Stanovisko práce: Transperineálně prováděné navigované biopsie prostaty mají srovnatelnou výtěžnost a představují nižší riziko infekčních komplikací než biopsie transrektální. Cíl: V současné době se do popředí zájmu dostávají biopsie prostaty prováděné transperineálním přístupem. V našem souboru jsme retrospektivně hodnotili výtěžnost transperineálně prováděných biopsií a současně jejich bezpečnost především s ohledem na případné infekční komplikace. Pacienti a metoda: Od ledna 2019 do března 2020 jsme provedli 208 navigovaných fúzních US/MRI biopsií prostaty – transperineálním přístupem. Magnetická rezonance byla hodnocena systémem skórování PI‑RADS v2, respektive v2.1. U pacientů bez předchozí biopsie jsme odebrali systematicky vzorky z periferní zóny a dále nejméně tři vzorky z radiologem popsaného ložiska. U rebiopsií jsme odebírali nejméně tři vzorky z ložiska či ložisek, které byly hodnoceny dle PI‑RADS skóre 3 a více, neprováděli jsme systematickou biopsii. Výsledky: Výtěžnost metody v našem souboru, bez ohledu na PI‑RADS skóre, byla u primobiopsií 52,9 % prokázaných karcinomů, z toho 35,3 % klinic ky nesignifikatních a 17,6 % klinicky signifikantních. U rebiopsií pak bylo prokázáno 53,6 % karcinomů, z toho 38,6 % klinicky nesignifikantních a 15 % klinicky signifikatních. Při porovnání výtěžnosti dle daného PI‑RADS skóre bylo ve skupině PI‑RADS 3 celkově 68,5 % negativních, 31,5 % pozitivních (27,8 % nesignifikantních a 3,7 % signifikantních), ve skupině PI‑RADS 4 to bylo 44,3 % negativních a 55,7 % pozitivních (41,8 %, resp. 13,9 %), ve skupině PI‑RADS 5 pak 22,9 % negativních, 77,1 % pozitivních (43,8 % resp. 33,3 %). Prokázal se statisticky významný rozdíl ve výtěžnosti biopsií (P < 0,001). 182 pacientů absolvovalo výkon zcela bez komplikací. Stran infekčních komplikací jsme zaznamenali pouze dva pacienty s dysuriemi, ale bez průkazu bakteriální infekce. Závěr: Výtěžnost transperineálně prováděných fúzních biopsiích prostaty v našem souboru odpovídá literárním údajům. Zaznamenali jsme minimum komplikací, a proto se domníváme, že takto prováděné biopsie jsou bezpečnou alternativou.

Major statement: US/MRI fusion transperineal prostate biopsy has comparable yield and lower risk of infectious complications than transrectal biopsy. Purpose: Nowadays, prostate biopsies performed transperineally are gaining prominence. In our cohort, we retrospectively evaluated the yield of transperineally performed biopsies and at the same time their safety, especially with regard to infectious complications. Patients and methods: From January 2019 to March 2020, we performed 208 fusion US/MRI guided prostate biopsies – transperineally. Magnetic resonance imaging was evaluated by the PI-RADS vs 2 and vs 2.1 scoring systems, respectively. In biopsy naive patients we performed systematic biopsy from the peripheral zone and took at least three samples from the lesion described by the radiologist. In patients with repeated biopsy, we made a targeted biopsy with at least three samples from the lesion or lesions PI-RADS ≥ 3, but we did not make a systematic biopsy. Results: The overall yield of the method in our group, regardless of the PI-RADS score, was 52.9 % of proven cancers in biopsy naive patients, of which 35.3 % were clinically insignificant and 17.6 % were clinically significant. In rebiopsy, 53.6 % of cancers were detected, of which 38.6 % were clinically insignificant and 15 % were clinically significant When comparing the yield according to the PIRADS score, in the PI-RADS 3 group a total of 68.5 % were negative, 31.5 % positive (27.8 % insignificant and 3.7 % significant), in the PI-RADS 4 group it was 44.3 % negative and 55.7 % positive (41.8 % and 13.9 %, respectively), in the PI-RADS 5 group 22.9 % negative, 77.1 % positive (43.8 % and 33.3 %, respectively). There was a statistically significant difference in the yield of biopsies (Chi-square test of independence for contingency tables, P < 0.001). We also assessed the complications of the procedure and we found that 182 patients underwent the procedure without any complications. As our main outcome measure, infectious complications, we recorded only two patients with dysuria, but without evidence of bacterial infection. Conclusion: The yield of transperineally performed prostate biopsy in our cohort corresponds to literature data. We have noticed a minimum of complications, and therefore we believe that biopsy performed this way is a safe alternative.

• Klíčová slova
• transperineální biopsie prostaty,
• MeSH
• biopsie * metody   MeSH
• chirurgie s pomocí počítače metody   MeSH
• infekce močového ústrojí MeSH
• lidé MeSH
• nádory prostaty * diagnóza   MeSH
• pooperační komplikace MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH

Knee cartilage and meniscus are living tissue, but have limited opportunities for growth and renewal. If they are not burdened for long time, there is a breach of metabolism in the deeper tissues. Many negative changes may be substantially eliminated by periodic various activities. Appropriate load (alternating medium intensity) stimulates the growth of cartilage and muscle and thus prevents them from wasting. When loads are occurring, with elastic deformation of cartilage synovial fluid is extruded from the matrix into the articular capsule slot and the density of the matrix grows. With removing load synovial fluid flows back into the cartilage. Given the intracharacteristics of the knee (spatial insufficiency) display changes directly inside the meniscus and cartilage is problematic. Detection and modeling of mechanical response of tissue structures to external mechanical loading is possible using non-invasive imaging methods. Fairly accurate representation with wide application in patients provides magnetic resonance imaging (MRI). MRI use is overwhelmingly performed in supine without burdening the limbs, which can lead to some extent misleading information, even though the unloaded cartilage is exposed to pressure induced by muscle tone. From the point of evaluating changes in knee cartilage to various long-lasting stress following publications are subject to literary critival review. The findings in this paper are obtained mainly on the study of avaliable literature. The authors use to evaluate changes different parameter setting of MRI and thus try to get the most detailed information about the observed structures in various specific types of loads.

• Klíčová slova
• degenerace, zátěž,
• MeSH
• chrupavka anatomie a histologie   fyziologie   patologie   MeSH
• femur anatomie a histologie   fyziologie   patologie   MeSH
• kolenní kloub anatomie a histologie   fyziologie   patologie   MeSH
• koleno MeSH
• kyčelní kloub anatomie a histologie   fyziologie   patologie   MeSH
• lidé MeSH
• ligamentum collaterale tibiale anatomie a histologie   fyziologie   patologie   MeSH
• magnetická rezonanční tomografie metody   přístrojové vybavení   využití   MeSH
• meniskus MeSH
• metaanalýza jako téma MeSH
• osteoartróza diagnóza   komplikace   MeSH
• statistika jako téma MeSH
• tělesná námaha fyziologie   MeSH
• tibie anatomie a histologie   fyziologie   patologie   MeSH
• Check Tag
• lidé MeSH

• MeSH
• dospělí MeSH
• echokardiografie MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční angiografie metody   MeSH
• magnetická rezonanční tomografie metody   MeSH
• nemoci srdce diagnóza   MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

Přítomnost kardiostimulátoru (KS) nebo implantabilního kardioverteru-defibrilátoru (ICD) v těle pacienta byla doposud absolutní kontraindikací pro vyšetření magnetickou rezonancí (magnetic resonance imaging – MRI). V posledních několika letech jsou na trh uváděny podmíněně MR kompatibilní implantabilní přístroje umožňující pacientům MR vyšetření za specifických podmínek podstoupit. Rekapitulujeme současný stav poznání v této oblasti a přinášíme přehled dostupných MR kompatibilních KS a ICD. Vyšetření magnetickou rezonancí by u těchto pacientů mělo být prováděno v případech, v nichž požadovanou informaci nelze získat jinou zobrazovací metodou.

Implanted cardiac pacemaker (PM) or implantable cardioverter defibrillator (ICD) has been so far considered a contra-indication to magnetic resonance imaging (MRI). In the last few years MRI conditional cardiac implantable electronic devices have been marketed enabling patients undergo MRI under specific conditions. We present current state of the art and provide overview of available MRI conditional devices. Magnetic resonance imaging in these patients should be performed only in cases where the requested information can not be obtained using alternative imaging technique.

• MeSH
• bezpečnost vybavení MeSH
• defibrilátory implantabilní * klasifikace   kontraindikace   normy   MeSH
• design vybavení MeSH
• hodnocení rizik MeSH
• kardiostimulace umělá kontraindikace   MeSH
• kardiostimulátor * klasifikace   kontraindikace   normy   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * kontraindikace   škodlivé účinky   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• spotřebitelská bezpečnost produktů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

The left atrium plays an integral role in cardiac performance. Data regarding the left atrial size, volume, function, and structure are clinically important in the management of patients with different diagnoses. Moreover, left atrial size and function were recognized as robust predictors of poor outcome across a broad range of cardiac diseases. These data are usually obtained using echocardiography. MRI can be used as an alternative tool or in clinical or experimental situations when more exact and detailed assessment is required. In the left atrial functional analysis, MRI is considered to be a gold standard technique that overcomes many of the limitations associated with echocardiographic assessment. In comparison with the other techniques, late gadolinium enhancement provides a unique opportunity to assess left atrial myocardial tissue in vivo. Complex cardiac magnetic resonance data may help to make a diagnosis, determine a prognosis and provide an impact on therapeutic actions.This review summarizes the potential role of cardiac magnetic resonance in left atrium assessment, with special emphasis on recent data and the potential future research directions.

• MeSH
• kontrastní látky MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• nemoci srdce diagnóza   MeSH
• srdeční síně patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Theranostics is a novel paradigm integrating therapy and diagnostics, thereby providing new prospects for overcoming the limitations of traditional treatments. In this context, perfluorocarbons (PFCs) are the most widely used tracers in preclinical fluorine-19 magnetic resonance (19F MR), primarily for their high fluorine content. However, PFCs are extremely hydrophobic, and their solutions often display reduced biocompatibility, relative instability, and subpar 19F MR relaxation times. This study aims to explore the potential of micellar 19F MR imaging (MRI) tracers, synthesized by polymerization-induced self-assembly (PISA), as alternative theranostic agents for simultaneous imaging and release of the non-steroidal antileprotic drug clofazimine. In vitro, under physiological conditions, these micelles demonstrate sustained drug release. In vivo, throughout the drug release process, they provide a highly specific and sensitive 19F MRI signal. Even after extended exposure, these fluoropolymer tracers show biocompatibility, as confirmed by the histological analysis. Moreover, the characteristics of these polymers can be broadly adjusted by design to meet the wide range of criteria for preclinical and clinical settings. Therefore, micellar 19F MRI tracers display physicochemical properties suitable for in vivo imaging, such as relaxation times and non-toxicity, and high performance as drug carriers, highlighting their potential as both diagnostic and therapeutic tools.

• MeSH
• biokompatibilní materiály chemie   MeSH
• fluor chemie   MeSH
• fluorokarbony chemie   MeSH
• halogenace MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• micely MeSH
• myši MeSH
• nanočástice * chemie   terapeutické užití   MeSH
• teranostická nanomedicína * MeSH
• zobrazování fluorovou magnetickou rezonancí * metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Zobrazovací metody představují nedílnou součást akutní medicíny. V emergentním zobrazování mozku se pro své výhody nejčastěji uplatňuje CT. Se zvyšující se dostupností MR přístrojů představuje MR v indikovaných případech výhodnou alternativu CT. Volbu zobrazovací metody je nutné volit ve spolupráci klinika a radiologa s ohledem na očekávaný přínos a klinický stav pacienta. Článek popisuje některé stavy a skutečnosti, kdy je s výhodou upřednostnit MR před CT.

Imaging methods are an integral part of acute medicine. In emergent brain imaging, CTis most often used for its benefits. With the increasing availability of MRI devices, MRI is the preferred alternative to CTin the indicated cases. The choice of imaging method must be chosen in collaboration with the clinic and radiologist with respect to the expected benefit and clinical status of the patient. The papere describes some indications and facts where it is preferable in favor of MRI over CT.

OBJECTIVES: To compare the performance of transvaginal and transabdominal ultrasound with that of the first-line staging method (contrast-enhanced computed tomography (CT)) and a novel technique, whole-body magnetic resonance imaging with diffusion-weighted sequence (WB-DWI/MRI), in the assessment of peritoneal involvement (carcinomatosis), lymph-node staging and prediction of non-resectability in patients with suspected ovarian cancer. METHODS: Between March 2016 and October 2017, all consecutive patients with suspicion of ovarian cancer and surgery planned at a gynecological oncology center underwent preoperative staging and prediction of non-resectability with ultrasound, CT and WB-DWI/MRI. The evaluation followed a single, predefined protocol, assessing peritoneal spread at 19 sites and lymph-node metastasis at eight sites. The prediction of non-resectability was based on abdominal markers. Findings were compared to the reference standard (surgical findings and outcome and histopathological evaluation). RESULTS: Sixty-seven patients with confirmed ovarian cancer were analyzed. Among them, 51 (76%) had advanced-stage and 16 (24%) had early-stage ovarian cancer. Diagnostic laparoscopy only was performed in 16% (11/67) of the cases and laparotomy in 84% (56/67), with no residual disease at the end of surgery in 68% (38/56), residual disease ≤ 1 cm in 16% (9/56) and residual disease > 1 cm in 16% (9/56). Ultrasound and WB-DWI/MRI performed better than did CT in the assessment of overall peritoneal carcinomatosis (area under the receiver-operating-characteristics curve (AUC), 0.87, 0.86 and 0.77, respectively). Ultrasound was not inferior to CT (P = 0.002). For assessment of retroperitoneal lymph-node staging (AUC, 0.72-0.76) and prediction of non-resectability in the abdomen (AUC, 0.74-0.80), all three methods performed similarly. In general, ultrasound had higher or identical specificity to WB-DWI/MRI and CT at each of the 19 peritoneal sites evaluated, but lower or equal sensitivity in the abdomen. Compared with WB-DWI/MRI and CT, transvaginal ultrasound had higher accuracy (94% vs 91% and 85%, respectively) and sensitivity (94% vs 91% and 89%, respectively) in the detection of carcinomatosis in the pelvis. Better accuracy and sensitivity of ultrasound (93% and 100%) than WB-DWI/MRI (83% and 75%) and CT (84% and 88%) in the evaluation of deep rectosigmoid wall infiltration, in particular, supports the potential role of ultrasound in planning rectosigmoid resection. In contrast, for the bowel serosal and mesenterial assessment, abdominal ultrasound had the lowest accuracy (70%, 78% and 79%, respectively) and sensitivity (42%, 65% and 65%, respectively). CONCLUSIONS: This is the first prospective study to document that, in experienced hands, ultrasound may be an alternative to WB-DWI/MRI and CT in ovarian cancer staging, including peritoneal and lymph-node evaluation and prediction of non-resectability based on abdominal markers of non-resectability. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

• MeSH
• celotělové zobrazování statistika a číselné údaje   MeSH
• difuzní magnetická rezonance statistika a číselné údaje   MeSH
• dospělí MeSH
• epiteliální ovariální karcinom diagnostické zobrazování   patologie   MeSH
• invazivní růst nádoru MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické uzliny patologie   MeSH
• magnetická rezonanční tomografie statistika a číselné údaje   MeSH
• nádory vaječníků diagnostické zobrazování   patologie   MeSH
• peritoneální nádory diagnostické zobrazování   patologie   MeSH
• prospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Laryngeal mask UNIQUE® (LMAU) is supraglottic airway device with good clinical performance and low failure rate. Little is known about the ideal position of the LMAU on the magnetic resonance imaging (MRI) and whether radiological malposition can be associated with clinical performance (audible leak) in children. The primary aim of the study was to evaluate incidence of the radiologic malposition of the LMAU according to size. The secondary outcome was the clinical performance and associated complications (1st attempt success rate, audible leak) in LMAUs in correct position vs. radiologically misplaced LMAUs. METHODS: In prospective observational study, all paediatric patients undergoing MRI of the brain under general anaesthesia with the LMAU were included (1.9.2016-16.5.2017). The radiologically correct position: LMAU in hypopharynx, proximal cuff opposite to the C1 or C2 and distance A (proximal cuff end and aditus laryngis) ≤ distance B (distal cuff end and aditus laryngis). Malposition A: LMAU outside the hypopharynx. Malposition B: proximal cuff outside C1-C2. Malposition C: distance A ≥ distance B. We measured distances on the MRI image. Malposition incidence between LMAU sizes and first attempt success rate in trainees and consultant groups was compared using Fisher exact test, difference in incidence of malpositions using McNemar test and difference in leakage according to radiological position using two-sample binomial test. RESULTS: Overall 202 paediatric patients were included. The incidence of radiologically defined malposition was 26.2% (n = 53). Laryngeal mask was successfully inserted on the 1st attempt in 91.1% (n = 184) cases. Audible leak was detected in 3.5% (n = 7) patients. The radiologically defined malposition was present in 42.9% (n = 3) cases with audible leak. The rate of associated complications was 1.5% (n = 3): laryngospasm, desaturation, cough. In 4.0% (n = 8) the LMAU was soiled from blood. Higher incidence of radiological malposition was in LMAU 1.0, 1.5 and LMAU 3, 4 compared to LMAU 2 or LMAU 2.5 (p < 0.001). CONCLUSION: Malposition was not associated with impaired clinical performance (audible leak, complications) of the LMAU or the need for alternative airway management. TRIAL REGISTRATION: Clinicaltrials.gov (NCT02940652) Registered 18 October 18 2016.

• MeSH
• celková anestezie metody   MeSH
• dítě MeSH
• kašel epidemiologie   etiologie   MeSH
• kojenec MeSH
• laryngální masky * škodlivé účinky   MeSH
• laryngismus epidemiologie   etiologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladiství MeSH
• mozek diagnostické zobrazování   MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• zajištění dýchacích cest metody   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: Duchenne muscular dystrophy (DMD) patients are monitored periodically for cardiac involvement, including cardiac MRI with gadolinium-based contrast agents (GBCA). Texture analysis (TA) offers an alternative approach to assess late gadolinium enhancement (LGE) without relying on GBCA administration, impacting DMD patients' care. The study aimed to evaluate the prognostic value of selected TA features in the LGE assessment of DMD patients. RESULTS: We developed a pipeline to extract TA features of native T1 parametric mapping and evaluated their prognostic value in assessing LGE in DMD patients. For this evaluation, five independent TA features were selected using Boruta to identify relevant features based on their importance, least absolute shrinkage and selection operator (LASSO) to reduce the number of features, and hierarchical clustering to target multicollinearity and identify independent features. Afterward, logistic regression was used to determine the features with better discrimination ability. The independent feature inverse difference moment normalized (IDMN), which measures the pixel values homogeneity in the myocardium, achieved the highest accuracy in classifying LGE (0.857 (0.572-0.982)) and also was significantly associated with changes in the likelihood of LGE in a subgroup of patients with three yearly examinations (estimate: 23.35 (8.7), p-value = 0.008). Data are presented as mean (SD) or median (IQR) for normally and non-normally distributed continuous variables and numbers (percentages) for categorical ones. Variables were compared with the Welch t-test, Wilcoxon rank-sum, and Chi-square tests. A P-value < 0.05 was considered statistically significant. CONCLUSION: IDMN leverages the information native T1 parametric mapping provides, as it can detect changes in the pixel values of LGE images of DMD patients that may reflect myocardial alterations, serving as a supporting tool to reduce GBCA use in their cardiac MRI examinations.

• MeSH
• dítě MeSH
• Duchennova muskulární dystrofie * diagnostické zobrazování   patologie   MeSH
• gadolinium MeSH
• kontrastní látky MeSH
• lidé MeSH
• magnetická rezonanční tomografie * metody   MeSH
• mladiství MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH