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INTRODUCTION AND OBJECTIVES: Sarcopenia is a common complication of end-stage liver disease (ESLD), but its exact relationship to myosteatosis and frailty remains unclear. In this pilot study, we tested the feasibility of a specialized MRI protocol and automated image analysis in patients with ESLD. MATERIALS AND METHODS: In a single-center prospective study, adult liver transplant candidates with ESLD underwent assessment of muscle composition between 3/2022 and 6/2022 using the AMRA® MAsS Scan. The primary outcome of interest was feasibility of the novel MRI technique in patients with ESLD. We also tested if thigh muscle composition correlated with validated measures of frailty and sarcopenia. RESULTS: Eighteen subjects (71 % male, mean age 59 years) were enrolled. The most common etiologies of cirrhosis were alcohol-related liver disease (44 %) and non-alcohol-associated fatty liver disease (33 %), with a mean MELD-Na of 13 (± 4). The mean time needed to complete the MRI protocol was 14.9 min and only one patient could not complete it due to metal hardware in both knees. Forty-one percent of patients had adverse muscle composition (high thigh fat infiltration and low-fat free muscle volume) and these patients were more likely to have undergone a recent large volume paracentesis (43 % vs. 0 %, p < 0.02). The adverse muscle composition group performed significantly worse on the 6-minute walk test compared to the remainder of the cohort (379 vs 470 m, p < 0.01). CONCLUSIONS: The AMRA® MAsS Scan is feasible to perform in patients with ESLD and can be used to quantify myosteatosis, a marker of muscle quality and potentially muscle functionality in ESLD.
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Doença Hepática Terminal , Estudos de Viabilidade , Imageamento por Ressonância Magnética , Sarcopenia , Humanos , Projetos Piloto , Pessoa de Meia-Idade , Masculino , Feminino , Doença Hepática Terminal/diagnóstico por imagem , Doença Hepática Terminal/complicações , Estudos Prospectivos , Sarcopenia/diagnóstico por imagem , Sarcopenia/etiologia , Idoso , Transplante de Fígado , Fragilidade/diagnóstico por imagem , Fragilidade/complicações , Músculo Esquelético/diagnóstico por imagemRESUMO
There is a pressing need for disease-modifying therapies in patients suffering from neurodegenerative diseases, including Parkinson's disease (PD). However, these disorders face unique challenges in clinical trial designs to assess the neuroprotective properties of potential drug candidates. One of these challenges relates to the often unknown individual disease mechanisms that would, however, be relevant for targeted treatment strategies. Neuroinflammation and mitochondrial dysfunction are two proposed pathophysiological hallmarks and are considered to be highly interconnected in PD. Innovative neuroimaging methods can potentially help to gain deeper insights into one's predominant disease mechanisms, can facilitate patient stratification in clinical trials, and could potentially map treatment responses. This review aims to highlight the role of neuroinflammation and mitochondrial dysfunction in patients with PD (PwPD). We will specifically introduce different neuroimaging modalities, their respective technical hurdles and challenges, and their implementation into clinical practice. We will gather preliminary evidence for their potential use in PD research and discuss opportunities for future clinical trials.
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Cancer is one of the leading causes of human death worldwide, being one of the most serious problems faced by mankind. For the diagnosis, Magnetic Resonance Imaging (MRI), through effective contrast agents (Cas), has greatly helped in the diagnosis at the initial stages. However, it is necessary to include new compounds more effective and selective for cancer diagnosis. The complexes with Mn2+, Cu2+ and Zn2+ have received great attention due to their applications as CAs for MRI. Those materials can shorten the T2 and T2* transverse relaxation times. Thus, the representative structures for hyperfine coupling constants (HFCCs) were selected from docking results by frequency of occupancy calculations. From the Multivariate Analysis to obtain the PCA graphs in the choice of a representative conformations. it is possible to notice that the variable energy does not present a high correlation with the other variables, and structural factors, such as the spatial positions of the metal atoms, seem to be important in the reactivity of the complexes. Structural factors, such as the spatial positions of the metal atoms, seem to be important in the reactivity of the complexes. Theoretical findings suggest that the compounds are capable of increasing the Aiso values of the water molecules, but the complex [Zn(H2O)(NNO)] shows a greater influence, being more sensitive to the Electron paramagnetic resonance parameters than the complexes [CuCl(H2O)NNO] and [MnCl2(H2O)(NNO)] with the explicit solvent and the enzyme. MRI contrast agents have generated various problems due to their high toxicity. In this perspective, this compound may be a promising alternative for transporting the CAs into diseased tissue.Communicated by Ramaswamy H. Sarma.
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Meios de Contraste , Complexos de Coordenação , Humanos , Meios de Contraste/química , Manganês/química , Imageamento por Ressonância Magnética , Metais , Zinco/química , Complexos de Coordenação/químicaRESUMO
The underlying causes of Parkinson's disease are complex, and besides recent advances in elucidating relevant disease mechanisms, no disease-modifying treatments are currently available. One proposed pathophysiological hallmark is mitochondrial dysfunction, and a plethora of evidence points toward the interconnected nature of mitochondria in neuronal homeostasis. This also extends to iron and neuromelanin metabolism, two biochemical processes highly relevant to individual disease manifestation and progression. Modern neuroimaging methods help to gain in vivo insights into these intertwined pathways and may pave the road to individualized medicine in this debilitating disorder. In this narrative review, we will highlight the biological rationale for studying these pathways, how distinct neuroimaging methods can be applied in patients, their respective limitations, and which challenges need to be overcome for successful implementation in clinical studies.
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Doença de Parkinson , Humanos , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/metabolismo , Ferro/metabolismo , Neuroimagem , Mitocôndrias/metabolismoRESUMO
Introduction: This project aimed to investigate the association between biometric components of metabolic syndrome (MetS) with gray matter volume (GMV) obtained with magnetic resonance imaging (MRI) from a large cohort of community-based adults (n = 776) subdivided by age and sex and employing brain regions of interest defined previously as the "Neural Signature of MetS" (NS-MetS). Methods: Lipid profiles, biometrics, and regional brain GMV were obtained from the Genetics of Brain Structure (GOBS) image archive. Participants underwent T1-weighted MR imaging. MetS components (waist circumference, fasting plasma glucose, triglycerides, HDL cholesterol, and blood pressure) were defined using the National Cholesterol Education Program Adult Treatment Panel III. Subjects were grouped by age: early adult (18-25 years), young adult (26-45 years), and middle-aged adult (46-65 years). Linear regression modeling was used to investigate associations between MetS components and GMV in five brain regions comprising the NS-MetS: cerebellum, brainstem, orbitofrontal cortex, right insular/limbic cluster and caudate. Results: In both men and women of each age group, waist circumference was the single component most strongly correlated with decreased GMV across all NS-MetS regions. The brain region most strongly correlated to all MetS components was the posterior cerebellum. Conclusion: The posterior cerebellum emerged as the region most significantly associated with MetS individual components, as the only region to show decreased GMV in young adults, and the region with the greatest variance between men and women. We propose that future studies investigating neurological effects of MetS and its comorbidities-namely diabetes and obesity-should consider the NS-MetS and the differential effects of age and sex.
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Brown adipose tissue (BAT) is regarded as an interesting potential target for the treatment of obesity, diabetes, and cardiovascular diseases, and the detailed characterization of its structural and functional phenotype could enable an advance in these fields. Most studies evaluating BAT structure and function were performed in temperate climate regions, and we are yet to know how these findings apply to the 40% of the world's population living in tropical areas. Here, we used 18F-fluorodeoxyglucose positron emission tomography - magnetic resonance imaging to evaluate BAT in 45 lean, overweight, and obese volunteers living in a tropical area in Southeast Brazil. We aimed at investigating the associations between BAT activity, volume, metabolic activity, and BAT content of triglycerides with adiposity and cardiovascular risk markers in a sample of adults living in a tropical area and we showed that BAT glucose uptake is not correlated with leanness; instead, BAT triglyceride content is correlated with visceral adiposity and markers of cardiovascular risk. This study expands knowledge regarding the structure and function of BAT in people living in tropical areas. In addition, we provide evidence that BAT triglyceride content could be an interesting marker of cardiovascular risk.
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Tecido Adiposo Marrom , Doenças Cardiovasculares , Tecido Adiposo Marrom/diagnóstico por imagem , Tecido Adiposo Marrom/metabolismo , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Fluordesoxiglucose F18/metabolismo , Fatores de Risco de Doenças Cardíacas , Humanos , Obesidade/metabolismo , Fatores de Risco , Triglicerídeos/metabolismoRESUMO
Canine Cognitive Dysfunction is a neurological condition, that causes dogs to experience a wide variety of clinical signs. On rare occasions the symptoms may be unusual and severe, therefore they reminiscent of another disease. In this case report a 16 year and 8-month-old intact female poodle presented with circling, head pressing, and generalized ataxia. Prior clinical and neurologic examinations indicated the neurolocalisation to be forebrain. Morphometric brain parameters in MRI indicated otherwise. Quantitative MRI parameters such as the ventricle-brain index, interthalamic adhesion thickness, area, and the ratio of the interthalamic adhesion thickness to brain height may aid in the diagnosis of CCD.
A Disfunção Cognitiva Canina é uma condição neurológica, que faz com que os cães apresentem uma grande variedade de sinais clínicos. Em raras ocasiões, os sintomas podem ser incomuns e graves, portanto, lembram outras doenças. Neste relato de caso, uma cadela, da raça poodle, inteira de 16 anos e 8 meses de idade apresentou-se com movimentos circulares, pressão de cabeça e ataxia generalizada. Exames clínicos e neurológicos prévios indicaram que a neurolocalização era prosencéfalo. Os parâmetros morfométricos do cérebro na ressonância magnética indicaram o contrário. Parâmetros quantitativos de RM, como índice ventrículo-cérebro, espessura de adesão intertalâmica, área e a relação entre a espessura de adesão intertalâmica e a altura do cérebro podem auxiliar no diagnóstico de DCC.
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Background and Purpose: Prognostic models based on cardiovascular hemodynamic parameters may bring new information for an early assessment of patients with bicuspid aortic valve (BAV), playing a key role in reducing the long-term risk of cardiovascular events. This work quantifies several three-dimensional hemodynamic parameters in different patients with BAV and ranks their relationships with aortic diameter. Materials and Methods: Using 4D-flow CMR data of 74 patients with BAV (49 right-left and 25 right-non-coronary) and 48 healthy volunteers, aortic 3D maps of seventeen 17 different hemodynamic parameters were quantified along the thoracic aorta. Patients with BAV were divided into two morphotype categories, BAV-Non-AAoD (where we include 18 non-dilated patients and 7 root-dilated patients) and BAV-AAoD (where we include the 49 patients with dilatation of the ascending aorta). Differences between volunteers and patients were evaluated using MANOVA with Pillai's trace statistic, Mann-Whitney U test, ROC curves, and minimum redundancy maximum relevance algorithm. Spearman's correlation was used to correlate the dilation with each hemodynamic parameter. Results: The flow eccentricity, backward velocity, velocity angle, regurgitation fraction, circumferential wall shear stress, axial vorticity, and axial circulation allowed to discriminate between volunteers and patients with BAV, even in the absence of dilation. In patients with BAV, the diameter presented a strong correlation (> |+/-0.7|) with the forward velocity and velocity angle, and a good correlation (> |+/-0.5|) with regurgitation fraction, wall shear stress, wall shear stress axial, and vorticity, also for morphotypes and phenotypes, some of them are correlated with the diameter. The velocity angle proved to be an excellent biomarker in the differentiation between volunteers and patients with BAV, BAV morphotypes, and BAV phenotypes, with an area under the curve bigger than 0.90, and higher predictor important scores. Conclusions: Through the application of a novel 3D quantification method, hemodynamic parameters related to flow direction, such as flow eccentricity, velocity angle, and regurgitation fraction, presented the best relationships with a local diameter and effectively differentiated patients with BAV from healthy volunteers.
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ABSTRACT Introduction: Transcranial Doppler ultrasonography (TCD) is a technique that allows measurement of blood flow from the basal intracerebral vessels. It is relatively inexpensive, non-invasive, can be performed at the bedside, and allows monitoring in acute emergency settings and for prolonged periods with a high temporal resolution, making it ideal for studying the haemodynamics within the intracranial arteries in neuro-Behcet's disease (NBD) and neuro-psychiatric lupus (NPSLE). Our aim was to assess the cerebral haemodynamic patterns in patients with NBD and NPSLE using TCD, while brain lesions were examined using magnetic resonance imaging (MRI). Material and methods: Case-control prospective study of 30 neuro-Behcet's disease patients, 25 neuro-psychiatric lupus patients and 26 healthy age-matched volunteers. All patients and healthy controls were examined by TCD. Only the groups of patients underwent cranial magnetic resonance imaging (MRI). Results: Transcranial Doppler (TCD) values for middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA) in NBD, NPSLE and control groups were measured. The results showed that there was a significant decrease in mean blood flow velocities in all the arteries examined in NBD and NPSLE patients. There was also a significant increase in the pulsatile index of PCA, VA and BA between NBD and NPSLE patients. The same results were obtained when comparing NBD versus controls. However, there was no significant difference between the NPSLE patients and the control group. The MRI lesions described were parenchymal lesions in 14 patients (46.7%), and vascular lesions in 4 patients (13.3%). Vascular lesions co-existed with parenchymal lesions (mixed lesion). Parenchymal lesions were in white matter (40%), thalamus (26.7%), brain stem (26.7%) and cerebellum (20%). While, in NPSLE, 23 patients were normal (92%) and only two patients had a vascular lesion (8%). Conclusion: There was a significant decrease in mean blood flow and a significant increase in the pulsatile index among both NBD and NPSLE patients, according to the TCD values.
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Humanos , Masculino , Feminino , Adulto , Infecções , Doenças Estomatognáticas , Infecções do Sistema Nervoso Central , Síndrome de Behçet , Vasculite Associada ao Lúpus do Sistema Nervoso Central , Doenças da BocaRESUMO
Menopause transition can be interpreted as a vulnerable state characterized by estrogen deficiency with detrimental systemic effects as the low-grade chronic inflammation that appears with aging and partly explains age-related disorders as cancer, diabetes mellitus and increased risk of cognitive impairment. Over the course of a lifetime, estrogen produces several beneficial effects in healthy neurological tissues as well as cardioprotective effects, and anti-inflammatory effects. However, clinical evidence on the efficacy of hormone treatment in menopausal women has failed to confirm the benefit reported in observational studies. Unambiguously, enhanced verbal memory is the most robust finding from longitudinal and cross-sectional studies, what merits consideration for future studies aiming to determine estrogen neuroprotective efficacy. Estrogen related brain activity and functional connectivity remain, however, unexplored. In this context, the resting state paradigm may provide valuable information about reproductive aging and hormonal treatment effects, and their relationship with brain imaging of functional connectivity may be key to understand and anticipate estrogen cognitive protective effects. To go in-depth into the molecular and cellular mechanisms underlying rapid-to-long lasting protective effects of estrogen, we will provide a comprehensive review of cognitive tasks used in animal studies to evaluate the effect of hormone treatment on cognitive performance and discuss about the tasks best suited to the demonstration of clinically significant differences in cognitive performance to be applied in human studies. Eventually, we will focus on studies evaluating the DMN activity and responsiveness to pharmacological stimulation in humans.
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Background: How the prefrontal cortex (PFC) recovers its functionality following lesions remains a conundrum. Recent work has uncovered the importance of transient low-frequency oscillatory activity (LFO; < 4 Hz) for the recovery of an injured brain. We aimed to determine whether persistent cortical oscillatory dynamics contribute to brain capability to support 'normal life' following injury. Methods: In this 9-year prospective longitudinal study (08/2012-2021), we collected data from the patient E.L., a modern-day Phineas Gage, who suffered from lesions, impacting 11% of his total brain mass, to his right PFC and supplementary motor area after his skull was transfixed by an iron rod. A systematic evaluation of clinical, electrophysiologic, brain imaging, neuropsychological and behavioural testing were used to clarify the clinical significance of relationship between LFO discharge and executive dysfunctions and compare E.L.´s disorders to that attributed to Gage (1848), a landmark in the history of neurology and neuroscience. Findings: Selective recruitment of the non-injured left hemisphere during execution of unimanual right-hand movements resulted in the emergence of robust LFO, an EEG-detected marker for disconnection of brain areas, in the damaged right hemisphere. In contrast, recruitment of the damaged right hemisphere during contralateral hand movement, resulted in the co-activation of the left hemisphere and decreased right hemisphere LFO to levels of controls enabling performance, suggesting a target for neuromodulation. Similarly, transcranial magnetic stimulation (TMS), used to create a temporary virtual-lesion over E.L.'s healthy hemisphere, disrupted the modulation of contralateral LFO, disturbing behaviour and impairing executive function tasks. In contrast to Gage, reasoning, planning, working memory, social, sexual and family behaviours eluded clinical inspection by decreasing LFO in the delta frequency range during motor and executive functioning. Interpretation: Our study suggests that modulation of LFO dynamics is an important mechanism by which PFC accommodates neurological injuries, supporting the reports of Gage´s recovery, and represents an attractive target for therapeutic interventions. Funding: Fundação de Amparo Pesquisa Rio de Janeiro (FAPERJ), Universidade Federal do Rio de Janeiro (intramural), and Fiocruz/Ministery of Health (INOVA Fiocruz).
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Cocaine use disorder (CUD) is characterized by a compulsive search for cocaine. Several studies have shown that cocaine users exhibit cognitive deficits, including lack of inhibition and decision-making as well as brain volume and diffusion-based white-matter alterations in a wide variety of brain regions. However, the non-specificity of standard volumetric and diffusion-tensor methods to detect structural micropathology may lead to wrong conclusions. To better understand microstructural pathology in CUD, we analyzed 60 CUD participants (3 female) and 43 non-CUD controls (HC; 2 female) retrospectively from our cross-sectional Mexican SUD neuroimaging dataset (SUDMEX-CONN), using multi-shell diffusion-weighted imaging and the neurite orientation dispersion and density imaging (NODDI) analysis, which aims to more accurately model microstructural pathology. We used Viso values of NODDI that employ a three-compartment model in white (WM) and gray-matter (GM). These values were also correlated with clinical measures, including psychiatric severity status, impulsive behavior and pattern of cocaine and tobacco use in the CUD group. We found higher whole-brain microstructural pathology in WM and GM in CUD patients than controls. ROI analysis revealed higher Viso-NODDI values in superior longitudinal fasciculus, cingulum, hippocampus cingulum, forceps minor and Uncinate fasciculus, as well as in frontal and parieto-temporal GM structures. We also found correlations between significant ROI and impulsivity, onset age of cocaine use and weekly dosage with Viso-NODDI. However, we did not find correlations with psychopathology measures. Overall, although their clinical relevance remains questionable, microstructural pathology seems to be present in CUD both in gray and white matter.
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Transtornos Relacionados ao Uso de Cocaína/patologia , Cocaína/farmacologia , Substância Cinzenta/patologia , Hipocampo/patologia , Neuritos/patologia , Substância Branca/patologia , Adulto , Encéfalo/patologia , Estudos Transversais , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Comportamento Impulsivo , Imageamento por Ressonância Magnética , Masculino , México , Estudos RetrospectivosRESUMO
Resumen: Los oligodendrogliomas anaplásicos son gliomas infiltrantes grado III de la organización mundial de la salud (OMS). Son tumores poco frecuentes y representan el 5-10% de todas las neoplasias intracraneales primarias. Su incidencia es de 0.3 por 100.000 habitantes por año en Estados Unidos. Con frecuencia se presentan en adultos entre los 40-60 años de edad. Los síntomas principales pueden ser déficit motor, déficit cognitivos y síntomas de aumento de la presión intracraneal. Su comportamiento en resonancia magnética muestra un aspecto heterogéneo con necrosis, degeneración quística y hemorragia intratumoral. Las presentaciones quísticas extensas son poco frecuentes. Reportamos el caso de un oligodendroglioma anaplásico de aspecto predominantemente quístico en una mujer joven.
Abstract: Anaplastic oligodendrogliomas are grade III infiltrating gliomas of the World Health Organization (WHO). They are rare tumors and represent 5-10% of all primary intracranial neoplasms. Its incidence is 0.3 per 100.000 inhabitants per year in the United States. They often occur in adults between 40-60 years of age. The main symptoms may be motor deficit, cognitive deficits and symptoms of increased intracranial pressure. Its behavior in MRI shows a heterogeneous appearance with necrosis, cystic degeneration and intratumoral hemorrhagic. Extensive cystic presentations are rare. We report the case of an anaplastic oligodendroglioma of predominantly cystic appearance in a young woman.
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Humanos , Feminino , Adulto , Oligodendroglioma/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Oligodendroglioma/patologia , Neoplasias Encefálicas/patologia , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Meios de ContrasteRESUMO
OBJECTIVE: To evaluate joint effusion and positioning of the articular disc through magnetic resonance imaging (MRI) before and after two different arthrocentesis techniques. METHODS: Twenty-six patients with dislocation of the articular disc without reduction (ADDwoR) were included and randomly divided into two groups: single needle arthrocentesis with distention of the upper compartment of the TMJ (A1) and conventional arthrocentesis with 2 needles (A2). RESULTS: A statistically significant difference was observed between the different effusion categories (p = 0.009). No differences were found comparing both treatment modalities concerning the position of the mandibular condyle and the articular disc. CONCLUSION: Conventional arthrocentesis was able to change the effusion variable, whereas the single needle arthrocentesis was not. Both techniques were responsible for altering the position of the mandibular head or the disc-head complex, projecting them to a more anterior position related to the increase in the final maximum interincisal distance.
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Luxações Articulares , Transtornos da Articulação Temporomandibular , Artrocentese , Humanos , Imageamento por Ressonância Magnética , Amplitude de Movimento Articular , Articulação Temporomandibular , Disco da Articulação Temporomandibular , Resultado do TratamentoRESUMO
OBJECTIVES: Cerebral ischemia seriously threatens human health and is characterized by high rates of incidence, disability and death. Developing an ideal animal model of cerebral ischemia that reflects the human clinical features is critical for pathological studies and clinical research. The goal of this study is to establish a local cerebral ischemia model in rhesus macaque, thereby providing an optimal animal model to study cerebral ischemia. METHODS: Eight healthy rhesus monkeys were selected for this study. CT scans were performed before the operation to exclude cerebral vascular and intracranial lesions. Under guidance and monitoring with digital subtraction angiography (DSA), a microcatheter was inserted into the M1 segment of the middle cerebral artery (MCA) via the femoral artery. Then, autologous white thrombi were introduced to block blood flow. Immediately following embolization, multisequence MRI was used to monitor cerebrovascular and brain parenchymal conditions. Twenty-four hours after embolization, 2 monkeys were sacrificed and subjected to perfusion, fixation and pathological examination. RESULTS: The cerebral ischemia model was established in 7 rhesus monkeys; one animal died during intubation. DSA and magnetic resonance angiography (MRA) indicated the presence of an arterial occlusion. MRI showed acute local cerebral ischemia. HE staining revealed infarct lesions formed in the brain tissues, and thrombi were present in the cerebral artery. CONCLUSION: We established a rhesus macaque model of local cerebral ischemia by autologous thrombus placement. This model has important implications for basic and clinical research on cerebral ischemia. MRI and DSA can evaluate the models to ensure accuracy and effectiveness.
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Humanos , Animais , Masculino , Infarto Cerebral/diagnóstico por imagem , Isquemia Encefálica/diagnóstico por imagem , Angiografia Digital , China , Macaca mulatta , Modelos Biológicos , Modelos CardiovascularesRESUMO
Abstract: Optic Neuritis (ON) is a condition caused by the inflammation of the optic nerve, causing diminished visual acuity and ocular pain. It is tightly related to Multiple Sclerosis (MS), often being the first demyelinating event. There is a 31% risk of recurrence during the first 10 years after the diagnosis, and 48% of the patients end up being diagnosed with Multiple Sclerosis1. Imaging studies like brain MRI (Magnetic Resonance Imaging) have a critical role in the diagnosis and prognosis of ON, as well as in the recognition of MS.2 The patient is a 11-year-old girl with recurrent ON and past medical history of Acute Disseminated Encephalomyelitis (ADEM) when she was 5 years old. ON diagnosis was based on clinical findings as well as on ophtalmologic, electrophysiologic and imaging studies. The recurrent episodes of ON improved after the use of high dose steroids. Recurrences were observed after titration of the dose, but remission was achieved after adjustment of treatment. During one of the recurrent episodes, blood work was performed to evaluate possible underlying infectious, demyelinating or autoinmmune process. Anti-MOG antibodies were found positive. The patient at the moment is not presenting with any other criteria suggesting MS or Optic Neuromyelitis, but long term follow up is adviced. Key words: Optic neuritis (ON), multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), magnetic resonance imaging (MRI), cerebrospinal fluid (CSF), right eye (RE); visual acuity (VA), optic neuromyelitis (ONM)
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Humanos , Neurite Óptica , Encefalomielite Aguda Disseminada , Imageamento por Ressonância Magnética , Líquido Cefalorraquidiano , Anticorpos , Esclerose MúltiplaRESUMO
El cistoadenoma hepático es una neoplasia muy rara, con menos de 250 casos reportados en la literatura mundial, que se da con mayor frecuencia en mujeres. Por la dificultad de diferenciar el quiste simple y el quiste hidatídico con el cistoadenoma hepático; así como su recidiva y posibilidad de displasia o carcinoma, si no es tratado mediante resección completa, es que presentamos el caso de una mujer de 56 años con historia de quiste hepático simple tratado en 2 oportunidades con destechamiento simple y que recidivaron, ya que se trataba de un cistoadenoma hepático.
Hepatic cystadenoma is a very rare neoplasm, with less than 250 cases reported in the world literature, which occurs more frequently in women. Due to the difficulty of differentiating the simple cyst and the hydatid cyst with the hepatic cystadenoma; as well as its recurrence and possibility of dysplasia or carcinoma, if it is not treated by complete resection, we present the case of a woman of 56 years old with history of simple hepatic cyst treated on 2 occasions with simple hepatic cyst unroofing and that they relapsed, so it was a hepatic cystadenoma.
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Renal imaging has become a fundamental part of clinical care for patients with kidney disease. Imaging strategies for the kidney have been evolving during the past hundred years and have been even more rapidly changing during the past couple of decades due to the development of modern computed tomographic techniques, magnetic resonance imaging, and more sophisticated ultrasonographic techniques, such as contrast-enhanced ultrasonography. Applying the correct radiologic study for the clinical situation maximizes the diagnostic accuracy of the imaging, and a judicious choice between techniques helps limit radiation dose and potential adverse events. This Core Curriculum outlines the imaging modalities currently in use in radiology departments and is divided into 3 sections: (1) a review of the development of renal imaging and an outline of modalities available to the nephrologist, (2) imaging strategies for select clinical situations, and (3) a discussion of some potential adverse events from imaging, including effects of iodinated contrast on kidney function, risks of gadolinium-based contrast agents in kidney failure, and potential risks of imaging techniques that use ionizing radiation.
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Rim/diagnóstico por imagem , Imagem Multimodal/métodos , Obstrução da Artéria Renal/diagnóstico , Idoso , Angiografia por Tomografia Computadorizada/métodos , Humanos , Angiografia por Ressonância Magnética/métodos , Masculino , Reprodutibilidade dos Testes , Ultrassonografia Doppler/métodosRESUMO
Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure caused by a broad spectrum of congenital and acquired disease processes, which are currently divided into five groups based on the 2013 WHO classification. Imaging plays an important role in the evaluation and management of PH, including diagnosis, establishing etiology, quantification, prognostication and assessment of response to therapy. Multiple imaging modalities are available, including radiographs, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, echocardiography and invasive catheter angiography (ICA), each with their own advantages and disadvantages. In this article, we review the comprehensive role of imaging in the evaluation of PH.
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PURPOSE: To combine the technique of respiratory gating and compressed sensing (CS) with the objective of accelerating mouse abdominal magnetic resonance imaging (MRI). MATERIALS AND METHODS: To obtain the maximum acceleration, phase-encoding data from a phantom and mouse were obtained on a 4.7â¯Tesla scanner using the respiratory gating technique. The fully sampled data (FSD) were used to construct reference images and to provide samples to simulate retrospective undersampled data (UD) acquisition using respiratory gating. The UD and 95% of the UD on acceleration 2-5 rates were acquired and used for image reconstruction by CS. Quantitative assessment of reconstructed images was performed by structural similarity index (SSIM), peak signal-to-noise ratio (PSNR) and root mean square error (RMSE). RESULTS: The proposed method can accelerate phantom and mouse abdominal MRI acquisition between 2 and 4 rates by reducing the amount of FSD. For phantom UD acquisition, the mean time was reduced in 45.9% and for the acquisition of 95% of UD in 67.8%. For mouse abdominal image UD acquisition, the mean time was reduced in 44.6% and for the acquisition of 95% of UD in 62.5%. The metrics results show that the reconstructed image from UD and 95% of UD by using CS maintains an optimal agreement with their reference images (similarity above 0.88 for phantom and 0.93 for mouse). CONCLUSION: This study presents a novel approach to accelerate mouse abdominal MRI combining respiratory gating technique and CS without the use of expensive hardware and capable of achieving up to 4 acceleration rate without image degradation.