scholarly journals P412 Effectiveness of ustekinumab in fistulising perianal Crohn′s disease refractory or intolerant to anti-TNF

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S419-S420
Author(s):  
D Carpio ◽  
C Calviño-Suarez ◽  
J Martínez-Cadilla ◽  
G Molina ◽  
M T Vázquez-Rey ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Clinical Response ◽  
Treatment Initiation ◽  
Resonance Imaging ◽  
Dose Intensification ◽  
Main Indication ◽  
Before And After ◽  
Radiological Response ◽  
Magnetic Resonance Imaging Mri ◽  
Therapeutic Alternatives

Abstract Background The management of fistulising perianal Crohn′s disease (pCD) is a challenging problem for patients and physicians. New therapeutic alternatives are needed, particularly in anti-TNF refractory patients. Data regarding ustekinumab (UST) effectiveness in pCD are scarce. Our aim was to evaluate the clinical and radiologic effectiveness of UST in pCD patients refractory or intolerant to anti-TNF. Methods We conducted a multi-center retrospective observational study. All patients with anti-TNF refractory pCD treated with UST were evaluated. Demographic and clinical variables including concomitant drugs were registered. Clinical response was evaluated at 16 weeks and 12 months and was defined as a reduction of 50% of draining fistulas or a marked reduction in fistula drainage. In patients with a magnetic resonance imaging (MRI) before and after treatment initiation, radiologic response was defined according to Ng Score (healed, partial response, unchanged, deterioration). Results Thirty-two patients were included, 68.8% female, median age 44,11 (IQR 36.28-48.56). Median time from diagnosis to UST initiation was 12.94 years (IQR 7.52-19.52), 90.6% had received previously 2 anti-TNF (37.5% also vedolizumab) and 46.9% had more than 2 fistulas. In 22 patients (68.8%) pCD was the main indication for UST treatment while in the remaining 31.2% the main indication was luminal disease. Fifteen patients (46.9%) received antibiotics at the initiation of UST, 8 (25%) combo therapy with thiopurines and 21 (65.6%) had setons. Patients received a 6mg/kg IV dose and 87.5% received 90mg/8 week SQ for maintenance. Dose intensification was needed in 20 patients (62.5%) at a median of 13 months (IQR 8.00-19.5). Fifteen patients (46,9%) achieved clinical response at week 16, while 18/30 (60%) had clinical response at 12 months (three of them were in clinical remission). Nineteen patients (59,4%) had an MRI performed pre and post-treatment at a median of 15 months (IQR 10-19). 10/19 patients (52.6%) achieved a radiological response although no patient had all fistulas healed. In the multivariate analysis the only factor associated with clinical response at 12 months was the presence of setons at UST initiation (OR 7.0; IC95% 1.3-37.9). There were no factors significantly associated with radiological response or clinical response at week 16. Four patients experienced adverse effects (three perianal abscesses and one transient skin rash). Conclusion Ustekinumab was effective in achieving clinical and radiological response in anti-TNF-refractory fistulising pCD patients, although clinical and radiological remission was rare. Most patients needed UST dose intensification in this highly refractory cohort. Adverse effects were infrequent, mainly perianal abscesses.

scholarly journals Preoperative measurements on MRI in Chiari 1 patients fail to predict outcome after decompressive surgery

2021 ◽  
Author(s):  
Miro-Pekka Jussila ◽  
Juho Nissilä ◽  
Minna Vakkuri ◽  
Päivi Olsén ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
University Hospital ◽  
Resonance Imaging ◽  
Surgical Decision ◽  
Postoperative Mri ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
Surgical Decision Making ◽  
Mri Evaluation ◽  
Outcome Of Surgery

Abstract Background The purpose of our study was to research the parameters of magnetic resonance imaging (MRI) that would predict the outcome of surgery in patients with Chiari 1 malformation (CM1) and to evaluate changes in MRI parameters after surgery. Methods Fifty-one patients (19 children, 13 adolescents, and 19 adults) operated on due to CM1 in Oulu University Hospital between 2004 and 2018 were evaluated. Seventeen parameters were measured from the preoperative MRI and 11 from the postoperative MRI. The correlations between the MRI parameters and the clinical variables before and after surgery were analyzed. Results The majority (88.2%) of the patients had favorable surgical outcomes. Postoperatively, subjective symptoms improved in 88.6% of the patients and syringomyelia in 81.8%. The location of the cerebellar tonsils, when measured in relation to the C2 synchondrosis or the end plate, postoperatively moved cranially in 51.0% (n = 26), did not change in 27.4% (n = 14), and moved caudally in 21.6% (n = 11) of the patients. However, neither the location of the tonsils nor any other parameters measured from pre- or postoperative MRI correlated with the patients’ symptoms or surgical outcomes. Conclusions No specific parameters on preoperative MRI evaluation were predictive of the outcome of surgery, emphasizing clinical examination in surgical decision-making. Furthermore, the postoperative MRI parameters did not correlate with the surgical outcomes. Thus, routine postoperative imaging is suggested only for patients with preoperatively diagnosed syringomyelia or worsening of symptoms.

scholarly journals Effect of an Insulation Device in Preventing Hypothermia during Magnetic Resonance Imaging Examinations for Dogs and Cats under General Anesthesia

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2378
Author(s):  
Eri Onozawa ◽  
Daigo Azakami ◽  
Seri Seki ◽  
Yuji Hamamoto ◽  
Katsumi Ishioka
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
General Anesthesia ◽  
Room Temperature ◽  
The Body ◽  
Body Temperatures ◽  
Resonance Imaging ◽  
Control Groups ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri

Dogs and cats under general anesthesia may develop hypothermia. When performing a magnetic resonance imaging (MRI) examination, it is not possible to place a magnetic material in the MRI room, and MRI equipment requires a low room temperature. This study investigated the effectiveness of a heat insulating device that prevented hypothermia during MRI examinations in dogs and cats. The animals that underwent MRI examinations under general anesthesia were divided into control groups (no covering) and heat insulating groups (wearing bubble wrap and down cloth blankets), and their body temperatures were measured before and after the MRI examinations. The changes in body temperatures were as follows: control dogs (n = 17), median of −1.0 (from −2.5 to 0.3) °C; heat insulated dogs (n = 7), −0.3 (from −0.8 to 0.2) °C; control cats (n = 14), −1.85 (from −2.7 to −0.6) °C; and heat insulated cats (n = 12), −0.8 (from −1.5 to −0.1) °C. These results revealed that the bubble wrap and down cloth blanket significantly prevented hypothermia and heat loss from the body surface during MRI examinations of dogs and cats.

scholarly journals Texture analysis of orbital magnetic resonance imaging for monitoring and predicting treatment response to glucocorticoid in patients with thyroid-associated ophthalmopathy

2021 ◽  
Author(s):  
Yue-Yue Wang ◽  
Qian Wu ◽  
Lu Chen ◽  
Wen Chen ◽  
Tao Yang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Texture Analysis ◽  
Disease Duration ◽  
Clinical Activity ◽  
Resonance Imaging ◽  
Thyroid Associated Ophthalmopathy ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
Optimal Efficiency

Purpose: To evaluate the value of magnetic resonance imaging (MRI)-based texture analysis of extraocular muscle (EOM) and orbital fat (OF) in monitoring and predicting the response to glucocorticoid (GC) therapy in patients with thyroid-associated ophthalmopathy (TAO). Methods: Thirty-seven active and moderate-to-severe TAO patients (responders, n=23; unresponders, n=14) were retrospectively enrolled. MRI-based texture parameters (entropy, uniformity, skewness and kurtosis) of EOM and OF were measured before and after GC therapy, and compared between groups. Correlations between the changes of clinical activity score (CAS) and imaging parameters before and after treatment were assessed. Receiver operating characteristic curves were used to evaluate the predictive value of identified variables. Results: Responsive TAOs showed significantly decreased entropy and increased uniformity at EOM and OF after GC therapy (p<0.01), while unresponders showed no significance. Changes of entropy and uniformity at EOM and OF were significantly correlated with changes of CAS before and after treatment (p<0.05). Responders showed significantly lower entropy and higher uniformity at EOM than unresponders before treatment (p<0.01). Entropy and uniformity of EOM and disease duration were identified as independent predictors for responsive TAOs. Combination of all three variables demonstrated optimal efficiency (area under curve, 0.802) and sensitivity (82.6%), and disease duration alone demonstrated optimal specificity (100%) for predicting responsive TAOs. Conclusion: MRI-based texture analysis can reflect histopathological heterogeneity of orbital tissues. It could be useful for monitoring and predicting the response to GC in TAO patients.

scholarly journals The role of PET and MRI in evaluating the feasibility of skin-sparing mastectomy following neoadjuvant therapy

2018 ◽  
Vol 46 (2) ◽  
pp. 626-636
Author(s):  
Fatma Umit Malya ◽  
Huseyin Kadioglu ◽  
Huseyin Kazim Bektasoglu ◽  
Zuhal Gucin ◽  
Seyma Yildiz ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Skin Involvement ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
Histopathological Results

Objective To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study. Demographic, clinical, radiological and histopathological features of the patients were recorded. Results A total of 30 patients were included in the study with a mean age of 52.6 years (range, 35–70 years). Sensitivity and specificity for detecting skin involvement in LABC was 100%/10% (62%/85%) with MRI and 60%/80% (12%/92%) with PET before (after) NAC, respectively. When radiological skin involvement was assessed in relation to the final histopathological results, the preNAC PET results and histopathological skin involvement were not significantly different; and there was no difference between postNAC MRI and histopathological skin involvement. Conclusions As preNAC PET and postNAC MRI more accurately determined skin involvement, it might be possible to use these two radiological evaluation methods together to assess patient suitability for skin-sparing mastectomy in selected patients.

scholarly journals Do magnetic resonance training in spondyloarthritis improve the performance of rheumatologists for the recognition of sequences and lesions?

2020 ◽  
pp. 8-11
Author(s):  
Rodrigo Garcia Salinas ◽  
Josefina Marin ◽  
Gabriel Aguilar ◽  
Dario Aguerre ◽  
Santiago Ruta ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Axial Spondyloarthritis ◽  
Individual Characteristics ◽  
Theoretical Knowledge ◽  
Resonance Imaging ◽  
Physician Characteristics ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Image

Introduction: Magnetic resonance imaging (MRI) is a fundamental diagnostic tool in axial spondyloarthritis, it has allowed us, unlike radiography, to diagnose this pathology much earlier. Objective: To estimate the percentage of correct answers in the recognition of SpA MRI lesions and theoretical knowledge, before and after performing an educational intervention. Estimate if the good performance in the tests is associated with individual characteristics of the doctors. Methods: A test was carried out with 10 questions (7 for image recognition and 3 for theoretical knowledge) before and after the development of an MRI image workshop in EspA in diferents cities in Argentina. The correct response number was considered before and after the workshop, and those who achieved more than 12 points between the two evaluations were considered good performance. The following physician characteristics were collected. Results: A total of 106 physicians were evaluated. The results of the tests (total 10 questions) before and after the workshop were 53% and 68% correct, respectively (p:0.000). 65% of the physicians achieved a good performance (more than 12 correct).

MRI of the Elbow: How to Do It

2021 ◽  
Vol 25 (04) ◽  
pp. 538-545
Author(s):  
Shila Pazahr ◽  
Reto Sutter ◽  
Veronika Zubler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Mr Arthrography ◽  
Resonance Imaging ◽  
Main Indication ◽  
Additional Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Indirect Mr Arthrography ◽  
Rule Out

AbstractThe diagnostic cascade for elbow complaints starts with the physical examination and radiographs that already can clarify or rule out many causes. Depending on the suspected pathology, additional imaging is necessary. Magnetic resonance imaging (MRI) has the advantage of accurately demonstrating a broad spectrum of diseases. The main indication for noncontrast MRI of the elbow is chronic epicondylitis. For magnetic resonance (MR) arthrography, it is suspected chondral and osteochondral abnormalities. Indirect MR arthrography is an option when direct arthrography is not practicable. MR arthrography of the elbow with traction is feasible, with promising results for the assessment of the radiocapitellar cartilage.

Synthesis of Zn-Doped Manganese Ferrite Nanoparticles Via Coprecipitation Method for Magnetic Resonance Imaging Contrast Agent

2014 ◽  
Vol 5 (4) ◽  
Author(s):  
Firooz Salehpour ◽  
Ainaz Khorramdin ◽  
Hooman Shokrollahi ◽  
Arastoo Pezeshki ◽  
Farhad Mirzaei ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Magnetite Nanoparticles ◽  
Lattice Parameter ◽  
Coprecipitation Method ◽  
Material Structure ◽  
Resonance Imaging ◽  
Before And After ◽  
Magnetic Resonance Imaging Contrast ◽  
Magnetic Resonance Imaging Mri

Two different preparations of biocompatible magnetic nanoparticles (MNPs), both (MnFe2O4 and Mn0.91Zn0.09Fe2O4) coated with methoxy polyethylene glycol aldehyde (m-PEG-CHO) were prepared through coprecipitation method. The prepared powder was reanalyzed for material structure with an X-ray diffractometer (XRD) and for particle size using a transition electron microscope (TEM). Magnetic saturation (MS) and coercivity (HC) of the formed particles were examined by a vibrating sample magnetometer (VSM). Surface structure of the samples was characterized by Fourier transform infrared spectroscopy (FTIR). Biocompatible ferrofluids were intravenously injected into four rabbits. Then the magnetic resonance (MR) images of brain were obtained by magnetic resonance imaging (MRI) experiments before and after intravenous injection of ferrofluids. The MNPs demonstrate super paramagnetic behavior with a spinel structure measuring 30–40 nm in size. Doping of these magnetite nanoparticles with zinc resulted in decreases in crystallite size from 24.23 nm to 21.15 nm, the lattice parameter from 8.45 Å to 8.43 Å and the coercivity from 41.20 Oe to 13.07 Oe. On the other hand, saturation magnetization increased from 50.12 emu/g to 57.36 emu/g following zinc doping. Image exposure analysis revealed that the reduction of MR signal intensity for zinc-doped magnetite nanoparticles was more than nondoped nanoparticles (shorter T2 relaxation time) thereby making the images darker.

scholarly journals Systemic inflammatory response in infants with craniostenosis sedated with propofol

2021 ◽  
Vol 11 (3) ◽  
pp. 297-306
Author(s):  
Viktoriia I. Gurskaya ◽  
Vadim P. Ivanov ◽  
Vitalii Yu. Novikov ◽  
Natalia V. Draygina ◽  
Irina A. Savvina
Keyword(s):  
Blood Plasma ◽  
Brain Mri ◽  
Short Exposure ◽  
Intravenous Sedation ◽  
Resonance Imaging ◽  
Intravenous Anesthesia ◽  
Tumor Necrosis Factors ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

AIM: This study aimed to investigate the possible effect of intravenous anesthesia (sedation) with propofol on the levels of several cytokines (interleukin [IL]-6, IL-8, IL-10, and tumor necrosis factors-) and S100B protein in the blood plasma of children aged 1 year with craniostenosis. MATERIALS AND METHODS: Twenty patients aged 112 months diagnosed with non-syndromic forms of craniosynostosis, who underwent magnetic resonance imaging (MRI) of the brain under propofol sedation, were classified according to ASA I-II class. Peripheral blood sampling was performed before and after the drug administration, followed by laboratory analysis. RESULTS: A significant increase was found in the serum level of IL-6 (p = 0.004) when intravenous sedation with propofol was used for 29 4.93 min. CONCLUSION: Short exposure of children aged 1 year with craniostenosis to hypnotic propofol during brain MRI significantly increased the level of the pro-inflammatory cytokine IL-6 in the blood plasma.

scholarly journals NIMG-59. ADVERSE EFFECTS OF IMAGE TILING FOR AUTOMATIC DEEP LEARNING GLIOMA SEGMENTATION IN MRI

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi174-vi174
Author(s):  
G Anthony Reina ◽  
Siddhesh Thakur ◽  
Ravi Panchumarthy ◽  
Spyridon Bakas
Keyword(s):  
Deep Learning ◽  
Adverse Effects ◽  
Computational Analysis ◽  
Resonance Imaging ◽  
Contrast Variation ◽  
Abnormal Signal ◽  
Tile Size ◽  
Magnetic Resonance Imaging Mri ◽  
Tumor Extent ◽  
Intense Signal

Abstract BACKGROUND Application of deep learning to neuro-oncology has shown promising clinically relevant results for tumor classification, localization, and segmentation. Hardware limitations, typically memory size of graphics cards, prevent magnetic resonance imaging (MRI) volumes from being processed as a whole, and hence they are divided into smaller, overlapping tiles. Deep learning algorithms (e.g., U-Net) can then be trained and applied for predictions on such tiles, followed by their combination/stitching as the final prediction for the whole volume. We investigate the hypothesis that image tiling options, such as tile placing, size, overlap, and stitching, introduce variations with adverse effects on predictions, both in terms of inconsistency and accuracy. METHODS We utilized the publicly available BraTS 2018 dataset of 285 baseline pre-operative MRI glioma scans, with corresponding expert tumor boundary annotations. We implemented a 3D U-Net to predict boundaries of the whole tumor extent, by virtue of the abnormal hyper-intense signal of T2-FLAIR scans. RESULTS Simply flipping the tile horizontally, or translating it by one voxel, produces different predictions. Use of small tiles (64x64x64 voxels) yields substantially more false positive predictions than when using larger tile size (i.e., 128x128x128 voxels). Overlapping tiles produce conflicting predictions, leading to ambiguous interpretations upon their stitching. In areas of overlapping tiles, rounding followed by averaging the overlapping predictions produce superior results to the inverse sequence. All these are particularly noticeable in the margins of the abnormal signal and in areas of large contrast variation. CONCLUSIONS Although tiling is a workaround for hardware limitations, it introduces variations detrimental to accuracy. Tiling of neuro-oncology scans for computational analysis using deep learning leads to non-generalizable, non-reproducible results, thereby affecting the performance and potential clinical translatability of such algorithms. Careful considerations and standardization recommendations should be established and appropriately documented for performing such analyses, in order to avoid misinterpretation of results.

scholarly journals White matter lesions in Fabry disease before and after enzyme replacement therapy: a 2-year follow-up

2006 ◽  
Vol 64 (3b) ◽  
pp. 711-717 ◽  
Author(s):  
Laura B. Jardim ◽  
Flávio Aesse ◽  
Leonardo M. Vedolin ◽  
Cláudio Pitta-Pinheiro ◽  
João Marconato ◽  
...  
Keyword(s):  
White Matter ◽  
Enzyme Replacement Therapy ◽  
Fabry Disease ◽  
Replacement Therapy ◽  
White Matter Lesions ◽  
Resonance Imaging ◽  
Enzyme Replacement ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri

PURPOSE: To report the clinical and neuroimaging, central nervous system (CNS) findings of patients with Fabry disease (FD) during 24 months of enzyme replacement therapy (ERT) with agalsidase-alpha. METHOD: Eight patients were included. Six completed 24 months of ERT. Clinical and magnetic resonance imaging (MRI) data were obtained at 0, 12 and 24 months of ERT. White matter lesions (WML) were evaluated as well as their relation to age, symptoms and neurological examination (CNS score). RESULTS: MRI was stable in 3 patients. WML and CNS score worsened in one patient, fluctuated in another, and improved in the sixth patient. In the whole series, there were 15 WML at baseline, and 19 at the 24th month. In two years, 4 lesions disappeared, whereas 8 appeared. CONCLUSION: A widespread pattern of silent WML in FD was seen. In two years, some WML appeared, and some disappeared. If these phenomena were related to the natural history, remains to be demonstrated.

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