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1.
Rev. inf. cient ; 100(1): 1-12, ene.-feb. 2021. tab
Article in Spanish | LILACS | ID: biblio-1156702

ABSTRACT

RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica es una patología frecuente, prevenible y tratable. La prevalencia está entre el 2,5 - 3,5 % de la población en general y asciende al 19 % en los mayores de 65 años. Objetivos: Describir las características clínicas, funcionales e imagenológicas de los pacientes diagnosticados con enfermedad pulmonar obstructiva crónica en el servicio de Neumología del Hospital Clínico Quirúrgico "Hermanos Ameijeiras" en el período diciembre de 2018 a marzo de 2020. Método: Se realizó un estudio descriptivo y transversal en 171 pacientes egresados por enfermedad pulmonar obstructiva crónica. Las variables medidas fueron: edad, sexo, evaluación nutricional, adicción tabáquica, ocupación laboral, síntomas y signos clínicos, clasificación de la enfermedad según su severidad espirométrica y hallazgos imagenológicos. Resultados: Predominaron los pacientes del sexo masculino (56,9 %) con edad entre 60 a 69 años (26,9 %) y normopesos (39,2 %). El 64,9 % fueron fumadores y el 49,1 % presentaron exposición a sustancias inorgánicas como ocupación laboral. Predominó la tos húmeda y la disnea grado 3 (56,14 y 55,0 %). Según la gravedad de la enfermedad, la forma moderada fue la más frecuente (46,2 %). En relación a los hallazgos tomográficos predominó el patrón enfisematoso, en su variante centrolobulillar (55,6 %). Conclusiones: Las manifestaciones clínicas más evidentes son la disnea y la tos húmeda. La gravedad moderada fue la variante espirométrica más reportada y el patrón enfisematoso a forma centrolobulillar fue el hallazgo tomográfico más evidente.


ABSTRACT Introduction: Chronic obstructive pulmonary disease is a common, preventable and treatable pathology. The prevalence is between 2.5-3.5% of the population in general and rises up to 19% in those over 65 years of age. Objectives: To describe the clinical, functional and imaging characteristics of patients diagnosed with chronic obstructive pulmonary disease in the pneumology service of the Hospital Clínico Quirúrgico "Hermanos Ameijeiras" in the period December 2018 to March 2020. Method: A descriptive cross-sectional study was carried out in 171 patients discharged for chronic obstructive pulmonary disease. The variables measured were: age, gender, nutritional evaluation, smoking addiction, occupation, clinical symptoms and signs, classification of the disease according to its spirometric severity and imaging findings. Results: Male patients (56.9%) with ages between 60 and 69 years (26.9%) and normal weight (39.2%) predominated. 64.9% were smokers and 49.1% had exposure to inorganic substances at work. Wet cough (56.14) and grade 3 dyspnea (55.0%) predominated. According to the severity of the disease, the moderate form was the most frequent (46.2%). Regarding the tomographic findings, the emphysematous pattern prevailed in its centrilobular variant (55.6%). Conclusions: The most obvious clinical manifestations are dyspnea and wet cough. Moderate severity was the most reported spirometric variant and the centrilobular emphysematous pattern was the most evident tomographic finding.


RESUMO Introdução: A doença pulmonar obstrutiva crônica é uma patologia comum, evitável e tratável. A prevalência está entre 2,5 - 3,5 % da população em geral e aumenta para 19% nas pessoas com mais de 65 anos de idade. Objetivo: Descrever as características clínicas, funcionais e de imagem dos pacientes com diagnóstico de doença pulmonar obstrutiva crônica atendidos no Serviço de Pneumologia do Hospital Clínico Quirúrgico "Hermanos Ameijeiras" no período de dezembro de 2018 a março de 2020. Método: Estudo descritivo e transversal, realizado em 171 pacientes que receberam alta por doença pulmonar obstrutiva crônica. As variáveis mensuradas foram: idade, sexo, avaliação nutricional, tabagismo, ocupação laboral, sintomas e sinais clínicos, classificação da doença quanto à gravidade espirométrica e achados de imagem. Resultados: Predominaram pacientes do sexo masculino (56,9%) com idade entre 60 e 69 anos (26,9%) e peso normal (39,2%). 64,9% eram fumantes e 49,1% tinham exposição a substâncias inorgânicas como ocupação laboral. Predominaram tosse úmida e dispneia grau 3 (56,14 e 55,0%). De acordo com a gravidade da doença, a forma moderada foi a mais frequente (46,2%). Quanto aos achados tomográficos, prevaleceu o padrão enfisematoso, em sua variante centrolobular (55,6%). Conclusões: As manifestações clínicas mais evidentes são dispneia e tosse úmida. Gravidade moderada foi a variante espirométrica mais relatada e o padrão enfisematoso centrolobular foi o achado tomográfico mais evidente.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Tomography, Emission-Computed/methods , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies
3.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1142108

ABSTRACT

Los tumores pseudopapilares del páncreas son tumores de origen pancreático poco frecuentes y de etiología desconocida. Comprenden entre el 0.2 y 2.7% de los carcinomas de páncreas. Hasta 2015 hay 900 casos reportados en la literatura, siendo una minoría en etapa diseminada. Son tumores voluminosos, de bajo potencial maligno, que se presentan con mayor frecuencia en mujeres jóvenes entre 18 y 35 años. Generalmente son asintomáticos o manifiestan clínicamente síntomas inespecíficos como dolor abdominal o presencia de masa abdominal. Anatómicamente se localizan con mayor frecuencia en la cola del páncreas, seguidos por la cabeza y el cuerpo. El tratamiento de elección es la resección quirúrgica. El rol de la quimioterapia en la enfermedad irresecable o avanzada no está claramente definido. Son tumores de excelente pronóstico, con sobrevida a 5 años de casi 100%.Se presentan cuatro casos clínicos y se hace una revisión de la literatura.


Pseudopapillary tumors of the pancreas are tumors of pancreatic origin with a low frequency and an unknown etiology. They account for 0.2 - 2.7 % of all pancreatic carcinomas. Up to 2015 there were approximately 900 well documented cases with only a small minority of them in a metastatic stage. This tumors could reach large proportions and they occur predominantly in young women between 18 and 35 years of age. Most of patients are asymptomatic or have non specific symptoms including abdominal pain or palpable abdominal mass. The most common localization is the tail of the pancreas, followed by the head and the body. Complete resection is the treatment of choice. It is not clearly stablished the rol of chemotherapy in metastatic disease. There are tumors with a favorable prognosis, with an overall 5 year survival rate about 95%. Herein, we report four clinical cases and a literatura review.


Os tumores pseudopapilares do pâncreas são tumores de origem pancreática pouco frequentes e de etiologia desconhecida. Compreendem entre 0.2 e 2.7% dos carcinomas de pâncreas. Até 2015 há 900 casos relatados na literatura, sendo uma minoria em etapa disseminada. São tumores volumosos, de baixo potencial maligno, que se apresentam com maior frequência em mulheres jovens entre 18 e 35 anos. Geralmente são assintomáticos ou apresentam clinicamente sintomas inespecíficos como dor abdominal ou presença de massa abdominal. Anatomicamente, localizam-se mais frequentemente na cauda do pâncreas, seguidos por cabeça e corpo. O tratamento de escolha é a ressecção cirúrgica. O papel da quimioterapia na doença irressecável ou avançada não está claramente definido. São tumores de excelente prognóstico, com sobrevida a 5 anos de quase 100%. Apresentam-se quatro casos clínicos e faz-se uma revisão da literatura.


Subject(s)
Humans , Female , Adult , Middle Aged , Pancreatic Neoplasms/surgery , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Pseudocyst/surgery , Pancreatic Pseudocyst/diagnostic imaging , Adenocarcinoma of Lung/secondary , Pancreatectomy , Tomography, Emission-Computed , Follow-Up Studies , Rare Diseases , Positron Emission Tomography Computed Tomography , Adenocarcinoma of Lung/surgery , Adenocarcinoma of Lung/drug therapy , Adenocarcinoma of Lung/diagnostic imaging
5.
Rev. méd. Urug ; 36(2): 155-162, 2020. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1115818

ABSTRACT

Resumen: En la evaluación de la carcinomatosis peritoneal (CP) la imagenología contribuye al diagnóstico preciso de compromiso peritoneal, aunque su eficacia es aún limitada. La tomografía computada (TC) es el estudio de imagen más utilizado y el PET-TC es cada vez más solicitado en la valoración de diferentes neoplasias. El objetivo del presente trabajo es evaluar el rendimiento de la TC y el PET-TC en el diagnóstico de CP en tumores digestivos y ginecológicos. Material y método: estudio retrospectivo, observacional, de 11 casos operados de CP en los que previamente se había realizado TC o PET-TC, o ambos. Se analizan los resultados de los estudios imagenológicos por separado y en conjunto, y se comparan con los hallazgos intraoperatorios y anatomopatológicos. Resultados: la TC fue concordante en 8 de 10 casos (S 78%, E 100%, VPP 100%, VPN 33%), mientras que el PET-TC lo fue en 9 de 11 pacientes (S 100%, VPP 81%). Al considerar en conjunto la TC y el PET-TC, la sensibilidad fue de 100% y el VPP de 82%. Conclusiones: en los resultados obtenidos se constata una subestimación de la CP en la imagenología a causa de las características de los nódulos y su patrón de captación. En el PET-TC, un SUV > 6 podría aumentar la probabilidad diagnóstica de carcinomatosis. Esta breve serie de casos permite sugerir que TC y el 18FGD PET-TC deben ser solicitados y analizados en forma conjunta para incrementar su rendimiento, aunque la exploración quirúrgica continúa siendo el método más eficaz para el diagnóstico y evaluación de la CP.


Summary: Imagenology contributes to the accurate diagnosis of peritoneal compromise in the assessment of peritoneal carcinomatosis, although its effectiveness is still limited. CT is the most frequently used study and PET/CT is graduallly more requested in the assessment of different neoplasms. This study aims to assess performance of CT and PET/CT for diagnosis of peritoneal carcinomatosis in digestive and gynecological tumours. Method: retrospective, observational study of 11 cases operated on peritoneal carcinomatosis after a CT and/or PET/CT had been performed. The results of both image studies were analysed separately and altogether and they were subsequently compared to intraoperative and pathology studies. Results: CT matched findings in 8 out of 10 cases (sensitivity 78%, specificity 100%, positive predictive value 100%, negative predictive value 33%), whereas PET/TC matched in 9 out of 11 patients (sensitivity 100%, PPV 81%). When considered together, sensitivity was 100% y el PPV de 82%. Conclusions: the results of the study confirm imagenology studies overestimate peritoneal carcinomatosis based on the characteristics of nodules and its uptake pattern. In CT/PET, SUV> 6 could increase the probability of diagnosing carcinomatosis. This small series of cases enables our suggesting CT and 18F-FDG PET-TC to be requested and analysed together to increase its efficiency, although surgical exploration continues to be the most effective method to diagnose and assess peritoneal carcinomatosis.


Resumo: Na avaliação da carcinomatose peritoneal (CP) as técnicas de imagem contribuem ao diagnóstico preciso do compromisso peritoneal, embora sua eficácia ainda seja limitada. A tomografia computadorizada (TC) é o estudo de imagens mais utilizado e a tomografia computadorizada por emissão de pósitrons (PET-TC) é cada vez mais solicitado na avaliação de diferentes neoplasias. O objetivo do presente trabalho, é avaliar o rendimento da TC e do PET-TC no diagnóstico de CP em tumores digestivos e ginecológicos. Material e método: estudo retrospectivo, observacional de 11 casos de carcinomatose peritoneal operados nos quais previamente se havia realizado TC e/ou PET-TC. Os resultados de ambos estudos foram estudados isoladamente e em conjunto e foram comparados com os achados intraoperatórios e histopatológicos. Resultados: a TC foi concordante em 8 de 10 casos (S 78%, E 100%, VPP 100%, VPN 33%), e o PET-TC em 9 de 11 pacientes (S 100%, VPP 81%). A sensibilidade foi de 100% e o VPP de 82% quando ambos estudos foram analisados conjuntamente. Conclusoes: observa-se nos resultados uma subestimação da CP nas técnicas de imagem, devido às características dos nódulos e seu padrão de captação. No PET-TC, um SUV > 6 poderia aumentar a probabilidade de diagnosticar carcinomatose. Esta breve série de casos permite sugerir que a TC e o 18FGD PET-TC devem ser solicitados e analisados em forma conjunta para aumentar o rendimento. No entanto a exploração cirúrgica continua sendo o método mais eficaz para o diagnóstico e avaliação da CP.


Subject(s)
Peritoneal Neoplasms/diagnostic imaging , Tomography, Emission-Computed , Positron Emission Tomography Computed Tomography
6.
Rev. Assoc. Med. Bras. (1992) ; 65(2): 100-104, Feb. 2019.
Article in English | LILACS | ID: biblio-990322

ABSTRACT

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Subject(s)
Humans , Male , Female , Biopsy/methods , Laparoscopy/methods , Kidney/pathology , Kidney Diseases/pathology , Retroperitoneal Space , Tomography, Emission-Computed , Practice Guidelines as Topic , Kidney Diseases/diagnostic imaging
7.
Article in English | WPRIM | ID: wpr-760238

ABSTRACT

Kawasaki disease (KD) is a systemic vasculitis in infants and young children. However, its natural history has not been fully elucidated because the first case was reported in the late 1960s and patients who have recovered are just now entering middle age. Nevertheless, much evidence has raised concerns regarding the subclinical vascular changes that occur in post-KD patients. KD research has focused on coronary artery aneurysms because they are directly associated with fatality. However, aneurysms have been reported in other extracardiac muscular arteries and their fate seems to resemble that of coronary artery aneurysms. Arterial strokes in KD cases are rarely reported. Asymptomatic ischemic lesions were observed in a prospective study of brain vascular lesions in KD patients with coronary artery aneurysms. The findings of a study of single-photon emission computed tomography suggested that asymptomatic cerebral vasculitis is more common than we believed. Some authors assumed that the need to consider the possibility of brain vascular lesions in severe cases of KD regardless of presence or absence of neurological symptoms. These findings suggest that KD is related with cerebrovascular lesions in children and young adults. Considering the fatal consequences of cerebral vascular involvement in KD patients, increased attention is required. Here we review our understanding of brain vascular involvement in KD.


Subject(s)
Aneurysm , Arteries , Brain , Central Nervous System , Child , Coronary Vessels , Humans , Infant , Middle Aged , Mucocutaneous Lymph Node Syndrome , Natural History , Prospective Studies , Stroke , Systemic Vasculitis , Tomography, Emission-Computed , Vasculitis , Vasculitis, Central Nervous System , Young Adult
8.
Article in English | WPRIM | ID: wpr-763146

ABSTRACT

PURPOSE: The purpose of this study was to detect the lymphatic drainage pattern of internal mammary area and verify the concept of internal mammary sentinel lymph node (IM-SLN) in breast. MATERIALS AND METHODS: A small particle radiotracer ((99m)Tc-Dextran 40) was prepared and tested. (99m)Tc-Dextran 40 was injected into intraparenchyma at the sound breast by a modified radiotracer injection technique. Subsequently, dynamic single-photon emission computed tomography (SPECT), computed tomography (CT), and SPECT/CT combination images were performed to identify the radioactive lymph vessels and internal mammary lymph nodes (IMLNs). The direction of lymph drainage and the location of the IMLNs were identified in the SPECT/CT imaging. RESULTS: The radiochemical purity of (99m)Tc-Dextran 40 was > 95%. (99m)Tc-Dextran 40 could drainage into first, second, and third lymph node and the radioactive lymph node could be detected by the γ detector in the animal experiment. After (99m)Tc-Dextran 40 injecting into intraparenchyma, 50.0% cases (15/30) were identified the drainage lymphatic vessels and radioactive IMLNs by SPECT. The drainage lymphatic vessel was found from injection point to the first IMLN (IM-SLN) after 10.5±0.35 minutes radiotracer injection, and then (99m)Tc-Dextran 40 was accumulated into the IM-SLN. The combination imaging of SPECT/CT showed the second IMLN received the lymph drainage from the IM-SLN. The lymphatic drainage was step by step in the internal mammary area. CONCLUSION: The lymph was identified to drain from different regions of the breast to IM-SLN, and then outward from IM-SLN to other IMLN consecutively. It demonstrated the concept of the IM-SLN and provided more evidences for the application of internal mammary sentinel lymph node biopsy.


Subject(s)
Animal Experimentation , Breast Neoplasms , Breast , Drainage , Lymph Nodes , Lymphatic Vessels , Sentinel Lymph Node Biopsy , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
9.
Article in English | WPRIM | ID: wpr-786488

ABSTRACT

The authors present two cases in which the ruptured popliteal (Baker's) cysts remained undetected and were diagnosed only during an isotope investigation. The aim was to describe a specific imaging sign, the “arch sign”, that is indicative of ruptured Baker's cysts. In both cases, the whole-body imaging was performed 2 hours after injection of 706.7 MBq of Tc-99m-MDP. Single-photon emission computed tomography (SPECT) imaging was performed to localize an accumulation of the radiopharmaceutical. An analysis of literature was performed to connect these cases with previously reported data and to detect the pathognomonic radio image sign of ruptured popliteal cysts. The arch-shaped distribution of the radiopharmaceutical below the knee joints was seen already on the whole-body bone scan image in both cases. An anterior view of SPECT MIP images showed the arched accumulation of the Tc-99m-MDP bone tracer along the postero-medial aspect of the right calf secondary to synovial fluid leak from a ruptured Baker's cyst. The similar arthroscintigrams were published since 1971 without recognizing this sign as pathognomonic. Tc-99m-MDP bone scanning is sensitive for a Baker's cyst with synovial effusion, and distribution of a radiopharmaceutical in the medial posterior calf in a shape of an arch, the arch sign, may serve as an indicator of a ruptured popliteal cyst.


Subject(s)
Knee Joint , Popliteal Cyst , Synovial Fluid , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
10.
Article in English | WPRIM | ID: wpr-786485

ABSTRACT

Liposome is one of the oldest yet most successful nanomedicine platforms. Doxil®, PEGylated liposome loaded with doxorubicin (DOX), was approved by the FDA in 1995 for the treatment of AIDS-related Kaposi's sarcoma, and it was the first approval for nanomedicine. Since then, liposome-based therapeutics were approved for the treatment of various diseases and many clinical trials are underway. The success of the liposome-based therapeutics was due to following factors: (1) ease of synthesis, (2) biocompatibility, (3) the ability to load both hydrophilic and hydrophobic agents, and (4) long circulation property after application of polyethylene glycol (PEG). Recently, more functionalities are introduced to liposome platform, which are (1) in vivo imaging probes for optical, magnetic resonance imaging (MRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT), (2) pH and temperature-sensitive lipid moiety, and (3) novel agents for photodynamic and photothermal therapies (PDT, PTT). These conventional and newly tested advantages make the liposome to be one of the most promising nanoplatforms for theranostics.


Subject(s)
Doxorubicin , Hydrogen-Ion Concentration , Liposomes , Magnetic Resonance Imaging , Nanomedicine , Polyethylene Glycols , Positron-Emission Tomography , Sarcoma, Kaposi , Theranostic Nanomedicine , Tomography, Emission-Computed
11.
Article in English | WPRIM | ID: wpr-786473

ABSTRACT

Targeted alpha therapy (TAT) is an active area of drug development as a highly specific and highly potent therapeutic modality that can be applied to many types of late-stage cancers. In order to properly evaluate its safety and efficacy, understanding biokinetics of alpha-emitting radiopharmaceuticals is essential. Quantitative imaging of alpha-emitting radiopharmaceuticals is often possible via imaging of gammas and positrons produced during complex decay chains of these radionuclides. Analysis of the complex decay chains for alpha-emitting radionuclides (Tb-149, At-211, Bi-212 (decayed from Pb-212), Bi-213, Ra-223, Ac- 225, and Th-227) with relevance to imageable signals is attempted in this mini-review article. Gamma camera imaging, single-photon emission computed tomography, positron emission tomography, bremsstrahlung radiation imaging, Cerenkov luminescence imaging, and Compton cameras are briefly discussed as modalities for imaging alpha-emitting radiopharmaceuticals.


Subject(s)
Electrons , Luminescence , Positron-Emission Tomography , Radioisotopes , Radionuclide Imaging , Radiopharmaceuticals , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
12.
Article in English | WPRIM | ID: wpr-786471

ABSTRACT

BACKGROUND: Molecular imaging such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) can provide the crucial pharmacokinetic-pharmacodynamic information of a drug non-invasively at an early stage of clinical drug development. Nevertheless, not much has been known how molecular imaging has been actually used in drug development studies.METHODS: We searched PubMed using such keywords as molecular imaging, PET, SPECT, drug development, and new drug, or any combination of those to select papers in English, published from January 1, 1990, to December 31, 2015. The information about the publication year, therapeutic area of a drug candidate, drug development phase, and imaging modality and utility of imaging were extracted.RESULTS: Of 10,264 papers initially screened, 208 papers met the eligibility criteria. The more recent the publication year, the bigger the number of papers, particularly since 2010. The two major therapeutic areas using molecular imaging to develop drugs were oncology (47.6%) and the central nervous system (CNS, 36.5%), in which efficacy (63.5%) and proof-of-concept through either receptor occupancy (RO) or other than RO (29.7%), respectively, were the primary utility of molecular imaging. PET was used 4.7 times more frequently than SPECT. Molecular imaging was most frequently used in phase I clinical trials (40.8%), whereas it was employed rarely in phase 0 or exploratory IND studies (1.4%).CONCLUSIONS: The present study confirmed the trend that molecular imaging has been more actively employed in recent clinical drug development studies although its adoption was rather slow and rare in phase 0 studies.


Subject(s)
Central Nervous System , Clinical Trials, Phase I as Topic , Molecular Imaging , Positron-Emission Tomography , Publications , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
13.
Article in English | WPRIM | ID: wpr-786458

ABSTRACT

PURPOSE: Left ventricular (LV) ejection fraction (EF) is an important parameter for assessing cardiac systolic function and predicting prognosis in patients with cardiovascular disease. The aim of this study was to evaluate the feasibility of assessing LVEF by Tl-201 hybrid myocardial single-photon emission computed tomography (SPECT)/CT using two attenuation correction methods in patients with angina pectoris.METHODS: A total of 339 patients with angina pectoris (62.8 ± 12.9 years, male:female = 206:133) were analyzed. All patients underwent Tl-201 myocardial SPECT/CT and transthoracic two-dimensional (2D) echocardiograph. We compared LVEF assessed by SPECT/CT using two attenuation correction methods: CT-based attenuation correction (CTAC) and non-attenuation correction (non-AC) methods and 2D echocardiography.RESULTS: LVEF assessed by either of the two attenuation correction techniques and 2D echocardiography showed moderate correlation in all patients with angina pectoris (r = 0.487 for CTAC and r = 0.473 for non-AC, p < 0.001). Results were similar in the subgroup of patients with perfusion abnormalities on myocardial SPECT/CT images. Overall diagnostic performances were similar for the CTAC and non-AC methods for evaluating normal and decreased LVEF by myocardial SPECT/CT.CONCLUSION: LVEF measured by the CTAC method of Tl-201-gated myocardial SPECT/CT was comparable with the conventional non-AC method in patients with angina pectoris and in the subgroup of patients with perfusion abnormality. Tl-201-gated myocardial hybrid SPECT/CT can be a reliable tool in the assessment of LVEF in clinic.


Subject(s)
Angina Pectoris , Cardiovascular Diseases , Echocardiography , Humans , Methods , Perfusion , Prognosis , Stroke Volume , Tomography, Emission-Computed
14.
Article in English | WPRIM | ID: wpr-786446

ABSTRACT

OBJECTIVE: A recently introduced single-photon emission computed tomography (SPECT), based on cadmium-zinc-telluride (CZT) detectors (D-SPECT), supports high energy resolution for cardiac imaging. Importantly, the high energy resolution may allow simultaneous dual-isotope (SDI) imaging (e.g., using Tc-99m and I-123). We quantitatively evaluated Tc-99m/I-123 SDI imaging by D-SPECT in comparison with conventional T1-201/I-123.MATERIALS AND METHODS: Energy resolution was measured as a percentage of the full width at half maximum(FWHM) for Tc-99m, I-123, and Tl-201. The impact of cross-talk and reconstructed image contrast were quantified by measuring the contrast-to-noise ratio (CNR), and the transmural defect contrast in the left ventricle wall (CTD) induced by a difference in energy, for combinations of Tc-99m/I-123 or Tl-201/I-123, using an RH-2 cardiac phantom. Corresponding measurement was also carried out in Anger SPECT (A-SPECT).RESULTS: The energy resolution of the D-SPECTsystem was 5.4%/5.1%for Tc-99m/I-123 and 5.4%/5.3%for Tl-201/I-123, which was approximately two times higher than the A-SPECT. No notable difference was confirmed in the CNRs of the two systems, but T1-201/I-123 showed overall higher value than Tc-99m/I-123. Compared to A-SPECT, CTD of D-SPECT significantly increased with both Tc-99m/I-123 and T1-201/I-123 (p < 0.05). In DSPECT, the combination of Tc-99m/I-123 had a slightly better CTD than T1-201/I-123. In addition, CTD of Tc-99m/I-123 was improved with scatter correction at both nuclides (p < 0.05), but in Tl-201/I-123, no significant improvement was confirmed in I-123 (p > 0.05).CONCLUSION: D-SPECT was considered to be capable of performing high-quality SDI imaging using Tc-99m/I-123.


Subject(s)
Anger , Heart Ventricles , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
15.
Article | WPRIM | ID: wpr-763549

ABSTRACT

OBJECTIVE: The aims of this study were to investigate the effects of daily low-dose tadalafil on cognitive function and to examine whether there was a change in cerebral blood flow (CBF) in patients with erectile dysfunction (ED) and mild cognitive impairment. METHODS: Male patients aged 50 to 75 years with at least three months of ED (International Index of Erectile Function [IIEF]-5 score ≤ 21) and mild cognitive impairment (Montreal Cognitive Assessment [MoCA] score ≤ 22) were included in the study. The subjects were prescribed a low-dose PDE5 inhibitor (tadalafil 5 mg) to be taken once daily for eight weeks. Changes in MoCA score and single-photon emission computed tomography (SPECT) study between the two time-points were assessed by paired t tests. RESULTS: Overall, 30 male patients were assigned to the treatment group in this study and 25 patients completed the eight-week treatment course. Five patients were withdrawn due to adverse events such as myalgia and dizziness. Mean baseline IIEF and MoCA scores were 7.52 ± 4.84 and 18.92 ± 1.78. After the eight-week treatment, mean IIEF and MoCA scores were increased to 12.92 ± 7.27 (p < 0.05) and 21.8 ± 1.71 (p < 0.05), respectively. Patients showed increased relative regional CBF in the postcentral gyrus, precuneus, and brainstem after tadalafil administration versus at baseline (p < 0.001). CONCLUSION: The results of this prospective clinical study suggest that daily use of tadalafil 5 mg increases some regional CBF and improves cognitive function in patients with ED and mild cognitive impairment.


Subject(s)
Brain Stem , Cerebrovascular Circulation , Clinical Study , Cognition , Dizziness , Erectile Dysfunction , Humans , Male , Methylenebis(chloroaniline) , Cognitive Dysfunction , Myalgia , Parietal Lobe , Perfusion , Phosphodiesterase Inhibitors , Prospective Studies , Somatosensory Cortex , Tadalafil , Tomography, Emission-Computed
16.
Psychiatry Investigation ; : 662-670, 2019.
Article in English | WPRIM | ID: wpr-760982

ABSTRACT

The neuroimaging has been applied in the study of pathophysiology in major depressive disorder (MDD). In this review article, several kinds of methodologies of neuroimaging would be discussed to summarize the promising biomarkers in MDD. For the magnetic resonance imaging (MRI) and magnetoencephalography field, the literature review showed the potentially promising roles of frontal lobes, such as anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC). In addition, the limbic regions, such as hippocampus and amygdala, might be the potentially promising biomarkers for MDD. The structures and functions of ACC, DLPFC, OFC, amygdala and hippocampus might be confirmed as the biomarkers for the prediction of antidepressant treatment responses and for the pathophysiology of MDD. The functions of cognitive control and emotion regulation of these regions might be crucial for the establishment of biomarkers. The near-infrared spectroscopy studies demonstrated that blood flow in the frontal lobe, such as the DLPFC and OFC, might be the biomarkers for the field of near-infrared spectroscopy. The electroencephalography also supported the promising role of frontal regions, such as the ACC, DLPFC and OFC in the biomarker exploration, especially for the sleep electroencephalogram to detect biomarkers in MDD. The positron emission tomography (PET) and single-photon emission computed tomography (SPECT) in MDD demonstrated the promising biomarkers for the frontal and limbic regions, such as ACC, DLPFC and amygdala. However, additional findings in brainstem and midbrain were also found in PET and SPECT. The promising neuroimaging biomarkers of MDD seemed focused in the fronto-limbic regions.


Subject(s)
Amygdala , Biomarkers , Brain Stem , Depression , Depressive Disorder, Major , Electroencephalography , Frontal Lobe , Gyrus Cinguli , Hippocampus , Magnetic Resonance Imaging , Magnetoencephalography , Mesencephalon , Neuroimaging , Positron-Emission Tomography , Prefrontal Cortex , Spectroscopy, Near-Infrared , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
17.
Article in English | WPRIM | ID: wpr-760880

ABSTRACT

With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, post-double switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ≤0.9 g/dL) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.


Subject(s)
Adhesives , Arteries , Cardiac Surgical Procedures , Child , Child, Preschool , Chyle , Chylous Ascites , Embolization, Therapeutic , Endoscopy, Gastrointestinal , Female , Heart Defects, Congenital , Heart Septal Defects, Ventricular , Humans , Ligation , Lymphatic Abnormalities , Lymphography , Pleurodesis , Postoperative Complications , Protein-Losing Enteropathies , Pulmonary Atresia , Rehabilitation , Serum Albumin , Thoracic Duct , Tomography, Emission-Computed , Weight Gain
18.
Int. j. odontostomatol. (Print) ; 12(2): 142-146, jun. 2018. graf
Article in Spanish | LILACS | ID: biblio-954256

ABSTRACT

RESUMEN: La sialometaplasia necrotizante (SN) es una rara enfermedad benigna, inflamatoria, autolimitante, que afecta más frecuentemente a las glándulas salivales menores y que comúnmente se asocia a las ubicadas en la porción más posterior del paladar duro. Su etiología no esta clara, la mayoría de los autores sugieren que una lesión química, física o biológica de los vasos sanguíneos produciría cambios isquémicos, que provocarían infarto del tejido glandular con necrosis, inflamación e intento de reparación. Clínicamente puede presentarse como una úlcera de márgenes irregulares, ligeramente elevados y lecho necrótico, mientras que histopatológicamente se caracteriza por presentar metaplasia escamosa de conductos y acinos e hiperplasia pseudoepiteliomatosa del epitelio mucoso. La similitud de sus características clínicas e histopatológicas con algunas lesiones glandulares malignas de la cavidad oral, puede resultar en tratamientos innecesarios, considerando que la SN se trata de una patología autoresolutiva, por lo que es fundamental realizar un correcto diagnóstico clínico e histopatológico para evitar tratamientos quirúrgicos mutilantes o innecesarios. En el presente trabajo se presenta un caso de una mujer joven, con diagnóstico de SN, con sus características clínicas, histopatológicas y la evolución de la lesión.


ABSTRACT: The Necrotizing Sialometaplazia (NS) it's a rare self-limiting, inflammatory, benign disease, that most frequently affects the minor salivary glands and it is commonly associated to the glands located at the most posterior portion of the hard palate. Its etiology is not clear. Most authors suggest that a chemical, physical or biological lesion of the blood vessels would produce ischemic changes, which lead to infarction of muscle tissue with necrosis, inflammation and attempts to repair. Clinically it can present as a slightly elevated ulcer with irregular edges and necrotic bed, while histopathologically it is characterized for present squamous metaplasia of ducts and acini and pseudoepitheliomatous hyperplasia of mucosal epithelium. The similarity of its clinical and histopathological characteristics with some malignant glandular lesions of the oral cavity, can result in unnecessary treatments, considering that NS is a self-sustaining pathology, it is therefore essential to perform a correct clinical and histopathological diagnosis to avoid mutilating or unnecessary surgical treatments. In the present work we present the case of a young woman, with diagnosis of NS, with its clinical and histopathological characteristics and the evolution of the lesion.


Subject(s)
Humans , Female , Adult , Sialometaplasia, Necrotizing/diagnosis , Carcinoma, Squamous Cell/diagnosis , Salivary Glands/pathology , Biopsy , Tomography, Emission-Computed , Palate, Hard , Diagnosis, Differential
19.
Article in Spanish | LILACS | ID: biblio-997058

ABSTRACT

INTRODUCCIÓN: El desarrollo tecnológico con los equipos de Tomografía Multidetector permite evaluar la formación de placas de calcio en las arterias coronarias, categorizarlas y relacionarlas con los factores de riesgo. El objetivo fue determinar la asociación de la puntuación de calcio con la hipertensión arterial, sobrepeso y obesidad, dislipidemia (colesterol total, LDL, HDL), diabetes mellitus tipo 2 y tabaquismo. MÉTODOS: Se trata de un estudio transversal con 67 pacientes a quienes se realizó el examen la puntuación de calcio con Tomografía Multidetector de 64 cortes y sincronización de la frecuencia cardíaca 60 ± 5 latidos por minuto, en el Departamento de Imagenología del Hospital de Especialidades José Carrasco Arteaga, entre Marzo - Agosto de 2016. Se aplicó una encuesta adaptada para este estudio y con el consentimiento informado. Los datos fueron analizados con el Software SPSS versión 20, la cuantificación del calcio fue de 0 negativo y > 0 positivo. RESULTADOS: La mediana de edad fue 62 años, el 55.2 % fueron hombres, el 50.7 % estaban entre 45 a 64 años, se identificó a 9 pacientes con hipertensión arterial (13.4 %), 35 pacientes tenían sobrepeso (52.2 %) y 41 pacientes con triglicéridos elevados (61.2 %). Se determinó asociación entre la variable "presión arterial sistólica en mmHg ≥ 140" RP 1.76 (IC 95 %: 1.01 ­ 3.08 P: 0.036); el resto de variables no fueron significativas. CONCLUSIONES: La puntuación de calcio positivo está asociada a la presión arterial sistólica ≥ 140 mmHgtudio Transversal: Correlación entre la Puntuación del Calcio y la Tomografía Multidetector Coronaria


BACKGROUND: The technological development with the Multidetector Tomography Equipment allows evaluating the formation of calcium plaques in the coronary arteries, categorizing them and relating them to the risk factors. The aim was to determine the calcium score with hypertension, overweight and obesity, dyslipidemia (total cholesterol, LDL, HDL), type 2 diabetes mellitus and smoking. METHODS: It is a cross-sectional study with 67 patients who underwent the examination of the calcium score with 64-slice Multidetector Tomography with synchronization of the heart rate 60 ± 5 beats per minute, in the Department of Imaging of the José Carrasco Arteaga Specialties Hospital between March - August, 2016. A survey adapted for this study and with informed consent was applied. The data were analyzed with SPSS Software version 20, the calcium quantification was 0 negative and > 0 positive. RESULTS: The median age was 62 years, 55.2 % were men, 50.7 % between 45 and 64 years, 9 patients with hypertension (13.4 %), 35 overweight patients (52.2 %) and 41 patients with high triglycerides (61.2 %). An association was determined between the variable "systolic blood pressure in mmHg ≥ 140" RP 1.76 (95 % CI: 1.01 - 3.08 P: 0.036); the rest of the variables were not significant. CONCLUSIONS: The positive calcium score is associated with systolic blood pressure ≥ 140 mmHg.


Subject(s)
Humans , Tomography, Emission-Computed , Calcium , Coronary Stenosis , Cholesterol
20.
Article in English | WPRIM | ID: wpr-717625

ABSTRACT

Accurate identification of the epileptogenic zone is an important prerequisite in presurgical evaluation of refractory epilepsy since it affects seizure-free outcomes. Apart from structural magnetic resonance imaging (sMRI), delineation has been traditionally done with electroencephalography and nuclear imaging modalities. Arterial spin labelling (ASL) sequence is a non-contrast magnetic resonance perfusion technique capable of providing similar information. Similar to single-photon emission computed tomography, its utility in epilepsy is based on alterations in perfusion linked to seizure activity by neurovascular coupling. In this article, we discuss complementary value that ASL can provide in the evaluation and characterization of some basic substrates underlying epilepsy. We also discuss the role that ASL may play in sMRI negative epilepsy and acute scenarios such as status epilepticus.


Subject(s)
Electroencephalography , Epilepsy , Magnetic Resonance Imaging , Neuroimaging , Neurovascular Coupling , Perfusion , Seizures , Status Epilepticus , Tomography, Emission-Computed
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