OBJECTIVES: Accurate detection of metastatic brain lesions (MBL) is critical due to advances in radiosurgery. We compared the results of three readers in detecting MBL using T1-weighted 2D spin echo (SE) and sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences with whole-brain coverage at both 1.5 T and 3 T. METHODS: Fifty-six patients evaluated for MBL were included and underwent a standard protocol (1.5 T, n = 37; 3 T, n = 19), including postcontrast T1-weighted SE and SPACE. The rating was performed by three raters in two sessions > six weeks apart. The true number of MBL was determined using all available imaging including follow-up. Intraclass correlations for intra-rater and inter-rater agreement were calculated. Signal intensity ratios (SIR; enhancing lesion, white matter) were determined on a subset of 46 MBL > 4 mm. A paired t-test was used to evaluate postcontrast sequence order and SIR. Reader accuracy was evaluated by the coefficient of determination. RESULTS: A total of 135 MBL were identified (mean/subject 2.41, SD 6.4). The intra-rater agreement was excellent for all 3 raters (ICC = 0.97-0.992), as was the inter-rater agreement (ICC = 0.995 SE, 0.99 SPACE). Subjective qualitative ratings were lower for SE images; however, signal intensity ratios were higher in SE sequences. Accuracy was high in all readers for both SE (R2 0.95-0.96) and SPACE (R2 0.91-0.96) sequences. CONCLUSIONS: Although SE sequences are superior to gradient echo sequences in the detection of small MBL, they have long acquisition times and frequent artifacts. We show that T1-weighted SPACE is not inferior to standard thin-slice SE sequences in the detection of MBL at both imaging fields. CRITICAL RELEVANCE STATEMENT: Our results show the suitability of 3D T1-weighted turbo spin echo (TSE) sequences (SPACE, CUBE, VISTA) in the detection of brain metastases at both 1.5 T and 3 T. KEY POINTS: • Accurate detection of brain metastases is critical due to advances in radiosurgery. • T1-weighted SE sequences are superior to gradient echo in detecting small metastases. • T1-weighted 3D-TSE sequences may achieve high resolution and relative insensitivity to artifacts. • T1-weighted 3D-TSE sequences have been recommended in imaging brain metastases at 3 T. • We found T1-weighted 3D-TSE equivalent to thin-slice SE at 1.5 T and 3 T.
- Publikační typ
- časopisecké články MeSH
PURPOSE: The main aim of the study was to compare the diagnostic performance of Prostate Imaging Reporting and Data System (PI-RADS) versions 1 and 2 for detection of prostate carcinoma (PCa) and clinically significant prostate carcinoma (CSPCa). The second aim was to evaluate the potential benefit of adding the apparent diffusion coefficient (ADC) and prostate specific antigen (PSA) density to the standard evaluation protocol. METHODS: A total of 167 consecutive patients with elevated PSA underwent magnetic resonance imaging. The images were evaluated prospectively using both versions of the PI-RADS and the results compared with 12-core template biopsy and magnetic resonance/transrectal ultrasound fusion biopsy. Receiver-operating characteristic (ROC) curves were compared for each scoring system using DeLong\'s test. The area under the curve (AUC) was calculated for ADC and PSA density for lesions scored 4. RESULTS: PI-RADS V2 had high discriminative ability for PCa prediction with an AUC of 0.824 (95% CI 0.763 to 0.885), compared to an AUC of 0.724 (95% CI 0.654 to 0.794) for PI-RADS V1 (p = 0.0335). ADC demonstrated a higher discriminative ability with an AUC of 0.702 (95% CI 0.548 to 0.856) in CSPCa prediction. Using the obtained ADC threshold of 828x10^-6 mm^2/s improved specificity to 86.73% with a sensitivity of 60.38%. CONCLUSION: PI-RADS version 2 exhibited significantly higher discriminative ability for PCa and CSPCa detection compared to PI-RADS version 1. Using the ADC can improve the tumor predictability of PI-RADS version 2 in lesions scored 4.
- MeSH
- adenokarcinom diagnóza diagnostické zobrazování patologie MeSH
- biopsie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- nádory prostaty diagnóza diagnostické zobrazování patologie MeSH
- prospektivní studie MeSH
- prostata diagnostické zobrazování patologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ultrasonografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
OBJECTIVES: Although schizencephaly belongs to the class of neurodevelopmental disorders, which are a well-known predisposing factor for psychosis, there is a lack of relevant studies and diagnostic guidelines on this relationship. METHOD: A case report of first-episode psychosis with persistent negative symptoms associated with schizencephaly is described and compared with 7 other cases found in the literature. RESULTS: We found perinatal pathology, cognitive deficit, and EEG abnormality in a patient with atypical initial symptoms of psychosis such as olfactory hallucinations. Abnormal EEG findings (left frontal spikes and frontal intermittent rhythmic delta activity) called for magnetic resonance imaging, which revealed left parieto-occipital closed-lip schizencephaly. The patient exhibited a partial response to low-dose amisulpride treatment. CONCLUSION: We conclude that schizencephaly in our patient was at first asymptomatic and later developed into clinically manifest schizophrenia-like disorder. Both magnetic resonance imaging and EEG were essential tools for establishing this diagnosis.
- MeSH
- dospělí MeSH
- elektroencefalografie MeSH
- fenotyp MeSH
- lidé MeSH
- mozek patofyziologie MeSH
- psychotické poruchy komplikace patologie patofyziologie MeSH
- schizencefalie komplikace patofyziologie MeSH
- schizofrenie komplikace patologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Cíle: Cílem práce je porovnat výsledky měření objemu prostaty pomocí transrektálního ultrazvuku (TRUS) a magnetické rezonance (MR) mezi urology s různou mírou zkušeností a vlivu těchto rozdílů na PSA denzitu. Metody: Soubor obsahuje pacienty, kterým byla mezi únorem 2015 a listopadem 2018 změřena prostata před odběrem punkční biopsie. Všichni pacienti před TRUS absolvovali multiparametrickou MR prostaty na 1,5T přístroji Signa HDXT GE s endorektální cívkou. Sonografické měření bylo provedeno na přístroji Toshiba Applio 500 pomocí end fire transrektální sondy. TRUS měření prostaty prováděli tři urologové s dvaceti, sedmi a dvěma lety zkušeností v oboru. Velikost prostaty byla u TRUS i MR vypočtena z měření největších rozměrů ve třech rovinách pomocí vzorce "šířka x výška x hloubka x 0,523". Ze zjištěných velikostí prostaty byla následně dopočítána PSA denzita (PSA/velikost prostaty v ml). Výsledky: Celkově bylo hodnoceno 582 pacientů. Průměrný věk pacientů byl 62,86 let (31-91), průměrné PSA bylo 8,70ng/ml (0,53-75,00). Průměrný rozdíl velikosti mezi TRUS a MR měřením prostaty byl +8,41 ml, u vyšetřujícího s dvaceti lety praxe potom +3,66ml, u vyšetřujícího se sedmi lety praxe +11,19ml a u vyšetřujícího se dvěma lety praxe +8,12 ml. Průměrný rozdíl v PSA denzitě mezi TRUS a MR byl -0,025ng/ml/ml. Při použití hraniční hodnoty PSA denzity k indikaci biopsie 0,15ng/ml/ml a 0,20ng/ml/ml by bylo při TRUS měření bioptováno o 8 % respektive o 6 % méně pacientů než při použití MR. Závěr: Transrektální ultrasonografie v našem souboru ve srovnání s magnetickou rezonancí velikost prostaty nadhodnocovala. Tento rozdíl, promítnutý do PSA denzit by znamenal 6-8% rozdíl v indikacích biopsií prostaty na základě PSA denzity v závislosti na použité hraniční hodnotě.
Aim: The aim of this study is to compare prostate volumes and calculated PSA densities measured by transrectal ultrasound performed by urologists with different levels of experience, and prostate volumes calculated based on magnetic resonance measurements. Methods: The study comprises patients who underwent transrectal needle biopsy between February 2015 and November 2018. All of these patients underwent a multiparametric prostate MR using 1,5T Signa HDXT GE with endorectal coil beforehand. The ultrasound measurement, done using the Toshiba Applio 500 device with end‑fire endorectal probe, was performed by three urologists with two, seven and 20 years of clinical experience. Prostate volume was in all patients calculated by using the largest diameters in three perpendicular axes in the "width x height x length x 0.523 "formula. PSA density was then calculated as total PSA/prostate volume in millilitres. Results: A total of 582 were evaluated. The mean age was 62.86 years (31-91), average PSA was 8.70 ng/ml (0.53-75.00). The mean difference between TRUS and MR measurement was +8.41 ml. The difference was +3.66 ml for the examiner with twenty years of experience, +11.19 ml for the examiner with seven years of experience and +8.12 ml for the examiner with two years of experience. The average difference in PSA density between TRUS and MR was ‑0.025 ng/ml/ml. Using the PSA density cut‑off value of 0.15 ng/ml/ml and 0.20 ng/ ml/ml to indicate prostate biopsy, 8 % or 6 % less patients would have undergone prostate biopsy when using TRUS than with MR respectively. Conclusion: In this cohort, transrectal ultrasonography yielded larger prostate volume estimates than magnetic resonance imaging; subsequently 6 % or 8 % less biopsies would have been performed when using PSA density as the only criterion for prostate biopsy.
- Klíčová slova
- velikost prostaty, PSA denzita,
- MeSH
- dospělí MeSH
- klinická studie jako téma MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- prostata * diagnostické zobrazování MeSH
- prostatický specifický antigen MeSH
- senioři MeSH
- transrektální ultrazvuk o vysoké intenzitě metody MeSH
- velikost orgánu MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
OBJECTIVE: The effects of aging, magnetic field and the voxel localization on measured concentrations of citrate (Cit), creatine (Cr), cholines (Cho) and polyamines (PA) in a healthy prostate were evaluated. MATERIALS AND METHODS: 36 examinations at both 1.5T and 3T imagers of 52 healthy subjects aged 19-71 years were performed with PRESS 3D-CSI sequences (TE = 120 and 145 ms). Concentrations in laboratory units and their ratios to citrate were calculated using the LCModel technique. Absolute concentrations were also obtained after the application of correction coefficients. Statistical analysis was performed using a robust linear mixed effects model. RESULTS: Significant effects of aging, the magnetic field strength and the voxel position in central (CZ) or peripheral (PZ) zones on all measured metabolites were found. The concentrations (mmol/kg wet tissue) including prediction intervals in a range of 20-70 years were found: Cit: 7.9-17.2; Cho: 1.4-1.7; Cr: 2.8-2.5; PA (as spermine): 0.6-2.1 at 3T in CZ. In PZ, the concentrations were higher by about 10 % as compared to CZ. CONCLUSION: Increasing citrate and spermine concentrations with age are significant and correlate well with a recently described increase of zinc in the prostate. These findings should be considered in decision-making if the values obtained from a subject are in the range of control values.
- MeSH
- cholin chemie MeSH
- citráty chemie MeSH
- dospělí MeSH
- kreatinin chemie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie * MeSH
- magnetické pole MeSH
- mladý dospělý MeSH
- nádory prostaty diagnostické zobrazování metabolismus patologie MeSH
- polyaminy chemie MeSH
- prostata diagnostické zobrazování metabolismus MeSH
- rozhodování MeSH
- senioři MeSH
- spermin analýza MeSH
- zinek analýza MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
Chronic airflow limitation, caused by chronic obstructive pulmonary disease (COPD) or by asthma, is believed to change the shape and the position of the diaphragm due to an increase in lung volume. We have made a comparison of magnetic resonance imaging (MRI) of diaphragm in supine position with pulmonary functions, respiratory muscle function and exercise tolerance. We have studied the differences between patients with COPD, patients with asthma, and healthy subjects. Most interestingly we found the lung hyperinflation leads to the changes in diaphragmatic excursions during the breathing cycle, seen in the differences between the maximal expiratory diaphragm position (DPex) in patients with COPD and control group (p=0.0016). The magnitude of the diaphragmatic dysfunction was significantly related to the airflow limitation expressed by the ratio of forced expiratory volume in 1 s to slow vital capacity (FEV(1)/SVC), (%, p=0.0007); to the lung hyperinflation expressed as the ratio of the residual volume to total lung capacity (RV/TLC), (%, p=0.0018) and the extent of tidal volume constrain expressed as maximal tidal volume (V(Tmax)), ([l], p=0.0002); and the ratio of tidal volume to slow vital capacity (V(T)/SVC), (p=0.0038) during submaximal exercise. These results suggest that diaphragmatic movement fails to contribute sufficiently to the change in lung volume in emphysema. Tests of respiratory muscle function were related to the position of the diaphragm in deep expiration, e.g. neuromuscular coupling (P(0.1)/V(T)) (p=0.0232). The results have shown that the lung volumes determine the position of the diaphragm and function of the respiratory muscles. Chronic airflow limitation seems to change the position of the diaphragm, which thereafter influences inspiratory muscle function and exercise tolerance. There is an apparent relationship between the position of the diaphragm and the pulmonary functions and exercise tolerance.
- MeSH
- bránice patofyziologie MeSH
- bronchiální astma patofyziologie MeSH
- chronická obstrukční plicní nemoc patofyziologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- respirační funkční testy MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
