodentine with 2.5%, 5% and 7.5% YbF3 was significantly higher than unmodified Biodentine (P ≤ 0.05). Unmodified Biodentine showed the highest mean compressive strength values compared to all other groups (p≤ 0.05). The addition of YbF3 to Biodentine has extended the final setting time except for the 2.5% YbF3 group that showed no significant difference compared to the control. All groups showed an alkaline pH at 28 days, ESEM coupled with EDX analysis showed evidence of dense globules of calcium phosphate on the surface indicating enhancement of bioactivity. Conclusion: 2.5% YbF3 can be a promising radiopacifying agent to Biodentine with improvement in radiopacity, bioactive potential and maintaining the setting time and compressive strength at acceptable level as indicated by the ISO standards (AU)
Objetivo: O estudo buscou avaliar a radiopacidade, resistência à compressão, tempo de presa e bioatividade da Biodentina modificada por Trifluoreto de itérbio (YbF3). Materiais e Métodos: YbF3 foi incorporado ao pó de Biodentina e dividido em 4 grupos (X0, X1, X2 e X3) de acordo com a concentração de YbF3; 0%, 2.5%, 5% e 7.5% do peso, respectivamente. Os espécimes foram preparados para cada experimento com um total de 40 espécimes para cada teste (n=10 por grupo). A radiopacidade foi determinada através do uso equivalente em milímetros de alumínio. A resistência a compressão foi avaliada através do uso de uma máquina de teste universal. O tempo inicial e final foi avaliado através de uma agulha de Gillmore. O potencial bioativo foi avaliado através do Microscópio Eletrônico de Varredura (ESEM), conectado com a análise de espectroscopia de raios X por energia dispersiva (EDX) e difração de raio X (DRX). O pH foi mensurado através do uso de um pHmetro. Os dados foram analisados pelo ANOVA seguido do Test Tukey. Resultados: A radiopacidade nos grupos X1, X2 e X3 foi significantemente maior do que no grupo X0. O grupo X0 mostrou a maior resistência à compressão comparado com os outros grupos. A adição de YbF3 a Biodentina excedeu o tempo final exceto pelo grupo X1, que não apresentou diferença estatística significante quando comparado com o grupo X0. Todos os grupos apresentaram um pH alcalino com 28 dias. ESEM com análise EDX mostrou evidência de densos glóbulos de fosfato de cálcio na superfície, indicando uma melhora na bioatividade. Conclusão: 2.5% YbF3 é um promissor radiopacificador para Biodentina, que aumentou a radiopacidade e potencial bioativo enquanto manteve o tempo definido e a resistência à compressão em níveis aceitáveis como indica a norma ISO.(AU)
Subject(s)
Ytterbium , Contrast Media , Dental Materials , DentistryABSTRACT
SUMMARY: The application of stereology in hepatobiliary conditions is essential in liver volume estimation. Computerized topographic scan with contrast is a reliable method in liver scanning for precise boundaries demarcation. Liver volumetry varies in relation to different factors. Reports showed a correlation of liver volume with sex and body mass index. Steady relation between age and ethnicity is not established. This study aimed to design a protocol for liver volume measurement and apply it in the estimation of volume among the Sudanese population use stereology. Recruitment of the study population was obtained in the royal scan clinic in Khartoum by making an announcement for participation in the study. Patients with a history of hepatobiliary diseases were excluded. CT abdomen with contrast was obtained in DICOM format and transferred to computer-based software for image analysis. A protocol was designed and validated and then applied in volume estimation using software MRIcro for image display, ImageJ for volume estimation, and Onis 2.6 as image viewer. 300 apparently healthy volunteers were recruited. The protocol reliability result was 0.805. Absolute mean liver volume was 3261.32 ± 1365.313 cm3. High liver volume among females was detected than among males. A positive correlation was detected between volume and body mass index (p-value 0.001) regardless of sex. Relation with age showed a rough steady rise till the age of 50 years then it started to decline steadily. The relationship was detected in liver volume with sex and body mass index. More studies are needed to investigate the relationship between ethnicity and age groups.
RESUMEN: La aplicación de la estereología en condiciones hepatobiliares es fundamental en la estimación del volumen hepático. El escaneo topográfico computarizado con contraste es un método confiable en el escaneo del hígado para la demarcación precisa de sus límites. La volumetría hepática varía en función de diferentes factores. Los informes mostraron una correlación del volumen del hígado con el sexo y el índice de masa corporal. No se establece una relación estable entre la edad y la etnia. Este estudio tuvo como objetivo diseñar un protocolo para la medición del volumen hepático de la población sudanesa usando la estereología. El reclutamiento de la población de estudio fue realizado en la clínica de exploración real en Jartum mediante un anuncio de participación. Se excluyeron los pacientes con antecedentes de enfermedades hepatobiliares. Se obtuvo TC de abdomen con contraste en formato DICOM y se transfirió a un software informático para el análisis de imágenes. Se diseñó y validó un protocolo y luego se aplicó en la estimación de volumen utilizando el software MRIcro para la visualización de imágenes, ImageJ para la estimación de volumen y Onis 2.6 como visor de imágenes. Se reclutaron 300 voluntarios sanos. El resultado de la fiabilidad del protocolo fue 0,805. El volumen hepático medio absoluto fue 3261,32 ± 1365,313 cm3. Se detectó un volumen más elevado de hígado en las mujeres que en los hombres. Se detectó una correlación positiva entre el volumen y el índice de masa corporal (valor de p 0,001) independientemente del sexo. La relación con la edad mostró un aumento continuo y brusco hasta los 50 años, luego comenzó a disminuir de manera constante. Se detectó la relación del volumen hepático con el sexo y el índice de masa corporal. Se necesitan más estudios para investigar la relación entre la etnia y los grupos etarios.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Liver/anatomy & histology , Liver/diagnostic imaging , Organ Size , Tomography, X-Ray Computed , Body Mass Index , Sex Factors , Cross-Sectional Studies , Age Factors , Liver Transplantation , Contrast Media , Imaging, Three-DimensionalABSTRACT
SUMMARY: N-Acetylcysteine (NAC) is used for contrast induced acut kidney injury (CI-AKI) prophylaxis because of its antioxidant effects. Paricalcitol, which has reno-protective effects, is likely to provide a more effective prophylaxis when added to NAC treatment. The study was designed based on this hypothesis. The study was organised to include 4 groups each consisting of 7 rats. Group 1 was the control group, and Group 2 included rats with CI-AKI. Rats in Group 3 were administered NAC at a dose of 100 mg/kg via oral gavage once a day for 5 days. Rats in group 4 were administered paricalcitol at a dose of 0.4 mcg/kg once a day for 5 days in addition to NAC. CI-AKI was induced after the treatments in both groups. The study was terminated on the sixth day. Samples were collected from the rats' sera and kidney tissues to study oxidant and antioxidant parameters; kidney function tests were also studied. There were significant differences between the contrast nephropathy group (Group 2) and NAC and NAC+paricalcitol groups with respect to serum urea and creatinine levels. When the same groups were compared regarding oxidant (TOS-MDA) and antioxidant (TAC-Paraoxonase) parameters, we observed that the oxidant parameters increased in serum and kidney tissue samples with NAC use, and that effect was strengthened by the addition of paricalcitol to NAC treatment. However, despite increased antioxidant effectiveness, we observed no decrease in urea and creatinine levels when paricalcitol was added for CI-AKI in rats. There was no significant difference between Group 3 and Group 4. Paricalcitol provides a more potent antioxidant effect in both serum and kidney tissue samples when added to NAC treatment in rats with CI-AKI. Despite increased antioxidant parameters, however, paricalcitol does not provide a significant decrease in urea and creatinine levels.
RESUMEN: Debido a sus efectos atioxidantes la N- acetilcisteína (NAC) se usa para la profilaxis de la lesión renal aguda inducida por contraste (CI-AKI). Es probable que el paricalcitol, que tiene efectos renoprotectores, proporcione una profilaxis más eficaz cuando se agrega al tratamiento con NAC. En base a esta hipótesis el estudio fue diseñado para incluir cuatro grupos cada uno compuesto por siete ratas. El grupo 1 fue el grupo control y el grupo 2 incluyó ratas con CI-AKI. A las ratas del Grupo 3 se les administró NAC con una dosis de 100 mg/kg por sonda oral una vez al día, durante 5 días. A las ratas del grupo 4 se les administró paricalcitol a una dosis de 0,4 mcg/kg una vez al día durante 5 días, además de NAC. Se indujo CI-AKI después de los tratamientos en ambos grupos. El estudio finalizó el sexto día. Se recolectaron muestras de suero y tejidos renales de ratas para estudiar los parámetros oxidantes y antioxidantes; También se estudiaron las pruebas de función renal. Hubo diferencias significativas entre el grupo de nefropatía por contraste (Grupo 2) y los grupos NAC y NAC+paricalcitol con respecto a los niveles séricos de urea y creatinina. Cuando se compararon los mismos grupos con respecto a los parámetros oxidantes (TOS-MDA) y antioxidantes (TAC-Paraoxonase), observamos que los parámetros oxidantes aumentaron en muestras de suero y tejido renal con el uso de NAC, y ese efecto se vio reforzado por la adición de paricalcitol a tratamiento NAC. Sin embargo, a pesar de una mayor eficacia antioxidante, no observamos una disminución en los niveles de urea y creatinina cuando se agregó paricalcitol para CI-AKI en ratas. No hubo diferencias significativas entre el Grupo 3 y el Grupo 4. El paricalcitol proporciona un efecto antioxidante más potente tanto en muestras de suero como de tejido renal cuando se agrega al tratamiento con NAC en ratas con CI-AKI. Sin embargo, a pesar del aumento de los parámetros antioxidantes, el paricalcitol no proporciona una disminución sig- nificativa en los niveles de urea y creatinina.
Subject(s)
Animals , Rats , Acetylcysteine/administration & dosage , Ergocalciferols/administration & dosage , Acute Kidney Injury/prevention & control , Antioxidants/administration & dosage , Acetylcysteine/pharmacology , Ergocalciferols/pharmacology , Rats, Wistar , Oxidative Stress/drug effects , Contrast Media/adverse effects , Acute Kidney Injury/chemically induced , Antioxidants/pharmacologyABSTRACT
Abstract Nanobubbles are nanometer size bubbles having different constituents of varying physicochemical characteristic for the inner core and outer shell. Nanobubbles are mainly fabricated to improve the stability, bioavailability and improve the biodistribution of the delivered drug to the specific targeted site. Their small sizes bubbles allow the possibility of extravasation from blood vessels into the surrounding tissues and ultrasound-targeted site-specific release with minimal invasiveness. Nanobubbles are developing as important contrast agents for imaging and carriers for drug delivery at targeted region. Sonication is the primary method for preparation of nanobubbles followed by thin-layer evaporation, high shear emulsification, mechanical agitation and coacervation or coalescence. With exposure to ultrasound/extracorporeal shock waves, the drug is liberated from the nanobubbles into the target cells. This review paper is an effort to reveal the different formulation development techniques briefly and varying shell and core content for developing nanobubbles.
Subject(s)
Pharmaceutical Preparations/analysis , Drug Delivery Systems/adverse effects , Blood Vessels , Genetic Therapy/adverse effects , Contrast Media/pharmacology , MethodsABSTRACT
OBJECTIVE@#To investigate the value of quantitative synthetic magnetic resonance imaging (SyMRI) in distinguishing between benign and malignant breast lesions.@*METHODS@#We retrospectively collected data of preoperative conventional MRI and multi-dynamic multi-echo sequences from 95 patients with breast lesions showing mass-type enhancement on DCE-MRI, including 27 patients with benign lesions and 68 with malignant lesions. The MRI features of the lesions (shape, margin, internal enhancement pattern, time-signal intensity curve, and T2WI signal) were analyzed, and for each lesion, SyMRI-generated quantitative parameters including T1 and T2 relaxation time and proton density (PD) were measured before and after enhancement and recorded as T1p, T2p, PDp and T1e, T2e, and PDe, respectively. The relative change rate of each parameter was calculated. Logistic regression and all-subset regression analyses were performed for variable selection to construct diagnostic models of the breast lesions, and receiver-operating characteristic (ROC) analysis was used to assess the performance of each model for differentiation of benign and malignant lesions.@*RESULTS@#There were significant differences in the MRI features between benign and malignant lesions (P < 0.05). All the SyMRI-generated quantitative parameters, with the exception of T2e and Pdp, showed significant differences between benign and malignant lesions (P < 0.05). Among the constructed diagnostic models, the model based on all the DCE-MRI features combined with SyMRI parameters T2p and T1e (DCE-MRI+T2p+T1e) showed the best performance in the differential diagnosis malignant breast masses with an AUC of 0.995 (95% CI: 0.983-1.000).@*CONCLUSION@#Quantitative SyMRI can be used for differential diagnosis of benign and malignant breast lesions.
Subject(s)
Breast/diagnostic imaging , Breast Neoplasms/diagnostic imaging , Contrast Media , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging/methods , ROC Curve , Retrospective StudiesABSTRACT
A biphasic hyperbaric injector based on BLDC is designed for alternate and mixed injection of contrast medium and normal saline in the process of contrast medium injection in hospital. The driver hardware and algorithm are optimized especially for high-pressure and high-speed injection requirements. The interface APP is designed with parameter-input and real-time pressure-plotting of injector's ports as two main functions. The whole device can realize the preset function and has high stability after testing.
Subject(s)
Contrast Media , InjectionsABSTRACT
Contrast-enhanced ultrasound (CEUS) is a new form of ultrasound (US) that can dynamically display microvessels in a highly sensitive manner. The purpose of this study was to investigate the efficacy of CEUS for characterizing testicular lesions in comparison with conventional US. Forty-seven patients with testicular lesions were enrolled. The histopathology results revealed that 31 cases were neoplastic (11 cases of seminomas, 8 nonseminomatous germ cell tumors, 8 lymphomas, 2 Leydig cell tumors, and 2 nonspecific tumors), and 16 cases were nonneoplastic (8 cases of infarctions, 3 epidermoid cysts, and 5 inflammation). The indicators of shallow lobulated morphology and cystic-solid echogenicity on conventional US were suggestive of germ cell tumors. More indicators on CEUS were found to be useful for characterizing testicular lesions. All the neoplastic lesions showed hyperenhancement on CEUS. Moreover, germ cell tumors presented with heterogeneous enhancement (73.7%, 14/19), a twisted blood vessel pattern, rapid wash-in and wash-out, and peripheral rim hyperenhancement signs. Lymphoma was characterized by nonbranching linear vessel patterns (87.5%, 7/8), rapid wash-in and slow wash-out. In nonneoplastic lesions, infarction and epidermoid cysts showed no enhancement, and abscesses were observed with marginal irregular enhancement. The sensitivity, specificity, and accuracy of CEUS for differentiating between neoplastic and nonneoplastic lesions were 100%, 93.8%, and 97.9%, respectively, and these values were higher than those for conventional US (90.3%, 62.5%, and 80.9%, respectively). CEUS can sensitively reflect the microvascular perfusion in testicular lesions and offers high accuracy for characterizing them.
Subject(s)
Contrast Media , Diagnosis, Differential , Epidermal Cyst , Humans , Lymphoma , Male , Neoplasms, Germ Cell and Embryonal/diagnostic imaging , Sensitivity and Specificity , Testicular Neoplasms/diagnostic imaging , Ultrasonography/methodsABSTRACT
BR55 is an ultrasound contrast agent targeting vascular endothelial growth factor receptor 2,which can be used to detect tumor neovascularization and improve the diagnostic accuracy.Overseas researchers have used BR55 for human ultrasound molecular imaging,which showed good safety and tolerance.We reviewed the research progress on BR55 applied in the evaluation of tumor neovascularization from the composition,characteristics,animal experiments,and clinical studies of BR55.
Subject(s)
Animals , Contrast Media , Humans , Microbubbles , Molecular Imaging/methods , Neovascularization, Pathologic/diagnostic imaging , Ultrasonography/methods , Vascular Endothelial Growth Factor Receptor-2/analysisABSTRACT
Gas vesicles are a unique class of gas-filled protein nanostructures which are commonly found in cyanobacteria and Halobacterium. The gas vesicles may scatter sound waves and generate harmonic signals, which enabled them to have the potential to become a novel ultrasound contrast agent. However, the current hypertonic cracking method for isolating gas vesicles contains tedious operational procedures and is of low yield, thus not suitable for large-scale application. To overcome these technical challenges, we developed a rapid and efficient method for isolating gas vesicles from Microcystis. The new H2O2-based method increased the yield by three times and shortened the operation time from 24 hours to 7 hours. The H2O2 method is not only suitable for isolation of gas vesicles from laboratory-cultured Microcystis, but also suitable for colonial Microcystis covered with gelatinous sheath. The gas vesicles isolated by H2O2 method showed good performance in ultrasound contrast imaging. In conclusion, this new method shows great potential for large-scale application due to its high efficiency and wide adaptability, and provides technical support for developing gas vesicles into a biosynthetic ultrasonic contrast agent.
Subject(s)
Contrast Media , Cyanobacteria , Hydrogen Peroxide , Microcystis , Proteins/chemistryABSTRACT
INTRODUCTION@#This study aimed to evaluate the potential of non-contrast-enhanced magnetic resonance (MR) imaging as an imaging surveillance tool for detection of hepatocellular carcinoma (HCC) in at-risk patients and to compare the performance of non-contrast MR imaging with ultrasonography (US) as a screening modality for the same.@*METHODS@#In this retrospective study, patients diagnosed with HCC between 1 January 2010 and 31 December 2015 were selected from our institution's cancer registry. Patients who underwent MR imaging and had US performed within three months of the MR imaging were included. For each MR imaging, two non-contrast MR imaging sequences - T2-weighted fat-saturated (T2-W FS) sequence and diffusion-weighted imaging (DWI) - were reviewed for the presence of suspicious lesions. A non-contrast MR image was considered positive if the lesion was seen on both sequences. The performance of non-contrast MR imaging was compared to that of hepatobiliary US for the detection of HCC.@*RESULTS@#A total of 73 patients with 108 HCCs were evaluated. Sensitivity of non-contrast MR imaging for the detection of HCC using T2-W FS and DWI was 93.2%, which was significantly higher than that of US, which was 79.5% (p = 0.02). In a subgroup of 55 patients with imaging features of liver cirrhosis, the sensitivity of non-contrast MR imaging was 90.9%, which was also significantly higher than that of US, which was 74.5% (p = 0.02).@*CONCLUSION@#Our pilot study showed that non-contrast MR imaging, using a combination of T2-W FS and DWI, is a potential alternative to US as a screening tool for surveillance of patients at risk for HCC.
Subject(s)
Carcinoma, Hepatocellular/pathology , Contrast Media , Diffusion Magnetic Resonance Imaging/methods , Gadolinium DTPA , Humans , Liver Neoplasms/pathology , Magnetic Resonance Imaging/methods , Pilot Projects , Retrospective Studies , Sensitivity and SpecificityABSTRACT
OBJECTIVE@#To explore the value of micro-flow imaging (MFI) in evaluating blood flow characteristics and differential diagnosis of gallbladder polypoid lesions.@*METHODS@#We retrospectively analyzed the clinical data and ultrasound images of 73 patients with gallbladder polypoid lesions, including 24 patients with pathologically confirmed neoplastic polyps (n=24) and 49 with non-neoplastic polyps (n=49). All the patients underwent conventional ultrasound, MFI and contrast enhanced ultrasound (CEUS) before cholecystectomy. The blood flow characteristics of the lesions in color Doppler flow imaging (CDFI) and MFI were compared, and the consistency of the findings by these two modalities with those of CEUS were evaluated by weighted Kappa consistency test. The diagnostic performance of MFI for gallbladder polypoid lesions was assessed.@*RESULTS@#There were significant differences between MFI and CDFI in the evaluation of blood flow characteristics of gallbladder polypoid lesions (χ2=37.684, P < 0.001). MFI showed better performance than CDFI in displaying the blood flow characteristics of the polyps. The consistency in the findings was 0.118 between CDFI and CEUS and 0.816 between MFI and CEUS. The sensitivity, specificity and accuracy of MFI in distinguishing neoplastic polyps from non-neoplastic polyps were 75.00%, 93.88% and 87.67%, respectively.@*CONCLUSION@#MFI has a good consistency with CEUS in displaying the blood flow characteristics of gallbladder polypoid lesions and can accurately distinguish neoplastic polyps from non-neoplastic polyps, thus providing new ultrasound diagnostic evidence to support clinical decisions on optimal treatments of gallbladder polypoid lesions.
Subject(s)
Contrast Media , Diagnosis, Differential , Gallbladder Diseases/diagnostic imaging , Humans , Polyps/pathology , Retrospective StudiesABSTRACT
ABSTRACT Objective: Contrast-enhanced brain magnetic resonance imaging (MRI) is routinely performed in children with central precocious puberty (CPP). We evaluated the value of a dedicated sellar MRI protocol without contrast enhancement in girls with CPP. Subjects and methods: This study included 261 girls diagnosed with CPP. We performed sellar MRI scanning without gadolinium enhancement of the hypothalamic-pituitary area (HPA) at the pituitary level, including additional T2-weighted imaging of whole-brain scans to check for other lesions. We evaluated the prevalence of intracranial lesions via this MR protocol. In addition,the correlation between the clinical parameters and morphology of the pituitary gland on the images was assessed. Results: Intracranial lesions were detected in 17 (6.5%) of the 261 girls. Of the 17 girls with abnormalities, 16 (94.1%) had findings in brain areas other than the HPA. The weight, height, Tanner stage of patients were significantly (p < 0.05) higher in the group with greater pituitary height. Patient weight and height, Tanner stage of breast development, and luteinizing hormone (LH) levels were significantly (p < 0.05) greater in those with a higher pituitary grade as determined on sellar MRI. Conclusion: A dedicated unenhanced sellar MRI protocol provides valuable information on brain lesions and pituitary morphology. We found a significantly low prevalence of brain lesions among girls with CPP. Analysis of the height or shape of the pituitary gland on sellar MRI revealed significant correlations with the weight, height, Tanner stage, and LH levels of the patients.
Subject(s)
Humans , Female , Puberty, Precocious/epidemiology , Puberty, Precocious/diagnostic imaging , Luteinizing Hormone , Magnetic Resonance Imaging , Prevalence , Contrast Media , GadoliniumABSTRACT
Resumo Fundamento Em 2007, a Food and Drug Administration (FDA) determinou revisões sobre segurança dos agentes de contraste ecocardiográfico (ACE) disponíveis no mercado após relatos de mortes. Ao longo desses anos, diversos estudos comprovaram a segurança dos ACE, porém com poucos estudos relacionados ao SonoVue®. Objetivos Avaliar a segurança do SonoVue® durante o ecocardiograma sob estresse farmacológico (EEF) por meio da análise da incidência de reações alérgicas e da comparação entre os grupos quanto ao surgimento de arritmia, efeitos colaterais menores e eventos adversos. Métodos Estudo observacional, prospectivo, no qual 2.346 pacientes foram submetidos ao EEF e divididos em dois grupos: grupo 1 com ACE (n=1.099) e grupo 2 sem ACE (n=1.247). Os pacientes foram avaliados durante o EEF - 24 horas e 30 dias. Foi definido p significativo quando <0,05. Resultados O grupo 1 apresentou efeitos colaterais mais leves, como cefaleia (5/0,5% vs. 19/1,5%, p=0,012) e hipertensão reativa (3/0,3% vs . 19/1,5%, p=0,002), menos arritmias como extrassístoles ventriculares (180/16,4% vs . 247/19,8%, p=0,032) e taquicardia paroxística supraventricular (2/0,2% vs . 15/1,2%, p=0,003), assim como nenhum evento adverso como infarto agudo do miocárdio (IAM) e óbito. No grupo 2, um paciente apresentou IAM <24h (1/01%) e dois óbitos <30 dias (2/0,1%). Urticária relacionada ao SonoVue® foi observada em 3 (0,3%) pacientes sem reação anafilática. Conclusão SonoVue® demonstrou segurança durante o EEF, não sendo observados morte, IAM ou reação anafilática. Observou-se menor incidência de efeitos colaterais mais leves e arritmias no grupo que utilizou o ACE, assim como baixa incidência de reações alérgicas leves.
Abstract Background In 2007, the United States Food and Drug Administration mandated safety reviews of commercially available echocardiographic contrast agents (ECA), following reports of death. During the past years, different studies have proven the safety of ECA, but there have been few studies on SonoVue®. Objectives To evaluate the safety of SonoVue® during pharmacological stress echocardiography (PSE), by analyzing the incidence of allergic reactions and comparing groups regarding the appearance of arrhythmia, minor side effects and adverse events. Methods In this observational, prospective study, 2346 patients underwent PSE, and they were divided into the following 2 groups: group 1 with ECA (n = 1099) and group 2 without ECA (n = 1247). Patients were evaluated during PSE, at 24 hours, and at 30 days. Statistical significance was defined as p < 0.05. Results Group 1 had fewer minor side effects, such as headache (5/0.5% versus 19/1.5%, p = 0.012) and less reactive hypertension (3/0.3% versus 19/1.5%, p = 0.002); fewer arrhythmias, such as ventricular extrasystoles (180/16.4% versus 247/19.8%, p = 0.032) and paroxysmal supraventricular tachycardia (2/0.2% versus 15/1.2%, p = 0.003); and no adverse events, such as acute myocardial infarction (AMI) or death. In group 2, 1 patient had AMI in < 24 hours (1/01%), and there were 2 deaths in < 30 days (2/0.1%). SonoVue®-related urticaria was seen in 3 (0.3%) patients, without anaphylactic reaction. Conclusion SonoVue® demonstrated safety during PSE. No cases of death, AMI, or anaphylactic reaction were observed. There was a lower incidence of minor side effects and arrhythmias in the group that received ECA, as well as a low incidence of mild allergic reactions.
Subject(s)
Humans , Contrast Media/adverse effects , Echocardiography, Stress , Phospholipids , Sulfur Hexafluoride , United States , Echocardiography , Prospective StudiesABSTRACT
Introducción: La Nefropatía Inducida por Contraste (NIC) es una complicación causada por la ad-ministración intravenosa de medios de contrastes para estudios imagenológicos, lo cual incrementa la morbi-mortalidad y costos hospitalarios. La incidencia oscila el 2% en personas sin factores de riesgo, pudiendo llegar hasta el 25 a 50% cuando se asocian factores predisponentes. El objetivo de este estudio fue evaluar el desarrollo de NIC en pacientes oncológicos y no oncológicos hospitaliza-dos, sus características clínicas, prevalencia, factores asociados y aplicación de una escala de riesgo pre exposición. Metodología: Se realizó un estudio de casos y controles en los Hospitales "Abel Gilbert Pontón" y el Instituto Oncológico Nacional "Dr. Juan Tanca Marengo" - Guayaquil en el período Abril a Septiembre del 2020. La muestra fue no probabilística, de pacientes con y sin diagnóstico oncológico. En ambos grupos se requirió una tomografía contrastada. Se registró edad, sexo, tipo de cáncer, presencia de Diabetes Tipo 2 (DMT2), Hipertensión arterial, creatinina basal y a las 48 horas. Se usó una escala de preexposición para NIC. Se compara las prevalencias con Chi2, y las asociaciones con Odds Ratio. Resultados: Fueron 100 casos y 100 controles. La prevalencia de NIC fue 28% en no oncológicos y 22% en oncológicos (P=0.33), el factor de riesgo asociado fue la Diabetes Mellitus tipo 2 (OR 2.19 [IC95% 1.0007 4.808; P=0.0498). El valor de creatinina previa no tuvo efecto sobre el desenlace de nefropatía. La distribución de categorías pre exposición no mostró diferencias significativas entre los pacientes que desarrollaron NIC en relación con los que no desarrollaron (P=0.063). Conclusión: El desarrollo de NIC no se ve influenciado por edad, sexo, paciente e HTA, pero si se ve asociado a la presencia de DM2. La estratificación de riesgo pre exposición no fue de utilidad en este caso, su distribución fue similar en pacientes con o sin NIC
Introduction: Contrast Induced Nephropathy (CIN) is a complication caused by intravenous administration of contrast media for imaging studies, which increases morbidity and mortality and hospital costs. The incidence ranges from 2% in people without risk factors, and can reach up to 25 to 50% when predisposing factors are associated. The objective of this study was to evaluate the develop-ment of CIN in hospitalized cancer and non-cancer patients, their clinical characteristics, prevalence, associated factors, and the application of a pre-exposure risk scale. Methodology: A case-control study was carried out at the "Abel Gilbert Pontón" Hospitals and the "Dr. Juan Tanca Marengo "- Guayaquil in the period April to September 2020. The sample was non-probabilistic, of patients with and without oncological diagnosis. Contrast tomography was required in both groups. Age, sex, type of cancer, presence of Type 2 Diabetes (T2DM), arterial hypertension, creatinine at baseline and at 48 hours were recorded. A pre-exposure scale for CIN was used. The prevalences are compared with Chi2, and the associations with Odds Ratio. Results: There were 100 cases and 100 controls. The prevalence of CIN was 28% in non-cancer patients and 22% in oncological patients (P = 0.33). The associated risk factor was Type 2 Diabetes Mellitus (OR 2.19 [95% CI 1.0007 - 4.808; P = 0.0498). The previous creatinine value had no effect on the outcome of nephropathy. The distribution of pre-exposure categories did not show significant differences between the patients who developed CIN in relation to those who did not develop (P = 0.063). Conclusion: The development of CIN is not influenced by age, sex, patient and hypertension, but is associated with the presence of DM2. Pre-exposure risk stratification was not useful in this case, its distribution was similar in patients with or without CIN
Subject(s)
Humans , Adult , Middle Aged , Contrast Media , Kidney Diseases , Tomography , Risk Factors , CreatinineABSTRACT
Resumo Fundamento: Em associação às estatinas, os inibidores da pró-proteína convertase subtilisina/kexina tipo 9 (PCSK9) demonstraram ser eficazes na redução de eventos cardiovasculares em pacientes de alto risco. Objetivo: Analisar a custo-efetividade da implementação de evolocumabe para pacientes com alto risco de eventos cardiovasculares no contexto do Sistema Único de Saúde (SUS) no Brasil. Métodos: Um modelo de Markov foi utilizado, baseando-se em uma amostra ambulatorial de pacientes com doença arterial coronariana. Os desfechos primários analisados foram infarto agudo do miocárdio, acidente vascular cerebral isquêmico (AVCi), revascularização do miocárdio e morte cardiovascular. O resultado foi expresso por meio da razão de custo-efetividade incremental (RCEI), considerando-se uma taxa de desconto de 5% ao ano, e uma análise de sensibilidade foi realizada, tendo em vista a imprecisão de valores. Resultados: Selecionaram-se 61 pacientes com risco cardiovascular estimado em 35% em 10 anos, se em uso de atorvastatina 80mg/dia, e em 22,75%, se adicionado o evolocumabe. O custo global por paciente no período de 10 anos foi de R$ 46.522,44 no grupo em monoterapia com atorvastatina versus R$ 236.141,85 na terapia combinada, com uma efetividade global de 0,54 e 0,73, respectivamente. Isso resultou em uma RCEI R$ 1.011.188,07 (R$ 864.498,95 a R$ 1.296.748,43) por desfecho cardiovascular evitado. Conclusões: Apesar de não existirem padrões nacionais para custo-efetividade, os dados encontrados sugerem que a estratégia de associação do evolocumabe à terapia com estatina não é, no momento, custo-efetiva.
Abstract Background: Hypertrophic cardiomyopathy (HCM) and left ventricular hypertrophy (LVH) secondary to systemic hypertension (HTN) may be associated with left atrial (LA) functional abnormalities. Objectives: We aimed to characterize LA mechanics in HCM and HTN and determine any correlation with the extent of left ventricular (LV) fibrosis measured by cardiac magnetic resonance (CMR) in HCM patients. Methods: Two-dimensional speckle tracking-derived longitudinal LA function was acquired from apical views in 60 HCM patients, 60 HTN patients, and 34 age-matched controls. HCM patients also underwent CMR, with measurement of late gadolinium enhancement (LGE) extension. Association with LA strain parameters was analyzed. Statistical significance was set at p<0.05. Results: Mean LV ejection fraction was not different between the groups. The E/e' ratio was impaired in the HCM group and preserved in the control group. LA mechanics was significantly reduced in HCM, compared to the HTN group. LA strain rate in reservoir (LASRr) and in contractile (LASRct) phases were the best discriminators of HCM, with an area under the curve (AUC) of 0.8, followed by LA strain in reservoir phase (LASr) (AUC 0.76). LASRr and LASR-ct had high specificity (89% and 91%, respectively) and LASr had sensitivity of 80%. A decrease in 2.79% of LA strain rate in conduit phase (LASRcd) predicted an increase of 1cm in LGE extension (r2=0.42, β 2.79, p=0.027). Conclusions: LASRr and LASRct were the best discriminators for LVH secondary to HCM. LASRcd predicted the degree of LV fibrosis assessed by CMR. These findings suggest that LA mechanics is a potential predictor of disease severity in HCM.
Subject(s)
Humans , Cardiomyopathy, Hypertrophic/prevention & control , Antibodies, Monoclonal, Humanized/therapeutic use , Hypertension/drug therapy , Anticholesteremic Agents/therapeutic use , State Medicine , Brazil , Cost-Benefit Analysis , Hypertrophy, Left Ventricular/prevention & control , Contrast Media , Antibodies, Monoclonal, Humanized/economics , Gadolinium , Anticholesteremic Agents/economicsABSTRACT
Resumo Fundamento A insuficiência cardíaca com fração de ejeção reduzida (ICFEr) é uma doença de alta prevalência que requer hospitalizações repetidas e causa morbimortalidade significativa. Portanto, o reconhecimento precoce de preditores de resultados desfavoráveis é essencial para o manejo do paciente. Objetivo O objetivo do presente estudo é investigar a relação entre realce tardio pelo gadolínio (RTG) detectado por ressonância magnética cardíaca (RMC) e os parâmetros de repolarização, como o intervalo QT corrigido (QTc), intervalo Tp-e, ângulo QRS-T frontal detectado pelo eletrocardiograma (ECG) de 12 derivações na ICFEr. Método Neste estudo observacional, retrospectivo, de centro único, foram incluídos 97 pacientes consecutivos com ICFEr submetidos à RMC. A população do estudo foi dividida em dois grupos, de acordo com a presença de RTG. Foram registradas medidas ecocardiográficas e de RMC e características demográficas. Os intervalos QTc, intervalos Tp-e, e ângulos QRS-T frontais foram calculados a partir do ECG. Um valor de p <0,05 foi considerado estatisticamente significativo. Resultados O RTG foi detectado em 52 (53,6%) de 97 pacientes com ICFEr. Os intervalos QTc (p=0,001), intervalos Tp-e (p<0,001), e os ângulos QRS-T frontais (p<0,001) foram significativamente maiores no grupo RTG quando comparados ao grupo não-RTG. Na análise de regressão univariada realizada para investigar os preditores de RTG na ICFEr, todos os três parâmetros de repolarização alcançaram valores significativos, mas na análise multivariada o único parâmetro de repolarização que permaneceu significativo foi o intervalo Tp-e (OR = 1,085 IC 95% 1,032-1,140, p=0,001). Conclusão Com o prolongamento do intervalo Tp-e, pode-se prever a presença de fibrose miocárdica, a qual é um substrato arritmogênico, em pacientes com ICFEr.
Abstract Background Heart failure with reduced ejection fraction (HFrEF) is a highly prevalent disease that requires repeating hospitalizations, causes significant morbidity and mortality. Therefore, early recognition of poor outcome predictors is essential for patient management. Objective The aim of the present study is to investigate the relationship between late gadolinium enhancement (LGE) detected by cardiac magnetic resonance (CMR) and repolarization parameters such as corrected QT (QTc) interval, Tp-e interval, frontal QRS-T angle detected by 12 lead electrocardiograph (ECG) in HFrEF. Method In this single-center, retrospective observational study included 97 consecutive HFrEF patients who had CMR scan. Study population was divided into two groups according to the presence of LGE. Echocardiographic and CMR measurements and demographic features were recorded. QTc intervals, Tp-e intervals, frontal QRS-T angles were calculated from the ECG. A p-value less than 0.05 was considered statistically significant. Results LGE was detected in 52 (53.6%) out of 97 HFrEF patients. QTc intervals (p=0.001), Tp-e intervals (p<0.001), frontal QRS-T angles (p<0.001) were found to be significantly higher in LGE group when compared to non-LGE group. In univariate regression analysis which was performed to investigate the predictors of LGE in HFrEF, all three repolarization parameters were reached significant values but in multivariate analysis the only repolarization parameter remained significant was Tp-e interval (OR=1.085 95% CI 1.032-1.140, p=0.001). Conclusion With the prolongation of the Tp-e interval, the presence of myocardial fibrosis which is an arrhythmogenic substrate, can be predicted in patients with HFrEF.
Subject(s)
Humans , Gadolinium , Heart Failure/diagnostic imaging , Stroke Volume , Predictive Value of Tests , Contrast MediaABSTRACT
ABSTRACT BACKGROUND: Crohn's disease (CD) is an inflammatory bowel disease characterized by a chronic and recurrent inflammation of the gastrointestinal tract caused by an interaction of genetic and environmental factors. OBJECTIVE: To compare the quality and acceptance of two different oral contrast volumes for computed tomography enterography in Crohn's disease patients. METHODS: A cross-sectional study was conducted in 58 consecutive Crohn's disease patients who randomly received an oral contrast agent composed of 78.75 g polyethylene glycol diluted in either 1,000 mL or 2,000 mL of water. An examination was performed to evaluate the presence of inflammation or complications in the small bowel. The variables included the quality of intestinal segment filling and luminal distension, and oral contrast agent acceptance and tolerance in the patients. Statistical analysis included descriptive statistics and association tests. RESULTS: A total of 58 patients were assessed, in which 58.6% were female, 34.5% exhibited clinically-active disease, and 63.8% were receiving biologic therapy. As for comparative analysis between the two different volumes of oral contrast, no statistically significant difference was found regarding bowel loop filling (P=0.58) and adequate luminal distension (P=0.45). Patients who received a larger volume (2,000 mL) exhibited side-effects more frequently (51.7% vs 31.0%; P=0.06) and had greater difficulty ingesting the agent (65.5% vs 37.9%; P=0.07) compared with a volume of 1,000 mL. CONCLUSION: The quality of computed tomography enterography was not influenced by the contrast volume. However, acceptance and tolerance were better in the 1,000 mL group.
RESUMO CONTEXTO: A doença de Crohn (DC) é uma doença inflamatória intestinal caracterizada por uma inflamação crônica e recorrente do trato gastrointestinal causada por uma interação de fatores genéticos e ambientais. OBJETIVO: Comparar a qualidade e aceitação de dois volumes diferentes de contraste oral para enterografia por tomografia computadorizada em pacientes com doença de Crohn. MÉTODOS: Um estudo transversal foi conduzido em 58 pacientes com doença de Crohn que receberam aleatoriamente um agente de contraste oral composto por 78,75 g de polietilenoglicol diluído em 1.000 mL ou 2.000 mL de água. Um exame foi realizado para avaliar a presença de inflamação ou complicações no intestino delgado. As variáveis incluíram a qualidade do preenchimento do segmento intestinal e distensão luminal e aceitação e tolerância do contraste oral nos pacientes. A análise estatística incluiu estatística descritiva e testes de associação. RESULTADOS: Foram avaliados 58 pacientes, dos quais 58,6% eram mulheres, 34,5% apresentavam doença clinicamente ativa e 63,8% estavam recebendo terapia biológica. Quanto à análise comparativa entre os dois diferentes volumes de contraste oral, não foi encontrada diferença estatisticamente significativa em relação ao enchimento da alça intestinal (P=0,58) e distensão luminal adequada (P=0,45). Pacientes que receberam um volume maior (2.000 mL) exibiram efeitos colaterais com mais frequência (51,7% vs 31,0%; P=0,06) e tiveram maior dificuldade para ingerir o agente (65,5% vs 37,9%; P=0,07) em comparação com um volume de 1.000 mL. CONCLUSÃO: A qualidade da entero-tomografia computadorizada não foi influenciada pelo volume de contraste. No entanto, aceitação e tolerância foram melhores no grupo de 1.000 mL.