1,720,980 research outputs found
Diffuse myocardial fibrosis in patient with diabetes mellitus type-II assessed by Cardiac Magnetic Resonance T1 mapping technique
Full text linkPurpose: Diabetic cardiomyopathy (DCM) can be cause of a progressive dysfunction of ventricular contractility with the evolution to heart failure, independently of ischaemic heart disease or hypertension. Early stages of DCM are asymptomatic and characterized by various degrees of myocardial fibrosis. Our aim is to non-invasively detect myocardial fibrotic infiltration in DM-II patients, to assess its relationship with ventricular function abnormalities and to compared our results with a group of healthy controls.
Methods and Materials: 100 patients affected by DM-II (57 man, 43 women) with preserved ventricular function and no history of ischaemic disease and 20 matching controls underwent contrast cardiac MR (CMR) between September 2014 and July 2017. Imaging protocol included: modified Look-Locker sequence before and 20 minutes after a double dose of 0.1 mmol/kg
gadoterate meglumine injection; T2-mapping; ventricular function module; tagged-cineMR module and late gadolinium enhanced (LGE) imaging. Native myocardial T1 (nT1) and T2 values, extracellular volume fraction (ECV), ventricular torsion angle and myocardial strain values have been calculated and correlated to glycated haemoglobin (HbA1c) and duration of disease. Pearson Correlation, Mann-Whitney test and unpaired T-test were used for statistical analysis.
Results: Patient group had higher nT1 and ECV values compared to controls (1018.29±73.28 ms vs.975±38 ms, 29.2±0.07% vs. 22.8±4.3% respectively, p<0.05 for both), whereas no significant differences occurred in T2 measurements (47.61±2.7ms vs. 47.0±2.8ms respectively, p=0.23). nT1 and ECV correlated with HbA1c (nT1: r2=0.99, p<0.0001; ECV: r2=0,07; p<0.005) and disease duration (nT1: r2=0.99, p<0.0001;ECV: r2=0,70 p<0,001) in DM-II patients. nT1 and ECV correlate positively torsion (nT1: r2=0.31, p<0.001; ECV: r2=0.30;p<0.001) and negatively with strain values in tagged-cineMR analysis (nT1 with global longitudinal and circunferential strain: both r2=-0.97, p<0.0001; ECV: r2=0.63 and r2=0.76, p<0.0001). LGE with ischemic pattern was found in eight patients as marker of silent infarction.
Conclusion: In DM-II patients with preserved ventricular function, HbA1c values and disease duration showed a significant correlation to myocardial nT1 and ECV increase, as reflection of diffuse fibrosis, and geometrical modification
Heart and Lung Fibrosis in a Patient with COVID-19-Related Myocarditis
Full text linkA COVID-19 patient, in whom pneumonia lesions were first detected by chest computed tomography, was further evaluated by cardiac magnetic resonance (CMR) due to a suspected myocarditis. Beyond heart alterations, CMR revealed peculiar features of affected pulmonary areas in T1 mapping sequences and showed a particular distribution of late gadolinium enhancement in the same regions. The noninvasive assessment of the cellular, fluid, or fibrotic content of lung lesions may provide key information about the underlying pathophysiological pathways in the search of a tailored medical therapy and ventilatory support for COVID-19 patients
Four-dimensional cardiac computed tomography in mitral valve endocarditis obstructing the left ventricle outflow tract
No full text[No abstract available
Heart and lung involvement detected by native T1 and T2 mapping magnetic resonance imaging in a patient with coronavirus disease-19
Full text linkA 57-year-old woman was presented to our coronavirus disease-2019 (COVID-19) dedicated coronary care unit following chest pain, fever, and concomitant increased high-sensitivity cardiac troponin
Giant Adrenal Cavernous Hemangioma: A Rare Abdominal Mass
No full textAn 84-year-old woman with left flank pain presented to our institution. Contrast-enhanced computed tomography demonstrated a large spherical adrenal mass (diameter 13 cm) showing features of a benign lesion. Histologic examination revealed a giant adrenal hemangioma. Surgical resection was curative, with no recurrence at 2 years of follow-up. Surgery is usually recommended for symptomatic patients or in the case of a large lesion (>6 cm) because of the possibility of the coexistence of a malignancy or potential complications (ie, hemorrhage, rupture). (C) 2013 Elsevier Inc
Circumflex coronary artery-coronary sinus fistula: computed tomography angiography imaging
No full text[No abstract available
Alternatives to surgery for the treatment of myomas
No full textUterine fibroids are benign neoplasms that can cause distressing symptoms in women during their reproductive age. They are often associated with menorrhagia that can determine anemia or bulk-related symptoms. Different treatment options are available: medical therapy has the goal to treat related symptoms, while semi-invasive or non-invasive uterus-sparing procedures aim to treat symptoms and eventually to determine a reduction in fibroids size. In this review we illustrate the current semi-invasive and totally non-invasive most frequently used uterus sparing procedures available. A review of the literature along with personal experience will offer the readers a panoramic view of these up-to-date treatments to be considered as different possibilities to treat women affected by uterine fibroids looking for uterus conserving non-surgical approach
Cardiac magnetic resonance imaging of transient myocardial dysfunction in a patient treated with checkpoint-targeted immunotherapy
No full textHere we report the case of a 70-year-old man presented to the emergency department because of sudden dyspnoea
First experience of real-time elastography with transvaginal approach in assessing response to MRgFUS treatment of uterine fibroids
No full textPURPOSE:
Definition of the role of real-time elastography (RTE) in the evaluation of response to treatment of uterine fibroids using MRgFUS in symptomatic patients.
MATERIALS AND METHODS:
28 women with 34 symptomatic fibroids, selected for MRgFUS, were enrolled. The patients were preliminarily studied with MRI and suprapubic and transvaginal ultrasound examination including RTE; the follow-up was performed immediately after treatment, at 3 months and 12 months with the same technique. Each lesion was evaluated by looking for ultrasound parameters (volume, resistance index) and RTE strain ratio (SR). Before and after treatment, all patients completed three questionnaires for symptom evaluation (e.g., uterine fibroids symptoms and quality of life).
RESULTS:
Of the 27 treated fibroids, only 14 had an effective treatment with non-perfused volume (NPV) >70 %. After 3 months of treatment, 17/21 patients presented significant decrease of uterine bleeding. A positive correlation between %NVP and percentage of fibroid volume decrease was seen. Reduction of SR value from t0 to t2 was found in 19/27 fibroids, particularly significant in fibroids with NPV > 70 %. A significant positive correlation between the percentage of symptom decrease and %SR decrease was found. At the time of statistical analysis, 12/21 patients reached the 12-month follow-up: they showed a further reduction of SR.
CONCLUSION:
RTE is a valid method able to support standard ultrasound examination in the evaluation of uterine fibroids, since it allows demonstrating the decrease of rigidity, which can be quantified with the SR parameter. It could be included in a pre-treatment multiparametric evaluation of patients looking for MRgFUS eligibility and in follow-up when it could assess the response to treatment
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