scholarly journals P1675BONE DENSITOMETRY IN RENAL TRANSPLANTED PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ana Carina Ferreira ◽  
Marco Mendes ◽  
Cecília Silva ◽  
Patrícia Cotovio ◽  
Inês Aires ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Negative Correlation ◽  
Bone Biopsy ◽  
Agatston Score ◽  
Z Score ◽  
Vascular Calcifications ◽  
X Ray ◽  
T Score ◽  
Neck Fracture ◽  
Z Scores

Abstract Background and Aims Renal transplant and associated immunosuppression can influence bone volume. Presently, the data is conflicting with older studies showing bone loss after transplant, while recent ones didn’t conclude the same. The aim of this study was to analyse the relations between bone-related molecules [phosphorus (Pi), Calcium (Ca), Magnesium (Mg), parathyroid hormone (PTH), bone alkaline phosphatase (bAP), calcitonin, vitamin D (vitD), alpha-klotho, fibroblast grow factor (FGF) 23, sclerostin] and bone densitometry findings in renal transplanted patients. Method We performed a prospective cohort study of a consecutive sample of de novo single renal transplanted patients in our unit. At inclusion, demographic, clinical and transplant-related data were collected, X-ray of the pelvis and hands (Adragão score) and echocardiographic findings were recorded. All patients were submitted to a laboratorial evaluation and a bone biopsy at baseline (time 0). Patients were followed for 12 months, after which performed laboratorial evaluation, 2nd bone biopsy, echocardiogram, X-ray of pelvis and hands, bone densitometry (DXA) and non-contrast cardiac CT for Agatston score (time 1). Continuous variables are presented as medians and categorical variables as frequencies. Associations between variables were performed using Wilcoxon matched-pairs test and Spearman correlation test. STATA software was used and p < 0.05 was considered statistically significant. Results We recruited 85 patients from 1st October 2015 to 1st March 2018. At the end of 12 months, 6 patients refuse to perform the 2nd evaluation, 5 had primary non-function of the kidney graft, 1 had no 1st bone biopsy sample in time 0 and 4 patients died. We performed a 2nd evaluation in 69 patients and included those in this study. Mean age 50.2±12.4 years, 48 men, 53 caucasian (78.8%), median BMI 24.5 (22.7 – 27.8), median dialysis vintage 55 months (42 – 84). Patients had a median cumulative steroid dose of 5692.5 (5260 – 7250) mg. At 12 months, the median FRAX value for osteoporotic fracture was 3.5 (2.2 – 6.2) and for femoral neck fracture was 0.8 (0.2 – 2.7). The DXA findings are shown in Table 1. We found a negative correlation between vascular calcifications (Agatston Score and respective calcium percentile) and T and Z score of femoral neck (p=0.04), but not with the other DXA variables. Total femur variables (DMO, T-score, Z-score) were correlated with sclerostin values in time 1 (p<0.01), and there was a trend for correlation between the spine DXA variables (DMO, T-score, Z-score) and sclerostin in time 1 (p=0.08, p=0.07, p=0.04). Spine DXA variables were negatively associated with alpha-klotho in time 0 (p=0.04, p=0.05, p=0.06). We didn’t found correlations with Pi, Ca or bAP. There was a negative correlation between FRAX osteoporotic and femoral neck fracture values and alpha-klotho in time 1 (p=0.002; p=0.003). Conclusion We found an inverse correlation between T and Z scores of femoral neck and coronary vascular calcifications. Regarding bone-derived hormones, Spine T and Z scores and FRAX values negatively correlated with alfa-klotho. Sclerostin seems to be associated with high mineral density.

MO574MINERAL AND BONE DISORDERS CHANGES IN RENAL TRANSPLANTED PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ana Carina Ferreira ◽  
Marco Mendes ◽  
Cecília Silva ◽  
Patrícia Cotovio ◽  
Inês Aires ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Bone Biopsy ◽  
Serum Levels ◽  
Agatston Score ◽  
Vascular Calcifications ◽  
Bone Disorders ◽  
X Ray ◽  
Bone Disorder ◽  
Echocardiographic Findings

Abstract Background and Aims Successful renal transplant restores many physiologic abnormalities, including improvement of chronic kidney disease- mineral and bone disorder (CKD-MBD) syndrome. The primary aims of this study were: analyse the changes and evolution of the 3 components of CKD-MBD pre and 1 year post renal transplantation: the mineral abnormalities, the bone disorders and the vascular calcifications; and to correlate fibroblast grow factor 23 (FGF23), klotho and sclerostin serum levels with bone histomorphometric parameters and CV disease. The secondary aims were to study the evolution of other bone related parameters and correlate those with bone biopsies data, as well as to validate Adragão vascular calcification score in a population of renal transplant patients. Method We performed a prospective cohort study of a consecutive sample of de novo single renal transplanted patients in our unit. At inclusion, demographic, clinical and transplant-related data were collected, X-ray of the pelvis and hands (for Adragão score) and echocardiographic findings were recorded. All patients were submitted to a bone biopsy and laboratorial evaluation at baseline (time 0 – T0). Patients were followed for 12 months (time 1 – T1), after which performed laboratorial evaluation, a 2nd bone biopsy, echocardiogram, X-ray of pelvis and hands, bone densitometry and non-contrast cardiac CT (Agatston score). Continuous variables are presented as medians and categorical variables as frequencies. Differences between T0 and T1 were accessed by Wilcoxon matched-pairs test and paired McNemar test. Correlations between bone histomorphometric findings and severity of vascular calcifications with demographic and laboratorial parameters were obtained with Wilcoxon rank-sum test or Kruskall Wallis test. STATA software was used and p < 0.05 was considered statistically significant. Results We recruited 84 patients in a 28 month-period. At the end of 12 months, 69 patients performed a 2nd evaluation. Median age 53 years, 48 men, 53 caucasian, median dialysis vintage 55 months. We observe a significant reduction on phosphorus, magnesium, PTH, calcitonin, sclerostin, bone alkaline phosphatase and FGF23. Both calcium and alpha-klotho serum levels increase, with no significant changes in vitamin D levels. 68% of the patients presented renal osteodystrophy at the 2nd bone biopsy, and we observed a significant increase in the development of low turnover bone disorder, with no major changes in volume or mineralization. Changes in alpha-klotho, bAP and sclerostin (from T0 to T1) were important determinants of changes in turnover, mineralization and volume, respectively. Despite not being statistically significant, we were able to observe an improvement in the cortical bone porosity. Vascular calcifications and echocardiographic findings weren’t different comparing to the baseline (Median Adragão score was 1 in both evaluations, and valve calcifications were present in 22% and 23% of patients, with no changes in LVMI). The median Agatston score was 48.5, being the median adjusted percentile of 82%. FGF23 and sclerostin were found to be independent risk factors for extra-osseous calcifications, as well as low bone volume, cortical porosity and osteoid volume. Adragão score and valve calcifications correlated well with the increased severity of coronary calcifications determined by Agatston score (absolute and percentile). Conclusion In conclusion, renal transplantation improves two of the three components of CKD-MBD (biochemical and bone disorders), slowing the progression of vascular calcifications. FGF23, sclerostin and bAP seemed to be key parameters in understanding the bone changes observed in post transplant period, and these hormones also interfere with extra osseous calcification severity. Adragão score seems to be a good tool to access vascular calcifications in renal transplanted patients.

Size-adjustment techniques of lumbar spine dual energy X-ray absorptiometry measurements in assessing bone mineralization in children on maintenance hemodialysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nanees Salem ◽  
Ashraf Bakr
Keyword(s):  
Bone Mineralization ◽  
Dual Energy ◽  
Maintenance Hemodialysis ◽  
Z Score ◽  
Normal Height ◽  
X Ray ◽  
Significant Difference ◽  
Z Scores ◽  
Size Adjustment ◽  
Height For Age

Abstract Objectives Growing skeleton is uniquely vulnerable to impaired mineralization in chronic kidney disease (CKD). Continued debate exists about the optimal method to adjust for body size when interpreting dual energy X-ray absorptiometry (DXA) scans in children with CKD given the burden of poor growth. The study aimed to evaluate the clinical usefulness of size-adjustment techniques of lumber-spine DXA measurements in assessing bone mineralization in children with kidney failure on maintenance hemodialysis (HD). Methods Case-control study included 93 children on maintenance HD (9–18 years; 48 males). Participants were subjected to spinal-DXA-scan to obtain areal bone mineral density (aBMD; g/cm2). Volumetric-BMD (vBMD; g/cm3) was mathematically estimated. Z-scores of aBMD for chronological age (aBMDZ-CA), aBMD adjusted for height age (aBMDZ-HA), and vBMDZ-score were calculated using mean and SD values of age subgroups of 442 healthy controls (7–18 years). Results In short-for-age CKD patients, aBMDZ-CA was significantly lower than vBMDZ-score, while aBMDZ-HA was significantly higher than aBMDZ-CA and vBMDZ-score. In normal height-for-age CKD patients, no significant difference between aBMDZ-scores and vBMDZ-score was detected. aBMDZ-CA was significantly lower and aBMDZ-HA was significantly higher in short-for-age compared to normal height-for-age patients without significant differences in vBMDZ-score. We observed age-related decrements in the percentage of HD patients with normal densitometric Z-scores, the effect of age was less pronounced in aBMDZ-HA than vBMDZ-score. vBMDZ-score correlated negatively with age, but not with heightZ-score. Conclusions Estimated vBMD seems to be a convenient size-adjustment approach of spinal-DXA measurements in assessing BMD especially in older short-for-age children with CKD. aBMDZ-CA underestimates, while aBMDZ-HA overestimates BMD in such patients.

scholarly journals Evaluation of Bone Mineral Density in Subjects with Primary Hyperparathyroidism by Dual Energy X-Ray Absorptiometry

2018 ◽  
Vol 20 (2) ◽  
pp. 129
Author(s):  
Rezwana Haque ◽  
Raihan Hussain ◽  
Shamim MF Begum
Keyword(s):  
Bone Loss ◽  
Femoral Neck ◽  
Primary Hyperparathyroidism ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Group A ◽  
Group B ◽  
Bone Condition

<p><strong><em>Objective:</em></strong><strong> </strong>Bone loss is a major complication of primary hyperparathyroidism (PHPT), and the extent of bone loss is an important factor for parathyroidectomy. Studies focused on this issue of bone loss in subjects with PHPT are quite rare in our country. This study will help the physicians to take proper action by giving an exact reflection of bone condition in subjects with PHPT. The purpose of this study was to evaluate the bone condition by measuring Bone Mineral Density (BMD), in subjects with PHPT using Dual Energy X-ray Absorptiometry (DEXA) and compare these findings with individuals without PHPT.</p><p><strong><em>Patients and Methods:</em></strong><strong> </strong>It was an analytic cross sectional study (group comparison) carried out at National Institute of Nuclear Medicine and Allied Sciences (NINMAS) BSMMU campus, Dhaka from July 2015-December 2016. Subjects of PHPT diagnosed by biochemical evaluation (increased serum calcium and parathyroid hormone concentrations), between age ranges 15-45 years were selected as group-A. Individuals without biochemical evidence of PHPT or other major illness causing bone loss were selected as comparison group or as group-B. The subjects underwent BMD test by DEXA at lumbar spines from L1-L4 vertebra and the left femoral neck using Norland XR-46 densitometer. BMD was classified according to WHO criteria. Data presented on categorical form were analyzed using chi-squared test. While the data presented on continuous scale were analyzed using student’s t-test. In each analysis, level of significance was 5% and P value &lt;0.05 was considered significant. Data were processed and analyzed with the help of computer software SPSS, version 20.</p><p><strong><em>Results:</em></strong><strong> </strong>Total number of 90 subjects were selected for this study, 45 subjects with PHPT were in group-A and equal number of subjects without PHPT were in group-B. The findings derived from data analysis showed, a significantly more male participants in group-A. The mean age of group-A and group-B was 37.24 ± 8.03 years and 38.20 ± 5.74 years respectively. Mean BMI of group-A was 25.10 ± 4.35 kg/m<sup>2  </sup>in compare to 29.43 ± 5.17 kg/m<sup>2</sup> in group-B. Higher BMI was noted in both groups. PHPT subjects with high BMI had low BMD. BMD expressed in absolute value (gm/cm<sup>2</sup>) and T score. BMD was significantly low in group-A (with PHPT) than in group-B (without PHPT), (p&lt;0.0001). In group-A, prevalence of low BMD was 62.2% (osteopenia 37.8%  and osteoporosis 24.4%)  at lumbar spine and 84.5% (osteopenia 35.6% and osteoporosis 48.9%) at femoral neck. PHPT subjects had significant difference in both T score and BMD between lumbar spine and femoral neck.</p><p><strong><em>Conclusion:</em></strong><strong> </strong>Primary hyperparathyroidism (PHPT) is shown to be associated with significantly reduced BMD especially at femoral neck. Thus, an increased fracture risk should consider if it is left untreated.</p><p>Bangladesh J. Nuclear Med. 20(2): 129-135, July 2017</p>

scholarly journals FEMORAL NECK FRACTURES GARDEN I AND II: EVALUATION OF THE DEVIATION IN LATERAL VIEW

2017 ◽  
Vol 25 (2) ◽  
pp. 107-109 ◽  
Author(s):  
Natália Zalc Leonhardt ◽  
Lucas da Ponte Melo ◽  
David Gonçalves Nordon ◽  
Fernando Brandão de Andrade e Silva ◽  
Kodi Edson Kojima ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Comparative Study ◽  
Femoral Neck Fracture ◽  
Lateral View ◽  
Femoral Neck Fractures ◽  
Level Of Evidence ◽  
X Ray ◽  
Neck Fracture ◽  
Anteroposterior View ◽  
Retrospective Comparative Study

ABSTRACT Objective: To evaluate the rate of deviation in the lateral radiographic incidence in patients with femoral neck fracture classified as non-diverted in the anteroposterior view (Garden I and II). Methods: Nineteen selected patients with femoral neck fractures classified as Garden I and II were retrospectively evaluated, estimating the degree of deviation in the lateral view. Results: Fifteen cases (79%) presented deviations in lateral view, with a mean of 18.6 degrees (±15.5). Conclusion: Most fractures of the femoral neck classified as Garden I and II present some degree of posterior deviation in the X-ray lateral view. Level of Evidence III, Retrospective Comparative Study.

scholarly journals Femoral Neck Width Predict Low Bone Mass in Patients with Multiple Hereditary Exostoses

2021 ◽  
Author(s):  
Kazu Matsumoto ◽  
Hiroyasu Ogawa ◽  
Satoshi Nozawa ◽  
Haruhiko Akiyama
Keyword(s):  
Femoral Neck ◽  
Bone Mass ◽  
Z Score ◽  
Low Bone Mass ◽  
Mineral Density ◽  
Multiple Hereditary Exostoses ◽  
Neck Width ◽  
T Score ◽  
Significant Difference ◽  
Femoral Neck Width

Abstract Background: Recent report revealed multiple hereditary exostoses (MHE) patients showed the osteoporosis. This study aimed to determine if proximal femur deformities can indicate low bone mass in MHE patients and to investigate the correlation between Z-score or T-score and hip geometry parameters. Patients and Methods: Twenty MHE patients from unrelated families were included in this study. Bone mineral density (BMD) of both femoral neck (n = 40) was examined using dual-energy x-ray absorptiometry. We examined femoral neck axis length (FNAL), femoral head diameter (FHD), femoral neck width (FNW), femoral shaft width (FSW), and femoral neck angle (FNA) and calculated the femoral head-neck ratio (FHNR=FHD/FNW). We examined the correlation between these parameters and Z-score or T-score using linear regression analysis followed by Spearman rank correlation coefficient.Results: Of the patients, 91.7% (22 of 24) male and 100% (16 of 16) female had a Z-score <0 in the femoral neck area. Results also showed that the femoral neck area of 62.5% (15 of 24) male and 56.3% (9 of 16) female patients are within the range for osteopenia. The femoral neck are of seven patients (17.5%) were found to be within the range for osteoporosis. These results suggest that MHE patients tend to have low bone mass. We found a significant correlation between FNW and Z-score (r = -0.3924, P = 0.0123), but there was no significant difference between Z-score and FNAL, FHD, FSW, NSA, and FHNR. We also found that there were significant differences between T-score and FNW and T-score and FHNR (r = -0.4787, P = 0.0018 and r = 0.3636, P = 0.0211, respectively). There was no significant difference between T-score and the other parameters.Conclusions: We found that the femoral neck width significantly correlates with Z-score or T-score. These results suggest that the femoral neck width may be a reliable predicting factor of bone mineral density.

scholarly journals Occult femoral neck fractures

2014 ◽  
Vol 13 (4) ◽  
pp. 264-268
Author(s):  
Valentinas Uvarovas ◽  
Andrius Vaitiekus ◽  
Igoris Šatkauskas
Keyword(s):  
Mortality Rate ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fractures ◽  
Urgent Problem ◽  
Occult Fracture ◽  
Secondary Fracture ◽  
Plain Radiographs ◽  
X Ray ◽  
Neck Fracture

Occult femoral neck fractures are becoming an urgent problem for aging population. In general the term “occult fracture” is used to denote fractures which are occult on plain radiographs, but found to be present on other imaging modalities or intra-operatively. Estimated incidence of occult femoral neck fracture is 2 to 10 per cent according to the literature. There is a risk of secondary fracture displacement, and other related complications in case of late diagnosis of these fractures. Timely diagnosis of these fractures in elderly patients improves treatment outcomes, reduces invalidity risk. The higher mortality rate is associated with well diagnosed femoral neck fractures whose treatment was delayed for reasons other than missing X-ray evidence of a fracture.

scholarly journals T Scores, FRAX, Frailty Phenotype, Falls, and Its Relationship to Fractures in Patients on Maintenance Hemodialysis

2021 ◽  
Vol 8 ◽  
pp. 205435812110411
Author(s):  
Maryam Jafari ◽  
Salman Anwar ◽  
Kaval Kour ◽  
Shubrandu Sanjoy ◽  
Kunal Goyal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Assessment Tools ◽  
Cross Sectional ◽  
X Ray ◽  
Frailty Status ◽  
T Score ◽  
History Of ◽  
Fracture Assessment ◽  
Frax Score

Background: Despite the magnitude of fracture and the consequences in patients receiving hemodialysis, optimal risk assessment tools in this population are not well explored. Frailty and falls—known risk factors for fracture in chronic kidney disease (CKD) and non-CKD populations—are common in patients receiving hemodialysis (HD) therapy. While the relationship between T scores in relation to fractures in patients receiving HD is recognized, there is a paucity of data to the additional contributions of fracture assessment tool (FRAX), frailty status, and falls in its relationship with fracture. Objectives: To evaluate the clinical utility of adding FRAX, frailty status, and falls to T scores at the femoral neck to determine whether it enhances fracture discrimination in patients on maintenance HD. Design: A cross-sectional observational study. Setting: Two main dialysis units in Regina, Saskatchewan, Canada. Patients: A total of 109 patients on maintenance HD at two dialysis units from January 1, 2017, to December 31, 2018, were included in the study. Measurements: Fracture (the main outcome) was documented based on the review of medical charts, self-recall, and additionally vertebral fractures were identified by an x-ray. Areal bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA). FRAX score was calculated using an online algorithm based on 11 clinical risk factors. We calculated the FRAX score for hip fracture and major osteoprotoic fracture with and without the inclusion of BMD. Frailty was assessed using the Fried criteria, which included assessments of unintentional weight loss, weakness (handgrip strength), slowness (walking speed), and questionnaires for physical activity and self-perceived exhaustion. Patients were enquired about the history and frequency of falls. Methods: A total of 131 patients underwent frailty assessments at the two dialysis units during the dialysis treatment. Following frailty assessments, they were referred for DXA scans and upon receipt of the results undertook FRAX questionnaires. They were additionally sent for lumbar x-rays and contacted for a history of falls. Association between the BMD-T score, FRAX, frailty status, falls, with fracture were examined with sequential multivariable logistic regression models. Differences were considered statistically significant at P values <.05. Results: A total of 109 patients were included in the data analysis. The composite of fracture occurred in 37.6% of patients. About 59.3% were identified as frail, and 29% of the participants had at least one fall in the last year. On multivariate regression analysis, each lower standard deviation (SD) in femoral neck T score was associated with 48% higher odds of fracture (odds ratio [OR] = 1.48; 95% confidence interval [CI] 1.20-1.68, P = .005). With the inclusion for FRAX scores (hip), the OR for fracture remained significant at 1.38 (OR = 1.38, 95% CI 1.04-1.63, P = .043). The addition of frailty status and history of falls did not further improve the model. Low T score and FRAX were both independent risk factors in patients on HD therapy. Limitations: This is a single-center study with a small sample size which limits the generalizability of the findings. Due to the cross-sectional study, associations identified may be difficult to interpret. Conclusions: Both BMD measurements by DXA and FRAX are useful tools to assess fracture in patients receiving HD. The addition of frailty status and history of falls is not associated with fractures in this population. Larger prospective studies are needed to determine whether the inclusion of frailty and falls to the conventional models will improve fracture assessment in the population receiving HD. Trial Registration: The study was not registered on a publicly accessible registry as it did not involve health care intervention on human participants.

scholarly journals P1696VASCULAR CALCIFICATION IN RENAL TRANSPLANTED PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ana Carina Ferreira ◽  
Marco Mendes ◽  
Cecília Silva ◽  
Patrícia Cotovio ◽  
Inês Aires ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Bone Biopsy ◽  
Vascular Calcifications ◽  
X Ray ◽  
Time Points ◽  
Progression Of Vascular Calcifications

Abstract Background and Aims Chronic kidney disease – mineral and bone disorder (CKD-MBD) is a well-known syndrome in end stage renal disease. Vascular calcifications are one of its components. Renal transplantation seemed to halt the progression of vascular calcifications. The aim of this study was to analyse the progression of vascular calcifications in a cohort of renal transplanted patients, and the associations of those with the old and new bone-derived hormones. Method We performed a prospective cohort study of a consecutive sample of de novo single renal transplanted patients in our unit. All patients were submitted to a bone biopsy and laboratorial evaluation at baseline (time 0) including measurements of calcium (Ca), phosphorus (Pi), magnesium (Mg), vitamin D (vitD), calcitonin, parathyroid hormone (PTH), bone alkaline phosphatase (bAP) and total alkaline phosphatase (tAP), alpha-klotho, fibroblast grow-factor 23 (FGF23) and sclerostin. Patients were followed for 12 months, after which performed a second bone biopsy and laboratorial evaluation (time 1). At inclusion, demographic, clinical and transplant-related data were collected, X-ray of the pelvis and hands (Adragão score) and echocardiographic findings were recorded. At the end of the study, echocardiogram, X-ray of pelvis and hands, bone densitometry and non-contrast cardiac CT (Agatston score) were performed. Immunosuppression included induction therapy followed by tacrolimus, mycophenolate mofetil and prednisolone. Continuous variables are presented as medians and categorical variables as frequencies. Associations between variables were performed using Wilcoxon rank sum test and Spearman correlation test. STATA software was used and p &lt; 0.05 was considered statistically significant. Results We recruited 85 patients from 1st October 2015 to 1st March 2018. Mean age 50.1±12.7 years, 59 men (69.4%), 66 caucasian (77.6%), median BMI 25.1±3.4. At the end of 12 months, 6 patients refuse to perform the 2nd evaluation, 5 had primary non-function of the kidney graft, 1 had no sample on bone biopsy in time 0 and 4 patients died. We performed a 2nd evaluation in 69 patients and included those in this study. The median baseline and 12 months Adragão score had no differences [1 (0 – 2)]. The median coronary artery calcium score was 48.5 (0 – 535) and median percentile was 80 (0 – 92.5). Valvular calcifications were present in 15 and 16 patients at baseline and after 1 year respectively, with no statistical difference between the two time points. Coronary artery calcium scores were correlated with age (p&lt;0.001), two time points Adragão score (p&lt;0.001), presence of valvular calcification in time 1 evaluation (p=0.004), baseline calcium (p=0.02), baseline and 1-year sclerostin (p=0.01; p=0.04). Coronary artery calcium scores were higher in patients with highest values of FGF23 at baseline (p=0.04). Using a pairwise correlation, vitamin D levels (r=0.4, p=0.0004), iPTH (r=0.6, p&lt;0.001) and total cholesterol levels (r=-0.3, p=0.01) were correlated with the score. Coronary calcium Percentile (adjusted for age, gender and race) was correlated with Adragão score in the two time points (p=0.0001; p=0.002), with presence of valvular calcifications in time 1 evaluation (p=0.02), baseline and 1-year calcium serum levels (p=0.004; p=0.02) and baseline sclerostin (p=0.01). Conclusion In conclusion, vascular calcifications stabilize after renal transplant. Adragão score, that is a less expensive exam than cardiac CT, can assess vascular calcifications in renal transplanted patients. Only calcium and sclerostin correlated with both Agatston scores and coronary calcium percentiles.

scholarly journals Resting-state functional MRI in an intraoperative MRI setting: proof of feasibility and correlation to clinical outcome of patients

2016 ◽  
Vol 125 (2) ◽  
pp. 401-409 ◽  
Author(s):  
Constantin Roder ◽  
Edyta Charyasz-Leks ◽  
Martin Breitkopf ◽  
Karlheinz Decker ◽  
Ulrike Ernemann ◽  
...  
Keyword(s):  
Functional Mri ◽  
Negative Correlation ◽  
Resting State ◽  
Clinical Condition ◽  
Characteristic Curve ◽  
Significant Negative Correlation ◽  
Intraoperative Mri ◽  
Neurological Deficits ◽  
Z Score ◽  
Z Scores

OBJECTIVE The authors' aim in this paper is to prove the feasibility of resting-state (RS) functional MRI (fMRI) in an intraoperative setting (iRS-fMRI) and to correlate findings with the clinical condition of patients pre- and postoperatively. METHODS Twelve patients underwent intraoperative MRI-guided resection of lesions in or directly adjacent to the central region and/or pyramidal tract. Intraoperative RS (iRS)–fMRI was performed pre- and intraoperatively and was correlated with patients' postoperative clinical condition, as well as with intraoperative monitoring results. Independent component analysis (ICA) was used to postprocess the RS-fMRI data concerning the sensorimotor networks, and the mean z-scores were statistically analyzed. RESULTS iRS-fMRI in anesthetized patients proved to be feasible and analysis revealed no significant differences in preoperative z-scores between the sensorimotor areas ipsi- and contralateral to the tumor. A significant decrease in z-score (p < 0.01) was seen in patients with new neurological deficits postoperatively. The intraoperative z-score in the hemisphere ipsilateral to the tumor had a significant negative correlation with the degree of paresis immediately after the operation (r = −0.67, p < 0.001) and on the day of discharge from the hospital (r = −0.65, p < 0.001). Receiver operating characteristic curve analysis demonstrated moderate prognostic value of the intraoperative z-score (area under the curve 0.84) for the paresis score at patient discharge. CONCLUSIONS The use of iRS-fMRI with ICA-based postprocessing and functional activity mapping is feasible and the results may correlate with clinical parameters, demonstrating a significant negative correlation between the intensity of the iRS-fMRI signal and the postoperative neurological changes.

Sign in / Sign up

Export Citation Format

Share Document