Effect of early sleep apnoea treatment with adaptive servo-ventilation in acute stroke patients on cerebral lesion evolution and neurological outcomes: study protocol for a multicentre, randomized controlled, rater-blinded, clinical trial (eSATIS: early S
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01.12.2021 |
Duss S.B.
Brill A.K.
Baillieul S.
Horvath T.
Zubler F.
Flügel D.
Kägi G.
Benz G.
Bernasconi C.
Ott S.R.
Korostovtseva L.
Sviryaev Y.
Salih F.
Endres M.
Tamisier R.
Gouveris H.
Winter Y.
Denier N.
Wiest R.
Arnold M.
Schmidt M.H.
Pépin J.L.
Bassetti C.L.A.
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Trials |
10.1186/s13063-020-04977-w |
0 |
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© 2021, The Author(s). Background: Sleep-disordered breathing (SDB) is highly prevalent in acute ischaemic stroke and is associated with worse functional outcome and increased risk of recurrence. Recent meta-analyses suggest the possibility of beneficial effects of nocturnal ventilatory treatments (continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV)) in stroke patients with SDB. The evidence for a favourable effect of early SDB treatment in acute stroke patients remains, however, uncertain. Methods: eSATIS is an open-label, multicentre (6 centres in 4 countries), interventional, randomized controlled trial in patients with acute ischaemic stroke and significant SDB. Primary outcome of the study is the impact of immediate SDB treatment with non-invasive ASV on infarct progression measured with magnetic resonance imaging in the first 3 months after stroke. Secondary outcomes are the effects of immediate SDB treatment vs non-treatment on clinical outcome (independence in daily functioning, new cardio-/cerebrovascular events including death, cognition) and physiological parameters (blood pressure, endothelial functioning/arterial stiffness). After respiratory polygraphy in the first night after stroke, patients are classified as having significant SDB (apnoea-hypopnoea index (AHI) > 20/h) or no SDB (AHI < 5/h). Patients with significant SDB are randomized to treatment (ASV+ group) or no treatment (ASV− group) from the second night after stroke. In all patients, clinical, physiological and magnetic resonance imaging studies are performed between day 1 (visit 1) and days 4–7 (visit 4) and repeated at day 90 ± 7 (visit 6) after stroke. Discussion: The trial will give information on the feasibility and efficacy of ASV treatment in patients with acute stroke and SDB and allows assessing the impact of SDB on stroke outcome. Diagnosing and treating SDB during the acute phase of stroke is not yet current medical practice. Evidence in favour of ASV treatment from a randomized multicentre trial may lead to a change in stroke care and to improved outcomes. Trial registration: ClinicalTrials.gov NCT02554487, retrospectively registered on 16 September 2015 (actual study start date, 13 August 2015), and www.kofam.ch (SNCTP000001521).
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Effect of early sleep apnoea treatment with adaptive servo-ventilation in acute stroke patients on cerebral lesion evolution and neurological outcomes: study protocol for a multicentre, randomized controlled, rater-blinded, clinical trial (eSATIS: early S
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01.12.2021 |
Duss S.B.
Brill A.K.
Baillieul S.
Horvath T.
Zubler F.
Flügel D.
Kägi G.
Benz G.
Bernasconi C.
Ott S.R.
Korostovtseva L.
Sviryaev Y.
Salih F.
Endres M.
Tamisier R.
Gouveris H.
Winter Y.
Denier N.
Wiest R.
Arnold M.
Schmidt M.H.
Pépin J.L.
Bassetti C.L.A.
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Trials |
10.1186/s13063-020-04977-w |
0 |
Ссылка
© 2021, The Author(s). Background: Sleep-disordered breathing (SDB) is highly prevalent in acute ischaemic stroke and is associated with worse functional outcome and increased risk of recurrence. Recent meta-analyses suggest the possibility of beneficial effects of nocturnal ventilatory treatments (continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV)) in stroke patients with SDB. The evidence for a favourable effect of early SDB treatment in acute stroke patients remains, however, uncertain. Methods: eSATIS is an open-label, multicentre (6 centres in 4 countries), interventional, randomized controlled trial in patients with acute ischaemic stroke and significant SDB. Primary outcome of the study is the impact of immediate SDB treatment with non-invasive ASV on infarct progression measured with magnetic resonance imaging in the first 3 months after stroke. Secondary outcomes are the effects of immediate SDB treatment vs non-treatment on clinical outcome (independence in daily functioning, new cardio-/cerebrovascular events including death, cognition) and physiological parameters (blood pressure, endothelial functioning/arterial stiffness). After respiratory polygraphy in the first night after stroke, patients are classified as having significant SDB (apnoea-hypopnoea index (AHI) > 20/h) or no SDB (AHI < 5/h). Patients with significant SDB are randomized to treatment (ASV+ group) or no treatment (ASV− group) from the second night after stroke. In all patients, clinical, physiological and magnetic resonance imaging studies are performed between day 1 (visit 1) and days 4–7 (visit 4) and repeated at day 90 ± 7 (visit 6) after stroke. Discussion: The trial will give information on the feasibility and efficacy of ASV treatment in patients with acute stroke and SDB and allows assessing the impact of SDB on stroke outcome. Diagnosing and treating SDB during the acute phase of stroke is not yet current medical practice. Evidence in favour of ASV treatment from a randomized multicentre trial may lead to a change in stroke care and to improved outcomes. Trial registration: ClinicalTrials.gov NCT02554487, retrospectively registered on 16 September 2015 (actual study start date, 13 August 2015), and www.kofam.ch (SNCTP000001521).
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Functional connectivity studies in migraine: What have we learned?
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20.11.2019 |
Skorobogatykh K.
Van Hoogstraten W.
Degan D.
Prischepa A.
Savitskaya A.
Ileen B.
Bentivegna E.
Skiba I.
D'Acunto L.
Ferri L.
Sacco S.
Hansen J.
Amin F.
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Journal of Headache and Pain |
10.1186/s10194-019-1047-3 |
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© 2019 The Author(s). Background: Resting-state functional connectivity (FC) MRI has widely been used to understand migraine pathophysiology and to identify an imaging marker of the disorder. Here, we review what we have learned from FC studies. Methods: We performed a literature search on the PubMed website for original articles reporting data obtained from conventional resting-state FC recording in migraine patients compared with healthy controls or during and outside of migraine attacks in the same patients. Results: We found 219 articles and included 28 in this review after screening for inclusion and exclusion criteria. Twenty-five studies compared migraine patients with healthy controls, whereas three studies investigated migraine patients during and outside of attacks. In the studies of interictal migraine more alterations of more than 20 FC networks (including amygdala, caudate nucleus, central executive, cerebellum, cuneus, dorsal attention network, default mode, executive control, fronto-parietal, hypothalamus, insula, neostriatum, nucleus accumbens, occipital lobe, periaqueductal grey, prefrontal cortex, salience, somatosensory cortex I, thalamus and visual) were reported. We found a poor level of reproducibility and no migraine specific pattern across these studies. Conclusion: Based on the findings in the present review, it seems very difficult to extract knowledge of migraine pathophysiology or to identify a biomarker of migraine. There is an unmet need of guidelines for resting-state FC studies in migraine, which promote the use of homogenous terminology, public availability of protocol and the a priori hypothesis in line with for instance randomized clinical trial guidelines.
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Outcome of isolated fetal talipes: A systematic review and meta-analysis
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01.11.2019 |
Di Mascio D.
Buca D.
Khalil A.
Rizzo G.
Makatsariya A.
Sileo F.
Liberati M.
Benedetti Panici P.
Acharya G.
D'Antonio F.
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Acta Obstetricia et Gynecologica Scandinavica |
10.1111/aogs.13637 |
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© 2019 Nordic Federation of Societies of Obstetrics and Gynecology Introduction: The aim of this systematic review was to explore the outcome of fetuses with a prenatal diagnosis of isolated talipes. Material and methods: Medline, Embase, Cinahl, and Clinicaltrials.gov databases were searched. The outcomes explored were: associated anomalies detected at follow-up ultrasound examination; fetal magnetic resonance imaging (MRI) and birth; chromosomal abnormalities detected with standard and chromosomal microarray analysis, intrauterine, neonatal, and perinatal death, and termination of pregnancy; rate of surgical and nonsurgical treatment; neurodevelopmental outcome; and false-positive rate of prenatal diagnosis. Meta-analyses of proportions were used to combine data. Results: Twenty-five studies (1567 fetuses) were included. Associated anomalies were detected in 7.8% (95% CI 0.1%-29.3%) of cases at follow-up ultrasound, and in 4.0% (95% CI 0.1%-13.2%) of cases, fetal MRI identified anomalies not detected at ultrasound assessment. Similarly, 7.0% (95% CI 3.4%-11.7%) of cases labeled as isolated talipes on prenatal imaging were found to have associated anomalies at birth. Abnormal karyotype was present in 3.6% (95% CI 1.7%-6.2%) of fetuses, whereas no anomaly was found at chromosomal microarray analysis, although this outcome was reported by only 1 study. Intrauterine death occurred in 0.99% (95% CI 0.4%-1.9%) of fetuses, whereas the corresponding figures for neonatal death and termination of pregnancy were 1.5% (95% CI 0.6%-2.6%) and 2.2% (95% CI 1.2%-3.4%), respectively. Surgical management of anomalies after birth was found in 41.7% (95% CI 27.0%-57.2%) of fetuses with isolated talipes, and 54.8% (95% CI 31.5%-77.0%) had nonsurgical management of the anomalies after birth. Abnormal neurodevelopmental outcome was reported in 7.6% (95% CI 1.0%-19.4%) of children, although this analysis was affected by the small number of included cases and short time of follow up. Conclusions: Isolated talipes detected on prenatal ultrasound carries a generally good prognosis. The incidence of additional abnormalities detected on fetal MRI, aneuploidy, or neurodevelopmental disability is relatively low. However, longitudinal ultrasound assessment during pregnancy and a thorough postnatal evaluation are recommended to rule out associated anomalies that may significantly impact short- and long-term prognosis.
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Added value of diffusion-weighted MRI for nodal radiotherapy planning in pelvic malignancies
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01.10.2019 |
Sushentsev N.
Martin H.
Rimmer Y.
Barrett T.
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Clinical and Translational Oncology |
10.1007/s12094-019-02068-0 |
1 |
Ссылка
© 2019, Federación de Sociedades Españolas de Oncología (FESEO). Purpose: To evaluate the added value of diffusion-weighted imaging (DWI) to T2-weighted imaging (T2WI) for improved identification of pelvic lymph nodes (LN) by radiation oncologists. Methods/patients: This retrospective study included 20 patients with histopathologically proven node-negative prostate cancer. All patients underwent 3T-MRI of the prostate; matched axial T2WI and DWI sequences were assessed by an experienced uro-radiologist as the reference standard. Consultant and specialist registrar radiation oncologists were asked to identify all LN first on T2WI alone (read 1) and then on T2WI and DWI combined (read 2); LN were measured in size and divided into true positives (TP), false positives (FP) and false negatives (FN). Sensitivity, positive predictive value (PPV) and false negative rate (FNR) were then calculated and compared using Pearson’s Chi square test. Results: A total of 177 LN comprised the reference standard. 16 TP, 16 FP and 161 FN LN (sensitivity 9.0%, PPV 50.0%, FNR 91.0%) and 124, 15 and 53 LN (70.1%, 89.2%, 30%) were identified by reader 1 on reads 1 and 2, respectively; χ2 (2, N = 385) = 137.8, p < 0.0001. 27, 21 and 150 LN (15.3%, 56.3%, 84.8%) and 120, 13 and 57 LN (67.8%, 90.2%, 32.2%) were identified by reader 2 on the two reads; χ2 (2, N = 388) = 102.4, p < 0.0001. Conclusions: Adding DWI to T2WI significantly improved identification of pelvic LN by radiation oncologists and can therefore be regarded as a useful LN contouring technique for RT planning in pelvic malignancies.
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Prospective evaluation of the performance of [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT(MRI) for lymph node staging in patients undergoing superextended salvage lymph node dissection after radical prostatectomy
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01.09.2019 |
Abufaraj M.
Grubmüller B.
Zeitlinger M.
Kramer G.
Seitz C.
Haitel A.
Baltzer P.
Hacker M.
Wadsak W.
Pfaff S.
Wiatr T.
Mitterhauser M.
Shariat S.
Hartenbach M.
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European Journal of Nuclear Medicine and Molecular Imaging |
10.1007/s00259-019-04361-0 |
1 |
Ссылка
© 2019, The Author(s). Purpose: To assess the accuracy of [68Ga]-PSMA-11 PET/CT or [68Ga]-PSMA-11 PET/MRI (PSMA-11 PET/CT(MRI)) for lymph node (LN) staging using salvage LN dissection (SLND) in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). Patients and methods: In a prospective study, 65 consecutive patients who developed BCR after RP underwent SLND after PSMA-11 PET/CT(MRI) between 2014 and 2018. Extended SLND up to the inferior mesenteric artery was performed in all patients. Regional and template-based correlations between the presence of LN metastases on histopathology and whole-body PSMA-11 PET/CT(MRI) results were evaluated. The diagnostic accuracy of PSMA-11 PET/CT(MRI) was also evaluated in relation to PSA level at the time of SLND. Results: The median age of the patients at the time of SLND was 65 years (IQR 63–69 years) and the median PSA level was 1.4 ng/ml (IQR 0.8–2.9 ng/ml). Before SLND, 50 patients (77%) had additional therapy after RP (26.2% androgen-deprivation therapy and 50.8% radiotherapy). The median number of LNs removed on SLND was 40 (IQR 33–48) and the median number of positive nodes was 4 (IQR 2–6). LN metastases were seen in 13.8% of resected LNs (317 of 2,292). LNs positive on PSMA-11 PET/CT(MRI) had a median diameter of 7.2 mm (IQR 5.3–9 mm). Metastatic LNs in regions negative on PSMA-11 PET had a median diameter of 3.4 mm (IQR 2.1–5.4 mm). In a regional analysis, the sensitivity of PSMA-11 PET/CT(MRI) ranged from 72% to 100%, and the specificity from 96% to 100%. Region-specific positive and negative predictive values ranged from 95% to 100% and 93% to 100%, respectively. Conclusion: PSMA-11 PET/CT(MRI) has a very good performance for the identification of LN metastases in patients with BCR after RP. The high diagnostic accuracy in the regional and subregional analyses demonstrates the potential of this approach to enable a region-directed instead of a complete bilateral therapeutic intervention. The performance of PSMA-11 PET/CT(MRI) is dependent on the PSA level and the size of the metastatic deposit.
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Brain and cognitive development in adolescents with anorexia nervosa: A systematic review of FMRI studies
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01.08.2019 |
Olivo G.
Gaudio S.
Schiöth H.
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Nutrients |
10.3390/nu11081907 |
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© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Anorexia nervosa (AN) is an eating disorder often occurring in adolescence. AN has one of the highest mortality rates amongst psychiatric illnesses and is associated with medical complications and high risk for psychiatric comorbidities, persisting after treatment. Remission rates range from 23% to 33%. Moreover, weight recovery does not necessarily reflect cognitive recovery. This issue is of particular interest in adolescence, characterized by progressive changes in brain structure and functional circuitries, and fast cognitive development. We reviewed existing literature on fMRI studies in adolescents diagnosed with AN, following PRISMA guidelines. Eligible studies had to: (1) be written in English; (2) include only adolescent participants; and (3) use block-design fMRI. We propose a pathogenic model based on normal and AN-related neural and cognitive maturation during adolescence. We propose that underweight and delayed puberty—caused by genetic, environmental, and neurobehavioral factors—can affect brain and cognitive development and lead to impaired cognitive flexibility, which in turn sustains the perpetuation of aberrant behaviors in a vicious cycle. Moreover, greater punishment sensitivity causes a shift toward punishment-based learning, leading to greater anxiety and ultimately to excessive reappraisal over emotions. Treatments combining physiological and neurobehavioral rationales must be adopted to improve outcomes and prevent relapses.
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Polarity-specific modulation of pain processing by transcranial direct current stimulation - A blinded longitudinal fMRI study
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24.10.2018 |
Naegel S.
Biermann J.
Theysohn N.
Kleinschnitz C.
Diener H.
Katsarava Z.
Obermann M.
Holle D.
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Journal of Headache and Pain |
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0 |
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© 2018 The Author(s). Background: To enrich the hitherto insufficient understanding regarding the mechanisms of action of transcranial direct current stimulation (tDCS) in pain disorders, we investigated its modulating effects on cerebral pain processing using functional magnetic resonance imaging (fMRI). Methods: Thirteen right-handed healthy participants received 20 min of 1.5 mA tDCS applied over the primary motor cortex thrice and under three different stimulation pattern (1.anodal-tDCS, 2.cathodal-tDCS, and 3.sham-tDCS) in a blinded cross-over design. After tDCS neural response to electric trigeminal-nociceptive stimulation was investigated using a block designed fMRI. Results: Pain stimulation showed a distinct activation pattern within well-established brain regions associated with pain processing. Following anodal tDCS increased activation was detected in the thalamus, basal ganglia, amygdala, cingulate, precentral, postcentral, and dorsolateral prefrontal cortex, while cathodal t-DCS showed decreased response in these areas (pFWE < 0.05). Interestingly the observed effect was reversed in both control conditions (visual- and motor-stimulation). Behavioral data remained unchanged irrespective of the tDCS stimulation mode. Conclusions: This study demonstrates polarity-specific modulation of cerebral pain processing, in reconfirmation of previous electrophysiological data. Anodal tDCS leads to an activation of the central pain-network while cathodal tDCS does not. Results contribute to a network-based understanding of tDCS's impact on cerebral pain-processing.
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Radiological methods in diagnostics of focal liver lesions
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01.01.2018 |
Schekoturov I.
Bakhtiozin R.
Serova N.
Shantarevich M.
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Russian Electronic Journal of Radiology |
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0 |
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© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Purpose. A special place among liver diseases is occupied by various tumors and tumor-like lesions. In recent years in clinical practice the possibilities of correct diagnosis have increased significantly as a result of the introduction of advanced diagnostic equipment and wide usage of various contrast agents at studies of the abdominal cavity using the ultrasound method (US), multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). In addition, the differential diagnosis of benign and malignant lesions has been simplified even when the size of the lesions is less than 1 cm. This scientific review describes the capabilities of the "routine" method of the liver diagnostics – US, as well as the latest techniques that are being introduced into the modern practice such as: US with intravenous contrast enhancement, US elastography and perfusion CT and MRI. The advantages of each method are presented as well as the limitations of their use in clinical practice.
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Trachea multiple diverticula in patient with tracheobronchomegaly. Rare clinical case
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01.01.2018 |
Koroleva I.
Mishchenko M.
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Russian Electronic Journal of Radiology |
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0 |
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© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. Demonstration of a rare case of trachea pathology using various research methods: modern radiological methods and instrumental methods of diagnosis. Results. Functional CT and MRI methods allowed reveal tracheal wall pathological changes in a patient with trachea diverticula and tracheobronchomegaly, to determine indi-cations and contraindications to surgical interventions. According to the rarity of the tracheal diverticula detection in combination with tracheo-bronchomegaly, radiologists, thoracic surgeons and pulmonologists need to know the pathomorphology of the disease, the clinical manifestations of this condition which are non-specific and may mask other respiratory processes. Of course, we cannot exclude these states from the differential diagnosis in patients with frequent inflammatory diseases of broncho-pulmonary system. Conclusion. Comprehensive diagnosis of pathological changes of the trachea and trachral walls in this category of patients, helps to solve question of surgical intervention or conservative treatment. This greatly reduces the number of unjustified surgical interven-tions, eliminates the risk of postoperative complications and improves the quality of pa-tient's life.
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Brain perfusion, cognitive functions, and vascular age in middle aged patients with essential arterial hypertension
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01.01.2018 |
Parfenov V.
Ostroumova T.
Perepelova E.
Perepelov V.
Kochetkov A.
Ostroumova O.
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Kardiologiya |
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1 |
Ссылка
© 2018 Media Sphera Publishing Group.All right reserved. Objective. This study aimed to assess the cognitive functions and cerebral blood flow measured with arterial spin labeling (ASL) and their possible correlations with vascular age in untreated middle-aged patients with grade 1-2 essential arterial hypertension (EAH). Methods. We examined 73 subjects aged 40-59 years (33 with EAH and 40 healthy volunteers [controls]). Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Trail Making test (part A and part B), Stroop Color and Word Test, verbal fluency test (phonemic verbal fluency and semantic verbal fluency), 10-item word list learning task. All subjects underwent brain MRI. MRI protocol included ASL. Vascular age was calculated by two techniques-using Framingham Heart Study risk tables and SCORE project scales. Results. Patients with EAH had lower performance on phonemic verbal fluency test and lower mean MoCA score (29.2±1.4 vs. 28.1±1.7 points) compared to controls (13.4±3.2, p=0.002; 29.2±1.4, p=0.001, respectively). White matter hyperintensities (WMH) were present in 7.5 % controls and in 51.5 % EAH patients (p=0.0002). Cerebral blood flow (CBF) in EAH patients was lower in both right (39.1±5.6 vs. 45.8±3.2 ml/100 g/min) and left frontal lobes of the brain (39.2±6.2 45.2±3.6 ml/100 g/min, respectively) compared to controls (p<0.001). EAH patients without WMH had lower CBF compared to controls (right frontal lobe: 39.5±5.1 ml/100 g/min, p=0.0002; left frontal lobe: 38.9±4.3 ml/100 g/min, p=0.00002). In EAH patients vascular age (57.7±7.4 and 64.6±11.0 years as measured by SCORE project scales and Framingham Heart Study risk tables, respectively) was significantly (p<0.001) greater than chronological one (50.2±6.2 years) and was significantly (p<0.001) higher than the corresponding values in the control group. Correlation analysis revealed negative significant associations between vascular age and MoCA score, phonemic verbal fluency test score and CBF. Conclusions. Treatment-naive middle-aged patients with uncomplicated grade 1-2 EAH compared to normotensive controls have lower mean scores in phonemic fluency test and MoCA, lower CBF, even in the absence of WMH, which correlates with vascular age, particularly with the value calculated by Framingham Heart Study risk tables. Early vascular ageing is important factor of brain impairment in hypertension in middle-aged patients even at early stages of EAH.
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Postmortem MRI characteristics of nonimmune fetal hydrops
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01.01.2018 |
Tumanova U.
Lyapin V.
Bychenko V.
Serova N.
Shchegolev A.
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Russian Electronic Journal of Radiology |
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1 |
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© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. Post-mortem MRI characteristics of the distribution and severity of nonimmune fetal hydrops (NFH). Materials and methods. The analysis of autopsy material of 2 stillborn and 22 newborns, divided into three groups was carried out. Group I consisted of the bodies of the dead due to NFH, group II - the bodies of newborns who died with the presence of general edema syndrome in the absence of NFH, group III (control) - the bodies of deceased newborns in the absence of NFH and general edema syndrome. Before autopsy, MRI was performed. On T1- and T2-weighted images was determined by the thickness and signal intensity of the skin with subcuta-neous tissue and the subsequent calculation of the tissue hydration index. The volume of fluid in the pericardial cavity, pleural and abdominal cavities determined when using three-dimensional processing of the obtained tomograms and calculated their specific volume in the corresponding cavities. Results. The values of the specific volume of free fluid in the pleural cavities and abdominal cavity less than 8% should be considered a natural postmortem sign, rather than the life-time accumulation of transudate, when examining the bodies of deceased newborns on the first day after death. The mean values of absolute and specific volumes of pleural fluid had the maxi-mum values in the NFH observations, exceeding the values of the control group by 6.3 and 5.1 times, respectively. The highest values of the absolute amount of ascites were observed in the group with general edema syndrome. In the NFH group, all cases had hydrothorax, 85.7% of cases had ascites, and 42.9% had hydropericardium. In the group of newborns with general ede-ma syndrome, hydrothorax was detected in 57.1%, ascites - in 85.7%, and hydropericardium - in 42.9% of cases. The thickness of the skin with subcutaneous tissue depended on the localization and group of research. The most pronounced deviations from the control level were recorded for the average values of the skin thickness of the anterior chest wall in group I and the scalp of the fronto-parietal region in group II. The mean values of the tissue hydration index were higher in the group with NFH, and the lowest in the control group. Conclusion. Postmortem MRI performing, allows an objective assessment of the nature and severity of anasarca and pathological fluid accumulations in the serous cavities of dead fe-tuses and newborns. In this regard, postmortem MRI is recommended as a mandatory component of the autopsy of the bodies of fetuses and newborns that died as a result of nonimmune fetal hydrops.
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hip-spine syndrome (Literature review)
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01.01.2018 |
Meskhi K.
Kargaltsev A.
Makarov M.
Vorona B.
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Russian Electronic Journal of Radiology |
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0 |
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© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. The incidence of hip osteoarthritis and degenerative lumbar spine stenosis increases with the lifespan. The combination of these two conditions is not rare and is known as “hip-spine syndrome” in literature. Due to the similarity of symptoms the main problem is to determine the primary pain generator. Solving this diagnostic problem can lead to proper treatment, surgical or other. Purpose. To provide the literature review of the hip-spine syndrome. Materials and methods. We analyzed articles published on https://www.ncbi.nlm.nih.gov/pubmed during 2004-2018 searching for keywords: «radiographic and clinical hip osteoarthritis» - 1141 results, «lumbar spine stenosis and MRI canal» - 521 results and «hip-spine syndrome» - 35 results, 54 items were chosen due to the objective. Results. Primary source of pain for patients with hip-spine syndrome often remains unclear. The existing diagnostic algorithms are imperfect, about 25% of patients do not feel relief of pain after spine surgery or total hip arthroplasty. Mandatory x-ray examination in case of unknown source of pain is important and can show changes in hip and lumbar spine. That can help to change the way of search for pain generator Conclusion. It is necessary to create new diagnostic algorithms that will be harmless for patients and will be with maximum value for surgeons.
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PET/CT and whole body MRI in diagnosis of sarcoid reaction
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01.01.2018 |
Subbotin Y.
Plaksa I.
Bakhtiozin R.
Volkonskiy M.
Shipuleva I.
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Russian Electronic Journal of Radiology |
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0 |
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© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. To present abilities and limitations of Whole body MRI and FDG-PET/CT in the setting of sarcoid reaction and to stress the importance of use of broader differential diagnosis during interpreting its results. Materials and methods. The observation is introduced from clinical practice, examination was performed on 1.5 Tesla MRI scanner with the acquisition of four regions of interest: head and neck, thorax, abdomen, pelvis and upper thigh. Scanning protocol included diffusion-weighted imaging sequence. Results. The examination has let us exclude the presence of the active tumor tissue in breast cancer patient after systemic neoadjuvant treatment and drew our attention to false positive PET/CT result, which in turn led to change of further treatment strategy. Conclusions. Interpretation of FDG-PET/CT should be done in a complex manner with clinical, laboratory and radiological data correlation.
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Assessment of kidney perfusion in patients with urolithiasis using radiological methods
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01.01.2018 |
Aleksandrova K.
Serova N.
Rudenko V.
Kapanadze L.
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Russian Electronic Journal of Radiology |
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0 |
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© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Urolithiasis (ICD) is one of one the most actual health problem in the world. The significant prevalence of urolithiasis in the population (at least 5% of the population in industrially developed countries) forces us to constantly investigate the etiology and pathogenesis, look for effective prevention mechanisms, improve diagnostic methods and develop new technologies for conservative and operative treatment. The relevance of urolithiasis in connection with global demographic shifts has become especially important in recent years. The constant displacement of the age pyramid of the developed countries society towards the proportion of elderly and senile populations leads to an increase in the ICD frequency. The development of endoscopic equipment, the creation of new contact lithotripotors improving the methods of nephrolithotripsy have made it possible to solve the problem of ICD. Currently, one of the topical issues is the choice of diagnostic method to predict and evaluate the effectiveness of treatment in patients with ICD. Studies have shown that urolithiasis directly affects intracellular hemodynamics. The change in renal blood flow in ICD patients depends on the nature of urodynamic disturbances, localization and size of the calculus, the duration of the disease, the presence of complications and the age of the patient. Therefore, evaluation of perfusion is necessary in studying of kidney function.
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Cardiac mri in patient with isolated myocardial infarction of the right ventricle
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01.01.2018 |
Stukalova O.
Meladze N.
Butorova E.
Pevzner D.
Ternovoy S.
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Russian Electronic Journal of Radiology |
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© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: The aim of our work is demonstrating the efficacy of magnetic resonance imaging (MRI) of heart with gadolinium contrasting for diagnosis of rare cardiac pathology - isolated myocardial infarction of the right ventricle. Materials and methods: The study of patient A. 46 years old, transferred to the intensive care unit of the Institute of Clinical Cardiology from the city hospital where he has hospitalized with a diagnosis - acute pneumonia. The following studies were carried such MSCT-pulmonography, MRI of the heart contrast enhancement, MSCT coronary angiography. Results: Using MRI of the heart with contrast enhancement, an isolated myocardial infarction of the right ventricle has detected. The conclusion: MRI of the heart with contrast enhancement is the method of choice in diagnosis for suspected myocardial infarction of the right ventricle.
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Recent updates on whole-body MRI in oncology
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01.01.2018 |
Subbotin Y.
Bakhtiozin R.
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Russian Electronic Journal of Radiology |
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© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: In recent years, whole-body MRI have been increasingly used in the field of oncological radiology owing to its advantages such as: yield of high-quality diagnostic information in relatively short scan time, lack of radioisotope or intravenous contrast use, and comparingly low examination cost in contrast to traditional nuclear medicine techniques. Aim of this article is to bring the overview of whole-body MRI as a technique and current applications of its use in oncological radiology.
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<sup>18</sup>F-FDG PET/CT in the diagnostics of endometrial cancer
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01.01.2018 |
Aretinskiy A.
Ternovoy S.
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Russian Electronic Journal of Radiology |
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© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This article is dedicated to analysis of use PET-CT with 18F-FDG for the last 10 years. Determining the presence of metastasis in regional lymph nodes and distant sites in endometrial cancer is an important diagnostic step aimed at the choice of treatment tactics and improvement of surgical treatment results. If the process is beyond the uterus itself, it significantly worsens the prognosis of survival. In addition, in these cases, it is necessary to change the treatment and surgical tactics. Determination of stage 1 and 2 of the process gives an optimistic prognosis for the survival of patients. Currently, ultrasound, magnetic resonance imaging and, to a much lesser extent, computed tomography are used to assess the prevalence of the process. The diagnostic value of these methods according to some authors does not exceed 66-73%. In this regard, it is justified to work on finding more reliable methods that will more accurately determine the presence of metastatic disease in, both regional lymph nodes and distant organs. One of such promising methods is the use of positron emission tomography combined with computed tomography (PET/CT), using as radiotracer 18 - fluorodeoxyglucose. This article is a review of the scientific literature on this problem over the past 10 years and is devoted to the evaluation of the diagnostic accuracy of PET/CT with 18F-FDG.
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Normal temporomandibular joint structure and function determined by ultrasound
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01.01.2018 |
Bekreev V.
Ivanov S.
Burenchev D.
Gruzdeva T.
Yurkevich R.
Gharamyan B.
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Russian Electronic Journal of Radiology |
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© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The purpose of this study was to determine ultrasound criteria of normal temporomandibular joint structure and function. Materials and methods. Prospective study was conducted upon normal 16 TMJs of 9 patients (4 male, 5 female with mean age of 22.9 years) without clinical or radiological signs of disc displacement. All the patients underwent high-resolution ultrasound (Samsung SONO ACE R3, 12 MHz linear probe) and MR imaging of TMJs with the mouth closed and during the maximal mandibular range of motion. Both examinations were performed and interpreted independently by blinded expert operators. Results. Mouth opening range varied from 4.4 cm to 5.4 cm, average amount was defined as 4.94 ± 0.39 cm. Also average heights of the front, middle and rear parts of disc were measured (0,42 ± 0,07 cm; 0,35 ± 0,07 cm and 0,41 ± 0,05 cm, respectively). Structure of the TMJ disc can be defined as fine-grained, hypoechoic and homogeneous. The average height of lower joint space was defined as 0,12 ± 0,03 cm. Average amount of maximal parasagittal mandible condyle movement was defined as 14.7 ± 1.38 mm. Conclusion. Obtained results of ultrasound criteria of normal temporomandibular joint structure and function correspond to the provisions of normal human anatomy and the norm values established for the MRI of the TMJ. Thus, ultrasound criteria of normal temporomandibular joint can be used for assessment of TMJ internal degenerative diseases.
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Possibilities of postmortem radiological studies for evaluation of lung lesions
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01.01.2018 |
Tumanova U.
Serova N.
Bychenko V.
Shchegolev A.
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Russian Electronic Journal of Radiology |
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© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The literature data and the results of our own research, which demonstrate the possibilities of using radiological research methods for the analysis of the lungs lesions in deceased patients, are presented. It is shown that the postmortem computed tomography (CT) allows to identify abnormalities of the chest bones, as well as to establish the presence, precise localization and volume of gas and air accumulations, including pneumothorax. The literature data on the comparison of postmortem CT lung characteristics, including the density of their tissue, with data of histological examination of lung preparations and causes of death in adult patients, are presented. It is noted that postmortem magnetic resonance imaging (MRI) is more expedient for the detection of the lungs pathology in dead fetuses and deceased newborns. The possibilities of postmortem MRI for the diagnosis of congenital pneumonia, hemorrhages in the lung tissue, pulmonary edema, hydrothorax, as well as for differential diagnosis of stillbirth and the death of a living newborn are shown. Differential diagnostic signs of pulmonary artery thromboembolism and postmortem blood clots are indicated. The possibilities of postmortem CT and MRI for noninvasive determination of the sizes and weight of the lungs, including for assessment of pulmonary hypoplasia in newborns with congenital diaphragmatic hernia, are described. It is concluded that the postmortem radiological methods of investigation can be used to analyze of the lung lesions and determine the causes of death. The combined use of CT and MRI is recommended for a full analysis. It is emphasized that postmortem radiological examination can not be an alternative to pathological and forensic autopsy. Radiological methods should be used as a supplement to the autopsy, including as a kind of "guide" for a better definition of pathological processes during the autopsy.
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