Eight weeks of <Emphasis Type="Italic">Capoeira</Emphasis> progressive training program increases flexibility of beginners

Background

No study has investigated the alterations in the flexibility of beginners using an experimental protocol with basic techniques of Capoeira.

Purpose

To analyze the effects of 8 weeks of Capoeira progressive training program on the flexibility of beginners.

Methods

Twenty-one individuals divided in two groups (Capoeira: n = 13; 26.1 ± 7.2 years; 22.7 ± 2.7 kg m^2(?1) and control: n = 08; 27.1 ± 0.5 years; 24.3 ± 3.3 kg m^2(?1)) participated in the study. The Capoeira group performed 8 weeks of Capoeira progressive training program (two sessions per week lasting 60 min each). The experimental protocol used was exclusively based on the basic techniques of a programmed Capoeira training system. Before and after the intervention, measurements were performed aiming to analyze (1) trunk flexion flexibility through a sit-and-reach test using a Wells’ Bench (WB_tf), (2) passive tension (PT_hf), and (3) maximum amplitude of hip flexion (MA_hf) through goniometry.

Results

A two-way ANOVA revealed a main effect of group by time interaction to PT_hf (F = 11.797; P = 0.003; η _p ²  = 0.383) and MA_hf (F = 9.650; P = 0.006; η _p ²  = 0.337). No significant main effect of group by time interaction occurred to WB_tf (F = 3.320; P = 0.084; η _p ²  = 0.149). The relative changes (? %) before and after the intervention in both groups showed that the Capoeira group significantly differed to the control group in the PT_hf (Capoeira: 46.2 ± 29.9 % vs. control: 5.7 ± 27.6 %; P = 0.003) and MA_hf (Capoeira: 22.4 ± 24.5 % vs. control: ?6.1 ± 13.1 %; P = 0.006).

Conclusion

Eight weeks of Capoeira progressive training program resulted in a significant improvement in angular flexibility for beginners.

     

CTA/V detection of bilateral sigmoid sinus dehiscence and suspected idiopathic intracranial hypertension in unilateral pulsatile tinnitus

Purpose

This aimed to evaluate the prevalence and extent of bilateral sigmoid sinus dehiscence (SSD) and to explore the presence of idiopathic intracranial hypertension (IIH) in patients with unilateral pulsatile tinnitus (PT) with CTA/V.

Methods

Sixty PT patients (52 females; 40.4 ±?11.6 years [20–72]) who underwent CTA/V and 30 non-PT patients (27 females; 38.4 ±?14.7 years [12–62]) were enrolled in this study. The primary outcome measure was the radiographic presence of SSD. The index of transverse sinus stenosis (ITSS) was obtained by multiplying the stenosis scale values for each transverse sinus, and once was ≥?4, the presence of IIH was suspected.

Results

The prevalence and extent of SSD on symptomatic side (78%; maximum transverse diameter, MTD 0.49?±?0.23; maximum vertical diameter, MVD 0.50?±?0.26 cm) were significantly higher and larger than those on asymptomatic side (50%, P?<?0.001; MTD 0.35?±?0.18, P?= 0.006; MVD 0.30?±?0.15 cm, P?<?0.001) in the study group and those (20%, P?<?0.001; MTD 0.36?±?0.18, P?= 0.073; MVD 0.30?±?0.22 cm, P?<?0.048) in the control group. The presence of SSD showed significant correlation with both PT (logistic regression analysis, OR 4.167 [1.450–11.97]; P?=?0.008) and suspected IIH (OR 16.25 [1.893–139.5]; P?=?0.011).

Conclusion

In PT patients, SSD has a significant correlation with PT and a potential correlation with IIH.

     

Chronic hepatitis B: correlation of abnormal features on T2-weighted imaging and dynamic contrast-enhanced imaging with hepatic histopathology

Objectives

To investigate the correlations between abnormal features on liver magnetic resonance (MR) T2-weighted imaging (T2WI) and dynamic contrast-enhanced (DCE) imaging and the pathological findings in chronic hepatitis B.

Materials and methods

Sixty-seven patients with chronic hepatitis B and 18 normal controls who were undergone an abdominal MR imaging were analyzed retrospectively. Patchy hyperintensities, linear and reticular hyperintensities in liver and periportal edema on T2WI and abnormal intrahepatic enhancement signals on DCE imaging were noted. The correlations between the abnormal features detected on hepatic T2WI and DCE imaging, and the levels of inflammatory activity and fibrosis were determined.

Results

Logistic regression analysis showed increased patchy hyperintensities (B = 1.869, P = 0.001) on T2WI and patchy enhancement (B = 1.596, P = 0.004) at the arterial phase along with increased inflammatory activity. However, linear and reticular hyperintensities (B = 2.356, P = 0.000) on T2WI, and meshwork enhancement (B = 2.191, P = 0.000) at the equilibrium phase, all correlated with fibrosis. Moreover, periportal edema mainly correlated with the inflammatory activities (B = 2.635, P = 0.001).

Conclusions

In chronic hepatitis B patients, patchy hyperintensities on T2WI, periportal edema, and patchy enhancement at the arterial phase can predict moderate-to-severe inflammatory activities, whereas intrahepatic linear and reticular hyperintensities on T2WI, and meshwork enhancement at the equilibrium phase can predict moderate-to-severe fibrosis.

     

Ultra-low-dose CT coronary angiography using 128-slice dual source CT with low concentration contrast agent: initial experience

Purpose

To optimize and evaluate an ultra-low-dose (ULD) technique for CT coronary angiography (CTCA).

Materials and methods

Eighty-two patients were randomly divided into two groups. ULD and routine CTCA were performed in groups A and B. Image quality, radiation dose and contrast agent were evaluated.

Results

The effective dose (ED) was 0.20 ± 0.01 mSv for the ULD technique, a decrease of 87% (t = ? 21.182, P < 0.001) compared with the control group. The total iodine content was 8.10 ± 0 g, a decrease of 62% (t = ? 73.458, P < 0.001) compared with 21.10 ± 1.15 g for the control group. The assessment rates for both groups were the same (99.26 vs 99.64%, χ ²  = 0.727, P = 0.394). The contrast-to-noise ratio was 19.31 ± 7.95 for group A and 20.73 ± 5.07 for group B: the difference was not statistically significant (t = ? 1.678, P = 0.095).

Conclusion

Using an ultra-low radiation dose and contrast agent technique, while maintaining an assessable image and improving the safety of the medical examination, was a feasible and reliable method for CTCA.

     

Diaphragm height varies with arm position: comparison between angiography and CT

Purpose

To investigate how elevation of the arms affects diaphragm height.

Materials and methods

We retrospectively reviewed angiography and computed tomography (CT) portography data from 44 patients who were treated for hepatocellular carcinoma at our institution from July 2013 to May 2014. Diaphragm height was determined independently by two radiologists as the distance from the upper edge of the first lumbar vertebra to the highest point of the right diaphragm. The differences in height between angiography and CT images were compared using a paired t-test. We also evaluated the influence of table height and distance between X-ray tube and flat panel detector [source–image distance (SID)] on a phantom model.

Results

Diaphragm height was higher on CT images [mean ± standard deviation (SD), 113.2 ± 27.2 mm] than on angiography images (105.5 ± 27.8 mm; P < 0.001). Inter-rater correlation was excellent both in angiography (R = 0.920; P < 0.001) and CT (R = 0.950; P < 0.001) measurements. Table height and SID had no influence on diaphragm height measurements (P = 0.33).

Conclusion

The diaphragm elevation was observed on CT with arm elevation compared with angiography without arm elevation.

     

Effect of changes in perfusion defect size during serial regadenoson myocardial perfusion imaging on cardiovascular outcomes in high-risk patients

Background

The prognostic value of single-photon emission computed tomography myocardial perfusion imaging (MPI) is well established. There is a paucity of data on the prognostic value of changes in perfusion defect size (PDS) on serial MPIs.

Methods

From the MPI database at the University of Alabama at Birmingham, consecutive patients who underwent two regadenoson stress MPIs between July 2008 and March 2013 were identified. The MPIs were analyzed side-by-side using an automated software program for presence and change in PDS. Improvement in PDS was defined as a reduction ≥5% of left ventricle. A drop in left ventricular ejection fraction (LVEF) was defined as a decrease ≥5%. The primary outcome was a composite of death, myocardial infarction (MI), and coronary revascularization (CR).

Results

There were 698 patients (61 ± 11 years, 53% male, 48% diabetes, 25% prior MI, 49% prior CR) who underwent two regadenoson MPIs within 16 ± 9 months for clinical indications. The primary outcome occurred in 167 (24%) patients (8% death, 9% MI, 15% CR) during 24 ± 16 months of follow-up after the second MPI. The MPIs were normal in both studies in 399 (57%, Group 1), showed improvement in 94 (14%, Group 2, PDS 15% ± 16% vs 28% ± 18%, P < .001) and no change or worsening in 205 patients (29%, Group 3, 28% ± 17% vs 20% ± 17%, P < .001). The best outcomes were seen in Group 1 and the worst in Group 3 (log-rank P < .001). Similar trends were seen for the components of the primary outcome (P = .04 for death, P < .001 for MI, P < .001 for CR). In a Cox-regression model that adjusted for baseline factors including PDS and LVEF on initial MPI, the hazard ratios for primary outcome were 2.0 (P = .02) and 3.9 (P < .001) for Groups 2 and 3 compared to Group 1, respectively. In addition, an LVEF drop ≥5% was independently associated with the primary outcome (HR 1.5, P = .01).

Conclusion

Changes in PDS and LVEF on serial MPIs provide incremental prognostic information to initial and follow-up MPI findings. Lack of improvement or an increase in PDS and a drop in LVEF identify high-risk patients.

     

Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip

Objectives:

We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome.

Methods:

Hip MRA performed at our institution (3/2012–1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed.

Results:

N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen.

Conclusions:

GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.

     

Automatic calculation of myocardial external efficiency using a single <Superscript>11</Superscript>C-acetate PET scan

Background

Myocardial external efficiency (MEE) is defined as the ratio of kinetic energy associated with cardiac work [forward cardiac output (FCO)*mean systemic pressure] and the chemical energy from oxygen consumed (MVO₂) by the left ventricular mass (LVM). We developed a fully automated method for estimating MEE based on a single ¹¹C-acetate PET scan without ECG-gating.

Methods and Results

Ten healthy controls, 34 patients with aortic valve stenosis (AVS), and 20 patients with mitral valve regurgitation (MVR) were recruited in a dual-center study. MVO₂ was calculated using washout of ¹¹C -acetate activity. FCO and LVM were calculated automatically using dynamic PET and parametric image formation. FCO and LVM were also obtained using cardiac magnetic resonance (CMR) in all subjects. The correlation between MEE_PET-CMR and MEE_PET was high (r = 0.85, P < 0.001) without significant bias. MEE_PET was 23.6 ± 4.2% for controls and was lowered in AVS (17.2 ± 4.3%, P < 0.001) and in MVR (18.0 ± 5.2%, P = 0.004). MEE_PET was strongly associated with both NYHA class (P < 0.001) and the magnitude of valvular dysfunction (mean aortic gradient: P < 0.001, regurgitant fraction: P = 0.009).

Conclusion

A single ¹¹C-acetate PET yields accurate and automated MEE results on different scanners. MEE might provide an unbiased measurement of the phenotypic response to valvular disease.

     

Impact of high resolution 3 tesla MR neurography (MRN) on diagnostic thinking and therapeutic patient management

Objective

To evaluate the impact of magnetic resonance neurography (MRN) on diagnostic thinking and therapeutic choices in patients with suspected peripheral neuropathy.

Methods

IRB approval was obtained for this HIPAA-compliant study. Questionnaires were administered to six surgeons regarding the diagnosis and treatment in 85 patients suspected of having peripheral neuropathy, before (pretest) and after (posttest) MRN. Multiple outcome measures related to diagnostic confidence and surgical decision-making were assessed.

Results

The final cohort included 81 patients (30 men and 51 women, age 47?±?17 years). The following changes were observed from pretest to posttest questionnaires: 23 % in nerve involvement (P?<?0.05), 48 % in degree of confidence of nerve involvement (P?<?0.01), 27 % in grade of injury (P?<?0.05), 33 % in differential diagnosis (P?<?0.05), 63 % in degree of confidence in need for surgery (P?<?0.001), 41 % in timing of surgery (P?<?0.01), 30 % in approach to surgery (P?<?0.05), 58 % in degree of confidence in approach to surgery (P?<?0.001), 30 % in estimated length of surgery (P?<?0.05) and 27 % in length of incision (P?<?0.05). The dichotomous decision regarding surgical or nonsurgical treatment changed from pro to con in 17 %.

Conclusion

MRN results significantly influenced the diagnostic thinking and therapeutic recommendations of peripheral nerve surgeons.

Key Points

? In patients with peripheral neuropathy, MRN significantly impacts diagnostic thinking. ? In patients with peripheral neuropathy, MRN significantly impacts therapeutic choices. ? 3-T MRN should be considered in presurgical planning of patients with peripheral neuropathy.

     

Can we predict the size of frequently used autografts in ACL reconstruction?

Purpose

This study presents a method to measure the size of quadriceps, patellar tendon and hamstring autografts using preoperative magnetic resonance imaging (MRI).

Methods

Sixty-two subjects with a mean age of 25 ± 10 years who underwent ACL surgery between 2011 and 2014 were included. Patient anthropometric data were recorded for all subjects. During surgery, the respective autograft was harvested and measured using commercially available graft sizers. MRI measurements were performed by two raters, who were blinded to the intra-operative measurements.

Results

The inter- and intra-rater reliability was ≥0.8 for all MRI measurements. The intra-class correlation coefficient between the MRI measurement of the graft and the actual size of the harvested graft was 0.639. There were significant correlations between quadriceps tendon thickness and height (r = 0.3, p < 0.03), weight (r = 0.3, p < 0.01), BMI (r = 0.3, p < 0.04) and gender (r = ?0.4, p < 0.002) and patellar tendon thickness and height (r = 0.4, p < 0.01), weight (r = 0.3, p < 0.01) and gender (r = ?0.4, p < 0.012).

Conclusion

Preoperative MRI measurements of quadriceps, patellar tendon and hamstring graft size are highly reliable with moderate-to-good accuracy. Significant correlations between patient anthropometric data and the thicknesses of the quadriceps and patellar tendons were observed. Obtaining this information can be useful for preoperative planning and to help counsel patients on appropriate graft choices prior to surgery.

Level of evidence

III.

     

Apparent left ventricular cavity dilatation during PET/CT in hypertrophic cardiomyopathy: Clinical predictors and potential mechanisms

Background

Apparent left ventricular cavity dilatation (LVCD) in patients with hypertrophic cardiomyopathy (HCM) is an incompletely understood phenomenon. We aimed at investigating its clinical predictors and potential mechanisms.

Methods

Sixty one HCM patients underwent N-13-ammonia PET for visual evaluation of LVCD, transient ischemic dilatation (TID) index, myocardial blood flow (MBF), coronary flow reserve (CFR), and regional myocardial perfusion (rMP). TID index was also derived at 2–4 and 15–20 minutes.

Results

Visual LVCD and quantitative TID (>1.13 abnormal) agreement were excellent (k 0.91; P < .0001). LVCD-positive (n = 32) patients had greater LV thickness (2.26 ± 0.59 vs 1.92 ± 0.41 cm; P = .005), but lower stress MBF (1.66 ± 0.42 vs 2.07 ± 0.46 mL/minute/g; P < .0001), and CFR (1.90 ± 0.46 vs 2.46 ± 0.69; P < .0001) than LVCD-negative (n = 29) patients. Abnormal rMP was present in 31/32 LVCD-positive but only 12/29 (P < .0001) LVCD-negative. TID index was higher at 2–4 (1.30 ± 0.13) than at 15–20 minutes (1.27 ± 0.12; P = .001) in LVCD-positive, whereas it was the same (1.04 ± 0.07 vs 1.04 ± 0.07; P = .9) in LVCD-negative. In multivariate analysis, global peak MBF, abnormal rMP, and LV thickness were the best predictors of LVCD.

Conclusion

Apparent LVCD is a common finding in HCM, intimately related to abnormal myocardial perfusion, globally impaired vasodilator flow reserve, and degree of hypertrophy. In addition to regional and/or diffuse subendocardial ischemia, some degree of true LV chamber dilatation may also contribute to the occurrence of apparent LVCD in HCM.

     

Relationship between tibial spine size and the occurrence of osteochondritis dissecans: an argument in favour of the impingement theory

Purpose

Pathophysiology of osteochondritis dissecans (OCD) of the medial femoral condyle remains uncertain. Specifically, the relationship between the size of the anterior tibial spine (ATS) and the presence of OCD has not been explored. The purpose of this study was to evaluate the relationship between ATS size and the occurrence of OCD.

Methods

Seventy-nine children between 8 and 17 years of age were included in two groups: OCD (n = 37) and control (n = 42). The groups were matched in terms of age, gender, BMI and weight. Two independent observers performed an MRI analysis of the size of the tibial spine and intercondylar notch relative to the size of the respective epiphyses. For this study, the “S ratio” was calculated by dividing the height of the tibial spine by the height of the tibial epiphysis. The “N ratio” was calculated by dividing the height of the notch by the height of the femoral epiphysis. These two ratios for both groups were compared using Student’s t test.

Results

The mean value of the S ratio in the OCD group was 0.39 ± 0.06; the mean value of the S ratio in the control group was 0.32 ± 0.03 (P = 0.004). The mean value of the N ratio in the OCD group was 0.70 ± 0.08; the mean value of the N ratio in the control group was 0.70 ± 0.07 (n.s.).

Conclusion

This study’s findings confirm our hypothesis that patients with OCD have a more prominent tibial spine than in patients without OCD.

Level of evidence

IV.

     

Testosterone and cortisol response to acute intermittent and continuous aerobic exercise in sedentary men

Purpose

Different types of physical activity can induce different hormonal and physiological responses. In this study, we examined the testosterone, cortisol, creatine kinase (CK) and lactate dehydrogenase (LDH) response to acute intermittent (IE) and continuous (CE) aerobic exercise in sedentary men.

Methods

In this single-blinded randomised crossover study, eleven sedentary healthy males completed protocols (CE and IE) on two different days separated by a 1-week washout period. CE comprised 40 min of running on a treadmill at 60% of reserve heart rate. IE consisted of 40 min of running on a treadmill with intensity alternating between 50% (2 min) and 80% (1 min) of reserve heart rate. Blood samples were taken before and immediately after each exercise session.

Results

Serum testosterone concentrations increased significantly after IE (+8.0%, P = 0.021) and decreased non-significantly after CE (?5.8%, P = 0.409). The IE response was greater than the CE response (P = 0.01). Cortisol concentration decreased in both IE and CE exercise (P = 0.001 and P = 0.016, respectively), by ?33.6 and ?34.6%, respectively. The testosterone to cortisol ratio increased significantly after both forms of exercise (IE: P = 0.003; CE: P = 0.041). CK concentrations significantly increased from PRE to POST (IE: +20.6%, P = 0.001; CE: +26.5%, P = 0.046). Despite the increase in concentrations of LDH, the changes were not significant (F _{(3, 30)} = 1.01, P = 0.402; IE: +11.4% and CE: +23.1%).

Conclusions

In summary, it seems that intermittent exercise can be more useful in the development of body anabolic processes in sedentary men due to pronounced increases in testosterone.

     

Twelve weeks of soccer-specific training: effects on mucosal immunity,salivary alpha-amylase and body composition in male African youths

Purpose

The primary aim of this study was to determine the levels of salivary secretory IgA (sIgA) and salivary alpha-amylase (sAA) in young, black male soccer players, before and after 12 weeks of soccer-specific training.

Methods

Thirty-four children (11–13 years) who were part of a youth soccer development training academy, participated in the study. The participants underwent 12 weeks of soccer-specific training. Resting saliva samples were collected 48 h before the commencement, and 48 h after the completion, of the training program. Samples were taken between 07:30 and 08:30, 90 min after waking. Body fat percentage (BF %), lean body mass (LBM) and cardiorespiratory fitness (CRF) were also measured.

Results

Significant differences were found between pre- and post-training for body mass index (BMI) (P < 0.05), waist-to-hip ratio (P < 0.05), height (P < 0.0001), BF % (P < 0.0001) and LBM (P < 0.0001). sIgA secretion rate increased significantly from pre- to post-training (P < 0.05) however, no significant differences were found in sAA concentration (P > 0.05), sAA secretion rate (P > 0.05) or sIgA concentration (P > 0.05). The magnitude of differences from pre- to post-training applying Cohen’s d effect sizes (ES) were moderate (>0.5) for estimated VO_2max, sAA, sAA secretion rate, sIgA and sIgA secretion rate.

Conclusion

These findings suggest that, 12 weeks of soccer-specific training enhances mucosal immunity and body composition and may have an effect on the sympathetic nervous system in black, male youths.

     

1-23I-MIBG thyroid uptake: Implications for MIBG imaging of the heart

Background

123I-MIBG has been widely used in patients with heart failure and neurological disorders. The patients are pre-treated with Lugol’s oral solution or potassium perchlorate to prevent thyroid uptake of unlabeled 123I to limit the thyroid radiation exposure. However, despite the inhibition of the iodide pump, the thyroid is frequently visualized. The aim of this study was to study the pattern of thyroid uptake.

Methods

We reviewed the 123I-MIBG images of 57 patients studied in three different centers in Italy for cardiac (n = 42) or neurological (n = 15) indications. They were imaged at 15 minutes and 4 hours after injection and in all patients, the thyroid was included in the imaging field of view. In 2 of the 3 centers, the patients were pre-treated with Lugol’s oral solution and/or potassium perchlorate (group 1) but in the third center, they were not (group 2). The following imaging parameters were evaluated: heart-to-mediastinum ratio (H/M), thyroid-to-mediastinum ratio (T/M) at 4 hours, and tracer wash out from the heart (HWO) and from the thyroid (TWO).

Results

In the cardiac patients, the HWO was 22.98 ± 7.16% and TWO was 11.4 ± 11.86% (P < .0001). The TWO was 12.2 ± 13.1% in group 1 and 10.05 ± 8.97% in group 2 (P = NS). In the neurological patients the HWO was 26 ± 8.1% and the TWO was 20.32 ± 6.41 (P < .05). The difference in TWO was statistically significant (P < .01) between cardiac and neurological patients, whereas the HWO was not. The 4-hour H/M was 1.49 ± 0.23 in cardiac patients vs 1.4 ± 0.39 in neurological patients (P = NS). The 4-hour T/M was 1.33 ± 0.3 in cardiac patients vs 1.15 ± 0.13 in neurological patients (P < 0.05).

Conclusion

The thyroid visualization in MIBG imaging is likely an expression of thyroid sympathetic innervation. The differences in TWO and T/M ratio in cardiac and neurological patients probably express differences in thyroid dopaminergic receptors. Thus, pre-treatment with potassium perchlorate or Lugol’s solution may not be justified in patients undergoing 123I-MIBG imaging in whom the risk of side effects due to pre-treatment could be higher than the risk due to thyroid radiation exposure.

     

Comparison of the diagnostic accuracies of very low stress-dose with standard-dose myocardial perfusion imaging: Automated quantification of one-day,stress-first SPECT using a CZT camera

Background

Previous studies have demonstrated accurate diagnosis of reduced dose myocardial perfusion imaging (MPI) using Cadmium-Zinc-Telluride (CZT) technology. We compared the diagnostic performances of very low stress-dose (<2 mSv) with standard-dose stress-first, quantitative MPI using a CZT camera.

Methods

Patients without known coronary artery– disease who underwent a stress-first Tc-99 m sestamibi CZT-MPI and invasive coronary angiography (ICA), and low-risk patients without ICA were included. A stress-rest standard-dose (10/30 mCi) MPI and a low-dose (5/15 mCi) MPI were compared. Normal limits for quantification were developed from 40 (20 males) low-risk patients, and total perfusion deficit (TPD) was derived.

Results

208 patients who underwent MPI and ICA, and 76 low-risk patients were included. Of these, 128 had a standard-dose MPI and 156 had a low-dose MPI. Stress-doses in low-dose and standard-dose groups were 5.9 ± 1.2 vs 10.2 ± 0.5 mCi (1.7 ± 0.3 vs 3.0 ± 0.1 mSv), respectively, P < 0.001, and stress-rest effective radiation was 6.9 ± 1.1 vs 11.7 ± 0.4 mSv, respectively, P < 0.001. Sensitivity, specificity, and accuracy values in the low-dose and standard-dose groups were 86.1%, 76.6%, and 81.4%; and 90.6%, 78.1%, and 84.4%, respectively, P = ns. Using TPD prone, specificity values were 84.9% and 80.3%, respectively, P = ns.

Conclusion

One-day stress-first MPI with 50% radiation reduction and a very low stress-dose (<2 mSv) using CZT technology and quantitative supine and prone analysis provided a high diagnostic value, similar to standard-dose MPI.

     

Evaluation of chronic inflammatory demyelinating polyneuropathy: 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (3D SHINKEI)

Objective

To evaluate the usefulness of 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (SHINKEI) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods

This institutional review board-approved retrospective study included 14 CIDP patients and nine normal subjects. The signal-to-noise ratio (SNR), contrast ratio (CR), and the size of the cervical ganglions and roots were measured by two raters.

Results

The SNRs of the ganglions and roots were larger in patients with CIDP (9.55?±?3.87 and 9.81?±?3.64) than in normal subjects (7.21?±?2.42 and 5.70?±?2.14, P?<?0.0001, respectively). The CRs of the ganglions and roots were larger in patients with CIDP (0.77?±?0.08 and 0.68?±?0.12) than in normal subjects (0.72?±?0.07 and 0.53?±?0.11, P?<?0.0001, respectively). The sizes of the ganglions and the roots were larger in patients with CIDP (6.44?±?1.61 mm and 4.89?±?1.94 mm) than in normal subjects (5.24?±?1.02 mm and 3.39?±?0.80 mm, P?<?0.0001, respectively).

Conclusions

Patients with CIDP could be distinguished from controls on 3D SHINKEI.

Key points

? 3D SHINKEI could visualize brachial plexus with high spatial resolution.? CIDP patients showed increased SNR, CR, and the size of brachial plexus.? 3D SHINKEI could discriminate CIDP patients from normal subjects.

     

Comparison of bone mineral density in adolescent male soccer and basketball players

Purpose

The aim of this study was to compare bone mineral density (BMD) in adolescent male basketball (BB) and soccer (S) players.

Methods

The study included Estonian national youth league level participants: 12 BB (16.3 ± 0.7 years, 186.8 ± 6.6 cm, 80.9 ± 11.9 kg) and 15 S players (16.0 ± 0.3 years, 178.5 ± 8.1 cm, 66.3 ± 6.8 kg). All participants had a history of 7.9 ± 2.9 years of training, with training loads of 9.2 ± 1.8 h per week. Body composition and BMD were determined by dual X-ray absorptiometry (DXA).

Results

BB were significantly taller, heavier and had greater lean body mass (LBM) compared to S. No significant (P < 0.05) differences existed in age, body fat %, sports participation, and weekly training load. BB had significantly (P < 0.05) greater BMD values in total body, lumbar spine, right arm, left arm, right leg, right femur, right femoral neck, and right femoral shaft compared to S. The biggest between-groups difference (P < 0.001) existed in upper extremities (25–28%). LBM was the main determinant for all BMD variables.

Conclusions

Regular participation in basketball and soccer practice in adolescent males is associated with enhanced BMD in loaded sites specific to demands of the sport. Basketball practice seems to have higher impact on non-weight bearing bones, compared to soccer.

     

Evaluation of reproducibility of the MOCART score in patients with osteochondral lesions of the talus repaired using the autologous matrix-induced chondrogenesis technique

Purpose

To evaluate the applicability and reproducibility of magnetic resonance observation of cartilage repair tissue (MOCART) score for morphological evaluation of osteochondral lesions of the talus (OLT) repaired using autologous matrix-induced chondrogenesis (AMIC) technique.

Methods

Two radiologists (R1–R2) and two orthopaedists (O1–O2) independently reviewed 26 ankle MRIs performed on 13 patients (6 females; age: 38.9 ± 15.9, 14–63) with OLT repaired using AMIC. The MRIs were performed at 6 and 12 months from surgery. For inter/intra-observer agreement evaluation for each variable of the MOCART, we used Cohen’s kappa coefficient. Progression of MOCART between 6- and 12-month evaluation was assessed using the Wilcoxon test. The Spearman’s correlation coefficient was used to evaluate the correlation between baseline lesion size and MOCART.

Results

The inter-observer agreement between R1 and R2 ranged from poor (adhesions, k = 0.124) to almost perfect (subchondral bone, k = 0.866), between O1 and O2 from absent (effusion, k = ?0.190) to poor (surface, k = 0.172), and between R1 and O1 from absent (cartilage interface, k = ?0.324) to fair (signal intensity, k = 0.372). The intra-observer agreement of R1 ranged from poor (signal intensity, k = 0.031) to substantial (subchondral lamina, k = 0.677), while that of O1 from absent (subchondral bone, k = ?0.061) to substantial (surface, k = 0.663). There was a significant increase of MOCART between 6- and 12-month evaluation of R1 (Z = ?2.672; P = 0.008), R2 (Z = ?2.721; P = 0.007) and O1 (Z = ?3.034; P = 0.002). Conversely, the increase of MOCART of O2 was not significant (Z = ?1.665; P = 0.096). Inverse correlation between lesion size at baseline and MOCART was significant at 12-month evaluation (?0.726; P = 0.005).

Conclusion

MRI has an important role in the follow-up of surgical repaired OLT, but MOCART score does not seem to be sufficiently reproducible to be applied for this purpose.