Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 812
Filter
1.
Rev. cuba. oftalmol ; 34(3): e997, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1352032

ABSTRACT

Se realizó una revisión bibliográfica con el objetivo de obtener información actualizada acerca de las características, diagnóstico y tratamiento del síndrome del uno y medio. Se emplearon principalmente las bases de datos disponibles en Infomed, Google Scholar y Pubmed. El síndrome del uno y medio es una entidad infrecuente, que se caracteriza por parálisis de la mirada conjugada horizontal y alteración del fascículo longitudinal medial ipsilateral secundario a diversas etiologías, entre las que se incluyen la enfermedad cerebrovascular y la esclerosis múltiple. Clínicamente se presenta con exotropía y nistagmo a la abducción. Su diagnóstico puede ser establecido en la exploración por las alteraciones típicas de los movimientos oculares, mientras que la imagen de resonancia magnética cerebral resulta indispensable para el diagnóstico diferencial y etiológico(AU)


One and a half syndrome is an infrequent condition characterized by conjugate horizontal gaze palsy and ipsilateral medial longitudinal fasciculus alteration secondary to various etiologies, including cerebrovascular disease and multiple sclerosis. Clinically, it presents with exotropia and abduction nystagmus. Its diagnosis may be established during exploration, due to the typical eye movement alterations, whereas brain magnetic resonance imaging is indispensable for differential and etiological diagnosis. A bibliographic review was conducted to obtain updated information about the characteristics, diagnosis and treatment of one and a half syndrome. Use was made of the databases available in Infomed, Google Scholar and Pubmed(AU)


Subject(s)
Humans , Magnetic Resonance Imaging/methods , Cerebrovascular Disorders/etiology , Exotropia/diagnosis , Diagnosis, Differential , Multiple Sclerosis/etiology , Review Literature as Topic , Databases, Bibliographic
2.
Rev. bras. neurol ; 57(3): 32-36, jul.-set. 2021.
Article in English | LILACS | ID: biblio-1342529

ABSTRACT

The extensive white matter of the brain, which comprises about one half of its volume, is constituted by an intricate and interwoven assemble of nerve fibers. The WMH (leukoaraiosis) represent the most frequent ischemic type of lesion of SVD, affecting the white matter. These lesions may be apparent or normal appearing on neuroimaging. In both cases such lesions may interrupt the affected white matter fibers, with consequent disconnection syndromes, and atrophy of the denervated grey matter structures. These conditions affect the structural neural networks (connectome), with functional repercussion on the cognitive and behavioral domains.


A extensa substância branca do cérebro, que compreende cerca da metade do seu volume, é constituída por um intricado e entrelaçado conjunto de fibras nervosas. As HSB (hiperintensidades da substância branca) (leucoaraiose) representam o mais frequente tipo de lesão isquêmica da DPV (doença dos pequenos vasos) que afeta a substância branca. Essas lesões podem ser aparentes ou de aparência normal na neuroimagem. Em ambos os casos tais lesões podem interromper essas fibras da substância branca, com consequente síndromes por desconexão e atrofia de estruturas de substância cinzenta desnervadas. Essas condições afetam as redes neurais estruturais (conectoma), com repercussão funcional nos domínios cognitivo e do comportamento.


Subject(s)
Humans , Aged , Aged, 80 and over , White Matter/physiopathology , White Matter/diagnostic imaging , Magnetic Resonance Imaging/methods , Denervation , Leukoaraiosis/pathology
5.
Rev. bras. neurol ; 57(2): 5-7, abr.-jun. 2021. ilus, tab
Article in English | LILACS | ID: biblio-1280756

ABSTRACT

Superficial Siderosis (SS) is an uncommon condition caused by hemosiderin deposition into the subarachnoid space. SS is characterized by cerebellar ataxia, progressive sensorineural hearing loss and pyramidal signs, but is often an unrecognized disorder. Magnetic Resonance Imaging (MRI) is the diagnostic procedure of choice due its high sensitivity to hemosiderin deposits in addition to being a non-invasive exam. This paper aims to describe a case of SS and to perform a literature review about SS etiologies, neuroimaging features and clinical characteristics. A 65-year-old man came to a neurology outpatient clinic with seizures and cerebellar ataxia with a history of car accident and severe traumatic brain injury 45 years ago. MRI SWAN showed a hyposignal in the cisterns of the base and on the cerebellar surface and T1-weighted images left hippocampal sclerosis.


A Siderose Superficial (SS) é uma condição rara causada por depósitos de hemossiderina no espaço subaracnóideo. SS é caracterizada por ataxia cerebelar, perda neurosensorial auditiva progressiva e sinais piramidais, mas é frequentemente uma desordem de difícil diagnóstico. A Ressonância Magnética (RM) é o exame de escolha para o diagnóstico devido a sua alta sensibilidade aos depósitos de hemossiderina, além de ser um exame não invasivo. Este artigo tem como objetivo descrever um caso de SS e realizar uma revisão da literatura sobre as etiologias da SS, suas características na neuroimagem e suas características clínicas. Um homem de 65 anos de idade procurou o ambulatório de neurologia com convulsões e ataxia cerebelar. Ele informou histórico de acidente automobilístico e lesão cerebral traumática grave há 45 anos. A RNM SWAN mostrou hipossinal nas cisternas da base e na superfície cerebelar e as imagens em T1 evidenciaram a presença de esclerose hipocampal esquerda.


Subject(s)
Humans , Male , Aged , Siderosis/etiology , Siderosis/drug therapy , Siderosis/diagnostic imaging , Seizures , Magnetic Resonance Imaging/methods , Cerebellar Ataxia , Lamotrigine/administration & dosage , Lamotrigine/pharmacology
8.
Rev. cuba. reumatol ; 22(3): e844, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144532

ABSTRACT

Aunque los métodos de imágenes aún no se han introducido en los criterios de clasificación de la miositis, el uso de imágenes musculares en la evaluación de las miopatías inflamatorias idiopáticas (MII) ha crecido a lo largo de los años. Las diferentes técnicas de imagen han demostrado ser útiles, pero la RM sigue siendo el estándar de oro para la imagen muscular. Sin embargo, el alto costo y las contraindicaciones en algunos pacientes, hacen considerar otros métodos como el ultrasonido muscular. Esta revisión tiene el objetivo de ofrecer una visión general de las diferentes técnicas de ultrasonido que se han estudiado y proporcionar información a los reumatólogos sobre el papel actual del ultrasonido para diagnosticar las MII. Existen diversos factores que pueden influir en la medición de los parámetros musculares: estandarizar la configuración de la máquina, el plano de visión y la posición del paciente, ya que pueden afectar la medición de la intensidad del eco y el grosor muscular. En el caso de las miopatías inflamatorias influyen otros factores en los resultados de la imagen: sexo, edad, escala de grises de la imagen, cambios en la calidad muscular, intensidad del eco, grosor, tamaño y ecogenicidad muscular. La ecografía muscular es una herramienta próxima en la evaluación de los trastornos neuromusculares y las miopatías inflamatorias. Es fácilmente aplicable en diversos entornos clínicos, no tiene contraindicaciones y proporciona una alternativa rentable a otras modalidades de imágenes como la resonancia magnética(AU)


Although imaging methods have not yet been introduced into the myositis classification criteria, the use of muscle imaging in the evaluation of IIMs has grown over the years. Different imaging techniques have proven helpful, but MRI remains the gold standard for muscle imaging. In this review, the objective is to provide an overview of the different ultrasound techniques that have been studied and to provide information to rheumatologists about the current role of ultrasound in the field of IIM. Development: There are multiple factors that can influence the measurement of muscle parameters that must be considered. First, it is important to standardize the machine configuration, the plane of vision and the position of the patient, as these can affect the measurement of echo intensity and muscle thickness. Conventionally, a linear ultrasound probe is used with sufficient frequency (at least 6-12 MHz) to obtain images of the peripheral skeletal muscle. Magnetic resonance imaging remains the gold standard for muscle imaging. However, the role as a diagnostic tool in the field of IIMs has grown over the years, and the promising results of new advanced imaging techniques suggest that it has not yet reached its full potential(AU)


Subject(s)
Magnetic Resonance Spectroscopy , Muscular Diseases/diagnostic imaging , Myositis/diagnostic imaging , Magnetic Resonance Imaging/methods
9.
ABC., imagem cardiovasc ; 33(4): eabc97, 20200000.
Article in Portuguese | LILACS | ID: biblio-1146296

ABSTRACT

Fundamento: O infarto do miocárdio é uma das principais causas de morbimortalidade no mundo, e 13,2% dos pacientes com síndrome coronariana aguda apresentam coronárias sem obstrução significativa, denominada MINOCA (do inglês Myocardial Infarction with Non-Obstructive Coronary Artery, Infarto do Miocárdio sem Doença Coronariana Obstrutiva). Apesar do MINOCA ter evolução mais favorável que o infarto do miocárdio por obstrução coronariana, seu prognóstico não é benigno. A ressonância magnética cardíaca é o exame que apresenta importância no diagnóstico das diversas causas de MINOCA, e seu valor prognóstico não está completamente elucidado. Objetivo: Avaliar o valor prognóstico da ressonância magnética cardíaca na detecção de eventos adversos maiores em pacientes com MINOCA. Métodos: Coorte prospectiva por meio de coleta de dados de pacientes admitidos na urgência de pacientes com hospital terciário, diagnosticados com MINOCA, no período de 2012 a 2019. Resultados: Foram avaliados 179 pacientes com seguimento médio de 45 ± 21 meses, sendo 52% do sexo masculino, com idade média de 57,3 ± 15,5 anos. Observou-se incidência de eventos adversos maiores de 17,9%. A taxa de mortalidade ao final do acompanhamento foi de 3,8%. Na análise multivariada, apenas a ressonância magnética cardíaca com resultado normal se mostrou como preditor independente de bom prognóstico (hazard ratio: 0,09; intervalo de confiança de 95% 0,01- 0,88; p = 0,04), com curva de Kaplan-Meier apresentando diferença significativa (log-rank x2 = 9,83; p = 0,02) na predição de eventos adversos maiores. Conclusão: A ressonância magnética cardíaca normal mostrou-se como variável independente de bom prognóstico nessa população, podendo ser útil na estratificação de risco de pacientes com MINOCA.


Background: Myocardial infarction is one of the major causes of morbidity and mortality worldwide and 13.2% of patients with acute coronary syndrome have normal or unobstructed coronary arteries, called MINOCA (Myocardial Infarction with Non-Obstructive Coronary Artery). Cardiac magnetic resonance (CMR) is the gold standard for investigating the etiology of acute coronary syndrome. Although MINOCA has a more benign evolution than myocardial infarction due to coronary obstruction, its prognostic factors are not completely elucidated. Objective: To evaluate prognosis, predictive factors and describe the incidence of major adverse cardiovascular events in patients with MINOCA. Methods: Prospective cohort through data collection of patients admitted to the emergency department of a tertiary hospital, diagnosed with MINOCA from 2012 to 2019. The mean follow-up was 45 months, the outcomes considered were: death, rehospitalization due to cardiac causes, recurrence of chest pain, myocardial revascularization (MACE).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Acute Coronary Syndrome/diagnostic imaging , Hypertension/complications , Myocardial Infarction/diagnostic imaging , Magnetic Resonance Imaging/methods , Multivariate Analysis , Cohort Studies , Outcome Assessment, Health Care
10.
Rev. cuba. inform. méd ; 12(2): e394, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144459

ABSTRACT

En radiología se utilizan varias técnicas imagenológicas para el diagnóstico de enfermedades y la asistencia en intervenciones quirúrgicas con el objetivo de determinar la ubicación y dimensión exacta de un tumor cerebral. Técnicas como la Tomografía por Emisión de Positrones y la Resonancia Magnética permiten determinar la naturaleza maligna o benigna de un tumor cerebral y estudiar las estructuras del cerebro con neuroimágenes de alta resolución. Investigadores a nivel internacional han utilizado diferentes técnicas para la fusión de la Tomografía por Emisión de Positrones y Resonancia Magnética al permitir la observación de las características fisiológicas en correlación con las estructuras anatómicas. La presente investigación tiene como objetivo elaborar un proceso para la fusión de neuroimágenes de Tomografía por Emisión de Positrones y Resonancia Magnética. Para ello se definieron 5 actividades en el proceso y los algoritmos a utilizar en cada una, lo cual propició identificar los más eficientes para aumentar la calidad en el proceso de fusión. Como resultado se obtuvo un proceso de fusión de neuroimágenes basado en un esquema híbrido Wavelet y Curvelet que garantiza obtener imágenes fusionadas de alta calidad(AU)


In radiology, various imaging techniques are used for the diagnosis of diseases and assistance in surgical interventions with the aim of determining the exact location and dimension of a brain tumor. Techniques such as Positron Emission Tomography and Magnetic Resonance can determine the malignant or benign nature of a brain tumor and study brain structures with high-resolution neuroimaging. International researchers have used different techniques for the fusion of Positron Emission Tomography and Magnetic Resonance, allowing the observation of physiological characteristics in correlation with anatomical structures. The present research aims to develop a process for the fusion of neuroimaging of Positron Emission Tomography and Magnetic Resonance Imaging. Five activities were defined in the process and the algorithms to be used in each one, which led identifying the most efficient ones to increase the quality in the fusion process. As a result, a neuroimaging fusion process was obtained based on a hybrid Wavelet and Curvelet scheme that guarantees high quality merged images(AU)


Subject(s)
Algorithms , Magnetic Resonance Imaging/methods , Positron-Emission Tomography/methods , Wavelet Analysis , Neuroimaging/methods , Cerebral Ventricle Neoplasms/diagnostic imaging
12.
Säo Paulo med. j ; 138(4): 310-316, July-Aug. 2020. tab
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1139710

ABSTRACT

ABSTRACT BACKGROUND: The accuracy of magnetic resonance imaging (MRI) for making the diagnosis of subscapularis tears presents wide variation in the literature and there are few prospective studies. OBJECTIVE: To compare the findings from MRI and arthroscopy for diagnosing subscapularis tears. DESIGN AND SETTING: Diagnostic test study performed in a tertiary care hospital. METHODS: We included patients who underwent arthroscopic rotator cuff repair and who had firstly undergone high magnetic field MRI without contrast. The images were independently evaluated by a shoulder surgeon and two musculoskeletal radiologists. Sensitivity, specificity, positive and negative predictive values, accuracy and inter and intra-observer agreement were calculated. RESULTS: MRIs on 200 shoulders were evaluated. The incidence of subscapularis tears was 69.5% (41.5% partial and 28.0% full-thickness). The inter and intra-observer agreement was moderate for detection of subscapularis tears. The shoulder surgeon presented sensitivity of 51.1% to 59.0% and specificity of 91.7% to 94.4%. The radiologists showed sensitivity of 83.5% to 87.1% and specificity of 41% to 45.9%. Accuracy ranged from 60.5% to 73.0%. CONCLUSION: The 1.5-T MRIs without contrast showed mean sensitivity of 70.2% and mean specificity of 61.9% for detection of subscapularis tears. Sensitivity was higher for the musculoskeletal radiologists, while specificity was higher for the shoulder surgeon. The mean accuracy was 67.6%, i.e. lower than that of rotator cuff tears overall.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Tendon Injuries/diagnostic imaging , Magnetic Resonance Imaging/methods , Rotator Cuff/diagnostic imaging , Rotator Cuff Injuries/diagnostic imaging , Arthroscopy , Observer Variation , Predictive Value of Tests , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , Rotator Cuff/surgery , Diagnostic Tests, Routine , Rotator Cuff Injuries/surgery
13.
Medicina (B.Aires) ; 80(3): 253-270, jun. 2020. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1125077

ABSTRACT

Una de cada 4 coronariografías realizadas por isquemia miocárdica presenta lesiones menores al 50% Este dato desencadenó un creciente interés en la comunidad médica. La Sociedad Americana de Cardiología publicó recientemente un artículo que describe la posición consensuada de un grupo de expertos sobre la fisiopatología, el diagnóstico y el tratamiento de esta entidad. Nuestro trabajo refleja una revisión narrativa y la posición de un grupo de expertos pertenecientes a diferentes instituciones con servicios de Cardiología jerarquizados. Aborda aspectos fisiopatológicos y diagnósticos para comprender el enfoque actual del tratamiento, tanto en pacientes que ingresan con diagnóstico de MINOCA (infa rto de miocardio con lesiones angiográficas no graves) o de INOCA (angina e isquemia demostradas, pero sin lesiones coronarias que justifiquen este síndrome).


One in every four coronarographies performed to study myocardial ischemia shows coronary angiographic stenosis less than 50%. This data triggered an increasing interest in the medical community. The American Society of Cardiology recently published a position paper about the pathophysiology, diagnosis and treatment of this entity. Our group performed a narrative review reflecting the opinion of cardiology experts from different centers in Argentina. It aims physiopatologic and diagnostic aspect to understand the current approach in patients with MINOCA (myocardial infarction with non-obstructive coronary arteries) e INOCA (demonstrated angina and ischemia but without coronary lesions that justify this syndrome).


Subject(s)
Humans , Male , Female , Myocardial Ischemia/physiopathology , Myocardial Ischemia/diagnostic imaging , Clinical Decision-Making , Myocardial Infarction/physiopathology , Myocardial Infarction/diagnostic imaging , Prognosis , Magnetic Resonance Imaging/methods , Cineangiography/methods , Tomography, X-Ray Computed/methods , Risk Factors , Coronary Angiography/methods , Coronary Vessels/physiopathology , Coronary Vessels/diagnostic imaging
14.
J. coloproctol. (Rio J., Impr.) ; 40(2): 163-167, Apr.-Jun. 2020. graf
Article in English | LILACS | ID: biblio-1134975

ABSTRACT

ABSTRACT Purpose Pelvic floor dysfunction has a high prevalence in the adult population. The Dynamic and Multiplanar Evaluation of the Pelvic Floor (DMRIPF) represents an ideal tool for multidisciplinary management. The purpose of this analysis is to evaluate the added value of the Dynamic and Multiplanar Evaluation of the Pelvic Floor in patients with suspected pelvic floor disorders. Methods Retrospective analysis of a consecutive series of patients who underwent a DMRIPF due to suspected pelvic floor disorders between April 2005 and July 2019. Results 359 patients were included. The average number of diagnoses achieved by physical examination was 1.2 vs. 2.5 by the Dynamic and Multiplanar Evaluation of the Pelvic Floor (p < 0.001). Physical examination found a single pathology in 80.8 % of cases. Anterior rectocele (AR) was the most frequent isolated diagnosis on physical examination (68 %). On the Dynamic and Multiplanar Evaluation of the Pelvic Floor, anterior rectocele was diagnosed as an isolated condition in 10.9 %. In 231 cases, anterior rectocele was associated with up to 5 other pelvic floor disorders. The number of individuals with associated pathologies of the posterior and anterior compartments tripled. It modified physical examination findings in 17 % of individuals and, in 63.5 %, allowed the identification of additional pelvic floor pathologies that were missed by physical examination. The Dynamic and Multiplanar Evaluation of the Pelvic Floor had greater added value in patients with anterior rectocele (59.6 % vs. 20.9 %; p < 0.001). Female gender was also associated with a greater diagnostic yield (p < 0.001). Conclusion The Dynamic and Multiplanar Evaluation of the Pelvic Floor allows the detection of multi-compartment defects that could otherwise go undetected, or even alter the initial clinical diagnosis, representing an ideal tool for multidisciplinary approach of pelvic floor dislocations, allowing a comprehensive therapeutic planning.


RESUMO Objetivo A disfunção do assoalho pélvico tem alta prevalência na população adulta. A avaliação dinâmica e multiplanar do assoalho pélvico (DMRIPF) representa uma ferramenta ideal para o gerenciamento multidisciplinar. O objetivo desta análise é avaliar o valor agregado da avaliação dinâmica e multiplanar do assoalho pélvico em pacientes com suspeita de distúrbios do assoalho pélvico. Métodos Análise retrospectiva de uma série consecutiva de pacientes submetidos à avaliação dinâmica e multiplanar do assoalho pélvico por suspeita de distúrbios do assoalho pélvico entre Abril de 2005 e Julho de 2019. Resultados 359 pacientes foram incluídos. O número médio de diagnósticos alcançados pelo exame físico foi de 1,2vs. 2,5 pela avaliação dinâmica e multiplanar do assoalho pélvico p < 0,001. O exame físico encontrou uma única patologia em 80.8 % dos casos. A retocele anterior (RA) foi o diagnóstico isolado mais frequente no exame físico (68 %). Na avaliação dinâmica e multiplanar do assoalho pélvico, a retocele anterior foi diagnosticada como uma condição isolada em 10.9 %. Em 231 casos, a retocele anterior foi associada a até 5 outros distúrbios do assoalho pélvico. O número de indivíduos com patologias associadas dos compartimentos posterior e anterior triplicou. Modificou os achados do exame físico em 17 % dos indivíduos e em 63.5 %; permitiu a identificação de outras patologias do assoalho pélvico que foram esquecidas pelo exame físico. A avaliação dinâmica e multiplanar do assoalho pélvico teve maior valor agregado em pacientes com retocele anterior (59.6 % vs.20.9 %; p < 0,001. O sexo feminino também foi associado a um maior rendimento diagnóstico p < 0,001. Conclusão A avaliação dinâmica e multiplanar do assoalho pélvico permite a detecção de defeitos multicompartimentários que, de outra forma, poderiam não ser detectados, ou mesmo alterar o diagnóstico clínico inicial, representando uma ferramenta ideal para a abordagem multidisciplinar das luxações do assoalho pélvico, permitindo um planejamento terapêutico abrangente.


Subject(s)
Humans , Male , Female , Magnetic Resonance Imaging/methods , Pelvic Floor Disorders/diagnosis , Physical Examination/methods , Pelvic Floor/pathology , Rectocele/diagnosis
15.
Int. j. odontostomatol. (Print) ; 14(1): 124-130, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1056511

ABSTRACT

RESUMEN: En la historia de la Endodoncia, se han utilizado distintos métodos para determinar la longitud de los canales radiculares, como sensación táctil y radiografías. Últimamente, han adquirido gran importancia los localizadores apicales electrónicos, por su gran precisión. Actualmente se ha incorporado el uso de imagenología con Cone Beam. Debido a que existen muchas formas de medir dicha longitud, es necesario ponerlos a prueba y ver si se asemejan a la técnica gold estándar definida en la literatura como el localizador electrónico de foramen apical. El propósito de esta investigación es determinar si existen diferencias estadísticamente significativas en la medida de la longitud de trabajo entre el localizador electrónico de foramen apical, y el uso de Cone Beam procesado con el software 3D endo de Dentsply Sirona. Para esto, se seleccionaron 30 premolares extraídos; se les tomó un Cone Beam para ser analizados con el software 3D endo y medir la longitud de trabajo. Una vez hecho esto, se realizó manualmente cavidad de acceso y se preparó el tercio cervical con fresas Gates Glidden 1 y 2; luego, los dientes fueron colocados en un modelo Pro Train, que asemejó las propiedades de los dientes en la cavidad oral, para permitir el uso del localizador electrónico de foramen y determinar la longitud de trabajo. Una vez obtenidos los datos, fueron comparados a través del Test de Proporciones (p=0.05 hipotético), dando como resultado p=0,2 lo que indica que no existen diferencias estadísticamente significativas en la medida de la longitud de trabajo entre ambos métodos.


ABSTRACT: Various methods have been used in the history of endodontics, to determine the length of the root canals (working length), such as tactile sensation and X-rays. Recently, apical locators have acquired importance, due to their precision. The use of Cone Beam has now also been incorporated. Because there are many ways to measure this length, it is necessary to test them and see if they resemble the standard gold measurement technique defined in the literature as the electronic apex locators. The purpose of this research is to determine whether there are statistically significant differences in the working length between the electronic apex locators, and the use of Cone Beam processed with the Software 3D Endo by Dentsply Sirona. For this, 30 extracted pre-molars were selected, for Cone Beam tomography and 3D endo Software analysis, to measure the working length. Once this was carried out, cavity preparation was performed manually, and the cervical third approached with gates glidden drills 1 and 2. Subsequently, the teeth were placed in a Pro Train model, which resembled the properties of the teeth in the oral cavity, to allow the use of the electronic apex locators to determine the working length.Once the data were obtained, they were compared through the proportions Test (p = 0.05 hypothetical), resulting in p = 0.2, indicating that there are no statistically significant differences in the working length between the two methods.


Subject(s)
Humans , Tooth/anatomy & histology , Software , Imaging, Three-Dimensional , Surgery, Computer-Assisted/methods , Endodontics/standards , Magnetic Resonance Imaging/methods , Chile , Cone-Beam Computed Tomography/methods , Odontometry
16.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 6-13, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055355

ABSTRACT

Objective: To test the feasibility and to present preliminary results of a neuroimaging protocol to evaluate adolescent depression in a middle-income setting. Methods: We assessed psychotropic medication-free adolescents (age range 14-16 years) with a diagnosis of major depressive disorder (MDD). Participants underwent a comprehensive clinical evaluation and both structural and functional magnetic resonance imaging (fMRI). In this pilot study, a preliminary single-group analysis of resting-state fMRI (rs-fMRI) data was performed, with a focus on the default mode network (DMN), cognitive control network (CCN), and salience network (SN). Results: The sample included 29 adolescents with MDD (mean age 16.01, SD 0.78) who completed the protocol. Only two participants were excluded due to MRI quality issues (head movement), and were not included in the analyses. The scans showed significant connectivity between the medial prefrontal cortex and posterior cingulate cortex (DMN), the ACC and anterior insula (SN), and the lateral prefrontal cortex and dorsal parietal cortex (CCN). Conclusion: We demonstrated the feasibility of implementing a complex neuroimaging protocol in a middle-income country. Further, our preliminary rs-fMRI data revealed patterns of resting-state connectivity consistent with prior research performed in adolescents from high-income countries.


Subject(s)
Humans , Male , Adolescent , Magnetic Resonance Imaging/methods , Depressive Disorder, Major/diagnostic imaging , Neuroimaging/methods , Quality Control , Socioeconomic Factors , Brazil , Cerebral Cortex/diagnostic imaging , Feasibility Studies , Surveys and Questionnaires , Reproducibility of Results , Depressive Disorder, Major/physiopathology , Neural Pathways , Neuropsychological Tests
18.
Rev. méd. Panamá ; 40(1): 14-20, ene.2020. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1099573

ABSTRACT

Introducción: Los gliomas son tumores malignos altamente celulares del sistema ner­ vioso central. Su grado histológico preoperatorio es de utilidad en el manejo quirúrgico, por lo que la resonancia magnética con secuencias avanzadas intenta brindar mayor información tumoral. Objetivo: Relacionar el coeficiente aparente de difusión (CAD) y celularidad de los gliomas de pacientes entre enero 2015 a diciembre 2017. Metodo­ logía: Retrospectivamente se obtuvieron de archivos clínicos la edad, sexo, tipo, grado histológico y sitio anatómico. Se calculó el CAD en 5mm 2 en los estudios de resonancia magnética preoperatorias y se utilizó las laminillas para conteo de celularidad en 5mm 2 digitalmente. Se utilizó análisis estadísticos descriptivos y coeficiente de correlación entre CDA con celularidad. Se utilizaron valores de p < 0.05 para significancia estadís­ tica. Resultados: 46 casos fueron incluidos, 56.5% fueron hombres. El rango de 41­64 años fueron los más afectados. El glioblastoma fue el tipo histológico más frecuente (47.8%), así como los gliomas de alto grado (73.9%). El 95.7% fueron supratentoriales. La celularidad promedio fue de 3970 ± 2900 vs 2436 ± 948 núcleos/5mm 2 (p = 0.13), con valores promedio de CDA mínimo de 0.813 x 10­3 ± 0.229 mm 2 /s vs 1.052 x 10­3 ± 0.196 mm 2 /s (p = 0.002), para los gliomas de alto y bajo grado respectivamente. La co­ rrelación entre CDA y celularidad fue débil (R = ­ 0.13, p = 0.37). Conclusión: Existe co­ rrelación débil inversamente proporcional entre el CDA y la celularidad con distinción de gliomas de bajo y alto grado con valores de CDA mínimos


Introduction: Gliomas are highly cellular malignant tumors of the central nervous sys­ tem. Its preoperative histological grade is useful in surgical management, so magnetic resonance imaging with advanced sequences tries to provide more tumor information. Objective: Correlate apparent diffusion coefficient (ADC) and cellularity of gliomas of patients between January 2015 to December 2017. Methodology: Data of age, sex, ty­ pe, histologic grade and anatomic site were retrospectively obtained from clinical archi­ ves. The preoperative magnetic resonance ADC was calculated in a 5 mm 2 region of interest and the microscope slides were used for the cellularity digitally count in 5 mm 2 . Descriptive statistical analysis and correlation coefficient between ADC and cellularity were used. Values of p <0.05 were used for statistical significance. Results: 46 cases were included, 56.5% were men. The 41­64 years ranges were the most affected. Glio­ blastoma was the most frequent histological type (47.8%), as well as high grade glio­ mas (73.9%). 95.7% were supratentorial. The average cellularity was 3970 ± 2900 vs 2436 ± 948 nuclei/ 5mm 2 (p = 0.13), with average minimum ADC values of 0.813 x 10­3 ± 0.229 mm 2 /s vs 1052 x 10­3 ± 0.196 mm 2 /s (p = 0.002), for high­ and low­grade glio­ mas, respectively. The correlation between ADC and cellularity was weak (R = ­ 0.13, p = 0.37). Conclusions: There is a weak inversely proportional correlation between ADC and cellularity. With distinction of low­ and high­grade gliomas with minimum ADC values


Subject(s)
Humans , Male , Female , Middle Aged , Astrocytes/pathology , Glioma/epidemiology , Oligodendroglioma/epidemiology , Magnetic Resonance Imaging/methods , Glioblastoma/physiopathology
19.
Rev. Assoc. Med. Bras. (1992) ; 66(1): 31-35, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091903

ABSTRACT

SUMMARY Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient's symptoms.


RESUMO A hipercolesterolemia familiar homozigótica, uma doença patogênica rara do metabolismo da lipoproteína intimamente relacionada com a doença cardiovascular aterosclerótica prematura, pode conduzir a uma elevada deficiência e mortalidade. A hipercolesterolemia familiar homozigótica afeta tipicamente não só a raiz aórtica, comprometendo os óstios coronários, mas também outros territórios, como a carótida, a aorta descendente e as artérias renais. Imagens de ressonância magnética multicontraste de alta resolução (RM) fornecem um método validado e útil para caracterizar quantitativamente as placas de aterosclerose da artéria carótida. No entanto, muito poucos estudos foram feitos sobre a avaliação da composição da placa em doentes com hipercolesterolemia familiar homozigótica utilizando ressonância magnética de alta resolução. Este trabalho deve avaliar o valor da ressonância magnética no acesso à doença da artéria carótida em doentes com hipercolesterolemia familiar homozigótica. Descrevemos um paciente de 28 anos de Pequim, China, que se apresentou à clínica neurológica com visão turva intermitente do olho direito, dor de cabeça, náuseas e vômitos por oito anos sem causas aparentes. Suspeitava-se de hipercolesterolemia familiar com base no histórico médico e no exame laboratorial. O ultrassom Doppler carotídeo mostrou uma artéria carótida bilateral comum, artéria carótida interna e parede da carótida externa espessando-se com sinais hiperecoicos. Posteriormente, a ressonância multicontraste de alta resolução da carótida mostrou calcificação com áreas hipointensas localizadas na camada média da placa, com estenose moderada. A placa localizada na bifurcação direita da artéria carótida comum estendia-se até a artéria carótida interna, causando estenose do lúmen próxima à oclusão. O paciente foi tratado com endarterectomia da artéria carótida direita. Em seis meses de acompanhamento, não houve recorrência dos sintomas do paciente.


Subject(s)
Humans , Female , Adult , Thrombosis/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Magnetic Resonance Imaging/methods , Carotid Stenosis/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Hyperlipoproteinemia Type II/diagnostic imaging , Carotid Artery, External/pathology , Carotid Artery, External/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Artery, Internal/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Plaque, Atherosclerotic/pathology , Carotid Intima-Media Thickness , Computed Tomography Angiography/methods
20.
Rev. Assoc. Med. Bras. (1992) ; 66(1): 74-80, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091899

ABSTRACT

SUMMARY OBJECTIVE This study aims to investigate the application value of magnetic resonance (MR) hydrography of the inner ear in cochlear implantation. METHODS 146 patients were enrolled. MR hydrography and spiral CT examinations for the intracranial auditory canal were performed before surgery, and all imaging results were statistically analyzed in order to explore the application value of MR hydrography of the inner ear in cochlear implantation. RESULTS 146 patients (292 ears) were examined. Among these patients, 13 were diagnosed with abnormal vestibular aqueducts (20 ears) by MR hydrography, while five were diagnosed with this disease by CT; 15 patients were diagnosed with inner ear malformation (19 ears) by MR hydrography, while 11 were diagnosed by CT (four were misdiagnosed); five patients were diagnosed with internal acoustic canal stenosis (eight ears) by MR hydrography, while two were diagnosed by CT (three were misdiagnosed); and four patients were diagnosed with cochlear fibrosis (five ears) by MR hydrography, while four were diagnosed by CT (four ears). The correct rate of diagnosis was 77.40% (113/146) based on CT, while the rate was 93.84% (137/146) based on MR hydrography. CONCLUSIONS MR hydrography imaging technique can be applied to the preoperative evaluation of cochlear implantation, providing accurate and reliable anatomic information on the inner membranous labyrinth and nerves in the internal acoustic canal and an accurate basis for the diagnosis of cochlear fibrosis and nerve development. This has a guiding significance for the selection of treatment schemes.


RESUMO OBJETIVO Este estudo visa investigar o valor da aplicação da hidrografia por ressonância magnética (RM) do ouvido interno no implante coclear. MÉTODOS Cento e quarenta e seis pacientes foram inscritos. Os exames da hidrografia por RM e do CT espiral para o canal auditivo intracraniano foram executados antes da cirurgia, e todos os resultados da imagem foram analisados estatisticamente, a fim de explorar o valor da aplicação da hidrografia por RM do ouvido interno no implante coclear. RESULTADOS Centro e quarenta e seis pacientes (292 ouvidos) foram examinados. Dentre esses pacientes, 13 foram diagnosticados com aquedutos vestibulares anormais (20 ouvidos) pela hidrografia por RM, enquanto cinco pacientes foram diagnosticados com esta doença pelo CT; 15 pacientes foram diagnosticados com malformação do ouvido interno (19 ouvidos) pela hidrografia por RM, enquanto 11 pacientes foram diagnosticados por CT (quatro foram diagnosticados erroneamente); cinco pacientes foram diagnosticados com estenose de canal acústico interno (oito ouvidos) pela hidrografia por RM, enquanto dois pacientes foram diagnosticados por CT (três foram diagnosticados erroneamente); e quatro pacientes foram diagnosticados com fibrose coclear (cinco ouvidos) pela hidrografia por RM, enquanto quatro foram diagnosticados por CT (quatro ouvidos). A taxa correta de diagnóstico foi de 77,40% (113/146) com base no CT, enquanto a taxa foi de 93,84% (137/146) com base na hidrografia por RM. CONCLUSÕES A técnica de imagem da hidrografia por RM pode ser aplicada à avaliação pré-operatória do implante coclear, que pode fornecer informações anatômicas precisas e confiáveis sobre o labirinto membranoso interno e os nervos no canal acústico interno, além de uma base exata para o diagnóstico da fibrose coclear e do desenvolvimento do nervo. Isso tem um significado orientador para a seleção de esquemas de tratamento.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Magnetic Resonance Imaging/methods , Cochlear Implantation/methods , Ear, Inner/diagnostic imaging , Reference Values , Reproducibility of Results , Tomography, Spiral Computed/methods , Preoperative Period , Hearing Loss, Sensorineural/surgery , Hearing Loss, Sensorineural/diagnostic imaging , Ear, Inner/surgery , Labyrinth Diseases/surgery , Labyrinth Diseases/diagnostic imaging , Middle Aged
SELECTION OF CITATIONS
SEARCH DETAIL