This Special Issue of
entitled "Leading Diagnosis on Chest Imaging" provides an overview of recent technical developments in chest imaging and their clinical relevance, with a special focus on ...dual-energy CT (DECT) imaging ....
This Special Issue of
entitled "Advances in CT Images" provides an interesting selection of articles on recent technical developments in CT imaging with a special focus on spectral imaging, including ...dual-energy CT (DECT) and photon-counting CT (PCCT) ....
Vaccination plays an important role in the fight against SARS-CoV-2 to minimie the spread of coronavirus disease 2019 (COVID-19) and its life-threatening complications. Myocarditis has been reported ...as a possible and rare adverse consequence of different vaccines, and its clinical presentation can range from influenza-like symptoms to acute heart failure. We report a case of a 30-year-old man who presented progressive dyspnea and constrictive retrosternal pain after receiving SARS-CoV-2 vaccine. Cardiac magnetic resonance and laboratory data revealed typical findings of acute myopericarditis.
La vaccination joue un rôle important dans la lutte contre le SARS-CoV-2 afin de minimiser la propagation de la maladie à coronavirus 2019 (COVID-19) et ses complications potentiellement mortelles. La myocardite a été signalée comme une conséquence potentielle, indésirable et rare, de différents vaccins, et sa présentation clinique peut aller de symptômes de type grippal à une insuffisance cardiaque aiguë. Nous rapportons le cas d'un homme de 30 ans qui a présenté une dyspnée progressive et une douleur rétrosternale constrictive après avoir reçu le vaccin contre le SARS-CoV-2. La résonance magnétique cardiaque et les données de laboratoire ont révélé des résultats typiques d'une myopéricardite aiguë.
Cardiac fibrosis is a pathological process characterized by an excessive deposition of extracellular matrix (ECM) and an increased production of fibrillar collagen in the cardiac interstitium, mainly ...caused by the activation of cardiac fibroblasts and their transition into myofibroblasts. Oxidative stress is deeply implicated in the pathogenesis of cardiac fibrosis both directly and via its involvement in the tumor growth factor β1 (TGF-β1) signaling. Ellagic acid (EA) and punicic acid (PA) are the main components of the Punica granatum L (pomegranate) fruit and seed oil respectively, whose antioxidant, anti-inflammatory and anti-fibrotic effects have been previously described. Therefore, the aim of this study was to investigate the effects of EA or PA or EA+PA in an in vitro model of cardiac fibrosis. Immortalized Human Cardiac Fibroblasts (IM-HCF) were stimulated with 10 ng/ml of TGF-β1 for 24 h to induce a fibrotic damage. Cells were then treated with EA (1 µM), PA (1 µM) or EA+PA for additional 24 h. Both EA and PA reduced the pro-fibrotic proteins expressions and the intracellular reactive oxygen species (ROS) accumulation. The anti-oxidant activity was also observed by Nrf2 activation with the consequent TGF-β1-Smad2/3-MMP2/9 and Wnt/β-catenin signaling inhibition, thus reducing collagen production. EA and PA significantly inhibit NF-κB pathway and, consequently, TNF-α, IL-1β and IL-6 levels: the greater effect was observed when EA and PA were used in combination. These results suggest that EA, PA and in particular EA+PA might be effective in reducing fibrosis through their antioxidant and anti-inflammatory properties by the modulation of different molecular pathways.
•EA and PA reduce intracellular ROS accumulation and increase Nrf2 activation.•EA and PA inhibit NF-κB pathway and, consequently, TNF-α, IL-1β and IL-6 levels.•EA and PA reduce pro-fibrotic proteins.•EA and PA reduce fibrosis through their antioxidant and anti-inflammatory effects.
Objectives
To evaluate the diagnostic performance of a dual-energy computed tomography (DECT)-based technique using iodine quantification and fat fraction analysis for the diagnosis of early acute ...pancreatitis
Methods
In this retrospective study, 45 patients (35 men and 10 women; mean age, 54.9 ± 14.0 years) with early acute pancreatitis were included. Serum lipase levels and follow-up examinations served as the reference standard. A matched control group (
n
= 45) was assembled for evaluation of material decomposition values of normal pancreatic parenchyma. Three blinded radiologists independently interpreted all cases on conventional grayscale DECT series. In addition, readers re-evaluated all cases by manually performing region-of-interest (ROI) measurements on pancreatic-phase DECT material density images of the head, body, and tail of each patient’s pancreas. Receiver operating characteristic (ROC) curve analysis was performed to estimate the optimal threshold for discriminating between inflammatory and normal pancreas parenchyma.
Results
DECT-based iodine density values showed significant differences between inflammatory (1.8 ± 0.3 mg/mL) and normal pancreatic parenchyma (2.7 ± 0.7 mg/mL) (
p
≤ 0.01). Fat fraction measurements showed no significant differences (
p
= 0.08). The optimal iodine density threshold for the diagnosis of acute pancreatitis was 2.1 mg/mL with a sensitivity of 96% and specificity of 77%. Iodine quantification revealed an area under the curve (AUC) of 0.86, significantly higher compared to standard image evaluation of the radiologists (AUC, 0.80; sensitivity, 78%; specificity, 82%) (
p
< 0.01).
Conclusion
DECT using iodine quantification allows for diagnosis of early acute pancreatitis with higher sensitivity compared to standard image evaluation.
Key Points
• Iodine density values showed significant differences between inflammatory and normal pancreatic parenchyma.
• DECT using iodine quantification allows for diagnosis of early acute pancreatitis.
• An iodine density of ≤ 2.1 mg/mL optimizes the diagnosis of acute pancreatitis.
•Material decomposition-based DECT BMD assessment yields high diagnostic accuracy.•HU measurements show significantly lower diagnostic accuracy compared to DECT material decomposition.•Focal HU ...measurements should not be routinely used to diagnose osteoporosis.
To assess the diagnostic accuracy of phantomless dual-energy computed tomography (DECT)-based volumetric material decomposition to assess bone mineral density (BMD) of the lumbar spine for the detection of osteoporosis compared to Hounsfield unit (HU) measurements with dual x-ray absorptiometry (DXA) as reference standard.
A total of two hundred lumbar vertebrae in 53 patients (28 men, 25 women; mean age, 52 years, range, 23−87 years) who had undergone clinically-indicated third-generation dual-source DECT and DXA within 30 days were retrospectively analyzed. For volumetric BMD assessment, dedicated DECT postprocessing software using material decomposition was applied, which enables color-coded three-dimensional mapping of the trabecular BMD distribution. Manual HU measurements were performed by defining five trabecular regions of interest (ROI) per vertebra as suggested by literature. The DXA T-score served as standard of reference (osteoporosis: T < -2.5). Sensitivity, specificity and the area under the curve (AUC) were primary metrics of diagnostic accuracy.
An optimal patient-based DECT-derived BMD cut-off of 84 mg/cm³ yielded 96 % sensitivity (22/23) and 93 % specificity (28/30) for detecting osteoporosis, while an optimal CT attenuation cut-off of 139 HU showed 65 % sensitivity (15/23) and 93 % specificity (28/30) for the detection of osteoporosis. Overall patient-based AUC were 0.930 (volumetric DECT) and 0.790 (HU analysis) (p < .001). Pearson’s product-moment correlation showed higher correlation between DECT BMD and DXA values (r=0.780) compared to HU and DXA values (r=0.528) (p < .001).
Phantomless volumetric DECT yielded significantly more accurate BMD assessment of the lumbar spine and superior diagnostic accuracy of osteoporosis compared to HU measurements.
Crohn’s disease is a chronic inflammatory condition characterized by a transmural involvement of intestinal walls. Its diagnosis comes from a combination of clinical data, imaging findings and, above ...all, endoscopy with biopsy results, which are mandatory for achieving a definitive diagnosis. Even so, endoscopy information may be unavailable, for instance due to technical impairments or patient intolerance. On the radiological side, Magnetic Resonance Enterography is currently considered the imaging technique of choice for Crohn’s disease assessment, either at first diagnosis or follow-up. Nevertheless, the lack of radiation exposure as well as invasiveness has made this imaging approach suitable also for the evaluation of a number of small and large bowel diseases over recent years. However, it is important to remember that Magnetic Resonance Imaging findings are non-specific and that a wide overlap exists among Crohn’s disease and other intestinal conditions. The aim of this work was to provide a series of intestinal affections evaluated through Magnetic Resonance Enterography that resemble Crohn’s disease and that can be helpful in avoiding misinterpretation, especially when endoscopy data are missing.
Objectives
To evaluate objective and subjective image quality of a noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique in dual-energy computed tomography (DECT) angiography ...prior to transcatheter aortic valve replacement (TAVR).
Methods
Datasets of 47 patients (35 men; 64.1 ± 10.9 years) who underwent DECT angiography of heart and vascular access prior to TAVR were reconstructed with standard linear blending (F_0.5), VMI+, and traditional monoenergetic (VMI) algorithms in 10-keV intervals from 40–100 keV. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of 564 arterial segments were evaluated. Subjective analysis was rated by three blinded observers using a Likert scale.
Results
Mean SNR and CNR were highest in 40 keV VMI+ series (SNR, 27.8 ± 13.0; CNR, 26.3 ± 12.7), significantly (all
p
< 0.001) superior to all VMI series, which showed highest values at 70 keV (SNR, 18.5 ± 7.6; CNR, 16.0 ± 7.4), as well as linearly-blended F_0.5 series (SNR, 16.8 ± 7.3; CNR, 13.6 ± 6.9). Highest subjective image quality scores were observed for 40, 50, and 60 keV VMI+ reconstructions (all
p
> 0.05), significantly superior to all VMI and standard linearly-blended images (all
p
< 0.01).
Conclusions
Low-keV VMI+ reconstructions significantly increase CNR and SNR compared to VMI and standard linear-blending image reconstruction and improve subjective image quality in preprocedural DECT angiography in the context of TAVR planning.
Key Points
•
VMI+ combines increased contrast with reduced image noise
.
•
VMI+ shows substantially less image noise than traditional VMI
.
•
40-keV reconstructions show highest SNR/CNR of the aortic and iliofemoral access route
.
•
Observers overall prefer 60 keV VMI+ images
.
•
VMI+ DECT imaging helps improve image quality for TAVR planning
.
Chronic glucocorticoid (GC) therapy is the most common cause of iatrogenic osteoporosis and represents an important risk factor for osteoporosis and bone fractures. New therapeutic approaches are ...required in order to treat osteoporosis and reduce the side effects related to the use of anti-osteoporotic drugs. In this context, previous studies reported the efficacy of some isoflavones and carotenoids, such as lycopene and genistein, on the reduction of the risk of fracture related to osteoporosis. The aim of this study was to investigate the effects of a combined oral treatment, consisting of genistein and lycopene, in an experimental model of glucocorticoid-induced osteoporosis (GIO). GIO was induced by subcutaneous injection of methylprednisolone (MP, 30 mg/kg) for 60 days, whereas the control group (Sham) received saline solution only. Following induction, MP animals randomly were assigned to receive alendronate, genistein, lycopene, or the association of genistein and lycopene or saline solution for additional 60 days together with MP. Femurs obtained from the Sham group were used for osteoblasts extraction; they were then incubated with dexamethasone (DEX) for 24 h to be then treated with lycopene or genistein or the association of lycopene and genistein for an additional 24 h. Treatments with lycopene and genistein restored the impaired mineralization of cells observed following DEX treatment and stimulated osteoblast differentiation by increasing the depressed expression of bALP and RUNX2 (p < 0.0001). Wnt5a, β-catenin, and Nrf-2 expression were significantly increased following genistein and lycopene treatment (p < 0.0001), thus confirming their antioxidant activity as well as their ability in stimulating osteoblast function, mostly when genistein and lycopene were used in association. The combined treatment of genistein and lycopene improved the bone damage induced by glucocorticoids and significantly restored the normal architecture of bones as well as adequate interconnectivity of bone trabeculae, thus increasing bone mineral density parameters. The obtained data demonstrated that genistein and lycopene but in particular their association might prevent GC’s adverse effects, thus stimulating bone formation and reducing bone resorption, improving bone structure and microarchitecture, through different molecular pathways, such as the Wnt/β-catenin and the Nrf-2 signaling.
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